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Sample records for cut-off-mesa isolated rib

  1. Cutoff-mesa isolated rib optical waveguide for III-V heterostructure photonic integrated circuits

    Science.gov (United States)

    Vawter, G.A.; Smith, R.E.

    1998-04-28

    A cutoff mesa rib waveguide provides single-mode performance regardless of any deep etches that might be used for electrical isolation between integrated electrooptic devices. Utilizing a principle of a cutoff slab waveguide with an asymmetrical refractive index profile, single mode operation is achievable with a wide range of rib widths and does not require demanding etch depth tolerances. This new waveguide design eliminates reflection effects, or self-interference, commonly seen when conventional rib waveguides are combined with deep isolation etches and thereby reduces high order mode propagation and crosstalk compared to the conventional rib waveguides. 7 figs.

  2. Isolated rib fractures in geriatric patients

    OpenAIRE

    Elmistekawy, Elsayed M.; Hammad, Abd Almohsen M.

    2007-01-01

    Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical...

  3. Isolated rib fractures in geriatric patients

    Directory of Open Access Journals (Sweden)

    Elmistekawy Elsayed

    2007-01-01

    Full Text Available Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical conditions, complications, admission to intensive care unit (ICU, need for mechanical ventilation, length of ICU and hospital stay and mortality. Results: For the study, 39 patients who were 60 years old or more and admitted to the hospital because of isolated rib fractures were enrolled. There were 28 males (71.7% and 11 females (28.3% with mean age of (66.84 ± 4.7 years. No correlation was found between comorbidities and hospital outcomes except in those who were diabetic (P-value = 0.005 and those with chronic lung disease (P-value = 0.006. Pulmonary complications were the most frequent complications encountered in those patients. Pulmonary complications were: lung contusion in 8 patients (20.5% and pulmonary infection in 6 patients (15.8%. Conclusion: Elderly patients sustaining blunt chest trauma had significant morbidity and potential for mortality.

  4. Isolated Cervical Rib Fracture: A Rare Etiology of Thoracic Outlet Syndrome

    Directory of Open Access Journals (Sweden)

    Rayees Ahmad Dar

    2011-01-01

    Full Text Available Isolated fracture of a cervical rib is a very rare entity and usually presents as a painless swelling or as thoracic outlet syndrome. We describe a case of a 45-year-old woman with history of fall two months back. She presented with symptoms of neurogenic thoracic outlet syndrome for one month. Isolated left cervical rib fracture was documented on X-ray cervical spine. Her fractured cervical rib was resected through a supraclavicular approach, and symptoms resolved completely in the postoperative period.

  5. Establishing Streptomycin Epidemiological Cut-Off Values for Salmonella and Escherichia coli

    DEFF Research Database (Denmark)

    Migura, Lourdes Garcia; Sunde, Marianne; Karlsmose, Susanne

    2011-01-01

    This study was conducted to elucidate the accuracy of the current streptomycin epidemiological cut-off value (ECOFF) for Escherichia coli and Salmonella spp. A total of 236 Salmonella enterica and 208 E. coli isolates exhibiting MICs between 4 and 32 mg/L were selected from 12 countries. Isolates...

  6. Experimental research on the durability cutting tools for cutting-off steel profiles

    Directory of Open Access Journals (Sweden)

    Cristea Alexandru

    2017-01-01

    Full Text Available The production lines used for manufacturing U-shaped profiles are very complex and they must have high productivity. One of the most important stages of the fabrication process is the cutting-off. This paper presents the experimental research and analysis of the durability of the cutting tools used for cutting-off U-shaped metal steel profiles. The results of this work can be used to predict the durability of the cutting tools.

  7. Determinants of rib motion in flail chest.

    Science.gov (United States)

    Cappello, M; Legrand, A; De Troyer, A

    1999-03-01

    We have previously developed a canine model of isolated flail chest to assess the effects of this condition on the mechanics of breathing, and these studies have led to the conclusion that the respiratory displacement of the fractured ribs is primarily determined by the fall in pleural pressure (Delta Ppl) and the action of the parasternal intercostal muscles. The present studies were designed to test the validity of this conclusion. A flail was induced in six supine anesthetized animals by fracturing both dorsally and ventrally the second to fifth ribs on the right side of the chest, after which the phrenic nerve roots were bilaterally sectioned in the neck. Sectioning the phrenic nerves caused a 34% decrease in Delta Ppl, associated with a 39% increase in parasternal intercostal inspiratory EMG activity (p Delta Ppl during the subsequent inspiration, all animals again showed a clear-cut inward rib displacement. These observations therefore confirm that in dogs with flail chest, the inspiratory displacement of the fractured ribs is set by the balance between the force related to pleural pressure and that generated by the parasternal intercostals. These observations also point to the critical importance of the pattern of inspiratory muscle activation in determining the magnitude of rib cage paradox in such patients.

  8. Development of a high-quality cut-off wall using electrophoresis

    International Nuclear Information System (INIS)

    Kawachi, T.; Murahashi, H.

    1991-01-01

    Techniques to build a high-quality cut-off wall have been developed for storage facilities of low-level radioactive waste (LLW) as an emergency measures to prevent leakages. The cut-off wall is highly impermeable, nucleid-adsorptive and have long-term durability. Electrophoresis is used to form impermeable membrane of bentonite as main features of the cut-off wall. First of all, laboratory tests have been conducted to study ways of building barriers on site and to collect data on the barriers properties. Afterwards, on-site construction tests of a high-quality cut-off wall have been carried out. In this paper, we describe the process and results on the studies of the high-quality cut-off wall using electrophoresis

  9. On Computations of Duct Acoustics with Near Cut-Off Frequency

    Science.gov (United States)

    Dong, Thomas Z.; Povinelli, Louis A.

    1997-01-01

    The cut-off is a unique feature associated with duct acoustics due to the presence of duct walls. A study of this cut-off effect on the computations of duct acoustics is performed in the present work. The results show that the computation of duct acoustic modes near cut-off requires higher numerical resolutions than others to avoid being numerically cut off. Duct acoustic problems in Category 2 are solved by the DRP finite difference scheme with the selective artificial damping method and results are presented and compared to reference solutions.

  10. Cut-off frequency of magnetostrictive materials based on permeability spectra

    International Nuclear Information System (INIS)

    Meng Hao; Zhang Tianli; Jiang Chengbao

    2012-01-01

    The loss behavior and cut-off frequency of TbDyFe alloy and TbDyFe/epoxy composite have been investigated by measuring their permeability spectra. The loss factor of TbDyFe alloy increases exponentially as the frequency goes up, while it is almost unchanged for the TbDyFe/epoxy composite. The loss factor value for the TbDyFe composite is only 4.3% of that for the monolithic TbDyFe alloy at high frequency of 10 kHz under the peak magnetic induction of 10 mT. The cut-off frequency of TbDyFe/epoxy composite is 6800 kHz, 3 orders of magnitude larger than that of TbDyFe alloy. The cut-off frequency is found to be the ferromagnetic resonance frequency and can be calculated from Snoek's law. - Highlights: ► The cut-off frequency of TbDyFe alloy and TbDyFe/epoxy composite has been investigated. ► Permeability spectra are used to study loss behavior and cut-off frequency. ► A mathematic formula is deduced to predict the cut-off frequency. ► TbDyFe/epoxy composite presents high cut-off frequency of 6800 kHz.

  11. Cut-off Grade Optimization for Maximizing the Output Rate

    Directory of Open Access Journals (Sweden)

    A. Khodayari

    2012-12-01

    Full Text Available In the open-pit mining, one of the first decisions that must be made in production planning stage, after completing the design of final pit limits, is determining of the processing plant cut-off grade. Since this grade has an essential effect on operations, choosing the optimum cut-off grade is of considerable importance. Different goals may be used for determining optimum cut-off grade. One of these goals may be maximizing the output rate (amount of product per year, which is very important, especially from marketing and market share points of view. Objective of this research is determining the optimum cut-off grade of processing plant in order to maximize output rate. For performing this optimization, an Operations Research (OR model has been developed. The object function of this model is output rate that must be maximized. This model has two operational constraints namely mining and processing restrictions. For solving the model a heuristic method has been developed. Results of research show that the optimum cut-off grade for satisfying pre-stated goal is the balancing grade of mining and processing operations, and maximum production rate is a function of the maximum capacity of processing plant and average grade of ore that according to the above optimum cut-off grade must be sent to the plant.

  12. Tentative Colistin Epidemiological Cut-Off Value for Salmonella spp

    DEFF Research Database (Denmark)

    Agersø, Yvonne; Torpdahl, Mia; Zachariasen, Camilla

    2012-01-01

    . Interestingly, Salmonella Dublin and Salmonella Enteritidis belong to the same O-group (O:1, 9,12), suggesting that surface lipopolysaccharides (LPS) of the cell (O-antigen) play a role in colistin susceptibility. The epidemiological cut-off value of >2 mg/L for colistin suggested by European Committee...... on Antimicrobial Susceptibility Testing (EUCAST) is placed inside the distribution for both Salmonella Dublin and Salmonella Enteritidis. All tested Salmonella Dublin isolates, regardless of MIC colistin value, had identical pmrA and pmrB sequences. Missense mutations were found only in pmrA in one Salmonella...

  13. Cut-off of electric consumption in France. Assessment of the cut-off potential by process modulation in industrial and tertiary sectors in metropolitan France. Final report + Synthesis

    International Nuclear Information System (INIS)

    Bertholon, Marion; Streiff, Frederic; Marchal, David; Bouchet, Alexandre; Foucher, Julie-Anne; Hoffer, Alexandre; Millet, Bruno; Sorlier, Pierre; Peron, Nicolas; Creon, Nicolas; Lenet, Sylvain; Guillet, Frederic; Mounier, Cyril; Charton, Franck; Duclos, Herve; Lenain, Yves; MADEC, Marc; Lepretre, Pascale; Vasseur, Olivier; Rigard-Cerison, Aude; Guedou, Benjamin; Houvenagel, Olivier; Epelbaum, David; Briant, Marie-Helene; Osmont, Robin; Elasri, Sofia; Barreyre, Gildas; Adam, Julien

    2017-09-01

    This study mainly aims at characterising and assessing the cut-off potential in the French industrial and tertiary sectors by providing qualitative as well as quantitative elements, and by highlighting the different mechanisms of valorisation of existing and currently developed cut-off. It also proposes a comparison of the French context with that of some foreign countries (notably United Kingdom, Japan, and some regions of the USA). Thus, it comprises an identification and analysis of cut-off mechanisms and practices, an assessment of technical and technical-economic cut-off sources in France, and a discussion of economic and organisational brakes and obstacles to cut-off developments

  14. Critical test of isotropic periodic sum techniques with group-based cut-off schemes.

    Science.gov (United States)

    Nozawa, Takuma; Yasuoka, Kenji; Takahashi, Kazuaki Z

    2018-03-08

    Truncation is still chosen for many long-range intermolecular interaction calculations to efficiently compute free-boundary systems, macromolecular systems and net-charge molecular systems, for example. Advanced truncation methods have been developed for long-range intermolecular interactions. Every truncation method can be implemented as one of two basic cut-off schemes, namely either an atom-based or a group-based cut-off scheme. The former computes interactions of "atoms" inside the cut-off radius, whereas the latter computes interactions of "molecules" inside the cut-off radius. In this work, the effect of group-based cut-off is investigated for isotropic periodic sum (IPS) techniques, which are promising cut-off treatments to attain advanced accuracy for many types of molecular system. The effect of group-based cut-off is clearly different from that of atom-based cut-off, and severe artefacts are observed in some cases. However, no severe discrepancy from the Ewald sum is observed with the extended IPS techniques.

  15. Action of the isolated canine diaphragm on the lower ribs at high lung volumes.

    Science.gov (United States)

    De Troyer, André; Wilson, Theodore A

    2014-10-15

    The normal diaphragm has an inspiratory action on the lower ribs, but subjects with chronic obstructive pulmonary disease commonly have an inward displacement of the lateral portions of the lower rib cage during inspiration. This paradoxical displacement, conventionally called 'Hoover's sign', has traditionally been attributed to the direct action of radially oriented diaphragmatic muscle fibres. In the present study, the inspiratory intercostal muscles in all interspaces in anaesthetized dogs were severed so that the diaphragm was the only muscle active during inspiration. The displacements of the lower ribs along the craniocaudal and laterolateral axes and the changes in pleural pressure (∆Ppl) and transdiaphragmatic pressure were measured during occluded breaths and mechanical ventilation at different lung volumes between functional residual capacity (FRC) and total lung capacity. From these data, the separate effects on rib displacement of ∆Ppl and of the force exerted by the diaphragm on the ribs were determined. Isolated spontaneous diaphragm contraction at FRC displaced the lower ribs cranially and outward, but this motion was progressively reversed into a caudal and inward motion as lung volume increased. However, although the force exerted by the diaphragm on the ribs decreased with increasing volume, it continued to displace the ribs cranially and outward. These observations suggest that Hoover's sign is usually caused by the decrease in the zone of apposition and, thus, by the dominant effect of ∆Ppl on the lower ribs, rather than an inward pull from the diaphragm. © 2014 The Authors. The Journal of Physiology © 2014 The Physiological Society.

  16. Cut-off parameters in the one-dimensional two-fermion model

    International Nuclear Information System (INIS)

    Apostol, M.

    1982-07-01

    It is shown that the usual cut-off procedure (α cut-off parameter) employed in the boson representation of the fermion field opepators of the one-djmensional two-fermion model (TFM) is an incorrect one as the computator of the hermitean-conjugate field operators at the same space-point fails to fulfil a certain relationship which was pointed out long ago by Jordan. The complete form of the boson representation (including the zero-mode) of a single fermion field and the correct values of the cut-off parameter α is reviewed following Jordan and generalized to the TFM. The cut-off parameter α corresponds to a bandwidth cut-off and Jordan's boson representation is exact only in the limit α → 0. The additional zero-mode terms make the exact solution of the backscattering and umklapp scattering problem to be valid only if a supplementary condition is imposed on the coupling constants. Using the present bosonization technique all the inconsistencies of the TFM are removed. The one-particle Green's function and response functions of the Tomonaga-Luttinger model (TLM) are calculated and found to be identical with those obtained by direct diagram summation. The energy gap appearing in the spectrum of the TFM with backscattering and umklapp scattering for certain values of the coupling constants is shown to be proportional to the momentum transfer cut-off γ -1 which has to be kept finite while α goes to zero. Under such conditions the anticommunication relations and Jordan's commutator are invariant under the canonical transformation on the boson operators that diagonalizes the Hamiltonian of the TLM. The charge-density response function of the TFM with backscattering is perturbationally calculated up to the first order. The cut-off α -1 applies in the same way to terms which differ only by their spin indices in the expression of this response function. The charge-density response function is also evaluated at low frequencies for the exactly soluble TFM with

  17. Establishing pathological cut-offs for lateral ventricular volume expansion rates

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    Michael G. Dwyer

    Full Text Available Background: A percent brain volume change (PBVC cut-off of −0.4% per year has been proposed to distinguish between pathological and physiological changes in multiple sclerosis (MS. Unfortunately, standardized PBVC measurement is not always feasible on scans acquired outside research studies or academic centers. Percent lateral ventricular volume change (PLVVC is a strong surrogate measure of PBVC, and may be more feasible for atrophy assessment on real-world scans. However, the PLVVC rate corresponding to the established PBVC cut-off of −0.4% is unknown. Objective: To establish a pathological PLVVC expansion rate cut-off analogous to −0.4% PBVC. Methods: We used three complementary approaches. First, the original follow-up-length-weighted receiver operating characteristic (ROC analysis method establishing whole brain atrophy rates was adapted to a longitudinal ventricular atrophy dataset of 177 relapsing-remitting MS (RRMS patients and 48 healthy controls. Second, in the same dataset, SIENA PBVCs were used with non-linear regression to directly predict the PLVVC value corresponding to −0.4% PBVC. Third, in an unstandardized, real world dataset of 590 RRMS patients from 33 centers, the cut-off maximizing correspondence to PBVC was found. Finally, correspondences to clinical outcomes were evaluated in both datasets. Results: ROC analysis suggested a cut-off of 3.09% (AUC = 0.83, p < 0.001. Non-linear regression R2 was 0.71 (p < 0.001 and a − 0.4% PBVC corresponded to a PLVVC of 3.51%. A peak in accuracy in the real-world dataset was found at a 3.51% PLVVC cut-off. Accuracy of a 3.5% cut-off in predicting clinical progression was 0.62 (compared to 0.68 for PBVC. Conclusions: Ventricular expansion of between 3.09% and 3.51% on T2-FLAIR corresponds to the pathological whole brain atrophy rate of 0.4% for RRMS. A conservative cut-off of 3.5% performs comparably to PBVC for clinical outcomes. Keywords: Brain atrophy

  18. Normal Limits of Electrocardiogram and Cut-Off Values for Left ...

    African Journals Online (AJOL)

    Gender difference exists in some cut-off values for LVH. This study defined the normal limits for electrocardiographic variables for young adult Nigerians. Racial factor should be taken into consideration in interpretation of ECG. Keywords: Normal limits, Electrocardiogram, Cut-off values, Left ventricular hypertrophy, Young ...

  19. Defining obesity cut-off points for migrant South Asians.

    Directory of Open Access Journals (Sweden)

    Laura J Gray

    Full Text Available Body mass index (BMI and waist circumference (WC are used to define cardiovascular and type 2 diabetes risk. We aimed to derive appropriate BMI and WC obesity cut-off points in a migrant South Asian population.4688 White Europeans and 1333 South Asians resident in the UK aged 40-75 years inclusive were screened for type 2 diabetes. Principal components analysis was used to derive a glycaemia, lipid, and a blood pressure factor. Regression models for each factor, adjusted for age and stratified by sex, were used to identify BMI and WC cut-off points in South Asians that correspond to those defined for White Europeans.For South Asian males, derived BMI obesity cut-off points equivalent to 30.0 kg/m(2 in White Europeans were 22.6 kg/m(2 (95% Confidence Interval (95% CI 20.7 kg/m(2 to 24.5 kg/m(2 for the glycaemia factor, 26.0 kg/m(2 (95% CI 24.7 kg/m(2 to 27.3 kg/m(2 for the lipid factor, and 28.4 kg/m(2 (95% CI 26.5 kg/m(2 to 30.4 kg/m(2 for the blood pressure factor. For WC, derived cut-off points for South Asian males equivalent to 102 cm in White Europeans were 83.8 cm (95% CI 79.3 cm to 88.2 cm for the glycaemia factor, 91.4 cm (95% CI 86.9 cm to 95.8 cm for the lipid factor, and 99.3 cm (95% CI 93.3 cm to 105.2 cm for the blood pressure factor. Lower ethnicity cut-off points were seen for females for both BMI and WC.Substantially lower obesity cut-off points are needed in South Asians to detect an equivalent level of dysglycemia and dyslipidemia as observed in White Europeans. South Asian ethnicity could be considered as a similar level of risk as obesity (in White Europeans for the development of type 2 diabetes.

  20. Topological and sizing optimization of reinforced ribs for a machining centre

    Science.gov (United States)

    Chen, T. Y.; Wang, C. B.

    2008-01-01

    The topology optimization technique is applied to improve rib designs of a machining centre. The ribs of the original design are eliminated and new ribs are generated by topology optimization in the same 3D design space containing the original ribs. Two-dimensional plate elements are used to replace the optimum rib topologies formed by 3D rectangular elements. After topology optimization, sizing optimization is used to determine the optimum thicknesses of the ribs. When forming the optimum design problem, multiple configurations of the structure are considered simultaneously. The objective is to minimize rib weight. Static constraints confine displacements of the cutting tool and the workpiece due to cutting forces and the heat generated by spindle bearings. The dynamic constraint requires the fundamental natural frequency of the structure to be greater than a given value in order to reduce dynamic deflection. Compared with the original design, the improvement resulting from this approach is significant.

  1. Classifying post-stroke fatigue: Optimal cut-off on the Fatigue Assessment Scale.

    Science.gov (United States)

    Cumming, Toby B; Mead, Gillian

    2017-12-01

    Post-stroke fatigue is common and has debilitating effects on independence and quality of life. The Fatigue Assessment Scale (FAS) is a valid screening tool for fatigue after stroke, but there is no established cut-off. We sought to identify the optimal cut-off for classifying post-stroke fatigue on the FAS. In retrospective analysis of two independent datasets (the '2015' and '2007' studies), we evaluated the predictive validity of FAS score against a case definition of fatigue (the criterion standard). Area under the curve (AUC) and sensitivity and specificity at the optimal cut-off were established in the larger 2015 dataset (n=126), and then independently validated in the 2007 dataset (n=52). In the 2015 dataset, AUC was 0.78 (95% CI 0.70-0.86), with the optimal ≥24 cut-off giving a sensitivity of 0.82 and specificity of 0.66. The 2007 dataset had an AUC of 0.83 (95% CI 0.71-0.94), and applying the ≥24 cut-off gave a sensitivity of 0.84 and specificity of 0.67. Post-hoc analysis of the 2015 dataset revealed that using only the 3 most predictive FAS items together ('FAS-3') also yielded good validity: AUC 0.81 (95% CI 0.73-0.89), with sensitivity of 0.83 and specificity of 0.75 at the optimal ≥8 cut-off. We propose ≥24 as a cut-off for classifying post-stroke fatigue on the FAS. While further validation work is needed, this is a positive step towards a coherent approach to reporting fatigue prevalence using the FAS. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Environmental sampling: Issues for the cut-off regime

    International Nuclear Information System (INIS)

    Fearey, B.L.

    1995-01-01

    The fissile material cut-off treaty (FMCT) initiative under the Conference on Disarmament mandate is envisioned to include certain aspects of environmental sampling and monitoring. One of the intents of this treaty is to bring certain non-NPT signatories (e.g., threshold states) under this treaty agreement along with the nuclear weapon states (NWSs). This paper provides a brief overview of some of the relevant issues that may be involved in the implementation and use of environmental monitoring for (1) verification of the cut-off regime declarations, (2) the detection of undeclared activities, and, (3) application in non-routine inspections. The intent is to provide backstopping information important for treaty negotiators. Specific issues addressed within this paper include signature sampling, differences in the proposed detection regime, potential signature integrators, specific examples and spoofing concerns. Many of these issues must be carefully considered and weighed in order to create a credibly verifiable inspection regime. Importantly, the cut-off treaty must enable nondiscriminatory implementation, while carefully assuring that nonproliferation treaty requirements are maintained (i.e., preventing unintentional release of critical weapons design information--potentially through environmental sampling and analysis)

  3. Explaining the use of attribute cut-off values in decision making by means of involvement

    DEFF Research Database (Denmark)

    Peschel, Anne O.; Grebitus, Carola; Colson, Gregory

    2016-01-01

    evidence on consumers’ heterogeneous use of attribute cut-offs with a unique focus on the relationship with consumer involvement, a key component in consumer choice theory. Behavioral data from an online choice experiment on beef steak employing shelf simulations are combined with questions defining...... a latent class model identifies several key consumer segments (e.g., a price sensitive group) based on their choice behavior and reveals that the relationship between involvement, cut-off use and cut-off violations is not uniform across consumer segments....... respondents’ attribute cut-off values and their validated Personal Involvement Inventory (PII). Evidence from the analysis indicates that consumers who are highly involved are more likely to exhibit attribute cut-off values and are less likely to violate their cut-off values. Further investigation using...

  4. Axial and transverse tensile properties Zr-2.5Nb pressure tube off-cuts

    International Nuclear Information System (INIS)

    Shah, Priti K.; Dubey, J.S.; Shriwastaw, R.S.; Balakrishnan, K.S.; Anantharaman, S.; Chakravartty, J.K.

    2011-01-01

    Zr-2.5Nb alloys in cold worked and stress relieved (CWSR) condition serves as pressure boundary for hot coolant in Indian Pressurized Heavy Water Reactor (IPHWR). Due to both microstructural and crystallographic anisotropy, the mechanical properties in general and fracture behavior in particular are anisotropic for this material. To understand the anisotropic mechanical behavior of the Zr-2.5Nb pressure tubes of IPHWRs, tension tests were carried out on the RAPS-2 and KAPS-2 pressure tube off-cuts. Off-cuts are the small pieces cut from the two ends of a pressure tube before installing it into the PHWR. Miniature flat tensile specimens (without applying any flattening treatment to the pressure tube) of both longitudinal (or axial) and transverse orientation were fabricated from the off-cuts. Tension tests were carried out both at room temperature and 300 deg C. The transverse specimens showed higher strength and lower elongation than that of the axial ones. The back-end off-cuts showed higher strength compared to front-end off-cuts along axial direction whereas the same is not true for transverse direction specimens. One typical plot obtained in the testing of one of the off-cut is shown. The paper will discuss about the importance of the work carried out, test specimens, test method and results obtained in detail

  5. Hemoglobin cut-off values in healthy Turkish infants

    Institute of Scientific and Technical Information of China (English)

    Ahmet Arvas; Emel Gür; DurmuşDoğan

    2014-01-01

    Background: Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality. This study was undertaken to determine the cut-off value of hemoglobin for infant anemia. Methods: A cross-sectional retrospective study was carried out at well-baby clinics of a tertiary care hospital. A total of 1484 healthy infants aged between 4 to 24 months were included in the study. The relationship of hemoglobin (Hb) levels with mother age, birth weight, weight gain rate, feeding, and gender was evaluated. Results: The Hb levels were assessed in four age groups (4 months, 6 months, 9-12 months, and 15-24 months) and the cut-off values of Hb were determined. Hb cut-off values (5th percentile for age) were detected as 97 g/L and 93 g/L at 4 months and 6 months, respectively. In older infants, the 5th percentile was 90.5 g/L and 93.4 g/L at 9-12 months and 15-24 months, respectively. The two values were lower than the World Health Organization criteria for anemia, which could partly due to the lack of information on iron status in our population. However, this difference highlights the need for further studies on normal Hb levels in healthy infants in developing countries. Hb levels of females were higher in all age groups; however, a statistically significant difference was found in gender in only 6 month-old infants. No statistically significant difference was found among Hb levels, mother's age, birth weight, weight gain rate, and nutritional status. Conclusion: Hb cut-off values in infants should be re-evaluated and be compatible with growth and development of children in that community.

  6. Evaluación del ribósido de alopurinol contra la leishmaniasis cutánea ecuatoriana

    Directory of Open Access Journals (Sweden)

    Martha Chico

    1995-09-01

    Full Text Available Se realizó un estudio randomizado de 75 pacientes con leishmaniasis cutánea ecuatoriana con el fin de determinar el índice terapéutico de una nueva droga oral antileishmania, el ribósido de alopurinol más probenecid. Este agente fue evaluado comparándolo con controles positivos que se trataron con pentostam y con testigos no tratados. Las medidas de las lesiones disminuyeron rápidamente durante la terapia, lo que permitió determinar el porcentaje de cicatrización en los diferentes grupos. En el día 70 se realizó la evaluación de la curación de los pacientes en los diferentes grupos, obteniéndose: alopurinol (1.500 mg/6 h más probenecid (500 mgI6 h por 28 días, dió una curación con lesiones cicatrizadas en 10 (45,5% de los 22 pacientes. Con pentostam (20 mg Sblkgtdía, IM por 20 días se obtuvo una curación en 28 pacientes siendo esto el 100% de cicatrización. El grupo de no tratamiento presentó un porcentaje muy elevado de curación espontánea en 9 (75,0% de los 12 pacientes. Todos los pacientes con tratamiento fallido o recidivas recibieron posteriormente tratamiento con pentostam. Este estudio sugiere que el ribósido de alopurinol más probenecid no es una droga con mayor eficacia contra la leishmaniasis cutánea ecuatoriana.

  7. Risk of pneumonia in patients with isolated minor rib fractures: a nationwide cohort study.

    Science.gov (United States)

    Ho, Sai-Wai; Teng, Ying-Hock; Yang, Shun-Fa; Yeh, Han-Wei; Wang, Yu-Hsun; Chou, Ming-Chih; Yeh, Chao-Bin

    2017-01-13

    Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. Nationwide population-based cohort study. Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database. Non-traumatic patients were matched through 1:8 propensity-score matching according to age, sex, and comorbidities (namely diabetes, hypertension, cardiovascular disease, asthma and chronic obstructive pulmonary disease (COPD)) with the comparison cohort. We estimated the adjusted HRs (aHRs) by using the Cox proportional hazard model. A total of 709 patients with IMRFs and 5672 non-traumatic patients were included. The primary end point was the occurrence of pneumonia within 30 days. The incidence of pneumonia following IMRFs was 1.6% (11/709). The aHR for the risk of pneumonia after IMRFs was 8.94 (95% CI=3.79 to 21.09, ppneumonia following IMRFs. In the IMRF group, presence of single or two isolated rib fractures was associated with an increased risk of pneumonia with aHRs of 3.97 (95% CI 1.09 to 14.44, ppneumonia following IMRFs is low, patients with two isolated rib fractures were particularly susceptible to pneumonia. Physicians should focus on this complication, particularly in elderly patients and those with COPD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Raised BMI cut-off for overweight in Greenland Inuit--a review.

    Science.gov (United States)

    Andersen, Stig; Fleischer Rex, Karsten; Noahsen, Paneeraq; Sørensen, Hans Christian Florian; Mulvad, Gert; Laurberg, Peter

    2013-01-01

    Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. This led us to reconsider the cut-off point for overweight among Inuit in Greenland. We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Defining overweight according to the WHO cut-off of a BMI above 25 kg/m(2) in Greenland Inuit may overestimate the number of individuals with elevated BMI.

  9. Surface effect theory in binary alloys: surfaces with cut-off

    International Nuclear Information System (INIS)

    Kumar, V.; Silva, C.E.T.G. da; Moran-Lopez, J.L.

    1981-01-01

    A surface effect theory in binary alloys which ore ordered with surfaces with cut-off is presented. This theory is based in a model of pair interaction between first neighbours and includes long and short range effects. The (120) surface with sup(-) (110) monoatomic cut-off and terrace in the (110) planes of an alloy with body centered cubic structure is presented as example. Results for the concentrations in all the different surface sites are given. (L.C.) [pt

  10. Vertical cut-off walls for the containment of contaminated ground

    International Nuclear Information System (INIS)

    Jessberger, H.L.; Krubasik, K.; Beine, R.A.

    1997-01-01

    Vertical cut-off walls are widely used for the containment of contaminated sites, where a capping system is not sufficient for the protection of groundwater. Various types of cut-off walls are introduced and new developments are prescribed. Design and testing principles are outlined. Containment techniques are the appropriate measure for old landfills and abandoned industrial sites with contaminated ground and groundwater, too, since the shortage of financial resources in many countries classifies clean-up techniques as too cost intensive in most cases

  11. Cut-off frequencies of circumferential horizontal shear waves in various functionally graded cylinder shells.

    Science.gov (United States)

    Shen, Xiaoqin; Ren, Dawei; Cao, Xiaoshan; Wang, Ji

    2018-03-01

    In this study, cut-off frequencies of the circumferential SH waves in functionally graded piezoelectric-piezomagnetic material (FGPPM) cylinder shells with traction free, electrical and magnetic open boundary conditions are investigated analytically. The Wentzel-Kramers-Brillouin (WKB) method is employed for solving differential equations with variable coefficients for general cases. For comparison, Bessel functions and Kummer functions are used for solving cut-off frequency problems in homogenous and ideal FGPPM cylinder shells. It is shown that the WKB solution for the cut-off frequencies has good precise. The set of cut-off frequencies is a series of approximate arithmetic progressions, for which the difference is a function of the density and the effective elastic parameter. The relationship between the difference and the gradient coefficient is described. These results provide theoretical guidance for the non-destructive evaluation of curved shells based on the cut-off frequencies. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Human papillomavirus testing in primary cervical screening and the cut-off level for hybrid capture 2 tests

    DEFF Research Database (Denmark)

    Rebolj, Matejka; Bonde, Jesper; Njor, Sisse Helle

    2011-01-01

    To determine the trade-off between the sensitivity and the specificity for high grade cervical intraepithelial neoplasia at hybrid capture 2 cut-off values above the standard = 1 relative light units/cut-off level (rlu/co).......To determine the trade-off between the sensitivity and the specificity for high grade cervical intraepithelial neoplasia at hybrid capture 2 cut-off values above the standard = 1 relative light units/cut-off level (rlu/co)....

  13. ACR Appropriateness Criteria® rib fractures.

    Science.gov (United States)

    Henry, Travis S; Kirsch, Jacobo; Kanne, Jeffrey P; Chung, Jonathan H; Donnelly, Edwin F; Ginsburg, Mark E; Heitkamp, Darel E; Kazerooni, Ella A; Ketai, Loren H; McComb, Barbara L; Parker, J Anthony; Ravenel, James G; Restrepo, Carlos Santiago; Saleh, Anthony G; Shah, Rakesh D; Steiner, Robert M; Suh, Robert D; Mohammed, Tan-Lucien H

    2014-11-01

    Rib fracture is the most common thoracic injury, present in 10% of all traumatic injuries and almost 40% of patients who sustain severe nonpenetrating trauma. Although rib fractures can produce significant morbidity, the diagnosis of associated complications (such as pneumothorax, hemothorax, pulmonary contusion, atelectasis, flail chest, cardiovascular injury, and injuries to solid and hollow abdominal organs) may have a more significant clinical impact. When isolated, rib fractures have a relatively low morbidity and mortality, and failure to detect isolated rib fractures does not necessarily alter patient management or outcome in uncomplicated cases. A standard posteroanterior chest radiograph should be the initial, and often the only, imaging test required in patients with suspected rib fracture after minor trauma. Detailed radiographs of the ribs rarely add additional information that would change treatment, and, although other imaging tests (eg, computed tomography, bone scan) have increased sensitivity for detection of rib fractures, there are little data to support their use. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 3 years by a multidisciplinary expert panel. The guideline development and review process include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances in which evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.

  14. Optimised cut-off function for Tersoff-like potentials for a BN nanosheet: a molecular dynamics study

    International Nuclear Information System (INIS)

    Kumar, Rajesh; Rajasekaran, G; Parashar, Avinash

    2016-01-01

    In this article, molecular dynamics based simulations were carried out to study the tensile behaviour of boron nitride nanosheets (BNNSs). Four different sets of Tersoff potential parameters were used in the simulations for estimating the interatomic interactions between boron and nitrogen atoms. Modifications were incorporated in the Tersoff cut-off function to improve the accuracy of results with respect to fracture stress, fracture strain and Young’s modulus. In this study, the original cut-off function was optimised in such a way that small and large cut-off distances were made equal, and hence a single cut-off distance was used with all sets of Tersoff potential parameters. The single value of cut-off distance for the Tersoff potential was chosen after analysing the potential energy and bond forces experienced by boron and nitrogen atoms subjected to bond stretching. The simulations performed with the optimised cut-off function help in identifying the Tersoff potential parameters that reproduce the experimentally evaluated mechanical behaviour of BNNSs. (paper)

  15. Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive.

    Science.gov (United States)

    Roy, Mononita; Molnar, Frank

    2013-01-01

    Fitness-to-drive guidelines recommend employing the Trail Making B Test (a.k.a. Trails B), but do not provide guidance regarding cut-off scores. There is ongoing debate regarding the optimal cut-off score on the Trails B test. The objective of this study was to address this controversy by systematically reviewing the evidence for specific Trails B cut-off scores (e.g., cut-offs in both time to completion and number of errors) with respect to fitness-to-drive. Systematic review of all prospective cohort, retrospective cohort, case-control, correlation, and cross-sectional studies reporting the ability of the Trails B to predict driving safety that were published in English-language, peer-reviewed journals. Forty-seven articles were reviewed. None of the articles justified sample sizes via formal calculations. Cut-off scores reported based on research include: 90 seconds, 133 seconds, 147 seconds, 180 seconds, and Trails B cut-offs of 3 minutes or 3 errors (the '3 or 3 rule'). Major methodological limitations of this body of research were uncovered including (1) lack of justification of sample size leaving studies open to Type II error (i.e., false negative findings), and (2) excessive focus on associations rather than clinically useful cut-off scores.

  16. Raised BMI cut-off for overweight in Greenland Inuit – a review

    Science.gov (United States)

    Andersen, Stig; Fleischer Rex, Karsten; Noahsen, Paneeraq; Sørensen, Hans Christian Florian; Mulvad, Gert; Laurberg, Peter

    2013-01-01

    Background Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. Objective This led us to reconsider the cut-off point for overweight among Inuit in Greenland. Design and findings We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Conclusion Defining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI. PMID:23986904

  17. Raised BMI cut-off for overweight in Greenland Inuit – a review

    Directory of Open Access Journals (Sweden)

    Stig Andersen

    2013-08-01

    Full Text Available Background. Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI, a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. Objective. This led us to reconsider the cut-off point for overweight among Inuit in Greenland. Design and findings. We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Conclusion. Defining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI.

  18. Azimuth cut-off model for significant wave height investigation along coastal water of Kuala Terengganu, Malaysia

    Science.gov (United States)

    Marghany, Maged; Ibrahim, Zelina; Van Genderen, Johan

    2002-11-01

    The present work is used to operationalize the azimuth cut-off concept in the study of significant wave height. Three ERS-1 images have been used along the coastal waters of Terengganu, Malaysia. The quasi-linear transform was applied to map the SAR wave spectra into real ocean wave spectra. The azimuth cut-off was then used to model the significant wave height. The results show that azimuth cut-off varied with the different period of the ERS-1 images. This is because of the fact that the azimuth cut-off is a function of wind speed and significant wave height. It is of interest to find that the significant wave height modeled from azimuth cut-off is in good relation with ground wave conditions. It can be concluded that ERS-1 can be used as a monitoring tool in detecting the significant wave height variation. The azimuth cut-off can be used to model the significant wave height. This means that the quasi-linear transform could be a good application to significant wave height variation during different seasons.

  19. Does surgical stabilization improve outcomes in patients with isolated multiple distracted and painful non-flail rib fractures?

    Science.gov (United States)

    Girsowicz, Elie; Falcoz, Pierre-Emmanuel; Santelmo, Nicola; Massard, Gilbert

    2012-03-01

    A best evidence topic was constructed according to a structured protocol. The question addressed was whether surgical stabilization is effective in improving the outcomes of patients with isolated multiple distracted and painful non-flail rib fractures. Of the 356 papers found using a report search, nine presented the best evidence to answer the clinical question. The authors, journal, date and country of publication, study type, group studied, relevant outcomes and results of these papers are given. We conclude that, on the whole, the nine retrieved studies clearly support the use of surgical stabilization in the management of isolated multiple non-flail and painful rib fractures for improving patient outcomes. The interest and benefit was shown not only in terms of pain (McGill pain questionnaire) and respiratory function (forced vital capacity, forced expiratory volume in 1 s and carbon monoxide diffusing capacity), but also in improved quality of life (RAND 36-Item Health Survey) and reduced socio-professional disability. Indeed, most of the authors justified surgical management based on the fact that the results of surgical stabilization showed improvement in short- and long-term patient outcomes, with fast reduction in pain and disability, as well as lower average wait before recommencing normal activities. Hence, the current evidence shows surgical stabilization to be safe and effective in alleviating post-operative pain and in improving patient recovery, thus enhancing the outcome after isolated multiple rib fractures. However, given the little published evidence, prospective trials are necessary to confirm these encouraging results.

  20. Age-adjusted high-sensitivity troponin T cut-off value for risk stratification of pulmonary embolism.

    Science.gov (United States)

    Kaeberich, Anja; Seeber, Valerie; Jiménez, David; Kostrubiec, Maciej; Dellas, Claudia; Hasenfuß, Gerd; Giannitsis, Evangelos; Pruszczyk, Piotr; Konstantinides, Stavros; Lankeit, Mareike

    2015-05-01

    High-sensitivity troponin T (hsTnT) helps in identifying pulmonary embolism patients at low risk of an adverse outcome. In 682 normotensive pulmonary embolism patients we investigate whether an optimised hsTnT cut-off value and adjustment for age improve the identification of patients at elevated risk. Overall, 25 (3.7%) patients had an adverse 30-day outcome. The established hsTnT cut-off value of 14 pg·mL(-1) retained its high prognostic value (OR (95% CI) 16.64 (2.24-123.74); p=0.006) compared with the cut-off value of 33 pg·mL(-1) calculated by receiver operating characteristic analysis (7.14 (2.64-19.26); pvalue of 45 pg·mL(-1) but not the established cut-off value of 14 pg·mL(-1) predicted an adverse outcome. An age-adjusted hsTnT cut-off value (≥14 pg·mL(-1) for patients aged risk (12.4% adverse outcome). Risk assessment of normotensive pulmonary embolism patients was improved by the introduction of an age-adjusted hsTnT cut-off value. A three-step approach helped identify patients at higher risk of an adverse outcome who might benefit from advanced therapy. Copyright ©ERS 2015.

  1. Determination of a saliva cotinine cut-off to distinguish pregnant smokers from pregnant non-smokers

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F

    2007-01-01

    Objective validation of smoking status is necessary. Earlier studies have used saliva cotinine concentrations between 14.2 and 30 ng/ml as cut-off values to distinguish pregnant smokers from non-smokers. However, these cut-offs derive from studies including men and non-pregnant women....... This constitutes a problem, as recent studies have reported an accelerated metabolism in pregnant smokers. The aim of this study was to determine the optimum cut-off cotinine level distinguishing pregnant smokers from pregnant non-smokers....

  2. Stress injury of the rib in a swimmer

    Energy Technology Data Exchange (ETDEWEB)

    Heincelman, Carrie [University of Cincinnati Medical Center, Department of Orthopaedic Surgery, Cincinnati, OH (United States); Brown, Seth; England, Eric; Mehta, Kaushal; Wissman, Robert D. [University of Cincinnati Medical Center, Department of Radiology, Cincinnati, OH (United States)

    2014-09-15

    Rib stress injuries are uncommonly reported but have been documented among athletes, most notably rowers. There have only been two prior case reports of rib stress injuries in swimmers, both of which were young females. Magnetic resonance (MR) imaging was either not obtained or the imaging characteristics were incompletely described. We present a case of an isolated third rib stress injury in a collegiate male swimmer diagnosed via MR imaging. We briefly discuss the possible etiologies for rib stress injuries, their MR appearance, as well as their treatment. (orig.)

  3. 76 FR 33161 - Installation and Use of Engine Cut-off Switches on Recreational Vessels

    Science.gov (United States)

    2011-06-08

    ... ``Proposed Rule'' and insert ``USCG-2009-0206'' in the ``Keyword'' box. Click ``Search,'' then click on the... ``read comments'' box, which will then become highlighted in blue. In the ``Keyword'' box, insert ``USCG... add definitions that describe the terms ``engine cut-off switch link,'' ``engine cut- off switch...

  4. Effect of the cut off frequency on rough point and flat surface contacts

    International Nuclear Information System (INIS)

    Meng, Fan Ming

    2012-01-01

    In the past years, contact between two bodies has been studied from various ways that do not consider the cut off frequency effect on the contact mechanism. This paper reports the correlation between rough point contact and flat surface contact at different cut off frequencies of filter. The similarity and difference between the two types of contact mechanisms are presented for materials with linear or elastic perfectly plastic deformation. The conjugate gradient method (CGM) is used for analysing the rough point contact, while the rough flat surface contact is studied with an improved CGM in which the influence coefficient for the elastic deformation of the rough flat surface is obtained with finite element method. Numerical results show that for the above two types of contacts, their von Mises stress and maximum shear stress are greatly affected by the cut-off frequency of a high pass filter. Moreover, a decrease in the cut-off frequency leads to an increase in the contact area and a decrease in the approach for the rough flat surface contact, while the opposite variations is for the point contact between rough bodies with the small radii

  5. Enhanced CT perfusion cut-off sign in midgut volvulus

    International Nuclear Information System (INIS)

    Henesch, Stephen M.; Jaramillo, Diego M.; Nance, Michael L.

    2006-01-01

    We present a case of malrotation with midgut volvulus in an infant in which we discovered a unique CT sign called the perfusion cut-off sign. We hope this case will help establish this crucial diagnosis in other cases. (orig.)

  6. Enhanced CT perfusion cut-off sign in midgut volvulus

    Energy Technology Data Exchange (ETDEWEB)

    Henesch, Stephen M.; Jaramillo, Diego M. [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Nance, Michael L. [Children' s Hospital of Philadelphia, Department of Surgery, Philadelphia, PA (United States)

    2006-04-15

    We present a case of malrotation with midgut volvulus in an infant in which we discovered a unique CT sign called the perfusion cut-off sign. We hope this case will help establish this crucial diagnosis in other cases. (orig.)

  7. Can semiquantitative measurements of SUVmax and cut-off values differentiate colorectal malignant from benign lessions?

    DEFF Research Database (Denmark)

    Nguyen, Tram; Hess, Søren; Petersen, Henrik

    2017-01-01

    , which also precludes a clinically significant cut-off value. The same applies to SUVpeak and SUVmean while TLG measures may be more indicative. CONCLUSION: Semi-quantitative measurements of SUVmax and cut-off values proved inadequate for differentiating colorectal malignancies from benign findings...

  8. Epidemiological cut-off values for Flavobacterium psychrophilum MIC data generated by a standard test protocol.

    Science.gov (United States)

    Smith, P; Endris, R; Kronvall, G; Thomas, V; Verner-Jeffreys, D; Wilhelm, C; Dalsgaard, I

    2016-02-01

    Epidemiological cut-off values were developed for application to antibiotic susceptibility data for Flavobacterium psychrophilum generated by standard CLSI test protocols. The MIC values for ten antibiotic agents against Flavobacterium psychrophilum were determined in two laboratories. For five antibiotics, the data sets were of sufficient quality and quantity to allow the setting of valid epidemiological cut-off values. For these agents, the cut-off values, calculated by the application of the statistically based normalized resistance interpretation method, were ≤16 mg L(-1) for erythromycin, ≤2 mg L(-1) for florfenicol, ≤0.025 mg L(-1) for oxolinic acid (OXO), ≤0.125 mg L(-1) for oxytetracycline and ≤20 (1/19) mg L(-1) for trimethoprim/sulphamethoxazole. For ampicillin and amoxicillin, the majority of putative wild-type observations were 'off scale', and therefore, statistically valid cut-off values could not be calculated. For ormetoprim/sulphadimethoxine, the data were excessively diverse and a valid cut-off could not be determined. For flumequine, the putative wild-type data were extremely skewed, and for enrofloxacin, there was inadequate separation in the MIC values for putative wild-type and non-wild-type strains. It is argued that the adoption of OXO as a class representative for the quinolone group would be a valid method of determining susceptibilities to these agents. © 2014 John Wiley & Sons Ltd.

  9. Influence of Different Cut-Off Values on the Diagnosis of Mild Cognitive Impairment in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    Inga Liepelt-Scarfone

    2011-01-01

    Full Text Available Comparable to Alzheimer's disease, mild cognitive impairment in Parkinson's disease (PD-MCI is associated with an increased risk for dementia. However different definitions of PD-MCI may have varying predictive accuracy for dementia. In a cohort of 101 nondemented Parkinson patients who underwent neuropsychological testing, the frequency of PD-MCI subjects and PD-MCI subtypes (i.e., amnestic/nonamnestic was determined by use of varying healthy population-based cut-off values. We also investigated the association between defined PD-MCI groups and ADL scales. Varying cut-off values for the definition of PD-MCI were found to affect frequency of PD-MCI subjects (9.9%–92.1% and, maybe more important, lead to a “shift” of proportion of detected PD-MCI subtypes especially within the amnestic single-domain subtype. Models using a strict cut-off value were significantly associated with lower ADL scores. Thus, the use of defined cut-off values for the definition of PD-MCI is highly relevant for comparison purposes. Strict cut-off values may have a higher predictive value for dementia.

  10. Equilibrium properties of blackbody radiation with an ultraviolet energy cut-off

    Science.gov (United States)

    Mishra, Dheeraj Kumar; Chandra, Nitin; Vaibhav, Vinay

    2017-10-01

    We study various equilibrium thermodynamic properties of blackbody radiation (i.e. a photon gas) with an ultraviolet energy cut-off. We find that the energy density, specific heat etc. follow usual acoustic phonon dynamics as have been well studied by Debye. Other thermodynamic quantities like pressure, entropy etc. have also been calculated. The usual Stefan-Boltzmann law gets modified. We observe that the values of the thermodynamic quantities with the energy cut-off is lower than the corresponding values in the theory without any such scale. The phase-space measure is also expected to get modified for an exotic spacetime appearing at Planck scale, which in turn leads to the modification of Planck energy density distribution and the Wien's displacement law. We found that the non-perturbative nature of the thermodynamic quantities in the SR limit (for both unmodified and modified cases), due to nonanalyticity of the leading term, is a general feature of the theory accompanied with an ultraviolet energy cut-off. We have also discussed the possible modification in the case of Big Bang and the Stellar objects and have suggested a table top experiment for verification in effective low energy case.

  11. Lactate clearance cut off for early mortality prediction in adult sepsis and septic shock patients

    Science.gov (United States)

    Sinto, R.; Widodo, D.; Pohan, H. T.

    2018-03-01

    Previous lactate clearance cut off for early mortality prediction in sepsis and septic shock patient was determined by consensus from small sample size-study. We investigated the best lactate clearance cut off and its ability to predict early mortality in sepsis and septic shock patients. This cohort study was conducted in Intensive Care Unit of CiptoMangunkusumo Hospital in 2013. Patients’ lactate clearance and eight other resuscitationendpoints were recorded, and theoutcome was observed during the first 120 hours. The clearance cut off was determined using receiver operating characteristic (ROC) analysis, and its ability was investigated with Cox’s proportional hazard regression analysis using other resuscitation endpoints as confounders. Total of 268 subjects was included, of whom 70 (26.11%) subjects died within the first 120 hours. The area under ROC of lactate clearance to predict early mortality was 0.78 (95% % confidence interval [CI] 0.71-0.84) with best cut off was <7.5% (sensitivity and specificity 88.99% and 81.4% respectively). Compared with group achieving lactate clearance target, group not achieving lactate clearance target had to increase early mortality risk (adjusted hazard ratio 13.42; 95%CI 7.19-25.07). In conclusion, the best lactate clearance cut off as anearly mortality predictor in sepsis and septic shock patients is 7.5%.

  12. BANKRUPTCY PREDICTION MODEL WITH ZETAc OPTIMAL CUT-OFF SCORE TO CORRECT TYPE I ERRORS

    Directory of Open Access Journals (Sweden)

    Mohamad Iwan

    2005-06-01

    This research has successfully attained the following results: (1 type I error is in fact 59,83 times more costly compared to type II error, (2 22 ratios distinguish between bankrupt and non-bankrupt groups, (3 2 financial ratios proved to be effective in predicting bankruptcy, (4 prediction using ZETAc optimal cut-off score predicts more companies filing for bankruptcy within one year compared to prediction using Hair et al. optimum cutting score, (5 Although prediction using Hair et al. optimum cutting score is more accurate, prediction using ZETAc optimal cut-off score proved to be able to minimize cost incurred from classification errors.

  13. Determination of a saliva cotinine cut-off to distinguish pregnant smokers from pregnant non-smokers

    DEFF Research Database (Denmark)

    Hegaard, Hanne K; Kjaergaard, Hanne; Møller, Lars F

    2007-01-01

    Objective validation of smoking status is necessary. Earlier studies have used saliva cotinine concentrations between 14.2 and 30 ng/ml as cut-off values to distinguish pregnant smokers from non-smokers. However, these cut-offs derive from studies including men and non-pregnant women. This consti...

  14. ribB and ribBA genes from Acidithiobacillus ferrooxidans: expression levels under different growth conditions and phylogenetic analysis.

    Science.gov (United States)

    Knegt, Fábio H P; Mello, Luciane V; Reis, Fernanda C; Santos, Marcos T; Vicentini, Renato; Ferraz, Lúcio F C; Ottoboni, Laura M M

    2008-01-01

    Acidithiobacillus ferrooxidans is a Gram-negative, chemolithoautotrophic bacterium involved in metal bioleaching. Using the RNA arbitrarily primed polymerase chain reaction (RAP-PCR), we have identified several cDNAs that were differentially expressed when A. ferrooxidans LR was submitted to potassium- and phosphate-limiting conditions. One of these cDNAs showed similarity with ribB. An analysis of the A. ferrooxidans ATCC 23270 genome, made available by The Institute for Genomic Research, showed that the ribB gene was not located in the rib operon, but a ribBA gene was present in this operon instead. The ribBA gene was isolated from A. ferrooxidans LR and expression of both ribB and ribBA was investigated. Transcript levels of both genes were enhanced in cells grown in the absence of K2HPO4, in the presence of zinc and copper sulfate and in different pHs. Transcript levels decreased upon exposure to a temperature higher than the ideal 30 degrees C and at pH 1.2. A comparative genomic analysis using the A. ferrooxidans ATCC 23270 genome revealed similar putative regulatory elements for both genes. Moreover, an RFN element was identified upstream from the ribB gene. Phylogenetic analysis of the distribution of RibB and RibBA in bacteria showed six different combinations. We suggest that the presence of duplicated riboflavin synthesis genes in bacteria must provide their host with some benefit in certain stressful situations.

  15. A study of full width at half maximum (FWHM) according to the filter's cut off level in SPECT camera

    International Nuclear Information System (INIS)

    Park, Soung Ock; Kwon, Soo Il

    2003-01-01

    Filtering is necessary to reduce statistical noise and to increase image quality in SPECT images. Noises controlled by low-pass filter designed to suppress high spatial frequency in SPECT image. Most SPECT filter function control the degree of high frequency suppression by choosing a cut off frequency. The location of cut off frequency determines the affect image noise and spatial resolution. If select the low cut off frequency, its provide good noise suppression but insufficient image quantity and high cut off frequencies increase the image resolution but insufficient noise suppression. The purpose of this study was to determines the optimum cut off level with comparison of FWHM according to cut off level in each filters-Band-limited, Sheep-logan, Sheep-logan Hanning, Generalized Hamming, Low pass cosine, Parazen and Butterworth filter in SPECT camera. We recorded image along the X, Y, Z-axis with 99m TcO 4 point source and measured FWHM by use profile curve. We find averaged length is 9.16 mm ∼ 18.14 mm of FWHM in X, Y, and Z-axis, and Band-limited and Generalized Hamming filters measures 9.16 mm at 0.7 cycle/pixel cut off frequency

  16. Localization of fluctuation measurement by wave scattering close to a cut off layer

    International Nuclear Information System (INIS)

    Zou, X.L.; Laurent, L.; Rax, J.M.; Lehner, T.

    1990-01-01

    The diagnostic of plasma fluctuations in tokamaks based on the scattering of an electromagnetic wave close to a cut off layer is investigated. A linear density profile is considered. An one-dimensional exact analysis is performed. Spatial and spectral localization of scattering process close to the cut off layer is studied and a modified Bragg rule is derived. The structure of pump and of scattered waves is analyzed. The diagnostic seems to be local and sensitive for low R fluctuations

  17. Using Cut-off grade isograms to delineate ore body and calculate parameter

    International Nuclear Information System (INIS)

    Yu Yongfeng; Zhu Xiaobing; Deng Yonghui

    2014-01-01

    Taking a uranium mine for an example, using cut-off grade isograms to achieve automatic delineation of ore body and calculation of parameters are explored. With center line of catalog sampling as baseline, the number of sampling and length of sampling constructing rectangular grid and grade as elevation value, isograms of cut-off grade were drawn, thus achieving the delineation of the ore body. Then, the other parameters of the ore body can be calculated. Compared with the traditional hand drawing method, the work efficiency was greatly improved, and the material inquiry was more convenient. (authors)

  18. Fast beam cut-off method in RF-knockout extraction for spot-scanning

    CERN Document Server

    Furukawa, T

    2002-01-01

    An irradiation method with magnetic scanning has been developed in order to provide accurate irradiation even for an irregular target shape. The scanning method has strongly required a lower ripple of the beam spill and a faster response to beam-on/off in slow extraction from a synchrotron ring. At HIMAC, RF-knockout extraction has utilized a bunched beam to reduce the beam-spill ripple. Therefore, particles near the resonance can be spilled out from the separatrices by synchrotron oscillation as well as by a transverse RF field. From this point of view, a fast beam cut-off method has been proposed and verified by both simulations and experiments. The maximum delay from the beam cut-off signal to beam-off has been improved to around 60 mu s from 700 mu s by a usual method. Unwanted dose has been considerably reduced by around a factor of 10 compared with that by the usual method.

  19. The normative score and the cut-off value of the Oswestry Disability Index (ODI).

    Science.gov (United States)

    Tonosu, Juichi; Takeshita, Katsushi; Hara, Nobuhiro; Matsudaira, Ko; Kato, So; Masuda, Kazuhiro; Chikuda, Hirotaka

    2012-08-01

    The Oswestry Disability Index (ODI) is one of the most common scoring systems used for patients with low back pain (LBP). Although the normative score of the ODI was reported to be 10.19 in a review article, no study has calculated the normative score after adjusting the value based on the age distribution. In addition, none of the previous studies has estimated the cut-off value which separates LBP with disability from LBP without disability. The purpose of this study was to estimate the normative score by adjusting the data for age distribution in Japan, and to determine the cut-off value which separates LBP with disability from LBP without disability. We conducted an internet survey on LBP using the Japanese version of the ODQ. A total of 1,200 respondents, composed of 100 males and 100 females in each age group (from the 20s to 70s), participated in this study. We also asked them to provide information about their backgrounds. We estimated the normative score after correcting for the age distribution of Japan. We also estimated the ODI of those with or without disability, the factors associated with the ODI, and the cut-off value which separates LBP with disability from LBP without disability. The participants' backgrounds were similar to the national survey. The normative score of the ODI was estimated at 8.73. The ODI of the LBP with disability group was 22.07. Those with sciatica and obese subjects showed higher ODI than those without. The optimal cut-off value was estimated to be 12. We defined the normative score and the cut-off value of the ODI.

  20. Spectrally selective solar absorber with sharp and temperature dependent cut-off based on semiconductor nanowire arrays

    Science.gov (United States)

    Wang, Yang; Zhou, Lin; Zheng, Qinghui; Lu, Hong; Gan, Qiaoqiang; Yu, Zongfu; Zhu, Jia

    2017-05-01

    Spectrally selective absorbers (SSA) with high selectivity of absorption and sharp cut-off between high absorptivity and low emissivity are critical for efficient solar energy conversion. Here, we report the semiconductor nanowire enabled SSA with not only high absorption selectivity but also temperature dependent sharp absorption cut-off. By taking advantage of the temperature dependent bandgap of semiconductors, we systematically demonstrate that the absorption cut-off profile of the semiconductor-nanowire-based SSA can be flexibly tuned, which is quite different from most of the other SSA reported so far. As an example, silicon nanowire based selective absorbers are fabricated, with the measured absorption efficiency above (below) bandgap ˜97% (15%) combined with an extremely sharp absorption cut-off (transition region ˜200 nm), the sharpest SSA demonstrated so far. The demonstrated semiconductor-nanowire-based SSA can enable a high solar thermal efficiency of ≳86% under a wide range of operating conditions, which would be competitive candidates for the concentrated solar energy utilizations.

  1. Anthropometric parameters’ cut-off points and predictive value for metabolic syndrome in women from Cartagena, Colombia

    Directory of Open Access Journals (Sweden)

    Gustavo José Mora-García

    2014-03-01

    Full Text Available Objective. To estimate anthropometric parameters’ (APs cut-off points and association for metabolic syndrome (MetS. Materials and methods. A cross-sectional study was carried out with a total of 434 adult women from Cartagena de Indias, Colombia, in 2012. APs measured were waist circumference (WC, body mass index (BMI, body adiposity index (BAI, waist-hip ratio (WHR and waist-height ratio (WHtR. Cut-off points were estimated by a receiver operating characteristic curve (ROC. Logistic regression was applied to estimate possible associations. Results. Cut-off points for WC, BMI, BAI, WHR and WHtR were 85 cm, 28 kg/m2, 39%, 0.80 and 56, respectively. Only WHtR was associated to MetS (OR=1.11, CI95% [1.07-1.15]. Conclusion. WC cut-off point was higher than those proposed for Latin-American women by the Joint Interim Statement (JIS. WHtR had a low predictive value for MetS.

  2. Mesa with Apron

    Science.gov (United States)

    2006-01-01

    23 September 2006 This Mars Global Surveyor (MGS) Mars Orbiter Camera (MOC) image shows a mesa and an impact grater just east of Phlegra Montes. The mesa is the eroded remnant of a once more extensive terrain. An apron of material surrounds the mesa. Location near: 38.5oN, 193.4oW Image width: 3 km (1.9 mi) Illumination from: lower left Season: Northern Spring

  3. The Cut-off Value of Blood Mercury Concentration in Relation to Insulin Resistance

    Directory of Open Access Journals (Sweden)

    Seok-Hoon Lee

    2017-09-01

    Full Text Available Background : Increased blood mercury concentration is associated with inflammation, and chronic inflammation can cause insulin resistance. We examined the cut-off value of blood mercury in relation to an increased score on the homeostasis model assessment for insulin resistance (HOMA-IR. Methods : We used data from the Korean National Health and Nutrition Examination Survey (2008–2010. Relevant data from 5,184 subjects (2,523 men and 2,661 women were analyzed cross-sectionally. General linear analysis was performed to evaluate the relationship between HOMA-IR score and blood mercury concentration. In addition, we determined the cut-off value of blood mercury concentration in relation to increased HOMA-IR score (> 2.34 using an ROC curve. Results : The mean value of blood mercury concentration in men and women was 5.88 μg/L and 4.11 μg/L, respectively. In men, comparing to the first quartile, HOMA-IR score increased significantly in the third and fourth blood mercury quartiles. In women, however, the increase in HOMA-IR score was not significant. The cut-off value that best represented the association between increased HOMA-IR score and blood mercury concentration in men was found to be 4.71 μg/L. Conclusion : Blood mercury concentration was associated with increased HOMA-IR score in men, and the cut-off value of blood mercury concentration that was correlated with increased HOMA-IR score was around 4.71 μg/L.

  4. Environmental trade-offs of tunnels vs cut-and-cover subways

    Science.gov (United States)

    Walton, M.

    1978-01-01

    Heavy construction projects in cities entail two kinds of cost - internal cost, which can be defined in terms of payments from one set of parties to another, and external cost, which is the cost borne by the community at large as the result of disutilities entailed in construction and operation. Environmental trade-offs involve external costs, which are commonly difficult to measure. Cut-and-cover subway construction probably entails higher external and internal cost than deep tunnel construction in many urban geological environments, but uncertainty concerning the costs and environmental trade-offs of tunneling leads to limited and timid use of tunneling by American designers. Thus uncertainty becomes a major trade-off which works against tunneling. The reverse is true in Sweden after nearly 30 years of subway construction. Econometric methods for measuring external costs exist in principle, but are limited in application. Economic theory based on market pressure does not address the real problem of urban environmental trade-offs. Nevertheless, the problem of uncertainty can be addressed by comparative studies of estimated and as-built costs of cut-and-cover vs tunnel projects and a review of environmental issues associated with such construction. Such a study would benefit the underground construction industry and the design of transportation systems. It would also help solve an aspect of the urban problem. ?? 1978.

  5. Selected nutrient contents, fatty acid composition, including conjugated linoleic acid, and retention values in separable lean from lamb rib loins as affected by external fat and cooking method.

    Science.gov (United States)

    Badiani, Anna; Montellato, Lara; Bochicchio, Davide; Anfossi, Paola; Zanardi, Emanuela; Maranesi, Magda

    2004-08-11

    Proximate composition and fatty acid profile, conjugated linoleic acid (CLA) isomers included, were determined in separable lean of raw and cooked lamb rib loins. The cooking methods compared, which were also investigated for cooking yields and true nutrient retention values, were dry heating of fat-on cuts and moist heating of fat-off cuts; the latter method was tested as a sort of dietetic approach against the more traditional former type. With significantly (P cooking losses, dry heating of fat-on rib-loins produced slightly (although only rarely significantly) higher retention values for all of the nutrients considered, including CLA isomers. On the basis of the retention values obtained, both techniques led to a minimum migration of lipids into the separable lean, which was higher (P cooking of the class of CLA isomers (including that of the nutritionally most important isomer cis-9,trans-11) was more similar to that of the monounsaturated than the polyunsaturated fatty acids.

  6. Current merchandising practices and characteristics of beef wholesale rib usage in three U.S. cities.

    Science.gov (United States)

    Wulf, D M; Romans, J R; Costello, W J

    1994-01-01

    Packers/processors, supermarket meat managers, and restaurant meat purchasers were surveyed to determine industry utilization of the beef wholesale rib. Nine packer/processors representing > 52% of the U.S. steer-heifer slaughter reported that more than two-thirds (68.5%) of the ribs were wholesaled as ribeye, lip-on (IMPS 112A) subprimals and that its predominance in the market makes it the standard for pricing. For merchandising variations of this cut (e.g., ribeye, lip-off), packer prices are adjusted to lip-on bases according to the relative yield. Excess fat was the most common complaint about ribeye steaks, reported by 78% of the packer/processors. In particular, 71% of them reported the "kernel" fat near the center of a ribeye steak between the longissimus and spinalis dorsi muscles is quite difficult to trim out and represents the greatest problem in merchandising. Forty-two percent of supermarket meat managers and 58% of restaurant meat purchasers thought the fat content of beef ribeyes discouraged consumers from purchasing all beef. Kernel fat was specifically cited by 36% of the restaurateurs. Alternative merchandising strategies should be employed to minimize the negative value effects of kernel fat. Even with excess fat being a concern to approximately half of the beef rib buyers, most still bought lip-on ribeyes and trimmed excess fat away. Apparently, they made this choice of lower price per weight, even though price per trimmed serving might be similar to lip-off ribeyes. Excess fat is being transported from packer/processor to buyers in the form of lip-on ribeyes because of the price relationships.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Prevalence and risk factors with overweight and obesity among Vietnamese adults: Caucasian and Asian cut-offs.

    Science.gov (United States)

    Trinh, Oanh T H; Nguyen, Nguyen D; Phongsavan, Philayrath; Dibley, Michael J; Bauman, Adrian E

    2009-01-01

    To determine the prevalence and factors associated with overweight/obesity among adults in Ho Chi Minh City (HCMC) using Caucasian and Asian cut-offs. A cross-sectional survey. In 2005, 1,971 adults aged 25-64 years in HCMC were randomly selected using a proportional to population size sampling method to estimate the prevalence of overweight and obesity, measured by body mass index (BMI) and waist circumference. Multivariable logistic models were used to examine associations between overweight/obesity and socioeconomic status, health-related behaviors, and biochemical indices of chronic disease risk. The prevalence of overweight and obesity using the Caucasian BMI cut-offs were 13.9% and 1.8% respectively, and those with the Asian BMI cut-offs were 27.5% and 5.7%, respectively. The abdominal adiposity rates were higher than the BMI overweight and obesity rates in women, but not in men. Increasing age, low education, high household wealth index, high levels of sitting and reclining time, cholesterol and high blood pressure were significantly associated with overweight and obesity. Current smoking and sedentary leisure time was significantly negatively associated with this status in men. Associations between overweight/obesity and metabolic disorders were evident using both cut-offs. Asian cut-offs identified more risk factors and therefore could be considered for defining at-risk groups. The results highlight the importance of intervention programs to prevent overweight/obesity in young adults.

