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Sample records for db-wbmra initial experience

  1. Initial Cooling Experiment (ICE)

    CERN Multimedia

    Photographic Service

    1978-01-01

    In 1977, in a record-time of 9 months, the magnets of the g-2 experiment were modified and used to build a proton/antiproton storage ring: the "Initial Cooling Experiment" (ICE). It served for the verification of the cooling methods to be used for the "Antiproton Project". Stochastic cooling was proven the same year, electron cooling followed later. Also, with ICE the experimental lower limit for the antiproton lifetime was raised by 9 orders of magnitude: from 2 microseconds to 32 hours. For its previous life as g-2 storage ring, see 7405430. More on ICE: 7711282, 7809081, 7908242.

  2. Initial Egyptian ECMO experience

    Directory of Open Access Journals (Sweden)

    Akram Abdelbary

    2016-04-01

    Results: A total of twelve patients received ECMO between January 2014 and June 2015. The mean age was 35.9 years. (range 13–65 years, 8 males, with VV ECMO in 10 patients, and VA ECMO in 2 patients. Out of ten patients of VV ECMO, one had H1N1 pneumonia, one had advanced vasculitic lung, four had bacterial pneumonia, two traumatic lung contusions and one with organophosphorus poisoning, and one undiagnosed etiology leading to severe ARDS. Lung injury score range was 3–3.8, PaO2/FiO2 (20–76 mechanical ventilation duration before ECMO 1–14 days, Femoro-jugular cannulation in 7 patients and femoro-femoral in 2 patients and femoro-subclavian in 1 patient; all patients were initially sedated and paralyzed for (2–4 days and ventilated on pressure controlled ventilation with Pmax of 25 cm H2O and PEEP of 10 cm H2O. In VA ECMO patients were cannulated percutaneously using femoro-femoral approach. One patient showed no neurologic recovery and died after 24 h, the other had CABG on ECMO however the heart didn’t recover and died after 9 days. Heparin intravenous infusion was used initially in all patients and changed to Bivalirudin in 2 patients due to possible HIT. Pump flow ranged from 2.6 to 6.5 L/min. Average support time was 12 days (range 2–24 days. Seven patients (63.3% were successfully separated from ECMO and survived to hospital discharge. Hospital length of stay ranged from 3 to 42 days, tracheostomy was done percutaneously in 5 patients and surgically in 3. Gastrointestinal bleeding occurred in 6 patients, VAP in 7 patients, neurologic complications in 1 patient with complete recovery, cardiac arrhythmias in 3 patients, pneumothorax in 9 patients, and deep venous thrombosis in 2 patients.

  3. INITIAL COOLING EXPERIMENT (ICE)

    CERN Multimedia

    1979-01-01

    ICE was built in 1977, using the modified bending magnets of the g-2 muon storage ring (see 7405430). Its purpose was to verify the validity of stochastic and electron cooling for the antiproton project. Stochastic cooling proved a resounding success early in 1978 and the antiproton project could go ahead, now entirely based on stochastic cooling. Electron cooling was experimented with in 1979. The 26 kV equipment is housed in the cage to the left of the picture, adjacent to the "e-cooler" located in a straight section of the ring. With some modifications, the cooler was later transplanted into LEAR (Low Energy Antiproton Ring) and then, with further modifications, into the AD (Antiproton Decelerator), where it cools antiprotons to this day (2006). See also: 7711282, 7802099, 7809081.

  4. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    2011-01-01

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field...... with a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with respect...... understandings of idea work are inscribed in the idea promoting initiatives as they to some degree have to fit with the understandings embedded in practice in order to work....

  5. EXPERIENCES WITH IDEA PROMOTING INITIATIVES

    DEFF Research Database (Denmark)

    Gish, Liv

    2011-01-01

    In new product development a central activity is to provide new ideas. Over the last decades experiences with stimulating employee creativity and establishing idea promoting initiatives have been made in industrial practice. Such initiatives are often labeled Idea Management – a research field...... with a growing interest. In this paper I examine three different idea promoting initiatives carried out in Grundfos, a leading pump manufacturer. In the analysis I address what understandings of idea work are inscribed in the initiatives and what role these initiatives play in the organization with respect...... understandings of idea work are inscribed in the idea promoting initiatives as they to some degree have to fit with the understandings embedded in practice in order to work....

  6. Energy efficiency initiatives: Indian experience

    Energy Technology Data Exchange (ETDEWEB)

    Dey, Dipankar [ICFAI Business School, Kolkata, (IBS-K) (India)

    2007-07-01

    India, with a population of over 1.10 billion is one of the fastest growing economies of the world. As domestic sources of different conventional commercial energy are drying up, dependence on foreign energy sources is increasing. There exists a huge potential for saving energy in India. After the first 'oil shock' (1973), the government of India realized the need for conservation of energy and a 'Petroleum Conservation Action Group' was formed in 1976. Since then many initiatives aiming at energy conservation and improving energy efficiency, have been undertaken (the establishment of Petroleum Conservation Research Association in 1978; the notification of Eco labelling scheme in 1991; the formation of Bureau of Energy Efficiency in 2002). But no such initiative was successful. In this paper an attempt has been made to analyze the changing importance of energy conservation/efficiency measures which have been initiated in India between 1970 and 2005.The present study tries to analyze the limitations and the reasons of failure of those initiatives. The probable reasons are: fuel pricing mechanism (including subsidies), political factors, corruption and unethical practices, influence of oil and related industry lobbies - both internal and external, the economic situation and the prolonged protection of domestic industries. Further, as India is opening its economy, the study explores the opportunities that the globally competitive market would offer to improve the overall energy efficiency of the economy. The study suggests that the Bureau of Energy Efficiency (BEE) - the newly formed nodal agency for improving energy efficiency of the economy may be made an autonomous institution where intervention from the politicians would be very low. For proper implementation of different initiatives to improve energy efficiency, BEE should involve more the civil societies (NGO) from the inception to the implementation stage of the programs. The paper also

  7. Robonaut Mobile Autonomy: Initial Experiments

    Science.gov (United States)

    Diftler, M. A.; Ambrose, R. O.; Goza, S. M.; Tyree, K. S.; Huber, E. L.

    2006-01-01

    A mobile version of the NASA/DARPA Robonaut humanoid recently completed initial autonomy trials working directly with humans in cluttered environments. This compact robot combines the upper body of the Robonaut system with a Segway Robotic Mobility Platform yielding a dexterous, maneuverable humanoid ideal for interacting with human co-workers in a range of environments. This system uses stereovision to locate human teammates and tools and a navigation system that uses laser range and vision data to follow humans while avoiding obstacles. Tactile sensors provide information to grasping algorithms for efficient tool exchanges. The autonomous architecture utilizes these pre-programmed skills to form complex behaviors. The initial behavior demonstrates a robust capability to assist a human by acquiring a tool from a remotely located individual and then following the human in a cluttered environment with the tool for future use.

  8. Return to Experience and Initial Wage Level

    DEFF Research Database (Denmark)

    Sørensen, Kenneth Lykke; Vejlin, Rune Majlund

    This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to nonparametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationship...

  9. Return to experience and initial wage level

    DEFF Research Database (Denmark)

    Sørensen, K.L.; Vejlin, R.

    2014-01-01

    This paper estimates the relationship between initial wage and return to experience. We use a Mincer-like wage model to non-parametrically estimate this relationship allowing for an unobservable individual permanent effect in wages and unobservable individual return to experience. The relationshi...

  10. Initial conditions of radiative shock experiments

    Energy Technology Data Exchange (ETDEWEB)

    Kuranz, C. C.; Drake, R. P.; Krauland, C. M.; Marion, D. C.; Grosskopf, M. J.; Rutter, E.; Torralva, B.; Holloway, J. P. [Department of Atmospheric, Oceanic and Space Science, University of Michigan, Center for Radiative Shock Hydrodynamics, 2455 Hayward Dr., Ann Arbor, Michigan 48109 (United States); Bingham, D.; Goh, J. [Department of Statistics and Actuarial Science, Simon Fraser University, Burnaby, BC, Canada V5A 1S6 (Canada); Boehly, T. R.; Sorce, A. T. [Laboratory for Laser Energetics, University of Rochester, New York 14623 (United States)

    2013-05-15

    We performed experiments at the Omega Laser Facility to characterize the initial, laser-driven state of a radiative shock experiment. These experiments aimed to measure the shock breakout time from a thin, laser-irradiated Be disk. The data are then used to inform a range of valid model parameters, such as electron flux limiter and polytropic γ, used when simulating radiative shock experiments using radiation hydrodynamics codes. The characterization experiment and the radiative shock experiment use a laser irradiance of ∼7 × 10{sup 14} W cm{sup −2} to launch a shock in the Be disk. A velocity interferometer and a streaked optical pyrometer were used to infer the amount of time for the shock to move through the Be disk. The experimental results were compared with simulation results from the Hyades code, which can be used to model the initial conditions of a radiative shock system using the CRASH code.

  11. Initial state radiation experiment at MAMI

    Directory of Open Access Journals (Sweden)

    Mihovilovič M.

    2014-05-01

    Full Text Available In an attempt to contribute further insight into the discrepancy between the Lamb shift and elastic scattering determinations of the proton charge radius, a new experiment at MAMI is underway, aimed at measuring proton form-factors at very low momentum transfers by using a new technique based on initial state radiation. This paper reports on the conclusions of the pilot measurement performed in 2010, whose main goal was to check the feasibility of the proposed experiment and to recognize and overcome any obstacles before running the full experiment. The modifications to the experimental apparatus are then explained which significantly improved the quality of data collected in the full scale experiment, which was successfully executed in August 2013. At the end first findings of the new experiment are discussed.

  12. Initial Commissioning Experience With the LCLS Injector

    Energy Technology Data Exchange (ETDEWEB)

    Akre, R.; Castro, J.; Ding, Y.; Dowell, D.H.; Emma, P.; Frisch, J.; Gilevich, A.; Hays, G.; Hering, P.; Huang, Z.; Iverson, R.; Krejcik, P.; Limborg-Deprey, C.; Loos, H.; Miahnahri, A.; Rivetta, C.; Saleski, M.; Schmerge, J.F.; Schultz, D.; Turner, J.; Welch, J.; /SLAC /DESY

    2007-11-02

    The Linac Coherent Light Source (LCLS) is a SASE xray Free-Electron Laser (FEL) project presently under construction at SLAC [1]. The injector section, from drive-laser and RF photocathode gun through first bunch compressor chicane, was installed in fall 2006. Initial system commissioning with an electron beam is taking place during the spring and summer of 2007. The second phase of construction, including second bunch compressor and full linac, will begin later, in the fall of 2007. We report here on experience gained during the first phase of machine commissioning, including RF photocathode gun, linac booster section, S-band and X-band RF systems, first bunch compressor, and the various beam diagnostics.

  13. Barrier experiment: Shock initiation under complex loading

    Energy Technology Data Exchange (ETDEWEB)

    Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2016-01-12

    The barrier experiments are a variant of the gap test; a detonation wave in a donor HE impacts a barrier and drives a shock wave into an acceptor HE. The question we ask is: What is the trade-off between the barrier material and threshold barrier thickness to prevent the acceptor from detonating. This can be viewed from the perspective of shock initiation of the acceptor subject to a complex pressure drive condition. Here we consider key factors which affect whether or not the acceptor undergoes a shock-to-detonation transition. These include the following: shock impedance matches for the donor detonation wave into the barrier and then the barrier shock into the acceptor, the pressure gradient behind the donor detonation wave, and the curvature of detonation front in the donor. Numerical simulations are used to illustrate how these factors affect the reaction in the acceptor.

  14. Liver transplantations in Bulgaria--initial experience.

    Science.gov (United States)

    Vladov, N; Mihaylov, V; Takorov, I; Vasilevski, I; Lukanova, T; Odisseeva, E; Katzarov, K; Simonova, M; Tomova, D; Konakchieva, M; Petrov, N; Mladenov, N; Sergeev, S; Mutafchiiski, V

    2014-01-01

    The filed of liver transplantation (LT) continues to evolve and is highly effective therapy for many patients with acute and chronic liver failure resulting from a variety of causes. Improvement of perioperative care, surgical technique and immunosuppression in recent years has led to its transformation into a safe and routine procedure with steadily improving results. The aim of this paper is to present the initial experience of the transplant team at Military Medical Academy - Sofia, Bulgaria. For the period of April 2007 - August 2014 the team performed 38 liver transplants in 37 patients (one retransplantation). Patients were followed up prospectively and retrospectively. In 36 (95%) patients a graft from a cadaveric donor was used and in two cases--a right liver grafts from live donor. The mean MELD score of the transplanted patients was 17 (9-40). The preferred surgical technique was "piggyback" with preservation of inferior vena cava in 33 (86%) of the cases and classical technique in 3 (8%) patients. The overall complication rate was 48%. Early mortality rate was 13% (5 patients). The overall 1- and 5-year survival is 81% and 77% respectivelly. The setting of a new LT program is a complex process which requires the effort and effective colaboration of a wide range of speciacialists (hepatologists, surgeons, anesthesiologists, psychologists, therapists, coordinators, etc.) and institutions. The good results are function of a proper selection of the donors and the recipients. Living donation is an alternative in the shortage of cadaveric donors.

  15. Experiences of Racism in Initial Teacher Education.

    Science.gov (United States)

    Garewal, Gurpreet

    1999-01-01

    Explores trainee teachers' perceptions and projections of racial discrimination while taking the postcompulsory teaching course in England. Experiences of four trainee teachers highlight the need for more support for teacher trainees, more cultural sensitivity among teacher educators, and the inclusion of cultural and racial issues in the course.…

  16. Initial experiments with Multiple Musical Gestures

    DEFF Research Database (Denmark)

    Jensen, Kristoffer; Graugaard, Lars

    2005-01-01

    The classic orchestra has a diminishing role in society, while hard-disc recorded music plays a predominant role today. A simple to use pointer interface in 2D for producing music is presented as a means for playing in a social situation. The sounds of the music are produced by a low......-level synthesizer, and the music is produced by simple gestures that are repeated easily. The gestures include left-to-right and right-to-left motion shapes for spectral envelope and temporal envelope of the sounds, with optional backwards motion for the addition of noise; downward motion for note onset and several...... other manipulation gestures. The initial position controls which parameter is being affected, the notes intensity is controlled by the downward gesture speed, and a sequence is finalized instantly with one upward gesture. The synthesis employs a novel interface structure, the multiple musical gesture...

  17. Women's initial experience of abnormal papanicolaou smear.

    Science.gov (United States)

    Mitchell, Susan; Hall, Vincent P

    2009-06-01

    To discover the early subjective experience of women affected by abnormal Papanicolaou smear, a qualitative study was undertaken with 8 North Carolina women, 4 to 12 months postnotification of their first abnormal result. Data were analyzed via grounded theory methodology to identify a core theory that could guide interventions to improve follow-up for cancer prevention. This theoretical process is described as a labyrinth journey-an imperative healing process undertaken by all participants, who undertook the following tasks: evaluating peril, seeking refuge, obtaining information, and reframing their self-image. Women who also learned they were infected with the human papillomavirus faced a prolonged sense of threat to their sense of sexual well-being. Their additional tasks related to reevaluating their sexual self-image, and they continued to work on these reframing tasks throughout their 1st year's journey. Progress through the labyrinth depended upon emotional or spiritual support, nonjudgmental acceptance and access to accurate information.

  18. SNS Target Systems initial operating experience

    Science.gov (United States)

    McManamy, T.; Forester, J.

    2009-02-01

    The SNS mercury target started operation with low beam power when commissioned on April 28, 2006. The beam power has been following a planned ramp up since then and has reached 340 kW as of February 2008. The target systems supporting neutron production include the target and mercury loop, the cryogenic and ambient moderator systems, reflector and vessel systems, bulk shielding and shutters systems, utility systems, remote handling systems and the associated instrumentation and controls. Availability for these systems has improved with time and reached 100% for the first 2000 hour neutron production run in fiscal year 2008. An overview of the operating experience and the planning to support continued power increases to 1.4 MW for these systems will be given in this paper.

  19. Initial experience with robot-assisted varicocelectomy

    Institute of Scientific and Technical Information of China (English)

    Tung Shu; Shaya Taghechian; Run Wang

    2008-01-01

    Aim: To determine if robot-assisted varicocelectomy can be safely and effectively performed when compared microscopic inguinal varicocelectomy. Methods: Eight patients aged 29.1 ± 12.5 years underwent microscopic subinguinal varicocelectomies: seven patients with left-sided repair, and one patient with bilateral repair. Eight patients aged 22.0 ± 8.0 years underwent robot-assisted varicocelectomies: seven patients with left-sided repair and one patient with bilateral repair. Results: The average operative time for microscopic inguinal varicocelectomy was 73.9 ± 12.2 min, whereas the robot-assisted technique took 71.1 ± 21.1 min. There were no difficulties in identifying and isolating vessels and the vas deferens with robot-assisted subinguinal varicocelectomy. Hand tremor was eliminated using the robotic procedure. Patients who underwent either microscopic or robot-assisted varicocelectomies were able to resume daily activities on the day of surgery and full activities within 2 weeks. There were complications or recurrences of varicocele. Conclusion: From our experience, compared to microscopic surgery,robot-assisted varicocelectomy can be safely and effectively performed, with the added benefit of eliminating hand tremor.

  20. Initial performance of the CUORE-0 experiment

    Energy Technology Data Exchange (ETDEWEB)

    Artusa, D.R. [University of South Carolina, Department of Physics and Astronomy, Columbia, SC (United States); INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); Avignone, F.T.; Chott, N.; Creswick, R.J.; Farach, H.A.; Rosenfeld, C.; Wilson, J. [University of South Carolina, Department of Physics and Astronomy, Columbia, SC (United States); Azzolini, O.; Keppel, G.; Palmieri, V. [INFN-Laboratori Nazionali di Legnaro, Padua (Italy); Balata, M.; Bucci, C.; Canonica, L.; Casali, N.; Di Vacri, M.L.; Goett, J.; Gorla, P.; Nisi, S.; Orlandi, D.; Pattavina, L.; Pirro, S.; Zarra, C. [INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); Banks, T.I. [INFN-Laboratori Nazionali del Gran Sasso, L' Aquila (Italy); University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Bari, G.; Deninno, M.M.; Moggi, N. [INFN-Sezione di Bologna, Bologna (Italy); Beeman, J. [Lawrence Berkeley National Laboratory, Materials Science Division, Berkeley, CA (United States); Bellini, F.; Cardani, L.; Cosmelli, C.; Ferroni, F.; Piperno, G. [Sapienza Universita di Roma, Dipartimento di Fisica, Rome (Italy); INFN-Sezione di Roma, Rome (Italy); Bersani, A. [INFN-Sezione di Genova, Genoa (Italy); Biassoni, M.; Brofferio, C.; Capelli, S.; Carrettoni, M.; Chiesa, D.; Clemenza, M.; Faverzani, M.; Ferri, E.; Fiorini, E.; Giachero, A.; Gironi, L.; Gotti, C.; Maiano, C.; Maino, M.; Nucciotti, A.; Pavan, M.; Sala, E.; Sisti, M.; Terranova, F.; Zanotti, L. [Universita di Milano-Bicocca, Dipartimento di Fisica, Milan (Italy); INFN-Sezione di Milano Bicocca, Milan (Italy); Cai, X.Z.; Cao, X.G.; Fang, D.Q.; Li, Y.L.; Ma, Y.G.; Tian, W.D.; Wang, H.W. [Shanghai Institute of Applied Physics (Chinese Academy of Sciences), Shanghai (China); Carbone, L.; Cremonesi, O.; Datskov, V.; Pessina, G.; Previtali, E.; Rusconi, C. [INFN-Sezione di Milano Bicocca, Milan (Italy); Dafinei, I.; Morganti, S.; Orio, F.; Pettinacci, V.; Tomei, C.; Vignati, M. [INFN-Sezione di Roma, Rome (Italy); Dally, A.; Ejzak, L.; Wielgus, L. [University of Wisconsin, Department of Physics, Madison, WI (United States); Di Domizio, S.; Fernandes, G.; Pallavicini, M. [INFN-Sezione di Genova, Genoa (Italy); Universita di Genova, Dipartimento di Fisica, Genoa (Italy); Freedman, S.J. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Fujikawa, B.K.; Han, K.; Mei, Y. [Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Giuliani, A.; Tenconi, M. [Centre de Spectrometrie Nucleaire et de Spectrometrie de Masse, Orsay Campus (France); Gutierrez, T.D. [California Polytechnic State University, Physics Department, San Luis Obispo, CA (United States); Haller, E.E. [Lawrence Berkeley National Laboratory, Materials Science Division, Berkeley, CA (United States); University of California, Department of Materials Science and Engineering, Berkeley, CA (United States); Heeger, K.M.; Lim, K.E.; Maruyama, R.H. [Yale University, Department of Physics, New Haven, CT (United States); Hennings-Yeomans, R.; Ouellet, J.L. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Nuclear Science Division, Berkeley, CA (United States); Huang, H.Z.; Liu, X.; Trentalange, S.; Winslow, L.A.; Zhu, B.X. [University of California, Department of Physics and Astronomy, Los Angeles, CA (United States); Kadel, R. [Lawrence Berkeley National Laboratory, Physics Division, Berkeley, CA (United States); Kazkaz, K.; Pedretti, M.; Sangiorgio, S.; Scielzo, N.D. [Lawrence Livermore National Laboratory, Livermore, CA (United States); Kolomensky, Yu.G. [University of California, Department of Physics, Berkeley, CA (United States); Lawrence Berkeley National Laboratory, Physics Division, Berkeley, CA (United States); Martinez, M. [Universidad de Zaragoza, Laboratorio de Fisica Nuclear y Astroparticulas, Saragossa (Spain); Nones, C. [Service de Physique des Particules, CEA/Saclay, Gif-sur-Yvette (France); Norman, E.B.; Wang, B.S. [Lawrence Livermore National Laboratory, Livermore, CA (United States); University of California, Department of Nuclear Engineering, Berkeley, CA (United States); O' Donnell, T. [University of California, Department of Physics, Berkeley, CA (United States); Smith, A.R. [Lawrence Berkeley National Laboratory, EH and S Division, Berkeley, CA (United States); Taffarello, L. [INFN-Sezione di Padova, Padua (Italy); Ventura, G. [Universita di Firenze, Dipartimento di Fisica, Florence (Italy); INFN-Sezione di Firenze, Florence (Italy); Wise, T. [University of Wisconsin, Department of Physics, Madison, WI (United States); Yale University, Department of Physics, New Haven, CT (United States); Zucchelli, S. [INFN-Sezione di Bologna, Bologna (Italy); Universita di Bologna, Dipartimento di Fisica, Bologna (Italy)

    2014-08-15

    CUORE-0 is a cryogenic detector that uses an array of tellurium dioxide bolometers to search for neutrinoless double-beta decay of {sup 130}Te. We present the first data analysis with 7.1kg . y of total TeO{sub 2} exposure focusing on background measurements and energy resolution. The background rates in the neutrinoless double-beta decay region of interest (2.47 to 2.57MeV) and in the α backgrounddominated region (2.70 to 3.90 MeV) have been measured to be 0.071 ± 0.011 and 0.019 ± 0.002 counts/(keV . kg . y), respectively. The latter result represents a factor of 6 improvement from a predecessor experiment, Cuoricino. The results verify our understanding of the background sources in CUORE-0, which is the basis of extrapolations to the full CUORE detector. The obtained energy resolution (full width at half maximum) in the region of interest is 5.7 keV. Based on themeasured background rate and energy resolution in the region of interest, CUORE-0 half-life sensitivity is expected to surpass the observed lower bound of Cuoricino with one year of live time. (orig.)

  1. Initial performance of the CUORE-0 experiment

    CERN Document Server

    Aguirre, C P; Avignone, F T; Azzolini, O; Balata, M; Banks, T I; Bari, G; Beeman, J; Bellini, F; Bersani, A; Biassoni, M; Brofferio, C; Bucci, C; Cai, X Z; Canonica, L; Cao, X G; Capelli, S; Carbone, L; Cardani, L; Carrettoni, M; Casali, N; Chiesa, D; Chott, N; Clemenza, M; Cosmelli, C; Cremonesi, O; Creswick, R J; Dafinei, I; Dally, A; Datskov, V; Deninno, M M; Di Domizio, S; di Vacri, M L; Ejzak, L; Fang, D Q; Farach, H A; Faverzani, M; Fernandes, G; Ferri, E; Ferroni, F; Fiorini, E; Freedman, S J; Fujikawa, B K; Giachero, A; Gironi, L; Giuliani, A; Goett, J; Gorla, P; Gotti, C; Gutierrez, T D; Haller, E E; Han, K; Heeger, K M; Hennings-Yeomans, R; Huang, H Z; Kadel, R; Kazkaz, K; Keppel, G; Kolomensky, Yu G; Li, Y L; Lim, K E; Liu, X; Ma, Y G; Maiano, C; Maino, M; Martinez, M; Maruyama, R H; Mei, Y; Moggi, N; Morganti, S; Nisi, S; Nones, C; Norman, E B; Nucciotti, A; O'Donnell, T; Orio, F; Orlandi, D; Ouellet, J L; Pallavicini, M; Palmieri, V; Pattavina, L; Pavan, M; Pedretti, M; Pessina, G; Pettinacci, V; Piperno, G; Pirro, S; Previtali, E; Rosenfeld, C; Rusconi, C; Sala, E; Sangiorgio, S; Scielzo, N D; Sisti, M; Smith, A R; Taffarello, L; Tenconi, M; Terranova, F; Tian, W D; Tomei, C; Trentalange, S; Vignati, M; Wang, B S; Wang, H W; Wielgus, L; Wilson, J; Winslow, L A; Wise, T; Zanotti, L; Zarra, C; Zhu, B X; Zucchelli, S

    2014-01-01

    CUORE-0 is a cryogenic detector that uses an array of tellurium dioxide bolometers to search for neutrinoless double-beta decay of ^{130}Te. We present the first data analysis with 7.1 kg y of total TeO_2 exposure focusing on background measurements and energy resolution. The background rates in the neutrinoless double-beta decay region of interest (2.47 to 2.57 MeV) and in the {\\alpha} background-dominated region (2.70 to 3.90 MeV) have been measured to be 0.071 \\pm 0.011 and 0.019 \\pm 0.002 counts/keV/kg/y, respectively. The latter result represents a factor of 6 improvement from a predecessor experiment, Cuoricino. The results verify our understanding of the background sources in CUORE-0, which is the basis of extrapolations to the full CUORE detector. The obtained energy resolution (full width at half maximum) in the region of interest is 5.7 keV. Based on the measured background rate and energy resolution in the region of interest, CUORE-0 half-life sensitivity is expected to surpass the observed lower b...

  2. Laparoscopic nephrectomy: initial experience with 120 cases.

    LENUS (Irish Health Repository)

    Cheema, I A

    2012-02-01

    Laparoscopic nephrectomy for both benign and malignant diseases of kidney is increasingly being performed. We report our experience with the first 120 consecutive laparoscopic nephrectomy performed in our hospital. It is the retrospective analysis of a prospectively maintained database of 4 years period. The parameters examined included age, gender, indications, operative time, blood loss, intraoperative and post operative complications. Mean age of surgery was 59 years (rang 19-84years). The indications for surgery included solid renal masses (71 patients), non-functioning kidneys (43), and collecting system tumours (6). The mean operating time was 132 minutes (range 75-270), average blood loss was 209 ml (range 0-1090) and average hospital stay was 4.7days (range 2-20). Bleeding, bowel injury and poor progression of laparoscopic procedure were the reasons in 7 (5.8%) cases converted to open surgery. There was 1 (0.8%) perioperative mortality. Eight (6.6%) patients developed post operative complications. Laparoscopic nephrectomy has inherent benefits and may be considered an alternate therapeutic option for kidney diseases with acceptable morbidity

  3. Laparoscopic nephrectomy: initial experience with 120 cases.

    LENUS (Irish Health Repository)

    Cheema, I A

    2010-02-01

    Laparoscopic nephrectomy for both benign and malignant diseases of kidney is increasingly being performed. We report our experience with the first 120 consecutive laparoscopic nephrectomy performed in our hospital. It is the retrospective analysis of a prospectively maintained database of 4 years period. The parameters examined included age, gender, indications, operative time, blood loss, intraoperative and post operative complications. Mean age of surgery was 59 years (rang 19-84years). The indications for surgery included solid renal masses (71 patients), non-functioning kidneys (43), and collecting system tumours (6). The mean operating time was 132 minutes (range 75-270), average blood loss was 209 ml (range 0-1090) and average hospital stay was 4.7days (range 2-20). Bleeding, bowel injury and poor progression of laparoscopic procedure were the reasons in 7 (5.8%) cases converted to open surgery. There was 1 (0.8%) perioperative mortality. Eight (6.6%) patients developed post operative complications. Laparoscopic nephrectomy has inherent benefits and may be considered an alternate therapeutic option for kidney diseases with acceptable morbidity

  4. Initial predictions in learning-to-forecast experiment

    NARCIS (Netherlands)

    C. Diks; T. Makarewicz

    2012-01-01

    In this paper we estimate the distribution of the initial predictions of the Heemeijer et al. [5] Learning-to-Forecast experiment. By design, these initial predictions were uninformed. We show that in fact they have a non-continuous distribution and that they systematically under-evaluate the fundam

  5. The NIF Shear Experiment: Emergent Coherent Structures and Initial Conditions

    Science.gov (United States)

    Flippo, K. A.; Doss, F. W.; Merritt, E. C.; di Stefano, C. A.; Devolder, B. G.; Kurien, S.; Kot, L.; Loomis, E. N.; Murphy, T. J.; Perry, T. S.; Kline, J. L.; Huntington, C. M.; Nagel, S. R.; MacLaren, S. A.; Schmidt, D. W.

    2016-10-01

    The NIF Shear experiments are designed to stress turbulence models at high Atwood numbers, high convective Mach number, and in a highly compressible regime. The NIF laser system is used to drive two hohlraums on either end of the experiment, which convert the laser drive into a bath of soft x-rays, 250eV in temperature. The counter-propagating shocks and flow, pressure balance the shear layer, such that it can grow due to the KH instability in the center of the experiment for 20 ns. These experiments are the first High Energy Density (HED) hydro-instability studies to show emergent coherent Kelvin-Helmholtz (KH) structures arising from random broadband seeds, and the first to control the phenomenological evolution of the tracer layer by controlling the initial surface roughness conditions. The change in initial conditions forces the system evolution on a different path that does not appear to reach a universal nor self-similar state by the end of the experiment. The experiment was modeled using the multi-physics hydrodynamic code RAGE with the BHR turbulence model. The initial scale-length of the model is modified to match the data. When the model is turned off, the pure hydrodynamics do not capture the behavior of the mixing layer and cannot match the data.

  6. Initial Homosexual Experiences of MSM in Surat City

    Directory of Open Access Journals (Sweden)

    Kumar Mukesh, Bansal RK

    2010-06-01

    Full Text Available This cross-sectional study among 200 Men having sex with men in Surat City explores their initial MSM experiences. Our findings reveal that MSM are sexually active with slightly more bisexual than homosexual. Over half had their first homosexual attraction and relationships before the age of 14 years commonly while playing with friends, though some were forced or raped into their first MSM experience by cousin, friend or elders and care takers. 94% the second homosexual encounter had occurred within 3 months of the first homosexual encounter. These two initial MSM experiences play an important role in future MSM inclinations and highlight the need to ensure that children do not enter into such early relationships before the age of consent. What merits special attention is that these experiences invariably occur during adolescence and their impression makes a lasting effect on their psyche and sexual inclination lifelong. Receptive anal sex emerges as the most common sexual act (89.5% and as the commonest reason for continuing with MSM relationships (26.5%. Friends are the main source (99.5% of entry into an MSM group.

  7. Dynamic crack initiation toughness : experiments and peridynamic modeling.

    Energy Technology Data Exchange (ETDEWEB)

    Foster, John T.

