WorldWideScience

Sample records for cuban multicenter study

  1. Santería grand slam: Afro-Cuban religious studies and the study of Afro-Cuban religion

    Directory of Open Access Journals (Sweden)

    Stephan Palmié

    2008-12-01

    Full Text Available [First paragraph] Living Santería: Rituals and Experiences in an Afro-Cuban Religion. MICHAEL ATWOOD MASON. Washington DC: Smithsonian Institution Press, 2002. ix + 165 pp. (Paper US$ 16.95 Divine Utterances: The Performance of Afro-Cuban Santería. KATHERINE J. HAGEDORN. Washington DC: Smithsonian Institution Press, 2001. xvi + 296 pp. (Cloth US$ 40.00 The Light Inside: Abakuá Society Arts and Cuban Cultural History. DAVID H. BROWN. Washington DC: Smithsonian Institution Press, 2003. xix + 286 pp. (Cloth US$ 44.23 Santería Enthroned: Art, Ritual, and Innovation in an Afro-Cuban Religion. DAVID H. BROWN. Chicago: The University of Chicago Press, 2003. xx + 413 pp. (Paper US$ 38.00 Ethnographic objects behave in curious ways. Although they clearly are “our constructions,” field sites and even topically circumscribed (rather than spatially delimited ethnographic problems lead double lives: places and problems change not merely because they factually undergo historical changes, but because researchers come to them from historically no less changeable epistemic vantage points. One can imagine generational cohorts of ethnographers marching across the same geographically or thematically defined terrain and seeing different things – not just because of substantial changes that have factually occurred, but because they have come to ask different questions. The process obviously has its dialectical moments. The figures we inscribe in writing from fleeting observations (based on changing theoretical conceptions are no less subject to history than the empirical grounds from which our discursive efforts call them forth. The result is a curious imbrication of partially autonomous, but also partly overlapping, historicities of lives and texts which, at times, are more difficult to keep apart than it would seem at first glance. At least in the study of Afro-Cuban religious culture, the two practical and discursive fields – one circumscribed

  2. Cubans abroad: a gendered case study on international migrations.

    Science.gov (United States)

    Núñez-Sarmiento, Marta

    2010-01-01

    Cubans who have migrated since the 1990s after living for two decades or more in their country of origin left with an embedded gender ideology that they acquired in a society where gender relations were undergoing radical transformations. As a result, Cuban feminization of migrations has its peculiarities. In this context, there are three issues to consider: explaining how gender relations attained in Cuba, as part of the overall attitudes gained since childhood, influenced Cuban migrants who have left the island permanently since 1990, introduced uniqueness in their migration processes, and made up a different feminization of migration; identifying the features of Cuban social structure that shaped the gender ideology of Cuban migrants; and producing new knowledge about Cuban international migration processes by using a gender perspective and by analyzing the gender relations prevailing in the years before the crisis of the 1990s, as well as since the beginning of the twenty-first century. The first part of this article focuses on gender distinctiveness of recent Cuban migrants, and the second summarizes some traits of the Cuban social structure—mainly referred to female employment—that could explain the gender training of the migrants.

  3. Demand for cuban tobacco as seen through cuban exports

    OpenAIRE

    Fernández de Pinedo Echevarría, Nadia

    2013-01-01

    During the nineteenth century Spain did not import the majority of Cuban tobacco, nor was most of it consumed in Spain. Spain neither consumed nor re-exported Cuban tobacco. Cuban tobacco, due to its high quality, was too expensive to be able to compete with tobacco of lesser quality which was, therefore, cheaper. The Spanish tax office preferred to take in huge amounts of money by taxing consumption in general rather than promoting Cuban tobacco. For this reason, Spain imported tobacco of me...

  4. Lifestyle Risk Factors and Cardiovascular Disease in Cubans and Cuban Americans

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    Melissa S. Burroughs Peña

    2012-01-01

    Full Text Available Cardiovascular disease is the leading cause of mortality in Cuba. Lifestyle risk factors for coronary heart disease (CHD in Cubans have not been compared to risk factors in Cuban Americans. Articles spanning the last 20 years were reviewed. The data on Cuban Americans are largely based on the Hispanic Health and Nutrition Examination Survey (HHANES, 1982–1984, while more recent data on epidemiological trends in Cuba are available. The prevalence of obesity and type 2 diabetes mellitus remains greater in Cuban Americans than in Cubans. However, dietary preferences, low physical activity, and tobacco use are contributing to the rising rates of obesity, type 2 diabetes mellitus, and CHD in Cuba, putting Cubans at increased cardiovascular risk. Comprehensive national strategies for cardiovascular prevention that address these modifiable lifestyle risk factors are necessary to address the increasing threat to public health in Cuba.

  5. Stories of Cuban-Americans Living and Learning Bilingually

    Science.gov (United States)

    Perez, Natasha

    2017-01-01

    This study explores the interplay of bilingualism, identity, literacy and culture for CubanAmerican students in the Cuban diaspora. I contextualize their experiences within the social, historical, and political background of Cuban immigration, situating their stories within the conflicting narratives of Cuban-American imagination in the U.S., to…

  6. Acute liver failure in Cuban children.

    Science.gov (United States)

    Silverio, César E; Smithen-Romany, Chleo Y; Hondal, Norma I; Díaz, Hetzel O; Castellanos, Marlen I; Sosa, Oramis

    2015-01-01

    Acute liver failure is rare in pediatric patients and is one of the most challenging medical emergencies due to its prognostic and therapeutic implications. The best scientific evidence worldwide comes from multicenter studies in developed countries. In Cuba, there are no prior studies of this disorder in children. Describe the main clinical features of Cuban children treated at a national referral center for acute liver failure, as defined by recognized diagnostic criteria for pediatric patients. A case series study was conducted comprising patients diagnosed with acute liver failure treated from 2005 to 2011 in the hepatology and liver transplant service at Havana's William Soler University Children's Hospital. Variables were age group, etiology of acute liver failure, grade of hepatic encephalopathy, blood chemistry variables, and clinical outcome (whether or not spontaneous recovery of liver function occurred). Associations between variables were assessed using contingency tables, and case fatality was calculated, as well as relative risk with its 95% confidence interval. The Mann-Whitney U test was used to compare means of laboratory test results. Median age of the 31 patients studied (14 boys and 17 girls) was 24 months (range 1-180). Time between symptom onset and diagnosis of acute liver failure was 25.1 days (SD 16.8). Infection was the most common etiology, present in 61.3% of cases (19/31); nonhepatotropic viruses, especially cytomegalovirus, predominated in infants. Spontaneous recovery occurred in 15 patients (48.4%), 3 (9.7%) received transplants, and 13 died, for a case fatality of 41.9%. Outcome was not associated with etiology (p = 0.106), but was statistically associated with degree of hepatic encephalopathy (p failure in Cuban children calls for further epidemiologic study and identification of local underlying determinants of this phenomenon.

  7. Cuban Roosters

    Science.gov (United States)

    Henn, Cynthia

    2004-01-01

    The rooster is an important symbol in Cuban culture. It represents strength and power. It is considered a compliment for a male to be called a rooster. Jesus Rivera, a folk artist, who is best known for using Cuban symbolism in his ceramics and illustrations, visited the class described in this article. Senor Rivera described the culture of Cuba…

  8. Ser Cubano (To Be Cuban): The Evolution of Cuban-American Literature.

    Science.gov (United States)

    Figueredo, Danilo H.

    1997-01-01

    Describes the generations of Cuban and Cuban American writers who have borne witness, in Spanish and now in English, to the oppression of Castro's regime, the pain of leaving Cuba, and the family conflicts occurring in the new land. Highlights the tragic figure of Reinaldo Arenas, a homosexual writer, anti-Castro activist, and immigrant. (GR)

  9. Cuban internationalism - an alternative form of globalization.

    Science.gov (United States)

    Castro, Maria; Melluish, Steve; Lorenzo, Alexis

    2014-10-01

    This paper looks at how the principles of internationalism have been integral to the Cuban healthcare system and to Cuba's cooperation and medical support in other countries around the world. The paper details the range and scope of Cuban health internationalism and the principles that underpin the Cuban approach of long-term collaboration, humane care, contextualization, trans-disciplinarity, respect for collective/historical memory and an ethical stance. The paper details the role of Cuban psychologists who have contributed to disaster relief work and gives an example of the Cuban approach in relation to Haiti following the earthquake in 2010.

  10. Cuban Voices: A Case Study of English Language Teacher Education

    Science.gov (United States)

    Smith, Steven John

    2016-01-01

    This case study uses qualitative research methods and a postcolonial paradigm to listen to the voices of Cuban teacher educators describing how they educate and prepare English language teachers in Cuba. English language teacher education in Cuba includes features that are considered innovative, contemporary and good practice in the Western world.…

  11. Co-occurrence of invasive Cuban Treefrogs and native treefrogs in PVC pipe refugia

    Science.gov (United States)

    Elston, Laura M.; Waddle, J. Hardin; Rice, Kenneth G.; Percival, H. Franklin

    2013-01-01

    The Cuban Treefrog (Osteopilus septentrionalis) was first introduced to Florida at Key West. Since this introduction, Cuban Treefrogs have spread to Miami and are now established throughout most of peninsular Florida. Cuban Treefrogs can become very abundant in areas they colonize. Several reasons contribute to their success, including a generalist diet, high fecundity and the ability to reproduce year-round, and use of disturbed or human-modified habitats. Scientists and managers are concerned that Cuban Treefrogs may contribute to the decline of native treefrogs. Cuban Treefrogs may exclude native treefrogs through both competition and predation. Because the evidence from our study and others suggests that Green and Squirrel Treefrogs do not alter their behavior to avoid Cuban Treefrogs, there is cause for concern that sampling with PVC pipes may increase the vulnerability of the native species to predation. This possibility needs further research, including whether other species of native treefrogs sympatric to where Cuban Treefrogs have invaded are also naïve to the possible threat posed by these frogs, and also if native treefrogs eventually learn to avoid Cuban Treefrogs.

  12. State of malnutrition in Cuban hospitals.

    Science.gov (United States)

    Barreto Penié, Jesús

    2005-04-01

    We assessed the current state of undernutrition as observed in 1905 patients hospitalized in 12 Cuban health care institutions, as part of a Latin American, multinational survey similar in design and goals. We surveyed 1905 randomly selected patients from 12 Cuban hospitals in a two-phase study. Patients' clinical charts were audited in phase 1, the Subjective Global Assessment was used to assess patients' nutritional status in phase 2. The study was locally conducted by a properly trained team. The frequency of undernutrition in Cuban hospitals was 41.2% (95% confidence interval = 38.9 to 43.4), and 11.1% of patients were considered severely undernourished. Statistically significant (P hospital services/specialties were identified: geriatrics (56.3%), critical care (54.8%), nephrology (54.3%), internal medicine (48.6%), gastroenterology (46.5%), and cardiovascular surgery (44.8%). Malnutrition rates increased progressively with prolonged length of stay. A high malnutrition rate was observed among participating hospitals. The design and inception of policies that foster intervention programs focusing on early identification of hospital malnutrition and its timely management is suggested to decrease its deleterious effects on outcomes of health care in the participating hospitals.

  13. 31 CFR 515.574 - Support for the Cuban People.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Support for the Cuban People. 515.574..., Authorizations, and Statements of Licensing Policy § 515.574 Support for the Cuban People. (a) Specific licenses....560(c) and other transactions that are intended to provide support for the Cuban people including, but...

  14. PLANNING AND MODEL CUBAN ECONOMIC

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    Kenilia Mariela Villalón-Madrazo

    2016-01-01

    Full Text Available Since the Revolution´s Triumph the country assumes that the planning is the axis, as instrument for the economic acting and of the constant development of the socialist relationships of production and it traces the rules required for the best operation in the Cuban economy, and it implants with these concepts the centralized economic pattern that responded to the existent outline in the Soviet Union and the European socialist countries, of centralized planning based on the material balances. In the current situation of the Cuban economy it is thought about bringing up to date the economic pattern in which will stay as priority the planning and not the market. Leaving what it is mentioned above, presently in this work is carried out the analysis of the economic models in Cuba and its linking with the planning, with the objective of giving to know how the pattern economic Cuban is implanted from the first years of the revolution and it has always been the planning its fundamental axis, and as the same one it has left modernizing during the 53 years of the Revolution. It has been carried out an analysis framed approximately in 10 year-old periods pointing out the internal and external factors that have impacted in the Cuban pattern, their adjustments and the role of planning. 

  15. Researching in education findings visibility: How Cubans are doing?

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    Torres, Paúl A.

    2012-07-01

    Full Text Available The paper presents an analysis of Cuban educational research visibility by considering international ranking positioning of intellectual production in the field of education. A case study is conducted with outstanding Cuban educational researchers comparing their results with other prestigious professionals in the continent. Finally, new basic resources are proposed and explained for improving Bibliometric indicators by taking advantage of Google Scholar potentials in favoring international ranking positioning.

  16. KNOWLEDGE MANAGEMENT IN CUBAN ENTERPRISES

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    Raúl Yoel La Fé Jiménez

    2017-10-01

    Full Text Available In Cuba the intensive use of knowledge has focused on some sectors more than others, despite the high level of training of human resources and the need to boost the Cuban economy with efficiency. This is the reason why the objective of this article is to propose a procedure for the implementation and improvement of knowledge management in Cuban companies. For this purpose, it was created a series of phases that follows a logical sequence for the implementation and improvement of knowledge management in any type of company.

  17. Nuclear analytical techniques in Cuban Sugar Industry

    International Nuclear Information System (INIS)

    Diaz Riso, O.; Griffith Martinez, J.

    1996-01-01

    This paper is a review concerning the applications of Nuclear Analytical Techniques in the Cuban sugar industry. The most complete elemental composition of final molasses (34 elements ) and natural zeolites (38) this last one employed as an auxiliary agent in sugar technological processes has been performed by means of Instrumental Neutron Activation Analysis (INAA) and X-Ray Fluorescence Analysis (XRFA). The trace elements sugar cane soil plant relationship and elemental composition of different types of Cuban sugar (rawr, blanco directo and refine) were also studied. As a result, valuable information referred to the possibilities of using these products in animal and human foodstuff so as in other applications are given

  18. The Cuban Vocational Education and Training System and Its Current Changes

    Science.gov (United States)

    Wolf, Stefan; Penton, Felipe A. Hernandez; Marin, Anna Lidia Beltran; Romero, Osvaldo

    2011-01-01

    The main purpose of the article is to inform about the Cuban Vocational Education and Training System. Based on the analyse of different studies, on expert interviews and on field experiences the authors give a clear overview of the Cuban VET-System. This description is embedded in the presentation of the general education system in Cuba and in a…

  19. [The beginning of the Cuban demographic revolution].

    Science.gov (United States)

    Hernandez Castellon, R

    1981-01-01

    The characteristics of the Cuban demographic revolution associated with the main economic, political, and social changes in the country are analyzed. The authors begin with a brief historical outline of the political-economic situation in the country in the middle of the 19th century. There is emphasis on the dependency of the Cuban economy and its monoproducer nature (with sugar being the major export). This was due to the Spanish colonization and to the subsequent American neocolonization. The discovery of the cause for yellow fever by a Cuban physician and the sanitation campaign conducted by the Americans contributed to a diminishing of mortality. A great migratory flow occurred due to the price of sugar in the world market. This must have influenced Cuban demographic patterns which are a major factor linked to the demographic revolution. The influence on proliferation of urbanization and educational trends is emphasized. The low participation in economic activities of women during the early part of the century did affect fertility levels. The trends in mortality throughout the period 1907-43 are pointed out. It was found that 1 major aspect which had a bearing on Cuban demographic patterns was the 2 large migratory flows. An analysis of growth rates in the population--which also confirms the demographic changes in Cuba--is presented. It is concluded that the 4th decade of this century witnessed Cuba's entry in a new stage of the demographic revolution, a stage in which decreased fertility and mortality go together to create a new period. (author's)

  20. Navigating hybridity: investigating the dance between culture and values within the cuban national education system.

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    Erik Byker

    2013-12-01

    Full Text Available Hybridity is the dynamic relationship between local and global factors that push and pull on people and nations. Hybridity is deeply situated in socio-contextual factors, like cultural beliefs, education, and political systems, that aid and hinder a people’s navigation of globalized phenomena. Simply put, hybridity is how people and societies adapt to a changing world. This article examines the case of Cuba in response to hybridity. Specifically, the article’s purpose is to examine ways that the Cuban National Education System impacts how Cubans navigate the global march towards hybridity. The article reports on a focused ethnographic study of a week long education trip to Cuba during February 2013. The ethnography includes over 100 hours of data collection, including semi-structured interviews with 26 Cuban participants. The study uses Freire’s (1970 notion of “humanizing pedagogy” to analyze how the impact of the Cuban National Education System values in the context of Cuba and larger global context. The study found that three values in particular, amor, solidaridad, and conciencia de derechos y response, were deeply embedded in the Cuban National Education System and effect the way that Cubans navigate the complex hybridity that situates their island nation.

  1. Where is the Cuban economy heading ?

    OpenAIRE

    Herrera , Rémy

    2006-01-01

    URL des Cahiers : http://mse.univ-paris1.fr/MSEFramCahier2006.htm; Cahiers de la Maison des Sciences Economiques 2006.32 - ISSN 1624-0340; This article is the introduction of an issue (to be published) of the U.S. review International Journal of Political Economy on the Cuban economy, and coordinated by Rémy Herrera. It deals with the progresses, but also with the deficiencies, of the Cuban revolution in the economic field, until the recent de-dollarization. It underlines its economic challen...

  2. Osteopilus septentrionalis (Cuban treefrog)

    Science.gov (United States)

    Glorioso, Brad M.; Steece, Aaron; Lemann, Zachary K.; Lazare, Remy; Beck, James W.

    2016-01-01

    USA: LOUISIANA: St. Tammany Parish: on private property on Allen Road in Slidell (ca. 30.262°N, 89.741°W; WGS 84). 2 April 2013. Aaron Steece. Verified by Hardin Waddle. Florida Museum of Natural History (UF 177727, photo voucher). New parish record. This adult was found ca. 2 m high on a branch at the edge of a wooded area behind a house. It was photographed and released, as the species identity and significance was unknown. The origin of this individual is unknown. The homeowner stated that he bought nursery plants often, but checked them thoroughly as he put them indoors. Since this initial finding, the homeowner learned more about Cuban Treefrogs and searched for them on many occasions at this location for two years, but detected no additional Cuban Treefrogs.

  3. The Dynamics of Cuba Anticyclones (CubANs) and Interaction With the Loop Current/Florida Current System

    Science.gov (United States)

    Kourafalou, Vassiliki; Androulidakis, Yannis; Le Hénaff, Matthieu; Kang, HeeSook

    2017-10-01

    Mesoscale anticyclonic eddies along the northern Cuban coast (CubANs) have been identified in the Straits of Florida, associated with the northward shift of the Florida Current (FC) and the anticyclonic curvature of the Loop Current (LC) at the western entrance of the Straits. The dynamics of CubAN eddies and their interaction with the LC/FC system are described for the first time using satellite, drifter and buoy data, and a high-resolution model. It is shown that the evolution of CubANs to the south of the FC front complements the evolution of cyclonic eddies to the north of the FC, advancing previous studies on synergy between FC meandering and eddy activity. Two types of CubAN eddies are characterized: (a) a main anticyclonic cell (type "A") within the core of the LC during retracted phase conditions, associated with the process of LC Eddy (LCE) shedding from an extended LC, and (b) an individual, distinct anticyclonic eddy that is released from the main LC core and is advected eastward, along the northern Cuban coast (type "B"). There are also mixed cases, when the process of LCE shedding has started, so a type "A" CubAN is being formed, in the presence of one or more eastward progressing type "B" eddies. CubAN evolution is associated with an increased mixed layer and weaker stratification of the upper ocean along the eddy's track. The cyclonic activity along the Cuban coast and wind-induced upwelling events also contribute to the evolution and fate of the CubAN eddies.

  4. Nuclear analytical techniques in Cuban sugar industry

    International Nuclear Information System (INIS)

    Diaz R, O.; Griffith M, J.

    1997-01-01

    This paper is a review concerning the application of Nuclear Analytical Techniques in the Cuban sugar industry. The most complete elemental composition of final molasses (34 elements) and natural zeolites (38) this last one employed as an auxiliary agent in sugar technological processe4s has been performed by means of instrumental Neutron Activation Analysis (INAA) and X-Ray Fluorescence Analysis (XRFA). The trace elemental sugar cane soill-plant relationship and elemental composition of different types of Cuban sugar (raw, blanco-directo and refine) were also studied. As a result, valuable information referred to the possibilities of using these products in animal and human foodstuff so as in the other applications are given. (author). 34 refs., 6 figs., 1 tab

  5. Cuban Science and the Open Access Alternative

    CERN Document Server

    Arencibia Jorge, Ricardo; Torricella-Morales, Raúl G

    2004-01-01

    Science in Cuba has experienced extraordinary development since the triumph of the Cuban Revolution, in spite of the blockade to which Cuba has been subjected by the United States Government, and thanks to the support and cooperation of the countries that were part of the former Socialist Block. However, after the destruction of the Socialist Block, the Cuban economy suffered through a restructuring process that included the reorganization of the traditional systems for spreading scientific information. At that moment, it was necessary to use alternative means to effectively publicise, to the international scientific community, the information generated by Cuban scientists and scholars. This paper briefly reviews this new era, the institutions that led the process of change, and the future projections based on knowledge of the digital environment and the creation of electronic and open access information sources.

  6. Multi-elemental characterization of Cuban natural zeolites

    International Nuclear Information System (INIS)

    Rizo, O.D.; Peraza, E.F.H.

    1997-01-01

    Concentration of 38 elements in samples from four important Cuban zeolite beds have been obtained by Instrumental Neutron Activation (INAA) and X-ray Fluorescence analyses (XRFA). In comparison with other analytical techniques good agreement was reached. The concentration values of minor element Ba, Sr, Zn and Mn and 25 trace element (including 9 REE) are at the first time reported in Cuban zeolite. It is important for the zeolite evaluation in different industrial uses. (author)

  7. Multi-elemental characterization of Cuban natural zeolites

    International Nuclear Information System (INIS)

    Diaz Rizo, O.; Herrera Peraza, E.F.

    1996-01-01

    Concentrations of 38 elements in samples from four important Cuban zeolite bed have beam obtained by Instrumental Neutron Activation (INAA) and X-Ray Fluorescence Analysis (XRFA). In comparison with other analytical techniques good agreement was achieved. The concentration values of minor element Ba, Sr, Zn, and Mn, and 25 trace element (including 9 REE) are at the first time reported in Cuban zeolite. It is important for the zeolite evaluation in different industrial uses

  8. Coordination of international multicenter studies: governance and administrative structure

    Directory of Open Access Journals (Sweden)

    Bangdiwala Shrikant I.

    2003-01-01

    Full Text Available A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE, illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators.

  9. 45 CFR 401.12 - Cuban and Haitian entrant cash and medical assistance.

    Science.gov (United States)

    2010-10-01

    ... cash and medical assistance (and related administrative costs) to Cuban and Haitian entrants according... 45 Public Welfare 2 2010-10-01 2010-10-01 false Cuban and Haitian entrant cash and medical... ENTRANT PROGRAM § 401.12 Cuban and Haitian entrant cash and medical assistance. Except as may be otherwise...

  10. The Cuban health care system and factors currently undermining it.

    Science.gov (United States)

    Nayeri, K

    1995-08-01

    This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external factors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more complex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the development of socialism in Cuba. The adoption of the Soviet model of economic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have undermined further social progress including in health care: low productivity of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development.

  11. Nostalgia, Shame and the Transplanted Cuban: "la cubana arrepentida"

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    Olga Lorenzo

    2005-03-01

    Full Text Available Literature can illuminate and extend our understanding of the affect of shame. In this paper, I will use extracts from my fictional works, published and in progress, and other fictional work and poetry by Cuban and Cuban-American exile writers to illustrate some aspects of shaming in relation to the experience of being a Cuban-American migrant in the United States, particularly relative to the sense of exilic nostalgia for the lost homeland. I will also look at how shame is used by the minority culture to control, erode or slow the process of assimilation and to try to maintain the illusion of the superiority of the minority culture.

  12. Cuban Landscapes

    DEFF Research Database (Denmark)

    Scarpaci, Joseph L.; Portela, Armando

    This accessible book offers a vivid geographic portrait of Cuba, exploring the island’s streetscapes, sugar cane fields, beaches, and rural settlements; its billboards, government buildings, and national landmarks. The authors illuminate how natural and built landscapes have shaped Cuban identity...... (cubanidad), and vice versa. They provide a unique perspective on Cuba’s distinct historical periods and political economies, from the colonial period through republicanism and today’s socialist era. Compelling topics include the legacies of slavery and the sugar industry, the past and future of urban...

  13. Evolving Cuban-CARICOM relations : a comparative cost/benefit analysis

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    Michael Erisman

    1995-01-01

    Full Text Available Survey of the basic developmental dynamics involved in the evolving Cuban-CARICOM relationship. On the basis of a cost-risk/benefit analysis, the author provides some projections regarding the future of this relationship. He concludes that there appear sufficient potential benefits for both sides to deepen the relationship. Cuban-CARICOM integration, however, has no top priority for either partner.

  14. Mechanistic Studies of Metal-Oxo Cubane Catalysts for Lightweight Solar Fuels Storage

    Science.gov (United States)

    2013-03-01

    13692. 4 “ Single - crystal growth, crystal and electronic structure of NaCoO2.” Takahashi, Y.; Gotoh, Y.; Akimoto, J. J. Sol. State Chem. 2003, 172, 22...bond formation by the Co–OEC catalysts. 2. A penetrating study of Co3 +|Co4+ self-exchange kinetics of Co4O4 cubanes and a detailed understanding of...construct the artificial leaf described in (7). 4. The examination of Co2+| Co3 + self-exchange in a faithful structural molecular analog of the 7

  15. Gamma radiation effects on the cuban antimeningococcic BC vaccine

    International Nuclear Information System (INIS)

    Padron Soler, E.; Romay Penabad, Z.; Le Riveran Morales, E.; Campa Huergo, C.; Sierra Gonzalez, G.; Alfalla Valdes, L.; Prieto Miranda, E.

    1994-01-01

    The effects of gamma rays on the Cuban antimeningococcic BC vaccine properties were studied. These were performanced by simulation with different bio burden of microbial pollutants. The isolated spores of the pollutants of non- aseptic areas were used. Its D10 was determined as 2.045 Gy. On that basis, the sterilization dose setting was performed. The quality of the irradiated vaccine was performed according to the Cuban standards: sterility, protein and polysaccharide concentration, immunogenicity, per cent of protein adsorption, nonspecific innocuousness. There were observed non negative effects on the vaccine of the radiation process in the dose range of 0-25 Gy. It was also studied the preservation of the properties of the irradiated vaccine, by storing it during one year at four celsius grade. The results were satisfactory

  16. The U.S. Navy and the Cuban Missile Crisis

    Science.gov (United States)

    1990-05-22

    telephone industries . However, the CIA 10 underestimated the hatred for Batista, even among the influential Cuban middle class, although Washington...for collective defense should Castro attempt to export his revolucion . Only days later, Kennedy slapped a trade embargo on Cuba, forbidding all exchange...and bribing foreign industrial firms to sabotage their Cuban 30 exports. Far from inspiring revolt, however, these sabotage activities actually had

  17. Human motivation by some Cuban theorists

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    Luis Alfredo González Collera

    2010-06-01

    Full Text Available The current article offers a summary of the theories of three outstanding Cuban psychologists, whic h have contributed with important knowledge to the motivational sphere of personality. These theoretical approaches constitute the epistemology of base to new studies about motivation in any area of knowledge, although they have a special emphasis on the educative and pedagogic area as well as on the personal development.

  18. Pedagogical professional training in Cuban educative context

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    Mayre Acosta Calderón

    2015-05-01

    Full Text Available The conception of the pedagogical professional training has evolved alongside with the educative changes that have taken place in the history of Cuban education. This research was intended to examine the evolution of professional training from the foundation of colleges of Education to the present. The study takes into account the relation of the instructive, educative and developing aspects; the development of the professional needs and their influence on cognitive and formative activity of learners and their professional performance; the components of contents included in the evaluation of the professional competence; and the comprehensive disciplinary approach of the formation process. Thus, this investigation is aimed at providing a historical analysis of the development of the pedagogical professional training, illustrating the continuity of the formative process in Cuban context. This study revealed the main trends of the pedagogical professional training for the General Senior High Education, It shows the movement from a former segmentation of instructive and educative components and emotional and intellectual educations to a and interconnected approach of both processes.

  19. THE CUBAN ENTERPRISE, COMPETITIVENESS, IMPROVEMENT BUSINESS AND QUALITY

    Directory of Open Access Journals (Sweden)

    Andrés Fernández-Companioni

    2016-01-01

    Full Text Available This article offers some reflections on the Cuban enterprise, its business process improvement and competitiveness that firms must have in entering the world market. It analyzes the economic policies of the last two Congresses of the Communist Party of Cuba that give importance to the role of the Cuban socialist state enterprise system. It conceptualizes the category: business. Knowledge of the categories: effectiveness, efficiency, effectiveness, competitiveness, quality and productivity must for Cuban entrepreneurs. To increase export capacity, we must address a number of factors such as quality and product innovation, the price level depends on the productivity of the inflation differential between countries and other factors with indirect effects on competitiveness, and service quality or corporate image. Are some of the mistakes made in business development in the country. Relate some of the quality awards granted in the world and which should aim to achieve the necessary visibility in international business. Relate some of the quality awards that are granted in the world and which should aim for Cuban entrepreneurs to achieve the necessary visibility in international business. It provides a table that lists the entities Award Winning Quality in Cuba until 2008. It shows a country ranking of the indicators of global competitiveness generated annually by The Global Competitiveness Report. Reasoning about the causes that led to the business improvement process (SPE (Legislative Decree 252 and Decree 281. 

  20. The nuclear issue in the cuban press. Challenges and realities

    International Nuclear Information System (INIS)

    Contreras Izquierdo, Marta; Rodriguez Guerra, Ingrids; Gonzalez Montoto, Iosbel; Fernandez Rondon, Manuel

    2005-01-01

    The work presents an analysis of the impact of nuclear issue on the Cuban press from 1990 to 2005 that was carried out by a group of communications specialists from nuclear area. An analysis of main challenges and actions of this group, aimed at informing the public the present situation of the Cuban nuclear programme and its perspectives, was also included

  1. The Cuban nuclear program and its Scientific and Technical Infrastructure

    International Nuclear Information System (INIS)

    Gandarias Cruz, D.; Codorniu Pujals, D.

    1995-01-01

    The present paper shows the aspects including the Cuban Nuclear Program and underlines its close connection with the strategy of economic, social and scientific technical development in the country, the organizing structure of the Cuban nuclear activity is explained. The application of nuclear techniques and research development activity in the nuclear field are also expressed in detailed in this paper

  2. The 1980 Cuban Crisis: Some Observations.

    Science.gov (United States)

    Copeland, Ronald

    1981-01-01

    Reviews the history of the 1980 Cuban migration to the United States. Examines policy questions concerning unexpected mass migrations and the way the U.S. government responds. The Haitian immigration is discussed similarly. (Author/APM)

  3. Kinanthropometric profile of Cuban women Olympic volleyball champions.

    Science.gov (United States)

    Carvajal, Wiliam; Betancourt, Hamlet; León, Sofia; Deturnel, Yanel; Martínez, Miriam; Echevarría, Ivis; Castillo, María Eugenia; Serviat, Noemí

    2012-04-01

    Athletes' kinanthropometric profiles are widely addressed in the scientific literature. Such profiles are particularly important in volleyball because absolute size contributes a significant percentage of total variance associated with athletic success. As in other team sports, volleyball players' kinanthropometric attributes correlate with the game's tactical demands. From 1992 through 2000, the Cuban women's volleyball team achieved top global performance, winning first place in three successive Summer Olympic Games. Describe the kinanthropometric profiles of Cuban women Olympic volleyball champions during 1992-2000 and compare these by position played. Measurements were taken of body composition, somatotype, proportionality and several anthropometric indicators in 41 Cuban women volleyball players, grouped by playing position. All were members of the national team that participated in the Summer Olympic Games in Barcelona (1992), Atlanta (1996) and Sydney (2000). Mean and standard deviations were calculated for all study variables. Analysis of variance was used to compare means for different positions for the variables weight; height; percent adipose, muscle and bone mass; body mass index; and muscle-to-bone ratio. Discriminant analysis was performed to identify anthropometric dimensions differentiating playing positions (center, spiker and setter), using pvolleyball players was balanced mesomorphic (2.7-3.6-2.9). Classified by position, centers (2.9-3.4-3.4) and spikers (2.8-3.6-2.9) presented an average mesomorphic-ectomorphic somatotype, and setters (2.6-3.7-2.6) were balanced mesomorphic. On assessing Somatotype Attitudinal Mean (SAM), centers and spikers showed more intrapositional homogeneity than that of setters. Centers were significantly taller (187.1±2.5 cm) than players in other positions. Centers' percent adipose tissue mass (28.9±2.7%) was significantly higher than that of setters (24.3±2.7%), who were leanest of all positions. The

  4. Insularity in “el sueño de las formas”: Divination of Cubanness in the poetic of Gaston Baquero

    OpenAIRE

    Águila Ajón, Marta

    2012-01-01

    This study explores the markers of Cuban identity in the poem Brandeburgo 1526 written by Gaston Baquero (La Habana 1914 - Madrid, 1997). The poet is one of the most powerful voices of the Origenes group and of Cuban Literaturel. The exploration I propose does not stem from a previous conceptualization of what constitutes Cubanness, but rather follows Cintio Vitier’s proposal from Lo cubano en la poesía. My study aims for a sensitive intuition of national identity  markers. “Brandeburgo 1526”...

  5. Determination of rare earth elements in sea sediments from the Cuban northwestern coast by instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Capote Rodriguez, G.; Perez Zayas, G.; Pena Fortes, B.; Diaz Riso, O.; Hernandez Rivero, A.T.

    1998-01-01

    The multielemental characterization of sea sediments from an important Cuban coast was performed using instrumental Neutron activation analysis. The obtained results shown an impoverishment of in the studied zone, in comparison with the data taken from other Cuban coaster zones

  6. Stakeholders' views on data sharing in multicenter studies.

    Science.gov (United States)

    Mazor, Kathleen M; Richards, Allison; Gallagher, Mia; Arterburn, David E; Raebel, Marsha A; Nowell, W Benjamin; Curtis, Jeffrey R; Paolino, Andrea R; Toh, Sengwee

    2017-09-01

    To understand stakeholders' views on data sharing in multicenter comparative effectiveness research studies and the value of privacy-protecting methods. Semistructured interviews with five US stakeholder groups. We completed 11 interviews, involving patients (n = 15), researchers (n = 10), Institutional Review Board and regulatory staff (n = 3), multicenter research governance experts (n = 2) and healthcare system leaders (n = 4). Perceptions of the benefits and value of research were the strongest influences toward data sharing; cost and security risks were primary influences against sharing. Privacy-protecting methods that share summary-level data were acknowledged as being appealing, but there were concerns about increased cost and potential loss of research validity. Stakeholders were open to data sharing in multicenter studies that offer value and minimize security risks.

  7. Synthesis and characterization of Mg-Al-layered double hydroxides intercalated with cubane-1,4-dicarboxylate anions.

    Science.gov (United States)

    Rezvani, Zolfaghar; Arjomandi Rad, Farzad; Khodam, Fatemeh

    2015-01-21

    In the present work, Mg2Al-layered double hydroxide (LDH) intercalated with cubane-1,4-dicarboxylate anions was prepared from the reaction of solutions of Mg(ii) and Al(iii) nitrate salts with an alkaline solution of cubane-1,4-dicarboxylic acid by using the coprecipitation method. The successful preparation of a nanohybrid of cubane-1,4-dicarboxylate(cubane-dc) anions with LDH was confirmed by powder X-ray diffraction, FTIR spectroscopy and thermal gravimetric analysis (TGA). The increase in the basal spacing of LDHs from 8.67 Å to 13.40 Å shows that cubane-dc anions were successfully incorporated into the interlayer space. Thermogravimetric analyses confirm that the thermal stability of the intercalated cubane-dc anions is greater than that of the pure form before intercalation because of host-guest interactions involving hydrogen bonds. The interlayer structure, hydrogen bonding, and subsequent distension of LDH compounds containing cubane-dc anions were shown by molecular simulation. The RDF (radial distribution function), mean square displacement (MSD), and self-diffusion coefficient were calculated using the trajectory files on the basis of molecular dynamics (MD) simulations, and the results indicated that the cubane-dc anions were more stable when intercalated into the LDH layers. A good agreement was obtained between calculated and measured X-ray diffraction patterns and between experimental and calculated basal spacings.

  8. The Cuban Scenario 25 Years after the Fall of the Berlin Wall

    Directory of Open Access Journals (Sweden)

    Onesimo Julian Moreira Seijos

    2014-11-01

    Full Text Available This paper examines the situation in Cuba after 25 years of the fall of the Berlin Wall. The Cuban political system has prevailed despite predictions foresaw its imminent end since the soviet-like socialism crumbled in East Europe and then in the USSR itself. Although the end of the cold war led to profound adjustments in the international system, the Cuban model remained almost unchanged; however, a Cuban repaired communism emerged in the nineties. Dollarization of the economy and permission for foreign investment affected the ideological purity as the main basis of the system persisted untouched. Nevertheless, since Raul Castro took over power from his brother Fidel in 2006 expectations for reform have increased. In fact, in 2011 the Sixth Congress of the Communist Party was held and some reforms have been implemented ever since. The paper focuses on the scope of those reforms as there are still many open questions about the future of the Cuban society.

  9. People on the Edge See More. A Conversation with the Cuban-American Writer Cristina García

    Directory of Open Access Journals (Sweden)

    Àngels Carabí

    2010-06-01

    Full Text Available L'entrevista amb l'escriptora cubano-americana Cristina Garciacute;a explora el tema de la identitat cubanoamericana i desvetlla la riquesa literagrave;ria que sorgeix de la fusioacute; de dues cultures, la cubana i la nord-americana, i com aquesta fusioacute; innova la literatura nord-americana tradicional. En la seva novelmiddot;la, emDreaming in Cuban/em (1992, l'escriptora explora els efectes de la Revolucioacute; castrista des de la perspectiva de les dones cubanes que van quedar-se a l'illa, aixiacute; com de les dones que emigraren als Estats Units. The conversation with Cuban-American writer Cristina Garciacute;a explores what it means to be Cuban-American, and reveals how to grow bicultural enriches mainstream American literature. In her novel emDreaming in Cuban/em (1992, the writer explores the effects of the Castro Revolution from the perspective of Cuban women who remained in Cuba, as well as from the experience of women who emigrated to the United States.

  10. Establishment of the exotic invasive Cuban treefrog (Osteopilus septentrionalis) in Louisiana

    Science.gov (United States)

    Glorioso, Brad M.; Waddle, J. Hardin; Muse, Lindy J.; Jennings, Nicole D.; Litton, Melanie; Hamilton, Joel; Gergen, Steven; Heckard, David

    2018-01-01

    The Cuban treefrog, Osteopilus septentrionalis, is native to Cuba, the Bahamas, and the Cayman Islands, and is invasive in areas where it has been introduced and established in the Caribbean as well as Florida. Despite repeated occurrences in several states over many years, it was not believed that Cuban treefrogs had successfully established outside of Florida in the mainland United States. From mid-September to mid-November 2017, we captured and removed 367 Cuban treefrogs in just four surveys in New Orleans, Louisiana. The impacts of this population on native treefrogs in this area is unknown but possibly severe as indicated by the paucity of observations of native treefrogs during our surveys. Eradication of this seemingly established population is improbable, but continued surveys will facilitate learning about the ecology and genetics of this novel population.

  11. The education in values on professionals´ formation from a cuban perspective

    Directory of Open Access Journals (Sweden)

    Bárbara del C. Roba Lazo

    2014-12-01

    Full Text Available The education in values has been a topic broadly approached in the last decades by authors of different latitudes. In the social development, this constitutes a great problem in the formation of the individuals to who, the social relationships allow them to value, to transform the reality and to be educated, what leads to the formation of the personality. The Cuban universities, as entities open to the society, win more and more partisans in the conception that their purpose is not only to transmit knowledge in its closed environment, but on the contrary, they represent a main socialized agent of education in values aware of the social mission that has given to it by the society that is built, like a formative institution able to solve the necessities of the society. For that reason, it is demanded the integral formation of the professionals. In the work it is approached the education in values from the perspective o the current Cuban society necessities that demands the development of a humanist pedagogy sustained in axiological bases that defend a new pedagogic ethics. It is carried out an analysis of the socialized agencies and the agents in charge of this process, as well as the historical antecedents of the education in values from the Cuban point of view in the different contexts the topic has been studied, as well as the contributions from the Cuban pedagogy to the development of it, indispensable from the integral formation of the Physical Culture professionals.

  12. Results of HBsAg examination with immunoelectrophoresis and radioimmunoassay in VPR, Laotian PDR and Cuban R

    Energy Technology Data Exchange (ETDEWEB)

    Michal, L; Szilagyiova, M; Zahradny, V; Holan, J; Krajnak, V [Komenskeho Univ., Martin (Czechoslovakia). Lekarska Fakulta; Padurova, J [Okresna Hygienicka Stanica, Zilina (Czechoslovakia)

    1984-06-21

    The results are compared of examining 112 Vietnamese, 30 Laotian and 50 Cuban citizens for HBsAg using IEP and RIA methods. Of the examined persons with no liver disorders HBsAg was found in 23 (31.5%) of the Vietnamese and 1 (2.5%) of the Cubans using the RIA method and only in 4 (5.5%) of the Vietnamese using the IEP method. Of the examined persons with liver disorders RIA found HBsAg in 12 (30.8%) of the Vietnamese, 5 (71.4%) of the Laotians and 2 (20.0%) of the Cubans while with IEP only in 3 (7.7%) Vietnamese 2 (28.6%) Laotians and 1 (10.0%) of the Cubans examined.

  13. Results of HBsAg examination with immunoelectrophoresis a radioimmunoassay in VPR, Laotian PDR and Cuban R

    International Nuclear Information System (INIS)

    Michal, L.; Szilagyiova, M.; Zahradny, V.; Holan, J.; Krajnak, V.

    1984-01-01

    The results are compared of examining 112 Vietnamese, 30 Laotian and 50 Cuban citizens for HBsAg using IEP and RIA methods. Of the examined persons with no liver disorders HBsAg was found in 23 (31.5%) of the Vietnamese and 1 (2.5%) of the Cubans using the RIA method and only in 4 (5.5%) of the Vietnamese using the IEP method. Of the examined persons with liver disorders RIA found HBsAg in 12 (30.8%) of the Vietnamese, 5 (71.4%) of the Laotians and 2 (20.0%) of the Cubans while with IEP only in 3 (7.7%) Vietnamese 2 (28.6%) Laotians and 1 (10.0%) of the Cubans examined. (author)

  14. Ethnobotany of pru, a traditional Cuban refreshment

    NARCIS (Netherlands)

    Volpato, G.; Godínez, D.

    2004-01-01

    Gouania polygama (Jacq.) Urban, Smilax domingensis Willd., and Pimenta dioica Merr., are three species widely used within Cuban ethnobotanical traditions and practices. Pru is a traditional refreshment and medicinal drink produced by their decoction and fermentation with sugar. It is claimed to have

  15. 45 CFR 400.62 - Treatment of eligible secondary migrants, asylees, and Cuban/Haitian entrants.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 2 2010-10-01 2010-10-01 false Treatment of eligible secondary migrants, asylees... secondary migrants, asylees, and Cuban/Haitian entrants. The State and local resettlement agencies must establish procedures to ensure that eligible secondary migrant refugees, asylees, and Cuban/Haitian entrants...

  16. Original Paper Multicenter study on antibiotic susceptibility ...

    African Journals Online (AJOL)

    Multicenter study on antibiotic susceptibility/resistance trends in the western region of Cameroon ... antibiotic era, IDs used to be serious threats because of lack or insufficient ...... antimicrobial use in livestock; AMR. Control., 116-122. Vandini ...

  17. Mexican and Cuban Composers in New York City circa 1880-1920

    Directory of Open Access Journals (Sweden)

    John Koegel

    2006-10-01

    Full Text Available Cuban musicians active in New  York in the 1860s through the 1890s such as Ignacio Cervantes, Emilio Agramonte, and Rosalia Chalia assisted in the struggle for Cuban independence from Spain from the vantage point of New York's Cuban émigré community, and they also established  a strong  presence in the city's musical life.  Important Mexican musicians such as Miguel Lerdo  de Tejada and Carlos Curti intermittently visited New York or were long-term residents there. This was especially true during the late- nineteenth century, when the forced political stability during the Porfiriato made possible the extended visits of Mexican musicians and ensembles to North American cities such as New York. The Mexican Revolution also sent Mexican musicians to the United States in search of political freedom as well as economic and artistic opportunities that were temporarily closed to them in Mexico.

  18. (Re) framing the nation : the Afro -Cuban challenge to Black and Latino struggles for American identity

    OpenAIRE

    Gosin, Monika

    2009-01-01

    This dissertation interrogates the complexity of late 20th and early 21st century racial projects, focusing on conflict and convergence among African Americans, Cuban exiles, and Afro-Cubans in the United States. A textual analysis of the African American Miami Times and the Spanish language El Herald/El Nuevo Herald during the 1980 Mariel exodus and 1994 Balsero crisis, reveals the concerns of Miami African Americans and Cubans related to issues of race, immigration, and national belonging. ...

  19. The cooperative identity in the cuban constitution. Currents challenges

    Directory of Open Access Journals (Sweden)

    Orestes Rodríguez Musa

    2013-12-01

    Full Text Available The work contribute with some valuations about the conception of the cooperative in the Cuban constitutionalism, with the purpose that the constitution can guide -like it corresponds- the legal implementation of the figure toward an integral perspective. To accomplish this goal, this article offers a characterization of the institution that illustrates about its identity. Then it analyzed the juridical dimension of the cooperative, pondering the different doctrinal postures that have tried to define its nature. Lastly, it argue that the current laws of the Cuban Constitution, influenced by a reduced conception of the institution, suffers some limitations that block the good use of the figure in a socioeconomic context in which it is called to transcend.

  20. Morphological measurements and body indices for Cuban Creole goats and their crossbreds

    Directory of Open Access Journals (Sweden)

    Edilberto Chacón

    2011-08-01

    Full Text Available In this work, linear body measures were taken and production indices calculated for 100 Cuban Creole goats and 100 crossbred goats in order to aid in the characterization of animal genetic resources in Cuba. Low variation was found for all indices of the Creole goats, showing homogeneity between the groups of animals studied. Most of the functional indices are related to the milk biotype which is in agreement the possible origin of the breed from animals of the Iberian Peninsula and Canary Islands. The crossbreds were more varied, mostly due to undesigned disorganized crossing. These data may help in identifying a commercial niche for the breed and contribute to in situ conservation of the Cuban Creole goat.

  1. Each Sheep with Its Mate: Marking Race and Legitimacy in Cuban Catholic Parish Archives, 1890-1940

    Directory of Open Access Journals (Sweden)

    Enid Lynette Logan

    2010-07-01

    Full Text Available Examines the politics of racialization in Cuba from the period after full emancipation to the restrictive immigration policy of the 1930s, through an analysis of the record-keeping practices of the Cuban Catholic Church. The study uses baptismal and marital records to record information on the intimate, racialized, and gendered domains of Cuban social life. Author points out that certain policies adopted by religious authoritites gestured towards inclusivism and egalitarianism, others served to reinforce hierarchies based upon race and rank.

  2. Validation of the Cuban Version of Addenbrooke's Cognitive Examination-Revised for Screening Mild Cognitive Impairment.

    Science.gov (United States)

    Broche-Pérez, Yunier; López-Pujol, Héctor Alejandro

    2017-01-01

    The diagnostic accuracy of the Cuban version of the revised Addenbrooke's Cognitive Examination (ACE-R) in identifying mild cognitive impairment (MCI) in comparison with the Mini-Mental State Examination (MMSE) was assessed. The Cuban ACE-R was administered to a group of 129 elderly subjects (92 cognitively healthy and 37 subjects with MCI). The t tests for independent samples were used to compare scores of different psychometric scales between groups, and effect sizes (Cohen's d) were calculated. Cronbach's coefficient α was used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for MCI was assessed by receiver operating characteristic (ROC) curves. The Cuban ACE-R had reliable internal consistency (Cronbach's coefficient α = 0. 879). The optimal cut-off score for ACE-R for detecting MCI was 84/85. The sensitivity and specificity of ACE-R to screen for MCI was superior to those of MMSE. The area under the ROC curve of the Cuban ACE-R was much larger than that of MMSE (0.93 and 0.63) for detecting MCI. The Cuban ACE-R is a valid screening tool for detecting cognitive impairment. It is more sensitive and accurate in screening for MCI than MMSE. © 2018 S. Karger AG, Basel.

  3. Sugarcane energy use: The Cuban case

    Energy Technology Data Exchange (ETDEWEB)

    Alonso-Pippo, Walfrido; Luengo, Carlos A. [Grupo Combustiveis Alternativos, DFA/IFGW/UNICAMP, CP 6165, CEP 13083-970 Campinas, Sao Paulo (Brazil); Koehlinger, John [Energy Consultant. 1322 Hepburn Ave 1, Louisville, KY 40204 (United States); Garzone, Pietro; Cornacchia, Giacinto [ENEA Trisaia Research Centre. Prot-STP. SS106 Jonica, Rotondella (Italy)

    2008-06-15

    This paper examines the history, methods, costs, and future prospects of Cuba's attempts to develop the energy potential of sugarcane. An overview of the main factors affecting the current sugarcane agro-industry in Cuba is provided, along with an analysis of why, despite attempts by the Cuban government to revive the country's sugarcane agro-industry, the industry continues to decline. The prevailing conditions and degree of modernization in Cuban sugar factories are evaluated. The sugar-agro industry's main production bottlenecks are studied. The fall in sugarcane yield from 57.5 ton/ha in 1991 to 22.4 ton/ha in 2005 and its relation to land use is explained. The socio-economic impact of the sugarcane agro-industry's downsizing is assessed. The governmental and quasi-governmental entities in charge of sugarcane energy use development and the country's legal framework are analyzed. The Cuban sugarcane agro-industry's opportunities in the growing international biofuels and bioenergy market are evaluated. To situate Cuba within the global bioenergy market, international best practices relating to the production and commercialization of biofuels are examined to determine the degree to which these experiences can be transferred to Cuba. The analysis of the Cuba sugar industry's biofuel potential is based on a comparative technical-economic assessment of three possible production scenarios: (1) the current situation, where only sugar is produced; (2) simultaneous production of sugar-anhydrous ethanol; and (3) production of sugar-ethanol and simultaneous generation of surplus electricity exported to a public grid. Some of the key assumptions underlying these analyses are as follows: Ethanol production and operation costs for a 7000 ton/day-sugar mill are estimated to be 0.25 and 0.23 USD/l, respectively. The influence of gasoline prices on sugar-ethanol production is also assessed. The kWh production and operation costs starting from

  4. Sugarcane energy use: The Cuban case

    International Nuclear Information System (INIS)

    Alonso-Pippo, Walfrido; Luengo, Carlos A.; Koehlinger, John; Garzone, Pietro; Cornacchia, Giacinto

    2008-01-01

    This paper examines the history, methods, costs, and future prospects of Cuba's attempts to develop the energy potential of sugarcane. An overview of the main factors affecting the current sugarcane agro-industry in Cuba is provided, along with an analysis of why, despite attempts by the Cuban government to revive the country's sugarcane agro-industry, the industry continues to decline. The prevailing conditions and degree of modernization in Cuban sugar factories are evaluated. The sugar-agro industry's main production bottlenecks are studied. The fall in sugarcane yield from 57.5 ton/ha in 1991 to 22.4 ton/ha in 2005 and its relation to land use is explained. The socio-economic impact of the sugarcane agro-industry's downsizing is assessed. The governmental and quasi-governmental entities in charge of sugarcane energy use development and the country's legal framework are analyzed. The Cuban sugarcane agro-industry's opportunities in the growing international biofuels and bioenergy market are evaluated. To situate Cuba within the global bioenergy market, international best practices relating to the production and commercialization of biofuels are examined to determine the degree to which these experiences can be transferred to Cuba. The analysis of the Cuba sugar industry's biofuel potential is based on a comparative technical-economic assessment of three possible production scenarios: (1) the current situation, where only sugar is produced; (2) simultaneous production of sugar-anhydrous ethanol; and (3) production of sugar-ethanol and simultaneous generation of surplus electricity exported to a public grid. Some of the key assumptions underlying these analyses are as follows: Ethanol production and operation costs for a 7000 ton/day-sugar mill are estimated to be 0.25 and 0.23 USD/l, respectively. The influence of gasoline prices on sugar-ethanol production is also assessed. The kWh production and operation costs starting from sugarcane bagasse are estimated at 0

  5. Approaches to facilitate institutional review board approval of multicenter research studies.

    Science.gov (United States)

    Marsolo, Keith

    2012-07-01

    Gaining Institutional Review Board (IRB) approval for a multicenter research study can be a lengthy and time-consuming process. It can increase the complexity of consent forms, decreasing patient understanding and lowering recruitment numbers. It also leads to increased costs through the duplication of effort. This paper examines some of the strategies used to streamline the IRB review process for multicenter studies and provides examples used by 2 existing multicenter comparative effectiveness research networks. A literature search was conducted to identify sources that described the challenges and potential strategies to facilitate multicenter IRB approval. The most promising avenues were identified and included in this review. Phone interviews were conducted with the Principal Investigators and Project Managers of 2 successful multicenter research networks to learn their "keys to success" and their lessons learned. Three strategies were identified that held the most promise: working with IRBs before submission, the use of central and/or federated IRBs, and the establishment of an umbrella protocol. Each of these strategies was used to some degree by the case study projects. Although the approaches documented here can help streamline the IRB approval process, they are not a "silver bullet." Because some of these approaches are still relatively new, empirical data are sparse. However, it is believed that they will significantly reduce the administrative burden of the project as a whole and lead to a decrease in the overall time to protocol approval.

  6. The Cuban Missile Crisis of 1962: A Case Study of the Tailored Use of Instruments of National Power

    National Research Council Canada - National Science Library

    Charney, Sean S

    2008-01-01

    President Kennedy and the EXCOM were able to achieve foreign policy success during the Cuban Missile Crisis because of their ability to tailor the pertinent IOPs and implement them to reach a desired...

  7. Taxonomic status and biology of the Cuban blackhawk, Buteogallus anthracinus gundlachii (AVES: Accipitridae)

    Science.gov (United States)

    Wiley, J.W.; Garrido, O.H.

    2005-01-01

    We reevaluate the taxonomic status of the Cuban population of the Common Black-Hawk (Buteogallus anthracinus) based on our examination of additional specimens, nests, eggs, and voice data. Buteogallus a. gundlachii is smaller than mainland populations of anthracinus and differs from mainland birds in plumage coloration and pattern. The common (alarm) call of gundlachii is a series of three or four notes, differing from that of mainland anthracinus, whose call consists of 9-24 notes. In the Isla de Pinos, Cuba, we observed gundlachii eating two species of land crabs (71.4%), centipedes (7.1%), lizards (10.7%), mammals (7.1%), and a bird (3.6%). We consider Buteogallus gundlachii Cabanis 1854 (1855), the Cuban Black-Hawk, to be a full species, endemic to Cuba, Isla de Pinos, and many of the cays of the Cuban Archipelago. ?? 2005 The Raptor Research Foundation, Inc.

  8. Prendas-Ngangas-Enquisos: turbulence and the influence of the dead in Cuban-Kongo material culture.

    Science.gov (United States)

    Ochoa, Todd Ramón

    2010-01-01

    Cuban-Kongo praise of the dead in Havana turns insistently around complex agglomerations of materials called "prendas,"ngangas," and "enquisos." This article addresses the ontological status of "prendas-ngangas-enquisos," which practitioners of Cuban-Kongo affliction practices care for as entities that determine the very possibility of their healing and harming craft. Cuban-Kongo societies of affliction, in Havana collectively referred to as "Palo," stake their claim to influence others in and through these entities. In this essay I seek to position the influence generated in prendas-ngangas-enquisos as a problem for Euro-American materialism, to be addressed not through symbolic or representational solutions but, rather, by refocusing the problem itself via alternate distributions of its epistemological, historical, and ethnographic elements. Contextualized within ethnographic description, I first propose that prendas-ngangas-enquisos do not conform to dialectical logic, and should thus be positioned conceptually as something other than "objects" or "fetishes." From there, I consider Creole turns on the term prenda and explore scholarly accounts of 19th-century Cuban slavery and manumission, which I place alongside what is known about pawn slavery among BaKongo people prior to and during the Atlantic slave trade. Having established a basic series of conceptual and historiographic coordinates, I then suggest ethnographically how prendas-ngangas-enquisos come to command others, thereby guaranteeing Cuban-Kongo healing and harming sovereignty in Cuba today.

  9. Methodology of Competences Management Assuming the Cuban Norm about Management of Human Capital

    OpenAIRE

    Santos, Armando Cuesta

    2011-01-01

    An applied research conducted in eight Cuban companies which follow the approach of skills in strategic management of human resources according to the standard Cuban CN: 3000-3002:2007 on human capital management, seeking a superior performance to higher productivity. It sought to manage the connection of individual work with the responsibilities for the strategic organizational performance. As a result we have obtained a metodology to manage the various skill levels expressed in this compani...

  10. Cuban Ocular Toxoplasmosis Epidemiology Study (COTES): incidence and prevalence of ocular toxoplasmosis in Central Cuba.

    Science.gov (United States)

    Bustillo, Jorge L; Diaz, Jose D; Pacheco, Idarmes C; Gritz, David C

    2015-03-01

    Serological studies indicate that rates of ocular toxoplasmosis (OT) vary geographically, with higher rates in tropical regions. Little is known about population-based rates of active OT. We aimed to describe the epidemiology of OT in Central Cuba. This large-population, cross-sectional cohort study used a prospective database at a large regional referral centre in Central Cuba. The patient database was searched for all patients who presented with OT during the 12-month study period from 1 April 2011 to 31 March 2012. Inclusion criteria were the clinical diagnosis of OT, characterised by focal retinochoroidal inflammation and a response to therapy as expected. Gender-stratified and age-stratified study population data from the 2012 Cuban Census were used to calculate incidence rates and prevalence ratios. Among 279 identified patients with OT, 158 presented with active OT. Of these, 122 new-onset and 36 prior-onset cases were confirmed. Based on the total population in the Sancti Spiritus province (466,106 persons), the overall incidence of active OT was 26.2 per 100,000 person-years (95% CI 21.7 to 31.3) with an annual prevalence ratio of 33.9 per 100,000 persons (95% CI 28.8 to 39.6). The incidence of active OT was lowest in the oldest age group and highest in patients aged 25-44 years (4.5 and 42.1 per 100,000 person-years, respectively). This first report describing population-based rates of OT in the Cuban population highlights the importance of patient age as a likely risk factor for OT. Disease rates were found to be highest in females and young to middle-aged adults. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  11. Digitizing dissent: cyborg politics and fluid networks in contemporary Cuban activism

    Directory of Open Access Journals (Sweden)

    Samuel Kellogg

    2016-06-01

    Full Text Available Communication technologies shape how political activist networks are produced and maintain themselves. In Cuba, despite ideologically and physically oppressive practices by the state, a severe lack of Internet access, and extensive government surveillance, a small network of bloggers and cyberactivists has achieved international visibility and recognition for its critiques of the Cuban government. This qualitative study examines the blogger collective known as Voces Cubanas in Havana, Cuba in 2012, advancing a new approach to the study of transnational activism and the role of technology in the construction of political narrative. Voces Cubanas is analyzed as a network of connections between human and non-human actors that produces and sustains powerful political alliances. Voces Cubanas and its allies work collectively to co-produce contentious political discourses, confronting the dominant ideologies and knowledges produced by the Cuban state. Transnational alliances, the act of translation, and a host of unexpected and improvised technologies play central roles in the production of these narratives, indicating new breed of cyborg sociopolitical action reliant upon fluid and flexible networks and the act of writing. 

  12. [The migration crisis of the summer of 1994. Balance and perspectives of Cuban emigration flows: 1984-1996].

    Science.gov (United States)

    Rodriguez Chavez, E

    1996-01-01

    "The article argues that the rafters crisis of 1994 and the resulting migration agreements between the United States and Cuba in 1994 and 1995 were a radical turn in policies and migration flows between the two countries. The article also describes the general evolution of Cuban migration flows towards the U.S. from the 1984 bilateral agreement up to 1996. As a context, it describes the structural elements of recent Cuban emigration and the place Cubans occupy in the general immigration from Latin America and the Caribbean." (EXCERPT)

  13. Preparation of high temperature superconductor ceramics using cuban reactives. Optimization of the synthesis method

    International Nuclear Information System (INIS)

    Leyva Fabelo, A.; Cruz, C.; Aragon, B.; Suarez, J.C.; Mora, M.

    1991-01-01

    Results of the crystallographic characterization of a group of Cuban Products, which are evaluated to be employed in HTSC fabrication are presented in this paper. The first results on the synthesis of HTSC (RBa 2 Cu 3 0 7δ , R= Y, La, Nd) using Cuban reactives, are presented. The so called 'solid state reaction method of synthesis' was optimized, obtaining a critical temperature of more than 93 k

  14. Application of cubane-type structures to hydro-treatment catalysis; Application des structures d'architecture cubane a la catalyse d'hydrotraitement

    Energy Technology Data Exchange (ETDEWEB)

    Marchand, K.

    2003-11-01

    [Mo{sub 3}S{sub 4}(H{sub 2}O){sub 9}]{sup 4+} has been prepared and supported on zeolites H-USY and NaY. Using this cluster as a precursor for HDT catalysts has many advantages: it is cationic, already in a sulfided form, and a promoter such as a second metal M' such as Cu, Ni or Pd can be incorporated to form Mo{sub 3}M'S{sub 4}{sup 4+}. The cubane structure was found unchanged after loading in the case of NaY (EXAFS, XPS) and although TEM showed that Mo was mainly on the outer surface of the zeolite crystals, DRX confirmed that a modification of the counter ion also occurred, and an isotherm was obtained with NaY zeolite. A thermal stability study was led under N{sub 2} and a mixture of H{sub 2}/H{sub 2}S to optimize the pretreatment of the catalysts. Those were subsequently pre-sulfided and tested in toluene hydrogenation and their activities with both types of zeolites turned out to be the same or even better than that of catalysts prepared by the classical route. An application to mixed cubane-type structures is also reported. (author)

  15. LORIS: A web-based data management system for multi-center studies.

    Directory of Open Access Journals (Sweden)

    Samir eDas

    2012-01-01

    Full Text Available LORIS (Longitudinal Online Research and Imaging System is a modular and extensible web-based data management system that integrates all aspects of a multi-center study: from heterogeneous data acquisition (imaging, clinical, behavior, genetics to storage, processing and ultimately dissemination. It provides a secure, user-friendly, and streamlined platform to automate the flow of clinical trials and complex multi-center studies. A subject-centric internal organization allows researchers to capture and subsequently extract all information, longitudinal or cross-sectional, from any subset of the study cohort. Extensive error-checking and quality control procedures, security, data management, data querying and administrative functions provide LORIS with a triple capability (i continuous project coordination and monitoring of data acquisition (ii data storage/cleaning/querying, (iii interface with arbitrary external data processing pipelines. LORIS is a complete solution that has been thoroughly tested through the full life cycle of a multi-center longitudinal project# and is now supporting numerous neurodevelopment and neurodegeneration research projects internationally.

  16. Requirements to cuban reinforcing steel under seismic demand; Exigencias al acero de refuerzo cubano ante la demanda sismica

    Energy Technology Data Exchange (ETDEWEB)

    Frometa Salas, Z. P.; Villalonga Vianez, J. A.

    2009-07-01

    The behaviour of steel manufactured according to the Cuban standard NC 7:02 is studied, in order to evaluate about the conformance to requirements of the seismic design. Steel bars of Grade G-40 and G-60, of all commercial diameters between 10 and 32 mm, were test with this purpose. An experimental program was developed, that include dimensional verifications, tensile testing, ben and rebend, hardness testing and chemical composition tests. The results showed that steel bars satisfy geometric and tensile requirements of Cuban standard, however, some tested samples fulfill the demands that establish some codes about the required ductility to adequate perform of building of reinforced concrete where prevalence the earthquake. Conclusions about the necessity to consider in the future Cuban standard, special requirements to steel that assist the necessities of the earthquake engineering. Proposals are suggested to guarantee the ductile behaviour of the steel of national production. (Author)

  17. Analysis of policy implications and challenges of the Cuban health assistance program related to human resources for health in the Pacific

    Directory of Open Access Journals (Sweden)

    Asante Augustine D

    2012-05-01

    Full Text Available Abstract Background Cuba has extended its medical cooperation to Pacific Island Countries (PICs by supplying doctors to boost service delivery and offering scholarships for Pacific Islanders to study medicine in Cuba. Given the small populations of PICs, the Cuban engagement could prove particularly significant for health systems development in the region. This paper reviews the magnitude and form of Cuban medical cooperation in the Pacific and analyses its implications for health policy, human resource capacity and overall development assistance for health in the region. Methods We reviewed both published and grey literature on health workforce in the Pacific including health workforce plans and human resource policy documents. Further information was gathered through discussions with key stakeholders involved in health workforce development in the region. Results Cuba formalised its relationship with PICs in September 2008 following the first Cuba-Pacific Islands ministerial meeting. Some 33 Cuban health personnel work in Pacific Island Countries and 177 Pacific island students are studying medicine in Cuba in 2010 with the most extensive engagement in Kiribati, the Solomon Islands, Tuvalu and Vanuatu. The cost of the Cuban medical cooperation to PICs comes in the form of countries providing benefits and paying allowances to in-country Cuban health workers and return airfares for their students in Cuba. This has been seen by some PICs as a cheaper alternative to training doctors in other countries. Conclusions The Cuban engagement with PICs, while smaller than engagement with other countries, presents several opportunities and challenges for health system strengthening in the region. In particular, it allows PICs to increase their health workforce numbers at relatively low cost and extends delivery of health services to remote areas. A key challenge is that with the potential increase in the number of medical doctors, once the local students

  18. Management of nuclear information and knowledge in Cuban institutions

    International Nuclear Information System (INIS)

    Garcia, A.G.; Rondon, C.F.; Aldama, C.L.; Aruca, L.A.; Labrada, C.

    2004-01-01

    In the framework of the management of information and the knowledge, the Cuban Agency of Nuclear Energy and Advanced Technologies recognizes as needful the establishment of the nuclear knowledge management system. In the rank of the Nuclear Ramal Program are executed projects, with the participation of all the Cuban nuclear institutions, focused to develop the web site and the intranet of the proper agency as support to the process of taking decisions, to develop the networking education system for human resources of these institutions and others that belong to the energy sector in Cuba, to introduce the data warehousing process for all institutions on corporate levels, to develop technology watching system for all the scientific and technical activities linked to the use and application of the peaceful use of nuclear energy, based on the information and knowledge contained in the databases of INIS, WIPO and RRIAN, between other purposes. (author)

  19. A technique for ecological studies of the cuban fly, 'Lixophaga diatraea' TOWNS., com o uso de tracador radioativo

    International Nuclear Information System (INIS)

    Sgrillo, R.B.; Wiendl, F.M; Walder, J.M.M; Arthur, V.

    1977-01-01

    The specific activity of 32 P required to label Cuban Fly (lixophaga diatraca) is determined. Results show that the radioisotope can be detected inside the bodies of G. mellonella host for at least 6 days, with effective half-life for the raioisotope of 2.8 days [pt

  20. ADASIR system: a Cuban learning experience from accidents and promotion of radiation safety culture

    International Nuclear Information System (INIS)

    Ferro Fernandez, Ruben; Ilizastigui Perez, Fidel; Fuente Puch, Andres de la

    2010-01-01

    The Cuban Regulatory Authority is carrying out a National Program for fostering and development of Safety Culture taking into account the wide recognition of the Human factors contribution to radiological events. The program includes the introduction of new regulatory practices and initiatives in order to increase the safety culture in Cuban facilities. The most recent of those initiatives is the System for Radiological Event Analysis, Dissemination and Learning, called ADASIR (Initials of the System's name in Spanish). The main purpose of this system is to provide a better understanding and knowledge of any radiological event reported both in the country and abroad reducing, this way, the possibility of a new occurrence of a similar event in our facilities. A team of regulatory and external experts make together a detailed review of all available information about the event and identify possible root causes, failed barriers and other important data of national interest. The results of such review are documented and sent to any Cuban facility or organization with potential for similar occurrence according to the equipment and practices they have. The document includes an specific checklist which could be used by the facilities to make a self-assessment and evaluate theirs strength and weakness in regards to a similar event. This paper presents the main characteristics and results of this new experience of Cuban Regulatory Authority. (author)

  1. Making sense of Santería: three books on Afro-Cuban religion

    Directory of Open Access Journals (Sweden)

    Stephan Palmié

    1996-07-01

    Full Text Available [First paragraph] Santeria from Africa to the New World: The Dead Sell Memories. GEORGE BRANDON. Bloomington: Indiana University Press, 1993. x + 206 pp. (Cloth US$31.50 Working the Spirit: Ceremonies of the African Diaspora. JOSEPH M. MURPHY. Boston: Beacon, 1994. xiii + 263 pp. (Cloth US$ 25.00 Walking with the Night: The Afro-Cuban World of Santeria. RAUL CANIZARES. Rochester VT: Destiny Books, 1993. xii + 148 pp. (Paper US$ 12.95 Since 1959, the steady exodus from revolutionary Cuba has led to the gradual emergence of an Afro-Cuban religious diaspora in the United States. While this phenomenon has attracted scholarly attention for some time, the literature has grown particularly rapidly in recent years. It is, perhaps, not entirely fortuitous that a spate of current academic publications on the subject coincided with a scramble by the popular media to exploit its exotic potential in the context of the 1993 U.S. Supreme Court case on animal sacrifice. Clearly, what has come to be called an Afro-Cuban "cultic renaissance" in exile holds promise both for sensationalist journalism and certain kinds of theoretical projects. Partly articulating with older, but politically reinvigorated debates about the relations between African and African-American cultures, partly addressing fundamental questions about conventional models of cultural boundedness and coherence, and, finally, calling into question both popular and academic notions of "modernity" (and its inevitable counterpart "tradition", the 292 New West Indian Guide/Nieuwe West-Indische Gids vol. 70 no. 3 &4 (1996problems posed by the emergence of an Afro-Cuban religious diaspora in the United States present a timely challenge.

  2. Customization and the Common Good: A Conversation with Larry Cuban.

    Science.gov (United States)

    Willis, Scott

    2002-01-01

    A conversation with Larry Cuban, Professor Emeritus of Education at Stanford University, about two contradictory trends in education: customization and standardization and their effect on the public schools' responsibilities to provide both individual and social benefits. (PKP)

  3. 31 CFR 515.546 - Accounts of Cuban sole proprietorships.

    Science.gov (United States)

    2010-07-01

    ... proprietorships. Specific licenses are issued unblocking sole proprietorships established under the laws of Cuba... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Accounts of Cuban sole proprietorships. 515.546 Section 515.546 Money and Finance: Treasury Regulations Relating to Money and Finance...

  4. Expanding the classroom with educational technology: A case study of a Cuban polytechnic high school

    Directory of Open Access Journals (Sweden)

    Anne Leftwich

    2014-12-01

    Full Text Available Polytechnic instruction has a common place in the Cuban education system (Gasperini, 2000. In polytechnic institutions, teachers leverage technological tools to prepare students for labor market competences. This case study examined a polytechnic institution in Cuba to consider how teachers defined educational technology. Based on teacher questionnaire responses, site-based teacher interviews, and field observations, technology was primarily viewed as a method for student preparation. In other words, teachers used technology to prepare students for their future careers and the technology they will need to be successful in that career. The study found that teachers highly valued their technical pedagogical training, believed that the growing spaces were an integral part of their technology based instruction, and claimed that the limited resources was their greatest barrier to integrating ICT in the classroom.

  5. Structure, thermodynamic and electronic properties of carbon-nitrogen cubanes and protonated polynitrogen cations

    Science.gov (United States)

    Chaban, Vitaly V.; Andreeva, Nadezhda A.

    2017-12-01

    Energy generation and storage are at the center of modern civilization. Energetic materials constitute quite a large class of compounds with a high amount of stored chemical energy that can be released. We hereby use a combination of quantum chemistry methods to investigate feasibility and properties of carbon-nitrogen cubanes and multi-charged polynitrogen cations in the context of their synthesis and application as unprecedented energetic materials. We show that the stored energy increases gradually with the nitrogen content increase. Nitrogen-poor cubanes retain their stabilities in vacuum, even at elevated temperatures. Such molecules will be probably synthesized at some point. In turn, polynitrogen cations are highly unstable, except N8H+, despite they are isoelectronic to all-carbon cubane. Kinetic stability of the cation decays drastically as its total charge increases. High-level thermodynamic calculations revealed that large amounts of energy are liberated upon decompositions of polynitrogen cations, which produce molecular nitrogen, acetylene, and protons. The present results bring a substantial insights to the design of novel high-energy compounds.