  8. Rib Fracture Diagnosis in the Panscan Era.

    Science.gov (United States)

    Murphy, Charles E; Raja, Ali S; Baumann, Brigitte M; Medak, Anthony J; Langdorf, Mark I; Nishijima, Daniel K; Hendey, Gregory W; Mower, William R; Rodriguez, Robert M

    2017-12-01

    With increased use of chest computed tomography (CT) in trauma evaluation, traditional teachings in regard to rib fracture morbidity and mortality may no longer be accurate. We seek to determine rates of rib fracture observed on chest CT only; admission and mortality of patients with isolated rib fractures, rib fractures observed on CT only, and first or second rib fractures; and first or second rib fracture-associated great vessel injury. We conducted a planned secondary analysis of 2 prospectively enrolled cohorts of the National Emergency X-Radiography Utilization Study chest studies, which evaluated patients with blunt trauma who were older than 14 years and received chest imaging in the emergency department. We defined rib fractures and other thoracic injuries according to CT reports and followed patients through their hospital course to determine outcomes. Of 8,661 patients who had both chest radiograph and chest CT, 2,071 (23.9%) had rib fractures, and rib fractures were observed on chest CT only in 1,368 cases (66.1%). Rib fracture patients had higher admission rates (88.7% versus 45.8%; mean difference 42.9%; 95% confidence interval [CI] 41.4% to 44.4%) and mortality (5.6% versus 2.7%; mean difference 2.9%; 95% CI 1.8% to 4.0%) than patients without rib fracture. The mortality of patients with rib fracture observed on chest CT only was not statistically significantly different from that of patients with fractures also observed on chest radiograph (4.8% versus 5.7%; mean difference -0.9%; 95% CI -3.1% to 1.1%). Patients with first or second rib fractures had significantly higher mortality (7.4% versus 4.1%; mean difference 3.3%; 95% CI 0.2% to 7.1%) and prevalence of concomitant great vessel injury (2.8% versus 0.6%; mean difference 2.2%; 95% CI 0.6% to 4.9%) than patients with fractures of ribs 3 to 12, and the odds ratio of great vessel injury with first or second rib fracture was 4.4 (95% CI 1.8 to 10.4). Under trauma imaging protocols that commonly

  9. Minimizing waste (off-cuts using cutting stock model: The case of one dimensional cutting stock problem in wood working industry

    Directory of Open Access Journals (Sweden)

    Gbemileke A. Ogunranti

    2016-09-01

    Full Text Available Purpose: The main objective of this study is to develop a model for solving the one dimensional cutting stock problem in the wood working industry, and develop a program for its implementation. Design/methodology/approach: This study adopts the pattern oriented approach in the formulation of the cutting stock model. A pattern generation algorithm was developed and coded using Visual basic.NET language. The cutting stock model developed is a Linear Programming (LP Model constrained by numerous feasible patterns. A LP solver was integrated with the pattern generation algorithm program to develop a one - dimensional cutting stock model application named GB Cutting Stock Program. Findings and Originality/value: Applying the model to a real life optimization problem significantly reduces material waste (off-cuts and minimizes the total stock used. The result yielded about 30.7% cost savings for company-I when the total stock materials used is compared with the former cutting plan. Also, to evaluate the efficiency of the application, Case I problem was solved using two top commercial 1D-cutting stock software.  The results show that the GB program performs better when related results were compared. Research limitations/implications: This study round up the linear programming solution for the number of pattern to cut. Practical implications: From Managerial perspective, implementing optimized cutting plans increases productivity by eliminating calculating errors and drastically reducing operator mistakes. Also, financial benefits that can annually amount to millions in cost savings can be achieved through significant material waste reduction. Originality/value: This paper developed a linear programming one dimensional cutting stock model based on a pattern generation algorithm to minimize waste in the wood working industry. To implement the model, the algorithm was coded using VisualBasic.net and linear programming solver called lpsolvedll (dynamic

  10. A geometric classification of traveling front propagation in the Nagumo equation with cut-off

    International Nuclear Information System (INIS)

    Popovic, N

    2011-01-01

    An important category of solutions to reaction-diffusion systems of partial differential equations is given by traveling fronts, which provide a monotonic connection between rest states and maintain a fixed profile when considered in a co-moving frame. Reaction-diffusion equations are frequently employed in the mean-field (continuum) approximation of discrete (many-particle) models; however, the quality of this approximation deteriorates when the number of particles is not sufficiently large. The (stochastic) effects of this discreteness have been modeled via the introduction of (deterministic) 'cut-offs' that effectively deactivate the reaction terms at points where the particle concentration is below a certain threshold. In this article, we present an overview of the effects of such a cut-off on the front propagation dynamics in a prototypical reaction-diffusion system, the classical Nagumo equation. Our analysis is based on the method of geometric desingularization ('blow-up'), in combination with dynamical systems techniques such as invariant manifolds and normal forms. Using these techniques, we categorize front propagation in the cut-off Nagumo equation in dependence of a control parameter, and we classify the corresponding propagation regimes ('pulled,' 'pushed,' and 'bistable') in terms of the bifurcation structure of a projectivized system of equations that is obtained from the original traveling front problem, after blow-up. In particular, our approach allows us to determine rigorously the asymptotics (in the cut-off parameter) of the correction to the front propagation speed in the Nagumo equation that is due to a cut-off. Moreover, it explains the structure of that asymptotics (logarithmic, superlinear, or sublinear) in dependence of the front propagation regime. Finally, it enables us to calculate the corresponding leading-order coefficients in the resulting expansions in closed form.

  11. Rib Fractures: To Fix or Not to Fix? An Evidence-Based Algorithm

    Directory of Open Access Journals (Sweden)

    Michael Bemelman

    2017-08-01

    Full Text Available Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures.

  12. A PROBLEM OF CUTTING OFF THE LAMINATED SEMIS TYPE PLATE

    Directory of Open Access Journals (Sweden)

    Florin Ciofu

    2012-11-01

    Full Text Available A problem often coped on many domains such as wood manufacturing, glass, plastics and metallic platework industry, is the shaping or cutting off a big plate in many pieces. With this purpose there are algorithms of optimizing for positioning the parts following to be cut off from a row plate. From mathematical point of view, in positioning the parts on a raw plate the number of solutions increase four times evrey time a new part is added, and in case of finding the best solution for about few hundreds of pieces or parts would require years of processing on the most performant computers nowadays – for an analogy remember the famous story with the rice beads which the King had to pay to the master teaching him the chess: twice more for each square of the chessboard; for the total quantity assessment, King ascertained that the crops in his whole life wouldn’t have been enough.

  13. Open Skies and monitoring a fissile materials cut-off treaty

    International Nuclear Information System (INIS)

    Allentuck, J.; Lemley, J.R.

    1995-01-01

    The Treaty on Open Skies (Open Skies) is intended among other things to provide, in the words of its preamble, means ''to facilitate the monitoring of compliance with existing or future arms control agreements.'' Open Skies permits overflights of the territory of member states by aircraft equipped with an array of sensors of various types. Their types and capabilities are treaty-limited. To find useful application in monitoring a cut-off treaty Open Skies would need to be amended. The number of signatories would need to be expanded so as to provide greater geographical coverage, and restrictions on sensor-array capabilities would need to be relaxed. To facilitate the detection of impending violations of a cut-off convention by Open Skies overflights, the data base provided by parties to the former should include among other things an enumeration of existing and former fuel cycle and research facilities including those converted to other uses, their precise geographic location, and a site plan

  14. A general equation to obtain multiple cut-off scores on a test from multinomial logistic regression.

    Science.gov (United States)

    Bersabé, Rosa; Rivas, Teresa

    2010-05-01

    The authors derive a general equation to compute multiple cut-offs on a total test score in order to classify individuals into more than two ordinal categories. The equation is derived from the multinomial logistic regression (MLR) model, which is an extension of the binary logistic regression (BLR) model to accommodate polytomous outcome variables. From this analytical procedure, cut-off scores are established at the test score (the predictor variable) at which an individual is as likely to be in category j as in category j+1 of an ordinal outcome variable. The application of the complete procedure is illustrated by an example with data from an actual study on eating disorders. In this example, two cut-off scores on the Eating Attitudes Test (EAT-26) scores are obtained in order to classify individuals into three ordinal categories: asymptomatic, symptomatic and eating disorder. Diagnoses were made from the responses to a self-report (Q-EDD) that operationalises DSM-IV criteria for eating disorders. Alternatives to the MLR model to set multiple cut-off scores are discussed.

  15. The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents.

    Science.gov (United States)

    Moon, Shinje; Park, Joon Sung; Ahn, Youhern

    2017-03-01

    The aim of this study was to establish ethnic- and gender-specific cut-off values of triglycerides and glucose index (TyG index) for clinical usefulness in a representative sample of Mexican American, Non-Hispanic White, Non-Hispanic Black, and Korean adolescents. The data were collected from datasets of the National Health and Nutrition Examination Survey between 1999 and 2012, and the Korean National Health and Nutrition Examination Survey between 2005 and 2013. Receiver operating characteristic curve analysis was used to find valid cut-off values of the TyG index for metabolic syndrome. The total number of eligible participants was 3,164 in the US and 4,873 in Korea. The optimal cut-off value with the Cook et al. definition revealed 8.55 in Mexican American, 8.55 in Non-Hispanic White, 8.35 in Non-Hispanic Black, and 8.45 in Korean, respectively. The cut-off value with the de Ferranti et al. definition was 8.45, 8.45, 8.15, and 8.35, and the cut-off value with the International Diabetes Federation definition was 8.65, 8.65, 8.15, and 8.55, respectively. These findings may be clinically useful for evaluating insulin resistance for determining metabolic abnormalities in adolescents.

  16. Nineth Rib Syndrome after 10(th) Rib Resection.

    Science.gov (United States)

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

    2016-07-01

    The 12(th) rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the 10(th) rib was not felt, and an image of the rib-cage confirmed that the left 10(th) rib was severed. When applying pressure from the legs to the 9(th) rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with 9(th) rib syndrome, and ultrasound-guided 9(th) and 10(th) intercostal nerve blocks were performed around the tips of the severed 10(th) rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the 9(th) rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left 10(th) rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining 10(th) rib to impinge on the 9(th) intercostal nerves, causing pain.

  17. A study of full width at half maximum (FWHM) according to the filter's cut off level in SPECT camera

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soung Ock [Dongnam Health College, Suwon (Korea, Republic of); Kwon, Soo Il [Kyonggi University, Suwon (Korea, Republic of)

    2003-06-15

    Filtering is necessary to reduce statistical noise and to increase image quality in SPECT images. Noises controlled by low-pass filter designed to suppress high spatial frequency in SPECT image. Most SPECT filter function control the degree of high frequency suppression by choosing a cut off frequency. The location of cut off frequency determines the affect image noise and spatial resolution. If select the low cut off frequency, its provide good noise suppression but insufficient image quantity and high cut off frequencies increase the image resolution but insufficient noise suppression. The purpose of this study was to determines the optimum cut off level with comparison of FWHM according to cut off level in each filters-Band-limited, Sheep-logan, Sheep-logan Hanning, Generalized Hamming, Low pass cosine, Parazen and Butterworth filter in SPECT camera. We recorded image along the X, Y, Z-axis with {sup 99m}TcO{sub 4} point source and measured FWHM by use profile curve. We find averaged length is 9.16 mm {approx} 18.14 mm of FWHM in X, Y, and Z-axis, and Band-limited and Generalized Hamming filters measures 9.16 mm at 0.7 cycle/pixel cut off frequency.

  18. Normal Limits of Electrocardiogram and Cut-Off Values for Left ...

    African Journals Online (AJOL)

    olayemitoyin

    The cut-off values for Sokolow-Lyon, Cornell and Araoye criteria for assessment of left ventricular hypertrophy. (LVH) were higher than those previously in ... MATERIALS AND METHODS. This was a cross-sectional descriptive ..... criteria, Araoye code system and Ogunlade criterion were derived from the addition of two or ...

  19. The contribution of rib fractures to chronic pain and disability.

    Science.gov (United States)

    Gordy, Stephanie; Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2014-05-01

    The contribution of rib fractures to chronic pain and disability is not well described. Two hundred three patients with rib fractures were followed for 6 months. Chronic pain was assessed using the McGill Pain Questionnaire Pain Rating Index and Present Pain Intensity (PPI) scales. Disability was defined as a decrease in work or functional status. The prevalence of chronic pain was 22% and disability was 53%. Acute PPI predicted chronic pain. Associated injuries, bilateral rib fractures, injury severity score, and number of rib fractures were not predictive of chronic pain. No acute injury characteristics were predictive of disability. Among 89 patients with isolated rib fractures, the prevalence of chronic pain was 28% and of disability was 40%. No injury characteristics predicted chronic pain. Bilateral rib fractures and acute PPI predicted disability. The contribution of rib fractures to chronic pain and disability is significant but unpredictable with conventional injury descriptors. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Screening for Internet Addiction: An Empirical Study on Cut-off Points for the Chen Internet Addiction Scale

    Directory of Open Access Journals (Sweden)

    Chih-Hung Ko

    2005-12-01

    Full Text Available The aim of this study was to establish the optimal cut-off points of the Chen Internet Addiction Scale (CIAS, to screen for and diagnose Internet addiction among adolescents in the community by using the well- established diagnostic criteria of Internet addiction. This survey of 454 adolescents used screening (57/58 and diagnostic (63/64 cut-off points of the CIAS, a self-reported instrument, based on the results of systematic diagnostic interviews by psychiatrists. The area under the curve of the receiver operating characteristic curve revealed that CIAS has good diagnostic accuracy (89.6%. The screening cut-off point had high sensitivity (85.6% and the diagnostic cut-off point had the highest diagnostic accuracy, classifying 87.6% of participants correctly. Accordingly, the screening point of the CIAS could provide a screening function in two-stage diagnosis, and the diagnostic point could serve as a diagnostic criterion in one-stage massive epidemiologic research.

  1. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia

    Science.gov (United States)

    Fiorentino, Marion; Sophonneary, Prak; Laillou, Arnaud; Whitney, Sophie; de Groot, Richard; Perignon, Marlène; Kuong, Khov; Berger, Jacques; Wieringa, Frank T.

    2016-01-01

    Background Early identification of children malnutrition is a priority. Acute malnutrition is defined by the World Health Organization as a mid-upper-arm circumference (MUAC) malnutrition in communities, but MUAC cut-offs currently recommended by WHO do not identify the majority of children with weight-for-height Z-score (5 yrs. Therefore, this study aimed at defining gender and age-specific cut-offs to improve sensitivity of MUAC as an indicator of acute malnutrition. Methods To establish new age and gender-specific MUAC cut-offs, pooled data was obtained for 14,173 children from 5 surveys in Cambodia (2011–2013). Sensitivity, false positive rates, and areas under receiver-operator characteristic curves (AUC) were calculated using wasting for children 80% with the new cut-offs in comparison with the current WHO cut-offs. Conclusion Gender and age specific MUAC cut-offs drastically increased sensitivity to identify children with WHZ-score malnutrition at the community level. PMID:26840899

  2. Projection systems with a cut-off line for automotive applications

    Science.gov (United States)

    Kloos, G.; Eichhorn, K.

    2005-08-01

    The lighting systems of a car provide a variety of challenges from the point of view of illumination science and technology. Engineering work in this field has to deal both with reflector and lens design as well as with opto-mechanical design and sensor technology. It has direct implications on traffic safety and the efficiency in which energy is used. Therefore, these systems are continuously improved and optimized. In this context, adaptive systems that we investigate for automotive applications gain increasing importance. The properties of the light distribution in the vicinity of the cut-off line are of key importance for the safe and efficient operation of automotive headlamps. An alternative approach is proposed to refine the description of these properties in an attempt to make it more quantitative. This description is intended to facilitate intercomparison between different systems and/or to study environmental influences on the cut-off line of a system under investigation. Designing projection systems it is necessary to take a delicate trade-off between efficiency, light-distribution characteristics, mechanical boundary conditions, and legal requirements into account. Considerations and results on optical properties of three-axial reflectors in dependence of layout parameters will be given. They can serve as a guideline for the optical workshop and for free-form optimization.

  3. Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study.

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Babai

    Full Text Available In this study we evaluated and redefined the optimum body mass index (BMI cut-off point for the Iranian population based on metabolic syndrome (MeS risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC as a cofactor of risk and compared the differences. This study is part of the largest surveillance programs conducted in Shiraz, Iran, termed the Shiraz Heart study. Our study sample included subjects between the ages of 20 to 65 years old. After excluding pregnant women, those with missing data and those with comorbid disease, a total of 12283 made up the study population. The participants underwent a series of tests and evaluations by trained professionals in accordance with WHO recommendations. Hypertension, abnormal fasting blood sugar (FBS, triglyceride (TG and high density lipoprotein cholesterol (HDL (in the context of the definition of metabolic syndrome were prevalent among 32.4%, 27.6%, 42.1 and 44.2% of our participants, respectively. Women displayed higher rates of overall obesity compared to men (based on the definition by the WHO as higher than 30 kg/m2. Regarding MeS, 38.9% of our population had the all symptoms of MeS which was more prevalent among women (41.5% vs. 36%. When excluding WC in the definition of MeS, results showed that males tend to show a higher rate of metabolic risk factors (19.2% vs. 15.6%. Results of multivariate analysis showed that parallel to an increase in BMI, the odds ratio (OR for acquiring each component of the metabolic syndrome increased (OR = 1.178; CI: 1.166-1.190. By excluding WC, the previous OR decreased (OR = 1.105; CI: 1.093-1.118. Receiver Operating Characteristic (ROC curve analysis showed that the optimum BMI cut-off point for predicting metabolic syndrome was 26.1 kg/m2 and 26.2 kg/m2 [Accuracy (Acc = 69% and 61%, respectively] for males and females, respectively. The overall BMI cut-off for both sexes was 26.2 kg/m2 (Acc = 65% with sensitivity and

  4. Accuracy of unfolded map method for determining the left ventricular border. Evaluation of the cut-off value from autopsy finding

    International Nuclear Information System (INIS)

    Sugibayashi, Keiichi; Abe, Yoshiteru; Suga, Yutaka

    1996-01-01

    To improve the quantification of the left ventricular surface area (LVSA) by unfolded map method, we evaluated the cut-off value for determining the left ventricular border. The LVSA measured by unfolded map was compared with those measured using myocardial phantom and autopsy findings. The relative error (RE) was calculated as difference between LVSA in phantom and area of unfolded map. In phantom study, the cut-off value was calculated as 73.3±0.5% when the RE was zero. In autopsy study, the cut-off value was 74.0±7.2%. The area of unfolded map had good correlation with LVSA at autopsy when the cut-off value was 74% (r=0.83, p<0.003). The diameter of left ventricle at autopsy was compared with that of beating heart obtained by two-dimensional echocardiography, because the area of unfolded map was greater than LVSA at autopsy. The ratio of LVSA at autopsy to beating heart was calculated as 1.37. The suitable cut-off value was evaluated as 55.6% when the unfolded map area obtained by autopsy was increased 1.37 magnifications. There was a good correlation between LVSA of unfolded map (cut-off=56%) and the LVSA at autopsy (r=0.90, p<0.001). These results suggest that the cut-off value for determining the left ventricular border in vivo is 56%. (author)

  5. Estimation of chemical carcass composition from 8th rib characteristics with Belgian blue double-muscled bulls.

    Science.gov (United States)

    De Campeneere, S; Fiems, L O; Van de Voorde, G; Vanacker, J M; Boucque, C V; Demeyer, D I

    1999-01-01

    Characteristics from the 8th rib cut: chemical composition, tissue composition after dissection, specific gravity (SG) and m. longissimus thoracis (LT) composition, collected on 17 Belgian Blue double-muscled fattening bulls were used to generate equations for predicting chemical carcass composition. Carcass composition was best predicted from chemical analysis of the 8th rib cut and the empty body weight (EBW) of the bull. Carcass chemical fat content (CCF, kg) was predicted from the 8th rib cut fat content (ether extract, 8RF, kg) by the following regression: CCF=1.94+27.37 8RF (R(2)=0.957, RSD =9.89%). A higher coefficient was found for carcass water (CCW, kg) predicted from 8RF and EBW: CCW=-2.26+0.28 EBW-34.28 8RF (R(2)=0.997, RSD=1.48%). No parameter was found to improve the prediction of CCP from EBW solely: CCP=-0.86+0.08 EBW (R(2) =0.992, RSD=2.61%). Prediction equations based solely on LT composition had low R(2) values of between 0.38 and 0.67, whereas no significant equations were found using SG. However, equations based on EBW had R(2) values between 0.78 and 0.99. Chemical components of the 8th rib cut in combination with EBW are most useful in predicting the chemical composition of the carcass of Belgian-Blue double-muscled bulls.

  6. Less-invasive stabilization of rib fractures by intramedullary fixation: a biomechanical evaluation.

    Science.gov (United States)

    Bottlang, Michael; Helzel, Inga; Long, William; Fitzpatrick, Daniel; Madey, Steven

    2010-05-01

    This study evaluated intramedullary fixation of rib fractures with Kirschner wires and novel ribs splints. We hypothesized that rib splints can provide equivalent fixation strength while avoiding complications associated with Kirschner wires, namely wire migration and cutout. The durability, strength, and failure modes of rib fracture fixation with Kirschner wires and rib splints were evaluated in 22 paired human ribs. First, intact ribs were loaded to failure to determine their strength. After fracture fixation with Kirschner wires and rib splints, fixation constructs were dynamically loaded to 360,000 cycles at five times the respiratory load to determine their durability. Finally, constructs were loaded to failure to determine residual strength and failure modes. All constructs sustained dynamic loading without failure. Dynamic loading caused three times more subsidence in Kirschner wire constructs (1.2 mm +/- 1.4 mm) than in rib splint constructs (0.4 mm +/- 0.2 mm, p = 0.09). After dynamic loading, rib splint constructs remained 48% stronger than Kirschner wire constructs (p = 0.001). Five of 11 Kirschner wire constructs failed catastrophically by cutting through the medial cortex, leading to complete loss of stability and wire migration through the lateral cortex. The remaining six constructs failed by wire bending. Rib splint constructs failed by development of fracture lines along the superior and interior cortices. No splint construct failed catastrophically, and all splint constructs retained functional reduction and fixation. Because of their superior strength and absence of catastrophic failure mode, rib splints can serve as an attractive alternative to Kirschner wires for intramedullary stabilization of rib fractures, especially in the case of posterior rib fractures where access for plating is limited.

  7. Age-adjusted D-dimer cut-off in the diagnostic strategy for deep vein thrombosis

    DEFF Research Database (Denmark)

    Nybo, Mads; Hvas, Anne-Mette

    2017-01-01

    BACKGROUND: Studies have indicated that use of an age-adjusted D-dimer cut-off value for patients above 50 years increases utility of the diagnostic strategy for pulmonary embolism. Evidence for the same approach regarding diagnosis of deep vein thrombosis (DVT) is, however, unclear. MATERIALS...... AND METHODS: A systematic literature review was conducted following the PRISMA Statement guideline to gather the existing knowledge on the use of an age-adjusted D-dimer cut-off in the diagnostic strategy for DVT. Studies were extracted from Medline and the Cochrane Library. The search period ended...

  8. Waist circumference cut-off points for identification of abdominal obesity among the tunisian adult population.

    Science.gov (United States)

    Bouguerra, R; Alberti, H; Smida, H; Salem, L B; Rayana, C B; El Atti, J; Achour, A; Gaigi, S; Slama, C B; Zouari, B; Alberti, K G M M

    2007-11-01

    Waist circumference (WC) is a convenient measure of abdominal adipose tissue. It itself is a cardiovascular disease (CVD) and diabetes-risk factor and is strongly linked to other CVD risk factors. There are, however, ethnic differences in the relationship of WC to the other risk factors. The aim of this study was to determine the optimal cut-off points of WC and body mass index (BMI) at which cardiovascular risk factors can be identified with maximum sensitivity and specificity in a representative sample of the Tunisian adult population and to investigate any correlation between WC and BMI. We used a sample of the Tunisian National Nutrition Survey, a cross-sectional population-based survey, conducted in 1996 on a large nationally representative sample, which included 3435 adults (1244 men and 2191 women) of 20 years or older. WC, BMI, blood pressure and fasting blood measurements (plasma glucose, total cholesterol, triglycerides) were recorded. Receiver operating characteristic (ROC) curve analysis was used to identify optimal cut-off values of WC and BMI to identify with maximum sensitivity and specificity the detection of high blood pressure, hyperglycaemia, high blood cholesterol and hypertriglyceridaemia. ROC curve analysis suggested WC cut-off points of 85 cm in men and 85 cm in women for the optimum detection of high blood pressure, diabetes and dyslipidaemia. The optimum BMI cut-off points for predicting cardiovascular risk factors were 24 kg/m(2) in men and 27 kg/m(2) in women. The cut-off points recommended for the Caucasian population differ from those appropriate for the Tunisian population. The data show a continuous increase in odds ratios of each cardiovascular risk factor, with increasing level of WC and BMI. WC exceeding 85 cm in men and 79 cm in women correctly identified subjects with a BMI of >/=25 kg/m(2), sensitivity of >90% and specificity of >83%. Based on the ROC analysis, we suggest a WC of 85 cm for both men and women as appropriate cut-off

  9. Determining the optimal system-specific cut-off frequencies for filtering in-vitro upper extremity impact force and acceleration data by residual analysis.

    Science.gov (United States)

    Burkhart, Timothy A; Dunning, Cynthia E; Andrews, David M

    2011-10-13

    The fundamental nature of impact testing requires a cautious approach to signal processing, to minimize noise while preserving important signal information. However, few recommendations exist regarding the most suitable filter frequency cut-offs to achieve these goals. Therefore, the purpose of this investigation is twofold: to illustrate how residual analysis can be utilized to quantify optimal system-specific filter cut-off frequencies for force, moment, and acceleration data resulting from in-vitro upper extremity impacts, and to show how optimal cut-off frequencies can vary based on impact condition intensity. Eight human cadaver radii specimens were impacted with a pneumatic impact testing device at impact energies that increased from 20J, in 10J increments, until fracture occurred. The optimal filter cut-off frequency for pre-fracture and fracture trials was determined with a residual analysis performed on all force and acceleration waveforms. Force and acceleration data were filtered with a dual pass, 4th order Butterworth filter at each of 14 different cut-off values ranging from 60Hz to 1500Hz. Mean (SD) pre-fracture and fracture optimal cut-off frequencies for the force variables were 605.8 (82.7)Hz and 513.9 (79.5)Hz, respectively. Differences in the optimal cut-off frequency were also found between signals (e.g. Fx (medial-lateral), Fy (superior-inferior), Fz (anterior-posterior)) within the same test. These optimal cut-off frequencies do not universally agree with the recommendations of filtering all upper extremity impact data using a cut-off frequency of 600Hz. This highlights the importance of quantifying the filter frequency cut-offs specific to the instrumentation and experimental set-up. Improper digital filtering may lead to erroneous results and a lack of standardized approaches makes it difficult to compare findings of in-vitro dynamic testing between laboratories. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Correlation between Body Mass Index, Gender, and Skeletal Muscle Mass Cut off Point in Bandung

    OpenAIRE

    Richi Hendrik Wattimena; Vitriana; Irma Ruslina Defi

    2017-01-01

    Objective: To determine the average skeletal muscle mass (SMM) value in young adults as a reference population; to analyze the correlation of gender, and body mass index to the cut off point; and to determine skeletal muscle mass cut off points of population in Bandung, Indonesia. Methods: This was a cross-sectional study involving 199 participants, 122 females and 77 males. The sampling technique used was the multistage random sampling. The participants were those who lived in four ma...

  11. ELISA Cut-off Point for the Diagnosis of Human Brucellosis; a Comparison with Serum Agglutination Test

    Directory of Open Access Journals (Sweden)

    Anahita Sanaei Dashti

    2012-03-01

    Full Text Available Background: Brucellosis is a world-wide disease, which has a diverse clinical manifestation, and its diagnosis has to be proven by laboratory data. Serum agglutination test (SAT is the most-widely used test for diagnosing brucellosis. The enzyme linked immunosorbent assay (ELISA can also determine specific antibody classes against brucella. It is a sensitive, simple and rapid test, which could be an acceptable alternative to SAT with fewer limitations, however, like any other new test it should be further evaluated and standardized for various populations. This study was planned to determine an optimal cut-off point, for ELISA which would offer maximum sensitivity and specificity for the test when compared to SAT.Methods: Four hundred and seven patients with fever and other compatible symptoms of brucellosis were enrolled in the study. Serum agglutination test, 2-Mercaptoethanol test, and ELISA were performed on their sera. Results: The cut-off point of 53 IU/ml of ELISA-IgG yielded the maximal sensitivity and specificity comparing to the other levels of ELISA-IgG, and was considered the best cut off-point of ELISA-IgG to diagnose acute brucellosis. At this cut-off, the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio were 84.09%, 85.38%, 62.20, 94.90, 5.75, 0.18, respectively.Conclusion: The best cut-off point of ELISA-IgG is 53 IU/ml, which yields the maximal sensitivity and specificity to diagnose acute brucellosis.

  12. Proceedings from the Fissile Material Cut-off seminar in Stockholm

    International Nuclear Information System (INIS)

    Arbman, G.

    1998-01-01

    The Swedish Defence Research Establishment hosted an international expert seminar on the subject of verifying a prohibition of the production of fissile material for nuclear weapons purpose (cut-off) in Stockholm, June 3-5 1998. The objective of the seminar was to provide an opportunity for informal discussions among scientific and technical experts on various technical matters relating to the verification of a future Fissile Material Cut-off Treaty (FMCT). A stated aim of the seminar was to keep issues of scope to a minimum. Invited speakers and commentators were given an opportunity to present their views as written contributions. The present seminar proceedings are essentially the result of these views. In addition, short summaries of the discussions following each session are included. Although an attempt was made to be as complete and accurate as possible in reproducing these discussions, the editors apologise if some important points or statements have been omitted. If so, the main reason is that the documentation of the discussions were based on written notes, not taped recordings. Eight longer contributions have been separately indexed

  13. Proceedings from the Fissile Material Cut-off seminar in Stockholm

    Energy Technology Data Exchange (ETDEWEB)

    Arbman, G. [ed.

    1998-07-01

    The Swedish Defence Research Establishment hosted an international expert seminar on the subject of verifying a prohibition of the production of fissile material for nuclear weapons purpose (cut-off) in Stockholm, June 3-5 1998. The objective of the seminar was to provide an opportunity for informal discussions among scientific and technical experts on various technical matters relating to the verification of a future Fissile Material Cut-off Treaty (FMCT). A stated aim of the seminar was to keep issues of scope to a minimum. Invited speakers and commentators were given an opportunity to present their views as written contributions. The present seminar proceedings are essentially the result of these views. In addition, short summaries of the discussions following each session are included. Although an attempt was made to be as complete and accurate as possible in reproducing these discussions, the editors apologise if some important points or statements have been omitted. If so, the main reason is that the documentation of the discussions were based on written notes, not taped recordings. Eight longer contributions have been separately indexed.

  14. Measurement of current drive profile using electron cyclotron wave attenuation near the O-mode cut-off

    International Nuclear Information System (INIS)

    Fidone, I.

    1991-01-01

    A method for determining the radial profile of the lower-hybrid current drive in tokamaks uing electron-cyclotron attenuation of the O-mode for frequencies ω near the cut-off frequency is discussed. The basic idea is that for a given wave frequency, the cut-off plays the role of a spatial filter selecting a variable portion of the non-inductive current. It is shown that the incremental attenuation resulting from a small increase of ω displays specific features related to the current density near the cut-off point. Using the relation between the wave damping and the current density it is possible to determine the radial profile of the current drive from the wave attenuation measurements. A numerical application is also presented for plasma parameters in the reactor regime

  15. Evaluation of epidemiological cut-off values indicates that biocide resistant subpopulations are uncommon in natural isolates of clinically-relevant microorganisms.

    Directory of Open Access Journals (Sweden)

    Ian Morrissey

    Full Text Available To date there are no clear criteria to determine whether a microbe is susceptible to biocides or not. As a starting point for distinguishing between wild-type and resistant organisms, we set out to determine the minimal inhibitory concentration (MIC and minimal bactericidal concentration (MBC distributions for four common biocides; triclosan, benzalkonium chloride, chlorhexidine and sodium hypochlorite for 3319 clinical isolates, with a particular focus on Staphylococcus aureus (N = 1635 and Salmonella spp. (N = 901 but also including Escherichia coli (N = 368, Candida albicans (N = 200, Klebsiella pneumoniae (N = 60, Enterobacter spp. (N = 54, Enterococcus faecium (N = 53, and Enterococcus faecalis (N = 56. From these data epidemiological cut-off values (ECOFFs are proposed. As would be expected, MBCs were higher than MICs for all biocides. In most cases both values followed a normal distribution. Bimodal distributions, indicating the existence of biocide resistant subpopulations were observed for Enterobacter chlorhexidine susceptibility (both MICs and MBCs and the susceptibility to triclosan of Enterobacter (MBC, E. coli (MBC and MIC and S. aureus (MBC and MIC. There is a concern on the potential selection of antibiotic resistance by biocides. Our results indicate however that resistance to biocides and, hence any potential association with antibiotic resistance, is uncommon in natural populations of clinically relevant microorganisms.

  16. Casimir effect in a d-dimensional flat spacetime and the cut-off method

    International Nuclear Information System (INIS)

    Svaiter, N.F.; Svaiter, B.F.

    1989-01-01

    The CasiMir efeect in a D-dimensional spacetime produced by a Hermitian massless scalar field in the presence of a pair of perfectly reflecting parallel flat plates is discussed. The exponential cut-off regularization method is employed. The regularized vacuum energy and the Casimir energy of this field are evaluated and a detailed analysis of the divergent terms in the regularized vacuum energy is carried out. The two-dimensional version of the Casimir effect is discussed by means of the same cut-off method. A comparison between the above method and the zeta function regularization procedure is presented in a way which gives the unification between these two methods in the present case. (author) [pt

  17. Low evaluation rate for osteoporosis among patients presenting with a rib fracture.

    Science.gov (United States)

    Kim, Whang; Gong, Hyun Sik; Lee, Seung Hoo; Park, Jin Woo; Kim, Kahyun; Baek, Goo Hyun

    2017-12-01

    This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture. We retrospectively reviewed all patients aged 50 years or older who were diagnosed with a rib fracture between January 2011 and April 2016 at a regional tertiary care university hospital near Seoul, South Korea. We excluded those who had been treated for osteoporosis or those with other concomitant fractures or fractures from a motor vehicle accident or cancer. We evaluated the frequency of dual energy X-ray absorptiometry (DXA) scan examinations in these patients. There were 231 patients with isolated rib fractures (132 men and 99 women). The mean age was 65 years. Rib fractures were most commonly diagnosed at the emergency department and most of the patients were referred to the department of thoracic surgery for follow-up evaluations. Of these 231 patients, 29 (12%) had DXA examinations after the injury, and only 9 (4%) of them did so within 6 months. Physicians specializing in orthopedic surgery, family medicine, internal medicine, rehabilitation medicine, and emergency medicine were ordering the examination. This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. This study suggests that increased emphasis or education for osteoporosis evaluation may be necessary for physicians who are often referred to for care of rib fractures.

  18. Chronic kidney disease : Defining clinical cut-offs for albumin:creatinine ratio

    NARCIS (Netherlands)

    Bakker, Stephan J L

    2013-01-01

    Albuminuria is rapidly gaining recognition as a marker of the presence and of the progression of chronic kidney disease (CKD). In a new study, Naresh et al. attempt to define cut-off values for percentage change in urinary albumin:creatinine ratio that reflect changes in CKD status rather than

  19. Prevalensi Sarkopenia pada Lansia di Komunitas (Community Dwelling berdasarkan Dua Nilai Cut-off Parameter Diagnosis

    Directory of Open Access Journals (Sweden)

    Vitriana

    2016-09-01

    Full Text Available Sarcopenia, aging muscle mass loss, and function syndromes can lead to decreased quality of life and increased elderly mortality. The availability of various screening methods and operational definitions in different studies has produced different findings of sarcopenia prevalence. The purpose of this study was to discover the prevalence of sarcopenia in Indonesian community-dwelling elderly based on muscle mass measured by bioimpedance analysis, handgrip strength using hand dynamometer, and physical performance based on six minutes walking test with two different cut-off point parameters of sarcopenia, i.e. the cut-off point recommended by Asian Working Group for Sarcopenia (AWGS and the cut-off point based on the reference used in Taiwan elderly population reference due to the lack of references for Indonesian elderly population. A cross-sectional study was conducted to 229 participants (71 men and 158 women from the community-dwelling elderly population between August and December 2014 in Bandung and Jatinangor. The results of the study showed that the sarcopenia prevalence in this study based on AWGS was 9.1% (7.4% in men and 1.7% in women while the prevalence based on the Taiwan reference revealed a prevalence of 40.6% (20.1% in men and 20.5% in women. This highly different prevalences shows the importance of defining a specific cut-off point for elderly population in community-dwelling Indonesia to get a more accurate sarcopenia prevalence.

  20. Secondary proton production at small atmospheric depths as a function of the geomagnetic cut-off

    Energy Technology Data Exchange (ETDEWEB)

    Papini, P. [Florence Univ. (Italy)]|[INFN, Florence (Italy); Grimani, C. [Perugia Univ. (Italy)]|[INFN, Perugia (Italy); Stephens, S.A. [Tata Institute of Fundamental Research, Bombay (International Commission on Radiation Units and Measurements)

    1995-09-01

    A detailed calculation of the energy spectrum of secondary protons in the atmosphere is being carried out in the energy range 20 MeV - 40 GeV. In this calculation, it is taken into account all processes leading to the production of secondary protons as a function of the atmospheric depth has been calculated using all relevant energy loss processes. In this paper, it is examine the effect of the geomagnetic cut-off on the spectral shape of secondary protons specially at energies below the geomagnetic cut-off for small atmospheric depths.

  1. Secondary proton production at small atmospheric depths as a function of the geomagnetic cut-off

    International Nuclear Information System (INIS)

    Papini, P.; Grimani, C.; Stephens, S.A.

    1995-01-01

    A detailed calculation of the energy spectrum of secondary protons in the atmosphere is being carried out in the energy range 20 MeV - 40 GeV. In this calculation, it is taken into account all processes leading to the production of secondary protons as a function of the atmospheric depth has been calculated using all relevant energy loss processes. In this paper, it is examine the effect of the geomagnetic cut-off on the spectral shape of secondary protons specially at energies below the geomagnetic cut-off for small atmospheric depths

  2. Fatigue life analysis of cracked gas receiver of emergency cut-off system in gas gathering station

    Science.gov (United States)

    Hu, Junzhi; Zhou, Jiyong; Li, Siyuan

    2017-06-01

    Small-scale air compressor and gas receiver are used as the driving gas of the emergency cut-off system in gas gathering station. Operation of block valve is ensured by starting and stopping compressor automatically. The frequent start-stop of compressor and the pressure fluctuation pose a threat to the service life of gas receiver, and then affect normal operation of the emergency cut-off system and security of gas gathering station. In this paper, the fatigue life of a pressure vessel with axial semi-elliptical surface crack in the inner wall is analyzed under the varying pressure by means of the theory of fracture mechanics. The influences of the amplitude of pressure fluctuation and the initial crack size on the residual life of gas receiver are discussed. It provides a basis for setting the working parameters of gas receiver of emergency cut-off system and determining the maintenance cycle.

  3. Retrospective Analysis of 513 Cases Diagnosed with Rib Fracture Secondary to Blunt Thorax Trauma

    Directory of Open Access Journals (Sweden)

    Serdar Ozkan

    2017-05-01

    Full Text Available Aim: This study aimed to analyze blunt chest trauma cases who were diagnosed with rib fracture and to examine the regional differences likely to appear in trauma cases and treatment approaches. Material and Method: 513 cases who applied to the Emergency Service and Department of Thoracic Surgery between October 2013 and December 2014 due to blunt trauma and were diagnosed with rib fracture were retrospectively examined. The cases were evaluated in terms of etiological factors, thoracic, and other system injuries accompanying the rib fracture, prognosis, and the treatments applied. Results: Isolated rib fracture was present in 266 of the cases. Thoracic organ injuries such as pneumothorax, hemothorax, hemopneumothorax, lung contusion, or laceration and sternal fracture accompanying the rib fracture were present in 247 of the cases. While one or two rib fractures were detected in 298 cases, six or more rib fractures were present in 28 cases. 78.2% of hemothorax cases, 85.3% of pneumothorax cases, 95.4% of hemopneumothorax cases, 81.8% of bilateral pneumothorax cases, 26% of bilateral hemothorax cases, and 71.4% of bilateral hemopneumothorax cases were treated by applying tube thoracostomy. 129 cases diagnosed with thoracic organ injury in addition to rib fracture but not subjected to surgical intervention, and 266 cases diagnosed with isolated rib fracture were discharged with full recovery after appropriate medical treatment. Discussion: Most of the rib fractures occurring due to blunt trauma are treated successfully with medical treatments and conservative approaches and do not need advanced surgical treatments.

  4. Derivation of the cut-off length from the quantum quadratic enhancement of a mass in vacuum energy constant Lambda

    Science.gov (United States)

    Fukushima, Kimichika; Sato, Hikaru

    2018-04-01

    Ultraviolet self-interaction energies in field theory sometimes contain meaningful physical quantities. The self-energies in such as classical electrodynamics are usually subtracted from the rest mass. For the consistent treatment of energies as sources of curvature in the Einstein field equations, this study includes these subtracted self-energies into vacuum energy expressed by the constant Lambda (used in such as Lambda-CDM). In this study, the self-energies in electrodynamics and macroscopic classical Einstein field equations are examined, using the formalisms with the ultraviolet cut-off scheme. One of the cut-off formalisms is the field theory in terms of the step-function-type basis functions, developed by the present authors. The other is a continuum theory of a fundamental particle with the same cut-off length. Based on the effectiveness of the continuum theory with the cut-off length shown in the examination, the dominant self-energy is the quadratic term of the Higgs field at a quantum level (classical self-energies are reduced to logarithmic forms by quantum corrections). The cut-off length is then determined to reproduce today's tiny value of Lambda for vacuum energy. Additionally, a field with nonperiodic vanishing boundary conditions is treated, showing that the field has no zero-point energy.

  5. Rib Radiography versus Chest Computed Tomography in the Diagnosis of Rib Fractures.

    Science.gov (United States)

    Sano, Atsushi

    2018-05-01

     The accurate diagnosis of rib fractures is important in chest trauma. Diagnostic images following chest trauma are usually obtained via chest X-ray, chest computed tomography, or rib radiography. This study evaluated the diagnostic characteristics of rib radiography and chest computed tomography.  Seventy-five rib fracture patients who underwent both chest computed tomography and rib radiography between April 2008 and December 2013 were included. Rib radiographs, centered on the site of pain, were taken from two directions. Chest computed tomography was performed using a 16-row multidetector scanner with 5-mm slice-pitch without overlap, and axial images were visualized in a bone window.  In total, 217 rib fractures were diagnosed in 75 patients. Rib radiography missed 43 rib fractures in 24 patients. The causes were overlap with organs in 15 cases, trivial fractures in 21 cases, and injury outside the imaging range in 7 cases. Left lower rib fractures were often missed due to overlap with the heart, while middle and lower rib fractures were frequently not diagnosed due to overlap with abdominal organs. Computed tomography missed 21 rib fractures in 17 patients. The causes were horizontal fractures in 10 cases, trivial fractures in 9 cases, and insufficient breath holding in 1 case.  In rib radiography, overlap with organs and fractures outside the imaging range were characteristic reasons for missed diagnoses. In chest computed tomography, horizontal rib fractures and insufficient breath holding were often responsible. We should take these challenges into account when diagnosing rib fractures. Georg Thieme Verlag KG Stuttgart · New York.

  6. Cough-induced rib fractures.

    Science.gov (United States)

    Hanak, Viktor; Hartman, Thomas E; Ryu, Jay H

    2005-07-01

    To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the Mayo Clinic in Rochester, Minn, over a 9-year period between January 1, 1996, and January 31, 2005. Bone densitometry data from patients' medical records were analyzed, and T scores were used to classify patients into bone density categories. The mean +/- SD age of the 54 study patients at presentation was 55+/-17 years, and 42 patients (78%) were female. Patients presented with chest wall pain after onset of cough. Rib fracture was associated with chronic cough (> or =3 weeks' duration) in 85% of patients. Rib fractures were documented by chest radiography, rib radiography, computed tomography, or bone scan. Chest radiography had been performed in 52 patients and revealed rib fracture in 30 (58%). There were 112 fractured ribs in 54 patients. One half of patients had more than one fractured rib. Right-sided rib fractures alone were present in 17 patients (26 fractured ribs), left-sided in 23 patients (35 fractured ribs), and bilateral in 14 patients (51 fractured ribs). The most commonly fractured rib on both sides was rib 6. The fractures were most common at the lateral aspect of the rib cage. Bone densitometry was done in 26 patients and revealed osteopenia or osteoporosis in 17 (65%). Cough-induced rib fractures occur primarily in women with chronic cough. Middle ribs along the lateral aspect of the rib cage are affected most commonly. Although reduced bone density is likely a risk factor, cough-induced rib fractures can occur in the presence of normal bone density.

  7. Revisiting AdS/CFT at a finite radial cut-off

    Energy Technology Data Exchange (ETDEWEB)

    Mandal, Gautam; Nayak, Pranjal [Department of Theoretical Physics,Tata Institute of Fundamental Research, Mumbai 400005 (India)

    2016-12-22

    We revisit AdS/CFT at a finite radial cut-off, specifically in the context of double trace perturbations, O{sub n}= O(x)(∂{sup 2}){sup n}O(x), with arbitrary powers n. As well-known, the standard GKPW prescription, applied to a finite radial cut-off, leads to contact terms in correlators. de Haro et al. http://dx.doi.org/10.1007/s002200100381 introduced bulk counterterms to remove these. This prescription, however, yields additional terms in the correlator corresponding to spurious double trace deformations. Further, if we view the GKPW prescription coupled with the prescription in http://dx.doi.org/10.1007/s002200100381, in terms of a boundary wavefunction, we find that it is incompatible with radial Schrödinger evolution (in the spirit of holographic Wilsonian RG). We consider a more general wavefunction satisfying the Schrödinger equation, and find that generically such wavefunctions generate both (a) double trace deformations and (b) contact terms. However, we find that there exist special choices of these wavefunctions, amounting to a new AdS/CFT prescription at a finite cut-off, so that both (a) and (b) are removed and we obtain a pure power law behaviour for the correlator. We compare these special wavefunctions with a specific RG scheme in field theory. We give a geometric interpretation of these wavefunctions; these correspond to some specific smearing of boundary points in the Witten diagrams. We present a comprehensive calculation of exact double-trace beta-functions for all couplings O{sub n} and match with a holographic computation using the method described above. The matching works with a mapping between the field theory and bulk couplings; such a map is highly constrained because the beta-functions are quadratic and exact on both sides. Our discussions include a generalization of the standard double-trace Wilson-Fisher flow to the space of the infinite number of couplings.

  8. Insulin Resistance Distribution and Cut-Off Value in Koreans from the 2008-2010 Korean National Health and Nutrition Examination Survey

    Science.gov (United States)

    Yun, Kyung-Jin; Han, Kyungdo; Kim, Mee Kyoung; Park, Yong-Moon; Baek, Ki-Hyun; Song, Ki-Ho; Kwon, Hyuk-Sang

    2016-01-01

    Background We sought to identify the distribution and cut-off value of the ‘homeostasis model assessment of insulin resistance’ (HOMA-IR) according to gender and menopausal status for metabolic syndrome in Koreans. Methods Data were from the Korean National Health and Nutrition Examination Survey in 2008–2010. The subjects included adults aged 20 years or older. We excluded participants who had diabetes or fasting serum glucose ≥ 7 mmol/L. Finally, 11,121 subjects (4,911 men, 3,597 premenopausal women, 2,613 postmenopausal women) were enrolled. The modified Adult Treatment Panel III criteria were used to define metabolic syndrome. Results The mean HOMA-IR was 2.11 (2.07–2.15) for men, 2.0 (1.97–2.04) for premenopausal women, and 2.14 (2.2–2.19) for postmenopausal women. The first cut-off values in men, premenopausal women, and postmenopausal women were 2.23 (sensitivity 70.6%, specificity 66.9%), 2.39 (sensitivity 72.3%, specificity 76.4%), and 2.48 (sensitivity 51.9%, specificity 80.2%), respectively. Based on the first HOMA-IR cut-off value, the prevalence of metabolic syndrome was 22.9% in men, 13.7% in premenopausal women, and 51.6% in postmenopausal women. The second cut-off value was around 3.2 in all three groups. Based on the second HOMA-IR cut-off value, the prevalence of metabolic syndrome was 50.8% in men, 42.5% in premenopausal women, and 71.6% in postmenopausal women. Conclusion In conclusion, the first cut-off values for HOMA-IR were 2.2–2.5 and the second cut-off value was 3.2 in Korea. The distribution of HOMA-IR showed differences according to gender and menopausal status. When we apply HOMA-IR, we should consider gender, menopausal status, and the prevalence of metabolic syndrome. PMID:27128847

  9. Rib fractures: comparison of associated injuries between pediatric and adult population.

    Science.gov (United States)

    Kessel, Boris; Dagan, Jasmin; Swaid, Forat; Ashkenazi, Itamar; Olsha, Oded; Peleg, Kobi; Givon, Adi; Alfici, Ricardo

    2014-11-01

    Rib fractures are considered a marker of exposure to significant traumatic energy. In children, because of high elasticity of the chest wall, higher energy levels are necessary for ribs to fracture. The purpose of this study was to analyze patterns of associated injuries in children as compared with adults, all of whom presented with rib fractures. A retrospective cohort study involving blunt trauma patients with rib fractures registered in the National Trauma Registry was conducted. Of 6,995 trauma victims who were found to suffer from rib fractures, 328 were children and 6,627 were adults. Isolated rib fractures without associated injuries occurred in 19 children (5.8%) and 731 adults (11%). More adults had 4 or more fractured ribs compared with children (P pneumothorax (P = .006), spleen, and liver injury (P < .001). Mortality rate was 5% in both groups. The incidence of associated head, thoracic, and abdominal solid organ injuries in children was significantly higher than in adults suffering from rib fractures. In spite of a higher Injury Severity Score and incidence of associated injuries, mortality rate was similar. Mortality of rib fracture patients was mostly affected by the presence of extrathoracic injuries. Copyright © 2014 Elsevier Inc. All rights reserved.

  10. Clinically Relevant Cut-off Points for the Diagnosis of Sarcopenia in Older Korean People.

    Science.gov (United States)

    Choe, Yu-Ri; Joh, Ju-Youn; Kim, Yeon-Pyo

    2017-11-09

    The optimal criteria applied to older Korean people have not been defined. We aimed to define clinically relevant cut-off points for older Korean people and to compare the predictive validity with other definitions of sarcopenia. Nine hundred and sixteen older Koreans (≥65 years) were included in this cross-sectional observational study. We used conditional inference tree analysis to determine cut-off points for height-adjusted grip strength (GS) and appendicular skeletal muscle mass (ASM), for use in the diagnosis of sarcopenia. We then compared the Korean sarcopenia criteria with the Foundation for the National Institutes of Health and Asian Working Group for Sarcopenia criteria, using frailty, assessed with the Korean Frailty Index, as an outcome variable. For men, a residual GS (GSre) of ≤ 0.25 was defined as weak, and a residual ASM (ASMre) of ≤ 1.29 was defined as low. Corresponding cut-off points for women were a GSre of ≤ 0.17 and an ASMre of ≤ 0.69. GSre and ASMre values were adjusted for height. In logistic regression analysis with new cut-off points, the adjusted odds ratios for pre-frail or frail status in the sarcopenia group were 3.23 (95% confidence interval [CI] 1.33-7.83) for the men and 1.74 (95% CI 0.91-3.35) for the women. In receiver operating characteristic curve analysis, the unadjusted area under the curve for Korean sarcopenia criteria in men and women were 0.653 and 0.608, respectively (p sarcopenia in older Korean people. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. An analysis of 214 cases of rib fractures

    Directory of Open Access Journals (Sweden)

    Sule Karadayi

    2011-01-01

    Full Text Available INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1 patients with an isolated rib fracture (RF1 (n = 50, 23.4%, 2 patients with two rib fractures (RF2 (n = 53, 24.8%, and 3 patients with more than two rib fractures (RF3 (n = 111, 51.9%. The patients were evaluated and compared according to the number of rib fractures, mean age, associated chest injuries (hemothorax, pneumothorax, and/or pulmonary contusion, and co-existing injuries to other systems. FINDINGS: The mean age of the patients was 51.5 years. The distribution of associated chest injuries was 30% in group RF1, 24.6% in group RF2, and 75.6% in group RF3 (p<0.05. Co-existing injuries to other systems were 24% in group RF1, 23.2% in group RF2, and 52.6% in group RF3 (p<0.05. Two patients (4% in group RF1, 2 patients (3.8% in group RF2, and 5 patients (4.5% in group RF3 (total n = 9; 4.2% died. CONCLUSION: Patients with any number of rib fractures should be carefully screened for co-existing injuries in other body systems and hospitalized to receive proper treatment.

  12. Landscape Evolution Comparison between Sacra Mensa, Mars and the Grand Mesa, Colorado, USA

    Science.gov (United States)

    Chesnutt, J. M.; Wegmann, K. W.; Cole, R. D.; Byrne, P. K.

    2017-12-01

    The Grand Mesa in Colorado is one of the largest and highest flat-topped mountains on Earth, and as such provides a compelling analog for Mars' Sacra Mensa. Both basalt-capped landforms are morphologically similar, enabling a landscape evolution comparison between the two that considers key differences in locale, composition, and environmental conditions. Sacra Mensa is nearly 50 times the area of Grand Mesa and towers 3 km above the surrounding area. The 1,300 km2 Grand Mesa rises 2 km above Grand Valley, and is bracketed by the Colorado and Gunnison Rivers in much the same way as Sacra Mensa is bounded by braided channels of Kasei Valles. The sustained incision by the Gunnison and Colorado was a key erosive force in the creation of the Grand Mesa, whereas punctuated but voluminous Hesperian glacio-fluvial floods are thought to have carved the Sacra Mensa. The Grand Mesa is undergoing extensive mass wasting, ranging from deadly landslides like the 2014 West Salt Creek rock avalanche to hundreds of slower-moving retrogressive slump blocks calving off the Miocene basalt cap. The genesis and modification of both landforms includes volcanic and fluvial activity, albeit in an inverted sequence. The Grand Mesa basalt cap has preserved the landform during the incision around its sides, whereas Sacra Mensa was likely carved by floods, with those flood channels later modified by lava flows. Recent (2015-2017) LiDAR surveys revealed massive and possible ancient landslides in many stream valleys and extensive earthflows on all sides of the Grand Mesa. In the case of the Grand Mesa, the large landslides are mainly occurring in one stratigraphic unit. In comparison, the western half of Sacra Mensa contains substantial slumping accompanied by landslides and debris flows, whereas the eastern half has relatively few such phenomena. Here, we report on the first Mesa-Mensa landscape evolution analog study. The surficial and bedrock mapping and 14C dating of key features of the

  13. Efficient Closed Form Cut-Off Planes and Propagation Planes Characteristics for Dielectric Slab Loaded Boundary Value Problems

    OpenAIRE

    Zafar, Junaid

    2012-01-01

    The geometrical relationship between the cut-off and propagating planes of any waveguide system is a prerequisite for any design process. The characterization of cut-off planes and optimisation are challenging for numerical methods, closed-form solutions are always preferred. In this paper Maxwells coupled field equations are used to characterise twin E-plane and H-plane slab loaded boundary value problems. The single mode bandwidths and dispersion characteristics of these structures are pres...

  14. [Analysis of Cut-off Value in Screening of Thalassemia by Capillary Hemoglobin Electrophoresis for Pregnant Women from Shenzhen Region of China].

    Science.gov (United States)

    Huo, Mei; Wu, Wen-Yuan; Liu, Mei; Gan, Zhi-Biao; Mao, Wei-Yu; Lin, Rong-Yao; Liu, Ai-Qin; He, Gui-Rong

    2016-04-01

    To investigate the cut-off value in screening of thalassemia in pregnant women from Shenzhen region by capillary hemoglobin electrophoresis. The data of capillary hemoglobin electrophoresis and genetic diagnosis of thalassemia from 2122 examined prenatal women were retrospectively analyzed. Capillary hemoglobin electrophoresis and α-, β- genetic diagnosis of thalassemia were carried out for every woman. Hemoglobin electrophoresis was performed using Capillarys 2 full-automated electrophoresis instrument. Gap polymerase chain reaction and reverse dot blot were used for genetic diagnosis of thalassemia genotyping test. The cut-off value in screening of thalassemia was determined by receiver operating characteristic curve and next to analyze the value of HbA2 and HbF in screening of thalassemia using the decided cut-off value. The areas under the curve (AUC(Roc)) of HbA2 for diagnosis of α-, β- thalassemia were 0.75 and 0.981 respectively, and the AUC(Roc) of HbF for diagnosis of β-thalassemia was 0.787. When HbA2 ≤ 2.55 was taken as the cut-off value of HbA2 for diagnosis of α-thalassemia, the sensitivity, specificity, positive likelihood ratio (LR(+)) and negative likelihood ratio (LR(-)) were 89.5%, 54.8%, 1.98, 0.19 respectively. When HbA2 ≥3.9 was taken as the cut off value of HbA2 for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 96.1%, 99.8% 480.5, 0.04 respectively. When HbF ≥0.75 was taken as the cut off value of HbF for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 83.6%, 61.8% respectively. The cut-off value in screening of thalassemia by capillarys 2 full automated electrophoresis instrument is different from that of the traditional method of hemoglobin electrophoresis, such as cellulose acetate membrane electrophoresis and agarose gel electrophoresis. Each laboratory should establish their own respective cut off value.

  15. The dischargeable cut-off score of Oswestry Disability Index (ODI) in the inpatient care for low back pain with disability.

    Science.gov (United States)

    Park, Sang-Won; Shin, Ye-Sle; Kim, Hye-Jin; Lee, Jin-Ho; Shin, Joon-Shik; Ha, In-Hyuk

    2014-10-01

    The admission due to low back pain (LBP) became prevalent cause of international economic losses. Since LBP patients with disability are often subject to inpatient care, it is important to determine the appropriate time of discharge. The purpose of this study is to set the cut-off value of appropriate Oswestry Disability Index (ODI) at the time of discharge. Of 1,394 LBP patients admitted in hospital specialized in spinal disease, 774 eligible patients with disability were included in this study. And several clinical variables including numerical rating score, ODI, satisfaction level were observed during the hospital stay. We considered satisfaction level as an important factor for discharge, categorized patients into satisfied group and dissatisfied group. Through the statistical analysis, appropriate factor for determining dischargeable patients satisfied with their current condition and its cut-off value of ODI were found. And proper predictors for the cut-off value were extracted statistically and logically from a pool of several clinical indexes. The ODI at the time of discharge was most accurate in determining dischargeable patients. The cut-off value of ODI was 30. Predictors were ODI questions 4 and 6. We set the cut-off value of dischargeable ODI for LBP inpatient with disability and found its predictor.

  16. Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women.

    Science.gov (United States)

    Subramoney, Sreevidya; Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

    2014-12-01

    To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. © 2014 the Nordic Societies of Public Health.

  17. X-ray Spectral Survey of WGACAT Quasars, II: Optical and Radio Properties of Quasars with Low Energy X-ray Cut-offs

    OpenAIRE

    Elvis, Martin; Fiore, Fabrizio; Giommi, Paolo; Padovani, Paolo

    1997-01-01

    We have selected quasars with X-ray colors suggestive of a low energy cut-off, from the ROSAT PSPC pointed archive. We examine the radio and optical properties of these 13 quasars. Five out of the seven quasars with good optical spectra show associated optical absorption lines, with two having high delta-v candidate systems. Two other cut-off quasars show reddening associated with the quasar. We conclude that absorption is highly likely to be the cause of the X-ray cut-offs, and that the abso...

  18. The first cut-off wall in the Indian Himalayas for the dam of the Dhauliganga hydroelectric project

    Energy Technology Data Exchange (ETDEWEB)

    Brunner, W.G. [Bauer Maschinen GmbH, Berlin (Germany)

    2006-07-01

    This paper provided details a Bauer cutter used to build a cut-off wall for the Dhaulinganga power plant project in the Himalayan mountains. The dam for the project was built as a 56 m high concrete-faced rockfill dam with a length of 270 m at the crown. A cut-off wall was constructed on the upstream side of the dam extending down from the dam's plinth to the bedrock level. A Bauer cutter was used to key the cut-off wall straight into the bedrock, which omitted the need for a grout curtain. The cut-off wall is 1 m thick and 70 m deep, with a total area of 8000 m{sup 2}. The wall was constructed as a series of primary and secondary panels. Excavation of the panels was carried out in single bites by the Bauer DHG hydraulic diaphragm wall grabs, supported a box chisel, cross chisel and a Bauer BC 40 rock cutter. Trench stability was provided by bentonite slurry. The closing forces were activated by a cylinder which was installed vertically inside the base body. The Bauer cutter continuously removed soil and rock from the bottom of the trench for mixing with the bentonite slurry. The slurry was then pumped through a ring main of hose pipes to a desanding plant where it was cleaned and returned to the trench. Advantages offered by using the cutter included a consistently high output, an extremely high degree of verticality, watertight joints, and the ability to cut through hard boulders. Use of the cutter at the Dhaulinganga site showed that the project could not be carried out successfully without the use of the cutter, which was used whenever grab and chisel methods were unable to achieve satisfactory rates of penetration. Deployment of the cutter was essential to key the cut-off wall into the underlying bedrock. It was concluded that the Dhualinganga project will provide a model for future power generation projects in the Indian Himalayas. 11 figs.

  19. Cut-off values of distal forearm bone density for the diagnosis of ...

    African Journals Online (AJOL)

    Background: The objective of this study was to establish a triage cut-off point or threshold for peripheral bone mineral density (BMD), applicable to black postmenopausal women, and that could be used as a screening method to differentiate between women with normal BMD, and those with possible central osteoporosis.

  20. Relationship between the optimum cut off frequency for Butter worth filter and lung-heart ratio in 99mTc myocardial SPECT

    International Nuclear Information System (INIS)

    Salihin Yusoff, M. N.; Zakaria, A.

    2010-01-01

    We investigated whether the lung-heart ratio parameter can be used to identify the optimum cut off frequency for Butter worth filter in 99m Tc myocardial SPECT imaging. Materials and Methods: This study involved a cardiac phantom system consisting of cardiac insert in which 1.10 cm cold defect was inserted into its myocardium wall and filled with 4.0 μCi/ml (0.148 MBq/ml) 99m Tc concentration. The cardiac insert was then put into a cylindrical tank which filled with six different 99m Tc concentrations as background. Thus, six target background concentrations ratios (T/B) were carried out. The lung-heart ratio was determined for every SPECT raw image obtained corresponding to each T/B. Then, 130 different combinations of filter parameters from Butter worth filter were utilized to reconstruct each SPECT raw image. The determination of count in myocardium, background, and defect regions of interest were performed for every reconstructed image. All the count values were then used to calculate contrast, signal-to-noise ratio, and defect size. Each criterion was graded (1 to 100) and then summed together to obtain total grade. The optimum cut off frequency for each lung-heart ratio was determined from the total grade. The relation between optimum cut off frequency for Butter worth filter and lung-heart ratio was established using linear regression. Results: There were good relationship between the optimum Butter worth cut off frequency and lung-heart ratio (R 2 = 0.864, p<0.01). The optimal cut off frequency correspond to the change in lung-heart ratio can be expressed by the equation: Optimum cut off frequency=0.715*lung-heart ratio + 0.227. Conclusion: This study suggests that the optimum cut off frequency for Butter worth filter should be determined by referring to lung-heart ratio in each patient study.

  1. Cough-induced rib fractures.

    Science.gov (United States)

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  2. On the Cut-off Point for Combinatorial Group Testing

    DEFF Research Database (Denmark)

    Fischer, Paul; Klasner, N.; Wegener, I.

    1999-01-01

    is answered by 1 if Q contains at least one essential object and by 0 otherwise. In the statistical setting the objects are essential, independently of each other, with a given probability p combinatorial setting the number k ... group testing is equal to p* = 12(3 - 5), i.e., the strategy of testing each object individually minimizes the average number of queries iff p >= p* or n = 1. In the combinatorial setting the worst case number of queries is of interest. It has been conjectured that the cut-off point of combinatorial...

  3. Epidemiological cut-off values for Flavobacterium psychrophilum MIC data generated by a standard test protocol

    DEFF Research Database (Denmark)

    Smith, P.; Endris, R.; Kronvall, G.

    2016-01-01

    -1 for florfenicol, ≤0.025 mg L-1 for oxolinic acid (OXO), ≤0.125 mg L-1 for oxytetracycline and ≤20 (1/19) mg L-1 for trimethoprim/sulphamethoxazole. For ampicillin and amoxicillin, the majority of putative wild-type observations were 'off scale', and therefore, statistically valid cut-off values...

  4. Stormwater Pollution Prevention Plan TA-60 Roads and Grounds Facility and Associated Sigma Mesa Staging Area

    Energy Technology Data Exchange (ETDEWEB)

    Sandoval, Leonard Frank [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-02-01

    This Stormwater Pollution Prevention Plan (SWPPP) is applicable to operations at the Technical Area -60 (TA-60) Roads and Grounds Facility and Associated Sigma Mesa Staging Area off Eniwetok Drive, in Los Alamos County, New Mexico.

  5. Rib fixation for severe chest deformity due to multiple rib fractures.

    Science.gov (United States)

    Igai, Hitoshi; Kamiyoshihara, Mitsuhiro; Nagashima, Toshiteru; Ohtaki, Yoichi

    2012-01-01

    The operative indications for rib fracture repair have been a matter of debate. However, several reports have suggested that flail chest, pain on respiration, and chest deformity/defect are potential conditions for rib fracture repair. We describe our experience of rib fixation in a patient with severe chest deformity due to multiple rib fractures. A 70-year-old woman was admitted with right-sided multiple rib fractures (2nd to 7th) and marked chest wall deformity without flailing caused by an automobile accident. Collapse of the chest wall was observed along the middle anterior axillary line. At 11 days after the injury, surgery was performed to repair the chest deformity, as it was considered to pose a risk of restrictive impairment of pulmonary function or chronic intercostal pain in the future. Operative findings revealed marked displacement of the superior 4 ribs, from the 2nd to the 5th, and collapse of the osseous chest wall towards the thoracic cavity. After exposure of the fracture regions, ribs fixations were performed using rib staplers. The total operation time was 90 minutes, and the collapsed portion of the chest wall along the middle anterior axillary line was reconstructed successfully.

  6. Body mass index and waist-to-height ratio cut-offs as predictors of high blood pressure in adolescents

    Directory of Open Access Journals (Sweden)

    Kurnia Febriana

    2015-04-01

    Full Text Available Background: Obesity is associated with increased risk for high blood pressure (BP. Although a routine BP measurement is indicated for all children visiting pediatric practice, recognition of children particularly at risk may save times. The aim of this study was to assess the cut-off point for body mass index (BMI and waist-to-height ratio (WHtR to predict high BP in adolescents. Methods: We conducted a cross-sectional study on 928 children aged 11 to 16 years in Yogyakarta. BP were measured using standard technique described by The Fourth Report on The Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. BMI was adjusted for age and sex using the WHO 2007 growth reference. WHtR was ratio of waist circumference related to height in centimeters. Receiver operating characteristic (ROC curves were used to estimate the best cut-offs. Results: The best cut-off point for BMI-for-age Z-score (BMIZ to predict high BP was 0.51 with sensitivity and specificity of 82% (95% CI = 78-86 and 76% (95% CI = 67-78 for systolic BP and sensitivity and specificity of 82% (95% CI = 78-86 and 72% (95% CI = 68-76 for diastolic BP. The best cut-off point for WHtR was 0.45, with sensitivity of 76% (95% CI = 67-78 and specificity of 74% (95% CI = 71-79 for systolic BP and sensitivity of 76% (95% CI = 72-80 and specificity of 70% (95% CI = 61-75 for diastolic BP.Conclusion: BMIZ of 0.51 and WHtR of 0.45 are the best cut-off point to predict high BP in adolescents.

  7. Poverty and cutting off the power: Evaluation of the social contract of the Electricite de France

    International Nuclear Information System (INIS)

    Wodon, Q. T.

    2003-01-01

    Measures put in place by the French Electric Utility, Electricite de France (EDF) to assist those in default of payment of their electricity bills are evaluated. When introduced in 1996, it was expected that the new measures would reduce the necessity of cutting off power to the poor by one third. Notwithstanding these expectations and some progress in reducing the rate of power cut-off, the number of instances where service was denied, has risen. The evaluation is based on the annual survey of poor clients of the EDF undertaken by the Polling Institute Lavialle. The annual survey concerns itself chiefly with the attitude towards the service and the quality of dialogue between the Utility and its clients. The analysis resulted in three conclusions: (1) EDF appears to make progress in dealing with the problem based on evidence of higher client satisfaction and lower rate of cutting off power; (2) there is evidence of important beneficial changes in the policies of local EDF centres; and (3) there is noticeable evidence of improved coordination with social services agencies and higher quality of information made available; both these factors should contribute to higher client satisfaction. In general, EDF is to be congratulated for their efforts to date, for commissioning the survey and for participating in the evaluation. Nevertheless, in France the instances of cutting off electricity to poor households is still a fact of life, despite the commitment and the new measures put in place by EDF. 21 refs., 7 tabs., 1 fig

  8. Surgical rib fixation

    OpenAIRE

    Marasco, Silvana

    2017-01-01

    Traumatic rib fracture injuries are being seen with increasing frequency in the hospital setting. They are often associated with other severe injuries and frequently require admission. The most severe form of rib fracture injury, flail chest, has a mortality of up to 33%. Rib fracture injuries have also been associated with chronic pain, malunion, deformity, disability and poor quality of life. Despite this, the standard of management for rib fracture injuries was, and in most ...