    2009-10-01

    This is a dissertation on research conducted studying the dynamic crack initiation toughness of a 4340 steel. Researchers have been conducting experimental testing of dynamic crack initiation toughness, K{sub Ic}, for many years, using many experimental techniques with vastly different trends in the results when reporting K{sub Ic} as a function of loading rate. The dissertation describes a novel experimental technique for measuring K{sub Ic} in metals using the Kolsky bar. The method borrows from improvements made in recent years in traditional Kolsky bar testing by using pulse shaping techniques to ensure a constant loading rate applied to the sample before crack initiation. Dynamic crack initiation measurements were reported on a 4340 steel at two different loading rates. The steel was shown to exhibit a rate dependence, with the recorded values of K{sub Ic} being much higher at the higher loading rate. Using the knowledge of this rate dependence as a motivation in attempting to model the fracture events, a viscoplastic constitutive model was implemented into a peridynamic computational mechanics code. Peridynamics is a newly developed theory in solid mechanics that replaces the classical partial differential equations of motion with integral-differential equations which do not require the existence of spatial derivatives in the displacement field. This allows for the straightforward modeling of unguided crack initiation and growth. To date, peridynamic implementations have used severely restricted constitutive models. This research represents the first implementation of a complex material model and its validation. After showing results comparing deformations to experimental Taylor anvil impact for the viscoplastic material model, a novel failure criterion is introduced to model the dynamic crack initiation toughness experiments. The failure model is based on an energy criterion and uses the K{sub Ic} values recorded experimentally as an input. The failure model

  8. Team learning in medical education: initial experiences at ten institutions.

    Science.gov (United States)

    Searle, Nancy S; Haidet, Paul; Kelly, P Adam; Schneider, Virginia F; Seidel, Charles L; Richards, Boyd F

    2003-10-01

    In the midst of curricular reforms that frequently call for reducing lectures and increasing small-group teaching, there is a crisis in faculty time for teaching. This paper describes the initial experiences of ten institutions with team learning (TL), a teaching method which fosters small-group learning in a large-class setting. After initial pilot studies at one institution, nine additional institutions implemented TL in one or more courses. Within 18 months, TL has been used in 40 courses (from.5% to 100% of the time) and all ten institutions will increase its use next year. We surmise that this relatively rapid spread of TL into the medical curriculum is due to the sound pedagogy and efficiency of TL as well as the modest financial resources and support we have provided to partner institutions.

  9. Initiating the development of multisensory integration by manipulating sensory experience.

    Science.gov (United States)

    Yu, Liping; Rowland, Benjamin A; Stein, Barry E

    2010-04-07

    The multisensory integration capabilities of superior colliculus neurons emerge gradually during early postnatal life as a consequence of experience with cross-modal stimuli. Without such experience neurons become responsive to multiple sensory modalities but are unable to integrate their inputs. The present study demonstrates that neurons retain sensitivity to cross-modal experience well past the normal developmental period for acquiring multisensory integration capabilities. Experience surprisingly late in life was found to rapidly initiate the development of multisensory integration, even more rapidly than expected based on its normal developmental time course. Furthermore, the requisite experience was acquired by the anesthetized brain and in the absence of any of the stimulus-response contingencies generally associated with learning. The key experiential factor was repeated exposure to the relevant stimuli, and this required that the multiple receptive fields of a multisensory neuron encompassed the cross-modal exposure site. Simple exposure to the individual components of a cross-modal stimulus was ineffective in this regard. Furthermore, once a neuron acquired multisensory integration capabilities at the exposure site, it generalized this experience to other locations, albeit with lowered effectiveness. These observations suggest that the prolonged period during which multisensory integration normally appears is due to developmental factors in neural circuitry in addition to those required for incorporating the statistics of cross-modal events; that neurons learn a multisensory principle based on the specifics of experience and can then apply it to other stimulus conditions; and that the incorporation of this multisensory information does not depend on an alert brain.

  10. Initial clinical experience with Dideco Kids D100 neonatal oxygenator.

    Science.gov (United States)

    Pace Napoleone, Carlo; Oppido, Guido; Angeli, Emanuela; Shekho, Nazar; De Toni, Erika; Bruzzi, Franco; Gargiulo, Gaetano

    2008-07-01

    We describe our initial clinical experience with the new hollow fibre membrane oxygenator Dideco Kids D100, used in five patients with a mean age of 21 +/- 28 days. The priming volume is 31 ml with a membrane surface area of 0.22 m2. Data were compared with those deriving from five patients treated with Dideco D901 Lilliput 1 oxygenator. Among patients treated by the new Dideco Kids D100 oxygenator, priming volume was significantly reduced and an easier blood gas delivery was evident.

  11. Initial NIF Shock Timing Experiments: Comparison with Simulation

    Science.gov (United States)

    Robey, H. F.; Celliers, P. M.; Boehly, T. R.; Datte, P. S.; Bowers, M. W.; Olson, R. E.; Munro, D. H.; Milovich, J. L.; Jones, O. S.; Nikroo, A.; Kroll, J. J.; Horner, J. B.; Hamza, A. V.; Bhandarkar, S. D.; Giraldez, E.; Castro, C.; Gibson, C. R.; Eggert, J. H.; Smith, R. F.; Park, H.-S.; Young, B. K.; Hsing, W. W.; Landen, O. L.; Meyerhofer, D. D.

    2010-11-01

    Initial experiments are underway to demonstrate the techniques required to tune the shock timing of capsule implosions on the National Ignition Facility (NIF). These experiments use a modified cryogenic hohlraum geometry designed to precisely match the performance of ignition hohlraums. The targets employ a re-entrant Au cone to provide optical access to the shocks as they propagate in the liquid deuterium-filled capsule interior. The strength and timing of the shocks is diagnosed with VISAR (Velocity Interferometer System for Any Reflector) and DANTE. The results of these measurements will be used to set the precision pulse shape for ignition capsule implosions to follow. Experimental results and comparisons with numerical simulation are presented.

  12. Scaffolding Students’ Initial Self-Access Language Centre Experiences

    Directory of Open Access Journals (Sweden)

    Robert Croker

    2012-09-01

    Full Text Available As the number of self-access language centres (SALCs in Japanese universities continues to grow, so too does the challenge of successfully introducing them to first-year university students, whose initial experiences of self-access language learning may otherwise be confusing and even unsettling. One approach is to carefully scaffold students’ first SALC encounters by connecting them with their classroom learning experiences. This paper discusses one such approach developed at a private university in central Japan, which was based upon a two-stage ‘push-pull’ ‘materials-light, people-focused’ strategy. Teachers initially ‘pushed’ their students to visit the SALC by giving them speaking ‘homework’ to be done there. The SALC then also offered interesting interactive events designed to ‘pull’ learners to continue to come. These push-pull activities could be done with few or no materials, and emphasized interaction with people rather than materials. This two-stage, push-pull strategy served as a bridge between the language classroom and a SALC, helping learners make the first steps in their transition from being a ‘classroom English learner’ to becoming a ‘SALC English user’.

  13. Effect of residents' previous laparoscopic surgery experience on initial robotic suturing experience.

    Science.gov (United States)

    Kilic, Gokhan Sami; Walsh, Teresa M; Borahay, Mostafa; Zeybek, Burak; Wen, Michael; Breitkopf, Daniel

    2012-01-01

    Objective. To assess the impact of gynecology residents' previous laparoscopic experience on the learning curve of robotic suturing techniques and the value of initial structured teaching in dry lab prior to surgery. Methods. Thirteen gynecology residents with no previous robotic surgery experience were divided into Group 1, consisting of residents with 2 or fewer laparoscopic experiences, and Group 2, consisting of residents with 3 or more laparoscopic experiences. Group 1 had a dry-laboratory training in suturing prior to their initial experience in the operating room. Results. For all residents, it took on average 382 ± 159 seconds for laparoscopic suturing and 326 ± 196 seconds for robotic suturing (P = 0.12). Residents in Group 1 had a lower mean suture time than residents in Group 2 for laparoscopic suturing (P = 0.009). The residents in Group 2, however, had a lower mean suture time on the robot compared to Group 1 (P = 0.5). Conclusion. Residents with previous laparoscopic suturing experience may gain more from a robotic surgery experience than those with limited laparoscopic surgery experience. In addition, dry lab training is more efficient than hands-on training in the initial phase of teaching for both laparoscopic and robotic suturing skills.

  14. PET/MR imaging of atherosclerosis: initial experience and outlook.

    Science.gov (United States)

    Rischpler, Christoph; Nekolla, Stephan G; Beer, Ambros J

    2013-01-01

    Hybrid scanners such as PET/CT have in the past emerged as a valuable modality in clinical routine as well as an important research tool. Recently, the newly developed fully integrated PET/MR scanners were introduced to the market, raising high expectations especially due to the excellent soft tissue contrast and functional imaging capabilities of MRI. In this issue of the American Journal of Nuclear Medicine and Molecular Imaging, initial experiences using a hybrid PET/MR scanner for carotid artery imaging in a group of patients with increased risk for atherosclerosis are described. This represents a proof-of-principle study, which could stimulate future applications of this powerful modality in atherosclerotic plaque imaging.

  15. Debris-flow initiation experiments using diverse hydrologic triggers

    Science.gov (United States)

    Reid, Mark E.; LaHusen, Richard G.; Iverson, Richard M.

    1997-01-01

    Controlled debris-flow initiation experiments focused on three hydrologic conditions that can trigger slope failure: localized ground-water inflow; prolonged moderate-intensity rainfall; and high-intensity rainfall. Detailed monitoring of slope hydrology and deformation provided exceptionally complete data on conditions preceding and accompanying slope failure and debris-flow mobilization. Ground-water inflow and high-intensity sprinkling led to abrupt, complete failure whereas moderate-intensity sprinkling led to retrogressive, block-by-block failure. Failure during ground-water inflow and during moderate-intensity sprinkling occurred with a rising water table and positive pore pressures. Failure during high-intensity sprinkling occurred without widespread positive pore pressures. In all three cases, pore pressures in most locations increased dramatically (within 2-3 seconds) during failure. In some places, pressures in unsaturated materials rapidly 'flashed' from zero to elevated positive values. Transiently elevated pore pressures and partially liquefied soil enhanced debris-flow mobilization.

  16. Initiation of a thrust fault revealed by analog experiments

    Science.gov (United States)

    Dotare, Tatsuya; Yamada, Yasuhiro; Adam, Juergen; Hori, Takane; Sakaguchi, Hide

    2016-08-01

    To reveal in detail the process of initiation of a thrust fault, we conducted analog experiments with dry quartz sand using a high-resolution digital image correlation technique to identify minor shear-strain patterns for every 27 μm of shortening (with an absolute displacement accuracy of 0.5 μm). The experimental results identified a number of "weak shear bands" and minor uplift prior to the initiation of a thrust in cross-section view. The observations suggest that the process is closely linked to the activity of an adjacent existing thrust, and can be divided into three stages. Stage 1 is characterized by a series of abrupt and short-lived weak shear bands at the location where the thrust will subsequently be generated. The area that will eventually be the hanging wall starts to uplift before the fault forms. The shear strain along the existing thrust decreases linearly during this stage. Stage 2 is defined by the generation of the new thrust and active displacements along it, identified by the shear strain along the thrust. The location of the new thrust may be constrained by its back-thrust, generally produced at the foot of the surface slope. The activity of the existing thrust falls to zero once the new thrust is generated, although these two events are not synchronous. Stage 3 of the thrust is characterized by a constant displacement that corresponds to the shortening applied to the model. Similar minor shear bands have been reported in the toe area of the Nankai accretionary prism, SW Japan. By comparing several transects across this subduction margin, we can classify the lateral variations in the structural geometry into the same stages of deformation identified in our experiments. Our findings may also be applied to the evaluation of fracture distributions in thrust belts during unconventional hydrocarbon exploration and production.

  17. Symetis Acurate Neo transfemoral aortic bioprosthesis - initial Polish experience.

    Science.gov (United States)

    Zembala, Michał; Hawranek, Michał; Wacławski, Jacek; Niklewski, Tomasz; Nadziakiewicz, Paweł; Koba, Rafał; Przybylski, Roman; Walas, Ryszard; Głowacki, Jan; Jazwiec, Tomasz; Garbacz, Marcin; Gąsior, Mariusz; Zembala, Marian

    2016-01-01

    Transcatheter aortic valve implantation (TAVI) has proven to be a valuable alternative to conventional surgical aortic valve replacement in high-risk and surgically inoperable patients who suffer from severe symptomatic aortic stenosis. With the second generation of TAVI devices improvements in both handling and performance are highly demanded. This brief clinical communication reports the first Polish experience with the second generation of transfemoral TAVI device--Symetis Acurate Neo. From November 19th 2014 until February 18th 2015 nine (n = 9) patients with severe symptomatic aortic stenosis have been operated on using the Symetis Acurate Neo. Patients were subject to seven-day evaluation and 30-day phone follow-up. The procedure was safely and successfully performed in all patients. A SMALL (S) valve (21-23 mm equivalent) was used in two patients, MEDIUM valve (M; 23-25 mm equivalent) in five patients, and a LARGE valve (L; 25-26 mm equivalent) in two patients. In three cases post-release balloon dilatation was required. There were no intraoperative complications and no major adverse events (as per VARC classification) during initial hospitalisation, including conduction or rhythm disturbances. In all cases, the mean gradient on the prosthetic valves was 7.8 mm Hg (10.2 mm Hg on the "S" valves). Rapid improvement in patients' functional class was noted. Perivalvular leak was evaluated as "mild" in three cases, "trace" in one, and "not existing" in five. This initial experience with the Symetis Acurate Neo demonstrates its good safety profile and excellent haemodynamics. Low radial stress of the valve results in minimal incidence of atrioventricular rhythm disturbances, and a sealing crown for nearly non-existent paravalvular leak.

  18. Initial results from the DSPlanar experiments on OMEGA

    Science.gov (United States)

    Dodd, E. S.; Merritt, E. C.; Montgomery, D. S.; Daughton, W.; Schmidt, D. W.; Cardenas, T.; Wilson, D. C.; Batha, S. H.

    2016-10-01

    Recently, LANL has begun a project aimed ultimately at fielding a neutron-producing double-shell capsule at the National Ignition Facility (NIF). Initial experiments have begun at both the NIF and OMEGA laser facilities over the last year. At OMEGA, halfraum-driven planar targets will be used to study physics issues important to double shell implosions, but outside of a convergent geometry. In particular, side-on radiography through a tube has advantages over imaging through the hohlraum and double-shell capsule at NIF. We plan to study a number physics issues with this platform, including both 1-d and higher dimensional effects. In 1-d, momentum transfer from the ablator to the inner shell, and the effect of pre-heat on the inner shell can be studied. Higher dimensional effects, in the form of hydrodynamic instabilities, can also be studied. Pre-heat expansion of the inner shell can lead to an unstable interface, which can be mitigated by a tamper layer. Manufacturing tolerances can be used to mitigate against feature-driven instability growth, such as from a glue joint or fill tube. Initial results on the amount pre-heat from various ablator materials will be given, along with a discussion of future plans. Supported under the US DOE by the LANS, LLC under contract DE-AC52-06NA25396. LA-UR-16-25044.

  19. Initially curved microplates under electrostatic actuation: theory and experiment

    KAUST Repository

    Saghir, S.

    2016-07-01

    Microplates are the building blocks of many micro-electro-mechanical systems. It is common for them to experience initial curvature imperfection due to residual stresses caused by the micro fabrication process. Such plates are essentially different from perfectly flat ones and cannot be modeled using flat plate models. In this paper, we adopt a dynamic analog of the von Karman governing equations of imperfect plates. These equations are then used to develop a reduced order model based on the Galerkin procedure, to simulate the static and dynamic behavior of the microplate under electrostatic actuation. To validate the simulation results, an initially curved imperfect microplate made of silicon nitride is fabricated and tested. The static behaviour of the microplate is investigated when applying a DC voltage Vdc. Then, the dynamic behaviour of the microplate is examined under the application of a harmonic AC voltage, Vac, superimposed to Vdc. The simulation results show good agreement with the experimentally measured responses. © 2016 IOP Publishing Ltd.

  20. Shock initiation experiments on ratchet grown PBX 9502

    Energy Technology Data Exchange (ETDEWEB)

    Gustavsen, Richard L [Los Alamos National Laboratory; Thompson, Darla G [Los Alamos National Laboratory; Olinger, Barton W [Los Alamos National Laboratory; Deluca, Racci [Los Alamos National Laboratory; Bartram, Brian D [Los Alamos National Laboratory; Pierce, Timothy H [Los Alamos National Laboratory; Sanchez, Nathaniel J [Los Alamos National Laboratory

    2010-01-01

    This study compares the shock initiation behavior of PBX 9502 pressed to less than nominal density (nominal density is 1.890 {+-} 0.005 g/cm{sup 3}) with PBX 9502 pressed to nominal density and then ''ratchet grown'' to low density. PBX 9502 is an insensitive plastic bonded explosive consisting of 95 weight % dry-aminated tri-amino-tri-nitro-benzene (TATB) and 5 weight % Kel-F 800 plastic binder. ''Ratchet growth'' - an irreversible increase in specific volume - occurs when an explosive based on TATB is temperature cycled. The design of our study is as follows: PBX 9502, all from the same lot, received the following four treatments. Samples in the first group were pressed to less than nominal density. These were not ratchet grown and used as a baseline. Samples in the second group were pressed to nominal density and then ratchet grown by temperature cycling 30 times between -54 C and +80 C. Samples in the final group were pressed to nominal density and cut into 100 mm by 25.4 mm diameter cylinders. During thermal cycling the cylinders were axially constrained by a 100 psi load. Samples for shock initiation experiments were cut perpendicular (disks) and parallel (slabs) to the axial load. The four sample groups can be summarized with the terms pressed low, ratchet grown/no load, axial load/disks, and axial load/slabs. All samples were shock initiated with nearly identical inputs in plate impact experiments carried out on a gas gun. Wave profiles were measured after propagation through 3, 4, 5, and 6 mm of explosive. Side by side comparison of wave profiles from different samples is used as a measure of relative sensitivity. All reduced density samples were more shock sensitive than nominal density PBX 9502. Differences in shock sensitivity between ratchet grown and pressed to low density PBX 9502 were small, but the low density pressings are slightly more sensitive than the ratchet grown samples.

  1. Initial Experience Using the Gore Embolic Filter in Carotid Interventions.

    Science.gov (United States)

    Hornung, Marius; Franke, Jennifer; Bertog, Stefan C; Gafoor, Sameer; Grunwald, Iris; Sievert, Horst

    2016-08-01

    This is the first clinical report on experience in the use of the Gore embolic filter in carotid interventions. It was designed as a guidewire and embolic protection system in carotid, peripheral, and coronary interventions. The ability to capture debris is driven by the frame of the filter, which is designed to improve vessel wall apposition and allows a short landing zone. We report the results of the first 20 consecutive patients undergoing carotid artery stenting using the Gore embolic filter in our institution. We analyzed technical success as well as the occurrence of transient ischemic attack (TIA), stroke, or death periprocedurally and through 30 days of follow-up. Mean patient age was 72 years and 12 patients (60%) were male. Seven patients were symptomatic and 4 patients suffered recurrent neurological events. Technical success was achieved in all procedures. In 1 patient, the retrieval catheter was caught between the proximal struts of the stent and required further retrieval maneuvers. Within 30 days of follow-up, 1 patient had a TIA. No stroke, death, or myocardial infarction occurred. This initial experience suggests that the Gore embolic filter device can be used safely for distal embolic protection during carotid stenting procedures with high technical success.

  2. [Initial experience in robot-assisted colorectal surgery in Mexico].

    Science.gov (United States)

    Villanueva-Sáenz, Eduardo; Ramírez-Ramírez, Moisés Marino; Zubieta-O'Farrill, Gregorio; García-Hernández, Luis

    Colorectal surgery has advanced notably since the introduction of the mechanical suture and the minimally invasive approach. Robotic surgery began in order to satisfy the needs of the patient-doctor relationship, and migrated to the area of colorectal surgery. An initial report is presented on the experience of managing colorectal disease using robot-assisted surgery, as well as an analysis of the current role of this platform. A retrospective study was conducted in order to review five patients with colorectal disease operated using a robot-assisted technique over one year in the initial phase of the learning curve. Gender, age, diagnosis and surgical indication, surgery performed, surgical time, conversion, bleeding, post-operative complications, and hospital stay, were analysed and described. A literature review was performed on the role of robotic assisted surgery in colorectal disease and cancer. The study included 5 patients, 3 men and 2 women, with a mean age of 62.2 years. Two of them were low anterior resections with colorectal primary anastomoses, one of them extended with a loop protection ileostomy, a Frykman-Goldberg procedure, and two left hemicolectomies with primary anastomoses. The mean operating time was 6hours and robot-assisted 4hours 20minutes. There were no conversions and the mean hospital stay was 5 days. This technology is currently being used worldwide in different surgical centres because of its advantages that have been clinically demonstrated by various studies. We report the first colorectal surgical cases in Mexico, with promising results. There is enough evidence to support and recommend the use of this technology as a viable and safe option. Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.

  3. Left atrial appendage occlusion: initial experience with the Amplatzer™ Amulet™.

    Science.gov (United States)

    Freixa, Xavier; Abualsaud, Ali; Chan, Jason; Nosair, Mohamed; Tzikas, Apostolos; Garceau, Patrick; Basmadjian, Arsène; Ibrahim, Réda

    2014-07-01

    The Amplatzer™ Amulet™ (Amulet) is the evolution of the Amplatzer™ Cardiac Plug, a dedicated device for percutaneous left atrial appendage (LAA) occlusion. The new device has been designed to facilitate the implantation process, improve the sealing performance and further reduce the risk of complications. The objective of the study was to describe the initial experience with the Amplatzer Amulet for percutaneous LAA occlusion. This was a prospective single-center study of patients undergoing percutaneous LAA occlusion. The indication for LAA closure was a formal contraindication for oral anticoagulation or previous history of stroke due to INR lability. All procedures were done under general anesthesia and transesophageal echocardiography (TEE) guidance. Transthoracic echocardiography was performed 24h after the procedure in order to rule out procedural complications before discharge. Further follow-up was done with a clinical visit and TEE at 1-3 months. Between July-2012 and June-2013, 25 patients with a mean CHA2DS2-VASC of 4.3 ± 1.7 underwent LAA occlusion with the Amplatzer Amulet. The device was successfully implanted in 24 patients (96%) without any procedural stroke, pericardial effusion or device embolization. None of the patients presented any clinical event at follow-up. Follow-up TEE showed complete LAA sealing in all patients with no residual leaks >3mm and no device embolization. One patient (4.1%) presented a device thrombosis at follow-up without clinical expression. In this initial series of patients, the Amulet showed a remarkable acute and short-term performance in terms of feasibility and safety as depicted by the high successful implantation rate and the low incidence of complications. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. [Laparoscopic distal gastrectomy for gastric cancer: initial experience].

    Science.gov (United States)

    Berrospi, Francisco; Celis, Juan; Ruíz, Eloy; Payet, Eduardo; Chávez, Iván; Young, Frank

    2008-01-01

    To report the initial experience with the laparoscopy-assisted distal gastrectomy (LADG) with D2 lymphadenectomy for gastric cancer. Between May 2006 and May 2007, 29 consecutive GC patients with gastric cancer underwent LADG with D2 lymphadenectomy. The operation consisted in a laparoscopic time to perform lymphadenectomy and mobilization of the distal stomach, followed by a minilaparotomy for exteriorization of the specimen and construction of a hand sewn anastomosis. Twenty-nine patients underwent LADG with D2 lymphadenectomy for gastric cancer. Mean age was 58.2 years. Mean operative time was 287.4 min. Mean number of lymph nodes resected was 42.6. Twelve patients were early gastric cancer, and seventeen were advanced gastric cancer. Mean proximal and distal resection margin were 5.8 cm and 3.5 cm, respectively. Resection margins were negative in all cases. Mean number of lymph nodes resected was 42.6. Thirty-day morbidity rate was 10.3 %. There were no postoperative deaths.CONCLUSION. The short-term results of our LADG with D2 lymphadenectomy for the treatment of gastric cancer shows that a radical surgery, in terms of resection margins and lymphadenectomy, can be done with low morbidity.

  5. Percutaneous MR-guided cryoablation of prostate cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Gangi, Afshin; Tsoumakidou, Georgia; Abdelli, Omar; Buy, Xavier [University Hospital of Strasbourg, Department of Interventional Radiology, Strasbourg (France); Mathelin, Michel de [University of Strasbourg, Lsiit, Strasbourg (France); Jacqmin, Didier; Lang, Herve [University Hospital of Strasbourg, Department of Urology, Strasbourg (France)

    2012-08-15

    We report our initial experience and the technical feasibility of transperineal prostate cryoablation under MR guidance. Percutaneous MR-guided cryoablation was performed in 11 patients with prostatic adenocarcinoma contraindicated for surgery (mean age: 72 years, mean Gleason score: 6.45, mean prostate-specific antigen (PSA): 6.21 ng/ml, T1-2c/N0/M0, mean: prostate volume 36.44 ml). Free-hand probe positioning was performed under real-time MR imaging. Four to seven cryoprobes were inserted into the prostate, depending on gland volume. The ice ball was monitored using real-time and high-resolution BLADE multi-planar imaging. Patients were followed at 1, 3, 6, 9 and 12 months after the procedure with serum PSA level and post-ablation MRI. Prostate cryoablation was technically feasible in 10/11 patients. The ice ball was clearly and sharply visualised in all cases as a signal-void area. Mean ice-ball volume was 53.3 ml. Mean follow-up was 15 months (range: 1-25). Mean PSA nadir was 0.33 ng/ml (range: 0.02-0.94 ng/ml). Mean hospitalisation was 5 days (range: 3-13). Complications included a urethro-rectal fistula, urinary infection, transient dysuria and scrotal pain. MR-guided prostate cryoablation is feasible and promising, with excellent monitoring of the ice ball. Future perspectives could include the use of MR guidance for focal prostate cancer cryotherapy. (orig.)

  6. [The transcatheter closure of patent ductus arteriosus. The initial experience].

    Science.gov (United States)

    Vázquez-Antona, C A; Rijlaarsdam, M; Gaspar, J; Gil Moreno, M; Buendía Hernández, A; Martínez Ríos, M A; Attie, F

    1993-01-01

    Percutaneous closure of the patent ductus arteriosus (PDA) has been recently reported to be an effective alternative in the treatment of patients with ductal shunting. We report the initial experience and results during follow-up of percutaneous ductal occlusion with the Rashkind occluder (USCI) in six patients with isolated PDA. Ages ranged from 3 to 23 years. Diagnosis was corroborated with two dimensional and Doppler echocardiography in all patients. During cardiac catheterization systolic pulmonary artery pressure oscillated between 22 and 64 mmHg and Qp/Qs ratio between 1.3 and 4.1. In two patients prosthesis of 12 mm were used and in the remaining prosthesis of 17 mm. Only one patient demonstrated total occlusion during immediate control aortography, the other patients presented central residual shunting over the occluder. In the three patients occlusion with balloon-catheter was added to the procedure, resulting in total occlusion in two and significant reduction of the shunt magnitude in one. Two technical problems were resolved satisfactorily. None of the cases presented device embolization. Mean follow-up was 23.8 months with control echocardiograms at 24 hours, 1, 4, 12 and 24 months. In all patients immediate reduction of the left atrial dimension was demonstrated. Three patients presented residual shunts in the first 24 hours. In two of them total occlusion had occurred after one month and the other patient persisted with a small residual shunt until one year after the procedure. In conclusion, in this small study group good results were obtained with percutaneous ductal closure.

  7. Our initial experience with percutaneous nephrolithotomy in children

    Directory of Open Access Journals (Sweden)

    Mehmet Hanifi Okur

    2014-03-01

    Full Text Available Objective: To present our initial experience on percutaneous nephrolithotomy (PCNL in children between March 2012 and November 2013. Methods: 13 renal units of 12 patients underwent PCNL. Patients were evaluated in terms of age, preoperatively in terms of urine, blood count, urine culture, serum biochemical, and routine coagulation tests and radiological examinations, stone location, stone burden (according to plain radiograph, preoperative use of nephrostomy and average fluoroscopic manipulation time. To facilitate access, prior mechanical dilatation was performed nephrostomy access tract. After the PCNL procedure, we placed nephrostomy in all patients postoperatively. They were evaluated with regard to residual stone, complications (according to the Clavien classification and outcomes. Results: Average age was 11 years (6-15. There was no abnormality in Laboratory Screening. Location of 11 stones was renal pelvis and 2 stones was pelvis + calyx. The average stone size was 260 mm². Preoperative acces were provided in 3 patients, others were intraoperatively. Average fluoroscopic manipulation time was 4,8 minutes (2-11. At the first postoperative day, 11 (85 % patients achieved a completely stone-free state. Complications were seen in 3 patients; failure of renal access in one patient (Grade 3b, urine leakage was observed after surgery in one (Grade 3a, postoperative blood transfusion required in one patient (Grade 2. The hospital stay duration was 5,5 days (5-7 days. Conclusions: Pediatric PCNL is a minimal invasive procedure which provides high rate of stone free and good cosmetics. İf there is adequate facilities and equipment with experienced persons, this procedure can easily be used in pediatric surgery clinics.

  8. Informal Science: Family Education, Experiences, and Initial Interest in Science

    Science.gov (United States)

    Dabney, Katherine P.; Tai, Robert H.; Scott, Michael R.

    2016-01-01

    Recent research and public policy have indicated the need for increasing the physical science workforce through development of interest and engagement with informal and formal science, technology, engineering, and mathematics experiences. This study examines the association of family education and physical scientists' informal experiences in…

  9. Professional Experience as a Wicked Problem in Initial Teacher Education

    Science.gov (United States)

    Southgate, Erica; Reynolds, Ruth; Howley, Peter

    2013-01-01

    Professional experience in teacher education is explored through the conceptual lens of the wicked problem. Wicked problems are socially constructed and complex. This paper outlines what is at stake in the framing of the problem of professional experience and how constructions of the problem make it difficult to find enduring solutions. The…

  10. Informal Science: Family Education, Experiences, and Initial Interest in Science

    Science.gov (United States)

    Dabney, Katherine P.; Tai, Robert H.; Scott, Michael R.

    2016-01-01

    Recent research and public policy have indicated the need for increasing the physical science workforce through development of interest and engagement with informal and formal science, technology, engineering, and mathematics experiences. This study examines the association of family education and physical scientists' informal experiences in…

  11. Initial Experiences with Retrieving Similar Objects in Simulation Data

    Energy Technology Data Exchange (ETDEWEB)

    Cheung, S-C S; Kamath, C

    2003-02-21

    Comparing the output of a physics simulation with an experiment, referred to as 'code validation,' is often done by visually comparing the two outputs. In order to determine which simulation is a closer match to the experiment, more quantitative measures are needed. In this paper, we describe our early experiences with this problem by considering the slightly simpler problem of finding objects in a image that are similar to a given query object. Focusing on a dataset from a fluid mixing problem, we report on our experiments with different features that are used to represent the objects of interest in the data. These early results indicate that the features must be chosen carefully to correctly represent the query object and the goal of the similarity search.

  12. Diffusion tensor imaging of periventricular leukomalacia – Initial experience

    Directory of Open Access Journals (Sweden)

    Eman M. Abdelsalam

    2014-12-01

    Conclusion: DTI proved to be a promising noninvasive method for assessing the severity of white matter tract injury in patients with PVL. This is owing to the capability of fiber-tracking techniques to provide more information for understanding the pathophysiologic features of sensorimotor and cognitive disability associated with PVL. This will allow for the early intervention and initiation of rehabilitation programs aiming for minimizing the associated neurological deficit.