  6. Evaluation of gas emissions and environmental impact of a Cuban thermal power plant

    International Nuclear Information System (INIS)

    Colas Aroche, Juan Alberto; Alvarez Hernandez, Orlando H; Fuentes Quevedo, Eduardo; Teutelo Nunnez, Raisa

    2006-01-01

    The present work shows the results obtained in the characterization of gas emissions and the impact of two fire-tube boilers in a Cuban thermal power plant. The results of the SO 2 and NO X sampling were collected in specific solutions for each pollutant. The sampling of suspended particulates in chimneys/pipes/stacks was made by collecting them in a filterholder for their analysis by means of the gravimetric method. Flow measurements were also made by using pressure sensors of Pilot tube-type speedometers. The dispersion modelling of pollutants poured out of the chimneys was developed running the program for the concentration calculation from continuous industrial sources and following the methodology approved by the Cuban standard according to Berliand model. The authors conclude that when burning national crude oil in the studied boilers, sulphur dioxide concentrations and suspended particulates are higher than the internationally standardized level

  7. US and Cuban Scientists Forge Collaboration on Arbovirus Research.

    Science.gov (United States)

    Pérez-Ávila, Jorge; Guzmán-Tirado, Maria G; Fraga-Nodarse, Jorge; Handley, Gray; Meegan, James; Pelegrino-Martínez de la Cotera, Jose L; Fauci, Anthony S

    2018-04-01

    After December 17, 2014, when the US and Cuban governments announced their intent to restore relations, the two countries participated in various exchange activities in an effort to encourage cooperation in public health, health research and biomedical sciences. The conference entitled Exploring Opportunities for Arbovirus Research Collaboration, hosted at Havana's Hotel Nacional, was part of these efforts and was the first major US-Cuban scientific conference in over 50 years. Its purpose was to share information about current arbovirus research and recent findings, and to explore opportunities for future joint research. The nearly 100 participants included leading arbovirus and vector transmission experts from ten US academic institutions, NIH, CDC, FDA and the US Department of Defense. Cuban participants included researchers, clinicians and students from Cuba's Ministry of Public Health, Pedro Kourí Tropical Medicine Institute, Center for Genetic Engineering and Biotechnology, Center for State Control of Medicines and Medical Devices and other health research and regulatory organizations. Topics highlighted at the three-day meeting included surveillance, research and epidemiology; pathogenesis, immunology and virology; treatment and diagnosis; vector biology and control; vaccine development and clinical trials; and regulatory matters. Concurrent breakout discussions focused on novel vector control, nonvector transmission, community engagement, Zika in pregnancy, and workforce development. Following the conference, the Pedro Kourí Tropical Medicine Institute and the US National Institute of Allergic and Infectious Diseases have continued to explore ways to encourage and support scientists in Cuba and the USA who wish to pursue arbovirus research cooperation to advance scientific discovery to improve disease prevention and control. KEYWORDS Arboviruses, flavivirus, Zika virus, chikungunya virus, dengue virus, research, disease vectors, Cuba, USA.

  8. 31 CFR 515.549 - Bank accounts and other property of non-Cuban citizens who were in Cuba on or after July 8, 1963.

    Science.gov (United States)

    2010-07-01

    ... non-Cuban citizens who were in Cuba on or after July 8, 1963. 515.549 Section 515.549 Money and... Licensing Policy § 515.549 Bank accounts and other property of non-Cuban citizens who were in Cuba on or... accounts and other property of non-Cuban citizens who have left Cuba, provided that they submit evidence...

  9. Photovoltaic Solar Energy as a Chance and a Need for the Development of the Cuban Economy

    International Nuclear Information System (INIS)

    Casal Rivera, Yanet; Parúas Cuza, Rafael

    2017-01-01

    The photovoltaic systems connected to the electric network as a great opportunity and a need for the Cuban economy. This works intends to present an analysis of a lot of aspects related to the economic feasibility of using solar energy generated by roof-mounted small photovoltaic systems such as some aspects related to the economic and environmental analysis and their contribution to the National and Township development as well as a study of the costs behaviors and its comparison concerning prices in reference to the normal electric power and the new investments for the minor sells of these systems to common people. Finally there is a proposition of actions to encourage the use of this kind of energy in the different sectors of the Cuban economy. (author)

  10. What is the Role of the Cuban Revolutionary Armed Forces (FAR) in a Post-Castro Cuba? What Role will the U.S. Military Play

    Science.gov (United States)

    1993-04-01

    through his brother Raul for the past 30 years. The Spanish heritage and machismo tradition of the Cuban male is strong: the long struggle the Cubans...himself on the air in an attempt to change the course of Cuban history. " (Oppenheimer 132). None of this machismo tradition has been lost on Fidel Castro

  11. In situ characterization of cofacial Co(IV) centers in Co4O4 cubane: Modeling the high-valent active site in oxygen-evolving catalysts.

    Science.gov (United States)

    Brodsky, Casey N; Hadt, Ryan G; Hayes, Dugan; Reinhart, Benjamin J; Li, Nancy; Chen, Lin X; Nocera, Daniel G

    2017-04-11

    The Co 4 O 4 cubane is a representative structural model of oxidic cobalt oxygen-evolving catalysts (Co-OECs). The Co-OECs are active when residing at two oxidation levels above an all-Co(III) resting state. This doubly oxidized Co(IV) 2 state may be captured in a Co(III) 2 (IV) 2 cubane. We demonstrate that the Co(III) 2 (IV) 2 cubane may be electrochemically generated and the electronic properties of this unique high-valent state may be probed by in situ spectroscopy. Intervalence charge-transfer (IVCT) bands in the near-IR are observed for the Co(III) 2 (IV) 2 cubane, and spectroscopic analysis together with electrochemical kinetics measurements reveal a larger reorganization energy and a smaller electron transfer rate constant for the doubly versus singly oxidized cubane. Spectroelectrochemical X-ray absorption data further reveal systematic spectral changes with successive oxidations from the cubane resting state. Electronic structure calculations correlated to experimental data suggest that this state is best represented as a localized, antiferromagnetically coupled Co(IV) 2 dimer. The exchange coupling in the cofacial Co(IV) 2 site allows for parallels to be drawn between the electronic structure of the Co 4 O 4 cubane model system and the high-valent active site of the Co-OEC, with specific emphasis on the manifestation of a doubly oxidized Co(IV) 2 center on O-O bond formation.

  12. 1rst Congress of the Cuban Society of Soil Sciences

    International Nuclear Information System (INIS)

    1988-01-01

    Abstracts from different works presented at the 1st Congress of the Cuban Society of Soil Sciences (Havana, December 1988) are contained in this book. Works have been performed on soil genesis, classification and cartography; soil erosion, conservation and improvement; agrochemicstry; soil physics and technology, and biology of soils

  13. Social workers’ construction of “family” in Cuban context: Ideas for a debate

    Directory of Open Access Journals (Sweden)

    Angela Isabel Peña Farias

    2015-12-01

    Full Text Available This paper presents preliminary research about the process of the construction of concepts in social work. In this case, it is referred to as a social worker’s construction of “family” as a concept and as a field of practice in a current Cuban context. Based on an exploratory and qualitative research design, the paper presents an analysis that also opens to the discussion about social work with families in Cuba. The findings shows that Cuban social workers think of family as a group with cohabitation and affinity, which is more important than consanguinity, as a dimension for family definitions. They also point at structures of family, special bonds in family network and the social internal and external functions of family in their definitions. Among these functions, the transmission of cultural values, as well as the emotional support and shelter for members, seems relevant.Regarding family as a field of practice, they all share the criteria that is necessary for practice to develop a contextual analysis of each situation that goes from macro-contextual aspects to the micro-reality of family. The importance of structural matters and their impact on family functions is also a common idea, which is nucleated around a multigenerational reality of Cuban families and evaluated as a positive or negative impact depending on the case in question.They consider social work with families, and social work in general, to be in a critical situation in relation to losing professionalization and social recognition. The reasons explaining these ideas have to do with the instability of social work institutionalization and the recent retraction of social services. These variations have obeyed the changes in a Cuban context that affects the entire welfare system and social work’s position in it.

  14. Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study

    OpenAIRE

    Gokaslan, Ziya L.; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A.; Hsu, Wellington K.; Qureshi, Sheeraz A.; Cho, Samuel K.; Baird, Evan O.; Mroz, Thomas E.; Fehlings, Michael; Arnold, Paul M.; Riew, K. Daniel

    2017-01-01

    Study Design: Multicenter retrospective study. Objectives: To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. Methods: A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patient...

  15. Corporate Social Responsibility: a proposal for its assessment in Cuban hotel facilities

    Directory of Open Access Journals (Sweden)

    Yusmelys Ferrales-Arias

    2017-12-01

    Full Text Available The present article, after addressing the fundamental elements that characterize the corporate social responsibility approach, proposes a procedure for its evaluation in Cuban hotel facilities through the use of instruments based on indicators developed for this purpose. The study focuses on measuring the degree of social responsibility and the level of responsible performance that allows the installation management to properly align the practices of social responsibility with the installation strategy.

  16. Creating a safety culture in the regulatory authority: The Cuban experience

    International Nuclear Information System (INIS)

    Ferro Fernandez, R.; Guillen Campos, A.

    2002-01-01

    The Cuban regulatory authority has been working during several years for the fostering and development of a high Safety Culture level in nuclear activities in the country. As starting point to achieve this objective the assessment of the Safety Culture level in the regulatory authority performance was considered an important issue. For this purpose a preliminary diagnosis was carried out by means of a national survey that allowed identifying some areas of the regulatory activity that required improvements in order to achieve a higher Safety Culture and to immediately implement appropriate actions. Two of the most important actions undertaken were: the statement of the regulatory authority Safety Policy which governs and determines the performance of this organization and its staff and also the implementation of a new interaction practice at top level between the regulatory authority and the utilities of the nuclear sector through the Annual Regulatory Conference. The present paper summarizes these two introduced practices into the Cuban regulatory activity. (author)

  17. ‘La Comida Mambisa’: food, farming, and Cuban identity, 1839-1999

    Directory of Open Access Journals (Sweden)

    Shannon Lee Dawdy

    2002-01-01

    Full Text Available Describes how Cuba developed a countrywide system of food meaning and production in the mid-19th c. that became a national, and eventually "nationalist", cuisine during Cuba's revolutionary moments. Author explains how the centrality of food within Cuban national identity was strongly related with the valency associated with the subsistence farming on small family farms ("sitios", producing these native foods and Caribbean ingredients, e.g. cassava, guava, and sweet potatoes. The self-sufficiency of these small farmers was in emerging nationalist discourses opposed to the large-scale, export-oriented, colonial plantations and to slavery. Many small family farmers, of which many were ex-slaves, participated in the armed struggles in part to defend their right of independent, subsistence agriculture. Author outlines how since the early, mid-19th-c. Creole nationalism, Creole food and the small farms remained associated with authentic Cuban folk culture and with national identity, and related to independence struggles, and self-sufficiency, including during and after the 1959 Revolution.

  18. A multicenter study on Leigh syndrome

    DEFF Research Database (Denmark)

    Sofou, Kalliopi; De Coo, Irenaeus F M; Isohanni, Pirjo

    2014-01-01

    BACKGROUND: Leigh syndrome is a progressive neurodegenerative disorder, associated with primary or secondary dysfunction of the mitochondrial oxidative phosphorylation. Despite the fact that Leigh syndrome is the most common phenotype of mitochondrial disorders in children, longitudinal natural...... history data is missing. This study was undertaken to assess the phenotypic and genotypic spectrum of patients with Leigh syndrome, characterise the clinical course and identify predictors of survival in a large cohort of patients. METHODS: This is a retrospective study of patients with Leigh syndrome...... to thrive, brainstem lesions on neuroimaging and intensive care treatment were significantly associated with poorer survival. CONCLUSIONS: This is a multicenter study performed in a large cohort of patients with Leigh syndrome. Our data help define the natural history of Leigh syndrome and identify novel...

  19. Immobilization of radioactive waste through cementation using Cuban zeolitic rock as additive

    International Nuclear Information System (INIS)

    Chales Suarez, G.; Castillo Gomez, R.

    1997-01-01

    The cementation of both simulated and real low level aqueous wastes using Cuban zeolite as additive is described. Mechanical characteristics and leach testing of the cemented waste forms has been studied. The results obtained have shown that the presence of zeolite in the cemented waste for reduces considerably the leach rates of Cs and Co and moreover, mechanical characteristics (set time and compressive strength) are better when compared with direct cementation of aqueous wastes. (author). 13 refs, 8 tabs

  20. soirées Rock - Cuban salsa, bachata and Kizomba workshops

    CERN Multimedia

    CERN Dancing Club

    2015-01-01

    The CERN Dancing Club organizes a Cuban salsa, bachata and Kizomba workshop open to everyone on Saturday 9 May in its B566 ballroom (See the poster). Furthermore, the club invites you to its Rock party. Club parties are free and open to everyone. You bring something to eat and the club offers the drinks (non alcoholic)    

  1. Response of booster dose of cuban recombinant hepatitis-B vaccine in nonresponder and hyporesponder children

    International Nuclear Information System (INIS)

    Dahifar, H.; Mousavi, F.; Ghorbani, A.

    2007-01-01

    Acute hepatitis B infection can debilitate a patient for weeks and occasionally has a fatal outcome, while chronic infection is a major threat to the individual. To assess response of nonresponder and hyporesponder children to booster dose of Cuban recombinant hepatitis B vaccine. An interventional, descriptive study has been conducted on children who had been immunized with Cuban recombinant Hepatitis B vaccine and their antibody titers were <10mIU/ml (nonresponder) and 10-100mIU/ml (hyporesponder) administered booster dose of the same vaccine in their Deltoid muscles. The response of 141 children with the mean age of 1.9 years to booster dose of vaccine were 94.3% and 100% vaccines with the first and second booster dose of vaccination respectively. The anti-HBs titer in nonresponders and hyporesponders were 468+-346 and 783+-346mIU/ml respectively with significant differences between two groups (P=0.001). This study demonstrate moderately increase antibody production in the majority of vaccines with single supplementary vaccine. (author)

  2. Present scenery of cuban legislation in the field of legal verification of dosimetric instruments used in radiological protection

    International Nuclear Information System (INIS)

    Salas G, Walwyn; Morales Monzon, J.A.; Hernandez Blanche, E.

    2001-01-01

    The main objective of legal metrology is to ensure the public guaranty from the point of view of safety, and the suitable accuracy of the measurements that are made on health, environmental applications, and trade. The International Organization of Legal Metrology included the ionizing radiation field on those for which the use of the verified measuring instruments are suggested. . The paper presents the advances of Cuban legislation in this field, promoted by issue of the Decree-Law 183 of Metrology. As part of such advances, the Cuban standards for verification NC 44:1999 'X and Gamma Radiation Measuring Instruments. Verification methods' is discussed. This standard was elaborated in the Cuban Secondary Standard Dosimetry Laboratory, and it is based on the available relevant international standards. Results from verification service during the year 2000 are also provided.(author)

  3. Evaluation and distribution of doses received by Cuban population due to environmental sources of radioactivity

    International Nuclear Information System (INIS)

    Zerquera, Juan T.; Prendes Alonso, Miguel; Fernandez Gomez, Isis M.; Lopez Bejerano, Gladys

    2008-01-01

    Full text: In the frame of a national research project supported by the Nuclear Energy Agency of the Ministry of Science, Technology and Environment of the Republic of Cuba doses received by Cuban population due to the exposure to existing in the environment sources of radiation were assessed. Direct measurements of sources representing 90% of average total doses to world population according to UNSCEAR data were made and estimations of doses were obtained for the different components of the total dose: doses due to the exposure to cosmic radiation, external terrestrial radiation, potassium contained in human body and inhalation and ingestion of radionuclides present in the environment. Using the obtained results it was made an estimation of total doses to Cuban population due to environmental radiation sources and the contributions of different dose components were assessed. This was carried out through a Monte Carlo simulation of the total doses using the parameter of dose distributions obtained for the different contributors (components) to total dose. On the basis of the estimations the average total effective dose to Cuban population due to the exposure to environmental sources was estimated as 1.1 ± 0.3 mSv per year. This low dose value is in the range of doses estimated by UNSCEAR for world population due to natural background and can be explained by the specific of Cuban environment: a majority of the population living at the sea level or at low altitudes, relative low content of primordial radionuclides in soils and high ventilation rates in dwellings. All the instructions specified in the Call for Abstracts should be taken into account. e/ 41 and 457. (author)

  4. Final results of the Cuban program for children from areas affected by the Chernobyl accident

    International Nuclear Information System (INIS)

    Medina, Julio; García, Omar

    2016-01-01

    From 1990 till 2011, a free health care program for children from areas affected by the Chernobyl accident was organized and implemented by the Cuban Government. A significant number of qualified personal in medicine and science collaborated with this program. The information gathered for more than 21 years and the conclusive results obtained in the program are presented here. During this time, 26 114 patients, 84 % children, mostly from Ukraine, Russia and Belarus were treated in the mentioned program. Other aspects of the Cuban medical assistance in Ukraine and the main results obtained in the radiological impact evaluation of the accident on the children treated in Cuba are also included. (author)

  5. Enhanced biodegradation of Pina Cuban crude oil by a culture of mixed marine bacteria

    Energy Technology Data Exchange (ETDEWEB)

    Joseph, I.N.; Perigo, E. [Ministry of Science. Inst. of Oceanography, La Habana (Cuba); Bergueiro, J.R.; Pita, A.; Mayol, M.A. [Balearic Island Univ., Palma de Mallorca, Islas Baleares (Spain); Navarro, A. [Ministry of Industry, Oil Research Center, La Habana (Cuba)

    1998-09-01

    The ability of a mixed marine bacteria culture to degrade Pina Cuban crude oil in the presence of nutrients and sea water was studied. Laboratory experiments were conducted in flasks with 100 ml of saline liquid containing 1 per cent crude. The flasks were inoculated with marine bacteria (IDO-225, IDO-226, and IDO-229) at a final concentration of 10{sup 6} cell/ml. The cultures were grown at 29 degrees C for 21 days. Bacterial growth, and surface and interfacial tension were measured after 5, 13 and 21 days. Results showed that the marine bacteria were effective in accelerating the biodegradation process of Pina Cuban oil. The efficiency of the process increased when nutrients were added to the system. This biopreparation also accelerated emulsification of the oil without any negative effects to the natural microbiota. The biological oxygen demand at five days and at the end of the experiment was determined. The biodegradation constant and the biochemical stabilization constant were also measured. 14 refs., 5 tabs., 4 figs.

  6. Enhanced biodegradation of Pina Cuban crude oil by a culture of mixed marine bacteria

    International Nuclear Information System (INIS)

    Joseph, I.N.; Perigo, E.; Bergueiro, J.R.; Pita, A.; Mayol, M.A.; Navarro, A.

    1998-01-01

    The ability of a mixed marine bacteria culture to degrade Pina Cuban crude oil in the presence of nutrients and sea water was studied. Laboratory experiments were conducted in flasks with 100 ml of saline liquid containing 1 per cent crude. The flasks were inoculated with marine bacteria (IDO-225, IDO-226, and IDO-229) at a final concentration of 10 6 cell/ml. The cultures were grown at 29 degrees C for 21 days. Bacterial growth, and surface and interfacial tension were measured after 5, 13 and 21 days. Results showed that the marine bacteria were effective in accelerating the biodegradation process of Pina Cuban oil. The efficiency of the process increased when nutrients were added to the system. This biopreparation also accelerated emulsification of the oil without any negative effects to the natural microbiota. The biological oxygen demand at five days and at the end of the experiment was determined. The biodegradation constant and the biochemical stabilization constant were also measured. 14 refs., 5 tabs., 4 figs

  7. Comparison of Major Immunoglobulins Intrathecal Synthesis Patterns in Ecuadorian and Cuban Patients with Angiostrongyliasis

    Science.gov (United States)

    Padilla-Docal, Bárbara; Dorta-Contreras, Alberto J.; Moreira, Juan M.; Martini-Robles, Luiggi; Muzzio-Aroca, Jenny; Alarcón, Fernando; Magraner-Tarrau, María Esther; Bu-Coifiu-Fanego, Raisa

    2011-01-01

    Angiostrongylus cantonensis meningitis was first reported in Cuba in 1981, and it was recently reported in South America. The aim of this paper is to evaluate the intrathecal immunoglobulin synthesis patterns from Cuba's and Ecuador's patients with angiostrongyliasis; 8 Ecuadorian patients from two different outbreaks and 28 Cuban patients were studied. Simultaneous blood and cerebrospinal fluid simples were taken. Immunoglobulin (Ig) A, IgM, IgG, and albumin were quantified by radial immunodiffusion. Corresponding Reibergrams were applied. A three-Ig pattern was the most frequent in the two groups, but IgM was presented in all Ecuadorian young mature patients; however, in the Cuban children, only 12 of 28 patients had intrathecal IgM, but about 90% had an IgA and IgG synthesis at time of later puncture. This indicates that, with a larger amount of parasites ingested, clinical symptoms are more severe, and a higher frequency of intrathecal IgM synthesis could be observed. This is discussed as a similarity with the intrathecal IgM synthesis in African trypanosomiasis. PMID:21363978

  8. The filtering, clear-cornea diathermal keratostomy: a minor Danish multicenter study

    DEFF Research Database (Denmark)

    Kessing, S.V.; Nissen, O.I.; Thygesen, J.

    2008-01-01

    PURPOSE: Is the new micropenetrating, clear-cornea procedure, intrastromal diathermal keratostomy (IDK), an alternative to the intricate "modern trabeculectomy"? METHODS: Prospective multicenter study. Four surgeons from 4 Danish eye departments attended an IDK course and subsequently decided whe...

  9. The enthalpy of sublimation of cubane

    International Nuclear Information System (INIS)

    Bashir-Hashemi, A.; Chickos, James S.; Hanshaw, William; Zhao Hui; Farivar, Behzad S.; Liebman, Joel F.

    2004-01-01

    The sublimation enthalpy of cubane, a key reference material for force field and quantum mechanical computations, was measured by combining the vaporization enthalpy at T = 298.15 K to the sum of the fusion enthalpy measured at T = 405 K and a solid-solid phase transition that occurs at T 394 K. The fusion and solid-solid phase transitions were measured previously. A sublimation enthalpy value of (55.2 ± 2.0) kJ mol -1 at T = 298.15 K was obtained. This value compares quite favorably the value obtained by comparing the sublimation enthalpy of similar substances as a function of their molar masses but is at odds with earlier measurements

  10. The enthalpy of sublimation of cubane

    Energy Technology Data Exchange (ETDEWEB)

    Bashir-Hashemi, A.; Chickos, James S.; Hanshaw, William; Zhao Hui; Farivar, Behzad S.; Liebman, Joel F

    2004-12-15

    The sublimation enthalpy of cubane, a key reference material for force field and quantum mechanical computations, was measured by combining the vaporization enthalpy at T = 298.15 K to the sum of the fusion enthalpy measured at T = 405 K and a solid-solid phase transition that occurs at T 394 K. The fusion and solid-solid phase transitions were measured previously. A sublimation enthalpy value of (55.2 {+-} 2.0) kJ mol{sup -1} at T = 298.15 K was obtained. This value compares quite favorably the value obtained by comparing the sublimation enthalpy of similar substances as a function of their molar masses but is at odds with earlier measurements.

  11. "Nation or death": the Cuban Revolution and the 1990’s crisis.

    Directory of Open Access Journals (Sweden)

    Julian Araujo Brito

    2012-05-01

    Full Text Available This article aims to analyze the survival conditions of the cuban political regime from the end of the cold war, during the “Special Period”. The breakdown of the socialist bloc between 1989 and 1991 certainly represented an important change of direction for the Cuban Revolution and generated an economic crisis of great proportions, which put at risk the very permanence of the revolutionary regime. However, it was allowed to survive - despite the diffi cult inner and outer conditions and the frequent contrary predictions – to its most delicate moment since the origin in 1959. Although there was a plan for economic reforms and policies to a lesser extent, the survival of the regime was bounded to its nationalistic appeal, what was the political legitimacy before the socialism crisis, as well as the defense of the social achievements of the 30 years of the revolutionary regime.

  12. Some historical tendencies of the methodological work direction in the education municipal level at the cuban context

    Directory of Open Access Journals (Sweden)

    Orlando Ramos-Álvarez

    2017-11-01

    Full Text Available This work leaves from the theoretical and empiric systematizing that shows the necessity to investigate how it has evolved and what factors they have conditioned the behavior of the methodological work direction in the education municipal level. The basic budgets of the educational are approached that serve of referents for the analysis of the relationships of the organizational functional levels of the methodological work. The study is carried out in the period 1959-2017, starting in 1959 as an important milestone in the conception of the Cuban educational system. When the Revolution triumphed there were two conceptions of Education, in Cuban educational practice, on the one hand the abandoned national education system, essentially pragmatic, totally incongruous and on the other the aspirations of the Revolutionary Government, which had been forged in the revolutionary struggle between 1953 and 1959.

  13. Participation of a coordinating center pharmacy in a multicenter international study.

    Science.gov (United States)

    Jeon, Jihyun Esther; Mighty, Janet; Lane, Karen; McBee, Nichol; Majkowski, Ryan; Mayo, Steven; Hanley, Daniel

    2016-11-15

    The activities of a coordinating center pharmacy (CCP) supporting a multicenter, international clinical trial are described. Serving in a research support role comparable to that of a commercial clinical trial supply company, a CCP within the Johns Hopkins Hospital Investigational Drug Service (JHH IDS) uses its management expertise and infrastructure to support multicenter trials, such as the recently completed Clot Lysis: Evaluating Accelerated Resolution of Intraventricular Hemorrhage, Phase III (CLEAR III) trial. The role of the CCP staff in supporting the CLEAR III trial was overall investigational product (IP) management through coordination of IP-related operations to ensure high-quality care for study participants at study sites in the United States and abroad. For the CLEAR III trial, the CCP coordinated IP supply activities; provided education to site pharmacists; developed study-specific documents, including pharmacy manuals; communicated with trial stakeholders, including third-party IP distributors; monitored treatment assignments; and performed quality assurance monitoring to ensure compliance with institutional, state, federal, and international regulations regarding IP procurement and storage. Acting as a CCP for a multicenter international study poses a number of operational challenges while providing opportunities for the CCP to contribute to research of global importance and enrich the skill sets of its personnel. The development and implementation of the CCP at JHH IDS for the CLEAR III trial included several responsibilities, such as IP supply management, communication, and database, regulatory, and finance management. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  14. An open multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and mixed urinary incontinence

    DEFF Research Database (Denmark)

    Lose, Gunnar; Sørensen, Helle Christina; Axelsen, Susanne Maigaard

    2010-01-01

    Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence.......Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This multicenter study was carried out to evaluate safety and efficacy of Bulkamid® for female stress and mixed urinary incontinence....

  15. The provincial archive as a place of memory: confronting oral and written sources on the role of former slaves in the Cuban war of independence (1895-98

    Directory of Open Access Journals (Sweden)

    Rebecca J. Scott

    2002-07-01

    Full Text Available Focuses on the study of the role of former slaves in the Cuban War of Independence, in light of the avoidance of the theme of race within this war in Cuban historiography. Author discusses reasons for the silence on race issues, and for the historic construction of the "myth" of racial equality in this era. Then, she points at the difficulties in the studying of the presence of former slaves among the Cuban soldiers in the War of Independence, due to the absence of racial labels for the registered soldiers. She describes how the research on the theme became more local, and focused on the Cienfuegos region, in part because of Cienfuegos' extensive local archive. Then, she outlines the different approaches to research on the matter by the archives' director Orlando García Martínez, by Michael Zeuske, and by the author herself. The latter explains how she extended her archival research with oral testimonies of descendants in Cienfuegos of black soldiers, and how through examining life histories, collective biographies, and genealogies, she ascertained that the number of former slaves in the rebellious Cuban army was relatively small, but the number of free-born blacks and mulattoes was high.

  16. Chest radiographic data acquisition and quality assurance in multicenter studies

    International Nuclear Information System (INIS)

    Cleveland, R.H.; Schluchter, M.; Easley, K.A.; Wood, B.P.; Berdon, W.E.; Boechat, M.I.; Meziane, M.; Mellins, R.B.; Norton, K.I.; Singleton, E.; Trautwein, L.

    1997-01-01

    Background. Multicenter studies rely on data derived from different institutions. Forms can be designed to standardize the reporting process allowing reliable comparison of data. Objective. The purpose of the report is to provide a standardized method, developed as a part of a multicenter study of vertically transmitted HIV, for assessing chest radiographic results. Materials and methods. Eight hundred and five infants and children were studied at five centers; 3057 chest radiographs were scored. Data were entered using a forced-choice, graded response for 12 findings. Quality assurance measures and inter-rater agreement statistics are reported. Results. The form used for reporting chest radiographic results is presented. Inter-rater agreement was moderate to high for most findings, with the best correlation reported for the presence of bronchovascular markings and/or reticular densities addressed as a composite question (kappa = 0.71). The presence of nodular densities (kappa 0.56) and parenchymal consolidation (kappa = 0.57) had moderate agreement. Agreement for lung volume was low. Conclusion. The current tool, developed for use in the pediatric population, is applicable to any study involving the assessment of pediatric chest radiographs for a large population, whether at one or many centers. (orig.)

  17. Cuban Education in Neo-liberal Times: Socialist Revolutionaries and State Capitalism

    Science.gov (United States)

    Malott, Curry

    2007-01-01

    This article outlines the events that have led to Cuba's current engagement with global capitalism and the implications for Cuban education. The author looks at what Noam Chomsky (1999) has repeatedly referred to as "Cuba's trouble making in the hemisphere," such as it is. The author answers the question, "Why does the US government…

  18. Cuban and antinjerencismo in the Government of the Hundred Days

    Directory of Open Access Journals (Sweden)

    Lourdes María Rodríguez Rodríguez

    2005-12-01

    Full Text Available This article in essence expresses the characteristics of a government of the Neocolonial Republic, known by its heterogeneous distinction, and for its revolutionary projection in correspondence with the moment they lived, not only in its internal projection, but also in its foreign policy, in the international relationships area as a common expression of a Latin American feeling, that for the decade of the 30', it was an irrevocable reality: the anti colonial feeling; therefore it allows a better understanding of the process of formation of the nationality and of the Cuban nation, main objective of the study programs of the subject History of Cuba.

  19. Pb-210 behaviour in environmental samples from the Cuban east in 1993

    International Nuclear Information System (INIS)

    Perez Tamayo, L.; Suarez Pina, W.

    1996-01-01

    A method based in alpha and beta gross counting, is applied to research behaviour, during 1993, of Pb-210 in atmospheric depositional samples of six sites of the Cuban east. In five of these points, located distant from Cuban centers, the average Pb-210 aport to measured beta activity is predominant (80 +- 20 %) and maximum (> 50 % annual) is observed in coincidence with the first rain full peak. Such regularity may be explained, if assumption is made that principal source of Pb-210 are the continental air masses penetrating the insular atmosphere in winter and that mentioned radionuclide is deposit later with the spring rainfalls. In the sixth point, located at industrial zone, the alpha-beta activities rates are abnormally high, with maximums of 1.5 and 2.4 faced with peak raining and wet months respectively and probably originated by the input atmosphere of rich s in alpha emisors particles from industrial processes

  20. Mapping the Cuban Condition in Fernando Ortiz's Un catauro de cubanismos

    Directory of Open Access Journals (Sweden)

    Stephen Fay

    2010-07-01

    Full Text Available Explores the idiom-identity complex in Cuba in the first three decades of the twentieth century, concentrating on an emblematic catalog of the idiomatic raw material of the Cuban language community: Fernando Ortiz's vernacular dictionary, 'Un Catauro de cubanismos' from 1923. Author considers the critical complex of history, geography, and identity within Ortiz's dictionary.

  1. 31 CFR 515.415 - Travel to Cuba; transportation of certain Cuban nationals.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Travel to Cuba; transportation of... CONTROL REGULATIONS Interpretations § 515.415 Travel to Cuba; transportation of certain Cuban nationals... or a returning resident of the United States, from Cuba to the United States, unless otherwise...

  2. Litter assessment on 99 Cuban beaches: A baseline to identify sources of pollution and impacts for tourism and recreation.

    Science.gov (United States)

    Botero, C M; Anfuso, G; Milanes, C; Cabrera, A; Casas, G; Pranzini, E; Williams, A T

    2017-05-15

    Litter presence was assessed on the entire Cuban coastline, and includes 99 beaches from all Cuban regions, during field work carried out in 2012 and 2015. A standard method verified in several countries was applied, which classified beaches for nine types of litter into four grades (A-excellent to D-poor). Almost half of the Cuban beaches obtained excellent cleanliness scores, although many needed to be better managed. In this baseline, the most common types of residue were general litter (8% grade D and 35% grades B/C) and potentially harmful litter (Tourism Impacts seems to be related to visitor origin therefore choices to develop sustainable tourism in rural and village beaches (64%) appears low, if beach cleaning gross investment is focused on resort beaches (24%). Finally, this paper highlights geographical distribution and types of litter patterns. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Analysis of the Socio-Educational Dimension of the Cuban Woman in Negra of Wendy Guerra

    Directory of Open Access Journals (Sweden)

    Pilar Navarro Galiano

    2016-12-01

    Full Text Available This job is based on the novel written by the author Wendy Guerra, Negra. Firstly, a study about social and education situation of the cuban woman since the colonial phase to the present day is accomplished as well. Finally, the main topics in her novel Negra such as racism, sex, witchcraft, music, magic and religion will be analysed.

  4. “Latin-African” Solidarity – The Cuban Civilian Mission in Angola, 1975-1991

    Directory of Open Access Journals (Sweden)

    Christine Hatzky

    2014-06-01

    Full Text Available From 1975 to 1991, almost 500,000 Cubans were actively involved in the Angolan independence struggle and in building up Angola as an independent nation. Most of them were soldiers, but they also included doctors, teachers, building workers, and technicians.

  5. A Witness to French-Cuban Cooperation in Physics in the 1970s

    Science.gov (United States)

    Cernogora, Jacqueline

    In France in 1968 many lively discussions and debates took place at several universities and laboratories in which official authority was questioned. Very often in such debates someone would stand up and ask the previous speaker: "Who are you to assert such a thing?" or "From where are you speaking?" Forty years later, to avoid such questions, I will say right away "from where" I am writing this text, which is by no means an exhaustive study of French-Cuban collaboration in physics at that time, but rather a personal recollection.

  6. Study of external exposure doses received by Cuban population due to terrestrial component of the environmental radiation sources; Estudio de las dosis por exposicion externa que recibe la poblacion cubana debidas a la componente terrestre de la radiacion ambiental

    Energy Technology Data Exchange (ETDEWEB)

    Zerquera, Juan Tomas; Prendes Alonso, Miguel [Centro de Proteccion y Higiene de las Radiaciones, La Habana (Cuba); Brigido Flores, Osvaldo [Laboratorio de Vigilancia Radiologica Ambiental de Camaguey (Cuba); Hernandez Perez, Alberto [Laboratorio de Vigilancia Radiologica Ambiental de Oriente, Holguin (Cuba)

    2001-07-01

    The work presents the results of the study carried out to evaluate the doses that the Cuban population receives for the external exposition to the terrestrial component of the environmental sources of radiation. Starting from the carried out measurements it was possible to estimate the doses effective representative annual stockings that the Cuban population receives for external exposition to the terrestrial radiation, considering the permanency in indoors and outdoors. The dose received due to this component was 180{+-}14 mSv/year. These values are in the range of those reported internationally. (author)

  7. Intraoperative Death During Cervical Spinal Surgery: A Retrospective Multicenter Study.

    Science.gov (United States)

    Wang, Jeffrey C; Buser, Zorica; Fish, David E; Lord, Elizabeth L; Roe, Allison K; Chatterjee, Dhananjay; Gee, Erica L; Mayer, Erik N; Yanez, Marisa Y; McBride, Owen J; Cha, Peter I; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    A retrospective multicenter study. Routine cervical spine surgeries are typically associated with low complication rates, but serious complications can occur. Intraoperative death is a very rare complication and there is no literature on its incidence. The purpose of this study was to determine the intraoperative mortality rates and associated risk factors in patients undergoing cervical spine surgery. Twenty-one surgical centers from the AOSpine North America Clinical Research Network participated in the study. Medical records of patients who received cervical spine surgery from January 1, 2005, to December 31, 2011, were reviewed to identify occurrence of intraoperative death. A total of 258 patients across 21 centers met the inclusion criteria. Most of the surgeries were done using the anterior approach (53.9%), followed by posterior (39.1%) and circumferential (7%). Average patient age was 57.1 ± 13.2 years, and there were more male patients (54.7% male and 45.3% female). There was no case of intraoperative death. Death during cervical spine surgery is a very rare complication. In our multicenter study, there was a 0% mortality rate. Using an adequate surgical approach for patient diagnosis and comorbidities may be the reason how the occurrence of this catastrophic adverse event was prevented in our patient population.

  8. Hydrogen Evolution on Supported Incomplete Cubane-type [Mo3S4](4+) Electrocatalysts

    DEFF Research Database (Denmark)

    Jaramillo, Thomas; Bonde, Jacob Lindner; Zhang, Jingdong

    2008-01-01

    Electrocatalytic properties of biomimetic supported incomplete cubane-type [Mo3S4](4+) clusters are investigated. The activity toward the hydrogen evolution reaction (HER) is evaluated on both a high surface area gas diffusion electrode in a membrane electrode assembly and on highly orientated...

  9. Mass Spectrometry Imaging of Biological Tissue: An Approach for Multicenter Studies

    Energy Technology Data Exchange (ETDEWEB)

    Rompp, Andreas; Both, Jean-Pierre; Brunelle, Alain; Heeren, Ronald M.; Laprevote, Olivier; Prideaux, Brendan; Seyer, Alexandre; Spengler, Bernhard; Stoeckli, Markus; Smith, Donald F.

    2015-03-01

    Mass spectrometry imaging has become a popular tool for probing the chemical complexity of biological surfaces. This led to the development of a wide range of instrumentation and preparation protocols. It is thus desirable to evaluate and compare the data output from different methodologies and mass spectrometers. Here, we present an approach for the comparison of mass spectrometry imaging data from different laboratories (often referred to as multicenter studies). This is exemplified by the analysis of mouse brain sections in five laboratories in Europe and the USA. The instrumentation includes matrix-assisted laser desorption/ionization (MALDI)-time-of-flight (TOF), MALDI-QTOF, MALDIFourier transform ion cyclotron resonance (FTICR), atmospheric-pressure (AP)-MALDI-Orbitrap, and cluster TOF-secondary ion mass spectrometry (SIMS). Experimental parameters such as measurement speed, imaging bin width, and mass spectrometric parameters are discussed. All datasets were converted to the standard data format imzML and displayed in a common open-source software with identical parameters for visualization, which facilitates direct comparison of MS images. The imzML conversion also allowed exchange of fully functional MS imaging datasets between the different laboratories. The experiments ranged from overview measurements of the full mouse brain to detailed analysis of smaller features (depending on spatial resolution settings), but common histological features such as the corpus callosum were visible in all measurements. High spatial resolution measurements of AP-MALDI-Orbitrap and TOF-SIMS showed comparable structures in the low-micrometer range. We discuss general considerations for planning and performing multicenter studies in mass spectrometry imaging. This includes details on the selection, distribution, and preparation of tissue samples as well as on data handling. Such multicenter studies in combination with ongoing activities for reporting guidelines, a common

  10. Sucralfate versus cimetidine in reflux esophagitis. A single-blind multicenter study

    NARCIS (Netherlands)

    Hameeteman, W.; v d Boomgaard, D. M.; Dekker, W.; Schrijver, M.; Wesdorp, I. C.; Tytgat, G. N.

    1987-01-01

    A single-blind randomized multicenter study was performed in 42 patients with endoscopically documented reflux esophagitis. Patients were randomly given 400 mg cimetidine q.i.d. or a suspension of 1 g sucralfate q.i.d. for a period of 8 weeks. Forty patients were evaluated after 8 weeks. Symptomatic

  11. A two-dimensional hydrogen-bonded water layer in the structure of a cobalt(III) cubane complex.

    Science.gov (United States)

    Qi, Ji; Zhai, Xiang-Sheng; Zhu, Hong-Lin; Lin, Jian-Li

    2014-02-01

    A tetranuclear Co(III) oxide complex with cubane topology, tetrakis(2,2'-bipyridine-κ(2)N,N')di-μ2-carbonato-κ(4)O:O'-tetra-μ3-oxido-tetracobalt(III) pentadecahydrate, [Co4(CO3)2O4(C10H8N2)4]·15H2O, with an unbounded hydrogen-bonded water layer, has been synthesized by reaction of CoCO3 and 2,2'-bipyridine. The solvent water molecules form a hydrogen-bonded net with tetrameric and pentameric water clusters as subunits. The Co4O4 cubane-like cores are sandwiched between the water layers, which are further stacked into a three-dimensional metallo-supramolecular network.

  12. The Soviet-Cuban Connection in Central America and the Caribbean

    Science.gov (United States)

    1985-04-01

    bly for civilian use, was built primarily by armed clandestinely ferrying a cargo of military supplies to Cubans, despite the high unemployment on the...reorm an deocraic lecion. Th sucesive population now either own their land outright or par- governments of El Salvador have worked to follow ticipate as...launcher, airstrips and unloading their cargo of arms and am-munition. Air drops are also used. .’.. subsequently captured by communist forces after

  13. A scenario analysis of investment options for the Cuban power sector using the MARKAL model

    International Nuclear Information System (INIS)

    Wright, Evelyn L.; Belt, Juan A.B.; Chambers, Adam; Delaquil, Pat; Goldstein, Gary

    2010-01-01

    The Cuban power sector faces a need for extensive investment in new generating capacity, under a large number of uncertainties regarding future conditions, including: rate of demand growth, fluctuations in fuel prices, access to imported fuel, and access to investment capital for construction of new power plants and development of fuel import infrastructure. To identify cost effective investment strategies under these uncertainties, a supply and power sector MARKAL model was assembled, following an extensive review of available data on the Cuban power system and resource potentials. Two scenarios were assessed, a business-as-usual (BAU) scenario assuming continued moderate electricity load growth and domestic fuel production growth, and a high growth (HI) scenario assuming rapid electricity demand growth, rapid increase in domestic fuel production, and a transition to market pricing of electricity. Within these two scenarios sets, sensitivity analyses were conducted on a number of variables. The implications of least-cost investment strategies for new capacity builds, investment spending requirements, electricity prices, fuel expenditures, and carbon dioxide emissions for each scenario were assessed. Natural gas was found to be the cost effective fuel for new generation across both scenarios and most sensitivity cases, suggesting that access to natural gas, through increased domestic production and LNG import, is a clear priority for further analysis in the Cuban context.

  14. A scenario analysis of investment options for the Cuban power sector using the MARKAL model

    Energy Technology Data Exchange (ETDEWEB)

    Wright, Evelyn L.; Chambers, Adam; Delaquil, Pat; Goldstein, Gary [International Resources Group, 1211 Connecticut Avenue, NW, Suite 700, Washington, DC 20036 (United States); Belt, Juan A.B. [US Agency for International Development, 1300 Pennsylvania Avenue, NW, Washington, DC 20523-3800 (United States)

    2010-07-15

    The Cuban power sector faces a need for extensive investment in new generating capacity, under a large number of uncertainties regarding future conditions, including: rate of demand growth, fluctuations in fuel prices, access to imported fuel, and access to investment capital for construction of new power plants and development of fuel import infrastructure. To identify cost effective investment strategies under these uncertainties, a supply and power sector MARKAL model was assembled, following an extensive review of available data on the Cuban power system and resource potentials. Two scenarios were assessed, a business-as-usual (BAU) scenario assuming continued moderate electricity load growth and domestic fuel production growth, and a high growth (HI) scenario assuming rapid electricity demand growth, rapid increase in domestic fuel production, and a transition to market pricing of electricity. Within these two scenarios sets, sensitivity analyses were conducted on a number of variables. The implications of least-cost investment strategies for new capacity builds, investment spending requirements, electricity prices, fuel expenditures, and carbon dioxide emissions for each scenario were assessed. Natural gas was found to be the cost effective fuel for new generation across both scenarios and most sensitivity cases, suggesting that access to natural gas, through increased domestic production and LNG import, is a clear priority for further analysis in the Cuban context. (author)

  15. [Role of multicenter study groups for clinical research in hematology and oncology].

    Science.gov (United States)

    Gökbuget, N; Hoelzer, D

    2009-04-01

    During the past 25 years a highly effective infrastructure for clinical trials was developed in hematology. Following initial funding by the BMFT (Ministry for Research and Technology) a number of large multicenter study groups for leukemia and lymphoma were developed. Treatment results from these studies often represent the"gold standard". However, since no standard therapy is defined for these diseases, the study groups aim to treat all patients within treatment optimization trials (TOT) to combine research and care. They contribute considerably to quality control in therapy and diagnostics, e.g., by establishing central reference laboratories. The regulatory requirements for clinical trials were extended considerably after the activation of the 12th drug law and TOTs now have to fulfill requirements similar to registration trials in the pharmaceutical industry. Due to the considerable bureaucratic effort and increased costs, only few large multicenter trials could thereafter be initiated and a substantial disadvantage for independent academic research becomes clearly evident.

  16. Knowing the Place for the First Time: A Cuban Exile’s Story

    Directory of Open Access Journals (Sweden)

    Alejandra Morena

    2009-03-01

    Full Text Available Playa Abierta is a modern beach-side resort, one hundred kilometres west of Havana. Developed as a private resort in the 1950s, it was seized by the new revolutionary Cuban government in 1959 after its owner fled precipitately to Miami. This autobiographically centred and personally narrated paper reviews the history of Playa Abierta 1956 – 2006 through the eyes of a Cuban New Zealander ‘Marta’ whose uncle first developed the estate. In 1956 her holidays spent at Playa Abierta as a little girl were her most treasured Cuban moments. ‘At this altar’, she says, ‘my uncle was the high priest.’ In 1996 - after a 36-year absence from her native land - she returned for a visit, the only member of her extended family to have done so. Boldly and unannounced she walked through her uncle’s house – by then converted into a military recreational camp. On a subsequent visit, she met with members of her uncle’s domestic staff whose relationship to that same loved beach was by then of many decades. Whose Playa Abierta was she re-visiting now? Who were the true claimants to that family sacred site? Today as she reflects on the private and public meaning of Playa Abierta, her exultation has given way to more complex feelings. The wonder at re-discovering the beach’s beauty was overladen with the guilt of returning to Cuba while still under Castro’s communist rule. Her sense of belonging was later undermined by a sad realisation that those who had stayed behind were also Playa Abierta’s claimants. Above all, she is torn between family loyalties and the promise of a Revolution betrayed.

  17. A multicenter, long-term study on arrhythmias in children with Ebstein anomaly.

    NARCIS (Netherlands)

    Delhaas, T.; Sarvaas, G.J.; Rijlaarsdam, M.E.; Strengers, J.L.; Eveleigh, R.M.; Poulino, S.E.; Korte, C.L. de; Kapusta, L.

    2010-01-01

    To assess the prevalence, history, and treatment of arrhythmias, in particular preexcitation and Wolff-Parkinson-White (WPW) syndrome, in patients with Ebstein anomaly (EA) during childhood and adolescence, we performed a multicenter retrospective study of all consecutive live-born patients with EA,

  18. A Multicenter, Long-Term Study on Arrhythmias in Children with Ebstein Anomaly

    NARCIS (Netherlands)

    Delhaas, Tammo; Sarvaas, Gideon J. du Marchie; Rijlaarsdam, Marry E.; Strengers, Jan L.; Eveleigh, Rhona M.; Poulino, Sumayah E.; de Korte, Chris L.; Kapusta, Livia

    To assess the prevalence, history, and treatment of arrhythmias, in particular preexcitation and Wolff-Parkinson-White (WPW) syndrome, in patients with Ebstein anomaly (EA) during childhood and adolescence, we performed a multicenter retrospective study of all consecutive live-born patients with EA,

  19. Segmentation of age-related white matter changes in a clinical multi-center study

    DEFF Research Database (Denmark)

    Dyrby, Tim B.; Rostrup, E.; Baare, W.F.C.

    2008-01-01

    Age-related white matter changes (WMC) are thought to be a marker of vascular pathology, and have been associated with motor and cognitive deficits. In the present study, an optimized artificial neural network was used as an automatic segmentation method to produce probabilistic maps of WMC...... in a clinical multi-center study. The neural network uses information from T1- and T2-weighted and fluid attenuation inversion recovery (FLAIR) magnetic resonance (MR) scans, neighboring voxels and spatial location. Generalizability of the neural network was optimized by including the Optimal Brain Damage (OBD......) pruning method in the training stage. Six optimized neural networks were produced to investigate the impact of different input information on WMC segmentation. The automatic segmentation method was applied to MR scans of 362 non-demented elderly subjects from 11 centers in the European multi-center study...

  20. Optimizing the definition of intrauterine growth restriction: the multicenter prospective PORTO Study.

    LENUS (Irish Health Repository)

    Unterscheider, Julia

    2013-04-01

    The objective of the Prospective Observational Trial to Optimize Pediatric Health in Intrauterine Growth Restriction (IUGR) (PORTO Study), a national prospective observational multicenter study, was to evaluate which sonographic findings were associated with perinatal morbidity and mortality in pregnancies affected by growth restriction, originally defined as estimated fetal weight (EFW) <10th centile.

  1. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study

    NARCIS (Netherlands)

    von Renteln, Daniel; Fuchs, Karl-Hermann; Fockens, Paul; Bauerfeind, Peter; Vassiliou, Melina C.; Werner, Yuki B.; Fried, Gerald; Breithaupt, Wolfram; Heinrich, Henriette; Bredenoord, Albert J.; Kersten, Jan F.; Verlaan, Tessa; Trevisonno, Michael; Rösch, Thomas

    2013-01-01

    Pilot studies have indicated that peroral endoscopic myotomy (POEM) might be a safe and effective treatment for achalasia. We performed a prospective, international, multicenter study to determine the outcomes of 70 patients who underwent POEM at 5 centers in Europe and North America. Three months

  2. Normalization of US-Cuban Relations: Obama Doctrine and International Security in the Western Hemisphere

    Directory of Open Access Journals (Sweden)

    Piotr Łaciński

    2015-12-01

    Full Text Available Strained relations between the US and Cuba after the victory of the Cuban revolution were a permanent element of the destabilization of international security in the Western Hemisphere. During the Cold War, this destabilization was a function of the East-West confrontation. Since the end of Cold War the importance of Cuba as a Western Hemisphere entity hostile to the United States has diminished radically. Definite steps to normalize relations with Cuba have been taken only in 2014. The media named the change of policies of the US towards Cuba (and Iran as the Obama Doctrine. This article will try to prove that the continuation of the confron-tational and hostile US-Cuban relations after the collapse of the Eastern bloc was an exceptional and "unnatural" phenomenon from the perspective of realistic school of international relations, both for Washington and Havana.

  3. Soil hydraulic properties of Cuban soils

    International Nuclear Information System (INIS)

    Ruiz, M.E.; Medina, H.

    2004-01-01

    Because soil hydraulic properties are indispensable for determining soil water retention and soil water movement, their input for deterministic crop simulation models is essential. From these models is possible to access the effect of the weather changes, soil type or different irrigation schedules on crop yields. With these models, possibilities are provided to answer questions regarding virtual 'what happen if' experiments with a minimum of fieldwork. Nevertheless, determining soil hydraulic properties can be very difficult owing to unavailability of necessary equipment or the lack of personal with the proper knowledge for those tasks. These deficiencies are a real problem in developing countries, and even more so when there is not enough financial possibilities for research work. This paper briefly presents the way these properties have been accessed for Cuban soils, which methods have been used and the work now in progress. (author)

  4. Quality of life after neck dissection. Multicenter study

    International Nuclear Information System (INIS)

    Nibu, Ken-ichi; Onitsuka, Tetsuo; Kawabata, Kazuyoshi

    2010-01-01

    To assess the impact of modifications to radical neck dissection and radiotherapy on the postoperative quality of life, the study group 'Study on Standardization of Treatment for Lymph Node Metastasis of Head and Neck Cancer' performed a multicenter cross-sectional study using our self-administered neck dissection questionnaire and arm abduction test. While sparing levels IV and V improved most postoperative symptoms, such as stiffness and constriction of the neck were avoided as long as the sternocleidmastoid muscle (SCM) and the spinal accessory nerve were preserved. Resection of the SCM and spinal accessory nerve resulted in a drop shoulder and neck pain, respectively. Irradiation with a total dose of 50 Gy or more worsened stiffness of neck and shoulder. (author)

  5. New safety performance indicators for safety assessment of radioactive waste disposal facilities. Cuban experience

    International Nuclear Information System (INIS)

    Peralta Vital, J.L.; Castillo, R.G.; Olivera, J.

    2002-01-01

    The paper shows the Cuban experience on implementing geological disposal of radioactive waste and the necessity for identifying new safety performance indicators for the safety assessment (SA) of radioactive waste disposal facilities. The selected indicator was the concentration of natural radioactive elements (U, Ra, Th, K) in the Cuban geologic environment. We have carried out a group of investigations, which have allowed characterising the concentration for the whole Country, creating a wide database where this indicator is associated with the lithology. The main lithologies in Cuba are: the sedimentary rocks (70 percent of national occurrence), which are present in the three regions (limestone and lutite), and finally the igneous and metamorphic rocks. The results show the concentrations ranges of the natural radionuclides associated fundamentally to the variation in the lithology and geographical area of the Country. In Cuba, the higher concentration (ppm) of Uranium and Radium are referenced to the Central region associated to Skarn, while for Thorium (ppm) and Potassium (%), in the East region the concentration peaks in Tuffs have been found. The concentrations ranges obtained are preliminary, they characterise the behaviour of this parameter for the Cuban geology, but they do not represent limits for safety assessment purposes yet. Also other factors should be taken into account as the assessment context, time scales and others assumptions before establishing the final concentration limits for the natural radionuclides as a radiological and nuclear safety performance indicator complementary to dose and risk for safety assessment for radiological and nuclear facilities. (author)

  6. Fundamentación Científica de la Psiquiatría Cubana Actual Current Cuban Psychiatry: Its scientific foundation

    Directory of Open Access Journals (Sweden)

    Liuba Y Peña Galbán

    2007-08-01

    Full Text Available Se realiza un análisis metodológico conceptual de la Psiquiatría como ciencia partiendo de los criterios de los psiquiatras cubanos, coincidiendo en que es una rama de las Ciencias Médicas, en la cual el objeto de estudio es la enfermedad mental o el proceso salud enfermedad mental y sus acciones es el diagnóstico, tratamiento, etiopatogenia, rehabilitación y prevención de las mismas, así como su estudio epidemiológico y que incluye el carácter social e interdisciplinario. A partir de la reorientación de la Psiquiatría hacia la comunidad se hace una reflexión del significado e implicaciones de la misma. Se argumenta como en Cuba se aplica el Modelo de la Atención Comunitaria de Salud Mental a través de los Centros comunitarios de Salud Mental que constituyen la piedra angular del modelo cubano de atención comunitaria, con los que constituye la Psiquiatría comunitaria el nuevo paradigma de la Psiquiatría cubana actual. Se reconoce que el fundamento filosófico que sustenta a la Psiquiatría cubana actual es la teoría Marxista LeninistaA conceptual and methodological analysis of Psychiatry as a science is made, taking the Cuban psychiatrists' criteria as a starting point, referring to it as a branch of the Medical Sciences, in which the object of study is the mental illness or the process health-mental illness, being its actions the diagnosis, treatment, ethiology and pathogenesis, rehabilitation and prevention, as well as its epidemiological study that is related to the social and interdisciplinary levels. Starting with redirecting Psychiatry towards the community, a reflection is made of the meaning and implications of this science. It is documented the application of the Community Mental Health Attention Model that is applied through the community Centers of Mental Health, which constitute the cornerstone of the Cuban model of community attention. Thus, community Psychiatry represents the new paradigm of current Cuban

  7. Economic analysis of centralized vs. decentralized electronic data capture in multi-center clinical studies.

    Science.gov (United States)

    Walden, Anita; Nahm, Meredith; Barnett, M Edwina; Conde, Jose G; Dent, Andrew; Fadiel, Ahmed; Perry, Theresa; Tolk, Chris; Tcheng, James E; Eisenstein, Eric L

    2011-01-01

    New data management models are emerging in multi-center clinical studies. We evaluated the incremental costs associated with decentralized vs. centralized models. We developed clinical research network economic models to evaluate three data management models: centralized, decentralized with local software, and decentralized with shared database. Descriptive information from three clinical research studies served as inputs for these models. The primary outcome was total data management costs. Secondary outcomes included: data management costs for sites, local data centers, and central coordinating centers. Both decentralized models were more costly than the centralized model for each clinical research study: the decentralized with local software model was the most expensive. Decreasing the number of local data centers and case book pages reduced cost differentials between models. Decentralized vs. centralized data management in multi-center clinical research studies is associated with increases in data management costs.

  8. Internal Dosimetry and the pharmacokinetic of the Cuban Kit of Methoxy-Isobutyl-Isonitrile (MIBI) marked with 99mTc

    International Nuclear Information System (INIS)

    Torres, L.A.; Pereztol, O.; Rodriguez, J.L.; Alvarez, I.; Fraxedas, R.; Mesa, G.; Rodriguez, R.

    1998-01-01

    The objective of the present work consisted on evaluating the Internal Dosimetry and the pharmacokinetic of the Cuban Kit of Methoxy-Isobutyl-Isonitrile (MIBI) marked with 99mTc. In the dosimetry studies and biodistribution five healthy volunteers were included and in the pharmacokinetic studies five patients were included with less than 5% of probability of suffering illness of artery coronary

  9. Ecological approach of macrolide-lincosamides-streptogramin producing actinomyces from Cuban soils.

    Science.gov (United States)

    González, I; Niebla, A; Lemus, M; González, L; Iznaga, I O; Pérez, M E; Vallin, C

    1999-09-01

    We report in this study the frequency of Streptomyces strains to produce macrolide-lincosamide-streptogramin (MLS) antibiotics isolated from Cuban soils. The screening assay is based on the induction of MLS-resistance phenotype in a clinical isolated strain of Staphylococcus aureus S-18. Our results suggest that of 800 Streptomyces strains isolated from different soil samples, 6% were positives in the screening test used. The ferralitic red soil from Pinar del Río (north) provided the major percentage (3.6%) of MLS producing strains. The other soil samples tested belonging to Guira de Melena and Bauta in Havana, Matanzas City, Topes De Collantes (Villa Clara), and Soroa Mountains (Pinar del Rio) hill reached very low percentages.

  10. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study

    OpenAIRE

    Steihaug, Ole Martin; Gjesdal, Clara Gram; Bogen, Bård Erik; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

    2017-01-01

    Background: Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. Methods: A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory a...

  11. Feasible conditions for converting Cuban cane molasses into alcohol

    Energy Technology Data Exchange (ETDEWEB)

    Luchev, S

    1968-01-01

    Conditions for fermentation of Cuban cane molasses were found: 0.5 to 1.0% yeast, addition of 100g. H/sub 3/PO/sub 4/, 1 to 2 kg urea or (NH/sub 4/)/sub 2/SO/sub 4/ to 1 ton molasses, and fermentation at high molasses concentrations. During the process, solid residue formed containing mainly CaSO/sub 4/; this was limited when the molasses was clarified before the fermentation, or when it was distilled without the use of acids (particularly H/sub 2/SO/sub 4/), or when fermented molasses with a low alcohol content was distilled.

  12. MEDICAL TOURISM : Demand for Cuban Medical Tourism by Russian Consumers

    OpenAIRE

    Ulanova, Anastasia

    2015-01-01

    Medical tourism, often addressed as health tourism, is a new concept in terms of tourism industry in general, and it is also one of the rapidly developing and growing ones. This thesis gives information on the medical tourism in general and its history. It also revises the development stages of the medical tourism in the world. Cuban medical tourism is analyzed on its own, as well as Russian medical tourism and the demand for it. Medical tourism is rather popular among Russians due to various...

  13. Endemics under threat: an assessment of the conservation status of Cuban bats

    Directory of Open Access Journals (Sweden)

    Carlos Mancina

    2007-07-01

    Full Text Available Abstract Reviewing available information from published literature, museum database, personal communications and from the authors own field data, the conservation status of Cuban bats has been assessed using six qualitative parameters: abundance, distribution, roosting habits, aggregation level, forest dependence, and degree of endemism. The resulting Red List is analogous to that of the IUCN, species having been included in four categories of risk. Four out of the 26 extant bats of Cuba should be considered endangered, four vulnerable to extinction, twelve potentially threatened, and six in a stable situation. Most of the species of bats endemic to Cuba are under some form of threat. The major threats to the survival of Cuban bats are the destruction of forests and the modification of caves, the latter being critical habitats for the mostly cave-dwelling Cuban bat fauna. We argue that its conservation should be the result of a cooperative effort promoting research and habitat management. Riassunto Endemismi minacciati: una valutazione dello stato di conservazione dei chirotteri cubani. Lo stato di conservazione dei chirotteri cubani è stato valutato a partire da sei parametri qualitativi: abbondanza, distribuzione, roost utilizzati, livello di aggregazione, dipendenza da ambienti forestali e grado di endemismo. A questo scopo sono state esaminate le informazioni bibliografiche, i database dei musei e dati non pubblicati, in parte raccolti dagli stessi autori. La Lista Rossa risultante è analoga a quella dell’IUCN, comprendendo quattro categorie di rischio crescente. Delle 26 specie attualmente presenti a Cuba, 4 sono da considerarsi in pericolo di estinzione, 4 "vulnerabili", 12 "potenzialmente minacciate" e 6 "stabili". La maggior parte delle specie endemiche è in qualche misura minacciata. La deforestazione e l’alterazione delle cavità carsiche, che costituiscono un habitat

  14. Heterometal cubane-type MFe(3)S(4) clusters (M = Mo, V) trigonally symmetrized with hydrotris(pyrazolyl)borate(1-) and tris(pyrazolyl)methanesulfonate(1-) capping ligands.

    Science.gov (United States)

    Fomitchev, Dmitry V; McLauchlan, Craig C; Holm, R H

    2002-02-25

    A series of heterometal cubane-type clusters containing [VFe(3)S(4)](2+) and [MoFe(3)S(4)](3+,2+) cores has been prepared. Ligand substitution of [(DMF)(3)VFe(3)S(4)Cl(3)](-) affords [(Tpms)VFe(3)S(4)L(3)](2)(-) (L = Cl(-) (8), EtS(-) (9), p-MeC(6)H(4)S(-), p-MeC(6)H(4)O(-)). A new procedure for the preparation of molybdenum single cubanes is introduced by the reaction of recently reported [(Tp)MoS(S(4))](-) with FeCl(2)/NaSEt to afford [(Tp)MoFe(3)S(4)Cl(3)](-) (1, 75% yield). This procedure is more efficient that the existing multistep synthesis of single cubanes, which generally affords clusters of mirror symmetry. Also prepared were [(Tp)MoFe(3)S(4)L(3)](-) (L = EtS(-) (2), p-MeC(6)H(4)S(-)). Reduction of 1 with borohydride gives [(Tp)MoFe(3)S(4)Cl(3)](2-) (5, 67%). Owing to the nature of the heterometal ligand, all clusters have idealized trigonal symmetry, reflected in their (1)H NMR spectra. Trigonal structures are demonstrated by crystallography of (Bu(4)N)[1,2], (Bu(4)N)(2)[5] x MeCN, and (Me(4)N)(2)[8,9]. The availability of 1 and 5 allows the first comparison of structures and (57)Fe isomer shifts of [MoFe(3)S(4)](3+,2+) in a constant ligand environment. Small increases in most bond distances indicate that an antibonding electron is added in the reduction of 1. Collective synthetic and electrochemical results from this and other studies demonstrate the existence of the series of oxidation states [VFe(3)S(4)](3+,2+,1+) and [MoFe(3)S(4)](4+,3+,2+) whose relative stabilities within a given series are strongly ligand dependent. Isomer shifts indicate that the reduction of 1 largely affects the Fe(3) subcluster and are consistent with the formal descriptions [MoFe(3+)(2)Fe(2+)S(4)](3+) (1) and [MoFe(3+)Fe(2+)(2)S(4)](2+) (5). Reaction of 1 with excess Li(2)S in acetonitrile affords the double cubane [[(Tp)MoFe(3)S(4)Cl(2)](2)(mu(2)(-)S)](2)(-), whose sulfide-bridged structure is supported by two sequential reductions separated by 290 mV, in analogy with

  15. Performance of Ultrasound in the Diagnosis of Gout in a Multi-Center Study

    DEFF Research Database (Denmark)

    Ogdie, Alexis; Taylor, William J; Neogi, Tuhina

    2017-01-01

    OBJECTIVES: To examine the performance of ultrasound for the diagnosis of gout using presence of monosodium urate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multi-center observational cross-sectional stu...

  16. Sex and sentiment in Cuban tourism.

    Science.gov (United States)

    Babb, Florence E

    2010-01-01

    Helen Safa has been a leading program builder and pioneer in research that examines the complex intersections of gender, race, class, and nation in Latin America and the Caribbean. Her comparative research culminated in her influential book, The Myth of the Male Breadwinner: Women and Industrialization in the Caribbean (1995), which examined gender, family, and employment across three Caribbean societies. Over several decades Safa has inspired scholarship throughout the Caribbean and the Americas and her work is exemplary of engaged anthropology in the region. Here I present work I conducted in Cuba that was guided, like my work in Peru, Nicaragua, and southern Mexico by the writings of Safa and others who saw the critical need to bring gender into meaningful discussion in the field of Latin American and Caribbean studies. In what follows, drawn from my broader research on tourism in four nations, I explore and reflect on the contemporary dynamics of sex and romance tourism in Cuba. I suggest that the allure of this domain of tourism may be enhanced by Cuba's global political identity, and that Cuban women participating in commodified and intimate exchanges reveal an ability to get along in a market economy that generally excludes them.

  17. Descriptive epidemiology of the Multicenter ACL Revision Study (MARS) cohort.

    Science.gov (United States)

    Wright, Rick W; Huston, Laura J; Spindler, Kurt P; Dunn, Warren R; Haas, Amanda K; Allen, Christina R; Cooper, Daniel E; DeBerardino, Thomas M; Lantz, Brett Brick A; Mann, Barton J; Stuart, Michael J

    2010-10-01

    Revision anterior cruciate ligament (ACL) reconstruction has worse outcomes than primary reconstructions. Predictors for these worse outcomes are not known. The Multicenter ACL Revision Study (MARS) Group was developed to perform a multisurgeon, multicenter prospective longitudinal study to obtain sufficient subjects to allow multivariable analysis to determine predictors of clinical outcome. To describe the formation of MARS and provide descriptive analysis of patient demographics and clinical features for the initial 460 enrolled patients to date in this prospective cohort. Cross-sectional study; Level of evidence, 2. After training and institutional review board approval, surgeons began enrolling patients undergoing revision ACL reconstruction, recording patient demographics, previous ACL reconstruction methods, intra-articular injuries, and current revision techniques. Enrolled subjects completed a questionnaire consisting of validated patient-based outcome measures. As of April 1, 2009, 87 surgeons have enrolled a total of 460 patients (57% men; median age, 26 years). For 89%, the reconstruction was the first revision. Mode of failure as deemed by the revising surgeon was traumatic (32%), technical (24%), biologic (7%), combination (37%), infection (MARS Group has been able to quickly accumulate the largest revision ACL reconstruction cohort reported to date. Traumatic reinjury is deemed by surgeons to be the most common single mode of failure, but a combination of factors represents the most common mode of failure. Allograft graft choice is more common in the revision setting than autograft. Concomitant knee injury is extremely common in this population.

  18. OSBPL10, RXRA and lipid metabolism confer African-ancestry protection against dengue haemorrhagic fever in admixed Cubans.

    Directory of Open Access Journals (Sweden)

    Beatriz Sierra

    2017-02-01

    Full Text Available Ethnic groups can display differential genetic susceptibility to infectious diseases. The arthropod-born viral dengue disease is one such disease, with empirical and limited genetic evidence showing that African ancestry may be protective against the haemorrhagic phenotype. Global ancestry analysis based on high-throughput genotyping in admixed populations can be used to test this hypothesis, while admixture mapping can map candidate protective genes. A Cuban dengue fever cohort was genotyped using a 2.5 million SNP chip. Global ancestry was ascertained through ADMIXTURE and used in a fine-matched corrected association study, while local ancestry was inferred by the RFMix algorithm. The expression of candidate genes was evaluated by RT-PCR in a Cuban dengue patient cohort and gene set enrichment analysis was performed in a Thai dengue transcriptome. OSBPL10 and RXRA candidate genes were identified, with most significant SNPs placed in inferred weak enhancers, promoters and lncRNAs. OSBPL10 had significantly lower expression in Africans than Europeans, while for RXRA several SNPs may differentially regulate its transcription between Africans and Europeans. Their expression was confirmed to change through dengue disease progression in Cuban patients and to vary with disease severity in a Thai transcriptome dataset. These genes interact in the LXR/RXR activation pathway that integrates lipid metabolism and immune functions, being a key player in dengue virus entrance into cells, its replication therein and in cytokine production. Knockdown of OSBPL10 expression in THP-1 cells by two shRNAs followed by DENV2 infection tests led to a significant reduction in DENV replication, being a direct functional proof that the lower OSBPL10 expression profile in Africans protects this ancestry against dengue disease.

  19. Soil-plant relation in Cuban sugar cane by instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Diaz Riso, O.; Griffith Martinez, J.

    1996-01-01

    This paper shows the result of soil-plant relation in samples from Cuban sugar canes of different soil types and cane varieties, using the INAA from thermal reactor. The behaviour of minor and trace elements in sugar cane leaves is uniform and independent of sugar cane variety or type of soil. The soil-plant relation shows four principal groups of micro elements, according to their absorption by the plant

  20. Decontamination of Cuban oysters using irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Cisneros Despaigne, E; Leyva Castillo, V; Martinez, L L; Lara Ortiz, C [Instituto de Nutricion e Higiene de los Alimentos (Cuba); Castillo Rodriguez, E [Centro Nacional de Salud Animal (Cuba)

    2001-04-01

    Oysters (Crassostrea virginica) collected on the Cuban coast near Havana were examined for contamination with Vibrio cholerae and other potentially pathogenic Vibrio species. The strains thus isolated were characterized and identified to species following standard methods, and their radiation resistance (D{sub 10}) was determined in pure culture. The Vibrio species most often isolated were V. cholerae, V. parahaemolyticus and V. Alginolyticus. Representative cultures from each species were later used to inoculate shucked oysters to determine the optimal radiation dose that would ensure elimination of 10{sup 8} colony forming units (CFU)/g. The highest proportion of isolates were identified as Vibrio parahaemolyticus and V. algynoliticus. Non-O1 strains of Vibrio cholerae were isolated from 50% of samples, but no V. cholerae O1 was identified. D{sub 10} values calculated for the various strains were low in relation to those in the literature. The radiation dose for decontaminating heavily inoculated (10{sup 8} CFU/g) oysters was 1.2 kGy. (author)

  1. Decontamination of Cuban oysters using irradiation

    International Nuclear Information System (INIS)

    Cisneros Despaigne, E.; Leyva Castillo, V.; Martinez, L.L.; Lara Ortiz, C.; Castillo Rodriguez, E.