  9. Defining Glaucomatous Optic Neuropathy from a Continuous Measure of Optic Nerve Damage - The Optimal Cut-off Point for Risk-factor Analysis in Population-based Epidemiology

    NARCIS (Netherlands)

    Ramdas, Wishal D.; Rizopoulos, Dimitris; Wolfs, Roger C. W.; Hofman, Albert; de Jong, Paulus T. V. M.; Vingerling, Johannes R.; Jansonius, Nomdo M.

    2011-01-01

    Purpose: Diseases characterized by a continuous trait can be defined by setting a cut-off point for the disease measure in question, accepting some misclassification. The 97.5th percentile is commonly used as a cut-off point. However, it is unclear whether this percentile is the optimal cut-off

  10. Rise time of proton cut-off energy in 2D and 3D PIC simulations

    Science.gov (United States)

    Babaei, J.; Gizzi, L. A.; Londrillo, P.; Mirzanejad, S.; Rovelli, T.; Sinigardi, S.; Turchetti, G.

    2017-04-01

    The Target Normal Sheath Acceleration regime for proton acceleration by laser pulses is experimentally consolidated and fairly well understood. However, uncertainties remain in the analysis of particle-in-cell simulation results. The energy spectrum is exponential with a cut-off, but the maximum energy depends on the simulation time, following different laws in two and three dimensional (2D, 3D) PIC simulations so that the determination of an asymptotic value has some arbitrariness. We propose two empirical laws for the rise time of the cut-off energy in 2D and 3D PIC simulations, suggested by a model in which the proton acceleration is due to a surface charge distribution on the target rear side. The kinetic energy of the protons that we obtain follows two distinct laws, which appear to be nicely satisfied by PIC simulations, for a model target given by a uniform foil plus a contaminant layer that is hydrogen-rich. The laws depend on two parameters: the scaling time, at which the energy starts to rise, and the asymptotic cut-off energy. The values of the cut-off energy, obtained by fitting 2D and 3D simulations for the same target and laser pulse configuration, are comparable. This suggests that parametric scans can be performed with 2D simulations since 3D ones are computationally very expensive, delegating their role only to a correspondence check. In this paper, the simulations are carried out with the PIC code ALaDyn by changing the target thickness L and the incidence angle α, with a fixed a0 = 3. A monotonic dependence, on L for normal incidence and on α for fixed L, is found, as in the experimental results for high temporal contrast pulses.

  11. [Research progress on the clinical value of Ki-67 in breast cancer and its cut-off definition].

    Science.gov (United States)

    Chen, Qing; Wu, Kejin

    2015-08-01

    Ki-67 has an important application value in clinical practice. However, it is still a little tough in clinical application because of the debate on the cut-off definition of Ki-67 index. This review summarizes most studies on the prognostic and predictive value of Ki-67, analyzes the reasons for the discrepancies among the studies cited, and presents the necessity and clinical significance of scientifically defining the cut-off of Ki-67 index, providing a theoretical basis for Ki-67 in clinical application.

  12. Investigation of the performance of cement-bentonite cut-off walls in aggressive ground at a disused gasworks site

    International Nuclear Information System (INIS)

    Tedd, P.; Holton, I.R.; Butcher, A.P.; Wallace, S.

    1997-01-01

    There has been an increased use of cement-bentonite slurry trench cut-off walls to control the lateral migration of pollution in the UK. Concerns inevitably exist about their performance in chemically aggressive ground particularly in the long term. To address some of the uncertainties a programme of field and laboratory research is being undertaken at a disused gasworks in the UK. Elevated levels of sulphate and other contaminants are present on the site and could potentially change the properties of the cement-bentonite. Two boxes, 10m square in plan, by 5m deep have been constructed, one with and one without an HDPE membrane, to isolate parts of the site. Local hydraulic gradients across the walls have been created by pumping from within the boxes. Isolated lengths of wall have been constructed which are being used to assess and develop in-situ testing techniques such as the piezocone for measuring permeability, strength and overall integrity of the wall

  13. Chemical Investigations of ISOL target units for carbon and nitrogen beams

    CERN Document Server

    Franberg, H; Gäggeler, H W; Köster, U

    2006-01-01

    Radioactive Ion Beams (RIB) are of significant interest in a number of applications. ISOL (Isotope Separation On Line) facilities provide RIB with high beam intensities and good beam quality. An atom that is produced within the ISOL target will first diffuse out from the target material. During the effusion towards the transfer line and into the ion source the many contacts with the surrounding surfaces may cause unacceptable delays in the transport and, hence, losses of the shorter-lived isotopes. We performed systematic chemical investigations of adsorption in a temperature and concentration regime relevant for ISOL targets and ion source units, with regard to COx and NOx on Al2O3 and SiO2. These materials are potential construction materials for the above mentioned areas. Off-line and on-line tests have been performed using a gas thermo-chromatography set-up with radioactive tracers. The experiments were performed at the PROTRAC facility at Paul Scherrer Institute in Villigen, Switzerland.

  14. Correlation between Body Mass Index, Gender, and Skeletal Muscle Mass Cut off Point in Bandung

    Directory of Open Access Journals (Sweden)

    Richi Hendrik Wattimena

    2017-09-01

    Full Text Available Objective: To determine the average skeletal muscle mass (SMM value in young adults as a reference population; to analyze the correlation of gender, and body mass index to the cut off point; and to determine skeletal muscle mass cut off points of population in Bandung, Indonesia. Methods: This was a cross-sectional study involving 199 participants, 122 females and 77 males. The sampling technique used was the multistage random sampling. The participants were those who lived in four major regions in Bandung, Indonesia: Sukajadi, Cicadas, Buah Batu, and Cibaduyut. Results: The average appendicular skeletal mass index (ASMI in females and males based on body mass index (BMI were identified. The average ASMI values for normal BMI in females was 5.982±0.462 kg/m2 while the average ASMI values normal BMI for males was 7.581±0.744 kg/m2 Conclusions: A correlation between BMI and ASMI that was considered statistically significant was found in females (0.7712; p<0.05 and a very significant correlation was seen in males (0.870; p<0.05. The cut off points were defined by the normal BMI, which were 5.059 for females and 6.093 for males.

  15. Serum anti-PLA2R antibody as a diagnostic biomarker of idiopathic membranous nephropathy: The optimal cut-off value for Chinese patients.

    Science.gov (United States)

    Liu, Yipeng; Li, Xuan; Ma, Chaoqun; Wang, Ping; Liu, Ju; Su, Hong; Zhuo, Hao; Kong, Xianglei; Xu, Dayu; Xu, Dongmei

    2018-01-01

    The M-type phospholipase A2 receptor (PLA2R) is a specific target autoantigen identified in idiopathic membranous nephropathy (IMN). The autoantibody against PLA2R (anti-PLA2R) may be used to diagnose IMN. However, the appropriate diagnosis cut-off value for Chinese patients with IMN has not been established. In total, 119 patients who underwent renal biopsy (57 patients with IMN and 62 patients with non-IMN glomerulonephritis) and 22 healthy individuals were recruited for our observation study from Qianfoshan Hospital between September 2011 and March 2016. The serum concentration of anti-PLA2R was measured using a quantitative enzyme-linked immunosorbent assay (ELISA). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and receiver operating characteristic (ROC) curve of anti-PLA2R in diagnosing IMN were analysed based on the ELISA detection. The sensitivity, specificity, PPV, and NPV of anti-PLA2R in the diagnosis of IMN in the Chinese patients were 82.5, 75, 69.1, and 86.3% for the 2RU/ml cut-off value; 78.9, 91.7, 86.5, and 86.5% for the 2.6RU/ml cut-off value; 59.6, 95.2, 89.5, and 77.7% for the 14RU/ml cut-off value; 50.9, 96.4, 90.6, and 74.3% for the 20RU/ml cut-off value; and 47.4, 97.6, 93.1, and 73.2% for the 40RU/ml cut-off value, respectively. The area under the ROC curve was 0.879. The cut-off value of 2.6RU/ml is recommended for the use of anti-PLA2R for the diagnosis of IMN in Chinese patients based on the ELISA. Copyright © 2017. Published by Elsevier B.V.

  16. The Portuguese version of the Outcome Questionnaire (OQ-45): Normative data, reliability, and clinical significance cut-offs scores.

    Science.gov (United States)

    Machado, Paulo P P; Fassnacht, Daniel B

    2015-12-01

    The Outcome Questionnaire (OQ-45) is one of the most extensively used standardized self-report instruments to monitor psychotherapy outcomes. The questionnaire is designed specifically for the assessment of change during psychotherapy treatments. Therefore, it is crucial to provide norms and clinical cut-off values for clinicians and researchers. The current study aims at providing study provides norms, reliability indices, and clinical cut-off values for the Portuguese version of the scale. Data from two large non-clinical samples (high school/university, N = 1,669; community, N = 879) and one clinical sample (n = 201) were used to investigate psychometric properties and derive normative data for all OQ-45 subscales and the total score. Significant and substantial differences were found for all subscales between the clinical and non-clinical sample. The Portuguese version also showed adequate reliabilities (internal consistency, test-retest), which were comparable to the original version. To assess individual clinical change, clinical cut-off values and reliable change indices were calculated allowing clinicians and researchers to monitor and evaluate clients' individual change. The Portuguese version of the OQ-45 is a reliable instrument with comparable Portuguese norms and cut-off scores to those from the original version. This allows clinicians and researchers to use this instrument for evaluating change and outcome in psychotherapy. This study provides norms for non-clinical and clinical Portuguese samples and investigates the reliability (internal consistency and test-retest) of the OQ-45. Cut-off values and reliable change index are provided allowing clinicians to evaluate clinical change and clients' response to treatment, monitoring the quality of mental health care services. These can be used, in routine clinical practice, as benchmarks for treatment progress and to empirically base clinical decisions such as continuation of treatment or considering

  17. Breaking Through the Multi-Mesa-Channel Width Limited of Normally Off GaN HEMTs Through Modulation of the Via-Hole-Length

    Science.gov (United States)

    Chien, Cheng-Yen; Wu, Wen-Hsin; You, Yao-Hong; Lin, Jun-Huei; Lee, Chia-Yu; Hsu, Wen-Ching; Kuan, Chieh-Hsiung; Lin, Ray-Ming

    2017-06-01

    We present new normally off GaN high-electron-mobility transistors (HEMTs) that overcome the typical limitations in multi-mesa-channel (MMC) width through modulation of the via-hole-length to regulate the charge neutrality screen effect. We have prepared enhancement-mode (E-mode) GaN HEMTs having widths of up to 300 nm, based on an enhanced surface pinning effect. E-mode GaN HEMTs having MMC structures and widths as well as via-hole-lengths of 100 nm/2 μm and 300 nm/6 μm, respectively, exhibited positive threshold voltages ( V th) of 0.79 and 0.46 V, respectively. The on-resistances of the MMC and via-hole-length structures were lower than those of typical tri-gate nanoribbon GaN HEMTs. In addition, the devices not only achieved the E-mode but also improved the power performance of the GaN HEMTs and effectively mitigated the device thermal effect. We controlled the via-hole-length sidewall surface pinning effect to obtain the E-mode GaN HEMTs. Our findings suggest that via-hole-length normally off GaN HEMTs have great potential for use in next-generation power electronics.

  18. The continuous cut-off method and the relativistic scattering of spin-1/2 particles

    International Nuclear Information System (INIS)

    Dolinszky, T.

    1979-07-01

    A high energy formula, obtained in the framework of the continuous cut-off approach, is shown to improve the correctness of the standard phase shift expression for Dirac scattering by two orders of magnitude in energy. (author)

  19. Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off

    Energy Technology Data Exchange (ETDEWEB)

    Luboldt, Wolfgang [Multiorgan Screening Foundation, Frankfurt (Germany); University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany); University Hospital Dresden, Clinic and Policlinic of Nuclear Medicine, Dresden (Germany); Volker, Teresa; Zoephel, Klaus; Kotzerke, Joerg [University Hospital Dresden, Clinic and Policlinic of Nuclear Medicine, Dresden (Germany); Wiedemann, Baerbel [University Hospital Dresden, Institute of Medical Informatics and Biometrics, Dresden (Germany); Wehrmann, Ursula [University Hospital Dresden, Clinic and Policlinic of Surgery, Dresden (Germany); Koch, Arne; Abolmaali, Nasreddin [University Hospital Dresden, Oncoray, Dresden (Germany); Toussaint, Todd; Luboldt, Hans-Joachim [Multiorgan Screening Foundation, Frankfurt (Germany); Middendorp, Markus; Gruenwald, Frank [University Hospital Frankfurt, Department of Nuclear Medicine, Frankfurt (Germany); Aust, Daniela [University Hospital Dresden, Department of Pathology, Dresden (Germany); Vogl, Thomas J. [University Hospital Frankfurt, Department of Radiology, Frankfurt am Main (Germany)

    2010-09-15

    To determine the performance of FDG-PET/CT in the detection of relevant colorectal neoplasms (adenomas {>=}10 mm, with high-grade dysplasia, cancer) in relation to CT dose and contrast administration and to find a PET cut-off. 84 patients, who underwent PET/CT and colonoscopy (n=79)/sigmoidoscopy (n=5) for (79 x 6+5 x 2)=484 colonic segments, were included in a retrospective study. The accuracy of low-dose PET/CT in detecting mass-positive segments was evaluated by ROC analysis by two blinded independent reviewers relative to contrast-enhanced PET/CT. On a per-lesion basis characteristic PET values were tested as cut-offs. Low-dose PET/CT and contrast-enhanced PET/CT provide similar accuracies (area under the curve for the average ROC ratings 0.925 vs. 0.929, respectively). PET demonstrated all carcinomas (n=23) and 83% (30/36) of relevant adenomas. In all carcinomas and adenomas with high-grade dysplasia (n=10) the SUV{sub max} was {>=}5. This cut-off resulted in a better per-segment sensitivity and negative predictive value (NPV) than the average PET/CT reviews (sensitivity: 89% vs. 82%; NPV: 99% vs. 98%). All other tested cut-offs were inferior to the SUV{sub max}. FDG-PET/CT provides promising accuracy for colorectal mass detection. Low dose and lack of iodine contrast in the CT component do not impact the accuracy. The PET cut-off SUV{sub max}{>=} 5 improves the accuracy. (orig.)

  20. Detection of relevant colonic neoplasms with PET/CT: promising accuracy with minimal CT dose and a standardised PET cut-off

    International Nuclear Information System (INIS)

    Luboldt, Wolfgang; Volker, Teresa; Zoephel, Klaus; Kotzerke, Joerg; Wiedemann, Baerbel; Wehrmann, Ursula; Koch, Arne; Abolmaali, Nasreddin; Toussaint, Todd; Luboldt, Hans-Joachim; Middendorp, Markus; Gruenwald, Frank; Aust, Daniela; Vogl, Thomas J.

    2010-01-01

    To determine the performance of FDG-PET/CT in the detection of relevant colorectal neoplasms (adenomas ≥10 mm, with high-grade dysplasia, cancer) in relation to CT dose and contrast administration and to find a PET cut-off. 84 patients, who underwent PET/CT and colonoscopy (n=79)/sigmoidoscopy (n=5) for (79 x 6+5 x 2)=484 colonic segments, were included in a retrospective study. The accuracy of low-dose PET/CT in detecting mass-positive segments was evaluated by ROC analysis by two blinded independent reviewers relative to contrast-enhanced PET/CT. On a per-lesion basis characteristic PET values were tested as cut-offs. Low-dose PET/CT and contrast-enhanced PET/CT provide similar accuracies (area under the curve for the average ROC ratings 0.925 vs. 0.929, respectively). PET demonstrated all carcinomas (n=23) and 83% (30/36) of relevant adenomas. In all carcinomas and adenomas with high-grade dysplasia (n=10) the SUV max was ≥5. This cut-off resulted in a better per-segment sensitivity and negative predictive value (NPV) than the average PET/CT reviews (sensitivity: 89% vs. 82%; NPV: 99% vs. 98%). All other tested cut-offs were inferior to the SUV max . FDG-PET/CT provides promising accuracy for colorectal mass detection. Low dose and lack of iodine contrast in the CT component do not impact the accuracy. The PET cut-off SUV max ≥ 5 improves the accuracy. (orig.)

  1. Definition of new cut-offs of BMI and waist circumference based on body composition and insulin resistance: differences between children, adolescents and adults.

    Science.gov (United States)

    Hübers, M; Pourhassan, M; Braun, W; Geisler, C; Müller, M J

    2017-09-01

    This study aims to determine associations between anthropometric traits, regional fat depots and insulin resistance in children, adolescents and adults to define new cut-offs of body mass index (BMI) or waist circumference (WC). Cross-sectional data were assessed in 433 children, adolescents and adults (aged: 6-60 years, BMI: 23.6 [21.0-27.7] kg m -2 ). Total adipose tissue (TAT), regional subcutaneous adipose tissue (SAT total , SAT trunk ) and visceral adipose tissue (VAT) were determined by whole-body magnetic resonance imaging, fat mass by air-displacement plethysmography. Insulin resistance was evaluated by homeostasis model assessment of insulin resistance (HOMA-IR). Bivariate as well as partial correlations and regression analyses were used. Cut-off values of BMI and WC related to regional fat depots and HOMA-IR were analysed by receiver operating characteristics curve. In adults, TAT, SAT total and SAT trunk increased linearly with increasing BMI and WC, whereas they followed a cubic function in children and adolescents with a steep increase at BMI and WC ≥1 standard deviation score and VAT at WC ≥2 standard deviation score. Sex differences were apparent in adults with women having higher masses of TAT and SAT and men having higher VAT. Using established BMI or WC cut-offs, correspondent masses of TAT, SAT total , SAT trunk and VAT increased from childhood to adulthood. In all age groups, there were positive associations between BMI, WC, SAT trunk , VAT and HOMA-IR. When compared with normative cut-offs of BMI or WC, HOMA-IR-derived cut-offs of regional fat depots were lower in all age groups. Associations between BMI, WC and regional fat depots varied between children, adolescents, young and older adults. When compared with BMI-derived and WC-derived values, an insulin resistance-derived cut-off corresponded to lower masses of regional fat depots. Thus, established BMI and WC cut-offs are not appropriate to assess metabolic disturbances associated

  2. Delayed pneumothorax complicating minor rib fracture after chest trauma.

    Science.gov (United States)

    Lu, Ming-Shian; Huang, Yao-Kuang; Liu, Yun-Hen; Liu, Hui-Ping; Kao, Chiung-Lun

    2008-06-01

    Pneumothorax (PTX) after trauma is a preventable cause of death. Drainage procedures such as chest tube insertion have been traditionally advocated to prevent fatal tension PTX. We evaluated the safety of close observation in patients with delayed PTX complicating rib fracture after minor chest trauma. Adult patients (>18 years) with a diagnosis of chest trauma and 3 or fewer fractured ribs were reviewed. Case patients were divided according to age, location and number of fractured ribs, mechanism of trauma, and initial pulmonary complication after thoracic trauma for comparative analysis. There were 207 male (70.2%) and 88 female (29.8%) patients whose ages ranged from 18 to 93 years (median, 55 years). The mechanisms of trauma were a motor vehicle accident in 207 patients, falls in 66, pedestrian injury in 10, and assaults in 14. Ninety-five patients sustained 1 rib fracture, 95 had 2 rib fractures, and 105 suffered 3 rib fractures. Right-sided injury occurred in 164 cases, left-sided injury did in 127, and bilateral injury did in 4. The most frequent location of rib fractures was from the fourth rib to the ninth rib. The initial pulmonary complications after trauma were PTX in 16 patients, hemothorax in 43, pneumohemothorax in 14, lung contusion in 75, and isolated subcutaneous emphysema (SubcEmph) in 33. Thirty percent of the patients (n = 5/16) who presented with traumatic PTX were observed safely without drainage. Delayed PTX was recorded in 16 patients, occurring mostly during the first 2 days of their admission. Associated extrathoracic injury was recorded in 189 patients. The mean hospital stay of the patients was 7.66 days. Longer hospital stay was related to increasing number of fractured ribs, need for thoracic drainage, and the presence of associated extrathoracic injury. The mortality rate for the entire group was 2%. The presence of SubcEmph was the only risk factor associated with the development of delayed PTX. Patients sustaining blunt chest

  3. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  4. Practical use of visual medial temporal lobe atrophy cut-off scores in Alzheimer's disease: Validation in a large memory clinic population

    International Nuclear Information System (INIS)

    Claus, Jules J.; Holl, Dana C.; Roorda, Jelmen J.; Staekenborg, Salka S.; Schuur, Jacqueline; Koster, Pieter; Tielkes, Caroline E.M.; Scheltens, Philip

    2017-01-01

    To provide age-specific medial temporal lobe atrophy (MTA) cut-off scores for routine clinical practice as marker for Alzheimer's disease (AD). Patients with AD (n = 832, mean age 81.8 years) were compared with patients with subjective cognitive impairment (n = 333, mean age 71.8 years) in a large single-centre memory clinic. Mean of right and left MTA scores was determined with visual rating (Scheltens scale) using CT (0, no atrophy to 4, severe atrophy). Relationships between age and MTA scores were analysed with regression analysis. For various MTA cut-off scores, decade-specific sensitivity and specificity and area under the curve (AUC) values, computed with receiver operator characteristic curves, were determined. MTA strongly increased with age in both groups to a similar degree. Optimal MTA cut-off values for the age ranges <65, 65-74, 75-84 and ≥85 were: ≥1.0, ≥1.5, ≥ 2.0 and ≥2.0. Corresponding values of sensitivity and specificity were 83.3% and 86.4%; 73.7% and 84.6%; 73.7% and 76.2%; and 84.0% and 62.5%. From this large unique memory clinic cohort we suggest decade-specific MTA cut-off scores for clinical use. After age 85 years, however, the practical usefulness of the MTA cut-off is limited. (orig.)

  5. Revisiting the Phadia/EliA cut-off values for anticardiolipin and anti-β2-glycoprotein I antibodies: a systematic evaluation according to the guidelines.

    Science.gov (United States)

    Bor, M V; Jacobsen, I-L Søtang; Gram, J B; Sidelmann, J J

    2018-01-01

    Background Phadia/EliA fluorescence enzyme immunoassays are widely used automated assays for anticardiolipin (aCL) and anti-β2-glycoprotein I (aβ2GPI) antibodies. To date, cut-off values for these assays have not been evaluated systematically and the evidence behind manufacturer's recommended cut-off values is not clear. Objective To determine Phadia/EliA cut-off values for antiphospholipid antibodies (aPL) according to the procedures suggested by guidelines. Methods A total of 266 blood donors (135 females and 131 males) were included. The pre-handling and analysis of the samples were performed according to the International Society on Thrombosis and Hemostasis (ISTH) guideline for solid phase aPL assays. Cut-off values and corresponding 90% confidence intervals (CI) for each antibody were established and outliers were handled according to the Clinical and Laboratory Standards Institute (CLSI) guideline for reference intervals. Samples from 377 consecutive patients, referred to our thrombophilia center with evidence of thrombosis or pregnancy morbidity were included for aPL testing. Results The in-house 99th (97.5th) percentile cut-off values were 11 (8.7), 12 (6.9) 8.5 (5.0) AU/mL for aβ2GPI IgG, IgM and IgA, and 21 (13) GPL-U/mL and 41 (25) MPL-U/mL for aCL IgG and IgM, respectively. The prevalence of positive results (%) defined by these cut-off values in patients with evidence of thrombosis or pregnancy morbidity was 9.5 (12.2), 1.6 (2.9), and 7.0 (9.9), and 0.8 (3.8) for aβ2GPI IgG, IgM, and aCL IgG and IgM respectively. The use of in-house 99th percentile cut-off values compared to the manufacturer suggested cut-off values resulted in 1 and 39 fewer samples for aβ2GPI and aCL to be classified as positive for aPL, respectively. Conclusions We present Phadia/EliA cut-off values with 90% CI for aPL determined systematically according to the ISTH and CLSI guidelines. These values are different from values previously determined, suggesting variation of a

  6. The assessment of anorexia in patients with cancer: cut-off values for the FAACT-A/CS and the VAS for appetite.

    Science.gov (United States)

    Blauwhoff-Buskermolen, S; Ruijgrok, C; Ostelo, R W; de Vet, H C W; Verheul, H M W; de van der Schueren, M A E; Langius, J A E

    2016-02-01

    Anorexia is a frequently observed symptom in patients with cancer and is associated with limited food intake and decreased quality of life. Diagnostic instruments such as the Anorexia/Cachexia Subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire and the visual analog scale (VAS) for appetite have been recommended in the assessment of anorexia, but validated cut-off values are lacking. This study aimed to obtain cut-off values of these instruments for the assessment of anorexia in patients with cancer. The FAACT-A/CS and the VAS for appetite were administered to patients with cancer before start of chemotherapy. As reference standard for anorexia, two external criteria were used: (1) a cut-off value of ≥2 on the anorexia symptom scale of the EORTC QLQ C-30 and (2) the question "Do you experience a decreased appetite?" (yes/no). ROC curves were used to examine the optimal cut-off values for the FAACT-A/CS and VAS. A total of 273 patients (58 % male; 64.0 ± 10.6 years) were included. The median score on the FAACT-A/CS was 38 (IQR 32-42) points and 77 (IQR 47-93) points on the VAS. Considering both external criteria, the optimal cut-off value for the FAACT-A/CS was ≤37 (sensitivity (se) 80 %, specificity (sp) 81 %, positive predictive value (PV(+)) 79 %, negative predictive value (PV(-)) 82 %) and for the VAS was ≤70 (se 76 %, sp 83 %, PV(+) 80 %, PV(-) 79 %). For the assessment of anorexia in patients with cancer, our study suggests cut-off values of ≤37 for the FAACT-A/CS and ≤70 for the VAS. Future studies should confirm our findings in other patient samples.

  7. Cut-Off Levels of Anti-Mullerian Hormone for The Prediction of Ovarian Response, In Vitro Fertilization Outcome and Ovarian Hyperstimulation Syndrome

    Directory of Open Access Journals (Sweden)

    Ali Salmassi

    2015-07-01

    Full Text Available Background: Evaluation of anti-mullerian hormone (AMH cut-off levels in assisted reproductive technology (ART as predictive factor for individualization of stimulation protocols and to avoid ovarian hyperstimulation syndrome (OHSS. Materials and Methods: In a retrospective study, 177 infertile patients were assessed for AMH in serum and follicular fluid (FF on the day of follicular puncture (FP, between 2012 and 2013 in Kiel, Germany. AMH levels and pregnancy rates were compared between low, moderate and high responders and cut-off levels of low and high responders. AMH cut-off levels in pathological cases were evaluated in analysis 1 (OHSS and in analysis 2 [polycystic ovarian syndrome, (PCOS] and compared in analysis 3 to normal endocrinological parameters. Results: AMH levels in FF were higher than in serum (P<0.001. AMH levels in serum and FF increased from low through moderate to high responders (P<0.001. Pregnancy rates were 14.7, 23.3 and 44.9% (P=0.009, respectively. AMH cut-off level for poor responders was 0.61 ng/ml in serum with a pregnancy rate of 13.8 and 37.1% for below and above of this level, respectively. For FF, it was 1.43 ng/ml. AMH levels in analysis 1 and 2 were significantly higher than in analysis 3 (P=0.001. AMH cut-off level for OHSS was 1.5 ng/ml in serum with OHSS rates of 80.8 and 19.2 % for above and below of the level, respectively. For FF, it was 2.7 ng/ml. PCOS patients had an AMH cut-off level of 3.9 ng/ml in serum and 6.8 ng/ml in FF, resulting in a PCOS rate of 100% above this level. Conclusion: AMH levels can help to assess ovarian response potential and guide ovarian stimulation while avoiding OHSS.

  8. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

  9. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

  10. Cutting through - open entries require proper support

    Energy Technology Data Exchange (ETDEWEB)

    Peng, S.S. [West Virginia University, Morgantown, WV (USA). Mining Engineering Dept.

    2000-06-01

    The paper explains the applications of open entries in mining and different roof techniques to relieve longwall abutment pressures. The primary support for the open (or cut-through) entries and recovery rooms are normally similar to other development entries in the same mines. The supplementary supports installed can be divided into the following three types: complete backfill of open entries, supplemental roof and/or rib-bolt reinforcement only - no standing support and rows of standing support with or without supplemental roof and/or rib-bolt reinforcement. 3 figs.

  11. Sinus cut-off sign: A helpful sign in the CT diagnosis of diaphragmatic rupture associated with pleural effusion

    International Nuclear Information System (INIS)

    Kaya, Seyda Ors; Karabulut, Nevzat; Yuncu, Gokhan; Sevinc, Serpil; Kiroglu, Yilmaz

    2006-01-01

    The objective of our study was to describe the 'sinus cut-off' sign at CT in the diagnosis of diaphragmatic rupture in patients with blunt abdominal trauma complicated with pleural effusion, and evaluate its utility in an experimental model. Between January 2004 and March 2005, we observed an unusual interruption of costophrenic sinus at CT in three patients with blunt abdominal trauma accompanied with pleural effusion. This observation prompted us to evaluate the utility of this sign in an experimental model. Laparotomically, we created 2 cm diapragmatic lacerations at each hemidiaphragm in two rabbits and pushed up the abdominal viscera with omentum through the defect. To simulate hemothorax, we also injected 5-10 mL of diluted contrast material into the pleural space. Using a dual-slice helical CT scanner, limited thoracoabdominal CT examination was performed before and after injection of intrapleural contrast material. The images were analyzed for the presence of CT signs for diaphragmatic injury. The left posterior costophrenic sulcus was interrupted in all of the three patients with left pleural effusion. While it was associated with other findings of diaphragmatic injury, the 'sinus cut-off sign' was the sole finding in one patient. The sinus cut-off sign was observed on the CT scans of 100% of the rabbits with a left and right sided diaphragmatic rupture. The 'sinus cut-off sign' is useful and can increase the CT detection of acute diaphragmatic injury associated with pleural effusion

  12. Push-out tests and evaluation of FRP perfobond rib shear connectors performance

    Science.gov (United States)

    Kolpasky, Ludvik; Ryjacek, Pavel

    2017-09-01

    The behavioural characteristics of FRP (fibre-reinforced polymer) perfobond rib shear connector was examined through push-out tests in order to verify the applicability for pedestrian bridge structure. The aim of this study is to determine interaction between high performance concrete slab and handmade FRP plate which represent web of the composite beam. Combination of these modern materials leads to structural system with both great load bearing capacity and also sufficient flexural stiffness of the composite element. Openings cut into the GFRP plate at a variable spacing allow GFRP reinforcement bars to be inserted to act as shear studs. Hand lay-up process can increase suitable properties of FRP for connection by perfobond rib shear connectors. In this study, three push-out tests on fiber-reinforced polymer were performed to investigate their shear behaviour. The results of the push-out tests on FRP perfobond rib shear connector indicates great promise for application in full scale structures.

  13. Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study.

    Science.gov (United States)

    Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

    2013-01-24

    To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Prevalence of smoking during pregnancy in Spain remains high. UC is a reliable biomarker for classifying

  14. Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study

    Science.gov (United States)

    Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

    2013-01-01

    Objectives To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. Design We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. Participants At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Results Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Conclusions Prevalence of smoking during pregnancy in

  15. Phase- and size-adjusted CT cut-off for differentiating neoplastic lesions from normal colon in contrast-enhanced CT colonography

    International Nuclear Information System (INIS)

    Luboldt, W.; Kroll, M.; Wetter, A.; Vogl, T.J.; Toussaint, T.L.; Hoepffner, N.; Holzer, K.; Kluge, A.

    2004-01-01

    A computed tomography (CT) cut-off for differentiating neoplastic lesions (polyps/carcinoma) from normal colon in contrast-enhanced CT colonography (CTC) relating to the contrast phase and lesion size is determined. CT values of 64 colonic lesions (27 polyps 0 . The slope m was determined by linear regression in the correlation (lesion ∝[xA + (1 - x)V]//H) and the Y-intercept y 0 by the minimal shift of the line needed to maximize the accuracy of separating the colonic wall from the lesions. The CT value of the lesions correlated best with the intermediate phase: 0.4A+ 0.6V(r=0.8 for polyps ≥10 mm, r=0.6 for carcinomas, r=0.4 for polyps <10 mm). The accuracy in the differentiation between lesions and normal colonic wall increased with the height implemented as divisor, reached 91% and was obtained by the dynamic cut-off described by the formula: cut-off(A,V,H) = 1.1[0.4A + 0.6V]/H + 69.8. The CT value of colonic polyps or carcinomas can be increased extrinsically by scanning in the phase in which 0.4A + 0.6V reaches its maximum. Differentiating lesions from normal colon based on CT values is possible in contrast-enhanced CTC and improves when the cut-off is adjusted (normalized) to the contrast phase and lesion size. (orig.)

  16. Sonography of occult rib and costal cartilage fractures: a case series.

    Science.gov (United States)

    Mattox, Ross; Reckelhoff, Kenneth E; Welk, Aaron B; Kettner, Norman W

    2014-06-01

    The purpose of this case series is to describe the use of diagnostic ultrasound (US) in the detection of occult rib and costal cartilage fractures presenting as chest wall pain to a chiropractic clinic. Three patients presented with chest wall pain and tenderness. Two of the patients presented with acute chest wall injury and 1 carried a previous diagnosis of rib fracture after trivial trauma 2 months earlier. Diagnostic US was selected as a non-ionizing imaging tool for these patients after negative digital radiography studies. All fractures were considered isolated as there was no associated injury, such as pneumothorax. Both of the acute cases were followed up to complete healing (evidence of osseous union) using US. All patients eventually achieved pain-free status. In these cases, US was more sensitive than radiography for diagnosing these cases of acute rib and costal cartilage fractures. Early recognition of rib injury could avoid potential complications from local manipulative therapy.

  17. Cut-off value of body fat in association with metabolic syndrome in Thai peri- and postmenopausal women.

    Science.gov (United States)

    Bintvihok, W; Chaikittisilpa, S; Panyakamlerd, K; Jaisamrarn, U; Taechakraichana, N

    2013-06-01

    Pathophysiologic changes during the menopause transition may contribute to the risk of metabolic syndrome (MetS). Body fat composition, particularly visceral fat, is highly associated with increased insulin resistance, abnormal carbohydrate metabolism and high blood pressure. We purposefully wished to determine the optimal cut-off values of body fat composition, including visceral fat, in order to predict MetS and to assess the prevalence of MetS in peri- and postmenopausal women. This cross-sectional study was conducted in a population-based, prospective cohort at the Menopause and Gynecology clinics, King Chulalongkorn Memorial Hospital. Body fat percentage and visceral fat rating were measured by a bioelectrical impedance analyzer (Tanita SC 330). MetS was diagnosed using the Harmonizing criteria of A Joint Interim Statement of IDF/NHLBI/AHA/WHF/IAS/IASO 2009. Receiver operating characteristic analyses were performed to determine the optimal cut-off values of body fat, visceral fat, waist circumference and body mass index to identify peri- and postmenopausal women at risk of MetS. Ninety-two perimenopausal and 446 postmenopausal women aged 40-60 years were recruited for the analyses. The optimal cut-off values for body fat percentage, visceral fat rating, waist circumference and body mass index for identifying women at risk of MetS were 34%, 7, 88 cm and 24 kg/m(2), respectively. The prevalence of MetS in this study was 27.9%. The optimal cut-off values to predict MetS of body fat percentage, visceral fat and waist circumference were established. Using the Harmonizing 2009 criteria, we found that approximately one out of four peri- and postmenopausal women in this study had MetS.

  18. Breaking Through the Multi-Mesa-Channel Width Limited of Normally Off GaN HEMTs Through Modulation of the Via-Hole-Length.

    Science.gov (United States)

    Chien, Cheng-Yen; Wu, Wen-Hsin; You, Yao-Hong; Lin, Jun-Huei; Lee, Chia-Yu; Hsu, Wen-Ching; Kuan, Chieh-Hsiung; Lin, Ray-Ming

    2017-12-01

    We present new normally off GaN high-electron-mobility transistors (HEMTs) that overcome the typical limitations in multi-mesa-channel (MMC) width through modulation of the via-hole-length to regulate the charge neutrality screen effect. We have prepared enhancement-mode (E-mode) GaN HEMTs having widths of up to 300 nm, based on an enhanced surface pinning effect. E-mode GaN HEMTs having MMC structures and widths as well as via-hole-lengths of 100 nm/2 μm and 300 nm/6 μm, respectively, exhibited positive threshold voltages (V th ) of 0.79 and 0.46 V, respectively. The on-resistances of the MMC and via-hole-length structures were lower than those of typical tri-gate nanoribbon GaN HEMTs. In addition, the devices not only achieved the E-mode but also improved the power performance of the GaN HEMTs and effectively mitigated the device thermal effect. We controlled the via-hole-length sidewall surface pinning effect to obtain the E-mode GaN HEMTs. Our findings suggest that via-hole-length normally off GaN HEMTs have great potential for use in next-generation power electronics.

  19. A specially designed cut-off gamma camera for high resolution SPECT of the brain

    International Nuclear Information System (INIS)

    Larsson, S.A.; Bergstrand, G.; Bergstedt, H.; Berg, J.; Flygare, O.; Schnell, P.O.; Anderson, N.; Lagergren, C.

    1984-01-01

    A modern gamma camera system for Single Photon Emission Computed Tomography (SPECT) has been modified in order to optimize examinations of the head. By cutting off a part of the detector housing at one edge, it has been possible to rotate the camera close to the skull, still covering the entire brain and the skull base. The minimum radius of rotation used was thereby reduced, in the mean, from 21.2 cm to 13.0 cm in examination of 18 patients. In combination with an adjustment of the 64 x 64 acquisition matrix to a field of view of 26x26 cm/sup 2/, the spatial resolution improved from 18.6 mm (FWHM) to 12.6 +- 0.3 mm (FWHM) using the conventional LEGP-collimator and to 10.4 +- 0.3 mm (FWHM) using the LEHR-collimator. No other modification than a slight cut of the light guide was made in the internal construction of the camera. Thus, the physical properties of the detector head are not essentially changed from those of a non-modified unit. The improved spatial resolution of the cut-off camera SPECT-system implies certain clinical advantages in studies of the brain, the cerebrospinal fluid (CSF)-space and the skull base

  20. Suggested cut-off values for vitamin D as a risk marker for total and cardiac death in patients with suspected acute coronary syndrome

    Directory of Open Access Journals (Sweden)

    Patrycja Anna Naesgaard

    2016-02-01

    Full Text Available Background: Several studies have demonstrated an association between low vitamin D levels and cardiovascular risk. Vitamin D cut off levels are still under debate. Objectives: To assess two cut-off levels, 40 nmol/L and 70 nmol/L, respectively, for vitamin D measured as 25-hydroxyvitamin D [25(OHD] in chest pain patients with suspected acute coronary syndrome.Methods: We investigated 1853 patients from coastal-Norway and inland Northern-Argentina. A similar database was used for pooling of data. 2-year follow-up data including all-cause mortality, cardiac death and sudden cardiac death in the total patient population were analyzed, applying univariate and multivariable analysis. Results: 255 patients with known vitamin D concentrations died. In the multivariable analysis, there was a decrease in total mortality above a cut-off level of 40 nmol/L and a decrease in cardiac death above a cut-off level of 70 nmol/L, [HRs of 0.66 (95% CI, 0.50 – 0.88, p = 0.004 and 0.46 (95% CI, 0.22 – 0.94, p = 0.034, respectively].Conclusion: Vitamin D cut-off levels of 40 nmol/L and 70 nmol/L, were related to total mortality and cardiac death, respectively.

  1. Effect of Aspect Ratio, Channel Orientation, Rib Pitch-to-Height Ratio, and Number of Ribbed Walls on Pressure Drop Characteristics in a Rotating Channel with Detached Ribs

    Directory of Open Access Journals (Sweden)

    K. Arun

    2007-01-01

    Full Text Available The present work involves experimental investigation of the effects of aspect ratio, channel orientation angle, rib pitch-to-height ratio (P/e, and number of ribbed walls on friction factor in orthogonally rotating channel with detached ribs. The ribs are separated from the base wall to provide a small region of flow between the base wall and the ribs. Experiments have been conducted at Reynolds number ranging from 10000–17000 with rotation numbers varying from 0–0.38. Pitch-to-rib height ratios (P/e of 5 and 10 at constant rib height-to-hydraulic diameter ratio (e/D of 0.1 and a clearance ratio (C/e of 0.38 are considered. The rib angle of attack with respect to mainstream flow is 90∘. The channel orientation at which the ribbed wall becomes trailing surface (pressure side on which the Coriolis force acts is considered as the 0∘ orientation angle. For one-wall ribbed case, channel is oriented from 0∘ to 180∘ about its axis in steps of 30∘ to change the orientation angle. For two-wall ribbed case, the orientation angle is changed from 0∘ to 90∘ in steps of 30∘. Friction factors for the detached ribbed channels are compared with the corresponding attached ribbed channel. It is found that in one-wall detached ribbed channel, increase in the friction factor ratio with the orientation angle is lower for rectangular channel compared to that of square channel for both the pitch-to-rib height ratios of 5 and 10 at a given Reynolds number and rotation number. Friction factor ratios of two-wall detached ribbed rectangular channel are comparable with corresponding two-wall detached ribbed square channel both under stationary and rotating conditions.

  2. Refining Game Addiction Questionnairs: Evidence for a natural cut-off point?

    OpenAIRE

    Nielsen, Rune Kristian

    2013-01-01

    This paper presents data from a pilot study, which was designed to illuminate critical flaws in the currently used instruments used to measure the prevalence of ‘computer game addiction’. The study found that the prevalence rate could be set anywhere between 23% and 0,6% depending on how the data set is scored. Thus demonstrating how an arbitrarily set of cut-off point in prevalence studies can yield wildly varying prevalence rates. The data further show that making implicit assumptions about...

  3. Addenbrooke's Cognitive Examination and Individual Domain Cut-Off Scores for Discriminating between Different Cognitive Subtypes of Parkinson's Disease.

    Science.gov (United States)

    Berankova, Dagmar; Janousova, Eva; Mrackova, Martina; Eliasova, Ilona; Kostalova, Milena; Skutilova, Svetlana; Rektorova, Irena

    2015-01-01

    Objective. The main aim of this study was to verify the sensitivity and specificity of Addenbrooke's Cognitive Examination-Revised (ACE-R) in discriminating between Parkinson's disease (PD) with normal cognition (PD-NC) and PD with mild cognitive impairment (PD-MCI) and between PD-MCI and PD with dementia (PD-D). We also evaluated how ACE-R correlates with neuropsychological cognitive tests in PD. Methods. We examined three age-matched groups of PD patients diagnosed according to the Movement Disorder Society Task Force criteria: PD-NC, PD-MCI, and PD-D. ROC analysis was used to establish specific cut-off scores of ACE-R and its domains. Correlation analyses were performed between ACE-R and its subtests with relevant neuropsychological tests. Results. Statistically significant differences between groups were demonstrated in global ACE-R scores and subscores, except in the language domain. ACE-R cut-off score of 88.5 points discriminated best between PD-MCI and PD-NC (sensitivity 0.68, specificity 0.91); ACE-R of 82.5 points distinguished best between PD-MCI and PD-D (sensitivity 0.70, specificity 0.73). The verbal fluency domain of ACE-R demonstrated the best discrimination between PD-NC and PD-MCI (cut-off score 11.5; sensitivity 0.70, specificity 0.73) while the orientation/attention subscore was best between PD-MCI and PD-D (cut-off score 15.5; sensitivity 0.90, specificity 0.97). ACE-R scores except for ACE-R language correlated with specific cognitive tests of interest.

  4. Finite GUE Distribution with Cut-Off at a Shock

    Science.gov (United States)

    Ferrari, P. L.

    2018-03-01

    We consider the totally asymmetric simple exclusion process with initial conditions generating a shock. The fluctuations of particle positions are asymptotically governed by the randomness around the two characteristic lines joining at the shock. Unlike in previous papers, we describe the correlation in space-time without employing the mapping to the last passage percolation, which fails to exists already for the partially asymmetric model. We then consider a special case, where the asymptotic distribution is a cut-off of the distribution of the largest eigenvalue of a finite GUE matrix. Finally we discuss the strength of the probabilistic and physically motivated approach and compare it with the mathematical difficulties of a direct computation.

  5. Atraumatic First Rib Fracture

    OpenAIRE

    Koray Aydogdu

    2014-01-01

    Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  6. [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins under epidural anesthesia].

    Science.gov (United States)

    Liu, Jinliang; Li, Keyao; Ju, Zhenlong; Bai, Yan

    2011-03-01

    To study the indications, methods and experience of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. 52 cases with multiple rib fractures were performed internal fixation with absorbable rib-connecting-pins under epidural anesthesia. All cases were followed up for 1 to 12 months, with an average of 5 months. All fractures were achieved healing in 3 to 6 months after the operation and were not found chest wall deformity. Absorbable rib-connecting-pins fixation is a simple and effective method and worthies recommending to perform operation for the appropriate cases with multiple rib fractures.

  7. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  8. Adiposity cut-off points for cardiovascular disease and diabetes risk in the Portuguese population: The PORMETS study

    Science.gov (United States)

    Severo, Milton; Santos, Ana Cristina

    2018-01-01

    Objectives The contribution of adiposity to cardiovascular and diabetes risk justifies the inclusion of an adiposity measure, usually waist circumference, in the definition of metabolic syndrome. However, waist circumference thresholds differ across populations. Our aim was to assess which adiposity measure performs the best in identifying the metabolic syndrome in a sample of Portuguese participants and to estimate cut-off values for these measures. Methods Data were obtained from a cross-sectional study (PORMETS study) conducted in Portugal between 2007 and 2009. A representative sample of non-institutionalized adults, comprising 3,956 participants, aged 18 years and older, was evaluated. A structured questionnaire was administered, collecting information on personal medical history, socio-demographics and behavioral characteristics. Anthropometrics, blood pressure and venous blood samples were also obtained. Metabolic syndrome was defined according to the Joint Interim Statement of the International Diabetes Federation Task Force on Epidemiology recommended criteria. Elevated cardiometabolic risk was considered when two or more of the four criteria of metabolic syndrome were present, excluding the waist circumference component. A receiver operating characteristic curve was used to estimate cut-off points. Results This study found that waist-to-height ratio, waist circumference and body adiposity index performed better than other adiposity measures, such as body mass index. The estimated cut-off points for waist-to-height ratio, waist circumference and body adiposity index in women and men were 0.564 / 89 cm / 27.4 and 0.571 / 93.5 cm / 25.5, respectively. Conclusion As waist circumference is currently used as the adiposity measure in the definition of metabolic syndrome and as no relevant differences were observed between this measure and waist-to-height ratio, it is likely that no modification to the metabolic syndrome definition needs to be proposed. Moreover

  9. Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation.

    Directory of Open Access Journals (Sweden)

    Parisa Azimi

    Full Text Available Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH. This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC. The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24-35. Post-surgical success was 79.9% (n = 123 at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6, 5.4 (SD = 1.9 and 6.5 (SD = 1.7, respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703-0.926. This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice.

  10. Spontaneous rib fractures.

    Science.gov (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber

    2015-07-01

    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  11. The cut-off values of anthropometric variables for predicting mild cognitive impairment in Malaysian older adults: a large population based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Won H

    2017-02-01

    Full Text Available Huiloo Won,1 Zahara Abdul Manaf,2 Arimi Fitri Mat Ludin,3 Mohd Azahadi Omar,4 Rosdinom Razali,5 Suzana Shahar2 1Nutrition Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 2Dietetics Program, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 3Biomedical Science Program, School of Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 4Centre for Burden of Disease Research, Institute for Public Health, Ministry of Health Malaysia, 5Department of Psychiatry, Faculty of Medicine, Hospital Canselor Tuanku Muhriz, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia Purpose: Older adults are at risk of mild cognitive impairment (MCI, and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI and waist circumference (WC for predicting the risk of MCI in older Malaysian adults.Methods: A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis.Results: A BMI cut-off value of 26 kg/m2 (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8% was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8% for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7% for women. The optimum calf circumference (CC cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity

  12. 36 CFR 7.39 - Mesa Verde National Park.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Mesa Verde National Park. 7... SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.39 Mesa Verde National Park. (a) Visiting of... the admission of commercial automobiles and buses to Mesa Verde National Park, contained in § 5.4 of...

  13. Rib fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000539.htm Rib fracture - aftercare To use the sharing features on this page, please enable JavaScript. A rib fracture is a crack or break in one or ...

  14. Practical use of visual medial temporal lobe atrophy cut-off scores in Alzheimer's disease: Validation in a large memory clinic population

    Energy Technology Data Exchange (ETDEWEB)

    Claus, Jules J.; Holl, Dana C.; Roorda, Jelmen J. [Tergooi Hospital, Department of Neurology, Blaricum (Netherlands); Staekenborg, Salka S. [Tergooi Hospital, Department of Neurology, Blaricum (Netherlands); VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam (Netherlands); Schuur, Jacqueline [Tergooi Hospital, Department of Geriatrics, Blaricum (Netherlands); Koster, Pieter [Tergooi Hospital, Department of Radiology, Blaricum (Netherlands); Tielkes, Caroline E.M. [Tergooi Hospital, Department of Medical Psychology, Blaricum (Netherlands); Scheltens, Philip [VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam (Netherlands)

    2017-08-15

    To provide age-specific medial temporal lobe atrophy (MTA) cut-off scores for routine clinical practice as marker for Alzheimer's disease (AD). Patients with AD (n = 832, mean age 81.8 years) were compared with patients with subjective cognitive impairment (n = 333, mean age 71.8 years) in a large single-centre memory clinic. Mean of right and left MTA scores was determined with visual rating (Scheltens scale) using CT (0, no atrophy to 4, severe atrophy). Relationships between age and MTA scores were analysed with regression analysis. For various MTA cut-off scores, decade-specific sensitivity and specificity and area under the curve (AUC) values, computed with receiver operator characteristic curves, were determined. MTA strongly increased with age in both groups to a similar degree. Optimal MTA cut-off values for the age ranges <65, 65-74, 75-84 and ≥85 were: ≥1.0, ≥1.5, ≥ 2.0 and ≥2.0. Corresponding values of sensitivity and specificity were 83.3% and 86.4%; 73.7% and 84.6%; 73.7% and 76.2%; and 84.0% and 62.5%. From this large unique memory clinic cohort we suggest decade-specific MTA cut-off scores for clinical use. After age 85 years, however, the practical usefulness of the MTA cut-off is limited. (orig.)

  15. Insulin resistance in obese children and adolescents: HOMA-IR cut-off levels in the prepubertal and pubertal periods.

    Science.gov (United States)

    Kurtoğlu, Selim; Hatipoğlu, Nihal; Mazıcıoğlu, Mümtaz; Kendirici, Mustafa; Keskin, Mehmet; Kondolot, Meda

    2010-01-01

    Childhood obesity is associated with an increased risk for insulin resistance. The underlying mechanism for the physiological increase in insulin levels in puberty is not clearly understood. The aim of the present study was to determine the cut-off values for homeostasis model assessment for insulin resistance (HOMA-IR) in obese children and adolescents according to gender and pubertal status. Two hundred and eight obese children and adolescents (141 girls, 127 boys) aged between 5 and 18 years were included in the study. The children were divided into prepubertal and pubertal groups. A standard oral glucose tolerance test (OGTT) was carried out in all children. A total insulin level exceeding 300 μU/mL in the blood samples, collected during the test period, was taken as the insulin resistance criterion. Cut-off values for HOMA-IR were calculated by receiver operating characteristic (ROC) analysis. In the prepubertal period, the rate of insulin resistance was found to be 37% in boys and 27.8% in girls,while in the pubertal period, this rate was 61.7% in boys and 66.7% in girls. HOMA-IR cut-off values for insulin resistance in the prepubertal period were calculated to be 2.67 (sensitivity 88.2%, specificity 65.5%) in boys and 2.22 (sensitivity 100%, specificity 42.3%) in girls, and in the pubertal period, they were 5.22 (sensitivity 56%, specificity 93.3%) in boys and 3.82 (sensitivity 77.1%, specificity 71.4%) in girls. Since gender, obesity and pubertal status are factors affecting insulin resistance, cut-off values which depend on gender and pubertal status, should be used in evaluation of insulin resistance.

  16. Putative Dementia Cases Fluctuate as a Function of Mini-Mental State Examination Cut-Off Points.

    Science.gov (United States)

    Rosa, Ilka M; Henriques, Ana G; Wiltfang, Jens; da Cruz E Silva, Odete A B

    2018-01-01

    As the population ages, there is a growing need to quickly and accurately identify putative dementia cases. Many cognitive tests are available; among those commonly used are the Cognitive Dementia Rating (CDR) and the Mini-Mental Status Examination (MMSE). The aim of this work was to compare the validity and reliability of these cognitive tests in a primary care based cohort (pcb-Cohort). The MMSE and the CDR were applied to 568 volunteers in the pcb-Cohort. Distinct cut-off points for the MMSE were considered, namely MMSE 27, MMSE 24, and MMSE PT (adapted for the Portuguese population). The MMSE 27 identified the greatest number of putative dementia cases, and, as determined by the ROC curve, it was the most sensitive and specific of the MMSE cut-offs considered. Putative predictive or risk factors identified included age, literacy, depression, and diabetes mellitus (DM). DM has previously been indicated as a risk factor for dementia and Alzheimer's disease. Comparatively, the MMSE 27 cut-off has the greatest sensibility (94.9%) and specificity (66.3%) when compared to MMSE PT and MMSE 24. Upon comparing MMSE and CDR scores, the latter identified a further 146 putative dementia cases, thus permitting one to propose that in an ideal situation, both tests should be employed. This increases the likelihood of identifying putative dementia cases for subsequent follow up work, thus these cognitive tests represent important tools in patient care. Further, this is a significant study for Portuguese populations, where few of these studies have been carried out.

  17. Use of cut-off values as meaningfulness limits in probabilistic studies and its effect on NPPs risk assessment and safety improvement

    International Nuclear Information System (INIS)

    Petrangeli, G.; Valeri, A.; Zaffiro, C.

    1991-01-01

    This paper discusses the use of cut-off values in probabilistic risk assessment/probabilistic safety assessment (PRA/PSA) of nuclear power plants (NPPs), in order to explore under which conditions this practice may help improve the meaningfulness of the results of the analyses and safety of plants, and how it may affect the assessment of risk. Reference is made, in particular, to some past practical applications, also taken from the experience of the authors within the frame of the Italian licensing process. The paper describes the Italian probabilistic criteria which use probabilistic targets and cut-off values to assess safety and identify plant safety improvements. The rationale of the approach is also discussed in the paper and results of sample applications are illustrated. The paper concludes that the use of cut-off values, if properly implemented, could be productive to improve the plant safety as it helps the analyst to focus on a restricted field of analysis, ignoring lower probability and less known events. It also points out that cut-off values should be considered as living numbers to be lowered and even eliminated as soon as significant advancements are made, through research and operational experience, in the knowledge of the pertinent events

  18. Ribbing disease

    International Nuclear Information System (INIS)

    Mukkada, Philson J; Franklin, Teenu; Rajeswaran, Rangasami; Joseph, Santhosh

    2010-01-01

    Ribbing disease is a rare sclerosing dysplasia that involves long tubular bones, especially the tibia and femur. It occurs after puberty and is reported to be more common in women. In this article we describe how Ribbing disease can be differentiated from diseases like Engelmann-Camurati disease, van Buchem disease, Erdheim-Chester disease, osteoid osteoma, chronic osteomyelitis, stress fracture, etc

  19. The Potential of Established Fitness Cut-off Points for Monitoring Women with Fibromyalgia: The al-Ándalus Project.

    Science.gov (United States)

    Castro-Piñero, José; Aparicio, Virginia A; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Borges-Cosic, Milkana; Soriano-Maldonado, Alberto; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

    2017-05-01

    The aim of the present study was to determinate whether fitness cut-off points discriminate the severity of major fibromyalgia symptoms and health-related quality of life. Additionally, we investigated which American Colleague of Rheumatology (ACR) fibromyalgia criteria (1990 vs. modified 2010) better discriminate fibromyalgia symptomatology. A total of 488 women with fibromyalgia and 200 non-fibromyalgia (control) women participated. All participants underwent both the 1990 and the modified 2010 ACR preliminary criteria (hereinafter 1990c and m-2010c, respectively). We used fitness cut-off points (Senior Fitness Tests Battery plus handgrip strength test) to discriminate between presence and absence of fibromyalgia. Additionally, we employed several instruments to assess fibromyalgia symptoms. Fitness cut-off points discriminated between high and low levels of the main symptoms the disease in all age groups (P from fibromyalgia diagnosis and monitoring. Moreover, the effect size of the differences in symptoms between women with fibromyalgia and controls were overall larger using the m-2010c compared with the 1990c, except for the tender points count, reflecting better the polysymptomatic distress condition of fibromyalgia. © Georg Thieme Verlag KG Stuttgart · New York.

  20. Physical and cut-off effects of heavy sea quarks

    CERN Document Server

    Knechtli, Francesco; Bruno, Mattia; Finkenrath, Jacob; Leder, Björn; Marinkovic, Marina; Sommer, Rainer

    2014-01-01

    We simulate a theory with two dynamical O($a$) improved Wilson quarks whose mass $M$ ranges from a factor eight up to a factor two below the charm quark mass and at three values of the lattice spacing ranging from 0.066 to 0.034 fm. This theory is a prototype to study the decoupling of heavy quarks. We measure the mass and cut-off dependence of ratios of gluonic observables defined from the Wilson flow or the static potential. The size of the 1/$M$ corrections can be determined and disentangled from the lattice artifacts. The difference with the pure gauge theory is at the percent level when two quarks with a mass of the charm quark are present.

  1. [Internal fixation treatment of multiple rib fractures with absorbable rib-connecting-pins].

    Science.gov (United States)

    Liu, Jinliang; Li, Keyao; He, Jianning

    2011-01-01

    To study the indications, methods, and therapeutic effect of absorbable rib-connecting-pins fixation in the treatment of multiple rib fractures. Between March 2007 and September 2009, 40 patients with multiple rib fractures received internal fixation with absorbable rib-connecting-pins, including 8 one-side flail chest and 1 two-side flail chest. There were 32 males and 8 females with an average age of 39.8 years (range, 25-72 years). The injury was caused by traffic accident in 32 cases, falling from height in 6 cases, and blunt hitting in 2 cases. Preoperatively, imaging data of the chest X-ray or spiral CT three-dimensional (3D) examination showed that all patients had multiple ribs fractures and displacement. The number of fractured ribs was 4-10 (median, 6), and the fracture location ranged from the 2nd to the 10th ribs. Of them, 28 cases were accompanied by hemathorax, pneumothorax or hemopneumothorax; 5 cases by thoracic organ injury; and 10 cases by other part trauma. The time from injury to hospitalization was less than 1 day in 26 cases, 1-3 days in 12 cases, and 3-6 days in 2 cases, and the time from hospitalization to operation was 3 hours to 3 days (mean, 1.2 days). The median fixation rib number was 5 (range, 3-8). The mean operative time, the time in bed, and hospitalization days were 32 minutes (range, 15-50 minutes), 4.5 days (range, 2-7 days), and 11.2 days (range, 5-18 days), respectively. All incisions healed by first intention. No pulmonary infection, pulmonary atelectasis, intrathoracic infection or other complications occurred. All cases were followed up 6-12 months (mean, 8 months). PaO2 [(86.6 +/- 2.2) mmHg (1 mm Hg = 0.133 kPa)] and SpO2 (97.2% +/- 0.6%) at 2 hours after operation were obviously improved when compared with preoperative ones (PaO2 (53.6 + 4.7) mm Hg and SpO2 (86.2% + 1.8%)], showing significant differences (t = 2.971, P = 0.005; t = 2.426, P = 0.020). The chest X-ray films or spiral CT 3D indicated that fracture of rib

  2. Attenuation bands and cut-off frequencies for ELF electromagnetic waves

    International Nuclear Information System (INIS)

    Rauch, J.L.; Lefeuvre, F.; Cerisier, J.C.; Berthelier, J.J.; Boud'ko, N.; Michailova, G.; Kapustina, O.

    1985-01-01

    The propagation characteristic of ELF (10 Hz - 1500 Hz) electromagnetic waves observed on ARCAD 3, in three different zones: low L value (L 6). Unambiguous determinations of the wave normal directions are obtained from the interpretations of the measurements of four (3 magnetic, 1 electric) wave field components. The technique that is used, is based on the Means method in the cases of highly polarized waves and on the Storey and Lefeuvre WDF method in the other cases. A particular emphasis is put on the propagation characteristics of the waves, in a multiple ion plasma, and on the cut-off frequencies which appear at and below the local proton gyrofrequency

  3. Flocking of the Motsch-Tadmor Model with a Cut-Off Interaction Function

    Science.gov (United States)

    Jin, Chunyin

    2018-04-01

    In this paper, we study the flocking behavior of the Motsch-Tadmor model with a cut-off interaction function. Our analysis shows that connectedness is important for flocking of this kind of model. Fortunately, we get a sufficient condition imposed only on the model parameters and initial data to guarantee the connectedness of the neighbor graph associated with the system. Then we present a theoretical analysis for flocking, and show that the system achieves consensus at an exponential rate.

  4. Scanning tunnelling microscope light emission: Finite temperature current noise and over cut-off emission.

    Science.gov (United States)

    Kalathingal, Vijith; Dawson, Paul; Mitra, J

    2017-06-14

    The spectral distribution of light emitted from a scanning tunnelling microscope junction not only bears its intrinsic plasmonic signature but is also imprinted with the characteristics of optical frequency fluc- tuations of the tunnel current. Experimental spectra from gold-gold tunnel junctions are presented that show a strong bias (V b ) dependence, curiously with emission at energies higher than the quantum cut-off (eV b ); a component that decays monotonically with increasing bias. The spectral evolution is explained by developing a theoretical model for the power spectral density of tunnel current fluctuations, incorporating finite temperature contribution through consideration of the quantum transport in the system. Notably, the observed decay of the over cut-off emission is found to be critically associated with, and well explained in terms of the variation in junction conductance with V b . The investigation highlights the scope of plasmon-mediated light emission as a unique probe of high frequency fluctuations in electronic systems that are fundamental to the electrical generation and control of plasmons.

  5. Waist circumference cut-off values to predict the incidence of hypertension: an estimation from a Brazilian population-based cohort.

    Science.gov (United States)

    Gus, M; Cichelero, F Tremea; Moreira, C Medaglia; Escobar, G Fortes; Moreira, L Beltrami; Wiehe, M; Fuchs, S Costa; Fuchs, F Danni

    2009-01-01

    Central obesity is a key component in the definition of the metabolic syndrome, but the cut-off values proposed to define abnormal values vary among different guidelines and are mostly based on cross-sectional studies. In this study, we identify the best cut-off values for waist circumference (WC) associated with the incidence of hypertension. Participants for this prospectively planned cohort study were 589 individuals who were free of hypertension and selected at random from the community of Porto Alegre, Brazil. Hypertension was defined by a blood pressure measurement >or= 140/90 mmHg or the use of blood pressure lowering drugs. A logistic regression model established the association between WC and the incidence of hypertension. A receiver operating characteristics (ROC) curve analysis was used to select the best WC cut-off point to predict the incidence of hypertension. During a mean follow-up of 5.5+/-0.9 years, 127 subjects developed hypertension. The hazard ratios for the development of hypertension, adjusted for age, baseline systolic blood pressure, alcohol consumption, gender and scholarship were 1.02 (95% CI; 1.00-1.04; P=0.02) for WC. The best cut-off WC values to predict hypertension were 87 cm in men and 80 cm in women, with an area under the curve of 0.56 (95% CI; 0.47-0.64; P=0.17) and 0.70 (95% CI; 0.63-0.77; Phypertension in individuals living in communities in Brazil, and this risk begins at lower values of WC that those recommended by some guidelines.

  6. Fourier phase analysis on equilibrium gated radionuclide ventriculography: range of phase spread and cut-off limits in normal individuals

    International Nuclear Information System (INIS)

    Ramaiah, Vijayaraghavan L.; Harish, B.; Sunil, H.V.; Selvakumar, Job; Ravi Kishore, A.G.; Nair, Gopinathan

    2011-01-01

    To define the range of phase spread on equilibrium gated radionuclide ventriculography (ERNV) in normal individuals and derive the cut-off limit for the parameters to detect cardiac dyssynchrony. ERNV was carried out in 30 individuals (age 53±23 years, 25 males and 5 females) who had no history of cardiovascular disease. They all had normal left ventricular ejection fraction (LVEF 55-70%) as determined by echocardiography, were in sinus rhythm, with normal QRS duration (≤120 msec) and normal coronary angiography. First harmonic phase analysis was performed on scintigraphic data acquired in best septal view. Left and right ventricular standard deviation (LVSD and RVSD, respectively) and interventricular mechanical delay (IVMD), the absolute difference of mean phase angles of right and left ventricle, were computed and expressed in milliseconds. Mean + 3 standard deviation (SD) was used to derive the cut-off limits. Average LVEF and duration of cardiac cycle in the study group were 62.5%±5.44% and 868.9±114.5 msec, respectively. The observations of LVSD, RVSD and right and left ventricular mean phase angles were shown to be normally distributed by Shapiro-Wilk test. Cut-off limits for LVSD, RVSD and IVMD were calculated to be 80 msec, 85 msec and 75 msec, respectively. Fourier phase analysis on ERNV is an effective tool for the evaluation of synchronicity of cardiac contraction. The cut-off limits of parameters of dyssynchrony can be used to separate heart failure patients with cardiac dyssynchrony from those without. ERNV can be used to select patients for cardiac resynchronization therapy. (author)

  7. Factors in selecting serum samples for use in determining the positive/negative threshold (cut-off) in ELISA

    International Nuclear Information System (INIS)

    Jacobson, R.H.

    1998-01-01

    The threshold (cut-off) that defines whether a test result is seropositive or seronegative is calculated by testing serum samples from a subpopulation of animals that is assumed to represent the target population in all aspects. For this proposition to be true, it is essential to consider the variables in the target population that must be represented in the subpopulation. Without representation of the variables in the subpopulation, it is likely that the cut-off selected for the test will be errant and will misclassify animals as to their infection status. The purpose of this paper is to identify a few of the principal variables that need to be taken into account when selecting a subpopulation of animals for test validation. (author)

  8. Optimizing rib width to height and rib spacing to deck plate thickness ratios in orthotropic decks

    Directory of Open Access Journals (Sweden)

    Abdullah Fettahoglu

    2016-12-01

    Full Text Available Orthotropic decks are composed of deck plate, ribs, and cross-beams and are frequently used in industry to span long distances, due to their light structures and load carrying capacities. Trapezoidal ribs are broadly preferred as longitudinal stiffeners in design of orthotropic decks. They supply the required stiffness to the orthotropic deck in traffic direction. Trapezoidal ribs are chosen in industrial applications because of their high torsional and buckling rigidity, less material and welding needs. Rib width, height, spacing, thickness of deck plate are important parameters for designing of orthotropic decks. In the scope of this study, rib width to height and rib spacing to deck plate thickness ratios are assessed by means of the stresses developed under different ratios of these parameters. For this purpose a FE-model of orthotropic bridge is generated, which encompasses the entire bridge geometry and conforms to recommendations given in Eurocode 3 Part 2. Afterwards necessary FE-analyses are performed to reveal the stresses developed under different rib width to height and rib spacing to deck plate thickness ratios. Based on the results obtained in this study, recommendations regarding these ratios are provided for orthotropic steel decks occupying trapezoidal ribs.