  13. The Planeterrella experiment: from individual initiative to networking

    CERN Document Server

    Lilensten, Jean; Grimald, Sandrine; Brekke, Asgeir; Fluckiger, Erwin; Vanlommel, Petra; Wedlund, Cyril Simon; Barthélémy, Mathieu; Garnier, Philippe

    2013-01-01

    Space weather is a relatively new discipline which is generally unknown to the wider public, despite its increasing importance to all of our daily lives. Outreach activities can help in promoting the concept of space weather. In particular the visual beauty and excitement of the aurora make these lights a wonderful inspirational hook. A century ago Norwegian experimental physicist Kristian Birkeland, one of the founding fathers of modern space science, demonstrated with his Terrella experiment the formation of the aurora. Recently a modernised version of the Terrella has been designed. This Planeterrella experiment is very flexible, allowing the visualization of many phenomena occurring in our space environment. Although the Planeterrella was originally designed to be small to be demonstrated locally by a scientist, the Planeterrella has proved to be a very successful public outreach experiment. We believe that its success is due to two main factors (i) the Planeterrella is not patented and the plans are give...

  14. Radiofrequency Ablation for Iatrogenic Thyroid Artery Pseudoaneurysm: Initial Experience.

    Science.gov (United States)

    Jun, Ye Kyeong; Jung, So Lyung; Byun, Ho Kyun; Baek, Jung Hwan; Sung, Jin Yong; Sim, Jung Suk

    2016-10-01

    Eight iatrogenic thyroid pseudoaneurysms (ITPAs) after thyroid biopsy are reported. The mean ITPA diameter was 7.2 mm (range 4 to 12 mm). Ultrasound (US)-guided compression was initially performed at the neck of the ITPA in all cases. Among them, 4 ITPAs persisted (50%) in which radiofrequency (RF) ablation was performed. Mean RF ablation time and power were 13.5 seconds (range 5 to 24 seconds) and 20 W (range 10 to 50 W), respectively. All 4 cases were treated with RF ablation without any complications.

  15. Initial operation with sodium in the Madison Dynamo Experiment.

    Science.gov (United States)

    Kendrick, R.; Spence, Ej; Forest, C. B.; O'Connell, R.; Nornberg, Md; Canary, Hw; Wright, A.; Robinson, K.

    1999-11-01

    A new liquid metal MHD experiment has been constructed at the University of Wisconsin to test several key predictions of dynamo theory: magnetic instabilities driven by sheared flow, the effects of turbulence on current generation, and the back-reaction of the self-generated magnetic field on the fluid motion which brings saturation. This presentation describes the engineering design of the experiment, which is a 0.5 m radius spherical vessel, filled with liquid sodium at 150 ^circC. The experiment is designed to achieve a magnetic Reynolds number in excess of 100, which requires approximately 80 Hp of mechanical drive, producing flow velocities in sodium of 15 m/s through impellers. Handling liquid sodium offers a number of technical challenges, but routine techniques have been developed over the past several decades for safely handling large quantities for the fast breeder reactor. The handling strategy is discussed, technical details concerning seals and pressurization are presented, and safety elements are highlighted.

  16. Initial experience with ocriplasmin in the treatment of vitreomacular traction

    Directory of Open Access Journals (Sweden)

    José Maurício Botto de Barros Garcia

    2016-04-01

    Full Text Available ABSTRACT This study aimed to report the clinical and structural outcomes of intravitreal ocriplasmin in the treatment of vitreomacular interface disorders in two tertiary centers in Brazil. A retrospective study was performed by reviewing medical records and spectral domain optical coherence tomography (SD-OCT findings of seven patients who were treated with a single ocriplasmin injection. A total of 57.14% of patients achieved resolution of vitreomacular traction as evidenced by SD-OCT. Regarding our functional results, 87.71% maintained or improved visual acuity after follow-up. To the best of our knowledge, this is the first study reporting initial results of ocriplasmin therapy in Brazil.

  17. Coherent fluctuations in the initial TFTR D-T experiments

    Energy Technology Data Exchange (ETDEWEB)

    Fredrickson, E.; Chang, Z.Y.; Budny, R.V.

    1995-03-01

    The initial operation of TFTR with approximately equal power in the tritium and deuterium neutral beam injectors has resulted in the production of fusion power in excess of 9MW and central {beta}{sub {alpha}} > 0.25%. This {beta}{sub {alpha}} is within a factor of 2--3 of the {beta}{sub {alpha}} in projections of ITER performance. Effects of this {alpha} population on TAE modes, sawteeth and fishbone activity are being searched for. The D-T plasmas are also being studied for evidence of changes in MHD activity which might be attributed to the fast {alpha} population. This paper reports on the activity in the Alfven range of frequencies in the D-T plasmas and on detailed measurements of the MHD activity preceding major disruptions in D-D and D-T.

  18. Cardiac biplane strain imaging: initial in vivo experience

    Energy Technology Data Exchange (ETDEWEB)

    Lopata, R G P; Nillesen, M M; Thijssen, J M; De Korte, C L [Clinical Physics Laboratory, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Verrijp, C N; Lammens, M M Y; Van der Laak, J A W M [Department of Pathology, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Singh, S K; Van Wetten, H B [Department of Cardiothoracic Surgery, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands); Kapusta, L [Pediatric Cardiology, Department of Pediatrics, Radboud University Nijmegen Medical Centre, Nijmegen (Netherlands)], E-mail: R.Lopata@cukz.umcn.nl

    2010-02-21

    In this study, first we propose a biplane strain imaging method using a commercial ultrasound system, yielding estimation of the strain in three orthogonal directions. Secondly, an animal model of a child's heart was introduced that is suitable to simulate congenital heart disease and was used to test the method in vivo. The proposed approach can serve as a framework to monitor the development of cardiac hypertrophy and fibrosis. A 2D strain estimation technique using radio frequency (RF) ultrasound data was applied. Biplane image acquisition was performed at a relatively low frame rate (<100 Hz) using a commercial platform with an RF interface. For testing the method in vivo, biplane image sequences of the heart were recorded during the cardiac cycle in four dogs with an aortic stenosis. Initial results reveal the feasibility of measuring large radial, circumferential and longitudinal cumulative strain (up to 70%) at a frame rate of 100 Hz. Mean radial strain curves of a manually segmented region-of-interest in the infero-lateral wall show excellent correlation between the measured strain curves acquired in two perpendicular planes. Furthermore, the results show the feasibility and reproducibility of assessing radial, circumferential and longitudinal strains simultaneously. In this preliminary study, three beagles developed an elevated pressure gradient over the aortic valve ({delta}p: 100-200 mmHg) and myocardial hypertrophy. One dog did not develop any sign of hypertrophy ({delta}p = 20 mmHg). Initial strain (rate) results showed that the maximum strain (rate) decreased with increasing valvular stenosis (-50%), which is in accordance with previous studies. Histological findings corroborated these results and showed an increase in fibrotic tissue for the hearts with larger pressure gradients (100, 200 mmHg), as well as lower strain and strain rate values.

  19. Cardiac biplane strain imaging: initial in vivo experience

    Science.gov (United States)

    Lopata, R. G. P.; Nillesen, M. M.; Verrijp, C. N.; Singh, S. K.; Lammens, M. M. Y.; van der Laak, J. A. W. M.; van Wetten, H. B.; Thijssen, J. M.; Kapusta, L.; de Korte, C. L.

    2010-02-01

    In this study, first we propose a biplane strain imaging method using a commercial ultrasound system, yielding estimation of the strain in three orthogonal directions. Secondly, an animal model of a child's heart was introduced that is suitable to simulate congenital heart disease and was used to test the method in vivo. The proposed approach can serve as a framework to monitor the development of cardiac hypertrophy and fibrosis. A 2D strain estimation technique using radio frequency (RF) ultrasound data was applied. Biplane image acquisition was performed at a relatively low frame rate (cardiac cycle in four dogs with an aortic stenosis. Initial results reveal the feasibility of measuring large radial, circumferential and longitudinal cumulative strain (up to 70%) at a frame rate of 100 Hz. Mean radial strain curves of a manually segmented region-of-interest in the infero-lateral wall show excellent correlation between the measured strain curves acquired in two perpendicular planes. Furthermore, the results show the feasibility and reproducibility of assessing radial, circumferential and longitudinal strains simultaneously. In this preliminary study, three beagles developed an elevated pressure gradient over the aortic valve (Δp: 100-200 mmHg) and myocardial hypertrophy. One dog did not develop any sign of hypertrophy (Δp = 20 mmHg). Initial strain (rate) results showed that the maximum strain (rate) decreased with increasing valvular stenosis (-50%), which is in accordance with previous studies. Histological findings corroborated these results and showed an increase in fibrotic tissue for the hearts with larger pressure gradients (100, 200 mmHg), as well as lower strain and strain rate values.

  20. Management support to e-business initiatives: The Croatian experience

    Directory of Open Access Journals (Sweden)

    Mario Spremić

    2003-01-01

    Full Text Available After defining e-business and explaining why an evolutionary aspect of moving to e-business is required, the dimensions of e-business is defined with respect to differences between traditional business, partial, or pure e-business. Also, a model for moving to e-business is illustrated. The e-business evolving model is divided into six stages and represents an evolutionary aspect of migrating to e-business. Finally, the results of the research study on current practices in evolving e-business in the most successful Croatian companies are given. In this research, some aspects of business process innovation and e-business usage have been investigated (general e-business issues with levels of e-business usage, key objectives of participating in e-business, alignment of business strategy with e-business initiatives, initiation of e-business projects and e-business planning issues, especially e-business funding. The questionnaire was sent to 400 CEOs or CIOs in Croatian companies selected from the Register of the ‘400 Biggest’ Croatian companies which were ranked according to their 2001 annual revenue and which were most likely to represent the structure of the Croatian economy. Although they represent less than 1% of the total number of registered companies in Croatia, the sampled companies hold 73% of the equity capital of the whole Croatian economy, they contribute with 65% in the total Croatian economy’s export balance and they employ 37% of the total number of people employed in Croatia.

  1. The Planeterrella experiment: from individual initiative to networking

    Directory of Open Access Journals (Sweden)

    Garnier Pierre

    2013-02-01

    Full Text Available Space weather is a relatively new discipline, which is still largely unknown amongst the wider public despite its increasing importance in all of our daily lives. Outreach activities can promote awareness of space weather. In particular the visual beauty and excitement of the aurora make these lights a wonderful inspirational hook to enhance understanding of space weather in a general audience. A century ago, the Norwegian experimental physicist Kristian Birkeland, one of the founding fathers of modern space science, demonstrated with his Terrella experiment the formation of the aurora. Recently, a modernized version of the Terrella has been designed. This “Planeterrella” experiment allows the visualization of many phenomena that occur in our space environment. Although the Planeterrella was originally a local project, it has developed to become a very successful international public outreach experiment. We believe that its success is due to mainly two factors (i the Planeterrella is not patented and the plans are free to any public institute and (ii the project is widely advertised using national and European scientific networks such as COST ES 0803, as well as press releases, books and web sites. Today, seven Planeterrellas are in operation, four more are under construction in four different countries and several more are being planned. During the last five years, about 50 000 people in Europe have attended live Planeterrella demonstration on the formation of auroral light, the space environment and space weather. Many more have seen the Planeterrella being demonstrated on TV. The Planeterrella received the first international prize for outreach activities from the Europlanet Framework 7 program in 2010 and the French Ministry of Science outreach prize “Le goût des sciences” in November 2012. This paper describes the process that led to the construction of the first Planeterrella and discusses how the Planeterrella project developed

  2. The Planeterrella experiment: from individual initiative to networking

    Science.gov (United States)

    Lilensten, J.; Provan, G.; Barthelemy, M.; Simon Wedlund, C.; Gronoff, G.; Vanlommel, P.; Brekke, A.; Garnier, P.; Grimald Rochel, S.

    2013-12-01

    Space weather is a relatively new discipline, which is still largely unknown amongst the wider public despite its increasing importance in all of our daily lives. Outreach activities can promote awareness of space weather. In particular the visual beauty and excitement of the aurora make these lights a wonderful inspirational hook to enhance understanding of space weather in a general audience. A century ago, the Norwegian experimental physicist Kristian Birkeland, one of the founding fathers of modern space science, demonstrated with his Terrella experiment the formation of the aurora. Recently, a modernized version of the Terrella has been designed in France. This ';';Planeterrella'' experiment allows the visualization of many phenomena that occur in our space environment. Although the Planeterrella was originally a local project, it has developed to become a very successful international public outreach experiment. We believe that its success is due to mainly two factors (i) the Planeterrella is not patented and the plans are free to any public institute and (ii) the project is widely advertised using national and scientific networks, as well as press releases, books and web sites. Today, nine Planeterrellas are in operation, six more are under construction in five different countries including in the US and several more are being planned. During the last five years, about 55 000 people in Europe have attended live Planeterrella demonstration on the formation of auroral light, the space environment and space weather. Many more have seen the Planeterrella being demonstrated on TV. It is now used for education, outreach, scientific, and artistic purposes. We will describes this process and discuss how the Planeterrella project developed to become an international public outreach phenomenon. We also examine some of the lessons learnt along the way such as patented or not, big or small, automatized or hand-operated, and the cost of the overall project. A star (close

  3. Operational experience during initial beam commissioning of the LHC

    CERN Document Server

    Fuchsberger, K; Arduini, G; Assmann, R; Bailey, R; Bruning, O; Goddard, B; Kain, V; Lamont, M; MacPherson, A; Meddahi, M; Papotti, G; Pojer, M; Ponce, L; Redaelli, S; Solfaroli Camillocci, M; Venturini Delsolaro, W; Wenninger, J

    2010-01-01

    After the incident on the 19th September 2008 and more than one year without beam the commissioning of the LHC started again on November 20, 2009. Progress was rapid and collisions under stable beam conditions were established at 1.2 TeV within 3 weeks. In 2010 after qualification of the new quench protection system the way to 3.5 TeV was open and collision were delivered at this energy after a month of additional commissioning. This paper describes the experiences and issues encountered during these first periods of commissioning with beam.

  4. Robotic-assisted partial Nephrectomy: initial experience in South America

    Directory of Open Access Journals (Sweden)

    Gustavo C. Lemos

    2011-08-01

    Full Text Available OBJECTIVE:To report the initial outcomes of robotic-assisted partial nephrectomy in a tertiary center in South America. MATERIAL AND METHODS: From 11/2008 to 12/2009, a total of 16 transperitoneal robotic-assisted partial nephrectomies were performed in 15 patients to treat 18 kidney tumors. One patient with bilateral tumor had two procedures, while two patients with two synchronous unilateral tumors had a single operation to remove them. Eleven (73% patients were male and the right kidney was affected in 7 (46% patients. The median patient age and tumor size were 57 years old and 30 mm, respectively. Five (28% tumors were hilar and/or centrally located. RESULTS: The median operative time, warm ischemia time and estimated blood loss was 140 min, 27 min and 120 mL, respectively. Blood transfusion was required in one patient with bilateral tumor, and one additional pyelolithotomy was performed due to a 15mm stone located in the renal pelvis. The histopathology analysis showed 15 (83% malignant tumors, which 10 (67% were clear cell carcinoma. The median hospital stay was 72 hrs and no major complication was observed. CONCLUSION: Robotic-assisted partial nephrectomy is safe and represents a valuable option to perform minimally invasive nephron-sparing surgery.

  5. Initial experience with tadalafil in pediatric pulmonary arterial hypertension.

    Science.gov (United States)

    Takatsuki, Shinichi; Calderbank, Michelle; Ivy, David Dunbar

    2012-06-01

    This study aimed to investigate the safety, tolerability, and effects of tadalafil on children with pulmonary arterial hypertension (PAH) after transition from sildenafil or after tadalafil received as initial therapy. A total of 33 pediatric patients with PAH were retrospectively evaluated. Of the 33 patients, 29 were switched from sildenafil to tadalafil. The main reason for the change from sildenafil was once-daily dosing. The average dose of sildenafil was 3.4 ± 1.1 mg/kg/day, and that of tadalafil was 1.0 ± 0.4 mg/kg/day. For 14 of the 29 patients undergoing repeat catheterization, statistically significant improvements were observed after transition from sildenafil to tadalafil in terms of mean pulmonary arterial pressure (53.2 ± 18.3 vs. 47.4 ± 13.7 mmHg; p sildenafil to tadalafil including headache, nausea, myalgia, nasal congestion, flushing, and allergic reaction. Two patients discontinued tadalafil due to migraine or allergic reaction. One patient receiving sildenafil had no breakthrough syncope after transition to tadalafil. Tadalafil can be safely used for pediatric patients with PAH and may prevent disease progression.

  6. Initial Active MHD Spectroscopy Experiments on Alcator C-MOD

    Science.gov (United States)

    Schmittdiel, D. A.; Snipes, J. A.; Granetz, R. S.; Parker, R. R.; Wolfe, S. M.; Fasoli, A.

    2002-11-01

    The Active MHD Spectroscopy system is a new diagnostic on C-MOD that will be used to study low frequency MHD modes and TAE's present at high B_tor, n_e, and Te ˜= T_i. The present system consists of two antennas, power amplifiers, and an impedance matching network. Each antenna is 15 × 25 cm with five turns, an inductance of ˜10 μH, and is covered by boron nitride tiles. The two antennas are placed at the same toroidal location, symmetrically above and below the midplane. Each antenna is driven by a ˜1 kW power amplifier in the range of 1 kHz - 1 MHz with an expected antenna current ˜10 A, which will produce a vacuum field of ˜0.5 G at the q = 1.5 surface. This diagnostic is designed to excite high n ( ˜20) stable TAE's and initial results regarding their frequency, mode structure, and damping rate will be presented. Evolution of these modes could also provide information on the q profile to compare with MSE measurements, which will be important for planned lower hybrid current drive operation in 2003.

  7. Initial Diagnostics for the National Spherical Torus Experiment

    Energy Technology Data Exchange (ETDEWEB)

    A.L. Roquemore; B. McCormack; D. Johnson; H. Kugel; R. Kaita; and the NSTX Team

    1999-06-01

    The spherical torus (ST) approach to magnetic confinement has many attractive features as both a fusion reactor concept and a volume neutron source. The National Spherical Torus Experiment (NSTX) is under construction at the Princeton Plasma Physics Laboratory (PPPL), and it is designed to achieve plasma parameters needed for a proof-of-principle test of the ST concept. Discharges with magnetic fields of 2.3 kG on axis and plasma currents of 1 MA will be heated with 6 MW of radio frequency (RF) power and 5 MW of neutral beams, and pulse lengths up to 5 seconds are planned. Central electron temperatures of about 4 keV are expected with RF heating, and theoretical studies show that high values of b and b{sub n} can be achieved.

  8. PET/MRI in head and neck cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Platzek, Ivan; Laniado, Michael [Dresden University Hospital, Department of Radiology, Dresden (Germany); Beuthien-Baumann, Bettina [Dresden University Hospital, Department of Nuclear Medicine, Dresden (Germany); Schneider, Matthias [Dresden University Hospital, Oral and Maxillofacial Surgery, Dresden (Germany); Gudziol, Volker [Dresden University Hospital, Department of Otolaryngology, Dresden (Germany); Langner, Jens; Schramm, Georg; Hoff, Joerg van den [Institute of Bioinorganic and Radiopharmaceutical Chemistry, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Kotzerke, Joerg [Dresden University Hospital, Nuclear Medicine, Dresden (Germany)

    2013-01-15

    To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG ({sup 18}F-fluorodeoxyglucose) for initial staging of head and neck cancer. The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81 years (median 64 years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267-395 MBq FDG, 348 MBq on average). The maximum standardized uptake values (SUV{sub max}) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets. No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUV{sub max} than the conventional PET scanner for both the tumour (p < 0.0001) and the cerebellum (p = 0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p = 0.001). The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. (orig.)

  9. Application of robotics in general surgery: initial experience.

    Science.gov (United States)

    Nguyen, Ninh T; Hinojosa, Marcelo W; Finley, David; Stevens, Melinda; Paya, Mahbod

    2004-10-01

    Robotic surgery was recently approved for clinical use in general abdominal surgery. The aim of this study was to review our experience with the da Vinci surgical system during laparoscopic general surgical procedures. Eighteen patients underwent robotically assisted laparoscopic abdominal surgery between June 2002 and March 2003. Main outcome measures were operative time, room setup time, robotic arm-positioning and surgical time, blood loss, conversion to laparoscopy, length of stay, and morbidity. The types of robotically assisted laparoscopic procedures were excision of gastric leiomyoma (n = 1), Heller myotomy (n = 1), cholecystectomy (n = 2), gastric banding (n = 2), Nissen fundoplication (n = 4), and gastric bypass (n = 8). The mean room setup time was 63 +/- 14 minutes, and the mean robotic arm-positioning time was 16 +/- 7 minutes. Conversion to laparoscopy occurred in two (11%) of 18 cases because of equipment difficulty (n = 1) and technical difficulty (n = 1). Estimated blood loss was 91 +/- 71 mL. The mean operative time was 156 +/- 42 minutes, and the robotic operative time was 27% of the total operative time. The mean length of hospital stay was 2.2 +/- 1.5 days. There was one postoperative wound infection and one anastomotic stricture. Robotically assisted laparoscopic abdominal surgery is feasible and safe; however, the theoretical advantages of the da Vinci surgical system were not clinically apparent.

  10. The role of psychological support in cardiac surgery: initial experience

    Directory of Open Access Journals (Sweden)

    Fabrizio Sansone

    2011-11-01

    Full Text Available The scientific literature has pointed out several predictors of negative outcome after surgery such as pain and depression, negatively affecting the postoperative outcome in cardiac surgery. From January 2009 until June 2010, 15 patients scheduled for cardiac surgery were enrolled. The patients were assessed by psychological evaluation either in the hospital stay either in the rehabilitation period with the aim of identifying their emotional condition (sentiments about the onset of the disease, support received from family and friends even by means of preformed tests for anxiety and depression (tests of Stay and Back. Thus, in our preliminary experience, the psychological evaluation failed to detect the occurrence of postoperative complications. Conversely, the psychological evaluation is very effective in detecting a poor emotional state and the psychological support decreases the degree of anxiety and depression with positive effects on postoperative outcome. In conclusion, a standardize test for anxiety and depression should be used for patients at hospital admission to detect who may benefits by psychological support.

  11. Initial experience with a nuclear medicine viewing workstation

    Science.gov (United States)

    Witt, Robert M.; Burt, Robert W.

    1992-07-01

    Graphical User Interfaced (GUI) workstations are now available from commercial vendors. We recently installed a GUI workstation in our nuclear medicine reading room for exclusive use of staff and resident physicians. The system is built upon a Macintosh platform and has been available as a DELTAmanager from MedImage and more recently as an ICON V from Siemens Medical Systems. The workstation provides only display functions and connects to our existing nuclear medicine imaging system via ethernet. The system has some processing capabilities to create oblique, sagittal and coronal views from transverse tomographic views. Hard copy output is via a screen save device and a thermal color printer. The DELTAmanager replaced a MicroDELTA workstation which had both process and view functions. The mouse activated GUI has made remarkable changes to physicians'' use of the nuclear medicine viewing system. Training time to view and review studies has been reduced from hours to about 30-minutes. Generation of oblique views and display of brain and heart tomographic studies has been reduced from about 30-minutes of technician''s time to about 5-minutes of physician''s time. Overall operator functionality has been increased so that resident physicians with little prior computer experience can access all images on the image server and display pertinent patient images when consulting with other staff.

  12. Initial experience with a newly developed cementless hip endoprosthesis.

    Science.gov (United States)

    Hach, V; Delfs, G

    2009-01-01

    The HELICA-Endoprosthesis is a newly developed cementless hip prosthesis for dogs. It was implanted in 39 dogs that had severe hip osteoarthritis and a history of hip pain, as well as in one dog that had chronic hip luxation. One dog had a bilateral arthroplasty. The body weight of the patients ranged between 22 and 54 kg and their ages between nine months and 10 years. Both the femoral stem and acetabular component of the prosthesis were screwed into position following bony preparation. Additional fixation was not necessary as the components remain fixed in position until osteointegration is complete. There are currently five sizes of prosthesis available, and the various components such as the stem, cup and head are readily interchangeable. Although it appeared that good osseous anchorage of the prostheses in the bone on the surgery table had been obtained, three patients experienced both stem and cup loosening (one week, three weeks and six months after surgery). In one animal, stem loosening was observed six weeks after surgery, and another dog experienced a cup loosening two weeks postoperatively. Most of the complications were due to technical errors that occurred during the learning phase. Surgical revisions were successful in three out of five animals. In two animals we had to perform a femoral head and neck excision. Two other animals experienced radiographic bone resorption underneath the segmented collar of the femoral prosthesis but did not show any significant clinical signs of lameness. Another dog that showed signs of ischial neuropraxy after surgery, recovered completely within six weeks after surgery. All of the dogs were capable of weight bearing on the operated leg one day after surgery. The main advantage of the HELICA-Endoprosthesis is the relatively easy surgical technique and short surgery time. The initial clinical results in these 40 cases have been very encouraging. The aim of this study was to assess the early clinical results in these 39

  13. Laparoscopic colorectal surgery: what to expect from an initial experience

    Directory of Open Access Journals (Sweden)

    Fábio Ramos Teixeira

    2012-06-01

    Full Text Available Laparoscopic colorectal surgery is less traumatic when compared to traditional surgery techniques, with well-established advantages. The objective of this study was to report the experience in laparoscopic surgical treatment of colorectal diseases. METHOD: Catalog all patients submitted to laparoscopic colorectal surgery performed by one surgeon and perform a descriptive analysis of key data from these records. RESULTS: The study analyzed data from 43 patients who underwent laparoscopic colorectal surgery. Most were females (n=30; 69.77% in relation to males (n=13; 30.23%, mean age of 57.21 years old. Among the indications for surgery, diverticular disease was the most frequent (n=20; 46.51%, followed by malignancy (n=13; 30.23%. Most patients underwent rectosigmoidectomy (n=28; 65.12%, followed by right hemicolectomy (n=6; 13.95%, with conversions in five cases (11.63%. The study observed a tendency towards increased number of surgeries, reduced average operative time as well as decreased conversions to laparotomy along the studied period. CONCLUSION: Laparoscopic colorectal surgery is a safe procedure, and with the technical development of the team, the results have been increasingly good.A videolaparoscopia colorretal apresenta-se como uma tática operatória menos traumática com vantagens bem-estabelecidas. O objetivo deste trabalho foi apresentar a experiência no tratamento cirúrgico videolaparoscópico das afecções colorretais. MÉTODO: Catalogar todos os pacientes submetidos à cirurgia colorretal videolaparoscópica realizadas por um único cirurgião e realizar uma análise descritiva dos principais dados a partir dos prontuários destes. RESULTADOS: O estudo analisou dados de 43 pacientes que foram submetidos à cirurgia colorretal por videolaparoscopia. A maioria era do gênero feminino (n=30; 69,77% em relação ao masculino (n=13; 30,23% com média de idade de 57,21 anos. Dentre as indicações cirúrgicas, doença diverticular

  14. CORONARY ANGIOGRAPHY WITH DUAL SOURCE COMPUTED TOMOGRAPHY: INITIAL EXPERIENCE

    Institute of Scientific and Technical Information of China (English)

    Zhu-hua Zhang; Wen-min Zhao; Wen-bin Mou; Li-ren Zhang; Wen-ling Zhu; Qi Miao; Qi Fang; Zheng-yu Jin; Shu-yang Zhang; Song-bai Lin; Dong-jing Li; Ling-yan Kong; Yi-ning Wang; Lan Song; Yun Wang

    2007-01-01

    To explore the scan technique and image quality of coronary angiography with dual source computed tomography (CT) without oral metoprolol preparation.Methods Plain and enhanced dual source CT coronary angiography without oral metoprolol preparation was prospectively performed in 600 patients. Calcium scoring with plain scan images as well as multi-planar reconstruction( MPR ), maximum intensity projection (MIP), and volume rendering technique (VRT) reconstruction with enhanced scan images were performed in all cases. The scan technique and post-reconstruction experience was summarized. The image quality was classified as 1 to 4 points, and coronary segments classified according to the American Heart Association standards were evaluated.Results The average calcium score of the 600 cases was 213.6 ± 298.7 (0-3 216. 5). The average heart rate of the enhanced scan was 82.1 ± 16.2 (47-139) bpm. The post-reconstruction methods with which coronary segments could be shown as best as possible consisted of single phase reconstruction method, two or more phases supplemented method, and electrocardiogram editing method. Altogether 8 457 coronary segments were evaluated, among which 97.2% were evaluated as point 1, 1.7% point 2, 0.5% point 3, and0.6% point 4. The coronary segments in 261 cases were completely normal, while 360 segments were diagnosed with < 50% stenosis and 625 segments with ≥50%stenosis.Conclusions Excellent coronary artery image can be obtained with dual source CT in patients with any heart rate without oral metoprolol preparation. Heart rate is not a major source of the artifact, coronary segments can be well shown with single or multiple-phase reconstruction method.

  15. Digital breast tomosynthesis (DBT): initial experience in a clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Skaane, Per; Gullien, Randi; Eben, Ellen B.; Haakenaasen, Unni; Naess Jebsen, Ingvild; Krager, Mona [Dept of Radiology, Oslo Univ. Hospital Ullevaal, Univ. of Oslo, Oslo (Norway)], e-mail: PERSKA@ous-hf.no; Bjoerndal, Hilde [Dept of Radiology, Oslo Univ. Hospital The Norwegian Radium Hospital, Oslo (Norway); Ekseth, Ulrika [Curato Roentgen Institute, Oslo (Norway); Jahr, Gunnar [Dept. of Radiology, Oslo Univ. Hospital Rikshospitalet, Oslo (Norway)

    2012-06-15

    false-positive findings. The side-by-side feature analysis showed higher conspicuity scores for tomosynthesis compared to conventional 2D for cancers presenting as spiculated masses and distortions. Conclusion: Tomosynthesis is a promising new technique. Our preliminary clinical experience shows that there is a potential for increasing the sensitivity using this new technique, especially for cancers manifesting as spiculated masses and distortions.

  16. The WIND-HAARP Experiment: Initial Results of High Power Radiowave Interactions with Space Plasmas

    Science.gov (United States)

    1997-11-10

    Results from the first science experiment with the new HF Active Auroral Research Program ( HAARP ) facility in Alaska are reported. The initial...experiments involved transmission of high frequency waves from HAARP to the NASA/WIND satellite. The objective was to investigate the effects of space

  17. Comparing overflow and wave-overtopping induced breach initiation mechanisms in an embankment breach experiment

    Directory of Open Access Journals (Sweden)

    van Damme Myron

    2016-01-01

    Full Text Available As part of the SAFElevee project Delft University of Technology collabored with Flanders Hydraulics Research, and Infram B.V. in the preperation and execution of a full scale embankment breach experiment in November 2015. This breach experiment was performed on an 3.5m high embankment with a sand core and clay outer layer situated along the tidal river Scheldt in Belgium near Schellebelle. During the experiment a wave overtopping simulator and overflow simulator were used to initiate a breach. Both simulators were placed near the top of the waterside slope. The use of the simulators facilitated comparison between the effects of continueous overflow and the effects of intermittent wave overtopping. This paper presents the data collected during the experiment, describe the development of hypotheses on the failure processes using the latest insights, and comment on the failure initiation process of a grass covered flood embankment with a clay outer layer and a sandy core.

  18. Commissioning and initial experimental program of the BGO-OD experiment at ELSA

    Directory of Open Access Journals (Sweden)

    Alef S.

    2016-01-01

    Full Text Available BGO-OD is a new meson photoproduction experiment at the ELSA facility of Bonn University. It aims at the investigation of non strange and strange baryon excitations, and is especially designed to be able to detect weekly bound meson-baryon type structures. The setup for the BGO-OD experiment is presented, the characteristics of the photon beam and the detector performances are shown and the initial experimental program is discussed.