    2001-01-01

    Oysters (Crassostrea virginica) collected on the Cuban coast near Havana were examined for contamination with Vibrio cholerae and other potentially pathogenic Vibrio species. The strains thus isolated were characterized and identified to species following standard methods, and their radiation resistance (D 10 ) was determined in pure culture. The Vibrio species most often isolated were V. cholerae, V. parahaemolyticus and V. Alginolyticus. Representative cultures from each species were later used to inoculate shucked oysters to determine the optimal radiation dose that would ensure elimination of 10 8 colony forming units (CFU)/g. The highest proportion of isolates were identified as Vibrio parahaemolyticus and V. algynoliticus. Non-O1 strains of Vibrio cholerae were isolated from 50% of samples, but no V. cholerae O1 was identified. D 10 values calculated for the various strains were low in relation to those in the literature. The radiation dose for decontaminating heavily inoculated (10 8 CFU/g) oysters was 1.2 kGy. (author)

  2. Structural and magnetic characterization of three tetranuclear Cu(II) complexes with face-sharing-dicubane/double-open-cubane like core framework

    International Nuclear Information System (INIS)

    Paul, Aparup; Bertolasi, Valerio; Figuerola, Albert; Manna, Subal Chandra

    2017-01-01

    Three novel tetranuclear copper(II) complexes namely [Cu 4 (L 1 ) 4 ]∙2(dmf) (1), [Cu 4 (L 1 ) 4 ] (2) and [Cu 4 (L 2 ) 2 (HL 2 ) 2 (H 2 O) 2 ]∙2(ClO 4 )·6(H 2 O) (3) (H 2 L 1 , (E)−2-((1-hydroxybutan-2-ylimino)methyl)phenol; H 2 L 2 , (E)−2-((1-hydroxybutan-2-ylimino)methyl)−6-methoxyphenol)) were synthesized from the self-assembly of copper(II) perchlorate and the tridentate Schiff base ligands. The structural determination reveals that crystallizes in the monoclinic system with space group C2/c, whereas both the and crystallize in the triclinic system with space group P-1. and possess face-sharing dicubane core, on the other hand complex 3 has double open cubane core structure. The copper(II) ions in the cubane core are in distorted square planar geometries, and weak π…π and C–H…π interactions lead to formation of a 2D supramolecular architecture for and . At room temperature and , exhibit fluorescence with a quantum yield (Φ s ) of 0.47, 0.49 and 0.38, respectively. Variable temperature magnetic susceptibility measurements in the range 2–300 K indicate an overall weak antiferromagnetic exchange coupling in all complexes. The PHI program was used to study their magnetic behaviour. In agreement with their face-sharing dicubane structure, a Hamiltonian of the type H =– J 1 (S 1 S 2 +S 1 S 2’ +S 1' S 2 +S 1' S 2’ ) – J 2 S 1 S 1’ , where S 1 = S 1’ = S 2 = S 2’ = S Cu =1/2, was used for studying and . Simulations performed suggest magnetic exchange constants with values close to J 1 =−20 cm −1 and J 2 =0 cm -1 for these complexes. On the other hand, the spin Hamiltonian H =– J 1 (S 1 S 4 +S 2 S 3 ) – J 2 (S 1 S 3 +S 2 S 4 ) – J 3 S 1 S 2 , where S 1 = S 2 = S 3 = S 4 = S Cu =1/2, was used to study the magnetic behaviour of the double open cubane core of and a good agreement between the experimental and simulated results was found by using the parameters g 1 = g 2 =2.20, g 3 = g 4 =2.18, J 1 =−36 cm -1 , J 2

  3. Oxygen-atom transfer chemistry and thermolytic properties of a di-tert-butylphosphate-ligated Mn4O4 cubane.

    Science.gov (United States)

    Van Allsburg, Kurt M; Anzenberg, Eitan; Drisdell, Walter S; Yano, Junko; Tilley, T Don

    2015-03-16

    [Mn4O4{O2P(OtBu)2}6] (1), an Mn4O4 cubane complex combining the structural inspiration of the photosystem II oxygen-evolving complex with thermolytic precursor ligands, was synthesized and fully characterized. Core oxygen atoms within complex 1 are transferred upon reaction with an oxygen-atom acceptor (PEt3), to give the butterfly complex [Mn4O2{O2P(OtBu)2}6(OPEt3)2]. The cubane structure is restored by reaction of the latter complex with the O-atom donor PhIO. Complex 1 was investigated as a precursor to inorganic Mn metaphosphate/pyrophosphate materials, which were studied by X-ray absorption spectroscopy to determine the fate of the Mn4O4 unit. Under the conditions employed, thermolyses of 1 result in reduction of the manganese to Mn(II) species. Finally, the related butterfly complex [Mn4O2{O2P(pin)}6(bpy)2] (pin = pinacolate) is described. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Structural and magnetic characterization of a tetranuclear copper(II) cubane stabilized by intramolecular metal cation-π interactions.

    Science.gov (United States)

    Papadakis, Raffaello; Rivière, Eric; Giorgi, Michel; Jamet, Hélène; Rousselot-Pailley, Pierre; Réglier, Marius; Simaan, A Jalila; Tron, Thierry

    2013-05-20

    A novel tetranuclear copper(II) complex (1) was synthesized from the self-assembly of copper(II) perchlorate and the ligand N-benzyl-1-(2-pyridyl)methaneimine (L(1)). Single-crystal X-ray diffraction studies revealed that complex 1 consists of a Cu4(OH)4 cubane core, where the four copper(II) centers are linked by μ3-hydroxo bridges. Each copper(II) ion is in a distorted square-pyramidal geometry. X-ray analysis also evidenced an unusual metal cation-π interaction between the copper ions and phenyl substituents of the ligand. Calculations based on the density functional theory method were used to quantify the strength of this metal-π interaction, which appears as an important stabilizing parameter of the cubane core, possibly acting as a driving parameter in the self-aggregation process. In contrast, using the ligand N-phenethyl-1-(2-pyridyl)methaneimine (L(2)), which only differs from L(1) by one methylene group, the same synthetic procedure led to a binuclear bis(μ-hydroxo)copper(II) complex (2) displaying intermolecular π-π interactions or, by a slight variation of the experimental conditions, to a mononuclear complex (3). These complexes were studied by X-ray diffraction techniques. The magnetic properties of complexes 1 and 2 are reported and discussed.

  5. A Multicenter Study of the Presentation, Treatment, and Outcomes of Cervical Dural Tears.

    Science.gov (United States)

    O'Neill, Kevin R; Fehlings, Michael G; Mroz, Thomas E; Smith, Zachary A; Hsu, Wellington K; Kanter, Adam S; Steinmetz, Michael P; Arnold, Paul M; Mummaneni, Praveen V; Chou, Dean; Nassr, Ahmad; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Smith, Justin S; Shaffrey, Christopher; Tannoury, Chadi A; Tannoury, Tony; Gokaslan, Ziya L; Gum, Jeffrey L; Hart, Robert A; Isaacs, Robert E; Sasso, Rick C; Bumpass, David B; Bydon, Mohamad; Corriveau, Mark; De Giacomo, Anthony F; Derakhshan, Adeeb; Jobse, Bruce C; Lubelski, Daniel; Lee, Sungho; Massicotte, Eric M; Pace, Jonathan R; Smith, Gabriel A; Than, Khoi D; Riew, K Daniel

    2017-04-01

    Retrospective multicenter case series study. Because cervical dural tears are rare, most surgeons have limited experience with this complication. A multicenter study was performed to better understand the presentation, treatment, and outcomes following cervical dural tears. Multiple surgeons from 23 institutions retrospectively identified 21 rare complications that occurred between 2005 and 2011, including unintentional cervical dural tears. Demographic data and surgical history were obtained. Clinical outcomes following surgery were assessed, and any reoperations were recorded. Neck Disability Index (NDI), modified Japanese Orthopaedic Association (mJOA), Nurick classification (NuC), and Short-Form 36 (SF36) scores were recorded at baseline and final follow-up at certain centers. All data were collected, collated, and analyzed by a private research organization. There were 109 cases of cervical dural tears among 18 463 surgeries performed. In 101 cases (93%) there was no clinical sequelae following successful dural tear repair. There were statistical improvements ( P < .05) in mJOA and NuC scores, but not NDI or SF36 scores. No specific baseline or operative factors were found to be associated with the occurrence of dural tears. In most cases, no further postoperative treatments of the dural tear were required, while there were 13 patients (12%) that required subsequent treatment of cerebrospinal fluid drainage. Analysis of those requiring further treatments did not identify an optimum treatment strategy for cervical dural tears. In this multicenter study, we report our findings on the largest reported series (n = 109) of cervical dural tears. In a vast majority of cases, no subsequent interventions were required and no clinical sequelae were observed.

  6. Synthesis, structure and properties of tellurium cubane clusters of niobium and tantalum [M4(μ4-O)(μ3-Te)4(CN)12]6- (M=Nb, Ta)

    International Nuclear Information System (INIS)

    Fedin, V.P.; Kalinina, I.V.; Virovets, A.V.; Fenske, D.

    2001-01-01

    A new cubane cluster complex K 6 [Ta 4 (μ 4 -O)(μ 3 -Te) 4 (CN) 12 ] · KOH · 4H 2 O was prepared by high-temperature synthesis from a mixture of TaTe 4 and KCN with subsequent crystallization from aqueous solutions. The compound was characterized by the methods of cyclic voltammetry, X-ray diffraction analysis, IR, Raman and absorption spectroscopies. Comparative study of clusters [M 4 OTe 4 (CN) 12 ] 6- (M=Nb, Ta) containing μ 4 -O-ligands and being the first examples of molecular chalcogenide cubane complexes for group 5 metals of the Periodic System, was made [ru

  7. Cuban entities management. Cedrux just around the corner.

    Directory of Open Access Journals (Sweden)

    Tamara Rodríguez Sánchez

    2011-12-01

    Full Text Available The direction of the country as part of strengthening entities management and the informatization of Cuban society, presented the need to create a System of Enterprise Resource Planning (ERP, which would be able to computerize management processes of business and budgeted entities on national scale. It is in this way that since July 2008 CEDRUX product was developed composed by 15 subsystems. It will constitute the core on which new solutions will be developed that will extend its functionalities in a constantly way, including new entities management processes and allowing constant updating. In its first operational phase that will be in this very year 2011, Cedrux will only integrate 9 subsystems that will answer the economic needs of any organization.

  8. Euclidean supergravity and multi-centered solutions

    Directory of Open Access Journals (Sweden)

    W.A. Sabra

    2017-04-01

    Full Text Available In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein–Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D=5, N=2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein–Maxwell multi-centered solutions are also presented.

  9. Castro’s Ploy-America’s Dilemma: The 1980 Cuban Boatlift

    Science.gov (United States)

    1988-12-01

    Even the music in Cuba had become politicized- few romantic songs were played. Mercedes and her family liked to go to the beach for recreation. Because...of religious beliefs through scientific materialistic propaganda."’ 2-5 The government employed such harassing tech- niques as blaring loud music from...dollars, two blue-topped Cuban government turismo boats quickly appeared in the harbor to sell goods to the woaters. Ham sandwiches cost $i one day, $3

  10. Environmental Management in the Process of Purification of Cuban Furfural in the Chemical Bioactive Center Plant

    Directory of Open Access Journals (Sweden)

    Ing. Liset Rodríguez-Machín

    2016-02-01

    Full Text Available It is necessary to establish in the installed equipment, operating conditions and quality specifications in the purification of furfural produced in Cuba. To do this some literature review and experiments are carried out. The approved batches by the quality control are quantified as well as the heat and evaporation losses and the impact on workers health. Energy management is performed by identifying electricity as the energy source of higher consumption. Some measures are applied like coating the evaporator portions that are required together with condenser modification and improvement of the room ventilation. As a result it was shown that it is possible to purify the Cuban furfural in the installed equipment, the process efficiency increases in 5,5 %, the evaporation losses decrease and non-acceptance by quality control drops. If the imported furfural is replaced by the Cuban are saved about 39 000 • per year production.

  11. Facebook social uses by young Cubans on the island

    Directory of Open Access Journals (Sweden)

    Liliam Marrero Santana

    2017-10-01

    Full Text Available It proposes an approach to the social uses of the social networking site (SNS Facebook made by a group of young Cubans residents in the country, as a result of a qualitative research of an empirical-descriptive nature. The virtual ethnography is the main methodological strategy and it is complemented with the application of different techniques like the documentary and literature review, the semi-structured interview and the discussion group. As a part of the analysis’ results, are referred some of the determinant factors of the social uses of Facebook and are described the practices of the young associated with the better use of the techno-communicatives codes of the computing platform, the content production and the collective construction of meaning in this particular network environment. Among the main conclusions of the study, the relevance of the category social uses for the analysis of socio-historical and cultural processes mediated by and mediators of ICT is reaffirmed.

  12. Simplified Therapeutic Intervention Scoring System : The TISS-28 items - Results from a multicenter study

    NARCIS (Netherlands)

    Miranda, DR; deRijk, A; Schaufeli, W

    Objectives: To validate a simplified version of the Therapeutic Intervention Scoring System, the TISS-28, and to determine the association of TISS-28 with the time spent on scored and nonscored nursing activities. Design: Prospective, multicenter study. Setting: Twenty-two adult medical, surgical,

  13. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study

    OpenAIRE

    Marie Sylvianne Rabodoarivelo; A Brandao; M C Cergole Novella; A G C. Bombonatte; B Imperiale; N Rakotosamimanana; N Morcillo; V Rasolofo; J C Palomino; A Martin

    2018-01-01

    Background: In low-income countries, rapid detection of tuberculosis (TB) drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF) and isoniazid (INH) resistance. Methods: This was a multicenter study. Molecular detection of ...

  14. Quality of life in a group of Cuban women with breast cancer

    International Nuclear Information System (INIS)

    Izquierdo-Gonzalez, Marlen

    2009-01-01

    Was studied a group of 16 Cuban patients, undergoing surgery and treatment for breast cancer oncospecific with survival greater than anno to assess the impact of the diagnosis, surgery and concomitant treatment on quality of life. The quality of life in the study group is similar to that of reference groups and other breast cancer patients with more than one year of survival, with better physical functioning. The evaluation of the exponents of emotional state, such as nervousness, worry, irritability and depression, showed that the evaluation of the quality of the emotional scale offers significantly lower values of other country groups, but corresponds with that reported for women with breast cancer survival time with the same and equal to the value obtained for cancer patients in treatment and less than a year survival. (Author)

  15. Healthy Eating Index scores associated with symptoms of depression in Cuban-Americans with and without type 2 diabetes: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Exebio Joel C

    2011-12-01

    Full Text Available Abstract Background Low diet quality and depression symptoms are independently associated with poor glycemic control in subjects with type 2 diabetes (T2D; however, the relationship between them is unclear. The aim of this study was to determine the association between diet quality and symptoms of depression among Cuban-Americans with and without T2D living in South Florida. Methods Subjects (n = 356 were recruited from randomly selected mailing list. Diet quality was determined using the Healthy Eating Index-2005 (HEI-05 score. Symptoms of depression were assessed using the Beck Depression Inventory (BDI. Both linear and logistic regression analyses were run to determine whether or not these two variables were related. Symptoms of depression was the dependent variable and independent variables included HEI-05, gender, age, marital status, BMI, education level, A1C, employment status, depression medication, duration of diabetes, and diabetes status. Analysis of covariance was used to test for interactions among variables. Results An interaction between diabetes status, gender and HEI-05 was found (P = 0.011. Among males with a HEI-05 score ≤ 55.6, those with T2D had a higher mean BDI score than those without T2D (11.6 vs. 6.6 respectively, P = 0.028. Among males and females with a HEI-05 score ≤ 55.6, females without T2D had a higher mean BDI score compared to males without T2D (11.0 vs. 6.6 respectively, P = 0.012 Conclusions Differences in symptoms of depression according to diabetes status and gender are found in Cuban-Americans with low diet quality.

  16. Founded: Genetic Reconstruction of Lineage Diversity and Kinship Informs Ex situ Conservation of Cuban Amazon Parrots (Amazona leucocephala).

    Science.gov (United States)

    Milián-García, Yoamel; Jensen, Evelyn L; Madsen, Jeanette; Álvarez Alonso, Suleiky; Serrano Rodríguez, Aryamne; Espinosa López, Georgina; Russello, Michael A

    2015-01-01

    Captive breeding is a widespread conservation strategy, yet such programs rarely include empirical genetic data for assessing management assumptions and meeting conservation goals. Cuban Amazon parrots (Amazona leucocephala) are considered vulnerable, and multiple on-island captive populations have been established from wild-caught and confiscated individuals of unknown ancestry. Here, we used mitochondrial haplotypic and nuclear genotypic data at 9 microsatellite loci to quantify the extent and distribution of genetic variation within and among captive populations in Zapata Swamp and Managua, Cuba, and to estimate kinship among breeders (n = 88). Using Bayesian clustering analysis, we detected 2 distinct clusters within the Zapata population, one of which was shared with Managua. Individuals from the cluster unique to Zapata possessed mitochondrial haplotypes with affinities to Cuban subspecies (A. l. leucocephala, A. l. palmarum); the shared cluster was similar, but also included haplotypes closely related to the subspecies restricted to Cayman Brac (A. l. hesterna). Overall mean kinship was low within each captive population (-0.026 to -0.012), with 19 and 11 recommended breeding pairs in Zapata and Managua, respectively, ranked according to mean kinship and informed by molecular sexing. Our results highlight the importance of understanding population history within ex situ management programs, while providing genetic information to directly inform Cuban parrot conservation. © The American Genetic Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. Examining the influence of family environments on youth violence: a comparison of Mexican, Puerto Rican, Cuban, non-Latino Black, and non-Latino White adolescents.

    Science.gov (United States)

    Estrada-Martínez, Lorena M; Padilla, Mark B; Caldwell, Cleopatra Howard; Schulz, Amy Jo

    2011-08-01

    Existing research rarely considers important ethnic subgroup variations in violent behaviors among Latino youth. Thus, their risk for severe violent behaviors is not well understood in light of the immense ethnic and generational diversity of the Latino population in the United States. Grounded in social control theory and cultural analyses of familism, we examine differences in the risk for severe youth violence, as well its associations with family cohesion, parental engagement, adolescent autonomy, household composition, and immigrant generation among Mexican (n = 1,594), Puerto Rican (n = 586), Cuban (n = 488), and non-Latino Black (n = 4,053), and White (n = 9,921) adolescents with data from the National Longitudinal Study of Adolescent Health. Results indicate a gradient of risk; White youth had the lowest risk for severe violence and Puerto Rican youth had the highest risk compared to all other racial/ethnic subgroups. Within-group analysis indicates that family factors are not universally protective or risk-inducing. While family cohesion decreased the risk of severe violence among all groups, parental engagement was associated with increased risk among Blacks and Whites, and adolescent autonomy was associated with increased risk among Puerto Ricans and Cubans. In addition, Cuban and White adolescents who lived in single parent households or who did not live with their parents, had higher risk for severe violent behaviors than their counterparts who lived in two parent households. Among Latinos, the association of immigrant generation was in opposite directions among Mexicans and Cubans. We conclude that family and immigration factors differentially influence risk for violence among Latino subgroups and highlight the significance of examining subgroup differences and developing intervention strategies that are tailored to the needs of each ethnic subgroup.

  18. O rastro do dragão em quatro narradores cubanos The trail of the dragon in four cuban writers

    Directory of Open Access Journals (Sweden)

    Rogelio Rodríguez Coronel

    2013-06-01

    Full Text Available Seguindo o rastro da cultura chinesa na cultura e literatura cubanas, este trabalho revela-se como um espaço para a discussão de um tema pouco tratado pela crítica, a presença chinesa na constituição da literatura cubana. O "rastro do dragão" é acompanhado desde o século XVII até a contemporaneidade, passando pela obra de autores como Severo Sarduy, Ramón Meza, José Martí e José Lezama Lima, máximos expoentes da modernidade nas letras em Cuba.Siguiendo las huellas de la cultura china en la cultura y la literatura cubanas, este trabajo se revela como un espacio para la discusión de un tema escasamente tratado por la crítica, la presencia china en la constitución de la literatura cubana. La "huella del dragón" es seguida en este estudio, desde el siglo XVII hasta la contemporaneidad, pasando por la obra de autores como Severo Sarduy, Ramón Meza, José Martí e José Lezama Lima, máximos exponentes de la modernidad de las letras en Cuba.Following the trail of Chinese culture in Cuban culture and literature, the paper discusses the Chinese presence in Cuban literature, a subject seldom covered by literary criticism, "The Trail of the...Dragon" is traced in this study from the XVII Century to the present, covering the work of such writers as Severo Sarduy, Ramón Meza, José Martí and José Lezama Lima, outstanding exponents of modernism in Cuban letters.

  19. Neutron activation analysis of final molasses from cuban sugar industry

    International Nuclear Information System (INIS)

    Griffith, J.; Gonzalez, E.; Rosenberg, R.J.; Diaz-Rizo, O.

    1996-01-01

    Thermal and epithermal non-destructive activation analyses have been performed on samples of final molasses from 14 different sugar factories , covering the most important regions in Cuba. From the first measurement after irradiation at the Triga Mark reactor (VTT), the concentration of more than 15 elements is reported. The almost constant elemental composition shows that they can be used equally for different purposes as animal foodstuff and for the manufacture of biotechnological products. This work is part of a research project developed in order to establish a complete characterization of Cuban sugar molasses. (author). 7 refs., 2 tabs

  20. Acute necrotizing pancreatitis: a multicenter study.

    Science.gov (United States)

    Fernández-Cruz, L; Navarro, S; Valderrama, R; Sáenz, A; Guarner, L; Aparisi, L; Espi, A; Jaurietta, E; Marruecos, L; Gener, J

    1994-04-01

    A multicenter study of acute necrotizing pancreatitis (ANP) classified in accordance with the Balthazar criteria (grades D and E), has been performed in 12 teaching hospitals. A total of 233 patients were reviewed, and the mortality rate was 26.6%. The most common etiology was biliary pancreatitis (45.5%). Among the complications, shock, renal insufficiency, pulmonary insufficiency and hemorrhagic gastritis were associated with a mortality rate of 51-66%. Diffuse fluid collections were associated with a higher mortality rate (26.8%) than localized fluid collections (14.5%). In 106 patients with gallstone pancreatitis, early surgery was performed in 17, and 5 patients (29.4%) died. No mortality was observed in 32 patients with delayed surgery. Sphincterotomy was performed in 13 patients, and 4 (30.7%) died. Early surgery (necrosectomy and closed peritoneal lavage) was undertaken in 75 patients, with a mortality rate of 39%. In conclusion, the morbidity and mortality rates of ANP can be improved with proper monitoring, adequate supportive care and the judicious use of surgery based on clinical and morphological findings.

  1. Perspectives for Distributed Observations of Near-Earth Space Using a Russian-Cuban Observatory

    Science.gov (United States)

    Bisikalo, D. V.; Savanov, I. S.; Naroenkov, S. A.; Nalivkin, M. A.; Shugarov, A. S.; Bakhtigaraev, N. S.; Levkina, P. A.; Ibragimov, M. A.; Kil'pio, E. Yu.; Sachkov, M. E.; Kartashova, A. P.; Fateeva, A. M.; Uratsuka, Marta R. Rodriguez; Estrada, Ramses Zaldivar; Diaz, Antonio Alonsa; Rodríguez, Omar Pons; Figuera, Fidel Hernandes; Garcia, Maritza Garcia

    2018-06-01

    The creation of a specialized network of large, wide-angle telescopes for distributed observations of near-Earth space using a Russian-Cuban Observatory is considered. An extremely important goal of routine monitoring of near-Earth and near-Sun space is warding off threats with both natural and technogenic origins. Natural threats are associated with asteroids or comets, and technogenic threats with man-made debris in near-Earth space. A modern network of ground-based optical instruments designed to ward off such threats must: (a) have a global and, if possible, uniform geographic distribution, (b) be suitable for wide-angle, high-accuracy precision survey observations, and (c) be created and operated within a single network-oriented framework. Experience at the Institute of Astronomy on the development of one-meter-class wide-angle telescopes and elements of a super-wide-angle telescope cluster is applied to determine preferences for the composition of each node of such a network. The efficiency of distributed observations in attaining maximally accurate predictions of the motions of potentially dangerous celestial bodies as they approach the Earth and in observations of space debris and man-made satellites is estimated. The first estimates of astroclimatic conditions at the proposed site of the future Russian-Cuban Observatory in the mountains of the Sierra del Rosario Biosphere Reserve are obtained. Special attention is given to the possible use of the network to carry out a wide range of astrophysical studies, including optical support for the localization of gravitational waves and other transient events.

  2. Economic feasibility study of an electric generation project from bagasse gasification in a cuban sugar mill

    International Nuclear Information System (INIS)

    Torres Fernández, Alfredo; Almazán del Olmo, Oscar; Hernández, Bárbara

    2015-01-01

    Some solid fuels which are very pollutant and with low value could be transformed into a clean gas that could be used in many industrial applications for its physical properties and for being easy transported. Then, electricity generation is one of the most important applications. In this case, electricity could be generated, cleanly and efficiently, through the use of synthesis gas that replaces the natural gas in a combined cycle (Biomass Integrated Gasification Combined Cycle (BIGCC)).In this paper, we carry out an economic feasibility study of the project about the implementation of Biomass Integrated Gasification Combined Cycle (BIGCC) in a 10000 tc/d sugar mill from bagasse gasification in order to demonstrate, from the economic point of view, the possibility of investment in this kind of technology considering the current conditions of Cuban sugar industry.Later, a sensitivity analysis is presented to show first, the break-even point associated to the project and second, the variations of financial indicators due to changes on the total amount of investments, which is a very helpful element for making right decisions in the project investment process. (author)

  3. Conducting multicenter research in healthcare simulation: Lessons learned from the INSPIRE network.

    Science.gov (United States)

    Cheng, Adam; Kessler, David; Mackinnon, Ralph; Chang, Todd P; Nadkarni, Vinay M; Hunt, Elizabeth A; Duval-Arnould, Jordan; Lin, Yiqun; Pusic, Martin; Auerbach, Marc

    2017-01-01

    Simulation-based research has grown substantially over the past two decades; however, relatively few published simulation studies are multicenter in nature. Multicenter research confers many distinct advantages over single-center studies, including larger sample sizes for more generalizable findings, sharing resources amongst collaborative sites, and promoting networking. Well-executed multicenter studies are more likely to improve provider performance and/or have a positive impact on patient outcomes. In this manuscript, we offer a step-by-step guide to conducting multicenter, simulation-based research based upon our collective experience with the International Network for Simulation-based Pediatric Innovation, Research and Education (INSPIRE). Like multicenter clinical research, simulation-based multicenter research can be divided into four distinct phases. Each phase has specific differences when applied to simulation research: (1) Planning phase , to define the research question, systematically review the literature, identify outcome measures, and conduct pilot studies to ensure feasibility and estimate power; (2) Project Development phase , when the primary investigator identifies collaborators, develops the protocol and research operations manual, prepares grant applications, obtains ethical approval and executes subsite contracts, registers the study in a clinical trial registry, forms a manuscript oversight committee, and conducts feasibility testing and data validation at each site; (3) Study Execution phase , involving recruitment and enrollment of subjects, clear communication and decision-making, quality assurance measures and data abstraction, validation, and analysis; and (4) Dissemination phase , where the research team shares results via conference presentations, publications, traditional media, social media, and implements strategies for translating results to practice. With this manuscript, we provide a guide to conducting quantitative multicenter

  4. Industrial property for science’s management, technology and innovation in Cuban State companies

    OpenAIRE

    Contreras Villavicencio, Dulce María; Suárez Gutiérrez, Evelio; Moreno Cruz, Marta Milagros; Correa Álvarez, Pascual

    2017-01-01

    The paper synthesizes some research on industrial property aspects from the socio-legal perspective and financial accounting. Its focus to the socialist state enterprise adaptation in his economic fact, social and environmental responsibility as a fundamental Cuban model reach, competitiveness and high performance in socialist state enterprise. It outlines criteria on the ordering and implementation of industrial property through the management of science and technology, protection and dissem...

  5. Historical personalities of the Cuban education. A reflection necesary

    Directory of Open Access Journals (Sweden)

    Yordan Nápoles-Ramírez

    2017-04-01

    Full Text Available Along the History of the Cuban education, the teaching and the learning of the life and work of the historical personalities has constituted a priority. However, the tendency has prevailed to alone to approach in the different teaching levels the historical personalities from a political-military focus, without conceiving an integrative treatment that embraces other spheres of the social activity. Equal limitations exist in reconstructing the historical context where the same ones were developed and to analyze their narrow one with the diverse social sectors that accompanied her. The present article seeks to demonstrate the necessity to transform the treatment of the historical personalities at the present time. 

  6. Use of neuronal networks in the modeling of the doses that receives the Cuban population by potassium-40 contained in their organism

    International Nuclear Information System (INIS)

    Zerquera, Juan Tomas; Prendes Alonso, Miguel; Lopez Bejerano, Gladys M.; Acosta Rodriguez, Nancy

    2001-01-01

    The potassium 40 constitutes the main source natural present in the organism that influences in the effective dose that people receive. With the objective of evaluating the contribution from this component to the doses received by the Cuban population, a study was developed in order to evaluate the doses for this cause. A representative sample was selected based on the distribution of Cuban population by sex and ages. The measurements were carried out in the Whole Body Counter of the Center for Radiation Protection and Hygiene. For the estimate of the doses an uniform distribution of potassium was assumed in the whole body and the methodology was used recommended by the ICRP. The values of annual effective dose varies between 93 and 209 mSv for the feminine sex and 102 and 212 mSv for the masculine sex. With the obtained values they were the adjustment coefficients for the functions dose-age for each one of the sexes. At the same time it was possible to model the estimate of the doses by means of a neural network that, trained with the obtained experimental data, it allows to estimate the due doses directly to the potassium 40 starting from the sex data, age, height and corporal weight. The effective dose mediates yearly for the public's members it was estimated in 149 ± 6 mSv, starting from the experimental data and the Cuban population's specific characteristics. (author)

  7. 78 FR 9573 - Delegation of Authority To Suspend the Provisions of Title III of the Cuban Liberty and...

    Science.gov (United States)

    2013-02-08

    ... Authority To Suspend the Provisions of Title III of the Cuban Liberty and Democratic Solidarity (LIBERTAD... Liberty and Democratic Solidarity (LIBERTAD) Act of 1996 (Public Law 104-114; 22 U.S.C. 6021-6091), as...

  8. Recurrent Laryngeal Nerve Palsy After Cervical Spine Surgery: A Multicenter AOSpine Clinical Research Network Study.

    Science.gov (United States)

    Gokaslan, Ziya L; Bydon, Mohamad; De la Garza-Ramos, Rafael; Smith, Zachary A; Hsu, Wellington K; Qureshi, Sheeraz A; Cho, Samuel K; Baird, Evan O; Mroz, Thomas E; Fehlings, Michael; Arnold, Paul M; Riew, K Daniel

    2017-04-01

    Multicenter retrospective study. To investigate the risk of symptomatic recurrent laryngeal nerve palsy (RLNP) following cervical spine surgery, to examine risk factors for its development, and to report its treatment and outcomes. A multicenter study from 21 high-volume surgical centers from the AOSpine North America Clinical Research Network was performed. Each center screened for rare complications following cervical spine surgery, including RLNP. Patients were included if they underwent cervical spine surgery (levels from C2 to C7) between January 1, 2005 and December 31, 2011. Data were analyzed with regard to complication treatment and outcome. Cases were compared to a control group from the AOSpine CSM and CSM-I studies. Three centers reported 19 cases of RLNP from a cohort of 1345 patients. The reported incidence of RLNP ranged from 0.6% to 2.9% between these 3 centers. Fifteen patients (79%) in the RLNP group were approached from the left side. Ten patients (52.6%) required treatment for RLNP-6 required medical therapy (steroids), 1 interventional treatment (injection laryngoplasty), and 3 conservative therapy (speech therapy). When examining outcomes, 73.7% (14/19) of cases resolved completely, 15.8% (3/19) resolved with residual effects, and in 10.5% (2/19) of cases this could not be determined. In this multicenter study examining rare complications following cervical spine surgery, the risk of RLNP after cervical spine surgery ranged from 0.6% to 2.9% between centers. Though rare, it was found that 16% of patients may experience partial resolution with residual effects, and 74% resolve completely.

  9. Contribution gives the cosmic radiation to the doses for exhibition to the natural radiation in the Cuban population

    International Nuclear Information System (INIS)

    Tomas Zerquera, J.; Peres Sanchez, D.; Prendes Alonso, M

    1998-01-01

    With the objective to specify the preponderant contribution the cosmic component the radiation in the dose that the Cuban population receives you carries out a program she gives mensurations she gives this component in the whole country

  10. Prevalence and Genotype Distribution of Pneumocystis jirovecii in Cuban Infants and Toddlers with Whooping Cough

    Science.gov (United States)

    Monroy-Vaca, Ernesto X.; de Armas, Yaxsier; Illnait-Zaragozí, María T.; Toraño, Gilda; Diaz, Raúl; Vega, Dania; Alvarez-Lam, Ileana; Calderón, Enrique J.

    2014-01-01

    This study describes the prevalence and genotype distribution of Pneumocystis jirovecii obtained from nasopharyngeal (NP) swabs from immunocompetent Cuban infants and toddlers with whooping cough (WC). A total of 163 NP swabs from 163 young Cuban children with WC who were admitted to the respiratory care units at two pediatric centers were studied. The prevalence of the organism was determined by a quantitative PCR (qPCR) assay targeting the P. jirovecii mitochondrial large subunit (mtLSU) rRNA gene. Genotypes were identified by direct sequencing of mtLSU ribosomal DNA (rDNA) and restriction fragment length polymorphism (RFLP) analysis of the dihydropteroate synthase (DHPS) gene amplicons. qPCR detected P. jirovecii DNA in 48/163 (29.4%) samples. mtLSU rDNA sequence analysis revealed the presence of three different genotypes in the population. Genotype 2 was most common (48%), followed in prevalence by genotypes 1 (23%) and 3 (19%); mixed-genotype infections were seen in 10% of the cases. RFLP analysis of DHPS PCR products revealed four genotypes, 18% of which were associated with resistance to sulfa drugs. Only contact with coughers (prevalence ratio [PR], 3.51 [95% confidence interval {CI}, 1.79 to 6.87]; P = 0.000) and exposure to tobacco smoke (PR, 1.82 [95% CI, 1.14 to 2.92]; P = 0.009) were statistically associated with being colonized by P. jirovecii. The prevalence of P. jirovecii in infants and toddlers with WC and the genotyping results provide evidence that this population represents a potential reservoir and transmission source of P. jirovecii. PMID:24131683

  11. Environment education for taking of decision. One challenge for the sector cuban cooperative

    Directory of Open Access Journals (Sweden)

    Miladys Garrido Cervera

    2015-12-01

    The present work have like purpose demonstrate the importance that reviewer include the environment theme in the process of taking of decisions in the farming cooperative to make up the aspect 133 of the economic politic and social in the new Cuban economic model. To do that one analysis about the environment education and the relationship tighten what have with the cooperative development for the guarantee of good practice, guarantee real one development sustainable.

  12. 3d-4f {Co(II)3Ln(OR)4} Cubanes as Bio-Inspired Water Oxidation Catalysts.

    Science.gov (United States)

    Evangelisti, Fabio; Moré, René; Hodel, Florian; Luber, Sandra; Patzke, Greta Ricarda

    2015-09-02

    Although the {CaMn4O5} oxygen evolving complex (OEC) of photosystem II is a major paradigm for water oxidation catalyst (WOC) development, the comprehensive translation of its key features into active molecular WOCs remains challenging. The [Co(II)3Ln(hmp)4(OAc)5H2O] ({Co(II)3Ln(OR)4}; Ln = Ho-Yb, hmp = 2-(hydroxymethyl)pyridine) cubane WOC series is introduced as a new springboard to address crucial design parameters, ranging from nuclearity and redox-inactive promoters to operational stability and ligand exchange properties. The {Co(II)3Ln(OR)4} cubanes promote bioinspired WOC design by newly combining Ln(3+) centers as redox-inactive Ca(2+) analogues with flexible aqua-/acetate ligands into active and stable WOCs (max. TON/TOF values of 211/9 s(-1)). Furthermore, they open up the important family of 3d-4f complexes for photocatalytic applications. The stability of the {Co(II)3Ln(OR)4} WOCs under photocatalytic conditions is demonstrated with a comprehensive analytical strategy including trace metal analyses and solution-based X-ray absorption spectroscopy (XAS) investigations. The productive influence of the Ln(3+) centers is linked to favorable ligand mobility, and the experimental trends are substantiated with Born-Oppenheimer molecular dynamics studies.

  13. The cooperative a road for the economic and social development in the Cuban pattern

    Directory of Open Access Journals (Sweden)

    Claudio Alberto Rivera Rodríguez

    2014-06-01

    Full Text Available The present work has as purpose, to evaluate the antecedents, development, current situation and perspectives of the cooperative in the Cuban economic pattern. In the article, they are studied, from the antecedents of the emergence of the agricultural cooperative, until their stages, making emphasis in the problems that affect the normal development in these ways of property and administration in the objective and subjective order. Finally he/she is carried out a brief analysis of the emergence of the cooperatives in other sectors of the economy, evaluating the premises and importance of this transformation in the economic, productive and social order.

  14. The treatment process of understanding scientific texts: A necessity in the current Cuban university

    Directory of Open Access Journals (Sweden)

    Yanet María Guerra Santana

    2016-06-01

    Full Text Available This work has as main purpose to emphasize the need for treatment of the process of understanding scientific texts in the university today, for the development of science and technology has placed at the forefront in every race the problem of processing scientific information. The ability to produce scientific texts has been somewhat spontaneity in the curriculum of professional training in Cuban university, which has resulted in some professionals do not yet have linguistic, discursive and strategic " tools " best to communicate the style of science, hence the study of the process of understanding of scientific texts in undergraduate currently constitute a need in our universities.

  15. Comparison of Childrearing Practices of Anglos, Cuban-Americans, and Latin Americans. Occasional Papers Series, Dialogues #5.

    Science.gov (United States)

    Escovar, Luis; Escovar, Peggy L.

    In this report perceived childrearing practices among three cultural groups (American Anglos, Cuban Americans, and Latin Americans) were compared. Subjects were 445 college students (168 males and females from universities in Colombia and Venezuela, and 154 from a university in South Florida). A multivariate analysis of covariance was used to…

  16. The Cooperatives of Second Degree in the Cuban Agricultural System and the paper of the Marketing of Relationship

    Directory of Open Access Journals (Sweden)

    Juan Carlos Prego Regalado

    2015-12-01

    Full Text Available The cooperative movement in Cuba extends quickly to diverse sectors of the national economy and he/she consolidates in the agricultural sector with a great impact in the society, it will demand it the constitution of cooperative of second degree, with the purpose of elevating the integration of the productive chains of the agricultural system. The present work has for objective to deepen in the paper of the cooperatives of second degree in the Cuban agricultural system, as well as in the relationship marketing like a tool that it stimulates the articulation of the bond among the cooperatives of first and second degree with attachment to the principles of the cooperativism and moderated to the characteristics, conditions and peculiarities in the context of the process of Bring up to date of the Cuban Economic Pattern.

  17. Studies of kinematic elements in two multicenter sunspot groups

    International Nuclear Information System (INIS)

    Korobova, Z.B.

    1983-01-01

    Some features of kinematic elements (KE) in two multicenter sunspot groups were studied using Tashkent full-disc white light heliograms. KE and morphological elements do not reveal any relationship. A KE coincides with a unipolar or multipolar spot or with part of a spot. It may also contain an extended stream including several spots. Relation of KE to large-scale photospheric magnetic fields is less clear. The line of polarity reversal is, in most cases, the deviding line between two adjacent KE. At the same time, a KE can contain spots of both polarities. Sunspot trajectories in the leading polarity regions show the best similarity. Interactions of KE are greatly influenced by the meridional drift. (author)

  18. Helicobacter pylori cagA and vacA genotypes in Cuban and Venezuelan populations

    Directory of Open Access Journals (Sweden)

    Diana Ortiz-Princz

    2010-05-01

    Full Text Available The aim of this study was to determine the presence of Helicobacter pylori cytotoxin-associated gene (cagA/vacuolating cytotoxin gene (vacA among patients with chronic gastritis in Cuba and Venezuela. Gastric antrum biopsies were taken for culture, DNA extraction and PCR analysis. Amplification of vacA and cagA segments was performed using two regions of cagA: 349 bp were amplified with the F1/B1 primers and the remaining 335 bp were amplified with the B7629/B7628 primers. The VA1-F/VA1-R set of primers was used to amplify the 259-bp (s1 or 286-bp (s2 product and the VAG-R/VAG-F set of primers was used to amplify the 567-bp (m1 or 642-bp (m2 regions of vacA. cagA was detected in 87% of the antral samples from Cuban patients and 80.3% of those from Venezuelan patients. All possible combinations of vacA regions were found, with the exception of s2/m1. The predominant combination found in both countries was s1/m1. The percentage of cagA+ strains was increased by the use of a second set of primers and a greater number of strains was amplified with the B7629/B7628 primers in the Cuban patients (p = 0.0001. There was no significant difference between the presence of the allelic variants of vacA and cagA in both populations. The predominant genotype was cagA+/s1m1 in both countries. The results support the necessary investigation of isolates circulating among the human population in each region.

  19. The Cuban National Healthcare System: Characterization of primary healthcare services.

    Directory of Open Access Journals (Sweden)

    Keli Regina DAL PRÁ

    2015-10-01

    Full Text Available This article presents a report on the experience of healthcare professionals in Florianópolis, who took the course La Atención Primaria de Salud y la Medicina Familiar en Cuba [Primary Healthcare and Family Medicine in Cuba], in 2014. The purpose of the study is to characterize the healthcare units and services provided by the Cuban National Healthcare System (SNS and to reflect on this experience/immersion, particularly on Cuba’s Primary Healthcare Service. The results found that in comparison with Brazil’s Single Healthcare System (SUS Cuba’s SNS Family Healthcare (SF service is the central organizing element of the Primary Healthcare Service. The number of SF teams per inhabitant is different than in Brazil; the programs given priority in the APS are similar to those in Brazil and the intersectorial nature and scope of the services prove to be effective in the resolution of healthcare problems.

  20. Radiological Characterization of cuban coffee and estimation of the doses received by the population due to coffee consumption

    International Nuclear Information System (INIS)

    Fernandez Gomez, I.M.; Rodriguez Castro, G.; Perez Sanchez, D.

    1996-01-01

    The purpose of this paper is to study the radioactivity levels in the coffee produced and consumed in our country and to estimate the doses received by the Cuban people due to its consumption. As a results of this study the most relevant radionuclide was K 40 , due to the concentration levels found only considering it when estimating the annual committed dose that is received thought this via. The K 40 concentration value present in the infusion represented a dose for the consumer of 15.6 u Sv/year

  1. Structural and magnetic characterization of three tetranuclear Cu(II) complexes with face-sharing-dicubane/double-open-cubane like core framework

    Energy Technology Data Exchange (ETDEWEB)

    Paul, Aparup [Department of Chemistry and Chemical Technology, Vidyasagar University, Midnapore 721102, West Bengal (India); Bertolasi, Valerio [Dipartimento di Scienze Chimiche e Farmaceutiche, Centro di Strutturistica Diffrattometrica, Università di Ferrara, Via L. Borsari, 46, 44100 Ferrara (Italy); Figuerola, Albert [Departament de Química Inorgànica i Orgànica (Secció de Química Inorgànica) and Institut de Nanociència i Nanotecnologia (IN2UB), Universitat de Barcelona, Martí i Franquès 1-11, 08028 Barcelona (Spain); Manna, Subal Chandra, E-mail: scmanna@mail.vidyasagar.ac.in [Department of Chemistry and Chemical Technology, Vidyasagar University, Midnapore 721102, West Bengal (India)

    2017-05-15

    Three novel tetranuclear copper(II) complexes namely [Cu{sub 4}(L{sup 1}){sub 4}]∙2(dmf) (1), [Cu{sub 4}(L{sup 1}){sub 4}] (2) and [Cu{sub 4}(L{sup 2}){sub 2}(HL{sup 2}){sub 2}(H{sub 2}O){sub 2}]∙2(ClO{sub 4})·6(H{sub 2}O) (3) (H{sub 2}L{sup 1}, (E)−2-((1-hydroxybutan-2-ylimino)methyl)phenol; H{sub 2}L{sup 2}, (E)−2-((1-hydroxybutan-2-ylimino)methyl)−6-methoxyphenol)) were synthesized from the self-assembly of copper(II) perchlorate and the tridentate Schiff base ligands. The structural determination reveals that crystallizes in the monoclinic system with space group C2/c, whereas both the and crystallize in the triclinic system with space group P-1. and possess face-sharing dicubane core, on the other hand complex 3 has double open cubane core structure. The copper(II) ions in the cubane core are in distorted square planar geometries, and weak π…π and C–H…π interactions lead to formation of a 2D supramolecular architecture for and . At room temperature and , exhibit fluorescence with a quantum yield (Φ{sub s}) of 0.47, 0.49 and 0.38, respectively. Variable temperature magnetic susceptibility measurements in the range 2–300 K indicate an overall weak antiferromagnetic exchange coupling in all complexes. The PHI program was used to study their magnetic behaviour. In agreement with their face-sharing dicubane structure, a Hamiltonian of the type H =– J{sub 1}(S{sub 1}S{sub 2}+S{sub 1}S{sub 2’}+S{sub 1'}S{sub 2}+S{sub 1'}S{sub 2’}) – J{sub 2}S{sub 1}S{sub 1’}, where S{sub 1} = S{sub 1’} = S{sub 2} = S{sub 2’} = S{sub Cu} =1/2, was used for studying and . Simulations performed suggest magnetic exchange constants with values close to J{sub 1} =−20 cm{sup −1} and J{sub 2} =0 cm{sup -1} for these complexes. On the other hand, the spin Hamiltonian H =– J{sub 1}(S{sub 1}S{sub 4}+S{sub 2}S{sub 3}) – J{sub 2}(S{sub 1}S{sub 3}+S{sub 2}S{sub 4}) – J{sub 3}S{sub 1}S{sub 2}, where S{sub 1} = S{sub 2} = S{sub 3} = S{sub 4

  2. Distinguishing Features of Cuban Children Referred for Professional Help Because of ADHD: Looking beyond the Symptoms

    Science.gov (United States)

    Schneider, Barry H.; Normand, Sebastien; Sotares deToro, Maria del Pilar; Santana Gonzalez, Yorkys; Guilarte Tellez, Jorge Antonio; Carbonell Naranjo, Migdalia; Musle, Miriam; Diaz Socarras, Felix Javier; Robaey, Philippe

    2011-01-01

    Objective: To distinguish Cuban children clinically referred because of ADHD from an at-risk community sample and a community control group in terms of symptoms, associated difficulties and impairment of family and peer relations. Method: Parents and teachers of 1,036 children (6-8 years old) completed an established ADHD rating scale and a…

  3. A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group

    NARCIS (Netherlands)

    Ruzicka, T.; Bieber, T.; Schöpf, E.; Rubins, A.; Dobozy, A.; Bos, J. D.; Jablonska, S.; Ahmed, I.; Thestrup-Pedersen, K.; Daniel, F.; Finzi, A.; Reitamo, S.

    1997-01-01

    Tacrolimus (FK 506) is an effective immunosuppressant drug for the prevention of rejection after organ transplantation, and preliminary studies suggest that topical application of tacrolimus is effective in the treatment of atopic dermatitis. We conducted a randomized, doubleblind, multicenter study

  4. Bolting multicenter solutions

    Energy Technology Data Exchange (ETDEWEB)

    Bena, Iosif [Institut de Physique Théorique, Université Paris Saclay, CEA, CNRS, 91191 Gif-sur-Yvette Cedex (France); Bossard, Guillaume [Centre de Physique Théorique, Ecole Polytechnique, CNRS, Université Paris-Saclay, 91128 Palaiseau Cedex (France); Katmadas, Stefanos; Turton, David [Institut de Physique Théorique, Université Paris Saclay, CEA, CNRS, 91191 Gif-sur-Yvette Cedex (France)

    2017-01-30

    We introduce a solvable system of equations that describes non-extremal multicenter solutions to six-dimensional ungauged supergravity coupled to tensor multiplets. The system involves a set of functions on a three-dimensional base metric. We obtain a family of non-extremal axisymmetric solutions that generalize the known multicenter extremal solutions, using a particular base metric that introduces a bolt. We analyze the conditions for regularity, and in doing so we show that this family does not include solutions that contain an extremal black hole and a smooth bolt. We determine the constraints that are necessary to obtain smooth horizonless solutions involving a bolt and an arbitrary number of Gibbons-Hawking centers.

  5. Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review

    OpenAIRE

    H?rtl, Roger; Alimi, Marjan; Abdelatif Boukebir, Mohamed; Berlin, Connor D.; Navarro-Ramirez, Rodrigo; Arnold, Paul M.; Fehlings, Michael G.; Mroz, Thomas E.; Riew, K. Daniel

    2017-01-01

    Study Design: Retrospective study and literature review. Objective: To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. Methods: We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17?625 patients who went through cervical spine surgery (levels from C2 to C7) between Januar...

  6. [Information management in multicenter studies: the Brazilian longitudinal study for adult health].

    Science.gov (United States)

    Duncan, Bruce Bartholow; Vigo, Álvaro; Hernandez, Émerson; Luft, Vivian Cristine; Ahlert, Hubert; Bergmann, Kaiser; Mota, Eduardo

    2013-06-01

    Information management in large multicenter studies requires a specialized approach. The Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil - Brazilian Longitudinal Study for Adult Health) has created a Datacenter to enter and manage its data system. The aim of this paper is to describe the steps involved, including the information entry, transmission and management methods. A web system was developed in order to allow, in a safe and confidential way, online data entry, checking and editing, as well as the incorporation of data collected on paper. Additionally, a Picture Archiving and Communication System was implemented and customized for echocardiography and retinography. It stores the images received from the Investigation Centers and makes them available at the Reading Centers. Finally, data extraction and cleaning processes were developed to create databases in formats that enable analyses in multiple statistical packages.

  7. Treatment of traumatic thoracolumbar spine fractures : A multicenter prospective randomized study of operative versus nonsurgical treatment

    NARCIS (Netherlands)

    Siebenga, Jan; Leferink, Vincent J. M.; Segers, Michiel J. M.; Elzinga, Matthijs J.; Bakker, Fred C.; Haarman, Henk J. Th. M.; Rommens, Pol M.; ten Duis, Henk-Jan; Patka, Peter

    2006-01-01

    Study Design. Multicenter prospective randomized trial. Objective. To test the hypotheses that thoracolumbar AO Type A spine fractures without neurologic deficit, managed with short-segment posterior stabilization will show an improved radiographic outcome and at least the same functional outcome as

  8. A prospective, randomized multicenter study comparing APD and CAPD treatment

    DEFF Research Database (Denmark)

    Bro, S; Bjorner, J B; Tofte-Jensen, P

    2000-01-01

    , dialysis-related complications, dialysis-related expenses. RESULTS: The quality-of-life studies showed that significantly more time for work, family, and social activities was available to patients on APD compared to those on CAPD (p ...) treatment with respect to quality of life and clinical outcomes in relation to therapy costs. DESIGN: A prospective, randomized multicenter study. SETTING: Three Danish CAPD units. PATIENTS: Thirty-four adequately dialyzed patients with high or high-average peritoneal transport characteristics were included...... were assessed at baseline and after 6 months by the self-administered short-form SF-36 generic health survey questionnaire supplemented with disease- and treatment-specific questions. Therapy costs were compared by evaluating dialysis-related expenses. MAIN OUTCOME MEASURES: Quality-of-life parameters...

  9. Test-retest and between-site reliability in a multicenter fMRI study.

    Science.gov (United States)

    Friedman, Lee; Stern, Hal; Brown, Gregory G; Mathalon, Daniel H; Turner, Jessica; Glover, Gary H; Gollub, Randy L; Lauriello, John; Lim, Kelvin O; Cannon, Tyrone; Greve, Douglas N; Bockholt, Henry Jeremy; Belger, Aysenil; Mueller, Bryon; Doty, Michael J; He, Jianchun; Wells, William; Smyth, Padhraic; Pieper, Steve; Kim, Seyoung; Kubicki, Marek; Vangel, Mark; Potkin, Steven G

    2008-08-01

    In the present report, estimates of test-retest and between-site reliability of fMRI assessments were produced in the context of a multicenter fMRI reliability study (FBIRN Phase 1, www.nbirn.net). Five subjects were scanned on 10 MRI scanners on two occasions. The fMRI task was a simple block design sensorimotor task. The impulse response functions to the stimulation block were derived using an FIR-deconvolution analysis with FMRISTAT. Six functionally-derived ROIs covering the visual, auditory and motor cortices, created from a prior analysis, were used. Two dependent variables were compared: percent signal change and contrast-to-noise-ratio. Reliability was assessed with intraclass correlation coefficients derived from a variance components analysis. Test-retest reliability was high, but initially, between-site reliability was low, indicating a strong contribution from site and site-by-subject variance. However, a number of factors that can markedly improve between-site reliability were uncovered, including increasing the size of the ROIs, adjusting for smoothness differences, and inclusion of additional runs. By employing multiple steps, between-site reliability for 3T scanners was increased by 123%. Dropping one site at a time and assessing reliability can be a useful method of assessing the sensitivity of the results to particular sites. These findings should provide guidance toothers on the best practices for future multicenter studies.

  10. Analysis of the potentiality for implementing of the cleaner production and adopting a sustainable consumption in the Cuban entrepreneurial system

    International Nuclear Information System (INIS)

    Tortosa Ferrer, Barbara Ivette; Orue Valdes, Sonia; Mena Ulecia, Karel

    2007-01-01

    The world economic development has conduced to increase the worsening of the environment as result of the natural resources pollution. The tendency has been toward the unsustainable exploitation of natural resources, to increasing of the goods and services production, as well as, to elevated consumption. In this sense, many countries have planed environmental policies addressed to reducing of pollution introducing cleaner production practices and promoting the adoption of responsible consumption. This article shows the existing potentiality in a selected Cuban companies group for introducing and applying of the cleaner production, as well as, the adoption of a sustainable consumption start from analysis of the obtained results in short-term assessments (quick scans) carried out by the Cuban Environment Agency Focal Point of the National Cleaner Production Network in the period between 2004 and 2007

  11. Energetic and economic evaluation of solar thermal and photovoltaic cooling system in Cuban hotel

    International Nuclear Information System (INIS)

    Díaz Torres, Yamile; Valdivia Nodal, Yarelis; Castellanos Molina, Luis Miguel; Torres del Toro, Migdalia; Monteagudo Llanes, José

    2015-01-01

    The present paper discusses the energetic and economic feasibility of using two configurations of solar cooling in a Cuban Hotel. The air conditioning hybrid system schemes are: conventional system (Chiller) interconnected in parallel with a solar- powered absorption cooling system (SACS); and a photovoltaic cooling system (PCS). There were analyzed by methodologies and thermodynamic principles governing these technologies. The results show that their uses are alternatives for reducing energy consumption and environmental impact. (full text)

  12. On the pursuit of a nuclear development capability: The case of the Cuban nuclear program

    Science.gov (United States)

    Benjamin-Alvarado, Jonathan Calvert

    1998-09-01

    While there have been many excellent descriptive accounts of modernization schemes in developing states, energy development studies based on prevalent modernization theory have been rare. Moreover, heretofore there have been very few analyses of efforts to develop a nuclear energy capability by developing states. Rarely have these analyses employed social science research methodologies. The purpose of this study was to develop a general analytical framework, based on such a methodology to analyze nuclear energy development and to utilize this framework for the study of the specific case of Cuba's decision to develop nuclear energy. The analytical framework developed focuses on a qualitative tracing of the process of Cuban policy objectives and implementation to develop a nuclear energy capability, and analyzes the policy in response to three models of modernization offered to explain the trajectory of policy development. These different approaches are the politically motivated modernization model, the economic and technological modernization model and the economic and energy security model. Each model provides distinct and functionally differentiated expectations for the path of development toward this objective. Each model provides expected behaviors to external stimuli that would result in specific policy responses. In the study, Cuba's nuclear policy responses to stimuli from domestic constraints and intensities, institutional development, and external influences are analyzed. The analysis revealed that in pursuing the nuclear energy capability, Cuba primarily responded by filtering most of the stimuli through the twin objectives of economic rationality and technological advancement. Based upon the Cuban policy responses to the domestic and international stimuli, the study concluded that the economic and technological modernization model of nuclear energy development offered a more complete explanation of the trajectory of policy development than either the

  13. Economic Impact of Dengue: Multicenter Study across Four Brazilian Regions

    Science.gov (United States)

    Martelli, Celina Maria Turchi; Siqueira, Joao Bosco; Parente, Mirian Perpetua Palha Dias; Zara, Ana Laura de Sene Amancio; Oliveira, Consuelo Silva; Braga, Cynthia; Pimenta, Fabiano Geraldo; Cortes, Fanny; Lopez, Juan Guillermo; Bahia, Luciana Ribeiro; Mendes, Marcia Costa Ooteman; da Rosa, Michelle Quarti Machado; de Siqueira Filha, Noemia Teixeira; Constenla, Dagna; de Souza, Wayner Vieira

    2015-01-01

    Background Dengue is an increasing public health concern in Brazil. There is a need for an updated evaluation of the economic impact of dengue within the country. We undertook this multicenter study to evaluate the economic burden of dengue in Brazil. Methods We estimated the economic burden of dengue in Brazil for the years 2009 to 2013 and for the epidemic season of August 2012- September 2013. We conducted a multicenter cohort study across four endemic regions: Midwest, Goiania; Southeast, Belo Horizonte and Rio de Janeiro; Northeast: Teresina and Recife; and the North, Belem. Ambulatory or hospitalized cases with suspected or laboratory-confirmed dengue treated in both the private and public sectors were recruited. Interviews were scheduled for the convalescent period to ascertain characteristics of the dengue episode, date of first symptoms/signs and recovery, use of medical services, work/school absence, household spending (out-of-pocket expense) and income lost using a questionnaire developed for a previous cost study. We also extracted data from the patients’ medical records for hospitalized cases. Overall costs per case and cumulative costs were calculated from the public payer and societal perspectives. National cost estimations took into account cases reported in the official notification system (SINAN) with adjustment for underreporting of cases. We applied a probabilistic sensitivity analysis using Monte Carlo simulations with 90% certainty levels (CL). Results We screened 2,223 cases, of which 2,035 (91.5%) symptomatic dengue cases were included in our study. The estimated cost for dengue for the epidemic season (2012–2013) in the societal perspective was US$ 468 million (90% CL: 349–590) or US$ 1,212 million (90% CL: 904–1,526) after adjusting for under-reporting. Considering the time series of dengue (2009–2013) the estimated cost of dengue varied from US$ 371 million (2009) to US$ 1,228 million (2013). Conclusions The economic burden

  14. A national multicenter registration study. Omalizumb in children in Denmark

    DEFF Research Database (Denmark)

    Spangberg, Katrien; Jørgensen, Inger Merete; Agertoft, Lone

    Background: In Denmark, Omalizumab is approved to treat children with severe persistent allergic asthma older than 6 years of age. No systematic registration of the efficacy in the Danish child population according to asthma symptoms or of the efficacy on co-morbid allergic symptoms exists. Results...... from a pilot study show that a broad panel of outcome measures is necessary to evaluate the efficacy of Omalizumab treatment as no change in lung function could be demonstrated Aim: To provide a standardized systematic registration in order to create a database enrolling children with severe allergic...... asthma treated with Omalizumab. Method and study design: A national multicenter registration and follow-up study based on children with clinical persistent severe allergic asthma including both retrospective and prospective registration. Inclusion criteria: • 6-18 years of age. • Severe persistent...

  15. Gabapentin in traumatic nerve injury pain: A randomized, double-blind, placebo-controlled, cross-over, multi-center study

    DEFF Research Database (Denmark)

    Gordh, Torsten E; Stubhaug, Audun; Jensen, Troels S

    2008-01-01

    A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400mg/day. The study comprised a run...

  16. Immune Response Induction and New Effector Mechanisms Possibly Involved in Protection Conferred by the Cuban Anti-Meningococcal BC Vaccine

    Science.gov (United States)

    Pérez, Oliver; Lastre, Miriam; Lapinet, José; Bracho, Gustavo; Díaz, Miriam; Zayas, Caridad; Taboada, Carlos; Sierra, Gustavo

    2001-01-01

    This report explores the participation of some afferent mechanisms in the immune response induced by the Cuban anti-meningococcal vaccine VA-MENGOC-BC. The induction of delayed-type hypersensitivity in nursing babies and lymphocyte proliferation after immunization is demonstrated. The presence of gamma interferon IFN-γ and interleukin-2 (IL-2) mRNAs but absence of IL-4, IL-5, and IL-10 mRNAs were observed in peripheral blood mononuclear cells from immunized subjects after in vitro challenge with outer membrane vesicles. In addition, some effector functions were also explored. The presence of opsonic activity was demonstrated in sera from vaccinees. The role of neutrophils as essential effector cells was shown. In conclusion, we have shown that, at least in the Cuban adult population, VA-MENGOC-BC induces mechanisms with a T-helper 1 pattern in the afferent and effector branches of the immune response. PMID:11401992

  17. Comparative Study for Efficacy and Safety of Adenoidectomy according to the Surgical Method: A Prospective Multicenter Study.

    Directory of Open Access Journals (Sweden)

    Jeong-Whun Kim

    Full Text Available There have been several operative techniques for adenoidectomy and their efficacy and morbidity are different according to the technique. This prospective multicenter study was aimed to compare the efficacy and morbidity of coblation adenoidectomy (CA with those of power-assisted adenoidectomy.Prospective multi-institutional study.Children who underwent CA, power-assisted adenoidectomy with cauterization (PAA+C or without cauterization (PAA-C due to adenoid hypertrophy were enrolled from 13 hospitals between July 2013 and June 2014. Mean operation time, degree of intraoperative bleeding and postoperative bleeding rate were evaluated.A total of 388 children (mean age ± standard deviation = 6.6 ± 2.5 years; 245 males and 143 females were included. According to the adenoidectomy technique, the children were classified into 3 groups: (1 CA (n = 116; (2 PAA+C (n = 153; and (3 PAA-C (n = 119. Significant differences were not found in age and sex among three groups. In the CA group, mean operation time was significantly shorter (P < 0.001 and degree of intraoperative bleeding was significantly less (P < 0.001 compared to PAA+C or PAA-C group. Delayed postoperative bleeding rate of PAA-C group was significantly higher than that of CA or PAA+C group (P = 0.016.This prospective multicenter study showed that CA was superior to PAA in terms of mean operation time and degree of intraoperative bleeding.

  18. The Financial Structure and its Impact on Financial -Economic Results in Cuban Companies

    Directory of Open Access Journals (Sweden)

    María Esperanza González-del-Foyo

    2016-06-01

    Full Text Available The financial structure refers to the way a company finances its assets through a combination of equity, debtor hybrid securities. Financial decisions are important in business management, on which heavily rely the viability and rentability of business. Hence the need for managers to know and analyze the financing structure in order to evaluate the impact on its results from the point of view of risk, cost and performance. In the article the main theories of financial structure are based, and the different approaches for its study. Considerations are made on this issue in the Cuban economy, and techniques are applied to evaluate the impact of financing in the form of risk and performance against the company on the “Cecilio Sanchez Valiente” in Santiago de Cuba.

  19. Screening for primary aldosteronism in an argentinian population: a multicenter prospective study.

    Science.gov (United States)

    Leal Reyna, Mariela; Gómez, Reynaldo M; Lupi, Susana N; Belli, Susana H; Fenili, Cecilia A; Martínez, Marcela S; Ruibal, Gabriela F; Rossi, María A; Chervin, Raúl A; Cornaló, Dora; Contreras, Liliana N; Costa, Liliana; Nofal, María T; Damilano, Sergio A; Pardes, Ester M

    2015-10-01

    Primary aldosteronism (PA) is characterized by the autonomous overproduction of aldosterone. Its prevalence has increased since the use of the aldosterone (ALD)/plasma renin activity (PRA) ratio (ARR). The objective of this study is to determine ARR and ARC (ALD/plasma renin concentration ratio) cut-off values (COV) and their diagnostic concordance (DC%) in the screening for PA in an Argentinian population.Design multicenter prospective study. We studied 353 subjects (104 controls and 249 hypertensive patients). Serum aldosterone, PRA and ARR were determined. In 220 randomly selected subjects, 160 hypertensive patients and 60 controls, plasma renin concentration (PRC) was simultaneously measured and ARC was determined. According to the 95th percentile of controls, we determined a COV of 36 for ARR and 2.39 for ARC, with ALD ≥ 15 ng/dL. In 31/249 hypertensive patients, ARR was ≥ 36. PA diagnosis was established in 8/31 patients (23/31 patients did not complete confirmatory tests). DC% between ARR and ARC was calculated. A significant correlation between ARR and ARC (r = 0.742; p 0.3 ng/mL/h and PRC > 5 pg/mL. DC% for ARR and ARC above or below 36 and 2.39 was 79.1%, respectively. This first Argentinian multicenter study determined a COV of 36 for ARR and 2.39 for ARC. Applying an ARR ≥ 36 in the hypertensive group, we confirmed PA in a higher percentage of patients than the previously reported one in our population. As for ARC, further studies are needed for its clinical application, since DC% is acceptable only for medium range renin values.

  20. Revolutionizing Cuban Psychiatry: The Freud Wars, 1955-1970.

    Science.gov (United States)

    Lambe, Jennifer Lynn

    2017-01-01

    This article traces the battle over Freud within Cuban psychiatry from its pre-1959 origins through the "disappearance" of Freud by the early 1970s. It devotes particular attention to the visit of two Soviet psychiatrists to Cuba in the early 1960s as part of a broader campaign to promote Pavlov. The decade-long controversy over Freud responded to both theoretical and political concerns. If for some Freud represented political conservatism and theoretical mystification, Pavlov held out the promise of a dialectical materialist future. Meanwhile, other psychiatrists clung to psychodynamic perspectives, or at least the possibility of heterogeneity. The Freudians would end up on the losing side of this battle, with many departing Cuba over the course of the 1960s. But banishing Freud did not necessarily make for stalwart Pavlovians-or vanguard revolutionaries. Psychiatry would find itself relegated to a handmaiden position in the work of revolutionary mental engineering, with the government itself occupying the vanguard.

  1. Who Donates Their Body to Science? An International, Multicenter, Prospective Study

    Science.gov (United States)

    Cornwall, Jon; Perry, Gary F.; Louw, Graham; Stringer, Mark D.

    2012-01-01

    The altruistic act of body donation provides a precious resource for both teaching and researching human anatomy. However, relatively little is known about individuals who donate their bodies to science (donors), and in particular whether donors in different geographical locations share similar characteristics. A multicenter prospective survey of…

  2. Elliptic genera from multi-centers

    Energy Technology Data Exchange (ETDEWEB)

    Gaddam, Nava [Institute for Theoretical Physics and Center for Extreme Matter and Emergent Phenomena,Utrecht University, 3508 TD Utrecht (Netherlands)

    2016-05-13

    I show how elliptic genera for various Calabi-Yau threefolds may be understood from supergravity localization using the quantization of the phase space of certain multi-center configurations. I present a simple procedure that allows for the enumeration of all multi-center configurations contributing to the polar sector of the elliptic genera — explicitly verifying this in the cases of the quintic in ℙ{sup 4}, the sextic in Wℙ{sub (2,1,1,1,1)}, the octic in Wℙ{sub (4,1,1,1,1)} and the dectic in Wℙ{sub (5,2,1,1,1)}. With an input of the corresponding ‘single-center’ indices (Donaldson-Thomas invariants), the polar terms have been known to determine the elliptic genera completely. I argue that this multi-center approach to the low-lying spectrum of the elliptic genera is a stepping stone towards an understanding of the exact microscopic states that contribute to supersymmetric single center black hole entropy in N=2 supergravity.

  3. The QUASAR reproducibility study, Part II: Results from a multi-center Arterial Spin Labeling test-retest study

    DEFF Research Database (Denmark)

    Petersen, Esben Thade; Mouridsen, Kim; Golay, Xavier

    2010-01-01

    Quantitative STAR labeling of Arterial Regions or QUASAR), a method providing user independent quantification of CBF in a large test-retest study across sites from around the world, dubbed "The QUASAR reproducibility study". Altogether, 28 sites located in Asia, Europe and North America participated...... and a total of 284 healthy volunteers were scanned. Minimal operator dependence was assured by using an automatic planning tool and its accuracy and potential usefulness in multi-center trials was evaluated as well. Accurate repositioning between sessions was achieved with the automatic planning tool showing...

  4. The QUASAR reproducibility study, Part II: Results from a multi-center Arterial Spin Labeling test-retest study

    DEFF Research Database (Denmark)

    Petersen, Esben; Mouridsen, Kim; Golay, Xavier

    2009-01-01

    Quantitative STAR labeling of Arterial Regions or QUASAR), a method providing user independent quantification of CBF in a large test-retest study across sites from around the world, dubbed "The QUASAR reproducibility study". Altogether, 28 sites located in Asia, Europe and North America participated...... and a total of 284 healthy volunteers were scanned. Minimal operator dependence was assured by using an automatic planning tool and its accuracy and potential usefulness in multi-center trials was evaluated as well. Accurate repositioning between sessions was achieved with the automatic planning tool showing...

  5. Report of a Brazilian multicenter study on nephropathic cystinosis.

    Science.gov (United States)

    Vaisbich, Maria Helena; Koch, Vera H

    2010-01-01

    The Brazilian Multicenter Nephropathic Study Group, founded in 1999, is currently composed of 16 pediatric nephrology units, which are coordinated by the Pediatric Nephrology Unit of Instituto da Criança--HCFMUSP. This Study Group intends to better know our patients, their special characteristics and facilitates the treatment. To present an update on the demographics of the ongoing study participants with interest on renal function status, response to therapy, and extra-renal complications. Patient recruitment to the study is based on informed consent and has been supported by the Brazilian Society of Nephrology, by the creation of an electronic homepage and by the participation in medical meetings and publications in medical periodicals. Our study protocol involves the initial and follow-up questionnaire, the measurement of intraleukocyte cystine content, initiation and follow-up therapy with cysteamine, and clinical patient follow-up based on a protocol of subsidiary exams. We identified 102 patients (42 females) with nephropathic cystinosis in Brazil since 1999. Forty-six children are followed at the Instituto da Criança/SP, 15 at the Hospital Pequeno Príncipe/PR, 12 at the UNICAMP/SP, 10 at the Unidade de Transplante Renal - HCFMUSP/SP and 3 at the Santa Casa/SP; the remaining patients are followed at the Instituto da Criança and at their respective doctors' offices in different nephrology services in Brazil. Of these patients, 23/102 (22.5%) have normal renal function, 19/102 (18.6%) are in chronic renal failure with conservative treatment, 26/102 are on dialysis (18 on peritoneal dialysis and 8 on hemodialysis), and 34/102 received a renal transplant. The extra-renal involvement diagnosed was: hypothyroidism in 63 patients, diabetes mellitus in 8 patients, muscular involvement in 7 patients, a compromised central nervous system in 5 patients, hepatic complications in 5 patients, and deglutition dysfunction in 2 patients. During this period, 10

  6. MRI, PET/CT and ultrasound in the preoperative staging of endometrial cancer - A multicenter prospective comparative study

    DEFF Research Database (Denmark)

    Antonsen, Sofie Leisby; Jensen, Lisa Neerup; Loft, Annika

    2012-01-01

    OBJECTIVES: The aim of this prospective multicenter study was to evaluate and compare the diagnostic performance of PET/CT, MRI and transvaginal two-dimensional ultrasound (2DUS) in the preoperative assessment of endometrial cancer (EC). METHODS: 318 consecutive women with EC were included when...

  7. Vitamin A values of wild-caught Cuban tree frogs (Osteopilus septentrionalis) and marine toads (Rhinella marina) in whole body, liver, and serum.

    Science.gov (United States)

    Sullivan, Kathleen E; Fleming, Greg; Terrell, Scott; Smith, Dustin; Ridgley, Frank; Valdes, Eduardo V

    2014-12-01

    Recent issues surrounding captive amphibians are often nutritionally related problems, such as hypovitaminosis A. Although supplementation of frogs with vitamin A is a topic of investigation, the underlying issue is understanding vitamin A metabolism in amphibian species. To develop a range of "normal" vitamin A concentrations for captive amphibians, baseline vitamin A concentrations must be established in wild amphibian species. In this study, two species, Cuban tree frogs (Osteopilus septentrionalis; n = 59) and marine toads (Rhinella marina; n = 20) were collected from the wild as part of an invasive species control program at Zoo Miami, Miami, Florida. Serum, liver, and whole body samples were analyzed for vitamin A content. The Cuban tree frogs showed higher concentrations on average of vitamin A in serum (82.8 ppb), liver (248.3 IU/g), and whole body (5474.7 IU/kg) samples compared with marine toads (60.1 ppb; 105.3 IU/g; 940.7 IU/kg, respectively), but differences were not significant (P = 0.22). What can be considered "normal" values of vitamin A concentrations across different amphibian species requires further investigation. Although all amphibians collected in this study appeared healthy, a larger sample size of animals, with known health histories and diets, may provide stronger evidence of normal expectations.

  8. Multielement determination in Cuban red mangrove samples using nuclear and related analytical techniques

    International Nuclear Information System (INIS)

    Estevez Alvarez, J.R.; Aguiar Lambert, D.; Montero Alvarez, A.; Pupo Gonzalez, I.; Padilla Alvarez, R.; Gonzalez Garcia, H.; Ramirez Sasco, M.