  9. Prolonged pain and disability are common after rib fractures.

    Science.gov (United States)

    Fabricant, Loic; Ham, Bruce; Mullins, Richard; Mayberry, John

    2013-05-01

    The contribution of rib fractures to prolonged pain and disability may be underappreciated and undertreated. Clinicians are traditionally taught that the pain and disability of rib fractures resolves in 6 to 8 weeks. This study was a prospective observation of 203 patients with rib fractures at a level 1 trauma center. Chest wall pain was evaluated by the McGill Pain Questionnaire (MPQ) pain rating index (PRI) and present pain intensity (PPI). Prolonged pain was defined as a PRI of 8 or more at 2 months after injury. Prolonged disability was defined as a decrease in 1 or more levels of work or functional status at 2 months after injury. Predictors of prolonged pain and disability were determined by multivariate analysis. One hundred forty-five male patients and 58 female patients with a mean injury severity score (ISS) of 20 (range, 1 to 59) had a mean of 5.4 rib fractures (range, 1 to 29). Forty-four (22%) patients had bilateral fractures, 15 (7%) had flail chest, and 92 (45%) had associated injury. One hundred eighty-seven patients were followed 2 months or more. One hundred ten (59%) patients had prolonged chest wall pain and 142 (76%) had prolonged disability. Among 111 patients with isolated rib fractures, 67 (64%) had prolonged chest wall pain and 69 (66%) had prolonged disability. MPQ PPI was predictive of prolonged pain (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.4 to 2.5), and prolonged disability (OR, 2.2; 95% CI, 1.5 to 3.4). The presence of significant associated injuries was predictive of prolonged disability (OR, 5.9; 95% CI, 1.4 to 29). Prolonged chest wall pain is common, and the contribution of rib fractures to disability is greater than traditionally expected. Further investigation into more effective therapies that prevent prolonged pain and disability after rib fractures is needed. Copyright © 2013 Elsevier Inc. All rights reserved.

  10. Bifid rib: A rare anomaly

    Directory of Open Access Journals (Sweden)

    Mythili Krishnan Rathinasabapathi

    2015-01-01

    Full Text Available A case of the bifid rib was found during routine bone study. The distal part of the osseous rib bifurcated into two divisions with an angle of 60°. Both divisions had their own costal cartilage. Bifid rib is a congenital abnormality of the rib cage and usually asymptomatic, often discovered incidentally on chest X-ray. Effects of this neuroskeletal anomaly can include respiratory difficulties and neurological limitations.

  11. Calidad de las aceitunas de mesa.

    Directory of Open Access Journals (Sweden)

    Garrido Fernández, Antonio

    1999-06-01

    Full Text Available The paper comments the different regulations related to table olives at national or international scales. The Unified Qualitative standard Applying to Table Olives in International Trade and COI/Codex (International Olive Oil Council, IOC, and IOC/Codex Alimentarius, «Reglamentación Técnico Sanitaria para la elaboración, circulación y venta de aceitunas de mesa» (Spanish, «Normas de calidad para la exportación de aceitunas de mesa» (Spanish, and the United States Standards for Grades of Green and Canned Ripe Olives (USA are especially considered. The effects of the new regulations on Nutritional Labelling (mainly in USA, applications of the Analysis and Control of Critical Points (ACCP, and the problems derived from the application of the ISO 9000, or EN 29000, to this Sector are also discussed.

    El trabajo comenta las diferentes normas, tanto nacionales como internacionales, que regulan los aspectos de la calidad de las aceitunas de mesa. Se comentan especialmente la Norma Cualitativa Unificada Aplicable a Aceitunas de Mesa en el Comercio Internacional y las correspondientes COI/CODEX (Consejo Oleícola Internacional, COI, y COI/Codex Alimentarius, respectivamente, la Reglamentación Técnico Sanitaria para la elaboración, circulación, y venta de aceitunas de mesa (española, las Normas de calidad para la exportación de Aceitunas de Mesa (española, y las «United States Standards for Grades of Green and Canned Ripe Olives» (USA. Asimismo se analizan las implicaciones de las nuevas reglamentaciones sobre etiquetado nutricional (principalmente en el comercio con USA, la aplicación del Análisis de Riesgos y Control de Puntos Críticos (ARCPC, y la necesidad de adaptar el Sector al cumplimiento de las diversas normas de la serie ISO 9000 o su equivalente EN 29000.

  12. Multiple Rib Nonunion: Open Reduction and Internal Fixation and Iliac Crest Bone Graft Aspirate.

    Science.gov (United States)

    Kaplan, Daniel J; Begly, John; Tejwani, Nirmal

    2017-08-01

    Rib fractures are a common chest injury that can typically be treated nonoperatively. However, a percentage of these will go on to nonunion, either because of unique characteristics of the fracture itself or because of a variety of poor healing factors of the host. If a patient has continued symptomology beyond 3 months, surgeons may consider operative management. Although isolated resection of fibrous scar tissue from the nonunion site may be sufficient in some cases, it may also be necessary to provide additional structural integrity to the rib depending on the extent of the fracture pattern and resection. This goal can be achieved operatively with rib plating and bone grafting to promote healing. This video demonstrates the use of plating in the treatment of rib nonunion. It begins with relevant background information on rib fractures and nonunions, then details the approach, open reduction and internal fixation of 3 ribs using plates and bone graft aspirate. Pearls and pitfalls are included during the surgical technique aspect of the video to both help guide surgeons new to the procedure and provide potentially advantageous technical details to more experienced surgeons.

  13. The warm dark matter halo mass function below the cut-off scale

    Science.gov (United States)

    Angulo, Raul E.; Hahn, Oliver; Abel, Tom

    2013-10-01

    Warm dark matter (WDM) cosmologies are a viable alternative to the cold dark matter (CDM) scenario. Unfortunately, an accurate scrutiny of the WDM predictions with N-body simulations has proven difficult due to numerical artefacts. Here, we report on cosmological simulations that, for the first time, are devoid of those problems, and thus are able to accurately resolve the WDM halo mass function well below the cut-off. We discover a complex picture, with perturbations at different evolutionary stages populating different ranges in the halo mass function. On the smallest mass scales we can resolve, identified objects are typically centres of filaments that are starting to collapse. On intermediate mass scales, objects typically correspond to fluctuations that have collapsed and are in the process of relaxation, whereas the high-mass end is dominated by objects similar to haloes identified in CDM simulations. We then explicitly show how the formation of low-mass haloes is suppressed, which translates into a strong cut-off in the halo mass function. This disfavours some analytic formulations that predict a halo mass function that would extend well below the free streaming mass. We argue for a more detailed exploration of the formation of the smallest structures expected to form in a given cosmology, which, we foresee, will advance our overall understanding of structure formation.

  14. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

    Directory of Open Access Journals (Sweden)

    Michael Bemelman

    2016-02-01

    Full Text Available More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

  15. The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

    Science.gov (United States)

    Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

    2016-01-01

    More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation. PMID:26889439

  16. Focusing of high intensity ultrasound through the rib cage using a therapeutic random phased array

    Science.gov (United States)

    Bobkova, Svetlana; Gavrilov, Leonid; Khokhlova, Vera; Shaw, Adam; Hand, Jeffrey; #, ||

    2010-01-01

    A method for focusing high intensity ultrasound through a rib cage that aims to minimize heating of the ribs whilst maintaining high intensities at the focus (or foci) is proposed and tested theoretically and experimentally. Two approaches, one based on geometric acoustics and the other accounting for diffraction effects associated with propagation through the rib cage, are investigated theoretically for idealized source conditions. It is shown that for an idealized radiator the diffraction approach provides a 23% gain in peak intensity and results in significantly less power losses on the ribs (1% versus 7.5% of the irradiated power) compared with the geometric one. A 2D 1-MHz phased array with 254 randomly distributed elements, tissue mimicking phantoms, and samples of porcine rib cages are used in experiments; the geometric approach is used to configure how the array is driven. Intensity distributions are measured in the plane of the ribs and in the focal plane using an infra-red camera. Theoretical and experimental results show that it is possible to provide adequate focusing through the ribs without overheating them for a single focus and several foci, including steering at ± 10–15 mm off and ± 20 mm along the array axis. Focus splitting due to the periodic spatial structure of ribs is demonstrated both in simulations and experiments; the parameters of splitting are quantified. The ability to produce thermal lesions with a split focal pattern in ex vivo porcine tissue placed beyond the rib phantom is also demonstrated. The results suggest that the method is potentially useful for clinical applications of HIFU for which the rib cage lies between the transducer(s) and the targeted tissue. PMID:20510186

  17. Verification arrangements for the proposed fissile material cut-off treaty

    International Nuclear Information System (INIS)

    Bragin, V.

    2001-01-01

    Since the mid-1950's, an agreement to terminate the production of fissile material for nuclear weapons has been on the agenda. On December 16, 1993, the UNGA adopted Resolution A/RES/48/75/L which recommends ''the negotiation in the most appropriate international forum of a non-discriminatory, multilateral and internationally and effectively verifiable treaty banning the production of fissile material for nuclear weapons and other nuclear explosive devices''. The proposed Fissile Material Cut-off Treaty (FMCT) is still one of the most important items on the multilateral disarmament and non-proliferation agenda. Successful achievement of the FMCT would be an important step towards the goal of eliminating nuclear weapons. (author)

  18. Methods for identifying the cost effective case definition cut-off for sequential monitoring tests: an extension of Phelps and Mushlin

    Science.gov (United States)

    Longo, Roberta; Baxter, Paul; Hall, Peter; Hewison, Jenny; Afshar, Mehran; Hall, Geoff; McCabe, Christopher

    2015-01-01

    The arrival of personalized medicine in the clinic means that treatment decisions will increasingly rely on test results. The challenge of limited health care resources means that the dissemination of these technologies will be dependent on their value in relation to their cost; i.e. their cost effectiveness. Phelps and Mushlin have described how to optimize tests to meet cost effectiveness target. However, when tests are applied repeatedly the case mix of the patients tested changes with each administration, and this impacts upon the value of each subsequent test administration. In this paper we present a modification of Phelps and Mushlin’s framework for diagnostic tests; to identify the cost effective cut-off for monitoring tests. Using the Ca125 test monitoring for relapse in Ovarian Cancer, we show how the repeated use of the initial cut-off can lead to a substantially increased false negative rate compared to the monitoring cut-off – over 20% higher than in this example – with the associated harms for individual and population health. PMID:24488576

  19. Optimal cut-off levels to define obesity: body mass index and waist circumference, and their relationship to cardiovascular disease, dyslipidaemia, hypertension and diabetes in Malaysia.

    Science.gov (United States)

    Zaher, Zaki Morad Mohd; Zambari, Robayaah; Pheng, Chan Siew; Muruga, Vadivale; Ng, Bernard; Appannah, Geeta; Onn, Lim Teck

    2009-01-01

    Many studies in Asia have demonstrated that Asian populations may require lower cut-off levels for body mass index (BMI) and waist circumference to define obesity and abdominal obesity respectively, compared to western populations. Optimal cut-off levels for body mass index and waist circumference were determined to assess the relationship between the two anthropometric- and cardiovascular indices. Receiver operating characteristics analysis was used to determine the optimal cut-off levels. The study sample included 1833 subjects (mean age of 44+/-14 years) from 93 primary care clinics in Malaysia. Eight hundred and seventy two of the subjects were men and 960 were women. The optimal body mass index cut-off values predicting dyslipidaemia, hypertension, diabetes mellitus, or at least one cardiovascular risk factor varied from 23.5 to 25.5 kg/m2 in men and 24.9 to 27.4 kg/m2 in women. As for waist circumference, the optimal cut-off values varied from 83 to 92 cm in men and from 83 to 88 cm in women. The optimal cut-off values from our study showed that body mass index of 23.5 kg/m2 in men and 24.9 kg/m2 in women and waist circumference of 83 cm in men and women may be more suitable for defining the criteria for overweight or obesity among adults in Malaysia. Waist circumference may be a better indicator for the prediction of obesity-related cardiovascular risk factors in men and women compared to BMI. Further investigation using a bigger sample size in Asia needs to be done to confirm our findings.

  20. Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.

    Directory of Open Access Journals (Sweden)

    Fernanda Mattos de Souza

    Full Text Available An interferon-γ release assay, QuantiFERON-TB (QFT test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI. Here, we compared the performance of QFT with tuberculin skin test (TST measured at two different cut-off points among primary health care work (HCW in Brazil.A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points.We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31, and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22. We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value.Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.

  1. Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.

    Science.gov (United States)

    de Souza, Fernanda Mattos; do Prado, Thiago Nascimento; Pinheiro, Jair dos Santos; Peres, Renata Lyrio; Lacerda, Thamy Carvalho; Loureiro, Rafaela Borge; Carvalho, Jose Américo; Fregona, Geisa; Dias, Elias Santos; Cosme, Lorrayne Beliqui; Rodrigues, Rodrigo Ribeiro; Riley, Lee Wood; Maciel, Ethel Leonor Noia

    2014-01-01

    An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil. A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points. We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value. Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.

  2. Rib fractures and their association With solid organ injury: higher rib fractures have greater significance for solid organ injury screening.

    Science.gov (United States)

    Rostas, Jack W; Lively, Timothy B; Brevard, Sidney B; Simmons, Jon D; Frotan, Mohammad A; Gonzalez, Richard P

    2017-04-01

    The purpose of this study was to identify patients with rib injuries who were at risk for solid organ injury. A retrospective chart review was performed of all blunt trauma patients with rib fractures during the period from July 2007 to July 2012. Data were analyzed for association of rib fractures and solid organ injury. In all, 1,103 rib fracture patients were identified; 142 patients had liver injuries with 109 (77%) associated right rib fractures. Right-sided rib fractures with highest sensitivity for liver injury were middle rib segment (5 to 8) and lower segment (9 to 12) with liver injury sensitivities of 68% and 43%, respectively (P rib fractures. Left middle segment rib fractures and lower segment rib fractures had sensitivities of 80% and 63% for splenic injury, respectively (P Rib fractures higher in the thoracic cage have significant association with solid organ injury. Using rib fractures from middle plus lower segments as indication for abdominal screening will significantly improve rib fracture sensitivity for identification of solid organ injury. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Evaluation of an Optimal Cut-Off Point for the Ki-67 Index as a Prognostic Factor in Primary Breast Cancer: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Rumiko Tashima

    Full Text Available The Ki-67 index is an important biomarker for indicating the proliferation of cancer cells and is considered to be an effective prognostic factor for breast cancer. However, a standard cut-off point for the Ki-67 index has not yet been established. Therefore, the aim of this retrospective study was to determine an optimal cut-off point in order to establish it as a more accurate prognostic factor. Immunohistochemical analysis of the Ki-67 index was performed on 4329 patients with primary breast cancer from August 1987 to March 2012. Out of this sample, there were 3186 consecutive cases from September 1997 with simultaneous evaluations of ER, PgR and HER2 status. Cox's proportional hazard model was used to perform univariate and multivariate analyses of the factors related to OS. The hazard ratios (HR and the p values were then compared to determine the optimal cut-off point for the Ki-67 index. The median Ki-67 index value was 20.5% (mean value 26.2%. The univariate analysis revealed that there was a statistically significant negative correlation with DFS and OS and the multivariate analysis revealed that the Ki-67 index value was a significant factor for DFS and OS. The top seven cut-off points were then carefully chosen based on the results of the univariate analysis using the lowest p-values and the highest HR as the main selection criteria. The multivariate analysis of the factors for OS showed that the cut-off point of 20% had the highest HR in all of the cases. However, the cutoff point of 20% was only a significant factor for OS in the Luminal/HER2- subtype. There was no correlation between the Ki-67 index value and OS in any of the other subtypes. These data indicate that the optimal cut-off point of 20% is the most effective prognostic factor for Luminal/HER2- breast cancer.

  4. Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn's disease with fecal calprotectin

    Directory of Open Access Journals (Sweden)

    Juan María Vázquez-Morón

    Full Text Available Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. Methods: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. Results: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06 predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08 predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170, mucosal healing (calprotectin ≤ 71 and uncertainty (71 > calprotectin < 170, with significant differences in endoscopic values (F = 26.407, p < 0.01. Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89% or mucosal healing (75% vs 87% in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

  5. Mining on the Mesa

    Energy Technology Data Exchange (ETDEWEB)

    Sprouls, M.W.

    1994-10-01

    Peabody Western Coal Co. is the owner of Black Mesa and Kayenta coal opencast mines, both sited on Hopi and Navajo lands. 93% of the employees are native American, mostly Navajo. Kayenta is the larger and extracts coal with draglines. Sulphur content is high so the coal has to be analyzed and carefully blended before use. Black Mesa also uses draglines, here quality control is not as important as it is at Kayenta. Coal is transported to power stations using slurry pipelines. Both mines are heavily involved in land reclamation, leaving a landscape that makes better grazing than it did before mining. 2 figs.

  6. Cut-off value of FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction in a Korean population

    Directory of Open Access Journals (Sweden)

    Chung KS

    2016-08-01

    Full Text Available Kyung Soo Chung,1,2 Ji Ye Jung,1,2 Moo Suk Park,1,2 Young Sam Kim,1,2 Se Kyu Kim,1,2 Joon Chang,1,2 Joo Han Song1,2 1Division of Pulmonology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; 2Institute of Chest Disease, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Forced expiratory volume in 1 second (FEV1/forced expiratory volume in 6 seconds (FEV6 has been proposed as an alternative to FEV1/forced vital capacity (FVC for detecting airway obstruction. A fixed cut-off value for FEV1/FEV6 in a Korean population is lacking. We investigated a fixed cut-off for FEV1/FEV6 as a surrogate for FEV1/FVC for detecting airway obstruction.Materials and methods: We used data obtained in the 5 years of the Fifth and Sixth Korean National Health and Nutrition Examination Survey. A total of 14,978 participants aged ≥40 years who underwent spirometry adequately were the study cohort. “Airway obstruction” was a fixed cut-off FEV1/FVC <70% according to the Global Initiative for Chronic Obstructive Lung Disease guidelines. We also used European Respiratory Society/Global Lung Initiative 2012 equations for the FEV1/FVC lower limit of normal.Results: Among the 14,978 participants (43.5% male, 56.5% female; mean age: 56.9 years for men and 57.0 years for women, 14.0% had obstructive lung function according to a fixed cut-off FEV1/FVC <70%. Optimal FEV1/FEV6 cut-off for predicting FEV1/FVC <70% was 75% using receiver operating characteristic curve analyses (area under receiver operating characteristic curve =0.989, 95% confidence interval 0.987–0.990. This fixed cut-off of FEV1/FEV6 showed 93.8% sensitivity, 94.8% specificity, 74.7% positive predictive value, 98.9% negative predictive value, and 0.8 Cohen’s kappa coefficient. When compared with FEV1/FVC < lower limit of normal, FEV1/FEV6 <75% tended to over-diagnose airflow limitation (just like a fixed cut-off

  7. Nineth Rib Syndrome after 10th Rib Resection

    OpenAIRE

    Yu, Hyun Jeong; Jeong, Yu Sub; Lee, Dong Hoon; Yim, Kyoung Hoon

    2016-01-01

    The 12th rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractur...

  8. Diagnostic Cut-Off Levels of Plasma Brain Natriuretic Peptide to Distinguish Left Ventricular Failure in Emergency Setting

    International Nuclear Information System (INIS)

    Hussain, A.; Afridi, F. I.; Lutfi, I. A.

    2014-01-01

    Objective: To determine the diagnostic cut-off values of brain natriuretic (BNP) peptide to establish left ventricular failure in patients presenting with dyspnoea in emergency department. Study Design: Descriptive study. Place and Duration of Study: Ziauddin University Hospital, Karachi, from July to December 2011. Methodology: BNP estimation was done on Axysm analyzer with kit provided by Abbott diagnostics, while the Doppler echocardiography was done on Toshiba style (UICW-660A) using 2.5 MHz and 5.0 MHz probes. Log transformation was done to normalize the original BNP values. A receiver operating curve was plotted to determine the diagnostic cut-off value of BNP which can be used to distinguish CHF from other causes of dyspnoea. Statistical analysis was performed by SPSS version 17. Results: A total of 92 patients presenting with dyspnoea in the emergency department were studied. There were 38/92 (41.3%) males and 54/92 (58.7%) females, and the average age of the study population was 64 A +- 14.1 years. These patients had BNP levels and Doppler echocardiography done. The average BNP was found to be 1117.78 A +- 1445.74 pg/ml. In log transformation, the average was found to be 2.72 A +- 0.58. BNP value of 531 pg/ml was found to be the cut off to distinguish between cardiogenic and non-cardiogenic causes of dyspnoea. Conclusion: BNP value of 531 pg/ml can distinguish CHF from other conditions as a cause of dyspnoea in emergency. (author)

  9. Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

    2016-01-01

    BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD...... on the PDAS and the severity-ranges for mild, moderate, and severe PD were defined using the Clinical Global Impression - Severity scale (CGI-S) as reference by means of pair-wise receiver operating characteristic (ROC) analyses. Subsequently, it was tested whether remission on the PDAS could separate...... the effects of Olanzapine+Sertraline vs. Olanzapine+Placebo through an intention-to-treat, mixed-effects logistic regression of the data from STOP-PD. RESULTS: According to the ROC analyses, the ideal cut-off for remission of PD was a PDAS total score moderate...

  10. Segmentation of ribs in digital chest radiographs

    Science.gov (United States)

    Cong, Lin; Guo, Wei; Li, Qiang

    2016-03-01

    Ribs and clavicles in posterior-anterior (PA) digital chest radiographs often overlap with lung abnormalities such as nodules, and cause missing of these abnormalities, it is therefore necessary to remove or reduce the ribs in chest radiographs. The purpose of this study was to develop a fully automated algorithm to segment ribs within lung area in digital radiography (DR) for removal of the ribs. The rib segmentation algorithm consists of three steps. Firstly, a radiograph was pre-processed for contrast adjustment and noise removal; second, generalized Hough transform was employed to localize the lower boundary of the ribs. In the third step, a novel bilateral dynamic programming algorithm was used to accurately segment the upper and lower boundaries of ribs simultaneously. The width of the ribs and the smoothness of the rib boundaries were incorporated in the cost function of the bilateral dynamic programming for obtaining consistent results for the upper and lower boundaries. Our database consisted of 93 DR images, including, respectively, 23 and 70 images acquired with a DR system from Shanghai United-Imaging Healthcare Co. and from GE Healthcare Co. The rib localization algorithm achieved a sensitivity of 98.2% with 0.1 false positives per image. The accuracy of the detected ribs was further evaluated subjectively in 3 levels: "1", good; "2", acceptable; "3", poor. The percentages of good, acceptable, and poor segmentation results were 91.1%, 7.2%, and 1.7%, respectively. Our algorithm can obtain good segmentation results for ribs in chest radiography and would be useful for rib reduction in our future study.

  11. Appraisal and standardization of curvilinear velocity (VCL) cut-off values for CASA analysis of Japanese quail (Coturnix japonica) sperm.

    Science.gov (United States)

    Farooq, U; Malecki, I A; Mahmood, M; Martin, G B

    2017-06-01

    One of the basic steps in objective analysis of sperm motility is the subdivision of a motile sperm population into slow, medium and rapid categories based on their velocity. However, for CASA analysis of quail sperm, the velocity values for categorization of slow, medium and rapid sperm have not yet been standardized. To identify the cut-off values of "velocity curvilinear" (VCL) for quail sperm categorization, we captured and analysed 22,300 tracks of quail sperm using SCA ® -CASA. The median and mean VCL values were 85 and 97 μm/s. To define the VCL cut-off values, we used two methods. In the first, we identified the upper (rapid sperm) and lower (slow sperm) cut-off values using: (i) median VCL ± 25% or ± 50% or ± 75% of median VCL value; (ii) first and third quartile values of VCL data (i.e. 25% cut-off setting); and (iii) 33% and 66% of VCL data. Among these settings, sperm categories and their corresponding motility characteristics recorded using the "25%" setting (i.e. slow ≤36 ≤ medium ≤154 ≤ rapid) were found the most realistic and coherent with male ranking by fertility. In the second method, we calculated heteroscedasticity in the total VCL data using PCA and the two-step clustering method. With this approach, the mean of the high and low clusters was 165 and 51 μm/s, respectively. Together, the mean from two methods suggested that, for SCA ® -CASA categorization of quail sperm, sperm should be classed as "rapid" at VCL ≥160 μm/s and "slow" at VCL ≤45 μm/s. © 2017 Blackwell Verlag GmbH.

  12. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI

    International Nuclear Information System (INIS)

    Schoennagel, B.P.; Karul, M.; Avanesov, M.; Bannas, P.; Gold, G.; Großterlinden, L.G.; Rupprecht, M.; Adam, G.; Yamamura, J.

    2014-01-01

    Highlights: • Isolated syndesmotic injury is a frequent finding after acute ankle trauma. • Cut-off values and accuracy of plain film radiograph measurements were determined. • The TFCS and the MCS have the potential to detect isolated syndesmotic injury. • Appropriate cut-off values allow detection of isolated syndesmotic injury. • Only MRI reveals severity of isolated syndesmotic injury and concomitant injuries. - Abstract: Objectives: To determine cut-off values and the accuracy of plain film measurements for the detection of isolated syndesmotic injury after acute ankle trauma and to investigate MRI findings of concomitant ankle injury. Methods: Eighty-four consecutive patients with absent fracture in plain film radiographs were prospectively evaluated for isolated syndesmotic injury after acute ankle trauma. The tibiofibular clear space (TFCS), the tibiofibular overlap (TFO), and the medial clear space (MCS) were independently assessed in plain radiographs by two readers. MRI performed at 3 T within 24 h served as the reference standard. MRI was evaluated for syndesmotic injury, using a four-scale grading system (0 = normal syndesmosis, 1a = periligamentous edema, 1b = intraligamentous edema, 2 = partial rupture, 3 = complete rupture), and for concomitant ankle injury. Inter-observer variability for x-ray measurements was assessed using Bland–Altman diagrams. ROC analyses were performed to determine cut-off values and sensitivity and specificity for TFCS, TFO, and MCS. Results: Eleven of 84 patients (13.1%) revealed syndesmotic injury (Grade 2 or 3) according to MRI. Between patients with and without syndesmotic injury significantly different measurements were obtained for TFCS (p = 0.003) and MCS (p = 0.04). ROC derived cut-off values were 5.3 mm for TFCS, 2.8 mm for TFO, and 2.8 mm for MCS. Sensitivity and specificity was 82% and 75% for TFCS, 36% and 78% for TFO, and 73% and 59% for MCS. The bias and limits of agreement were −0.04 mm and [−1

  13. Isolated syndesmotic injury in acute ankle trauma: Comparison of plain film radiography with 3 T MRI

    Energy Technology Data Exchange (ETDEWEB)

    Schoennagel, B.P., E-mail: b.schoennagel@uke.uni-hamburg.de [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Karul, M.; Avanesov, M.; Bannas, P.; Gold, G. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Großterlinden, L.G. [Department of Trauma-, Hand- and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany); Rupprecht, M. [Department of Pediatric Orthopedics, Children' s Hospital Hamburg-Altona, Bleickenallee 38, 22763 Hamburg (Germany); Adam, G.; Yamamura, J. [Department of Diagnostic and Interventional Radiology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg (Germany)

    2014-10-15

    Highlights: • Isolated syndesmotic injury is a frequent finding after acute ankle trauma. • Cut-off values and accuracy of plain film radiograph measurements were determined. • The TFCS and the MCS have the potential to detect isolated syndesmotic injury. • Appropriate cut-off values allow detection of isolated syndesmotic injury. • Only MRI reveals severity of isolated syndesmotic injury and concomitant injuries. - Abstract: Objectives: To determine cut-off values and the accuracy of plain film measurements for the detection of isolated syndesmotic injury after acute ankle trauma and to investigate MRI findings of concomitant ankle injury. Methods: Eighty-four consecutive patients with absent fracture in plain film radiographs were prospectively evaluated for isolated syndesmotic injury after acute ankle trauma. The tibiofibular clear space (TFCS), the tibiofibular overlap (TFO), and the medial clear space (MCS) were independently assessed in plain radiographs by two readers. MRI performed at 3 T within 24 h served as the reference standard. MRI was evaluated for syndesmotic injury, using a four-scale grading system (0 = normal syndesmosis, 1a = periligamentous edema, 1b = intraligamentous edema, 2 = partial rupture, 3 = complete rupture), and for concomitant ankle injury. Inter-observer variability for x-ray measurements was assessed using Bland–Altman diagrams. ROC analyses were performed to determine cut-off values and sensitivity and specificity for TFCS, TFO, and MCS. Results: Eleven of 84 patients (13.1%) revealed syndesmotic injury (Grade 2 or 3) according to MRI. Between patients with and without syndesmotic injury significantly different measurements were obtained for TFCS (p = 0.003) and MCS (p = 0.04). ROC derived cut-off values were 5.3 mm for TFCS, 2.8 mm for TFO, and 2.8 mm for MCS. Sensitivity and specificity was 82% and 75% for TFCS, 36% and 78% for TFO, and 73% and 59% for MCS. The bias and limits of agreement were −0.04 mm and [−1

  14. Increasing heat transfer of non-Newtonian nanofluid in rectangular microchannel with triangular ribs

    Science.gov (United States)

    Shamsi, Mohammad Reza; Akbari, Omid Ali; Marzban, Ali; Toghraie, Davood; Mashayekhi, Ramin

    2017-09-01

    In this study, computational fluid dynamics and the laminar flow of the non-Newtonian fluid have been numerically studied. The cooling fluid includes water and 0.5 wt% Carboxy methyl cellulose (CMC) making the non-Newtonian fluid. In order to make the best of non-Newtonian nanofluid in this simulation, solid nanoparticles of Aluminum Oxide have been added to the non-Newtonian fluid in volume fractions of 0-2% with diameters of 25, 45 and 100 nm. The supposed microchannel is rectangular and two-dimensional in Cartesian coordination. The power law has been used to speculate the dynamic viscosity of the cooling nanofluid. The field of numerical solution is simulated in the Reynolds number range of 5 nanoparticles as well as the use for nanoparticles with smaller diameters lead to greater heat transfer. Among all the studied forms, the triangular rib from with an angle of attack 30° has the biggest Nusselt number and the smallest pressure drop along the microchannel. Also, an increase in the angle of attack and as a result of a sudden contact between the fluid and the ribs and also a reduction in the coflowing length (length of the rib) cause a cut in heat transfer by the fluid in farther parts from the solid wall (tip of the rib).

  15. X-ray diagnosis of rib chondrosarcoma

    International Nuclear Information System (INIS)

    Smakova, M.S.

    1982-01-01

    A study was made on X-ray images of 24 patients, suffering from rib chondrosarcoma with relapses. X-ray symptoms of rib chondrosarcoma, depending on process localization were improved. Chondrosarcoma of rib cartilage is characterized by soft-tissue component with calcareous inclusions or without them. Chondrosarcoma of rib bone is characterized by destruction and soft-tissue component. Chondrosarcoma relapses were localized in soft tissues

  16. Accessory caudal axial and pelvic ribs

    International Nuclear Information System (INIS)

    Bohutova, J.; Kolar, J.; Vitovec, J.; Vyhnanek, L.

    1980-01-01

    Accessory caudal ribs are reported as an extremely curious anomaly in five patients. Once the fracture of this rib was a source of pains after injury. The different shapes of the ribs are documented in this clinical survey which is the most extensive in the present literature. Anomalous ribs arise due to inappropriate segmentation during the embryonal development of the axial skeleton. (orig.) [de

  17. MESA, PÚLPITO E PALCO

    OpenAIRE

    Calvani, Carlos Eduardo

    2015-01-01

    O artigo aborda a relação entre arte e religião a partir da liturgia cristã. Na primeira parte, apresenta historicamente, três centros visuais dos espaços litúrgicos nos quais se desenvolve o culto cristão -mesa, púlpito e palco – destacando simbolismos e significados atribuídos a cada um desses centros. A mesa (ou altar) caracteriza as liturgias de matriz católica; a centralidade do púlpito é a marca visual das liturgias protestantes reformadas; o palco, por sua vez, emerge, principalmente n...

  18. Two-dimensional multi-heart cutting centrifugal partition chromatography-liquid chromatography for the preparative isolation of antioxidants from Edelweiss plant.

    Science.gov (United States)

    Marlot, Léa; Batteau, Magali; Escofet, Marie-Claire; Nuccio, Sylvie; Coquoin, Véronique; De Vaumas, René; Faure, Karine

    2017-06-30

    The Edelweiss plant has been recognized as a very valuable source of anti-aging principles due to its composition of antioxidants compounds: leontopodic acid A and 3,5-dicaffeoylquinic acid. In this work, off-line multi-heart cutting CPC-LC separation was set up at industrial scale in order to isolate and produce new high quality reference material of these two antioxidants from Edelweiss. For this purpose, CPC and HPLC methods were developed and optimized at laboratory scale and a comprehensive CPCxHPLC analysis of the crude extract was established. Thereby, the CPC method led to a first separation of the target compounds according to their partition coefficient in the solvent system and the HPLC method was performed on the recovered fractions to lead to a second separation. A 2D CPCxHPLC plot was established in order to know the fractions to select at the industrial scale. Then, the CPC and HPLC methods were transferred at industrial scale and the multi-heart cutting CPC-LC was performed in off-line mode. Using CPC with methyl ter-butyl ether-water 1:1 (v/v) solvent system and LC with Denali C18 column, 2g of crude extract sample were injected and leontopodic acid A and 3,5-dicaffeoylquinic acid were recovered with purity over 97%. The compounds were identified by MS and NMR. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    Directory of Open Access Journals (Sweden)

    Isidoro González-Álvaro

    Full Text Available To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI in patients with chronic polyarthritis.Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR] including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC analysis. The areas under ROC (AUC were compared to those of validated indexes (SDAI, CDAI, DAS28. ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI.The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5, moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756 and CDAI (AUCs: 0.789 and 0.728. HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values.The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  20. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    Science.gov (United States)

    González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  1. Quantum fields and Poisson processes: Interaction of a cut-off boson field with a quantum particle

    International Nuclear Information System (INIS)

    Bertrand, J.; Rideau, G.; Gaveau, B.

    1985-01-01

    The solution of the Schroedinger equation for a boson field interacting with a quantum particle is written as an expectation on a Poisson process counting the variations of the boson-occupation numbers for each momentum. An energy cut-off is needed for the expectation to be meaningful. (orig.)

  2. An optimal cut-off point for the calving interval may be used as an indicator of bovine abortions.

    Science.gov (United States)

    Bronner, Anne; Morignat, Eric; Gay, Emilie; Calavas, Didier

    2015-10-01

    The bovine abortion surveillance system in France aims to detect as early as possible any resurgence of bovine brucellosis, a disease of which the country has been declared free since 2005. It relies on the mandatory notification and testing of each aborting cow, but under-reporting is high. This research uses a new and simple approach which considers the calving interval (CI) as a "diagnostic test" to determine optimal cut-off point c and estimate diagnostic performance of the CI to identify aborting cows, and herds with multiple abortions (i.e. three or more aborting cows per calving season). The period between two artificial inseminations (AI) was considered as a "gold standard". During the 2006-2010 calving seasons, the mean optimal CI cut-off point for identifying aborting cows was 691 days for dairy cows and 703 days for beef cows. Depending on the calving season, production type and scale at which c was computed (individual or herd), the average sensitivity of the CI varied from 42.6% to 64.4%; its average specificity from 96.7% to 99.7%; its average positive predictive value from 27.6% to 65.4%; and its average negative predictive value from 98.7% to 99.8%. When applied to the French bovine population as a whole, this indicator identified 2-3% of cows suspected to have aborted, and 10-15% of herds suspected of multiple abortions. The optimal cut-off point and CI performance were consistent over calving seasons. By applying an optimal CI cut-off point to the cattle demographics database, it becomes possible to identify herds with multiple abortions, carry out retrospective investigations to find the cause of these abortions and monitor a posteriori compliance of farmers with their obligation to report abortions for brucellosis surveillance needs. Therefore, the CI could be used as an indicator of abortions to help improve the current mandatory notification surveillance system. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Comparison of Postoperative Pain Relief by Intercostal Block Between Pre-rib Harvest and Post-rib Harvest Groups

    International Nuclear Information System (INIS)

    Bashir, M. M.; Shahzad, M. A.; Yousaf, M. N.; Khan, B. A.; Khan, F. A.

    2014-01-01

    Objective: To compare intercostal nerve block before and after rib harvest in terms of mean postoperative pain score and mean postoperative tramadol usage. Study Design: Randomized controlled trial. Place and Duration of Study: Department of Plastic Surgery, Mayo Hospital, KEMU, Lahore, from January 2011 to July 2012. Methodology: Patients (n = 120) of either gender with ASA class-I and II requiring autogenous costal cartilage graft were inducted. Patients having history of local anaesthetic hypersensitivity and age 60 years were excluded. Subjects were randomly assigned to pre-rib harvest (group-1) and post-rib harvest (group-2). Local anaesthetic mixture was prepared by adding 10 milliliters 2% lidocaine to 10 milliliters 0.5% bupivacaine to obtain a total 20 ml solution. Group-1 received local anaesthetic infiltration along the proposed incision lines and intercostals block before the rib harvest. Group-2 received the infiltration and block after rib harvest. Postoperative consumption of tramadol and pain scores were measured at 6 and 12 hours postoperatively using VAS. Results: Mean age was 31.43 A +- 10.78 years. The mean pain scores at 6 hours postoperatively were 1.033 A +- 0.609 and 2.4667 A +- 0.812 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean pain scores at 12 hours postoperatively were 1.45 A +- 0.565 and 3.65 A +- 0.633 in pre-rib harvest and post-rib harvest groups respectively (p < 0.0001). The mean tramadol used postoperatively in first 24 hours was 169 A +- 29.24 mg and 255 A +- 17.70 mg in prerib harvest and post-rib harvest groups respectively (p < 0.0001). Conclusion: Intercostal block administered before rib harvest as preemptive strategy result in decreased postoperative pain scores and narcotic use. (author)

  4. Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events.

    Science.gov (United States)

    Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka

    2018-01-01

    An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p<0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021). IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  5. Anatomical variation of human thoracic rib in dry bone.

    Directory of Open Access Journals (Sweden)

    Dr. Nalini Konkani

    2017-12-01

    Full Text Available Introduction: The Ribs are essential structure of osseous thorax and provide information that aids in the interpretation of radiologic images. The purpose of this study to investigate variations in thoracic rib and its morphological & clinical importance. So, In present study attempted to find out additional intercostal spaces due to bifurcation of ribs, less intercostal space due to fusion of ribs, variation of the normal ribs like, gap in the rib, fusion of one rib to another at a shaft of rib. Congenital abnormalities of the ribs are usually asymptomatic, often discovered incidentally on chest X-ray. Effects of this neuroskeletal anomaly can include respiratory difficulties and neurological limitations.Material & Method: The study was carried out in Bone Store of Department of Anatomy, B. J. Medical College, Ahmedabad, Gujarat. Study was carried out on 500 human dried ribs. And the variations in the ribs are studied. We got variation in the human ribs and studied. Result : Variations were seen like out of 500 ribs, Bifid rib having two ends 9(1.8%, rib having bifid space 2(0.4%, fusion rib at the level of shaft 1(0.2%, fusion of first rib and second rib 1(0.2%,first rib having two ends 1(0.2%. Conclusion: Bifid rib is an anatomical variant where the sternal end of the rib is cleaved into two. So we can rule out mesodermal abnormalities, parenchymal lung disease, chest wall tumor or costal fracture.

  6. The analytic regularization ζ function method and the cut-off method in Casimir effect

    International Nuclear Information System (INIS)

    Svaiter, N.F.; Svaiter, B.F.

    1990-01-01

    The zero point energy associated to a hermitian massless scalar field in the presence of perfectly reflecting plates in a three dimensional flat space-time is discussed. A new technique to unify two different methods - the ζ function and a variant of the cut-off method - used to obtain the so called Casimir energy is presented, and the proof of the analytic equivalence between both methods is given. (author)

  7. The RIB production target for the SPES project

    Science.gov (United States)

    Monetti, Alberto; Andrighetto, Alberto; Petrovich, Carlo; Manzolaro, Mattia; Corradetti, Stefano; Scarpa, Daniele; Rossetto, Francesco; Martinez Dominguez, Fernando; Vasquez, Jesus; Rossignoli, Massimo; Calderolla, Michele; Silingardi, Roberto; Mozzi, Aldo; Borgna, Francesca; Vivian, Gianluca; Boratto, Enrico; Ballan, Michele; Prete, Gianfranco; Meneghetti, Giovanni

    2015-10-01

    Facilities making use of the Isotope Separator On-Line (ISOL) method for the production of Radioactive Ion Beams (RIB) attract interest because they can be used for nuclear structure and reaction studies, astrophysics research and interdisciplinary applications. The ISOL technique is based on the fast release of the nuclear reaction products from the chosen target material together with their ionization into short-lived nuclei beams. Within this context, the SPES (Selective Production of Exotic Species) facility is now under construction in Italy at INFN-LNL (Istituto Nazionale di Fisica Nucleare — Laboratori Nazionali di Legnaro). The SPES facility will produce RIBs mainly from n-rich isotopes obtained by a 40 MeV cyclotron proton beam (200 μA) directly impinging on a uranium carbide multi-foil fission target. The aim of this work is to describe and update, from a comprehensive point of view, the most important results obtained by the analysis of the on-line behavior of the SPES production target assembly. In particular an improved target configuration has been studied by comparing different codes and physics models: the thermal analyses and the isotope production are re-evaluated. Then some consequent radioprotection aspects, which are essential for the installation and operation of the facility, are presented.

  8. Seismic analysis of the frame structure reformed by cutting off column and jacking based on stiffness ratio

    Science.gov (United States)

    Zhao, J. K.; Xu, X. S.

    2017-11-01

    The cutting off column and jacking technology is a method for increasing story height, which has been widely used and paid much attention in engineering. The stiffness will be changed after the process of cutting off column and jacking, which directly affects the overall seismic performance. It is usually necessary to take seismic strengthening measures to enhance the stiffness. A five story frame structure jacking project in Jinan High-tech Zone was taken as an example, and three finite element models were established which contains the frame model before lifting, after lifting and after strengthening. Based on the stiffness, the dynamic time-history analysis was carried out to research its seismic performance under the EL-Centro seismic wave, the Taft seismic wave and the Tianjin artificial seismic wave. The research can provide some guidance for the design and construction of the entire jack lifting structure.

  9. The optimum cut-off value to differentiate Echinococcus granulosus sensu stricto from other species of E. granulosus sensu lato using larval rostellar hook morphometry.

    Science.gov (United States)

    Soriano, S V; Pierangeli, N B; Pianciola, L A; Mazzeo, M; Lazzarini, L E; Debiaggi, M F; Bergagna, H F J; Basualdo, J A

    2015-01-01

    Cystic echinococcosis caused by Echinococcus granulosus sensu lato is one of the most important helminth zoonoses in the world; it affects both humans and livestock. The disease is endemic in Argentina and highly endemic in the province of Neuquén. Considerable genetic and phenotypic variation has been demonstrated in E. granulosus, and ten different genotypes (G1-G10) have been identified using molecular tools. Echinococcus granulosus sensu lato may be considered a species complex, comprised of E. granulosus sensu stricto (G1-G3), E. equinus (G4), E. ortleppi (G5) and E. canadensis (G6-G10). In endemic areas, the characterization of cystic echinococcosis molecular epidemiology is important in order to apply adequate control strategies. A cut-off value for larval large hook total length to distinguish E. granulosus sensu stricto isolates from those produced by other species of the complex was defined for the first time. Overall, 1780 larval hooks of 36 isolates obtained from sheep (n= 11, G1), goats (n= 10, G6), cattle (n= 5, G6) and pigs (n= 10, G7) were analysed. Validation against molecular genotyping as gold standard was carried out using the receiver operating characteristic (ROC) curve analysis. The optimum cut-off value was defined as 26.5 μm. The proposed method showed high sensitivity (97.8%) and specificity (91.1%). Since in most endemic regions the molecular epidemiology of echinococcosis includes the coexistence of the widely distributed E. granulosus sensu stricto G1 strain and other species of the complex, this technique could be useful as a quick and economical tool for epidemiological and surveillance field studies, when fertile cysts are present.

  10. Anatomically contoured plates for fixation of rib fractures.

    Science.gov (United States)

    Bottlang, Michael; Helzel, Inga; Long, William B; Madey, Steven

    2010-03-01

    : Intraoperative contouring of long bridging plates for stabilization of flail chest injuries is difficult and time consuming. This study implemented for the first time biometric parameters to derive anatomically contoured rib plates. These plates were tested on a range of cadaveric ribs to quantify plate fit and to extract a best-fit plating configuration. : Three left and three right rib plates were designed, which accounted for anatomic parameters required when conforming a plate to the rib surface. The length lP over which each plate could trace the rib surface was evaluated on 109 cadaveric ribs. For each rib level 3-9, the plate design with the highest lP value was extracted to determine a best-fit plating configuration. Furthermore, the characteristic twist of rib surfaces was measured on 49 ribs to determine the surface congruency of anatomic plates with a constant twist. : The tracing length lP of the best-fit plating configuration ranged from 12.5 cm to 14.7 cm for ribs 3-9. The corresponding range for standard plates was 7.1-13.7 cm. The average twist of ribs over 8-cm, 12-cm, and 16-cm segments was 8.3 degrees, 20.6 degrees, and 32.7 degrees, respectively. The constant twist of anatomic rib plates was not significantly different from the average rib twist. : A small set of anatomic rib plates can minimize the need for intraoperative plate contouring for fixation of ribs 3-9. Anatomic rib plates can therefore reduce the time and complexity of flail chest stabilization and facilitate spanning of flail segments with long plates.

  11. Turbulent flow in a ribbed channel: Flow structures in the vicinity of a rib

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2010-01-01

    PIV measurements are performed in a channel with periodic ribs on one wall. The emphasis of this study is to investigate the flow structures in the vicinity of a rib in terms of mean velocities, Reynolds stresses, probability density functions (PDF), and two-point correlations. The PDF distribution......-based visualization is applied to the separation bubble upstream of the rib. Salient critical points and limit cycles are extracted, which gives clues to the physical processes occurring in the flow....

  12. Defining the optimal cut-off values for liver enzymes in diagnosing blunt liver injury.

    Science.gov (United States)

    Koyama, Tomohide; Hamada, Hirohisa; Nishida, Masamichi; Naess, Paal A; Gaarder, Christine; Sakamoto, Tetsuya

    2016-01-25

    Patients with blunt trauma to the liver have elevated levels of liver enzymes within a short time post injury, potentially useful in screening patients for computed tomography (CT). This study was performed to define the optimal cut-off values for serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in patients with blunt liver injury diagnosed with contrast enhanced multi detector-row CT (CE-MDCT). All patients admitted from May 2006 to July 2013 to Teikyo University Hospital Trauma and Critical Care Center, and who underwent abdominal CE-MDCT within 3 h after blunt trauma, were retrospectively enrolled. Using receiver operating characteristic (ROC) curve analysis, the optimal cut-off values for AST and ALT were defined, and sensitivity and specificity were calculated. Of a total of 676 blunt trauma patients 64 patients were diagnosed with liver injury (Group LI+) and 612 patients without liver injury (Group LI-). Group LI+ and LI- were comparable for age, Revised Trauma Score, and Probability of survival. The groups differed in Injury Severity Score [median 21 (interquartile range 9-33) vs. 17 (9-26) (p tool for CT scan in patients otherwise eligible for observation only or as a transfer criterion to a facility with CT scan capability.

  13. Flow rates through earthen, geomembrane ampersand composite cut-off walls

    International Nuclear Information System (INIS)

    Tachavises, C.; Benson, C.H.

    1997-01-01

    Flow rates through soil-bentonite (SIB), geomembrane (GM), and composite geomembrane-soil (CGS) cut-off walls were determined using a numerical model of ground water flow. Various geological and wall conditions were simulated. Results of the simulations show that flow rates past all wall types are affected by hydraulic conductivities of the aquifer and underlying confining layer. Flow rates past GM walls with perfect joints are very low, provided the confining layer has low hydraulic conductivity. However, if a small fraction of the joints are defective, GM walls can be ineffective in blocking flow. CGS walls with a low hydraulic conductivity shell are less sensitive to joint defects. CGS walls with good shells typically have lower flow rates than SB and GM walls, even if the CGS wall contains defective joints

  14. Cut-off scaling of high-harmonic generation driven by a femtosecond visible optical parametric amplifier

    International Nuclear Information System (INIS)

    Cirmi, Giovanni; Lai, Chien-Jen; Granados, Eduardo; Huang, Shu-Wei; Sell, Alexander; Hong, Kyung-Han; Moses, Jeffrey; Keathley, Phillip; Kärtner, Franz X

    2012-01-01

    We studied high-harmonic generation (HHG) in Ar, Ne and He gas jets using a broadly tunable, high-energy optical parametric amplifier (OPA) in the visible wavelength range. We optimized the noncollinear OPA to deliver tunable, femtosecond pulses with 200-500 µJ energy at the 1 kHz repetition rate with excellent spatiotemporal properties, suitable for HHG experiments. By tuning the central wavelength of the OPA while keeping other parameters (energy, duration and beam size) constant, we experimentally studied the scaling law of cut-off energy with the driver wavelength in helium. Our measurements show a λ 1.7+0.2 dependence of the HHG cut-off photon energy over the full visible range in agreement with previous experiments of near- and mid-IR wavelengths. By tuning the central wavelength of the driver source, the high-order harmonic spectra in the extreme ultraviolet cover the full range of photon energy between ∼25 and ∼100 eV. Due to the high coherence intrinsic in HHG, as well as the broad and continuous tunability in the extreme UV range, a high energy, high repetition rate version of this source might be an ideal seed for free electron lasers.

  15. Painful rib hump: a new clinical sign for detecting intraspinal rib displacement in scoliosis due to neurofibromatosis

    Directory of Open Access Journals (Sweden)

    Katsalouli Marina

    2006-06-01

    Full Text Available Abstract Background Spinal cord compression and associate neurological impairment is rare in patients with scoliosis and neurofibromatosis. Common reasons are vertebral subluxation, dislocation, angulation and tumorous lesions around the spinal canal. Only twelve cases of intraspinal rib dislocation have been reported in the literature. The aim of this report is to present a case of rib penetration through neural foramen at the apex of a scoliotic curve in neurofibromatosis and to introduce a new clinical sign for its detection. Methods A 13-year-old girl was evaluated for progressive left thoracic kyphoscoliotic curve due to a type I neurofibromatosis. Clinical examination revealed multiple large thoracic and abdominal "cafe-au-lait" spots, neurological impairment of the lower limbs and the presence of a thoracic gibbous that was painful to pressure at the level of the left eighth rib (Painful Rib Hump. CT-scan showed detachment and translocation of the cephalic end of the left eighth rib into the adjacent enlarged neural foramen. The M.R.I. examination of the spine showed neither cord abnormality nor neurogenic tumor. Results The patient underwent resection of the intraspinal mobile eighth rib head and posterior spinal instrumentation and was neurologically fully recovered six months postoperatively. Conclusion Spine surgeons should be aware of intraspinal rib displacement in scoliotic curves in neurofibromatosis. Painful rib hump is a valuable diagnostic tool for this rare clinical entity.

  16. Hybrid rib-slot-rib plasmonic waveguide with deep-subwavelength mode confinement and long propagation length

    Directory of Open Access Journals (Sweden)

    Kai Zheng

    2016-08-01

    Full Text Available We propose a hybrid plasmonic waveguide where a combined rib-slot-rib structure is added on the metal substrate within a low-index gap region. The optical properties of the quasi-TM fundamental mode are numerically calculated using the finite element method. Compared to the traditional hybrid plasmonic waveguide, our designed waveguiding structure can support modes with tighter confinement and longer propagation length, by properly adjusting the geometry of the rib-slot-rib structure and the gap height. In details, it can provide the hybrid mode with mode area λ2/12000 and reasonable propagation distance 23.78 μm, simultaneously. Its excellent optical performance can facilitate potential applications in ultra-compact nanophotonic devices and circuits.

  17. Physical Activity Questionnaire for children and adolescents: English norms and cut-off points.

    Science.gov (United States)

    Voss, Christine; Ogunleye, Ayodele A; Sandercock, Gavin R H

    2013-08-01

    The Physical Activity Questionnaire for Children and Adolescents (PAQ-C/-A) provides general estimates of physical activity levels. Following recent expert recommendations for using the PAQ for population surveillance, the aim of this paper was twofold: first, to describe normative PAQ data for English youth; and second, to determine a criterion-referenced PAQ-score cut-off point. Participants (n = 7226, 53% boys, 10-15 years) completed an anglicized version of the PAQ. Peak oxygen uptake (VO2peak ) was predicted from PACER lap count according to latest FITNESSGRAM standards and categorized into "at-risk" and "no-risk" for metabolic syndrome. ROC curves were drawn for each age-sex group to identify PAQ scores, which categorized youth into "sufficiently active" versus "low-active" groups, using cardiorespiratory fitness as the criterion-referenced standard. PAQ scores were higher in boys than in girls and declined with age. Mean PAQ score was a significant, albeit relatively weak (area under the curve PAQ scores of ≥2.9 for boys and ≥2.7 for girls were identified as cut-off points, although it may be more appropriate to use lower, age-specific PAQ scores for girls of 13, 14 and 15 years (2.6, 2.4, 2.3, respectively). The normative and criterion-referenced PAQ values may be used to standardize and categorize PAQ scores in future youth population studies. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

  18. Nozzle airfoil having movable nozzle ribs

    Science.gov (United States)

    Yu, Yufeng Phillip; Itzel, Gary Michael

    2002-01-01

    A nozzle vane or airfoil structure is provided in which the nozzle ribs are connected to the side walls of the vane or airfoil in such a way that the ribs provide the requisite mechanical support between the concave side and convex side of the airfoil but are not locked in the radial direction of the assembly, longitudinally of the airfoil. The ribs may be bi-cast onto a preformed airfoil side wall structure or fastened to the airfoil by an interlocking slide connection and/or welding. By attaching the nozzle ribs to the nozzle airfoil metal in such a way that allows play longitudinally of the airfoil, the temperature difference induced radial thermal stresses at the nozzle airfoil/rib joint area are reduced while maintaining proper mechanical support of the nozzle side walls.

  19. MESA. An ERL project for particle physics experiments

    Energy Technology Data Exchange (ETDEWEB)

    Hug, Florian [Institut fuer Kernphysik, Universitaet Mainz (Germany)

    2016-07-01

    The Mainz Energy-recovering Superconducting Accelerator (MESA) will be constructed at the Institut fuer Kernphysik of the Johannes Gutenberg University of Mainz. The accelerator is a low energy continuous wave (CW) recirculating electron linac for particle physics experiments. MESA will be operated in two different modes serving mainly two experiments: the first is the external beam (EB) mode, where the beam is dumped after being used with the external fixed target experiment P2, whose goal is the measurement of the weak mixing angle with highest accuracy. The required beam current for P2 is 150 μA with polarized electrons at 155 MeV. In the second operation mode MESA will be run as an energy recovery linac (ERL). In an ERL the energy of the electrons is recovered after their experimental use by decelerating them in the superconducting acceleration cavities. The experiment served in this mode is a (pseudo) internal fixed target experiment named MAGIX. It demands an unpolarized beam of 1 mA at 105 MeV. In a later construction stage of MESA the achievable beam current in ERL-mode shall be upgraded to 10 mA. Within this talk an overview of the MESA project will be given highlighting the challenges of operation with high density internal gas targets and the (*new*) physics applications.

  20. A cautionary note about the cross-national and clinical validity of cut-off points for the Maslach Burnout Inventory.

    Science.gov (United States)

    Schaufeli, W B; Van Dierendonck, D

    1995-06-01

    In the present study, burnout scores of three samples, as measured with the Maslach Burnout Inventory, were compared: (1) the normative American sample from the test-manual (N = 10,067), (2) the normative Dutch sample (N = 3,892), and (3) a Dutch outpatient sample (N = 142). Generally, the highest burnout scores were found for the outpatient sample, followed by the American and Dutch normative samples, respectively. Slightly different patterns were noted for each of the three components. Probably sampling bias, i.e., the healthy worker effect, or cultural value patterns, i.e., femininity versus masculinity, might be responsible for the results. It is concluded that extreme caution is required when cut-off points are used to classify individuals by burnout scores; only nation-specific and clinically derived cut-off points should be employed.

  1. Cerebrospinal fluid neopterin analysis in neuropediatric patients: establishment of a new cut off-value for the identification of inflammatory-immune mediated processes.

    Directory of Open Access Journals (Sweden)

    Marta Molero-Luis

    Full Text Available OBJECTIVE: A high level of cerebrospinal fluid (CSF neopterin is a marker of central nervous system inflammatory-immune mediated processes. We aimed to assess data from 606 neuropediatric patients, describing the clinical and biochemical features of those neurological disorders presenting CSF neopterin values above a new cut-off value that was defined in our laboratory. METHODS: To establish the new CSF neopterin cut-off value, we studied two groups of patients: Group 1 comprised 68 patients with meningoencephalitis, and Group 2 comprised 52 children with a confirmed peripheral infection and no central nervous system involvement. We studied 606 CSF samples from neuropediatric patients who were classified into 3 groups: genetic diagnosis (A, acquired/unknown etiologic neurologic diseases (B and inflammatory-immune mediated processes (C. RESULTS: The CSF neopterin cut-off value was 61 nmol/L. Out of 606 cases, 56 presented a CSF neopterin level above this value. Group C had significantly higher CSF neopterin, protein and leukocyte values than the other groups. Sixteen of twenty-three patients in this group had a CSF neopterin level above the cut-off, whereas three and seven patients presented increased leukocyte and protein values, respectively. A significant association was found among CSF neopterin, proteins and leukocytes in the 606 patients. White matter disturbances were associated with high CSF neopterin concentrations. CONCLUSIONS: Although children with inflammatory-immune mediated processes presented higher CSF neopterin values, patients with other neurological disorders also showed increased CSF neopterin concentrations. These results stress the importance of CSF neopterin analysis for the identification of inflammatory-immune mediated processes.

  2. Fluid dynamics of Ribbed Annuli

    International Nuclear Information System (INIS)

    McCreery, G. E.; Pink, R. J.; Condie, K. G.; McEligot, D. M.

    2003-01-01

    Typical advanced gas-cooled reactor designs use periodic spacer ribs to center rods in circular cooling channels, e.g., as for control rods (General Atomics and others) and fuel rods (HTTR). In contrast to classical studies of axisymmetric annuli, the flow becomes three-dimensional but is typically periodic in the circumferential direction and - in some cases - in the streamwise direction. Fundamental measurements have been obtained for two idealizations of these complex geometries: an annulus with three ribs circumferentially and one with four. Laser Doppler Velocimetry (LDV) was employed with INEEL's unique Matched-Index-of-Refraction (MIR) flow facility to determine the velocity and turbulence fields. The initial experiment was aimed at obtaining benchmark data to test the capabilities of CFD (Computational Fluid Dynamics) codes to handle ribbed annular geometries without the complications of turbulent transport. The Reynolds number was about 1120. These conditions correspond to some stages during a pressurized cooldown (LOFA) event. Power spectral densities were obtained to determine the eddy shedding frequency downstream of the ribs. For the second experiment LDV measurements were obtained in another ribbed-annular model at a higher flow rate. For this nominally turbulent flow, evidence of laminarization appears in the flow converging to pass between ribs. The measurements indicated flow details which could be useful for assessment of CFD codes

  3. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing.

    Science.gov (United States)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4-6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low

  4. The cut-off point of dual energy X-ray and laser of calcaneus osteoporosis diagnosis in postmenopausal women

    International Nuclear Information System (INIS)

    Salimzadeh, A.; Forough, B.; Olia, B.; Alishiri, G. H.; Ghasemzadeh, A.

    2005-01-01

    Dual X-Ray Absorptiometry is a method which can extensively be used for bone mineral densitometry . Another more recent method is dual energy X-ray and laser, which associate with dual X ray absorptiometry, assisted by laser measure heel thickness. In this study the cut off points for dual energy X-ray and laser of calcaneus in the diagnosis of osteoporosis in different bone regions in postmenopausal women had been determined. Materials and Methods: In 268 postmenopausal women, BMD of the spinal and femoral regions was measured by DM, and the value for the calcaneous was measured by dual energy X-ray and laser. The agreement of the two methods in the diagnosis of osteoporosis and optimal cut-off point for dual energy X-ray and laser in defining osteoporosis was obtained. What obtained was the agreement of the two methods in the diagnosis of osteoporosis, as well as the optimal cut-off point for dual energy X-ray and laser in defining osteoporosis. Results: Dual X-Ray Absorptiometry showed osteoporosis in 40.7% of cases with 35.2% in L2-L4, 16.2% in the femoral neck, and 11.7% for the femoral total region. The dual energy X-ray and laser found osteoporosis, considering -2.5 SD as a threshold, in 26.1% of cases. Agreement of the two methods in the diagnosis of osteoporosis (Kappa score) was 0.443 for the lumbar region, 0.464 for the neck, and, 0.421 for total femur regions (all P values were significant). Using Receiver Operating Characteristic curves, it was found that a T-score of -2.1, -2.6 and -2.4 as the optimal cut-off point of dual energy X-ray and laser in the diagnosis of osteoporosis in the lumbar spine, the neck and total region of femur, respectively. Conclusion: The results of this study showed a moderate agreement between the two methods in the diagnosis of osteoporosis. It seems that the dual energy X-ray and laser cannot be used as a substitute for the DM method, but it can be used as a screening method to find (to diagnose) osteoporosis

  5. India and the fissile material cut-off treaty: policy options

    International Nuclear Information System (INIS)

    Nayan, Rajiv

    2011-01-01

    The international community inside and outside the Conference of Disarmament is underscoring the need for concluding a fissile material cut-off treaty (FMCT). The Indian government, for a long period, has been sponsoring the idea. Notwithstanding the international stagnation, the issue has been instigating periodic debate in India on the Indian approach. The periodic revival of the issue requires that India revisit its policy on fissile material production as well as its approach towards a possible EVICT. This article examines the question: should India's approach to conclude an FMCT be within the UN institutional framework? The new international reality is pushing for a new context, new realignments and a fresh outlook for an FMCT. India should take its own time to support conclusion of an FMCT so that its national interests and security are not adversely affected. (author)

  6. High harmonic generation at the tunneling ionization of atoms by intense laser radiation near the classical cut-off

    Science.gov (United States)

    Gets, A. V.; Krainov, V. P.

    2018-01-01

    The yield of spontaneous photons at the tunneling ionization of atoms by intense low-frequency laser radiation near the classical cut-off is estimated analytically by using the three-step model. The Bell-shaped dependence in the universal photon spectrum is explained qualitatively.

  7. The Potential of Established Fitness Cut-off Points for Monitoring Women with Fibromyalgia : The al-Ándalus Project

    NARCIS (Netherlands)

    Castro-Piñero, José; Aparicio, Virginia A; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Borges-Cosic, Milkana; Soriano-Maldonado, Alberto; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

    2017-01-01

    The aim of the present study was to determinate whether fitness cut-off points discriminate the severity of major fibromyalgia symptoms and health-related quality of life. Additionally, we investigated which American Colleague of Rheumatology (ACR) fibromyalgia criteria (1990 vs. modified 2010)

  8. Interannual rainfall variability over the Cape south coast of South Africa linked to cut-off low associated rainfall

    CSIR Research Space (South Africa)

    Engelbrecht, CJ

    2014-10-01

    Full Text Available The influence of cut-off low (COL) associated rainfall on interannual rainfall variability over the Cape south coast region of South Africa for the period 1979-2011 is investigated. COLs are objectively identified and tracked on daily average 500 h...

  9. Exploration of the optimal diameter cut-off value in patients with nonfunctional adrenal tumor suitable for surgery

    Directory of Open Access Journals (Sweden)

    Dan-dan LIU

    2016-12-01

    Full Text Available Objective  To analyze the pathology of the patients with nonfunctional adrenal tumor (NFA, and explore the optimal diameter cut-off value. Methods  The clinical data of 243 patients with NFA, evaluated in the Department of Endocrinology and operated in the Department of Urology of General Hospital of Chinese PLA from Feb. 1996 to Jan. 2016, were collected. The patients were divided into two groups according to pathology: those in real demand of surgery were classified to the surgery-need group (n=57, while the others were categorized as the surgery-unwanted group (n=186. The general situation, pathological type and tumor diameter of the two groups and the factors affecting the surgery were analyzed, and the ROC curve was used to explore the optimal surgery cut-off value, which represents the maximum value of the sum of sensitivity and specificity. Results  Of the 57 patients in surgery-need group (27 males and 30 females, the lesions were on the right in 31 cases, on the left in 25 cases, and on bilateral sides in 1 case; the median of lesion diameter was 4.5cm, and the average age was 41.5±12.1 years old. Of the 186 patients in surgery-unwanted group (87 males and 99 females, the lesions were on the right in 99 cases, on the left in 86 cases, and on bilateral sides in 1 case; the median of lesion diameter was 3.0cm, and the average age was 50.6±10.9 years old. Logistic regression revealed that lesion diameter might be a risk factor (OR=1.340, 95%CI 1.266-1.418, P=0.000 and age be a protective factor (OR=0.942, 95%CI 0.929-0.955, P=0.000 for real demand of surgery. The area under the ROC curve (AUC of lesion diameter was 0.757(95%CI 0.681-0.833. The optimal cut-off value was 4.1cm (sensitivity 60.7% and specificity 83.0%. Conclusions  Younger patients with bigger lesion diameter may have greater possibility for surgery. The optimal surgery cut-off value of the lesion diameter is 4.1cm. DOI: 10.11855/j.issn.0577-7402.2016.11.11

  10. Break-apart interphase fluorescence in situ hybridization assay in papillary thyroid carcinoma: on the road to optimizing the cut-off level for RET/PTC rearrangements.

    Science.gov (United States)

    Colato, Chiara; Vicentini, Caterina; Cantara, Silvia; Pedron, Serena; Brazzarola, Paolo; Marchetti, Ivo; Di Coscio, Giancarlo; Chilosi, Marco; Brunelli, Matteo; Pacini, Furio; Ferdeghini, Marco

    2015-05-01

    Chromosomal rearrangements of the RET proto-oncogene is one of the most common molecular events in papillary thyroid carcinoma (PTC). However, their pathogenic role and clinical significance are still debated. This study aimed to investigate the prevalence of RET/PTC rearrangement in a cohort of BRAF WT PTCs by fluorescence in situ hybridization (FISH) and to search a reliable cut-off level in order to distinguish clonal or non-clonal RET changes. Forty BRAF WT PTCs were analyzed by FISH for RET rearrangements. As controls, six BRAFV600E mutated PTCs, 13 follicular adenomas (FA), and ten normal thyroid parenchyma were also analyzed. We performed FISH analysis on formalin-fixed, paraffin-embedded tissue using a commercially available RET break-apart probe. A cut-off level equivalent to 10.2% of aberrant cells was accepted as significant. To validate FISH results, we analyzed the study cohort by qRT-PCR. Split RET signals above the cut-off level were observed in 25% (10/40) of PTCs, harboring a percentage of positive cells ranging from 12 to 50%, and in one spontaneous FA (1/13, 7.7%). Overall, the data obtained by FISH matched well with qRT-PCR results. Challenging findings were observed in five cases showing a frequency of rearrangement very close to the cut-off. FISH approach represents a powerful tool to estimate the ratio between broken and non-broken RET tumor cells. Establishing a precise FISH cut-off may be useful in the interpretation of the presence of RET rearrangement, primarily when this strategy is used for cytological evaluation or for targeted therapy. © 2015 European Society of Endocrinology.

  11. Model based rib-cage unfolding for trauma CT

    Science.gov (United States)

    von Berg, Jens; Klinder, Tobias; Lorenz, Cristian

    2018-03-01

    A CT rib-cage unfolding method is proposed that does not require to determine rib centerlines but determines the visceral cavity surface by model base segmentation. Image intensities are sampled across this surface that is flattened using a model based 3D thin-plate-spline registration. An average rib centerline model projected onto this surface serves as a reference system for registration. The flattening registration is designed so that ribs similar to the centerline model are mapped onto parallel lines preserving their relative length. Ribs deviating from this model appear deviating from straight parallel ribs in the unfolded view, accordingly. As the mapping is continuous also the details in intercostal space and those adjacent to the ribs are rendered well. The most beneficial application area is Trauma CT where a fast detection of rib fractures is a crucial task. Specifically in trauma, automatic rib centerline detection may not be guaranteed due to fractures and dislocations. The application by visual assessment on the large public LIDC data base of lung CT proved general feasibility of this early work.

  12. European quality assurance and quality control for cut-off walls and caps

    International Nuclear Information System (INIS)

    Jefferis, S.A.