  19. Initiating Transdisciplinarity in Academic Case Study Teaching: Experiences from a Regional Development Project in Salzburg, Austria

    Science.gov (United States)

    Muhar, Andreas; Vilsmaier, Ulli; Glanzer, Michaela; Freyer, Bernhard

    2006-01-01

    Purpose: The purpose of this paper is to describe experiences with the initiation of transdisciplinarity in academic case study teaching with special reference to regional planning, based on the case study "Leben 2014 (Life 2014)--perspectives for regional development in the national park region Ober-pinz-gau, Salzburg".…

  20. "Elite" Career-Changers and Their Experience of Initial Teacher Education

    Science.gov (United States)

    Wilkins, Chris

    2017-01-01

    This study explores the motivation of "high-status" professionals to change career and enter teaching, and their experience of undertaking initial teacher education (ITE) programmes in England. The study builds on previous research which found that career-changers are disproportionately more likely to fail to complete their ITE studies,…

  1. Initial Experience with the Extracorporeal HIFU Knife with 49 Patients: Japanese Experience

    Science.gov (United States)

    Ganaha, F.; Okuno, T.; Lee, C. O.; Shimizu, T.; Osako, K.; Oka, S.; Lee, K. H.; Chen, W. Z.; Zhu, H.; Park, S. H.; Qi, Z.; Shi, D.; Song, H. S.

    2005-03-01

    Forty nine patients with 63 tumours were treated with the Chongqing Haifu knife, as an adjunct to intra-arterial chemoinfusion. Treatment targets included breast (20 lesions), liver (16), bone (8), lymph-node (6), soft tissue (4), lung and pleura (4), pancreas (2), kidney (2) and adrenal gland (1). Follow-up contrast MRI was performed at 3 weeks to assess the effects of HIFU ablation. All cases completed the planned treatment. Of 25 lesions treated with the intention of complete tumour ablation, complete necrosis was obtained in 19 lesions (76%) including 4 secondary success cases. Among 32 lesions having partial and palliative treatment, tumour size was decreased in 6 lesions (21%), and good pain control was obtained in 6 out of 7 patients (86%). Skin injury was the most common complication after HIFU (16%), and was mostly a superficial dermal burn that did not necessitate any treatment. However, there was one patient with deep skin injury at an operation scar which resulted in skin perforation. Other adverse events included soft tissue swelling, prolonged fever, anorexia, persistent pain, shortness of the breath, sacroiliac joint fracture and prolonged diarrhoea. In our limited experience, superficial lesions (e.g. breast cancer, bone, soft tissue, lymph-node and pleural metastasis) appear to be good candidates for HIFU treatment. There appears to be a role for the HIFU knife in pain control for patients with bone metastasis and pancreatic cancer.

  2. Influence of the initial soil water content on Beerkan water infiltration experiments

    Science.gov (United States)

    Lassabatere, L.; Loizeau, S.; Angulo-Jaramillo, R.; Winiarski, T.; Rossier, Y.; Delolme, C.; Gaudet, J. P.

    2012-04-01

    Understanding and modeling of water flow in the vadose zone are important with regards water management and infiltration devices design. Water infiltration process clearly depends on initial soil water content, in particular for sandy soils with high organic matter content. This study investigates the influence of initial water content on water infiltration in a hydrophobic sandy soil and on the related derivation of hydraulic parameters using the BEST algorithm (Lassabatere et al., 2006). The studied sandy soil has a high total organic content decreasing from 3.5% (w/w) at the surface to 0.5% (w/w) below 1cm depth. The highest TOC at surface was due to the presence of a dense biofilm and resulted in a high surface hydrophobicity under dry conditions (low initial water contents). The water infiltration experiments consisted in infiltrating known volumes of water through a simple ring at null pressure head (Beerkan method). The infiltrations were performed during three successive days after a dry period with a storm event between the first and the second day (5 mm) and another between the second and the third day (35 mm). These events resulted in an increase in initial water contents, from less than 5% for the first day to around 10% for the last day. Experiments were performed for appropriate conditions for Beerkan experiments: initial water contents below 1/4 of the saturated water content and uniform water profile resulting from water redistribution after each rainfall event. The analysis of the infiltration data clearly highlights the strong effect of hydrophobicity. For the driest initial conditions (first day), infiltration rates increased with time, whereas they decreased with time for wetter conditions. Such a decrease agreed with the principles of water infiltration without hydrophobicity. In addition, total cumulative infiltrations were far higher for the wettest conditions. Regarding hydraulic characterization, only the data obtained during the last

  3. Experiments and simulations on the incompressible, Rayleigh-Taylor instability with small wavelength initial perturbations

    Science.gov (United States)

    Roberts, Michael Scott

    The Rayleigh-Taylor instability is a buoyancy driven instability that takes place in a stratified fluid system with a constant acceleration directed from the heavy fluid into the light fluid. In this study, both experimental data and numerical simulations are presented. Experiments are performed primarily using a lithium-tungstate aqueous solution as the heavy liquid, but sometimes a calcium nitrate aqueous solution is used for comparison purposes. Experimental data is obtained for both miscible and immiscible fluid combinations. For the miscible experiments the light liquid is either ethanol or isopropanol, and for the immiscible experiments either silicone oil or trans-anethole is used. The resulting Atwood number is either 0.5 when the lithium-tungstate solution is used or 0.2 when the calcium nitrate solution is used. These fluid combinations are either forced or left unforced. The forced experiments have an initial perturbation imposed by vertically oscillating the liquid containing tank to produce Faraday waves at the interface. The unforced experiments rely on random interfacial fluctuations, due to background noise, to seed the instability. The liquid combination is partially enclosed in a test section that is accelerated downward along a vertical rail system causing the Rayleigh-Taylor instability. Accelerations of approximately 1g (with a weight and pulley system) or 10g (with a linear induction motor system) are experienced by the liquids. The tank is backlit and digitally recorded with high speed video cameras. These experiments are then simulated with the incompressible, Navier-Stokes code Miranda. The main focus of this study is the growth parameter (α) of the mixing region produced by the instability after it has become apparently self-similar and turbulent. The measured growth parameters are compared to determine the effects of miscibility and initial perturbations (of the small wavelength, finite bandwidth type used here). It is found that while

  4. Migration experience and premarital sexual initiation in urban Kenya: an event history analysis.

    Science.gov (United States)

    Luke, Nancy; Xu, Hongwei; Mberu, Blessing U; Goldberg, Rachel E

    2012-06-01

    Migration during the formative adolescent years can affect important life-course transitions, including the initiation of sexual activity. In this study, we use life history calendar data to investigate the relationship between changes in residence and timing of premarital sexual debut among young people in urban Kenya. By age 18, 64 percent of respondents had initiated premarital sex, and 45 percent had moved at least once between the ages of 12 and 18. Results of the event history analysis show that girls and boys who move during early adolescence experience the earliest onset of sexual activity. For adolescent girls, however, other dimensions of migration provide protective effects, with greater numbers of residential changes and residential changes in the last one to three months associated with later sexual initiation. To support young people's ability to navigate the social, economic, and sexual environments that accompany residential change, researchers and policymakers should consider how various dimensions of migration affect sexual activity.

  5. Causes and outcomes of revisional bariatric surgery: initial experience at a single center

    OpenAIRE

    2014-01-01

    Purpose Bariatric surgery has become more prevalent owing to the worldwide obesity epidemic. With the growing number of bariatric procedures performed annually, the requirement for revisional and secondary operations is increasing accordingly. This study aimed to evaluate the initial experience of revisional bariatric surgery at a single specialized center. Methods A retrospective review of the prospectively established database identified all patients who underwent revisional bariatric surge...

  6. Initial experience with a first-to-market member accountability-based insurance product.

    Science.gov (United States)

    Woll, Douglas R; Nelson, David R

    2010-10-01

    We describe the initial experience with a first-to-market health insurance product design based on principles of both member and purchaser accountability. Two benefit levels were offered, enhanced and standard. Qualification for the enhanced benefit level was obtained through members' commitment to follow their physicians' recommended treatment plan. Employers were offered a discount of 10% in exchange for offering this new product and promoting a healthy work environment. Membership in the product grew beyond expectations, and several health improvements were noted.

  7. Thermophysical Property Estimation by Transient Experiments: The Effect of a Biased Initial Temperature Distribution

    Directory of Open Access Journals (Sweden)

    Federico Scarpa

    2015-01-01

    Full Text Available The identification of thermophysical properties of materials in dynamic experiments can be conveniently performed by the inverse solution of the associated heat conduction problem (IHCP. The inverse technique demands the knowledge of the initial temperature distribution within the material. As only a limited number of temperature sensors (or no sensor at all are arranged inside the test specimen, the knowledge of the initial temperature distribution is affected by some uncertainty. This uncertainty, together with other possible sources of bias in the experimental procedure, will propagate in the estimation process and the accuracy of the reconstructed thermophysical property values could deteriorate. In this work the effect on the estimated thermophysical properties due to errors in the initial temperature distribution is investigated along with a practical method to quantify this effect. Furthermore, a technique for compensating this kind of bias is proposed. The method consists in including the initial temperature distribution among the unknown functions to be estimated. In this way the effect of the initial bias is removed and the accuracy of the identified thermophysical property values is highly improved.

  8. Experience shapes our odor perception but depends on the initial perceptual processing of the stimulus.

    Science.gov (United States)

    Sinding, Charlotte; Coureaud, Gérard; Bervialle, Boris; Martin, Christophe; Schaal, Benoist; Thomas-Danguin, Thierry

    2015-07-01

    The questions of whether configural and elemental perceptions are competitive or exclusive perceptual processes and whether they rely on independent or dependent mechanisms are poorly understood. To examine these questions, we modified perceptual experience through preexposure to mixed or single odors and measured the resulting variation in the levels of configural and elemental perception of target odor mixtures. We used target mixtures that were spontaneously processed in a configural or an elemental manner. The AB binary mixture spontaneously involved the configural perception of a pineapple odor, whereas component A smelled like strawberry and component B smelled like caramel. The CD mixture produced the elemental perceptions of banana (C) and smoky (D) odors. Perceptual experience was manipulated through repeated exposure to either a mixture (AB or CD) or the components (A and B or C and D). The odor typicality rating data recorded after exposure revealed different influences of experience on odor mixtures and single-component perception, depending both on the type of exposure (components or mixture) and the mixture's initial perceptual property (configural or elemental). Although preexposure to A and B decreased the pineapple typicality of the configural AB mixture, preexposure to AB did not modify its odor quality. In contrast, preexposure to the CD elemental mixture induced a quality transfer between the components. These results emphasize the relative plasticity of odor mixture perception, which is prone to experience-induced modulations but depends on the stimulus's initial perceptual properties, suggesting that configural and elemental forms of odor mixture perception rely on rather independent processes.

  9. Magnetohydrodynamic simulation of solid-deuterium-initiated Z-pinch experiments

    Energy Technology Data Exchange (ETDEWEB)

    Sheehey, Peter Trogdon [Univ. of California, Los Angeles, CA (United States)

    1994-02-01

    Solid-deuterium-initiated Z-pinch experiments are numerically simulated using a two-dimensional resistive magnetohydrodynamic model, which includes many important experimental details, such as ``cold-start`` initial conditions, thermal conduction, radiative energy loss, actual discharge current vs. time, and grids of sufficient size and resolution to allow realistic development of the plasma. The alternating-direction-implicit numerical technique used meets the substantial demands presented by such a computational task. Simulations of fiber-initiated experiments show that when the fiber becomes fully ionized rapidly developing m=0 instabilities, which originated in the coronal plasma generated from the ablating fiber, drive intense non-uniform heating and rapid expansion of the plasma column. The possibility that inclusion of additional physical effects would improve stability is explored. Finite-Larmor-radius-ordered Hall and diamagnetic pressure terms in the magnetic field evolution equation, corresponding energy equation terms, and separate ion and electron energy equations are included; these do not change the basic results. Model diagnostics, such as shadowgrams and interferograms, generated from simulation results, are in good agreement with experiment. Two alternative experimental approaches are explored: high-current magnetic implosion of hollow cylindrical deuterium shells, and ``plasma-on-wire`` (POW) implosion of low-density plasma onto a central deuterium fiber. By minimizing instability problems, these techniques may allow attainment of higher temperatures and densities than possible with bare fiber-initiated Z-pinches. Conditions for significant D-D or D-T fusion neutron production may be realizable with these implosion-based approaches.

  10. Initial Scaling Studies and Conceptual Thermal Fluids Experiments for the Prismatic NGNP Point Design

    Energy Technology Data Exchange (ETDEWEB)

    D. M. McEligot; G. E. McCreery

    2004-09-01

    The objective of this report is to document the initial high temperature gas reactor scaling studies and conceptual experiment design for gas flow and heat transfer. The general approach of the project is to develop new benchmark experiments for assessment in parallel with CFD and coupled CFD/ATHENA/RELAP5-3D calculations for the same geometry. Two aspects of the complex flow in an NGNP are being addressed: (1) flow and thermal mixing in the lower plenum ("hot streaking" issue) and (2) turbulence and resulting temperature distributions in reactor cooling channels ("hot channel" issue). Current prismatic NGNP concepts are being examined to identify their proposed flow conditions and geometries over the range from normal operation to decay heat removal in a pressurized cooldown. Approximate analyses are being applied to determine key non-dimensional parameters and their magnitudes over this operating range. For normal operation, the flow in the coolant channels can be considered to be dominant forced convection with slight transverse property variation. The flow in the lower plenum can locally be considered to be a situation of multiple buoyant jets into a confined density-stratified crossflow -- with obstructions. Experiments are needed for the combined features of the lower plenum flows. Missing from the typical jet experiments are interactions with nearby circular posts and with vertical posts in the vicinity of vertical walls - with near stagnant surroundings at one extreme and significant crossflow at the other. Two heat transfer experiments are being considered. One addresses the "hot channel" problem, if necessary. The second experiment will treat heated jets entering a model plenum. Unheated MIR (Matched-Index-of-Refraction) experiments are first steps when the geometry is complicated. One does not want to use a computational technique which will not even handle constant properties properly. The MIR experiment will simulate flow features of the paths of jets

  11. Effects of Initial Conditions on Compressible Mixing in Supernova-Relevant Laboratory Experiments

    Energy Technology Data Exchange (ETDEWEB)

    Miles, A R; Edwards, M; Greenough, J

    2004-04-30

    In core-collapse supernovae, strong blast waves drive interfaces susceptible to Rayleigh-Taylor (RT), Richtmyer-Meshkov (RM), and Kelvin-Helmholtz (KH) instabilities. In addition, perturbation growth can result from material expansion in large-scale velocity gradients behind the shock front. Laser-driven experiments are designed to produce a strongly shocked interface whose evolution is a scaled version of the unstable hydrogen-helium interface in core-collapse supernovae such as SN 1987A. The ultimate goal of this research is to develop an understanding of the effect of hydrodynamic instabilities and the resulting transition to turbulence on supernovae observables that remain as yet unexplained. In this paper, we summarize recent results from our computational study of unstable systems driven by high Mach number shock and blast waves. For planar multimode systems, compressibility effects preclude the emergence of a regime of self-similar instability growth independent of the initial conditions (IC's) by allowing for memory of the initial conditions to be retained in the mix-width at all times. With higher-dimensional blast waves, divergence restores the properties necessary for establishment of the self-similar state, but achieving it requires very high initial characteristic mode number and high Mach number for the incident blast wave. Initial conditions predicted by some recent stellar calculations are incompatible with self-similarity.

  12. Initial utility experience with cluster of three Mod-2 wind turbine systems

    Science.gov (United States)

    Seely, D. B.; Warchol, E. J.; Butler, N. G.; Ciranny, S.

    1982-01-01

    This paper describes the initial utility experiences of operating three MOD-2s during the Engineering Acceptance Testing. Electrical quantities of bus voltage, phase currents and power are initially being recorded to evaluate impacts to customers on the 69-kV subtransmission line during synchronization and operation of one or more WTSs. To date, effects on the system have been essentially undetectable. Measurements of television signal strengths were taken at an existing television remote pickup and relay station at the WTS site. Potential TV signal interference problems from the WTSs have been avoided by replacing the remote pickups with microwave repeater links for the four TV channels received from Portland, Oregon. Preliminary measurements of audible and sub-audible noise levels indicate that the upwind rotor, tubular tower design of the MOD-2 does not have the pulsing high intensity infrasound problems experienced by the MOD-1 machine at Boone, North Carolina.

  13. Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania

    Directory of Open Access Journals (Sweden)

    Moshi Mainen J

    2007-01-01

    Full Text Available Abstract Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics. The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General

  14. Maximizing the Workshop Experience: An Example from the PTRA Rural Initiatives Program

    Science.gov (United States)

    Burns, Teresa

    2003-11-01

    Since the summer of 2001, the Rural Initiative of the Physics Teaching Resource Agents have led summer workshops for high school and middle school physics teachers at several universities nationwide. From the site at Coastal Carolina University where teachers learned about radioactivity and nuclear physics, assistant professor Teresa Burns describes how high school teacher Lucas Mullen was able to build a curriculum tied to South Carolina State Science Standards around the content he learned at the workshop. This is one example of how a workshop experience can lead to better teaching practices through exposure to content material and current accepted practices in physics education research.

  15. Reactivity Initiated Accident Test Series RIA Scoping Test Experiment Operating Specification

    Energy Technology Data Exchange (ETDEWEB)

    N/A

    1978-06-01

    This document describes the experiment operating specifications for the Reactivity Initiated Accident (RIA) Scoping Test to be conducted in the Power Burst Facility (PBF) at the Idaho National Engineering Laboratory. The primary objectives of the RIA research are to determine fuel failure thresholds, modes, and consequences as functions of (a) enthalpy insertion, (b) irradiation history, and (c) fuel design. Coolant conditions of pressure, temperature, and flow rate that are typical of hot-startup conditions in commercial boiling water reactors (BWRs) will be used in the first six RIA tests, termed Series I.

  16. Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

    DEFF Research Database (Denmark)

    Watt, Sara; Agerlin, Niels; Romner, Bertil

    2012-01-01

    A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide...... a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS), the "virtual off" setting and compatibility with magnetic...

  17. Sex reassignment surgery for male to female transsexuals: initial experience in Okayama university hospital.

    Directory of Open Access Journals (Sweden)

    Nagai,Atsushi

    2005-10-01

    Full Text Available

    The first case of sex reassignment surgery (SRS in our hospital was performed in January 2001; as of February, 2005, 4 cases of MTF-SRS had been performed. In the 2 most recent cases, we used penile and scrotal skin flaps to avoid complications. The depth and width of the new vagina was made to be adequate for sexual intercourse. Future attention should be focused on devising a surgical technique that will help prevent the complications of partial necrosis of the epidermal skin and wound dehiscence. Although ours is only an initial experience, we describe our surgical technique herein.

  18. Initial experience with stereoscopic visualization of three-dimensional ultrasound data in surgery.

    Science.gov (United States)

    Gronningsaeter, A; Lie, T; Kleven, A; Mørland, T; Langø, T; Unsgård, G; Myhre, H O; Mårvik, R

    2000-11-01

    Initial in vivo and in vitro experiments were performed to evaluate the feasibility of stereoscopically displaying three-dimensional (3D) ultrasound data from neurosurgery, laparoscopic surgery, and vascular surgery. Stereoscopic visualization was illustrated by four video sequences, which can be downloaded from http://www.us.unimed. sintef.no/. These sequences show a brain tumor, hepatic arteries in relation to the gallbladder, a model that mimics a neuroendoscope in a cyst, and a "flight" into model of an artery with an intima flap. The experiments indicate that stereoscopic display of ultrasound data is feasible when there is sufficient contrast between the objects of interest and the surrounding tissue. True 3D vision improves perception, thus enhancing the ability to understand complex anatomic structures such as irregular lesions and tortuous vessels.

  19. Comparison between initial Magnetized Liner Inertial Fusion experiments and integrated simulations

    Science.gov (United States)

    Sefkow, A. B.; Gomez, M. R.; Geissel, M.; Hahn, K. D.; Hansen, S. B.; Harding, E. C.; Peterson, K. J.; Slutz, S. A.; Koning, J. M.; Marinak, M. M.

    2014-10-01

    The Magnetized Liner Inertial Fusion (MagLIF) approach to ICF has obtained thermonuclear fusion yields using the Z facility. Integrated magnetohydrodynamic simulations provided the design for the first neutron-producing experiments using capabilities that presently exist, and the initial experiments measured stagnation radii rstag < 75 μm, temperatures around 3 keV, and isotropic neutron yields up to YnDD = 2 ×1012 from imploded liners reaching peak velocities around 70 km/s over an implosion time of about 60 ns. We present comparisons between the experimental observables and post-shot degraded integrated simulations. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the National Nuclear Security Administration under Contract DE-AC04-94AL85000.

  20. Initial Off-Axis Neutral Beam Checkout and Physics Experiments on DIII-D

    Science.gov (United States)

    van Zeeland, M. A.; Ferron, J. R.; Hyatt, A. W.; Murphy, C. J.; Petty, C. C.; Prater, R.; Scoville, J. T.; Heidbrink, W. W.; Muscatello, C. M.; Park, J. M.; Murakami, M.; Pace, D. C.; Holcomb, C. T.; Grierson, B. A.; Tobias, B. J.; Solomon, W. M.; Moyer, R. A.

    2011-10-01

    Two of the eight neutral beam sources on DIII-D have been modified to allow vertical steering, with the injection angle varying from horizontal to downward at an angle of 16.5 degrees for off-axis deposition. Initial experiments to assess the basic beam functionality, geometry, and confinement were carried out. Dα images of beam into gas and plasma yield beam neutral profiles and are key in assessing beam shape and clipping. Neutron and fast-ion Dα (FIDA) diagnostics verify classical behavior of the off-axis beam ions in MHD-quiescent conditions. An initial physics experiment takes advantage of the downward steered beams to vary the fast-ion gradient ∇βf from centrally peaked to hollow. Systematic scans determine the stability and impact of reversed shear Alfvén eigenmodes and toroidal Alfvén eigenmodes as a function of ∇βf . Supported by US DOE under DE-FC02-04ER54698, SC-G903402, DE-AC05-00OR22725, DE-AC05-06OR23100, DE-AC52-07NA27344, DE-AC02-09CH11466, & DE-FG02-07ER54917.

  1. Initial Experience with a Cone-beam Breast Computed Tomography-guided Biopsy System

    Science.gov (United States)

    Seifert, Posy J; Morgan, Renee C; Conover, David L; Arieno, Andrea L

    2017-01-01

    Objective: To evaluate our initial experience with a cone-beam breast computed tomography (BCT)-guided breast biopsy system for lesion retrieval in phantom studies for use with a cone-beam BCT imaging system. Materials and Methods: Under the Institutional Review Board approval, a phantom biopsy study was performed using a dedicated BCT-guided biopsy system. Fifteen biopsies were performed on each of the small, medium, and large anthropomorphic breast phantoms with both BCT and stereotactic guidance for comparison. Each set of the 45 phantoms contained masses and calcification clusters of varying sizes. Data included mass/calcium retrieval rate and dose and length of procedure time for phantom studies. Results: Phantom mass and calcium retrieval rate were 100% for BCT and stereotactic biopsy. BCT dose for small and medium breast phantoms was found to be equivalent to or less than the corresponding stereotactic approach. Stereotactic-guided biopsy dose was 34.2 and 62.5 mGy for small and medium breast phantoms, respectively. BCT-guided biopsy dose was 15.4 and 30.0 mGy for small and medium breast phantoms, respectively. Both computed tomography biopsy and stereotactic biopsy study time ranged from 10 to 20 min. Conclusion: Initial experience with a BCT-guided biopsy system has shown to be comparable to stereotactic biopsy in phantom studies with equivalent or decreased dose. PMID:28217404

  2. Intraoperative 3-tesla MRI in the management of paediatric cranial tumours - initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Avula, Shivaram; Garlick, Deborah; Abernethy, Laurence J. [Alder Hey Children' s NHS Foundation Trust, Department of Radiology, Liverpool (United Kingdom); Mallucci, Connor L. [Alder Hey Children' s Hospital, Department of Neurosurgery, Liverpool (United Kingdom); Pizer, Barry [Alder Hey Children' s Hospital, Department of Oncology, Liverpool (United Kingdom); Crooks, Daniel [Walton Centre for Neurology and Neurosurgery, Department of Pathology, Liverpool (United Kingdom)

    2012-02-15

    Intraoperative MRI (ioMRI) has been gaining recognition because of its value in the neurosurgical management of cranial tumours. There is limited documentation of its value in children. To review the initial experience of a paediatric 3-Tesla ioMRI unit in the management of cranial tumours. Thirty-eight children underwent ioMRI during 40 cranial tumour resections using a 3-Tesla MR scanner co-located with the neurosurgical operating theatre. IoMRI was performed to assess the extent of tumour resection and/or to update neuronavigation. The intraoperative and follow-up scans, and the clinical records were reviewed. In 27/40 operations, complete resection was intended. IoMRI confirmed complete resection in 15/27 (56%). As a consequence, surgical resection was extended in 5/27 (19%). In 6/27 (22%), ioMRI was equivocal for residual tumour. In 13/40 (33%) operations, the surgical aim was to partially resect the tumour. In 7 of the 13 (54%), surgical resection was extended following ioMRI. In our initial experience, ioMRI has increased the rate of complete resection, with intraoperative surgical strategy being modified in 30% of procedures. Collaborative analysis of ioMRI by the radiologist and neurosurgeon is vital to avoid errors in interpretation. (orig.)

  3. The Model Parameter Estimation Experiment (MOPEX): Its structure, connection to other international initiatives and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Wagener, T; Hogue, T; Schaake, J; Duan, Q; Gupta, H; Andreassian, V; Hall, A; Leavesley, G

    2006-05-08

    The Model Parameter Estimation Experiment (MOPEX) is an international project aimed at developing enhanced techniques for the a priori estimation of parameters in hydrologic models and in land surface parameterization schemes connected to atmospheric models. The MOPEX science strategy involves: database creation, a priori parameter estimation methodology development, parameter refinement or calibration, and the demonstration of parameter transferability. A comprehensive MOPEX database has been developed that contains historical hydrometeorological data and land surface characteristics data for many hydrologic basins in the United States (US) and in other countries. This database is being continuously expanded to include basins from various hydroclimatic regimes throughout the world. MOPEX research has largely been driven by a series of international workshops that have brought interested hydrologists and land surface modelers together to exchange knowledge and experience in developing and applying parameter estimation techniques. With its focus on parameter estimation, MOPEX plays an important role in the international context of other initiatives such as GEWEX, PUB and PILPS. This paper outlines the MOPEX initiative, discusses its role in the scientific community and briefly states future directions.

  4. Initial Experiences of Simultaneous Laparoscopic Resection of Colorectal Cancer and Liver Metastases

    Directory of Open Access Journals (Sweden)

    L. T. Hoekstra

    2012-01-01

    Full Text Available Introduction. Simultaneous resection of primary colorectal carcinoma (CRC and synchronous liver metastases (SLMs is subject of debate with respect to morbidity in comparison to staged resection. The aim of this study was to evaluate our initial experience with this approach. Methods. Five patients with primary CRC and a clinical diagnosis of SLM underwent combined laparoscopic colorectal and liver surgery. Patient and tumor characteristics, operative variables, and postoperative outcomes were evaluated retrospectively. Results. The primary tumor was located in the colon in two patients and in the rectum in three patients. The SLM was solitary in four patients and multiple in the remaining patient. Surgical approach was total laparoscopic (2 patients or hand-assisted laparoscopic (3 patients. The midline umbilical or transverse suprapubic incision created for the hand port and/or extraction of the specimen varied between 5 and 10 cm. Median operation time was 303 (range 151–384 minutes with a total blood loss of 700 (range 200–850 mL. Postoperative hospital stay was 5, 5, 9, 14, and 30 days. An R0 resection was achieved in all patients. Conclusions. From this initial single-center experience, simultaneous laparoscopic colorectal and liver resection appears to be feasible in selected patients with CRC and SLM, with satisfying short-term results.

  5. New perspectives on sea use management: initial findings from European experience with marine spatial planning.

    Science.gov (United States)

    Douvere, Fanny; Ehler, Charles N

    2009-01-01

    Increased development pressures on the marine environment and the potential for multiple use conflicts, arising as a result of the current expansion of offshore wind energy, fishing and aquaculture, dredging, mineral extraction, shipping, and the need to meet international and national commitments to biodiversity conservation, have led to increased interest in sea use planning with particular emphasis on marine spatial planning. Several European countries, on their own initiative or driven by the European Union's Marine Strategy and Maritime Policy, the Bergen Declaration of the North Sea Conference, and the EU Recommendation on Integrated Coastal Zone Management, have taken global leadership in implementing marine spatial planning. Belgium, The Netherlands, and Germany in the North Sea, and the United Kingdom in the Irish Sea, have already completed preliminary sea use plans and zoning proposals for marine areas within their national jurisdictions. This paper discusses the nature and context of marine spatial planning, the international legal and policy framework, and the increasing need for marine spatial planning in Europe. In addition, the authors review briefly three marine spatial planning initiatives in the North Sea and conclude with some initial lessons learned from these experiences.

  6. The Lusi seismic experiment: An initial study to understand the effect of seismic activity to Lusi

    Energy Technology Data Exchange (ETDEWEB)

    Karyono, E-mail: karyonosu@gmail.com [Agency for Meteorology, Climatology and Geophysics (BMKG), Jakarta (Indonesia); OSLO University (Norway); Padjadjaran University (UNPAD), Bandung (Indonesia); Mazzini, Adriano; Sugiharto, Anton [OSLO University (Norway); Lupi, Matteo [ETH Zurich (Switzerland); Syafri, Ildrem [Padjadjaran University (UNPAD), Bandung (Indonesia); Masturyono,; Rudiyanto, Ariska; Pranata, Bayu; Muzli,; Widodo, Handi Sulistyo; Sudrajat, Ajat [Agency for Meteorology, Climatology and Geophysics (BMKG), Jakarta (Indonesia)

    2015-04-24

    The spectacular Lumpur Sidoarjo (Lusi) eruption started in northeast Java on the 29 of May 2006 following a M6.3 earthquake striking the island [1,2]. Initially, several gas and mud eruption sites appeared along the reactivated strike-slip Watukosek fault system [3] and within weeks several villages were submerged by boiling mud. The most prominent eruption site was named Lusi. The Lusi seismic experiment is a project aims to begin a detailed study of seismicity around the Lusi area. In this initial phase we deploy 30 seismometers strategically distributed in the area around Lusi and along the Watukosek fault zone that stretches between Lusi and the Arjuno Welirang (AW) complex. The purpose of the initial monitoring is to conduct a preliminary seismic campaign aiming to identify the occurrence and the location of local seismic events in east Java particularly beneath Lusi.This network will locate small event that may not be captured by the existing BMKG network. It will be crucial to design the second phase of the seismic experiment that will consist of a local earthquake tomography of the Lusi-AW region and spatial and temporal variations of vp/vs ratios. The goal of this study is to understand how the seismicity occurring along the Sunda subduction zone affects to the behavior of the Lusi eruption. Our study will also provide a large dataset for a qualitative analysis of earthquake triggering studies, earthquake-volcano and earthquake-earthquake interactions. In this study, we will extract Green’s functions from ambient seismic noise data in order to image the shallow subsurface structure beneath LUSI area. The waveform cross-correlation technique will be apply to all of recordings of ambient seismic noise at 30 seismographic stations around the LUSI area. We use the dispersive behaviour of the retrieved Rayleigh waves to infer velocity structures in the shallow subsurface.