    1998-01-01

    In the present work the contents of Al; K; Ca; Mn; Fe; Ni; Cu; Zn; Sr; Cd and Pb in red mangroves (Rhizophora mangle) from different Cuban regions are determined, using Energy Dispersive X-Ray Fluorescence (Emission-Transmission (Et) and I/C methods), Atomic Absorption Spectrophotometry (AAS), and Polarography (Anodic Stripping Voltametry method). Biological Certified Reference Materials (CRM) are employed for the tracing of the tracing of the curves of the relative I/C method and for the evaluation of the analytical results accuracy. The reliability of the results is also checked by statistical means. Standard deviations and the detection limits of each method are reported. Finally, the obtained values for the concentration of the different elements in each studied ecosystem are presented; a detailed discussion about their significance will be performed in a further paper

  9. In vitro antimicrobial assessment of Cuban propolis extracts

    Directory of Open Access Journals (Sweden)

    Lianet Monzote

    2012-12-01

    Full Text Available Propolis is a resinous mixture of different plant exudates collected by honeybees. Currently, propolis is widely used as a food supplement and in folk medicine. We have evaluated 20 Cuban propolis extracts of different chemical types, brown (BCP, red and yellow (YCP, with respect to their in vitro antibacterial, antifungal and antiprotozoal properties. The extracts inhibited the growth of Staphylococcus aureus and Trichophyton rubrum at low µg/mL concentrations, whereas they were not active against Escherichia coli and Candida albicans. The major activity of the extracts was found against the protozoa Leishmania, Trypanosoma and Plasmodium, although cytotoxicity against MRC-5 cells was also observed. The BCP-3, YCP-39 and YCP-60 extracts showed the highest activity against P. falciparum, with 50% of microbial growth (IC50 values of 0.2 µg/mL. A positive correlation between the biological activity and the chemical composition was observed for YCP extracts. The most promising antimicrobial activity corresponds to YCP subtype B, which contains acetyl triterpenes as the main constituents. The present in vitro study highlights the potential of propolis against protozoa, but further research is needed to increase selectivity towards the parasite. The observed chemical composition-activity relationship of propolis can contribute to the identification of the active principles and standardisation of this bee product.

  10. Research priorities for a multi-center child abuse pediatrics network - CAPNET.

    Science.gov (United States)

    Lindberg, Daniel M; Wood, Joanne N; Campbell, Kristine A; Scribano, Philip V; Laskey, Antoinette; Leventhal, John M; Pierce, Mary Clyde; Runyan, Desmond K

    2017-03-01

    Although child maltreatment medical research has benefited from several multi-center studies, the new specialty of child abuse pediatrics has not had a sustainable network capable of pursuing multiple, prospective, clinically-oriented studies. The Child Abuse Pediatrics Network (CAPNET) is a new multi-center research network dedicated to child maltreatment medical research. In order to establish a relevant, practical research agenda, we conducted a modified Delphi process to determine the topic areas with highest priority for such a network. Research questions were solicited from members of the Ray E. Helfer Society and study authors and were sorted into topic areas. These topic areas were rated for priority using iterative rounds of ratings and in-person meetings. The topics rated with the highest priority were missed diagnosis and selected/indicated prevention. This agenda can be used to target future multi-center child maltreatment medical research. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Structure, magnetic properties, polarized neutron diffraction, and theoretical study of a copper(II) cubane.

    Science.gov (United States)

    Aronica, Christophe; Chumakov, Yurii; Jeanneau, Erwann; Luneau, Dominique; Neugebauer, Petr; Barra, Anne-Laure; Gillon, Béatrice; Goujon, Antoine; Cousson, Alain; Tercero, Javier; Ruiz, Eliseo

    2008-01-01

    The paper reports the synthesis, X-ray and neutron diffraction crystal structures, magnetic properties, high field-high frequency EPR (HF-EPR), spin density and theoretical description of the tetranuclear CuII complex [Cu4L4] with cubane-like structure (LH2=1,1,1-trifluoro-7-hydroxy-4-methyl-5-aza-hept-3-en-2-one). The simulation of the magnetic behavior gives a predominant ferromagnetic interaction J1 (+30.5 cm(-1)) and a weak antiferromagnetic interaction J2 (-5.5 cm(-1)), which correspond to short and long Cu-Cu distances, respectively, as evidence from the crystal structure [see formulate in text]. It is in agreement with DFT calculations and with the saturation magnetization value of an S=2 ground spin state. HF-EPR measurements at low temperatures (5 to 30 K) provide evidence for a negative axial zero-field splitting parameter D (-0.25+/-0.01 cm(-1)) plus a small rhombic term E (0.025+/-0.001 cm(-1), E/D = 0.1). The experimental spin distribution from polarized neutron diffraction is mainly located in the basal plane of the CuII ion with a distortion of yz-type for one CuII ion. Delocalization on the ligand (L) is observed but to a smaller extent than expected from DFT calculations.

  12. Stabilization of Reduced Molybdenum-Iron-Sulfur Single and Double Cubane Clusters by Cyanide Ligation

    Science.gov (United States)

    Pesavento, Russell P.; Berlinguette, Curtis P.; Holm, R. H.

    2008-01-01

    Recent work has shown that cyanide ligation increases the redox potentials of Fe4S4 clusters, enabling the isolation of [Fe4S4(CN)4]4−, the first synthetic Fe4S4 cluster obtained in the all-ferrous oxidation state (Scott, T. A.; Berlinguette, C. P.; Holm, R. H.; Zhou, H.-C., Proc. Natl. Acad. Sci. USA 2005, 102, 9741). The generality of reduced cluster stabilization has been examined with MoFe3S4 clusters. Reaction of single cubane [(Tp)MoFe3S4(PEt3)3]1+ and edge-bridged double cubane [(Tp)2Mo2Fe6S8(PEt3)4] with cyanide in acetonitrile affords [(Tp)MoFe3S4(CN)3]2− (2) and [(Tp)2Mo2Fe6S8(CN)4]4− (5), respectively. Reduction of 2 with KC14H10 yields [(Tp)MoFe3S4(CN)3]3− (3). Clusters were isolated in ca. 70–90% yields as Et4N+ or Bu4N+ salts; Clusters 3 and 5 contain all-ferrous cores; 3 is the first [MoFe3S4]1+ cluster isolated in substance. The structures of 2 and 3 are very similar; the volume of the reduced cluster core is slightly larger (2.5%), a usual effect upon reduction of cubane-type Fe4S4 and MFe3S4 clusters. Redox potentials and 57Fe isomer shifts of [(Tp)MoFe3S4L3]2−,3 and [(Tp)2Mo2Fe6S8L4]4−,3− clusters with L = CN, PhS, halide, and PEt3 are compared. Clusters with π-donor ligands (L = halide, PhS) exhibit larger isomer shifts and lower (more negative) redox potentials while π-acceptor ligands (L = CN, PEt3) induce smaller isomer shifts and higher (less negative) redox potentials. When potentials of 3/2 and [(Tp)MoFe3S4(SPh)3]3−/2− are compared, cyanide stabilizes 3 by 270 mV vs. the reduced thiolate cluster, commensurate with the 310 mV stabilization of [Fe4S4(CN)4]4− vs. [Fe4S4(SPh)4]4− where four ligands differ. These results demonstrate the efficacy of cyanide stabilization of lower cluster oxidation states. (Tp = hydrotris(pyrazolyl)borate(1−)). PMID:17279830

  13. Stabilization of reduced molybdenum-iron-sulfur single- and double-cubane clusters by cyanide ligation.

    Science.gov (United States)

    Pesavento, Russell P; Berlinguette, Curtis P; Holm, R H

    2007-01-22

    Recent work has shown that cyanide ligation increases the redox potentials of Fe(4)S(4) clusters, enabling the isolation of [Fe(4)S(4)(CN)4]4-, the first synthetic Fe(4)S(4) cluster obtained in the all-ferrous oxidation state (Scott, T. A.; Berlinguette, C. P.; Holm, R. H.; Zhou, H.-C. Proc. Natl. Acad. Sci. U.S.A. 2005, 102, 9741). The generality of reduced cluster stabilization has been examined with MoFe(3)S(4) clusters. Reaction of single-cubane [(Tp)MoFe(3)S(4)(PEt(3))3]1+ and edge-bridged double-cubane [(Tp)2Mo(2)Fe(6)S(8)(PEt(3))4] with cyanide in acetonitrile affords [(Tp)MoFe(3)S(4)(CN)3]2- (2) and [(Tp)2Mo(2)Fe(6)S(8)(CN)4]4- (5), respectively. Reduction of 2 with KC(14)H(10) yields [(Tp)MoFe(3)S(4)(CN)3]3- (3). Clusters were isolated in approximately 70-90% yields as Et(4)N+ or Bu(4)N+ salts; clusters 3 and 5 contain all-ferrous cores, and 3 is the first [MoFe(3)S(4)]1+ cluster isolated in substance. The structures of 2 and 3 are very similar; the volume of the reduced cluster core is slightly larger (2.5%), a usual effect upon reduction of cubane-type Fe(4)S(4) and MFe(3)S(4) clusters. Redox potentials and 57Fe isomer shifts of [(Tp)MoFe(3)S(4)L3]2-,3- and [(Tp)2Mo(2)Fe(6)S(8)L(4)]4-,3- clusters with L = CN-, PhS-, halide, and PEt3 are compared. Clusters with pi-donor ligands (L = halide, PhS) exhibit larger isomer shifts and lower (more negative) redox potentials, while pi-acceptor ligands (L = CN, PEt3) induce smaller isomer shifts and higher (less-negative) redox potentials. When the potentials of 3/2 and [(Tp)MoFe(3)S(4)(SPh)3]3-/2- are compared, cyanide stabilizes 3 by 270 mV versus the reduced thiolate cluster, commensurate with the 310 mV stabilization of [Fe(4)S(4)(CN)4]4- versus [Fe(4)S(4)(SPh)4]4- where four ligands differ. These results demonstrate the efficacy of cyanide stabilization of lower cluster oxidation states. (Tp = hydrotris(pyrazolyl)borate(1-)).

  14. Diagnostic performance of computed tomography coronary angiography (from the Prospective National Multicenter Multivendor EVASCAN Study).

    Science.gov (United States)

    Gueret, Pascal; Deux, Jean-François; Bonello, Laurent; Sarran, Anthony; Tron, Christophe; Christiaens, Luc; Dacher, Jean-Nicolas; Bertrand, David; Leborgne, Laurent; Renard, Cedric; Caussin, Christophe; Cluzel, Philippe; Helft, Gerard; Crochet, Dominique; Vernhet-Kovacsik, Hélène; Chabbert, Valérie; Ferrari, Emile; Gilard, Martine; Willoteaux, Serge; Furber, Alain; Barone-Rochette, Gilles; Jankowski, Adrien; Douek, Philippe; Mousseaux, Elie; Sirol, Marc; Niarra, Ralph; Chatellier, Gilles; Laissy, Jean-Pierre

    2013-02-15

    Computed tomographic coronary angiography (CTCA) has been proposed as a noninvasive test for significant coronary artery disease (CAD), but only limited data are available from prospective multicenter trials. The goal of this study was to establish the diagnostic accuracy of CTCA compared to coronary angiography (CA) in a large population of symptomatic patients with clinical indications for coronary imaging. This national, multicenter study was designed to prospectively evaluate stable patients able to undergo CTCA followed by conventional CA. Data from CTCA and CA were analyzed in a blinded fashion at central core laboratories. The main outcome was the evaluation of patient-, vessel-, and segment-based diagnostic performance of CTCA to detect or rule out significant CAD (≥50% luminal diameter reduction). Of 757 patients enrolled, 746 (mean age 61 ± 12 years, 71% men) were analyzed. They underwent CTCA followed by CA 1.7 ± 0.8 days later using a 64-detector scanner. The prevalence of significant CAD in native coronary vessels by CA was 54%. The rate of nonassessable segments by CTCA was 6%. In a patient-based analysis, sensitivity, specificity, positive and negative predictive values, and positive and negative likelihood ratios of CTCA were 91%, 50%, 68%, 83%, 1.82, and 0.18, respectively. The strongest predictors of false-negative results on CTCA were high estimated pretest probability of CAD (odds ratio [OR] 1.97, p <0.001), male gender (OR 1.5, p <0.002), diabetes (OR 1.5, p <0.0001), and age (OR 1.2, p <0.0001). In conclusion, in this large multicenter study, CTCA identified significant CAD with high sensitivity. However, in routine clinical practice, each patient should be individually evaluated, and the pretest probability of obstructive CAD should be taken into account when deciding which method, CTCA or CA, to use to diagnose its presence and severity. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Anti-HBs in immunized children with cuban hepatitis B vaccine and impact of booster dose after five years

    International Nuclear Information System (INIS)

    Dahifar, H.; Mousavi, F.; Ghorbani, A.

    2008-01-01

    Hepatitis B virus infection and associated diseases are a major public health problem. This study was planned to find out the persistence of antibody against hepatitis B surface antigen in Iranian vaccinated children after five years. Anti-HBs titers in a group of healthy good - responder children who were vaccinated with Cuban hepatitis B vaccine in infancy were measured after five years. Children with antibody titers <100 mlU/ml were revaccinated and retested after four weeks. Mean anti-HBs titers in 68 children (29 females, 39 males) were 482.1 mlU/ml at six months after the third dose of primary vaccination and 153 mlU/ml at five years later. Total mean anti-HBs titers in 36 (52.9%) children out of 68 (17 females, 19 males) were 38.3 mlU/ml and 4(5.8%) of 68 children (two of each sexes) had no detectable antibody after five years. Total mean anti-HBs titers in these hypo- responder and non- responder were 774.3 mlU/ml and 625.5 mlU/ml respectively after booster dose. In a group of children, who were immunized with Cuban hepatitis B vaccine from birth, anti-HBS titers fell at 6.5 years of age and almost half of children became hypo responder or no responder and their anti-HBs titers developed secondary rise after booster vaccination. All children showed immunologic memory to a booster dose. (author)

  16. Coordination of international multicenter studies: governance and administrative structure Coordinación de estudios multicéntricos internacionales: estructura administrativa y reglamentación

    Directory of Open Access Journals (Sweden)

    Shrikant I. Bangdiwala

    2003-01-01

    Full Text Available A well-conducted multicenter study needs to assure standardization, uniformity of procedures, high data quality, and collaboration across sites. This manuscript describes the organization and dynamics of multicenter studies, focusing on governance and administrative structures among countries of diverse cultures. The organizational structure of a multicenter study is described, and a system for oversight and coordination, along with roles and responsibilities of participants in the multicenter study, are presented. The elements of a governance document are also reviewed, along with guidelines and policies for effective collaboration. The experience of an ongoing multi-country collaboration, the World Studies of Abuse in the Family Environment (WorldSAFE, illustrates the implementation of these guidelines. It is essential that multicenter studies have an objective coordinating center and that the investigators jointly develop a written governance document to enable collaboration and preserve collegiality among participating investigators.La ejecución de estudios multicéntricos requiere el establecimiento de procedimientos uniformes, control de calidad, asegurar estandarización, y la colaboración entre las instituciones participantes. Este trabajo describe la estructura y la dinámica de los estudios multicéntricos internacionales, enfocando los aspectos de administración y reglamentación. Se describe la estructura organizativa de un estudio multicéntrico, así como los roles de los integrantes de un sistema de supervisión y coordinación. Se presentan los elementos de un documento de reglamentación y se describen algunas guías y políticas para una colaboración eficaz. La experiencia del estudio internacional colaborativo World Studies of Abuse in the Family Environment (WorldSAFE se utiliza como ejemplo de la aplicación de estas normas. Un centro de coordinación estadística, así como un documento de auto-reglamentación son

  17. Surgical site infections in Italian Hospitals: a prospective multicenter study

    Directory of Open Access Journals (Sweden)

    Ippolito Giuseppe

    2008-03-01

    Full Text Available Abstract Background Surgical site infections (SSI remain a major clinical problem in terms of morbidity, mortality, and hospital costs. Nearly 60% of SSI diagnosis occur in the postdischarge period. However, literature provides little information on risk factors associated to in-hospital and postdischarge SSI occurrence. A national prospective multicenter study was conducted with the aim of assessing the incidence of both in-hospital and postdisharge SSI, and the associated risk factors. Methods In 2002, a one-month, prospective national multicenter surveillance study was conducted in General and Gynecological units of 48 Italian hospitals. Case ascertainment of SSI was carried out using standardized surveillance methodology. To assess potential risk factors for SSI we used a conditional logistic regression model. We also reported the odds ratios of in-hospital and postdischarge SSI. Results SSI occurred in 241 (5.2% of 4,665 patients, of which 148 (61.4% during in-hospital, and 93 (38.6% during postdischarge period. Of 93 postdischarge SSI, sixty-two (66.7% and 31 (33.3% were detected through telephone interview and questionnaire survey, respectively. Higher SSI incidence rates were observed in colon surgery (18.9%, gastric surgery (13.6%, and appendectomy (8.6%. If considering risk factors for SSI, at multivariate analysis we found that emergency interventions, NNIS risk score, pre-operative hospital stay, and use of drains were significantly associated with SSI occurrence. Moreover, risk factors for total SSI were also associated to in-hospital SSI. Additionally, only NNIS, pre-operative hospital stay, use of drains, and antibiotic prophylaxis were associated with postdischarge SSI. Conclusion Our study provided information on risk factors for SSI in a large population in general surgery setting in Italy. Standardized postdischarge surveillance detected 38.6% of all SSI. We also compared risk factors for in-hospital and postdischarge SSI

  18. Prospective validation of a prognostic model for respiratory syncytial virus bronchiolitis in late preterm infants: a multicenter birth cohort study

    NARCIS (Netherlands)

    Blanken, M.O.; Koffijberg, H.; Nibbelke, E.E.; Rovers, M.M.; Bont, L.; Liem, K.D.; et al.,

    2013-01-01

    OBJECTIVES: This study aimed to update and validate a prediction rule for respiratory syncytial virus (RSV) hospitalization in preterm infants 33-35 weeks gestational age (WGA). STUDY DESIGN: The RISK study consisted of 2 multicenter prospective birth cohorts in 41 hospitals. Risk factors were

  19. The elementary concentration and the behavior of the iron in Cuban agricultural soils by means of the Neutron activation Analysis and Moessbauer Spectroscopy

    International Nuclear Information System (INIS)

    Furet, N. R.; Oddone, M.; Orihuela, D.L.

    1999-01-01

    Representative samples from Cuban agricultural soils, which have been benefited with industrial waste are studied by means of the methods of the Analysis for Instrumental Neutronic Activation and Moessbauer Spectroscopy. The elemental contents of Na, K, Ca, Fe, Cr, etc. are determined, and the influence of the industrial waste in the elemental concentrations is valued. The behavior of the iron is studied, like one of the important elements in several processes of development of the plants. The oxidation and coordination states of the Fe in soils are studied

  20. Cuban experience in dosimetry quality audit program in radiotherapy

    International Nuclear Information System (INIS)

    Alonso-Samper, J.L.; Dominguez, L.; Yip, F.G.; Laguardia, R.A.; Morales, J.L.; Larrinaga, E.

    2002-01-01

    Full text: Five years ago we started a National Program of Quality Assurance in Radiotherapy. This program was possible thanks to the cooperation between the Cuban Ministry of Health and the International Atomic Energy Agency (IAEA) in the Projects ARCAL XXX and CUB/6/011. In the framework of these projects a total of ten complete dosimetry set were acquired and a large number of medical physicists were trained. At the same time, the Cuban side signed a contract for nine cobalt units, which have been gradually installed and all of them are running at the moment. During more than 20 years Cuba has taken part in the IAEA/WHO TLD postal dose audit programs and our results have been inside the (+/-)5 % acceptance limit. Cuba also joined the IAEA Coordinated Research Program E2 40 07, to extend at a national level the experience of the TLD based audits, using the capability of our SSDL to measure TLD. At the same time the work of the already existing External Audit Group was consolidated. The National Program of Quality Assurance in Radiotherapy works on base of external on-site visits. The main objective is to avoid any accident and to improve the quality of the RT treatments. Every year each Radiotherapy service is visited by a qualified team of physicists with the objective to check the physical aspects of the quality of the RT treatment, it includes: Documents and Records, safety, mechanical and dosimetric aspects, treatment planning, also we use the fixed depth phantom to simulate and verify several techniques. Although the TLD postal audit results are acceptable, in our QA audits we have detected some problems that may deviate the dose delivery to patients in more than 5%, examples of which are: Not all the clinical plans are redundantly checked by an independent person; Not all the controls (daily, monthly and annual) are performed according to the protocols approved by the National QA Committee. In some cases the controls are not well recorded; Clinical

  1. Effectiveness and predictors of success of noninvasive ventilation during H1N1 pandemics: a multicenter study.

    Science.gov (United States)

    Nicolini, A; Tonveronachi, E; Navalesi, P; Antonelli, M; Valentini, I; Melotti, R M; Pigna, A; Carrassi, A; Righini, P; Ferrari Bravo, M; Pelosi, P; Nicoli, F; Cosentini, R; Vaschetto, R; Faenza, S; Nava, S

    2012-12-01

    The use of non-invasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF) due to H1N1 virus infection is controversial. In this multicenter study we aimed to assess the efficacy of NIV in avoiding endotracheal intubation (ETI) and to identify predictors of success or failure. In this prospective multicenter study, 98 patients with new pulmonary infiltrate(s) sustained by H1N1 virus and a PaO(2)/FiO229 and a PaO(2)/FIO(2)≤127 at admission and PaO2/FIO(2)≤149 after 1 hr of NIV were independently associated with the need for ETI. The early application of NIV, with the aim to avoid invasive ventilation, during the H1N1 pandemics was associated with an overall success rate of 47/98 (48%). Patients presenting at admission with an high SAPS II score and a low PaO(2)/FiO(2) ratio and/or unable to promptly correct gas exchange are at high risk of intubation and mortality.

  2. Statistics of the Iomazenil-multicenter study

    International Nuclear Information System (INIS)

    Hasler, P.H.; Beer-Wohlfahrt, H.; Schubiger, P.A.

    1990-01-01

    The 123 I-Ro 16-0154 (= Iomazenil) has been shown as a very potent benzodiazepine antagonist by Beer et al. (1990). In this study the in vitro and in vivo characteristics have been described. The preliminary clinical results revealed clearly images of the benzodiazepine receptor density in the brain. Also storage defects due to pathological CBF and changed receptor density were detected. The Iomazenil showed potential usefulness and therefore extended clinical tests in a multicenter study have been performed. The goals were twofold, first to define the normal benzodiazepine receptor distribution in a healthy human brain and second to investigate the possible diagnostic usefulness of Iomazenil in the case of partial epilepsy. Furthermore, on a few normal volunteers the pharmacokinetics should be determined and some patients with other dieseases (e.g. Alzheimer) would be screened. Some preliminary clinical results have already been published. Hoell et al. (1989) compared the biodistribution of Iomazenil in normal humans with the animal data published (Beer et al., 1990). They concluded that the distribution was similar. The radioactivity concentration in the plasma was virtually cleared after 15 min., cerebral uptake reached a maximum of 10-15 min p.i. and remained stable for about 20 min. Bangerl et al. (1990) found a reduction of benzodiazepine receptors in patients with Lennox-Gaustaut-syndrome. Bartenstein et al. (1989) compared early (30 min.) and late (2h) SPECT-images. They found that early images showed flow-phenomena and receptor binding, whereas late one corresponded clearly to receptor binding. Their findings confirm the results published by Beer et al. (1990). In this work the patient data of all participating clinical centers are evaluated and discussed. (author) 3 figs., 7 tabs., 5 refs

  3. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

    Science.gov (United States)

    Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

    2011-12-01

    New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

  4. Effects of Cuban Crude Oil on the Process of Leach, Sedimentation and Distillation in Nicaro

    Directory of Open Access Journals (Sweden)

    Ing. María Elena Magaña-Haynes

    2015-11-01

    Full Text Available ine"> Cuban crude in the process of leaching, sedimentation and distillation ofthe processed minerals at “René Ramos Latour” Company was evaluated. Two periods of testswere performed; one when oil was introduced into the furnace by spear and the other when itwas introduced by spear and chamber. The results demonstrated the feasibility of using theCuban crude in reduction and leaching process of mineral by the use of spear and chamber aswell. Nickel and cobalt extractions achieved by stepwise exceed values found in the relatedliterature. Deposition of mineral was good reaching values of 1,736 -1,745 kg/m3 at the bottomof the sedimentation stage leach and 1,774 -1,807 kg/m3 in the washing stage. The thickenerswere maintained with high clear liquor level throughout the test with values between 28,0-30,0ppm. The sedimentation rate achieved low values both in the first and in the second leachingstage. Sedimentation unit area was 0,23 m2 /T day, so that no sedimentation problems werepresented. It was observed an increase in the sulfur content up to values of 6,52 g/L for a nickelcontent of 12,0g/L, which caused that the dissolved nickel in downloading stills were of 0,392 g/L and 2,58 g/L of ammonia. The sulfur content in the nickel carbonate was increased upto 6,30 %, which is 2,5 % higher than conventional.

  5. Scaling cigars in the Cuban tourism economy Configurar a escala dos charutos na economia do turismo em Cuba

    Directory of Open Access Journals (Sweden)

    Valerio Simoni

    2009-11-01

    Full Text Available Taking scale as an object of analysis (Tsing 2000, this article examines how competing scale-making projects emerge in different layers of the Cuban tourism economy. I consider how tourists and Cubans interact along contested chains of production and distribution of cigars, and therefore become entangled in bundles of ideas, discourses, practices and materialities. These constitute different scaling propositions on which tourists and Cubans converge or diverge, and which inform the success of encounters within the tourism economy. Highlighted is the importance of understanding how scaling propositions are enacted and negotiated within tourism. I conclude that the realm of tourism is a particularly fruitful platform to investigate how competing scale-making projects and notions of scale are played out in the contemporary world.Tomando a escala (Tsing 2000 como objecto de análise, este artigo aborda a forma como emergem projectos concorrentes de configuração de escala a diferentes níveis da economia turística cubana. É examinada a interacção de turistas e cubanos no âmbito de cadeias de produção e distribuição controversas, e as formas como, assim, uns e outros se envolvem em conjuntos de ideias, discursos, práticas e materialidades. Estes constituem diferentes propostas de configuração de escala em que turistas e cubanos convergem ou divergem e que determinam o sucesso dos encontros no seio da economia turística. É aqui sublinhada a importância de compreendermos como as propostas de configuração de escala são apresentadas e negociadas no âmbito do turismo. Conclui-se que o campo do turismo constitui uma plataforma particularmente fértil para o estudo de como noções de escala e projectos de configuração de escala concorrentes se desenvolvem no mundo contemporâneo.

  6. Accuracy evaluation of five blood glucose monitoring systems obtained from the pharmacy: a European multicenter study with 453 subjects

    NARCIS (Netherlands)

    Tack, C.J.; Pohlmeier, H.; Behnke, T.; Schmid, V.; Grenningloh, M.; Forst, T.; Pfutzner, A.

    2012-01-01

    BACKGROUND: This multicenter study was conducted to evaluate the performance of five recently introduced blood glucose (BG) monitoring (BGM) devices under daily routine conditions in comparison with the YSI (Yellow Springs, OH) 2300 Stat Plus glucose analyzer. METHODS: Five hundred one diabetes

  7. Modificaciones en las calderas igneotubulares cubanas // Modifications in the Cuban boilers of fire tube

    Directory of Open Access Journals (Sweden)

    I. Pérez Mallea

    1998-01-01

    Full Text Available El objetivo de este trabajo es optimizar y diseñar las calderas igneotubulares nacionales, incluyendo las de inversión de llama yagua caliente. Con este fin se creo un software como soporte científico técnico que permite realizar los diferentes cálculosverificativos a través de los cuales se optimiza._________________________________________________________________________Abstract .The objective of this work is the optimizing and designing of the Cuban boilers of fire tube, including those of inverting offlame and hot water. A software have been developed as technical scientific supper for different calculations and optimizingprocess.

  8. Analysis of controversial items in the theoretical design of the undergraduate's thesis at the Cuban University of Informatics Sciences (UIS.

    Directory of Open Access Journals (Sweden)

    Rolando Quintana Aput

    2011-03-01

    Full Text Available The present paper encloses the analysis of some troubles related to the development of theoretical design concerning the undergraduate thesis at the Cuban University of Informatics Sciences (UIS. This analysis proves to be decisive due to the existing demand for improving professionals training in the fields of investigation related to computing world.

  9. An antecedent of the new teacher’s training school: an approach to a behavioral model and a school model from the perspective of the history of Cuban education

    Directory of Open Access Journals (Sweden)

    González, E. A.

    2011-07-01

    Full Text Available The paper is intended to portray the most important qualities and attitudes that distinguish the model of a teacher’s training school, a project for educating would-be teachers for Kindergarten, Primary School and Special Education. The idea that Cuban Pedagogy is a natural source of ideas for sustaining such model as well as characterizing social agents’ attitudes and the institution’s features is argued. A logical-historic analysis is carried out, starting by considering some of the most important Cuban school teachers’ criteria, from which the author infers the qualities and ethical attitudes that characterize the social participants and the whole institution.

  10. Identification of protein binding in pictorial art Cuban

    International Nuclear Information System (INIS)

    Mendoza, Ariadna; Correa, Maurin; Maqueira, Isis

    2011-01-01

    In this paper were implemented microanalysis methodologies by histochemical analysis, and infrared spectroscopy to determine the nature of the binder in paintings and Gas Chromatography (GC) coupled to Mass Spectrometry (MS) for identification of protein binders of common use in tempera technique with the aim of having these methods as part of the identification of artistic materials in Cuban cultural heritage carried out by Archaeometry Laboratory of Havana city's Historian Cabinet. The methodologies implemented were evaluated using model samples of traditional painting techniques with variable protein binder: yolk, egg white, casein, nut oil and animal glue; ageing for 5 years. The models samples were correctly identified. It was determined the interference of pigments with the presence of nitrogen by histochemical analysis with Amido Black dye. IR spectroscopy technique allowed to differentiate between oily and mixed (oil plus protein) techniques and tempera with yolk. Oily technique was identified in wall paintings of the New San Francisco church (XIX century) and the Obrapia House (XVII century) and the technique of tempera with animal glue in the polychrome of the XVIII century which represents St. John the Evangelist belonging to the San Juan de Letran church

  11. A multicenter prospective study of patients undergoing open ventral hernia repair with intraperitoneal positioning using the monofilament polyester composite ventral patch

    DEFF Research Database (Denmark)

    Berrevoet, Frederik; Doerhoff, Carl; Muysoms, Filip

    2017-01-01

    PURPOSE: This study assessed the recurrence rate and other safety and efficacy parameters following ventral hernia repair with a polyester composite prosthesis (Parietex™ Composite Ventral Patch [PCO-VP]). PATIENTS AND METHODS: A single-arm, multicenter prospective study of 126 patients undergoing...

  12. Seismic and geological interpretation on petroleum exploration in the Cuban economic area in the Gulf of Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Sora Monroy, America; Lopez, Sofia; Dominguez, Rene; Socorro, Rafael; Sanchez, Jorge; Toucet, Sonia [Cupet -Companhia Cubana de Petroleo, Havana (Cuba)

    2004-07-01

    From the decade of the 50'up to now, many seismic survey were acquired in the Cuban Economic area in the Gulf of Mexico, both, deep water and near short along the littoral, which have contribute to prepare the structural model as well the evolutional one. During the period comprise from June to December 2000, 7330 Km. of seismic lines were acquired over 70 lines in an area of 110000 square Km. that covers the Exclusive Economic area of Cuba. In this area the water depth varies from 500 m to 3500 m. The biggest depth is located at the central part of the whole area. The depth decreases toward the shell and the island's littoral (up to less than 1000 m). Seismic data were processed at CGG' processing in France. Geovector Plus was used as seismic processing software. All the information was calibrate by the wells in the area. The principal wells were DP535 and DP540. The general featuring of seismic image let us to get the map from the main geological elements in this area. In the area we were following two principal horizons: the green one associated to the Middle Cretaceous and the blue one associated to the top of Jurassic. We made the structural maps from the Middle Cretaceous and the Top of Jurassic, and did the seism stratigraphic analysis. We found 16 sequences. We did the chronograph table in this area and we made six maps from different seismic sequences. This analysis let us to define the most important area to continue studying in the Cuban economic area in the Gulf of Mexico on the petroleum exploration. (author)

  13. Peripheral nerve field stimulation (PNFS) in chronic low back pain: a prospective multicenter study.

    Science.gov (United States)

    Kloimstein, Herwig; Likar, Rudolf; Kern, Michael; Neuhold, Josef; Cada, Miroslav; Loinig, Nadja; Ilias, Wilfried; Freundl, Brigitta; Binder, Heinrich; Wolf, Andreas; Dorn, Christian; Mozes-Balla, Eva Maria; Stein, Rolf; Lappe, Ivo; Sator-Katzenschlager, Sabine

    2014-02-01

    The goal of this study was to evaluate the long-term efficacy and safety of peripheral nerve field stimulation (PNFS) for chronic low back pain (cLBP). In this prospective, multicenter observational study, 118 patients were admitted to 11 centers throughout Austria and Switzerland. After a screening visit, all patients underwent a trial stimulation period of at least seven days before implantation of the permanent system. Leads were placed in the subcutaneous tissues of the lower back directly in the region of greatest pain. One hundred five patients were implanted with a permanent stimulating system. Patients' evaluation of pain and functional levels were completed before implantation and one, three, and six months after implantation. Adverse events, medication usage, and coverage of the painful area and predictive value of transcutaneous electrical nerve stimulation (TENS) were monitored. All pain and quality-of-life measures showed statistically significant improvement during the treatment period. These included the average pain visual analog scale, the Oswestry Disability Questionnaire, the Becks Depression Inventory, and the Short Form-12 item Health survey. Additionally, medication usage with opioids, nonsteroidal anti-inflammatory drugs, and anti-convulsants showed a highly significant reduction. Complications requiring surgical intervention were reported in 9.6% of the patients. The degree of coverage of painful areas seems to be an important criterion for efficacy of PNFS, whereas TENS is presumably no predictor. This prospective, multicenter study confirms that PNFS is an effective therapy for the management of cLBP. Significant improvements in many aspects of the pain condition were measured, and complications were minimal. © 2013 International Neuromodulation Society.

  14. Feasibility evaluation of two solar cooling systems applied to a cuban hotel. Comparative analysis

    International Nuclear Information System (INIS)

    Díaz Torres, Yamile; Valdivia Nodal, Yarelis; Monteagudo Yanes, José Pedro; Miranda Torres, Yudit

    2016-01-01

    The article presents an analysis of technical and economic feasibility of using two configurations of solar cooling in a Cuban hotel. HVAC hybrid schemes are: a cooler of ice water vapor compression (chiller) interconnected in parallel with a smaller capacity chiller, first with a solar-powered absorption cooling system (SACS), and then with a photovoltaic cooling system(PSC). Both were simulated taking into account the weather conditions in the region, thermodynamic calculation methodologies and principles that govern these technologies. The results show that the use of these alternatives contributes to reducing energy consumption and the environmental impact of heating, ventilation and air conditioning systems (HVAC). Economic analysis highlights that PCS is more favorable than the SACS taking into account the cooling cost generation (CCG) but energy assessment indicates that SACS has higher thermal performance for the case study to which it is applied. (author)

  15. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: The RESOLVE study

    NARCIS (Netherlands)

    Jeremias, Allen; Maehara, Akiko; Généreux, Philippe; Asrress, Kaleab N.; Berry, Colin; Bruyne, de B. (Bernard); Davies, Justin E.; Escaned, Javier; Fearon, W.F. (William); Gould, K. Lance; Johnson, Nils P.; Kirtane, Ajay J.; Koo, Bon Kwon; Marques, Koen M.; Nijjer, Sukhjinder; Oldroyd, K.G. (Keith); Petraco, Ricardo; Piek, Jan J.; Pijls, Nico H.; Redwood, Simon; Siebes, M.; Spaan, J.A.E.; van 't Veer, Marcel; Mintz, Gary S.; Stone, Gregg W.

    2014-01-01

    Objectives This study sought to examine the diagnostic accuracy of the instantaneous wave-free ratio (iFR) and resting distal coronary artery pressure/aortic pressure (Pd/Pa) with respect to hyperemic fractional flow reserve (FFR) in a core laboratory-based multicenter collaborative study.

  16. Population size of Cuban Parrots Amazona leucocephala and Sandhill Cranes Grus canadensis and community involvement in their conservation in northern Isla de la Juventud, Cuba

    Science.gov (United States)

    Aguilera, X.G.; Alvarez, V.B.; Wiley, J.W.; Rosales, J.R.

    1999-01-01

    The Cuban Sandhill Crane Grus canadensis nesiotes and Cuban Parrot Amazona leucocephala palmarum are considered endangered species in Cuba and the Isla de la Juventud (formerly Isla de Pinos). Coincident with a public education campaign, a population survey for these species was conducted in the northern part of the Isla de la Juventud on 17 December 1995, from 06hoo to 10hoo. Residents from throughout the island participated, manning 98 stations, with 1-4 observers per station. Parrots were observed at 60 (61.2%) of the stations with a total of 1320, maximum (without correction for duplicate observations), and 1100, minimum (corrected), individuals counted. Sandhill cranes were sighted at 38 (38.8%) of the stations, with a total of 115 individuals. Cranes and parrots co-occurred at 20 (20.4%) of the stations.

  17. Structural and magnetic characterization of three tetranuclear Cu(II) complexes with face-sharing-dicubane/double-open-cubane like core framework

    Science.gov (United States)

    Paul, Aparup; Bertolasi, Valerio; Figuerola, Albert; Manna, Subal Chandra

    2017-05-01

    Three novel tetranuclear copper(II) complexes namely [Cu4(L1)4]•2(dmf) (1), [Cu4(L1)4] (2) and [Cu4(L2)2(HL2)2(H2O)2]•2(ClO4)·6(H2O) (3) (H2L1, (E)-2-((1-hydroxybutan-2-ylimino)methyl)phenol; H2L2, (E)-2-((1-hydroxybutan-2-ylimino)methyl)-6-methoxyphenol)) were synthesized from the self-assembly of copper(II) perchlorate and the tridentate Schiff base ligands. The structural determination reveals that complex 1 crystallizes in the monoclinic system with space group C2/c, whereas both the complexes 2 and 3 crystallize in the triclinic system with space group P-1. Complexes 1 and 2 possess face-sharing dicubane core, on the other hand complex 3 has double open cubane core structure. The copper(II) ions in the cubane core are in distorted square planar geometries, and weak π…π and C-H…π interactions lead to formation of a 2D supramolecular architecture for complexes 1 and 2. At room temperature complexes 1, 2 and 3, exhibit fluorescence with a quantum yield (Φs) of 0.47, 0.49 and 0.38, respectively. Variable temperature magnetic susceptibility measurements in the range 2-300 K indicate an overall weak antiferromagnetic exchange coupling in all complexes. The PHI program was used to study their magnetic behaviour. In agreement with their face-sharing dicubane structure, a Hamiltonian of the type H =- J1(S1S2+S1S2'+S1'S2+S1'S2') - J2S1S1', where S1 = S1' = S2 = S2' = SCu =1/2, was used for studying complexes 1 and 2. Simulations performed suggest magnetic exchange constants with values close to J1 =-20 cm-1 and J2 =0 cm-1 for these complexes. On the other hand, the spin Hamiltonian H =- J1(S1S4+S2S3) - J2(S1S3+S2S4) - J3S1S2, where S1 = S2 = S3 = S4 = SCu =1/2, was used to study the magnetic behaviour of the double open cubane core of complex 3 and a good agreement between the experimental and simulated results was found by using the parameters g1 = g2 =2.20, g3 = g4 =2.18, J1 =-36 cm-1, J2 =-44 cm-1 and J3 =0 cm-1.

  18. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

    OpenAIRE

    Kim, Young Won; Park, Jinsung; Chung, Hong; Kim, Hong-Wook; Kim, Hyung Joon; Jung, Jae Hung; Kim, Won Tae

    2015-01-01

    Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33), aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6%) completed the study according to...

  19. Resistance patterns to beta-lactams and quinolones in clinical isolates of bacteria from Cuban hospitals.

    Science.gov (United States)

    Gonzáles, I; Niebla, A; Vallin, C

    1995-01-01

    The resistance patterns to 26 beta-lactams and 8 quinolones of clinical isolates from Cuban hospitals were evaluated using the disk susceptibility test, according to the NCCLS guidelines (1992). The genera studied were Escherichia sp (320), Enterobacter sp (10), Klebsiella sp (90), Proteus sp (10), Pseudomonas sp (90), Serratia sp (20), and Staphylococcus sp (80). Higher resistance to beta-lactams was observed in the genera Pseudomonas, Escherichia and Klebsiella. For fluoroquinolones we found no significant resistance, with the exception of the genus Klebsiella. The most effective antibiotics were cephalosporins of the second and third generations, fluoroquinolones, and non-classical beta-lactams (cephamycins, moxalactam and monobactams). On the contrary, a pronounced resistance was found to penicillin, oxacillin, ticarcillin, ampicillin, methicillin, nalidixic acid and cinoxacin. These resistance patterns correspond to the high consumption of these antibiotics throughout the country.

  20. Industrial property for science’s management, technology and innovation in Cuban State companies

    Directory of Open Access Journals (Sweden)

    Dulce María Contreras Villavicencio

    2017-08-01

    Full Text Available The paper synthesizes some research on industrial property aspects from the socio-legal perspective and financial accounting. Its focus to the socialist state enterprise adaptation in his economic fact, social and environmental responsibility as a fundamental Cuban model reach, competitiveness and high performance in socialist state enterprise. It outlines criteria on the ordering and implementation of industrial property through the management of science and technology, protection and dissemination of knowledge results as alternatives of regulation in chain of value to full cycle of innovation, dynamics of intangible heritage and relationships, exchange with marketing as business philosophy of business application. Strategies are proposed regarding the rights of this institution in the economic-organization management state.

  1. [Motivations for a consultation before adoption: A multicenter study].

    Science.gov (United States)

    Thieblemont, M; Francois, P; Poirier, V; Bosdure, E; Munck, M-R; Borsa-Dorion, A; Hazart, I; Moukagni-Pelzer, M; Brunel, D; Peyron, F; de Monleon, J-V

    2016-01-01

    While the number of international adoptions in France is decreasing, adopted children are older and in poorer health than they used to be. This phenomenon has resulted in an increase in the demand for preadoption consultations over the past several years. This study analyses the reasons for these consultations. Prospective multicenter study conducted from 1 January to 31 December 2013. Ten centers contributed to the study, i.e., 196 preadoption consultations. Seeking medical advice was the reason for 88% of the consultations, whether the advice was based on the study of an identified child's medical file (32%) or a country's healthcare characteristics, whether the country was identified (34%) or not (23%). In 6% of cases, the motive for preadoption consultations was social and familial, and in the last 5% it was to obtain general information about adoption and its procedures. In more than 40% of the cases, whether the child or the country identified, Russia is the subject of the consultation because of the complexity of the files and because of the dreaded but rarely mentioned fetal alcohol syndrome. The deterioration of adopted children's health is an additional worry for future adoption applicants. To provide them with the best information possible without making choices for them, specialists should have substantial experience in adoption before going into these preadoption consultations. Copyright © 2015. Published by Elsevier SAS.

  2. The Long-Term Multicenter Observational Study of Dabigatran Treatment in Patients With Atrial Fibrillation (RELY-ABLE) Study

    DEFF Research Database (Denmark)

    Connolly, S. J.; Wallentin, L.; Ezekowitz, M. D.

    2013-01-01

    . There is a need for longer-term follow-up of patients on dabigatran and for further data comparing the 2 dabigatran doses. Methods and Results Patients randomly assigned to dabigatran in RE-LY were eligible for the Long-term Multicenter Extension of Dabigatran Treatment in Patients with Atrial Fibrillation (RELY...

  3. A European multicenter randomized double-blind placebo-controlled monotherapy clinical trial of milnacipran in treatment of fibromyalgia

    DEFF Research Database (Denmark)

    Branco, Jaime C; Zachrisson, Olof; Perrot, Serge

    2010-01-01

    This randomized, double-blind, placebo-controlled, multicenter study investigated the efficacy and safety of milnacipran in the treatment of fibromyalgia (FM) in a European population.......This randomized, double-blind, placebo-controlled, multicenter study investigated the efficacy and safety of milnacipran in the treatment of fibromyalgia (FM) in a European population....

  4. Toward Developing a Specific Outcome Instrument for Spine Trauma : An Empirical Cross-sectional Multicenter ICF-Based Study by AOSpine Knowledge Forum Trauma

    NARCIS (Netherlands)

    Oner, F. Cumhur; Sadiqi, Said; Lehr, A. Mechteld; Aarabi, Bizhan; Dunn, Robert N.; Dvorak, Marcel F.; Fehlings, Michael G.; Kandziora, Frank; Post, Marcel W.; Rajasekaran, S.; Vialle, Luiz; Vaccaro, Alexander R.

    2015-01-01

    Study Design. Empirical cross-sectional multicenter study. Objective. To identify the most commonly experienced problems by patients with traumatic spinal column injuries, excluding patients with complete paralysis. Summary of Background Data. There is no disease or condition-specific outcome

  5. Prediction of functional recovery after revascularization using quantitative gated myocardial perfusion SPECT: a multi-center cohort study in Japan

    International Nuclear Information System (INIS)

    Nakajima, Kenichi; Tamaki, Nagara; Kuwabara, Yoichi; Kawano, Masaya; Matsunari, Ichiro; Taki, Junichi; Nishimura, Shigeyuki; Yamashina, Akira; Ishida, Yoshio; Tomoike, Hitonobu

    2008-01-01

    Prediction of left ventricular functional recovery is important after myocardial infarction. The impact of quantitative perfusion and motion analyses with gated single-photon emission computed tomography (SPECT) on predictive ability has not been clearly defined in multi-center studies. A total of 252 patients with recent myocardial infarction (n = 74) and old myocardial infarction (n = 175) were registered from 25 institutions. All patients underwent resting gated SPECT using 99m Tc-hexakis-2-methoxy-isobutyl isonitrile (MIBI) and repeated the study after revascularization after an average follow-up period of 132 ± 81 days. Visual and quantitative assessment of perfusion and wall motion were performed in 5,040 segments. Non-gated segmental percent uptake and end-systolic (ES) percent uptake were good predictors of wall motion recovery and significantly differed between improved and non-improved groups (66 ± 17% and 55 ± 18%, p 99m Tc-MIBI uptake provided a useful predictor of wall motion improvement. Application of quantitative approach with non-gated and ES percent uptake enhanced predictive accuracy over visual analysis particularly in a multi-center study. (orig.)

  6. Multicenter core laboratory comparison of the instantaneous wave-free ratio and resting Pd/Pa with fractional flow reserve: the RESOLVE study

    NARCIS (Netherlands)

    Jeremias, Allen; Maehara, Akiko; Généreux, Philippe; Asrress, Kaleab N.; Berry, Colin; de Bruyne, Bernard; Davies, Justin E.; Escaned, Javier; Fearon, William F.; Gould, K. Lance; Johnson, Nils P.; Kirtane, Ajay J.; Koo, Bon-Kwon; Marques, Koen M.; Nijjer, Sukhjinder; Oldroyd, Keith G.; Petraco, Ricardo; Piek, Jan J.; Pijls, Nico H.; Redwood, Simon; Siebes, Maria; Spaan, Jos A. E.; van 't Veer, Marcel; Mintz, Gary S.; Stone, Gregg W.

    2014-01-01

    This study sought to examine the diagnostic accuracy of the instantaneous wave-free ratio (iFR) and resting distal coronary artery pressure/aortic pressure (Pd/Pa) with respect to hyperemic fractional flow reserve (FFR) in a core laboratory-based multicenter collaborative study. FFR is an index of

  7. Nuclear Magnetic Resonance skull in Cuban families first diagnosed with Friedreich's ataxia

    International Nuclear Information System (INIS)

    Cruz Marinno, Tania; Alvarez Cuesta, Jose Alberto; Aguilera Rodriguez, Raul; Velazquez Perez, Luis

    2011-01-01

    Friedreich's ataxia is characterized by age of onset before 25 years, progressive ataxia, dysarthria, absent deep tendon reflexes and impaired vibration sense. This research was conducted in order to describe the imaging features of central nervous system structures in the early Cuban families diagnosed with the disease. A team of 0.23 Tesla-PANORAMA-Phylips Medical Systems, with a standard head coil, axial slices were obtained using 5mm thick FLAIR sequences, T1 and T2, and sagittal T1 and T2 in three individuals with confirmatory molecular diagnosis of Friedreich's ataxia and six healthy controls matched by age and sex. The morphological structures most affected are the cervical spinal cord, cerebellum and pons, which provides in vivo evidence that the disease leads to atrophy of these structures

  8. Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study.

    Science.gov (United States)

    Li, An; Li, Wenxiong; Hao, Fengtong; Wang, Haishi

    2016-01-01

    To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning. This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment. Seventy-five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p treatment group (p poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival. © 2016 S. Karger AG, Basel.

  9. Confirmation of the correct application of the gamma spectrometric method carried out in the Cuban Center for Radiation Protection and Hygiene

    International Nuclear Information System (INIS)

    Fernandez Gomez, Isis M.; Carrazana Gonzalez, Jorge A.; Capote Ferrera, Eduardo

    2008-01-01

    One of the technical requirements of the standard ISO/IEC 17025:2006 is that the laboratories that use standard methods shall confirm that they can properly operate these before introducing the tests or calibrations. Among the testing activities that execute the Environmental Radiological Surveillance Laboratory of the Cuban Center for Radiation Protection and Hygiene, is the determination of gamma radionuclides by gamma spectrometry with HPGe detectors. This test has been accredited by the Cuban Accreditation Body, according to the standard ISO/IEC 17025:2005. Fulfilling the requirements of this standard, regarding the selection of methods, the laboratory uses internationally standard method for its gamma spectrometry determinations. For this reason it was necessary to confirm the correct application of the selected method before incorporating it as scientific-technical service that the institution offers. With this purpose the method confirmation using certified reference materials of different matrixes and for the different geometries used in the laboratory were carried out. The obtained results of this study were processed statistically to check the precision and trueness of the same ones. In this sense, the laboratory participates periodically in interlaboratory comparison programs that include the radionuclides analysis by gamma spectrometry, as another form of accuracy confirmation of the results that the laboratory reports. In this paper the design of the realized intralaboratory study, as well as the results of it are presented. From the obtained results in the realized study, as well as from the interlaboratory comparison programs, it is possible to conclude that the method used in the laboratory is executed appropriately and it is under control. (author)

  10. Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study.

    Science.gov (United States)

    Duque, A; Martínez, P-J; Giraldo, A; Gualtero, D-F; Ardila, C-M; Contreras, A; Duarte, S; Lafaurie, G-I

    2017-07-01

    The validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches. 578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination. The optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test. Self-reported smoking and serum cotinine test ≥ 10ng/ml are accurate ,complementary and more reliable methods to assess the patient's smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. The serum cotinine level is more reliable to make associations with the patient's periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies.

  11. Cuban regulatory politics with relationship to the Radioactive lightning rod employment

    International Nuclear Information System (INIS)

    Lopez Forteza; Yamil; Jerez Vegueria, Pablo F.; Quevedo Garcia, Jose R.; Diaz Guerra, Pedro; Dumenigo Gonzalez, Cruz

    2003-01-01

    The radioactive lightning rod employment for the protection of facilities against atmospheric discharges reached its maximum splendor in the years 80. It was in fact at the end of this decade when the technical considerations arose, with relationship to the justification of this practice that finally took to that the production of such teams was abolished. For the regulatory authorities, however, it continues having validity the question related with the control of those lightning rod that you/they stay in use, as well as the relative one to the establishment of a coherent national politics with the international practice. Presently work the results of the last 10 years of control of the radioactive lightning rod use are presented in Cuba and the radiological evaluation carried out on the base of this experience. Lastly, it exposes the Cuban regulatory politics established with relationship to the employment of this teams in the country

  12. Effect of Metoprolol Versus Carvedilol on Outcomes in MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy)

    DEFF Research Database (Denmark)

    Ruwald, Martin H; Ruwald, Anne-Christine H; Jøns, Christian

    2013-01-01

    This study sought to compare the effects of metoprolol and carvedilol in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study.......This study sought to compare the effects of metoprolol and carvedilol in the MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy) study....

  13. One-year results of a prospective randomized, evaluator-blinded, multicenter study comparing TVT and TVT Secur.

    OpenAIRE

    Andrada Hamer, Maria; Larsson, Per-Göran; Teleman, Pia; Bergqvist, Christina Eten; Persson, Jan

    2012-01-01

    INTRODUCTION AND HYPOTHESIS: The aim of this prospective randomized multicenter study was to compare retropubic tension-free vaginal tape (TVT) with TVT Secur in terms of efficacy and safety. METHODS: We set out to enrol 280 stress urinary incontinent (SUI) women with a half-time interim analysis of short-term cure and adverse events. The short-term results have previously been published. Of the133 randomized women, 125 underwent surgery, and 121 (TVT n = 61, TVT Secur n = 60)...

  14. Asymbiotic germination in vitro in seeds of four species of Cuban orchids

    Directory of Open Access Journals (Sweden)

    Loexis Rodríguez

    2001-04-01

    Full Text Available About the most of 300 species of Cuban native orchids is have few reference of the micropropagation in the science literature. However, the biotechnical techniques fulfill an important acting in the rescue of threatened species. By that in the laboratory of Vegetable Biotechnology of the Mountain Development Center in Guantanamo, aspects related with the germination were studied in vitro of Campylocentrum micrantrum, Encyclia cochleata, Epidendrum difforme and Oceoclade maculata using the salts of the culture medium Murashige and Skoog (1962 and Knudson (1946, increasing with activate charcoal (0; 1; 2 g.l-1, Agar tachnical No. 3 6 g.l-1 and the adjusted pH at 5.6. The seeds was incubated under conditions of 16 hours light to intensity of 27 uMol.m².s-¹ and 24 ± 1 °C. The reached results showed that the germination of the studied species was obtained under different times and conditions of the medium of cultivation where it stood out for the smallest time used for the germination Encyclia cochleata to the eight weeks in the salts of Murashige and Skoog (1962 and without the addition of activated charcoal, as long as Oceoclade maculata needed 24 weeks to germinate. Key words: antioxidante, biotechnology, flowers, micropropagación, native species

  15. Cuban typical doses for 99mTc-DMSA renal gammagraphy studies: a methodology for the establishment of reference levels

    International Nuclear Information System (INIS)

    Diaz Barreto, M.; Varela Corona, C.; Lopez Bejerano, G.M.; Perea Diaz, M.; Paz Viera, J.E.

    2008-01-01

    Since a handful of years ago, international rules on Radiological Protection include the principle of optimization of given dose to patients, if this procedure doesn't lessen diagnosis quality, and the establishment of reference levels of activity. For these reasons, the Radiological Protection staff of Cuban Institute of Nephrology's Nuclear Medicine Service, where morpho functional renal studies are carried out, 70% on infants and young children, started a research on that way. Thus, because their biggest incidence, 99m Tc -DMSA renal gammagraphy studies were chosen, using a General Electric 400 AT Planar Gamma Camera. Studied sample was randomly selected, including adults (12 peoples) and children (23); divided into 4 groups, lessen given dose step by step. Other items were kept in mind in the research, such age, weight, time delayed between administrations and image getting, getting time of each view and total time of the study, as well as radiopharmaceuticals quality and Gamma Camera performance. Image quality was evaluated for each case, using both, objective and subjective criteria. Objective evaluation was done by using contrast/noise ratios and variance of the random noise. They were used to develop clustering and discriminant analysis over the independent variables to detect groups with differentiated image quality from the physical and mathematical point of view. Subjective evaluation was performed using the criteria of two expert observers who had no information about the activity levels used. They evaluated image quality separately, giving a good, regular or bad evaluation for each image. As a conclusion, we found that it is possible to reduce the given activities in 50% and thus, indirectly, to reduce doses for workers and for the public. Additionally, we propose a methodology for the establishment of reference levels for 99m Tc -DMSA renal gammagraphy studies in Cuba, both, for adults and paediatric patients. (author)

  16. Gene expression signatures predict outcome in non-muscle invasive bladder carcinoma - a multi-center validation study

    DEFF Research Database (Denmark)

    Andersen, Lars Dyrskjøt; Zieger, Karsten; Real, Francisco X.

    2007-01-01

    and carcinoma in situ (CIS) and for predicting disease recurrence and progression. EXPERIMENTAL DESIGN: We analyzed tumors from 404 patients diagnosed with bladder cancer in hospitals in Denmark, Sweden, England, Spain, and France using custom microarrays. Molecular classifications were compared with pathologic....... CONCLUSION: This multicenter validation study confirms in an independent series the clinical utility of molecular classifiers to predict the outcome of patients initially diagnosed with non-muscle-invasive bladder cancer. This information may be useful to better guide patient treatment....

  17. Requirements for a text that integrates the oncological pharmacy into the Cuban national health care system

    International Nuclear Information System (INIS)

    Arbesú Michelena, Ma Antonieta; Sedeño Argilagos, C. Caridad; Fernández Argüelles, Rogelio Alberto

    2015-01-01

    Introduction: oncological patients are cared for at all health care system levels. The pharmaceutical professional requires unifying instructions for his/her work in order to be part of the health team. Currently, there is no domestic literature for the pharmaceutical services, mainly that one devoted to oncological area, which comprises in just one text all the functional requirements and directs his/her professional daily work. Objective: to verify the requirement for national integral literature for the development of the oncological pharmaceutical service work. Methods: one two-question questionnaire was designed to assess the knowledge of experts and another with eight questions to learn about the requirement for literature on oncological pharmaceutical service adapted to the conditions of the Cuban health system. The questionnaires were e-mailed to 15 pharmacists who had an outstanding experience in several activities of the oncological pharmacy. Results: ten university experts, with 14.5 years of work experience as average in assistance activities from three provinces, responded. Two were excluded because their low level of information on oncological activity; poor incorporation of the pharmacist involved in services to activities inherent to his/her formation. All the experts believed that it was necessary to have a comprehensive text on the tasks, functions and activities linked to the oncological patient care, and to use the formal learning pathways for updating. A positive association with the favorable answers (1.40) was noticed. Conclusions: there exists a need for a text as a guide of the oncological pharmaceutical services according to the demands of the Cuban health care system. (author) 1

  18. [The reactogenicity and immunogenicity of the first Cuban vaccine against human leptospirosis].

    Science.gov (United States)

    Martínez Sánchez, R; Obregón Fuentes, A M; Pérez Sierra, A; Baly Gil, A; Díaz González, M; Baró Suárez, M; Menéndez Capote, R; Ruiz Pérez, A; Sierra González, G; López Chávez, A U

    1998-01-01

    A controlled double-blind trial was conducted with the participation of 80 adult volunteers of both sexes, who were randomly divided into groups of 40 individuals each one. The case-base study received the vaccine and the control group was administered placebo to know the safety, the behaviour of reactogenicity, and to star the immunogenicity studies of the first Cuban vaccine against human leptospirosis. The vaccine used in the case-base study was an inactivated and trivalent vaccine containing strains of Leptospira canicola, icterohaemorrhagiae and pomona, since they have the highest circulation in the country. The results obtained showed the inocuity of the vaccine as no adverse severe reactions were detected. The general symptomatology observed was low, where as febricula was the most common general symptom. It appeared during the first 3 days of observation and there were no significant differences between the 2 group. Only a mild pain at the site of the injection was reported as a local symptom, which was more frequent in the vaccinated group than in the control group (7.8 against 1.5%, respectively). The seroconversion obtained was of 29% by microagglutination, and of 34.2% by ELISA. The final results allowed to conclude that this vaccine is safe for human adults at the ages under study, and give the possibility to continue other studies in more advanced stages to complete the requirements for obtaining its license.

  19. Identification of sentinel lymph nodes in vulvar carcinoma patients with the aid of a patent blue V injection: a multicenter study

    NARCIS (Netherlands)

    Ansink, A. C.; Sie-Go, D. M.; van der Velden, J.; Sijmons, E. A.; de Barros Lopes, A.; Monaghan, J. M.; Kenter, G. G.; Murdoch, J. B.; ten Kate, F. J.; Heintz, A. P.

    1999-01-01

    BACKGROUND: The aim of this multicenter study was to investigate the feasibility and negative predictive value of sentinel lymph node detection with blue dye in vulvar carcinoma patients. METHODS: In patients with squamous cell carcinoma of the vulva without suspicious groin lymph nodes, patent blue

  20. Prevalence of hospital malnutrition in Latin America: the multicenter ELAN study.

    Science.gov (United States)

    Correia, M Isabel T D; Campos, Antonio Carlos L

    2003-10-01

    We determined the nutrition status and prevalence of malnutrition as determined by the Subjective Global Assessment in Latin America, investigated the awareness of the health team with regard to nutrition status, evaluated the use of nutritional therapy, and assessed the governmental policies regulating the practice of nutritional therapy in each country. This cross-sectional, multicenter epidemiologic study enrolled 9348 hospitalized patients older than 18 y in Latin America. Student's t test and chi-square tests were used to analyze univariate analysis and multiple logistic regression analysis, respectively. Malnutrition was present in 50.2% of the patients studied. Severe malnutrition was present in 11.2% of the entire group. Malnutrition correlated with age (>60 y), presence of cancer and infection, and longer length of hospital stay (P policies ruling the practice of nutritional therapy exist only in Brazil and Costa Rica. Hospital malnutrition in Latin America is highly prevalent. Despite this prevalence, physicians' awareness of malnutrition is weak, nutritional therapy is not used routinely, and governmental policies for nutritional therapy are scarce.

  1. Underweight and malnutrition in home care: A multicenter study.

    Science.gov (United States)

    Lahmann, Nils A; Tannen, Antje; Suhr, Ralf

    2016-10-01

    This study aimed to provide representative figures about the prevalence of underweight and malnutrition among home care clients, and to determine the associated risk factors and the provided nutritional nursing interventions. In 2012, a multicenter point prevalence study was conducted among 878 randomly selected clients from 100 randomly selected home care services across Germany. Following a standardized study protocol, demographics, nutritional assessments (Body Mass Index, Malnutrition Universal Screening Tool (MUST), Mini nutritional Assessment - short form (MNA-sf), nurses' clinical judgment on nutritional status) and interventions were assessed. Common nutritional risk factors for underweight and malnutrition were analyzed in a logistic regression model. Malnutrition figures varied between 4.8% (MNA-sf) and 6.8% (MUST), underweight between 8.7% (BMI malnutrition assessments (MNA-sf 48.8%, MUST 39.1%) due to a lack of information on many clients' loss of weight within the past 3-6 months. Regular weighing was performed in 33.6-57.3% of all clients, depending on weight and nutritional status. Mental overload (OR 8.1/4.4), needs help with feeding (OR 5.0/2.8) and loss of appetite (OR 3.6/3.9) were highly associated with malnutrition/underweight. Malnutrition and underweight are important issues in home care clients. Regular weighing should be performed in all home care clients so that a potential weight loss can be detected in time. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  2. Diagnostic imaging and interventional radiology of hepatocellular carcinoma: A multicenter study on 290 cases

    International Nuclear Information System (INIS)

    Dalla Palma, Ludovico; Puzzi Mucelli, Roberto; Sponza, Massimo; De Santis, Mario; Gandini, Giovanni; Matricardi, Luigi; Rossi, Cristina

    1997-01-01

    The authors report of a multicenter study on the diagnosis and interventional therapy of hepatocellular carcinoma (HCC).The first aim -diagnostic - was to evaluate the sensitivity of 4 imaging techniques, namely ultrasonography (US), Computed Tomography (CT), digital arteriography (DSA) and Lipiodol CT (LCT), in hepatocellular carcinoma detection. The accuracy of these techniques was also investigated in tumor staging, which is important for treatment planning.The second aim - treatment - consisted in assessing the therapeutic efficacy of intraarterial chemoembolization (CEAT) versus percutaneous ethanol injection (PEI) in non advanced hepatocellular carcinoma and of intraarterial chemoembolization versus no treatment (NT) in advanced hepatocellular carcinoma. Treatment efficacy was evaluated with the following randomized protocols

  3. Nitrogen Fertilization for Optimizing the Quality and Yield of Shade Grown Cuban Cigar Tobacco: Required Nitrogen Amounts, Application Schedules, Adequate Leaf Nitrogen Levels, and Early Season Diagnostic Tests

    Directory of Open Access Journals (Sweden)

    Borges A

    2014-12-01

    Full Text Available Nitrogen (N fertilizers have a decisive influence on the yield and quality of tobacco. Yield, percentage of plant N, wrapper leaf quality, and nicotine content are all important quality characteristics in tobacco growing. This work is an attempt to provide a tool for optimizing mineral N nutrition for Cuban cigar tobacco, using a strategy that links N supply with leaf N concentration and wrapper yield. Similar approaches developed worldwide have mainly involved Virginia and Burley tobacco types but not Cuban cigar tobacco. The objective of the current work is to identify the effects of fertilizer N levels and timing of application on each of the mentioned quality factors for shade grown Cuban cigar tobacco. Another purpose is to explore the usefulness of a quick method of assessing the N status of plants based on measuring leaf transmission at two different wavelengths (650 and 940 nm. The experiments were done in the main tobacco growing area of Cuba (Vueltabajo. In each experiment, nine separate treatments were used covering different levels and times of fertilizer N application. The same experiment was carried out in three different years (2005-2006, 2006-2007, 2007-2008 but as the results were similar only one set of data is described (2006-2007. The patterns of response to N fertilizer of all four quality measurements, including yield and wrapper leaf quality, were similar in the different replications of the experiments. The optimal fertilizer level was 140-190 kg N/ha (40% applied on days 8-10 after transplanting and 60% on days 18-20 after transplanting. The optimal N concentration of leaves taken at the central foliar level of the middle stalk position was 4.3-4.7% at harvest time. Leaf transmission measurements by means of the SPAD-502 Chlorophyll Meter in the early stages of growth were correlated with leaf chlorophyll and N concentration and provide an excellent guide for predicting Cuban cigar tobacco wrapper leaf yield.

  4. Burnout syndrome in nurses of Cuban cancer hospitals. Effectiveness of an intervention program. 2004-2009

    International Nuclear Information System (INIS)

    Chacón Roger, Margarita

    2009-01-01

    Studies on Professional Burnout Syndrome (SDP) Nursing identify factors that interact in its development. The objective of this research was to identify the magnitude of the SDP in the nursing staff of Cuban cancer hospitals, identify professional and personal factors involved in the wear process and validate the effectiveness of an intervention program. Three studies using descriptive, analytical and experimental designs were performed. The main results showed that this syndrome is present in 44.0% of subjects; factors were more associated risk: work overload, rotating shift, the 'task characteristics' and 'organization' as well as the excessive time interaction with patients. These factors interacted with academic training, 'extra work' for family care, personal characteristics and overload: high levels of state anxiety, avoidance and escape confrontations and orientations of the least Salutogenic personality. The consequences for the health were associated muscle pain, headaches and colds. The intervention focused on increasing knowledge on job stress and control, their effectiveness was demonstrated by decreased levels of the SDP and its consequences. (author)

  5. Socio-demographic and clinical profiles of paranoid and nonparanoid schizophrenia: a prospective, multicenter study in China.

    Science.gov (United States)

    Xiang, Yu-Tao; Wang, Chuan-Yue; Chiu, Helen F K; Weng, Yong-Zhen; Bo, Qi-Jing; Chan, Sandra S M; Lee, Edwin H M; Ungvari, Gabor S

    2011-07-01

    This study aimed to explore the socio-demographic and clinical characteristics of paranoid and nonparanoid subtypes of schizophrenia. In a multicenter, randomized, controlled, longitudinal study, 374 clinically stable schizophrenia patients were interviewed at entry with standardized assessment instruments and followed for 12-26 months. In the multivariate analysis, male sex, married marital status, urban abode, and more frequent relapse over the study period were independently associated with paranoid schizophrenia. The socio-demographic and clinical characteristics of Chinese patients with the paranoid subtype of schizophrenia are different from those of their Caucasian counterparts who are more likely to be women and have a better outcome. © 2010 Wiley Periodicals, Inc.

  6. Multicenter Study of the Clinical Presentation of Staphylococcus lugdunensis Bacteremia in Japan.

    Science.gov (United States)

    Ainoda, Yusuke; Takeshita, Nozomi; Hase, Ryota; Mikawa, Takahiro; Hosokawa, Naoto; Kawamura, Ichiro; Kurai, Hanako; Abe, Masahiro; Kimura, Muneyoshi; Araoka, Hideki; Fujita, Takahiro; Totsuka, Kyoichi; Mezaki, Kazuhisa; Sekiya, Noritaka; Ohmagari, Norio

    2017-07-24

    Staphylococcus lugdunensis (SL) is a bacterium with a highly pathogenicity than most other coagulase-negative Staphylococcus spp. (CoNS). In Japan, data on this pathogen are sparse, and the current prevalence of SL bacteremia is unknown. Therefore, we investigated the prevalence of SL in blood culture specimens in a prospective multicenter study across 5 facilities. A total of 3,284 patients had positive blood cultures, and 2,478 patients had bacteremia. Among the patients with bacteremia, 7 patients (0.28%) had SL bacteremia. A total of 281 patients had CoNS bacteremia, with SL accounting for 2.49% of these cases. Of the 7 patients with SL bacteremia, 1 patient (14.3%) had infective endocarditis, and 1 patient (14.3%) died within 30 days. In this study, SL resulted in the development of bacteremia in select patients. Clinicians in Japan should be aware of the prevalence of SL and the complications of SL bacteremia.

  7. NHash: Randomized N-Gram Hashing for Distributed Generation of Validatable Unique Study Identifiers in Multicenter Research.

    Science.gov (United States)

    Zhang, Guo-Qiang; Tao, Shiqiang; Xing, Guangming; Mozes, Jeno; Zonjy, Bilal; Lhatoo, Samden D; Cui, Licong

    2015-11-10

    A unique study identifier serves as a key for linking research data about a study subject without revealing protected health information in the identifier. While sufficient for single-site and limited-scale studies, the use of common unique study identifiers has several drawbacks for large multicenter studies, where thousands of research participants may be recruited from multiple sites. An important property of study identifiers is error tolerance (or validatable), in that inadvertent editing mistakes during their transmission and use will most likely result in invalid study identifiers. This paper introduces a novel method called "Randomized N-gram Hashing (NHash)," for generating unique study identifiers in a distributed and validatable fashion, in multicenter research. NHash has a unique set of properties: (1) it is a pseudonym serving the purpose of linking research data about a study participant for research purposes; (2) it can be generated automatically in a completely distributed fashion with virtually no risk for identifier collision; (3) it incorporates a set of cryptographic hash functions based on N-grams, with a combination of additional encryption techniques such as a shift cipher; (d) it is validatable (error tolerant) in the sense that inadvertent edit errors will mostly result in invalid identifiers. NHash consists of 2 phases. First, an intermediate string using randomized N-gram hashing is generated. This string consists of a collection of N-gram hashes f1, f2, ..., fk. The input for each function fi has 3 components: a random number r, an integer n, and input data m. The result, fi(r, n, m), is an n-gram of m with a starting position s, which is computed as (r mod |m|), where |m| represents the length of m. The output for Step 1 is the concatenation of the sequence f1(r1, n1, m1), f2(r2, n2, m2), ..., fk(rk, nk, mk). In the second phase, the intermediate string generated in Phase 1 is encrypted using techniques such as shift cipher. The result

  8. Two-year follow-up of an open-label multicenter study of polyacrylamide hydrogel (Bulkamid®) for female stress and stress-predominant mixed incontinence

    DEFF Research Database (Denmark)

    Toozs-Hobson, Philip; Al-Singary, Waleed; Fynes, Michelle

    2012-01-01

    Polyacrylamide hydrogel (PAHG, Bulkamid®) is a promising urethral bulking agent. This article presents the 2-year follow-up results of a multicenter study of PAHG injections for treating stress and stress-predominant mixed urinary incontinence....

  9. Trump And Obama’s “Cuban Legacy”

    Directory of Open Access Journals (Sweden)

    Kh. Sh. Ulugova

    2017-01-01

    Full Text Available After the triumph of revolution in Cuba in 1959 Washington and Havana have been hostile to each other for more than half a century. Even the end of the Cold War and disintegration of the bipolar international system left intact the antagonism between the two. Only after Barack Obama came to power did normalization become possible. He admitted the failure of the policy of sanctions and declared a “new beginning” in US-Cuba relations. There is a risk now that under the new administration of Donald Trump the efforts made before can be neutralized if the US president keeps his recent pre-election promise and cancels all the previous agreements on normalization. The question remains open – whether Obama’s achievements in this regard will be preserved or Trump will manage to reverse the normalization policy of his predecessor. There will be either pragmatic Trump the businessman who understands the benefits of continuing Obama’s policy, or Trump the politician who will stand firm on his pre-election pledge to roll back on once promising initiative. The article analyzes the process of normalization initiated by Obama and Castro in 2014, explains its background motivations and builds various scenarios of further development of Cuban-American relations, as well as Trump’s policy towards Cuba. It is unlikely that the Trump administration will abandon what has already been achieved. It may entail significant political and economic costs, which is unacceptable for Trump the businessman. However, any new progressive steps towards the normalization should not be expected in the short term.