    1997-01-01

    Cut-off walls and caps both may be seriously compromised by small areas of substandard materials or work. Quality assurance/quality control is therefore of crucial importance and the paper sets out the issues that need to be addressed when designing a quality plan for a containment. Consideration is given to the purpose of the containment, the parameters to be controlled, specifications and standards and tests on raw and manufactured materials and on the in-situ containment. It is not the purpose of the paper to give detailed test procedures but rather to identify the questions that must be answered to develop a quality plan

  13. Effective moments of inertia and spin cut off parameters in Hf isotopes

    International Nuclear Information System (INIS)

    Razavi, R.; Sharifzadeh, N.; Farahmand, M.R.

    2011-01-01

    In all statistical theories the nuclear level density is the most characteristic quantity and plays a major role in the study of nuclear structure. Most experimental data on nuclear level density have been analyzed with analytical functions of the level density. On the basis of statistical models, the effective moments of inertia and spin cut off parameters have been determined for 176 Hf, 178 Hf and 180 Hf nuclei from extensive and complete level schemes and neutron resonance densities in low excitation energy levels. Then, moments of inertia of these nuclei have been determined by nuclear rotational model. The results have been compared with their corresponding rigid body value

  14. Cut-off scores of a brief neuropsychological battery (NBACE for Spanish individual adults older than 44 years old.

    Directory of Open Access Journals (Sweden)

    Montserrat Alegret

    Full Text Available The neuropsychological battery used in Fundació ACE (NBACE is a relatively brief, and easy to administer, test battery that was designed to detect cognitive impairment in the adulthood. The NBACE includes measures of cognitive information processing speed, orientation, attention, verbal learning and memory, language, visuoperception, praxis and executive functions. The aim of the present study was to establish the cut-off scores for impairment for different levels of age and education that could be useful in the cognitive assessment of Spanish subjects who are at risk for cognitive impairment, especially dementia. Data from 1018 patients with a mild dementia syndrome, and 512 cognitively healthy subjects, older than 44 years, from the Memory Clinic of Fundació ACE (Barcelona, Spain were analyzed. In the whole sample, cut-off scores and sensitivity/specificity values were calculated for six conditions after combining 3 age ranges (44 to 64; 65 to 74; and older than 74 years old by 2 educational levels (until Elementary school; and more than Elementary school. Moreover, general cut-offs are reported for Catalan and Spanish speakers. The results showed that most of NBACE tests reached good sensitivity and specificity values, except for Ideomotor praxis, Repetition and Verbal Comprehension tests, which had a ceiling effect. Word List Learning from the Wechsler Memory Scale-III and Semantic Verbal Fluency were the most useful tests to discriminate between cognitively healthy and demented subjects. The NBACE has been shown to be a useful tool able to detect cognitive impairment, especially dementia, in older than 44 years Spanish persons.

  15. Determination of cosmic ray (CR) ionization path and iono/atmospheric cut-off energy from CR intervals III, IV and V in the planetary environments

    International Nuclear Information System (INIS)

    Velinov, P.

    2001-01-01

    In this paper are determined the ionization path and cut-off energies of the cosmic ray (CR) nuclei in relation to the general interaction model 'CR - ionosphere-middle atmosphere'. Here the ionization path and the iono/atmospheric cut-off energies of the galactic CR, solar CR and anomalous CR are separately considered in each energetic range, without taking into account the particle transfer from one range in another. This more general approach will be the object of a further paper

  16. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures.

    Science.gov (United States)

    Chapman, Brandon C; Overbey, Douglas M; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T; French, Andrew; Johnson, Jeffrey L; Burlew, Clay C; Barnett, Carlton; Moore, Ernest E; Pieracci, Fredric M

    2016-12-01

    Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Retrospective cohort study of blunt trauma patients with rib fractures at a level I trauma center that had both a CXR and a CT chest. The CT finding of ≥ 3 additional fractures in patients with ≤ 3 rib fractures on CXR was considered clinically meaningful. Student's t-test and chi-square analysis were used for comparison. We identified 499 patients with rib fractures: 93 (18.6%) had CXR only, 7 (1.4%) had chest CT only, and 399 (79.9%) had both CXR and chest CT. Among these 399 patients, a total of 1,969 rib fractures were identified: 1,467 (74.5%) were missed by CXR. The median number of additional fractures identified by CT was 3 (range, 4 - 15). Of 212 (53.1%) patients with a clinically meaningful increase in the number of fractures, 68 patients underwent one or more clinical interventions: 36 SICU admissions, 20 pain catheter placements, 23 epidural placements, and 3 SSRF. Additionally, 70 patients had a chest tube placed for retained hemothorax or occult pneumothorax. Overall, 138 patients (34.5%) had a change in clinical management based upon CT chest. The chest X-ray missed ~75% of rib fractures seen on chest CT. Although patients with a clinical meaningful increase in the number of rib fractures were more likely to be admitted to the intensive care unit, there was no associated improvement in pulmonary outcomes.

  17. How different are the Kebara 2 ribs to modern humans?

    Science.gov (United States)

    Chapman, Tara; Beyer, Benoît; Sholukha, Victor; Semal, Patrick; Feipel, Veronique; Louryan, Stéphane; Van Sint Jan, Serge

    2017-12-30

    This study analyses rib geometric parameters of individual ribs of 14 modern human subjects (7 males and 7 females) in comparison to the reconstructed ribs of the Kebara 2 skeleton which was taken from the reconstruction of a Neandertal thorax by Sawyer & Maley (2005). Three-dimensional (3D) models were segmented from CT scans and each rib vertex cloud was placed into a local coordinate system defined from the rib principal axes. Rib clouds were then analysed using best fitting ellipses of the external contours of the cross-section areas. The centroid of each ellipse was then used to measure the centroidal pathway between each slice (rib midline). Curvature of the ribs was measured from the mid-line of the ribs as the sum of angles between successive centroids in adjacent cross sections. Distinct common patterns were noted in all rib geometric parameters for modern humans. The Kebara 2 reconstructed ribs also followed the same patterns. This study demonstrated that there are differences between the sexes in rib geometrical parameters, with females showing smaller rib width, chord length and arc length, but greater curvature (rib torsion, rib axial curvature, rib anterior-posterior bending) than males. The Kebara 2 reconstructed ribs were within the modern human range for the majority of geometrical parameters.

  18. A study of insulin resistance by HOMA-IR and its cut-off value to identify metabolic syndrome in urban Indian adolescents.

    Science.gov (United States)

    Singh, Yashpal; Garg, M K; Tandon, Nikhil; Marwaha, Raman Kumar

    2013-01-01

    Insulin resistance (IR) and associated metabolic abnormalities are increasingly being reported in the adolescent population. Cut-off value of homeostasis model of assessment IR (HOMA-IR) as an indicator of metabolic syndrome (MS) in adolescents has not been established. This study aimed to investigate IR by HOMA-IR in urban Indian adolescents and to establish cut-off values of HOMA-IR for defining MS. A total of 691 apparently healthy adolescents (295 with normal body mass index (BMI), 205 overweight, and 199 obese) were included in this cross-sectional study. MS in adolescents was defined by International Diabetes Federation (IDF) and Adult Treatment Panel III (ATP III) criteria. IR was calculated using the HOMA model. Mean height, waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR), and blood pressure were significantly higher in boys as compared to girls. The HOMA-IR values increased progressively from normal weight to obese adolescents in both sexes. Mean HOMA-IR values increased progressively according to sexual maturity rating in both sexes. HOMA-IR value of 2.5 had a sensitivity of >70% and specificity of >60% for MS. This cut-off identified larger number of adolescents with MS in different BMI categories (19.7% in normal weight, 51.7% in overweight, and 77.0% in obese subjects) as compared to the use of IDF or ATP III criteria for diagnosing MS. Odds ratio for having IR (HOMA-IR of >2.5) was highest with WHtR (4.9, p pHOMA-IR increased with sexual maturity and with progression from normal to obese. A HOMA-IR cut-off of 2.5 provided the maximum sensitivity and specificity in diagnosing MS in both genders as per ATP III and IDF criteria.

  19. A 3' UTR-derived non-coding RNA RibS increases expression of cfa and promotes biofilm formation of Salmonella enterica serovar Typhi.

    Science.gov (United States)

    Zhao, Xin; Liu, Rui; Tang, Hao; Osei-Adjei, George; Xu, Shungao; Zhang, Ying; Huang, Xinxiang

    2018-05-08

    Bacterial non-coding RNAs (ncRNAs) are widely studied and found to play important roles in regulating various cellular processes. Recently, many ncRNAs have been discovered to be transcribed or processed from 3' untranslated regions (3' UTRs). Here we reported a novel 3' UTR-derived ncRNA, RibS, which could influence biofilm formation of Salmonella enterica serovar Typhi (S. Typhi). RibS was confirmed to be a ∼700 nt processed product produced by RNase III-catalyzed cleavage from the 3' UTR of riboflavin synthase subunit alpha mRNA, RibE. Overexpression of RibS increased the expression of the cyclopropane fatty acid synthase gene, cfa, which was located at the antisense strand. Biofilm formation of S. Typhi was enhanced by overexpressing RibS both in the wild type strain and cfa deletion mutant. Deletion of cfa attenuated biofilm formation of S. Typhi, while complementation of cfa partly restored the phenotype. Moreover, overexpressing cfa enhanced the biofilm formation of S. Typhi. In summary, RibS has been identified as a novel ncRNA derived from the 3' UTR of RibE that promotes biofilm formation of S. Typhi, and it appears to do so, at least in part, by increasing the expression of cfa. Copyright © 2018 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

  20. Receiver Operating Characteristic (ROC to Determine Cut-Off Points of Biomarkers in Lung Cancer Patients

    Directory of Open Access Journals (Sweden)

    Heidi L. Weiss

    2004-01-01

    Full Text Available The role of biomarkers in disease prognosis continues to be an important investigation in many cancer studies. In order for these biomarkers to have practical application in clinical decision making regarding patient treatment and follow-up, it is common to dichotomize patients into those with low vs. high expression levels. In this study, receiver operating characteristic (ROC curves, area under the curve (AUC of the ROC, sensitivity, specificity, as well as likelihood ratios were calculated to determine levels of growth factor biomarkers that best differentiate lung cancer cases versus control subjects. Selected cut-off points for p185erbB-2 and EGFR membrane appear to have good discriminating power to differentiate control tissues versus uninvolved tissues from patients with lung cancer (AUC = 89% and 90%, respectively; while AUC increased to at least 90% for selected cut-off points for p185erbB-2 membrane, EGFR membrane, and FASE when comparing between control versus carcinoma tissues from lung cancer cases. Using data from control subjects compared to patients with lung cancer, we presented a simple and intuitive approach to determine dichotomized levels of biomarkers and validated the value of these biomarkers as surrogate endpoints for cancer outcome.

  1. Novel classification system of rib fractures observed in infants.

    Science.gov (United States)

    Love, Jennifer C; Derrick, Sharon M; Wiersema, Jason M; Pinto, Deborrah C; Greeley, Christopher; Donaruma-Kwoh, Marcella; Bista, Bibek

    2013-03-01

    Rib fractures are considered highly suspicious for nonaccidental injury in the pediatric clinical literature; however, a rib fracture classification system has not been developed. As an aid and impetus for rib fracture research, we developed a concise schema for classifying rib fracture types and fracture location that is applicable to infants. The system defined four fracture types (sternal end, buckle, transverse, and oblique) and four regions of the rib (posterior, posterolateral, anterolateral, and anterior). It was applied to all rib fractures observed during 85 consecutive infant autopsies. Rib fractures were found in 24 (28%) of the cases. A total of 158 rib fractures were identified. The proposed schema was adequate to classify 153 (97%) of the observed fractures. The results indicate that the classification system is sufficiently robust to classify rib fractures typically observed in infants and should be used by researchers investigating infant rib fractures. © 2013 American Academy of Forensic Sciences.

  2. The cut-off values of dietary energy intake for determining metabolic syndrome in hemodialysis patients: A clinical cross-sectional study

    Science.gov (United States)

    Duong, Tuyen Van; Wong, Te-Chih; Chen, Hsi-Hsien; Chen, Tzen-Wen; Chen, Tso-Hsiao; Hsu, Yung-Ho; Peng, Sheng-Jeng; Kuo, Ko-Lin; Wang, Chi-Sin; Tseng, I-Hsin; Feng, Yi-Wei; Chang, Tai-Yue; Su, Chien-Tien

    2018-01-01

    Dietary energy intake strongly linked to dialysis outcomes. We aimed to explore the optimal cut-off point of energy intake (EI) for identification of metabolic syndrome (MetS) in hemodialysis patients. The cross-sectional data of 243 hemodialysis patients from multi-dialysis centers in Taiwan was used. The dietary intake was assessed by using the three-day dietary questionnaire, and a 24-hour dietary recall, clinical and biochemical data were also evaluated. The MetS was diagnosed by the Harmonized Metabolic Syndrome criteria. The receiver operating characteristic (ROC) curve was to depict the optimal cut-off value of EI for the diagnosis of MetS. The logistic regression was also used to explore the association between inadequate EI and MetS. The optimal cut-off points of EI for identifying the MetS were 26.7 kcal/kg/day for patients aged less than 60 years, or with non-diabetes, and 26.2 kcal/kg/day for patients aged 60 years and above, or with diabetes, respectively. The likelihood of the MetS increased with lower percentiles of energy intake in hemodialysis patients. In the multivariate analysis, the inadequate dietary energy intake strongly determined 3.24 folds of the MetS. The assessment of dietary EI can help healthcare providers detecting patients who are at risk of metabolic syndrome. PMID:29538427

  3. The Optimal Cut-Off Value of Neutrophil-to-Lymphocyte Ratio for Predicting Prognosis in Adult Patients with Henoch–Schönlein Purpura

    Science.gov (United States)

    Park, Chan Hyuk; Han, Dong Soo; Jeong, Jae Yoon; Eun, Chang Soo; Yoo, Kyo-Sang; Jeon, Yong Cheol; Sohn, Joo Hyun

    2016-01-01

    Background The development of gastrointestinal (GI) bleeding and end-stage renal disease (ESRD) can be a concern in the management of Henoch–Schönlein purpura (HSP). We aimed to evaluate whether the neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of adult patients with HSP. Methods Clinical data including the NLR of adult patients with HSP were retrospectively analyzed. Patients were classified into three groups as follows: (a) simple recovery, (b) wax & wane without GI bleeding, and (c) development of GI bleeding. The optimal cut-off value was determined using a receiver operating characteristics curve and the Youden index. Results A total of 66 adult patients were enrolled. The NLR was higher in the GI bleeding group than in the simple recovery or wax & wane group (simple recovery vs. wax & wane vs. GI bleeding; median [IQR], 2.32 [1.61–3.11] vs. 3.18 [2.16–3.71] vs. 7.52 [4.91–10.23], P<0.001). For the purpose of predicting simple recovery, the optimal cut-off value of NLR was 3.18, and the sensitivity and specificity were 74.1% and 75.0%, respectively. For predicting development of GI bleeding, the optimal cut-off value was 3.90 and the sensitivity and specificity were 87.5% and 88.6%, respectively. Conclusions The NLR is useful for predicting development of GI bleeding as well as simple recovery without symptom relapse. Two different cut-off values of NLR, 3.18 for predicting an easy recovery without symptom relapse and 3.90 for predicting GI bleeding can be used in adult patients with HSP. PMID:27073884

  4. Prognostic impact of proliferation for resected early stage 'pure' invasive lobular breast cancer: Cut-off analysis of Ki67 according to histology and clinical validation.

    Science.gov (United States)

    Carbognin, Luisa; Sperduti, Isabella; Fabi, Alessandra; Dieci, Maria Vittoria; Kadrija, Dzenete; Griguolo, Gaia; Pilotto, Sara; Guarneri, Valentina; Zampiva, Ilaria; Brunelli, Matteo; Orvieto, Enrico; Nortilli, Rolando; Fiorio, Elena; Parolin, Veronica; Manfrin, Erminia; Caliò, Anna; Nisticò, Cecilia; Pellini, Francesca; Scarpa, Aldo; Pollini, Giovanni Paolo; Conte, Pierfranco; Tortora, Giampaolo; Bria, Emilio

    2017-10-01

    The intent of this analysis was to investigate and validate the prognostic potential of Ki67 in a multi-center series of patients affected by early stage 'pure' invasive lobular carcinoma (ILC). Clinical-pathological data of patients affected by ILC were correlated with overall survival and disease-free survival (OS/DFS); data from a parallel invasive ductal carcinoma (IDC) patients' cohort were gathered as well. The maximally selected Log-Rank statistics analysis was applied to Ki67 continuous variable to estimate the appropriate cut-off. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed as well. Data from overall 1097 (457/222 ILC: training/validation set; 418 IDC) patients were gathered. The identified optimal Ki67 cut-offs were 4% and 14% for DFS in ILC and IDC cohort, respectively. In ILC patients, the Ki67 cut-off was an independent OS predictor. Ten-years OS and DFS were 89.9% and 77.2% (p = 0.007) and 79.4% and 69.2% (p = 0.03) for patients with Ki67 ≤ 4% and >4%, respectively. In IDC patients, 10-years OS was 93.8% and 71.7%, p = 0.02, DFS was 84.0% and 52.6%, p = 0.0003, for patients with Ki67 ≤ 14% and >14%, respectively. In the validation set, the optimal Ki67 OS cut-off was 5%. The STEPP analysis showed that in the presence of low Ki67 values, IDC patients have a better DFS than ILC patients, while with the increase of values the prognosis tends to overlap. Despite the retrospective design of the study, the prognostic relevance of Ki67 (as well as its optimal cut-off) seems to significantly differ according to breast cancer histology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Posterior-only spinal fusion without rib head resection for treating type I neurofibromatosis with intra-canal rib head dislocation

    Directory of Open Access Journals (Sweden)

    Dong Sun

    2013-12-01

    Full Text Available OBJECTIVES: Patients with Type I neurofibromatosis scoliosis with intra-canal rib head protrusion are extremely rare. Current knowledge regarding the diagnosis and treatment for this situation are insufficient. The purpose of this study is to share our experience in the diagnosis and surgical treatments for such unique deformities. METHODS: Six patients with Type I neurofibromatosis scoliosis with rib head dislocation into the spinal canal were diagnosed at our institution. Posterior instrumentation and spinal fusion without intra-canal rib head resection via a posterior-only approach was performed for deformity correction and rib head extraction. The efficacy and outcomes of the surgery were evaluated by measurements before, immediately and 24 months after the surgery using the following parameters: coronal spinal Cobb angle, apex rotation and kyphosis of the spine and the intra-canal rib head position. Post-operative complications, surgery time and blood loss were also evaluated. RESULTS: Patients were followed up for at least 24 months post-operatively. The three dimensional spinal deformity was significantly improved and the intra-canal rib head was significantly extracted from the canal immediately after the surgery. At follow-up 24 months after surgery, solid fusions were achieved along the fusion segments, and the deformity corrections and rib head positions were well maintained. There were no surgery-related complications any time after the surgery. CONCLUSIONS: Systematic examinations are needed to identify patients with Type I neurofibromatosis scoliosis with rib head dislocation into the canal who can be treated by posterior-only spinal fusion without rib head resection.

  6. Rib plating of acute and sub-acute non-union rib fractures in an adult with cystic fibrosis: a case report.

    Science.gov (United States)

    Dean, Nathan C; Van Boerum, Don H; Liou, Theodore G

    2014-10-01

    Rib fractures associated with osteoporosis have been reported to occur ten times more frequently in adults with cystic fibrosis. Fractures cause chest pain, and interfere with cough and sputum clearance leading to worsened lung function and acute exacerbations which are the two main contributors to early mortality in cystic fibrosis. Usual treatment involves analgesics and time for healing; however considerable pain and disability result due to constant re-injury from chronic repetitive cough. Recently, surgical plating of rib fractures has become commonplace in treating acute, traumatic chest injuries. We describe here successful surgical plating in a White cystic fibrosis patient with multiple, non-traumatic rib fractures. A-37-year old White male with cystic fibrosis was readmitted to Intermountain Medical Center for a pulmonary exacerbation. He had developed localized rib pain while coughing 2 months earlier, with worsening just prior to hospital admission in conjunction with a "pop" in the same location while bending over. A chest computerized tomography scan at admission demonstrated an acute 5th rib fracture and chronic non-united 6th and 7th right rib fractures. An epidural catheter was placed both for analgesia and to make secretion clearance possible in preparation for the surgery performed 2 days later. Under general anesthesia, he had open reduction and internal fixation of the right 5th, 6th and 7th rib fractures with a Synthes Matrix rib set. After several days of increased oxygen requirements, fever, fluid retention, and borderline vital signs, he stabilized. Numerical pain rating scores from his ribs were lower post-operatively and he was able to tolerate chest physical therapy and vigorous coughing. In our case report, rib plating with bone grafting improved rib pain and allowed healing of the fractures and recovery, although the immediate post-op period required close attention and care. We believe repair may be of benefit in selected cystic

  7. Chondroblastoma of rib : case report

    International Nuclear Information System (INIS)

    Kim, Dong Hun; Kim, Kyung Rae; Ryu, Sang Wan

    2004-01-01

    Chondroblastoma is an uncommon, benign, cartilaginous neoplasm originating in an epiphysis or apophysis of a long tubular bone. The rib is an unusual site for chondroblastoma. The authors describe a case of chondroblastoma of the rib and present a brief review of the literature

  8. Chondroblastoma of rib : case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Hun; Kim, Kyung Rae; Ryu, Sang Wan [Kwangju Hospital, Kwangju (Korea, Republic of)

    2004-07-01

    Chondroblastoma is an uncommon, benign, cartilaginous neoplasm originating in an epiphysis or apophysis of a long tubular bone. The rib is an unusual site for chondroblastoma. The authors describe a case of chondroblastoma of the rib and present a brief review of the literature.

  9. Refining Game Addiction Questionnairs: Evidence for a natural cut-off point?

    DEFF Research Database (Denmark)

    Nielsen, Rune Kristian

    2013-01-01

    This paper presents data from a pilot study, which was designed to illuminate critical flaws in the currently used instruments used to measure the prevalence of ‘computer game addiction’. The study found that the prevalence rate could be set anywhere between 23% and 0,6% depending on how the data...... is unique in the field of prevalence studies of computer game addiction both in its design and its findings. The findings and conclusions need to be addressed by future research in the area.......’ from ‘addicted gamers’ by making implicit assumptions about negative effects explicit will cause prevalence rates to drop even further. Unexpectedly, the data from this modified questionnaire provides preliminary evidence for a natural cut-off point that clearly separates addicted play from normal play...

  10. Third molar cut-off value in assessing the legal age of 18 in Saudi population.

    Science.gov (United States)

    AlQahtani, Sakher; Kawthar, Alemad; AlAraik, Ayman; AlShalan, Ahmad

    2017-03-01

    Teeth plays a major role in forensic sciences especially in age assessment of an individual, which can be used to aid in criminal or civil matters. The importance of teeth comes from their ability to survive inhumation well and because they are hardly affected by exogenous and endogenous factors. Third molars are the only teeth still developing after the age of 14 years and during the legal age of adulthood, which is 18 years. The consequences of criminal violation can strongly affect the individual's life, it is important to set different parameters to decide whether an individual is a minor or an adult in the absence of documents. Depending on the different legal requirement, such parameters can set above 90% probability for criminal matters and from 51% to civil matters. The aim of this research was to find the cut-off value of third molar development for the legal age of 18 amongst Saudi individuals using the third molar maturity index method by Cameriere et al. (2008) [17]. This was a cross sectional study on 300 archived orthopantomogram (OPG) of healthy Saudi patients between the ages 14 and 22 years attending the Dental Hospital at King Saud University, Riyadh, Saudi Arabia. All OPGs were taken by PLANMECA - ProMax machine and evaluated by the Romaxis software. The inclusion criteria were good quality OPGs taken during the course of treatment. All patients were healthy with no systemic diseases or disorders with the presence of third molars and clear root apex. The lower left mandibular third molar (LL3rdM) was assessed using third molar maturity index (I3m) to determine if the individual is younger or older than 18 years old. The cut-off value of I3m for the Saudi population was (I3mage of adulthood in Saudi population and the cut-off value of I3m is similar to other populations. Although dental age assessment by means of third molar development is useful, it still has its limitation because of its variation in position, morphology and development

  11. Ordinary mode reflectometry. Modification of the scattering and cut-off responses due to the shape of localized density fluctuations

    International Nuclear Information System (INIS)

    Fanack, C.; Boucher, I.; Heuraux, S.; Leclert, G.; Clairet, F.; Zou, X.L.

    1996-01-01

    Ordinary wave reflectometry in a plasma containing a localized density perturbation is studied with a 1-D model. The phase response is studied as a function of the wavenumber and position of the perturbation. It is shown that it strongly depends upon the perturbation shape and size. For a small perturbation wavenumber, the response is due to the oscillation of the cut-off layer. For larger wavenumbers, two regimes are found: for a broad perturbation, the phase response is an image of the perturbation itself; for a narrow perturbation, it is rather an image of the Fourier transform. For tokamak plasmas it turns out that, for the fluctuation spectra usually observed, the phase response comes primarily from those fluctuations that are localized at the cut-off. Results of a 2-D numerical model show that geometry effects are negligible for the scattering by radial fluctuations. (author)

  12. Performance tests of an abrasive cut-off systems for the finishing of high-precision casts

    OpenAIRE

    A. Fedoryszyn; W. T. Meksa; G. Woźnicki

    2008-01-01

    The paper summarizes the performance data of a newly designed and engineered grinding and cut-off system. The machine is used for separation of models manufactured by the investment casting method. The machine comprises the following units:- base supporting other assemblies and elements: abrasive disc holder and drives; this solution enables an easy replacement and access to holding elements while a belt transmission allows the disc rpm to be varied,- mechanism moving the spindle in the horiz...

  13. Waste Isolation Pilot Plant: Alcove Gas Barrier trade-off study

    International Nuclear Information System (INIS)

    Lin, M.S.; Van Sambeek, L.L.

    1992-07-01

    A modified Kepner-Tregoe method was used for a trade-off study of Alcove Gas Barrier (AGB) concepts for the Waste Isolation Pilot Plant. The AGB is a gas-constraining seal to be constructed in an alcove entrance drift. In this trade-off study, evaluation criteria were first selected. Then these criteria were classified as to their importance to the task, assigning a weighting value to each aspect. Eleven conceptual design alternatives were developed based on geometrical/geological considerations, construction materials, constructibility, and other relevant factors and evaluated

  14. Quantitative assessment of isolated rapid eye movement (REM) sleep without atonia without clinical REM sleep behavior disorder: clinical and research implications.

    Science.gov (United States)

    Sasai-Sakuma, Taeko; Frauscher, Birgit; Mitterling, Thomas; Ehrmann, Laura; Gabelia, David; Brandauer, Elisabeth; Inoue, Yuichi; Poewe, Werner; Högl, Birgit

    2014-09-01

    Rapid eye movement (REM) sleep without atonia (RWA) is observed in some patients without a clinical history of REM sleep behavior disorder (RBD). It remains unknown whether these patients meet the refined quantitative electromyographic (EMG) criteria supporting a clinical RBD diagnosis. We quantitatively evaluated EMG activity and investigated its overnight distribution in patients with isolated qualitative RWA. Fifty participants with an incidental polysomnographic finding of RWA (isolated qualitative RWA) were included. Tonic, phasic, and 'any' EMG activity during REM sleep on PSG were quantified retrospectively. Referring to the quantitative cut-off values for a polysomnographic diagnosis of RBD, 7/50 (14%) and 6/50 (12%) of the patients showed phasic and 'any' EMG activity in the mentalis muscle above the respective cut-off values. No patient was above the cut-off value for tonic EMG activity or phasic EMG activity in the anterior tibialis muscles. Patients with RWA above the cut-off value showed higher amounts of RWA during later REM sleep periods. This is the first study showing that some subjects with incidental RWA meet the refined quantitative EMG criteria for a diagnosis of RBD. Future longitudinal studies must investigate whether this subgroup with isolated qualitative RWA is at an increased risk of developing fully expressed RBD and/or neurodegenerative disease. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Cut-off values for classifying active children and adolescentes using the Physical Activity Questionnaire: PAQ-C and PAQ-ACut-off values for classifying active children and adolescents using the Physical Activity Questionnaire: PAQ-C and PAQ-A.

    Science.gov (United States)

    Benítez-Porres, Javier; Alvero-Cruz, José Ramón; Sardinha, Luis B; López-Fernández, Iván; Carnero, Elvis A

    2016-09-20

    The Physical Activity Questionnaire for children and adolescents (PAQ-C & PAQ-A) has been widely used in research and field settings. However, there is a lack of information about its final score meaning. To determine PAQ-C and PAQ-A score cut-off values using physical activity (PA) thresholds objectively measured as reference criteria. 146 children (n = 83 boys, n = 63 girls) and 234 adolescents (n = 115 boys, n = 119 girls) participated in this study. Accelerometers (Actigraph GT3X) were used to assess objectively PA during one-week, afterwards PAQ was filled by the participants. As participants met or not the international PA recommendations for total, moderate-vigorous (MVPA) or light PA, three categorical variables of two levels were created. ROC curves procedure were carried out to obtain score cut-off points for identifying the positive category recommendation. ROC curves analysis estimated 2.75 and 2.73 score cut-off points to discriminate > 60 minutes of MVPA for PAQ-A and PAQ-C respectively (PAQ-A AUC = 0.68, p 0.05). Also 60 minutes of MVPA was achieved with a total volume of 10,664 steps/day in children and 9,701 steps/day in adolescents. Our results suggest that PAQ-A can be a useful tool to classify adolescents as active or inactive following international recommendations as criteria. However, we could not find a significant cut-off for PAQ-C score.

  16. Alternative Fuels Data Center: Mesa Unified School District Reaps Economic

    Science.gov (United States)

    and Environmental Benefits with Propane Buses Mesa Unified School District Reaps Economic and School District Reaps Economic and Environmental Benefits with Propane Buses on Facebook Tweet about Alternative Fuels Data Center: Mesa Unified School District Reaps Economic and Environmental Benefits with

  17. Evaluation of the Rib Lesions by Bone Scanning

    International Nuclear Information System (INIS)

    Park, Hyung Gun; Lee, Dong Soo; Lee, Myung Chul; Cho, Bo Youn; Koh, Chang Soon

    1983-01-01

    In order to establish criteria for distinguishing between occult fracture and metastases, we have reviewed 52 records of cancer patients and 24 of rib fracture patients referred for bone scanning. In 52 patients with biopsy-proven malignancy, multiple linear increased uptake of the ribs was found in 32 cases(61.5%), and was the most common finding. In 24 patients with rib fracture, all but 1 had fecal increased uptake of the ribs, and lesions almost always aligned in a row. By analyzing the appearance of rib lesions in total 76 patients, it was concluded that there is a high probability that rib lesions detected by bone scanning are bony metastases if 1) they are multiple linear as opposed to fecal, and 2) they are not aligned in the same location

  18. MODULES FOR EXPERIMENTS IN STELLAR ASTROPHYSICS (MESA): PLANETS, OSCILLATIONS, ROTATION, AND MASSIVE STARS

    International Nuclear Information System (INIS)

    Paxton, Bill; Cantiello, Matteo; Bildsten, Lars; Arras, Phil; Brown, Edward F.; Dotter, Aaron; Mankovich, Christopher; Montgomery, M. H.; Stello, Dennis; Timmes, F. X.; Townsend, Richard

    2013-01-01

    We substantially update the capabilities of the open source software package Modules for Experiments in Stellar Astrophysics (MESA), and its one-dimensional stellar evolution module, MESA star. Improvements in MESA star's ability to model the evolution of giant planets now extends its applicability down to masses as low as one-tenth that of Jupiter. The dramatic improvement in asteroseismology enabled by the space-based Kepler and CoRoT missions motivates our full coupling of the ADIPLS adiabatic pulsation code with MESA star. This also motivates a numerical recasting of the Ledoux criterion that is more easily implemented when many nuclei are present at non-negligible abundances. This impacts the way in which MESA star calculates semi-convective and thermohaline mixing. We exhibit the evolution of 3-8 M ☉ stars through the end of core He burning, the onset of He thermal pulses, and arrival on the white dwarf cooling sequence. We implement diffusion of angular momentum and chemical abundances that enable calculations of rotating-star models, which we compare thoroughly with earlier work. We introduce a new treatment of radiation-dominated envelopes that allows the uninterrupted evolution of massive stars to core collapse. This enables the generation of new sets of supernovae, long gamma-ray burst, and pair-instability progenitor models. We substantially modify the way in which MESA star solves the fully coupled stellar structure and composition equations, and we show how this has improved the scaling of MESA's calculational speed on multi-core processors. Updates to the modules for equation of state, opacity, nuclear reaction rates, and atmospheric boundary conditions are also provided. We describe the MESA Software Development Kit that packages all the required components needed to form a unified, maintained, and well-validated build environment for MESA. We also highlight a few tools developed by the community for rapid visualization of MESA star results

  19. Evidence for a maximum mass cut-off in the neutron star mass distribution and constraints on the equation of state

    Science.gov (United States)

    Alsing, Justin; Silva, Hector O.; Berti, Emanuele

    2018-04-01

    We infer the mass distribution of neutron stars in binary systems using a flexible Gaussian mixture model and use Bayesian model selection to explore evidence for multi-modality and a sharp cut-off in the mass distribution. We find overwhelming evidence for a bimodal distribution, in agreement with previous literature, and report for the first time positive evidence for a sharp cut-off at a maximum neutron star mass. We measure the maximum mass to be 2.0M⊙ sharp cut-off is interpreted as the maximum stable neutron star mass allowed by the equation of state of dense matter, our measurement puts constraints on the equation of state. For a set of realistic equations of state that support >2M⊙ neutron stars, our inference of mmax is able to distinguish between models at odds ratios of up to 12: 1, whilst under a flexible piecewise polytropic equation of state model our maximum mass measurement improves constraints on the pressure at 3 - 7 × the nuclear saturation density by ˜30 - 50% compared to simply requiring mmax > 2M⊙. We obtain a lower bound on the maximum sound speed attained inside the neutron star of c_s^max > 0.63c (99.8%), ruling out c_s^max c/√{3} at high significance. Our constraints on the maximum neutron star mass strengthen the case for neutron star-neutron star mergers as the primary source of short gamma-ray bursts.

  20. Nature and extent of lava-flow aquifers beneath Pahute Mesa, Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Prothro, L.B.; Drellack, S.L. Jr.

    1997-09-01

    Work is currently underway within the Underground Test Area subproject of the US Department of Energy/Nevada Operations Office Environmental Restoration Program to develop corrective action plans in support of the overall corrective action strategy for the Nevada Test Site as established in the Federal Facility Agreement and Consent Order (FFACO, 1996). A closure plan is currently being developed for Pahute Mesa, which has been identified in the FFACO as consisting of the Western and Central Pahute Mesa Corrective Action Units. Part of this effort requires that hydrogeologic data be compiled for inclusion in a regional model that will be used to predict a contaminant boundary for these Corrective Action Units. Hydrogeologic maps have been prepared for use in the model to define the nature and extent of aquifers and confining units that might influence the flow of contaminated groundwater from underground nuclear tests conducted at Pahute Mesa. Much of the groundwater flow beneath Pahute Mesa occurs within lava-flow aquifers. An understanding of the distribution and hydraulic character of these important hydrogeologic units is necessary to accurately model groundwater flow beneath Pahute Mesa. This report summarizes the results of a study by Bechtel Nevada geologists to better define the hydrogeology of lava-flow aquifers at Pahute Mesa. The purpose of this study was twofold: (1) aid in the development of the hydrostratigraphic framework for Pahute Mesa, and (2) provide information on the distribution and hydraulic character of lava-flow aquifers beneath Pahute Mesa for more accurate computer modeling of the Western and Central Pahute Mesa Corrective Action Units.

  1. Removal of methadone by extended dialysis using a high cut-off dialyzer: implications for the treatment of overdose and for pain management in patients undergoing light chain removal.

    Science.gov (United States)

    Arelin, Viktor; Schmidt, Julius J; Kayser, Nathalie; Kühn-Velten, W Nikolaus; Suhling, Hendrik; Eden, Gabriele; Kielstein, Jan T

    2016-06-01

    The synthetic opioid methadone hydrochloride has a low molecular weight of 346 D, a high volume of distribution (4 - 7 L/kg), and is lipophilic. It is used as an analgesic and for the maintenance treatment of opiate dependence. In drug addicts, methadone is frequently involved in mixed intoxications that can lead to death. Here we present the case of a drug addict in whom a high cut-off dialysis membrane together with extended dialysis was used in the setting of suspected overdose and acute kidney injury. Although the observed dialyzer plasma clearance (31.5 mL/min) and reduction ratio (38%) were higher than previously reported for standard hemodialysis, the total amount of methadone in the spent dialysate after 1 extended dialysis session was quite low. Hence, even extended dialysis with a high cut-off membrane does not seem to offer a clinically relevant benefit in the setting of overdose for enhanced methadone removal. On the other hand, in patients undergoing high cut-off dialysis for the removal of light chains, methadone could still be used as an analgesic without an additional dose after high cut-off hemodialysis.

  2. Human variation and body mass index: a review of the universality of BMI cut-offs, gender and urban-rural differences, and secular changes.

    Science.gov (United States)

    Mascie-Taylor, C G Nicholas; Goto, Rie

    2007-03-01

    Use of BMI as a surrogate for body fat percentage is debatable and universal BMI cut-off points do not seem appropriate; lower cut-off points than currently recommended by WHO should be used in some populations, especially in Asia. The adult WHO BMI database indicates that, on average, women are more obese than men, while men are more likely to be pre-obese than women. Urban rates of overweight and obesity are generally higher than rural rates in both sexes. The trend in pre-obesity and obesity over time is generally upward, with very marked increases in the USA and UK in both sexes over the last 10 years.

  3. Cut-off effect of radical TEMPO derivatives in olive oil-in-water emulsions.

    Science.gov (United States)

    Lopez de Arbina, Amaia; Rezende, Marcos Caroli; Aliaga, Carolina

    2017-06-01

    Three oil-in-water emulsions were prepared from mixtures of olive oil and Tween 20 in water. The effectiveness of a series of radical 2,2,6,6-tetramethylpiperidinoxyl (TEMPO) derivatives of variable lipophilicity in reactions with antioxidant Trolox, and as pyrene-fluorescence quenchers, was compared in the three emulsions. A "cut-off" effect was observed for the pyrene quenching by the probes, but not for their reaction with Trolox. The results were rationalized in terms of the amphiphobic nature of the probes, and the different locations of probe, pyrene and Trolox in the three-phase microheterogeneous systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Prospects for a fissile material cut-off: Achieving a successful NPT review process

    International Nuclear Information System (INIS)

    Kalinowski, M.

    1999-01-01

    Finding new and creative ways to overcome the current deadlock in progress in nuclear arms control became the most important question in the past year. For a long time it had been expected that after the conclusion of the Comprehensive Test Ban Treaty, the next step would be to ban production of fissile materials for weapon purposes. Three strategies are proposed for reaching relevant cut-off agreements. First suggests possible fore for achievement of relevant agreements, second is the proposal to begin with international register of inventories and production capabilities for all relevant nuclear materials, and the third one is ti identify equivalent steps obligatory for all the parties involved

  5. From Newton's Law to the Linear Boltzmann Equation Without Cut-Off

    Science.gov (United States)

    Ayi, Nathalie

    2017-03-01

    We provide a rigorous derivation of the linear Boltzmann equation without cut-off starting from a system of particles interacting via a potential with infinite range as the number of particles N goes to infinity under the Boltzmann-Grad scaling. More particularly, we will describe the motion of a tagged particle in a gas close to global equilibrium. The main difficulty in our context is that, due to the infinite range of the potential, a non-integrable singularity appears in the angular collision kernel, making no longer valid the single-use of Lanford's strategy. Our proof relies then on a combination of Lanford's strategy, of tools developed recently by Bodineau, Gallagher and Saint-Raymond to study the collision process, and of new duality arguments to study the additional terms associated with the long-range interaction, leading to some explicit weak estimates.

  6. Appropriate body mass index cut-offs to determine thinness, overweight and obesity in South Asian children in The Netherlands

    NARCIS (Netherlands)

    Wilde, J.A. de; Dommelen, P. van; Middelkoop, B.J.C.

    2013-01-01

    Background: Asian populations have an increased risk of developing cardiometabolic disorders at a lower body mass index (BMI) than other ethnic groups. Therefore, lower adult BMI cut-offs to determine overweight and obesity are recommended to assess the associated health risks for Asian (23 and 27.5

  7. Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and Treatment.

    Science.gov (United States)

    Talbot, Brett S; Gange, Christopher P; Chaturvedi, Apeksha; Klionsky, Nina; Hobbs, Susan K; Chaturvedi, Abhishek

    2017-01-01

    The ribs are frequently affected by blunt or penetrating injury to the thorax. In the emergency department setting, it is vital for the interpreting radiologist to not only identify the presence of rib injuries but also alert the clinician about organ-specific injury, specific traumatic patterns, and acute rib trauma complications that require emergent attention. Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic fractures. Specific attention is also required for flail chest and for fractures due to pediatric nonaccidental trauma. Rib fractures are associated with significant morbidity and mortality, both of which increase as the number of fractured ribs increases. Key complications associated with rib fracture include pain, hemothorax, pneumothorax, extrapleural hematoma, pulmonary contusion, pulmonary laceration, acute vascular injury, and abdominal solid-organ injury. Congenital anomalies, including supernumerary or accessory ribs, vestigial anterior ribs, bifid ribs, and synostoses, are common and should not be confused with traumatic pathologic conditions. Nontraumatic mimics of traumatic rib injury, with or without fracture, include metastatic disease, primary osseous neoplasms (osteosarcoma, chondrosarcoma, Ewing sarcoma, Langerhans cell histiocytosis, and osteochondroma), fibrous dysplasia, and Paget disease. Principles of management include supportive and procedural methods of alleviating pain, treating complications, and stabilizing posttraumatic deformity. By recognizing and accurately reporting the imaging findings, the radiologist will add value to the care of patients with thoracic trauma. Online supplemental material is available for this article. © RSNA, 2017.

  8. Diagnostic assessment without cut-offs: application of serology for the modelling of bovine digital dermatitis infection.

    Science.gov (United States)

    Vink, W D; Jones, G; Johnson, W O; Brown, J; Demirkan, I; Carter, S D; French, N P

    2009-11-15

    Bovine digital dermatitis (BDD) is an epidermitis which is a leading cause of infectious lameness. The only recognized diagnostic test is foot inspection, which is a labour-intensive procedure. There is no universally recognized, standardized lesion scoring system. As small lesions are easily missed, foot inspection has limited diagnostic sensitivity. Furthermore, interpretation is subjective, and prone to observer bias. Serology is more convenient to carry out and is potentially a more sensitive indicator of infection. By carrying out 20 serological assays using lesion-associated Treponema spp. isolates, three serogroups were identified. The reliability of the tests was established by assessing the level of agreement and the concordance correlation coefficient. Subsequently, an ELISA suitable for routine use was developed. The benchmark of diagnostic test validation is conventionally the determination of the key test parameters, sensitivity and specificity. This requires the imposition of a cut-off point. For serological assays with outcomes on a continuous scale, the degree by which the test result differs from this cut-off is disregarded. Bayesian statistical methodology has been developed which enables the assay result also to be interpreted on a continuous scale, thereby optimizing the information inherent in the test. Using a cross-sectional study dataset carried out on 8 representative dairy farms in the UK, the probability of infection, P(I), of each individual animal was estimated in the absence of a 'Gold Standard' by modelling I as a latent variable which was determined by lesion status, L as well as serology, S. Covariate data (foot hygiene score and age) were utilized to estimate P(L) when no lesion inspection was performed. Informative prior distributions were elicited where possible. The model was utilized for predictive inference, by computing estimates of P(I) and P(L) independently of the data. A more detailed and informative analysis of the farm

  9. Hydraulic Property and Soil Textural Classification Measurements for Rainier Mesa, Nevada Test Site, Nevada

    Science.gov (United States)

    Ebel, Brian A.; Nimmo, John R.

    2010-01-01

    This report presents particle size analysis, field-saturated hydraulic conductivity measurements, and qualitative descriptions of surficial materials at selected locations at Rainier Mesa, Nevada. Measurements and sample collection were conducted in the Rainier Mesa area, including unconsolidated sediments on top of the mesa, an ephemeral wash channel near the mesa edge, and dry U12n tunnel pond sediments below the mesa. Particle size analysis used a combination of sieving and optical diffraction techniques. Field-saturated hydraulic conductivity measurements employed a single-ring infiltrometer with analytical formulas that correct for falling head and spreading outside the ring domain. These measurements may prove useful to current and future efforts at Rainier Mesa aimed at understanding infiltration and its effect on water fluxes and radionuclide transport in the unsaturated zone.

  10. Problems in future negotiations for a treaty on the cut-off of fissile material for nuclear weapons

    International Nuclear Information System (INIS)

    Schaper, A.

    1999-01-01

    A treaty to end the production of fissile material for nuclear weapons, the so-called cutoff, is one of the most important next steps on the disarmament agenda.' But meanwhile, the Conference on Disarmament (CD) is deadlocked, and confidence in negotiations taking place in the near future is replaced by bewilderment at the inaction. The underlying conflict of the Comprehensive Test Ban Treaty (CTBT) negotiations can be summarized as nuclear disarmament versus nuclear nonproliferation. The same conflict is now blocking progress with negotiations in the CD on the Fissile Material Cut-off Treaty (FMCT). Nevertheless, the cut-off would be the major policy driver to insert transparency and irreversibility into the disarmament process,' and we need to harness all our efforts to overcome the current difficulties. The CTBT can be regarded as a tool to cap the qualitative nuclear arms race, for example to hinder the future development of qualitatively new nuclear explosives, and an FMCT can be seen as its quantitative counterpart, capping the amount of material available for new nuclear weapons. The complex questions involve political, technical, legal, and economic aspects and constitute a challenge for diplomats and decision makers

  11. A cut-off in the TeV gamma-ray spectrum of the SNR Cassiopeia A

    Science.gov (United States)

    Ahnen, M. L.; Ansoldi, S.; Antonelli, L. A.; Arcaro, C.; Babić, A.; Banerjee, B.; Bangale, P.; Barres de Almeida, U.; Barrio, J. A.; Becerra González, J.; Bednarek, W.; Bernardini, E.; Berti, A.; Bhattacharyya, W.; Biasuzzi, B.; Biland, A.; Blanch, O.; Bonnefoy, S.; Bonnoli, G.; Carosi, R.; Carosi, A.; Chatterjee, A.; Colak, M.; Colin, P.; Colombo, E.; Contreras, J. L.; Cortina, J.; Covino, S.; Cumani, P.; Da Vela, P.; Dazzi, F.; De Angelis, A.; De Lotto, B.; de Oña Wilhelmi, E.; Di Pierro, F.; Doert, M.; Domínguez, A.; Dominis Prester, D.; Dorner, D.; Doro, M.; Einecke, S.; Eisenacher Glawion, D.; Elsaesser, D.; Engelkemeier, M.; Fallah Ramazani, V.; Fernández-Barral, A.; Fidalgo, D.; Fonseca, M. V.; Font, L.; Fruck, C.; Galindo, D.; García López, R. J.; Garczarczyk, M.; Gaug, M.; Giammaria, P.; Godinović, N.; Gora, D.; Guberman, D.; Hadasch, D.; Hahn, A.; Hassan, T.; Hayashida, M.; Herrera, J.; Hose, J.; Hrupec, D.; Inada, T.; Ishio, K.; Konno, Y.; Kubo, H.; Kushida, J.; Kuveždić, D.; Lelas, D.; Lindfors, E.; Lombardi, S.; Longo, F.; López, M.; Maggio, C.; Majumdar, P.; Makariev, M.; Maneva, G.; Manganaro, M.; Mannheim, K.; Maraschi, L.; Mariotti, M.; Martínez, M.; Mazin, D.; Menzel, U.; Minev, M.; Mirzoyan, R.; Moralejo, A.; Moreno, V.; Moretti, E.; Neustroev, V.; Niedzwiecki, A.; Nievas Rosillo, M.; Nilsson, K.; Ninci, D.; Nishijima, K.; Noda, K.; Nogués, L.; Paiano, S.; Palacio, J.; Paneque, D.; Paoletti, R.; Paredes, J. M.; Pedaletti, G.; Peresano, M.; Perri, L.; Persic, M.; Prada Moroni, P. G.; Prandini, E.; Puljak, I.; Garcia, J. R.; Reichardt, I.; Rhode, W.; Ribó, M.; Rico, J.; Righi, C.; Saito, T.; Satalecka, K.; Schroeder, S.; Schweizer, T.; Shore, S. N.; Sitarek, J.; Šnidarić, I.; Sobczynska, D.; Stamerra, A.; Strzys, M.; Surić, T.; Takalo, L.; Tavecchio, F.; Temnikov, P.; Terzić, T.; Tescaro, D.; Teshima, M.; Torres-Albà, N.; Treves, A.; Vanzo, G.; Vazquez Acosta, M.; Vovk, I.; Ward, J. E.; Will, M.; Zarić, D.

    2017-12-01

    It is widely believed that the bulk of the Galactic cosmic rays is accelerated in supernova remnants (SNRs). However, no observational evidence of the presence of particles of PeV energies in SNRs has yet been found. The young historical SNR Cassiopeia A (Cas A) appears as one of the best candidates to study acceleration processes. Between 2014 December and 2016 October, we observed Cas A with the MAGIC telescopes, accumulating 158 h of good quality data. We derived the spectrum of the source from 100 GeV to 10 TeV. We also analysed ∼8 yr of Fermi-LAT to obtain the spectral shape between 60 MeV and 500 GeV. The spectra measured by the LAT and MAGIC telescopes are compatible within the errors and show a clear turn-off (4.6σ) at the highest energies, which can be described with an exponential cut-off at E_c = 3.5(^{+1.6}_{-1.0})_{stat} (^{+0.8}_{-0.9})_{sys} TeV. The gamma-ray emission from 60 MeV to 10 TeV can be attributed to a population of high-energy protons with a spectral index of ∼2.2 and an energy cut-off at ∼10 TeV. This result indicates that Cas A is not contributing to the high energy (∼PeV) cosmic ray sea in a significant manner at the present moment. A one-zone leptonic model fails to reproduce by itself the multiwavelength spectral energy distribution. Besides, if a non-negligible fraction of the flux seen by MAGIC is produced by leptons, the radiation should be emitted in a region with a low magnetic field (B⪅180 μG) like in the reverse shock.

  12. Predicting yields of high priced trimmed beef cuts by means of ...

    African Journals Online (AJOL)

    The linear models included carcass weight and visual assessment of fatness and conformation by means of seven fat and five conformation classes. Amount of variation accounted for (R2) was the most favourable for total yield (87.3%) and the least favourable for the rib-eye cut (43.5%). Carcass weight contributed to most ...

  13. Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007).

    Science.gov (United States)

    Esteghamati, Alireza; Ashraf, Haleh; Khalilzadeh, Omid; Zandieh, Ali; Nakhjavani, Manouchehr; Rashidi, Armin; Haghazali, Mehrdad; Asgari, Fereshteh

    2010-04-07

    We have recently determined the optimal cut-off of the homeostatic model assessment of insulin resistance for the diagnosis of insulin resistance (IR) and metabolic syndrome (MetS) in non-diabetic residents of Tehran, the capital of Iran. The aim of the present study is to establish the optimal cut-off at the national level in the Iranian population with and without diabetes. Data of the third National Surveillance of Risk Factors of Non-Communicable Diseases, available for 3,071 adult Iranian individuals aging 25-64 years were analyzed. MetS was defined according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria. HOMA-IR cut-offs from the 50th to the 95th percentile were calculated and sensitivity, specificity, and positive likelihood ratio for MetS diagnosis were determined. The receiver operating characteristic (ROC) curves of HOMA-IR for MetS diagnosis were depicted, and the optimal cut-offs were determined by two different methods: Youden index, and the shortest distance from the top left corner of the curve. The area under the curve (AUC) (95%CI) was 0.650 (0.631-0.670) for IDF-defined MetS and 0.683 (0.664-0.703) with the ATPIII definition. The optimal HOMA-IR cut-off for the diagnosis of IDF- and ATPIII-defined MetS in non-diabetic individuals was 1.775 (sensitivity: 57.3%, specificity: 65.3%, with ATPIII; sensitivity: 55.9%, specificity: 64.7%, with IDF). The optimal cut-offs in diabetic individuals were 3.875 (sensitivity: 49.7%, specificity: 69.6%) and 4.325 (sensitivity: 45.4%, specificity: 69.0%) for ATPIII- and IDF-defined MetS, respectively. We determined the optimal HOMA-IR cut-off points for the diagnosis of MetS in the Iranian population with and without diabetes.

  14. Fabrication study of GaAs mesa diodes for X-ray detection

    OpenAIRE

    Ng, J.S.; Meng, X.; Lees, J.E.; Barnett, A.; Tan, C.H.

    2014-01-01

    A study of leakage currents using GaAs mesa p-i-n diodes for X-ray photon counting is presented. Different wet chemical etching solution and etch depth were used in the fabrication of these mesa diodes. Low and uniform leakage currents were achieved when the diode fabrication used (i) a combination of main etching solution and finishing etching solution for the etching, and (ii) partially etched mesas. The diodes fabricated using these methods showed well-defined X-ray peaks when illuminated ...

  15. Design and Fabrication of Automatic Glass Cutting Machine

    Science.gov (United States)

    Veena, T. R.; Kadadevaramath, R. S.; Nagaraj, P. M.; Madhusudhan, S. V.

    2016-09-01

    This paper deals with the design and fabrication of the automatic glass or mirror cutting machine. In order to increase the accuracy of cut and production rate; and decrease the production time and accidents caused due to manual cutting of mirror or glass, this project aims at development of an automatic machine which uses a programmable logic controller (PLC) for controlling the movement of the conveyer and also to control the pneumatic circuit. In this machine, the work of the operator is to load and unload the mirror. The cutter used in this machine is carbide wheel with its cutting edge ground to a V-shaped profile. The PLC controls the pneumatic cylinder and intern actuates the cutter along the glass, a fracture layer is formed causing a mark to be formed below the fracture layer and a crack to be formed below the rib mark. The machine elements are designed using CATIA V5R20 and pneumatic circuit are designed using FESTO FLUID SIM software.

  16. Evaluation of Rib Fractures on a Single-in-plane Image Reformation of the Rib Cage in CT Examinations.

    Science.gov (United States)

    Dankerl, Peter; Seuss, Hannes; Ellmann, Stephan; Cavallaro, Alexander; Uder, Michael; Hammon, Matthias

    2017-02-01

    This study aimed to evaluate the diagnostic performance of using a reformatted single-in-plane image reformation of the rib cage for the detection of rib fractures in computed tomography (CT) examinations, employing different levels of radiological experience. We retrospectively evaluated 10 consecutive patients with and 10 patients without rib fractures, whose CT scans were reformatted to a single-in-plane image reformation of the rib cage. Eight readers (two radiologists, two residents in radiology, and four interns) independently evaluated the images for the presence of rib fractures using a reformatted single-in-plane image and a multi-planar image reformation. The time limit was 30 seconds for each read. A consensus of two radiologist readings was considered as the reference standard. Diagnostic performance (sensitivity, specificity, positive predictive value [PPV], and negative predictive value [NPV]) was assessed and evaluated per rib and per location (anterior, lateral, posterior). To determine the time limit, we prospectively analyzed the average time it took radiologists to assess the rib cage, in a bone window setting, in 50 routine CT examinations. McNemar test was used to compare the diagnostic performances. Single image reformation was successful in all 20 patients. The sensitivity, specificity, PPV, and NPV for the detection of rib fractures using the conventional multi-planar read were 77.5%, 99.2%, 89.9%, and 98.0% for radiologists; 46.3%, 99.7%, 92.5%, and 95.3% for residents; and 29.4%, 99.4%, 82.5%, and 93.9% for interns, respectively. Sensitivity, PPV, and NPV increased across all three groups of experience, using the reformatted single-in-plane image of the rib cage (radiologists: 85.0%, 98.6%, and 98.7%; residents: 80.0%, 92.8%, and 98.2%; interns: 66.9%, 89.9%, and 97.1%), whereas specificity did not change significantly (99.9%, 99.4%, and 99.3%). The diagnostic performance of the interns and residents was significantly better when

  17. Computed tomography measurement of rib cage morphometry in emphysema.

    Directory of Open Access Journals (Sweden)

    Nicola Sverzellati

    Full Text Available BACKGROUND: Factors determining the shape of the human rib cage are not completely understood. We aimed to quantify the contribution of anthropometric and COPD-related changes to rib cage variability in adult cigarette smokers. METHODS: Rib cage diameters and areas (calculated from the inner surface of the rib cage in 816 smokers with or without COPD, were evaluated at three anatomical levels using computed tomography (CT. CTs were analyzed with software, which allows quantification of total emphysema (emphysema%. The relationship between rib cage measurements and anthropometric factors, lung function indices, and %emphysema were tested using linear regression models. RESULTS: A model that included gender, age, BMI, emphysema%, forced expiratory volume in one second (FEV1%, and forced vital capacity (FVC% fit best with the rib cage measurements (R(2 = 64% for the rib cage area variation at the lower anatomical level. Gender had the biggest impact on rib cage diameter and area (105.3 cm(2; 95% CI: 111.7 to 98.8 for male lower area. Emphysema% was responsible for an increase in size of upper and middle CT areas (up to 5.4 cm(2; 95% CI: 3.0 to 7.8 for an emphysema increase of 5%. Lower rib cage areas decreased as FVC% decreased (5.1 cm(2; 95% CI: 2.5 to 7.6 for 10 percentage points of FVC variation. CONCLUSIONS: This study demonstrates that simple CT measurements can predict rib cage morphometric variability and also highlight relationships between rib cage morphometry and emphysema.

  18. ARFI cut-off values and significance of standard deviation for liver fibrosis staging in patients with chronic liver disease.

    Science.gov (United States)

    Goertz, Ruediger S; Sturm, Joerg; Pfeifer, Lukas; Wildner, Dane; Wachter, David L; Neurath, Markus F; Strobel, Deike

    2013-01-01

    Acoustic radiation force impulse (ARFI) elastometry quantifies hepatic stiffness, and thus degree of fibrosis, non-invasively. Our aim was to analyse the diagnostic accuracy of ARFI cut-off values, and the significance of a defined limit of standard deviation (SD) as a potential quality parameter for liver fibrosis staging in patients with chronic liver diseases (CLD). 153 patients with CLD (various aetiologies) undergoing liver biopsy, and an additional 25 patients with known liver cirrhosis, were investigated. ARFI measurements were performed in the right hepatic lobe, and correlated with the histopathological Ludwig fibrosis score (inclusion criteria: at least 6 portal tracts). The diagnostic accuracy of cut-off values was analysed with respect to an SD limit of 30% of the mean ARFI value. The mean ARFI elastometry showed 1.95 ± 0.87 m/s (range 0.79-4.40) in 178 patients (80 female, 98 male, mean age: 52 years). The cut-offs were 1.25 m/s for F ≥ 2, 1.72 m/s for F ≥ 3 and 1.75 m/s for F = 4, and the corresponding AUROC 80.7%, 86.2% and 88.7%, respectively. Exclusion of 31 patients (17.4%) with an SD higher than 30% of the mean ARFI improved the diagnostic accuracy: The AUROC for F ≥ 2, F ≥ 3 and F = 4 were 86.1%, 91.2% and 91.5%, respectively. The diagnostic accuracy of ARFI can be improved by applying a maximum SD of 30% of the mean ARFI as a quality parameter--which however leads to an exclusion of a relevant number of patients. ARFI results with a high SD should be interpreted with caution.

  19. Dental fear and caries in 6-12 year old children in Greece. Determination of dental fear cut-off points.

    Science.gov (United States)

    Boka, V; Arapostathis, K; Karagiannis, V; Kotsanos, N; van Loveren, C; Veerkamp, J

    2017-03-01

    To present: the normative data on dental fear and caries status; the dental fear cut-off points of young children in the city of Thessaloniki, Greece. Study Design: This is a cross-sectional study with two independent study groups. A first representative sample consisted of 1484 children from 15 primary public schools of Thessaloniki. A second sample consisted of 195 randomly selected age-matched children, all patients of the Postgraduate Paediatric Dental Clinic of Aristotle University of Thessaloniki. First sample: In order to select data on dental fear and caries, dental examination took place in the classroom with disposable mirrors and a penlight. All the children completed the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Second sample: In order to define the cut-off points of the CFSS-DS, dental treatment of the 195 children was performed at the University Clinic. Children⁁s dental fear was assessed using the CFSS-DS and their behaviour during dental treatment was observed by one calibrated examiner using the Venham scale. Statistical analysis of the data was performed with IBM SPSS Statistics 20 at a statistical significance level of fear. Mean differences between boys and girls were not significant. Caries was not correlated with dental fear. Second sample: CFSS-DSfear', scores 33-37 as 'borderline' and scores > 37 as 'dental fear'. In the first sample, 84.6% of the children did not suffer from dental fear (CFSS-DSfear was correlated to age and not to caries and gender. The dental fear cut-off point for the CFSS-DS was estimated at 37 for 6-12 year old children (33-37 borderlines).

  20. Rib fractures in blunt chest trauma - associated thoracic injuries

    Directory of Open Access Journals (Sweden)

    Iv. Dimitrov

    2017-09-01

    Full Text Available PURPOSE. The aim of our retrospective study was to analyze the patterns of associated thoracic injuries in patients underwent blunt chest trauma and rib fractures. METHODS. The study included 212 patients with rib fractures due to blunt thoracic trauma. The mechanism of trauma, the type of rib fracture and the type of associated injuries were analyzed. RESULTS. The patients were divided in two groups according to the number of fractured ribs-group I included the patients with up to two fractured ribs (72 patients-33,9%, and group II – with ≥3 fractured ribs (140 patients-66,1%. Associated chest injuries were present in 36 of the patients from group I (50%, and in 133 patients from group II (95%. Pulmonary contusion was the most common intrathoracicinjurie-65,6% of the cases. The mean hospital stay was 8, 7 days. The lethality rate was 16,9% -all of them due to the associated chest injuries. CONCLUSIONS. The mortality related to rib fractures is affected by the associated thoracic injuries, the advanced age, and the number of fractured ribs.

  1. MODULES FOR EXPERIMENTS IN STELLAR ASTROPHYSICS (MESA): PLANETS, OSCILLATIONS, ROTATION, AND MASSIVE STARS

    Energy Technology Data Exchange (ETDEWEB)

    Paxton, Bill; Cantiello, Matteo; Bildsten, Lars [Kavli Institute for Theoretical Physics, University of California, Santa Barbara, CA 93106 (United States); Arras, Phil [Department of Astronomy, University of Virginia, P.O. Box 400325, Charlottesville, VA 22904-4325 (United States); Brown, Edward F. [Department of Physics and Astronomy, National Superconducting Cyclotron Laboratory, and Joint Institute for Nuclear Astrophysics, Michigan State University, East Lansing, MI 48864 (United States); Dotter, Aaron [Research School of Astronomy and Astrophysics, The Australian National University, Weston, ACT 2611 (Australia); Mankovich, Christopher [Department of Physics, University of California, Santa Barbara, CA 93106 (United States); Montgomery, M. H. [Department of Astronomy and McDonald Observatory, University of Texas, Austin, TX 78712 (United States); Stello, Dennis [Sydney Institute for Astronomy (SIfA), School of Physics, University of Sydney, NSW 2006 (Australia); Timmes, F. X. [School of Earth and Space Exploration, Arizona State University, Tempe, AZ 85287 (United States); Townsend, Richard, E-mail: matteo@kitp.ucsb.edu [Department of Astronomy, University of Wisconsin-Madison, Madison, WI 53706 (United States)

    2013-09-15

    We substantially update the capabilities of the open source software package Modules for Experiments in Stellar Astrophysics (MESA), and its one-dimensional stellar evolution module, MESA star. Improvements in MESA star's ability to model the evolution of giant planets now extends its applicability down to masses as low as one-tenth that of Jupiter. The dramatic improvement in asteroseismology enabled by the space-based Kepler and CoRoT missions motivates our full coupling of the ADIPLS adiabatic pulsation code with MESA star. This also motivates a numerical recasting of the Ledoux criterion that is more easily implemented when many nuclei are present at non-negligible abundances. This impacts the way in which MESA star calculates semi-convective and thermohaline mixing. We exhibit the evolution of 3-8 M{sub Sun} stars through the end of core He burning, the onset of He thermal pulses, and arrival on the white dwarf cooling sequence. We implement diffusion of angular momentum and chemical abundances that enable calculations of rotating-star models, which we compare thoroughly with earlier work. We introduce a new treatment of radiation-dominated envelopes that allows the uninterrupted evolution of massive stars to core collapse. This enables the generation of new sets of supernovae, long gamma-ray burst, and pair-instability progenitor models. We substantially modify the way in which MESA star solves the fully coupled stellar structure and composition equations, and we show how this has improved the scaling of MESA's calculational speed on multi-core processors. Updates to the modules for equation of state, opacity, nuclear reaction rates, and atmospheric boundary conditions are also provided. We describe the MESA Software Development Kit that packages all the required components needed to form a unified, maintained, and well-validated build environment for MESA. We also highlight a few tools developed by the community for rapid visualization of MESA star

  2. What accounts for rib fractures in older adults?

    Science.gov (United States)

    Wuermser, Lisa-Ann; Achenbach, Sara J; Amin, Shreyasee; Khosla, Sundeep; Melton, L Joseph

    2011-01-01

    To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21-93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

  3. What Accounts for Rib Fractures in Older Adults?

    Directory of Open Access Journals (Sweden)

    Lisa-Ann Wuermser

    2011-01-01

    Full Text Available To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years, 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes.

  4. What Accounts for Rib Fractures in Older Adults?

    Science.gov (United States)

    Wuermser, Lisa-Ann; Achenbach, Sara J.; Amin, Shreyasee; Khosla, Sundeep; Melton, L. Joseph

    2011-01-01

    To address the epidemiology of rib fractures, an age- and sex-stratified random sample of 699 Rochester, Minnesota, adults age 21–93 years was followed in a long-term prospective study. Bone mineral density (BMD) was assessed at baseline, and fractures were ascertained by periodic interview and medical record review. During 8560 person-years of followup (median, 13.9 years), 56 subjects experienced 67 rib fracture episodes. Risk factors for falling predicted rib fractures as well as BMD, but both were strongly age-related. After age-adjustment, BMD was associated with rib fractures in women but not men. Importantly, rib fractures attributed to severe trauma were associated with BMD in older individuals of both sexes. Self-reported heavy alcohol use doubled fracture risk but did not achieve significance due to limited statistical power. Bone density, along with heavy alcohol use and other risk factors for falling, contributes to the risk of rib fractures, but no one factor predominates. Older women with rib fractures, regardless of cause, should be considered for an osteoporosis evaluation, and strategies to prevent falling should be considered in both sexes. PMID:22028986

  5. Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures.

    Science.gov (United States)

    Qiu, Meiguang; Shi, Zhanjun; Xiao, Jun; Zhang, Xuming; Ling, Shishui; Ling, Hao

    2016-12-01

    The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest ( n  = 38) and multiple non-flail rib fracture groups ( n  = 124). In the flail chest group, the mechanical ventilation time, ICU monitoring time, tracheostomies, thoracic deformity, and impaired pulmonary function and return to full-time employment were compared. In the multiple non-flail rib fracture group, fracture healing, visual analog scale (VAS) pain score, inpatient length of stay, atelectatic, pulmonary complications, and normal activity-returning time were compared. Patients in the flail chest operative fixation group had significantly shorter ICU stay, decreased ventilator requirements, fewer tracheostomies, less thoracic deformity and impaired pulmonary function, and more returned to full-time employment. Patients in the multiple non-flail rib fracture operative fixation had shorter hospital stay, less pain, earlier return to normal activity, more fracture healing, less atelectasis, and fewer pulmonary infections. This study demonstrates the potential benefits of surgical stabilization of flail chest and multiple non-flail rib fractures with plate fixation. When compared with conventional conservative management, operatively managed patients demonstrated improved clinical outcomes.