  7. The Lusi seismic experiment: An initial study to understand the effect of seismic activity to Lusi

    Science.gov (United States)

    Karyono, Mazzini, Adriano; Lupi, Matteo; Syafri, Ildrem; Masturyono, Rudiyanto, Ariska; Pranata, Bayu; Muzli, Widodo, Handi Sulistyo; Sudrajat, Ajat; Sugiharto, Anton

    2015-04-01

    The spectacular Lumpur Sidoarjo (Lusi) eruption started in northeast Java on the 29 of May 2006 following a M6.3 earthquake striking the island [1,2]. Initially, several gas and mud eruption sites appeared along the reactivated strike-slip Watukosek fault system [3] and within weeks several villages were submerged by boiling mud. The most prominent eruption site was named Lusi. The Lusi seismic experiment is a project aims to begin a detailed study of seismicity around the Lusi area. In this initial phase we deploy 30 seismometers strategically distributed in the area around Lusi and along the Watukosek fault zone that stretches between Lusi and the Arjuno Welirang (AW) complex. The purpose of the initial monitoring is to conduct a preliminary seismic campaign aiming to identify the occurrence and the location of local seismic events in east Java particularly beneath Lusi.This network will locate small event that may not be captured by the existing BMKG network. It will be crucial to design the second phase of the seismic experiment that will consist of a local earthquake tomography of the Lusi-AW region and spatial and temporal variations of vp/vs ratios. The goal of this study is to understand how the seismicity occurring along the Sunda subduction zone affects to the behavior of the Lusi eruption. Our study will also provide a large dataset for a qualitative analysis of earthquake triggering studies, earthquake-volcano and earthquake-earthquake interactions. In this study, we will extract Green's functions from ambient seismic noise data in order to image the shallow subsurface structure beneath LUSI area. The waveform cross-correlation technique will be apply to all of recordings of ambient seismic noise at 30 seismographic stations around the LUSI area. We use the dispersive behaviour of the retrieved Rayleigh waves to infer velocity structures in the shallow subsurface.

  8. Post-game analysis: An initial experiment for heuristic-based resource management in concurrent systems

    Science.gov (United States)

    Yan, Jerry C.

    1987-01-01

    In concurrent systems, a major responsibility of the resource management system is to decide how the application program is to be mapped onto the multi-processor. Instead of using abstract program and machine models, a generate-and-test framework known as 'post-game analysis' that is based on data gathered during program execution is proposed. Each iteration consists of (1) (a simulation of) an execution of the program; (2) analysis of the data gathered; and (3) the proposal of a new mapping that would have a smaller execution time. These heuristics are applied to predict execution time changes in response to small perturbations applied to the current mapping. An initial experiment was carried out using simple strategies on 'pipeline-like' applications. The results obtained from four simple strategies demonstrated that for this kind of application, even simple strategies can produce acceptable speed-up with a small number of iterations.

  9. Use of indocyanine green angiography in microsurgical subinguinal varicocelectomy - lessons learned from our initial experience.

    Science.gov (United States)

    Cho, Chak-Lam; Ho, Kwan-Lun; Chan, Wayne Kwun-Wai; Chu, Ringo Wing-Hong; Law, In-Chak

    2017-07-20

    Microsurgical subinguinal varicocelectomy (MSV) is generally considered the gold standard nowadays in view of the lower risk of complications and recurrence. To achieve complete ligation of veins while preserving testicular artery (TA) during the procedure remains challenging despite the application of high power optical magnification and micro-Doppler ultrasonography. The use of intraoperative indocyanine green angiography (ICGA) with infrared fluorescence operative micro-scope in MSV potentially lowers the incidence of TA injury and shortens the learning curve of nov-ice surgeons. We present our initial experience in the application of the technique in nine patients and explore the potential of the new adjunct. Copyright® by the International Brazilian Journal of Urology.

  10. The Case For Reporting Pro-Active Environmental Initiatives: A Malaysian Experiment On Stakeholder Influence Strategies

    Directory of Open Access Journals (Sweden)

    Evangeline Elijido-Ten

    2008-06-01

    Full Text Available The purpose of this research is to gain insights on the preferred strategies chosen by various stakeholder representatives to influence management to either provide/not provide environmental disclosures in an experimental setting. A typology of resource relationships and influence strategies is adapted as a framework to make sense of the views presented by various stakeholder representative groups. To facilitate a Malaysian experiment, qualitative interviews with the aid of a hypothetical vignette are conducted to understand how different stakeholder groups go about seeking what they want from the management. The findings in this exploratory study indicate that although the model is useful to understand the influence strategies taken by each stakeholder group, its effectiveness is tempered by the level of significance placed by these groups on the environmental initiative and their perception of how the event will affect their stake on the firm.

  11. Highlight report local initiatives. Experiences with electric transport; Highlight report lokale initiatieven. Ervaringen met elektrisch vervoer

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-06-15

    In March 2013 Linkingreen and XTNT started a survey on local electric transportation initiatives. The aim is to learn from the experiences, problems and obstacles of business users of electric vehicles: cars, vans or trucks, scooters, boats and special vehicles (e.g. garbage trucks) that are all-electric or plug-in (with plug). In this brief report, the main results are presented [Dutch] In maart 2013 is door Linkingreen en XTNT in opdracht van Agentschap NL een enquete uitgezet naar lokale initiatieven elektrisch vervoer. Doel is te leren wat de ervaringen, knelpunten en belemmeringen zijn van zakelijke gebruikers van elektrisch vervoer: personenauto's, bestel- of vrachtauto's, scooters, vaartuigen en bijzondere voertuigen (vuilniswagens etc.) die volledig elektrische of plug in (met stekker) zijn. In dit korte verslag zijn de belangrijkste resultaten opgenomen.

  12. LOW AMPLITUDE SINGLE AND MULTIPLE SHOCK INITIATION EXPERIMENTS AND MODELING OF LX-04

    Energy Technology Data Exchange (ETDEWEB)

    Vandersall, K S; Tarver, C M; Garcia, F; Chidester, S; Urtiew, P A; Forbes, J W

    2006-06-27

    Shock initiation experiments were performed on the plastic bonded explosive (PBX) LX-04 (85% HMX, 15% Viton binder) using single and multiple low amplitude shocks to obtain pressure history data for use in Ignition and Growth reactive flow modeling parameterization. A 100 mm diameter propellant driven gas gun was utilized to initiate the LX-04 explosive charges containing manganin piezoresistive pressure gauge packages placed between explosive discs. In the single shock experiments, the run distances to detonation at three shock pressures showed agreement with previously published data above 3 GPa. Even longer run distances to detonation were measured using 80 mm long by 145 mm diameter LX-04 charges impacted by low velocity projectiles from a 155 mm diameter gun. The minimum shock pressure required to cause low levels of exothermic reaction were determined for these large LX-04 charge dimensions. Multiple shocks were generated as double shocks by using a flyer plate with two materials and as reflected shocks by placing a high impedance material at the rear of the explosive charge. In both cases, the first shock pressure was not high enough to cause detonation of LX-04, and the second shock pressure, which would have been sufficient to cause detonation if generated by a single shock, failed to cause detonation. Thus LX-04 exhibited shock desensitization over a range of 0.6 to 1.4 GPa. The higher shock pressure LX-04 model was extended to accurately simulate these lower pressure and multiple shock gauge records. The shock desensitization effects observed with multiple shock compressions were partially accounted for in the model by using a critical compression corresponding to a shock pressure of 1.2 GPa. This shock desensitization effect occurs at higher pressures than those of other HMX-based PBX's containing higher HMX percentages.

  13. Initial experience of using the filter protection device during carotid artery stenting in Japan.

    Science.gov (United States)

    Takayama, Katsutoshi; Nakagawa, Hiroyuki; Iwasaki, Satoru; Taoka, Toshiaki; Miyasaka, Toshiteru; Myouchin, Kaoru; Wada, Takeshi; Sakamoto, Masahiko; Fukusumi, Akio; Nakagawa, Ichiro; Kurokawa, Shinichiro; Kichikawa, Kimihiko

    2008-07-01

    No filter protection devices for carotid artery stenting (CAS) have been formally approved for use in Japan; however, as of April 2008, the Angioguard XP (AGXP) was approved. This article describes our initial results using the AGXP during CAS for the treatment of carotid artery stenosis. A group of 15 patients (14 men) with a mean age of 72.3 years (range 53-81 years) were treated by CAS using the AGXP. Among them, 10 were symptomatic with >50% stenosis of the common or internal carotid artery (ICA), and 5 were asymptomatic with >70% stenosis. The rates of technical success, periprocedural stroke, ICA flow impairment, filter movement, and development of new ischemic lesions on diffusion-weighted imaging (DWI) were assessed. CAS using the AGXP was successful in all cases. There was one minor stroke, and flow impairment occurred in six patients. Filter movement averaged 1.9 vertebral bodies. DWI showed new ipsilateral ischemic lesions in eight of the patients. Initial clinical experience using the AGXP for CAS has been generally sufficient. However, attention must be paid to three problems when using the AGXP: the filter may move after placement; the filter may disturb blood flow in the ICA; and debris may pass around the filter.

  14. Endobronchial Ultrasound-directed Transbronchial Needle Aspiration in Diagnosis of Mediastinal Lesions: Initial Egyptian Experience.

    Science.gov (United States)

    Safwat, Tarek; Khattab, Adel; Haddad, Salwa El; Mostafa, Yasser; Korraa, Emad; Madkour, Ashraf; Fattah, Wael Abd El

    2009-01-01

    Mediastinal lesions represent a diagnostic challenge and often require invasive approaches. We evaluated the role of radial probe endobronchial ultrasound-directed transbronchial needle aspiration (EBUS-TBNA) in the evaluation of mediastinal lesions. Between March 2005 to February 2006, 30 consecutive patients with enlarged mediastinal lymph nodes from unknown etiologies or suspicious for metastatic bronchogenic carcinoma and mediastinal masses underwent EBUS-TBNA and were clinically followed up. EBUS-TBNA was applied under topical anesthesia, midazolam sedation with a mean dose of 4.6+1.7 mg and prolonged the examination by 14.7 minutes on average. EBUS-directed TBNA was performed in 17 lymph nodes and 13 mediastinal masses, achieving specific diagnosis in 82.3% (14/17) and 84.6% (11/13) of examined lesions, respectively, with an overall yield of 83%. The sensitivity, specificity, and accuracy of EBUS-TBNA in distinguishing benign from malignant mediastinal lesions were 89.4%, 100%, and 93.3%, respectively. EBUS was well tolerated by most of the patients with no TBNA-related complications. In conclusion, EBUS-TBNA of mediastinal lesions is a minimally invasive safe diagnostic technique with high yield, even in the hands of those with initial experience. This initial study is convincing and stimulating for widespread application of EBUS-TBNA in Egyptian bronchoscopy practice.

  15. Academics and Learners’ Perceptions on Blended Learning as a Strategic Initiative to Improve Student Learning Experience

    Directory of Open Access Journals (Sweden)

    Ying Adeline Ng Ling

    2017-01-01

    Full Text Available The increasingly tighter shift of socio-economic constraints on higher education sectors in the recent years has called for greater flexibilities in student learning experience both locally and abroad. To this end, we have recently implemented a Blended Learning Initiative in an attempt to provide better learning support and greater flexibility to our students. This initiative is also in line with the University’s aim of having 50% of our learning and teaching delivered on-line by 2020. In this report, we present our findings on academics and learners’ perceptions on the approach which were obtained through surveys. Results showed that blended learning approach was new to the academics and the factors for successful blended learning implementation were identified. Results also showed that learners appreciated the approach as it made learning more accessible and flexible. Furthermore, they also enjoyed the interesting online activities incorporated into their units. In addition, learners were also able to review and pace their own learning. They also perceived that they have the access to the resources and technical ability to cope with online learning materials and activities. Nonetheless, the survey also revealed that learners still prefer to have academics delivering information to them directly rather than a flipped classroom model. In conclusion, findings from this study provide insights that blended learning could be effective to supplement courses offered by the faculty.

  16. Implementation of electronic checklists in an oncology medical record: initial clinical experience.

    Science.gov (United States)

    Albuquerque, Kevin V; Miller, Alexis A; Roeske, John C

    2011-07-01

    The quality of any medical treatment depends on the accurate processing of multiple complex components of information, with proper delivery to the patient. This is true for radiation oncology, in which treatment delivery is as complex as a surgical procedure but more dependent on hardware and software technology. Uncorrected errors, even if small or infrequent, can result in catastrophic consequences for the patient. We developed electronic checklists (ECLs) within the oncology electronic medical record (EMR) and evaluated their use and report on our initial clinical experience. Using the Mosaiq EMR, we developed checklists within the clinical assessment section. These checklists are based on the process flow of information from one group to another within the clinic and enable the processing, confirmation, and documentation of relevant patient information before the delivery of radiation therapy. The clinical use of the ECL was documented by means of a customized report. Use of ECL has reduced the number of times that physicians were called to the treatment unit. In particular, the ECL has ensured that therapists have a better understanding of the treatment plan before the initiation of treatment. An evaluation of ECL compliance showed that, with additional staff training, > 94% of the records were completed. The ECL can be used to ensure standardization of procedures and documentation that the pretreatment checks have been performed before patient treatment. We believe that the implementation of ECLs will improve patient safety and reduce the likelihood of treatment errors.

  17. Microcosm experiments to study the interaction of solid and solute phases during initial soil development

    Science.gov (United States)

    Zimmermann, C.; Chabbi, S.; Schaaf, W.

    2009-04-01

    During the initial phase of soil formation mineral weathering, interactions between the solid and liquid phases as well as accumulation of organic matter play an important role for the development of soil properties and for the establishment of vegetation and the colonization of soil biota. Our study is part of the Transregional Collaborative Research Centre (SFB/TRR 38) ‘Patterns and processes of initial ecosystem development in an artificial catchment' funded by the Deutsche Forschungsgemeinschaft (DFG). The catchment ´Chicken Creeḱ close to Cottbus (Germany) has a size of 6 ha and is composed of a 3-4 m layer of Quaternary loamy to sandy sediments overlying a 1-2 m clay layer. To connect interactions between the soil solid phase and soil solution at the micro-scale with observed processes at the catchment scale we perform microcosm experiments with soil samples from the catchment under controlled laboratory conditions. The microcosm experiments are carried out in a climate chamber at constant 10 °C corresponding to the mean annual temperature of the region. In total 48 soil columns with a diameter of 14.4 cm and height of 30 cm were filled with substrates of two textural compositions reflecting the gradients observed at the catchment and a bulk density of 1.4-1.5 g*cm3. Within the microcosms it is possible to control the gaseous phase and the water fluxes by artificial irrigation. The irrigation runs automated and quasi-continuously four times a day with 6.6 ml each (in total 600 mm*yr-1). Irrigation amount and chemical composition of the artificial rainwater are based on the annual mean at the field site. Litter of two different plant species occurring at the catchment site (Lotus corniculatus, Calamagrostis epigejos) labelled with stable isotopes (δ13C; δ15N) is used for the experiments. All treatments including a control run with four replicates. The gaseous phase in the headspace of the microcosms is analysed continuously for CO2 and N2O contents

  18. Effect of Microgravity on Sinorhizobium meliloti: Initial Results from the SyNRGE Experiment

    Science.gov (United States)

    Roberts, Michael S.; Stutte, Gary W.

    2011-01-01

    SyNRGE (Symbiotic Nodulation in a Reduced Gravity Environment) was a sortie mission on STS-135 in the Biological Research in Canisters (BRIe) hardware to study the effect of microgravity on a plant-microbe symbiosis resulting in biological nitrogen fixation. Medicago truncatula, a model species of the legume family, was innoculated with its bacterial symbiont, Sinorhizobium meliloti, to observe early events associated with infection and nodulation in Petri Dish Fixation Units (PDFUs). Two sets of experiments were conducted in orbit and in 24-hour delayed ground controls. Experiment one was designed to determine if S. meliloti infect M. truncatula and initiate physiological changes associated with nodule formation. Roots of five-day-old M. truncatula cultivar Jemalong A17 (Enodll::gus) were innoculated 24 hr before launch with either S. meliloti strain 1021 or strain ABS7 and integrated into BRIC-PDFU hardware placed in a 4 C Cold Bag for launch on Atlantis. Innoculated plants and uninoculated controls were maintained in the dark at ambient temperature in the middeck of STS-135 for 11 days before fixation in RNA/ate/M by crew activation of the PDFU. Experiment two was designed to determine if microgravity altered the process of bacterial infection and host plant nodule formation. Seeds of two M. truncatula cultivar Jemalong A17 lines, the Enodll::gus used in experiment 1, and SUNN, a super-nodulating mutant of A17, were germinated on orbit for 11 days in the middeck cabin and returned to Earth alive inside of BRIC-PDFU's at 4 C S. meliloti strains 1021 and ABS7 were cultivated separately in broth culture on orbit and also returned to Earth alive. After landing, flight- and ground-grown plants and bacteria were transferred from BRIC-PDFU's into Nunc(TradeMark) 4-well plates for reciprocity crosses. Rates of plant growth and nodule development on Buffered Nodulation Medium (lacking nitrogen) were measured for 14 days. Bacteria cultivated in microgravity in the

  19. Heidelberg Ion Therapy Center (HIT): Initial clinical experience in the first 80 patients

    Energy Technology Data Exchange (ETDEWEB)

    Combs, Stephanie E. (Univ. Hospital of Heidelberg, Dept. of Radiation Oncology, Heidelberg (Germany)), E-mail: Stephanie.Combs@med.uni-heidelberg.de; Ellerbrock, Malte; Haberer, Thomas (Heidelberger Ionenstrahl Therapiezentrum (HIT), Im Neuenheimer Feld 450, 69120 Heidelberg (Germany)) (and others)

    2010-10-15

    The Heidelberg Ion Therapy Center (HIT) started clinical operation in November 2009. In this report we present the first 80 patients treated with proton and carbon ion radiotherapy and describe patient selection, treatment planning and daily treatment for different indications. Patients and methods. Between November 15, 2009 and April 15, 2010, 80 patients were treated at the Heidelberg Ion Therapy Center (HIT) with carbon ion and proton radiotherapy. Main treated indications consisted of skull base chordoma (n = 9) and chondrosarcoma (n = 18), malignant salivary gland tumors (n=29), chordomas of the sacrum (n = 5), low grade glioma (n=3), primary and recurrent malignant astrocytoma and glioblastoma (n=7) and well as osteosarcoma (n = 3). Of these patients, four pediatric patients aged under 18 years were treated. Results. All patients were treated using the intensity-modulated rasterscanning technique. Seventy-six patients were treated with carbon ions (95%), and four patients were treated with protons. In all patients x-ray imaging was performed prior to each fraction. Treatment concepts were based on the initial experiences with carbon ion therapy at the Gesellschaft fuer Schwerionenforschung (GSI) including carbon-only treatments and carbon-boost treatments with photon-IMRT. The average time per fraction in the treatment room per patient was 29 minutes; for irradiation only, the mean time including all patients was 16 minutes. Position verification was performed prior to every treatment fraction with orthogonal x-ray imaging. Conclusion. Particle therapy could be included successfully into the clinical routine at the Dept. of Radiation Oncology in Heidelberg. Numerous clinical trials will subsequently be initiated to precisely define the role of proton and carbon ion radiotherapy in radiation oncology.

  20. [Initial experiences with propofol (Disoprivan) for anesthesia induction in pediatric anesthesia].

    Science.gov (United States)

    Motsch, J; Must, W; Hutschenreuter, K

    1988-09-01

    Propofol is a new intravenous anesthetic agent that provides smooth and rapid induction of anesthesia. A short elimination half-life guarantees rapid recovery. Since it has been reformulated as an emulsion in soya bean oil, anaphylactoid reactions are unlikely to occur. As compared to adults, there is very little experience with propofol in pediatric anesthesia. The aim of this study was to evaluate propofol as an induction agent in children with respect to cardiovascular and respiratory effects and to investigate the incidence of other side-effects. METHOD. In 25 ASA I children aged 3-12 years (6.4 +/- 2.7 SD) anesthesia was induced with a single dose of propofol, after standard premedication with atropine 0.01 mg/kg and Thalamonal 0.04 ml/kg. Anesthesia was maintained with halothane, nitrous oxide, and oxygen. Blood pressure (BP), heart rate (HR), and arterial oxygen saturation (SaO2) were measured before and each minute for 6 min after propofol administration. The incidence of side-effects during induction of anesthesia as well as during recovery and the postoperative period were recorded. RESULTS. Propofol 2.5 mg/kg produced rapid and smooth induction of anesthesia. Mean arterial pressure decreased after 1 min by 14.3% with a maximum of 16.8% after 3 min. HR was influenced differently by propofol; children with initially high HR had a decrease in HR, whereas in children with a low initial rate, HR increased transiently. After 1 min, no further changes occurred. Although no apnea was observed, respiration was shallow and depressed, as indicated by a decrease in SaO2. Two children complained of pain and 4 of discomfort at the site of the injection; 1 of these developed transient phlebitis.(ABSTRACT TRUNCATED AT 250 WORDS)

  1. The Workplace Experiences of Beginning Teachers in Three Countries: A Message for Initial Teacher Education from the Field

    Science.gov (United States)

    du Plessis, Anna Elizabeth; Sunde, Eva

    2017-01-01

    Previous research indicates that beginning teachers are not fully prepared for what awaits them in the workforce. This study highlights the value of partnerships among higher education providers, schools and employers and links the experiences of beginning teachers to initial teacher education (ITE). Real-life experiences from the field provide…

  2. NUMERICAL EXPERIMENTS AND ANALYSIS OF DIGITAL FILTER INITIALIZATION FOR WRF MODEL

    Institute of Scientific and Technical Information of China (English)

    WANG Shu-chang; HUANG Si-xun; ZHANG Wei-min; ZHU Xiao-qian; CAO Xiao-qun; LI Yi

    2008-01-01

    Initialization and initial imbalance problem were discussed in the context of a three-dimensional variational data assimilation system of the new generation "Weather Research and Forecasting Model". Severaloptions of digital filter initialization have been tested with a rain storm case. It is shown that digital filter initialization, especially diabatic digital filter initialization and twice digital filter initialization, have effectively removed spurious high frequency noise from initial data for numerical weather prediction and produced balanced initial conditions. For six consecutive intermittent data assimilation cycles covering a 3-day period, mean initialization increments and impact on forecast variables are studied. DFI has been demonstrated to provide better adjustment of the hydrometeors and vertical velocity, reduced spin-up time, and improved forecast variables quantity.

  3. Balloon-augmented Onyx endovascular ligation: initial human experience and comparison with coil ligation.

    Science.gov (United States)

    Osanai, Toshiya; Bain, Mark D; Toth, Gabor; Hussain, M Shazam; Hui, Ferdinand K

    2015-08-01

    Carotid artery sacrifice remains an important procedure for cerebral vascular disorders despite the development of new endovascular devices. Conventional carotid artery sacrifice with detachable coils alone often requires numerous coils to complete occlusion. To describe the initial human experience with balloon-augmented Onyx and coil vessel sacrifice based on our previous experience with animals. We performed a retrospective review of patients who underwent carotid artery sacrifice between 2008 and 2012 in accordance with local investigational review board approval. Two methods were used to occlude carotid arteries-namely, combined Onyx and coil embolization and traditional coil embolization. We compared the two methods for the cost of embolizate, time to occlude the vessels, and the number of coils. Eight consecutive patients (combined group n=3, traditional group n=5) were assessed. The median cost of embolic material was $6321 in the combined Onyx and coil embolization group and $29 996 in the traditional coil embolization group. The median time from first coil placement to achievement of vessel occlusion was 52 min in the Onyx group and 113 min in the coil embolization group. The median number of coils used was 4 in the Onyx group and 35 in the coil embolization group (p<0.05). No symptomatic complications or recurrences were seen in the combined group. Balloon-augmented Onyx endovascular ligation may reduce costs and fluoroscopy times during vessel sacrifice. Further studies in a larger number of patients are needed to confirm these findings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Initial Results from the STEM Student Experiences Aboard Ships (STEMSEAS) Program

    Science.gov (United States)

    Lewis, J. C.; Cooper, S. K.; Thomson, K.; Rabin, B.; Alberts, J.

    2016-12-01

    The Science Technology Engineering and Math Student Experiences Aboard Ships (STEMSEAS) program was created as a response to NSF's call (through GEOPATHS) for improving undergraduate STEM education and enhancing diversity in the geosciences. It takes advantage of unused berths on UNOLS ships during transits between expeditions. During its 2016 pilot year - which consisted of three transits on three different research vessels in different parts of the country, each with a slightly different focus - the program has gained significant insights into how best to create and structure these opportunities and create impact on individual students. A call for applications resulted in nearly 900 applicants for 30 available spots. Of these applicants, 32% are from minority groups underrepresented in the geosciences (Black, Hispanic, or American Indian) and 20% attend community colleges. The program was able to sail socioeconomically diverse cohorts and include women, veterans, and students with disabilities and from two- and four-year colleges. Twenty-three are underrepresented minorities, 6 attend community colleges, 5 attend an HBCU or tribal college, and many are at HSIs or other MSIs. While longer term impact assessment will have to wait, initial results and 6-month tracking for the first cohort indicate that these kinds of relatively short but intense experiences can indeed achieve significant impacts on students' perception of the geosciences, in their understanding of STEM career opportunities, their desire to work in a geoscience lab setting, and to incorporate geosciences into non-STEM careers. Insights were also gained into the successful makeup of mentor/leader groups, factors to consider in student selection, necessary pre- and post-cruise logistics management, follow-up activities, structure of activities during daily life at sea, increasing student networks and access to mentorships, and leveraging of pre-existing resources and ship-based opportunities

  5. Pancreas Preservation With Viaspan, Celsior, and Custodiol Solutions: An Initial Experience.

    Science.gov (United States)

    Montiel-Casado, M C; Pérez-Daga, J A; Blanco-Elena, J A; Aranda-Narváez, J M; Sánchez-Pérez, B; Cabello-Díaz, M; Ruiz-Esteban, P; León-Díaz, F J; Gutiérrez-de la Fuente, C; Santoyo-Santoyo, J

    2016-11-01

    There is still controversy about which preservation solution in pancreas transplantation could be the best. The aim of this study was to analyze our initial experience with Custodiol solution (CuS) compared with Viaspan solution (VS) and Celsior solution (CS) in pancreas transplantation. A retrospective study included 94 consecutive pancreatic transplants, from 2007 until 2015. We compared 3 groups, depending on preservation solution: Viaspan (n = 41), Celsior (n = 40), or Custodiol (n = 13). The primary end point was patient and pancreas survival at 1 year after pancreas transplantation. The recipient and donor characteristics were similar except in cold ischemia time; it was higher with Celsior. No differences were found in postoperative complications and pancreas graft function at 3 months, 6 months, and 1 year (glucose, HbA1c, C-peptide, creatinine). The pancreas and patient survival at 1 year was comparable (pancreas survival: VS, 80%; CS, 90%; CuS, 92%; log-rank, 0.875; and patient survival: VS, 92%; CS, 97%; CuS, 100%; log-rank, 0.9). In our institution, the Custodiol solution in pancreas transplantation presented similar outcomes in terms of postoperative complications, pancreas graft function, and 1-year survival. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Implementing a robotics curriculum at an academic general surgery training program: our initial experience.

    Science.gov (United States)

    Winder, Joshua S; Juza, Ryan M; Sasaki, Jennifer; Rogers, Ann M; Pauli, Eric M; Haluck, Randy S; Estes, Stephanie J; Lyn-Sue, Jerome R

    2016-09-01

    The robotic surgical platform is being utilized by a growing number of hospitals across the country, including academic medical centers. Training programs are tasked with teaching their residents how to utilize this technology. To this end, we have developed and implemented a robotic surgical curriculum, and share our initial experience here. Our curriculum was implemented for all General Surgical residents for the academic year 2014-2015. The curriculum consisted of online training, readings, bedside training, console simulation, participating in ten cases as bedside first assistant, and operating at the console. 20 surgical residents were included. Residents were provided the curriculum and notified the department upon completion. Bedside assistance and operative console training were completed in the operating room through a mix of biliary, foregut, and colorectal cases. During the fiscal years of 2014 and 2015, there were 164 and 263 robot-assisted surgeries performed within the General Surgery Department, respectively. All 20 residents completed the online and bedside instruction portions of the curriculum. Of the 20 residents trained, 13/20 (65 %) sat at the Surgeon console during at least one case. Utilizing this curriculum, we have trained and incorporated residents into robot-assisted cases in an efficient manner. A successful curriculum must be based on didactic learning, reading, bedside training, simulation, and training in the operating room. Each program must examine their caseload and resident class to ensure proper exposure to this platform.

  7. CT-guided spinal injection: initial experience with Sprotte tip needles

    Energy Technology Data Exchange (ETDEWEB)

    Pua, Uei [Tan Tock Seng Hospital, Department of Diagnostic Radiology, Singapore (Singapore)

    2010-09-15

    The purpose of this paper is to describe our initial experience and to illustrate the potential benefits of using small caliber (25 and 27 G), noncutting pencil point needles (Sprotte) with single puncture coaxial technique in CT-guided spinal intervention (CTSI). From January 2009 to June 2009, Sprotte needles with single puncture coaxial technique were used in a total of ten patients for selective nerve root block (SNRB), facet joint block, and pars block under CT fluoroscopy (total of 16 target structures). All procedures were performed without conscious sedation, and visual analog scale (VAS) scores were recorded to determine pain related to needle placement. Total CT fluoroscopy time and out-of-plane needle deviation were obtained. Final needle position was documented by contrast injection for SNRBs and image capture for joint space cannulation. Sixteen out of the 16 structures were successfully targeted. No increase in VAS scores associated with needle placement was recorded, after infiltration of local anesthesia. Optimal peri-neurograms were obtained in all cases of SNRB, despite the side-hole opening in the Sprotte needles. Mean CT fluoroscopy time was 2 s (range 2-8 s per structure), and there was no case of out-of-plane needle deviation that required adjustment of the CT gantry. The use of small caliber Sprotte needles in CTSI is technically feasible and represents a potential refinement to current techniques in the management of chronic spinal pain. (orig.)

  8. A nonsurgical endodontics relational research database: the initial six years of experience.

    Science.gov (United States)

    Iqbal, Mian K; Shukovsky, Deborah Gortler; Wong, Steven; Vohra, Gayatri

    2008-09-01

    The purpose of this study was to report results of the initial six years of experience utilizing a nonsurgical root canal treatment (NSRCT) database; to compare patient characteristics, operative procedures, and patient outcomes observed in the database to those observed in other studies; and to discuss the potential benefits of a clinical endodontic database. A total of 7,372 NSRCT cases performed by endodontic residents at the University of Pennsylvania from 2000 to 2006 were evaluated. The odds ratio (OR) for caries and trauma being causative agents for NSRCT in

  9. Contrast-enhanced ultrasound in ovarian tumors – diagnostic parameters: method presentation and initial experience

    Science.gov (United States)

    MAXIM, ANITA-ROXANA; BADEA, RADU; TAMAS, ATILLA; TRAILA, ALEXANDRU

    2013-01-01

    The aim of this paper is to discuss and illustrate the use of contrast-enhanced ultrasound in evaluating ovarian tumors compared to conventional ultrasound, Doppler ultrasound and the histopathological analysis and suggest how this technique may best be used to distinguish benign from malignant ovarian masses. We present the method and initial experience of our center by analyzing the parameters used in contrast-enhanced ultrasound in 6 patients with ovarian tumors of uncertain etiology. For examination we used a Siemens ultrasound machine with dedicated contrast software and the contrast agent SonoVue, Bracco. The patients underwent conventional ultrasound, Doppler ultrasound and i.v. administration of the contrast agent. The parameters studied were: inflow of contrast (rise time), time to peak enhancement, mean transit time. The series of patients is part of an extensive prospective PhD study aimed at elaborating a differential diagnosis protocol for benign versus malignant ovarian tumors, by validating specific parameters for contrast-enhanced ultrasound. Although the method is currently used with great success in gastroenterology, urology and senology, its validation in gynecology is still in the early phases. Taking into consideration that the method is minimally invasive and much less costly that CT/MRI imaging, demonstrating its utility in oncologic gynecology would be a big step in preoperative evaluation of these cases. PMID:26527912

  10. Robotic liver resection: initial experience with three-arm robotic and single-port robotic technique.

    Science.gov (United States)

    Kandil, Emad; Noureldine, Salem I; Saggi, Bob; Buell, Joseph F

    2013-01-01

    Robotic-assisted surgery offers a solution to fundamental limitations of conventional laparoscopic surgery, and its use is gaining wide popularity. However, the application of this technology has yet to be established in hepatic surgery. A retrospective analysis of our prospectively collected liver surgery database was performed. Over a 6-month period, all consecutive patients who underwent robotic-assisted hepatic resection for a liver neoplasm were included. Demographics, operative time, and morbidity encountered were evaluated. A total of 7 robotic-assisted liver resections were performed, including 2 robotic-assisted single-port access liver resections with the da Vinci-Si Surgical System (Intuitive Surgical Sunnyvalle, Calif.) USA. The mean age was 44.6 years (range, 21-68 years); there were 5 male and 2 female patients. The mean operative time (± SD) was 61.4 ± 26.7 minutes; the mean operative console time (± SD) was 38.2 ± 23 minutes. No conversions were required. The mean blood loss was 100.7 mL (range, 10-200 mL). The mean hospital stay (± SD) was 2 ± 0.4 days. No postoperative morbidity related to the procedure or death was encountered. Our initial experience with robotic liver resection confirms that this technique is both feasible and safe. Robotic-assisted technology appears to improve the precision and ergonomics of single-access surgery while preserving the known benefits of laparoscopic surgery, including cosmesis, minimal morbidity, and faster recovery.