  10. The more frequent types of human papillomavirus in Cuban samples of cervix cancer

    International Nuclear Information System (INIS)

    Rios Hernandez, Maria de los Angeles; Hernandez Menendez, Maite; Aguilar Vela de Oro, Francisco Orlando

    2010-01-01

    Cervix cancer (UCC) is considered a sexually transmitted disease due to factors involved in its appearance and development and this infection is recognized as the main etiological agent of this entity. In Cuba this type of tumor is placed in 2nd category in incidence and in 4th place in mortality among the malignant disease affecting the female sex. The objective of present study is to determine the types of human virus papilloma (HVP) present in samples of cervix tumors in Cuban women, as well as to describe the behavior of different risk factors associated with this disease. Forty five samples of cervix cancer were analyzed and the presence of 20 types of HVP was determined by polymerase chain reaction with specific primers founding in them a 91,1% of positivity. Genotype 16 was the more prevalent, followed by the 18, 45, 31, 39, 51, 56, 59, PAP23A. The low risk type 6 and 11 weren't founded in samples. Promiscuity was the more interesting risk factor in our study. Knowledge of the viral types present in cervix cancer in our patients is very important when we approach the development and the use of prophylactic and therapeutical vaccines

  11. Integrating a Patient-Controlled Admission Program Into Mental Health Hospital Service: A Multicenter Grounded Theory Study

    DEFF Research Database (Denmark)

    Ellegaard, Trine; Bliksted, Vibeke Fuglsang; Mehlsen, Mimi Yung

    2018-01-01

    Patient-controlled admissions (PCAs) enable mental health patients by means of a contract to initiate an admission at a mental health hospital unit without using traditional admission procedures. This study was part of a 3-year Danish multicenter project, and we explored how mental health...... the mental health professionals strived to integrate PCA into clinical practice. The process was motivated by the idea of establishing a partnership with patients and involved two interrelated strategies to manage (a) the patient-related duties and (b) the admission contracts. The professionals moved from...

  12. Intraorganizational Communication and Job Satisfaction Among Flemish Hospital Nurses: An Exploratory Multicenter Study.

    Science.gov (United States)

    Vermeir, Peter; Downs, Cal; Degroote, Sophie; Vandijck, Dominique; Tobback, Els; Delesie, Liesbeth; Mariman, An; De Veugele, Myriam; Verhaeghe, Rik; Cambré, Bart; Vogelaers, Dirk

    2018-01-01

    Intraorganizational communication affects job satisfaction and turnover. The goal of this study was to explore relationships between communication and job satisfaction, intention to leave, and burnout among Flemish hospital nurses. A multicenter questionnaire study was conducted in three hospitals using the Communication Satisfaction Questionnaire, the Turnover Intention subscale of the Questionnaire on the Experience and Evaluation of Work, and the Maslach Burnout Inventory. A visual analog scale measured job satisfaction. The mean job satisfaction score was 7.49/10 (±1.43). Almost 7% of nurse participants (93/1,355) reported a high intent to leave, and 2.9% of the respondents (41/1,454) had a score indicative of burnout. All dimensions of communication were associated with job satisfaction. A low score on any dimension of communication satisfaction, except "Relationship With Employees," was associated with higher intent to leave and burnout. Study findings support the need for management interventions to enhance efficient communication and ensure high-quality care and patient safety.

  13. Force Projection, the 5th Marine Expeditionary Brigade, and the Planned Amphibious Assault during the 1962 Cuban Missile Crisis

    Science.gov (United States)

    2016-06-10

    was a threat to the peace and safety of the United States.15 Essentially, Monroe had just drawn a line in the sand that the United States intended to...toward Cuba would fluctuate between heavy-handed coercion to a hands-off approach.16 To manage and control Cuba (and protect U.S. interests) while...M. Beer , “The U.S. Navy and the Cuban Missile Crisis” (A Trident Scholar Project, U.S. Naval Academy, Annapolis, MD, 1990), 12. 32 Falcon, 22

  14. LAP-BAND for BMI 30-40: 5-year health outcomes from the multicenter pivotal study.

    Science.gov (United States)

    Dixon, J B; Eaton, L L; Vincent, V; Michaelson, R

    2016-02-01

    We performed a 5-year multicenter study to evaluate the safety and effectiveness of the LAP-BAND System surgery (LBS) in patients with obesity with a body mass index (BMI) of 30-39.9 kg m(-)(2). This pivotal study was designed to support LBS application to the US Food and Drug Administration for broadening the indications for surgery and the lower BMI indication was approved with 1-year data in 2011, with the intention to complete the 5-year evaluation. To present broad health outcome data including weight change, patient reported outcomes, comorbidity change and complications during the 5-year study. The study was conducted at seven US private practice clinical trial sites. We enrolled 149 BMI 30-39.9 subjects into a 5-year, multicenter, longitudinal, prospective post-approval study. Data for those completing each time point are presented. The predefined target of at least 30% excess weight loss was achieved by more than 76% of subjects by 1-year and at every year thereafter during the 5-year study. Mean percentage weight loss at 5 years was 15.9±12.4%. Sustained weight loss was accompanied by sustained improvement in generic and weight-specific quality of life, symptoms of depression and the prevalence of binge-eating disorder. The number of subjects with normal fasting triglyceride, high-density lipoprotein cholesterol, plasma glucose and HbA1c increased significantly between baseline and 5 years. Fifty-four months after LBS implantation, the rate of device explants without replacement was 5.4%; however, the rate of explants increased to 12.1% by month 60 owing to no cost-elective band removals offered to subjects at study exit. No deaths or unanticipated adverse device effects were reported. The LBS is safe and effective for people with BMI 30-39.9 with demonstrated improvements in weight loss, comorbidities and quality of life, and with a low explant rate through 5 years following treatment.

  15. La Naturaleza del Estado Cubano y el Llamado a La Inversion Extranjera: Crisis o Invitacion al Cambio (The Nature of the Cuban State and the Call for Foreign Investment: Crisis or Invitation to Change).

    Science.gov (United States)

    Campbell, Luis E. Hartly

    1995-01-01

    Presents a study of the period of crisis in modern Cuba dating back to 1991. An overview of the Cuban character is given in order to promote understanding of the environment that has permitted the present socialist government to remain in power since 1959. It is concluded that Cuba requires massive foreign investment in every sector for its…

  16. Bronchiectasis diagnosed after renal transplantation: a retrospective multicenter study.

    Science.gov (United States)

    Dury, Sandra; Colosio, Charlotte; Etienne, Isabelle; Anglicheau, Dany; Merieau, Elodie; Caillard, Sophie; Rivalan, Joseph; Thervet, Eric; Essig, Marie; Babinet, François; Subra, Jean-François; Toubas, Olivier; Rieu, Philippe; Launois, Claire; Perotin-Collard, Jeanne-Marie; Lebargy, François; Deslée, Gaëtan

    2015-11-07

    Bronchiectasis is characterized by abnormal, permanent and irreversible dilatation of the bronchi, usually responsible for daily symptoms and frequent respiratory complications. Many causes have been identified, but only limited data are available concerning the association between bronchiectasis and renal transplantation. We conducted a retrospective multicenter study of cases of bronchiectasis diagnosed after renal transplantation in 14 renal transplantation departments (French SPIESSER group). Demographic, clinical, laboratory and CT scan data were collected. Forty-six patients were included (mean age 58.2 years, 52.2 % men). Autosomal dominant polycystic kidney disease (32.6 %) was the main underlying renal disease. Chronic cough and sputum (50.0 %) were the major symptoms leading to chest CT scan. Mean duration of symptoms before diagnosis was 1.5 years [0-12.1 years]. Microorganisms were identified in 22 patients, predominantly Haemophilus influenzae. Hypogammaglobulinemia was observed in 46.9 % patients. Bronchiectasis was usually extensive (84.8 %). The total bronchiectasis score was 7.4 ± 5.5 with a significant gradient from apex to bases. Many patients remained symptomatic (43.5 %) and/or presented recurrent respiratory tract infections (37.0 %) during follow-up. Six deaths (13 %) occurred during follow-up, but none were attributable to bronchiectasis. These results highlight that the diagnosis of bronchiectasis should be considered in patients with de novo respiratory symptoms after renal transplantation. Further studies are needed to more clearly understand the mechanisms underlying bronchiectasis in this setting.

  17. BIOCHEMICAL CONTROL DURING LONG-TERM FOLLOW-UP OF 230 ADULT PATIENTS WITH CUSHING DISEASE: A MULTICENTER RETROSPECTIVE STUDY.

    Science.gov (United States)

    Geer, Eliza B; Shafiq, Ismat; Gordon, Murray B; Bonert, Vivien; Ayala, Alejandro; Swerdloff, Ronald S; Katznelson, Laurence; Lalazar, Yelena; Manuylova, Ekaterina; Pulaski-Liebert, Karen J; Carmichael, John D; Hannoush, Zeina; Surampudi, Vijaya; Broder, Michael S; Cherepanov, Dasha; Eagan, Marianne; Lee, Jackie; Said, Qayyim; Neary, Maureen P; Biller, Beverly M K

    2017-08-01

    Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-term control is not achieved in a substantial number of patients with CD. BLA = bilateral adrenalectomy CD = Cushing disease CS = Cushing syndrome eCRF = electronic case report form MRI = magnetic resonance imaging PCOS = polycystic ovary syndrome.

  18. Multi-Center Electronic Structure Calculations for Plasma Equation of State

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, B G; Johnson, D D; Alam, A

    2010-12-14

    We report on an approach for computing electronic structure utilizing solid-state multi-center scattering techniques, but generalized to finite temperatures to model plasmas. This approach has the advantage of handling mixtures at a fundamental level without the imposition of ad hoc continuum lowering models, and incorporates bonding and charge exchange, as well as multi-center effects in the calculation of the continuum density of states.

  19. A Multicenter Review of Superior Laryngeal Nerve Injury Following Anterior Cervical Spine Surgery.

    Science.gov (United States)

    Tempel, Zachary J; Smith, Justin S; Shaffrey, Christopher; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel; Kanter, Adam S

    2017-04-01

    A retrospective multicenter case-series study; case report and review of the literature. The anatomy and function of the superior laryngeal nerve (SLN) are well described; however, the consequences of SLN injury remain variable and poorly defined. The prevalence of SLN injury as a consequence of cervical spine surgery is difficult to discern as its clinical manifestations are often inconstant and frequently of a subclinical degree. A multicenter study was performed to better delineate the risk factors, prevalence, and outcomes of SLN injury. A retrospective multicenter case-series study involving 21 high-volume surgical centers from the AO Spine North America Clinical Research Network. Medical records for 17 625 patients who received subaxial cervical spine surgery from 2005 to 2011 were reviewed to identify occurrence of 21 predefined treatment complications. Descriptive statistics were provided for baseline patient characteristics. A retrospective review of the neurosurgical literature on SLN injury was also performed. A total of 8887 patients who underwent anterior cervical spine surgery at the participating institutions were screened, and 1 case of SLN palsy was identified. The prevalence ranged from 0% to 1.25% across all centers. The patient identified underwent a C4 corpectomy. The SLN injury was identified after the patient demonstrated difficulty swallowing postoperatively. He underwent placement of a percutaneous gastrostomy tube and his SLN palsy resolved by 6 weeks. This multicenter study demonstrates that identification of SLN injury occurs very infrequently. Symptomatic SLN injury is an exceedingly rare complication of anterior cervical spine surgery. The SLN is particularly vulnerable when exposing the more rostral levels of the cervical spine. Careful dissection and retraction of the longus coli may decrease the risk of SLN injury during anterior cervical surgery.

  20. Definition of Specific Functions and Procedural Skills Required by Cuban Specialists in Intensive Care and Emergency Medicine.

    Science.gov (United States)

    Véliz, Pedro L; Berra, Esperanza M; Jorna, Ana R

    2015-07-01

    INTRODUCTION Medical specialties' core curricula should take into account functions to be carried out, positions to be filled and populations to be served. The functions in the professional profile for specialty training of Cuban intensive care and emergency medicine specialists do not include all the activities that they actually perform in professional practice. OBJECTIVE Define the specific functions and procedural skills required of Cuban specialists in intensive care and emergency medicine. METHODS The study was conducted from April 2011 to September 2013. A three-stage methodological strategy was designed using qualitative techniques. By purposive maximum variation sampling, 82 professionals were selected. Documentary analysis and key informant criteria were used in the first stage. Two expert groups were formed in the second stage: one used various group techniques (focus group, oral and written brainstorming) and the second used a three-round Delphi method. In the final stage, a third group of experts was questioned in semistructured in-depth interviews, and a two-round Delphi method was employed to assess priorities. RESULTS Ultimately, 78 specific functions were defined: 47 (60.3%) patient care, 16 (20.5%) managerial, 6 (7.7%) teaching, and 9 (11.5%) research. Thirty-one procedural skills were identified. The specific functions and procedural skills defined relate to the profession's requirements in clinical care of the critically ill, management of patient services, teaching and research at the specialist's different occupational levels. CONCLUSIONS The specific functions and procedural skills required of intensive care and emergency medicine specialists were precisely identified by a scientific method. This product is key to improving the quality of teaching, research, administration and patient care in this specialty in Cuba. The specific functions and procedural skills identified are theoretical, practical, methodological and social contributions to

  1. CT perfusion-guided patient selection for endovascular recanalization in acute ischemic stroke: a multicenter study.

    Science.gov (United States)

    Turk, Aquilla S; Magarick, Jordan Asher; Frei, Don; Fargen, Kyle Michael; Chaudry, Imran; Holmstedt, Christine A; Nicholas, Joyce; Mocco, J; Turner, Raymond D; Huddle, Daniel; Loy, David; Bellon, Richard; Dooley, Gwendolyn; Adams, Robert; Whaley, Michelle; Fanale, Chris; Jauch, Edward

    2013-11-01

    The treatment of acute ischemic stroke is traditionally centered on time criteria, although recent evidence suggests that physiologic neuroimaging may be useful. In a multicenter study we evaluated the use of CT perfusion, regardless of time from symptom onset, in patients selected for intra-arterial treatment of ischemic stroke. Three medical centers retrospectively assessed stroke patients with a National Institute of Health Stroke Scale of ≥ 8, regardless of time from symptom onset. CT perfusion maps were qualitatively assessed. Patients with defined salvageable penumbra underwent intra-arterial revascularization of their occlusion. Functional outcome using the modified Rankin Score (mRS) was recorded. Two hundred and forty-seven patients were selected to undergo intra-arterial treatment based on CT perfusion imaging. The median time from symptom onset to procedure was 6 h. Patients were divided into two groups for analysis: ≤ 8 h and >8 h from symptom onset to endovascular procedure. We found no difference in functional outcome between the two groups (42.8% and 41.9% achieved 90-day mRS ≤ 2, respectively (p=1.0), and 54.9% vs 55.4% (p=1.0) achieved 90-day mRS ≤ 3, respectively). Overall, 48 patients (19.4%) had hemorrhages, of which 20 (8.0%) were symptomatic, with no difference between the groups (p=1.0). In a multicenter study, we demonstrated similar rates of good functional outcome and intracranial hemorrhage in patients with ischemic stroke when endovascular treatment was performed based on CT perfusion selection rather than time-guided selection. Our findings suggest that physiologic imaging-guided patient selection rather than time for endovascular reperfusion in ischemic stroke may be effective and safe.

  2. RESULTS OF MULTICENTER STUDY OF PIDOTIMOD FOR THE PROPHYLAXIS OF ACUTE RESPIRATORY INFECTIONS IN FREQUENTLY AILING CHILDREN

    Directory of Open Access Journals (Sweden)

    L.S. Namazova-Baranova

    2010-01-01

    Full Text Available The article describes actual pediatric problem — frequent development of respiratory infections in children. Authors present the results of Russian multicenter study of effectiveness and safety of pidotimod (Imunorix in frequently ailing children. It was shown that treatment with pidotimod during 30 days resulted in decreased rate of acute respiratory infections and their complications including ones with necessity of antibacterial therapy compared to children from control group. The dynamics of immunological rates in blood serum was studied.Key words: frequently ailing children, acute respiratory infections, prophylaxis, pidotimod.(Voprosy sovremennoi pediatrii — Current Pediatrics. 2010;9(2:40-44

  3. Cervical Spine Injury: A ten‑year multicenter analysis of evolution of ...

    African Journals Online (AJOL)

    Study Design: Retrospective study. Objective: To describe the evolution of care and risk factors for poor outcome in patients with cervical spine injury (CSI) treated at three centers in southeast Nigeria. Setting: Nigeria, southeast. Materials and Methods: A 10‑year retrospective multicenter analysis of patients with CSI, ...

  4. Investigation of the current situation of massive blood transfusion in different surgical departments: a large multicenter study in China

    OpenAIRE

    Sun, Yang; Jin, Zhan-Kui; Xu, Cui-Xiang; Dang, Qian-Li; Zhang, Li-Jie; Chen, Hong-Nan; Song, Yao-Jun; Yang, Jiang-Cun

    2015-01-01

    Objective: This study aims to learn about the current situation of surgical massive blood transfusion of different surgical departments in China’s Tertiary hospitals, which could provide the basis for the formulation of guidelines on massive blood transfusion. Method: A multicenter retrospective research on the application status of blood constituents during massive blood transfusion was conducted and a comparative analyses of survival and length of hospitalization in patients from different ...

  5. ?I have to live like I?m old.? Young adults? perspectives on managing hypertension: a multi-center qualitative study

    OpenAIRE

    Johnson, Heather M.; Warner, Ryan C.; LaMantia, Jamie N.; Bowers, Barbara J.

    2016-01-01

    Background In the U.S., young adults (18?39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults? unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults?: 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihy...

  6. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

    DEFF Research Database (Denmark)

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories

    2009-01-01

    AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph...... node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver...... study was performed. RESULTS: The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS...

  7. IgM myeloma: A multicenter retrospective study of 134 patients.

    Science.gov (United States)

    Castillo, Jorge J; Jurczyszyn, Artur; Brozova, Lucie; Crusoe, Edvan; Czepiel, Jacek; Davila, Julio; Dispenzieri, Angela; Eveillard, Marion; Fiala, Mark A; Ghobrial, Irene M; Gozzetti, Alessandro; Gustine, Joshua N; Hajek, Roman; Hungria, Vania; Jarkovsky, Jiri; Jayabalan, David; Laubach, Jacob P; Lewicka, Barbara; Maisnar, Vladimir; Manasanch, Elisabet E; Moreau, Philippe; Morgan, Elizabeth A; Nahi, Hareth; Niesvizky, Ruben; Paba-Prada, Claudia; Pika, Tomas; Pour, Ludek; Reagan, John L; Richardson, Paul G; Shah, Jatin; Spicka, Ivan; Vij, Ravi; Waszczuk-Gajda, Anna; Gertz, Morie A

    2017-08-01

    IgM myeloma is a rare hematologic malignancy for which the clinicopathological features and patient outcomes have not been extensively studied. We carried out a multicenter retrospective study in patients with diagnosis of IgM myeloma defined by >10% marrow involvement by monoclonal plasma cells, presence of an IgM monoclonal paraproteinemia of any size, and anemia, renal dysfunction, hypercalcemia, lytic lesions and/or t(11;14) identified by FISH. A total of 134 patients from 20 centers were included in this analysis. The median age at diagnosis was 65.5 years with a male predominance (68%). Anemia, renal dysfunction, elevated calcium and skeletal lytic lesions were found in 37, 43, 19, and 70%, respectively. The median serum IgM level was 2,895 mg dL -1 with 19% of patients presenting with levels >6,000 mg dL -1 . International Staging System (ISS) stages 1, 2, and 3 were seen in 40 (33%), 54 (44%), and 29 (24%) of patients, respectively. The malignant cells expressed CD20 (58%) and cyclin D1 (67%), and t(11;14) was the most common cytogenetic finding (39%). The median overall survival (OS) was 61 months. Higher ISS score was associated with worse survival (P = 0.02). Patients with IgM myeloma present with similar characteristics and outcomes as patients with more common myeloma subtypes. © 2017 Wiley Periodicals, Inc.

  8. Isolated optic nerve gliomas: a multicenter historical cohort study.

    Science.gov (United States)

    Shofty, Ben; Ben-Sira, Liat; Kesler, Anat; Jallo, George; Groves, Mari L; Iyer, Rajiv R; Lassaletta, Alvaro; Tabori, Uri; Bouffet, Eric; Thomale, Ulrich-Wilhelm; Hernáiz Driever, Pablo; Constantini, Shlomi

    2017-12-01

    OBJECTIVE Isolated optic nerve gliomas (IONGs) constitute a rare subgroup of optic pathway gliomas (OPGs). Due to the rarity of this condition and the difficulty in differentiating IONGs from other types of OPGs in most clinical series, little is known about these tumors. Currently, due to lack of evidence, they are managed the same as any other OPG. METHODS The authors conducted a multicenter retrospective cohort study aimed at determining the natural history of IONGs. Included were patients with clear-cut glioma of the optic nerve without posterior (chiasmatic/hypothalamic) involvement. At least 1 year of follow-up, 2 MRI studies, and 2 neuro-ophthalmological examinations were required for inclusion. RESULTS Thirty-six patients with 39 tumors were included in this study. Age at diagnosis ranged between 6 months and 16 years (average 6 years). The mean follow-up time was 5.6 years. Twenty-five patients had neurofibromatosis Type 1. During the follow-up period, 59% of the tumors progressed, 23% remained stable, and 18% (all with neurofibromatosis Type 1) displayed some degree of spontaneous regression. Fifty-one percent of the patients presented with visual decline, of whom 90% experienced further deterioration. Nine patients were treated with chemotherapy, 5 of whom improved visually. Ten patients underwent operation, and no local or distal recurrence was noted. CONCLUSIONS Isolated optic nerve gliomas are highly dynamic tumors. Radiological progression and visual deterioration occur in greater percentages than in the general population of patients with OPGs. Response to chemotherapy may be better in this group, and its use should be considered early in the course of the disease.

  9. Prevalence of genital Chlamydia trachomatis infections in Russia: systematic literature review and multicenter study.

    Science.gov (United States)

    Smelov, Vitaly; Thomas, Pierre; Ouburg, Sander; Morré, Servaas A

    2017-09-29

    A reliable overview of data on the prevalence of Chlamydia trachomatis (CT) in Russia is lacking and needed. All the available data on CT prevalence were analyzed in a systematic literature review on CT prevalence in Russia, strengthened with data from the multicenter study among 1263 people in the second-largest Russian megalopolis, St. Petersburg, testing for CT DNA in urethral, anal, cervical and prostate samples. A total of 10 articles met the inclusion criteria. The overall average prevalence of genital CT infections in Russian populations ranged from 2.9% to 33%. Risk factors included being symptomatic (P = 0.004; in men P Russia should be considered. © FEMS 2017. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Prospective, Multicenter Validation Study of Magnetic Resonance Volumetry for Response Assessment After Preoperative Chemoradiation in Rectal Cancer: Can the Results in the Literature be Reproduced?

    Energy Technology Data Exchange (ETDEWEB)

    Martens, Milou H., E-mail: mh.martens@hotmail.com [Department of Radiology, Maastricht University Medical Center, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht (Netherlands); Heeswijk, Miriam M. van [Department of Radiology, Maastricht University Medical Center, Maastricht (Netherlands); Department of Surgery, Maastricht University Medical Center, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht (Netherlands); Broek, Joris J. van den [Department of Surgery, Medical Center Alkmaar, Alkmaar (Netherlands); Rao, Sheng-Xiang [Department of Radiology, Maastricht University Medical Center, Maastricht (Netherlands); Department of Radiology, Fudan University, Shanghai (China); Vandecaveye, Vincent [Department of Radiology, University Hospital Leuven, Leuven (Belgium); Vliegen, Roy A. [Department of Radiology, Atrium Medical Center, Heerlen (Netherlands); Schreurs, Wilhelmina H. [Department of Surgery, Medical Center Alkmaar, Alkmaar (Netherlands); Beets, Geerard L. [Department of Surgery, Maastricht University Medical Center, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht (Netherlands); Lambregts, Doenja M.J. [Department of Radiology, Maastricht University Medical Center, Maastricht (Netherlands); Beets-Tan, Regina G.H. [Department of Radiology, Maastricht University Medical Center, Maastricht (Netherlands); GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht (Netherlands)

    2015-12-01

    Purpose: To review the available literature on tumor size/volume measurements on magnetic resonance imaging for response assessment after chemoradiotherapy, and validate these cut-offs in an independent multicenter patient cohort. Methods and Materials: The study included 2 parts. (1) Review of the literature: articles were included that assessed the accuracy of tumor size/volume measurements on magnetic resonance imaging for tumor response assessment. Size/volume cut-offs were extracted; (2) Multicenter validation: extracted cut-offs from the literature were tested in a multicenter cohort (n=146). Accuracies were calculated and compared with reported results from the literature. Results: The review included 14 articles, in which 3 different measurement methods were assessed: (1) tumor length; (2) 3-dimensonial tumor size; and (3) whole volume. Study outcomes consisted of (1) complete response (ypT0) versus residual tumor; (2) tumor regression grade 1 to 2 versus 3 to 5; and (3) T-downstaging (ypTmulticenter cohort, best results were obtained for the validation of the whole-volume measurements, in particular for the outcome ypT0 (accuracy 44%-80%), with the optimal cut-offs being 1.6 cm{sup 3} (after chemoradiation therapy) and a volume reduction of Δ80% to 86.6%. Accuracies for whole-volume measurements to assess tumor regression grade 1 to 2 were 52% to 61%, and for T-downstaging 51% to 57%. Overall accuracies for tumor length ranged between 48% and 53% and for 3D size measurement between 52% and 56%. Conclusions: Magnetic resonance volumetry using whole-tumor volume measurements can be helpful in rectal cancer response assessment with selected cut-off values. Measurements of tumor length or 3-dimensional tumor size are not helpful. Magnetic resonance volumetry is mainly accurate to assess a complete tumor response (ypT0) after chemoradiation therapy (accuracies up to 80%).

  11. Validation of standard operating procedures in a multicenter retrospective study to identify -omics biomarkers for chronic low back pain.

    Directory of Open Access Journals (Sweden)

    Concetta Dagostino

    Full Text Available Chronic low back pain (CLBP is one of the most common medical conditions, ranking as the greatest contributor to global disability and accounting for huge societal costs based on the Global Burden of Disease 2010 study. Large genetic and -omics studies provide a promising avenue for the screening, development and validation of biomarkers useful for personalized diagnosis and treatment (precision medicine. Multicentre studies are needed for such an effort, and a standardized and homogeneous approach is vital for recruitment of large numbers of participants among different centres (clinical and laboratories to obtain robust and reproducible results. To date, no validated standard operating procedures (SOPs for genetic/-omics studies in chronic pain have been developed. In this study, we validated an SOP model that will be used in the multicentre (5 centres retrospective "PainOmics" study, funded by the European Community in the 7th Framework Programme, which aims to develop new biomarkers for CLBP through three different -omics approaches: genomics, glycomics and activomics. The SOPs describe the specific procedures for (1 blood collection, (2 sample processing and storage, (3 shipping details and (4 cross-check testing and validation before assays that all the centres involved in the study have to follow. Multivariate analysis revealed the absolute specificity and homogeneity of the samples collected by the five centres for all genetics, glycomics and activomics analyses. The SOPs used in our multicenter study have been validated. Hence, they could represent an innovative tool for the correct management and collection of reliable samples in other large-omics-based multicenter studies.

  12. Ten years of work in Cuban Program to children from areas affected of Chernobyl accidents

    International Nuclear Information System (INIS)

    Garcia, Omar; Medina J, Julio

    2001-01-01

    In April of 2000 the Cuban program for specialised medical attention to children from areas affected by the radioactive contamination from the Chernobyl accident completed 10 years of work. In the program had been assisted more than 18 000 children and adults, among them 50 Brazilians related with the Goiania accident. A group of medical procedures and dosimetric, biomedical and psychological investigations have been carried out in the program. The main significant medical attention activities are the treatment of haematological disorders, among them, 120 leukaemia, the realisation of bone marrow transplants and the treatment of endocrinological and neoplasic illnesses. The dosimetric studies has allowed to create a database that accumulates information about internal contamination for 137Cs, internal, external, and total doses, of 7000 children. The analysis of the behaviour of all the medical information that is generated in the program in function of the contamination of the land and of the internal contamination of the children is also performed. The program has accumulated an experience of interest for physicians, psychologists and radiological emergencies experts.(author)

  13. Oral cancer in the UAE: a multicenter, retrospective study

    Science.gov (United States)

    Anis, Raeefa; Gaballah, Kamis

    2013-01-01

    Aim To determine the prevalence of various malignant oral lesions in the UAE and correlate cases of squamous cell carcinomas with age, gender, site, grade, clinical presentations at the time of diagnosis, and the prevalence of neck metastasis. Materials and methods A multicenter, retrospective study was conducted at four major hospitals in the UAE. The study was based on histopathology reports of biopsies of oral tissues. Results Of the 992 oral biopsy reports retrieved, 147 cases of malignant tumors were found which accounted for 14.9% of the total biopsies. Fifteen different types of malignant lesions were diagnosed, of which oral squamous cell carcinoma (OSCC) was the most prevalent and made up 11.4% of the overall oral biopsies retrieved. The commonest presentation of cancer was ulceration (31.17%), followed by lumps and white lesions. The most common site where the lesions were diagnosed was the tongue (51.9%), followed by the cheeks and lips. OSCC accounted for 77% of all malignancies reported. Neck dissections were conducted in only 20.8% of all OSCC cases diagnosed at Mafraq and Tawam hospitals, of which 43.75% showed evidence of neck metastasis. Conclusion Oral cancer is not an uncommon disease in the UAE. This may mandate more awareness campaigning, including screening procedures for early detection of cancerous lesions and other potentially malignant oral diseases. Elective neck dissections to detect lymph node metastasis should be more routinely performed, in particular for tongue carcinomas because of the early neck involvement potential. PMID:23985381

  14. Improving the family orientation process in Cuban Special Schools trough Nearest Prototype classification

    Directory of Open Access Journals (Sweden)

    Caballero-Mota, Y.

    2013-03-01

    Full Text Available Cuban Schools for children with Affective – Behavioral Maladies (SABM have as goal to accomplish a major change in children behavior, to insert them effectively into society. One of the key elements in this objective is to give an adequate orientation to the children’s families; due to the family is one of the most important educational contexts in which the children will develop their personality. The family orientation process in SABM involves clustering and classification of mixed type data with non-symmetric similarity functions. To improve this process, this paper includes some novel characteristics in clustering and prototype selection. The proposed approach uses a hierarchical clustering based on compact sets, making it suitable for dealing with non-symmetric similarity functions, as well as with mixed and incomplete data. The proposal obtains very good results on the SABM data, and over repository databases.

  15. For a Critique of Transatlantic Mestiza Territoriality: Challenging the Angolan-Cuban Revolutionary Community

    Directory of Open Access Journals (Sweden)

    Magdalena López

    2017-11-01

    Full Text Available This essay presents the transatlantic confluence of two hegemonic cultural traditions; the ideology of mestizaje and lusotropicalismo in the discourses of the Angolan and Cuban socialist regimes. The shared political utopia during the Angolan Civil War envisioned a South-South community, racially homogeneous. In the last part of the essay I review the works Dulces guerreros cubanos (1999 by Norberto Fuentes, Desconfiemos de los amaneceres apacibles (2011 by Emilio Comas Paret, Geração da Utopía (1992 by Pepetela, and Estação das Chuvas (1996 by José Eduardo Agualusa, in order to demonstrate socio-racial conflicts embedded in the leftist armed struggle. These narratives challenge the homogeneity of official discourses about identity that sustained the transatlantic mestiza territoriality. In doing so, they note a historical continuity of inequality and authoritarianism between colonial and postcolonial, between pre-national and revolutionary nation.

  16. Cuban experience with the therapeutic use of adult stem cells

    International Nuclear Information System (INIS)

    Hernandez Ramirez, Porfirio; Alfonso Simon, Amel; Aparicio Suarez, Jose L

    2011-01-01

    The basic and clinical researches carried out during past years on the stem cells and its therapeutic possibilities are at present times, one of the most interesting subjects of the contemporaneous medicine. There are advances in the study and application of adult stem cells showing remarkable advantages on the embryonic ones, since its handling is more simple, economic and they are obtained from the own subject to be treated. For the introduction in Cuba of the regenerative cellular therapy in the Institute of Hematology and Immunology the cellular sources selected were the adult stem cells derived from bone marrow and the mobilized ones to the peripheral blood. To make easy the expansion of treatment to other hospital centers, authors standardized a technique for the mobilization of the hematopoietic stem cells to peripheral blood using a granulocyte colony-stimulating factor (Filgrastim, of national production) developing a simple, economic and more tolerable method for patients. In this way, the cellular therapy has been expanded to 6 Cuban provinces and until April, 2009 562 cases with autologous adult stem cells transplant have been treated, from which the 81.7% to correspond to patients presenting with Angiology diseases with a significant reduction of major amputations. Also, the results have been very promising in the bone lesions and periodontal processes among other diseases treated. The results obtained until now may be considered as a new achievement of revolutionary science and of our national health systems and of science and technique. The method used is an economic and feasible procedure for the institutions with scarce resources

  17. The solar energy photovoltaic one option to the Cuban rural electrification

    Energy Technology Data Exchange (ETDEWEB)

    Alabart, J. A. [Centro de Investigaciones de Energia Solar (CIES), (Cuba); Friedman, D. [ECOSOL (COPEXTELL S. A.), (Cuba); Ramos, R.; Moreira, J.; Batista, I.; Garcia, R.; Rodriguez, M. [Centro de Investigaciones de Energia Solar (CIES), (Cuba)

    1995-12-31

    This paper analyzes the work done in Cuba over the last years in the field of photovoltaic, from its R and D and Industrial capacities to the Rural Electrification Program. Based on this work a Development Program for the PV industry is proposed, which is defected towards the integration of all necessary factors that will ensure a sustainable Rural Electrification Program. This program is divided in 5 main stages: 1. Import of solar cells and other elements for the assembly in Cuba of modules and diverse system components (1995-2005). 2. Production of solar cells from imported wafers (1997-2005). 3. Production of monocrystalline silicon wafers from imported plycrystalline silicon (1998-2005). 4. Production of polycrystalline silicon from Cuban silica sand (2000-2005). 5. Development and introduction of new technologies for the production of solar cells (2000-2005). The combination of the PV Development program and the Rural Electrification program will guarantee the supply of electricity to 100% of the Cuban population, and at same time accelerate the technological, industrial and research infrastructure on which a large scale national PV industry would be supported. The implementation of such a program would also make cost on the National Electrical Grid (NEG), avoiding the need for new generation facilities based on fossil fuels. [Espanol] Este articulo analiza el trabajo hecho en Cuba durante los ultimos anos en el campo de los fotovoltaicos, desde su Investigacion y Desarrollo y capacidades Industriales, hasta el Programa de Electrificacion Rural. Basado en este trabajo se propone un Programa de Desarrollo para la industria de PV que esta dirigido hacia la integracion de todos los factores necesarios que aseguraran un Programa de Electrificacion sostenido. Este programa esta dividido en 5 principales etapas: 1. Importacion de celdas solares y otros elementos para el ensamblado en Cuba de modulos y diversos componentes del sistema (1995-2005); 2. Produccion de

  18. The solar energy photovoltaic one option to the Cuban rural electrification

    Energy Technology Data Exchange (ETDEWEB)

    Alabart, J A [Centro de Investigaciones de Energia Solar (CIES), (Cuba); Friedman, D [ECOSOL (COPEXTELL S. A.), (Cuba); Ramos, R; Moreira, J; Batista, I; Garcia, R; Rodriguez, M [Centro de Investigaciones de Energia Solar (CIES), (Cuba)

    1996-12-31

    This paper analyzes the work done in Cuba over the last years in the field of photovoltaic, from its R and D and Industrial capacities to the Rural Electrification Program. Based on this work a Development Program for the PV industry is proposed, which is defected towards the integration of all necessary factors that will ensure a sustainable Rural Electrification Program. This program is divided in 5 main stages: 1. Import of solar cells and other elements for the assembly in Cuba of modules and diverse system components (1995-2005). 2. Production of solar cells from imported wafers (1997-2005). 3. Production of monocrystalline silicon wafers from imported plycrystalline silicon (1998-2005). 4. Production of polycrystalline silicon from Cuban silica sand (2000-2005). 5. Development and introduction of new technologies for the production of solar cells (2000-2005). The combination of the PV Development program and the Rural Electrification program will guarantee the supply of electricity to 100% of the Cuban population, and at same time accelerate the technological, industrial and research infrastructure on which a large scale national PV industry would be supported. The implementation of such a program would also make cost on the National Electrical Grid (NEG), avoiding the need for new generation facilities based on fossil fuels. [Espanol] Este articulo analiza el trabajo hecho en Cuba durante los ultimos anos en el campo de los fotovoltaicos, desde su Investigacion y Desarrollo y capacidades Industriales, hasta el Programa de Electrificacion Rural. Basado en este trabajo se propone un Programa de Desarrollo para la industria de PV que esta dirigido hacia la integracion de todos los factores necesarios que aseguraran un Programa de Electrificacion sostenido. Este programa esta dividido en 5 principales etapas: 1. Importacion de celdas solares y otros elementos para el ensamblado en Cuba de modulos y diversos componentes del sistema (1995-2005); 2. Produccion de

  19. Cuban experience in verification of the execution of the safety requirements during the transport of radioactive materials

    International Nuclear Information System (INIS)

    Quevedo Garcia, J.R.; Lopez Forteza, Y.

    2001-01-01

    The Cuban Regulatory Authority has paid special attention to the verification of the execution of the safety requirements during the transport of radioactive material in the country. With this purpose, the Authority has followed a consequent policy based on supplementary demands to those collections in the juridical mark settled down in 1987 in the sphere of transport of radioactive substances. In the work the technical approaches are exposed kept in mind when establishing the one referred politics, the current situation is characterized, the results are evaluated obtained in correspondence with the pursued objectives and the essential aspects are exposed to keep in mind for the adopted politics ulterior development. (author)

  20. Establishment of an Italian chronic migraine database: a multicenter pilot study.

    Science.gov (United States)

    Barbanti, Piero; Fofi, L; Cevoli, S; Torelli, P; Aurilia, C; Egeo, G; Grazzi, L; D'Amico, D; Manzoni, G C; Cortelli, P; Infarinato, F; Vanacore, N

    2018-05-01

    To optimize chronic migraine (CM) ascertainment and phenotype definition, provide adequate clinical management and health care procedures, and rationalize economic resources allocation, we performed an exploratory multicenter pilot study aimed at establishing a CM database, the first step for developing a future Italian CM registry. We enrolled 63 consecutive CM patients in four tertiary headache centers screened with face-to-face interviews using an ad hoc dedicated semi-structured questionnaire gathering detailed information on life-style, behavioral and socio-demographic factors, comorbidities, and migraine features before and after chronicization and healthcare resource use. Our pilot study provided useful insights revealing that CM patients (1) presented in most cases symptoms of peripheral trigeminal sensitization, a relatively unexpected feature which could be useful to unravel different CM endophenotypes and to predict trigeminal-targeted treatments' responsiveness; (2) had been frequently admitted to emergency departments; (3) had undergone, sometime repeatedly, unnecessary or inappropriate investigations; (4) got rarely illness benefit exemption or disability allowance only. We deem that the expansion of the database-shortly including many other Italian headache centers-will contribute to more precisely outline CM endophenotypes, hence improving management, treatment, and economic resource allocation, ultimately reducing CM burden on both patients and health system.

  1. Nationwide, Multicenter, Retrospective Study on High-Dose-Rate Brachytherapy as Monotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Yoshioka, Yasuo; Kotsuma, Tadayuki; Komiya, Akira; Kariya, Shinji; Konishi, Koji; Nonomura, Norio; Ogawa, Kazuhiko; Tanaka, Eiichi; Nishimura, Kensaku; Fujiuchi, Yasuyoshi; Kitamura, Hiroshi; Yamagami, Takuji; Yamasaki, Ichiro; Nishimura, Kazuo; Teshima, Teruki; Nakamura, Katsumasa; Itami, Jun

    2017-01-01

    Purpose: To present, analyze, and discuss results of a nationwide, multicenter, retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for low-, intermediate-, and high-risk prostate cancer. Methods and Materials: From 1995 through 2013, 524 patients, 73 (14%) with low-risk, 207 (40%) with intermediate-risk, and 244 (47%) with high-risk prostate cancer, were treated with HDR-BT as monotherapy at 5 institutions in Japan. Dose fractionations were 27 Gy/2 fractions for 69 patients (13%), 45.5 Gy/7 fractions for 168 (32%), 49 Gy/7 fractions for 149 (28%), 54 Gy/9 fractions for 130 (25%), and others for 8 (2%). Of these patients, 156 (30%) did not receive androgen deprivation therapy, and 202 patients (39%) did receive androgen deprivation therapy 3 years. Median follow-up time was 5.9 years (range, 0.4-18.1 years), with a minimum of 2 years for surviving patients. Results: After 5 years, respective actuarial rates of no biochemical evidence of disease, overall survival, cause-specific survival, and metastasis-free survival for all patients were 92%, 97%, 99%, and 94%. For low/intermediate/high-risk patients, the 5-year no biochemical evidence of disease rates were 95%/94%/89%, the 5-year overall survival rates were 98%/98%/94%, the 5-year cause-specific survival rates were 98%/100%/98%, and the 5-year metastasis-free survival rates were 98%/95%/90%, respectively. The cumulative incidence of late grade 2 to 3 genitourinary toxicity at 5 years was 19%, and that of late grade 3 was 1%. The corresponding incidences of gastrointestinal toxicity were 3% and 0% (0.2%). No grade 4 or 5 of either type of toxicity was detected. Conclusions: The findings of this nationwide, multicenter, retrospective study demonstrate that HDR-BT as monotherapy was safe and effective for all patients with low-, intermediate-, and high-risk prostate cancer.

  2. Nationwide, Multicenter, Retrospective Study on High-Dose-Rate Brachytherapy as Monotherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yasuo, E-mail: yoshioka@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Kotsuma, Tadayuki [Department of Radiation Oncology, Osaka National Hospital, Osaka (Japan); Komiya, Akira [Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama (Japan); Department of Urology, Chiba University Hospital, Chiba (Japan); Kariya, Shinji [Department of Radiology, Kochi Medical School, Kochi (Japan); Konishi, Koji [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Nonomura, Norio [Department of Urology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Tanaka, Eiichi [Department of Radiation Oncology, Osaka National Hospital, Osaka (Japan); Nishimura, Kensaku [Department of Urology, Osaka National Hospital, Osaka (Japan); Fujiuchi, Yasuyoshi; Kitamura, Hiroshi [Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama (Japan); Yamagami, Takuji [Department of Radiology, Kochi Medical School, Kochi (Japan); Yamasaki, Ichiro [Department of Urology, Kochi Medical School, Kochi (Japan); Nishimura, Kazuo [Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Teshima, Teruki [Department of Radiation Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka (Japan); Nakamura, Katsumasa [Department of Radiation Oncology, Hamamatsu University School of Medicine, Shizuoka (Japan); Itami, Jun [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan)

    2017-04-01

    Purpose: To present, analyze, and discuss results of a nationwide, multicenter, retrospective study on high-dose-rate brachytherapy (HDR-BT) as monotherapy for low-, intermediate-, and high-risk prostate cancer. Methods and Materials: From 1995 through 2013, 524 patients, 73 (14%) with low-risk, 207 (40%) with intermediate-risk, and 244 (47%) with high-risk prostate cancer, were treated with HDR-BT as monotherapy at 5 institutions in Japan. Dose fractionations were 27 Gy/2 fractions for 69 patients (13%), 45.5 Gy/7 fractions for 168 (32%), 49 Gy/7 fractions for 149 (28%), 54 Gy/9 fractions for 130 (25%), and others for 8 (2%). Of these patients, 156 (30%) did not receive androgen deprivation therapy, and 202 patients (39%) did receive androgen deprivation therapy <1 year, 112 (21%) for 1-3 years, and 54 (10%) for >3 years. Median follow-up time was 5.9 years (range, 0.4-18.1 years), with a minimum of 2 years for surviving patients. Results: After 5 years, respective actuarial rates of no biochemical evidence of disease, overall survival, cause-specific survival, and metastasis-free survival for all patients were 92%, 97%, 99%, and 94%. For low/intermediate/high-risk patients, the 5-year no biochemical evidence of disease rates were 95%/94%/89%, the 5-year overall survival rates were 98%/98%/94%, the 5-year cause-specific survival rates were 98%/100%/98%, and the 5-year metastasis-free survival rates were 98%/95%/90%, respectively. The cumulative incidence of late grade 2 to 3 genitourinary toxicity at 5 years was 19%, and that of late grade 3 was 1%. The corresponding incidences of gastrointestinal toxicity were 3% and 0% (0.2%). No grade 4 or 5 of either type of toxicity was detected. Conclusions: The findings of this nationwide, multicenter, retrospective study demonstrate that HDR-BT as monotherapy was safe and effective for all patients with low-, intermediate-, and high-risk prostate cancer.

  3. Colorectal Cancer and Long-Term Exposure to Trihalomethanes in Drinking Water: A Multicenter Case-Control Study in Spain and Italy

    OpenAIRE

    Villanueva, Cristina M.; Gracia-Lavedan, Esther; Bosetti, Cristina; Righi, Elena; Molina, Antonio José; Martín, Vicente; Boldo, Elena; Aragonés, Nuria; Pérez Gómez, Beatriz; Pollán, Marina; Gómez Acebo, Inés; Altzibar, Jone M.; Jiménez Zabala, Ana; Ardanaz, Eva; Peiró, Rosana

    2016-01-01

    Background: Evidence on the association between colorectal cancer and exposure to disinfection by-products in drinking water is inconsistent. Objectives: We assessed long-term exposure to trihalomethanes (THMs), the most prevalent group of chlorination by-products, to evaluate the association with colorectal cancer. Methods: A multicenter case?control study was conducted in Spain and Italy in 2008?2013. Hospital-based incident cases and population-based (Spain) and hospital-based (Italy) cont...

  4. Caracterización de los estudios de utilización de medicamentos publicados en revistas médicas cubanas, 1990-2003 Characterization of the studies of drug use published in Cuban medical journals, 1990-2003

    Directory of Open Access Journals (Sweden)

    Juan Antonio Furones Mourelle

    2006-04-01

    and characterize the studies of drug use that have been published in Cuban medical journals from 1990 to 2003. The universe of study was all those studies published in Cuban medical journals from the Editorial de Ciencias Médicas . The main variables characterizing these studies such as specialization of the main author, province and level of care where the study was conducted, type of study, pharmacological group and data source were described. Numbers and percents were the summary measures used. Results: 785 numbers of medical journals were reviewed in which only 31 related articles were found, and an increased publication was observed from the year 2000 on. Physicians were the main researchers (80,6% and the primary healthcare (67,7% represented the most used medical care level. Surveys (58,1% were the most used information source. Most of them were prescription-indication studies (48,4% and the most studied pharmacological group was the anti-infection drugs (29%. Conclusions: The publication of studies of drug use is poor in the Cuban medical journals, which may reflect a lower production of this kind of research

  5. Multicenter retrospective study of cetuximab plus platinum-based chemotherapy for recurrent or metastatic oral squamous cell carcinoma.

    Science.gov (United States)

    Yanamoto, Souichi; Umeda, Masahiro; Kioi, Mitomu; Kirita, Tadaaki; Yamashita, Tetsuro; Hiratsuka, Hiroyoshi; Yokoo, Satoshi; Tanzawa, Hideki; Uzawa, Narikazu; Shibahara, Takahiko; Ota, Yoshihide; Kurita, Hiroshi; Okura, Masaya; Hamakawa, Hiroyuki; Kusukawa, Jingo; Tohnai, Iwai

    2018-03-01

    The purpose of this study was to assess the efficacy and safety of cetuximab plus platinum-based chemotherapy for patients specifically diagnosed with recurrent or metastatic oral squamous cell carcinoma (OSCC). We conducted a multicenter retrospective observational study of patients who underwent first-line cetuximab plus platinum-based chemotherapy between December 2012 and June 2015. 65 patients received weekly cetuximab (week 1, 400 mg/m 2 ; subsequent weeks, 250 mg/m 2 ) plus a maximum of six 3-weekly cycles of cisplatin (80 or 100 mg/m 2 , day 1) or carboplatin (at an area under the curve of 5 mg/mL/min as a 1-h intravenous infusion on day 1) and 5-fluorouracil (800 or 1000 mg/m 2 /day, days 1-4). Patients with stable disease who received cetuximab plus platinum-based chemotherapy continued to receive cetuximab until disease progression or unacceptable toxicities, whichever occurred first. The median follow-up was 10.5 (range 1.2-34.2) months. The best overall response and the disease control rates were 46.2 and 67.7%, respectively. The median overall survival and progression-free survival rates were 12.1 and 7.8 months, respectively. The most common grades 3-4 adverse events were skin rash (9.2%) followed by leukopenia (6.2%). None of the adverse events were fatal. The results of our multicenter retrospective study, which was the largest of its kind to date, suggest that first-line cetuximab plus platinum-based chemotherapy is suitable and well-tolerated for the systemic therapy of recurrent or metastatic OSCC.

  6. ‘We feel stupid and we shouldn’t.’ Towards developing a communication support system for Cuban-trained medical students

    Directory of Open Access Journals (Sweden)

    Gasiorek, Jessica

    2014-12-01

    Full Text Available This article presents a case study of a small group of South African medical students who have returned to South Africa after six years of medical education in Cuba, where they were trained in a different language (Spanish and medical system (Cuban from what they will ultimately practice in as South African doctors. This study sought to better understand the linguistic, cultural, and communicative challenges that this group faced upon returning to South Africa, with the ultimate goal of creating materials to support the students’ language learning in the clinical domain. The researchers found that students reported considerable difficulties with (re-integrating into South African culture and clinical contexts; specific issues included encountering different types of medical issues in South Africa compared to Cuba and difficulty in understanding and using medical terminology in English and Afrikaans. This case study concludes with specific recommendations for developing learning materials that address these students’ unique linguistic and communicative needs.

  7. Divorce and Severity of Coronary Artery Disease: A Multicenter Study

    Directory of Open Access Journals (Sweden)

    Amin Daoulah

    2017-01-01

    Full Text Available The association between marital status and coronary artery disease (CAD is supported by numerous epidemiological studies. While divorce may have an adverse effect on cardiac outcomes, the relationship between divorce and severe CAD is unclear. We conducted a multicenter, observational study of consecutive patients undergoing coronary angiography during the period between April 1, 2013, and March 30, 2014. Of 1,068 patients, 124 (12% were divorced. Divorce was more frequent among women (27% compared to men (6%. Most divorced patients had been divorced only once (49%, but a subset had been divorced 2 (38% or ≥3 (12% times. After adjusting for baseline differences, there was no significant association between divorce and severe CAD in men. In women, there was a significant adjusted association between divorce and severe MVD (OR 2.31 [1.16, 4.59] or LMD (OR 5.91 [2.19, 15.99]. The modification of the association between divorce and severe CAD by gender was statistically significant for severe LMD (Pinteraction 0.0008 and marginally significant for CAD (Pinteraction 0.05. Among women, there was a significant adjusted association between number of divorces and severe CAD (OR 2.4 [95% CI 1.2, 4.5], MVD (OR 2.0 [95% CI 1.4, 3.0], and LMD (OR 3.4 [95% CI 1.9, 5.9]. In conclusion, divorce, particularly multiple divorces, is associated with severe CAD, MVD, and LMD in women but not in men.

  8. Multicenter observational prehospital resuscitation on helicopter study.

    Science.gov (United States)

    Holcomb, John B; Swartz, Michael D; DeSantis, Stacia M; Greene, Thomas J; Fox, Erin E; Stein, Deborah M; Bulger, Eileen M; Kerby, Jeffrey D; Goodman, Michael; Schreiber, Martin A; Zielinski, Martin D; O'Keeffe, Terence; Inaba, Kenji; Tomasek, Jeffrey S; Podbielski, Jeanette M; Appana, Savitri N; Yi, Misung; Wade, Charles E

    2017-07-01

    at any time point, although only 10% of the high-risk sample were able to be matched. Because of the unexpected imbalance in systolic blood pressure, Glasgow Coma Scale, and Injury Severity Score between systems with and without blood products on helicopters, matching was limited, and the results of this study are inconclusive. With few units transfused to each patient and small outcome differences between groups, it is likely large, multicenter, randomized studies will be required to detect survival differences in this important population. Level II.

  9. Antecedentes de la formación investigativa del psicólogo en Cuba / Antecedents of Cuban psychologist research training

    Directory of Open Access Journals (Sweden)

    Parra, Yanet

    2016-04-01

    Full Text Available El artículo presenta resultados parciales de una investigación sobre la formación de la competencia investigativa desde el dominio de recursos metodológicos cualitativos. El objetivo fue hacer un acercamiento a la comprensión del proceso de atención al componente investigativo en la formación del profesional de la psicología en Cuba. A partir del empleo de métodos teóricos se realiza un análisis del componente investigativo del proceso de formación del profesional que tomó como indicadores fundamentales el nivel de relevancia de la formación científica en el proceso de formación, la metodología que prevalece y el manejo de enfoques metodológicos de investigación. Los resultados principalesdescriben la significación otorgada al componente investigativo y los principales enfoques metodológicos asumidos. Palabras clave: , , . ABSTRACT The paper is an account of partial results of a research on the training of inquiring competence from the perspective of qualitative methodological resources. The research was aimed at making an initial approach to the understanding the education of Cuban psychologist as researchers. Several theoretical methods were used to reveal the main trends on the basis of the following indicators: relevance of scientific training in Cuban psychologist, prevailing methodology and research approach. The findings account for the significance given to the research component and the main approach they have been followed at different stages.

  10. [Immunodiagnosis of endemic mycoses and bronchopulmonary aspergillosis: a multicenter study in Argentina].

    Science.gov (United States)

    Canteros, C E; Rivas, M C; Soria, M; Lee, W; Perrotta, D; Rodero, L; Davel, G

    2004-01-01

    In order to contribute to the knowledge of the relative frequency of chronic fungal diseases and assess the performance of diagnostic laboratories in Argentina, a multicenter study was performed with the participation of 25 medical centers located in 12 different provinces and Buenos Aires City. Between 04-01-2000 and 03-30-2001, 965 serum specimens from patients clinically suspected of having histoplasmosis (HP), paracoccidioidomycosis (PCM), coccidioidomycosis (CM) or aspergilosis were analyzed. Agar immunodiffusion tests (IDD) were done locally. All positive and 35% of negative sera were retested in the reference center. Results of laboratories of origin showed 98.8% concordance with those of reference center. Antibodies against any of the etiological agents were detected in 120 specimens from 98 patients. Endemic mycoses (HP, PCM and CM) were diagnosed in 70 patients (71.4%) and aspergilosis in 28 (28.6%). The frequencies of the different mycoses in decreasing order were PCM 47 patients (47.9%), aspergilosis 28 patients (28.6%), HP 13 patients (13.3%) and CM 10 patients (10.2%). The study was carried out on a voluntary basis and some areas of the country were not represented. However, the frequencies were in range with the expected rates in the population under study.

  11. Study protocol of the B-CAST study: a multicenter, prospective cohort study investigating the tumor biomarkers in adjuvant chemotherapy for stage III colon cancer

    International Nuclear Information System (INIS)

    Ishiguro, Megumi; Mori, Masaki; Kakeji, Yoshihiro; Kanazawa, Akiyoshi; Kobayashi, Michiya; Okajima, Masazumi; Hyodo, Ichinosuke; Miyakoda, Keiko; Sugihara, Kenichi; Kotake, Kenjiro; Nishimura, Genichi; Tomita, Naohiro; Ichikawa, Wataru; Takahashi, Keiichi; Watanabe, Toshiaki; Furuhata, Tomohisa; Kondo, Ken

    2013-01-01

    Adjuvant chemotherapy for stage III colon cancer is internationally accepted as standard treatment with established efficacy. Several oral fluorouracil (5-FU) derivatives with different properties are available in Japan, but which drug is the most appropriate for each patient has not been established. Although efficacy prediction of 5-FU derivatives using expression of 5-FU activation/metabolism enzymes in tumors has been studied, it has not been clinically applied. The B-CAST study is a multicenter, prospective cohort study aimed to identify the patients who benefit from adjuvant chemotherapy with each 5-FU regimen, through evaluating the relationship between tumor biomarker expression and treatment outcome. The frozen tumor specimens of patients with stage III colon cancer who receives postoperative adjuvant chemotherapy are examined. Protein expression of thymidine phosphorylase (TP), dihydropyrimidine dehydrogenase (DPD), epidermal growth factor receptor (EGFR), and vascular endothelial growth factor (VEGF) are evaluated using enzyme-linked immunosorbent assay (ELISA). mRNA expression of TP, DPD, thymidylate synthase (TS) and orotate phosphoribosyl transferase (OPRT) are evaluated using reverse transcription polymerase chain reaction (RT-PCR). The patients’ clinical data reviewed are as follow: demographic and pathological characteristics, regimen, drug doses and treatment duration of adjuvant therapy, types and severity of adverse events, disease free survival, relapse free survival and overall survival. Then, relationships among the protein/mRNA expression, clinicopathological characteristics and the treatment outcomes are analyzed for each 5-FU derivative. A total of 2,128 patients from the 217 institutions were enrolled between April 2009 and March 2012. The B-CAST study demonstrated that large-scale, multicenter translational research using frozen samples was feasible when the sample shipment and Web-based data collection were well organized. The results

  12. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    OpenAIRE

    Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2010-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

  13. Interreader agreement in the assessment of magnetic resonance images of rheumatoid arthritis wrist and finger joints--an international multicenter study

    DEFF Research Database (Denmark)

    Østergaard, Mikkel; Klarlund, Mette; Lassere, M

    2001-01-01

    and iv Gd (Techniques A and C), these rates were 86% (synovitis) and 97% (bone lesions). Corresponding intraclass correlation coefficients (quadratic weighted kappas) were 0.44-0.68, mean 0.58 (synovitis), and 0.44-0.69, mean 0.62 (bone lesion), i.e., in the moderate to good range. Unweighted kappa...... values were in the low to moderate range, generally lowest for JSN (... in assessing synovitis and bone destruction in RA multicenter studies....

  14. Management system for the control of the Educative Project in the Higher Cuban Education

    Directory of Open Access Journals (Sweden)

    Lionel Rodolfo Baquero Hernández

    2016-06-01

    Full Text Available As part of the training of Cuban university students involved educational project that requires proper control of compliance. At the University of Information Science, is done through a digital model developed by the professor of the group which generates poor control and directly undermines the quality of the process. In this work the solution to the problem as basis of computerization, using OpenUP development methodology, programming language Java Script on the NetBeans platform version 8.0 as Integrated Development Environment, with ExtJS 3.4 framework is detailed, with version 8.0 of the Software Engineering tools Computer Assisted Visual Paradigm for modeling and PostgreSQL 9.3 as a management system database. The system also generates the associated compliance status of the activities that make up the educational project of a group, which facilitates the control and decision making reports.

  15. Pharmacokinetics and pharmacodynamics of medication in asphyxiated newborns during controlled hypothermia. The PharmaCool multicenter study

    Directory of Open Access Journals (Sweden)

    de Haan Timo R

    2012-05-01

    Full Text Available Abstract Background In the Netherlands, perinatal asphyxia (severe perinatal oxygen shortage necessitating newborn resuscitation occurs in at least 200 of the 180–185.000 newly born infants per year. International randomized controlled trials have demonstrated an improved neurological outcome with therapeutic hypothermia. During hypothermia neonates receive sedative, analgesic, anti-epileptic and antibiotic drugs. So far little information is available how the pharmacokinetics (PK and pharmacodynamics (PD of these drugs are influenced by post resuscitation multi organ failure and the metabolic effects of the cooling treatment itself. As a result, evidence based dosing guidelines are lacking. This multicenter observational cohort study was designed to answer the question how hypothermia influences the distribution, metabolism and elimination of commonly used drugs in neonatal intensive care. Methods/Design Multicenter cohort study. All term neonates treated with hypothermia for Hypoxic Ischemic Encephalopathy (HIE resulting from perinatal asphyxia in all ten Dutch Neonatal Intensive Care Units (NICUs will be eligible for this study. During hypothermia and rewarming blood samples will be taken from indwelling catheters to investigate blood concentrations of several antibiotics, analgesics, sedatives and anti-epileptic drugs. For each individual drug the population PK will be characterized using Nonlinear Mixed Effects Modelling (NONMEM. It will be investigated how clearance and volume of distribution are influenced by hypothermia also taking maturation of neonate into account. Similarly, integrated PK-PD models will be developed relating the time course of drug concentration to pharmacodynamic parameters such as successful seizure treatment; pain assessment and infection clearance. Discussion On basis of the derived population PK-PD models dosing guidelines will be developed for the application of drugs during neonatal hypothermia treatment. The

  16. Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Fairchild, Alysa, E-mail: alysa.fairchild@albertahealthservices.ca [Department of Radiation Oncology, Cross Cancer Institute, Edmonton, Alberta (Canada); Straube, William [Advanced Technology Consortium, Imaged-Guided Therapy QA Center, St. Louis, Missouri (United States); Laurie, Fran [Quality Assurance Review Center, Lincoln, Rhode Island (United States); Followill, David [Radiological Physics Center, University of Texas MD Anderson Cancer Centre, Houston, Texas (United States)

    2013-10-01

    Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question.

  17. Does Quality of Radiation Therapy Predict Outcomes of Multicenter Cooperative Group Trials? A Literature Review

    International Nuclear Information System (INIS)

    Fairchild, Alysa; Straube, William; Laurie, Fran; Followill, David

    2013-01-01

    Central review of radiation therapy (RT) delivery within multicenter clinical trials was initiated in the early 1970s in the United States. Early quality assurance publications often focused on metrics related to process, logistics, and timing. Our objective was to review the available evidence supporting correlation of RT quality with clinical outcomes within cooperative group trials. A MEDLINE search was performed to identify multicenter studies that described central subjective assessment of RT protocol compliance (quality). Data abstracted included method of central review, definition of deviations, and clinical outcomes. Seventeen multicenter studies (1980-2012) were identified, plus one Patterns of Care Study. Disease sites were hematologic, head and neck, lung, breast, and pancreas. Between 0 and 97% of treatment plans received an overall grade of acceptable. In 7 trials, failure rates were significantly higher after inadequate versus adequate RT. Five of 9 and 2 of 5 trials reported significantly worse overall and progression-free survival after poor-quality RT, respectively. One reported a significant correlation, and 2 reported nonsignificant trends toward increased toxicity with noncompliant RT. Although more data are required, protocol-compliant RT may decrease failure rates and increase overall survival and likely contributes to the ability of collected data to answer the central trial question

  18. A multi-center study on the attitudes of Malaysian emergency health care staff towards allowing family presence during resuscitation of adult patients

    OpenAIRE

    Sheng, Chew Keng; Lim, Chee Kean; Rashidi, Ahmad

    2010-01-01

    Abstracts Background The practice of allowing family members to witness on-going active resuscitation has been gaining ground in many developed countries since it was first introduced in the early 1990s. In many Asian countries, the acceptability of this practice has not been well studied. Aim We conducted a multi-center questionnaire study to determine the attitudes of health care professionals in Malaysia towards family presence to witness ongoing medical procedures during resuscitation. Me...

  19. The Anti-Osteoporotic Drug Preferences of Physiatrists: A Multicenter Descriptive Study

    Directory of Open Access Journals (Sweden)

    Yeşim Gökçe Kutsal

    2012-08-01

    Full Text Available Aim: The purpose of this multicenter descriptive study is to determine the preferences of physiatrists in our country for anti-osteoporotic drugs in patients with primary and secondary osteoporosis. Materials and Methods: This study was carried out in 10 provinces of Turkey. The diagnosis of osteoporosis was based on World Health Organization criteria using dual-energy x-ray absorptiometry. Patients with a spine and/or hip T-score ≤-2.5 were considered as osteoporotic. 714 patients over 18 years old with primary or secondary osteoporosis were included in the study. In addition to socio-demographic characteristics and chronic use of medications and/or additional systemic diseases that cause secondary osteoporosis were questioned and antiosteoporotic drugs that are recommended by their physicians were recorded.Results: The physicians’ preferred vitamin D and calcium as the prior treatment both in primary and secondary osteoporosis. The most commonly used anti-osteoporotic agent was alendronate from the biphosphonate group. It was followed by ibandronate, risedronate, strontium ranelate, calcitonin, zoledronate, raloxifene, parathyroid hormone (PTH and hormone replacement therapy (HRT in the primary osteoporosis and risedronate, ibandronate, calcitonin, strontium ranelate, zoledronate, PTH, HRT and raloxifene in the secondary osteoporosis, respectively. Conclusion: The physician should choose the most suitable treatment for the patient based on fracture risk, medical history, previous treatments for osteoporosis, concomitant diseases, treatment-induced risks and benefits, and the relation between financial cost and potential benefit. (Turkish Journal of Osteoporosis 2012;18: 42-6

  20. Predicting behavioral variant frontotemporal dementia with pattern classification in multi-center structural MRI data

    Directory of Open Access Journals (Sweden)

    Sebastian Meyer

    2017-01-01

    Conclusion: Our study demonstrates that MRI, a widespread imaging technology, can individually identify bvFTD with high accuracy in multi-center imaging data, paving the road to personalized diagnostic approaches in the future.

  1. Therapy response evaluation of malignant lymphoma in a multicenter study. Comparison of manual and semiautomatic measurements in CT

    International Nuclear Information System (INIS)

    Wessling, J.; Schuelke, C.; Koch, R.

    2014-01-01

    Purpose: Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach. (orig.)

  2. Therapy response evaluation of malignant lymphoma in a multicenter study. Comparison of manual and semiautomatic measurements in CT

    Energy Technology Data Exchange (ETDEWEB)

    Wessling, J.; Schuelke, C. [Muenster Univ. (Germany). Dept. of Clinical Radiology; Koch, R. [Muenster Univ. (Germany). Dept. of Medical Informatics and Biomathematics; and others

    2014-08-15

    Purpose: Comparison of manual one-/bi-dimensional measurements versus semi-automatically derived one-/bi-dimensional and volumetric measurements for therapy response evaluation of malignant lymphoma during CT follow-up examinations in a multicenter setting. Materials and Methods: MSCT data sets of patients with malignant lymphoma were evaluated before (baseline) and after two cycles of chemotherapy (follow-up) at radiological centers of five university hospitals. The long axis diameter (LAD), the short axis diameter (SAD) and the bi-dimensional WHO of 307 target lymph nodes were measured manually and semi-automatically using dedicated software. Lymph node volumetry was performed semi-automatically only. The therapeutic response was evaluated according to lymphoma-adapted RECIST. Results: Based on a single lymph node, semi-automatically derived multidimensional parameters allowed for significantly more accurate therapy response classification than the manual or the semi-automatic unidimensional parameters. Incorrect classifications were reduced by up to 9.6%. Compared to the manual approach, the influence of the study center on correct therapy classification is significantly less relevant when using semi-automatic measurements. Conclusion: Semi-automatic volumetry and bi-dimensional WHO significantly reduce the number of incorrectly classified lymphoma patients by approximately 9.6% in the multicenter setting in comparison to linear parameters. Semi-automatic quantitative software tools may help to significantly reduce wrong classifications that are associated with the manual assessment approach. (orig.)

  3. Effect of women's age on embryo morphology, cleavage rate and competence-A multicenter cohort study

    DEFF Research Database (Denmark)

    Grøndahl, Marie Louise; Christiansen, Sofie Lindgren; Kesmodel, Ulrik Schiøler

    2017-01-01

    This multicenter cohort study on embryo assessment and outcome data from 11,744 IVF/ICSI cycles with 104,830 oocytes and 42,074 embryos, presents the effect of women's age on oocyte, zygote, embryo morphology and cleavage parameters, as well as cycle outcome measures corrected for confounding.......0001) with increasing age. Maternal age had no effect on cleavage parameters or on the morphology of the embryo day 2 post insemination. Interestingly, initial hCG value after single embryo transfer followed by ongoing pregnancy was increased with age in both IVF (p = 0.007) and ICSI (p = 0.001) cycles. For the first...... time, we show that a woman's age does impose a significant footprint on early embryo morphological development (3PN). In addition, the developmentally competent embryos were associated with increased initial hCG values as the age of the women increased. Further studies are needed to elucidate...

  4. The Flowering and Bee-like Insurance, Economic Standards for the Cuban Apian’s Productions.

    Directory of Open Access Journals (Sweden)

    Remigio Eusebio Pérez Morejón

    2012-01-01

    Full Text Available This work grasped Cuban archipelago with the purpose of promoting the financial protection in agricultural sector, giving options of security to the country Apian’s producers against incontrollable natural risks. A study of the hurricanes in Cuba was carried out, so as evaluation of danger, vulnerability and sensitivity of the Apian’s echo-systems (AE; the analysis of occurrence frequency (OF demonstrate that in Cuba doesn’t exist low dangerous zones for the hurricanes impact. Recovery of heavy losses has delayed very variable time intervals which oscillate between 3 to 34 months. Considerable damages could be confirmed in arboreous covering of the (AE. As final results were presented the apian insurance as an economical necessity standard to transfer risks before whips of climatic changes, expressed in the increase of number and intensity of the hurricanes and long drought. It is proved that the losses in this lapse of time are assumed by the insurance enterprise in a 70 %, which economically justify the fact of protecting the apian productions to guarantees of itself and it was demonstrated that it is necessary and feasible the application of the proposal of apian insure. To the development of this work were used analysis methods statistical and survey.

  5. Magic and reality in the literature of the Cuban revolution

    Directory of Open Access Journals (Sweden)

    María Jesús Martín Sastre

    2013-12-01

    Full Text Available There is no innocent literature. Literature is made by love, by hate, by a woman, by an idea, by an injustice, by a hope, to praise or to criticize, but I think literature has never been isolated, pure, detached. [...] Literature cannot escape life and history (Manuel Cofiño Lopez, 1985: 9697. Cofiño Lopezs own literature is no exception. The clear contrast that he presents in The Last Woman and the upcoming battle between magic and reality, ignorance and culture, past and present has a purpose. The author raises the need to end with the old beliefs in order to progress.This inextricable link between magic and reality of the Revolution is present in several novels of the Cuban Revolution. It shows how the two interact, as well as how past and present intermingle. Moreover, we find that magic is present throughout, and is fully compatible with the Revolution. This does not make it erroneous to believe in the stories of Magic Realism. It is a mistake on the part of the revolution and those who write about it for attempting to deny people the magic of their superstitions and beliefs, since magic is not the enemy of progress. They are part of their lives and their culture, and are something that should be respected.

  6. Multi-centered AdS{sub 3} solutions from Virasoro conformal blocks

    Energy Technology Data Exchange (ETDEWEB)

    Hulík, Ondřej [Institute of Physics of the ASCR,Na Slovance 2, 182 21 Prague 8 (Czech Republic); Institute of Particle Physics and Nuclear Physics,Faculty of Mathematics and Physics, Charles University,V Holešovičkách 2, 180 00 Prague 8 (Czech Republic); Procházka, Tomáš [Arnold Sommerfeld Center for Theoretical Physics,Ludwig Maximilian University of Munich,Theresienstr. 37, D-80333 München (Germany); Raeymaekers, Joris [Institute of Physics of the ASCR,Na Slovance 2, 182 21 Prague 8 (Czech Republic)

    2017-03-24

    We revisit the construction of multi-centered solutions in three-dimensional anti-de Sitter gravity in the light of the recently discovered connection between particle worldlines and classical Virasoro conformal blocks. We focus on multi-centered solutions which represent the backreaction of point masses moving on helical geodesics in global AdS{sub 3}, and argue that their construction reduces to a problem in Liouville theory on the disk with Zamolodchikov-Zamolodchikov boundary condition. In order to construct the solution one needs to solve a certain monodromy problem which we argue is solved by a vacuum classical conformal block on the sphere in a particular channel. In this way we construct multi-centered gravity solutions by using conformal blocks special functions. We show that our solutions represent left-right asymmetric configurations of operator insertions in the dual CFT. We also provide a check of our arguments in an example and comment on other types of solutions.