  6. Plastic bowing of the ribs in children

    Energy Technology Data Exchange (ETDEWEB)

    Caro, P.A.; Borden, S. IV

    1988-06-01

    Four cases of plastic bowing of the ribs are presented. In three patients with Werdnig-Hoffman disease, plastic curvatures were associated with chronic pneumonia and atelectasis. We postulate that intrapulmonary retractive forces can deform ribs thinned by muscular atrophy. In turn, thoracic collapse can perpetuate lobar and segmental atelectasis. In one case of osteogenesis imperfecta without pneumonia, we believe normal muscle forces bent ribs weakened by deficiency of normal cortical architecture.

  7. Bilateral first rib fractures: A case report

    Directory of Open Access Journals (Sweden)

    Dilip Amonkar

    2014-01-01

    Full Text Available From the time first rib fractures were first described in 1869, they have been a source of anxiety to attendant trauma surgeons working in the accident and emergency department of major hospitals. First rib fractures are associated with major thoracic trauma and may involve injury to subclavian vessels, brachial plexus, and mediastinal structures. But these complications are more often seen following unilateral first rib fractures. In contrast, bilateral first rib fractures may follow insignificant trauma, suggesting a different mechanism involved. Serious vascular injuries and brachial plexus injuries are rare and angiograms for evaluation of these patients aren′t routinely warranted. The case that we report illustrates this very point.

  8. Modified rib pivot lateral thoracotomy: a case series.

    Science.gov (United States)

    Appelgrein, C; Hosgood, G

    2018-01-01

    To describe a modified rib pivot thoracotomy and its clinical application in client-owned dogs and cats. Case series of 24 dogs and 1 cat requiring a thoracotomy. A lateral thoracic incision over the required thoracic segment was made. The latissimus dorsi muscle was reflected dorsally. The predetermined rib was identified and the periosteum overlying the rib was elevated circumferentially, avoiding the intercostal neurovascular structures. Holes were pre-placed above and below the proposed osteotomy site. The rib was osteotomised and pivoted cranially. The pleura was incised and the required intrathoracic procedure was then performed. The thoracic cavity was closed by pre-placement of a suture through the pre-placed holes within the osteotomised rib. The pleura and intercostal musculature were closed, avoiding the intercostal neurovascular structures. The rib was re-apposed and the lateral approach was closed. The cases included were reviewed for both the rib pivoted as per the procedure required and postoperative complications. The study group comprised 8 Staffordshire Bull Terriers, 2 Poodles, 2 German Shepherd Dogs, 1 each of Basset Hound, Rhodesian Ridgeback, Golden Retriever, Australian Shepherd, Vizsla, Bull Mastiff, Schnauzer, Jack Russell Terrier, Bulldog, Deerhound, Labrador Retriever and Australian Terrier, and 1 cat. A modified rib pivot thoracotomy was performed for lung lobectomy (n = 11), oesophagectomy (7), subtotal pericardectomy (5), patent ductus arteriosus ligation (1) and thoracic duct ligation (1). Follow-up ranged from 2 to 40 weeks postoperatively. Postoperative complications included seroma formation in two dogs. A modified rib pivot thoracotomy should be considered as an alternative lateral thoracic approach with good exposure, minimal complications and low morbidity. © 2018 Australian Veterinary Association.

  9. A Novel and Validated Protocol for Performing MIC Tests to Determine the Susceptibility of Piscirickettsia salmonis Isolates to Florfenicol and Oxytetracycline

    Directory of Open Access Journals (Sweden)

    Sergio Contreras-Lynch

    2017-07-01

    Full Text Available This paper presents a validated protocol, using a novel, specifically formulated medium, to perform broth microdilution antimicrobial susceptibility assays of the salmonid bacterial pathogen Piscirickettsia salmonis. The minimum inhibitory concentrations (MIC for florfenicol and oxytetracycline against 58 P. salmonis isolates recovered from various outbreaks occurred in Chilean salmonid farms were determined using this protocol. Normalized resistance interpretation (NRI analysis was applied to these data to calculate appropriate protocol-specific epidemiological cut-off values. These cut-off values allow the isolates to be categorized as either fully susceptible wild type (WT members of this species, or as manifesting reduced susceptibility non-wild type (NWT. The distribution of MIC values of florfenicol was bimodal and the distribution of the normalized values for the putative WT observation had a standard deviation of 0.896 log2 μg mL-1. This analysis calculated a cut-off value of ≤0.25 μg mL-1 and categorized 33 (56% of the isolates as manifesting reduced susceptibility to florfenicol. For the oxytetracycline MIC data the NRI analysis also treated the distribution as bimodal. The distribution of the normalized values for the putative WT observation had a standard deviation of 0.951 log2 μg mL-1. This analysis gave a cut-off value of ≤0.5 μg mL-1 and categorized five isolates (9% as manifesting reduced susceptibility to oxytetracycline. The susceptibility testing protocol developed in this study was capable of generating MIC data from all the isolates tested. On the basis of the precision of the data it generated, and the degree of separation of values for WT and NWT it achieved, it is argued that this protocol has the performance characteristics necessary for it to be considered as a standard protocol.

  10. Blunt liver injury with intact ribs under impacts on the abdomen: a biomechanical investigation.

    Directory of Open Access Journals (Sweden)

    Yu Shao

    Full Text Available Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s. Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.

  11. Rib fracture repair: indications, technical issues, and future directions.

    Science.gov (United States)

    Nirula, Raminder; Diaz, Jose J; Trunkey, Donald D; Mayberry, John C

    2009-01-01

    Rib fracture repair has been performed at selected centers around the world for more than 50 years; however, the operative indications have not been established and are considered controversial. The outcome of a strictly nonoperative approach may not be optimal. Potential indications for rib fracture repair include flail chest, painful, movable rib fractures refractory to conventional pain management, chest wall deformity/defect, rib fracture nonunion, and during thoracotomy for other traumatic indication. Rib fracture repair is technically challenging secondary to the human rib's relatively thin cortex and its tendency to fracture obliquely. Nonetheless, several effective repair systems have been developed. Future directions for progress on this important surgical problem include the development of minimally invasive techniques and the conduct of multicenter, randomized trials.

  12. Modules for Experiments in Stellar Astrophysics (MESA): Convective Boundaries, Element Diffusion, and Massive Star Explosions

    Science.gov (United States)

    Paxton, Bill; Schwab, Josiah; Bauer, Evan B.; Bildsten, Lars; Blinnikov, Sergei; Duffell, Paul; Farmer, R.; Goldberg, Jared A.; Marchant, Pablo; Sorokina, Elena; Thoul, Anne; Townsend, Richard H. D.; Timmes, F. X.

    2018-02-01

    We update the capabilities of the software instrument Modules for Experiments in Stellar Astrophysics (MESA) and enhance its ease of use and availability. Our new approach to locating convective boundaries is consistent with the physics of convection, and yields reliable values of the convective-core mass during both hydrogen- and helium-burning phases. Stars with Meffects of Rayleigh-Taylor instabilities that, in combination with the coupling to a public version of the STELLA radiation transfer instrument, creates new avenues for exploring Type II supernova properties. These capabilities are exhibited with exploratory models of pair-instability supernovae, pulsational pair-instability supernovae, and the formation of stellar-mass black holes. The applicability of MESA is now widened by the capability to import multidimensional hydrodynamic models into MESA. We close by introducing software modules for handling floating point exceptions and stellar model optimization, as well as four new software tools - MESA-Web, MESA-Docker, pyMESA, and mesastar.org - to enhance MESA's education and research impact.

  13. Rib enlargement in premature infants with bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook [Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul (Korea, Republic of); Kim, Kyeong Ah [Anyang General Hospital, Anyang (Korea, Republic of)

    2000-04-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  14. Rib enlargement in premature infants with bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Yoon, Hye Kyung; Han, Kim Bokyung; Chang, Yun Sil; Choo, In Wook; Kim, Kyeong Ah

    2000-01-01

    The purpose of this study is to describe the rib changes seen in patients with brochopulmonary dysplasia (BPD). Serial chest radiographs of nine premature infants with BPD who showed diffuse rib enlargement were reviewed for hyperinflation, which was compared with the observed degree of rib enlargement. Vibrator chest physiotherapy was performed in all cases, and five infants underwent conventional ventilation plus high frequency oscillatory ventilation therapy. Their calcium level was normal whereas alkaline phosphatase and phosphate levels were high. In all infants except one, liver enzyme levels were normal. For the treatment of patent ductus arteriosus, infection, and BPD, medications including indomethacin, antibiotics, and dexamethasone were administered. Vitamin D was given to all patients with total parenteral nutrition. Rib enlargement was found to be severe (n=3D4), moderate (n=3D3), or mild (n=3D2) with undulating margins or posterior tapering (n=3D2). Hyperinflation was noted in eight patients, in seven of whom it was moderate to severe. Among these seven, rib enlargement was severe (n=3D2), moderate (n=3D3), or mild (n=3D2). In one infant with mild hyperinflation, rib enlargement was severe. Bilateral irregular infiltrates and atelectases were noted in all patients. In BPD patients, rib enlargement may be seen. In order to differentiate this process from systemic bone disease or bony dysplasia, an awareness of the rib changes occurring in patients with BPD may be important. (author)

  15. PICTORIAL INTERLUDE Beware the bifid rib!

    African Journals Online (AJOL)

    be associated with Gorlin-Goltz basal cell nevus syndrome, a rare autosomal dominant condition characterised by multiple nevoid basal cell carcinomas, jaw cysts and bifid ribs. Further features include other rib anomalies, deficiency of the lateral clavicle, mandibular hypoplasia, macrocephaly and mental retardation.1.

  16. Surgical Management of Rib Fractures: Strategies and Literature Review.

    Science.gov (United States)

    de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

    2014-06-01

    Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

  17. Plastic bowing of the ribs in children

    International Nuclear Information System (INIS)

    Caro, P.A.; Borden, S. IV

    1988-01-01

    Four cases of plastic bowing of the ribs are presented. In three patients with Werdnig-Hoffman disease, plastic curvatures were associated with chronic pneumonia and atelectasis. We postulate that intrapulmonary retractive forces can deform ribs thinned by muscular atrophy. In turn, thoracic collapse can perpetuate lobar and segmental atelectasis. In one case of osteogenesis imperfecta without pneumonia, we believe normal muscle forces bent ribs weakened by deficiency of normal cortical architecture. (orig.)

  18. [Analysis of 163 rib fractures by imaging examination].

    Science.gov (United States)

    Song, Tian-fu; Wang, Chao-chao

    2014-12-01

    To explore the applications of imaging examination on rib fracture sites in forensic identification. Features including the sites, numbers of the processed imaging examination and the first radiological technology at diagnosis in 56 cases of rib fractures from 163 injuries were retrospectively analyzed. The detection rate of the rib fractures within 14 days was 65.6%. The initial detection rate of anterior rib fracture proceeded by X-ray was 76.2%, then 90.5% detected at a second time X-ray, while the detection rate of CT was 66.7% and 80.0%, respectively. The initial detec- tion rate of rib fracture in axillary section proceeded by X-ray was 27.6%, then 58.6% detected at a second time X-ray, while the detection rate of CT was 54.3% and 80.4%, respectively. The initial detection rate of posterior rib fracture proceeded by X-ray was 63.6%, then 81.8% detected at a second time X-ray, while the detection rate of CT was 50.0% and 70.0%, respectively. It is important to pay attention to the use of combined imaging examinations and the follow-up results. In the cases of suspicious for rib fracture in axillary section, CT examination is suggested in such false X-ray negative cases.

  19. Discussion about different cut-off values of conventional hamstring-to-quadriceps ratio used in hamstring injury prediction among professional male football players.

    Science.gov (United States)

    Grygorowicz, Monika; Michałowska, Martyna; Walczak, Tomasz; Owen, Adam; Grabski, Jakub Krzysztof; Pyda, Andrzej; Piontek, Tomasz; Kotwicki, Tomasz

    2017-01-01

    To measure the sensitivity and specificity of differences cut-off values for isokinetic Hcon/Qcon ratio in order to improve the capacity to evaluate (retrospectively) the injury of hamstring muscles in professional soccer screened with knee isokinetic tests. Retrospective study. Medical and biomechanical data of professional football players playing for the same team for at least one season between 2010 and 2016 were analysed. Hamstring strain injury cases and the reports generated via isokinetic testing were investigated. Isokinetic concentric(con) hamstring(H) and quadriceps(Q) absolute strength in addition with Hcon/Qcon ratio were examined for the injured versus uninjured limbs among injured players, and for the injured and non-injured players. 2 x 2 contingency table was used for comparing variables: predicted injured or predicted uninjured with actual injured or actual uninjured. Sensitivity, specificity, accuracy, positive and negative predictive values, and positive and negative likelihood ratio were calculated for three different cut-off values (0.47 vs. 0.6 vs. 0.658) to compare the discriminative power of an isokinetic test, whilst examining the key value of Hcon/Qcon ratio which may indicate the highest level of ability to predispose a player to injury. McNemar's chi2 test with Yates's correction was used to determine agreement between the tests. PQStat software was used for all statistical analysis, and an alpha level of p hamstring injuries during the analysed period. None of these players sustained recurrence of hamstring injury. One player sustained hamstring strain injury on both legs, thus the total number of injuries was 12. Application of different cut-off values for Hcon/Qcon significantly affected the sensitivity and specificity of isokinetic test used as a tool for muscle injury detection. The use of 0.47 of Hcon/Qcon as a discriminate value resulted in significantly lower sensitivity when compared to 0.658 threshold (sensitivity of 16.7% vs

  20. Optimal Cut-Off Points for the Short-Negative Act Questionnaire and Their Association with Depressive Symptoms and Diagnosis of Depression

    DEFF Research Database (Denmark)

    Conway, Paul Maurice; Høgh (Hogh), Annie; Nabe-Nielsen, Kirsten

    2018-01-01

    to depressive symptoms and diagnosis of depression. Methods The study was based on a sample of 4882 participants from the Danish MODENA cohort study (year 2011), which included both the S-NAQ (score range 9–45) and a one-item measure applying the self-labelling method with a definition to assess occasional...... its criterion validity in relation to depressive symptoms (N = 4071) and diagnosis of depression (N = 4844). Results The S-NAQ cut-off points obtained were ≥12 and ≥16 when using occasional and frequent bullying as reference standards, respectively. Both cut-off points showed high classification.......44–1.86) were significantly associated with depressive symptoms. In the adjusted logistic regression analyses, both the first (odds ratio [OR] = 3.55, 95% CI = 1.98–6.38) and the second threshold of exposure (OR = 5.90, 95% CI = 2.93–11.88) were significantly associated with diagnosis of depression. Conclusions...

  1. Discussion about different cut-off values of conventional hamstring-to-quadriceps ratio used in hamstring injury prediction among professional male football players.

    Directory of Open Access Journals (Sweden)

    Monika Grygorowicz

    Full Text Available To measure the sensitivity and specificity of differences cut-off values for isokinetic Hcon/Qcon ratio in order to improve the capacity to evaluate (retrospectively the injury of hamstring muscles in professional soccer screened with knee isokinetic tests.Retrospective study.Medical and biomechanical data of professional football players playing for the same team for at least one season between 2010 and 2016 were analysed. Hamstring strain injury cases and the reports generated via isokinetic testing were investigated. Isokinetic concentric(con hamstring(H and quadriceps(Q absolute strength in addition with Hcon/Qcon ratio were examined for the injured versus uninjured limbs among injured players, and for the injured and non-injured players. 2 x 2 contingency table was used for comparing variables: predicted injured or predicted uninjured with actual injured or actual uninjured. Sensitivity, specificity, accuracy, positive and negative predictive values, and positive and negative likelihood ratio were calculated for three different cut-off values (0.47 vs. 0.6 vs. 0.658 to compare the discriminative power of an isokinetic test, whilst examining the key value of Hcon/Qcon ratio which may indicate the highest level of ability to predispose a player to injury. McNemar's chi2 test with Yates's correction was used to determine agreement between the tests. PQStat software was used for all statistical analysis, and an alpha level of p <0.05 was used for all statistical comparisons.340 isokinetic test reports on both limbs of 66 professional soccer players were analysed. Eleven players suffered hamstring injuries during the analysed period. None of these players sustained recurrence of hamstring injury. One player sustained hamstring strain injury on both legs, thus the total number of injuries was 12. Application of different cut-off values for Hcon/Qcon significantly affected the sensitivity and specificity of isokinetic test used as a tool for

  2. Completion Report for Well ER-12-3 Corrective Action Unit 99: Rainier Mesa - Shoshone Mountain

    International Nuclear Information System (INIS)

    2006-01-01

    Well ER-12-3 was drilled for the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, in support of the Nevada Environmental Restoration Project at the Nevada Test Site, Nye County, Nevada. The well was drilled in March and April 2005 as part of a hydrogeologic investigation program for the Rainier Mesa-Shoshone Mountain Corrective Action Unit. The overall purpose of the well was to gather subsurface data to better characterize the hydrogeology of central Rainier Mesa, especially in the older Tertiary volcanic rocks and Paleozoic sedimentary rocks. The main 47.0-centimeter hole was drilled to a depth of 799.2 meters and cased with 33.97-centimeter casing to 743.1 meters. The hole diameter was then decreased to 31.1 centimeters, and the well was drilled to a total depth of 1,496.0 meters. The completion string consisted of 13.97-centimeter stainless steel casing, with two slotted intervals open to the lower carbonate aquifer, suspended from 19.37-centimeter carbon steel casing. A piezometer string was installed outside the 33.97-centimeter casing to a depth of 467.1 meters to monitor a zone of perched water within the Tertiary volcanic section. Data gathered during and shortly after hole construction include composite drill cuttings samples collected every 3 meters (extra cuttings samples were collected from the Paleozoic rocks for paleontological analyses), sidewall core samples from 35 depths, various geophysical logs, and water level measurements. These data indicate that the well penetrated 674.2 meters of Tertiary volcanic rocks and 821.7 meters of Paleozoic dolomite and limestone. Forty-nine days after the well was completed, but prior to well development and testing, the water level inside the main hole was tagged at the depth of 949.1 meters, and the water level inside the piezometer string was tagged at 379.9 meters

  3. Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray.

    Science.gov (United States)

    Lederer, Wolfgang; Mair, Dieter; Rabl, Walter; Baubin, Michael

    2004-02-01

    Fractured ribs and sternum are frequent complications of thoracic compression during CPR in adults. This study was conducted to determine whether findings of plain chest radiography (CXR) correlate with post-mortem findings in patients who underwent cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest. CXR findings and autopsy results of CPR-related chest injuries comprising rib and sternum fractures were compared prospectively in 19 patients. Fractures were diagnosed in nine of 19 patients by means of radiology and in 18 of 19 patients by autopsy (rib fractures in 6/19 versus 17/19, P=0.002; sternum fractures in 5/19 versus in 9/19, P=0.227. The total number of isolated bone fractures detected by CXR was 18 (12 rib and six sternum fractures) and by autopsy 92 (83 rib and nine sternum fractures). The majority of rib fractures was located in the anterior part of the thoracic cage. Sternum fractures predominantly occurred in the lower third. Eight of 19 patients received either thrombolytic or antithrombotic treatment during CPR but no major bleeding complication associated with CPR was detected by autopsy. The findings of this study indicate that fractures associated with CPR are underreported in conventional radiographic investigations. No major bleeding complications related to CPR-associated fractures was detected.

  4. Outcomes after operative management of symptomatic rib nonunion.

    Science.gov (United States)

    Gauger, Erich M; Hill, Brian W; Lafferty, Paul M; Cole, Peter A

    2015-06-01

    To report the outcomes of rib reconstruction after painful nonunion. Retrospective case series. Level I trauma center. Between November 2007 and May 2013, 10 patients who presented with 16 rib nonunions and disabling pain were treated with reconstruction of their nonunited rib fractures. Rib nonunion reconstruction predominately with iliac crest bone graft and a tension band plate with a locked precontoured plating system for ribs. Demographic data, mechanism of injury, and number of rib nonunions were recorded. Operative procedure, length of follow-up, complications, Short Form Survey 36, and a patient questionnaire were also captured and documented. Eight of the 10 patients sustained their original fractures from a fall. Outcomes were available for the 10 patients at a mean follow-up of up of 18.6 months (range, 3-46 months). All 16 ribs went on to union with a mean time from reconstruction to union of 14.7 weeks (range, 12-24 weeks). At final follow-up, the mean mental and physical component Short Form Survey 36 scores were 54.4 and 43.5, respectively. Eight of the 10 patients were able to return to work and/or previous activities without limitations. Complications included 1 wound infection that resolved after irrigation and debridement with adjunctive antibiotics. One symptomatic implant was removed. Ten patients with 16 symptomatic rib nonunions were reconstructed using autologous bone graft and implant/mesh fixation manifesting in successful union with improved patient function and a low rate of complications. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

  5. Computational Investigations in Rectangular Convergent and Divergent Ribbed Channels

    Science.gov (United States)

    Sivakumar, Karthikeyan; Kulasekharan, N.; Natarajan, E.

    2018-05-01

    Computational investigations on the rib turbulated flow inside a convergent and divergent rectangular channel with square ribs of different rib heights and different Reynolds numbers (Re=20,000, 40,000 and 60,000). The ribs were arranged in a staggered fashion between the upper and lower surfaces of the test section. Computational investigations are carried out using computational fluid dynamic software ANSYS Fluent 14.0. Suitable solver settings like turbulence models were identified from the literature and the boundary conditions for the simulations on a solution of independent grid. Computations were carried out for both convergent and divergent channels with 0 (smooth duct), 1.5, 3, 6, 9 and 12 mm rib heights, to identify the ribbed channel with optimal performance, assessed using a thermo hydraulic performance parameter. The convergent and divergent rectangular channels show higher Nu values than the standard correlation values.

  6. Determining the cut-off point of osteoporosis based on the osteoporosis self-assessment tool, body mass index and weight in Taiwanese young adult women.

    Science.gov (United States)

    Chang, Shu Fang; Yang, Rong Sen

    2014-09-01

    To examine the cut-off point of the osteoporosis self-assessment tool, age, weight and body mass index for osteoporosis among young adult Taiwanese women, using a large-scale health examination database containing bone mineral density tests. The cut-off points of osteoporosis risk factors identified earlier focus on menopausal or senior Caucasian and Asian women. However, young adult Asian women have seldom been identified. A retrospective historical cohort study. Using the 2009-2011 health examination database of a large-scale medical centre in northern Taiwan, this study investigated young adult Asian women (i.e. range in age from 30-49 years) in Taiwan who had received dual-energy X-ray absorptiometry test. This study also explored the cut-off point, sensitivity, specificity and diagnostic accuracy of receiver operating characteristics of osteoporosis among young adult females in Taiwan. This study collected 2454 young adult Asian women in Taiwan. Cochran-Armitage analysis results indicated that the prevalence of osteoporosis increased with decreasing weight, body mass index and osteoporosis self-assessment method quartiles. According to the results of receiver operating characteristics, weight, body mass index and osteoporosis self-assessment tool approaches can generally be used as indicators to predict osteoporosis among young adult Asian women. Results of this study demonstrate that Taiwanese women contracting osteoporosis tend to be young and underweight, as well as having a low body mass index and osteoporosis self-assessment scores. Those results further suggest that the assessment indicators for cut-off points are appropriately suitable for young adult women in Taiwan. Early detection is the only available means of preventing osteoporosis. Professional nurses should apply convenient and accurate assessment procedures to help young adult women to adopt preventive strategies against osteoporosis early, thus eliminating the probability of osteoporotic

  7. Rib Fracture Fixation: Indications and Outcomes.

    Science.gov (United States)

    Senekjian, Lara; Nirula, Raminder

    2017-01-01

    Rib fractures are a frequently identified injury in the trauma population. Not only are multiple rib fractures painful, but they are associated with an increased risk of adverse outcomes. Pneumonia in particular can be devastating, especially to an elderly patient, but other complications such as prolonged ventilation and increased intensive care and hospital durations of stay have a negative impact on the patient. Computed tomography scan is the best modality to diagnosis rib fractures but the treatment of fractures is still evolving. Currently patient care involves a multidisciplinary approach that includes pain control, aggressive pulmonary therapy, and possibly surgical fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Rib cage pain

    Science.gov (United States)

    ... any of the following: Bruised, cracked, or fractured rib Inflammation of cartilage near the ... the best cures for a ribcage fracture . Follow your health care provider's instructions for treating ...

  9. Proposed cut-off value of CA19-9 for detecting pancreatic cancer in patients with diabetes: a case-control study.

    Science.gov (United States)

    Murakami, Mariko; Nagai, Yoshio; Tenjin, Ayumi; Tanaka, Yasushi

    2018-04-11

    Pancreatic cancer is a highly lethal malignancy. CA19-9 is a well-known marker for diagnosis of pancreatic cancer, but the serum CA19-9 level is reported to be elevated in patients with poorly controlled diabetes. This study evaluated the sensitivity, specificity, and cut-off value of serum CA19-9 for detection of pancreatic cancer in patients with diabetes. A case-control study of 236 patients was performed. The case group was selected from diabetic patients with pancreatic cancer, while one control was selected for each case from among diabetic patients without pancreatic cancer during the same period. The case group (n = 118) and the control group (n = 118) were matched for age, sex, and pancreatic cancer risk factors. Receiver operating characteristic (ROC) curves were plotted to determine the serum CA19-9 level that predicted pancreatic cancer. Then the sensitivity and specificity of CA19-9 were calculated for the threshold value. There were no significant differences of age, sex, BMI, smoking, alcohol intake, and HbA1c between the case and control groups. According to ROC analysis, a serum CA19-9 level of 75 U/mL had the maximum sensitivity and specificity for separating diabetic patients with or without pancreatic cancer. Using this cut-off value, the sensitivity and specificity of CA19-9 for pancreatic cancer was 69.5% and 98.2%, respectively, while the area under the ROC curve was 0.875 [95%CI: 0.826-0.924]. We propose that a serum CA19-9 level of 75 U/mL should be used as the cut-off value when screening patients with diabetes for pancreatic cancer.

  10. Bovine Tuberculosis in Cattle in the Highlands of Cameroon: Seroprevalence Estimates and Rates of Tuberculin Skin Test Reactors at Modified Cut-Offs

    Directory of Open Access Journals (Sweden)

    J. Awah-Ndukum

    2012-01-01

    Full Text Available The aim of this study was to obtain epidemiological estimates of bovine tuberculosis (TB prevalence in cattle in the highlands of Cameroon using two population-based tuberculin skin test (TST surveys in the years 2009 and 2010. However, prior to the TST survey in 2010, blood was collected from already chosen cattle for serological assay. Anti-bovine TB antibodies was detected in 37.17% of tested animals and bovine TB prevalence estimates were 3.59%–7.48%, 8.92%–13.25%, 11.77%–17.26% and 13.14%–18.35% for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and single TST, respectively. The agreement between TST and lateral flow was generally higher in TST positive than in TST negative subjects. The K coefficients were 0.119, 0.234, 0.251 and 0.254 for comparative TST at ≥4 mm, ≥3 mm and ≥2 mm cut-off points and the single TST groups, respectively. Chi square statistics revealed that strong (P48 associations existed between seroprevalence rates and TST reactors. The study suggested that using lateral flow assay and TST at severe interpretations could improve the perception of bovine TB in Cameroon. The importance of defining TST at modified cut-offs and disease status by post-mortem detection and mycobacterial culture of TB lesions in local environments cannot be overemphasised.

  11. Clinical Utility of Chest Computed Tomography in Patients with Rib Fractures CT Chest and Rib Fractures

    OpenAIRE

    Chapman, Brandon C.; Overbey, Douglas M.; Tesfalidet, Feven; Schramm, Kristofer; Stovall, Robert T.; French, Andrew; Johnson, Jeffrey L.; Burlew, Clay C.; Barnett, Carlton; Moore, Ernest E.; Pieracci, Fredric M.

    2016-01-01

    Background Chest CT is more sensitive than a chest X-ray (CXR) in diagnosing rib fractures; however, the clinical significance of these fractures remains unclear. Objectives The purpose of this study was to determine the added diagnostic use of chest CT performed after CXR in patients with either known or suspected rib fractures secondary to blunt trauma. Methods Retrospective coho...

  12. NPDES Permit for Mesa Verde National Park Wastewater Treatment Facility in Colorado

    Science.gov (United States)

    Under NPDES permit number CO-0034398, the United States Department of the Interior, National Park Service, Mesa Verde National Park is authorized to discharge from the Mesa Verde National Park wastewater treatment plant, in Montezuma County, Colo.

  13. Radiographic abnormalities of ribs in β-thalassemic children

    International Nuclear Information System (INIS)

    Singcharoen, T.; Piyachon, C.; Kulapongs, P.

    1988-01-01

    Bone change is one of the most outstanding manifestations of marrow hyperplasia in thalassemia patients. In the thorax, marrow hyperplasia widens the ribs, thins the cortices, and erases most of their trabecular patterns. Thus, a variety of radiologic changes of the ribs have been described. The chest radiographs of 33 Thai children with β-thalassemia major were reviewed, and a spectrum of rib changes were observed

  14. Comparison of ultrasonography and radiography in diagnosis of rib fractures.

    Science.gov (United States)

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-08-01

    Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. In this cross-sectional study, consecutive patients with minor blunt chest trauma and suspected rib fractures presenting in Imam Reza Hospital located in Mashhad-Iran, between April 2013 and October 2013 were assessed by USG and radiography. The radiography was performed in a posteroanterior (PA) chest projection and oblique rib view centered over the area of trauma. The time duration spent in taking USG and radiography were recorded. The prevalence and location of fractures revealed by USG and radiography were compared. Sixty-one suspected patients were assessed. The male to female ratio was 2.4:1 (43 men and 18 women) with a mean ± SD age of (44.3 ± 19.7) years. There were totally 59 rib fractures in 38 (62.3%) patients based on radiography and USG, while 23 (37.7%) patients had no diagnostic evidence of rib lesions. USG revealed 58 rib fractures in 33 (54.1%) of 61 suspected patients and radiographs revealed 32 rib fractures in 20 (32.8%) of 61 patients. A total of 58 (98.3%) rib fractures were detected by USG, whereas oblique rib view and PA chest radiography showed 27 (45.8%) and 24 (40.7%) rib fractures, respectively. The average duration of USG was (12 ± 3) min (range 7-17 min), whereas the duration of radiography was (27 ± 6) min (range 15-37 min). The kappa coefficient showed a low level of agreement between both USG and PA chest radiography (kappa coefficient = 0.28), and between USG and oblique rib view (kappa coefficient = 0.32). USG discloses more fractures than radiography in

  15. Measurement of local void fraction in a ribbed annulus

    International Nuclear Information System (INIS)

    Steimke, J.L.

    1992-01-01

    The computer code FLOWTRAN-TF is used to analyze hypothetical hydraulic accidents for the nuclear reactor at the Savannah River Site. During a hypothetical Large Break Loss-of-Coolant Accident (LOCA), reactor assemblies would contain a two-phase mixture of air and water which flows downward. Reactor assemblies consist of nested, ribbed annuli. Longitudinal ribs divide each annulus into four subchannels. For accident conditions, air and water can flow past ribs from one subchannel to another. For FLOWTRAN-TF to compute the size of those flows, it is necessary to know the local void fraction in the region of the rib. Measurements have previously been made of length-average void fraction in a ribbed annulus. However, no direct measurements were available of local void fraction. Due to the lack of data, a test was designed to measure local void fraction at the rib. One question addressed by the test was whether void fraction at the rib is solely a function of azimuthal-average void fraction or a function of additional variables such as pressure boundary conditions. This report provides a discussion of this test

  16. Single crystalline silicon solar cells with rib structure

    Directory of Open Access Journals (Sweden)

    Shuhei Yoshiba

    2017-02-01

    Full Text Available To improve the conversion efficiency of Si solar cells, we have developed a thin Si wafer-based solar cell that uses a rib structure. The open-circuit voltage of a solar cell is known to increase with deceasing wafer thickness if the cell is adequately passivated. However, it is not easy to handle very thin wafers because they are brittle and are subject to warpage. We fabricated a lattice-shaped rib structure on the rear side of a thin Si wafer to improve the wafer’s strength. A silicon nitride film was deposited on the Si wafer surface and patterned to form a mask to fabricate the lattice-shaped rib, and the wafer was then etched using KOH to reduce the thickness of the active area, except for the rib region. Using this structure in a Si heterojunction cell, we demonstrated that a high open-circuit voltage (VOC could be obtained by thinning the wafer without sacrificing its strength. A wafer with thickness of 30 μm was prepared easily using this structure. We then fabricated Si heterojunction solar cells using these rib wafers, and measured their implied VOC as a function of wafer thickness. The measured values were compared with device simulation results, and we found that the measured VOC agrees well with the simulated results. To optimize the rib and cell design, we also performed device simulations using various wafer thicknesses and rib dimensions.

  17. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    Science.gov (United States)

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; Pdisease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; Pdisease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  18. Microbiological Safety of Commercial Prime Rib Preparation Methods: Thermal Inactivation of Salmonella in Mechanically Tenderized Rib Eye.

    Science.gov (United States)

    Calle, Alexandra; Porto-Fett, Anna C S; Shoyer, Bradley A; Luchansky, John B; Thippareddi, Harshavardhan

    2015-12-01

    Boneless beef rib eye roasts were surface inoculated on the fat side with ca. 5.7 log CFU/g of a five-strain cocktail of Salmonella for subsequent searing, cooking, and warm holding using preparation methods practiced by restaurants surveyed in a medium-size Midwestern city. A portion of the inoculated roasts was then passed once through a mechanical blade tenderizer. For both intact and nonintact roasts, searing for 15 min at 260°C resulted in reductions in Salmonella populations of ca. 0.3 to 1.3 log CFU/g. For intact (nontenderized) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.4 log CFU/g. For tenderized (nonintact) rib eye roasts, cooking to internal temperatures of 37.8 or 48.9°C resulted in additional reductions of ca. 3.1 or 3.4 log CFU/g, respectively. Pathogen populations remained relatively unchanged for intact roasts cooked to 37.8 or 48.9°C and for nonintact roasts cooked to 48.9°C when held at 60.0°C for up to 8 h. In contrast, pathogen populations increased ca. 2.0 log CFU/g in nonintact rib eye cooked to 37.8°C when held at 60.0°C for 8 h. Thus, cooking at low temperatures and extended holding at relatively low temperatures as evaluated herein may pose a food safety risk to consumers in terms of inadequate lethality and/or subsequent outgrowth of Salmonella, especially if nonintact rib eye is used in the preparation of prime rib, if on occasion appreciable populations of Salmonella are present in or on the meat, and/or if the meat is not cooked adequately throughout.

  19. Bifid rib – usefulness of chest ultrasound. A case report

    Directory of Open Access Journals (Sweden)

    Magdalena Kryger

    2013-12-01

    Full Text Available The paper presents the possibility of using ultrasonography in the diagnosis of a congenital rib anomaly in the form of bifid rib. Bifid rib is a rare congenital abnormality of anterior chest wall. It manifests as a chest “lump.” Such lesions are detected during a routine physical examination or chest X-ray which is often performed for other reasons. The overall prevalence of bifid rib is estimated at 0.15% to 3.4% (mean 2% and it accounts for approximately 20% of all congenital rib anomalies. It is usually an unilateral lesion. The cases presented herein constitute the first pediatric cases in the available literature in which bifid rib anomaly was visualized by ultrasound examination.

  20. Epidural Analgesia after Rib Fractures.

    Science.gov (United States)

    Zaw, Andrea A; Murry, Jason; Hoang, David; Chen, Kevin; Louy, Charles; Bloom, Matthew B; Melo, Nicolas; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Pain associated with rib fractures impairs respiratory function and increases pulmonary morbidity. The purpose of this study was to determine how epidural catheters alter mortality and complications in trauma patients. We performed a retrospective study involving adult blunt trauma patients with moderate-to-severe injuries from January 1, 2004 to December 31, 2013. During the 10-year period, 526 patients met the inclusion criteria; 43/526 (8%) patients had a catheter placed. Mean age of patients with epidural catheter (CATH) was higher compared with patients without epidural catheter (NOCATH) (54 vs 48 years, P = 0.021), Injury Severity Score was similar (26 CATH vs 27 NOCATH, P = 0.84), and CATH had higher mean rib fractures (7.4 vs 4.1, P ribs fractured. The epidural cohort had longer hospital LOS and decreased mortality. In contrast to other studies, DVT rates were increased in patients who received epidural catheters.

  1. Assembly procedure for column cutting platform

    International Nuclear Information System (INIS)

    Routh, R.D.

    1995-01-01

    This supporting document describes the assembly procedure for the Column Cutting Platform and Elevation Support. The Column Cutting Platform is a component of the 241-SY-101 Equipment Removal System. It is set up on the deck of the Strongback Trailer to provide work access to cut off the upper portion of the Mitigation Pump Assembly (MPA). The Elevation Support provides support for the front of the Storage Container with the Strongback at an inclined position. The upper portion of the MPA must be cut off to install the Containment Caps on the Storage Container. The storage Container must be maintained in an inclined position until the Containment Caps are installed to prevent any residual liquids from migrating forward in the Storage Container

  2. Lower thoracic rib stress fractures in baseball pitchers.

    Science.gov (United States)

    Gerrie, Brayden J; Harris, Joshua D; Lintner, David M; McCulloch, Patrick C

    2016-01-01

    Stress fractures of the first rib on the dominant throwing side are well-described in baseball pitchers; however, lower thoracic rib fractures are not commonly recognized. While common in other sports such as rowing, there is scant literature on these injuries in baseball. Intercostal muscle strains are commonly diagnosed in baseball pitchers and have a nearly identical presentation but also a highly variable healing time. The diagnosis of a rib stress fracture can predict a more protracted recovery. This case series presents two collegiate baseball pitchers on one team during the same season who were originally diagnosed with intercostal muscle strains, which following magnetic resonance imaging (MRI) were found to have actually sustained lower thoracic rib stress fractures. The first sustained a stress fracture of the posterior aspect of the right 8th rib on the dominant arm side, while the second presented with a left-sided 10th rib stress fracture on the nondominant arm side. In both cases, MRI was used to visualize the fractures as plain radiographs are insensitive and commonly negative early in patient presentation. Patients were treated with activity modification, and symptomatic management for 4-6 weeks with a graduated return to throwing and competition by 8-10 weeks. The repetitive high stresses incurred by pitching may cause either dominant or nondominant rib stress fractures and this should be included in the differential diagnosis of thoracic injuries in throwers. It is especially important that athletic trainers and team physicians consider this diagnosis, as rib fractures may have a protracted course and delayed return to play. Additionally, using the appropriate imaging techniques to establish an accurate diagnosis can help inform return-to-play decisions, which have important practical applications in baseball, such as roster management and eligibility.

  3. Factors affecting visualization of posterior rib fractures in abused infants

    International Nuclear Information System (INIS)

    Kleinman, P.K.; Adams, V.I.; Blackbourne, B.D.; Marks, S.C.

    1987-01-01

    Rib fractures in abused infants commonly occur in the posterior rib arcs. Fractures occurring near the costovertebral articulations are usually identified radiographically only once callus has formed. To assess the factors influencing the visibility of fractures near the costovertical articulations, the authors studied 103 posterior rib fractures occurring in 16 abused infants. Radiologic findings were correlated with CT findings and pathologic material from nine ribs in four patients. The limited visibility of fractures relates to (1) the frequent superimposition of the transverse process over the rib fracture site, (2) a fracture line that crosses at an obliquity to the x-ray beam, and (3) nondisplacement of rib fragments due to preservation of the posterior periosteum. Fresh rib fractures invisible on a frontal projection may be clearly defined on axial CT scans, or on postmortem radiographs. A knowledge of the factors influencing the visibility of these important injuries is useful in planning an appropriate diagnostic evaluation of suspected infant abuse

  4. Performance tests of an abrasive cut-off systems for the finishing of high-precision casts

    Directory of Open Access Journals (Sweden)

    A. Fedoryszyn

    2008-10-01

    Full Text Available The paper summarizes the performance data of a newly designed and engineered grinding and cut-off system. The machine is used forseparation of models manufactured by the investment casting method. The machine comprises the following units:- base supporting other assemblies and elements: abrasive disc holder and drives; this solution enables an easy replacement and access toholding elements while a belt transmission allows the disc rpm to be varied,- mechanism moving the spindle in the horizontal, hence the abrasive disc position with respect to the batch can be precisely controlled,depending on the cast position and their shape,- holding and positioning-control of the batch to enable the fore and aft movements and rotations,- guide systems ensuring the travel of the batch in the specified direction and adjusting the travel speed to the required cutting rate,- centering, control, exhaust system, housing.Extensive tests were performed, including the tests of operating parameters of abrasive discs depending on the cast material, cyclograms ofthe applied treatment are obtained accordingly.

  5. Performance tests of an abrasive cut-off systems for the finishing of high-precision casts

    Directory of Open Access Journals (Sweden)

    A. Fedoryszyn

    2008-07-01

    Full Text Available The paper summarizes the performance data of a newly designed and engineered grinding and cut-off system. The machine is used for separation of models manufactured by the investment casting method. The machine comprises the following units:- base supporting other assemblies and elements: abrasive disc holder and drives; this solution enables an easy replacement and access to holding elements while a belt transmission allows the disc rpm to be varied,- mechanism moving the spindle in the horizontal, hence the abrasive disc position with respect to the batch can be precisely controlled, depending on the cast position and their shape,- holding and positioning-control of the batch to enable the fore and aft movements and rotations,- guide systems ensuring the travel of the batch in the specified direction and adjusting the travel speed to the required cutting rate,- centering, control, exhaust system, housingExtensive tests were performed, including the tests of operating parameters of abrasive discs depending on the cast material, cyclograms of the applied treatment are obtained accordingly.

  6. Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti

    Directory of Open Access Journals (Sweden)

    EL Mabchour A

    2015-10-01

    Full Text Available Asma EL Mabchour,1 Hélène Delisle,1 Colette Vilgrain,2 Philippe Larco,2 Roger Sodjinou,3 Malek Batal1 1Transition Nutritionnelle (TRANSNUT, WHO Collaborating Centre on Nutrition Changes and Development, Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada; 2Haitian Foundation for Diabetes and Cardiovascular Diseases (FHADIMAC, Port-au-Prince, Haiti; 3West Africa Health Organization (WAHO, Bobo-Dioulasso, Burkina Faso Purpose: Waist circumference (WC and waist-to-height ratio (WHtR are widely used as indicators of abdominal adiposity and the cut-off values have been validated primarily in Caucasians. In this study we identified the WC and WHtR cut-off points that best predicted cardiometabolic risk (CMR in groups of African (Benin and African ancestry (Haiti Black subjects. Methods: This cross-sectional study included 452 apparently healthy subjects from Cotonou (Benin and Port-au-Prince (Haiti, 217 women and 235 men from 25 to 60 years. CMR biomarkers were the metabolic syndrome components. Additional CMR biomarkers were a high atherogenicity index (total serum cholesterol/high density lipoprotein cholesterol ≥4 in women and ≥5 in men; insulin resistance set at the 75th percentile of the calculated Homeostasis Model Assessment index (HOMA-IR; and inflammation defined as high-sensitivity C-reactive protein (hsCRP concentrations between 3 and 10 mg/L. WC and WHtR were tested as predictors of two out of the three most prevalent CMR biomarkers. Receiver operating characteristic (ROC curves, Youden's index, and likelihood ratios were used to assess the performance of specific WC and WHtR cut-offs. Results: High atherogenicity index (59.5%, high blood pressure (23.2%, and insulin resistance (25% by definition were the most prevalent CMR biomarkers in the study groups. WC and WHtR were equally valid as predictors of CMR. Optimal WC cut-offs were 80 cm and 94 cm in men and women, respectively, which is exactly

  7. Isolation of Ganjam virus from ticks collected off domestic animals around Pune, Maharashtra, India.

    Science.gov (United States)

    Joshi, M V; Geevarghese, G; Joshi, G D; Ghodke, Y S; Mourya, D T; Mishra, A C

    2005-03-01

    Studies on viruses of zoonotic importance in certain villages around Pune were undertaken between December 2000 and January 2002. A total of 1,138 adult ticks belonging to six different species were collected off domestic animals and processed for virus isolation. Six virus isolates were obtained. All six isolates were identified as Ganjam virus by Quick Complement Fixation test and reverse transcriptase-polymerase chain reaction using RNA nucleocapsid gene amplification. Five isolates were from the pools of adult Hemaphysalis intermedia ticks, and one isolate was from a pool of adult Rhipecephalus hemaphysaloides. This is the first report of isolation of Ganjam virus from Maharashtra state of India.

  8. Modelling the Turbocharger Cut Off Application Due to Slow Steaming Operation 12RTA96C-B Engine

    Directory of Open Access Journals (Sweden)

    Karsten Wehner

    2017-09-01

    Full Text Available Out of the total operational costs of a ship, fuel costs account for by far the highest proportion. In view of the global economic situation and the rising oil prices, shipowners and charterers are looking for solutions to cut costs by reducing fuel consumption. Low load operation, also well-known as “slow steaming”, represents the currently most effective and popular measure to cut fuel costs and, in consequence, the total operational costs for increased competitiveness in the market. Low load operation is possible and there is an increasing trend to operate in these very low engine load ranges. As the engines were not designed for this operational condition, various retrofit modifications to the engine can compensate for this. By using low load operation, the reduction of the RPM gives problems when sailing at low speed.  A turbocharger (TC compresses inlet air to a high pressure and after cooling this compressed air it results in higher mass of air in the cylinder. But when running at a low power load this air reaches temperatures that are too low for an optimal combustion process. One of the solution comes from the company Wärtsilä. They install so called “low steam engine kits”. When this kit is installed it allows the engine operators to cut off one turbocharger of the engine, this result’s in a higher RPM for the operating turbochargers. When the remaining TC’s have a higher RPM their efficiency improves and gives the engine more air for combustion.The goal of this Bachelor thesis is to make a calculation modelling and prove that by switching off one or more turbocharger on the system will improve the efficiency in slow steaming operation. Beside that, this thesis is aims to estimated the performance of the engine in both operation condition.

  9. Invasion versus isolation: trade-offs in managing native salmonids with barriers to upstream movement.

    Science.gov (United States)

    Fausch, Kurt D; Rieman, Bruce E; Dunham, Jason B; Young, Michael K; Peterson, Douglas P

    2009-08-01

    Conservation biologists often face the trade-off that increasing connectivity in fragmented landscapes to reduce extinction risk of native species can foster invasion by non-native species that enter via the corridors created, which can then increase extinction risk. This dilemma is acute for stream fishes, especially native salmonids, because their populations are frequently relegated to fragments of headwater habitat threatened by invasion from downstream by 3 cosmopolitan non-native salmonids. Managers often block these upstream invasions with movement barriers, but isolation of native salmonids in small headwater streams can increase the threat of local extinction. We propose a conceptual framework to address this worldwide problem that focuses on 4 main questions. First, are populations of conservation value present (considering evolutionary legacies, ecological functions, and socioeconomic benefits as distinct values)? Second, are populations vulnerable to invasion and displacement by non-native salmonids? Third, would these populations be threatened with local extinction if isolated with barriers? And, fourth, how should management be prioritized among multiple populations? We also developed a conceptual model of the joint trade-off of invasion and isolation threats that considers the opportunities for managers to make strategic decisions. We illustrated use of this framework in an analysis of the invasion-isolation trade-off for native cutthroat trout (Oncorhynchus clarkii) in 2 contrasting basins in western North America where invasion and isolation are either present and strong or farther away and apparently weak. These cases demonstrate that decisions to install or remove barriers to conserve native salmonids are often complex and depend on conservation values, environmental context (which influences the threat of invasion and isolation), and additional socioeconomic factors. Explicit analysis with tools such as those we propose can help managers make

  10. Rib fracture following stereotactic body radiotherapy: a potential pitfall.

    Science.gov (United States)

    Stanic, Sinisa; Boike, Thomas P; Rule, William G; Timmerman, Robert D

    2011-11-01

    Although the incidence of rib fractures after conventional radiotherapy is generally low (rib fractures are a relatively common complication of stereotactic body radiotherapy. For malignancy adjacent to the chest wall, the incidence of rib fractures after stereotactic body radiotherapy is as high as 10%. Unrecognized bone fractures can mimic bone metastases on bone scintigraphy, can lead to extensive workup, and can even lead to consideration of unnecessary systemic chemotherapy, as treatment decisions can be based on imaging findings alone. Nuclear medicine physicians and diagnostic radiologists should always consider rib fracture in the differential diagnosis.

  11. Preoperative diagnosis of breast diseases by dynamic MR mammography. Cut off point establishment for signal intensity ratio

    International Nuclear Information System (INIS)

    Tsuchiya, Juji; Nagata, Takayasu; Kawagoe, Hajime; Tachibana, Susumu; Kajima, Toshihiko; Hoshino, Mutsuo; Uno, Takashi; Shimokawa, Kuniyasu.

    1997-01-01

    We have revealed that a dynamic study of the breast using MR imaging technique can estimate objectively benign-malignant differentiative diagnosis. Subjects were 41 cases of breast lesion, including 13 cases of breast cancer, 21 cases of mastopathy, six cases of fibroadenoma and one case of intraductal papillomatosis and the results of them were investigated in comparison with histopathological diagnosis. As so the method, we drew up time-signal intensity ratio curve plotting signal intensity ratio at each 30 second of dynamic MR mammography after Gd-DTPA administration. We found a especially high significant difference between cancer and mastopathy, within 90 second after Gd-DTPA administration (p=0.0000). Still more, we established cut off point concerning with establishment of 95% confidence interval, that is, at 30 second after Gd-DTPA administration of point equivalent 1.53 at 60 second equivalent 2.00, at 90 second equivalent 2.47, and about this estimating maneuver using the cut off point we named Dynamic ratio method. We can estimate preoperatively not only benign-malignant differentiative diagnosis with breast tumor, but also neighboring infiltration and lymph node metastasis of breast cancer using this Dynamic ratio method. Over again, Dynamic ratio method provides fine information to preoperative decision of resecting region for breast conserving surgery. The efficiency of this method is sensitivity=92.3%, specificity=89.3% and positive predictive value=80.0%. (author)

  12. Preoperative diagnosis of breast diseases by dynamic MR mammography. Cut off point establishment for signal intensity ratio

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Juji; Nagata, Takayasu; Kawagoe, Hajime; Tachibana, Susumu; Kajima, Toshihiko; Hoshino, Mutsuo [Ibi General Hospital, Gifu (Japan); Uno, Takashi; Shimokawa, Kuniyasu

    1997-12-01

    We have revealed that a dynamic study of the breast using MR imaging technique can estimate objectively benign-malignant differentiative diagnosis. Subjects were 41 cases of breast lesion, including 13 cases of breast cancer, 21 cases of mastopathy, six cases of fibroadenoma and one case of intraductal papillomatosis and the results of them were investigated in comparison with histopathological diagnosis. As so the method, we drew up time-signal intensity ratio curve plotting signal intensity ratio at each 30 second of dynamic MR mammography after Gd-DTPA administration. We found a especially high significant difference between cancer and mastopathy, within 90 second after Gd-DTPA administration (p=0.0000). Still more, we established cut off point concerning with establishment of 95% confidence interval, that is, at 30 second after Gd-DTPA administration of point equivalent 1.53 at 60 second equivalent 2.00, at 90 second equivalent 2.47, and about this estimating maneuver using the cut off point we named Dynamic ratio method. We can estimate preoperatively not only benign-malignant differentiative diagnosis with breast tumor, but also neighboring infiltration and lymph node metastasis of breast cancer using this Dynamic ratio method. Over again, Dynamic ratio method provides fine information to preoperative decision of resecting region for breast conserving surgery. The efficiency of this method is sensitivity=92.3%, specificity=89.3% and positive predictive value=80.0%. (author)

  13. Modeling unsaturated-zone flow at Rainier Mesa as a possible analog for a future Yucca Mountain

    International Nuclear Information System (INIS)

    Gauthier, J.H.

    1998-01-01

    Rainier Mesa is structurally similar to Yucca Mountain, and receives precipitation similar to the estimated long-term average for Yucca Mountain. Tunnels through the unsaturated zone at Rainier Mesa have encountered perched water and, after the perched water was drained, flow in fractures and faults. Although flow observations have been primarily qualitative, Rainier Mesa hydrology is a potential analog for Yucca Mountain hydrology in a wetter climate. In this paper, a groundwater flow model that has been used in the performance assessment of Yucca Mountain--the weeps model--is applied to Rainier Mesa. The intent is to gain insight in both Rainier Mesa and the weeps flow model

  14. Effect of Channel Orientation and Rib Pitch-to-Height Ratio on Pressure Drop in a Rotating Square Channel with Ribs on Two Opposite Surfaces

    Directory of Open Access Journals (Sweden)

    Prabhu S. V.

    2005-01-01

    Full Text Available The effect of channel orientation and rib pitch-to-height ratio on the pressure drop distribution in a rib-roughened channel is an important issue in turbine blade cooling. The present investigation is a study of the overall pressure drop distribution in a square cross-sectioned channel, with rib turbulators, rotating about an axis normal to the free stream. The ribs are configured in a symmetric arrangement on two opposite surfaces with a rib angle of 90 ∘ to the mainstream flow. The study has been conducted for three Reynolds numbers, namely, 13 000, 17 000, and 22 000 with the rotation number varying from 0– 0.38 . Experiments have been carried out for various rib pitch-to-height ratios ( P/e with a constant rib height-to-hydraulic diameter ratio ( e/D of 0.1 . The test section in which the ribs are placed on the leading and trailing surfaces is considered as the base case ( orientation angle= 0 ∘ , Coriolis force vector normal to the ribbed surfaces. The channel is turned about its axis in steps of 15 ∘ to vary the orientation angle from 0 ∘ to 90 ∘ . The overall pressure drop does not change considerably under conditions of rotation for the base case. However, for the other cases tested, it is observed that the overall pressure drop increases with an increase in the rotation number for a given orientation angle and also increases with an increase in the orientation angle for a given rotation number. This change is attributed to the variation in the separation zone downstream of the ribs due to the presence of the Coriolis force—local pressure drop data is presented which supports this idea. At an orientation angle of 90 ∘ (ribs on the top and bottom surfaces, Coriolis force vector normal to the smooth surfaces, the overall pressure drop is observed to be maximum during rotation. The overall pressure drop for a case with a rib pitch-to-height ratio of 5 on both surfaces is found to be the highest

  15. MESA - A new approach to low cost scientific spacecraft

    Science.gov (United States)

    Keyes, G. W.; Case, C. M.

    1982-09-01

    Today, the greatest obstacle to science and exploration in space is its cost. The present investigation is concerned with approaches for reducing this cost. Trends in the scientific spacecraft market are examined, and a description is presented for the MESA space platform concept. The cost drivers are considered, taking into account planning, technical aspects, and business factors. It is pointed out that the primary function of the MESA concept is to provide a satellite system at the lowest possible price. In order to reach this goal an attempt is made to benefit from all of the considered cost drivers. It is to be tried to work with the customer early in the mission analysis stage in order to assist in finding the right compromise between mission cost and return. A three phase contractual arrangement is recommended for MESA platforms. The phases are related to mission feasibility, specification definition, and design and development. Modular kit design promotes flexibility at low cost.

  16. Percentile curves for body fatness and cut-offs to define malnutrition in Russians

    Science.gov (United States)

    Nikolaev, D. V.; Rudnev, S. G.; Starunova, O. A.; Eryukova, T. A.; Kolesnikov, V. A.; Ponomareva, E. G.; Soboleva, N. P.; Sterlikov, S. A.

    2013-04-01

    Here, we report first results of the large-scale ongoing bioelectrical impedance body composition study in Russians. By the end of 2012, 216 out of 800 Russian Health Centres submitted raw bioimpedance data on 844,221 adults and children aged 5-80 years, representing nearly 0.6% of the Russian population, who were accessed cross-sectionally using the same type of bioimpedance meter, ABC-01 Medas. Estimates of overweight, obesity, and normal weight obesity prevalence in the general population, as well as characteristics of diagnostic sensitivity and specificity of the conventional WHO BMI-based criteria of obesity depending on age are obtained. The smoothed reference centile curves for percentage fat mass are constructed, and localized cut-offs for fatness and thinness are provided that can be used both at the individual and epidemiological levels.

  17. Percentile curves for body fatness and cut-offs to define malnutrition in Russians

    International Nuclear Information System (INIS)

    Nikolaev, D V; Eryukova, T A; Kolesnikov, V A; Rudnev, S G; Starunova, O A; Ponomareva, E G; Soboleva, N P; Sterlikov, S A

    2013-01-01

    Here, we report first results of the large-scale ongoing bioelectrical impedance body composition study in Russians. By the end of 2012, 216 out of 800 Russian Health Centres submitted raw bioimpedance data on 844,221 adults and children aged 5–80 years, representing nearly 0.6% of the Russian population, who were accessed cross-sectionally using the same type of bioimpedance meter, ABC-01 Medas. Estimates of overweight, obesity, and normal weight obesity prevalence in the general population, as well as characteristics of diagnostic sensitivity and specificity of the conventional WHO BMI-based criteria of obesity depending on age are obtained. The smoothed reference centile curves for percentage fat mass are constructed, and localized cut-offs for fatness and thinness are provided that can be used both at the individual and epidemiological levels.

  18. ELISA validation and determination of cut-off level for chloramphenicol residues in honey

    Directory of Open Access Journals (Sweden)

    Biernacki Bogumił

    2015-09-01

    Full Text Available An analytical validation of a screening ELISA for detection of chloramphenicol (CAP in honey was conducted according to the Commission Decision 2002/657/EC and Guidelines for the Validation of Screening Methods for Residues of Veterinary Medicines. The analyte was extracted from honey with a water and ethyl acetate mixture, and CAP concentrations were measured photometrically at 450 nm. The recovery rate of the analyte from spiked samples was 79%. The cut-off level of CAP in honey as the minimum recovery (0.17 units was established. Detection capability (CCβ was fixed at 0.25 μg kg−1. No relevant interferences between matrix effects and structurally related substances including florfenicol and thiamphenicol were observed. The ELISA method should be useful for determination of CAP residues in honey monitoring.

  19. Bats of Mesa Verde National Park, Colorado: composition, reproduction, and roosting habits.

    Science.gov (United States)

    O'Shea, Thomas J.; Cryan, Paul M.; Snider, E. Apple; Valdez, Ernest W.; Ellison, Laura E.; Neubaum, Daniel J.

    2011-01-01

    We determined the bat fauna at Mesa Verde National Park (Mesa Verde) in 2006 and 2007, characterized bat elevational distribution and reproduction, and investigated roosting habits of selected species. We captured 1996 bats of 15 species in mist nets set over water during 120 nights of sampling and recorded echolocation calls of an additional species. The bat fauna at Mesa Verde included every species of bat known west of the Great Plains in Colorado, except the little brown bat (Myotis lucifugus). Some species showed skewed sex ratios, primarily due to a preponderance of males. Thirteen species of bats reproduced at Mesa Verde. Major differences in spring precipitation between the 2 years of our study were associated with differences in reproductive rates and, in some species, with numbers of juveniles captured. Reduced reproductive effort during spring drought will have a greater impact on bat populations with the forecasted increase in aridity in much of western North America by models of global climate change. We radiotracked 46 bats of 5 species to roosts and describe the first-known maternity colonies of spotted bats (Euderma maculatum) in Colorado. All 5 species that we tracked to diurnal roosts relied almost exclusively on rock crevices rather than trees or snags, despite the presence of mature forests at Mesa Verde and the use of trees for roosts in similar forests elsewhere by some of these species. Comparisons with past bat surveys at Mesa Verde and in surrounding areas suggest no dramatic evidence for effects of recent stand-replacing fires on the composition of the bat community.

  20. Optimal waist circumference cut-off points and ability of different metabolic syndrome criteria for predicting diabetes in Japanese men and women: Japan Epidemiology Collaboration on Occupational Health Study

    Directory of Open Access Journals (Sweden)

    Huanhuan Hu

    2016-03-01

    Full Text Available Abstract Background We sought to establish the optimal waist circumference (WC cut-off point for predicting diabetes mellitus (DM and to compare the predictive ability of the metabolic syndrome (MetS criteria of the Joint Interim Statement (JIS and the Japanese Committee of the Criteria for MetS (JCCMS for DM in Japanese. Methods Participants of the Japan Epidemiology Collaboration on Occupational Health Study, who were aged 20–69 years and free of DM at baseline (n = 54,980, were followed-up for a maximum of 6 years. Time-dependent receiver operating characteristic analysis was used to determine the optimal cut-off points of WC for predicting DM. Time-dependent sensitivity, specificity, and positive and negative predictive values for the prediction of DM were compared between the JIS and JCCMS MetS criteria. Results During 234,926 person-years of follow-up, 3180 individuals developed DM. Receiver operating characteristic analysis suggested that the most suitable cut-off point of WC for predicting incident DM was 85 cm for men and 80 cm for women. MetS was associated with 3–4 times increased hazard for developing DM in men and 7–9 times in women. Of the MetS criteria tested, the JIS criteria using our proposed WC cut-off points (85 cm for men and 80 cm for women had the highest sensitivity (54.5 % for men and 43.5 % for women for predicting DM. The sensitivity and specificity of the JCCMS MetS criteria were ~37.7 and 98.9 %, respectively. Conclusion Data from the present large cohort of workers suggest that WC cut-offs of 85 cm for men and 80 cm for women may be appropriate for predicting DM for Japanese. The JIS criteria can detect more people who later develop DM than does the JCCMS criteria.

  1. Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

    Science.gov (United States)

    Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

    2017-04-01

    To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

  2. Prediction of individual patient response to chemotherapy by the fluorometric microculture cytotoxicity assay (FMCA) using drug specific cut-off limits and a Bayesian model.

    Science.gov (United States)

    Larsson, R; Nygren, P

    1993-01-01

    The semiautomated fluorometric microculture cytotoxicity assay (FMCA) based on the measurement of fluorescence generated from cellular hydrolysis of fluorescein diacetate (FDA) to fluorescein in microtiter plates, has been used for determination of cytotoxic drug resistance of tumor cells from patients with hematological and solid tumors. In the present study we describe a calibration procedure based on statistically derived cut-off limits and assay-predicted response probabilities using Bayes' theorem. Test results at a specified drug concentration were divided into three categories: low, intermediate or extreme drug resistance (LDR, IDR and EDR, respectively) using the median and median +1 standard deviation as the cut-off limits. When correlated with clinical outcome, LDR samples showed a higher response rate than expected, IDR a lower and EDR samples no response at all. The sensitivity and specificity of the test, using the median as cut-off limit, were 0.92 and 0.69 respectively. By fitting these test characteristics to a statistical model based on Bayes' theorem it is possible to calculate response probabilities for each individual patient taking into consideration not only the test characteristics and the particular assay result, but also the clinical and patient specific characteristics influencing the pre-test probability of response. EDR predicts clinical drug resistance with high specificity and is also observed in tumor types with high response rate.

  3. Case report: clinical and postmortem findings in four cows with rib fracture

    OpenAIRE

    Braun, Ueli; Warislohner, Sonja; Hetzel, Udo; Nuss, Karl

    2017-01-01

    BACKGROUND: Published reports of rib fractures in adult cattle are limited to the occurrence of chronic rib swellings caused by calluses, which are unremarkable from a clinical standpoint, whereas studies identifying clinical signs of rib fractures were not found in a literature search. This report describes the clinical and postmortem findings in four cows with rib fractures. CASE PRESENTATION: The 13th rib was fractured in three cows and the 11th rib in the remaining cow; three fractures...

  4. An analysis of 214 cases of rib fractures

    OpenAIRE

    Karadayi, Sule; Nadir, Aydin; Sahin, Ekber; Celik, Burcin; Arslan, Sulhattin; Kaptanoglu, Melih

    2011-01-01

    INTRODUCTION: Rib fractures are the most common type of injury associated with trauma to the thorax. In this study, we investigated whether morbidity and mortality rates increased in correlation with the number of fractured ribs. MATERIALS AND METHODS: Data from 214 patients with rib fractures who applied or were referred to our clinic between January 2007 and December 2008 were retrospectively evaluated. The patients were allocated into three groups according to the number of fractures: 1) p...

  5. RIBBED DOUBLE PIPE HEAT EXCHANGER: ANALYTICAL ANALYSIS

    Directory of Open Access Journals (Sweden)

    HUSSAIN H. AL-KAYIEM

    2011-02-01

    Full Text Available This paper presents the findings obtained by modeling a Double Pipe Heat Exchanger (DPHE equipped with repeated ribs from the inside for artificial roughing. An analytical procedure was developed to analyze the thermal and hydraulic performance of the DPHE with and without ribbing. The procedure was verified by comparing with experimental reported results and they are in good agreement. Several parameters were investigated in this study including the effect of ribs pitch to height ratios, P/e= 5, 10, 15, and 20, and ribs to hydraulic diameter ratios, e/Dh= 0.0595, 0.0765, and 0.107. These parameters were studied at various operating Reynolds number ranging from 2500 to 150000. Different installation configurations were investigated, too. An enhan-cement of 4 times in the heat transfer in terms of Stanton number was achieved at the expense of 38 times increase of pressure drop across the flow in terms of friction facto values.

  6. LOPEZ DE MESA Y LA MEDICINA

    Directory of Open Access Journals (Sweden)

    Humberto Roselli

    1985-04-01

    Full Text Available

    Hace apenas dos meses la Academia Nacional de Medicina y la Sociedad Colombiana de Historia de la Medicina iniciaban en este mismo recinto el homenaje del cuerpo médico colombiano a la memoria del Profesor Luis López de Mesa con motivo del primer centenario de su nacimiento, homenaje que ahora culmina con esta nueva sesión solenme conjunta.

    Fue la del Profesor López de Mesa una vida eminente en grado sumo, habiéndose destacado en todas las actividades que emprendiera, como se ha recordado profudamente en estos días. Autor de más de 20 obras que incluyeron novelas, tratados de sociología, de historia colombiana, ensayos filosóficos y reflexiones personales; hombre público que se destacó como Ministro de Educación, como parlamentario y diplomático, y luego como Ministro de Relaciones Exteriores, Rector de la Universidad Nacional; Académico y Presidente de la Academia Nacional de Medicina,Miembro de las de la Lengua, de Historia y de Ciencia Exactas, Físicas y Naturales; Presidente del Colegio Máximo de Academias; prácticamente no hubo campo de la inteligencia y de la cultura colombianas que el Profesor López de Mesa no hubiera tocado con éxito y en los cuales no hubiera dejado huellas de su pensamiento y de su trajín humanista. Se le considera como uno de los fundadores de la sociología en Colombia y un estilista difícil pero correcto y profundo. La trayectoria de su vida pública es aún ampliamente recordada en nuestro medio.

    En aquella ocasión hicimos un repaso de la carrera del Profesor López de Mesa como médico y psiquiatra y escudriñamos algunas de las circunstancias de su formación científica que habrían posteriormente de reflejarse en su obra como sociólogo y estadista.! En esta oportunidad resumimos aquellos y algunos otros detalles.

  7. [Segmental cut-off bridge and local floating technology for the treatment of ossification of ligamentum flavum in thoracic spine].

    Science.gov (United States)

    Liang, Wei-dong; Zhang, Jian; Sheng, Wei-bin

    2013-10-08

    To explore the efficacy and safety of segmental cut-off bridge and local floating technology for the treatment of ossification of ligamentum flavum (OLF) in thoracic spine. Retrospective study was performed in 98 patients with thoracic OLF who under went operation. There was 56 males and 42 females with an average age of 45.8 (35-73) years. The average duration of onset was 17 (3-51) months. The main clinical symptoms were numbness and paraesthesia (n = 90), lower limb weakness and walking trouble (n = 46), positive pyramidal tract signs (n = 33) and sphincter function obstacle (n = 9). OLF was screened and diagnosed by radiology, magnetic resonance imaging (MRI), computed tomography (CT) or CT myelography (CTM). A total of 142 OLF nidus were spotted. The lesions involved single segment (n = 32), double segments (n = 56), three segments (n = 6) and ≥ four segments (n = 4). And the locations were at upper thoracic segment (T1-4) (n = 34), middle thoracic segment (T5-8) (n = 23) and lower thoracic segment (T9-12) (n = 42). The OLF nidus were removed by local floating technology oft windowing at cephalic and caudal ends and a cut-off bridge at both sides of involved segments. Pre- and post-operative Japanese Orthopedic Association (JOA) scores and Epstein grades were recorded to evaluate the outcomes. The mean loss volume of blood was 320 ml and operative duration 155 min. All cases recovered independent activities. The mean follow-up period was 28 (13-48) months. The mean preoperative JOA score was 4.3 (1-8) points and the mean postoperative JOA score 9.7 (5-11) points. The recovery rate was 78.8%. According to Epstein grade, the excellent and good rate was 86.7%. As a common cause of thoracic spinal cord compression, OLF should be operated as early as possible. Based upon clinical and imaging findings, the application of segmental cut-off bridge and local floating technology is both safe and efficacious in the treatment of OLF in thoracic spine.