  11. Preparing beginning reading teachers: An experimental comparison of initial early literacy field experiences.

    Science.gov (United States)

    Al Otaiba, Stephanie; Lake, Vickie E; Greulich, Luana; Folsom, Jessica S; Guidry, Lisa

    2012-01-01

    This randomized-control trial examined the learning of preservice teachers taking an initial Early Literacy course in an early childhood education program and of the kindergarten or first grade students they tutored in their field experience. Preservice teachers were randomly assigned to one of two tutoring programs: Book Buddies and Tutor Assisted Intensive Learning Strategies (TAILS), which provided identical meaning-focused instruction (shared book reading), but differed in the presentation of code-focused skills. TAILS used explicit, scripted lessons, and the Book Buddies required that code-focused instruction take place during shared book reading. Our research goal was to understand which tutoring program would be most effective in improving knowledge about reading, lead to broad and deep language and preparedness of the novice preservice teachers, and yield the most successful student reading outcomes. Findings indicate that all pre-service teachers demonstrated similar gains in knowledge, but preservice teachers in the TAILS program demonstrated broader and deeper application of knowledge and higher self-ratings of preparedness to teach reading. Students in both conditions made similar comprehension gains, but students tutored with TAILS showed significantly stronger decoding gains.

  12. Single-port laparoscopic approach of the left liver: initial experience.

    Science.gov (United States)

    Camps Lasa, Judith; Cugat Andorrà, Esteban; Herrero Fonollosa, Eric; García Domingo, María Isabel; Sánchez Martínez, Raquel; Vargas Pierola, Harold; Rodríguez Campos, Aurora

    2014-11-01

    New technological advances have enabled the development of single-port laparoscopic surgery. This approach began with cholecystectomy and subsequently with other abdominal surgeries. However, few publications on laparoscopic liver surgery have described the use of complete single-port access. We present our initial experience of a single-port laparoscopic hepatectomy. Between May 2012 and December 2013, 5 single-port laparoscopic hepatectomies were performed: one for benign disease and four for colorectal liver metastases. The lesions were approached through a 3-5 cm right supraumbilical incision using a single-port access device. All the lesions were located in hepatic segments II or III. Four left lateral sectorectomies and one left hepatectomy were performed. Median operative time was 135 min. No cases were converted to conventional laparoscopic or open surgery. The oral intake began at 18 h. There were no postoperative complications and no patients required blood transfusion. The median hospital stay was 3 days. The degree of satisfaction was very good in 4 cases and good in one. Patients resumed their normal daily activities at 8 days. Single-port laparoscopic hepatectomy is safe and feasible in selected cases and may reduce surgical aggression and offer better cosmetic results. Comparative studies are needed to determine the real advantages of this approach. Copyright © 2014 AEC. Published by Elsevier Espana. All rights reserved.

  13. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery

    Science.gov (United States)

    Costa, Altair da Silva; Bachichi, Thiago; Holanda, Caio; Rizzo, Luiz Augusto Lucas Martins De

    2016-01-01

    ABSTRACT Objective: To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. Methods: This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks. PMID:28117476

  14. Initial clinical experience using the Echo Navigator~-system during structural heart disease interventions

    Institute of Scientific and Technical Information of China (English)

    Jan; Balzer; Tobias; Zeus; Katharina; Hellhammer; Verena; Veulemans; Silke; Eschenhagen; Eva; Kehmeier; Christian; Meyer; Tienush; Rassaf; Malte; Kelm

    2015-01-01

    AIM: To present our initial clinical experience using this innovative software solution for guidance of percutaneous structural heart disease interventions.METHODS: Left atrial appendage, atrial septal defect and paravalvular leak closure, transaortic valve repair and Mitra Clip procedures were performed in the catheter laboratory under fluoroscopic and echocardiographic guidance. The two-dimensional and three-dimensional images generated by the transesophageal echocardiography probe were interfaced with the fluoroscopic images in real-time using the Echo Navigator-system.RESULTS:The application of the novel image fusion technology was safe and led to a better appreciation of multimodality imaging guidance due to improved visualization of the complex relationship between catheter devices and anatomical structures.CONCLUSION:The Echo Navigator-system is a feasible and safe tool for guidance of interventional procedures in structural heart disease.This innovative technology may improve confidence of interventional cardiologists in targeting and positioning interventional devices in order to increase safety,accuracy,and efficacy of percutaneous interventions in the catheter laboratory.

  15. Initial experience with personal digital assistant-based reflectance photoplethysmograph for free tissue transfer monitoring.

    Science.gov (United States)

    Stack, Brendan C; Futran, Neal D; Zang, Billy; Scharf, John E

    2003-08-01

    Improved microsurgical technique has resulted in a high percentage of successful free tissue transfers. When a tissue transfer fails in the head and neck, however, the results are orocutaneous fistulas, carotid artery exposure, and deformity that adds morbidity, expense, and may delay adjuvant therapy. Postoperative monitoring of tissue perfusion can detect early problems in free tissue transfer that may allow for early intervention and salvage. The authors have demonstrated that reflectance photoplethysmography can detect perfusion changes in free tissue transfer within 5 minutes of a pedicle "insult" intraoperatively. Normative data for viable flaps from various donor sites have been established. The authors now report their initial experience with a newly developed reflectance photoplethysmograph based on a hand-held computer for routine clinical use. Their results are compared with a conventional surveillance protocol that included observation, bleeding to pin prick, and bedside duplex scanning of the vascular pedicle. In a series of 30 free tissue transfers (29 patients), there was one ischemic event (skin paddle loss only), which was detected by the monitor. The monitor was able to predict correctly (one flap) survival of a free tissue transfer even when duplex ultrasonic data were indicative of an absence of perfusion. Personal digital assistant-based photoplethysmography appears to be a promising device for bedside diagnosis of free tissue transfer viability or ischemia.

  16. Rising from failure and learning from success: The role of past experience in radical initiative taking

    NARCIS (Netherlands)

    D. Deichmann (Dirk); J.C.M. van den Ende (Jan)

    2014-01-01

    markdownabstract__Abstract__ We investigate how the successes and failures of people who initiate radical ideas influence (a) the inclination to take new personal initiatives and (b) the outcome of those initiatives. Using the data of 1,792 radical ideas suggested by 908 employees in a multinationa

  17. 78 FR 73518 - Notice Inviting Suggestions for New Experiments for the Experimental Sites Initiative; Federal...

    Science.gov (United States)

    2013-12-06

    ... based experiments designed to test alternative ways of administering the student financial assistance... the suggestions submitted in response to this notice the Secretary will design experiments and... the Congress. ] We are particularly interested in experiments that are designed to improve...

  18. Challenges conducting comparative effectiveness research: the Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE experience

    Directory of Open Access Journals (Sweden)

    Friedly JL

    2014-05-01

    Full Text Available Janna L Friedly,1,4 Zoya Bauer,2,4 Bryan A Comstock,3,4 Emily DiMango,5 Assiamira Ferrara,6 Susan S Huang,7 Elliot Israel,8 Jeffrey G Jarvik,2,4 Andrew A Nierenberg,9 Michael K Ong,10 David F Penson,11 Rebecca Smith-Bindman,12 Arthur E Stillman,13 William M Vollmer,6 Stephen M Warren,14 Chunliu Zhan,15 David Chu-Wen Hsia,15 Anne Trontell15 1Department of Rehabilitation Medicine, 2Department of Radiology, 3Department of Biostatistics, 4Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, Seattle, WA, 5Columbia University Medical Center, New York, NY, 6Kaiser Foundation Research Institute, Oakland, 7Division of Infectious Diseases and Health Policy Research Institute, University of California Irvine School of Medicine, Irvine, CA, 8Harvard Medical School, Pulmonary and Critical Care, Allergy and Immunology, Brigham and Women's Hospital, 9Massachusetts General Hospital, Boston, MA, 10Division of General Internal Medicine & Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, 11Vanderbilt University and Tennessee Valley VAHCC, Nashville, TN, 12Departments of Radiology and Biomedical Imaging, Health Policy, Epidemiology and Biostatistics, University of California, San Francisco, SF, 13Emory University, Atlanta, GA, 14Department of Plastic Surgery, Division of Clinical and Translational Research, NYU Langone Medical Center, New York, NY, 15Agency for Healthcare Research and Quality, Rockville, MD, USA Abstract: The Clinical and Health Outcomes Initiative in Comparative Effectiveness (CHOICE program, which includes 12 ongoing comparative effectiveness research (CER trials funded by the Agency for Healthcare Research and Quality under the American Recovery and Reinvestment Act of 2009, has had firsthand experience in dealing with the unique challenges of conducting CER since the trials started in the fall of 2010. This paper will explore the collective experience

  19. Initial experience of occluding special type patent ductus arterioses using the Amplatzer vascular plug

    Institute of Scientific and Technical Information of China (English)

    ZHANG Po; ZHU Xian-yang; WANG Qi-guang; ZHANG Duan-zhen; HAN Xiu-min

    2013-01-01

    Background Occluders licensed for clinical use are not fit for some special Krichenko E patent ductus arterioses.The Amplatzer vascular plug I (AVP1) has not been licensed for use for closure of patent ductus arteriose.We report our initial experience to occluding special type patent ductus arterioses with the AVP1-a single lobe device of single layer Nitinol mesh for short vessel landing zones.Methods Patients referred with small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter underwent occlusion using AVP1.All cases underwent pre-,intra-and post-procedural echocardiography and chest X-ray at the completion of the procedure,the next day and at a 30-day,3-month and 6-month follow-up visits.Device sizing for device waist diameter and length was based on aortography.Results From April 2008 to June 2012,26 patients with a mean age of (7.6±8.0) years (range 6 months-32 years)and a mean weight of (23.8±14.8) kg (range 7-67 kg) underwent successful patent ductus arteriose closure.The mean ductus diameter was (2.1±0.7) mm (range 1-3 mm).Transpulmonary (22/26) and transaortic approaches (4/26) were used.No persistent patency was observed after 24 hours and after one month.No device displacement,residual flow and iatrogenic coarctation of the aorta were observed after three months and six months.Conclusions The AVP1 makes it easy to close some Krichenko E patent ductus arterioses.Smaller delivery catheter profile and symmetric cylindrical device shape allow for use for small and long Krichenko E patent ductus arterioses 1 mm to 3 mm in diameter and small patients through transaortic approaches.Broader experience is required to further delineate device and patient selection as well as to document its long-term efficacy and safety.

  20. Social and Psychological Predictors of Initial Cigarette Smoking Experience: A Survey in Male College Students.

    Science.gov (United States)

    Menati, Walieh; Nazarzadeh, Milad; Bidel, Zeinab; Würtz, Morten; Menati, Rostam; Hemati, Rohollah; Yaghoubi, Maryam; Zareimanesh, Elham; Mohammadi, Mohammad Sabour; Akhlaghi Ardekani, Farzad; Tazval, Jafar; Delpisheh, Ali

    2016-01-01

    Knowledge about social and psychological risk factors for initial cigarette smoking experience (ICSE) is sparse. The present study aimed to estimate the prevalence of ICSE and to examine the psychological and social factors related to ICSE. In a cross-sectional survey, 1,511 male college students were recruited using multistage sampling techniques from four universities located within the city of Ilam, Iran. Self-administered multiple-choice questionnaires were distributed to students from March to June 2013. Risk factors for ICSE were evaluated using logistic regression models. Participants were 22.3 ± 2.4 years of age. ICSE prevalence was 30.6%. In multivariable adjusted analysis, risk taking behavior (odds ratio [OR] = 1.61; 95% confidence interval [CI] = 1.11-2.33), perceived peer smoking prevalence (OR = 2.48; 95% CI = 1.03-5.97), positive thoughts about smoking (OR = 1.06; 95% CI = 1.02-1.10), high self-efficacy (OR = 0.95, 95% CI [0.93, 0.98]), presence in smokers' gathering (OR = 4.45; 95% CI = 2.88-6.81), comity of smokers (OR = 2.56; 95% CI = 1.66, 3.92), very hard access to cigarettes (OR = 2.20; 95% CI = 1.16-4.16), close friends' medium reaction toward smoking (OR = 1.38; 95% CI = 1.02-1.88), and sporting activity (OR = 0.74; 95% CI = 0.56-0.98) were significantly associated with ICSE. This study identified that a combination of psychological and social variables account for up to 78% of the probability of ICSE. The most important protective factor against ICSE was physical activity, whereas the most important risk factor for ICSE was frequent gathering in the presence of smokers.

  1. SU-E-J-181: Magnetic Resonance Image-Guided Radiation Therapy Workflow: Initial Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Green, O; Kashani, R; Santanam, L; Wooten, H; Li, H; Rodriguez, V; Hu, Y; Mutic, S [Washington University School of Medicine, St. Louis, MO (United States); Hand, T; Victoria, J [ViewRay, Inc., Oakwood Village, OH (United States); Steele, C [Barnes Jewish Hospital, St Louis, MO (United States)

    2014-06-01

    Purpose: The aims of this work are to describe the workflow and initial clinical experience treating patients with an MRI-guided radiotherapy (MRIGRT) system. Methods: Patient treatments with a novel MR-IGRT system started at our institution in mid-January. The system consists of an on-board 0.35-T MRI, with IMRT-capable delivery via doubly-focused MLCs on three {sup 60} Co heads. In addition to volumetric MR-imaging, real-time planar imaging is performed during treatment. So far, eleven patients started treatment (six finished), ranging from bladder to lung SBRT. While the system is capable of online adaptive radiotherapy and gating, a conventional workflow was used to start, consisting of volumetric imaging for patient setup using visible tumor, evaluation of tumor motion outside of PTV on cine images, and real-time imaging. Workflow times were collected and evaluated to increase efficiency and evaluate feasibility of adding the adaptive and gating features while maintaining a reasonable patient throughput. Results: For the first month, physicians attended every fraction to provide guidance on identifying the tumor and an acceptable level of positioning and anatomical deviation. Average total treatment times (including setup) were reduced from 55 to 45 min after physician presence was no longer required and the therapists had learned to align patients based on soft-tissue imaging. Presently, the source strengths were at half maximum (7.7K Ci each), therefore beam-on times will be reduced after source replacement. Current patient load is 10 per day, with increase to 25 anticipated in the near future. Conclusion: On-board, real-time MRI-guided RT has been incorporated into clinical use. Treatment times were kept to reasonable lengths while including volumetric imaging, previews of tumor movement, and physician evaluation. Workflow and timing is being continuously evaluated to increase efficiency. In near future, adaptive and gating capabilities of the system will

  2. MRI-guided percutaneous laser ablation of small renal cell carcinoma: Initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Kariniemi, Juho; Ojala, Risto; Hellstroem, Pekka; Sequeiros, Roberto Blanco (Dept. of Radiology, Dept. of Surgery, Oulu Univ. Hospital, Oulu (Finland)), e-mail: juho.kariniemi@oulu.fi

    2010-05-15

    Background: The number of detected small renal cell carcinomas (RCCs) has been rising, largely due to advances in imaging. Open surgical resection is the standard management of small RCCs; however, imaging-guided percutaneous ablative therapies have emerged as a minimally invasive treatment alternative, especially for patients who are poor candidates for surgery. Purpose: To evaluate the initial clinical experience of magnetic resonance imaging (MRI)-guided percutaneous laser ablation of small RCCs. Material and Methods: Eight patients with 10 tumors were treated with percutaneous MRI-guided laser ablation. All tumors (diameter range 1.5-3.8 cm, mean 2.7 cm) were biopsy-proven RCCs. By using a 0.23 T open MRI system and general anesthesia in patients, one to four (mean 2.6) laser fibers were placed and the tumors were ablated under near real-time MRI control by observing the signal void caused by the temperature change in the heated tissue. The treatment was considered successful if the tumor showed no contrast enhancement at follow-up imaging. Results: All except one tumor were successfully ablated in one session. The first patient treated showed enhancing residual tumor in post-procedural MRI; she has thus far declined retreatment. One complication, a myocardial infarction, occurred; all other patients tolerated the procedure well. No local recurrence was discovered during the follow-up (range 12-30 months, mean 20 months). Conclusion: In this small group of patients with relatively short follow-up period, MRI-guided percutaneous laser ablation proved to be a promising treatment option for small RCCs

  3. Initial experience of percutaneous treatment of mitral regurgitation with MitraClip® therapy in Spain.

    Science.gov (United States)

    Carrasco-Chinchilla, Fernando; Arzamendi, Dabit; Romero, Miguel; Gimeno de Carlos, Federico; Alonso-Briales, Juan Horacio; Li, Chi-Hion; Mesa, Maria Dolores; Arnold, Roman; Serrador Frutos, Ana María; Pan, Manuel; Roig, Eulalia; Rodríguez-Bailón, Isabel; de la Fuente Galán, Luis; Hernández, José María; Serra, Antonio; Suárez de Lezo, José

    2014-12-01

    Symptomatic mitral regurgitation has an unfavorable prognosis unless treated by surgery. However, the European registry of valvular heart disease reports that 49% of patients with this condition do not undergo surgery. Percutaneous treatment of mitral regurgitation with MitraClip® has been proved a safe, efficient adjunct to medical treatment in patients with this profile. The objective of the present study is to describe initial experience of MitraClip® therapy in Spain. Retrospective observational study including all patients treated between November 2011 and July 2013 at the 4 Spanish hospitals recording the highest numbers of implantations. A total of 62 patients (77.4% men) were treated, mainly for restrictive functional mitral regurgitation (85.4%) of grade III (37%) or grade IV (63%), mean (standard deviation) ejection fraction 36% (14%), and New York Heart Association functional class III (37%) or IV (63%). Device implantation was successful in 98% of the patients. At 1 year, 81.2% had mitral regurgitation ≤ 2 and 90.9% were in New York Heart Association functional class ≤ II. One periprocedural death occurred (sepsis at 20 days post-implantation) and another 3 patients died during follow-up (mean, 9.1 months). Two patients needed a second implantation due to partial dehiscence of the first device and 2 others underwent heart transplantation. In Spain, MitraClip® therapy has principally been aimed at patients with functional mitral regurgitation, significant systolic ventricular dysfunction, and high surgical risk. It is considered a safe alternative treatment, which can reduce mitral regurgitation and improve functional capacity. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  4. Transperineal prostate biopsy with ECHO-MRI fusion. Biopsee system. Initial experience.

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    Romero-Selas, E; Cuadros, V; Montáns, J; Sánchez, E; López-Alcorocho, J M; Gómez-Sancha, F

    2016-06-01

    The aim of this study is to present our initial experience with the stereotactic echo-MRI fusion system for diagnosing prostate cancer. Between September 2014 and January 2015, we performed 50 prostate biopsies using the stereotactic echo-MRI fusion system. The 3-Tesla multiparameter MR images were superimposed using this image fusion system on 3D echo images obtained with the Biopsee system for the exact locating of areas suspected of prostate cancer. The lesions were classified using the Prostate Imaging Report and Date System. We assessed a total of 50 patients, with a mean age of 63 years (range, 45-79), a mean prostate-specific antigen level of 8 ng/mL (range, 1.9-20) and a mean prostate volume of 52mL (range, 12-118). Prostate cancer was diagnosed in 69% of the patients and intraepithelial neoplasia in 6%. The results of the biopsy were negative for 24% of the patients. The results of the biopsy and MRI were in agreement for 62% of the patients; however, 46% also had a tumour outside of the suspicious lesion. We diagnosed 46% anterior tumours and 33% apical tumours. One patient had a haematuria, another had a haematoma and a third had acute urine retention. Multiparametric prostatic MRI helps identify prostate lesions suggestive of cancer. The Biopsee echo-MRI fusion system provides for guided biopsy and increases the diagnostic performance, reducing the false negatives of classical biopsies and increasing the diagnosis of anterior tumours. Transperineal access minimises the risk of prostatic infection and sepsis. Copyright © 2015 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  5. Initial Australian experience with high dose indium-111 pentreotide therapy in progressive, symptomatic neuroendocrine tumours

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    Hicks, R.J.; Keady, M.A.; Johnson, V. [The Peter McCallum Cancer Institute, Melbourne, VIC (Australia). Department of Nuclear Medicine and PET

    1998-06-01

    Full text: Neuroendocrine tumours variably express somatostatin receptors enabling imaging using somatostatin analogues, including In-111 pentreotide. Due to the emission of Auger electrons in the decay of In-1 11, there is the potential to use this agent for therapy. Based on favourable experience with high dose In-111 pentreotide therapy a the University of Rotterdam, a prospective trial of this treatment was performed in 6 patients with progressive, symptomatic neuroendocrine tumours (carcinoid in 4 patients and glucagonoma in 2 patients). Patients were selected based on the presence of uptake at multiple sites on In-1 11 pentreotide scanning with intensity equal to or greater than splenic activity. Follow-up of haematology, endocrine and renal function was performed and serial imaging correlation of index lesions was performed. Three treatments of approximately 6.5 GBq of In-111 pentreotide were administered to each patient over 3-5 months. One pt with bone metastases from carcinoid had an initial flare in symptoms 1 week following treatment but subsequent palliation which lasted 6 months before requiring local radiotherapy. The three remaining carcinoid patients had symptomatic improvement and reduced 5-HIAA levels when abnormal at baseline. Both patients with glucagonoma had symptomatic improvement and reduction in glucagon levels. No patients had evidence of disease progression up to 6 months post-treatment in index lesions with high In-1 11 pentreotide uptake. One lesion with low uptake progressed despite regression in other lesions with high uptake in the same patient Minor transient lymphopaenia was seen following treatment but no clinically significant toxicity was noted. These preliminary results complement European data suggesting good palliation from high dose In-111 pentreotide therapy in patients with high somatostatin receptor expression

  6. Initial experience in Brazil with the Helex septal occluder for percutaneous occlusion of atrial septal defects

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    Pedra Carlos A.C.

    2003-01-01

    Full Text Available OBJECTIVE: To evaluate the initial clinical experience with the Helex septal occluder for percutaneous closure of atrial septal defects. METHODS: Ten patients underwent the procedure, 7 patients with ostium secundum atrial septal defects (ASD with hemodynamic repercussions and 3 patients with pervious foramen ovale (PFO and a history of stroke. Mean age was 33.8 years and mean weight was 55.4 kg. Mean diameter by transesophageal echocardiography and mean stretched ASD diameter were 11.33 ± 3.3mm, and 15.2 ± 3.8mm, respectively. The Qp/Qs ratio was 1.9 ± 0.3 in patients with ASD. RESULTS: Eleven occluders were placed because a patient with 2 holes needed 2 devices. It was necessary to retrieve and replace 4 devices in 3 patients. We observed immediate residual shunt (< 2mm in 4 patients with ASD, and in those with patent foramen ovale total occlusion of the defect occurred. No complications were noted, and all patients were discharged on the following day. After 1 month, 2 patients with ASD experienced trivial residual shunts (1mm. In 1 patient, we observed mild prolapse in the proximal disk in the right atrium, without consequences. CONCLUSION: The Helex septal occluder was safe and effective for occluding small to moderate atrial septal defects. Because the implantation technique is demanding, it requires specific training of the operator. Even so, small technical failures may occur in the beginning of the learning curve, but they do not involve patient safety.

  7. Initial experience with the Codman Certas adjustable valve in the management of patients with hydrocephalus

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    Watt Sara

    2012-09-01

    Full Text Available Abstract Background A new adjustable valve, the Codman CertasTM valve for treatment of hydrocephalus was introduced into clinical practice in January 2011. It has 8 different settings with an opening pressure varying from 36 to over 400 mm H2O at a flow rate of 20 mL/h. The 8th setting is designed to provide a "virtual off" function. The objective of this report is to describe the initial clinical experience with the CertasTM valve and evaluate clinical usage with the main focus on the portable adjustment device - Therapeutic Management System (TMS, the “virtual off” setting and compatibility with magnetic resonance imaging (MRI. Findings Forty-two patients with hydrocephalus from different etiologies were treated with the CertasTM adjustable shunt system. Data regarding implantation procedures, the use of the TMS system, x-ray imaging, and MRI procedures were recorded prospectively. All patients had clinical follow-up at four weeks after implantation and every three months until a stable clinical condition was obtained. The mean time for follow-up was 8.6 months (1–16.6. Seventy-one adjustments were performed with the TMS, 12 were problematic. Twenty-nine MRI procedures were performed and did not cause accidental resetting. Five patients were treated with the "virtual off" function for a period. Conclusions We found the CertasTM valve valuable in the treatment of hydrocephalus, usability of the TMS was high because it is small and portable, but in some cases we experienced adjustment problems with the first procedures performed by a surgeon, indicating that there is a learning curve. The "virtual off" function provided a possibility of treating over-drainage without the need for shunt ligation or other invasive procedures.

  8. Augmented Reality Guidance for the Resection of Missing Colorectal Liver Metastases: An Initial Experience.

    Science.gov (United States)

    Ntourakis, Dimitrios; Memeo, Ricardo; Soler, Luc; Marescaux, Jacques; Mutter, Didier; Pessaux, Patrick

    2016-02-01

    Modern chemotherapy achieves the shrinking of colorectal cancer liver metastases (CRLM) to such extent that they may disappear from radiological imaging. Disappearing CRLM rarely represents a complete pathological remission and have an important risk of recurrence. Augmented reality (AR) consists in the fusion of real-time patient images with a computer-generated 3D virtual patient model created from pre-operative medical imaging. The aim of this prospective pilot study is to investigate the potential of AR navigation as a tool to help locate and surgically resect missing CRLM. A 3D virtual anatomical model was created from thoracoabdominal CT-scans using customary software (VR RENDER(®), IRCAD). The virtual model was superimposed to the operative field using an Exoscope (VITOM(®), Karl Storz, Tüttlingen, Germany). Virtual and real images were manually registered in real-time using a video mixer, based on external anatomical landmarks with an estimated accuracy of 5 mm. This modality was tested in three patients, with four missing CRLM that had sizes from 12 to 24 mm, undergoing laparotomy after receiving pre-operative oxaliplatin-based chemotherapy. AR display and fine registration was performed within 6 min. AR helped detect all four missing CRLM, and guided their resection. In all cases the planned security margin of 1 cm was clear and resections were confirmed to be R0 by pathology. There was no postoperative major morbidity or mortality. No local recurrence occurred in the follow-up period of 6-22 months. This initial experience suggests that AR may be a helpful navigation tool for the resection of missing CRLM.

  9. Single-incision laparoscopic colectomy without using special articulating instruments: an initial experience

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    Trakarnsanga Atthaphorn

    2011-12-01

    Full Text Available Abstract Background Single-incision laparoscopic colectomy (SILC was introduced as a novel minimally invasive technique. The benefits of this technique include reducing number of the incision and cosmetic improvement. Unlike the conventional laparoscopic colectomy, majority of previously reported SILC need to be performed using special curved or articulated instruments. The purpose of this study is to demonstrate our initial experience of SILC, which could be performed using the standard laparoscopic instruments. Material and methods Retrospective review of 14 patients who underwent SILC at Siriraj Hospital from May to December 2010, patient's demographic data, perioperative outcomes, early postoperative complications and pathological data were collected and analyzed. Results The mean age of all patients was 60 years. The most common operation with SILC was sigmoidectomy (n = 9, followed by right hemicolectomy (n = 2, left hemicolectomy (n = 1, anterior resection (n = 1, and total colectomy (n = 1. The trocar insertion techniques were multi-fascial incision using regular port (n = 11 and GelPOINT® (n = 3. The mean operative time was 155 minutes (range 90-280 and the mean estimate blood loss was 32.1 mL (range 10-100. All patients were successfully operated without conversion. The mean length of hospital stay was 9 days (range 5-20. There was no mortality. The pathological results revealed colorectal cancer (n = 12, neoplastic polyp (n = 1 and Familial adenomatous polyposis (FAP (n = 1. The mean number of lymph nodes retrieval was 16.6 (range 3-34. Conclusion SILC can successfully and safely be performed with standard laparoscopic instruments. This technique might be an alternative procedure to conventional laparoscopic colectomy with better cosmetic result.

  10. Initial experience with extreme angle cervical screw for treatment of trauma and cervical spondylosis.

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    Mehta, Ankit I; Babu, Ranjith; Bagley, Carlos A; Grossi, Peter M; Gottfried, Oren N

    2014-03-01

    In this study, we have described our initial experience and surgical technique of extreme angle screw placement in the cervical and upper thoracic spine of a cohort of patients undergoing posterior fusion. This extreme angle screw facilitates rod placement without need for any coronal contouring of the rod or offset connectors despite the varied entry site locations for posterior instrumentation and the different trajectories and pathways of these screws. From ruary 2011 to July 2011, extreme angle screws were placed in twenty consecutive adult patients who underwent posterior cervical, occipital-cervical or cervical-thoracic fusions. The primary diagnosis was cervical spondylotic myelopathy (13), trauma (4), and pseudoarthrosis with stenosis (3). Eight patients had gross instability. A total of 196 screws were placed; half of the cases involved instrumentation at or within the C3-7 segments (10) and the others included constructs extending to occipital bone, C2, T1, or T2 (10). Of all twenty cases, there were no perioperative hardware complications. At long-term follow-up, two patients required reoperation, one for hardware failure and the other for single level symptomatic pseudoarthrosis. We conclude that extreme angle screw use in the posterior cervical spine provides an evolution in posterior instrumentation that maximizes the biomechanical strength of a construct, allows for easy rod placement, and may improve the restoration of sagittal alignment. Overall, extreme angle screws facilitate rod placement even for screws offset from the natural plane of the rod, thereby avoiding the need for coronal contouring or placement of offset connectors.

  11. Pneumatic reduction of intussusception in children at Korle Bu Teaching Hospital: An initial experience

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    Yaw Boateng Mensah

    2011-01-01

    Full Text Available Background: Intussusception is a common abdominal emergency in children which necessitates prompt diagnosis and management. Nonsurgical methods of managing this condition are rapidly gaining popularity with fluoroscopic-guided pneumatic reduction being one of such methods that has been used with great success in many countries. We present our initial experience with fluoroscopic-guided pneumatic reduction of intussusception at Korle Bu Teaching Hospital which is also the first time the technique has been used in Ghana. Materials and Methods: A total of 18 children were enrolled in the study between August 2007 and February 2008 at Korle Bu Teaching Hospital, Accra, Ghana. Patients were given air enema under fluoroscopic-guidance using locally assembled equipment. The intraluminal pressure was monitored with a pressure gauge and was not permitted to go above 120 mmHg. A total of three attempts of 3 min each were allowed. Results: There were 12 males and 6 females. The average age of the patients was 8.3 months (SD= 3 months. Twelve (67% of the cases were reduced successfully while 6 (33% failed to reduce. A majority of those that did not reduced had symptoms for at least 2 days. Bowel perforation occurred in three (16.7% cases. Conclusion: Pneumatic reduction of intussusception is a cost-effective and rapid method of management of intussusception. It however has limitations like high reported rate of bowel perforation and limited ability to identify lead points. The benefits however seem to outweigh these challenges, such as fluoroscopic-guided pneumatic reduction has a very high success rate. Fluoroscopic guided pneumatic reduction should be considered as one of the primary modes of reduction in Ghana and other neighbouring countries that are yet to practice it.