  7. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    Energy Technology Data Exchange (ETDEWEB)

    Zaknun, John J. [University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria); IAEA, Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, P.O. Box 100, Wien (Austria); Bal, Chandrasekhar [All India Institute of Medical Sciences, Department of Nuclear Medicine, New Delhi (India); Maes, Alex [Katholieke Universiteit Leuven, Leuven (Belgium); AZ Groeninge, Department of Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn [Chulalongkorn University, Nuclear Medicine Division, Department of Radiology, Bangkok (Thailand); Vazquez, Silvia [Instituto de Investigaciones Neurologicas, FLENI, Department of Radiology, Buenos Aires (Argentina); Dupont, Patrick [Katholieke Universiteit Leuven, Leuven (Belgium); Dondi, Maurizio [Ospedale Maggiore, Department of Nuclear Medicine, Bologna (Italy); International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Vienna (Austria)

    2008-01-15

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  8. Comparative analysis of MR imaging, Ictal SPECT and EEG in temporal lobe epilepsy: a prospective IAEA multi-center study

    International Nuclear Information System (INIS)

    Zaknun, John J.; Bal, Chandrasekhar; Maes, Alex; Tepmongkol, Supatporn; Vazquez, Silvia; Dupont, Patrick; Dondi, Maurizio

    2008-01-01

    MR imaging, ictal single-photon emission CT (SPECT) and ictal EEG play important roles in the presurgical localization of epileptic foci. This multi-center study was established to investigate whether the complementary role of perfusion SPECT, MRI and EEG for presurgical localization of temporal lobe epilepsy could be confirmed in a prospective setting involving centers from India, Thailand, Italy and Argentina. We studied 74 patients who underwent interictal and ictal EEG, interictal and ictal SPECT and MRI before surgery of the temporal lobe. In all but three patients, histology was reported. The clinical outcome was assessed using Engel's classification. Sensitivity values of all imaging modalities were calculated, and the add-on value of SPECT was assessed. Outcome (Engel's classification) in 74 patients was class I, 89%; class II, 7%; class III, 3%; and IV, 1%. Regarding the localization of seizure origin, sensitivity was 84% for ictal SPECT, 70% for ictal EEG, 86% for MRI, 55% for interictal SPECT and 40% for interictal EEG. Add-on value of ictal SPECT was shown by its ability to correctly localize 17/22 (77%) of the seizure foci missed by ictal EEG and 8/10 (80%) of the seizure foci not detected by MRI. This prospective multi-center trial, involving centers from different parts of the world, confirms that ictal perfusion SPECT is an effective diagnostic modality for correctly identifying seizure origin in temporal lobe epilepsy, providing complementary information to ictal EEG and MRI. (orig.)

  9. Relation between serum lipoperoxide concentrations and iron or copper status over one year in Cuban adult men

    Energy Technology Data Exchange (ETDEWEB)

    Arnaud, J.; Renversez, J.C.; Favier, A.E. [Dept. de Biologie Integree, CHUG, Grenoble (France); Fleites, P.; Perez-Cristia, R. [Centro national de Toxicologia (CENATOX), La Habana (Cuba); Chassagne, M.; Barnouin, J. [INRA, Unite d' Ecopathologie, Saint Genes Champanelle (France); Verdura, T. [Inst. Finlay, La Lisa, La Habana (Cuba); Garcia, I.G. [Inst. de Farmacia y Alimentos, La Coronela, La Lisa, Ciudad de la Habana (Cuba); Tressol, J.C. [INRA, Unite maladies metaboliques et micronutriments, Saint Genes Champanelle (France)

    2001-07-01

    The aims of this study were to determine the relations between iron and copper status and lipid peroxidation at different periods over one year in low-income and low-energy intake healthy subjects. The study was conducted in 199 middle-aged healthy Cuban men from March 1995 to February 1996. Iron status was assessed by the determination of serum ferritin, transferrin saturation, whole blood hemoglobin and iron intakes. Copper status was evaluated by the determination of serum copper and copper intakes. Serum thiobarbituric acid substances (TBARS) determination was used as an index of lipid peroxidation. Rank correlations were observed between serum TBARS concentrations and iron or copper status indices at different periods. In period 3 (end of the rainy season), serum TBARS and ferritin concentrations were maximum whereas blood hemoglobin levels and iron intake were minimum. Serum TBARS concentrations were significantly higher than the reference values of the laboratory whereas, iron and copper status were within the reference ranges. These results suggested that iron and copper status may be associated with lipid peroxidation in subjects without metal overloads and that variations over the year needed to be taken in account. (orig.)

  10. Novel 'heavy' dyes for retinal membrane staining during macular surgery: multicenter clinical assessment

    NARCIS (Netherlands)

    Veckeneer, Marc; Mohr, Andreas; Alharthi, Essam; Azad, Rajvardhan; Bashshur, Ziad F.; Bertelli, Enrico; Bejjani, Riad A.; Bouassida, Brahim; Bourla, Dan; Crespo, Iñigo Corcóstegui; Fahed, Charbel; Fayyad, Faisal; Mura, Marco; Nawrocki, Jerzy; Rivett, Kelvin; Scharioth, Gabor B.; Shkvorchenko, Dmitry O.; Szurman, Peter; van Wijck, Hein; Wong, Ian Y.; Wong, David S. H.; Frank, Johannes; Oellerich, Silke; Bruinsma, Marieke; Melles, Gerrit R. J.

    2014-01-01

    Purpose: To evaluate the feasibility of two novel heavy' dye solutions for staining the internal limiting membrane (ILM) and epiretinal membranes (ERMs), without the need for a prior fluid-air exchange, during macular surgery. Methods: In this prospective nonrandomized multicenter cohort study, the

  11. Caracterización y clasificación geoquímica de asfaltitas cubanas Geochemical characterization and classification of Cuban asphaltites

    Directory of Open Access Journals (Sweden)

    Zulema Dominguez

    2008-01-01

    Full Text Available Traditional biomarker parameters and aromatic compounds were applied to characterize and classify ten Cuban asphaltites (asphaltene-rich petroleum occurring as seeps or filling veins, joints, cavities and fissures. Genetic molecular parameters were compared in order to establish oil-oil correlations between samples. Thermal evolution was investigated using saturated biomarker and aromatic maturity parameters. All samples seem to represent petroleum in the early catagenetic stage. Statistical procedures used as auxiliary techniques show that they represent oils of Family II (marine anoxic carbonate sourced oils, except for 2 samples interpreted as belonging to Family III oils (normal marine siliciclastic suboxic sourced oils.

  12. A prospective, randomized, multicenter, controlled study of the safety of Seprafilm adhesion barrier in abdominopelvic surgery of the intestine.

    NARCIS (Netherlands)

    Beck, D.E.; Cohen, Z.; Fleshman, J.W.; Kaufman, H.S.; Goor, H. van; Wolff, B.G.

    2003-01-01

    INTRODUCTION: Seprafilm adhesion barrier (Seprafilm) has been proven to prevent adhesion formation after abdominal and pelvic surgery. This article reports safety results, including the postoperative incidence of abdominal and pelvic abscess and pulmonary embolism, from a large, multicenter trial

  13. Neutron activation analysis methodology of marine sediments of the Cuban shelf

    International Nuclear Information System (INIS)

    Garcia, G.

    1988-01-01

    It is described the methodology followed for the neutron activation analysis of marine sediments of the Cuban shelf. A total of 35 elements were determined by means of the employment of thermal and epithermal fluxes of a nuclear reactor as well as from the flux of a generator of 14 MeV neutrons. It is signaled the particularities of detection and measurement of some elements and their interferences, with and special mention of the correction over 153 Sm, 113m In(Sn), 65 Zn, 160 Th, 169 Yb, 75 Sc and 177 Lu. It is concluded that 82% of elements may be determined with epithermal neutrons and 41%, with thermal neutrons. Only Si is determined with 14 MeV neutrons. Moreover, it is recommended the optimal periods of decaying (''cooling'') by groups of elements. The determined elements were: Ag, As, Au, Ba, Br, Ce, Co, Cr, Cs, Eu, Fe, Hf, K, La, Lu, Mo, Na, Nd, Ni, Rb, Sb, Sc, Se, Si, Sm, Sn, Sr, Ta, Tb, Th, U, W, Yb, Zn and Zr. The accuracy varied between 1% and 5% to 19 elements, between 6% and 10% to 5 elements, between 11% and 30% to 6 elements and it was greater than 30% to 5 elements

  14. From individual to herd protection with pneumococcal vaccines: the contribution of the Cuban pneumococcal conjugate vaccine implementation strategy

    Directory of Open Access Journals (Sweden)

    Nivaldo Linares-Pérez

    2017-07-01

    Full Text Available A new pneumococcal conjugate vaccine is currently undergoing advanced clinical evaluation prior to its planned introduction in Cuba. The implementation of the pneumococcal vaccination strategy has been designed with consideration of the need to maximize both its direct and indirect effects. A novel approach is suggested, which addresses preschool children as the first-line target group to generate herd immunity in infants and to have an impact on transmission at the community level. The clinical evaluation pipeline is described herein, including evaluations of effectiveness, cost-effectiveness, and impact. The scientific contribution of the Cuban strategy could support a paradigm shift from individual protection to a population effect based on a rigorous body of scientific evidence.

  15. Evaluation of criteria for clinical control in a prospective, international, multicenter study of patients with COPD

    DEFF Research Database (Denmark)

    Miravitlles, Marc; Sliwinski, Pawel; Rhee, Chin Kook

    2018-01-01

    BACKGROUND: The concept of clinical control in COPD has been developed to help in treatment decisions, but it requires validation in prospective studies. METHOD: This international, multicenter, prospective study aimed to validate the concept of control in COPD [control = stability (no...... exacerbations or impairment in CAT scores) + low impact (low level of symptoms)]. Data from the screening visit was used to: investigate the level of control, compare characteristics of patients according to the control status, and perform a sensitivity analysis of the levels of control using either clinical...... criteria or questionnaires (COPD Assessment Test -CAT- or Clinical COPD Questionnaire -CCQ-). RESULTS: A total of 314 patients were analysed, mean age was 68.5 years and mean FEV1 was 52.6% of predicted. According to the prespecified criteria 21% of patients were classified as controlled, all of them...

  16. Diagnosis to Evaluate the Degree of the Customer’s Orientation in Cuban Enterprises.

    Directory of Open Access Journals (Sweden)

    Mirya Valdivia Hernández

    2013-09-01

    Full Text Available In the enterprise world of today, the organizations that occupy privileged places in the market, offer their products in the proper place and moment, with competitive prices and the appropriate quality at minimum possible cost. The use of quality as a strategic weapon implies the development of an organizational culture through out the enterprise parts, guided to obtain a final product or service that not only satisfies the customers´ expectations, but enhances them. The customers´ orientation and quality management has been object of different theories and enterprises focuses, which through their evolution have converged to the costumer. In this work it is proposed the implementation of a Procedure, scientifically validated, to evaluate the costumer’s orientation, to contribute to improve the Quality Management in the Cuban enterprises. In the diagnosis procedure the customers´ criteria are identified, the degree of the costumer’s orientation is evaluated and the incidences that influence on the quality management are analyzed. Some actions were proposed based on the diagnosis´ results to the possible causes solution.

  17. The Cuban experience in public health: does political will have a role?

    Science.gov (United States)

    Pagliccia, Nino; Alvarez Pérez, Adolfo

    2012-01-01

    The role of political will in public health has been largely ignored. In Cuba, however, for the past 50 years, political will has been the ultimate, encompassing intersectoral action in public health. The excellent achievements in population health in Cuba during these 50 years have been widely recognized. Researchers have sought to explain this "Cuban paradox" by focusing on a large array of public health factors, including health promotion, primary care activities, and intersectoral action on health determinants. These factors constitute necessary but not sufficient conditions to achieve good health outcomes. This article defines political will and uses the experience of Cuba to illustrate the potential role of political will in public health. The authors suggest a framework for the evaluation of political will aimed at achieving good health, examining the "Five R's of political will," five observable features that may provide systematic information on the direction and realization of political will: (1) renewal of commitment, (2) reform of the system, (3) resource development, (4) review of performance, and (5) responsible management. These five features focus the spotlight on the consistency between health goals and public discourse and action.

  18. Development and evaluation of an instrument to measure health-related quality of life in Cuban breast cancer patients receiving radiotherapy.

    Science.gov (United States)

    Lugo, Josefina; Nápoles, Misleidy; Pérez, Inés; Ordaz, Niurka; Luzardo, Mario; Fernández, Leticia

    2014-01-01

    INTRODUCTION Although modern technology has extended the survival of breast cancer patients, treatment's adverse effects impact their health-related quality of life. Currently, no instrument exists capable of identifying the range of problems affecting breast cancer patients receiving radiotherapy in Cuba's socioeconomic and cultural context. OBJECTIVES Construct and validate an instrument to measure the effects of breast cancer and radiotherapy on health-related quality of life in Cuban patients. METHODS The study was conducted at the Oncology and Radiobiology Institute, Havana, Cuba, from January 2010 through December 2011. Inclusion criteria were: adult female, histological diagnosis of breast cancer, treated with ambulatory radiotherapy, and written informed consent; patients unable to communicate orally or in writing, or who had neurologic or psychiatric conditions were excluded. Development phase: focus groups guided by a list of questions were carried out with 50 women. The patients reported 61 problems affecting their health-related quality-of-life. A nominal group (six oncologists and two nurses) identified the same problems. A syntactic analysis of the information was performed to create items for study and measurement scales. Content validity was determined by a nominal group of seven experts using professional judgment. Another 20 patients were selected to evaluate face validity. Validation phase: the instrument was applied to 230 patients at three different points: before radiotherapy, at the end of radiotherapy and four weeks after radiotherapy was concluded. Reliability, construct validity, discriminant validity, predictive validity, interpretability and response burden were evaluated. RESULTS The final instrument developed had 33 items distributed in 4 domains: physical functioning, psychological functioning, social and family relationships, and physical and emotional adverse effects of disease and treatment. There were two discrete items: perceived

  19. Use of neuronal networks in the modeling of the doses that receives the Cuban population by potassium-40 contained in their organism; Utilizacion de redes neuronales en la modelacion de las dosis que recibe la poblacion cubana por el potasio-40 contenido en su organismo

    Energy Technology Data Exchange (ETDEWEB)

    Zerquera, Juan Tomas; Prendes Alonso, Miguel; Lopez Bejerano, Gladys M.; Acosta Rodriguez, Nancy [Centro de Proteccion y Higiene de las Radiaciones, La Habana (Cuba)

    2001-07-01

    The potassium 40 constitutes the main source natural present in the organism that influences in the effective dose that people receive. With the objective of evaluating the contribution from this component to the doses received by the Cuban population, a study was developed in order to evaluate the doses for this cause. A representative sample was selected based on the distribution of Cuban population by sex and ages. The measurements were carried out in the Whole Body Counter of the Center for Radiation Protection and Hygiene. For the estimate of the doses an uniform distribution of potassium was assumed in the whole body and the methodology was used recommended by the ICRP. The values of annual effective dose varies between 93 and 209 mSv for the feminine sex and 102 and 212 mSv for the masculine sex. With the obtained values they were the adjustment coefficients for the functions dose-age for each one of the sexes. At the same time it was possible to model the estimate of the doses by means of a neural network that, trained with the obtained experimental data, it allows to estimate the due doses directly to the potassium 40 starting from the sex data, age, height and corporal weight. The effective dose mediates yearly for the public's members it was estimated in 149 {+-} 6 mSv, starting from the experimental data and the Cuban population's specific characteristics. (author)

  20. European multicenter analytical evaluation of the Abbott ARCHITECT STAT high sensitive troponin I immunoassay

    DEFF Research Database (Denmark)

    Krintus, Magdalena; Kozinski, Marek; Boudry, Pascal

    2014-01-01

    BACKGROUND: International recommendations highlight the superior value of cardiac troponins (cTns) for early diagnosis of myocardial infarction along with analytical requirements of improved precision and detectability. In this multicenter study, we investigated the analytical performance of a ne...

  1. Economic Benefit for Cuban Laurel Thrips Biological Control.

    Science.gov (United States)

    Shogren, C; Paine, T D

    2016-02-01

    The Cuban laurel thrips, Gynaikothrips ficorum Marchal (Thysanoptera: Phlaeothripidae), is a critical insect pest of Ficus microcarpa in California urban landscapes and production nurseries. Female thrips feed and oviposit on young Ficus leaves, causing the expanding leaves to fold or curl into a discolored leaf gall. There have been attempts to establish specialist predator natural enemies of the thrips, but no success has been reported. We resampled the same areas in 2013-2014 where we had released Montandoniola confusa (= morguesi) Streito and Matocq (Hemiptera: Anthocoridae) in southern California in 1995 but had been unable to recover individuals in 1997-1998. Thrips galls were significantly reduced in all three of the locations in the recent samples compared with the earlier samples. M. confusa was present in all locations and appears to be providing successful biological control. The value of the biological control, the difference between street trees in good foliage condition and trees with poor foliage, was $58,766,166. If thrips damage reduced the foliage to very poor condition, the value of biological control was $73,402,683. Total cost for the project was $61,830. The benefit accrued for every dollar spent on the biological control of the thrips ranged from $950, if the foliage was in poor condition, to $1,187, if the foliage was in very poor condition. The value of urban forest is often underappreciated. Economic analyses that clearly demonstrate the very substantial rates of return on investment in successful biological control in urban forests provide compelling arguments for supporting future efforts. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  2. Decision making in liver transplant selection committees: a multicenter study.

    Science.gov (United States)

    Volk, Michael L; Biggins, Scott W; Huang, Mary Ann; Argo, Curtis K; Fontana, Robert J; Anspach, Renee R

    2011-10-18

    To receive a liver transplant, patients must first be placed on a waiting list-a decision made at most transplant centers by a multidisciplinary committee. The function of these committees has never been studied. To describe decision making in liver transplant committees and identify opportunities for process improvement. Observational multicenter study. 4 liver transplant centers in the United States. 68 members of liver transplant committees across the 4 centers. 63 meetings were observed, and 50 committee members were interviewed. Recorded transcripts and field notes were analyzed by using standard qualitative sociologic methods. Although the structure of the meetings varied by center, the process was uniform and primarily involved inductive reasoning to review possible reasons for patient exclusion. Patients were excluded if they were too well, too sick (in the setting of advanced liver disease), or too old or had nonhepatic comorbid conditions, substance abuse problems, or other psychosocial barriers. Dominant themes in the discussions included member angst over deciding who lived or died, a high correlation between psychosocial barriers to transplantation and the patient's socioeconomic status, and the influence of external forces on decision making. Unwritten center policies and confusion regarding advocacy versus stewardship roles were consistently identified as barriers to effective group decision making. The use of qualitative methods provides broad understanding but limits specific inferences. The 4 centers may not reflect the practices of every transplant center nationwide. The difficult decisions made by liver transplant committees are reasonably consistent and well-intentioned, but the process might be improved by having more explicit written policies and clarifying roles. This may inform resource allocation in other areas of medicine. The Greenwall Foundation and the National Institutes of Health.

  3. A Multicenter Randomized Controlled Trial of Zephyr Endobronchial Valve Treatment in Heterogeneous Emphysema (TRANSFORM)

    NARCIS (Netherlands)

    Kemp, Samuel V.; Slebos, Dirk-Jan; Kirk, Alan; Kornaszewska, Malgorzata; Carron, Kris; Ek, Lars; Broman, Gustav; Hillerdal, Gunnar; Mal, Herve; Pison, Christophe; Briault, Amandine; Downer, Nicola; Darwiche, Kaid; Rao, Jagan; Huebner, Ralf-Harto; Ruwwe-Glosenkamp, Christof; Trosini-Desert, Valery; Eberhardt, Ralf; Herth, Felix J.; Derom, Eric; Malfait, Thomas; Shah, Pallav L.; Garner, Justin L.; ten Hacken, Nick H.; Fallouh, Hazem; Leroy, Sylvie; Marquette, Charles H.

    2017-01-01

    Rationale: Single-center randomized controlled trials of the Zephyr endobronchial valve (EBV) treatment have demonstrated benefit in severe heterogeneous emphysema. This is the first multicenter study evaluating this treatment approach. Objectives: To evaluate the efficacy and safety of Zephyr EBVs

  4. Thoracic Duct Injury Following Cervical Spine Surgery: A Multicenter Retrospective Review

    OpenAIRE

    Derakhshan, Adeeb; Lubelski, Daniel; Steinmetz, Michael P.; Corriveau, Mark; Lee, Sungho; Pace, Jonathan R.; Smith, Gabriel A.; Gokaslan, Ziya; Bydon, Mohamad; Arnold, Paul M.; Fehlings, Michael G.; Riew, K. Daniel; Mroz, Thomas E.

    2017-01-01

    Study Design: Multicenter retrospective case series. Objective: To determine the rate of thoracic duct injury during cervical spine operations. Methods: A retrospective case series study was conducted among 21 high-volume surgical centers to identify instances of thoracic duct injury during anterior cervical spine surgery. Staff at each center abstracted data for each identified case into case report forms. All case report forms were collected by the AOSpine North America Clinical Research Ne...

  5. Structural MRI correlates of cognitive impairment in patients with multiple sclerosis: A Multicenter Study.

    Science.gov (United States)

    Preziosa, Paolo; Rocca, Maria A; Pagani, Elisabetta; Stromillo, Maria Laura; Enzinger, Christian; Gallo, Antonio; Hulst, Hanneke E; Atzori, Matteo; Pareto, Deborah; Riccitelli, Gianna C; Copetti, Massimiliano; De Stefano, Nicola; Fazekas, Franz; Bisecco, Alvino; Barkhof, Frederik; Yousry, Tarek A; Arévalo, Maria J; Filippi, Massimo

    2016-04-01

    In a multicenter setting, we applied voxel-based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal-appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing-remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel-wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty-three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive-relevant WM tracts followed by atrophy of cognitive-relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel-wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS. © 2016 Wiley Periodicals, Inc.

  6. Spectral flow, and the spectrum of multicenter solutions

    International Nuclear Information System (INIS)

    Bena, Iosif; Bobev, Nikolay; Warner, Nicholas P.

    2008-01-01

    We discuss 'spectral-flow' coordinate transformations that take asymptotically four-dimensional solutions into other asymptotically four-dimensional solutions. We find that spectral flow can relate smooth three-charge solutions with a multicenter Taub-NUT base to solutions where one or several Taub-NUT centers are replaced by two-charge supertubes, and vice versa. We further show that multiparameter spectral flows can map such Taub-NUT centers to more singular centers that are either D2-D0 or pure D0-brane sources. Since supertubes can depend on arbitrary functions, we establish that the moduli space of smooth horizonless black-hole microstate solutions is classically of infinite dimension. We also use the physics of supertubes to argue that some multicenter solutions that appear to be bound states from a four-dimensional perspective are in fact not bound states when considered from a five- or six-dimensional perspective

  7. The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study

    International Nuclear Information System (INIS)

    Battistone, M.J.; Clegg, D.O.; Manaster, B.J.; Reda, D.J.

    1999-01-01

    Objective. To determine the prevalence of radiographic evidence of sacroiliitis in a large population of patients with psoriatic arthritis. Patients and design. Patients were recruited from 15 clinical centers. This was part of a large, multicenter study of patients with an established diagnosis of ankylosing spondylitis, psoriatic arthritis, or reactive arthritis. For this cohort, an established diagnosis of psoriatic arthritis was required, with cutaneous manifestations and involvement of at least three appendicular joints. At entry, patients were not selected for the presence of axial involvement. Radiographs - one anteroposterior view of the pelvis and one oblique view of each sacroiliac joint - were graded using the New York classification scale by a musculoskeletal radiologist masked to the specific diagnosis and clinical symptoms. Re-evaluation of 10% of the films 3 years later quantified intraobserver variability. Results. Two hundred and two patients with psoriatic arthritis were studied. Duration of the disease averaged 12 years; all patients had psoriasis and peripheral arthritis. The prevalence of radiographic evidence of sacroiliitis (grade 2 or higher) was 78%; 71% of these had grade 3 disease. Conclusions. Previously reported prevalence of sacroiliitis in patients with psoriatic arthritis ranges from 30% to 50%. The prevalence of radiographic evidence of sacroiliitis in this large multicenter cohort of patients with appendicular psoriatic arthritis was substantially higher. (orig.)

  8. The prevalence of sacroilitis in psoriatic arthritis: new perspectives from a large, multicenter cohort. A Department of Veterans Affairs Cooperative Study

    Energy Technology Data Exchange (ETDEWEB)

    Battistone, M.J.; Clegg, D.O. [Division of Rheumatology, University of Utah Medical Center, Salt Lake City, UT (United States)]|[Department of Medicine, Division of Rheumatology, Veterans Affairs Medical Center, Salt Lake City, UT (United States); Manaster, B.J. [Department of Radiology, Division of Musculoskeletal Imaging, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA (United States); Reda, D.J. [Cooperative Studies Program Coordinating Center, VA Hospital, Hines, IL (United States)

    1999-04-01

    Objective. To determine the prevalence of radiographic evidence of sacroiliitis in a large population of patients with psoriatic arthritis. Patients and design. Patients were recruited from 15 clinical centers. This was part of a large, multicenter study of patients with an established diagnosis of ankylosing spondylitis, psoriatic arthritis, or reactive arthritis. For this cohort, an established diagnosis of psoriatic arthritis was required, with cutaneous manifestations and involvement of at least three appendicular joints. At entry, patients were not selected for the presence of axial involvement. Radiographs - one anteroposterior view of the pelvis and one oblique view of each sacroiliac joint - were graded using the New York classification scale by a musculoskeletal radiologist masked to the specific diagnosis and clinical symptoms. Re-evaluation of 10% of the films 3 years later quantified intraobserver variability. Results. Two hundred and two patients with psoriatic arthritis were studied. Duration of the disease averaged 12 years; all patients had psoriasis and peripheral arthritis. The prevalence of radiographic evidence of sacroiliitis (grade 2 or higher) was 78%; 71% of these had grade 3 disease. Conclusions. Previously reported prevalence of sacroiliitis in patients with psoriatic arthritis ranges from 30% to 50%. The prevalence of radiographic evidence of sacroiliitis in this large multicenter cohort of patients with appendicular psoriatic arthritis was substantially higher. (orig.) With 3 figs., 4 tabs., 29 refs.

  9. Assessing the 2D Models of Geo-technological Variables in a Block of a Cuban Laterite Ore Body. Part IV Local Polynomial Method

    Directory of Open Access Journals (Sweden)

    Arístides Alejandro Legrá-Lobaina

    2016-10-01

    Full Text Available The local polynomial method is based on assuming that is possible to estimate the value of a U variable in any of the P coordinate through local polynomials estimated based on approximate data. This investigation analyzes the probability of modeling in two dimensions the thickness and nickel, iron and cobalt concentrations in a block of Cuban laterite ores by using the mentioned method. It was also analyzed if the results of modeling these variables depend on the estimation method that is used.

  10. Fifteen years of the cuban program, with children from areas affected by the Chernobyl accident

    International Nuclear Information System (INIS)

    Garcia, Omar; Medina, Julio

    2005-01-01

    The Cuban Chernobyl Program arrived to the 15th anniversary in March 2005. This program was designed to offers specialised medical attention and to develop a rehabilitation plan with children from areas affected by the Chernobyl accident. More than 21 500 children and adults had been assisted in the program up to the moment, with a significant set of medical procedures done. Dosimetric and biomedic research had been also carried out as part of the program. The most significant medical attention activities include the treatment of children with haematological disorders, including 120 leukaemia, bone marrow transplants, and the treatment of endocrine and cancer diseases. The dosimetric studies allow made a data base with information on internal 137Cs contamination, internal, external and total doses, children living location, and its contamination by 137Cs, and other significant information for radiological impact evaluation in more than 8000 children. The behaviour of all the medical information of the program in relation to the contamination of the land and the internal contamination of the children was analysed using this database. The program has accumulated an experience of interest for physicians, psychologists and in general persons interested in Chernobyl consequences. This paper present a summary of the main results obtained in the program

  11. A multicenter study on objective and subjective benefits with a transcutaneous bone-anchored hearing aid device

    DEFF Research Database (Denmark)

    Hougaard, Dan Dupont; Boldsen, Soren Kjaergaard; Jensen, Anne Marie

    2017-01-01

    Examination of objective as well as subjective outcomes with a new transcutaneous bone-anchored hearing aid device. The study was designed as a prospective multicenter consecutive case-series study involving tertiary referral centers at two Danish University Hospitals. A total of 23 patients were...... implanted. Three were lost to follow-up. Patients had single-sided deafness, conductive or mixed hearing loss. Intervention: Rehabilitative. Aided and unaided sound field hearing was evaluated objectively using (1) pure warble tone thresholds, (2) pure-tone average (PTA4), (3) speech discrimination score...... (SDS) in quiet, and (4) speech reception threshold 50% at 70 dB SPL noise level (SRT50%). Subjective benefit was evaluated by three validated questionnaires: (1) the IOI-HA, (2) the SSQ-12, and (3) a questionnaire evaluating both the frequency and the duration of hearing aid usage. The mean aided PTA4...

  12. Fibromyalgia as a cause of uncontrolled asthma: a case-control multicenter study.

    Science.gov (United States)

    Martinez-Moragon, Eva; Plaza, Vicente; Torres, Isabel; Rosado, Ana; Urrutia, Isabel; Casas, Xavier; Hinojosa, Belen; Blanco-Aparicio, Marina; Delgado, Julio; Quirce, Santiago; Sabadell, Carles; Cebollero, Pilar; Muñoz-Fernández, Ana

    2017-12-01

    Fibromyalgia can affect the control of asthma when both diseases are present in a single patient. To characterize asthma in patients with concomitant fibromyalgia to assess whether fibromyalgia is an independent factor of asthma severity that influences poor asthma control. We also evaluated how dyspnea is perceived by patients in order to demonstrate that alterations in the perception of airway obstruction may be responsible for poor asthma control. This was a cross-sectional case-control multicenter study, in which 56 patients in the asthma and fibromyalgia group were matched to 36 asthmatics by sex, approximate age, and asthma severity level. All patients were women. Study variables included the Asthma Control Test (ACT), the Mini Asthma Quality of Life Questionnaire (MiniAQLQ), the Nijmegen hyperventilation syndrome questionnaire, the Hospital Anxiety and Depression Scale, and perception of dyspnea after acute bronchoconstriction. Although patients in both study groups showed similar asthma severity and use of anti-asthmatic drugs, patients in the asthma and fibromyalgia group showed lower scores on the ACT and MiniAQLQ questionnaires, and higher scores of anxiety and depression as well as hyperventilation compared to asthma patients without fibromyalgia. All these differences were statistically significant. Fibromyalgia in patients with asthma influences poor control of the respiratory disease and is associated with altered perception of dyspnea, hyperventilation syndrome, high prevalence of depression and anxiety, and impaired quality of life. Fibromyalgia may be considered a risk factor for uncontrolled asthma in patients suffering from asthma and fibromyalgia concomitantly.

  13. Ethics Review of Pediatric Multi-Center Drug Trials

    NARCIS (Netherlands)

    Needham, Allison C.; Kapadia, Mufiza Z.; Offringa, Martin

    2015-01-01

    The assessment of safety and efficacy of therapeutics for children and adolescents requires the use of multi-centered designs. However, the need to obtain ethical approval from multiple independent research ethics boards (REBs) presents as a challenge to investigators and sponsors who must consider

  14. Trends in Radical Surgical Treatment Methods for Breast Malignancies in China: A Multicenter 10-Year Retrospective Study.

    Science.gov (United States)

    Zhang, Bai-Lin; Sivasubramaniam, Priya G; Zhang, Qian; Wang, Jing; Zhang, Bin; Gao, Ji-Dong; Tang, Zhong-Hua; Chen, Guo-Ji; Xie, Xiao-Ming; Wang, Zhongzhao; Yang, Hong-Jian; He, Jian-Jun; Li, Hui; Li, Jia-Yuan; Fan, Jin-Hu; Wang, Xiang; Qiao, You-Lin

    2015-09-01

    Incidence rates of breast cancer continue to rise in the People's Republic of China. The purpose of this study was to describe Chinese trends in radical surgical modalities and influential imaging and demographic factors for breast malignancies. This study was a hospital-based, multicenter, 10-year (1999-2008), retrospective study. Descriptive statistical tests were used to illustrate information regarding radical surgical trends for the treatment of breast malignancies. Chi-square tests were used to assess effect of demographic factors in addition to imaging and pathological data on the specific surgical method. A total of 4,211 patients were enrolled in the survey. Among them, 3,335 patients with stage 0 to stage III disease undergoing mastectomy or breast-conserving surgery (BCS) were included in the final analysis. The rate of BCS increased from 1.53% in 1999 to 11.88% in 2008. The rate of mastectomy declined over this time period, from 98.47% in 1999 to 88.12% in 2008, with increasing use of diagnostic imaging methods and pathological biopsies. A significantly greater percentage of patients with office work, high education levels, unmarried status, younger age, and early pathological stages preferred BCS compared with mastectomy. Rates of mastectomy in China remain elevated due to diagnosis at higher stages; however, because of increased use of diagnostic imaging, improvement of biopsy methods, and patient education, rates of less invasive lumpectomy are increasing and rates of mastectomy have decreased in China. In this study, 4,211 cases were collected from 1999 to 2008 through a multicenter retrospective study of varying geographic and socioeconomic areas to illustrate trends of surgeries in the People's Republic of China. The correlations between demographic and tumor characteristics and among methods of surgical treatment were explored. This study shows that the rate of breast-conserving surgery (BCS) increased and the rate of mastectomy declined over

  15. Duloxetine for the management of diabetic peripheral neuropathic pain: evidence-based findings from post hoc analysis of three multicenter, randomized, double-blind, placebo-controlled, parallel-group studies

    DEFF Research Database (Denmark)

    Kajdasz, Daniel K; Iyengar, Smriti; Desaiah, Durisala

    2007-01-01

    peripheral neuropathic pain (DPNP). METHODS: Data were pooled from three 12-week, multicenter, randomized, double-blind, placebo-controlled, parallel-group studies in which patients received 60 mg duloxetine either QD or BID or placebo. NNT was calculated based on rates of response (defined as >or=30...

  16. Surgical outcomes of robot-assisted rectal cancer surgery using the da Vinci Surgical System: a multi-center pilot Phase II study.

    Science.gov (United States)

    Tsukamoto, Shunsuke; Nishizawa, Yuji; Ochiai, Hiroki; Tsukada, Yuichiro; Sasaki, Takeshi; Shida, Dai; Ito, Masaaki; Kanemitsu, Yukihide

    2017-12-01

    We conducted a multi-center pilot Phase II study to examine the safety of robotic rectal cancer surgery performed using the da Vinci Surgical System during the introduction period of robotic rectal surgery at two institutes based on surgical outcomes. This study was conducted with a prospective, multi-center, single-arm, open-label design to assess the safety and feasibility of robotic surgery for rectal cancer (da Vinci Surgical System). The primary endpoint was the rate of adverse events during and after robotic surgery. The secondary endpoint was the completion rate of robotic surgery. Between April 2014 and July 2016, 50 patients were enrolled in this study. Of these, 10 (20%) had rectosigmoid cancer, 17 (34%) had upper rectal cancer, and 23 (46%) had lower rectal cancer; six underwent high anterior resection, 32 underwent low anterior resection, 11 underwent intersphincteric resection, and one underwent abdominoperineal resection. Pathological stages were Stage 0 in 1 patient, Stage I in 28 patients, Stage II in 7 patients and Stage III in 14 patients. Pathologically complete resection was achieved in all patients. There was no intraoperative organ damage or postoperative mortality. Eight (16%) patients developed complications of all grades, of which 2 (4%) were Grade 3 or higher, including anastomotic leakage (2%) and conversion to open surgery (2%). The present study demonstrates the feasibility and safety of robotic rectal cancer surgery, as reflected by low morbidity and low conversion rates, during the introduction period. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  17. Burnout Among Otolaryngology Residents in Saudi Arabia: A Multicenter Study.

    Science.gov (United States)

    Aldrees, Turki; Badri, Motasim; Islam, Tahera; Alqahtani, Khalid

    2015-01-01

    Determine the prevalence of, and associated risk factors for, burnout among otolaryngologist residents in Saudi Arabia. A cross-section study of multicenter hospitals in Saudi Arabia conducted in March 2013. Registered residents in Saudi Otolaryngology Board Program. The Maslach Burnout Inventory was used to measure burnout status. Questions supplementary to the Maslach Burnout Inventory were also included to identify associated potential risk factors such as demographic data, resident satisfaction, and work conditions. Of the initial 123 questionnaires that were distributed, 85 yielded responses, a rate of 69%. The mean age (standard deviation [SD]) of respondents was 29 (2.3) years. Of those, 67% (57/85) were men and 66% (55/85) were married. Resident levels were delineated: level 2, 19%; level 3, 33%; level 4, 29%; and level 5, 19%. The mean number of on-call days/month (SD) was 7 (2), clinics/week (SD) was 3 (1), sleep hours/day (SD) was 6 (1), and operations/week (SD) was 2 (1). The mean emotional exhaustion (EE) and depersonalization scores were high at 29.5 (SD = 9.6) and 10.7 (SD = 6), respectively. The mean personal accomplishment was low at 32.33 (SD = 6). The mean of all subscales did not differ by sex (EE p = 0.5; depersonalization p = 0.09; personal accomplishment p = 0.4). Mean EE differed by marital status, which was 31.2, 31.3, and 25.6 for married, divorced, and single, respectively, analysis of variance test p = 0.045. Burnout prevalence was found to be high among otolaryngologist residents in Saudi Arabia. The associated variables examined in this study should be addressed to decrease this level of burnout and provide residents with a less stressful work environment. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  18. Determination of serum albumin, analytical challenges: a French multicenter study.

    Science.gov (United States)

    Rossary, Adrien; Blondé-Cynober, Françoise; Bastard, Jean-Philippe; Beauvieux, Marie-Christine; Beyne, Pascale; Drai, Jocelyne; Lombard, Christine; Anglard, Ingrid; Aussel, Christian; Claeyssens, Sophie; Vasson, Marie-Paule

    2017-06-01

    Among the biological markers of morbidity and mortality, albumin holds a key place in the range of criteria used by the High Authority for Health (HAS) for the assessment of malnutrition and the coding of information system medicalization program (PMSI). If the principle of quantification methods have not changed in recent years, the dispersion of external evaluations of the quality (EEQ) data shows that the standardization using the certified reference material (CRM) 470 is not optimal. The aim of this multicenter study involving 7 sites, conducted by a working group of the French Society of Clinical Biology (SFBC), was to assess whether the albuminemia values depend on the analytical system used. The albumin from plasma (n=30) and serum (n=8) pools was quantified by 5 different methods [bromocresol green (VBC) and bromocresol purple (PBC) colorimetry, immunoturbidimetry (IT), immunonephelometry (IN) and capillary electrophoresis (CE)] using 12 analyzers. Bland and Altman's test evaluated the difference between the results obtained by the different methods. For example, a difference as high as 13 g/L was observed for the same sample between the methods (p albumin across the range of values tested compared to PBC (p albumin values inducing a difference of performance between the immunoprecipitation methods (IT vs IN, p albumin results are related to the technical/analyzer tandem used. This variability is usually not taken into account by the clinician. Thus, clinicians and biologists have to be aware and have to check, depending on the method used, the albumin thresholds identified as risk factors for complications related to malnutrition and PMSI coding.

  19. MiDas: automatic extraction of a common domain of discourse in sleep medicine for multi-center data integration.

    Science.gov (United States)

    Sahoo, Satya S; Ogbuji, Chimezie; Luo, Lingyun; Dong, Xiao; Cui, Licong; Redline, Susan S; Zhang, Guo-Qiang

    2011-01-01

    Clinical studies often use data dictionaries with controlled sets of terms to facilitate data collection, limited interoperability and sharing at a local site. Multi-center retrospective clinical studies require that these data dictionaries, originating from individual participating centers, be harmonized in preparation for the integration of the corresponding clinical research data. Domain ontologies are often used to facilitate multi-center data integration by modeling terms from data dictionaries in a logic-based language, but interoperability among domain ontologies (using automated techniques) is an unresolved issue. Although many upper-level reference ontologies have been proposed to address this challenge, our experience in integrating multi-center sleep medicine data highlights the need for an upper level ontology that models a common set of terms at multiple-levels of abstraction, which is not covered by the existing upper-level ontologies. We introduce a methodology underpinned by a Minimal Domain of Discourse (MiDas) algorithm to automatically extract a minimal common domain of discourse (upper-domain ontology) from an existing domain ontology. Using the Multi-Modality, Multi-Resource Environment for Physiological and Clinical Research (Physio-MIMI) multi-center project in sleep medicine as a use case, we demonstrate the use of MiDas in extracting a minimal domain of discourse for sleep medicine, from Physio-MIMI's Sleep Domain Ontology (SDO). We then extend the resulting domain of discourse with terms from the data dictionary of the Sleep Heart and Health Study (SHHS) to validate MiDas. To illustrate the wider applicability of MiDas, we automatically extract the respective domains of discourse from 6 sample domain ontologies from the National Center for Biomedical Ontologies (NCBO) and the OBO Foundry.

  20. Effect of H2O2 on the in vitro growth of Mycosphaerella fijiensis Cuban isolate

    Directory of Open Access Journals (Sweden)

    María I. Oloriz

    2014-04-01

    Full Text Available Black leaf streak disease (Mycosphaerella fijiensis Morelet is the main foliar disease of bananas and plantain. One of the possible mechanisms of resistance is the hypersensitive response observed in ‘Calcutta 4’ (Musa AA that involves the formation of reactive oxygen species. In order to determine the effect of H2O2 on the in vitro growth of M. fijiensis Cuban isolate CCIBP-Pf-83, several concentrations added to a culture medium PDB were tested. After seven days of incubation the mycelial dry weight was determined. It was found that with 30 mmol l-1 H2O2 in the culture medium, mycelial growth was stimulated and with 50 up to 100 mmol l-1 it decreased. The results provide elements for understanding plantpathogen interactions in this pathosystem. Key words: black leaf streak disease, in vitro culture, ROS

  1. In vivo field dependence of proton relaxation times in human brain, liver and skeletal muscle: a multicenter study

    DEFF Research Database (Denmark)

    Henriksen, O; de Certaines, J D; Spisni, A

    1993-01-01

    and MRS, the in vivo field dispersion of T1 and T2 has been measured in order to evaluate whether ex vivo data are representative for the in vivo situation. Brain, skeletal muscle, and liver of healthy human volunteers were studied. Fifteen MR units with a field strength ranging from 0.08 T to 1.5 T took......T1 and T2 relaxation times are fundamental parameters for signal contrast behaviour in MRI. A number of ex vivo relaxometry studies have dealt with the magnetic field dispersion of T1. By means of multicenter study within the frame of the COMAC BME Concerted Action on Tissue Characterization by MRI......, whereas no significant variations were seen for T2. Our in vivo data were generally in reasonable agreement with proposed models based on ex vivo measurements....

  2. Combined therapy with peritoneal dialysis and hemodialysis: a multicenter retrospective observational cohort study in Japan.

    Science.gov (United States)

    Maruyama, Yukio; Yokoyama, Keitaro; Nakayama, Masaaki; Higuchi, Chieko; Sanaka, Tsutomu; Tanaka, Yoshihide; Sakai, Ken; Mizuiri, Sonoo; Otsuka, Yasushi; Kuriyama, Satoru; Maeba, Teruhiko; Iwasawa, Hideaki; Nakao, Toshiyuki; Hosoya, Tatsuo

    2014-01-01

    Combining peritoneal dialysis (PD) and hemodialysis (HD) has been common treatment option in Japan. In this retrospective, multicenter, observational study, the clinical characteristics and outcomes of 104 patients (57 ± 11 years, males 72%) who had switched from PD alone to combined therapy with PD and HD were studied. Clinical parameters were measured at baseline and after 3 months of combined therapy. At baseline, urine volume, dialysate-to-plasma ratio of creatinine (D/P Cr), and total Kt/V were 150 ml/day (range: 0-2,000 ml/day), 0.67 ± 0.11, and 1.8 ± 0.4, respectively. During the first 3 months of combined therapy, body weight, urine volume, serum creatinine level, and D/P Cr decreased, whereas hemoglobin levels increased. In patients where PD does not result in acceptable outcomes, combined therapy with PD and HD may have potential benefits in terms of dialysis adequacy and hydration status. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=368389 © 2014 S. Karger AG, Basel.

  3. Macrolide use and the risk of vascular disease in HIV-infected men in the Multicenter AIDS Cohort Study

    DEFF Research Database (Denmark)

    Woolley, Ian J; Li, Xiuhong; Jacobson, Lisa P

    2007-01-01

    of macrolide prophylaxis on those outcomes. METHODS: A subcohort analysis was undertaken using data collected in the Multicenter AIDS Cohort Study to examine the relative risk of vascular events (myocardial infarction, unstable angina and ischaemic stroke). Cox proportional hazard model using age as the time...... scale with time varying cofactors obtained at each semi-annual visit were used to assess the independent effect of macrolide use. RESULTS: Controlling for other significant effects including race and smoking, HIV-infection was not independently associated with vascular events. Increased risk......BACKGROUND: There has been increasing concern that HIV-infected individuals may be more at risk for cardiovascular events in the highly-active antiretroviral therapy (HAART) era. This study examined the risk of thromboembolic events in HIV-infected and non-infected individuals and the effect...

  4. Clinicopathological Features of Ocular Adnexal Mantle-Cell Lymphoma in an International Multicenter Cohort

    DEFF Research Database (Denmark)

    Knudsen, Marina K H; Rasmussen, Peter K; Coupland, Sarah E

    2017-01-01

    Importance: To our knowledge, the clinical features of ocular adnexal mantle-cell lymphoma (OA-MCL) have not previously been evaluated in a large multicenter cohort. Objective: To characterize the clinical features of OA-MCL. Design, Setting, and Participants: This retrospective multicenter study...... included patient data collected from January 1, 1980, through December 31, 2015, at 6 eye cancer centers in 4 countries. Medical records of 55 patients with OA-MCL were reviewed; the median length of follow-up was 33 months. Main Outcomes and Measures: Overall survival, disease-specific survival....... Overall survival rates for the entire cohort were 65% at 3 years (95% CI, 52%-78%) and 34% at 5 years (95% CI, 21%-47%). Disease-specific survival after 5 years was 38% for the entire cohort (95% CI, 25%-51%); the disease-specific survival adjusted by eye cancer center was better in patients who had...

  5. Prevalence of incidental findings on magnetic resonance imaging: Cuban project to map the human brain

    International Nuclear Information System (INIS)

    Hernandez Gonzalez, Gertrudis de los Angeles; Alvarez Sanchez, Marilet; Jordan Gonzalez, Jose

    2010-01-01

    To determine the prevalence of incidental findings in healthy subjects of the Cuban Human Brain Mapping Project sample, it was performed a retrospective descriptive study of the magnetic resonance imaging (MRI) obtained from 394 healthy subjects that make up the sample of the project, between 2006-2007, with an age range of 18 to 68 years (mean 33,12), of which 269 (68,27 %) are male and 125 (31,73 %) are women. It was shown that 40,36 % had one or more anomaly in the magnetic resonance imaging (MRI). In total, the number of incidental findings was 188, 23,6 % of which were brain findings and 24,11 % were non-brain findings, among the latter, were the sinusopathy with 20,81 % and maxillary polyps with 3,30 %. The most prevalent brain findings were: intrasellar arachnoidocele, 11,93 %, followed by the prominence of the pituitary gland, 5,84 %, ventricular asymmetry, 1,77 % and bone defects, 1,02 %. Other brain abnormalities found with very low prevalence had no pathological significance, except for two cases with brain tumor, which were immediately sent to a specialist. Incidental findings in MRI are common in the general population (40,36 %), being the sinusopathy, and intrasellar arachnoidocele the most common findings. Asymptomatic individuals who have any type of structural abnormality provide invaluable information on the prevalence of these abnormalities in a presumably healthy population, which may be used as references for epidemiological studies

  6. Macrosomia Predictors in Infants Born to Cuban Mothers with Gestational Diabetes.

    Science.gov (United States)

    Cruz, Jeddú; Grandía, Raiden; Padilla, Liset; Rodríguez, Suilbert; Hernández García, Pilar; Lang Prieto, Jacinto; Márquez-Guillén, Antonio

    2015-07-01

    INTRODUCTION Fetal macrosomia is the most important complication in infants of women with diabetes, whether preconceptional or gestational. Its occurrence is related to certain maternal and fetal conditions and negatively affects maternal and perinatal outcomes. The definitive diagnosis is made at birth if a newborn weighs >4000 g. OBJECTIVE Identify which maternal and fetal conditions could be macrosomia predictors in infants born to Cuban mothers with gestational diabetes. METHODS A case-control study comprising 236 women with gestational diabetes who bore live infants (118 with macrosomia and 118 without) was conducted in the América Arias University Maternity Hospital, Havana, Cuba, during 2002-2012. The dependent variable was macrosomia (birth weight >4000 g). Independent maternal variables included body mass index at pregnancy onset, overweight or obesity at pregnancy onset, gestational age at diabetes diagnosis, pregnancy weight gain, glycemic control, triglycerides and cholesterol. Fetal variables examined included third-semester fetal abdominal circumference, estimated fetal weight at ≥28 weeks (absolute and percentilized by Campbell and Wilkin, and Usher and McLean curves). Chi square was used to compare continuous variables (proportions) and the student t test (X ± SD) for categorical variables, with significance threshold set at p gestational diabetes diagnosis, total fasting cholesterol and hypercholesterolemia. The highest OR for macrosomia were for maternal hypertriglyceridemia (OR 4.80, CI 2.34-9.84), third-trimester fetal abdominal circumference >75th percentile (OR 7.54, CI 4.04-14.06), and estimated fetal weight >90th percentile by Campbell and Wilkin curves (OR 4.75, CI 1.42-15.84) and by Usher and McLean curves (OR 8.81, CI 4.25-18.26). CONCLUSIONS Most variables assessed were predictors of macrosomia in infants of mothers with gestational diabetes. They should therefore be taken into account for future studies and for patient management

  7. Multicenter transversal two-phase study to determine a national prevalence of epilepsy in Algeria.

    Science.gov (United States)

    Moualek, Dalila; Pacha, Lamia Ali; Abrouk, Samira; Kediha, Mohamed Islam; Nouioua, Sonia; Aissa, Leila Ait; Bellatache, Mounia; Belarbi, Soreya; Slimani, Saddek; Khennouf, Houria; Fellahi, Lynda; El Amine Hamimed, Mohamed; Benali, Nadia; Chekkour, Mohamed Chahine; Maamoun, Ramdane; Dameche, Rachida; Assami, Salima; Tazir, Meriem

    2012-01-01

    The prevalence of epilepsy in Algeria is unknown. The aims of this multicenter transversal study were to determine the national prevalence and clinical characteristics of epilepsy in the Algerian population. This two-phase study was conducted in 5 circumscriptions and included 8,046 subjects aged over 2 months who attended the randomly selected public and private primary care clinics. In the phase 1 study, a questionnaire was submitted to the sample of patients. In the phase 2 study, all potentially epileptic people were examined by neurologists and a second questionnaire was submitted, eventually assessed by appropriate investigations. Sixty-seven patients were identified as having active epilepsy, giving a crude prevalence ratio of 8.32 per 1,000 (95% CI, 6.34-10.3) and an age-adjusted prevalence ratio of 8.9 per 1,000. The highest age-specific ratio was found in patients aged 10-19 years (16.92 per 1,000). Generalized seizures (68.7%) were more common than partial seizures (29.8%). Perinatal injuries were the major leading putative causes (11.9%). The prevalence of epilepsy of 8.32 determined in this study is relatively high. These results provide new epidemiological data and suggest that epilepsy remains an important public health issue to consider in Algeria. Copyright © 2012 S. Karger AG, Basel.

  8. Preliminary report: prescription of prism-glasses by the Measurement and Correction Method of H.-J. Haase or by conventional orthoptic examination: a multicenter, randomized, double-blind, cross-over study

    NARCIS (Netherlands)

    Simonsz, H. J.; van Els, J.; Ruijter, J. M.; Bakker, D.; Spekreijse, H.

    2001-01-01

    In a multicenter, randomized, double-blind, cross-over study in the Netherlands, the effectiveness of (prism-)glasses prescribed by the Measurement and Correction Method of H.-J. Haase (MKH) was compared to that of glasses prescribed by conventional orthoptic examination. Nine pairs of

  9. "Burnout in Medical Oncology Fellows: a Prospective Multicenter Cohort Study in Brazilian Institutions".

    Science.gov (United States)

    Cubero, Daniel I G; Fumis, Renata Rego Lins; de Sá, Thiago Hérick; Dettino, Aldo; Costa, Felipe Osório; Van Eyll, Brigitte M R H Adam; Beato, Carlos; Peria, Fernanda Maris; Mota, Augusto; Altino, José; Azevedo, Sérgio Jobim; da Rocha Filho, Duílio Reis; Moura, Melba; Lessa, Álvaro Edson Ramos; Del Giglio, Auro

    2016-09-01

    Burnout syndrome is a common occurrence among oncologists. Doctors enrolled in residency programs in clinical oncology are exposed to similar risk factors; however, few data are available in this population. This study assessed the occurrence of burnout and associated factors among first-year residents at Brazilian institutions. The present prospective, multicenter, cohort study was conducted with doctors enrolled in residency programs in clinical oncology at Brazilian institutions affiliated with the public health system. The participants answered a sociodemographic questionnaire, the Maslach Burnout Inventory (MBI), Lipp's Stress Inventory, and the Beck Depression Inventory (BDI), upon admission to the program and 6 and 12 months later. Of 37 eligible residency programs in 2009, 11 (30.6 %) agreed to participate in the study. Fifty-four residents, representing 100 % of new admissions to the participating institutions, were included. Most of the participants met the criteria for severe burnout upon admission to the residency programs (emotional exhaustion in 49.0 % and depersonalization in 64.7 %). The scores on MBI domains emotional exhaustion and depersonalization increased significantly (p burnout increased to 88 % at the end of that first year. The present study found a high prevalence of burnout among doctors enrolled in residency programs in clinical oncology at Brazilian institutions. A large fraction of the participants met the criteria for burnout syndrome upon admission to the program, which suggests that the problem began during the course of the previous residency program in internal medicine.

  10. Quantitative multi-parameter mapping of R1, PD*, MT and R2* at 3T: a multi-center validation

    Directory of Open Access Journals (Sweden)

    Nikolaus eWeiskopf

    2013-06-01

    Full Text Available Multi-center studies using magnetic resonance imaging facilitate studying small effect sizes, global population variance and rare diseases. The reliability and sensitivity of these multi-center studies crucially depend on the comparability of the data generated at different sites and time points. The level of inter-site comparability is still controversial for conventional anatomical T1-weighted MRI data. Quantitative multi-parameter mapping (MPM was designed to provide MR parameter measures that are comparable across sites and time points, i.e., 1mm high-resolution maps of the longitudinal relaxation rate (R1=1/T1, effective proton density (PD*, magnetization transfer saturation (MT and effective transverse relaxation rate (R2*=1/T2*. MPM was validated at 3T for use in multi-center studies by scanning five volunteers at three different sites. We determined the inter-site bias, inter-site and intra-site coefficient of variation (CoV for typical morphometric measures (i.e., gray matter probability maps used in voxel-based morphometry and the four quantitative parameters. The inter-site bias and CoV were smaller than 3.1% and 8%, respectively, except for the inter-site CoV of R2* (< 20%. The gray matter probability maps based on the MT parameter maps had a 14% higher inter-site reproducibility than maps based on conventional T1-weighted images. The low inter-site bias and variance in the parameters and derived gray matter probability maps confirm the high comparability of the quantitative maps across sites and time points. The reliability, short acquisition time, high resolution and the detailed insights into the brain microstructure provided by MPM makes it an efficient tool for multi-center imaging studies.

  11. [Enterococcal endocarditis: a multicenter study of 76 cases].

    Science.gov (United States)

    Martínez-Marcos, Francisco Javier; Lomas-Cabezas, José Manuel; Hidalgo-Tenorio, Carmen; de la Torre-Lima, Javier; Plata-Ciézar, Antonio; Reguera-Iglesias, José María; Ruiz-Morales, Josefa; Márquez-Solero, Manuel; Gálvez-Acebal, Juan; de Alarcón-González, Arístides

    2009-12-01

    Although enterococci occupy the third position among microorganisms producing infectious endocarditis (IE) following streptococci and Staphylococcus aureus, few multicenter studies have provided an in-depth analysis of enterococcal IE. Description of the characteristics of 76 cases of enterococcal left-sided infectious endocarditis (LSIE) (native: 59, prosthetic: 17) retrieved from the database of the Cardiovascular Infections Study Group of the Andalusian Society of Infectious Diseases, with emphasis on the comparison with non-enterococcal LSIE. Enterococci were the causal agent in 76 of the 696 episodes of LSIE (11%). Compared with non-enterococcal LSIE, enterococcal LSIE was more commonly seen in patients older than 65 (47.4% vs. 27.6%, P<0.0005), and those with chronic diseases (75% vs. 54.6%, P<0.001), calcified valves (18.6% vs. 10%, P<0.05), and previous urinary (30.3% vs. 2.1%, P<0.00001) or abdominal (10.5% vs. 3.1%, P<0.01) infections, and produced a higher rate of relapses (6.6% vs. 2.3%, P<0.05). Enterococcal LSIE was associated with fewer peripheral vascular or skin manifestations (14.5% vs. 27.1%, P<0.05) and fewer immunological phenomena (10.5% vs. 24%, P<0.01). Among the total of patients with enterococcal LSIE, 36.8% underwent valve surgery during hospitalization. In-hospital mortality was 32.9% for enterococcal LSIE, 9.3% for viridans group streptococci (VGS) LSIE and 48.6% for S. aureus LSIE (enterococci vs VGS: P<0.0001; enterococci vs S. aureus: P=0.02). Enterococcal LSIE patients treated with the combination of a penicillin or vancomycin plus an aminoglycoside (n=60) and those treated with ampicillin plus ceftriaxone (n=6) showed similar in-hospital mortality (26.7% vs 33.3%, P=0.66). High-level resistance to gentamicin was detected in 5 of 38 episodes of enterococcal LSIE (13.1%). Enterococcal LSIE appears in patients with well-defined clinical characteristics, and causes few peripheral vascular or skin manifestations and few immunological

  12. Management of radioactive wastes from non-power applications. The Cuban experience

    International Nuclear Information System (INIS)

    Benitez, J.C.; Salgado, M.; Jova, L.

    2001-01-01

    Full text: Origin of Radioactive Wastes. The wastes arisen from the applications of radioisotopes in medicine are mainly liquids and solid materials contaminated with short lived radionuclides and sealed sources used in radiotherapy and for sterilization of medical materials. Radioactive wastes from industrial applications are generally disused sealed sources used in level detection, quality control, smoke detection and non-destructive testing. The principal forms of wastes generated by research institutes are miscellaneous liquids, trash, biological wastes, and scintillation vials, sealed sources and targets. Solid radioactive wastes are mainly produced during research works, cleaning and decontamination activities and they consist of rags, paper, cellulose, plastics, gloves, clothing, overshoes, etc. Laboratory materials such as cans, polyethylene bags and glass bottles also contribute to the solid waste inventory. Small quantities of non-compactable wastes are also collected and received for treatment. They include wood pieces, metal scrap, defective components and tools. Radioactive Waste Management Policy and Infrastructure. Since 1994 the Cuban integral policy of nuclear development is entrusted to the Nuclear Energy Agency of the Ministry of Science, Technology and Environment (CITMA). The National Center for Nuclear Safety (CNSN) is responsible for the licensing and supervision of radioactive and nuclear installations. The CPHR is in charge of waste management policy and therefore is responsible for centralized collection, transportation, treatment, conditioning, long term storage, and disposal of radioactive waste, as well as for developing new waste conditioning and containment methods. Radioactive Waste Management Facilities. Waste Treatment and Conditioning Plant (WTCP). The present facility is a building that includes a technological area of 100 m 2 and a laboratory area with a surface of around 30 m 2 . Other areas to be distinguished inside the

  13. MOG-IgG in NMO and related disorders: A multicenter study of 50 patients. Part 2

    DEFF Research Database (Denmark)

    Jarius, Sven; Ruprecht, Klemens; Kleiter, Ingo

    2016-01-01

    ), and electrophysiological features of a large cohort of MOG-IgG-positive patients with optic neuritis (ON) and/or myelitis (n=50) as well as attack and long-term treatment outcomes. Methods: Retrospective multicenter study. Results: The sex ratio was 1:2.8 (m:f). Median age at onset was 31years (range 6-70). The disease......; end-of-dose relapses occurred 9-12 months after the first infusion. Coexisting autoimmunity was rare (9%). Wingerchuk's 2006 and 2015 criteria for NMO(SD) and Barkhof and McDonald criteria for multiple sclerosis (MS) were met by 28%, 32%, 15%, 33%, respectively; MS had been suspected in 36%. Disease...... severe disease course and the short median time to second attack support the use of prophylactic long-term treatments in patients with MOG-IgG-positive ON and/or myelitis. © 2016 The Author(s)....

  14. The impact of skin diseases on quality of life: A multicenter study.

    Science.gov (United States)

    Sanclemente, G; Burgos, C; Nova, J; Hernández, F; González, C; Reyes, M I; Córdoba, N; Arévalo, Á; Meléndez, E; Colmenares, J; Ariza, S; Hernández, G

    2017-04-01

    To date, no formal study has been published regarding how Colombian patients with skin disorders could be affected according to their perception of disease. To determine the impact in quality of life of skin diseases in a Colombian population. This multicenter study included patients with skin disease from almost the whole country. Individuals >18 years old; of any gender; with any skin disease and who signed informed consent, were included. We applied the Colombian validated version of the Skindex-29 instrument. A total of 1896 questionnaires had sufficient information for the analyses. No significant differences in sociodemographic characteristics of patients who returned the questionnaire incomplete vs. complete, were found. Participants mean age was 41.5 years. There were no statistical differences in men vs. women regarding the global (p=0.37), symptoms (p=0.71) and emotions (p=0.32) domains, whereas statistical differences were found in the function domain (p=0.04; Mann-Whitney U test). Psoriasis, contact dermatitis, atopic dermatitis, urticaria, hair disorders, Hansen's disease, scars, hyperhidrosis and genital human papillomavirus disease scored the highest. Skindex-29 score variability as a result of differences in the location of the skin lesions, their inflammatory or non-inflammatory nature, and the start of therapy. Even the most localized or asymptomatic skin lesion in our population leads to a disruption at some level of patient's wellness. This study adds well supported scientific data of the burden of skin diseases worldwide. Copyright © 2016 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Change in Care Dependency of Stroke Patients: A Longitudinal and Multicenter Study.

    Science.gov (United States)

    Nursiswati, Nursiswati; Halfens, Ruud J G; Lohrmann, Christa

    2017-06-01

    The study was conducted to investigate the change of care dependency in stroke patients from inpatient wards and outpatient units in Indonesia. This study is longitudinal and multicentered. One hundred and nine patients were included from four hospitals on the island of Java. Care dependency was assessed using the Indonesian version of the 15-item Care Dependency Scale (CDS) at five points in time: at inpatient wards for admission and discharge and at outpatient units after discharge in the 1st week, the 5th week, and the 13th week. Most of the patients were male (65.1%), and diagnosed with ischemic stroke (71.5%). The results showed that care dependency in stroke patients decreased significantly from admission to discharge, as well as from the 5th to the 13th week as measured by the CDS. At admission, 23.0% of the patients were completely dependent on care, and at the 13th week about 1.0% were. Patients' care dependency decreased significantly in all care dependency items of the CDS in the inpatient ward, but five care dependency items of the CDS did not significantly decrease in the outpatient unit. Based on the findings of this study, we recommend that hospital-based and community-based services should include continual care dependence monitoring using this comprehensive instrument. Care dependency is subject to change over time, therefore nurses have to plan and tailor adequate nursing care measures to patient needs in the different stages, especially with respect to the aspect of mobility. Copyright © 2017. Published by Elsevier B.V.

  16. International Comparability of 131I, 201TI and 99mTc Activity Measurements performed in Cuban Nuclear Medicine

    International Nuclear Information System (INIS)

    Oropesa, P; Serra, R; Hernandez, A.T.; Varela, C

    2006-01-01

    This paper refers about the International Comparability of 131 I, 201 TI and 99m Tc Activity Measurements performed in Cuban Nuclear Medicine. Traceability of activity measurements in nuclear medicine based in two aspects: Comparability of clinic results and the safe and effective use of drugs. A bilateral international comparison for activity measurements CIEMAT CENTIS DMR was done. 2000-2004 National Program for 99m Tc 201 TI, 131 I vial and syringe measurements in radionuclide calibrators including a simulated test for activity administration. It is employed the Cause Effect Diagram for the activity measurement result of a source in the calibrator and the statistical methods for comparing several characteristics of the obtained data. The result of the comparisons demonstrates that the measurement quality has increased from one year to another

  17. Undernutrition, risk of malnutrition and obesity in gastroenterological patients: A multicenter study

    Institute of Scientific and Technical Information of China (English)

    Massimiliano Rizzi; Silvia Mazzuoli; Nunzia Regano; Rosa Inguaggiato; Margherita Bianco; Gioacchino Leandro; Elisabetta Bugianesi; Donatella Noè; Nicoletta Orzes; Paolo Pallini; Maria Letizia Petroni; Gianni Testino; Francesco William Guglielmi

    2016-01-01

    AIM: To investigate the prevalence of undernutrition, risk of malnutrition and obesity in the Italian gastroenterological population. METHODS: The Italian Hospital Gastroenterology Association conducted an observational, cross-sectional multicenter study. Weight, weight loss, and body mass index were evaluated. Undernutrition was defined as unintentional weight loss > 10% in the last threesix months. Values of Malnutrition Universal Screening Tool(MUST) > 2, NRS-2002 > 3, and Mini Nutritional Assessment(MNA) from 17 to 25 identified risk of malnutrition in outpatients, inpatients and elderly patients, respectively. A body mass index ≥ 30 indicated obesity. Gastrointestinal pathologies were categorized into acute, chronic and neoplastic diseases. RESULTS: A total of 513 patients participated in the study. The prevalence of undernutrition was 4.6% in outpatients and 19.6% in inpatients. Moreover, undernutrition was present in 4.3% of the gastrointestinal patients with chronic disease, 11.0% of those with acute disease, and 17.6% of those with cancer. The risk of malnutrition increased progressively and significantly in chronic, acute and neoplastic gastrointestinal diseases in inpatients and the elderly population. Logistical regression analysis confirmed that cancer was a risk factor for undernutrition(OR = 2.7; 95%CI: 1.2-6.44, P = 0.02). Obesity and overweight were more frequent in outpatients. CONCLUSION: More than 63% of outpatients and 80% of inpatients in gastroenterological centers suffered from significant changes in body composition and required specific nutritional competence and treatment.

  18. Multicenter study of antimicrobial susceptibility of anaerobic bacteria in Korea in 2012.

    Science.gov (United States)

    Lee, Yangsoon; Park, Yeon Joon; Kim, Mi Na; Uh, Young; Kim, Myung Sook; Lee, Kyungwon

    2015-09-01

    Periodic monitoring of regional or institutional resistance trends of clinically important anaerobic bacteria is recommended, because the resistance of anaerobic pathogens to antimicrobial drugs and inappropriate therapy are associated with poor clinical outcomes. There has been no multicenter study of clinical anaerobic isolates in Korea. We aimed to determine the antimicrobial resistance patterns of clinically important anaerobes at multiple centers in Korea. A total of 268 non-duplicated clinical isolates of anaerobic bacteria were collected from four large medical centers in Korea in 2012. Antimicrobial susceptibility was tested by the agar dilution method according to the CLSI guidelines. The following antimicrobials were tested: piperacillin, piperacillin-tazobactam, cefoxitin, cefotetan, imipenem, meropenem, clindamycin, moxifloxacin, chloramphenicol, metronidazole, and tigecycline. Organisms of the Bacteroides fragilis group were highly susceptible to piperacillin-tazobactam, imipenem, and meropenem, as their resistance rates to these three antimicrobials were lower than 6%. For B. fragilis group isolates and anaerobic gram-positive cocci, the resistance rates to moxifloxacin were 12-25% and 11-13%, respectively. Among B. fragilis group organisms, the resistance rates to tigecycline were 16-17%. Two isolates of Finegoldia magna were non-susceptible to chloramphenicol (minimum inhibitory concentrations of 16-32 mg/L). Resistance patterns were different among the different hospitals. Piperacillin-tazobactam, cefoxitin, and carbapemems are highly active beta-lactam agents against most of the anaerobes. The resistance rates to moxifloxacin and tigecycline are slightly higher than those in the previous study.

  19. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study

    Directory of Open Access Journals (Sweden)

    Marie Sylvianne Rabodoarivelo

    2018-01-01

    Full Text Available Background: In low-income countries, rapid detection of tuberculosis (TB drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF and isoniazid (INH resistance. Methods: This was a multicenter study. Molecular detection of RIF and INH resistance was performed directly from smear-positive TB sputa spotted on a slide, FTA card, GenoCard, and ethanol using the Genotype MTBDRplus assay. The performance of the DNA extraction method from each storage support to detect drug resistance was assessed by calculating their sensitivity and specificity compared to the phenotypic method. Results: From all sites, the overall sensitivity and specificity for RIF-resistance detection was 88% and 85%, respectively, for slides, 86% and 92%, respectively, for GenoCard, 87% and 89%, respectively, for FTA card, and 88% and 92%, respectively, for ethanol. For INH-resistance detection, the overall sensitivity and specificity was 82% and 90%, respectively, for slides, 85% and 96%, respectively, for GenoCard, 86% and 92%, respectively, for FTA card, and 86% and 94%, respectively, for ethanol. Conclusion: Smear slides and filter cards showed to be very useful tools to facilitate DNA extraction from sputum samples with the potential to accelerate the detection of drug resistance in remote areas.

  20. Detection of multidrug-resistant tuberculosis from stored DNA Samples: A multicenter study.

    Science.gov (United States)

    Rabodoarivelo, Marie Sylvianne; Brandao, A; Cergole Novella, M C; C Bombonatte, A G; Imperiale, B; Rakotosamimanana, N; Morcillo, N; Rasolofo, V; Palomino, J C; Martin, A

    2018-01-01

    In low-income countries, rapid detection of tuberculosis (TB) drug resistance is often restricted by the difficulties of transporting and storing sputum samples from remote health centers to the reference laboratories where molecular tests are available. The aim of this study was to evaluate the performance of four transport and storage systems for molecular detection of rifampicin (RIF) and isoniazid (INH) resistance. This was a multicenter study. Molecular detection of RIF and INH resistance was performed directly from smear-positive TB sputa spotted on a slide, FTA card, GenoCard, and ethanol using the Genotype MTBDRplus assay. The performance of the DNA extraction method from each storage support to detect drug resistance was assessed by calculating their sensitivity and specificity compared to the phenotypic method. From all sites, the overall sensitivity and specificity for RIF-resistance detection was 88% and 85%, respectively, for slides, 86% and 92%, respectively, for GenoCard, 87% and 89%, respectively, for FTA card, and 88% and 92%, respectively, for ethanol. For INH-resistance detection, the overall sensitivity and specificity was 82% and 90%, respectively, for slides, 85% and 96%, respectively, for GenoCard, 86% and 92%, respectively, for FTA card, and 86% and 94%, respectively, for ethanol. Smear slides and filter cards showed to be very useful tools to facilitate DNA extraction from sputum samples with the potential to accelerate the detection of drug resistance in remote areas.

  1. "Socialismo, Cooperativismo y Derecho. Dialéctica necesaria para la actualización del modelo económico cubano" (Socialism, Cooperativism and Law. Dialectics necessary to update the Cuban economic model

    Directory of Open Access Journals (Sweden)

    Orestes Rodríguez Musa

    2012-01-01

    Full Text Available The aim of this study is to assess the legal perspectives of the cooperative in the restructuring of the Cuban socialist economic model. For this purpose it will start with analyzing the thought of the classics of Marxism around cooperatives, to ponder lessons that have full effect. In a second part it will value the common features of the relation State-law-and cooperative in the models attached —as the Cuban— to socialism real or classic. It concludes with constructive comments to the political Guidelines that will guide the expansion and legal renewal of the cooperative sector in Cuba.

  2. Safety and preliminary immunogenicity of Cuban pneumococcal conjugate vaccine candidate in healthy children: a randomized phase I clinical trial.