  8. Meat cuts and non-carcass of sheep finished on pasture with different levels of supplementation

    Directory of Open Access Journals (Sweden)

    Zaqueu Gonçalves Carvalho

    2015-02-01

    Full Text Available This study aimed to evaluate the yield of meat cuts and other body components of sheep kept on pasture Panicum maximum, Massai cultivar, fed increasing amounts of concentrate. The animals were divided into four treatments according to the concentrate intake in relation to body weight (zero, 0.7, 1.4 and 2.1%. After slaughter of the sheep, the weights of non-hollow viscera (tongue, lung, liver, diaphragm, kidney and spleen, hollow ones (trachea, esophagus, heart, gallbladder, bladder, rumen, omasum, abomasum, small and larger intestines, other components (blood, skin, feet, head, tail and mammary gland and fat in the viscera (omental, mesenteric, perirenal and cavity. In carcasses, the commercial cuts were made (shoulder, ribs, loin, leg, and neck. The cuts except the neck, did not alter their weights, however, there were changes in their proportions. Only the percentage of loin did not change. With the intake of 1.42% in concentrate for body weight, there was an increase of ribs over the leg. The total weight of the non-carcass did not change, however, there was variations in its proportion. Amongst the most noticeable changes is the amount of visceral fat, which greatly increased when the sheep ingested 1.35% in concentrate for body weight. Therefore, concentrate intake by culling ewes does not increase mass commercial cuts. The proportions of commercial cuts and other body constituents change diffusely. With the maturity has been reached, the observed weight gain is, in most cases, result of increased visceral fat.

  9. Retrospective analysis of insulin responses to standard dosed oral glucose tests (OGTs) via naso-gastric tubing towards definition of an objective cut-off value.

    Science.gov (United States)

    Warnken, Tobias; Delarocque, Julien; Schumacher, Svenja; Huber, Korinna; Feige, Karsten

    2018-01-19

    Insulin dysregulation (ID) with basal or postprandial hyperinsulinemia is one of the key findings in horses and ponies suffering from the equine metabolic syndrome (EMS). Assessment of ID can easily be performed in clinical settings by the use of oral glucose challenge tests. Oral glucose test (OGT) performed with 1 g/kg bodyweight (BW) glucose administered via naso-gastric tube allows the exact administration of a defined glucose dosage in a short time. However, reliable cut-off values have not been available so far. Therefore, the aim of the study was to describe variations in insulin response to OGT via naso-gastric tubing and to provide a clinical useful cut-off value for ID when using the insulin quantification performed with an equine-optimized insulin enzyme-linked immunosorbent assay. Data visualization revealed no clear separation in the serum insulin concentration of insulin sensitive and insulin dysregulated horses during OGT. Therefore, a model based clustering method was used to circumvent the use of an arbitrary limit for categorization. This method considered all data-points for the classification, taking into account the individual insulin trajectory during the OGT. With this method two clusters were differentiated, one with low and one with high insulin responses during OGT. The cluster of individuals with low insulin response was consistently detected, independently of the initialization parameters of the algorithm. In this cluster the 97.5% quantile of insulin is 110 µLU/mL at 120 min. We suggest using this insulin concentration of 110 µLU/mL as a cut-off value for samples obtained at 120 min in OGT. OGT performed with 1 g/kg BW glucose and administration via naso-gastric tubing can easily be performed under clinical settings. Application of the cut-off value of 110 µLU/mL at 120 min allows assessment of ID in horses.

  10. Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy

    International Nuclear Information System (INIS)

    Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil; Kim, Jin Hee

    2009-01-01

    This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest CT findings of rib fracture were analyzed. The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p=0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p=0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest CT, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p=0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p=0.001). Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis

  11. Radiation Induced Rib Fractures on Bone Scan after Breast Cancer Surgery and Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hae Won; Won, Kyoung Sook; Zeon, Seok Kil; Kim, Jin Hee [Keimyung University, School of Medicine, Daegu (Korea, Republic of)

    2009-08-15

    This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest CT findings of rib fracture were analyzed. The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p=0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p=0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest CT, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p=0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p=0.001). Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.

  12. Numerical investigations of rib fracture failure models in different dynamic loading conditions.

    Science.gov (United States)

    Wang, Fang; Yang, Jikuang; Miller, Karol; Li, Guibing; Joldes, Grand R; Doyle, Barry; Wittek, Adam

    2016-01-01

    Rib fracture is one of the most common thoracic injuries in vehicle traffic accidents that can result in fatalities associated with seriously injured internal organs. A failure model is critical when modelling rib fracture to predict such injuries. Different rib failure models have been proposed in prediction of thorax injuries. However, the biofidelity of the fracture failure models when varying the loading conditions and the effects of a rib fracture failure model on prediction of thoracic injuries have been studied only to a limited extent. Therefore, this study aimed to investigate the effects of three rib failure models on prediction of thoracic injuries using a previously validated finite element model of the human thorax. The performance and biofidelity of each rib failure model were first evaluated by modelling rib responses to different loading conditions in two experimental configurations: (1) the three-point bending on the specimen taken from rib and (2) the anterior-posterior dynamic loading to an entire bony part of the rib. Furthermore, the simulation of the rib failure behaviour in the frontal impact to an entire thorax was conducted at varying velocities and the effects of the failure models were analysed with respect to the severity of rib cage damages. Simulation results demonstrated that the responses of the thorax model are similar to the general trends of the rib fracture responses reported in the experimental literature. However, they also indicated that the accuracy of the rib fracture prediction using a given failure model varies for different loading conditions.

  13. Comparison of ultrasonography and radiography in diagnosis of rib fractures

    OpenAIRE

    Pishbin, Elham; Ahmadi, Koorosh; Foogardi, Molood; Salehi, Maryam; Seilanian Toosi, Farrokh; Rahimi-Movaghar, Vafa

    2017-01-01

    Purpose: Rib fractures are the most common skeletal thoracic injuries resulting from blunt chest trauma. Half of the rib fractures are not detected upon a precise physical evaluation and radiographs. Recently ultrasonography (USG) has been investigated to detect rib fractures. But based on literature the usefulness of USG varies widely. This study was conducted to investigate the role of USG in the detection of possible rib fractures in comparison with radiography. Methods: In this cross-s...

  14. Clinical and Radiologic Predictive Factors of Rib Fractures in Outpatients With Chest Pain.

    Science.gov (United States)

    Zhang, Liang; McMahon, Colm J; Shah, Samir; Wu, Jim S; Eisenberg, Ronald L; Kung, Justin W

    To identify the clinical and radiologic predictive factors of rib fractures in stable adult outpatients presenting with chest pain and to determine the utility of dedicated rib radiographs in this population of patients. Following Institutional Review Board approval, we performed a retrospective review of 339 consecutive cases in which a frontal chest radiograph and dedicated rib series had been obtained for chest pain in the outpatient setting. The frontal chest radiograph and dedicated rib series were sequentially reviewed in consensus by two fellowship-trained musculoskeletal radiologists blinded to the initial report. The consensus interpretation of the dedicated rib series was used as the gold standard. Multiple variable logistic regression analysis assessed clinical and radiological factors associated with rib fractures. Fisher exact test was used to assess differences in medical treatment between the 2 groups. Of the 339 patients, 53 (15.6%) had at least 1 rib fracture. Only 20 of the 53 (37.7%) patients' fractures could be identified on the frontal chest radiograph. The frontal chest radiograph had a sensitivity of 38% and specificity of 100% when using the rib series as the reference standard. No pneumothorax, new mediastinal widening or pulmonary contusion was identified. Multiple variable logistic regression analysis of clinical factors associated with the presence of rib fractures revealed a significant association of trauma history (odds ratio 5.7 [p rib fractures in this population demonstrated a significant association of pleural effusion with rib fractures (odds ratio 18.9 [p rib fractures received narcotic analgesia in 47.2% of the cases, significantly more than those without rib fractures (21.3%, p rib fractures have a higher association with a history of minor trauma and age ≥40 in the adult population. Radiographic findings associated with rib fractures include pleural effusion. The frontal chest radiograph alone has low sensitivity in

  15. Estimation of Groundwater Recharge at Pahute Mesa using the Chloride Mass-Balance Method

    Energy Technology Data Exchange (ETDEWEB)

    Cooper, Clay A [DRI; Hershey, Ronald L [DRI; Healey, John M [DRI; Lyles, Brad F [DRI

    2013-07-01

    Groundwater recharge on Pahute Mesa was estimated using the chloride mass-balance (CMB) method. This method relies on the conservative properties of chloride to trace its movement from the atmosphere as dry- and wet-deposition through the soil zone and ultimately to the saturated zone. Typically, the CMB method assumes no mixing of groundwater with different chloride concentrations; however, because groundwater is thought to flow into Pahute Mesa from valleys north of Pahute Mesa, groundwater flow rates (i.e., underflow) and chloride concentrations from Kawich Valley and Gold Flat were carefully considered. Precipitation was measured with bulk and tipping-bucket precipitation gauges installed for this study at six sites on Pahute Mesa. These data, along with historical precipitation amounts from gauges on Pahute Mesa and estimates from the PRISM model, were evaluated to estimate mean annual precipitation. Chloride deposition from the atmosphere was estimated by analyzing quarterly samples of wet- and dry-deposition for chloride in the bulk gauges and evaluating chloride wet-deposition amounts measured at other locations by the National Atmospheric Deposition Program. Mean chloride concentrations in groundwater were estimated using data from the UGTA Geochemistry Database, data from other reports, and data from samples collected from emplacement boreholes for this study. Calculations were conducted assuming both no underflow and underflow from Kawich Valley and Gold Flat. Model results estimate recharge to be 30 mm/yr with a standard deviation of 18 mm/yr on Pahute Mesa, for elevations >1800 m amsl. These estimates assume Pahute Mesa recharge mixes completely with underflow from Kawich Valley and Gold Flat. The model assumes that precipitation, chloride concentration in bulk deposition, underflow and its chloride concentration, have been constant over the length of time of recharge.

  16. Appropriate neck circumference cut-off points for metabolic syndrome in Turkish patients with type 2 diabetes.

    Science.gov (United States)

    Ozkaya, Ismail; Yardimci, Bulent; Tunckale, Aydin

    2017-12-01

    To investigate the association between neck circumference (NC), overweight, and metabolic syndrome (MS) in Turkish patients with type 2 diabetes. A total of 264 diabetic patients (mean age: 52.9±8.1 years) were recruited from two centers in Istanbul to perform anthropometric measurements, including waist and hip circumference, NC, and body mass index. Blood pressure, fasting glucose, and lipid profile (total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglyceride levels) were determined. NC correlated with waist circumference, systolic blood pressure, and triglycerides in men, whereas NC only correlated with waist circumference in women. Additionally, NC was shown to negatively correlate with high-density lipoprotein cholesterol in both men and women. Receiver operating characteristic analysis showed that the area under the curve for NC and overweight was 0.95 for both men and women (P<0.001). Moreover, a NC of 38cm for men and 37cm for women was the best cut-off point for determining overweight. The area under the curve for NC and MS was 0.87 for men and 0.83 for women (P<0.001). A NC of 39cm for men and 37cm for women was the best cut-off point to determine participants with MS. Our findings suggest a positive correlation of NC with MetS in Turkish patients with type 2 diabetes, and could be a useful and accurate tool to identify MS. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Developing MESA : an accelerated reliability test

    NARCIS (Netherlands)

    Baskoro, G.; Rouvroye, J.L.; Bacher, W.; Brombacher, A.C.

    2003-01-01

    This paper describes the on-going research on an accelerated reliability test strategy called MESA (Multiple Environment Stress Analysis) intended to find in a fast and efficient manner (potential) reliability problems during the design phase of high volume consumer products. This test has shown

  18. Reduction of rib fractures with a bioresorbable plating system: preliminary observations.

    Science.gov (United States)

    Vu, Kim-Chi; Skourtis, Mia E; Gong, Xi; Zhou, Minhao; Ozaki, Wayne; Winn, Shelley R

    2008-05-01

    Operative fixation of rib fractures can reduce morbidity and mortality. Currently, resorbable fixation devices are used in a variety of surgical procedures. A standard osteotomy was prepared in 30 New Zealand white rabbits at the 12th rib. Eighteen had surgical repair with bioresorbable plates and 12 underwent nonoperative management. Half the animals in each group were killed at 3-week postfracture and the remaining animals were killed at 6-week postfracture. Ribs were radiographed and processed histologically to assess fracture healing. Rib reduction was defined as the alignment of the rib ends in a structural condition similar to the prefractured state and quantitative radiomorphometry measured the radiopaque callus surrounding the rib injury sites. Statistical analysis was performed using Fisher's exact test and an unpaired Student's t test and significance was established at p rib fractures remained reduced in the operative group, whereas zero of six and three of six of the rib fractures remained reduced, respectively, in the nonoperative group. A statistically significant increase in radiopaque callus surrounding the rib injury sites was observed at 3 and 6 weeks in the fixed groups. Fixation of rib fractures with a bioresorbable miniplate system was superior to nonoperative treatment at the 3-week interval, with a statistically significant increase in radiopaque callus formation at both 3 and 6 weeks. Additional studies will evaluate the biomechanical outcomes and degradation tissue response after extended in vivo intervals.

  19. Cut-off scaling and multiplicative reformalization in the theory of critical phenomena

    International Nuclear Information System (INIS)

    Forgacs, G.; Solyom, J.; Zawadowski, A.

    1976-03-01

    In the paper a new method to study the critical fluctuations in systems of 4-epsilon dimensions around the phase transition point is developed. This method unifies the Kadanoff scaling hypothesis as formulated by Wilson by help of his renormalization group technique and the simple mathematical structure of the Lie equations of the Gell-Mann-Low multiplicative renormalization. The basic idea of the new method is that a change in the physical cut-off can be compensated by an effective coupling in such a way that the Green's function and vertex in the original and transformed system differ only by a multiplicative factor. The critical indices, the anomalous dimensions and the critical exponent describing the correction to scaling are determined to second order in epsilon. The specific heat exponent is also calculated, in four dimensions the effect of fluctuations appears in the form of logarithmic corrections. In the last sections the new method is compared to other ones and the differences are discussed. (Sz.N.Z.)

  20. Comparative study between rib imaging of DR dual energy subtraction technology and chest imaging

    International Nuclear Information System (INIS)

    Yu Jianming; Lei Ziqiao; Kong Xiangchuang

    2006-01-01

    Objective: To investigate the application value of DR dual energy subtraction technology in rib lesions. Methods: 200 patients were performed with chest DR dual energy subtraction, comparing the rib imaging between DR of thorax and chest imaging using ROC analysis. Results: Among the total of 200 patients, there are 50 cases of rib calcification, 7 cases of rib destruction, 22 cases of rib fracture. The calcification, destruction and fracture were displayed respectively by ribs below diaphragm and rib markings. The analytic parameter of rib imaging of DR dual energy subtraction Az is 0.9367, while that of rib imaging of chest Az is 0.6830. Conclusion: DR dual energy subtraction technology is superior to chest imaging in the displaying of rib lesion and ribs below diaphragm. (authors)

  1. Case report 467: Cystic chondroblastoma left 4th rib

    Energy Technology Data Exchange (ETDEWEB)

    Sundaram, M.; McGuire, M.H.; Naunheim, K.; Schajowicz, F.

    1988-03-01

    A case of chondroblastoma in an 18-year-old female arising from a rib near the costotransverse articulation (presumably from the epiphysis of the articular process) has been described. The destructive pattern noted in the rib, associated with a large soft tissue mass, favored a malignant lesion rather than a benign one. Histologically, this tumor had large cystic and hemorrhagic components, consistent with the diagnosis of a cystic chondroblastoma of a rib. Curiously, this patient, like two others with chondroblastoma in a rib was asymptomatic, and attention to the abnormality was drawn from a routine chest radiography. The patient remains disease-free one and a half-years following surgery.

  2. MESA: Supporting Teaching and Learning about the Marine Environment--Primary Science Focus

    Science.gov (United States)

    Preston, Christine

    2010-01-01

    The Marine Education Society of Australasia (MESA) Inc. is a national organisation of marine educators that aims to bring together people interested in the study and enjoyment of coastal and marine environments. MESA representatives and members organise education and interpretation activities in support of schools and communities during a number…

  3. Nutrient analysis of the Beef Alternative Merchandising cuts.

    Science.gov (United States)

    Desimone, T L; Acheson, R A; Woerner, D R; Engle, T E; Douglass, L W; Belk, K E

    2013-03-01

    The objective of this study was to generate raw and cooked nutrient composition data to identify Quality Grade differences in proximate values for eight Beef Alternative Merchandising (BAM) cuts. The data generated will be used to update the nutrient data in the USDA National Nutrient Database for Standard Reference (SR). Beef Rib, Oven-Prepared, Beef Loin, Strip Loin, and Beef Loin, Top Sirloin Butt subprimals were collected from a total of 24 carcasses from four packing plants. The carcasses were a combination of USDA Yield Grades 2 (n=12) and 3 (n=12), USDA Quality Grades upper two-thirds Choice (n=8), low Choice (n=8), and Select (n=8), and two genders, steer (n=16) and heifer (n=8). After aging, subprimals were fabricated into the BAM cuts, dissected, and nutrient analysis was performed. Sample homogenates from each animal were homogenized and composited for analysis of the following: proximate analysis, long chain and trans-fatty acids, conjugated linoleic acid, total cholesterol, vitamin B-12, and selenium. This study identified seven BAM cuts from all three Quality Grades that qualify for USDA Lean; seven Select cuts that qualify for USDA Extra Lean; and three Select cuts that qualify for the American Heart Association's Heart Healthy Check. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. High cut-off membranes in acute kidney injury and continuous renal replacement therapy.

    Science.gov (United States)

    Ricci, Zaccaria; Romagnoli, Stefano; Ronco, Claudio

    2017-11-24

    Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies.However, the enlargement of pore diameters brings some loss of albumin during treatment and this effect is still under evaluation, since there is a possibility that this is detrimental for the patient. A thorough review of the available clinical literature is reported in this paper with a reappraisal of the potential application of these new technologies.

  5. The Place of Ultrasonography in the Evaluation of Rib Fractures

    Directory of Open Access Journals (Sweden)

    Fulya Bakılan

    2015-12-01

    Full Text Available Objective: The aim of this study was to investigate whether ultrasonography is superior to chest x-ray in detecting rib fractures in patients with minor blunt chest trauma and chest pain. Materials and Methods: Ultrasonography findings of 32 patients with minor blunt chest trauma showing no evidence of a rib fracture on anteroposterior chest x-rays, were documented. Presence of cortical discontinuities, acoustic shadows, reverberation artifacts, and hematoma by ultrasonography was proposed as the diagnostic criteria for detecting the rib fracture. Results: Rib fracture was detected in 20 patients (62.5% according to ultrasonography results. A mildly displaced fracture was detected in 7 patients (35%, hematoma was detected in 3 patients (15% and multiple fractures (in 5th, 6th, 7th, and 8th ribs were detected in 1 patient (5%. Conclusion: The results of our study showed that ultrasonography is superior to chest x-ray, in detecting rib fractures.

  6. Successful use of combined high cut-off haemodialysis and bortezomib for acute kidney injury associated with myeloma cast nephropathy.

    LENUS (Irish Health Repository)

    Ward, F

    2012-05-01

    We present the case of a 58-year old female with de novo dialysis-dependent acute kidney injury (AKI) secondary to myeloma cast nephropathy. The patient underwent extended high cut-off haemodialysis (HCO-HD), in conjunction with bortezomib-based chemotherapy, and soon became dialysis independent with normal renal function. To our knowledge, this is the first time this treatment strategy has been employed successfully in an Irish centre.

  7. Modules for Experiments in Stellar Astrophysics (MESA): Giant Planets, Oscillations, Rotation, and Massive Stars

    OpenAIRE

    Paxton, Bill; Cantiello, Matteo; Arras, Phil; Bildsten, Lars; Brown, Edward F.; Dotter, Aaron; Mankovich, Christopher; Montgomery, M. H.; Stello, Dennis; Timmes, F. X.; Townsend, Richard

    2013-01-01

    We substantially update the capabilities of the open source software package Modules for Experiments in Stellar Astrophysics (MESA), and its one-dimensional stellar evolution module, MESA Star. Improvements in MESA Star's ability to model the evolution of giant planets now extends its applicability down to masses as low as one-tenth that of Jupiter. The dramatic improvement in asteroseismology enabled by the space-based Kepler and CoRoT missions motivates our full coupling of the ADIPLS adiab...

  8. Evaluation of model for end-stage liver disease score cut off values in patients with hepatic encephalopathy

    International Nuclear Information System (INIS)

    Khurram, M.; Qayyum, W.; Umar, M.; Abedin, Z.U.; Bushra, H.T.

    2015-01-01

    Model for End Stage Liver Disease (MELD) is scoring system used for prioritization of patients waiting liver transplantation. Patients with decompensated chronic liver disease (DCLD) with higher MELD score and hepatic encephalopathy (HE) have poor outcome. We planned to note association between short term mortality and various cut-off values of at admission MELD score in HCV related DCLD patients presenting with HE. Methods: In this descriptive case series, 208 Hepatitis C (HCV) related chronic liver disease (CLD) patients with HE were included. At admission serum bilirubin, creatinine and INR were sought to calculate MELD score. Patients who improved were discharged and kept under regular follow up. Outcome was categorized into alive or expired in 3 months after admission. Based on MELD score cut off values of >15, >20, >25 and >30, association with outcome was determined using Chi-square test. Results: One hundred and six (51%) patients were female. Mean patient age was 55.3±10.6 years. Outcome wise, 128 (61.5%) were alive and 80 (38.5%) expired. Mean MELD score of expired was 22.17±9.14. 55 (51%) patients with MELD score >15, 44 (65.7%) patients with >20, 30 (73.2%) patients with >25, and 21 (72.5%) patients with >30 expired. MELD score >20 had strongest association with outcome, p value less than o.01. Conclusion: At admission MELD score >20 are most significantly associated with poor outcome in DCLD patients with HE. (author)

  9. Understanding capacity fade in silicon based electrodes for lithium-ion batteries using three electrode cells and upper cut-off voltage studies

    Science.gov (United States)

    Beattie, Shane D.; Loveridge, M. J.; Lain, Michael J.; Ferrari, Stefania; Polzin, Bryant J.; Bhagat, Rohit; Dashwood, Richard

    2016-01-01

    Commercial Li-ion batteries are typically cycled between 3.0 and 4.2 V. These voltages limits are chosen based on the characteristics of the cathode (e.g. lithium cobalt oxide) and anode (e.g. graphite). When alternative anode/cathode chemistries are studied the same cut-off voltages are often, mistakenly, used. Silicon (Si) based anodes are widely studied as a high capacity alternative to graphite for Lithium-ion batteries. When silicon-based anodes are paired with high capacity cathodes (e.g. Lithium Nickel Cobalt Aluminium Oxide; NCA) the cell typically suffers from rapid capacity fade. The purpose of this communication is to understand how the choice of upper cut-off voltage affects cell performance in Si/NCA cells. A careful study of three-electrode cell data will show that capacity fade in Si/NCA cells is due to an ever-evolving silicon voltage profile that pushes the upper voltage at the cathode to >4.4 V (vs. Li/Li+). This behaviour initially improves cycle efficiency, due to liberation of new lithium, but ultimately reduces cycling efficiency, resulting in rapid capacity fade.

  10. Monte Carlo simulation on influence of cutting beds on density log in the horizontal wells

    International Nuclear Information System (INIS)

    Yu Huawei; Sun Jianmeng; Li Xiaopeng; Zhang Qiongyao; Li Na

    2009-01-01

    Cuttings debris may be deposited in the bottom of a horizontal hole because of gravity of the earth. It has lower density than the formation, so cuttings beds can have a significant effect on the density log responses. Monte Carlo method was used to study the effect of cuttings bed on the computed log density, with various formation densities and cuttings bed thicknesses of 0-5 cm in the horizontal borehole.In order to guarantee the reliability of results, simulation results were compared to the experimental data. MC simulations show that the density measurement can be corrected using the ridge-rib graph, if the thickness of the cutting bed is less than 2 cm. Otherwise, it is difficulty to correct the effect of the cutting bed on the formation density measurement. Finally, the cuttings beds correction charts and formulas for DSDL-8723 double-detector density logging tool which is in the horizontal borehole are made preliminarily. (authors)

  11. Scoliosis secondary to an unusual rib lesion.

    LENUS (Irish Health Repository)

    Burke, N G

    2012-04-01

    Tumours of the chest wall are uncommon and are usually malignant. A bone haemangioma is a rare benign vascular neoplasm, which more commonly occurs in middle-aged patients. We present the case of a scoliosis caused by a rib haemangioma in an adolescent male. Other causes of scoliosis secondary to rib lesions are discussed.

  12. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    Energy Technology Data Exchange (ETDEWEB)

    Chalumeau, Martin [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Foix-l' Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre [Service de Pneumologie et d' Allergologie Pediatriques, Hopital Necker-Enfants Malades, Paris (France); Gendrel, Dominique [Service de Pediatrie, Hopital Saint-Vincent-de-Paul, Paris (France); Ducou-le-Pointe, Hubert [Service de Radiologie, Hopital d' Enfants Armand-Trousseau, Avenue du Docteur Arnold Netter, 75571 Paris Cedex 12 (France)

    2002-09-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  13. Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants

    International Nuclear Information System (INIS)

    Chalumeau, Martin; Foix-l'Helias, Laurence; Scheinmann, Pierre; Zuani, Pierre; Gendrel, Dominique; Ducou-le-Pointe, Hubert

    2002-01-01

    Heading AbstractBackground. The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough.Objective. To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants.Materials and methods. We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris.Results. Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia.Conclusions. CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse. (orig.)

  14. PIV Measurements of Turbulent Flow in a Channel with Solid or Perforated Ribs

    DEFF Research Database (Denmark)

    Wang, Lei; Salewski, Mirko; Sundén, Bengt

    2011-01-01

    Particle image velocimetry measurements are performed in a channel with periodic ribs on one wall. We investigate the flow around two different rib configurations: solid and perforated ribs with a slit. The ribs obstruct the channel by 20% of its height and are arranged 10 rib heights apart. For ...

  15. Power of resting echocardiographic measurements to classify pulmonary hypertension patients according to European society of cardiology exercise testing risk stratification cut-offs.

    Science.gov (United States)

    Rehman, Michaela B; Garcia, Rodrigue; Christiaens, Luc; Larrieu-Ardilouze, Elisa; Howard, Luke S; Nihoyannopoulos, Petros

    2018-04-15

    Right ventricular function is the major determinant of morbidity and mortality in pulmonary arterial hypertension (PAH). The ESC risk assessment strategy for PAH is based on clinical status, exercise testing, NTproBNP, imaging and haemodynamics but does not include right ventricular function. Our aims were to test the power of resting echocardiographic measurements to classify PAH patients according to ESC exercise testing risk stratification cut-offs and to determine if the classification power of echocardiographic parameters varied in chronic thrombo-embolic pulmonary hypertension (CTEPH). We prospectively and consecutively recruited 46 PAH patients and 42 CTEPH patients referred for cardio-pulmonary exercise testing and comprehensive transthoracic echocardiography. Exercise testing parameters analyzed were peak oxygen consumption, percentage of predicted maximal oxygen consumption and the slope of ventilation against carbon dioxide production. Receiver operator characteristic curves were used to determine the optimal diagnostic cut-off values of echocardiographic parameters for classifying the patients in intermediate or high risk category according to exercise testing. Measurements of right ventricular systolic function were the best for classifying in PAH (area under the curve 0.815 to 0.935). Measurements of right ventricular pressure overload (0.810 to 0.909) were optimal for classifying according to exercise testing in CTEPH. Measurements of left ventricular function were of no use in either group. Measurements of right ventricular systolic function can classify according to exercise testing risk stratification cut-offs in PAH. However, this is not the case in CTEPH where pressure overload, rather than right ventricular function seems to be linked to exercise performance. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Night-time heart rate cut-off point definition by resting office tachycardia in untreated hypertensive patients: data of the Spanish ABPM registry.

    Science.gov (United States)

    Vinyoles, Ernest; de la Sierra, Alejandro; Roso, Albert; de la Cruz, Juan J; Gorostidi, Manuel; Segura, Julián; Banegas, José R; Martell-Claros, Nieves; Ruilope, Luís M

    2014-05-01

    Epidemiological studies have shown that an elevated resting heart rate (HR) is a risk factor for both total and cardiovascular mortality. Our aim was to estimate the night-time HR cut-off point that best predicts cardiovascular risk office tachycardia in hypertensive patients. Untreated hypertensive patients without concomitant cardiovascular diseases were included. Office and ambulatory HRs were measured. Cardiovascular risk office tachycardia was defined by office HR at least 85 beats per minute (bpm). Different night-time HR cut-offs were estimated by receiver operating characteristic curve analyses to predict cardiovascular risk office tachycardia. The best cut-off was selected on the basis of its combined sensitivity and specificity. A total of 32 569 hypertensive patients were included: 46.5% women, mean age (SD) 52 (14) years, office blood pressure 146 (16)/89 (11) mmHg, diabetes 10.3%, smoking 19.2%, BMI 29 (6.8) kg/m, office HR 77 (11.2) bpm, and night-time HR 64.9 (9.3) bpm. A total of 7070 (21.7%) patients were found to have cardiovascular risk office tachycardia. The night-time HR value that better predicted cardiovascular risk office tachycardia was more than 66 bpm. In comparison with patients with night HR below this value, those with night-time tachycardia were predominantly women, younger, with higher ambulatory blood pressure, greater BMI, and higher prevalence of diabetes and smoking. All comparisons were statistically significant (P less than 0.001). A mean night-time HR more than 66 bpm is a good predictor of cardiovascular risk office tachycardia in untreated hypertensive patients and could be considered a variable associated with an increased cardiovascular risk.

  17. Evaluation of serum galactomannan enzyme immunoassay at two different cut-offs for the diagnosis of invasive aspergillosis in patients with febrile neutropenia

    Directory of Open Access Journals (Sweden)

    Ritin Mohindra

    2017-01-01

    Full Text Available Background: Invasive aspergillosis (IA is an increasingly common and fatal opportunistic fungal infection in patients with haematological diseases. Early diagnosis is difficult as mycological culture techniques have low sensitivity and the radiological tools have low specificity. Galactomannan enzyme immunoassay (GEI detects galactomannan in the human serum with a reported sensitivity and specificity between 30% and 100%. Aims: The aim of this study was to analyse the role of GEI in diagnosis of IA in patients with febrile neutropenia and to evaluate the role of GEI in the diagnosis of IA as per the revised (2008 European Organization for Research and Treatment of Cancer–Mycoses Study Group (EORTC–MSG criteria at two different optical density (OD cut-offs of 0.5 and 1.0. Setting: This prospective study was conducted in Safdarjung Hospital, New Delhi, India. Methods: GEI testing was performed in adult patients of febrile neutropenia with evidence of IA. Results at two different OD indices (ODIs of 0.5 and 1.0 were analysed. The evaluation of the diagnostic parameter, that is, GEI was measured in terms of sensitivity, specificity and positive and negative predictive value and was validated with the revised (2008 EORTC–MSG diagnostic criteria of IA. Results: One hundred and eleven patients had evidence of IA, of which 79 patients were GEI positive when cut-off ODI was 0.5, whereas with cut-off ODI 1.0, 55 patients were GEI positive. Conclusion: ODI of 1.0 should be considered as positive while in patients with OD between 0.5 and 1.0, repeat sampling from the patient is recommended.

  18. Case report: clinical and postmortem findings in four cows with rib fracture.

    Science.gov (United States)

    Braun, Ueli; Warislohner, Sonja; Hetzel, Udo; Nuss, Karl

    2017-02-06

    Published reports of rib fractures in adult cattle are limited to the occurrence of chronic rib swellings caused by calluses, which are unremarkable from a clinical standpoint, whereas studies identifying clinical signs of rib fractures were not found in a literature search. This report describes the clinical and postmortem findings in four cows with rib fractures. The 13th rib was fractured in three cows and the 11th rib in the remaining cow; three fractures were on the right and one on the left side. Clinical and postmortem findings varied considerably, and percussion of the rib cage elicited a pain response in only one cow. One cow had generalised peritonitis because of perforation of the rumen by the fractured rib. One cow was recumbent because of pain and became a downer cow, and two other cows had bronchopneumonia, which was a sequel to osteomyelitis of the fracture site in one. In the absence of a history of trauma, the diagnosis of rib fracture based on clinical signs alone is difficult. Although rib fractures undoubtedly are very painful, the four cases described in this report suggest that they are difficult to diagnose in cattle because associated clinical signs are nonspecific.

  19. Peabody Western Coal cuts costs with bottom-dump haulers

    Energy Technology Data Exchange (ETDEWEB)

    Perla, S.; Baecker, G.; Morgan, W. [Empire Machinery, Mesa, AZ (United States)

    1995-04-01

    A new hauling concept has been introduced at the Black Mesa and Kayenta coal mines of the Peabody Western Coal Co. in northern Arizona, USA. The article describes the switch from Caterpillar 992 wheel loaders with 136 t bottom-dump trucks to 272 t bottom-dump trucks. Cat 789 off-highway trucks were modified to pull bottom-dump trucks. Haulage costs per ton of coal and cost per ton-mile have fallen significantly since the introduction of the new large hauling method. 7 figs., 2 photos.

  20. Quality of life after major trauma with multiple rib fractures.

    Science.gov (United States)

    Marasco, Silvana; Lee, Geraldine; Summerhayes, Robyn; Fitzgerald, Mark; Bailey, Michael

    2015-01-01

    Rib fractures are a common injury presenting to major trauma centres and community hospitals. Aside from the acute impact of rib fracture injury, longer-term morbidity of pain, disability and deformity have been described. Despite this, the mainstay of management for the vast majority of rib fracture injuries remains supportive only with analgesia and where required respiratory support. This study aimed to document the long-term quality of life in a cohort of major trauma patients with rib fracture injury over 24 months. Retrospective review (July 2006-July 2011) of 397 major trauma patients admitted to The Alfred Hospital with rib fractures and not treated with operative rib fixation. The main outcome measures were quality of life over 24 months post injury assessed using the Glasgow Outcome Scale Extended and SF12 health assessment forms and a pain questionnaire. Assessment over 24 months of major trauma patients with multiple rib fractures demonstrated significantly lower quality of life compared with published Australian norms at all time points measured. Return to work rates were poor with only 71% of those who were working prior to their accident, returning to any work. This study demonstrates a significant reduction in quality of life for rib fracture patients requiring admission to hospital, which does not return to the level of Australian norms for at least two years. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  1. In Vitro Dialysis of Cytokine-Rich Plasma With High and Medium Cut-Off Membranes Reduces Its Procalcific Activity.

    Science.gov (United States)

    Willy, Kevin; Hulko, Michael; Storr, Markus; Speidel, Rose; Gauss, Julia; Schindler, Ralf; Zickler, Daniel

    2017-09-01

    Recently developed high-flux (HF) dialysis membranes with extended permeability provide better clearance of middle-sized molecules such as interleukins (ILs). Whether this modulation of inflammation influences the procalcific effects of septic plasma on vascular smooth muscle cells (VSMCs) is not known. To assess the effects of high cut-off (HCO) and medium cut-off (MCO) membranes on microinflammation and in vitro vascular calcification we developed a miniature dialysis model. Plasma samples from lipopolysaccharide-spiked blood were dialyzed with HF, HCO, and MCO membranes in an in vitro miniature dialysis model. Afterwards, IL-6 concentrations were determined in dialysate and plasma. Calcifying VSMCs were incubated with dialyzed plasma samples and vascular calcification was assessed. Osteopontin (OPN) and matrix Gla protein (MGP) were measured in VSMC supernatants. IL-6 plasma concentrations were markedly lower with HCO and MCO dialysis. VSMC calcification was significantly lower after incubation with MCO- and HCO-serum compared to HF plasma. MGP and OPN levels in supernatants were significantly lower in the MCO but not in the HCO group compared to HF. In vitro dialysis of cytokine-enriched plasma samples with MCO and HCO membranes reduces IL-6 levels. The induction of vascular calcification by cytokine-enriched plasma is reduced after HCO and MCO dialysis. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  2. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points.

    Science.gov (United States)

    Riga, M; Komis, A; Maragkoudakis, P; Korres, G; Danielides, V

    2016-12-01

    Normative otoacoustic emission (OAE) suppression values are currently lacking and the role of cochlear efferent innervation in tinnitus is controversial. The aim of this study was to investigate the association between tinnitus and medial olivocochlear bundle (MOCB) malfunction. Potential suppression amplitude cut-off criteria that could differentiate participants with tinnitus from those without were sought. Mean suppression amplitudes of transient evoked OAEs and distortion product OAEs by contralateral white noise (50 dBSL) were recorded. Six mean suppression amplitudes criteria were validated as possible cut-off points. The population consisted of normal hearing (n = 78) or presbycusic adults (n = 19) with tinnitus or without (n = 28 and 13, respectively) chronic tinnitus (in total, n = 138 78 females/60males, aged 49 ± 14 years). Participants with mean suppression values lower than 0.5-1 dBSPL seem to present a high probability to report tinnitus (specificity 88-97%). On the other hand, participants with mean suppression values larger than 2-2.5dBSPL seem to present a high probability of the absence of tinnitus (sensitivity 87-99%). Correlations were stronger among participants with bilateral presence or absence of tinnitus. This study seem to confirm an association between tinnitus and low suppression amplitudes (<1 dBSPL), which might evolve into an objective examination tool, supplementary to conventional audiological testing.

  3. Establishing a sample-to cut-off ratio for lab-diagnosis of hepatitis C virus in Indian context

    OpenAIRE

    Tiwari, Aseem K.; Pandey, Prashant K.; Negi, Avinash; Bagga, Ruchika; Shanker, Ajay; Baveja, Usha; Vimarsh, Raina; Bhargava, Richa; Dara, Ravi C.; Rawat, Ganesh

    2015-01-01

    Introduction: Lab-diagnosis of hepatitis C virus (HCV) is based on detecting specific antibodies by enzyme immuno-assay (EIA) or chemiluminescence immuno-assay (CIA). Center for Disease Control reported that signal-to-cut-off (s/co) ratios in anti-HCV antibody tests like EIA/CIA can be used to predict the probable result of supplemental test; above a certain s/co value it is most likely to be true-HCV positive result and below that certain s/co it is most likely to be false-positive result. A...

  4. Antimicrobial Susceptibility of Flavobacterium psychrophilum from Chilean Salmon Farms and Their Epidemiological Cut-Off Values Using Agar Dilution and Disk Diffusion Methods.

    Science.gov (United States)

    Miranda, Claudio D; Smith, Peter; Rojas, Rodrigo; Contreras-Lynch, Sergio; Vega, J M Alonso

    2016-01-01

    Flavobacterium psychrophilum is the most important bacterial pathogen for freshwater farmed salmonids in Chile. The aims of this study were to determine the susceptibility to antimicrobials used in fish farming of Chilean isolates and to calculate their epidemiological cut-off (CO WT ) values. A number of 125 Chilean isolates of F. psychrophilum were isolated from reared salmonids presenting clinical symptoms indicative of flavobacteriosis and their identities were confirmed by 16S rRNA polymerase chain reaction. Susceptibility to antibacterials was tested on diluted Mueller-Hinton by using an agar dilution MIC method and a disk diffusion method. The CO WT values calculated by Normalized Resistance Interpretation (NRI) analysis allow isolates to be categorized either as wild-type fully susceptible (WT) or as manifesting reduced susceptibility (NWT). When MIC data was used, NRI analysis calculated a CO WT of ≤0.125, ≤2, and ≤0.5 μg mL -1 for amoxicillin, florfenicol, and oxytetracycline, respectively. For the quinolones, the CO WT were ≤1, ≤0.5, and ≤0.125 μg mL -1 for oxolinic acid, flumequine, and enrofloxacin, respectively. The disk diffusion data sets obtained in this work were extremely diverse and were spread over a wide range. For the quinolones there was a close agreement between the frequencies of NWT isolates calculated using MIC and disk data. For oxolinic acid, flumequine, and enrofloxacin the frequencies were 45, 39, and 38% using MIC data, and 42, 41, and 44%, when disk data were used. There was less agreement with the other antimicrobials, because NWT frequencies obtained using MIC and disk data, respectively, were 24 and 10% for amoxicillin, 8 and 2% for florfenicol, and 70 and 64% for oxytetracycline. Considering that the MIC data was more precise than the disk diffusion data, MIC determination would be the preferred method for susceptibility testing for this species and the NWT frequencies derived from the MIC data sets should be

  5. Completion Report for Well ER-20-7: Corrective Action Units 101 and 102: Central and Western Pahute Mesa

    Energy Technology Data Exchange (ETDEWEB)

    NSTec Environmental Restoration

    2010-04-28

    Well ER-20-7 was drilled for the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office in support of the Nevada Environmental Restoration Project at the Nevada Test Site, Nye County, Nevada. The well was drilled in June 2009 as part of the Pahute Mesa Phase II drilling program. The primary purpose of the well was to further investigate migration of radionuclides from the nearby, up-gradient TYBO and BENHAM underground nuclear tests, which originally was discovered at Well Cluster ER-20-5. This well also provided detailed hydrogeologic information in the Tertiary volcanic section that will reduce uncertainties within the Pahute Mesa-Oasis Valley hydrostratigraphic framework model. The main 44.45-centimeter hole was drilled to a depth of 681.8 meters and cased with 33.97-centimeter casing to 671.7 meters. The hole diameter was then decreased to 31.12 centimeters, and the well was drilled to total depth of 894.9 meters. The completion string, set to the depth of 890.0 meters, consists of 14.13-centimeter stainless-steel casing hanging from 19.37-centimeter carbon-steel casing. The 14.13-centimeter stainless-steel casing has one continuous slotted interval open to the Topopah Spring aquifer. Data collected during and shortly after hole construction include composite drill cuttings samples collected every 3.0 meters, sidewall core samples from 20 depth intervals, various geophysical logs, water quality (primarily tritium) measurements, and water level measurements. The well penetrated 894.9 meters of Tertiary volcanic rock, including two saturated welded-tuff aquifers. A fluid level measurement was obtained during open-hole geophysical well logging for the upper, Tiva Canyon, aquifer at the depth of 615.7 meters on June 19, 2009. The fluid level measured in the open hole on June 27, 2009,after the total depth was reached and the upper aquifer was cased off, was also at the depth of 615.7 meters. Preliminary field measurements indicated 1

  6. Automatic three-dimensional rib centerline extraction from CT scans for enhanced visualization and anatomical context

    Science.gov (United States)

    Ramakrishnan, Sowmya; Alvino, Christopher; Grady, Leo; Kiraly, Atilla

    2011-03-01

    We present a complete automatic system to extract 3D centerlines of ribs from thoracic CT scans. Our rib centerline system determines the positional information for the rib cage consisting of extracted rib centerlines, spinal canal centerline, pairing and labeling of ribs. We show an application of this output to produce an enhanced visualization of the rib cage by the method of Kiraly et al., in which the ribs are digitally unfolded along their centerlines. The centerline extraction consists of three stages: (a) pre-trace processing for rib localization, (b) rib centerline tracing, and (c) post-trace processing to merge the rib traces. Then we classify ribs from non-ribs and determine anatomical rib labeling. Our novel centerline tracing technique uses the Random Walker algorithm to segment the structural boundary of the rib in successive 2D cross sections orthogonal to the longitudinal direction of the ribs. Then the rib centerline is progressively traced along the rib using a 3D Kalman filter. The rib centerline extraction framework was evaluated on 149 CT datasets with varying slice spacing, dose, and under a variety of reconstruction kernels. The results of the evaluation are presented. The extraction takes approximately 20 seconds on a modern radiology workstation and performs robustly even in the presence of partial volume effects or rib pathologies such as bone metastases or fractures, making the system suitable for assisting clinicians in expediting routine rib reading for oncology and trauma applications.

  7. Various appearances of rib companion shadow mimicking a pathologic condition

    International Nuclear Information System (INIS)

    Choi, Yo Won; Yoo, Shi Joon; Im, Jung Gil

    1992-01-01

    We have observed that the companion shadow of the upper rib may be misinterpreted as a small pneumothorax or pleural plaque associated with asbestosis. To observe the radiographic characteristics of the normal companion shadow, we analyzed, on the posteroanterior(PA) chest radiographs, the companion shadow of 50 normal cases. Factors such as occurrence on each rib, the sharpness of the margin, the relative position to the rib, the shape and the thickness were observed. Also, we analyzed the displaced pleura of 4 pneumothorax cases to differentiate their findings from the findings of normal companion shadows. On 50 normal chest radiographs, 192 companion shadows were observed on the first to fourth ribs. In 173 of those shadows, the visceral margin of the companion shadow on the second rib simulated pneumothorax more closely than those on any other ribs due to its apical location and thinness. In six of 50 normal cases, the companion shadow in the first or second rib showed an inwardly convex lower margin, mimicking pleural plaque. The companion shadow was suggested on the plain chest radiograph by the following characteristics imultiplicity (47/50), thicker than normal pleura (3/4), persistent on serial films with the same shape and specific location(4/4)

  8. Experimental and numerical analysis of interlocking rib formation at sheet metal blanking

    Science.gov (United States)

    Bolka, Špela; Bratuš, Vitoslav; Starman, Bojan; Mole, Nikolaj

    2018-05-01

    Cores for electrical motors are typically produced by blanking of laminations and then stacking them together, with, for instance, interlocking ribs or welding. Strict geometrical tolerances, both on the lamination and on the stack, combined with complex part geometry and harder steel strip material, call for use of predictive methods to optimize the process before actual blanking to reduce the costs and speed up the process. One of the major influences on the final stack geometry is the quality of the interlocking ribs. A rib is formed in one step and joined with the rib of the preceding lamination in the next. The quality of the joint determines the firmness of the stack and also influences its. The geometrical and positional accuracy is thus crucial in rib formation process. In this study, a complex experimental and numerical analysis of interlocking rib formation has been performed. The aim of the analysis is to numerically predict the shape of the rib in order to perform a numerical simulation of the stack formation in the next step of the process. A detailed experimental research has been performed in order to characterize influential parameters on the rib formation and the geometry of the ribs itself, using classical and 3D laser microscopy. The formation of the interlocking rib is then simulated using Abaqus Explicit. The Hilll 48 constitutive material model is based on extensive and novel material characterization process, combining data from in-plane and out-of-plane material tests to perform a 3D analysis of both, rib formation and rib joining. The study shows good correlation between the experimental and numerical results.

  9. Opportunities for parity violating electron scattering experiments at the planned MESA facility

    Science.gov (United States)

    Aulenbacher, Kurt

    2011-11-01

    We suggest to start an accelerator physics project called the Mainz Energy recovering Superconducting Accelerator (MESA) as an extension to our experimental facilities. MESA may allow to introduce an innovative internal target regime based on the ERL principle. A second mode of operation will be to use an external polarized electron beam for parity violating experiments.

  10. Fabrication and variation of the cut-out yield of beef carcasses in Venezuela: anatomical description of the process and equivalency of cut nomenclature to North American counterparts

    Directory of Open Access Journals (Sweden)

    Angela Montero

    2014-06-01

    Full Text Available The typical processes of beef carcass fabrication in Venezuela are anatomically described and the equivalence in cut nomenclature with that of México and United States is provided. Additionally, 910 carcasses were fabricated to assess yield (kg and percentages of carcass weight in products (subprimals, subprimal groups of distinct commercial value (High, Medium, Low and by-products (bone, fat trimmings using mean values ± standard deviation (DE, coefficient of variation (CV and range of values. Once the carcass is ribbed at the 5th intercostal space, subprimals are obtained by deboning and dissecting the muscle masses (saw cutting is seldom used. In terms of yield, the top three (out of 18 individual subprimals were: Solomo Abierto (boneless Chuck Roll, 39.1± 10.88kg; 14.3± 2.84%, Costilla (bone-in Plate, 22kg± 4.15; 8.12± 0.88% and Solomo de Cuerito (boneless Rib and Loin, 21.6± 3.10kg; 8.0± 0.59%. Cutability values for High-Valued and Medium-Valued subprimal groups were 81.5± 10.3kg (30.2± 1.43% and 67.3± 14.57kg (24.8± 3.22%, respectively; the latter showing the highest CV (13.0%. Fat trimmings were the most variable by-product (10.1± 2.84%, CV = 28.0%. This report serves as a reference for future studies and could facilitate the commercial language for trading beef cuts between the countries involved

  11. A case of pathological rib fractures: focal osteolysis or osteoporosis?

    Science.gov (United States)

    Vrbanić, T S L; Novak, S; Sestan, B; Tudor, A; Gulan, G

    2008-03-01

    This paper reports on a unique, previously unreported, successful outcome in the case of a patient with focal osteolytic lesions of the ribs as a first sign of osteoporosis. The lesions were detected by chance after acute cough-induced rib fractures were seen on plain chest radiographs. The diagnosis had to be approached as a diagnosis of exclusion since known causes of the osteolytic process had to be eliminated. The authors describe multiple focal osteolytic lesions with rib fractures appearing in a pattern that could be confused with metastases. Laboratory results were normal. Final diagnosis was based on plain radiography, bone scan and bone densitometry. Pharmacomedical treatments for osteoporosis were applied. The patient was observed between the year 2000 and 2005. Five years later radiological and bone scintigraphy revealed resolution of the lesion. We conclude that osteoporosis should be included in the differential diagnosis of asymptomatic focal osteolysis of the ribs with rib fractures as a complication of acute cough. The case suggests that focal osteolytic lesions of the ribs may regress over time and become scintigraphically inactive.

  12. Rib fractures in trauma patients: does operative fixation improve outcome?

    Science.gov (United States)

    Majak, Peter; Næss, Pål A

    2016-12-01

    Renewed interest in surgical fixation of rib fractures has emerged. However, conservative treatment is still preferred at most surgical departments. We wanted to evaluate whether operative treatment of rib fractures may benefit severely injured patients. Several studies report a reduction in mechanical ventilation time, ICU length of stay (LOS), hospital LOS, pneumonia, need for tracheostomy, pain and costs in operatively treated patients with multiple rib fractures compared with patients treated nonoperatively. Although patient selection and timing of the operation seem crucial for successful outcome, no consensus exists. Mortality reduction has only been shown in a few studies. Most studies are retrospective cohort and case-control studies. Only four randomized control trials exist. Conservative treatment, consisting of respiratory assistance and pain control, is still the treatment of choice in the vast majority of patients with multiple rib fractures. In selected patients, operative fixation of fractured ribs within 72 h postinjury may lead to better outcome. More randomized control trials are needed to further determine who benefits from surgical fixation of rib fractures.

  13. Usefulness of Reformatted CT Rib Series in Patients with Thoracic Trauma

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Sung Nam; Park, Seong Hoon; Kim, Na Hyung; Juhng, Seon Kwan; Yoon, Kwon Ha [Dept. of Radiology and Institute for Radiological Imaging Science, Wonkwang University School of Medicine, Iksan (Korea, Republic of); Bang, Dong Ho [Dept. of Radiology, Aerospace Medical Center, Cheongwon (Korea, Republic of)

    2013-01-15

    To assess the value of adding a reformatted computed tomography (CT) rib series to transversely reconstructed CT imaging in the evaluation of rib fractures in patients with suspected traumatic thoracic injuries. One hundred consecutive patients with suspected traumatic thoracic injuries underwent 128-section multi-detector row CT. Transverse CT images with 5-mm-thick sections were reconstructed and rib series were reformatted using isotropic vogel data. Three independent radiologists, who were blinded to the data, interpreted the CT scans at 2 sessions with a 4-week interval between the sessions. Only transverse CT images were reviewed at the first session. At the second session, the CT images were reviewed along with the reformatted CT rib series. The following parameters were analyzed: receiver operating characteristic (Roc) curve, pairwise comparisons of Roc curves, sensitivity, specificity, positive predictive value, and negative predictive value. There were 153 rib fractures in 29 patients. The level of the area under the Roc curve, Az improved for all observers. The diagnostic sensitivity and specificity of each observer tended to improve in the second session. The mean confidence scores for all observers of patients with rib fractures improved significantly in the second session. A reformatted CT rib series together with transverse CT scan is useful for the evaluation of rib fracture.

  14. Optimal Cut-Offs of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to Identify Dysglycemia and Type 2 Diabetes Mellitus: A 15-Year Prospective Study in Chinese.

    Science.gov (United States)

    Lee, C H; Shih, A Z L; Woo, Y C; Fong, C H Y; Leung, O Y; Janus, E; Cheung, B M Y; Lam, K S L

    The optimal reference range of homeostasis model assessment of insulin resistance (HOMA-IR) in normal Chinese population has not been clearly defined. Here we address this issue using the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS), a prospective population-based cohort study with long-term follow-up. In this study, normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) were defined according to the 1998 World Health Organization criteria. Dysglycemia referred to IFG, IGT or T2DM. This study comprised two parts. Part one was a cross-sectional study involving 2,649 Hong Kong Chinese subjects, aged 25-74 years, at baseline CRISPS-1 (1995-1996). The optimal HOMA-IR cut-offs for dysglycemia and T2DM were determined by the receiver-operating characteristic (ROC) curve. Part two was a prospective study involving 872 subjects who had persistent NGT at CRISPS-4 (2010-2012) after 15 years of follow-up. At baseline, the optimal HOMA-IR cut-offs to identify dysglyceia and T2DM were 1.37 (AUC = 0.735; 95% confidence interval [CI] = 0.713-0.758; Sensitivity [Se] = 65.6%, Specificity [Sp] = 71.3%] and 1.97 (AUC = 0.807; 95% CI = 0.777-0.886; Se = 65.5%, Sp = 82.9%) respectively. These cut-offs, derived from the cross-sectional study at baseline, corresponded closely to the 75th (1.44) and 90th (2.03) percentiles, respectively, of the HOMA-IR reference range derived from the prospective study of subjects with persistent NGT. HOMA-IR cut-offs, of 1.4 and 2.0, which discriminated dysglycemia and T2DM respectively from NGT in Southern Chinese, can be usefully employed as references in clinical research involving the assessment of insulin resistance.

  15. Occurrence of emerging food-borne pathogenic Arcobacter spp. isolated from pre-cut (ready-to-eat) vegetables.

    Science.gov (United States)

    Mottola, Anna; Bonerba, Elisabetta; Bozzo, Giancarlo; Marchetti, Patrizia; Celano, Gaetano Vitale; Colao, Valeriana; Terio, Valentina; Tantillo, Giuseppina; Figueras, Maria José; Di Pinto, Angela

    2016-11-07

    Given that changes in consumer food behaviours have led to an increase in the demand for pre-cut ready-to-eat (RTE) vegetables, and that few data are currently available on the occurrence of Arcobacter spp. in such foods, the aim of the present study was to assess the occurrence of Arcobacter spp. that carry virulence-associated genes on pre-cut RTE vegetables, using cultural and molecular methods. Arcobacter was detected using biomolecular identification methods in 44/160 (27.5%) of the samples, of which 40/44 (90.9%) isolates corresponded to A. butzleri and 4/44 (9.1%) to A. cryaerophilus. Studying the incidence of 9 virulence-associated genes revealed the widespread distribution of these genes among the Arcobacter isolates tested. The results obtained in our research provided plenty of information on the health risks associated with the direct consumption of raw vegetables, and highlight the need to implement further studies at each level of the production chain, in order to obtain further information to help protect human health. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Rib Fracture Patterns and Radiologic Detection – A Restraint-Based Comparison

    OpenAIRE

    Crandall, Jeff; Kent, Richard; Patrie, James; Fertile, Jay; Martin, Peter

    2000-01-01

    This paper presents a study of the rib fracture patterns generated in simulated frontal collisions and the visibility of the rib fractures on plain film radiographs. Using 29 cadaver subjects, rib fractures were identified on oblique, lateral, and anteroposterior chest films by five radiologists independently and were compared with fractures found during a detailed necropsy. Physical, geometric, and experimental factors demonstrated an influence on the ability of a radiologist to identify rib...

  17. Annotated bibliography of the physical data of Rainier Mesa and Yucca Mountain

    International Nuclear Information System (INIS)

    Russell, C.E.

    1988-09-01

    Yucca Mountain, located on and adjacent to the Nevada Test Site (NTS) has been designated as the only site to undergo characterization to determine if it meets the criteria to become the Nation's first high-level nuclear waste repository. During this process, care must be taken to not compromise the site's integrity through excessive testing. In order to supplement the limited data to be gathered at Yucca Mountain, analog areas are to be considered. This annotated bibliography was compiled by the Desert Research Institute to help investigate ways in which Rainier Mesa could either be used as a supplemental repository test site or where existing Rainier Mesa data can be used either to support or refute test results from Yucca Mountain. Rainier Mesa, the location of numerous underground nuclear tests on the NTS, possesses some geologic characteristics similar to those of Yucca Mountain, which makes it a likely candidate for comparison. Almost 500 references regarding geology, hydrology, meteorology, biology, and archaeology were annotated and entered alpha-numerically into the bibliography. These references were categorized into 50 topics which are defined in Section 2 and presented in Section 3. Each reference is categorized as to whether it contains Yucca Mountain data, Rainier Mesa data, or both, and a final category consists of those reports that contain Rainier Mesa data that have already been applied to Yucca Mountain research. The annotated bibliography is presented in Section 4

  18. Re-evaluation of the fludrocortisone test: duration, NaCl supplementation and cut-off limits for aldosterone.

    Science.gov (United States)

    Westerdahl, Christina; Bergenfelz, Anders; Larsson, Johanna; Nerbrand, Christina; Valdemarsson, Stig; Wihl, Anders; Isaksson, Anders

    2009-01-01

    Primary aldosteronism (PA) is the most common form of secondary hypertension. Thus, the aims of this study were: (1) to clarify whether the fludrocortisone suppression test (FST), which confirms autonomous aldosterone secretion, is reliable when carried out during a shorter period of time and (2) to confirm the importance of NaCl supplementation. The cut-off limits already obtained for aldosterone in healthy subjects during the FST were applied in hypertensive patients with a high aldosterone to renin ratio (ARR). The healthy subjects were allocated to three groups. Fludrocortisone was administered 4 times daily over 4 days and sodium chloride was supplemented in 3 different doses. The result was applied in 24 hypertensive patients, in 24 healthy subjects (10 women (23-38 years old) and 14 men (23-58 years old)) and in 24 patients with hypertension and high ARR (16 women (45-74 years old) and 8 men (56-73 years old)). Blood pressure, aldosterone, renin, potassium and sodium were measured. After three days of FST, there was a significant decrease in the serum level of aldosterone in the healthy subjects, regardless of high or low sodium chloride supplementation (p<0.001). The decrease in serum aldosterone was significantly less pronounced in patients with PA than in healthy subjects and hypertensive patients without PA (p<0.001). The 95th percentile of plasma aldosterone at the end of the test was 225 pmol/L. The FST can be shortened to 3 days and a daily 500 mg NaCl supplementation is sufficient. A cut-off value for aldosterone of 225 pmol/L after 4 days with FST is appropriate.

  19. Using Logistic Regression for Validating or Invalidating Initial Statewide Cut-Off Scores on Basic Skills Placement Tests at the Community College Level

    Science.gov (United States)

    Secolsky, Charles; Krishnan, Sathasivam; Judd, Thomas P.

    2013-01-01

    The community colleges in the state of New Jersey went through a process of establishing statewide cut-off scores for English and mathematics placement tests. The colleges wanted to communicate to secondary schools a consistent preparation that would be necessary for enrolling in Freshman Composition and College Algebra at the community college…

  20. Nicotine cut-off value in human hair as a tool to distinguish active from passive smokers: A cross-sectional study in Japanese men.

    Science.gov (United States)

    Tsuji, Masayoshi; Kanda, Hideyuki; Hayakawa, Takehito; Mori, Yayoi; Ito, Teruna; Hidaka, Tomoo; Kakamu, Takeyasu; Kumagai, Tomohiro; Osaki, Yoneatsu; Kawazoe, Miki; Sato, Sei; Fukushima, Tetsuhito

    2017-07-19

    Nicotine concentration in hair is a useful marker of tobacco exposure. Detection of nicotine in the hair of non-smokers indicates passive smoking. Accurate measurement of nicotine among active and passive smokers can help in smoking cessation programs or programs designed to prevent secondhand smoke exposure. To establish, using high-performance liquid chromatography-ultraviolet detection (HPLC/UV), a hair nicotine cut-off value to distinguish active from passive smokers. Hair samples were collected from randomly chosen Japanese men (n= 192) between 2009 and 2011. Nicotine and cotinine levels in hair were measured using HPLC/UV with column-switching. T-tests and chi-square tests were performed to compare active and passive smokers, while receiver operating characteristic curves were used to evaluate the effectiveness of the cut-off value. There were 69 active smokers and 123 passive smokers. The nicotine and cotinine concentrations in hair were significantly higher in active than in passive smokers (psmokers. Nicotine and cotinine concentrations in hair clearly distinguished active from passive smokers.

  1. Rib fractures induced by coughing: an unusual cause of acute chest pain.

    Science.gov (United States)

    De Maeseneer, M; De Mey, J; Debaere, C; Meysman, M; Osteaux, M

    2000-03-01

    We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.

  2. Multiobjective Optimization of Turning Cutting Parameters for J-Steel Material

    Directory of Open Access Journals (Sweden)

    Adel T. Abbas

    2016-01-01

    Full Text Available This paper presents a multiobjective optimization study of cutting parameters in turning operation for a heat-treated alloy steel material (J-Steel with Vickers hardness in the range of HV 365–395 using uncoated, unlubricated Tungsten-Carbide tools. The primary aim is to identify proper settings of the cutting parameters (cutting speed, feed rate, and depth of cut that lead to reasonable compromises between good surface quality and high material removal rate. Thorough exploration of the range of cutting parameters was conducted via a five-level full-factorial experimental matrix of samples and the Pareto trade-off frontier is identified. The trade-off among the objectives was observed to have a “knee” shape, in which certain settings for the cutting parameters can achieve both good surface quality and high material removal rate within certain limits. However, improving one of the objectives beyond these limits can only happen at the expense of a large compromise in the other objective. An alternative approach for identifying the trade-off frontier was also tested via multiobjective implementation of the Efficient Global Optimization (m-EGO algorithm. The m-EGO algorithm was successful in identifying two points within the good range of the trade-off frontier with 36% fewer experimental samples.

  3. Comparison of virulence factors and capsular types of Streptococcus agalactiae isolated from human and bovine infections.

    Science.gov (United States)

    Emaneini, Mohammad; Khoramian, Babak; Jabalameli, Fereshteh; Abani, Samira; Dabiri, Hossein; Beigverdi, Reza

    2016-02-01

    Streptococcus agalactiae is a leading cause of human and bovine infections. A total of 194 S. agalactiae isolates, 55 isolates from bovines and 139 from humans, were analyzed for capsular types, virulence genes (scpB, hly, rib, bca and bac) and mobile genetic elements (IS1548 and GBSi1) using polymerase chain reaction (PCR) and multiplex PCR. Capsular type III was predominant (61%), followed by types V, II, Ib, and IV. The scpB, hly, bca and bac virulence genes were only found among human isolates. Twelve and 2 distinct virulence gene profiles were identified among human and bovine isolates respectively. The virulence gene profiles scpB- hly- IS1548- rib-bca (51%) and scpB- hly- IS1548- bca (19%) were only predominant among human isolates. The rib gene was the most common virulence gene in both human and bovine isolates. The study showed a high prevalence of virulence genes in S. agalactiae strains isolated from human infections, these result can support the idea that S. agalactiae isolated from humans and bovines are generally unrelated and probably belonged to separate populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Detecting outliers and/or leverage points: a robust two-stage procedure with bootstrap cut-off points

    Directory of Open Access Journals (Sweden)

    Ettore Marubini

    2014-01-01

    Full Text Available This paper presents a robust two-stage procedure for identification of outlying observations in regression analysis. The exploratory stage identifies leverage points and vertical outliers through a robust distance estimator based on Minimum Covariance Determinant (MCD. After deletion of these points, the confirmatory stage carries out an Ordinary Least Squares (OLS analysis on the remaining subset of data and investigates the effect of adding back in the previously deleted observations. Cut-off points pertinent to different diagnostics are generated by bootstrapping and the cases are definitely labelled as good-leverage, bad-leverage, vertical outliers and typical cases. The procedure is applied to four examples.

  5. Conditions of rib design for polycarbonate resin with high glossy surfaces

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Seong Won [Seoul National University of Science and Technology, Seoul (Korea, Republic of)

    2013-10-15

    Much attention has been being given to the importance of product surfaces in the field of plastic parts, as industrial design has become one of the key elements of product success. These plastic parts incorporate rib-like geometries on the non-appearance surfaces of plastic in order to increase the stiffness of rigidity of the section, but they often cause appearance problems of the product's surface overall by making a sink mark on that surface. The thickness, height and draft-angle of the rib are generally known as major parameters influencing the sink mark on the appearance surface. Therefore, designers of plastic parts must determine the variables of reinforcing ribs. The goal of this study is to find the optimum design variables in the mixing conditions of the thickness, the height and the draft angle of reinforcing ribs so that designers of plastic parts can easily determine the conditions of the reinforcing ribs as the part's section thickness varies within an objective limit in polycarbonate plastic resin and a high glossy surface that are widely applied in the creation of plastic products. We investigated the actual depths of sink marks on the surface of a specimen that was manufactured with an injection mold specifically for this study. Response surface methodology with the Box-Behnken design was used to analyze the regression curve of real depths with combinations of the thickness, height and draft angle of the ribs. The result shows that the most influential factor to increase the shrinkage is the thickness of ribs and that the optimum value of the rib thickness is a range from multiple of 0.25 to 0.34 of the section thickness. Also, the rib height and rib draft angle are not major factors that can change the sink amount.

  6. Conditions of rib design for polycarbonate resin with high glossy surfaces

    International Nuclear Information System (INIS)

    Jeong, Seong Won

    2013-01-01

    Much attention has been being given to the importance of product surfaces in the field of plastic parts, as industrial design has become one of the key elements of product success. These plastic parts incorporate rib-like geometries on the non-appearance surfaces of plastic in order to increase the stiffness of rigidity of the section, but they often cause appearance problems of the product's surface overall by making a sink mark on that surface. The thickness, height and draft-angle of the rib are generally known as major parameters influencing the sink mark on the appearance surface. Therefore, designers of plastic parts must determine the variables of reinforcing ribs. The goal of this study is to find the optimum design variables in the mixing conditions of the thickness, the height and the draft angle of reinforcing ribs so that designers of plastic parts can easily determine the conditions of the reinforcing ribs as the part's section thickness varies within an objective limit in polycarbonate plastic resin and a high glossy surface that are widely applied in the creation of plastic products. We investigated the actual depths of sink marks on the surface of a specimen that was manufactured with an injection mold specifically for this study. Response surface methodology with the Box-Behnken design was used to analyze the regression curve of real depths with combinations of the thickness, height and draft angle of the ribs. The result shows that the most influential factor to increase the shrinkage is the thickness of ribs and that the optimum value of the rib thickness is a range from multiple of 0.25 to 0.34 of the section thickness. Also, the rib height and rib draft angle are not major factors that can change the sink amount.

  7. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    International Nuclear Information System (INIS)

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas; Hajdu, Stefan; Soza, Grzegorz; Wimmer, Andreas

    2015-01-01

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  8. The ribs unfolded - a CT visualization algorithm for fast detection of rib fractures: effect on sensitivity and specificity in trauma patients

    Energy Technology Data Exchange (ETDEWEB)

    Ringl, Helmut; Lazar, Mathias; Toepker, Michael; Woitek, Ramona; Prosch, Helmut; Asenbaum, Ulrika; Balassy, Csilla; Toth, Daniel; Weber, Michael; Mang, Thomas [Medical University of Vienna, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria); Hajdu, Stefan [Medical University of Vienna, Department of Trauma Surgery, Vienna (Austria); Soza, Grzegorz; Wimmer, Andreas [Siemens AG, Healthcare Sector, Computed Tomography, Forchheim (Germany)

    2015-07-15

    To assess a radiologist's detection rate of rib fractures in trauma CT when reading curved planar reformats (CPRs) of the ribs compared to reading standard MPRs. Two hundred and twenty trauma CTs (146 males, 74 females) were retrospectively subjected to a software algorithm to generate CPRs of the ribs. Patients were split into two equal groups. Sixteen patients were excluded due to insufficient segmentation, leaving 107 patients in group A and 97 patients in group B. Two radiologists independently evaluated group A using CPRs and group B using standard MPRs. Two different radiologists reviewed both groups with the inverse methods setting. Results were compared to a standard of reference created by two senior radiologists. The reference standard identified 361 rib fractures in 61 patients. Reading CPRs showed a significantly higher overall sensitivity (P < 0.001) for fracture detection than reading standard MPRs, with 80.9 % (584/722) and 71.5 % (516/722), respectively. Mean reading time was significantly shorter for CPRs (31.3 s) compared to standard MPRs (60.7 s; P < 0.001). Using CPRs for the detection of rib fractures accelerates the reading of trauma patient chest CTs, while offering an increased overall sensitivity compared to conventional standard MPRs. (orig.)