  12. Robotic-assisted laparoscopic partial nephrectomy: initial experience in Brazil and a review of the literature

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    Carlo Camargo Passerotti

    2012-02-01

    Full Text Available CONTEXT AND PURPOSE: Partial nephrectomy has become the standard of care for renal tumors less than 4 cm in diameter. Controversy still exists, however, regarding the best surgical approach, especially when minimally invasive techniques are taken into account. Robotic-assisted laparoscopic partial nephrectomy (RALPN has emerged as a promising technique that helps surgeons achieve the standards of open partial nephrectomy care while offering a minimally invasive approach. The objective of the present study was to describe our initial experience with robotic-assisted laparoscopic partial nephrectomy and extensively review the pertinent literature. MATERIALS AND METHODS: Between August 2009 and February 2010, eight consecutive selected patients with contrast enhancing renal masses observed by CT were submitted to RALPN in a private institution. In addition, we collected information on the patients' demographics, preoperative tumor characteristics and detailed operative, postoperative and pathological data. In addition, a PubMed search was performed to provide an extensive review of the robotic-assisted laparoscopic partial nephrectomy literature. RESULTS: Seven patients had RALPN on the left or right sides with no intraoperative complications. One patient was electively converted to a robotic-assisted radical nephrectomy. The operative time ranged from 120 to 300 min, estimated blood loss (EBL ranged from 75 to 400 mL and, in five cases, the warm ischemia time (WIT ranged from 18 to 32 min. Two patients did not require any clamping. Overall, no transfusions were necessary, and there were no intraoperative complications or adverse postoperative clinical events. All margins were negative, and all patients were disease-free at the 6-month follow-up. CONCLUSIONS: Robotic-assisted laparoscopic partial nephrectomy is a feasible and safe approach to small renal cortical masses.Further prospective studies are needed to compare open partial nephrectomy with

  13. Percutaneous transcatheter closure of atrial septal defects: initial single-centre experience and follow-up results. Initial experience with three-dimensional echocardiography.

    Science.gov (United States)

    De Ridder, Serge; Suttorp, Maarten-Jan; Ernst, Sjef M P G; Six, Jacob A; Mannaerts, Herman F J; Kamp, Otto; Plokker, Thijs H W M; Jaarsma, Wybren

    2005-04-01

    Registry to report our single-centre experience in closing defects of the atrial septum. Between 1996 and 2001, transcatheter device closure of significant atrial septal defects was performed in 32 adults (mean age 45.1 years, range from 15 to 76 years), using different device types. Six patients had a patent foramen ovale (PFO) and 26 patients had a secundum atrial septal defect (ASD II). Defects were selected by means of two-dimensional transoesophageal echocardiography (2D TOE). For 12 defects additional three-dimensional transoesophageal echocardiography (3D TOE) was performed. Mean balloon-stretched diameter was 19.3 mm (range from 11 to 24 mm). A device was successfully placed in all PFO patients (100%) without complications at follow-up. Successful immediate device placement occurred in 24 out of 26 ASD patients. Two immediate placement failures, 1 device embolisation and 1 device non-fixation, occurred and required urgent surgery. There was 1 patient with pericardial effusion after the intervention, requiring pericardiocentesis. Three late placement failures occurred: 2 device embolisations and 1 device dislocation. Clinical success after 3 to 6 months follow-up, defined as the absence of shunt or small shunt, was achieved in all 6 PFO patients and in 21 out of 23 ASD patients (1 device embolisation, requiring surgery, occurred before follow-up was completed). Two patients with significant shunt, 1 late device dislocation and 1 late device embolisation, underwent elective surgery. For patient selection, 3D TOE proved useful in the evaluation of large and/or complex defects. Transcatheter device closure of carefully selected atrial septal defects is an alternative to surgery. Although the results are promising, surgical back-up is often needed.

  14. Greening of a Campus through Waste Management Initiatives: Experience from a Higher Education Institution in Thailand

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    Tangwanichagapong, Siwaporn; Nitivattananon, Vilas; Mohanty, Brahmanand; Visvanathan, Chettiyappan

    2017-01-01

    Purpose: This paper aims to describe the effects of 3R (reduce, reuse and recycle) waste management initiatives on a campus community. It ascertains the environmental attitudes and opinions of the residents and investigates their behavioral responses to waste management initiatives. Practical implications for enhancing sustainable waste management…

  15. Project Description Advanced Fuel Cycle Initiative AFC-2A and AFC-2B Experiments

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    AFCI AFC-2A and AFC-2B Experiments Project Executi

    2007-03-01

    The proposed AFC-2A and AFC-2B irradiation experiments are a continuation of the AFC-1 fuel test series currently in progress in the ATR. This document discusses the experiments and the planned activities that will take place.

  16. Initial Experience of Transurethral Resection with Pediatric Resectoscope for Incomplete Anterior Urethral Stricture

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    Won Seok Jang

    2013-04-01

    Full Text Available Purpose Endoscopic urethrotomy is an alternative method in treatment of urethral stricture. However, it have high recurrence rate because of the remained fibrotic tissue. Removal of the fibrotic tissue can maintain the patency of the urethral lumen after the procedure. We report the therapeutic efficacy of our initial experience using pediatric resectoscope for treating anterior urethral stricture in 16 cases. Materials and Methods From January 2009 to April 2011, transurethral resection with pediatric resectoscope was primarily performed on 16 patients with anterior urethral stricture. Retrograde urethrography, uroflowmetry, postvoid residual volume, IPSS score and QoL score were performed preoperatively. We used 11.5Fr pediatric resectoscope (Wolf and monopolar electrosurgical generator. The stricture was incised under vision at the 12 o'clock location or the site of maximum scar tissue or narrowing in asymmetric strictures for working space. After incision, transurethral resection with pediatric resectoscope was performed to all scar tissues. Monopolar cutting current was set on 45 watt and coagulation current was set on 30 watt, fulgurate mode. Postoperatively, drainage of the bladder was performed for 7 days using an 18F latex catheter. Patients were followed up by IPSS score, QoL score, uroflowmetry and postvoid residual volume. Results Successful results without recurrence were achieved in 11 of 16patients. Postoperative urethral dilation had been performed average 2.4 times (0∼6 times. When we classified the results by etiology, the number of successful results in strictures with a trauma, iatrogenic, or unknown cause was 5 (7/11, 3 (3/4 and 1 (1/1, respectively. In 5 patients who failed treatment, we repeated transurethral resection with pediatric resectoscope in 1 patient, and periodic urethral dilation in 4 patients. No operative complications occurred in any patients. Conclusions Transurethral resection with pediatric resectoscope

  17. Supporting ITM Missions by Observing System Simulation Experiments: Initial Design, Challenges and Perspectives

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    Yudin, V. A.; England, S.; Matsuo, T.; Wang, H.; Immel, T. J.; Eastes, R.; Akmaev, R. A.; Goncharenko, L. P.; Fuller-Rowell, T. J.; Liu, H.; Solomon, S. C.; Wu, Q.

    2014-12-01

    We review and discuss the capability of novel configurations of global community (WACCM-X and TIME-GCM) and planned-operational (WAM) models to support current and forthcoming space-borne missions to monitor the dynamics and composition of the Ionosphere-Thermosphere-Mesosphere (ITM) system. In the specified meteorology model configuration of WACCM-X, the lower atmosphere is constrained by operational analyses and/or short-term forecasts provided by the Goddard Earth Observing System (GEOS-5) of GMAO/NASA/GSFC. With the terrestrial weather of GEOS-5 and updated model physics, WACCM-X simulations are capable to reproduce the observed signatures of the perturbed wave dynamics and ion-neutral coupling during recent (2006-2013) stratospheric warming events, short-term, annual and year-to-year variability of prevailing flows, planetary waves, tides, and composition. With assimilation of the NWP data in the troposphere and stratosphere the planned-operational configuration of WAM can also recreate the observed features of the ITM day-to-day variability. These "terrestrial-weather" driven whole atmosphere simulations, with day-to-day variable solar and geomagnetic inputs, can provide specification of the background state (first guess) and errors for the inverse algorithms of forthcoming NASA ITM missions, such as ICON and GOLD. With two different viewing geometries (sun-synchronous, for ICON and geostationary for GOLD) these missions promise to perform complimentary global observations of temperature, winds and constituents to constrain the first-principle space weather forecast models. The paper will discuss initial designs of Observing System Simulation Experiments (OSSE) in the coupled simulations of TIME-GCM/WACCM-X/GEOS5 and WAM/GIP. As recognized, OSSE represent an excellent learning tool for designing and evaluating observing capabilities of novel sensors. The choice of assimilation schemes, forecast and observational errors will be discussed along with challenges

  18. Myocardial stress perfusion magnetic resonance: initial experience in a pediatric and young adult population using regadenoson

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    Noel, Cory V. [Baylor College of Medicine, Department of Pediatric Cardiology, Houston, TX (United States); Texas Children' s Hospital, Department of Pediatric Cardiology, Houston, TX (United States); Krishnamurthy, Ramkumar; Krishnamurthy, Rajesh [Texas Children' s Hospital, Department of Radiology, Houston, TX (United States); Moffett, Brady [Texas Children' s Hospital, Department of Pharmacology, Houston, TX (United States)

    2017-03-15

    Dipyridamole and adenosine are traditional pharmacological stressors for myocardial perfusion. Regadenoson, a selective adenosine A2A agonist, has a lower side effect profile with lower incidence of bronchospasm and bradycardia. There is a growing need for myocardial perfusion assessment within pediatrics. There is no report on the utility of regadenoson as a stress agent in children. To observe the safety and feasibility of regadenoson as a pharmacologic stressor for perfusion cardiac MR in a pilot cohort of pediatric patients weighing more than 40 kg who have congenital heart disease and pediatric acquired heart disease. We reviewed our initial experience with regadenoson stress cardiac MR in 31 pediatric patients 15.8 ± 1.7 years (range 12-22 years) with congenital heart disease and acquired heart disease. Mean patient weight was 60 ± 15 kg (range of 40-93 kg). All patients underwent cardiac MR because of concern for ischemia. The cohort included a heterogeneous group of patients at a pediatric institution with potential risk for ischemia. Subjects' heart rate and blood pressure were monitored and pharmacologic stress was induced by injection of 400 mcg of regadenoson. We evaluated their hemodynamic response and adverse effects using changes in vital signs and onset of symptoms. A pediatric cardiologist and radiologist qualitatively assessed myocardial perfusion and viability images. One child was unable to complete the stress perfusion portion of the examination, but did complete the remaining portion of the CMR. Resting heart rate was 72 ± 14 beats per minute (bpm) and rose to peak of 124 ± 17 bpm (95 ± 50% increase, P < 0.005) with regadenoson. Image quality was considered good or diagnostic in all cases. Three patients had irreversible perfusion defects. Four patients had reversible perfusion defects. Nine of the patients underwent cardiac catheterization with angiography and the findings showed excellent agreement. Regadenoson might be a safe and

  19. Initial experiences of implementation of functional integration (FI) in LEPRA India projects in Orissa.

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    Rao, V Prabhakara; Bhuskade, R A; Raju, M Sathi; Rao, P V Ranganadha; Desikan, K V

    2002-06-01

    In 2000, the Government of the State of Orissa (population 37 million) in India decided to introduce functional integration for the control of leprosy, in place of the long-established vertical programme, using the general health services and the primary health care system. This paper describes the initial (9 months) experience of implementing this strategy in two projects run by LEPRA India. One of these, in the district of Koraput, was established in 1991 and covers a population of 1.5 million people. The other, in Kalahandi district, started in 1997 and covers a population of 600,000. Both projects operate under difficult conditions with regard to terrain, the use of numerous tribal languages, illiteracy, water shortage, poor roads and communications. The preparatory phase included intensive health education of the public on leprosy, using a wide range of educational media and techniques. At the same time, LEPRA India supported the Government in the training and orientation of trainers, medical officers, primary health care staff and female health workers at village level. In all, over 2000 were trained. This paper describes all aspects of the implementation of functional integration in these two areas. In the 9-month period, 4207 suspect cases were referred to medical officers by health workers, but only 256 (6%) were confirmed as having leprosy. There were 169 confirmed self-reporting cases. Despite the clearly understood intention to involve primary health staff in case detection, 67% of all cases were in fact detected by LEPRA India, possibly due to overlapping attendance at clinics by vertical and general staff. There is obviously a need for further training of the general staff since only 6% of cases referred by them were confirmed as having leprosy. Steps must also be taken to ensure that the emphasis on case detection, confirmation and treatment shifts from the vertical to the general health staff. The supply of anti-leprosy drugs and steroids to primary

  20. E-learning course: Basis of Harvest and Preservation of Tissues – design and initial experience

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    Pavel Měřička

    2014-05-01

    Full Text Available Background: The design and initial experience with the e-learning course “Basis of Harvest and Preservation of Tissues” used as a support of an elective subject is presented. The aim of the e-learning course was to enable the students to learn the theoretical principles of the subject individually and to present the gained knowledge at the final seminar. Methods: All functions of the course were operated in Moodle, local application of the Charles University in Prague, Faculty of Medicine in Hradec Králové. The course was divided into 3 main topics corresponding with topics of lectures: 1. Principles of tissue and organ donation, 2. Low temperature preservation of cells, tissues and organs, 3. Quality and safety assurance in practice of tissue and procurement establishments. A test consisting of 5 questions selected randomly from the bank of questions followed each topic. If the student answers correctly at least 3 questions he is allowed to pass to the next topic. The fourth topic “Basic processes in the tissue establishment and principles of their validation” was added into the electronic version as a tool for repeating and improving of knowledge. The fifth topic was represented by a database for uploading theses presented by students at the final seminar. The final test consisted of 15 questions (5 ones from each basic topic. It was necessary to answer correctly at least 10 questions to receive a certificate of completing the course. Results: The course was put into operation during the summer term of the academic year 2012/2013. To the date 15 of September the total of 23 students enrolled (17, i.e. all students of the elective subject in the Czech version, 2 students of this subject in the English version, 2 postgraduate students and 2 medical doctors. All enrolled students used the course for on-line learning, downloading, or printing course study materials. All undergraduate students were obliged to use it for preparation

  1. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery.

    Science.gov (United States)

    Costa, Altair da Silva; Bachichi, Thiago; Holanda, Caio; Rizzo, Luiz Augusto Lucas Martins De

    2016-01-01

    To report an initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. This was a prospective observational study involving consecutive patients, ≤ 14 years of age, treated at a pediatric thoracic surgery outpatient clinic, for whom pulmonary resection (lobectomy or segmentectomy via muscle-sparing thoracotomy) was indicated. The parameters evaluated were air leak (as quantified with the digital system), biosafety, duration of drainage, length of hospital stay, and complications. The digital system was used in 11 children (mean age, 5.9 ± 3.3 years). The mean length of hospital stay was 4.9 ± 2.6 days, the mean duration of drainage was 2.5 ± 0.7 days, and the mean drainage volume was 270.4 ± 166.7 mL. The mean maximum air leak flow was 92.78 ± 95.83 mL/min (range, 18-338 mL/min). Two patients developed postoperative complications (atelectasis and pneumonia, respectively). The use of this digital system facilitated the decision-making process during the postoperative period, reducing the risk of errors in the interpretation and management of air leaks. Relatar a experiência inicial com um sistema de drenagem digital no pós-operatório de cirurgia torácica pediátrica. Estudo observacional e prospectivo envolvendo pacientes consecutivos do ambulatório de cirurgia torácica pediátrica da instituição, com idade até 14 anos, e com indicação de ressecção pulmonar (lobectomia e/ou segmentectomia através de toracotomia poupadora muscular). Os parâmetros avaliados foram perda aérea (quantificada com o sistema digital), biossegurança, tempo de drenagem, tempo de internação e complicações. O sistema digital foi utilizado em 11 crianças, com média de idade de 5,9 ± 3,3 anos. A média do tempo de internação foi de 4,9 ± 2,6 dias, a de tempo de drenagem foi de 2,5 ± 0,7 dias, e a de volume de drenagem foi de 270,4 ± 166,7 ml. A média da perda aérea máxima foi de 92,78 ± 95,83 ml

  2. Characterizing Design Cognition of High School Students: Initial Analyses Comparing Those with and without Pre-Engineering Experiences

    Science.gov (United States)

    Wells, John; Lammi, Matthew; Gero, John; Grubbs, Michael E.; Paretti, Marie; Williams, Christopher

    2016-01-01

    Reported in this article are initial results from of a longitudinal study to characterize the design cognition and cognitive design styles of high school students with and without pre-engineering course experience over a 2-year period, and to compare them with undergraduate engineering students. The research followed a verbal protocol analysis…

  3. The Relationship of a Pilot's Educational Background, Aeronautical Experience and Recency of Experience to Performance In Initial Training at a Regional Airline

    Science.gov (United States)

    Shane, Nancy R.

    The purpose of this study was to determine how a pilot's educational background, aeronautical experience and recency of experience relate to their performance during initial training at a regional airline. Results show that variables in pilots' educational background, aeronautical experience and recency of experience do predict performance in training. The most significant predictors include years since graduation from college, multi-engine time, total time and whether or not a pilot had military flying experience. Due to the pilot shortage, the pilots entering regional airline training classes since August 2013 have varied backgrounds, aeronautical experience and recency of experience. As explained by Edward Thorndike's law of exercise and the law of recency, pilots who are actively using their aeronautical knowledge and exercising their flying skills should exhibit strong performance in those areas and pilots who have not been actively using their aeronautical knowledge and exercising their flying skills should exhibit degraded performance in those areas. Through correlation, chi-square and multiple regression analysis, this study tests this theory as it relates to performance in initial training at a regional airline.

  4. Initial experiments on the effectiveness of telephone access to government services

    CSIR Research Space (South Africa)

    Cloete, Jacob PL

    2004-08-01

    Full Text Available - and post-experiment interviews and an observed experiment. The experiments were performed at the Department of Labour in Pretoria, South Africa, in November 2003. Unscreened participants were solicited from the queue of UIF applicants. 14 callers used..., a number of conclusions were reached. Although transaction- completion rates were comparable for the speech-input and DTMF systems, users were much more comfortable with the speech-based system as reflected in somewhat higher user-satisfaction...

  5. Sensitivity Experiments of an Eastward-Moving Southwest Vortex to Initial Perturbations

    Institute of Scientific and Technical Information of China (English)

    王智; 高坤

    2003-01-01

    Whether the initial conditions contain pronounced mesoscale signals is important to the simulation of the southwest vortex. An eastward-moving southwest vortex is simulated using the PSU/NCAR MM5. A modest degree of success is achieved, but the most serious failure is that the formation and displacement of the simulated vortex in its early phase are about fourteen hours later than the observed vortex. Considering the relatively sparse data on the mesoscale vortex and in an attempt to understand the cause of the forecast failure, an adjoint model is used to examine the sensitivity of the southwest vortex to perturbations of initial conditions. The adjoint sensitivity indicates how small perturbations of model variables at the initial time in the model domain can influence the vortex. A large sensitivity for zonal wind is located under 400 hPa, a large sensitivity for meridional wind is located under 500 hPa, a large sensitivity for temperature is located between 500 and 900 hPa, and almost all of the large sensitivity areas are located in the southwestern area. Based on the adjoint sensitivity results, perturbations are added to initial conditions to improve the simulation of the southwest vortex. The results show that the initial conditions with perturbations can successfully simulate the formation and displacement of the vortex; the wind perturbations added to the initial conditions appear to be a cyclone circulation under the middle level of the atmosphere in the southwestern area with an anticyclone circulation to its southwest; a water vapor perturbation added to initial conditions can strengthen the vortex and the speed of its displacement.

  6. Reproducibility of scratch assays is affected by the initial degree of confluence: Experiments, modelling and model selection.

    Science.gov (United States)

    Jin, Wang; Shah, Esha T; Penington, Catherine J; McCue, Scott W; Chopin, Lisa K; Simpson, Matthew J

    2016-02-01

    Scratch assays are difficult to reproduce. Here we identify a previously overlooked source of variability which could partially explain this difficulty. We analyse a suite of scratch assays in which we vary the initial degree of confluence (initial cell density). Our results indicate that the rate of re-colonisation is very sensitive to the initial density. To quantify the relative roles of cell migration and proliferation, we calibrate the solution of the Fisher-Kolmogorov model to cell density profiles to provide estimates of the cell diffusivity, D, and the cell proliferation rate, λ. This procedure indicates that the estimates of D and λ are very sensitive to the initial density. This dependence suggests that the Fisher-Kolmogorov model does not accurately represent the details of the collective cell spreading process, since this model assumes that D and λ are constants that ought to be independent of the initial density. Since higher initial cell density leads to enhanced spreading, we also calibrate the solution of the Porous-Fisher model to the data as this model assumes that the cell flux is an increasing function of the cell density. Estimates of D and λ associated with the Porous-Fisher model are less sensitive to the initial density, suggesting that the Porous-Fisher model provides a better description of the experiments.

  7. Seventh Fleet field training exercise : Fleet Battle Experiment Kilo : fires initiatives final report

    OpenAIRE

    Schacher, G. E.; Pilnick, Steve; Irvine, Nelson; Gallup, Shelley

    2003-01-01

    Fleet Battle Experiment Kilo was conducted during Seventh Fleet exercise Tandem Thrust 03. During the Field Training Exercise phase, testing of Time Sensitive Targets processes using the Joint Fires Network was carried out. This report contains results obtained on contributions made by the Joint Fires Network to Navy Time Sensitive Targeting and experiment lessons learned. NA

  8. Eating at worksites in Nordic countries: national experiences and policy initiatives

    DEFF Research Database (Denmark)

    Jørgensen, Michael Søgaard; Arsky, Gunn Helene; Brandhøj, Mia

    2010-01-01

    with healthier worksite eating schemes based on employee participation can change the worksite eating substantially, also at blue-collar worksites. However, the dissemination to other worksites not participating in experiments seems limited. There is need for more research in the embedding of experiments...

  9. Initial Results on Neutralized Drift Compression Experiments (NDCX-IA) for High Intensity Ion Beam

    CERN Document Server

    Roy, Prabir K; Baca, David; Bieniosek, Frank; Coleman, Joshua E; Davidson, Ronald C; Efthimion, Philip; Eylon, Shmuel; Gilson, Erik P; Grant Logan, B; Greenway, Wayne; Henestroza, Enrique; Kaganovich, Igor D; Leitner, Matthaeus; Rose, David; Sefkow, Adam; Sharp, William M; Shuman, Derek; Thoma, Carsten H; Vanecek, David; Waldron, William; Welch, Dale; Yu, Simon

    2005-01-01

    Ion beam neutralization and compression experiments are designed to determine the feasibility of using compressed high intensity ion beams for high energy density physics (HEDP) experiments and for inertial fusion power. To quantitatively ascertain the various mechanisms and methods for beam compression, the Neutralized Drift Compression Experiment (NDCX) facility is being constructed at Lawrence Berkeley National Laboratory (LBNL). In the first compression experiment, a 260 KeV, 25 mA, K+ ion beam of centimeters size is radially compressed to a mm size spot by neutralization in a meter-long plasma column and beam peak current is longitudinally compressed by an induction velocity tilt core. Instrumentation, preliminary results of the experiments, and practical limits of compression are presented. These include parameters such as emittance, degree of neutralization, velocity tilt time profile, and accuracy of measurements (fast and spatially high resolution diagnostic) are discussed.

  10. Assessment of pain experience in adults and children after bracket bonding and initial archwire insertion

    Directory of Open Access Journals (Sweden)

    Marcio José da Silva Campos

    2013-10-01

    Full Text Available INTRODUCTION: Ninety five percent of orthodontic patients routinely report pain, due to alterations in the periodontal ligament and surrounding soft tissues, with intensity and prevalence varying according to age. OBJECTIVE: This study aimed to assess toothache and buccal mucosal pain in adults and children during two initial phases of the orthodontic treatment. METHODS: The intensity of toothache and buccal mucosal pain reported by 20 patients, 10 children (11-13 years and 10 adults (18-37 years was recorded with the aid of a Visual Analog Scale (VAS, during 14 days - 7 days with bonded brackets only and 7 days with the initial archwire inserted. RESULTS: There was no significant difference in pain intensity among adults and children. After bracket bonding, 50% of the children and 70% of the adults reported pain. 70% of both groups reported pain after initial archwire insertion. While adults reported constant, low intensity, buccal mucosal pain, the children showed great variation of pain intensity, but with a trend towards decreasing pain during the assessment period. After initial archwire insertion the peaks of toothache intensity and prevalence occurred 24 hours in children and 48 hours in adults. CONCLUSIONS: In general, children reported pain less frequently than adults did, though with greater intensity.

  11. English as an Additional Language and Initial Teacher Education: Views and Experiences from Northern Ireland

    Science.gov (United States)

    Skinner, Barbara

    2010-01-01

    This paper addresses training for teaching English as an Additional Language (EAL) at initial teacher education (ITE) level in Northern Ireland. This small-scale qualitative study describes 15 primary and post-primary teachers' perspectives on their preparation for teaching EAL in Northern Ireland. It explores reflections on EAL content in ITE…

  12. Robotics in hepatobiliary surgery-initial experience, first reported case series from India

    Directory of Open Access Journals (Sweden)

    S. Goja

    2017-01-01

    Conclusion: This initial series adds to existing data on the feasibility of robotic hepatobiliary cases with inherent advantages of minimal invasive surgery, however with limitation of availability and use of devices like cavitron ultrasonic surgical aspirator (CUSA and higher operative cost.

  13. Experiments with Metadata-Derived Initial Values and Linesearch Bundle Adjustment in Architectural Photogrammetry

    Science.gov (United States)

    Börlin, N.; Grussenmeyer, P.

    2013-07-01

    According to the Waldhäusl and Ogleby (1994) "3 x 3 rules", a well-designed close-range architectural photogrammetric project should include a sketch of the project site with the approximate position and viewing direction of each image. This orientation metadata is important to determine which part of the object each image covers. In principle, the metadata could be used as initial values for the camera external orientation (EO) parameters. However, this has rarely been used, partly due to convergence problem for the bundle adjustment procedure. In this paper we present a photogrammetric reconstruction pipeline based on classical methods and investigate if and how the linesearch bundle algorithm of Börlin et al. (2004) and/or metadata can be used to aid the reconstruction process in architectural photogrammetry when the classical methods fail. The primary initial values for the bundle are calculated by the five-point algorithm by Nistér (Stewénius et al., 2006). Should the bundle fail, initial values derived from metadata are calculated and used for a second bundle attempt. The pipeline was evaluated on an image set of the INSA building in Strasbourg. The data set includes mixed convex and non-convex subnetworks and a combination of manual and automatic measurements. The results show that, in general, the classical bundle algorithm with five-point initial values worked well. However, in cases where it did fail, linesearch bundle and/or metadata initial values did help. The presented approach is interesting for solving EO problems when the automatic orientation processes fail as well as to simplify keeping a link between the metadata containing the plan of how the project should have become and the actual reconstructed network as it turned out to be.

  14. Sexual experience promotes adult neurogenesis in the hippocampus despite an initial elevation in stress hormones.

    Directory of Open Access Journals (Sweden)

    Benedetta Leuner

    Full Text Available Aversive stressful experiences are typically associated with increased anxiety and a predisposition to develop mood disorders. Negative stress also suppresses adult neurogenesis and restricts dendritic architecture in the hippocampus, a brain region associated with anxiety regulation. The effects of aversive stress on hippocampal structure and function have been linked to stress-induced elevations in glucocorticoids. Normalizing corticosterone levels prevents some of the deleterious consequences of stress, including increased anxiety and suppressed structural plasticity in the hippocampus. Here we examined whether a rewarding stressor, namely sexual experience, also adversely affects hippocampal structure and function in adult rats. Adult male rats were exposed to a sexually-receptive female once (acute or once daily for 14 consecutive days (chronic and levels of circulating glucocorticoids were measured. Separate cohorts of sexually experienced rats were injected with the thymidine analog bromodeoxyuridine in order to measure cell proliferation and neurogenesis in the hippocampus. In addition, brains were processed using Golgi impregnation to assess the effects of sexual experience on dendritic spines and dendritic complexity in the hippocampus. Finally, to evaluate whether sexual experience alters hippocampal function, rats were tested on two tests of anxiety-like behavior: novelty suppressed feeding and the elevated plus maze. We found that acute sexual experience increased circulating corticosterone levels and the number of new neurons in the hippocampus. Chronic sexual experience no longer produced an increase in corticosterone levels but continued to promote adult neurogenesis and stimulate the growth of dendritic spines and dendritic architecture. Chronic sexual experience also reduced anxiety-like behavior. These findings suggest that a rewarding experience not only buffers against the deleterious actions of early elevated

  15. Next generation experiments and models for shock initiation and detonation of solid explosives

    Energy Technology Data Exchange (ETDEWEB)

    Tarver, C M

    1999-06-01

    Current phenomenological hydrodynamic reactive flow models, such as Ignition and Growth and Johnson- Tang-Forest, when normalized to embedded gauge and laser velocimetry data, have been very successful in predicting shock initiation and detonation properties of solid explosives in most scenarios. However, since these models use reaction rates based on the compression and pressure of the reacting mixture, they can not easily model situations in which the local temperature, which controls the local reaction rate, changes differently from the local pressure. With the advent of larger, faster, parallel computers, microscopic modeling of the hot spot formation processes and Arrhenius chemical kinetic reaction rates that dominate shock initiation and detonation can now be attempted. Such a modeling effort can not be successful without nanosecond or better time resolved experimental data on these processes. The experimental and modeling approaches required to build the next generation of physically realistic reactive flow models are discussed.

  16. Initial results of NEXT-DEMO, a large-scale prototype of the NEXT-100 experiment

    CERN Document Server

    Álvarez, V; Cárcel, S; Castel, J; Cebrián, S; Cervera, A; Conde, C A N; Dafni, T; Dias, T H V T; Díaz, J; Egorov, M; Esteve, R; Evtoukhovitch, P; Fernandes, L M P; Ferrario, P; Ferreira, A L; Freitas, E D C; Gehman, V M; Gil, A; Goldschmidt, A; Gómez, H; Gómez-Cadenas, J J; González-Díaz, D; Gutiérrez, R M; Hauptman, J; Morata, J A Hernando; Herrera, D C; Iguaz, F J; Irastorza, I G; Jinete, M A; Labarga, L; Laing, A; Liubarsky, I; Lopes, J A M; Lorca, D; Losada, M; Luzón, G; Marí, A; Martín-Albo, J; Martínez, A; Miller, T; Moiseenko, A; Monrabal, F; Monteiro, C M B; Mora, F J; Moutinho, L M; Vidal, J Muñoz; da Luz, H Natal; Navarro, G; Nebot, M; Nygren, D; Oliveira, C A B; Palma, R; Pérez, J; Aparicio, J L Pérez; Renner, J; Ripoll, L; Rodríguez, A; Rodríguez, J; Santos, F P; Santos, J M F dos; Segui, L; Serra, L; Shuman, D; Simón, A; Sofka, C; Sorel, M; Toledo, J F; Tomás, A; Torrent, J; Tsamalaidze, Z; Vázquez, D; Veloso, J F C A; Villar, J A; Webb, R; White, J T; Yahlali, N

    2012-01-01

    NEXT-DEMO is a large scale prototype and demonstrator of the NEXT-100 High Pressure Xenon Gas TPC, which will search for the neutrinoless double beta decay of Xe-136 using 100-150 kg of enriched xenon gas. The apparatus was built to prove the expected performance of NEXT-100, namely, energy resolution better than 1% FWHM at 2.5 MeV and event topological reconstruction. In this paper we describe the operation and initial results of the detector.

  17. Seeding Entrepreneurship Across Campus Early Implementation Experiences of the Kauffman Campuses Initiative

    OpenAIRE

    Lara Hulsey; Linda Rosenberg; Benita Kim

    2006-01-01

    Entrepreneurship has long been a fundamental aspect of American society, serving as an important contributor to economic growth. However, only recently has entrepreneurship begun to develop as an academic field in U.S. colleges and universities. The Ewing Marion Kauffman Foundation launched the Kauffman Campuses Initiative in eight U.S. universities to encourage campuswide expansion of entrepreneurship programs and activities. This report provides a cross-site analysis of implementation exper...