    Science.gov (United States)

    Dotres, Carlos P; Puga, Rinaldo; Ricardo, Yariset; Broño, Carmen R; Paredes, Beatriz; Echemendía, Vladimir; Rosell, Sandra; González, Nadezhda; García-Rivera, Dagmar; Valdés, Yury; Goldblatt, David; Vérez-Bencomo, Vicente

    2014-09-15

    A new heptavalent conjugate vaccine (PCV7-TT) is under development in Cuba. PCV7-TT contains 2 μg of serotypes 1, 5, 14, 18C, 19F, 23F and 4 μg of 6B, each one conjugated to tetanus toxoid (TT). This vaccine was designed with the serotypes that cause most invasive pneumococcal diseases (IPD) worldwide. In the present study, we investigated the safety and explored the immunogenicity of PCV7-TT during a controlled, randomized and double blind clinical trial phase I in 4-5-year-old children. PCV7-TT was well tolerated and as safe as Synflorix used as control vaccine. Following a single-dose vaccination, all individual serotypes included in PCV7-TT induced statistically significant increase of IgG GMC and OPA GMT. These are the first clinical results of PCV7-TT in children and they pave the way toward next clinical trials in children and infants. This clinical trial was published in the Cuban Public Register of Clinical Trials with code RPCEC00000173. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Prevention of ICU delirium and delirium-related outcome with haloperidol: a study protocol for a multicenter randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Delirium is a frequent disorder in intensive care unit (ICU) patients with serious consequences. Therefore, preventive treatment for delirium may be beneficial. Worldwide, haloperidol is the first choice for pharmacological treatment of delirious patients. In daily clinical practice, a lower dose is sometimes used as prophylaxis. Some studies have shown the beneficial effects of prophylactic haloperidol on delirium incidence as well as on mortality, but evidence for effectiveness in ICU patients is limited. The primary objective of our study is to determine the effect of haloperidol prophylaxis on 28-day survival. Secondary objectives include the incidence of delirium and delirium-related outcome and the side effects of haloperidol prophylaxis. Methods This will be a multicenter three-armed randomized, double-blind, placebo-controlled, prophylactic intervention study in critically ill patients. We will include consecutive non-neurological ICU patients, aged ≥18 years with an expected ICU length of stay >1 day. To be able to demonstrate a 15% increase in 28-day survival time with a power of 80% and alpha of 0.05 in both intervention groups, a total of 2,145 patients will be randomized; 715 in each group. The anticipated mortality rate in the placebo group is 12%. The intervention groups will receive prophylactic treatment with intravenous haloperidol 1 mg/q8h or 2 mg/q8h, and patients in the control group will receive placebo (sodium chloride 0.9%), both for a maximum period of 28-days. In patients who develop delirium, study medication will be stopped and patients will subsequently receive open label treatment with a higher (therapeutic) dose of haloperidol. We will use descriptive summary statistics as well as Cox proportional hazard regression analyses, adjusted for covariates. Discussion This will be the first large-scale multicenter randomized controlled prevention study with haloperidol in ICU patients with a high risk of delirium, adequately

  4. Multi-Center Traffic Management Advisor Operational Field Test Results

    Science.gov (United States)

    Farley, Todd; Landry, Steven J.; Hoang, Ty; Nickelson, Monicarol; Levin, Kerry M.; Rowe, Dennis W.

    2005-01-01

    The Multi-Center Traffic Management Advisor (McTMA) is a research prototype system which seeks to bring time-based metering into the mainstream of air traffic control (ATC) operations. Time-based metering is an efficient alternative to traditional air traffic management techniques such as distance-based spacing (miles-in-trail spacing) and managed arrival reservoirs (airborne holding). While time-based metering has demonstrated significant benefit in terms of arrival throughput and arrival delay, its use to date has been limited to arrival operations at just nine airports nationally. Wide-scale adoption of time-based metering has been hampered, in part, by the limited scalability of metering automation. In order to realize the full spectrum of efficiency benefits possible with time-based metering, a much more modular, scalable time-based metering capability is required. With its distributed metering architecture, multi-center TMA offers such a capability.

  5. Aripiprazole for Irritability in Asian Children and Adolescents with Autistic Disorder: A 12-Week, Multinational, Multicenter, Prospective Open-Label Study.

    Science.gov (United States)

    Kim, Hyo-Won; Park, Eun-Jin; Kim, Ji-Hoon; Boon-Yasidhi, Vitharon; Tarugsa, Jariya; Reyes, Alexis; Manalo, Stella; Joung, Yoo-Sook

    2018-04-24

    We investigated the effectiveness and tolerability of aripiprazole in the treatment of irritability in Asian children and adolescents (6-17 years) with autistic disorder in a 12-week, multinational, multicenter, open-label study. Sixty-seven subjects (10.0 ± 3.1 years old, 52 boys) were enrolled and treated with flexibly dosed aripiprazole for 12 weeks (mean dose, 5.1 ± 2.5 mg; range 2-15 mg). Aripiprazole significantly reduced the mean caregiver-rated scores for the Irritability, Lethargy/Social Withdrawal, Stereotypy, Hyperactivity, and Inappropriate Speech subscales of the Aberrant Behavior Checklist from baseline to week 12 (p autistic disorder. Further studies with larger sample sizes and longer treatment durations are required.

  6. Prevalence of pilomatricoma in Turner syndrome: findings from a multicenter study.

    Science.gov (United States)

    Handler, Marc Z; Derrick, Kristina M; Lutz, Richard E; Morrell, Dean S; Davenport, Marsha L; Armstrong, April W

    2013-05-01

    The absence of data on the prevalence of pilomatricoma among patients with Turner syndrome served as the catalyst for this multicenter investigation. To ascertain the prevalence of pilomatricoma among patients with Turner syndrome and to determine any association between the development of pilomatricomas and the use of exogenous hormones in patients with Turner syndrome. A retrospective medical record review from January 1, 2000, through January 1, 2010, was performed of all patients with Turner syndrome. Data on pilomatricomas and the use of hormone therapy were collected. University of California-Davis Medical Center, University of Nebraska Medical Center, and The University of North Carolina at Chapel Hill. Patients with a diagnosis of Turner syndrome. Prevalence of concomitant pilomatricoma and diagnosis of Turner syndrome. Secondary outcome measures included the use of the exogenous hormones estrogen or recombinant human growth hormone (rhGH). In total, 311 patients with Turner syndrome were identified from these 3 institutions. Among them, 8 patients (2.6%) were diagnosed as having pilomatricomas. Before the development of pilomatricomas, 5 patients had been treated with rhGH but not estrogen, 1 patient had received estrogen but not rhGH, and 2 patients did not receive either therapy. Although the prevalence of pilomatricoma among the general population is unknown, this study demonstrates a high prevalence (2.6%) of pilomatricomas among patients with Turner syndrome. No apparent relationship was noted among our patients or in the literature between the use of rhGH and the development of pilomatricomas.

  7. ICA-based artifact removal diminishes scan site differences in multi-center resting-state fMRI

    NARCIS (Netherlands)

    R.A. Feis (Rogier A.); S.M. Smith (Stephen); N. Filippini (Nicola); G. Douaud (Gwenaëlle); E.G.P. Dopper (Elise); V. Heise (Verena); A.J. Trachtenberg (Aaron J.); J.C. van Swieten (John); M.A. van Buchem (Mark); S.A.R.B. Rombouts (Serge); C.E. Mackay (Clare E.)

    2015-01-01

    textabstractResting-state fMRI (R-fMRI) has shown considerable promise in providing potential biomarkers for diagnosis, prognosis and drug response across a range of diseases. Incorporating R-fMRI into multi-center studies is becoming increasingly popular, imposing technical challenges on data

  8. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

    Science.gov (United States)

    Steihaug, Ole Martin; Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

    2017-01-01

    Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

  9. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Ole Martin Steihaug

    Full Text Available Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a the feasibility of determining sarcopenia in patients with acute hip fracture, b the prevalence of sarcopenia and c associations of sarcopenia with nutritional status and comorbidities.A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score.Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37% were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR 1.4 per 5 years, 95% confidence interval (CI [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0].Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility.

  10. Sarcopenia in patients with hip fracture: A multicenter cross-sectional study

    Science.gov (United States)

    Gjesdal, Clara Gram; Bogen, Bård; Kristoffersen, Målfrid Holen; Lien, Gunhild; Ranhoff, Anette Hylen

    2017-01-01

    Background Sarcopenia is prevalent in older persons and is a risk factor for falls, fractures, and mortality. The aim of this study was to determine a) the feasibility of determining sarcopenia in patients with acute hip fracture, b) the prevalence of sarcopenia and c) associations of sarcopenia with nutritional status and comorbidities. Methods A multicenter cross-sectional study on sarcopenia in male and female patients with acute hip fracture. Participants were previously ambulatory and living in the community. Sarcopenia was assessed postoperatively with muscle mass estimated by anthropometry using triceps skinfold, arm circumference, height, weight and sex. Grip strength was measured by Jamar dynamometer and pre-fracture mobility was by self-report using the New Mobility Score. Results Out of 282 patients, 202 were assessed for sarcopenia of whom 74 (37%) were diagnosed as sarcopenic. Sarcopenia was associated with age, odds ratio (OR) 1.4 per 5 years, 95% confidence interval (CI) [1.1, 1.8], ASA Physical Status Classification System score, OR 2.3 per point, 95% CI [1.3, 4.3] and number of medications at discharge, OR 1.2 per medication, 95% CI [1.0, 1.3] and inversely associated with BMI, OR 0.8, 95% CI [0.7, 0.9] and serum albumin, OR 0.9, 95% CI [0.8,1.0]. Conclusions Thirty-seven percent of assessed subjects were diagnosed with sarcopenia. Our data demonstrates that the prevalence of sarcopenia is associated with older age, malnutrition and comorbidities. Determining sarcopenia at the bedside was feasible in postoperative hip fracture patients by using grip strength, estimation of muscle mass by anthropometry and self-reported mobility. PMID:28902873

  11. Levels of lead-210 (210Pb) and polonium 210 (210Po) in Cuban Tobacco products

    International Nuclear Information System (INIS)

    Brigido, F.O.; Barrerras Caballero, A.; Alvarez Rodriguez, D.; Montalvan Estrada, A.

    1999-01-01

    The release of 210Po in tobacco smoke and the radiation dose for man have been studied because of the high incidence of lung cancer among smoker. The electroplating of polonium at two different times onto copper disks and further measurement of alpha activity was the meted used for 210 Po determination in tobacco products. The Polonium daughter is used to determine both the 210Pb and 210Po using the Baseman equations for radioactive growth and decay. A cigarette contains between 10.6 and 14.7 mBq of 210Pb with an average activity of 13.0 mBq and between 8.5 and 12.3 mBq of 210Po with an average activity of 10.4 mBq for different Cuban cigarette brands. For a person smoking a pack of 20 cigarettes a day, the values of intakes estimated range from 32 to 44 mBq for 210Pb and from 34 to 49 mBq for 210 Po with an average daily intake of 39 mBq for 210 Pb and 42 mBq for 210Po. The annual effective dose estimated due to inhalation of these nuclides contained in cigarette smoke shows a value of 66[Sv and was in correspondence with world-wide range dose, 46 - 90 mSv.year 1 - for tobacco product consumption

  12. Profilaxis perioperatoria en cirugía urológica en hospitales cubanos Perioperative prophylaxis in urological surgery at Cuban hospitals

    Directory of Open Access Journals (Sweden)

    Humberto Guanche Garcell

    2011-12-01

    descriptive study was conducted over May-December, 2009 by application of self-administered questionnaire which assessed the existence of a politic (written document of prophylactic use and of recommendations for prophylaxis en selected procedures, the moment to administer the initial dose and the potential length of prophylactic regime as well as the antimicrobials used. Results: there was information from 24 hospitals (36.6 % of the Cuban urology services including institutions from the eleven provinces (84.6 %. In 17 services there are written politics (70.8 %. Most of them have indications of prophylaxis for assessed procedures and in 100 % of services to prostate transurethral resection, open or laparoscopic surgery including intestine, therapeutical cystoscopy and endoscopic internal urethrotomy. The 29.2 % of services recommended that the onset of prophylaxis be the night before, the 41.7 % 60 minutes before procedure and the 29.2 % during the anesthetic induction. Authors recommended 24 hours-higher outlines in most of procedures, except for the diagnostic or therapeutical cystoscopy. Different antimicrobials or combinations of it are used with predominance of ciprofloxacin and cefazolin. Conclusion: there is variability in practices of antimicrobials prescription in perioperative prophylaxis in Cuban urology services being necessary a national consensus contributing to improve the quality of fulfilment of this preventive practice.

  13. Evaluation of a multi-atlas based method for segmentation of cardiac CTA data: a large-scale, multicenter, and multivendor study

    International Nuclear Information System (INIS)

    Kirisli, H. A.; Schaap, M.; Klein, S.; Papadopoulou, S. L.; Bonardi, M.; Chen, C. H.; Weustink, A. C.; Mollet, N. R.; Vonken, E. J.; Geest, R. J. van der; Walsum, T. van; Niessen, W. J.

    2010-01-01

    Purpose: Computed tomography angiography (CTA) is increasingly used for the diagnosis of coronary artery disease (CAD). However, CTA is not commonly used for the assessment of ventricular and atrial function, although functional information extracted from CTA data is expected to improve the diagnostic value of the examination. In clinical practice, the extraction of ventricular and atrial functional information, such as stroke volume and ejection fraction, requires accurate delineation of cardiac chambers. In this paper, we investigated the accuracy and robustness of cardiac chamber delineation using a multiatlas based segmentation method on multicenter and multivendor CTA data. Methods: A fully automatic multiatlas based method for segmenting the whole heart (i.e., the outer surface of the pericardium) and cardiac chambers from CTA data is presented and evaluated. In the segmentation approach, eight atlas images are registered to a new patient's CTA scan. The eight corresponding manually labeled images are then propagated and combined using a per voxel majority voting procedure, to obtain a cardiac segmentation. Results: The method was evaluated on a multicenter/multivendor database, consisting of (1) a set of 1380 Siemens scans from 795 patients and (2) a set of 60 multivendor scans (Siemens, Philips, and GE) from different patients, acquired in six different institutions worldwide. A leave-one-out 3D quantitative validation was carried out on the eight atlas images; we obtained a mean surface-to-surface error of 0.94±1.12 mm and an average Dice coefficient of 0.93 was achieved. A 2D quantitative evaluation was performed on the 60 multivendor data sets. Here, we observed a mean surface-to-surface error of 1.26±1.25 mm and an average Dice coefficient of 0.91 was achieved. In addition to this quantitative evaluation, a large-scale 2D and 3D qualitative evaluation was performed on 1380 and 140 images, respectively. Experts evaluated that 49% of the 1380 images

  14. Nutritional Deficiencies in Children of the First 3 Years of Life, According to a Multicenter Study in Ukraine

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2015-04-01

    Full Text Available Taking into account the fact that in Ukraine today there is not enough researches that summarize the data on the nutritional status of young children, the prevalence of eating disorders and lack of basic macro- and micronutrients in children, the multicenter study on nutrition of children from 9 months to 3 years of life has been carried out. It was found that the present dietary intake of infants is unbalanced, contains excess energy and proteins, lack of zinc, iron, calcium, and vitamins A, D, E, B6, B12, B1. Due to unbalanced diet, the use of special infant formula instead of unmodified bovine milk in feeding young child can increase consumption of important nutrients (calcium, iron, iodine, vitamin E, D and folates.

  15. Nutritional Deficiencies in Children of the First 3 Years of Life, According to a Multicenter Study in Ukraine

    Directory of Open Access Journals (Sweden)

    S.L. Nyankovsky

    2013-08-01

    Full Text Available Taking into account the fact that in Ukraine today there is not enough researches that summarize the data on the nutritional status of young children, the prevalence of eating disorders and lack of basic macro- and micronutrients in children, the multicenter study on nutrition of children from 9 months to 3 years of life has been carried out. It was found that the present dietary intake of infants is unbalanced, contains excess energy and proteins, lack of zinc, iron, calcium, and vitamins A, D, E, B6, B12, B1. Due to unbalanced diet, the use of special infant formula instead of unmodified bovine milk in feeding young child can increase consumption of important nutrients (calcium, iron, iodine, vitamin E, D and folates.

  16. CT-based attenuation correction and resolution compensation for I-123 IMP brain SPECT normal database: a multicenter phantom study.

    Science.gov (United States)

    Inui, Yoshitaka; Ichihara, Takashi; Uno, Masaki; Ishiguro, Masanobu; Ito, Kengo; Kato, Katsuhiko; Sakuma, Hajime; Okazawa, Hidehiko; Toyama, Hiroshi

    2018-03-19

    Statistical image analysis of brain SPECT images has improved diagnostic accuracy for brain disorders. However, the results of statistical analysis vary depending on the institution even when they use a common normal database (NDB), due to different intrinsic spatial resolutions or correction methods. The present study aimed to evaluate the correction of spatial resolution differences between equipment and examine the differences in skull bone attenuation to construct a common NDB for use in multicenter settings. The proposed acquisition and processing protocols were those routinely used at each participating center with additional triple energy window (TEW) scatter correction (SC) and computed tomography (CT) based attenuation correction (CTAC). A multicenter phantom study was conducted on six imaging systems in five centers, with either single photon emission computed tomography (SPECT) or SPECT/CT, and two brain phantoms. The gray/white matter I-123 activity ratio in the brain phantoms was 4, and they were enclosed in either an artificial adult male skull, 1300 Hounsfield units (HU), a female skull, 850 HU, or an acrylic cover. The cut-off frequency of the Butterworth filters was adjusted so that the spatial resolution was unified to a 17.9 mm full width at half maximum (FWHM), that of the lowest resolution system. The gray-to-white matter count ratios were measured from SPECT images and compared with the actual activity ratio. In addition, mean, standard deviation and coefficient of variation images were calculated after normalization and anatomical standardization to evaluate the variability of the NDB. The gray-to-white matter count ratio error without SC and attenuation correction (AC) was significantly larger for higher bone densities (p correction. The proposed protocol showed potential for constructing an appropriate common NDB from SPECT images with SC, AC and spatial resolution compensation.

  17. Expanding the Use of Time-Based Metering: Multi-Center Traffic Management Advisor

    Science.gov (United States)

    Landry, Steven J.; Farley, Todd; Hoang, Ty

    2005-01-01

    Time-based metering is an efficient air traffic management alternative to the more common practice of distance-based metering (or "miles-in-trail spacing"). Despite having demonstrated significant operational benefit to airspace users and service providers, time-based metering is used in the United States for arrivals to just nine airports and is not used at all for non-arrival traffic flows. The Multi-Center Traffic Management Advisor promises to bring time-based metering into the mainstream of air traffic management techniques. Not constrained to operate solely on arrival traffic, Multi-Center Traffic Management Advisor is flexible enough to work in highly congested or heavily partitioned airspace for any and all traffic flows in a region. This broader and more general application of time-based metering is expected to bring the operational benefits of time-based metering to a much wider pool of beneficiaries than is possible with existing technology. It also promises to facilitate more collaborative traffic management on a regional basis. This paper focuses on the operational concept of the Multi-Center Traffic Management Advisor, touching also on its system architecture, field test results, and prospects for near-term deployment to the United States National Airspace System.

  18. Fingolimod Treatment in Relapsing-Remitting Multiple Sclerosis Patients: A Prospective Observational Multicenter Postmarketing Study

    Directory of Open Access Journals (Sweden)

    Rocco Totaro

    2015-01-01

    Full Text Available Objective. The aim of this prospective observational multicenter postmarketing study was to evaluate fingolimod efficacy in a real world clinical setting. Methods. One hundred forty-two subjects with relapsing-remitting multiple sclerosis (RRMS were enrolled in three multiple sclerosis centers throughout Central and Southern Italy between January 2011 and September 2013. After enrollment, regular visits and EDSS assessment were scheduled every 3 months, and MRI scan was obtained every 12 months. Patients were followed up from 1 to 33 months (mean 14.95 ± 9.15 months. The main efficacy endpoints included the proportion of patients free from clinical relapses, from disability progression, from magnetic resonance imaging activity, and from any disease activity. Results. Out of 142 patients enrolled in the study, 88.1% were free from clinical relapse and 69.0% were free from disability progression; 68.5% of patients remained free from new or newly enlarging T2 lesions and 81.7% of patients were free from gadolinium enhancing lesions. Overall the proportion of patients free from any disease activity was 41.9%. Conclusions. Our data in a real world cohort are consistent with previous findings that yield convincing evidence for the efficacy of fingolimod in patients with RRMS.

  19. Data on serologic inflammatory biomarkers assessed using multiplex assays and host characteristics in the Multicenter AIDS Cohort Study (MACS

    Directory of Open Access Journals (Sweden)

    Heather S. McKay

    2016-12-01

    Full Text Available This article contains data on the associations between fixed and modifiable host characteristics and twenty-three biomarkers of inflammation and immune activation measured longitudinally in a cohort of 250 HIV-uninfected men from the Multicenter AIDS Cohort Study (1984–2009 after adjusting for age, study site, and blood draw time of day using generalized gamma regression. This article also presents associations between each biomarker and each host characteristic in a sample restricted to 2001–2009. These data are supplemental to our original research article entitled “Host factors associated with serologic inflammatory markers assessed using multiplex assays” (McKay, S. Heather, Bream, H. Jay, Margolick, B. Joseph, Martínez-Maza, Otoniel, Phair, P. John, Rinaldo, R. Charles, Abraham, G. Alison, L.P. Jacobson, 2016 [1].

  20. Multicenter comparative study of conventional mechanical gas ventilation to tidal liquid ventilation in oleic acid injured sheep.

    Science.gov (United States)

    Wolfson, Marla R; Hirschl, Ronald B; Jackson, J Craig; Gauvin, France; Foley, David S; Lamm, Wayne J E; Gaughan, John; Shaffer, Thomas H

    2008-01-01

    We performed a multicenter study to test the hypothesis that tidal liquid ventilation (TLV) would improve cardiopulmonary, lung histomorphological, and inflammatory profiles compared with conventional mechanical gas ventilation (CMV). Sheep were studied using the same volume-controlled, pressure-limited ventilator systems, protocols, and treatment strategies in three independent laboratories. Following baseline measurements, oleic acid lung injury was induced and animals were randomized to 4 hours of CMV or TLV targeted to "best PaO2" and PaCO2 35 to 60 mm Hg. The following were significantly higher (p ventilation, physiologic shunt, plasma lactate, lung interleukin-6, interleukin-8, myeloperoxidase, and composite total injury score. No significant laboratories by treatment group interactions were found. In summary, TLV resulted in improved cardiopulmonary physiology at lower ventilatory requirements with more favorable histological and inflammatory profiles than CMV. As such, TLV offers a feasible ventilatory alternative as a lung protective strategy in this model of acute lung injury.

  1. Medical students and controversial ethical issues: results from the multicenter study SBRAME.

    Science.gov (United States)

    Lucchetti, Giancarlo; de Oliveira, Leandro Romani; Leite, José Roberto; Lucchetti, Alessandra Lamas Granero

    2014-12-15

    Medical students(MS) will face ethical issues throughout their lives as doctors. The present study aims to investigate medical students' opinions on controversial ethical issues and factors associated with these opinions. SBRAME (Spirituality and Brazilian Medical Education) is a multicenter study involving 12 Brazilian medical schools with 5950 MS. Participants completed a questionnaire that collected information on socio-demographic data, medical schools characteristics, religious beliefs and opinions on controversial ethical issues. Of all MS, 3630 participated in the survey (61.0%). The sample was 53.8% women and the mean age was 22.5 years. In general, most MS have no objections to prescription of birth control (90.8%), adult stem cell use (87.5%), embryonic stem cell use (82.0%) and abortion for genetic reasons (51.2%). Approximately half of students have no objections to human cloning (47.3%), 45.7% to withdrawal of artificial life support, 41.4% to euthanasia and 23.3% to abortion for failed contraception. Socio-demographic data such as age, gender and income had little influence on MS opinions. On the other hand, medical schools characteristics (number of medical students in the university, year of medical school foundation, location of the university and type of university) and religious aspects (religious affiliation, religious attendance, non-organizational religiousness and intrinsic religiousness) were highly correlated with their opinions. In general, MS with more supportive opinions on controversial ethical issues were less religious and from non-traditional (newer), urban, public and bigger universities. The current study reveals MS have different opinions regarding controversial ethical issues. Noteworthy, these opinions seem to be shaped more by university characteristics and religious beliefs than socio-demographic data.

  2. Decadal variability in growth of the Caribbean spiny lobster Panulirus argus (Decapoda: Paniluridae in Cuban waters

    Directory of Open Access Journals (Sweden)

    Maria Estela de León

    2005-09-01

    Full Text Available Annual von Bertalanffy growth parameters of the Caribbean spiny lobster (Panulirus argus in Cuban waters were estimated from a long term study (40 years by length-based methods ELEFAN and the new version of SLCA. Data of around 800 000 lobsters (with carapace length ranging 14 to 199mm were randomly sampled in artificial shelters (a non selective fishing gear very common in the lobster fishery, through the field monitory program established for this species since 1963 in 14 localities of southwestern Cuban shelf. The software ELEFAN showed problems to converge in an optimal combination of the instantaneous growth coefficient (K and the asymptotic length (L8 of the von Bertalanffy equation, whereas the new SLCA software produced value estimates of K between 0.20 and 0.27 year-1 and values of L8 between 177 and 190 mm carapace length, all within the range reported in the literature. The standardized anomalies of both parameters showed the presence of cycles along the analyzed time series. Decadal variability in growth parameters was revealed through the spectral analysis indicating cycles of 16 and 20 years for K and of 16 years for L8. The incidence of some factors such as biomass and temperature that modulate growth in this crustacean was explored, using a nonlinear multiple regression model. These combined factors explained 33% and 69% of the variability of K and L8 respectively. The growth coefficient appeared to be maximum with annual mean sea surface temperature of 28.1º C and the largest L 8is reached at a annual men biomass level of 23 000 t. These results should be the basis to understand the Cuban lobster population dynamics. Rev. Biol. Trop. 53(3-4: 475-486. Epub 2005 Oct 3.Los parámetros de crecimiento anuales para la langosta espinosa del Caribe (Panulirus argus en aguas cubanas se estimaron para una serie de 40 años de datos de composición por longitud, a través de los métodos indirectos basados en la talla ELEFAN y el nuevo

  3. How Many Samples and How Many Culture Media To Diagnose a Prosthetic Joint Infection: a Clinical and Microbiological Prospective Multicenter Study.

    Science.gov (United States)

    Bémer, Pascale; Léger, Julie; Tandé, Didier; Plouzeau, Chloé; Valentin, Anne Sophie; Jolivet-Gougeon, Anne; Lemarié, Carole; Kempf, Marie; Héry-Arnaud, Geneviève; Bret, Laurent; Juvin, Marie Emmanuelle; Giraudeau, Bruno; Corvec, Stéphane; Burucoa, Christophe

    2016-02-01

    Although numerous perioperative samples and culture media are required to diagnose prosthetic joint infection (PJI), their exact number and types have not yet been definitely determined with a high level of proof. We conducted a prospective multicenter study to determine the minimal number of samples and culture media required for accurate diagnosis of PJI. Over a 2-year period, consecutive patients with clinical signs suggesting PJI were included, with five perioperative samples per patient. The bacteriological and PJI diagnosis criteria were assessed using a random selection of two, three, or four samples and compared with those obtained using the recommended five samples (references guidelines). The results obtained with two or three culture media were then compared with those obtained with five culture media for both criteria. The times-to-positivity of the different culture media were calculated. PJI was confirmed in 215/264 suspected cases, with a bacteriological criterion in 192 (89%). The PJI was monomicrobial (85%) or polymicrobial (15%). Percentages of agreement of 98.1% and 99.7%, respectively, for the bacteriological criterion and confirmed PJI diagnosis were obtained when four perioperative samples were considered. The highest percentages of agreement were obtained with the association of three culture media, a blood culture bottle, a chocolate agar plate, and Schaedler broth, incubated for 5, 7, and 14 days, respectively. This new procedure leads to significant cost saving. Our prospective multicenter study showed that four samples seeded on three culture media are sufficient for diagnosing PJI. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  4. Factors associated with nursing students' academic success or failure: a retrospective Italian multicenter study.

    Science.gov (United States)

    Dante, A; Valoppi, G; Saiani, L; Palese, A

    2011-01-01

    With the increasing standardization of nursing education in Europe under the Bologna Process Declaration (1999), there is a growing interest in defining a common concept of academic success and/or failure, measuring associated factors and comparing differences and similarities between different countries. While there is literature available on these issues from other countries, the phenomenon has not been studied in Italy. The aim of this study was to define the factors associated with academic success or failure in an Italian cohort of nursing students on a bachelor's degree course. A retrospective multicenter study design was adopted. All students enrolling in the academic year 2004-05 on two different bachelor's courses in the north of Italy were interviewed. Only 81 of the 117 students considered (69.2%) concluded their course in three years. Multivariate analysis identified two factors determining academic success/failure: good results in the entry examination for the bachelor's degree in nursing sciences were associated with academic success (OR 4.217, IC(95%) 1.501-11.84), while family commitments, e.g. caring for children or elderly people were associated with academic failure (OR 0.120, IC(95%) 0.03-0.471). Academic failure has a strong impact on students, their families, the teaching faculties and the community, and its prevention is a challenge in the countries with a shortage of nurses. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Factors associated to depression and anxiety in medical students: a multicenter study

    Directory of Open Access Journals (Sweden)

    Fernanda Brenneisen Mayer

    2016-10-01

    Full Text Available Abstract Background To evaluate personal and institutional factors related to depression and anxiety prevalence of students from 22 Brazilian medical schools. Methods The authors performed a multicenter study (August 2011 to August 2012, examining personal factors (age, sex, housing, tuition scholarship and institutional factors (year of the medical training, school legal status, location and support service in association with scores of Beck Depression Inventory (BDI and State Trait Anxiety Inventory (STAI. Results Of 1,650 randomly selected students, 1,350 (81.8 % completed the study. The depressive symptoms prevalence was 41 % (BDI > 9, state-anxiety 81.7 % and trait-anxiety in 85.6 % (STAI > 33. There was a positive relationship between levels of state (r = 0,591, p < 0.001 and trait (r = 0,718, p < 0.001 anxiety and depression scores. All three symptoms were positively associated with female sex and students from medical schools located in capital cities of both sexes. Tuition scholarship students had higher state-anxiety but not trait-anxiety or depression scores. Medical students with higher levels of depression and anxiety symptoms disagree more than their peers with the statements “I have adequate access to psychological support” and “There is a good support system for students who get stressed”. Conclusions The factors associated with the increase of medical students’ depression and anxiety symptoms were female sex, school location and tuition scholarship. It is interesting that tuition scholarship students showed state-anxiety, but not depression and trait-anxiety symptoms.

  6. Multicenter Study of Brain Volume Abnormalities in Children and Adolescent-Onset Psychosis

    Science.gov (United States)

    Reig, Santiago; Parellada, Mara; Castro-Fornieles, Josefina; Janssen, Joost; Moreno, Dolores; Baeza, Inmaculada; Bargalló, Nuria; González-Pinto, Ana; Graell, Montserrat; Ortuño, Felipe; Otero, Soraya; Arango, Celso; Desco, Manuel

    2011-01-01

    The goal of the study is to determine the extent of structural brain abnormalities in a multicenter sample of children and adolescents with a recent-onset first episode of psychosis (FEP), compared with a sample of healthy controls. Total brain and lobar volumes and those of gray matter (GM), white matter, and cerebrospinal fluid (CSF) were measured in 92 patients with a FEP and in 94 controls, matched for age, gender, and years of education. Male patients (n = 64) showed several significant differences when compared with controls (n = 61). GM volume in male patients was reduced in the whole brain and in frontal and parietal lobes compared with controls. Total CSF volume and frontal, temporal, and right parietal CSF volumes were also increased in male patients. Within patients, those with a further diagnosis of “schizophrenia” or “other psychosis” showed a pattern similar to the group of all patients relative to controls. However, bipolar patients showed fewer differences relative to controls. In female patients, only the schizophrenia group showed differences relative to controls, in frontal CSF. GM deficit in male patients with a first episode correlated with negative symptoms. Our study suggests that at least part of the GM deficit in children and adolescent-onset schizophrenia and in other psychosis occurs before onset of the first positive symptoms and that, contrary to what has been shown in children-onset schizophrenia, frontal GM deficits are probably present from the first appearance of positive symptoms in children and adolescents. PMID:20478821

  7. A Multicenter Comparative Study of Impulse Control Disorder in Latin American Patients With Parkinson Disease.

    Science.gov (United States)

    Ramírez Gómez, Carolina Candelaria; Serrano Dueñas, Marcos; Bernal, Oscar; Araoz, Natalia; Sáenz Farret, Michel; Aldinio, Victoria; Montilla, Verónica; Micheli, Federico

    Impulse control disorder (ICD) is a common adverse effect in patients with Parkinson disease who receive dopamine agonists; however, other factors are involved in its manifestations. To study the frequency and factors involved in the development of this adverse effect in a Latin American population, we conducted a cross-sectional multicenter study. Two hundred fifty-five patients in 3 Latin American centers were evaluated by examination and application of scales (Unified Parkinson's Disease Rating Scale, Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale, Hoehn and Yahr, Clinical Impression of Severity Index for Parkinson's Disease). Of the patients, 27.4% had ICD, most of whom were on dopamine agonists. Other associated risk factors included a younger age at onset of Parkinson disease, moderate symptoms, a shorter evolution of the clinical manifestations, rapid eye movement (REM) sleep disorder behavior, and the consumption of tea, mate, and alcohol. The frequency of ICD is higher in Latin America than in Anglo-Saxon populations. Consuming tea and mate, in addition to the use of dopamine agonists, is a factor that may demonstrate a genetic link that predisposes patients to the establishment of an ICD.

  8. Kinetic and Related Determinants of Plasma Triglyceride Concentration in Abdominal Obesity: Multicenter Tracer Kinetic Study.

    Science.gov (United States)

    Borén, Jan; Watts, Gerald F; Adiels, Martin; Söderlund, Sanni; Chan, Dick C; Hakkarainen, Antti; Lundbom, Nina; Matikainen, Niina; Kahri, Juhani; Vergès, Bruno; Barrett, P Hugh R; Taskinen, Marja-Riitta

    2015-10-01

    Patients with obesity and diabetes mellitus have increased risk of cardiovascular disease. A major cause is an atherogenic dyslipidemia related primarily to elevated plasma concentrations of triglyceride-rich lipoproteins. The aim of this study was to clarify determinants of plasma triglyceride concentration. We focused on factors that predict the kinetics of very-low density lipoprotein 1 (VLDL1) triglycerides. A multicenter study using dual stable isotopes (deuterated leucine and glycerol) and multicompartmental modeling was performed to elucidate the kinetics of triglycerides and apoB in VLDL1 in 46 subjects with abdominal obesity and additional cardiometabolic risk factors. Results showed that plasma triglyceride concentrations were dependent on both the secretion rate (r=0.44, Ptriglycerides and VLDL1-apoB. Liver fat mass was independently and directly associated with secretion rates of VLDL1-triglycerides (r=0.56, Ptriglycerides (r=0.48, Ptriglyceride concentrations in abdominal obesity are determined by the kinetics of VLDL1 subspecies, catabolism being mainly dependent on apoC-III concentration and secretion on liver fat content. Reduction in liver fat and targeting apoC-III may be an effective approach for correcting triglyceride metabolism atherogenic dyslipidemia in obesity. © 2015 American Heart Association, Inc.

  9. The QUASAR reproducibility study, Part II: Results from a multi-center Arterial Spin Labeling test-retest study.

    Science.gov (United States)

    Petersen, Esben Thade; Mouridsen, Kim; Golay, Xavier

    2010-01-01

    Arterial Spin Labeling (ASL) is a method to measure perfusion using magnetically labeled blood water as an endogenous tracer. Being fully non-invasive, this technique is attractive for longitudinal studies of cerebral blood flow in healthy and diseased individuals, or as a surrogate marker of metabolism. So far, ASL has been restricted mostly to specialist centers due to a generally low SNR of the method and potential issues with user-dependent analysis needed to obtain quantitative measurement of cerebral blood flow (CBF). Here, we evaluated a particular implementation of ASL (called Quantitative STAR labeling of Arterial Regions or QUASAR), a method providing user independent quantification of CBF in a large test-retest study across sites from around the world, dubbed "The QUASAR reproducibility study". Altogether, 28 sites located in Asia, Europe and North America participated and a total of 284 healthy volunteers were scanned. Minimal operator dependence was assured by using an automatic planning tool and its accuracy and potential usefulness in multi-center trials was evaluated as well. Accurate repositioning between sessions was achieved with the automatic planning tool showing mean displacements of 1.87+/-0.95 mm and rotations of 1.56+/-0.66 degrees . Mean gray matter CBF was 47.4+/-7.5 [ml/100 g/min] with a between-subject standard variation SD(b)=5.5 [ml/100 g/min] and a within-subject standard deviation SD(w)=4.7 [ml/100 g/min]. The corresponding repeatability was 13.0 [ml/100 g/min] and was found to be within the range of previous studies.

  10. Approaches to Climate Change & Health in Cuba: Guillermo Mesa MD MPhil, Director, Disasters & Health, National School of Public Health. Paulo Ortiz MS PhD, Senior Researcher, Climate Center, Cuban Meteorology Institute.

    Science.gov (United States)

    Mesa, Guillermo; Ortiz, Paulo; Gorry, Conner

    2015-04-01

    The US National Institutes of Health predict climate change will cause an additional 250,000 deaths between 2030 and 2050, with damages to health costing US$2-$4 billion by 2030. Although much debate still surrounds climate change, island ecosystems-such as Cuba's-in the developing world are arguably among the most vulnerable contexts in which to confront climate variability. Beginning in the 1990s, Cuba launched research to develop the evidence base, set policy priorities, and design mitigation and adaptation actions specifically to address climate change and its effects on health. Two researchers at the forefront of this interdisciplinary, intersectoral effort are epidemiologist Dr Guillermo Mesa, who directed design and implementation of the nationwide strategy for disaster risk reduction in the Cuban public health system as founding director of the Latin American Center for Disaster Medicine (CLAMED) and now heads the Disasters and Health department at the National School of Public Health; and Dr Paulo Ortiz, a biostatistician and economist at the Cuban Meteorology Institute's Climate Center (CENCLIM), who leads the research on Cuba's Climate and Health project and is advisor on climate change and health for the UN Economic Commission for Latin America and the Caribbean (ECLAC).

  11. Health care utilization in patients with gout: a prospective multicenter cohort study.

    Science.gov (United States)

    Singh, Jasvinder A; Bharat, Aseem; Khanna, Dinesh; Aquino-Beaton, Cleopatra; Persselin, Jay E; Duffy, Erin; Elashoff, David; Khanna, Puja P

    2017-05-31

    All published studies of health care utilization in gout have been cross-sectional to date, and most used a patient-reported diagnosis of gout. Our objective was to assess health care utilization and its predictors in patients with physician-confirmed gout in a prospective cohort study. In a multi-center prospective cohort study of U.S. veterans with rheumatologist-confirmed gout (N = 186; two centers), we assessed patient self-reported overall and gout-specific health care utilization with the Gout Assessment Questionnaire (GAQ) every 3-months for a 9-month period. Comparisons were made using the student's t test or the chi-square, Wilcoxon rank sum test or Fisher exact test, as appropriate. Mixed effects Poisson regression was used to assess potential correlates of gout-related health care utilization. Mean age was 64.6 years, 98% were men, 13% Hispanic or Latino, 32% were African-American, 6% did not graduate high school, mean serum urate was 8.3 and mean Deyo-Charlson score was 3.1. During the past year, mean gout-related visits were as follows: rheumatologist, 1.5; primary care physician, 2 visits; ≥1 inpatient visits, 7%; ≥1 ER visits, 26%; and urgent care/walk-in visit, 33%. In longitudinal analyses, African-American race and gout flares in the last 3 months were associated with significantly higher rate ratio of gout-related outpatient visits. African-American race and lack of college education were associated with significantly higher rate ratio for gout-related urgent visits and overnight stays. African-American race and recent gout flares were associated with higher outpatient utilization and African-American race and no college education with higher urgent or inpatient utilization. Future studies should examine whether modifiable predictors of utilization can be targeted to reduce healthcare utilization in patients with gout.

  12. [The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire].

    Science.gov (United States)

    Goebel, G; Hiller, W

    1994-03-01

    The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. The present paper describes traditional diagnostic methods of ENT practice as well as the Tinnitus Questionnaire (TQ) which has been evaluated in a number of studies. This instrument differentiates between emotional and cognitive distress, auditory perceptual difficulties and self-experienced intrusiveness produced by the tinnitus. The results of a German multicenter study are presented which show that the TQ can be used to demonstrate differences of tinnitus distress under different clinical conditions (e.g., ENT clinic vs psychosomatic clinic and in- vs out-patient care). The TQ can be employed for comparative studies in different tinnitus-related institutions and for the evaluation of the relative effects of different treatment approaches.

  13. Multicenter Study of Staging and Therapeutic Predictors of Hepatocellular Carcinoma Recurrence following Transplantation.

    Science.gov (United States)

    Welling, Theodore H; Eddinger, Kevin; Carrier, Kristen; Zhu, Danting; Kleaveland, Tyler; Moore, Derek E; Schaubel, Douglas E; Abt, Peter L

    2018-05-05

    Orthotopic liver transplantation (OLT) and resection are effective treatments for hepatocellular carcinoma (HCC). However, optimizing OLT and limiting HCC recurrence remains a vexing problem. New HCC MELD and allocation algorithms provide greater observation of HCC patients, many while receiving local-regional treatments. Potential benefits of local-regional treatment for limiting HCC recurrence post-OLT remain incompletely understood. Therefore we aimed to define HCC specific prognostic factors affecting recurrence in a contemporary, multi-center cohort of HCC patients undergoing OLT and specifically whether local-regional therapies limited recurrence. We identified 441 patients undergoing OLT for HCC at three major transplant centers from 2008-2013. Cox regression was used to analyze covariate-adjusted recurrence and mortality rates post-OLT. "Bridging" or "down-staging" therapy was used in 238 patients (54%) with transarterial chemoembolization (TACE) being used in 170 (71%) of treated patients. The survival rate post-OLT was 88% and 78% at 1 and 3 years, respectively, with HCC recurrence (28% of deaths) significantly increasing mortality rate (HR=19.87, pOLT. Local-regional therapy to achieve a pathologic response (decreasing tumor size) can limit HCC recurrences post-OLT. This article is protected by copyright. All rights reserved. © 2018 by the American Association for the Study of Liver Diseases.

  14. Validation of the Spanish version of the Hip Outcome Score: a multicenter study.

    Science.gov (United States)

    Seijas, Roberto; Sallent, Andrea; Ruiz-Ibán, Miguel Angel; Ares, Oscar; Marín-Peña, Oliver; Cuéllar, Ricardo; Muriel, Alfonso

    2014-05-13

    The Hip Outcome Score (HOS) is a self-reported questionnaire evaluating the outcomes of treatment interventions for hip pathologies, divided in 19 items of activities of daily life (ADL) and 9 sports' items. The aim of the present study is to translate and validate HOS into Spanish. A prospective and multicenter study with 100 patients undergoing hip arthroscopy was performed between June 2012 and January 2013. Crosscultural adaptation was used to translate HOS into Spanish. Patients completed the questionnaire before and after surgery. Feasibility, reliability, internal consistency, construct validity (correlation with Western Ontario and McMaster Universities Osteoarthritis Index), ceiling and floor effects and sensitivity to change were assessed for the present study. Mean age was 45.05 years old. 36 women and 64 men were included. Feasibility: 13% had at least one missing item within the ADL subscale and 17% within the sport subscale. Reliability: the translated version of HOS was highly reproducible with intraclass correlation coefficient of 0.95 for ADL and 0.94 for the sports subscale. Internal consistency was confirmed with Cronbach's alpha >0.90 in both subscales. Construct validity showed statistically significant correlation with WOMAC. Ceiling effect was observed in 6% and 12% for ADL and sports subscale, respectively. Floor effect was found in 3% and 37% ADL and sports subscale, respectively. Large sensitivity to change was shown in both subscales. The translated version of HOS into Spanish has shown to be feasible, reliable and sensible to changes for patients undergoing hip arthroscopy. This validated translation of HOS allows for comparisons between studies involving either Spanish- or English-speaking patients. Prognostic study, Level I.

  15. Carotid Artery Injury in Anterior Cervical Spine Surgery: Multicenter Cohort Study and Literature Review.

    Science.gov (United States)

    Härtl, Roger; Alimi, Marjan; Abdelatif Boukebir, Mohamed; Berlin, Connor D; Navarro-Ramirez, Rodrigo; Arnold, Paul M; Fehlings, Michael G; Mroz, Thomas E; Riew, K Daniel

    2017-04-01

    Retrospective study and literature review. To provide more comprehensive data about carotid artery injury (CAI) or cerebrovascular accident (CVA) related to anterior cervical spine surgery. We conducted a retrospective, multicenter, case series study involving 21 high-volume surgical centers from the AOSpine North America Clinical Research Network. Medical records of 17 625 patients who went through cervical spine surgery (levels from C2 to C7) between January 1, 2005, and December 31, 2011, were analyzed. Also, we performed a literature review using Medline and PubMed databases. The following terms were used alone, and in combination, to search for relevant articles: cervical, spine, surgery, complication, iatrogenic, carotid artery, injury, cerebrovascular accident, CVA, and carotid stenosis. Among 17 625 patients that were analyzed, no cases were reported to experienced CAI or CVA after cervical spine surgery. Nevertheless, in our PubMed search we found 157 articles, but only 5 articles matched our study objective criteria; 2 cases were reported to present CAI and 3 cases presented CVA. CAI and CVA related to anterior cervical spine surgeries are extremely rare. We were not able to find neither in our retrospective study nor in our literature research a correlation between the type or length of anterior cervical spine procedure with CVA or CAI complications. However, surgeons should be aware of the possibility of vascular complications and minimize intraoperative direct vascular manipulations or retraction. Preoperative screening for underlying vascular pathology and risk factors is also important.

  16. A multicenter qualitative study on preventing hospital-acquired urinary tract infection in US hospitals.

    Science.gov (United States)

    Saint, Sanjay; Kowalski, Christine P; Forman, Jane; Damschroder, Laura; Hofer, Timothy P; Kaufman, Samuel R; Creswell, John W; Krein, Sarah L

    2008-04-01

    Although urinary tract infection (UTI) is the most common hospital-acquired infection, there is little information about why hospitals use or do not use a range of available preventive practices. We thus conducted a multicenter study to understand better how US hospitals approach the prevention of hospital-acquired UTI. This research is part of a larger study employing both quantitative and qualitative methods. The qualitative phase consisted of 38 semistructured phone interviews with key personnel at 14 purposefully sampled US hospitals and 39 in-person interviews at 5 of those 14 hospitals, to identify recurrent and unifying themes that characterize how hospitals have addressed hospital-acquired UTI. Four recurrent themes emerged from our study data. First, although preventing hospital-acquired UTI was a low priority for most hospitals, there was substantial recognition of the value of early removal of a urinary catheter for patients. Second, those hospitals that made UTI prevention a high priority also focused on noninfectious complications and had committed advocates, or "champions," who facilitated prevention activities. Third, hospital-specific pilot studies were important in deciding whether or not to use devices such as antimicrobial-impregnated catheters. Finally, external forces, such as public reporting, influenced UTI surveillance and infection prevention activities. Clinicians and policy makers can use our findings to develop initiatives that, for example, use a champion to promote the removal of unnecessary urinary catheters or exploit external forces, such public reporting, to enhance patient safety.

  17. Race, Ethnicity, Psychosocial Factors, and Telomere Length in a Multicenter Setting.

    Directory of Open Access Journals (Sweden)

    Shannon M Lynch

    Full Text Available Leukocyte telomere length(LTL has been associated with age, self-reported race/ethnicity, gender, education, and psychosocial factors, including perceived stress, and depression. However, inconsistencies in associations of LTL with disease and other phenotypes exist across studies. Population characteristics, including race/ethnicity, laboratory methods, and statistical approaches in LTL have not been comprehensively studied and could explain inconsistent LTL associations.LTL was measured using Southern Blot in 1510 participants from a multi-ethnic, multi-center study combining data from 3 centers with different population characteristics and laboratory processing methods. Main associations between LTL and psychosocial factors and LTL and race/ethnicity were evaluated and then compared across generalized estimating equations(GEE and linear regression models. Statistical models were adjusted for factors typically associated with LTL(age, gender, cancer status and also accounted for factors related to center differences, including laboratory methods(i.e., DNA extraction. Associations between LTL and psychosocial factors were also evaluated within race/ethnicity subgroups (Non-hispanic Whites, African Americans, and Hispanics.Beyond adjustment for age, gender, and cancer status, additional adjustments for DNA extraction and clustering by center were needed given their effects on LTL measurements. In adjusted GEE models, longer LTL was associated with African American race (Beta(β(standard error(SE = 0.09(0.04, p-value = 0.04 and Hispanic ethnicity (β(SE = 0.06(0.01, p-value = 0.02 compared to Non-Hispanic Whites. Longer LTL was also associated with less than a high school education compared to having greater than a high school education (β(SE = 0.06(0.02, p-value = 0.04. LTL was inversely related to perceived stress (β(SE = -0.02(0.003, p<0.001. In subgroup analyses, there was a negative association with LTL in African Americans with a high

  18. The Experience of Surrogate Decision Makers on Being Approached for Consent for Patient Participation in Research. A Multicenter Study.

    Science.gov (United States)

    Burns, Karen E A; Prats, Clara Juando; Maione, Maria; Lanceta, Mary; Zubrinich, Celia; Jeffs, Lianne; Smith, Orla M

    2017-02-01

    Recruitment in critical care research differs from other contexts in important ways: patients lack decision-making capacity, uncertainty exists regarding patient prognosis, and critical illnesses are often associated with appreciable morbidity and mortality. We aimed to describe the experiences of surrogate decision makers (SDMs) in being approached for consent for critically ill patients to participate in research. A multicenter, qualitative study involving semistructured interviews with 26 SDMs, who provided or declined surrogate consent for research participation, at 5 Canadian centers nested within a multicenter observational study of research recruitment practices. Transcripts were reviewed by three qualitative researchers, and data were analyzed using grounded theory and a narrative critical analysis. SDMs were guided by an overarching desire for the patient to live. Surrogate research decision-making involved three sequential stages: (1) being approached; (2) reflecting on participation; and (3) making a decision. In stage 1, SDMs identified factors (their expectations, how they were approached, the attributes of the person approaching, and study risks and benefits) that characterized their consent encounter and affirmed a preference to be approached in person. If SDMs perceived the risk of participation to be too high or felt patients may not benefit from participation, they did not contemplate further. In stage 2, SDMs who knew the patient's wishes or had a deeper understanding of research prioritized the patient's wishes and the perceived benefits of participation. Without this information, SDMs prioritized obtaining more and better care for the patient, considered what was in their mutual best interests, and valued healthcare professional's knowledge. Trust in healthcare professionals was essential to proceeding further. In stage 3, SDMs considered six factors in rendering decisions. SDMs engaged in three sequential stages and considered six factors in

  19. Diabetes-related mortality among Mexican Americans, Puerto Ricans, and Cuban Americans in the United States La mortalidad relacionada con la diabetes en mexicanoestadounidenses, puertorriqueños y cubanoestadounidenses en los Estados Unidos

    Directory of Open Access Journals (Sweden)

    Chrystal A. S. Smith

    2005-12-01

    Full Text Available OBJECTIVES: Hispanics are the most rapidly growing minority group in the United States, and Mexican Americans, Puerto Ricans and Cuban Americans are the three largest Hispanic subgroups. Among Hispanics, type 2 diabetes is the fifth leading cause of death. This paper examines diabetes-related mortality in Mexican Americans, Puerto Ricans, and Cuban Americans over 35 years of age in the United States during 1996 and 1997. METHODS: Using data from the National Vital Statistics System and the 1990 and 2000 censuses, we calculated age-adjusted and age-specific diabetes-related death rates for Mexican Americans, Puerto Ricans, and Cuban Americans over 35 years of age. Diabetes-related deaths were determined to be any death for which diabetes was coded as either the underlying or contributing cause of death. RESULTS: The diabetes-related mortality rate for Mexican Americans (251 per 100 000 and Puerto Ricans (204 deaths per 100 000 was twice as high as the diabetes-related mortality rate for Cuban Americans (101 deaths per 100 000. Cuban American decedents had the highest proportion of deaths with diabetes coded as the underlying cause of death (44%. After diabetes, heart disease (31% followed by cancer (8% and stroke (6% were the most frequent primary underlying causes of diabetes-related deaths in all three ethnic groups. CONCLUSION: Our analyses of these data demonstrate that diabetes-related mortality differed among Mexican Americans, Puerto Ricans and Cuban Americans more than 35 years of age in the United States in 1996 and 1997. Socioeconomic factors such as low educational attainment and low income may be factors that contributed to the disparities in these mortality rates for different subgroups. Further research is needed to update these findings and to investigate explanatory risk factors. Diversity among Hispanic subgroups has persisted in recent years and should be considered when health policies and services targeted at these populations

  20. Rapid virological response of telaprevir and boceprevir in a Brazilian cohort of HCV genotype 1 patients: a multicenter longitudinal study

    Directory of Open Access Journals (Sweden)

    Borba HHL

    2017-01-01

    Full Text Available Helena HL Borba,1 Astrid Wiens,1 Laiza M Steimbach,1 Fernanda S Tonin,1 Maria LA Pedroso,2 Cláudia AP Ivantes,3 Fernando Fernandez-Llimos,4 Roberto Pontarolo1 1Pharmaceutical Sciences Postgraduate Research Program, Department of Pharmacy, 2Gastroenterology Service, Hospital de Clínicas, Federal University of Paraná, 3Guidance and Counseling Center, Curitiba City Hall, Curitiba, Paraná, Brazil; 4Department of Social Pharmacy, Faculty of Pharmacy, Research Institute for Medicines, University of Lisboa, Lisbon, Portugal Background: Chronic hepatitis C is a major public health issue, but there is a gap in the literature regarding the effectiveness and safety of direct-acting antiviral agents in the Brazilian population. The main aim of this study was to describe the effectiveness of boceprevir and telaprevir in patients treated at public health care institutions in Brazil.Materials and methods: A prospective longitudinal and multicenter study was conducted in five centers in the State of Paraná between September 2014 and June 2016. Data regarding effectiveness and safety were collected from medical records of patients treated with boceprevir or telaprevir. The effectiveness outcome comprised the rapid virological response (RVR. Multivariate analysis was performed to verify the influence of independent variables (ie, age, gender, baseline viral load on RVR achievement.Results: Data were collected from 117 patients with chronic hepatitis C virus (HCV genotype 1 infection. Fifteen patients received treatment with boceprevir and 102 received telaprevir. The mean age was 51.6 years, 64.1% were male, 44.4% were infected with HCV subtype 1a, 62.4% had a high baseline viral load (≥800,000 IU/mL and 33% were cirrhotic. Furthermore, 79.5% of patients achieved RVR (26.7% in the boceprevir group and 87.3% in the telaprevir group. Multivariate analysis demonstrated that the type of protease inhibitor (boceprevir or telaprevir and the baseline viral load

  1. European multicenter study on melanoma immunoscintigraphy by means of 99mTc-labelled monoclonal antibody fragments

    International Nuclear Information System (INIS)

    Siccardi, A.G.; Viale, G.; Natali, P.G.; Scassellati, G.A.; Ferrone, S.

    1990-01-01

    A total of 493 melanoma patients were investigated by 20 European nuclear medicine departments by means of the same 99m Tc-labelled immunoradiopharmaceutical and the same immunoscintigraphy (ISG) protocol. (i) No chemical or clinical toxicity was detected during or following the studies. (ii) Positive results were obtained in 287/363 (79%) patients (321 carrying known lesions and 42 carrying previously occult lesions): In 231 (80%) of them, 402/402 lesions were imaged; in the remaining 56 ISG-positive patients, 108/204 lesions were imaged; in 76 patients 0/122 lesions were imaged. (iii) The fraction of melanoma lesions visualized by ISG was 510/728 (70.1%); 605 of these lesions were already documented at the time of the study, and 123 were previously occult. (iv) A total of 218 documented melanoma lesions (30%) were not visualized by ISG in 132 patients: About 70% of the ISG-negative lesions were of small size (less than 2 cm diameter). (v) The melanoma nature of 69/123 previously occult lesions was confirmed by clinical criteria and/or additional investigations in follow-up studies. The results obtained in this study are similar to those obtained in the Italian Multicenter Study which had previously been carried out with 258 melanoma patients. (orig.)

  2. Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus : Economic evaluation alongside the DALI study, a European multicenter randomized controlled trial

    NARCIS (Netherlands)

    Broekhuizen, K. (Karen); D. Simmons (David); R. Devlieger (Roland); A. Van Assche (Andre); G. Jans (Goele); S. Galjaard (Sander); R. Corcoy (Rosa); J.M. Adelantado (Juan M); F. Dunne (Fidelma); G. Desoye (Gernot); J. Harreiter (Jurgen); A. Kautzky-Willer (Alexandra); P. Damm (Peter); E.R. Mathiesen (Elisabeth); D.M. Jensen (Dorte M.); L. Andersen (Liselotte); A. Lapolla (Annunziata); M.G. Dalfra (Maria G.); A. Bertolotto (Alessandra); E. Wender-Ozegowska (Ewa); A. Zawiejska (Agnieszka); D.J. Hill (David); F.J. Snoek (Frank); J.G.M. Jelsma (Judith G. M.); J.E. Bosmans (Judith); M.N. van Poppel (Mireille); van Dongen, J.M. (Johanna M.)

    2018-01-01

    markdownabstract__Background:__ Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the

  3. An Angiopoietin-2 gene polymorphism in unexplained intrauterine fetal death: a multi-center study.

    Science.gov (United States)

    Huber, Ambros; Grimm, Christoph; Pietrowski, Detlef; Zeillinger, Robert; Bettendorf, Hertha; Husslein, Peter; Hefler, Lukas

    2005-02-01

    Angiopoietin-2 (Ang-2) is a potent regulator of angiogenesis and vascular tone. As vascular processes have been proposed to be involved in the pathogenesis of pregnancy associated complications such as late unexplained intrauterine fetal death (IUFD), we determined whether a common G/A polymorphism of the Ang-2 gene (ANGPT2) is associated with this condition. In a multicenter case-control study, we evaluated the common G/A polymorphism within exon 4 of the ANGPT2 gene using PCR in 90 women with IUFD and 90 healthy women with at least one uncomplicated full term pregnancy and no history of IUFD. Genotype (p=0.2; OR=1.4 [0.8-2.6]) and allele frequencies (p=0.1; OR=1.4 [0.9-2.1]) of the ANGPT2 polymorphism did not differ between women with IUFD and healthy women. A multivariate regression analysis with smoking habits and preexisting diabetes as covariates did not change the results. We are the first to report on a common polymorphism of the ANGPT2 gene in patients with late IUFD. The investigated ANGPT2 poylmorphism does not seem to be a candidate gene for IUFD in Caucasian women.

  4. Desire to Have Children Among Transgender People in Germany: A Cross-Sectional Multi-Center Study.

    Science.gov (United States)

    Auer, Matthias K; Fuss, Johannes; Nieder, Timo O; Briken, Peer; Biedermann, Sarah V; Stalla, Günter K; Beckmann, Matthias W; Hildebrandt, Thomas

    2018-05-01

    Many trans individuals undergo medical interventions that result in irreversible loss of fertility. Little is known about their desire to have children and attitudes toward fertility preservation options. To study how the desire for children and the use of fertility preservation options varies among trans women and trans men in different transitioning stages in Germany. In this cross-sectional multi-center study, N = 99 trans women and N = 90 trans men were included. Of these, 26 of each sex were just about to start medical treatment. Outcome parameter were the prevalence and determinants of a desire to have children in trans persons. Before treatment, a desire for children was significantly higher in trans men compared to trans women (P = .016). In contrast, in those who had already started treatment, a current desire to have children was equally present in about one fourth of participants of both genders while the interest in having children in the future was significantly higher in trans women (69.9%) than in trans men (46.9%; P = .034). Although 76.1% of trans women and 76.6% of trans men indicated that they had at least thought about preserving germ cells before starting medical transition, only 9.6% of trans women and 3.1% of trans men had put this idea into practice. Most trans men in both groups indicated that insemination of a female partner with sperm from an unrelated donor was a suitable option to fulfill their child wish, potentially explaining their low interest in preserving their own germ cells. Finally, a logistic regression analysis accounting for potential confounders revealed that overall trans women were more than twice as likely to have a current desire to have children (odds ratio 2.58), and this wish was on average 5.3% lower with each year of increasing age. A low level of fertility preservation among trans persons is contrasted by a high level of desire for children. This highlights the importance of counseling trans individuals

  5. Air contamination for predicting wound contamination in clean surgery: A large multicenter study.

    Science.gov (United States)

    Birgand, Gabriel; Toupet, Gaëlle; Rukly, Stephane; Antoniotti, Gilles; Deschamps, Marie-Noelle; Lepelletier, Didier; Pornet, Carole; Stern, Jean Baptiste; Vandamme, Yves-Marie; van der Mee-Marquet, Nathalie; Timsit, Jean-François; Lucet, Jean-Christophe

    2015-05-01

    The best method to quantify air contamination in the operating room (OR) is debated, and studies in the field are controversial. We assessed the correlation between 2 types of air sampling and wound contaminations before closing and the factors affecting air contamination. This multicenter observational study included 13 ORs of cardiac and orthopedic surgery in 10 health care facilities. For each surgical procedure, 3 microbiologic air counts, 3 particles counts of 0.3, 0.5, and 5 μm particles, and 1 bacteriologic sample of the wound before skin closure were performed. We collected data on surgical procedures and environmental characteristics. Of 180 particle counts during 60 procedures, the median log10 of 0.3, 0.5, and 5 μm particles was 7 (interquartile range [IQR], 6.2-7.9), 6.1 (IQR, 5.4-7), and 4.6 (IQR, 0-5.2), respectively. Of 180 air samples, 50 (28%) were sterile, 90 (50%) had 1-10 colony forming units (CFU)/m(3) and 40 (22%) >10 CFU/m(3). In orthopedic and cardiac surgery, wound cultures at closure were sterile for 24 and 9 patients, 10 and 11 had 1-10 CFU/100 cm(2), and 0 and 6 had >10 CFU/100 cm(2), respectively (P air microbial counts (P contamination (P = .22). This study suggests that particle counting is a good surrogate of airborne microbiologic contamination in the OR. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  6. Determinants of Severity in Acute Pancreatitis: A Nation-wide Multicenter Prospective Cohort Study.

    Science.gov (United States)

    Sternby, Hanna; Bolado, Federico; Canaval-Zuleta, Héctor J; Marra-López, Carlos; Hernando-Alonso, Ana I; Del-Val-Antoñana, Adolfo; García-Rayado, Guillermo; Rivera-Irigoin, Robin; Grau-García, Francisco J; Oms, Lluís; Millastre-Bocos, Judith; Pascual-Moreno, Isabel; Martínez-Ares, David; Rodríguez-Oballe, Juan A; López-Serrano, Antonio; Ruiz-Rebollo, María L; Viejo-Almanzor, Alejandro; González-de-la-Higuera, Belén; Orive-Calzada, Aitor; Gómez-Anta, Ignacio; Pamies-Guilabert, José; Fernández-Gutiérrez-Del-Álamo, Fátima; Iranzo-González-Cruz, Isabel; Pérez-Muñante, Mónica E; Esteba, María D; Pardillos-Tomé, Ana; Zapater, Pedro; de-Madaria, Enrique

    2018-04-18

    The aim of this study was to compare and validate the different classifications of severity in acute pancreatitis (AP) and to investigate which characteristics of the disease are associated with worse outcomes. AP is a heterogeneous disease, ranging from uneventful cases to patients with considerable morbidity and high mortality rates. Severity classifications based on legitimate determinants of severity are important to correctly describe the course of disease. A prospective multicenter cohort study involving patients with AP from 23 hospitals in Spain. The Atlanta Classification (AC), Revised Atlanta Classification (RAC), and Determinant-based Classification (DBC) were compared. Binary logistic multivariate analysis was performed to investigate independent determinants of severity. A total of 1655 patients were included; 70 patients (4.2%) died. RAC and DBC were equally superior to AC for describing the clinical course of AP. Although any kind of organ failure was associated with increased morbidity and mortality, persistent organ failure (POF) was the most significant determinant of severity. All local complications were associated with worse outcomes. Infected pancreatic necrosis correlated with high morbidity, but in the presence of POF, it was not associated to higher mortality when compared with sterile necrotizing pancreatitis. Exacerbation of previous comorbidity was associated with increased morbidity and mortality. The RAC and DBC both signify an advance in the description and differentiation of AP patients. Herein, we describe the complications of the disease independently associated to morbidity and mortality. Our findings are valuable not only when designing future studies on AP but also for the improvement of current classifications.

  7. Results of a Multicenter, Randomized, Double-Masked, Placebo-Controlled Clinical Study of the Efficacy and Safety of Visomitin Eye Drops in Patients with Dry Eye Syndrome.

    Science.gov (United States)

    Brzheskiy, Vladimir V; Efimova, Elena L; Vorontsova, Tatiana N; Alekseev, Vladimir N; Gusarevich, Olga G; Shaidurova, Ksenia N; Ryabtseva, Alla A; Andryukhina, Olga M; Kamenskikh, Tatiana G; Sumarokova, Elena S; Miljudin, Eugeny S; Egorov, Eugeny A; Lebedev, Oleg I; Surov, Alexander V; Korol, Andrii R; Nasinnyk, Illia O; Bezditko, Pavel A; Muzhychuk, Olena P; Vygodin, Vladimir A; Yani, Elena V; Savchenko, Alla Y; Karger, Elena M; Fedorkin, Oleg N; Mironov, Alexander N; Ostapenko, Victoria; Popeko, Natalia A; Skulachev, Vladimir P; Skulachev, Maxim V

    2015-12-01

    This article presents the results of an international, multicenter, randomized, double-masked, placebo-controlled clinical study of Visomitin (Mitotech LLC, Moscow, Russian Federation) eye drops in patients with dry eye syndrome (DES). Visomitin is the first registered (in Russia) drug with a mitochondria-targeted antioxidant (SkQ1) as the active ingredient. In this multicenter (10 sites) study of 240 subjects with DES, study drug (Visomitin or placebo) was self-administered three times daily (TID) for 6 weeks, followed by a 6-week follow-up period. Seven in-office study visits occurred every 2 weeks during both the treatment and follow-up periods. Efficacy measures included Schirmer's test, tear break-up time, fluorescein staining, meniscus height, and visual acuity. Safety measures included adverse events, slit lamp biomicroscopy, tonometry, blood pressure, and heart rate. Tolerability was also evaluated. This clinical study showed the effectiveness of Visomitin eye drops in the treatment of signs and symptoms of DES compared with placebo. The study showed that a 6-week course of TID topical instillation of Visomitin significantly improved the functional state of the cornea; Visomitin increased tear film stability and reduced corneal damage. Significant reduction of dry eye symptoms (such as dryness, burning, grittiness, and blurred vision) was also observed. Based on the results of this study, Visomitin is effective and safe for use in eye patients with DES for protection from corneal damage. Mitotech LLC.

  8. Effectiveness of Psychosocial Interventions in Complex Palliative Care Patients: A Quasi-Experimental, Prospective Multicenter Study.

    Science.gov (United States)

    Mateo-Ortega, Dolors; Gómez-Batiste, Xavier; Maté, Jorge; Beas, Elba; Ela, Sara; Lasmarias, Cristina; Limonero, Joaquín T

    2018-03-13

    To determine whether specific psychosocial interventions can ease discomfort in palliative care (PC) patients, particularly in those with high levels of pain or emotional distress. Changes in the psychological parameters of 8333 patients were assessed in a quasi-experimental, prospective, multicenter, single group pretest/post-test study. Psychosocial care was delivered by 29 psychosocial care teams (PSTs; 137 professionals). Pre- and post-intervention changes in these variables were assessed: mood, anxiety, and emotional distress. Patients were classified as complex, when presented with high levels of anxiety, mood, suffering (or perception of time as slow), and distress (or unease, or discomfort), or noncomplex. These groups were compared to assess changes in suffering-related parameters from baseline. Psychosocial interventions reduced patients' suffering. These interventions were more effective in complex patients. After successive psychosocial interventions, the level of suffering in complex patients decreased until close to parity with noncomplex patients, suggesting that patients with major complexity could benefit most from specific psychosocial treatment. These findings support the importance of assessing and treating patients' psychosocial needs.

  9. Tug-of-war between classical and multicenter bonds in H-(Be)n-H species

    Science.gov (United States)

    Lundell, Katie A.; Boldyrev, Alexander I.

    2018-05-01

    Quantum chemical calculations were performed for beryllium homocatenated compounds [H-(Be)n-H]. Global minimum structures were found using machine searches (Coalescence Kick method) with density functional theory. Chemical bonding analysis was performed with the Adaptive Natural Density Partitioning method. It was found that H-(Be)2-H and H-(Be)3-H clusters are linear with classical two-center two-electron bonds, while for n > 3, three-dimensional structures are more stable with multicenter bonding. Thus, at n = 4, multicenter bonding wins the tug-of-war vs. the classical bonding.

  10. Antecedents of organizational citizenship behavior among Iranian nurses: a multicenter study.

    Science.gov (United States)

    Taghinezhad, Fakhredin; Safavi, Mahboobe; Raiesifar, Afsaneh; Yahyavi, Sayed Hossein

    2015-10-08

    Organizational citizenship behavior (OCB) improves efficiency and employees' participation and generally provides a good ambiance. This study was conducted to determine the role of job satisfaction (JS), organizational commitment (OC) and procedural justice (PJ) in explaining OCB among nurses working in fifteen educational-treatment centers in Tehran-Iran, to provide guidelines for health care managers' further understanding of how to encourage citizenship behavior among nurses. In this multi-center descriptive-correlational study 373 nurses were evaluated through a Multi-stage cluster sampling method after obtaining approval from the Ethics Committee of Islamic Azad University, Tehran Medical Branch and Tehran University of Medical Sciences Research Deputy. Nurses who signed the informed consent and holding a bachelor or master degree, having a minimum one year of job experience and not having organizational management position during the questionnaire distribution were included in the study. In order to collect data, Demographic questionnaire, Podsakoff et al. (Leadersh Q 1(2):107-142, 1990) OCB questionnaire, OC questionnaire, Aelterman et al. (Educ Stud 33(3):285-297, 2007) JS questionnaire and PJ questionnaire were used. These questionnaires were translated into Persian and content validity was confirmed by an expert group; their reliability was calculated by the internal consistency Cronbach alpha coefficient and it was satisfied. Data were analyzed by descriptive statistics, Comparative mean tests, correlation coefficient and multiple-regression in the SPSS software version 11. The general mean and all five aspects of OCB that ranked higher than 3 were evaluated in a "quite desired" state. The mean for perceived procedural justice, the general mean for JS and the mean of general grade for OC from the nurses' was in "quite desired" state. Finding from multiple regression indicated that OC and PJ exhibit about 19 % of OCB variance totally which is

  11. Assessment of thromboprophylaxis in medical patients hospitalized in Andalusia. A multicenter study.

    Science.gov (United States)

    Navarro Puerto, M A; Medrano Ortega, F J; Izquierdo Guerrero, R; Calderón Sandubete, E; Buzón-Barrera, M L; Marín-León, I

    2015-04-01

    Hospitalized patients are a population at risk for venous thromboembolism (VTE). The PRETEMED-2007 clinical practice guidelines help identify high-risk medical patients who are suited to thromboprophylaxis. These guidelines therefore provide a standard for prophylaxis in such patients. We evaluated the risk of VTE and the adjustment of thromboprophylaxis to the standards of the PRETEMED-2007 guidelines in patients hospitalized in internal medicine departments. An observational, cross-sectional multicenter study was performed in 2010 in 16 hospitals in Andalusia and included 20 consecutive patients per center. The study variables were age, sex, risk factors for VTE and hemorrhage, the risk-adjusted PRETEMED of VTE, adjustment of thromboembolic prophylaxis at admission and at discharge and hospital mortality. The study included 293 patients (57.8% men) with a mean age of 69 (±15) years. The most common triggers for VTE were acute severe infection (27.3%) and neoplasia (16.4%). Some 43.4% of the patients presented a risk of hemorrhage. The risk of VTE at admission and discharge was high in 47.8% and 31% and moderate in 8.2% and 10.6%, respectively. A total of 91.7% and 17.3% of the patients underwent prophylaxis with low-molecular-weight heparin on admission and at discharge, respectively. The prescription was appropriate for 59.9% of the patients at admission (overutilization 38.4%, underutilization 1.7%) and for 74.7% at discharge (overutilization 5.4%, underutilization 19.9%). The adjustment was greater in patients older than 60 years and with greater hemorrhagic risk. For 60% of the patients admitted to the departments of internal medicine in Andalusia, the thromboprophylaxis was appropriate. The inadequacy of thromboprophylaxis (40%) is mostly due to overutilization. These results suggest significant space for improvement. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  12. Nutrition-related risk indexes and long-term mortality in noncritically ill inpatients who receive total parenteral nutrition (prospective multicenter study).