  9. Lidocaine Skin Patch (Lidopat® 5%) Is Effective in the Treatment of Traumatic Rib Fractures: A Prospective Double-Blinded and Vehicle-Controlled Study.

    Science.gov (United States)

    Cheng, Yu-Jen

    2016-01-01

    The purpose of this study was to determine the efficacy of the Lidopat(®) 5% skin patch in relieving rib fracture pain. From June 2009 to May 2011, 44 trauma patients with isolated rib fractures were enrolled in this study and randomized in a double-blind method into 2 groups. The experimental group (group E: 27 patients) used a Lidopat(®) 5% skin patch at the trauma site and took an oral analgesic drug for pain relief. The placebo group (group P: 17 patients) used a placebo vehicle patch and an oral analgesic drug. The mean age, weight and hospital stay of patients were 56.8 ± 13.8 years, 67.4 ± 12.6 kg and 6.34 ± 1.3 days, respectively. In the first 4 days, there were no significant differences in pain scores between the groups (p > 0.05). After the 5th day, the average pain score was significantly less in group E (mean 1.5) than in group P (mean 3.10; p fractured ribs between groups (p = 0.904). The use of meperidine and the length of hospital stay (6.0 vs. 6.9 days) were both significantly less in group E (p = 0.043 and 0.009, respectively). In this study, the use of the Lidopat(®) 5% skin patch in patients with isolated rib fractures alleviated pain and shortened the hospital stay, and a lower dose of pain-relieving medication was used. © 2015 S. Karger AG, Basel.

  10. Streptophage-mediated control of off-flavour taint producing streptomycetes isolated from barramundi ponds

    Directory of Open Access Journals (Sweden)

    Jodi Anne Jonns

    2017-06-01

    Following the determination of the streptophage susceptibility of the isolates one of the most odourous streptomycete species (USC-14510 was selected to be tested further using different pond simulations resembling real-life applications. Geosmin was tested as the indicator of off-flavour taint production and as it has been previously reported that the cyanobacteria-actinomycete interactions occurring in ponds result in even greater levels of geosmin and 2-methylisoborneol, the geosmin levels for the isolate in the presence of cyanobacteria and streptophages were also tested. Findings indicated that the highly odourous Streptomyces species (USC-14510 once infected with streptophages, can lose its capacity to produce off-flavour taints. Pond simulation studies also revealed geosmin production was significantly reduced when streptophages were introduced into the pond water where streptomycete species were grown. The bacteriophage control method developed in the presented study might again confirm significant potential for the bacteriophage-mediated remediation strategy to be adapted by the aquaculture industry.

  11. Chondroblastoma of rib in situs inversus

    Directory of Open Access Journals (Sweden)

    Purwa R Patil

    2014-01-01

    Full Text Available Chondroblastoma is a rare benign cartilaginous tumour accounting for approximately 1% of all bone tumours. It commonly arises from epiphysis of a long bone, particularly the humerus, tibia and femur. Rib is an extremely rare site for this tumour with a few cases reported in the literature. It is commonly seen in children and adults between the ages of 10 - 20 years. Although roentgenographic findings are quite common characteristic of this tumour, it can sometimes be misdiagnosed as giant cell tumour, osteogenic sarcoma and myeloma on histopathology. We report a 26-year-old male patient with situs inversus and chondroblastoma of rib. To the best of our knowledge, this is the first case of chondroblastoma of the rib in a patient of situs inversus. Segmental resection is the treatment of choice. It usually behaves in a benign fashion, but few cases have shown local recurrences and distant metastasis; hence, follow-up of the patient is essential.

  12. DMol3/COSMO-RS prediction of aqueous solubility and reactivity of selected Azo dyes: Effect of global orbital cut-off and COSMO segment variation

    CSIR Research Space (South Africa)

    Wahab, OO

    2018-01-01

    Full Text Available Aqueous solubility and reactivity of four azo dyes were investigated by DMol3/COSMO-RS calculation to examine the effects of global orbital cut-off and COSMO segment variation on the accuracies of theoretical solubility and reactivity. The studied...

  13. Optimal body fat percentage cut-off values for identifying cardiovascular risk factors in Mongolian and Han adults: a population-based cross-sectional study in Inner Mongolia, China.

    Science.gov (United States)

    Li, Yanlong; Wang, Hailing; Wang, Ke; Wang, Wenrui; Dong, Fen; Qian, Yonggang; Gong, Haiying; Xu, Guodong; Li, Guoju; Pan, Li; Zhu, Guangjin; Shan, Guangliang

    2017-04-17

    The present study was designed to determine the optimal cut-off values of body fat percentage (BF%) for the detection of cardiovascular disease (CVD) risk factors in Mongolian and Han adults. This cross-sectional study involving 3221 Chinese adults (2308 Han and 913 Mongolian) aged 20-80 years was conducted in Inner Mongolia Autonomous Region, China, in 2014. Data from a standardised questionnaire, physical examination and blood sample were obtained. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic curves to predict the risk of diabetes, hypertension and dyslipidaemia. Binary logistic regression analysis was performed to evaluate the OR of each CVD risk factor according to obesity defined by BF%. Mean BF% levels were lower in men than in women (22.54±5.77 vs 32.95±6.18 in Han, 23.86±5.72 vs 33.98±6.40 in Mongolian population, respectively; ppopulation, the area under curve (AUC) values for BF% ranged from 0.589 to 0.699 for men and from 0.711 to 0.763 for women. Compared with men, AUCs for diabetes and clustering of ≥2 risk factors in women were significantly higher (ppopulation. In Han adults, the optimal BF% cut-off values to detect CVD risk factors varied from 18.7% to 24.2% in men and 32.7% to 35.4% in women. In Mongolian population, the optimal cut-off values of BF% for men and women ranged from 21.0% to 24.6% and from 35.7% to 40.0%, respectively. Subjects with high BF% (≥24% in men, ≥34% in women) had higher risk of CVD risk factors in Han (age-adjusted ORs from 1.479 to 3.680, 2.660 to 4.016, respectively). In Mongolia, adults with high BF% (≥25% in men, ≥35% in women) had higher risk of CVD risk factors (age-adjusted ORs from 2.587 to 3.772, 2.061 to 4.882, respectively). The optimal BF% cut-offs for obesity for the prediction of CVD risk factors in Chinese men and women were approximately 24% and 34% for Han adults and 25% and 35% for Mongolian

  14. Advances in Understanding Air Pollution and Cardiovascular Diseases: The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air)

    Science.gov (United States)

    Kaufman, Joel D.; Spalt, Elizabeth W.; Curl, Cynthia L.; Hajat, Anjum; Jones, Miranda R.; Kim, Sun-Young; Vedal, Sverre; Szpiro, Adam A.; Gassett, Amanda; Sheppard, Lianne; Daviglus, Martha L.; Adar, Sara D.

    2016-01-01

    The Multi-Ethnic Study of Atherosclerosis and Air Pollution (MESA Air) leveraged the platform of the MESA cohort into a prospective longitudinal study of relationships between air pollution and cardiovascular health. MESA Air researchers developed fine-scale, state-of-the-art air pollution exposure models for the MESA Air communities, creating individual exposure estimates for each participant. These models combine cohort-specific exposure monitoring, existing monitoring systems, and an extensive database of geographic and meteorological information. Together with extensive phenotyping in MESA—and adding participants and health measurements to the cohort—MESA Air investigated environmental exposures on a wide range of outcomes. Advances by the MESA Air team included not only a new approach to exposure modeling but also biostatistical advances in addressing exposure measurement error and temporal confounding. The MESA Air study advanced our understanding of the impact of air pollutants on cardiovascular disease and provided a research platform for advances in environmental epidemiology. PMID:27741981

  15. Reports on various anomalies of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Brinkmann, G.; Brix, F.

    1988-02-01

    Three patients are presented who were suffering from different anomalies of the ribs: There was one each plus and minus variant and a female patient with Gorlin-Goltz syndrome (basal cell nevus syndrome) demonstrating several changes in the ribs as an expression of a genetically determined segmentation disturbance. These presentations are followed by a detailed discussion on the types and causes of such anomalies.

  16. Reports on various anomalies of the ribs

    International Nuclear Information System (INIS)

    Brinkmann, G.; Brix, F.

    1988-01-01

    Three patients are presented who were suffering from different anomalies of the ribs: There was one each plus and minus variant and a female patient with Gorlin-Goltz syndrome (basal cell nevus syndrome) demonstrating several changes in the ribs as an expression of a genetically determined segmentation disturbance. These presentations are followed by a detailed discussion on the types and causes of such anomalies. (orig.) [de

  17. To choose the cut-off point of ferritin for differentiation between benign from malignant pleural-peritoneal effusion

    International Nuclear Information System (INIS)

    Yang Liu; Yang Wenjing; Liu Junfeng; Yu Jiuru

    2005-01-01

    To explore the level of ferritin for differentiating the benign from malignant pleural and peritoneal effusion, 218 pleural-peritoneal effusion samples from patients with different kinds of diseases were determined for ferritin (P Ft ) by RIA, in the meanwhile serum ferritin (S Ft ) was also determined. According to clinical diagnosis, these samples were divided into two groups: benign and malignant. P Ft and S Ft were compared between these two groups, and the ratio of P Ft to S Ft was counted. The ROC curve was used to choose the best cut-off point P Ft for differentiating benign from malignant pleural and peritoneal effusion. The results showed that in the benign effusion group the P Ft was 142.4±38.6 μg/L, S Ft was 89.7±43.5 μg/L, and P Ft / S Ft was 1.46±0.55, whereas in the group of malignant effusion the corresponding figures were 576.5±239.l μg/L, 189.±81.7 μg/L, and 3.67±1.48, respectively. The cut-off point for differentiating benign from malignant pleural and peritoneal effusion was 400 μg/L. Our differentiation standards are: P Ft ≥400 μg/L,P Ft /S Ft ≥3 for the malignant pleural and peritoneal ef- fusion, and P Ft Ft /S Ft <3 for the benign effusion. The sensitivity is 84.5%, the specificity is 87.5%, and the accuracy is 92.8%. (authors)

  18. The prevalence of cervical ribs in Enugu, Nigeria

    African Journals Online (AJOL)

    2015-11-18

    Nov 18, 2015 ... ... prevalence of cervical ribs and its variation with sex and age among patients ... The patients' identities were removed from the ... syndrome, only 8–10% actually has cervical rib as ... Anatomy, symptoms, diagnosis, and treatment. ... Illinois: American Association of Neurological Surgeons; 1998. p. 157-70.

  19. Cut-off values for classifying active children and adolescents using the Physical Activity Questionnaire: PAQ-C and PAQ-A

    OpenAIRE

    Benítez-Porres, Javier; Alvero-Cruz, José Ramón; Sardinha, Luis B.; López-Fernández, Iván; Carnero, Elvis A.

    2016-01-01

    Introduction: The Physical Activity Questionnaire for children and adolescents (PAQ-C & PAQ-A) has been widely used in research and field settings. However, there is a lack of information about its final score meaning. Objective: To determine PAQ-C and PAQ-A score cut-off values using physical activity (PA) thresholds objectively measured as reference criteria. Methods: 146 children (n = 83 boys, n = 63 girls) and 234 adolescents (n = 115 boys, n = 119 girls) participated in this study. Accel...

  20. Accuracy of the WHO’s body mass index cut-off points to measure gender- and age-specific obesity in middle-aged adults living in the city of Rio de Janeiro, Brazil

    Directory of Open Access Journals (Sweden)

    Wollner Materko

    2017-09-01

    Full Text Available Introduction. Obesity is defined by the World Health Organization (WHO as a disease characterized by the excessive accumulation of body fat. Obesity is considered a public health problem, leading to serious social, psychological and physical problems. However, the appropriate cut-off point of body mass index (BMI based on body fat percentage (BF% for classifying an individual as obese in middle-aged adults living in Rio de Janeiro remains unclear. Materials and methods. This was a prospective cross-sectional study comprising of 856 adults (413 men and 443 women living in Rio de Janeiro, Brazil ranging from 30-59 years of age. The data were collected over a two year period (2010-2011, and all participants were underwent anthropometric evaluation. The gold standard was the percentage of body fat estimated by bioelectrical impedance analysis. The optimal sensitivity and specificity were attained by adjusting BMI cut-off values to predict obesity based on the WHO criteria: BF% >25% in men and >35% in women, according to the receiver operating characteristic curve (ROC analysis adjusted for age and for the whole group.Results. The BMI cut-offs for predicting BF% were 29.9 kg/m2 in men and 24.9 kg/m2 in women. Conclusions. The BMI that corresponded to a BF% previously defining obesity was similar to that of other Western populations for men but not for women. Furthermore, gender and age specific cut-off values are recommended in this population.

  1. Laser Ion Source Development for ISOL Systems at RIA

    CERN Document Server

    Liu, Yuan; Beene, James R; Bilheux, Hassina Z; Brueck, Kim; Geppert, Christopher; Havener, Charles; Kessler, Thomas; Krause, Herbert F; Schultz, David R; Stracener, Dan; Vane, C R; Wendt, Klaus

    2005-01-01

    The isobaric purity of radioactive ion beams (RIBs) is of crucial importance to many experiments. Laser ion sources based on resonant photoionization have already proved to be of great value at existing ISOL RIB facilities. In these ion sources, ions of a selected isotope are produced by laser radiation via stepwise atomic resonant excitations followed by ionization in the last transition. Because each element has its own unique atomic energy levels, the resonant photoionization process can provide elemental selectivity of nearly 100%. We have initiated a research effort to develop a prototype laser ion source with the potential to achieve the high selectivity and high efficiency required for research with ISOL-generated RIBs at the Rare Isotope Accelerator (RIA). A pilot experiment has been conducted to demonstrate resonant photoionization of three atomic species using all-solid-state tunable Ti:Sapphire lasers. Three Ti:Sapphire lasers were provided by the University of Mainz and used in the experiment for ...

  2. A mechanical chest compressor closed-loop controller with an effective trade-off between blood flow improvement and ribs fracture reduction.

    Science.gov (United States)

    Zhang, Guang; Wu, Taihu; Song, Zhenxing; Wang, Haitao; Lu, Hengzhi; Wang, Yalin; Wang, Dan; Chen, Feng

    2015-06-01

    Chest compression (CC) is a significant emergency medical procedure for maintaining circulation during cardiac arrest. Although CC produces the necessary blood flow for patients with heart arrest, improperly deep CC will contribute significantly to the risk of chest injury. In this paper, an optimal CC closed-loop controller for a mechanical chest compressor (OCC-MCC) was developed to provide an effective trade-off between the benefit of improved blood perfusion and the risk of ribs fracture. The trade-off performance of the OCC-MCC during real automatic mechanical CCs was evaluated by comparing the OCC-MCC and the traditional mechanical CC method (TMCM) with a human circulation hardware model based on hardware simulations. A benefit factor (BF), risk factor (RF) and benefit versus risk index (BRI) were introduced in this paper for the comprehensive evaluation of risk and benefit. The OCC-MCC was developed using the LabVIEW control platform and the mechanical chest compressor (MCC) controller. PID control is also employed by MCC for effective compression depth regulation. In addition, the physiological parameters model for MCC was built based on a digital signal processor for hardware simulations. A comparison between the OCC-MCC and TMCM was then performed based on the simulation test platform which is composed of the MCC, LabVIEW control platform, physiological parameters model for MCC and the manikin. Compared with the TMCM, the OCC-MCC obtained a better trade-off and a higher BRI in seven out of a total of nine cases. With a higher mean value of cardiac output (1.35 L/min) and partial pressure of end-tidal CO2 (15.7 mmHg), the OCC-MCC obtained a larger blood flow and higher BF than TMCM (5.19 vs. 3.41) in six out of a total of nine cases. Although it is relatively difficult to maintain a stable CC depth when the chest is stiff, the OCC-MCC is still superior to the TMCM for performing safe and effective CC during CPR. The OCC-MCC is superior to the TMCM in

  3. Solute removal capacity of high cut-off membrane plasma separators.

    Science.gov (United States)

    Ohkubo, Atsushi; Kurashima, Naoki; Nakamura, Ayako; Miyamoto, Satoko; Iimori, Soichiro; Rai, Tatemitsu

    2013-10-01

    In vitro blood filtration was performed by a closed circuit using high cut-off membrane plasma separators, EVACURE EC-2A10 (EC-2A) and EVACURE EC-4A10 (EC-4A). Samples were obtained from sampling sites before the plasma separator, after each plasma separator, and from the ultrafiltrate of each separator. The sieving coefficient (S.C.) of total protein (TP), albumin (Alb), IgG, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), fibrinogen (Fib), antithrombin III (AT-III), and coagulation factor XIII (FXIII) were calculated. The S.C. of each solute using EC-2A and EC-A4 were as follows; TP: 0.25 and 0.56, Alb: 0.32 and 0.73, IgG: 0.16 and 0.50, IL-6:0.73 and 0.95, IL-8:0.85 and 0.82, TNF-α: 1.07 and 0.99, Fib: 0 and 0, FXIII: 0.07 and 0.17, respectively. When compared with the conventional type of membrane plasma separators, EVACURE could efficiently remove cytokines while retaining coagulation factors such as fibrinogen. Moreover, EC-2A prevented protein loss, whereas EC-4A could remove approximately 50% of IgG. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  4. Prevalence of Abuse Among Young Children with Rib Fractures: A Systematic Review

    Science.gov (United States)

    Paine, Christine Weirich; Fakeye, Oludolapo; Christian, Cindy W.; Wood, Joanne N.

    2016-01-01

    Objectives We aimed to estimate the prevalence of abuse in young children presenting with rib fractures and to identify demographic, injury, and presentation-related characteristics that affect the probability that rib fractures are secondary to abuse. Methods We searched PubMed/MEDLINE and CINAHL databases for articles published in English between January 1, 1990 and June 30, 2014 on rib fracture etiology in children ≤ 5 years old. Two reviewers independently extracted predefined data elements and assigned quality ratings to included studies. Study-specific abuse prevalences and the sensitivities, specificities, and positive and negative likelihood ratios of patients’ demographic and clinical characteristics for abuse were calculated with 95% confidence intervals. Results Data for 1,396 children ≤ 48 months old with rib fractures were abstracted from 10 articles. Among infants Rib fracture location was not associated with likelihood of abuse. The retrospective design of the included studies and variations in ascertainment of cases, inclusion/exclusion criteria, and child abuse assessments prevented further meta-analysis. Conclusions Abuse is the most common cause of rib fractures in infants rib fractures and characteristics associated with abusive rib fractures. PMID:27749806

  5. Use of a 90° drill and screwdriver for rib fracture stabilization.

    Science.gov (United States)

    Nickerson, Terry P; Kim, Brian D; Zielinski, Martin D; Jenkins, Donald; Schiller, Henry J

    2015-03-01

    Rib fracture stabilization has become a more accepted practice although stabilization of the most cephalad ribs presents a unique challenge. We present our experience with use of a 90° drill and screwdriver to bridge these difficult rib fractures. This retrospective review included patients who underwent rib fracture stabilization from August 1, 2009, through September 30, 2012. Patients were divided into two groups: those whose procedure used the 90° device and those that did not. Data were compared using standard statistical analysis and reported as percentages and medians [interquartile ranges]. P values rib stabilized was different between the 2 groups (3 [2-5] vs. 5 [2-9]; P = 0.001), with more third rib stabilizations in the 90° group (38 vs. 20%; P = 0.04) as well as more total number of ribs fixed (5 vs. 4; P = 0.001). There was no difference in operative time between the 2 groups. The surgical reach for rib fracture stabilization has been extended with use of a 90° drill and screwdriver. High fractures under the scapula where access is technically challenging can be stabilized without prolonging operative times.

  6. Post-accelerator LINAC design for the VECC RIB project

    Indian Academy of Sciences (India)

    acclerator type of RIB facility. The scheme utilises the existing = 130 room temperature variable energy cyclotron machine as the primary accelerator for the production of RIBs and radio frequency quadrupole (RFQ) and LINAC modules for ...

  7. Modified Cut-Off Value of the Urine Protein-To-Creatinine Ratio Is Helpful for Identifying Patients at High Risk for Chronic Kidney Disease: Validation of the Revised Japanese Guideline.

    Science.gov (United States)

    Yamamoto, Hiroyuki; Yamamoto, Kyoko; Yoshida, Katsumi; Shindoh, Chiyohiko; Takeda, Kyoko; Monden, Masami; Izumo, Hiroko; Niinuma, Hiroyuki; Nishi, Yutaro; Niwa, Koichiro; Komatsu, Yasuhiro

    2015-11-01

    Chronic kidney disease (CKD) is a global public health issue, and strategies for its early detection and intervention are imperative. The latest Japanese CKD guideline recommends that patients without diabetes should be classified using the urine protein-to-creatinine ratio (PCR) instead of the urine albumin-to-creatinine ratio (ACR); however, no validation studies are available. This study aimed to validate the PCR-based CKD risk classification compared with the ACR-based classification and to explore more accurate classification methods. We analyzed two previously reported datasets that included diabetic and/or cardiovascular patients who were classified into early CKD stages. In total, 860 patients (131 diabetic patients and 729 cardiovascular patients, including 193 diabetic patients) were enrolled. We assessed the CKD risk classification of each patient according to the estimated glomerular filtration rate and the ACR-based or PCR-based classification. The use of the cut-off value recommended in the current guideline (PCR 0.15 g/g creatinine) resulted in risk misclassification rates of 26.0% and 16.6% for the two datasets. The misclassification was primarily caused by underestimation. Moderate to substantial agreement between each classification was achieved: Cohen's kappa, 0.56 (95% confidence interval, 0.45-0.69) and 0.72 (0.67-0.76) in each dataset, respectively. To improve the accuracy, we tested various candidate PCR cut-off values, showing that a PCR cut-off value of 0.08-0.10 g/g creatinine resulted in improvement in the misclassification rates and kappa values. Modification of the PCR cut-off value would improve its efficacy to identify high-risk populations who will benefit from early intervention.

  8. Calculation of cut-off values based on the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI) pemphigus scoring systems for defining moderate, significant and extensive types of pemphigus.

    Science.gov (United States)

    Boulard, C; Duvert Lehembre, S; Picard-Dahan, C; Kern, J S; Zambruno, G; Feliciani, C; Marinovic, B; Vabres, P; Borradori, L; Prost-Squarcioni, C; Labeille, B; Richard, M A; Ingen-Housz-Oro, S; Houivet, E; Werth, V P; Murrell, D F; Hertl, M; Benichou, J; Joly, P

    2016-07-01

    Two pemphigus severity scores, Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI), have been proposed to provide an objective measure of disease activity. However, the use of these scores in clinical practice is limited by the absence of cut-off values that allow differentiation between moderate, significant and extensive types of pemphigus. To calculate cut-off values defining moderate, significant and extensive pemphigus based on the ABSIS and PDAI scores. In 31 dermatology departments in six countries, consecutive patients with newly diagnosed pemphigus were assessed for pemphigus severity, using ABSIS, PDAI, Physician's Global Assessment (PGA) and Dermatology Life Quality Index (DLQI) scores. Cut-off values defining moderate, significant and extensive subgroups were calculated based on the 25th and 75th percentiles of the ABSIS and PDAI scores. The median ABSIS, PDAI, PGA and DLQI scores of the three severity subgroups were compared in order to validate these subgroups. Ninety-six patients with pemphigus vulgaris (n = 77) or pemphigus foliaceus (n = 19) were included. The median PDAI activity and ABSIS total scores were 27·5 (range 3-84) and 34·8 points (range 0·5-90·5), respectively. The respective cut-off values corresponding to the first and third quartiles of the scores were 15 and 45 for the PDAI, and 17 and 53 for ABSIS. The moderate, significant and extensive subgroups were thus defined, and had distinguishing median ABSIS (P cut-off values of 15 and 45 for PDAI and 17 and 53 for ABSIS, to distinguish moderate, significant and extensive pemphigus forms. Identifying these pemphigus activity subgroups should help physicians to classify and manage patients with pemphigus. © 2016 British Association of Dermatologists.

  9. Biomechanical rationale and evaluation of an implant system for rib fracture fixation

    OpenAIRE

    Bottlang, M.; Walleser, S.; Noll, M.; Honold, S.; Madey, S. M.; Fitzpatrick, D.; Long, W. B.

    2010-01-01

    Background Biomechanical research directed at developing customized implant solutions for rib fracture fixation is essential to reduce the complexity and to increase the reliability of rib osteosynthesis. Without a simple and reliable implant solution, surgical stabilization of rib fractures will remain underutilized despite proven benefits for select indications. This article summarizes the research, development, and testing of a specialized and comprehensive implant solution for rib fractur...

  10. Flow and heat transfer in parallel channel attached with equally-spaced ribs, 2

    International Nuclear Information System (INIS)

    Kunugi, Tomoaki; Takizuka, Takakazu

    1980-09-01

    Using a computer code for the analysis of the flow and heat transfer in a parallel channel attached with equally-spaced ribs, calculations are performed when a pitch to rib-width ratio is 7 : 1, a rib-width to rib-height ratio is 2 : 1 and a channel-height to rib-height is 3 : 1. Assuming that the fluid properties and the heat-flux at the wall of this channel are constant, characteristics of the flow and heat transfer are analyzed in the range of Reynolds number from 10 to 250. The following results are obtained: (1) The separation region behind a rib grows downstream with the increase of Reynolds number. (2) The pressure drop of ribbed channel is greater than that of the smooth channel, and increases as Reynolds number increases. (3) The mean Nusselt number of ribbed channel is about 10 - 11 at the upper wall and about 7.5 at the lower wall in the range of Reynolds number from 10 to 250. (author)

  11. Rocking at 81 and Rolling at 34: ROC Cut-Off Scores for the Negative Acts Questionnaire–Revised in Serbia

    Science.gov (United States)

    Petrović, Ivana B.; Vukelić, Milica; Čizmić, Svetlana

    2017-01-01

    Researchers are still searching for the ways to identify different categories of employees according to their exposure to negative acts and psychological experience of workplace bullying. We followed Notelaers and Einarsen’s application of the ROC analysis to determine the NAQ-R cut-off scores applying a “lower” and “higher” threshold. The main goal of this research was to develop and test different gold standards of personal and organizational relevance in determining the NAQ-R cut-off scores in a specific cultural and economic context of Serbia. Apart from combining self-labeling as a victim with self-perceived health, the objectives were to test the gold standards developed as a combination of self-labeling with life satisfaction, self-labeling with intention to leave and a complex gold standard based on self-labeling, self-perceived health, life satisfaction and intention to leave taken together. The ROC analysis on Serbian workforce data supports applying of different gold standards. For identifying employees in a preliminary stage of bullying, the most applicable was the gold standard based on self-labeling and intention to leave (score 34 and higher). The most accurate identification of victims could be based on the most complex gold standard (score 81 and higher). This research encourages further investigation of gold standards in different cultures. PMID:28119652

  12. Differentiating the Causes of Spontaneous Rib Fracture After Breast Cancer.

    Science.gov (United States)

    Harris, Susan R

    2016-12-01

    Spontaneous rib fracture after treatment for primary breast cancer is not uncommon. Although metastatic disease accounts for about 30% of spontaneous rib fractures and should constitute the first line of diagnostic investigation, other possible contributors include primary osteoporosis or secondary osteoporosis resulting from cancer treatments. Chemotherapy-induced menopause, aromatase inhibitors, radiation therapy, and long-term bisphosphonate use can all contribute to bone fragility, including spontaneous rib fractures in the latter 3. Drawing on recent breast cancer practice guidelines as well as population-based studies of fracture risk for women with a history of breast cancer and systematic reviews, this Perspective will provide an update on recent developments in understanding how to differentiate the possible reasons for non-traumatic rib fracture in women treated for breast cancer. In addition to describing the various possible causes of spontaneous rib fracture, the recommended medical and imaging procedures for differentiating among the potential causes will be presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Investigation into the heat transfer performance of helically ribbed surfaces

    International Nuclear Information System (INIS)

    Firth, R.J.

    1981-12-01

    The first part of an investigation into flow and heat transfer in annular channels and seven pin clusters is described. One of the main aims of the project is to improve cluster heat transfer prediction codes for helically ribbed surfaces. A study is made of the heat transfer and flow characteristics of a helically ribbed pin in an annular channel. It is shown that the swirling flow, which is induced by the helical ribs, gives rise to substantially enhanced diffusivity levels. This phenomenon had not been taken into account by previous analysis techniques. The methods for analysing heat transfer and pressure drop data from annular channels which were originally developed for non-swirling flow are generalised to accommodate swirling flow. The new methods are shown to be consistent with empirical data. Roughness parameter data is presented for helically ribbed surfaces with an axial rib pitch into height ratio of about 7. (author)

  14. Operative Fixation of Rib Fractures Indications, Techniques, and Outcomes.

    Science.gov (United States)

    Galos, David; Taylor, Benjamin; McLaurin, Toni

    2017-01-01

    Rib fractures are extremely common injuries and vary in there severity from single nondisplaced fractures to multiple segmental fractures resulting in flail chest and respiratory compromise. Historically, rib fractures have been treated conservatively with pain control and respiratory therapy. However this method may not be the best treatment modality in all situations. Operative fixation of select rib fractures has been increasing in popularity especially in patients with flail chest and respiratory compromise. Newer techniques use muscle sparing approaches and precontoured locking plate technology to obtain stable fixation and allow improved respiration. Current reports shows that rib fracture fixation offers the benefits of improved respiratory mechanics and improved pain control in the severe chest wall injury with resultant improvement in patient outcomes by decreasing time on the ventilator, time in the intensive care unit, and overall hospital length of stay.

  15. A new method for detection of the electron temperature in laser-plasma short wave cut off of stimulated Raman scattering spectrum

    International Nuclear Information System (INIS)

    Zhang Jiatai

    1994-01-01

    From the theory of stimulated Raman scattering (SRS) three wave interaction, a new method of detecting the electron temperature in laser-plasma is obtained. SRS spectrum obtained from Shenguang No. 12 Nd-laser experiments are analysed. Using the wave length of short wave cut off of SRS, the electron temperature in corona plasma region is calculated consistently. These results agree reasonable with X-ray spectrum experiments

  16. Radiological, computertomographic, pathoanatomical and histological examination of the rib cartilage of the dog

    International Nuclear Information System (INIS)

    Lorber, B.

    2000-06-01

    This study was concerned with the representation and description of the rib cartilage of the dog and the abnormalities of such by means of radiological, computer tomographic, pathoanatomical and histological examinations and the comparison of the results of the various examination methods. The study material consisted of 100 ventral thorax walls of dogs of different ages and breeds. In 39 of the subjects, no abnormalities of rib cartilage other than unremarkable calcification were observed. Among the subjects, there were 11 puppies (0-3 months), whose rib cartilage appeared soft tissue dense due to the absence of calcification, 14 juvenile animals (4-18 months), the rib cartilage of which showed a typical finely granulated structure, and 14 adult dogs (over 18 months), whose rib cartilage exhibited a homogeneous to net-like calcified appearance. In the calcified rib cartilage, the histological section showed a centrally located spongiosa rod surrounded by a hyaline cartilage shell. The calcification tendency of the first pair of rib cartilage was remarkable: in 70 dogs, the first pair of rib cartilage remained uncalcified despite calcification of the other rib cartilage. Sixty-one dogs exhibited rib cartilage abnormalities. According to the radiological appearance of the abnormalities, they were divided into groups and their incidence was calculated. Abnormalities seen included interruption in the continuity of the calcified rib cartilage with and without callus formation, enlargement of rib cartilage, cuff formation, and abnormalities on the Articulationes sternocostales (projections in or around articulations, calcified and fractured joint surfaces). In addition, remarkable calcification patterns were observed. By means of CT examination the densities of the tissue forming the various abnormalities was determined. In the course of the pathoanatomical examination, it was shown that the interruptions in continuity with callus and the various enlarged areas of the

  17. Current Observational Constraints to Holographic Dark Energy Model with New Infrared cut-off via Markov Chain Monte Carlo Method

    OpenAIRE

    Wang, Yuting; Xu, Lixin

    2010-01-01

    In this paper, the holographic dark energy model with new infrared (IR) cut-off for both the flat case and the non-flat case are confronted with the combined constraints of current cosmological observations: type Ia Supernovae, Baryon Acoustic Oscillations, current Cosmic Microwave Background, and the observational hubble data. By utilizing the Markov Chain Monte Carlo (MCMC) method, we obtain the best fit values of the parameters with $1\\sigma, 2\\sigma$ errors in the flat model: $\\Omega_{b}h...

  18. First Rib Fracture Resulting in Horner's Syndrome.

    Science.gov (United States)

    Lin, You-Cheng; Chuang, Ming-Tsung; Hsu, Chin-Hao; Tailor, Al-Rahim Abbasali; Lee, Jung-Shun

    2015-12-01

    First rib fractures and traumatic Horner's syndrome are both quite rare, which can make it difficult to properly diagnose the combination of these 2 conditions in the emergency department. These conditions may be associated with severe medical emergencies, such as ongoing carotid dissection. We present the case of a 33-year-old man who sustained fractures to his right second, third, and fourth ribs and a delay in the diagnosis of left Horner's syndrome after he was involved in a traffic accident. Left Horner's syndrome was caused by a left transverse fracture of the first rib. This fracture was not detected on chest radiographs and required a 3-dimensional reconstructed neck computed tomography scan for detection. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: In the diagnosis of carotid artery dissection, conventional angiography is the criterion standard but is considered invasive. CTA is less invasive, time-saving, and can show more anatomic structures in the neck in addition to the carotid arteries. It is a good screening diagnostic modality in the traumatology department. Although the treatments for Horner's syndrome and first rib fracture are conservative, the early diagnosis of both conditions can resolve the anxiety and uncertainty experienced by both doctors and patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Optimal cut?off value of alanine aminotransferase level to precisely estimate the presence of fatty liver in patients with poorly controlled type?2 diabetes

    OpenAIRE

    Tanabe, Akihito; Tatsumi, Fuminori; Okauchi, Seizo; Yabe, Hiroki; Tsuda, Tomohiro; Okutani, Kazuma; Yamashita, Kazuki; Nakashima, Koji; Kaku, Kohei; Kaneto, Hideaki

    2016-01-01

    Optimal cut?off value of ALT level to precisely estimate the presence of fatty liver was as low as 28.0?U/L. We should consider the possibility of fatty liver even when ALT level is within normal range in subjects with poorly controlled type 2 diabetes.

  20. Acute rib fracture diagnosis in an infant by US: a matter of child protection

    International Nuclear Information System (INIS)

    Kelloff, Jennifer; Spivey, Maria; Hulett, Rebecca

    2009-01-01

    Rib fractures in infants and children are highly specific for inflicted injury in the absence of a major accidental injury or underlying bone disorder. We present a 9-week-old infant diagnosed with an acute rib fracture by US at the site where physicians palpated chest wall crepitus when no rib fractures had been visualized on the skeletal survey, including oblique views of the ribs. Based on the US diagnosis of the acute rib fracture the infant was taken into protective custody. Follow-up skeletal survey 2 weeks later revealed healing fractures of the left 6th and 7th posterolateral ribs and right 7th, 8th and 9th anterolateral ribs. We were unable to locate previous reports describing the diagnosis of rib fractures in infants by US. (orig.)

  1. Acute rib fracture diagnosis in an infant by US: a matter of child protection

    Energy Technology Data Exchange (ETDEWEB)

    Kelloff, Jennifer; Spivey, Maria [Washington University School of Medicine, Department of Pediatrics, Section on Child Abuse and Neglect, St. Louis Children' s Hospital, One Children' s Place, Box 8116, St. Louis, MO (United States); Hulett, Rebecca [Washington University School of Medicine, Department of Radiology, St. Louis Children' s Hospital, St. Louis, MO (United States)

    2009-01-15

    Rib fractures in infants and children are highly specific for inflicted injury in the absence of a major accidental injury or underlying bone disorder. We present a 9-week-old infant diagnosed with an acute rib fracture by US at the site where physicians palpated chest wall crepitus when no rib fractures had been visualized on the skeletal survey, including oblique views of the ribs. Based on the US diagnosis of the acute rib fracture the infant was taken into protective custody. Follow-up skeletal survey 2 weeks later revealed healing fractures of the left 6th and 7th posterolateral ribs and right 7th, 8th and 9th anterolateral ribs. We were unable to locate previous reports describing the diagnosis of rib fractures in infants by US. (orig.)

  2. Prevalence and characteristics of rib fractures in ex-preterm infants.

    Science.gov (United States)

    Lucas-Herald, Angela; Butler, Sandra; Mactier, Helen; McDevitt, Helen; Young, David; Ahmed, Syed Faisal

    2012-12-01

    This study aimed to identify the prevalence and characteristics of rib fractures in ex-preterm infants. Infants born at rib fractures, and the case notes of all affected individuals were scrutinized. Of the 3318 eligible preterm infants, 1446 had a total of 9386 chest radiographs. Of these infants, 26 (1.8%) were identified as having a total of 62 rib fractures. Their median (range) gestation at birth was 26 weeks (23-34). The median chronological age of these infants at the time of the radiograph was 14 weeks (5 weeks to 8 months). The median corrected gestational age at the time of the radiograph was 39 weeks (34 weeks to 4 months). Of the 62 fractures, 27 (36%) were sited posteriorly, and 15 (53%) of the infants with posterior rib fractures were diagnosed with osteopathy of prematurity. Classic risk including conjugated hyperbilirubinemia and diuretics, were present in 23 of 26 (88%) infants. A full skeletal survey was performed in 8 of 26 (31%). Investigations for nonaccidental injury occurred in 4 of 26 (15%) cases. Evidence of rib fractures is present in ~2% of ex-preterm infants. The evaluation of these fractures in infancy requires a detailed neonatal history irrespective of the site of rib fracture.

  3. A clinically based prognostic index for diffuse large B-cell lymphoma with a cut-off at 70 years of age significantly improves prognostic stratification

    DEFF Research Database (Denmark)

    Gang, Anne O.; Pedersen, Michael; d'Amore, Francesco

    2015-01-01

    The introduction of rituximab and generally improved health among elderly patients have increased the survival of patients with diffuse large B-cell lymphoma (DLBCL). The International Prognostic Index (IPI) from 1992 is based on pre-rituximab data from clinical trials including several lymphoma ...... dehydrogenase (LDH), stage and albumin level, and (2) a separate age-adjusted DLBCL-PI for patients 1 extranodal lesion, however excluding stage....... subtypes. We applied IPI factors to a population-based rituximab-treated cohort of 1990 patients diagnosed 2000-2010 and explored new factors and the optimal prognostic age cut-off for DLBCL. Multivariate-analyses (MVA) confirmed the prognostic value of all IPI factors except the presence of > 1 extranodal...... lesion. The optimal age cut-off was 70 years. In a MVA of albumin, lymphocyte count, sex, immunoglobulin G, bulky disease, hemoglobin and B-symptoms, only albumin was prognostic. We propose: (1) a modified DLBCL prognostic index (DLBCL-PI) including: age (70 years), performance status (PS), lactate...

  4. Rib forming tool for tubing

    Science.gov (United States)

    Rowley, James P.; Lewandowski, Edward F.; Groh, Edward F.

    1976-01-01

    Three cylindrical rollers are rotatably mounted equidistant from the center of a hollow tool head on radii spaced 120.degree. apart. Each roller has a thin flange; the three flanges lie in a single plane to form an internal circumferential rib in a rotating tubular workpiece. The tool head has two complementary parts with two rollers in one part of the head and one roller in the other part; the two parts are joined by a hinge. A second hinge, located so the rollers are between the two hinges, connects one of the parts to a tool bar mounted in a lathe tool holder. The axes of rotation of both hinges and all three rollers are parallel. A hole exposing equal portions of the three roller flanges is located in the center of the tool head. The two hinges permit the tool head to be opened and rotated slightly downward, taking the roller flanges out of the path of the workpiece which is supported on both ends and rotated by the lathe. The parts of the tool head are then closed on the workpiece so that the flanges are applied to the workpiece and form the rib. The tool is then relocated for forming of the next rib.

  5. Determination of the stresses and displacements in the cut off curtain body executed by the > method

    International Nuclear Information System (INIS)

    Snisarenko, V.I.; Mel'nikov, A.I.

    1994-01-01

    Construction of the cut-off-curtain (COC) is analyzed as a possible variant to reduce the rate of radioactive horizontal migration. Such constructions can be executed by the > method. The theoretical analysis of the stress-strained state of the carried out using the methods of the theory of elasticity and of the limit equilibrium of the strewing medium. Theoretical dependences are obtained and formulas for practical calculations of the COC-body stress-strained state in the depth intervals which are of practical interest are suggested. The dependences obtained may be used to calculate the consolidation parameters and filtration coefficients, to choose materials for the COC body, geometrical size and film elements included

  6. First rib fractures as an indicator of injury severity in major trauma

    OpenAIRE

    Sammy, I.A.; Chatha, H.; Lecky, F.; Bouamra, O.; Fragoso Iniguez, M.; Sattout, A.; Hickey, M.

    2016-01-01

    Introduction First rib fractures are traditionally considered indicators of increased morbidity and mortality in major trauma. However, this relationship has not been definitively proven. With an increase in computed tomography in major trauma, and the likely increase in detection of first rib fractures, this study re-evaluates whether first rib fractures are an indicator of injury severity. Discussion This study suggests that major trauma patients with first rib fractures have increased ISS ...

  7. Direct Extraction of InP/GaAsSb/InP DHBT Equivalent-Circuit Elements From S-Parameters Measured at Cut-Off and Normal Bias Conditions

    DEFF Research Database (Denmark)

    Johansen, Tom Keinicke; Leblanc, Rémy; Poulain, Julien

    2016-01-01

    A unique direct parameter extraction method for the small-signal equivalent-circuit model of InP/GaAsSb/InP double heterojunction bipolar transistors (DHBTs) is presented. $S$-parameters measured at cut-off bias are used, at first, to extract the distribution factor $X_{0}$ for the base-collector......A unique direct parameter extraction method for the small-signal equivalent-circuit model of InP/GaAsSb/InP double heterojunction bipolar transistors (DHBTs) is presented. $S$-parameters measured at cut-off bias are used, at first, to extract the distribution factor $X_{0}$ for the base......-collector capacitance at zero collector current and the collector-to-emitter overlap capacitance $C_{ceo}$ present in InP DHBT devices. Low-frequency $S$-parameters measured at normal bias conditions then allows the extraction of the external access resistances $R_{bx}$, $R_{e}$, and $R_{cx}$ as well as the intrinsic...

  8. [Rib cage ostheosynthesis. Literature review and case reports].

    Science.gov (United States)

    Jiménez-Quijano, Andrés; Varón-Cotés, Juan Carlos; García-Herreros-Hellal, Luis Gerardo; Espinosa-Moya, Beatriz; Rivero-Rapalino, Oscar; Salazar-Marulanda, Michelle

    2015-01-01

    Fractures of the chest wall include sternum and rib fractures. Traditionally they are managed conservatively due to the anatomy of the rib cage that allows most of them to remain stable and to form a callus that unites the fractured segments. In spite of this management, some patients present with chronic pain or instability of the wall which makes them require some type of fixation. The present article performs a literature review based on 4 cases. The first case was a 61 year-old man with blunt chest trauma, with a great deformity of the chest wall associated with subcutaneous emphysema, and pneumothorax. The second case was a 51 year-old man with blunt chest trauma, initially managed at another institution, who despite treatment, had persistent pain and dyspnoea. The third case was a 30 year-old man that suffered a motor vehicle accident, with resulting pain and crepitation of the rib cage and with diagnostic images showing multiple rib fractures. The last case is a 62 year-old man that fell down the stairs, with blunt chest trauma with high intensity pain, dyspnoea and basal ipsilateral hypoventilation. Rib fracture fixation offers a good alternative in selected patients to decrease associated morbidity, leading to a patient's fast return to his or her working life. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  9. Emerging from the rib: resolving the turtle controversies.

    Science.gov (United States)

    Rice, Ritva; Riccio, Paul; Gilbert, Scott F; Cebra-Thomas, Judith

    2015-05-01

    Two of the major controversies in the present study of turtle shell development involve the mechanism by which the carapacial ridge initiates shell formation and the mechanism by which each rib forms the costal bones adjacent to it. This paper claims that both sides of each debate might be correct-but within the species examined. Mechanism is more properly "mechanisms," and there is more than one single way to initiate carapace formation and to form the costal bones. In the initiation of the shell, the rib precursors may be kept dorsal by either "axial displacement" (in the hard-shell turtles) or "axial arrest" (in the soft-shell turtle Pelodiscus), or by a combination of these. The former process would deflect the rib into the dorsal dermis and allow it to continue its growth there, while the latter process would truncate rib growth. In both instances, though, the result is to keep the ribs from extending into the ventral body wall. Our recent work has shown that the properties of the carapacial ridge, a key evolutionary innovation of turtles, differ greatly between these two groups. Similarly, the mechanism of costal bone formation may differ between soft-shell and hard-shell turtles, in that the hard-shell species may have both periosteal flattening as well as dermal bone induction, while the soft-shelled turtles may have only the first of these processes. © 2015 Wiley Periodicals, Inc.

  10. Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future.

    Science.gov (United States)

    Tang, Qi; Li, Xueqin; Song, Peipei; Xu, Lingzhong

    2015-12-01

    Diabetes mellitus (DM) appears to be increasing rapidly, threatening to reduce life expectancy for humans around the globe. The International Diabetes Federation (IDF) has estimated that there will be 642 million people living with the disease by 2040 and half as many again who will be not diagnosed. This means that pre-DM screening is a critical issue. Insulin resistance (IR) has emerged as a major pathophysiological factor in the development and progression of DM since it is evident in susceptible individuals at the early stages of DM, and particularly type 2 DM (T2DM). Therefore, assessment of IR via the homeostasis model assessment of IR (HOMA-IR) is a key index for the primary prevention of DM and is thus found in guidelines for screening of high-risk groups. However, the cut-off values of HOMA-IR differ for different races, ages, genders, diseases, complications, etc. due to the complexity of IR. This hampers the determination of specific cut-off values of HOMA-IR in different places and in different situations. China has not published an official index to gauge IR for primary prevention of T2DM in the diabetic and non-diabetic population except for children and adolescents ages 6-12 years. Hence, this article summarizes developments in research on IR, HOMA-IR, and pre-DM screening in order to provide a reference for optimal cut-off values of HOMA-IR for the diagnosis of DM in the Chinese population.

  11. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury.

    Science.gov (United States)

    Franceschini, Marco; Massimiani, Maria Pia; Paravati, Stefano; Agosti, Maurizio

    2016-01-01

    Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM-admission FIM)/(Maximum possible FIM-Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.

  12. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury.

    Directory of Open Access Journals (Sweden)

    Marco Franceschini

    Full Text Available Return to work (RTW for people with acquired brain injury (ABI represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery between admission and discharge was assessed by Functional Independent Measure (FIM gain, through the Montebello Rehabilitation Factor Score (MRFS, which was obtained as follows: (discharge FIM-admission FIM/(Maximum possible FIM-Admission FIM x 100. The cut-off value (criterion deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%. Considering the Mini Mental State Examination (MMSE and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.

  13. Antimicrobial Susceptibility of Flavobacterium psychrophilum from Chilean Salmon Farms and their Epidemiological Cut-off Values using Agar Dilution and Disk Diffusion Methods

    Directory of Open Access Journals (Sweden)

    Claudio D Miranda

    2016-11-01

    Full Text Available Flavobacterium psychrophilum is the most important bacterial pathogen for freshwater farmed salmonids in Chile. The aims of this study were to determine the susceptibility to antimicrobials used in fish farming of Chilean isolates and to calculate their epidemiological cut-off (COWT values. A number of 125 Chilean isolates of F. psychrophilum were isolated from reared salmonids presenting clinical symptoms indicative of flavobacteriosis and their identities were confirmed by 16S rRNA polymerase chain reaction. Susceptibility to antibacterials was tested on diluted Mueller-Hinton by using an agar dilution MIC method and a disk diffusion method. The COWT values calculated by Normalised Resistance Interpretation (NRI analysis allow isolates to be categorized either as wild-type fully susceptible (WT or as manifesting reduced susceptibility (NWT. When MIC data was used, NRI analysis calculated a COWT of ≤ 0.125 μg mL-1, ≤ 2 μg mL-1 and ≤ 0.5 μg mL-1 for amoxicillin, florfenicol and oxytetracycline, respectively. For the quinolones, the COWT were ≤1 μg mL-1, ≤ 0.5 μg mL-1 and ≤ 0.125 μg mL-1 for oxolinic acid, flumequine and enrofloxacin respectively. The disc diffusion data sets obtained in this work were extremely diverse and were spread over a wide range. For the quinolones there was a close agreement between the frequencies of NWT isolates calculated using MIC and disc data. For oxolinic acid, flumequine and enrofloxacin the frequencies were 45, 39 and 38% using MIC data, and 42, 41 and 44%, when disc data were used. There was less agreement with the other antimicrobials, because NWT frequencies obtained using MIC and disc data respectively, were 24% and 10% for amoxicillin, 8% and 2% for florfenicol and 70% and 64% for oxytetracycline. Considering that the MIC data was more precise than the disc diffusion data, MIC determination would be the preferred method for susceptibility testing for this species and the NWT frequencies

  14. Corrective Action Investigation Plan for Corrective Action Unit 99: Rainier Mesa/Shoshone Mountain, Nevada Test Site, Nevada

    International Nuclear Information System (INIS)

    McCord, John

    2004-01-01

    This Corrective Action Investigation Plan (CAIP) was developed for Corrective Action Unit (CAU) 99, Rainier Mesa/Shoshone Mountain. The CAIP is a requirement of the ''Federal Facility Agreement and Consent Order'' (FFACO) agreed to by the State of Nevada, the U.S. Department of Energy (DOE), and the U.S. Department of Defense (DoD) (FFACO, 1996). The FFACO addresses environmental restoration activities at U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) facilities and sites including the underground testing area(s) of the Nevada Test Site (NTS). This CAIP describes the investigation activities currently planned for the Rainier Mesa/Shoshone Mountain CAU. These activities are consistent with the current Underground Test Area (UGTA) Project strategy described in Section 3.0 of Appendix VI, Revision No. 1 (December 7, 2000) of the FFACO (1996) and summarized in Section 2.1.2 of this plan. The Rainier Mesa/Shoshone Mountain CAU extends over several areas of the NTS (Figure 1-1) and includes former underground nuclear testing locations in Areas 12 and 16. The area referred to as ''Rainier Mesa'' includes the geographical area of Rainier Mesa proper and the contiguous Aqueduct Mesa. Figure 1-2 shows the locations of the tests (within tunnel complexes) conducted at Rainier Mesa. Shoshone Mountain is located approximately 20 kilometers (km) south of Rainier Mesa, but is included within the same CAU due to similarities in their geologic setting and in the nature and types of nuclear tests conducted. Figure 1-3 shows the locations of the tests conducted at Shoshone Mountain. The Rainier Mesa/Shoshone Mountain CAU falls within the larger-scale Rainier Mesa/Shoshone Mountain Investigation Area, which also includes the northwest section of the Yucca Flat CAU as shown in Figure 1-1. Rainier Mesa and Shoshone Mountain lie adjacent to the Timber Mountain Caldera Complex and are composed of volcanic rocks that erupted from the

  15. Mesa Verde--A Year-Round High School. A Descriptive Report of 1980-81.

    Science.gov (United States)

    Housden, Terry; Holmes, Lynda

    Mesa Verde High School was constructed in 1974 and is the last high school built in the San Juan (California) Unified District. It serves students in grades 9 through 12 and has an open enrollment policy. Mesa Verde operates on a year-round schedule with students divided into three tracks. Basically, each track is in session for 9 weeks and then…

  16. Rib fractures under anterior-posterior dynamic loads: experimental and finite-element study.

    Science.gov (United States)

    Li, Zuoping; Kindig, Matthew W; Kerrigan, Jason R; Untaroiu, Costin D; Subit, Damien; Crandall, Jeff R; Kent, Richard W

    2010-01-19

    The purpose of this study was to investigate whether using a finite-element (FE) mesh composed entirely of hexahedral elements to model cortical and trabecular bone (all-hex model) would provide more accurate simulations than those with variable thickness shell elements for cortical bone and hexahedral elements for trabecular bone (hex-shell model) in the modeling human ribs. First, quasi-static non-injurious and dynamic injurious experiments were performed using the second, fourth, and tenth human thoracic ribs to record the structural behavior and fracture tolerance of individual ribs under anterior-posterior bending loads. Then, all-hex and hex-shell FE models for the three ribs were developed using an octree-based and multi-block hex meshing approach, respectively. Material properties of cortical bone were optimized using dynamic experimental data and the hex-shell model of the fourth rib and trabecular bone properties were taken from the literature. Overall, the reaction force-displacement relationship predicted by both all-hex and hex-shell models with nodes in the offset middle-cortical surfaces compared well with those measured experimentally for all the three ribs. With the exception of fracture locations, the predictions from all-hex and offset hex-shell models of the second and fourth ribs agreed better with experimental data than those from the tenth rib models in terms of reaction force at fracture (difference rib responses and bone fractures for the loading conditions considered, but coarse hex-shell models with constant or variable shell thickness were more computationally efficient and therefore preferred. Copyright 2009 Elsevier Ltd. All rights reserved.

  17. Flank pseudohernia following posterior rib fracture: a case report.

    Science.gov (United States)

    Butensky, Adam M; Gruss, Leah P; Gleit, Zachary L

    2016-10-01

    A pseudohernia is an abdominal wall bulge that may be mistaken for a hernia but that lacks the disruption of the abdominal wall that characterizes a hernia. Thus, the natural history and treatment of this condition differ from those of a hernia. This is the first report of a pseudohernia due to cough-associated rib fracture. A case of pseudohernia due to fractures of the 10 th and 11 th ribs in a 68-year-old white woman is presented. The patient suffered from a major coughing episode 1 year prior to her presentation, after which she noted a progressively enlarging bulge in her left flank. Computed tomography demonstrated a bulge in the abdominal wall containing bowel and spleen but with all muscle and fascial layers intact; in addition, lateral 10 th rib and posterior 11 th rib fractures were noted. As there was no defect in muscle or fascia, we diagnosed a pseudohernia, likely due to a denervation injury from the fractured ribs. Symptomatic treatment was recommended, including wearing a corset and referral to a pain management clinic. Symptomatic treatment is thought to be the mainstay of therapy for pseudohernias, as surgical intervention is unlikely to be of benefit.

  18. FEATURES OF WELDED TITANIUM STRUCTURE ELEMENT DESTRUCTION (RIBBED PANELS UNDER VIBRATION LOADS

    Directory of Open Access Journals (Sweden)

    Mr. Pavel V. Bakhmatov

    2016-12-01

    Full Text Available The article presents data on the experimental studies results of welded ribbed panel vibration load of the BT-20 titanium alloy. It was established that in the areas of attachment, there is elevated dynamic alternating stress, which in combination with the "hard" of the sample holder creates favorable conditions for the emergence and development of fatigue cracks, and stress concentrators greatly reduce the time before the formation of the hearth destruction. An exception in these zones of superficial defects do not affect the nature and kinetics of destruction. Construction of titanium alloys made in the application of gas-laser cutting blanks for optimal regimes in the technical environment of nitrogen and subsequent heat treatment on vibration reliability is not inferior to design, made by traditional technology.

  19. Surficial Geologic Map of Mesa Verde National Park, Montezuma County, Colorado

    Science.gov (United States)

    Carrara, Paul E.

    2012-01-01

    Mesa Verde National Park in southwestern Colorado was established in 1906 to preserve and protect the artifacts and dwelling sites, including the famous cliff dwellings, of the Ancestral Puebloan people who lived in the area from about A.D. 550 to A.D. 1300. In 1978, the United Nations designated the park as a World Heritage Site. The geology of the park played a key role in the lives of these ancient people. For example, the numerous (approximately 600) cliff dwellings are closely associated with the Cliff House Sandstone of Late Cretaceous age, which weathers to form deep alcoves. In addition, the ancient people farmed the thick, red loess (wind-blown dust) deposits on the mesa tops, which because of its particle size distribution has good moisture retention properties. The soil in this loess cover and the seasonal rains allowed these people to grow their crops (corn, beans, and squash) on the broad mesa tops. Today, geology is still an important concern in the Mesa Verde area because the landscape is susceptible to various forms of mass movement (landslides, debris flows, rockfalls), swelling soils, and flash floods that affect the park's archeological sites and its infrastructure (roads, septic systems, utilities, and building sites). The map, which encompasses an area of about 100 mi2 (260 km2), includes all of Mesa Verde National Park, a small part of the Ute Mountain Indian Reservation that borders the park on its southern and western sides, and some Bureau of Land Management and privately owned land to the north and east. Surficial deposits depicted on the map include: artificial fills, alluvium of small ephemeral streams, alluvium deposited by the Mancos River, residual gravel on high mesas, a combination of alluvial and colluvial deposits, fan deposits, colluvial deposits derived from the Menefee Formation, colluvial deposits derived from the Mancos Shale, rockfall deposits, debris flow deposits, earthflow deposits, translational and rotational landslide

  20. Epidural analgesia in patients with traumatic rib fractures

    DEFF Research Database (Denmark)

    Duch, P; Møller, M H

    2015-01-01

    BACKGROUND: Traumatic rib fractures are a common condition associated with considerable morbidity and mortality. Observational studies have suggested improved outcome in patients receiving continuous epidural analgesia (CEA). The aim of the present systematic review of randomised controlled trials...... (RCTs) was to assess the benefit and harm of CEA compared with other analgesic interventions in patients with traumatic rib fractures. METHODS: We performed a systematic review with meta-analysis and trial sequential analysis (TSA). Eligible trials were RCTs comparing CEA with other analgesic...... interventions in patients with traumatic rib fractures. Cumulative relative risks (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were estimated, and risk of systematic and random errors was assessed. The predefined primary outcome measures were mortality, pneumonia and duration...

  1. Cryptococcus haglerorum, sp. nov., an anamorphic basidiomycetous yeast isolated from nests of the leaf-cutting ant Atta sexdens.

    NARCIS (Netherlands)

    Middelhoven, W.J.; Fonseca, A.; Carreiro, S.C.; Pagnocca, F.C.; Bueno, O.C.

    2003-01-01

    A yeast strain (CBS 8902) was isolated from the nest of a leaf-cutting ant and was shown to be related to Cryptococcus humicola. Sequencing of the D1/D2 region of the 26S ribosomal DNA and physiological characterization revealed a separate taxonomic position. A novel species named Cryptococcus

  2. Cuts of dairy-origin cattle fed mesquite pod meal in replacement of corn

    Directory of Open Access Journals (Sweden)

    Marina de Paula Almeida

    2017-09-01

    Full Text Available This study was carried out in order to assess commercial front and rear cuts of dairy-origin cattle fed mesquite pod meal. Twenty-five non-castrated male bovines (Holstein-Zebu, distributed according to a completely randomized design, with five animals per treatment, were used. The feed contained about 121.2 and 544.98 g kg-1 of crude protein and total digestible nutrients, respectively, and was composed of tifton grass hay, cornmeal, soybean meal, mesquite pod meal and mineral salt. The right half carcass of each animal was separated between the 5th and 6th ribs, in front and rear quarters, from which commercial cuts were obtained. There was no effect (p > 0.05 as to the replacement of corn for mesquite pod meal on the weights and yields of front cuts (shoulder, brisket, chuck, hump and flanks and rear cuts (tenderloin, shank, knuckle, thin flank, flat, eye round, rump tail, top side, cap of rump, rump, cut of rump, striploin, cap of cube roll. Mesquite pod meal can substitute cornmeal in 100% in the concentrate without changes in weight and yield of the commercial front and rear cuts of male bovines of dairy origin.

  3. The Efficacy of Platelet-Rich Plasma in the Treatment of Rib Fractures.

    Science.gov (United States)

    Gunay, Samil; Candan, Huseyin; Yılmaz, Rahsan; Eser, Irfan; Aydoğmus, Umit

    2017-10-01

    Background  Rib fracture is the most common result of thoracic traumas. Intrapulmonary shunt, alveolar capillary membrane damage, intra-alveolar hemorrhage, and hypoxia may develop following rib fractures. Therefore, prompt treatment is important. The aim of this experimental study was to analyze the effects of platelet-rich plasma (PRP) on rib fractures to secure a speedier and more efficient treatment method. Materials and Methods  The study involved 18 New Zealand white rabbits, randomly divided into three groups as Group 1, the sham group with no surgical intervention; Group 2, the control group in which simple rib fractures were applied and no treatment; and Group 3, in which rib fractures were applied and then PRP treatment was administered. Results  The mean recovery plate thickness measurements were found to be statistically significantly higher in the PRP group compared with the other groups ( p  rib fractures and used easily in pseudoarthrosis, surgical fracture, or flail chest. Georg Thieme Verlag KG Stuttgart · New York.

  4. Flow instability and critical heat flux in a ribbed annulus

    International Nuclear Information System (INIS)

    Yang, B.W.; Dougherty, T.; Fighetti, C.; Kokolis, S.; Reddy, G.D.; McAssey, E.V. Jr.; Coutts, A.

    1993-01-01

    An experimental program has been conducted to determine the onset of flow instability point in a heated annulus which is divided into four sub channels by non-conducting ribs. The onset of flow instability is identified by the minimum point in the pressure drop-velocity curve. Comparison with a ribless annulus show that the presence of ribs increases the minimum point velocity. In addition, data are presented which show that under certain conditions premature CHF can be induced by the ribs

  5. Vital capacity helps predict pulmonary complications after rib fractures.

    Science.gov (United States)

    Carver, Thomas W; Milia, David J; Somberg, Chloe; Brasel, Karen; Paul, Jasmeet

    2015-09-01

    Traumatic rib fractures are associated with significant morbidity. Vital capacity (VC) assesses pulmonary function; however, limited data link VC to patient outcomes. Our objective was to determine if VC predicted complications and disposition in patients with rib fractures. This is a retrospective chart review of all patients with fractured ribs admitted to a Level 1 trauma center during a 4-year period. Patients were excluded if no VC was performed within 48 hours of admission. Data collected included demographics, hospital/intensive care unit length of stay, epidural, discharge to home versus extended care facility, mortality, chest Abbreviated Injury Scale (AIS) score, Injury Severity Score (ISS), number of rib fractures, hemothorax/pneumothorax, presence of pulmonary contusion, presence of chest tube, chronic obstructive pulmonary disease, and average daily VC (percentage of predicted). Pulmonary complication was defined as pneumonia, need for intubation, new home O2 requirement, readmission for pulmonary issue, or intensive care unit transfer. Statistical analysis was performed using χ and multivariate logistic regression. Of 801 patients with rib fractures, 683 had VC performed within 48 hours. Average age was 53 years, median ISS was 13 (interquartile range, 9-18), and median length of stay was 5 days. Most (72%) were discharged home, and 26% went to extended care facility. Ten percent developed a pulmonary complication, and there were nine deaths. Every 10% increase in VC was associated with 36% decrease in likelihood of pulmonary complication. Patients with a VC greater than 50% had a significantly lower association of pulmonary complication (p = 0.017), and a VC of less than 30% was independently associated with pulmonary complication (odds ratio, 2.36). Patients with fractured ribs and VC of less than 30% have significant association for pulmonary complication. Higher VC is associated with lower likelihood of pulmonary complication. VC may help

  6. Rib head protrusion into the central canal in type 1 neurofibromatosis

    International Nuclear Information System (INIS)

    Ton, Jimmy; Yen, Philip; Stein-Wexler, Rebecca; Gupta, Munish

    2010-01-01

    Intraspinal rib head dislocation is an important but under-recognized consequence of dystrophic scoliosis in patients with neurofibromatosis 1 (NF1). To present clinical and imaging findings of intraspinal rib head dislocation in NF1. We retrospectively reviewed clinical presentation, imaging, operative reports and post-operative courses in four NF1 patients with intraspinal rib head dislocation and dystrophic scoliosis. We also reviewed 17 cases from the English literature. In each of our four cases of intraspinal rib head dislocation, a single rib head was dislocated on the convex apex of the curve, most often in the mid- to lower thoracic region. Cord compression occurred in half of these patients. Analysis of the literature yielded similar findings. Only three cases in the literature demonstrates the MRI appearance of this entity; most employ CT. All of our cases include both MRI and CT; we review the subtle findings on MRI. Although intraspinal rib head dislocation is readily apparent on CT, sometimes MRI is the only cross-sectional imaging performed. It is essential that radiologists become familiar with this entity, as subtle findings have significant implications for surgical management. (orig.)

  7. Isolation and Selection of Epiphytic Yeast for Biocontrol of Botrytis cinerea Pers. on Table Grapes Aislación y Selección de Levaduras Epífitas para el Biocontrol de Botrytis cinerea Pers. en Uva de Mesa

    Directory of Open Access Journals (Sweden)

    Marisol Vargas

    2012-09-01

    Full Text Available Botrytis cinerea Pers., the causal agent of gray mold, infects more than 200 plant species. This pathogen has traditionally been controlled by fungicides. However, with the increasing demand for pesticide-free foods new control strategies are needed. The objective of this study was to isolate and select grapevine (Vitis vinifera L. epiphytic yeasts for the biocontrol of B. cinerea in table grapes. Of the total isolated yeasts (n = 256, 32 exhibited mycelial growth inhibition in dual cultures with a halo > 4 mm, and eight of these isolates inhibited > 90% of conidial germination. When evaluating increasing concentrations on conidial germination inhibition, a dose-dependent response was observed with EC90 values from 0.45 x 10(5 to 0.22 x 10(8 cells mL-1. The antagonistic activity of six yeasts against B. cinerea in table grape berries 'Flame Seedless' increased as the yeast colonization time increased from 1 to 24 h on the berries, resulting in a higher biocontrol activity on B. cinerea. These results show the effectiveness of grapevine epiphytic yeasts as biocontrol agents of B. cinerea on table grapes.Botrytis cinerea Pers., agente causal de la pudrición gris, infecta a más de 200 especies vegetales. Tradicionalmente, este patógeno ha sido controlado con fungicidas; sin embargo, la creciente demanda de alimentos libres de pesticidas hace necesario el uso de nuevas estrategias de control. El objetivo de este estudio fue aislar y seleccionar levaduras epífitas de vid (Vitis vinifera L. para el biocontrol de B. cinerea en uva de mesa. Del total de levaduras aisladas (n = 256, 32 presentaron inhibición del crecimiento micelial, en cultivos duales, con un halo > 4 mm y ocho de estos aislamientos inhibieron la germinación de conidias > 90%. Al evaluar concentraciones crecientes de levaduras sobre la inhibición de la germinación de conidias, se observó una respuesta dosis-dependiente, con valores de CE90 de 0,45 x 10(5 a 0,22 x 10(8 c

  8. Improving vertebra segmentation through joint vertebra-rib atlases

    Science.gov (United States)

    Wang, Yinong; Yao, Jianhua; Roth, Holger R.; Burns, Joseph E.; Summers, Ronald M.

    2016-03-01

    Accurate spine segmentation allows for improved identification and quantitative characterization of abnormalities of the vertebra, such as vertebral fractures. However, in existing automated vertebra segmentation methods on computed tomography (CT) images, leakage into nearby bones such as ribs occurs due to the close proximity of these visibly intense structures in a 3D CT volume. To reduce this error, we propose the use of joint vertebra-rib atlases to improve the segmentation of vertebrae via multi-atlas joint label fusion. Segmentation was performed and evaluated on CTs containing 106 thoracic and lumbar vertebrae from 10 pathological and traumatic spine patients on an individual vertebra level basis.