    Science.gov (United States)

    Tapia, María José; Ocón, Julia; Cabrejas-Gómez, Carmen; Ballesteros-Pomar, María D; Vidal-Casariego, Alfonso; Arraiza-Irigoyen, Carmen; Olivares, Josefina; Conde-García, Ma Carmen; García-Manzanares, Álvaro; Botella-Romero, Francisco; Quílez-Toboso, Rosa P; Cabrerizo, Lucio; Rubio, Miguel A; Chicharro, Luisa; Burgos, Rosa; Pujante, Pedro; Ferrer, Mercedes; Zugasti, Ana; Petrina, Estrella; Manjón, Laura; Diéguez, Marta; Carrera, Ma José; Vila-Bundo, Anna; Urgelés, Juan Ramón; Aragón-Valera, Carmen; Sánchez-Vilar, Olga; Bretón, Irene; García-Peris, Pilar; Muñoz-Garach, Araceli; Márquez, Efren; del Olmo, Dolores; Pereira, José Luis; Tous, María C; Olveira, Gabriel

    2015-10-01

    Malnutrition in hospitalized patients is associated with an increased risk of death, in both the short and the long term. The purpose of this study was to determine which nutrition-related risk index predicts long-term mortality better (three years) in patients who receive total parenteral nutrition (TPN). This prospective, multicenter study involved noncritically ill patients who were prescribed TPN during hospitalization. Data were collected on Subjective Global Assessment (SGA), Nutritional Risk Index (NRI), Geriatric Nutritional Risk Index (GNRI), body mass index, albumin and prealbumin, as well as long-term mortality. Over the 1- and 3-year follow-up periods, 174 and 244 study subjects (28.8% and 40.3%) respectively, died. Based on the Cox proportional hazards survival model, the nutrition-related risk indexes most strongly associated with mortality were SGA and albumin (Nutrition and Metabolism. All rights reserved.

  13. A multicenter study shows PTEN deletion is strongly associated with seminal vesicle involvement and extracapsular extension in localized prostate cancer.

    Science.gov (United States)

    Troyer, Dean A; Jamaspishvili, Tamara; Wei, Wei; Feng, Ziding; Good, Jennifer; Hawley, Sarah; Fazli, Ladan; McKenney, Jesse K; Simko, Jeff; Hurtado-Coll, Antonio; Carroll, Peter R; Gleave, Martin; Lance, Raymond; Lin, Daniel W; Nelson, Peter S; Thompson, Ian M; True, Lawrence D; Brooks, James D; Squire, Jeremy A

    2015-08-01

    Loss of the phosphatase and tensin homolog (PTEN) tumor suppressor gene is a promising marker of aggressive prostate cancer. Active surveillance and watchful waiting are increasingly recommended to patients with small tumors felt to be low risk, highlighting the difficulties of Gleason scoring in this setting. There is an urgent need for predictive biomarkers that can be rapidly deployed to aid in clinical decision-making. Our objectives were to assess the incidence and ability of PTEN alterations to predict aggressive disease in a multicenter study. We used recently developed probes optimized for sensitivity and specificity in a four-color FISH deletion assay to study the Canary Retrospective multicenter Prostate Cancer Tissue Microarray (TMA). This TMA was constructed specifically for biomarker validation from radical prostatectomy specimens, and is accompanied by detailed clinical information with long-term follow-up. In 612 prostate cancers, the overall rate of PTEN deletion was 112 (18.3%). Hemizygous PTEN losses were present in 55/612 (9.0%) of cancers, whereas homozygous PTEN deletion was observed in 57/612 (9.3%) of tumors. Significant associations were found between PTEN status and pathologic stage (P free survival (number of events = 189), pre-operative prostate specific antigen (PSA) (P free survival in multivariate models, as were seminal vesicle invasion, extracapsular extension, and Gleason score, and preoperative PSA. Furthermore, these data demonstrate that the assay can be readily introduced at first diagnosis in a cost effective manner analogous to the use of FISH for analysis of HER2/neu status in breast cancer. Combined with published research beginning 17 years ago, both the data and tools now exist to implement a PTEN assay in the clinic. © 2015 The Authors. The Prostate, published by Wiley Periodicals, Inc.

  14. Cost-effectiveness of healthy eating and/or physical activity promotion in pregnant women at increased risk of gestational diabetes mellitus : Economic evaluation alongside the DALI study, a European multicenter randomized controlled trial

    NARCIS (Netherlands)

    Broekhuizen, Karen; Simmons, David; Devlieger, Roland; van Assche, André; Jans, Goele; Galjaard, Sander; Corcoy, Rosa; Adelantado, Juan M.; Dunne, Fidelma; Desoye, Gernot; Harreiter, Jürgen; Kautzky-Willer, Alexandra; Damm, Peter; Mathiesen, Elisabeth R.; Jensen, Dorte M.; Andersen, Liselotte L.; Lapolla, Annunziata; Dalfra, Maria G.; Bertolotto, Alessandra; Wender-Ozegowska, Ewa; Zawiejska, Agnieszka; Hill, David; Snoek, Frank J.; Jelsma, Judith G.M.; Bosmans, Judith E.; van Poppel, Mireille N.M.; van Dongen, Johanna M.

    2018-01-01

    Background: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions

  15. Utility of an Abbreviated Dizziness Questionnaire to Differentiate Between Causes of Vertigo and Guide Appropriate Referral: A Multicenter Prospective Blinded Study.

    Science.gov (United States)

    Roland, Lauren T; Kallogjeri, Dorina; Sinks, Belinda C; Rauch, Steven D; Shepard, Neil T; White, Judith A; Goebel, Joel A

    2015-12-01

    Test performance of a focused dizziness questionnaire's ability to discriminate between peripheral and nonperipheral causes of vertigo. Prospective multicenter. Four academic centers with experienced balance specialists. New dizzy patients. A 32-question survey was given to participants. Balance specialists were blinded and a diagnosis was established for all participating patients within 6 months. Multinomial logistic regression was used to evaluate questionnaire performance in predicting final diagnosis and differentiating between peripheral and nonperipheral vertigo. Univariate and multivariable stepwise logistic regression were used to identify questions as significant predictors of the ultimate diagnosis. C-index was used to evaluate performance and discriminative power of the multivariable models. In total, 437 patients participated in the study. Eight participants without confirmed diagnoses were excluded and 429 were included in the analysis. Multinomial regression revealed that the model had good overall predictive accuracy of 78.5% for the final diagnosis and 75.5% for differentiating between peripheral and nonperipheral vertigo. Univariate logistic regression identified significant predictors of three main categories of vertigo: peripheral, central, and other. Predictors were entered into forward stepwise multivariable logistic regression. The discriminative power of the final models for peripheral, central, and other causes was considered good as measured by c-indices of 0.75, 0.7, and 0.78, respectively. This multicenter study demonstrates a focused dizziness questionnaire can accurately predict diagnosis for patients with chronic/relapsing dizziness referred to outpatient clinics. Additionally, this survey has significant capability to differentiate peripheral from nonperipheral causes of vertigo and may, in the future, serve as a screening tool for specialty referral. Clinical utility of this questionnaire to guide specialty referral is discussed.

  16. The association between concomitant use of serotonergic antidepressants and lithium-induced polyuria. A multicenter medical chart review study.

    Science.gov (United States)

    Wilting, I; Egberts, A C G; Movig, K L L; Laarhoven, J H M van; Heerdink, E R; Nolen, W A

    2008-07-01

    A previous study aimed at revealing the prevalence and determinants of lithium induced polyuria suggested an increased risk of polyuria (urine volume > or =3 L/24 h) in those using serotonergic antidepressants next to lithium. The objective of our study was to re-evaluate this secondary finding in another study population. We performed a multicenter medical chart review study in patients using lithium in whom a 24-hour urine volume had been determined. We included 116 patients, twelve (26%)of the 46 patients with polyuria used serotonergic antidepressants compared to ten (14%) of the 70 patients without polyuria. We found an increased risk of polyuria in lithium users concurrently using serotonergic antidepressants (oddsratio 2.86; 95% confidence interval 1.00-8.21), adjusted for age, gender, use of antiepileptics and thyreomimetics. Our results confirm the previous secondary finding of an increased risk of polyuria in patients using serotonergic antidepressants next to lithium. Physicians should take this into account when evaluating polyuria in patients using lithium and when choosing an antidepressant in patients using lithium.

  17. DNA polymorphisms in cuban varieties of avocado (persea americana mill.) as detected by inverse sequence tagged repeat (ISTR) analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ramirez, M; Fuentes, J L [Centro de Estudios Aplicados al Desarrollo Nuclear, La Habana (Cuba); Rodriguez, N N; Cueto, J [Max Planck Institut fur Zuchtungsforschung (MPIZ), Koln (Germany); Becker, D; Rohde, W [Instituto de Investigaciones en Fruticultura Tropical (IIFT). C. Habana (Cuba)

    2001-07-01

    A survey of the genetic diversity among commercial Cuban avocado varieties was initiated using ISTR analysis. ISTR markers were efficient in detecting polymorphisms among the genotypes. The obtained dissimilarities values ranged from 0.24 between var. Suardia and Hass to 1.00 between Lula and Los Moros or CHI-3 with an average dissimilarity of 0.78. A cluster analysis was performed based on dissimilarity using UPGMA as the clustering method. The efficiency of UPGMA in estimating genetic relationships between varieties was corroborated by the cophenetic correlation coefficients, which indicated that the distortion degree in the relationship of the estimated dissimilarities was minimal. Ecological groups were not adequately represented in the dendrogram. Thus, West Indians, Guatemalan and Mexican genotypes were positioned across the dendrogram. The utility of ISTR for genotype identification and assessment of genetic diversity in commercial avocado varieties is discussed.

  18. DNA polymorphisms in cuban varieties of avocado (persea americana mill.) as detected by inverse sequence tagged repeat (ISTR) analysis

    International Nuclear Information System (INIS)

    Ramirez, M; Fuentes, J. L.; Rodriguez, N.N.; Cueto, J.; Becker, D.; Rohde, W.

    2001-01-01

    A survey of the genetic diversity among commercial Cuban avocado varieties was initiated using ISTR analysis. ISTR markers were efficient in detecting polymorphisms among the genotypes. The obtained dissimilarities values ranged from 0.24 between var. Suardia and Hass to 1.00 between Lula and Los Moros or CHI-3 with an average dissimilarity of 0.78. A cluster analysis was performed based on dissimilarity using UPGMA as the clustering method. The efficiency of UPGMA in estimating genetic relationships between varieties was corroborated by the cophenetic correlation coefficients, which indicated that the distortion degree in the relationship of the estimated dissimilarities was minimal. Ecological groups were not adequately represented in the dendrogram. Thus, West Indians, Guatemalan and Mexican genotypes were positioned across the dendrogram. The utility of ISTR for genotype identification and assessment of genetic diversity in commercial avocado varieties is discussed

  19. Factors contributing to disability in rheumatoid arthritis patients: An Egyptian multicenter study.

    Science.gov (United States)

    Hammad, Marwa; Eissa, Mervat; Dawa, Ghada A

    2018-04-30

    Minimizing disability and enhancing physical function to its optimal levels is still a challenge in management of rheumatoid arthritis (RA). The aim is to identify factors leading to disability in RA. This is a cross-sectional Egyptian multicenter study carried out on 215 RA patients attending to our inpatient and outpatient rheumatology clinics during 4 months starting from April to July 2017 who agreed to participate in the study; 170 patients were from Cairo University hospitals and 45 from Zagazig University hospitals. We recorded a number of possible risk factors including demographic, clinical, serological and therapeutic factors. The assessment of patients' disability was done using Modified HAQ (MHAQ). A significant positive correlation was found between MHAQ and different markers of activity in addition to age and depression score (P<0.001). Illiteracy accounted for higher MHAQ scores (P=0.001). A higher MHAQ was found in patients with ischemic heart disease (P<0.05). Patients with erosions on X-rays had significantly higher MHAQ scores. Subluxations also accounted for higher MHAQ scores (P=0.000). Aging, illiteracy, disease activity, erosions, subluxations, depression and ischemic heart disease were all related to higher disability. Good control of disease activity which in turn reduces erosions and subluxations is mandatory. Screening for depression and proper use of anti-depressants is of great value. Proper screening and prophylaxis is recommended against ischemic heart disease by controlling modifiable risk factors like obesity, dyslipidaemia, hypertension, smoking and sedentary lifestyle. Copyright © 2018 Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. The reliability of echocardiographic left ventricular wall motion index to identify high-risk patients for multicenter studies

    DEFF Research Database (Denmark)

    Gislason, Gunnar H; Gadsbøll, Niels; Quinones, Miguel A

    2006-01-01

    that were screened for inclusion into the DIAMOND-CHF and DIAMOND-MI trials were reevaluated by an external expert echocardiographer. WMI was calculated using the 16-segment LV model. RESULTS: The external echocardiographer systematically found lower values of WMI than the core laboratory. The average...... difference in WMI was 0.18 (SD: 0.33) in the DIAMOND-CHF trial and 0.09 (SD: 0.33) in the DIAMOND-MI trial. The difference in WMI exceeded 0.33 in 34% of the patients in both trials. The cutoff value for inclusion into the DIAMOND trials was WMI ... overall agreement for identifying patients with severe impairment of LV function. This not only underscores the value of LV-WMI as a useful tool for selecting high-risk patients to be included in multicenter studies but also serves to warn against the use of rigid cutoff values for WMI in the treatment...

  1. Risk Factors for Malnutrition among Older Adults in the Emergency Department: A Multicenter Study.

    Science.gov (United States)

    Burks, Collin E; Jones, Christopher W; Braz, Valerie A; Swor, Robert A; Richmond, Natalie L; Hwang, Kay S; Hollowell, Allison G; Weaver, Mark A; Platts-Mills, Timothy F

    2017-08-01

    Among older adults, malnutrition is common, often missed by healthcare providers, and influences recovery from illness or injury. To identify modifiable risk factors associated with malnutrition in older patients. Prospective cross-sectional multicenter study. 3 EDs in the South, Northeast, and Midwest. Non-critically ill, English-speaking adults aged ≥65 years. Random time block sampling was used to enroll patients. The ED interview assessed malnutrition using the Mini Nutritional Assessment Short-Form. Food insecurity and poor oral health were assessed using validated measures. Other risk factors examined included depressive symptoms, limited mobility, lack of transportation, loneliness, and medication side effects, qualified by whether the patient reported the risk factor affected their diet. The population attributable risk proportion (PARP) for malnutrition was estimated for each risk factor. In our sample (n = 252), the prevalence of malnutrition was 12%. Patient characteristics associated with malnutrition included not having a college degree, being admitted to the hospital, and residence in an assisted living facility. Of the risk factors examined, the PARPs for malnutrition were highest for poor oral health (54%; 95% CI 16%, 78%), food insecurity (14%; 95% CI 3%, 31%), and lack of transportation affecting diet (12%; 95% CI 3%, 28%). Results of this observational study identify multiple modifiable factors associated with the problem of malnutrition in older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  2. Normative data for Aδ contact heat evoked potentials in adult population: a multicenter study.

    Science.gov (United States)

    Granovsky, Yelena; Anand, Praveen; Nakae, Aya; Nascimento, Osvaldo; Smith, Benn; Sprecher, Elliot; Valls-Solé, Josep

    2016-05-01

    There has been a significant increase over recent years in the use of contact heat evoked potentials (CHEPs) for the evaluation of small nerve fiber function. Measuring CHEP amplitude and latency has clinical utility for the diagnosis and assessment of conditions with neuropathic pain. This international multicenter study aimed to provide reference values for CHEPs to stimuli at 5 commonly examined body sites. Contact heat evoked potentials were recorded from 226 subjects (114 females), distributed per age decade between 20 and 79 years. Temperature stimuli were delivered by a thermode (32°C-51°C at a rate of 70°C/s). In phase I of the study, we investigated side-to-side differences and reported the maximum normal side-to-side difference in Aδ CHEP peak latency and amplitude for leg, forearm, and face. In phase II, we obtained normative data for 3 CHEP parameters (N2P2 amplitude, N2 latency, and P2 latency), stratified for gender and age decades from face, upper and lower limbs, and overlying cervical and lumbar spine. In general, larger CHEP amplitudes were associated with higher evoked pain scores. Females had CHEPs of larger amplitude and shorter latency than males. This substantive data set of normative values will facilitate the clinical use of CHEPs as a rapid, noninvasive, and objective technique for the assessment of patients presenting with neuropathic pain.

  3. Association of Fetal Abdominal–Head Circumference Size Difference With Shoulder Dystocia: A Multicenter Study

    Science.gov (United States)

    Endres, Loraine; DeFranco, Emily; Conyac, Theresa; Adams, Marci; Zhou, Ying; Magner, Kristin; O'Rourke, Luke; Bernhard, Kiley A.; Siddiqui, Danish; McCormick, Anna; Abramowicz, Jacques; Merkel, Ronald; Jawish, Rana; Habli, Mounira; Floman, Alissa; Magann, Everett F.; Chauhan, Suneet P.

    2015-01-01

    Objective This study aims to determine if shoulder dystocia is associated with a difference in the fetal abdominal (AC) to head circumference (HC) of 50 mm or more noted on antenatal ultrasound. Study Design A multicenter matched case–control study was performed comparing women who had shoulder dystocia to controls who did not. Women with vaginal births of live born nonanomalous singletons ≥ 36 weeks of gestation with an antenatal ultrasound within 4 weeks of delivery were included. Controls were matched for gestational age, route of delivery, and diabetes status. Results We identified 181 matched pairs. Only 5% of the fetuses had an AC to HC of ≥ 50 mm. The proportion of AC to HC difference of ≥ 50 mm was significantly higher in shoulder dystocia cases (8%) than controls (1%, p = 0.002). With multivariate regression, the three significant factors associated with shoulder dystocia were AC to HC ≥ 50 mm (odds ratio [OR], 7.3; confidence interval [CI], 1.6–33.3; p = 0.010), femur length (OR, 1.1; CI, 1.0–1.2; p = 0.002), and induced labor (OR, 1.8; CI, 1.1–3.1; p = 0.027). Conclusion A prenatal ultrasound finding of a difference in AC to HC of ≥ 50 mm while uncommon is associated with shoulder dystocia. PMID:26495163

  4. Preparation and response in case of natural disasters: Cuban programs and experience.

    Science.gov (United States)

    Mas Bermejo, Pedro

    2006-01-01

    Inadequate preparation for national disasters is frequently particularly devastating in lower income countries. The Cuba's location has a diversity of potential natural disasters, including hurricanes, non-tropical depressions, tropical storms, tropical cyclones, and severe local storms, all with intense rains and winds, earthquakes and droughts. Cuban preparation, at all levels, is geared to these predominant threats. Planning for natural disasters is integral to the political and economic life of Cuba, nationally and locally. On several occasions, United Nations (UN) officials have pointed to Cuba as a model for developing countries preparing for hurricanes and other natural disasters. A global policy for managing the risks of natural disasters could improve continuity of assistance for development and reduce the necessity of humanitarian aid. Planning in advance of disasters is a feasible way of helping people, by reducing expenses of emergencies, recuperation, and reconstruction. As climate changes accelerate, many researchers fear a period of irreversible and uncontrollable change. While the atmosphere continues to warm, it generates more intense rains, more frequent heat waves, and more ferocious storms. Thus, achieving better protection of developing countries from an increasing onslaught of natural disasters will only grow in importance. Even though Cuba's contribution to know-how has been recognized by United Nations' officials, progress toward more adequate preparation worldwide has been slow. To support other countries beyond conveying the lessons, Cuba now offers specially trained personnel to cooperate immediately with any country suffering a natural disaster.

  5. Reduced innate immunity of Cuban Treefrogs at leading edge of range expansion.

    Science.gov (United States)

    Goetz, Scott M; Romagosa, Christina M; Appel, Arthur G; Guyer, Craig; Mendonça, Mary T

    2017-12-01

    During geographic range expansion, populations of non-indigenous species at the invasion front may benefit from directing resources away from immune defense. To test this hypothesis, we investigated the strength of two innate immune components in populations of invasive Cuban Treefrogs (Osteopilus septentrionalis) in a long-colonized area (core region) and at the invasion front (leading-edge region). First, we compared the region-specific metabolic response of frogs injected with an endotoxin that induces systemic inflammation (lipopolysaccharide, LPS) to sham-injected control frogs pooled from both regions. Males and females were analyzed independently because we detected a sex-related difference in mass-independent metabolism of control frogs, with males exhibiting a significantly higher metabolic rate (F 1, 21  = 29.02, P leading-edge populations, there was no significant difference in the metabolic rate of LPS-injected and control frogs (males, P  = 0.195; females, P  = 0.132). Second, we directly compared bacterial killing ability of frog blood plasma between regions. Bactericidal ability of plasma was significantly greater in frogs from the core region in comparison with those at the leading edge (F 1, 26   = 28.67, P < 0.001). For both immune components that we examined, populations from the core exhibited stronger immune responses. Our findings support hypotheses predicting an inverse relationship between immunity and range expansion. © 2018 Wiley Periodicals, Inc.

  6. Multi-center study on the characteristics and treatment strategies of patients with Graves' orbitopathy: the first European Group on Graves' Orbitopathy experience

    NARCIS (Netherlands)

    Prummel, Mark F.; Bakker, Annemieke; Wiersinga, Wilmar M.; Baldeschi, Lelio; Mourits, Maarten P.; Kendall-Taylor, Pat; Perros, Petros; Neoh, Chris; Dickinson, A. Jane; Lazarus, John H.; Lane, Carol M.; Heufelder, Armin E.; Kahaly, George J.; Pitz, Suzanne; Orgiazzi, Jacques; Hullo, Alain; Pinchera, Aldo; Marcocci, Claudio; Sartini, Maria S.; Rocchi, Roberto; Nardi, Marco; Krassas, Gerry E.; Halkias, A.

    2003-01-01

    To improve management of patients with Graves' orbitopathy, a multi-center collaborative approach is necessary in order to have large enough sample sizes for meaningful randomized clinical trials. This is hampered by a lack of consensus on how to investigate the eye condition. The European Group on

  7. EX-MET study: exercise in prevention on of metabolic syndrome - a randomized multicenter trial: rational and design.

    Science.gov (United States)

    Tjønna, Arnt Erik; Ramos, Joyce S; Pressler, Axel; Halle, Martin; Jungbluth, Klaus; Ermacora, Erika; Salvesen, Øyvind; Rodrigues, Jhennyfer; Bueno, Carlos Roberto; Munk, Peter Scott; Coombes, Jeff; Wisløff, Ulrik

    2018-04-02

    Metabolic syndrome substantially increases risk of cardiovascular events. It is therefore imperative to develop or optimize ways to prevent or attenuate this condition. Exercise training has been long recognized as a corner-stone therapy for reducing individual cardiovascular risk factors constituting the metabolic syndrome. However, the optimal exercise dose and its feasibility in a real world setting has yet to be established. The primary objective of this randomized trial is to investigate the effects of different volumes of aerobic interval training (AIT) compared to the current exercise guideline of moderate-intensity continuous training (MICT) on the composite number of cardiovascular disease risk factors constituting the metabolic syndrome after a 16 week, 1-year, and 3-year follow-up. This is a randomized international multi-center trial including men and women aged ≥30 years diagnosed with the metabolic syndrome according to the International Diabetes Federation criteria. Recruitment began in August 2012 and concluded in December 2016. This trial consists of supervised and unsupervised phases to evaluate the efficacy and feasibility of different exercise doses on the metabolic syndrome in a real world setting. This study aims to include and randomize 465 participants to 3 years of one of the following training groups: i) 3 times/week of 4 × 4 min AIT at 85-95% peak heart rate (HRpeak); ii) 3 times/week of 1 × 4 min AIT at 85-95% HRpeak; or iii) 5-7 times/week of ≥30 min MICT at 60-70% HRpeak. Clinical examinations, physical tests and questionnaires are administered to all participants during all testing time points (baseline, 16 weeks and after 1-, and 3-years). This multi-center international trial indeed aims to ease the burden in healthcare/economic cost arising from treating end-stage CVD related conditions such as stroke and myocardial infarction, that could eventually emerge from the metabolic syndrome condition. Clinical

  8. Sentinel node biopsy for early-stage melanoma - Accuracy and morbidity in MSLT-I, an international multicenter trial

    NARCIS (Netherlands)

    Morton, DL; Cochran, AJ; Thompson, JF; Elashoff, R; Essner, R; Glass, EC; Mozzillo, N; Nieweg, OE; Roses, DF; Hoekstra, HJ; Karakousis, CP; Reintgen, DS; Coventry, BJ; Wang, HJ

    Objective:The objective of this study was to evaluate, in an international multicenter phase III trial, the accuracy, use, and morbidity of intraoperative lymphatic mapping and sentinel node biopsy (LM/SNB) for staging the regional nodal basin of patients with early-stage melanoma. Summary

  9. Multicenter study differentiated thyroid carcinoma (MSDS). Diminished acceptance of adjuvant external beam radiotherapy

    International Nuclear Information System (INIS)

    Biermann, M.; Pixberg, M.K.; Schober, O.; Schuck, A.; Willich, N.; Heinecke, A.; Koepke, W.; Schmid, K.W.; Dralle, H.

    2003-01-01

    Aim: The Multicenter Study Differentiated Thyroid Carcinoma (MSDS) is an ongoing study in Germany, Austria, and Switzerland on the clinical benefit of adjuvant external beam radiotherapy (RTx) for locally invasive differentiated thyroid carcinoma (DTC) in TNM stages pT4 pNO/1/xMO/x (5th ed. 1997). Methods: MSDS was designed as a prospective randomized trial. Patients receive thyroidectomy, radioiodine therapy (RIT) to ablate the thyroid remnant, and TSH-suppressive L-thyroxine therapy with or without RTx after documented elimination of cervical iodine-131 uptake (http://msds-studie.uni-muenster.de). Results: 311 patients were enrolled between January 2000 and March 2003. 279 patients met the trial's inclusion criteria. 45 consented to randomization, of whom 17 were randomized into treatment arm A (RTx) and 18 into arm B (no RTx). Advised by the trial's independent Data Monitoring and Safety Committee, the MSDS steering committee decided to terminate randomization in April 2003 and continue MSDS as a prospective cohort study. 23 of the 234 patients in the observation arm of the trial were prescribed RTx by their physicians. Thus, 14% of the trial cohort were randomized or assigned to receive RTx (intention-to-treat analysis). In contrast, at least 44% of all patients with pT4 papillary DTC in Germany in the nationwide PCES study underwent RTx in 1996 (p 2 -test). Conclusions: Acceptance of external beam RTx as a treatment modality for DTC has receded to a degree that accrual of a sufficient number of patients for a randomized trial has been impossible. Observation of the trial cohort is continued in order to assess clinical event rates with and without RTx and chronic RTx toxicity. (orig.) [de

  10. Shigella isolates from the global enteric multicenter study inform vaccine development.

    Science.gov (United States)

    Livio, Sofie; Strockbine, Nancy A; Panchalingam, Sandra; Tennant, Sharon M; Barry, Eileen M; Marohn, Mark E; Antonio, Martin; Hossain, Anowar; Mandomando, Inacio; Ochieng, John B; Oundo, Joseph O; Qureshi, Shahida; Ramamurthy, Thandavarayan; Tamboura, Boubou; Adegbola, Richard A; Hossain, Mohammed Jahangir; Saha, Debasish; Sen, Sunil; Faruque, Abu Syed Golam; Alonso, Pedro L; Breiman, Robert F; Zaidi, Anita K M; Sur, Dipika; Sow, Samba O; Berkeley, Lynette Y; O'Reilly, Ciara E; Mintz, Eric D; Biswas, Kousick; Cohen, Dani; Farag, Tamer H; Nasrin, Dilruba; Wu, Yukun; Blackwelder, William C; Kotloff, Karen L; Nataro, James P; Levine, Myron M

    2014-10-01

    Shigella, a major diarrheal disease pathogen worldwide, is the target of vaccine development. The Global Enteric Multicenter Study (GEMS) investigated burden and etiology of moderate-to-severe diarrheal disease in children aged Shigella was 1 of the 4 most common pathogens across sites and age strata. GEMS Shigella serotypes are reviewed to guide vaccine development. Subjects' stool specimens/rectal swabs were transported to site laboratories in transport media and plated onto xylose lysine desoxycholate and MacConkey agar. Suspect Shigella colonies were identified by biochemical tests and agglutination with antisera. Shigella isolates were shipped to the GEMS Reference Laboratory (Baltimore, MD) for confirmation and serotyping of S. flexneri; one-third of isolates were sent to the Centers for Disease Control and Prevention for quality control. Shigella dysenteriae and S. boydii accounted for 5.0% and 5.4%, respectively, of 1130 Shigella case isolates; S. flexneri comprised 65.9% and S. sonnei 23.7%. Five serotypes/subserotypes comprised 89.4% of S. flexneri, including S. flexneri 2a, S. flexneri 6, S. flexneri 3a, S. flexneri 2b, and S. flexneri 1b. A broad-spectrum Shigella vaccine must protect against S. sonnei and 15 S. flexneri serotypes/subserotypes. A quadrivalent vaccine with O antigens from S. sonnei, S. flexneri 2a, S. flexneri 3a, and S. flexneri 6 can provide broad direct coverage against these most common serotypes and indirect coverage against all but 1 (rare) remaining subserotype through shared S. flexneri group antigens. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  11. The effectiveness and safety of amisulpride in Chinese patients with schizophrenia: An 8‐week, prospective, open‐label, multicenter, single‐arm study

    Science.gov (United States)

    Liang, Ying; Cao, Changan; Zhu, Cheng; Wang, Chuanyue; Zhang, Congpei; Dong, Fang; Yang, Fude; Deng, Hong; Yu, Jingjie; Tang, Jisheng; Su, Lei; Xin, Limin; Hong, Ling; Gao, Minglong; Tang, Muni; Xie, Shiping; Lu, Shuiping; Liu, Tiebang; Xu, Xiaojin; Wang, Xijin; Li, Xuanzi; Wang, Xueyi; Li, Yi; Zhang, Yong; Chen, Zhiyu

    2016-01-01

    Abstract Introduction This study evaluated the effectiveness and safety of amisulpride in Chinese schizophrenia patients. Methods A multicenter, single‐arm Phase IV study (NCT01795183). Chinese patients with schizophrenia received amisulpride for 8 weeks. The primary endpoint was ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. Results A total of 316 patients were enrolled; 295 were included in the effectiveness analysis; 66.8% (197/295) achieved ≥50% decrease in Positive and Negative Syndrome Scale total score from Baseline to Week 8. Nine patients discontinued treatment because of adverse events. Discussion Amisulpride had clinical effectiveness and was relatively well tolerated in Chinese patients with schizophrenia. PMID:27020720

  12. Scattering of charged particles by a multicenter potential

    International Nuclear Information System (INIS)

    Gerasimov, O.I.; Stienko, A.G.

    1994-01-01

    Exact expressions are obtained for the amplitude and elastic cross section in the case of scattering of charged particles by a multicenter pseudopotential that includes the Coulomb potential and an arbitrary number of short-range potentials (modeled by zero-range potentials). Asymptotic limits are calculated and explicit expressions are found for the amplitudes of scattering by few-nucleon complexes modeled by superpositions of the Coulomb potential and purely point potentials

  13. La mujer como sujeto social ante el problema ambiental desde la realidad cubana./The woman as a social subject to the environmental problem from the Cuban reality.

    Directory of Open Access Journals (Sweden)

    Luisa Carrión Cabrera

    2015-09-01

    Full Text Available RESUMEN El análisis de la mujer como sujeto social ante el problema ambiental en el contexto cubano, se convierte en una necesidad para alcanzar el desarrollo sostenible, para dicho análisis se discuten acerca de los cuatro ejes que facilitan la valoración de los procesos sociales en su vínculo con el medio ambiente (lo ambiental como problemática en la producción filosófica en el contexto cubano y su relación con la mujer como sujeto social; el desequilibrio en las condiciones de existencia en los espacios privados (familiar; los problemas ambientales y su impacto en la mujer y el papel creciente de la actividad social del sujeto, a partir de sus tipos y proyecciones sociales para el logro del desarrollo sostenible. ABSTRACT The analysis of women as social subject to the environmental problem in the Cuban context, it becomes a necessity for sustainable development, for this analysis are discussed on the four axes that facilitate the assessment of social processes in its link with the environment (environmental and philosophical problems in production in the Cuban context and its relationship with the woman as a social subject, the imbalance in living conditions in the private sphere (family environmental problems and their impact on women and the increasing role of the social activity of the subject, based on their types and social implications for the achievement of sustainable development.

  14. Multicenter study of endoscopic preoperative biliary drainage for malignant hilar biliary obstruction: E-POD hilar study.

    Science.gov (United States)

    Nakai, Yousuke; Yamamoto, Ryuichi; Matsuyama, Masato; Sakai, Yuji; Takayama, Yukiko; Ushio, Jun; Ito, Yukiko; Kitamura, Katsuya; Ryozawa, Shomei; Imamura, Tsunao; Tsuchida, Kouhei; Hayama, Jo; Itoi, Takao; Kawaguchi, Yoshiaki; Yoshida, Yu; Sugimori, Kazuya; Shimura, Kenji; Mizuide, Masafumi; Iwai, Tomohisa; Nishikawa, Ko; Yagioka, Hiroshi; Nagahama, Masatsugu; Toda, Nobuo; Saito, Tomotaka; Yasuda, Ichiro; Hirano, Kenji; Togawa, Osamu; Nakamura, Kenji; Maetani, Iruru; Sasahira, Naoki; Isayama, Hiroyuki

    2018-05-01

    Endoscopic nasobiliary drainage (ENBD) is often recommended in preoperative biliary drainage (PBD) for hilar malignant biliary obstruction (MBO), but endoscopic biliary stent (EBS) is also used in the clinical practice. We conducted this large-scale multicenter study to compare ENBD and EBS in this setting. A total of 374 cases undergoing PBD including 281 ENBD and 76 EBS for hilar MBO in 29 centers were retrospectively studied. Extrahepatic cholangiocarcinoma (ECC) accounted for 69.8% and Bismuth-Corlette classification was III or more in 58.8% of the study population. Endoscopic PBD was technically successful in 94.6%, and adverse event rate was 21.9%. The rate of post-endoscopic retrograde cholangiopancreatography pancreatitis was 16.0%, and non-endoscopic sphincterotomy was the only risk factor (odds ratio [OR] 2.51). Preoperative re-intervention was performed in 61.5%: planned re-interventions in 48.4% and unplanned re-interventions in 31.0%. Percutaneous transhepatic biliary drainage was placed in 6.4% at the time of surgery. The risk factors for unplanned procedures were ECC (OR 2.64) and total bilirubin ≥ 10 mg/dL (OR 2.18). In surgically resected cases, prognostic factors were ECC (hazard ratio [HR] 0.57), predraiange magnetic resonance cholangiopancreatography (HR 1.62) and unplanned re-interventions (HR 1.81). EBS was not associated with increased adverse events, unplanned re-interventions, or a poor prognosis. Our retrospective analysis did not demonstrate the advantage of ENBD over EBS as the initial PBD for resectable hilar MBO. Although the technical success rate of endoscopic PBD was high, its re-intervention rate was not negligible, and unplanned re-intervention was associated with a poor prognosis in resected hilar MBO. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  15. Axial Globe Position Measurement: A Prospective Multi-center Study by the International Thyroid Eye Disease Society

    Science.gov (United States)

    Bingham, Chad M.; Sivak-Callcott, Jennifer A.; Gurka, Matthew J.; Nguyen, John; Hogg, Jeffery P.; Feldon, Steve E.; Fay, Aaron; Seah, Lay-Leng; Strianese, Diego; Durairaj, Vikram D.; Uddin, Jimmy; Devoto, Martin H.; Harris, Matheson; Saunders, Justin; Osaki, Tammy H.; Looi, Audrey; Teo, Livia; Davies, Brett W.; Elefante, Andrea; Shen, Sunny; Realini, Tony; Fischer, William; Kazim, Michael

    2015-01-01

    Purpose Identify a reproducible measure of axial globe position (AGP) for multicenter studies of patients with thyroid eye disease (TED). Methods This is a prospective, international, multicenter, observational study in which 3 types of AGP evaluation were examined: radiologic, clinical, and photographic. In this study, computed tomography (CT) was the modality to which all other methods were compared. CT AGP was measured from an orthogonal line between the anterior lateral orbital rims to the cornea. All CT measurements were made at a single institution by 3 individual clinicians. Clinical evaluation was performed with exophthalmometry. Three clinicians from each clinical site assessed AGP with 3 different exophthalmometers and horizontal palpebral width using a ruler. Each physician made 3 separate measurements with each type of exophthalmometer, not in succession. All photographic measurements were made at a single institution. AGP was measured from lateral photographs in which a standard marker was placed at the anterior lateral orbital rim. Horizontal and vertical palpebral fissure were measured from frontal photographs. Three trained readers measured 3 separate times, not in succession. Exophthalmometry and photography method validity was assessed by agreement with CT (mean differences calculation, ICC’s, Bland-Altman figures). Correlation between palpebral fissure and CT AGP was assessed with Pearson correlation. Intraclinician and interclinician reliability was evaluated using intraclass correlation coefficients (ICC). Results Sixty-eight patients from 7 centers participated. CT mean AGP was 21.37mm (15.96 – 28.90mm) right, 21.22mm (15.87 – 28.70mm) left (ICC 0.996 and 0.995). Exophthalmometry AGP fell between 18mm and 25mm. Intraclinician agreement across exophthalmometers was ideal (ICC 0.948 – 0.983). Agreement between clinicians was greater than 0.85 for all upright exophthalmometry measurements. Photographic mean AGP was 20.47mm (10.92 – 30

  16. Emotional exhaustion is associated with work related stressors: a cross-sectional multicenter study in Malaysian public hospitals.

    Science.gov (United States)

    Khoo, Erwin J; Aldubai, Sami; Ganasegeran, Kurubaran; Lee, Bernice Xe; Zakaria, Nurul A; Tan, Kah K

    2017-06-01

    Emotional exhaustion is an important component of burnout. Burnout is common among doctors. It affects the physical and mental health of doctors, their performance and the quality of care they provide. This study aimed to investigate the level and factors associated with emotional exhaustion among doctors in pediatric practice in Malaysia. A self-administered questionnaire was used in this multicenter cross-sectional study. It included questions on the socio-demographics, work characteristics, Emotional Exhaustion, Perceived Stress Scale and sources of job stress. Descriptive, univariate and multivariate analysis were conducted using the SPSS software. A total of 197 doctors working in the Pediatric department in eight hospitals returned complete questionnaire. High and moderate emotional exhaustion was reported by 25.4% and 24.4% doctors, respectively. In bivariate analysis, 29 out of the 38 items of sources of stress showed significant association with emotional exhaustion (p appreciation from supervisors, lack of incentives and promotions, time pressures and deadlines to meet, and setting unrealistic goals of having them imposed on oneself (p workplace but not with socio-demographic factors.

  17. Health status, resource consumption, and costs of dysthymia. A multi-center two-year longitudinal study.

    Science.gov (United States)

    Barbui, Corrado; Motterlini, Nicola; Garattini, Livio

    2006-02-01

    In this study we estimated the health status, resource consumption and costs of a large cohort of patients with early and late-onset dysthymia. The DYSCO (DYSthymia COsts) project is a multi-center observational study which prospectively followed for two years a randomly chosen sample of patients with dysthymia in the Italian primary health care system. A total of 501 patients were followed for two years; 81% had early-onset dysthymic disorder. During the study, improvement was seen in most domains of the 36-Item Short Form Health Survey (SF-36) questionnaire. Comparison of the SF-36 scores for the two groups showed that only the physical health index significantly differed during the two years. The use of outpatient consultations, laboratory tests and diagnostic procedures was similar in the two groups, but patients with early-onset dysthymia were admitted significantly more than late-onset cases. Hospital admissions were almost entirely responsible for the higher total cost per patient per year of early-onset dysthymia. A first limitation of this study is that general practitioners were selected on the basis of their willingness to participate, not at random; secondly, no information was collected on concomitant psychiatric comorbidities. The present study provides the first prospective, long-term data on service use and costs in patients with dysthymia. Differently from patients with early-onset dysthymia, patients with late-onset dysthymia were admitted less and cost less.

  18. A multicenter reproducibility study of single-voxel 1H-MRS of the medial temporal lobe

    International Nuclear Information System (INIS)

    Traeber, Frank; Block, Wolfgang; Guer, Okan; Schild, Hans H.; Freymann, Nikolaus; Heun, Reinhard; Jessen, Frank; Kucinski, Thomas; Hammen, Thilo; Ende, Gabriele; Pilatus, Ulrich; Hampel, Harald

    2006-01-01

    Proton magnetic resonance spectroscopy ( 1 H-MRS) has provided evidence for a reduction of N-acetyl-aspartate (NAA) in the medial temporal lobe (MTL) in cerebral disorders such as Alzheimer's Disease. Within the 1 H-MRS study of the German Research Network on Dementia, we determined the multicenter reproducibility of single-voxel 1 H-MRS of the MTL. At five sites with 1.5T MR systems, single-voxel 1 H spectra from the MTL of an identical healthy subject were measured. The same subject was also examined at one of the sites five times to assess intracenter stability. The protocol included water-suppressed spectra with TE 272 ms and TE 30 ms and unsuppressed spectra for absolute quantification of metabolite concentrations. The intracenter reproducibility of absolute NAA concentration, expressed as coefficient of variation (CV), was 1.8%. CV for the concentrations of creatine (Cr), choline (Cho), and myoinositol (MI) and for the ratios NAA/Cr, NAA/Cho, and MI/NAA varied by 11-16%. Intercenter CV was 3.9% for NAA and were below 10% for all other metabolites and metabolic ratios. Our study demonstrates that quantitative assessment of NAA with single-voxel MRS can be performed with high intercenter reproducibility. This is the basis for applying 1 H-MRS in large-scale early recognition and treatment studies in MTL affecting disorders. (orig.)

  19. Conversion to belatacept in maintenance kidney-transplant patients: A retrospective multicenter European study.

    Science.gov (United States)

    Darres, Amandine; Ulloa, Camillo; Brakemeier, Susanne; Garrouste, Cyril; Bestard, Oriol; Del Bello, Arnaud; Sberro Soussan, Rebecca; Dürr, Michael; Budde, Klemens; Legendre, Christophe; Kamar, Nassim

    2018-03-22

    The use of belatacept is not yet approved for maintenance kidney-transplant patients. This retrospective multicenter European study aimed to assess the efficacy and safety of conversion to belatacept in a large cohort of patients in a real-life setting, and to identify the predictive factors for improved kidney function after the switch. Two-hundred and nineteen maintenance kidney-transplant patients from 5 European kidney-transplant centers were converted to belatacept at 21.2 (0.1-337.1) months posttransplantation, mainly because of impaired kidney function. Thirty-two patients were converted to belatacept within the first 3 months posttransplantation. The mean duration of follow-up was 21.9±20.2 months. The actuarial rate of patients still on belatacept-based therapy was 77.6%. Mean estimated glomerular-filtration rate (eGFR) increased from 32±16.4 at baseline to 38±20 mL/min/1.73 m (ppredictive factor for a significant increase in eGFR (of 5 and 10 mL/min/1.73 m at 3 and 12 months after the switch, respectively). Eighteen patients (8.2%) presented with an acute-rejection episode after conversion; 3 developed a donor-specific antibody (DSA). Overall efficacy and safety were good, including for the 35 patients that had a DSA at conversion. The conversion to belatacept was effective, especially when performed early after transplantation.

  20. Multielement determination in Cuban red mangrove samples using nuclear and related analytical techniques; Determinacion multielemental en muestras de mangles cubanos utilizando tecnicas analiticas nucleares y conexas

    Energy Technology Data Exchange (ETDEWEB)

    Estevez Alvarez, J R; Aguiar Lambert, D; Montero Alvarez, A; Pupo Gonzalez, I; Padilla Alvarez, R [Centro de Estudios Aplicados al Desarrollo Nuclear, La Habana (Cuba); Gonzalez Garcia, H; Ramirez Sasco, M [Centro de Ingenieria y Manejo Ambiental de Bahias y Costas, La Habana (Cuba)

    1999-12-31

    In the present work the contents of Al; K; Ca; Mn; Fe; Ni; Cu; Zn; Sr; Cd and Pb in red mangroves (Rhizophora mangle) from different Cuban regions are determined, using Energy Dispersive X-Ray Fluorescence (Emission-Transmission (Et) and I/C methods), Atomic Absorption Spectrophotometry (AAS), and Polarography (Anodic Stripping Voltametry method). Biological Certified Reference Materials (CRM) are employed for the tracing of the tracing of the curves of the relative I/C method and for the evaluation of the analytical results accuracy. The reliability of the results is also checked by statistical means. Standard deviations and the detection limits of each method are reported. Finally, the obtained values for the concentration of the different elements in each studied ecosystem are presented; a detailed discussion about their significance will be performed in a further paper.

  1. A multicenter prospective study to assess the effect of early cleavage on embryo quality, implantation, and live-birth rate.

    Science.gov (United States)

    de los Santos, Maria José; Arroyo, Gemma; Busquet, Ana; Calderón, Gloria; Cuadros, Jorge; Hurtado de Mendoza, Maria Victoria; Moragas, Marta; Herrer, Raquel; Ortiz, Agueda; Pons, Carme; Ten, Jorge; Vilches, Miguel Angel; Figueroa, Maria José

    2014-04-01

    To investigate the impact of early cleavage (EC) on embryo quality, implantation, and live-birth rates. Prospective cross-sectional study. Multicenter study. Seven hundred embryo transfers and 1,028 early-stage human embryos. None. Implantation according to the presence of EC and embryo quality. The presence of EC is associated with embryo quality, especially in cycles with autologous oocytes. However, the use of EC as an additional criterion for selecting an embryo for transfer does not appear to significantly improve likelihood of implantation. Furthermore, embryos that presented EC had live-birth rates per implanted embryo similar to those that did not show any sign of cleavage. At least for conventional embryo culture and morphologic evaluations, the additional evaluation of EC in embryos may not be valuable to improve embryo implantation. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: Data from a European multicenter retrospective study.

    Science.gov (United States)

    Mekinian, Arsène; Lazzaroni, Maria Grazia; Kuzenko, Anna; Alijotas-Reig, Jaume; Ruffatti, Amelia; Levy, Pierre; Canti, Valentina; Bremme, Katarina; Bezanahary, Holy; Bertero, Tiziana; Dhote, Robin; Maurier, Francois; Andreoli, Laura; Benbara, Amélie; Tigazin, Ahmed; Carbillon, Lionel; Nicaise-Roland, Pascale; Tincani, Angela; Fain, Olivier

    2015-06-01

    In European multicenter study, we aimed to describe the real-life hydroxychloroquine use in APS patients during pregnancy and determine its benefit in refractory obstetrical APS. We analyzed the outcome of pregnancies treated by hydroxychloroquine in patients with APS or asymptomatic antiphospholipid (aPL) antibodies carriers. Thirty patients with APS with 35 pregnancies treated by hydroxychloroquine were analyzed. Comparing the outcome of pregnancies treated by the addition of hydroxychloroquine to previous pregnancies under the conventional treatment, pregnancy losses decreased from 81% to 19% (phydroxychloroquine amount (400mg per day) were the factors associated with pregnancy outcome. Considering 14 patients with previous refractory obstetrical APS (n=5 with obstetrical and thrombotic primary APS and n=9 with purely obstetrical APS), all with previous pregnancy losses under treatment (aspirin with LMWH in 11 cases and LMWH in 3 cases), the addition of hydroxychloroquine resulted in live born babies in 11/14 (78%) cases (phydroxychloroquine addition in patients with refractory obstetrical APS and raises the need of prospective studies to confirm our preliminary study. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. COMPULS: design of a multicenter phenotypic, cognitive, genetic, and magnetic resonance imaging study in children with compulsive syndromes

    Directory of Open Access Journals (Sweden)

    Jilly Naaijen

    2016-10-01

    Full Text Available Abstract Background Compulsivity, the closely linked trait impulsivity and addictive behaviour are associated with several neurodevelopmental disorders, including attention-deficit/hyperactivity disorder (ADHD, autism spectrum disorder (ASD, and obsessive compulsive disorder (OCD. All three disorders show impaired fronto-striatal functioning, which may be related to altered glutamatergic signalling. Genetic factors are also thought to play an important role in the aetiology of compulsivity-related disorders. Methods The COMPULS study is a multi-center study designed to investigate the relationship between the traits compulsivity, impulsivity, and, to a lesser extent, addictive behaviour within and across the neurodevelopmental disorders ADHD, ASD, and OCD. This will be done at the phenotypic, cognitive, neural, and genetic level. In total, 240 participants will take part in COMPULS across four different sites in Europe. Data collection will include diagnostic interviews, behavioural questionnaires, cognitive measures, structural, functional and spectral neuroimaging, and genome-wide genetic information. Discussion The COMPULS study will offer the unique opportunity to investigate several key aspects of compulsivity across a large cohort of ADHD, ASD and OCD patients.

  4. [Multicenter Ozurdex® assessment for diabetic macular edema: MOZART study].

    Science.gov (United States)

    Guigou, S; Hajjar, C; Parrat, E; Merite, P Y; Pommier, S; Matonti, F; Prost-Magnin, O; Meyer, F

    2014-06-01

    To evaluate the efficiency and safety of intravitreal implant of 0.7mg dexamathasone in visual impairment due to diabetic macular edema (DME). This was a retrospective, multicenter, study. Seventy-four patients, with a mean age of 65 years, followed for at least 6 months (mean follow-up: 9.8 months) were included in 5 French eye clinics (P 1.5 collective). The mean systolic blood pressure was 138mmHg and the mean HbA1c was 7.2%. We monitored 2 systemic parameters: blood pressure and glycemic balance. Best-corrected visual acuity (BCVA), central retinal thickness (CRT, Spectralis OCT), intraocular pressure (IOP) and cataract progression are studied at baseline and then at 1, 2, 4 and 6 months. The average CRT decrease was: 239μm at month 2 (M2) and 135μm at month 6 (M6). The mean improvement from baseline of BCVA is 8.5 letters at M2 and 7.6 letters at M6. A gain greater than 15 letters is found in 27% of patients at M6. For naive patients the BCVA is 71 letters versus 60 letters (P<0.05). Patients with a baseline CRT <500mmHg have a BCVA of 66 letters versus 57 letters (P<0.05). The mean rate injections was 1.2 at 6 months with an average of 5.4 months for reinjection. Ocular hypertension greater than 25mmHg, managed by topical treatment, is observed in 13.4% of patients. No glaucoma surgery was necessary. Dexamethasone has an anatomical and functional effectiveness in the treatment of DME. Outcomes for naive patients and lower CRT suggest that the duration of diabetes mellitus and previous treatments are negative factors of recovery. Side effects are rare and manageable. Ozurdex(®) seems to be a treatment for visual impairment due to DME with a favorable safety profile. Patient follow-up must be adapted to half-life of the product with a control before M1 (intraocular pressure) and before M5 (DME recurrence, BCVA). Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Neonatal outcome following new assisted reproductive technology regulations in Turkey - a nationwide multicenter point prevalence study.

    Science.gov (United States)

    Kultursay, Nilgun; Yalaz, Mehmet; Koroglu, Ozge Altun

    2015-01-01

    In March 2010, a new legislation about assisted reproductive technology (ART) activities, favoring single embryo transfer, was introduced in Turkey. Consequences of new regulations on neonatal outcome have not been evaluated in multicenter studies yet. In this study, our aim was to evaluate neonatal outcome of infants from medically assisted reproduction (MAR) pregnancies in the post-legislation era. A point prevalence study was conducted at 51 centers in Turkey on 1 April 2013. Data about fertility treatments and neonatal characteristics were evaluated for "live births" (Group 1) and "patients being cared in the NICU" (Group 2). Seventeen (4%) of 420 infants in group 1, and 89 (8.1%) of 1094 infants in group 2 were born after MAR pregnancies. The ratio of multiple births in MAR pregnancies was still very high as 47.1% for group 1, 69.1% for group 2 infants. MAR babies constituted 9.9% of infants in Level 3 NICUs and 7.6% infants in Level 2 NICUs. MAR was associated with increased risk of multiple births and prematurity. After the new legislation, multiple birth rates are still high in MAR pregnancies, resulting in unfavorable neonatal outcomes. Efforts to decrease multiple birth rates should be encouraged.

  6. Linear mixed-effects models for central statistical monitoring of multicenter clinical trials

    OpenAIRE

    Desmet, L.; Venet, D.; Doffagne, E.; Timmermans, C.; BURZYKOWSKI, Tomasz; LEGRAND, Catherine; BUYSE, Marc

    2014-01-01

    Multicenter studies are widely used to meet accrual targets in clinical trials. Clinical data monitoring is required to ensure the quality and validity of the data gathered across centers. One approach to this end is central statistical monitoring, which aims at detecting atypical patterns in the data by means of statistical methods. In this context, we consider the simple case of a continuous variable, and we propose a detection procedure based on a linear mixed-effects model to detect locat...

  7. Adversity and Syndemic Production Among Men Participating in the Multicenter AIDS Cohort Study: A Life-Course Approach

    Science.gov (United States)

    Lim, Sin How; Plankey, Michael W.; Chmiel, Joan S.; Guadamuz, Thomas T.; Kao, Uyen; Shoptaw, Steven; Carrico, Adam; Ostrow, David; Stall, Ron

    2013-01-01

    Objectives. We tested a theory of syndemic production among men who have sex with men (MSM) using data from a large cohort study. Methods. Participants were 1551 men from the Multicenter AIDS Cohort Study enrolled at 4 study sites: Baltimore, Maryland–Washington, DC; Chicago, Illinois; Los Angeles, California; and Pittsburgh, Pennsylvania. Participants who attended semiannual visits from April 1, 2008, to March 31, 2009, completed an additional survey that captured data about events throughout their life course thought to be related to syndemic production. Results. Using multivariate analysis, we found that the majority of life-course predictor variables (e.g., victimization, internalized homophobia) were significantly associated with both the syndemic condition and the component psychosocial health outcomes (depressive symptoms, stress, stimulant use, sexual compulsivity, intimate partner violence). A nested negative binomial analysis showed that the overall life course significantly explained variability in the syndemic outcomes (χ2 = 247.94; P < .001; df = 22). Conclusions. We identified life-course events and conditions related to syndemic production that may help to inform innovative interventions that will effectively disentangle interconnecting health problems and promote health among MSM. PMID:23153154

  8. Clinical manifestations of colorectal cancer patients from a large multicenter study in Colombia.

    Science.gov (United States)

    Bohorquez, Mabel; Sahasrabudhe, Ruta; Criollo, Angel; Sanabria-Salas, María Carolina; Vélez, Alejandro; Castro, Jorge Mario; Marquez, Juan Ricardo; Mateus, Gilbert; Bolaños, Fernando; Panqueva, Cesar; Restrepo, Jose Ignacio; Puerta, Juan Dario; Murillo, Raul; Bravo, María Mercedes; Hernández, Gustavo; Rios, Angela; Prieto, Rodrigo; Tomlinson, Ian; Echeverry, Magdalena; Carvajal-Carmona, Luis G

    2016-10-01

    Colorectal cancer (CRC) is a major public health problem, and its incidence is rising in developing countries. However, studies characterizing CRC clinicopathological features in cases from developing countries are still lacking. The goal of this study was to evaluate clinicopathological and demographic features in one of the largest CRC studies in Latin America.The study involved over 1525 CRC cases recruited in a multicenter study in Colombia between 2005 and 2014 as part of ongoing genetic and epidemiological studies. We gathered clinicopathological data such as age at diagnosis, sex, body mass index, tobacco and alcohol consumption, family history of cancer, and tumor features including location, histological type, and stage. Statistical analyses were performed to test the association between age of onset, sex, and clinical manifestations.The average age at CRC diagnosis was 57.4 years, with 26.5% of cases having early-onset CRC (diagnosed by age 50 years). Most cases were women (53.2%; P = 0.009), 49.2% were overweight or obese, 49.1% were regular alcohol drinkers, 52% were smokers/former smokers, and 12.2% reported relatives with cancer. Most tumors in the study were located in the rectum (42.7%), were adenocarcinomas (91.5%), and had advanced stage (T3-T4, 79.8%). Comparisons by sex found that male cases were more likely to be obese (36.5% vs 31.1%; P = 0.001), less likely to have a family history of cancer (9.7% vs 15.3%; P = 0.016), and more likely to have advanced-stage tumors (83.9% vs 76.1%; P = 0.036). Comparisons by age of onset found that early-onset cases were more likely to be women (59.3% vs 51.0%; P = 0.005) and report a family history of cancer (17.4% vs 10.2%; P = 0.001).To our knowledge, our study is the largest report of clinicopathological characterization of Hispanic CRC cases, and we suggest that further studies are needed to understand CRC etiology in diverse Hispanic populations.

  9. Golimumab in patients with active rheumatoid arthritis after treatment with tumor necrosis factor a inhibitors: findings with up to five years of treatment in the multicenter, randomized, double-blind, placebo-controlled, phase 3 GO-AFTER study

    NARCIS (Netherlands)

    Smolen, Josef S.; Kay, Jonathan; Doyle, Mittie; Landewé, Robert; Matteson, Eric L.; Gaylis, Norman; Wollenhaupt, Jürgen; Murphy, Frederick T.; Xu, Stephen; Zhou, Yiying; Hsia, Elizabeth C.

    2015-01-01

    Introduction: The aim of this study was to assess long-term golimumab therapy in rheumatoid arthritis (RA) patients who discontinued previous tumor necrosis factor-alpha (TNF)-inhibitor(s). Methods: Patients enrolled into this multicenter, randomized, double-blind, placebo-controlled study of active

  10. The Use of the OMERACT Ultrasound Tenosynovitis Scoring System in Multicenter Clinical Trials.

    Science.gov (United States)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Naredo, Esperanza; Iagnocco, Annamaria; Möller, Ingrid; D'Agostino, Maria-Antonietta; Gandjbakhch, Frédérique; Terslev, Lene

    2018-02-01

    To test the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) ultrasound (US) scoring system for tenosynovitis when applied in a multicenter design. RA patients with US-verified tenosynovitis were recruited when scheduled for treatment intensification. Tenosynovitis was assessed at baseline, and 3 and 6 months followup, using the semiquantitative OMERACT scoring system. Expressed in median (25th; 75th percentiles), the overall greyscale and Doppler score decreased significantly from baseline at 4 (2; 7) and 3 (2; 6), to 6 months at 2 (0; 3) and 0 (0; 1, p The OMERACT US scoring system for tenosynovitis showed high responsiveness, supporting its use for diagnosing and monitoring tenosynovitis in multicenter trials.

  11. The Prevalence and Clinical Features of Non-responsive Gastroesophageal Reflux Disease to Practical Proton Pump Inhibitor Dose in Korea: A Multicenter Study.

    Science.gov (United States)

    Park, Hong Jun; Park, Soo Heon; Shim, Ki Nam; Kim, Yong Sung; Kim, Hyun Jin; Han, Jae Pil; Kim, Yong Sik; Bang, Byoung Wook; Kim, Gwang Ha; Baik, Gwang Ho; Kim, Hyung Hun; Park, Seon Young; Kim, Sung Soo

    2016-07-25

    In Korea, there are no available multicenter data concerning the prevalence of or diagnostic approaches for non-responsive gastroesophageal reflux disease (GERD) which does not respond to practical dose of proton pump inhibitor (PPI) in Korea. The purpose of this study is to evaluate the prevalence and the symptom pattern of non-responsive GERD. A total of 12 hospitals who were members of a Korean GERD research group joined this study. We used the composite score (CS) as a reflux symptom scale which is a standardized questionnaire based on the frequency and severity of typical symptoms of GERD. We defined "non-responsive GERD" as follows: a subject with the erosive reflux disease (ERD) whose CS was not decreased by at least 50% after standard-dose PPIs for 8 weeks or a subject with non-erosive reflux disease (NERD) whose CS was not decreased by at least 50% after half-dose PPIs for 4 weeks. A total of 234 subjects were analyzed. Among them, 87 and 147 were confirmed to have ERD and NERD, respectively. The prevalence of non-responsive GERD was 26.9% (63/234). The rates of non-responsive GERD were not different between the ERD and NERD groups (25.3% vs. 27.9%, respectively, p=0.664). There were no differences between the non-responsive GERD and responsive GERD groups for sex (p=0.659), age (p=0.134), or BMI (p=0.209). However, the initial CS for epigastric pain and fullness were higher in the non-responsive GERD group (p=0.044, p=0.014, respectively). In conclusion, this multicenter Korean study showed that the rate of non-responsive GERD was substantially high up to 26%. In addition, the patients with the non-responsive GERD frequently showed dyspeptic symptoms such as epigastric pain and fullness.

  12. The Effectiveness of Silodosin for Nocturnal Polyuria in Elderly Men With Benign Prostatic Hyperplasia: A Multicenter Study

    Directory of Open Access Journals (Sweden)

    Young Won Kim

    2015-09-01

    Full Text Available Purpose: To investigate improvement in nocturia and nocturnal polyuria in nocturnal polyuria patients after silodosin administration by using a 3-day frequency volume chart. Methods: This was a prospective multicenter study. We enrolled nocturnal polyuria patients (nocturnal polyuria index [NPi]>0.33, aged ≥60 years, diagnosed with the 3-day frequency volume charts of patients with benign prostatic hyperplasia taking α-blockers. Of the 54 patients, 30 (55.6% completed the study according to the study protocol (per-protocol group, and 24 dropped out (dropout group. Results: Of the 24 patients in the dropout group, 5 withdrew consent due to side effects or lack of efficacy, 7 were lost to follow-up at 4 weeks, 8 were lost to follow-up at 12 weeks, and 4 dropped out due to failure to complete 3-day frequency volume charts at 12 weeks. In the per-protocol group, there was significant improvement in the International Prostate Symptom Score (IPSS, especially question numbers 1, 3, 4, 5, 6, 7, and the quality of life question (P=0.001, P=0.007, P0.33. Considering the high dropout rate of our study due to no implementation of 3-day frequency volume charts, prospective and large-scale studies are needed to confirm our results.

  13. Nationwide Multicenter Reference Interval Study for 28 Common Biochemical Analytes in China.

    Science.gov (United States)

    Xia, Liangyu; Chen, Ming; Liu, Min; Tao, Zhihua; Li, Shijun; Wang, Liang; Cheng, Xinqi; Qin, Xuzhen; Han, Jianhua; Li, Pengchang; Hou, Li'an; Yu, Songlin; Ichihara, Kiyoshi; Qiu, Ling

    2016-03-01

    A nationwide multicenter study was conducted in the China to explore sources of variation of reference values and establish reference intervals for 28 common biochemical analytes, as a part of the International Federation of Clinical Chemistry and Laboratory Medicine, Committee on Reference Intervals and Decision Limits (IFCC/C-RIDL) global study on reference values. A total of 3148 apparently healthy volunteers were recruited in 6 cities covering a wide area in China. Blood samples were tested in 2 central laboratories using Beckman Coulter AU5800 chemistry analyzers. Certified reference materials and value-assigned serum panel were used for standardization of test results. Multiple regression analysis was performed to explore sources of variation. Need for partition of reference intervals was evaluated based on 3-level nested ANOVA. After secondary exclusion using the latent abnormal values exclusion method, reference intervals were derived by a parametric method using the modified Box-Cox formula. Test results of 20 analytes were made traceable to reference measurement procedures. By the ANOVA, significant sex-related and age-related differences were observed in 12 and 12 analytes, respectively. A small regional difference was observed in the results for albumin, glucose, and sodium. Multiple regression analysis revealed BMI-related changes in results of 9 analytes for man and 6 for woman. Reference intervals of 28 analytes were computed with 17 analytes partitioned by sex and/or age. In conclusion, reference intervals of 28 common chemistry analytes applicable to Chinese Han population were established by use of the latest methodology. Reference intervals of 20 analytes traceable to reference measurement procedures can be used as common reference intervals, whereas others can be used as the assay system-specific reference intervals in China.

  14. Evaluation of possible associated factors for early childhood caries and severe early childhood caries: a multicenter cross-sectional survey

    NARCIS (Netherlands)

    Özen, B.; van Strijp, A.J.P.; Özer, L.; Olmus, H.; Genc, A.; Cehreli, S.B.

    2016-01-01

    Objectives: The present study evaluated associated factors for developing early childhood caries (ECC) and Severe-ECC (S-ECC) in a group of children aged 24–71 months. Potential positive effects of early dental visit on formation of ECC is investigated as well. Study Design: This was a multicenter,

  15. Software-based evaluation of toric IOL orientation in a multicenter clinical study.

    Science.gov (United States)

    Kasthurirangan, Sanjeev; Feuchter, Lucas; Smith, Pamela; Nixon, Donald

    2014-12-01

    To evaluate the rotational stability of a new one-piece hydrophobic acrylic toric intraocular lens (IOL) using a custom-developed software for analysis of slit-lamp photographs. In a prospective, multicenter study, 174 eyes were implanted with the TECNIS Toric IOL (Abbott Medical Optics, Inc., Santa Ana, CA). A custom-developed software was used to analyze high-resolution slit-lamp photographs of 156 eyes taken at day 1 (baseline) and 1, 3, and 6 months postoperatively. The software uses iris and sclera landmarks to align the baseline image and later images for comparison. Validation of software was performed through repeated analyses of protractor images rotated from 0.1° to 10.0° and randomly selected photographs of 20 eyes. Software validation showed precision (repeatability plus reproducibility variation) of 0.02° using protractor images and 2.22° using slit-lamp photographs. Good quality slit-lamp images and clear landmarks were necessary for precise measurements. At 6 months, 94.2% of eyes had 5° or less change in IOL orientation versus baseline; only 2 eyes (1.4%) had axis shift greater than 30°. Most eyes were within 5° or less of rotation between 1 and 3 months (92.9%) and 3 and 6 months (94.1%). Mean absolute axis change (± standard deviation) from 1 day to 6 months was 2.70° ± 5.51°. The new custom software was precise and quick in analyzing slit-lamp photographs to determine postoperative toric IOL rotation. Copyright 2014, SLACK Incorporated.

  16. Dermatology Medical Education: A Multicenter Survey Study of the Undergraduate Perspective of the Dermatology Clinical Clerkship.

    Science.gov (United States)

    Davari, Parastoo; Millsop, Jillian W; Johnson, Mary Ann N; Takahashi, Stefani R; Peng, David H; Badger, Joanna; Bahr, Brooks A; Shinkai, Kanade; Li, Chin-Shang; Fazel, Nasim

    2017-12-15

    Limited data are available regarding the undergraduate dermatology clinical clerkship curriculum in the United States. Our primaryaim is to assess medical students' perspectives of the dermatology clinical clerkship. A multicenter survey study was conducted, which included four California dermatology academic programs. A 17-item questionnaire was designed to investigate medical student perception with regard tothe overall educational value of the various teaching aspects of the dermatology clinical clerkship. A total of 152 medical student surveys were completed. Over half of the medical students felt proficient in diagnosing the most commondermatologic conditions. Eighty-seven percent of medical students were very satisfied with the dermatology clerkship. Ninety-one percent of students felt the length of the clerkship was appropriate. The vast majority of medical students reported a high level of proficiency in the treatment and diagnosis of common skin disorders. In contrast, our findings suggest that medical students may not begaining sufficient hands-on experience in conducting certain dermatologic procedures following the dermatology clerkship. Overall, medical studentperception of the dermatology clinical clerkship was mostly positive.

  17. Factors Associated With Domestic Violence Against Women in Iran: An Exploratory Multicenter Community-Based Study.

    Science.gov (United States)

    Saffari, Mohsen; Arslan, Syed Asadullah; Yekaninejad, Mir Saeid; Pakpour, Amir H; Zaben, Faten Al; Koenig, Harold G

    2017-06-01

    Domestic violence against women committed by intimate partners is a worldwide concern especially in developing countries. The aim of this study was to assess the problem among Iranian women and identify associated risk factors. Using a cross-sectional multicenter design, 1,600 women in six different areas of Iran were surveyed. A measure of domestic violence against women was administered and demographic information collected. Logistic regression models were used to identify factors associated with domestic violence. The prevalence of domestic violence among participants were emotional (64%), physical (28%), and sexual (18%). Higher education (both women and their partners), employment status of partner (being employed), and lower number of children lowered the risk, whereas history of previous marriage (for either women or their partners), unstable marriage, substance abuse, crowded family situation, and lower socioeconomic status increased the risk of domestic violence. There is a high prevalence of domestic violence, particularly emotional, against women by their partners. Preventive measures are recommended such as increasing public awareness, improving in socioeconomic status of families, educating women about what they can do, and encouraging counseling for the couple or the woman alone.

  18. Pelvic organ prolapse repair using the Uphold™ Vaginal Support System: a 1-year multicenter study.

    Science.gov (United States)

    Altman, Daniel; Mikkola, Tomi S; Bek, Karl Möller; Rahkola-Soisalo, Päivi; Gunnarsson, Jonas; Engh, Marie Ellström; Falconer, Christian

    2016-09-01

    The objective was to assess safety and clinical outcomes in women operated on using the Uphold™ Lite Vaginal Support System. We carried out a 1-year, multicenter, prospective, single cohort study of 207 women with symptomatic Pelvic Organ Prolapse Quantification (POP-Q) stage ≥2 apical pelvic organ prolapse, with or without concomitant anterior vaginal wall prolapse. Safety data were collected using a standardized questionnaire. Anatomical outcome was assessed by the POP-Q and subjective outcomes by the Pelvic Floor Distress Inventory after 2 months and 1 year using a one-way repeated measures analysis of variance. Pain was evaluated using a visual analog scale. The overall rate of serious complications was 4.3 % (9 out of 207 patients), including 3 patients with bladder perforations, 1 with bleeding >1,000 ml, 2 who had undergone re-operations with complete mesh removal because of pain, and 3 surgical interventions during follow-up because of mesh exposure. POP-Q stage ≤1 after 1 year was 94 % and subjective symptom relief was reported by 91 % of patients (p transvaginal mesh kits.

  19. Development and Feasibility Testing of a Critical Care EEG Monitoring Database for Standardized Clinical Reporting and Multicenter Collaborative Research.

    Science.gov (United States)

    Lee, Jong Woo; LaRoche, Suzette; Choi, Hyunmi; Rodriguez Ruiz, Andres A; Fertig, Evan; Politsky, Jeffrey M; Herman, Susan T; Loddenkemper, Tobias; Sansevere, Arnold J; Korb, Pearce J; Abend, Nicholas S; Goldstein, Joshua L; Sinha, Saurabh R; Dombrowski, Keith E; Ritzl, Eva K; Westover, Michael B; Gavvala, Jay R; Gerard, Elizabeth E; Schmitt, Sarah E; Szaflarski, Jerzy P; Ding, Kan; Haas, Kevin F; Buchsbaum, Richard; Hirsch, Lawrence J; Wusthoff, Courtney J; Hopp, Jennifer L; Hahn, Cecil D

    2016-04-01

    The rapid expansion of the use of continuous critical care electroencephalogram (cEEG) monitoring and resulting multicenter research studies through the Critical Care EEG Monitoring Research Consortium has created the need for a collaborative data sharing mechanism and repository. The authors describe the development of a research database incorporating the American Clinical Neurophysiology Society standardized terminology for critical care EEG monitoring. The database includes flexible report generation tools that allow for daily clinical use. Key clinical and research variables were incorporated into a Microsoft Access database. To assess its utility for multicenter research data collection, the authors performed a 21-center feasibility study in which each center entered data from 12 consecutive intensive care unit monitoring patients. To assess its utility as a clinical report generating tool, three large volume centers used it to generate daily clinical critical care EEG reports. A total of 280 subjects were enrolled in the multicenter feasibility study. The duration of recording (median, 25.5 hours) varied significantly between the centers. The incidence of seizure (17.6%), periodic/rhythmic discharges (35.7%), and interictal epileptiform discharges (11.8%) was similar to previous studies. The database was used as a clinical reporting tool by 3 centers that entered a total of 3,144 unique patients covering 6,665 recording days. The Critical Care EEG Monitoring Research Consortium database has been successfully developed and implemented with a dual role as a collaborative research platform and a clinical reporting tool. It is now available for public download to be used as a clinical data repository and report generating tool.

  20. Multicenter study of environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in 48 Canadian hospitals.

    Science.gov (United States)

    Poupeau, Céline; Tanguay, Cynthia; Caron, Nicolas J; Bussières, Jean-François

    2018-01-01

    Context Oncology workers are occupationally exposed to antineoplastic drugs. This exposure can induce adverse health effects. In order to reduce their exposure, contamination on surfaces should be kept as low as possible. Objectives To monitor environmental contamination with cyclophosphamide, ifosfamide, and methotrexate in oncology pharmacy and patient care areas in Canadian hospitals. To describe the impact of some factors that may limit contamination. Methods This is a descriptive study. Twelve standardized sites were sampled in each participating center (six in the pharmacy and six in patient care areas). Samples were analyzed for the presence of cyclophosphamide, ifosfamide, and methotrexate by ultra-performance liquid chromatography tandem mass spectrometry technology. Descriptive statistical analyses were done and results were compared with a Kolmogorov-Smirnov test for independent samples. Results In 2015, 48 hospitals participated in this study (48/202, 24%). Overall, 34% (181/525) of the samples were positive for cyclophosphamide, 8% (41/525) for ifosfamide, and 6% (31/525) for methotrexate. The 75th percentile value of cyclophosphamide surface concentration was 6.9 pg/cm 2 . For ifosfamide and methotrexate, they were lower than the limit of detection. Centers who prepared more antineoplastic drugs per year and centers who used more cyclophosphamide per year showed significantly higher surface contamination ( p contamination. Conclusion In comparison with other multicenter studies that were conducted in Canada, the concentration of antineoplastic drugs measured on surfaces is decreasing. Regular environmental monitoring is a good practice in order to maintain contamination as low as reasonably achievable.