  18. Initiating an Action Research Programme for University EFL Teachers: Early Experiences and Responses

    Directory of Open Access Journals (Sweden)

    Anne Burns

    2016-10-01

    Full Text Available Accounts of how teacher educators begin to plan, develop, and support action research programmes for language teachers are rare, as are descriptions of the responses of the teachers who participate. This article documents and analyses the initial processes of introducing and supporting a new programme of action research for language teachers at the Universidad Chileno-Británica de Cultura (UCBC in Santiago, Chile. To evaluate the setting up of the programme and how the teachers have perceived it in its early stages, the authors, who are the programme facilitators, have conducted a meta- study. Data include workshop and meeting recordings, workshop observation notes, a reflective account, and a teacher questionnaire. The findings indicate that the teachers value the input and collaboration provided by an initial workshop, and subsequent meetings and discussions, very highly, but that issues of time, student involvement, and academic literature are areas for further debate and development. The article ends by drawing out the broader implications for UCBC and for others wishing to initiate similar action research programmes.

  19. Initial Experience of Laparoendoscopic Single-Site Radical Prostatectomy Requiring Well-Equipped Appliances and a Skilled Technique

    Directory of Open Access Journals (Sweden)

    Joo Yong Lee

    2010-12-01

    Full Text Available We report an initial experience in laparoendoscopic single-site radical prostatectomy (LESSRP using a homemade single-port device for prostate cancer. A 63-year-old man was diagnosed with prostate cancer. The patient underwent LESSRP using an Alexis® wound retractor, which was inserted through an umbilical incision. A homemade single-port device was made by fixing a 61/2 surgical glove to the retractor’s outer ring and securing the glove finger to the end of 4 trocars with a tie. Using the flexible laparoscopic and rigid instruments, LESSRP was performed using a procedure similar to conventional laparoscopic radical prostatectomy (LRP. In the current case, we could not perform complete LESSRP, so we report our initial experience and consider the reason why laparoendoscopic single-site surgery was converted to conventional LRP.

  20. Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

    Science.gov (United States)

    Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge

    2016-12-04

    Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

  1. Outcome of MRI-guided vacuum-assisted breast biopsy – initial experience at Institute of Oncology Ljubljana, Slovenia

    OpenAIRE

    Zebic-Sinkovec, Marta; Hertl, Kristijana; Kadivec, Maksimiljan; Cavlek, Mihael; Podobnik, Gasper; Snoj, Marko

    2012-01-01

    Background. Like all breast imaging modalities MRI has limited specificity and the positive predictive value for lesions detected by MRI alone ranges between 15 and 50%. MRI guided procedures (needle biopsy, presurgical localisation) are mandatory for suspicious findings visible only at MRI, with potential influence on therapeutic decision. The aim of this retrospective study was to evaluate our initial clinical experience with MRI-guided vacuum-assisted breast biopsy as an alternative to sur...

  2. An Experience-Based Learning Framework: Activities for the Initial Development of Sustainability Competencies

    Science.gov (United States)

    Caniglia, Guido; John, Beatrice; Kohler, Martin; Bellina, Leonie; Wiek, Arnim; Rojas, Christopher; Laubichler, Manfred D.; Lang, Daniel

    2016-01-01

    Purpose: This paper aims to present an experience-based learning framework that provides a bottom-up, student-centered entrance point for the development of systems thinking, normative and collaborative competencies in sustainability. Design/methodology/approach: The framework combines mental mapping with exploratory walking. It interweaves…

  3. Initial Clinical Experience With Surgical Technique of Robot-assisted Transperitoneal Laparoscopic Partial Nephrectomy

    Directory of Open Access Journals (Sweden)

    Cheng-Kuang Yang

    2009-12-01

    Conclusion: Robot-assisted LPN is feasible and may be a viable alternative to open or LPN in selected patients with small exophytic renal tumors. Compared with standard LPN, the robotic assisted LPN approach with precise renal reconstruction under a safe warm ischemia time is feasible and can be easily adopted by those with experience in robot-assisted surgery.

  4. Initial tensile test results from J316 stainless steel irradiated in the HFIR spectrally tailored experiment

    Energy Technology Data Exchange (ETDEWEB)

    Pawel, J.E.; Grossbeck, M.L.; Rowcliffe, A.F. [Oak Ridge National Lab., TN (United States)] [and others

    1995-04-01

    The objective of this work is to determine the effects of neutron irradiation on the mechanical properties of austenitic stainless steel alloys. In this experiment, the spectrum has been tailored to reduce the thermal neutron flux and achieve a He/dpa level near that expected in a fusion reactor.

  5. Experiences of Student Speech-Language Pathology Clinicians in the Initial Clinical Practicum: A Phenomenological Study

    Science.gov (United States)

    Nelson, Lori A.

    2011-01-01

    Speech-language pathology literature is limited in describing the clinical practicum process from the student perspective. Much of the supervision literature in this field focuses on quantitative research and/or the point of view of the supervisor. Understanding the student experience serves to enhance the quality of clinical supervision. Of…

  6. Initial experience with transperitoneal laparoscopic nephrectomy in an Irish hospital setting.

    LENUS (Irish Health Repository)

    Forde, J C

    2009-08-01

    Laparoscopic nephrectomy has gained widespread acceptance as a treatment for both benign and malignant conditions and is becoming increasingly popular in Irish hospitals. We report a single surgeon, single centre experience with 20 consecutive laparoscopic nephrectomies comparing them to 20 open cases performed prior to the establishment of a laparoscopic service.

  7. Initiation of subduction at Atlantic-type margins: Insights from laboratory experiments

    Science.gov (United States)

    Faccenna, Claudio; Giardini, Domenico; Davy, Philippe; Argentieri, Alessio

    1999-02-01

    We have performed scaled lithospheric experiments to simulate the behavior of a ocean-continent plate system subjected to compressional strain over a geological timescale. Experiments have been constructed using sand and silicone putty, representing the brittle upper crust and the ductile lower crust/upper mantle, respectively; the layers floated on glucose syrup simulating the asthenosphere. Compressional stress is achieved by displacing a piston at constant velocity perpendicular to the plate margin. We investigate the influence of four parameters: (1) the negative buoyancy of oceanic lithosphere, (2) the horizontal body forces between continent and ocean, and (3) the brittle and (4) the ductile strength of the passive margin. Two numbers express the importance of these parameters: the Argand number (Ar), representing the ratio between the body force of continent and its integrated strength, and the buoyancy number (F), representing the ratio between the buoyancy force of ocean and its ductile resistance. We obtain three scenarios. In experiments with Ar 3 and F 1 the continent collapses toward the ocean, producing back-arc extension and subduction, simulating the post-Alpine Neogene evolution of the Mediterranean area. In experiments with Ar 3 and F > 1 the passive margin slowly evolves toward trench nucleation with the formation of a viscous mantle instability. We conclude that the latter model can be applied to the evolution of Atlantic-type margins, where there is evidence of this ongoing process.

  8. Investigating the Impact of Mediated Learning Experiences on Cooperative Peer Communication during Group Initiatives

    Science.gov (United States)

    White, Robert; Dinos, Sokratis

    2010-01-01

    This study investigates how structured Mediated Learning Experiences may improve peer-cooperative communication within problem-solving task exercises. Two groups (n = 22) of Year 8 students (mean age 13 +/- 5 months) were randomly selected to participate in this study. The study began with two one-hour sessions of activity-based problem-solving…

  9. An Experience-Based Learning Framework: Activities for the Initial Development of Sustainability Competencies

    Science.gov (United States)

    Caniglia, Guido; John, Beatrice; Kohler, Martin; Bellina, Leonie; Wiek, Arnim; Rojas, Christopher; Laubichler, Manfred D.; Lang, Daniel

    2016-01-01

    Purpose: This paper aims to present an experience-based learning framework that provides a bottom-up, student-centered entrance point for the development of systems thinking, normative and collaborative competencies in sustainability. Design/methodology/approach: The framework combines mental mapping with exploratory walking. It interweaves…

  10. Teachers' Experiences of a Single-Sex Initiative in a Co-Education School

    Science.gov (United States)

    Gray, Colette; Wilson, Joanne

    2006-01-01

    Argued to "raise boys' grades" and "boost boys' academic achievement", single-sex classes in coeducation schools is one strategy among a plethora aimed at raising standards. This paper explores the experiences of teachers in one coeducation post-primary school that sought to raise academic performance, particularly among boys, and to improve…

  11. Graduate Medical Education as a Lever for Collaborative Change: One Institution's Experience with a Campuswide Patient Safety Initiative.

    Science.gov (United States)

    Vath, Richard J; Musso, Mandi W; Rabalais, Lauren S; Dunbar, Alston; Hosea, Stephen; Johnson, Angela C; Bolton, Michael; Rhynes, Vernon K; Caffery, Terrell S; Tynes, L Lee; Mantzor, Savarra; Miller, Bahnsen; Calongne, Laurinda L

    2016-01-01

    The 2013 closure of a public hospital in Baton Rouge, LA transformed graduate medical education (GME) at Our Lady of the Lake Regional Medical Center (OLOL). Administrators were tasked with incorporating residents into patient safety and quality improvement initiatives to fulfill regulatory obligations. This report outlines our experiences as we built these patient safety and quality improvement initiatives in a rapidly expanding independent academic medical center. We joined the Alliance of Independent Academic Medical Centers (AIAMC) to meet and learn from national peers. To fulfill the scholarly activity requirement of the AIAMC's National Initiative IV, we formed a multidisciplinary team to develop a patient safety education project. Prioritized monthly team meetings allowed for project successes to be celebrated and circulated within the organization. The public-private partnership that more than quadrupled the historic size of GME at OLOL has, in the past 2 years, led to the development of an interdisciplinary team. This team has expanded to accommodate residency program leadership from across the campus. Our National Initiative IV project won a national award and inspired several follow-up initiatives. In addition, this work led to the formation of a Patient Safety and Clinical Quality Improvement fellowship that matched its first fellow in 2015. Through the commitment and support of hospital and medical education leaders, as well as a focus on promoting cultural change through scholarly activity, we were able to greatly expand patient safety and quality improvement efforts in our institution.

  12. Fostering of Less Commonly Taught Language Initiatives — The Minnesota Experience

    Directory of Open Access Journals (Sweden)

    Leonard Anthony Polakiewicz

    2007-01-01

    Full Text Available First, let me express my sincere gratitude to NCOLCTL for awarding me this prestigious recognition bearing the name of a man who was responsible for many important initiatives and contributions relating to the promotion of the interests of LCTLs. Although for the past 36 years I have been teaching Russian and Polish, in my discussion today I will focus mainly on Polish, the less common of my less commonly taught languages. We can view the future of LCTLs in two ways: paraphrasing Anton Chekhov—one is the view that everything passes and nothing matters; the other view is that nothing passes and everything matters. If we are guided by the first outlook in assessing the present and future status of LCTLs we will conclude that despite all of our initiatives to promote and safeguard the interests of LCTLs, in the final analysis developments beyond our control will threaten the survival of LCTLs as part of institutionalized curriculum at many institutions. Thus, all of our efforts will prove to be in vain.

  13. Initial 10-year Experience of Sperm Cryopreservation Services for Cancer Patients

    Directory of Open Access Journals (Sweden)

    Hong-Chiang Chang

    2006-01-01

    Full Text Available Offering sperm cryopreservation to preserve the fertility of male cancer patients is a relatively recent service in Asia. This study analyzed the types of cancer, timing of collection, sperm quality, and utilization for reproductive services by patients during a 10-year period at a medical center in Taiwan. A total of 75 oncology patients elected to freeze sperm for fertility preservation at our medical center during the initial 10 years of the availability of this service. The mean age of the patients was 25.7 years. Storage was discontinued in 13 (17% patients and their survival duration was 13.1 ±11.1 months. The utilization rate of sperm cryo-preservation was 2.8% (75/2642. The types of cancer varied, with leukemia (35%, lymphoma (25%, and testicular cancer (13% comprising the largest groups. A significantly lower sperm count was found in patients with chronic myelogenous leukemia, suggesting the need for earlier sperm collection after initiation of cancer treatment. Only three (4% patients utilized their specimens for reproductive purposes. There was no clinical pregnancy during the study period, although one biochemical pregnancy was achieved. The low rates of sperm cryostorage for fertility preservation in cancer patients in this study suggest that there is a need for greater emphasis of this option for male oncology patients whose fertility is likely to be affected by chemotherapeutic treatment.

  14. The Accelerating Access Initiative: experience with a multinational workplace programme in Africa.

    Science.gov (United States)

    Van der Borght, S; Janssens, V; Schim van der Loeff, M F; Kajemba, A; Rijckborst, H; Lange, J M A; Rinke de Wit, T F

    2009-10-01

    A multinational company with operations in several African countries was committed to offer antiretroviral treatment to its employees and their dependants. The Accelerating Access Initiative (AAI), an initiative of six pharmaceutical companies and five United Nations' agencies, offered the possibility of obtaining brand antiretroviral drugs (ARVs) at 10% of the commercial price. PharmAccess, a foundation aimed at removing barriers to AIDS treatment in Africa, helped to establish an HIV policy and treatment guidelines, and a workplace programme was rolled out from September 2001. Private sector employers in Africa are keen to take more responsibility in HIV prevention and AIDS care. An important hurdle for African employers remains the price and availability of ARVs. The programme encountered various hurdles, among them the need for multiple contracts with multiple companies, complex importation procedures, taxes levied on ARVs, lack of support from pharmaceutical companies in importation and transportation, slow delivery of the drugs, lack of institutional memory in pharmaceutical companies and government policies excluding the company from access to ARVs under the AAI. The launch of the AAI enabled this multinational company to offer access to ARVs to its employees and dependants. The private sector should have access to these discounted drugs under the AAI. A network of local AAI offices should be created to assist in logistics of drugs ordering, purchase and clearance. No taxes should be levied on ARVs.

  15. Radiopurity control in the NEXT-100 double beta decay experiment: procedures and initial measurements

    CERN Document Server

    Alvarez, V; Bettini, A; Borges, F I G M; Carcel, S; Castel, J; Catala, J M; Cebrian, S; Cervera, A; Conde, C A N; Dafni, T; Dias, T H V T; Diaz, J; Egorov, M; Esteve, R; Evtoukhovitch, P; Fernandes, L M P; Ferrario, P; Ferreira, A L; Ferrer-Ribas, E; Freitas, E D C; Gehman, V M; Gil, A; Giomataris, I; Goldschmidt, A; Gomez, H; Gomez-Cadenas, J J; Gonzalez, K; Gonzalez-Diaz, D; Gutierrez, R M; Hauptman, J; Morata, J A Hernando; Herrera, D C; Herrero, V; Iguaz, F J; Irastorza, I G; Kalinnikov, V; Labarga, L; Liubarsky, I; Lopes, J A M; Lorca, D; Losada, M; Luzon, G; Mari, A; Martin-Albo, J; Martinez, A; Miller, T; Moiseenko, A; Monrabal, F; Monteiro, C M B; Monzo, J M; Mora, F J; Moutinho, L M; Vidal, J Munoz; da Luz, H Natal; Navarro, G; Nebot, M; Nygren, D; Oliveira, C A B; de Solorzano, A Ortiz; Palma, R; Perez, J; Aparicio, J L Perez; Renner, J; Ripoll, L; Rodriguez, A; Rodriguez, J; Santos, F P; Santos, J M F dos; Segui, L; Serra, L; Shuman, D; Simon, A; Sofka, C; Sorel, M; Toledo, J F; Tomas, A; Torrent, J; Tsamalaidze, Z; Vazquez, D; Velicheva, E; Veloso, J F C A; Villar, J A; Webb, R C; Weber, T; White, J; Yahlali, N

    2012-01-01

    The Neutrino Experiment with a Xenon TPC (NEXT) is intended to investigate the neutrinoless double beta decay of 136Xe, which requires a severe suppression of potential backgrounds. An extensive screening and material selection process is underway for NEXT since the control of the radiopurity levels of the materials to be used in the experimental set-up is a must for rare event searches. First measurements based on Glow Discharge Mass Spectrometry and gamma-ray spectroscopy using ultra-low background germanium detectors at the Laboratorio Subterr\\'aneo de Canfranc (Spain) are described here. Activity results for natural radioactive chains and other common radionuclides are summarized, being the values obtained for some materials like copper and stainless steel very competitive. The implications of these results for the NEXT experiment are also discussed.

  16. Role of laser myringotomy in a pediatric otolaryngology practice: initial experience

    Science.gov (United States)

    Shah, Udayan K.

    2001-05-01

    A new technology (OtoLAM) to fenestrate the tympanic membrane with the carbon dioxide laser (CO2), in the office or the operating room, has been introduced over the last three years. While not new conceptually, this product offers the ability to easily create a precise window into the middle ear using a portable system. Controversy regarding the indications and benefits of this technique, amplified by the costs of the system and the marketing of the technology prior to extensive clinical testing, has plagued the clinical application of this technology. We report our experience over the past year with this system in a busy pediatric otolaryngology practice. Laser fenestration of the tympanic membrane has been useful for the insertion of tympanostomy tubes, and for the minimally invasive evaluation of the middle ear. Our small experience to date reveals that there is a limited role for laser tympanic membrane fenestration in a busy pediatric otolaryngology practice.

  17. Shock initiation behavior of PBXN-9 determined by gas gun experiments

    Energy Technology Data Exchange (ETDEWEB)

    Sanchez, Nathaniel J [Los Alamos National Laboratory; Gustavsen, Richard L [Los Alamos National Laboratory; Hooks, Daniel E [Los Alamos National Laboratory

    2009-01-01

    The shock to detonation transition was evaluated in the HMX based explosive PBXN-9 by a series of light-gas gun experiments. PBXN-9 consists of 92 wt% HMX, 2wt% Hycar 4054 & 6 wt% dioctyl adipate with a density of 1.75 g/cm{sup 3} and 0.8% voids. The experiments were designed to understand the specifics of wave evolution and the run distance to detonation as a function of input shock pressure. These experiments were conducted on gas guns in order to vary the input shock pressure accurately. The primary diagnostics were embedded magnetic gauges, which are based on Faraday's law of induction, and Photon Doppler Velocimetry (PDV). The run distance to detonation vs. shock pressure, or 'Pop plot,' was redefined as log(X*) = 2.14-1.82 log(P), which is substantially different than previous data. The Hugoniot was refined as U{sub s} = 2.32 + 2.21 U{sub p}. This data will be useful for the development of predictive models for the safety and performance of PBXN-9 along with providing increased understanding of HMX based explosives in varying formulations.

  18. Initial experience with optical-CT scanning of RadBall Dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Oldham, M; Clift, C; Thomas, A; Farfan, E; Foley, T; Jannik, T; Adamovics, J; Holmes, C; Stanley, S, E-mail: Mark.Oldham@Duke.ed

    2010-11-01

    The RadBall dosimeter is a novel device for providing 3-D information on the magnitude and distribution of contaminant sources of unknown radiation in a given hot cell, glovebox, or contaminated room. The device is presently under evaluation by the National Nuclear Lab (NNL, UK) and the Savannah River National Laboratory (SRNL, US), for application as a diagnostic device for such unknown contaminants in the nuclear industry. A critical component of the technique is imaging the dose distribution recorded in the RadBall using optical-CT scanning. Here we present our initial investigations using the Duke Mid-sized Optical-CT Scanner (DMOS) to image dose distributions deposited in RadBalls exposed to a variety of radiation treatments.

  19. Antimicrobial Resistance Control Strategies: A Coordinated Research Initiative Experience in the Asia Pacific Region.

    Science.gov (United States)

    Lapierre, Lisette; Asenjo, Gabriela; Vergara, Constanza; Cornejo, Javiera

    2017-05-01

    The objective was to gather information on the status of antimicrobial surveillance in the Asia Pacific region and suggest control strategies. Twenty-one economies of the Asia Pacific region participated in this initiative. A survey was conducted on antimicrobial use and surveillance throughout the region. A workshop was carried out to create awareness about the issue and discuss the implementation of control strategies. Based on the survey results and workshop conclusions, it can be established that there is better understanding of the implications of antimicrobial resistance in the human medicine area. Only few economies take actions to control antimicrobial resistance on a veterinary/agricultural level. To confront antimicrobial resistance, it is critical to raise awareness; cooperation between all countries is needed to apply international standards, to be able to have harmonized public policies. Countries must align and improve their systems for surveillance and monitoring of antimicrobial resistance in human, animals, and the environment.

  20. Robotic pulmonary lobectomy for lung cancer treatment: program implementation and initial experience

    Directory of Open Access Journals (Sweden)

    Ricardo Mingarini Terra

    Full Text Available ABSTRACT Objective: To describe the implementation of a robotic thoracic surgery program at a public tertiary teaching hospital and to analyze its initial results. Methods: This was a planned interim analysis of a randomized clinical trial aimed at comparing video-assisted thoracoscopic surgery and robotic surgery in terms of the results obtained after pulmonary lobectomy. The robotic surgery program developed at the Instituto do Câncer do Estado de São Paulo, in the city of São Paulo, Brazil, is a multidisciplinary initiative involving various surgical specialties, as well as anesthesiology, nursing, and clinical engineering teams. In this analysis, we evaluated the patients included in the robotic lobectomy arm of the trial during its first three months (from April to June of 2015. Results: Ten patients were included in this analysis. There were eight women and two men. The mean age was 65.1 years. All of the patients presented with peripheral tumors. We performed right upper lobectomy in four patients, right lower lobectomy in four, and left upper lobectomy in two. Surgical time varied considerably (range, 135-435 min. Conversion to open surgery or video-assisted thoracoscopic surgery was not necessary in any of the cases. Intraoperative complications were not found. Only the first patient required postoperative transfer to the ICU. There were no deaths or readmissions within the first 30 days after discharge. The only postoperative complication was chest pain (grade 3, in two patients. Pathological examination revealed complete tumor resection in all cases. Conclusions: When there is integration and proper training of all of the teams involved, the implementation of a robotic thoracic surgery program is feasible and can reduce morbidity and mortality.

  1. Initial Thomson Scattering Survey of Local Helicity Injection and Ohmic Plasmas at the Pegasus Toroidal Experiment

    Science.gov (United States)

    Schlossberg, D. J.; Bodner, G. M.; Bongard, M. W.; Fonck, R. J.; Winz, G. R.

    2014-10-01

    A multipoint Thomson scattering diagnostic has recently been installed on the Pegasus ST. The system utilizes a frequency-doubled Nd:YAG laser (λ0 ~ 532 nm), spectrometers with volume phase holographic gratings, and a gated, intensified CCD camera. It provides measurements of Te and ne at 8 spatial locations for each spectrometer once per discharge. A new multiple aperture and beam dump system has been implemented to mitigate interference from stray light. This system has provided initial measurements in the core region of plasmas initiated by local helicity injection (LHI), as well as conventional Ohmic L- and H-mode discharges. Multi-shot averages of low-density (ne ~ 3 ×1018 m-3) , Ip ~ 0 . 1 MA LHI discharges show central Te ~ 75 eV at the end of the helicity injection phase. Ip ~ 0 . 13 MA Ohmic plasmas at moderate densities (ne ~ 2 ×1019 m-3) have core Te ~ 150 eV in L-mode. Generally, these plasmas do not reach transport equilibrium in the short 25 ms pulse length available. After an L-H transition, strong spectral broadening indicates increasing Te, to values above the range of the present spectrometer system with a high-dispersion VPH grating. Near-term system upgrades will focus on deploying a second spectrometer, with a lower-dispersion grating capable of measuring the 0.1-1.0 keV range. The second spectrometer system will also increase the available number of spatial channels, enabling study of H-mode pedestal structure. Work supported by US DOE Grant DE-FG02-96ER54375.

  2. Multi-frequency harmonic arrays: initial experience with a novel transducer concept for nonlinear contrast imaging.

    Science.gov (United States)

    Forsberg, Flemming; Shi, William T; Jadidian, Bahram; Winder, Alan A

    2004-12-01

    Nonlinear contrast imaging modes such as second harmonic imaging (HI) and subharmonic imaging (SHI) are increasingly important for clinical applications. However, the performance of currently available transducers for HI and SHI is significantly constrained by their limited bandwidth. To bypass this constraint, a novel transducer concept termed multi-frequency harmonic transducer arrays (MFHA's) has been designed and a preliminary evaluation has been conducted. The MFHA may ultimately be used for broadband contrast enhanced HI and SHI with high dynamic range and consists of three multi-element piezo-composite sub-arrays (A-C) constructed so the center frequencies are 4f(A) = 2f(B) = f(C) (specifically 2.5/5.0/10.0 MHz and 1.75/3.5/7.0 MHz). In principle this enables SHI by transmitting on sub-array C receiving on B and, similarly, from B to A as well as HI by transmitting on A receiving on B and, likewise, from B to C. Initially transmit and receive pressure levels of the arrays were measured with the elements of each sub-array wired in parallel. Following contrast administration, preliminary in vitro HI and SHI signal-to-noise ratios of up to 40 dB were obtained. In conclusion, initial design and in vitro characterization of two MFHA's have been performed. They have an overall broad frequency bandwidth of at least two octaves. Due to the special design of the array assembly, the SNR for HI and SHI was comparable to that of regular B-mode and better than commercially available HI systems. However, further research on multi-element MFHA's is required before their potential for in vivo nonlinear contrast imaging can be assessed.

  3. Conceptual design of initial opacity experiments on the national ignition facility

    Science.gov (United States)

    Heeter, R. F.; Bailey, J. E.; Craxton, R. S.; Devolder, B. G.; Dodd, E. S.; Garcia, E. M.; Huffman, E. J.; Iglesias, C. A.; King, J. A.; Kline, J. L.; Liedahl, D. A.; McKenty, P. W.; Opachich, Y. P.; Rochau, G. A.; Ross, P. W.; Schneider, M. B.; Sherrill, M. E.; Wilson, B. G.; Zhang, R.; Perry, T. S.

    2017-02-01

    Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative-convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures eV and electron densities 21~\\text{cm}-3$ . The iron will be probed using continuum X-rays emitted in a ps, diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design, of the NIF beams deliver 500 kJ to the mm diameter hohlraum, and the remaining directly drive the CH capsule with 200 kJ. Calculations indicate this capsule backlighter should outshine the iron sample, delivering a point-projection transmission opacity measurement to a time-integrated X-ray spectrometer viewing down the hohlraum axis. Preliminary experiments to develop the backlighter and hohlraum are underway, informing simulated measurements to guide the final design.

  4. SU-E-E-05: Initial Experience On Physics Rotation of Radiological Residents

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, J; Williams, D; DiSantis, D; Hardy, P; Oates, M [University of Kentucky, Lexington, KY (United States)

    2014-06-01

    Purpose: The new ABR core exam integrates physics into clinical teaching, with an emphasis on understanding image quality, image artifacts, radiation dose and patient safety for each modality and/or sub-specialty. Accordingly, physics training of radiological residents faces a challenge. A traditional teaching of physics through didactic lectures may not fully fulfill this goal. It is also difficult to incorporate physics teaching in clinical practice due to time constraints. A dedicated physics rotation may be a solution. This study is to evaluate a full week physics workshop developed for the first year radiological residents. Methods: The physics rotation took a full week. It included three major parts, introduction lectures, hand-on experiences and observation of technologist operation. An introduction of basic concepts was given to each modality at the beginning. Hand-on experiments were emphasized and took most of time. During hand-on experiments, residents performed radiation measurements, studied the relationship between patient dose and practice (i.e., fluoroscopy), investigated influence of acquisition parameters (i.g., kV, mAs) on image quality, and evaluated image quality using phantoms A physics test before and after the workshop was also given but not for comparison purpose. Results: The evaluation shows that the physics rotation during the first week of residency in radiology is preferred by all residents. The length of a full week of physics workshop is appropriate. All residents think that the intensive workshop can significantly benefit their coming clinical rotations. Residents become more comfortable regarding the use of radiation and counseling relevant questions such as a pregnant patient risk from a CE PE examination. Conclusion: A dedicated physics rotation, assisting with didactic lectures, may fulfill the requirements of physics of the new ABR core exam. It helps radiologists deeply understand the physics concepts and more efficiently use

  5. Initial experience in setting up a medical student first responder scheme in South Central England.

    Science.gov (United States)

    Seligman, William H; Ganatra, Sameer; England, David; Black, John J M

    2016-02-01

    Prehospital emergency medicine (PHEM) is a recently recognised subspecialty of emergency medicine, and anaesthetics, intensive care and acute medicine, in the UK, and yet it receives little to no mention in many undergraduate medical curricula. However, there is growing interest in PHEM among medical students and junior doctors. Several programmes are in existence across the UK that serve to provide teaching and exposure of prehospital care to medical students and junior doctors. However, relatively few students are able to gain significant first-hand experience of treating patients in the prehospital phase. In this short report, we discuss our experience of launching the student first responder (SFR) scheme across three counties in the Thames Valley. Medical students are trained by the regional ambulance service and respond to life-threatening medical emergencies in an ambulance response vehicle. The scheme is likely to benefit the ambulance service by providing a wider pool of trained volunteer first responders able to attend to emergency calls, to benefit patients by providing a quick response at their time of need, and to benefit medical students by providing first-hand experience of medical emergencies in the community. In its first 15 months of operation, SFRs were dispatched to 343 incidents. This scheme can serve as a training model for other ambulance services and medical schools across the UK. 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/

  6. Initial Results from the Radiation Dosimetry Experiment (RaD-X) Balloon Flight Mission

    Science.gov (United States)

    Mertens, Christopher J.

    2015-01-01

    The NASA Radiation Dosimetry Experiment (RaD-X) high-altitude balloon mission was successfully launched from Fort Sumner, New Mexico USA on 25 September, 2015. Over 15 hours of science data were obtained from four dosimeters at altitudes above about 25 km. The four dosimeters flown on the RaD-X science payload are a Hawk version 3.0 Tissue Equivalent Proportional Counter (TEPC) manufactured by Far West Technologies, a Liulin dosimeter-spectrometer produced by the Solar Research and Technology Institute, Bulgarian Academy of Sciences, a total ionizing dose detector manufactured by Teledyne Microelectronic Technologies, and the RaySure detector provided by the University of Surrey.

  7. [Initial experiences with the new environmental medicine course in graduate education].

    Science.gov (United States)

    Nemitz, B

    1995-08-01

    The "master of environmental medicine" is a new medical subspeciality in Germany. Specialised physicians can qualify for it, if they have spent at least an additional period of 1.5 years at a recognized institution in the field. Furthermore the attendance of a 200 hours comprehensive specialist's training course is required. Preliminary experience with this comprehensive course, as offered by our institution (Academy of Occupational and Environmental Medicine, Berlin, Germany) is lined out. Additionally, details of the curriculum, which was specifically designed for this purpose by our institution, are given. The results of an evaluation-procedure (questionnaire) among those participants, who completed the first parts of the course, are discussed.

  8. Strain localization and evolving kinematic efficiency of initiating strike-slip faults within wet kaolin experiments

    Science.gov (United States)

    Hatem, Alexandra E.; Cooke, Michele L.; Toeneboehn, Kevin

    2017-08-01

    Using wet kaolin experiments, we document the evolution of strain localization during strike-slip fault maturation under variable boundary conditions (pre-existing fault, depth of and distribution of basal shear). While the nature of the basal shear influences strain localization observed at the clay surface, similarities between experiments reveal a general conceptual model of strain accommodation. First, shear strain is accommodated as distributed shear (Stage 0), then by development of echelon faults (Stage I), then by interaction, lengthening and propagation of those echelon faults (Stage II) and, finally, by slip along through-going fault (Stage III). Stage II serves as a transitory period when the system reorganizes after sufficient strain localization. Here, active fault system complexity is maximized as faults link producing apparent rotation of active fault surfaces without material rotation. As the shear zone narrows, off-fault deformation decreases while fault slip and kinematic efficiency increases. We quantify kinematic efficiency as the ratio of fault slip to applied displacement. All fault systems reach a steady-state efficiency in excess of 80%. Despite reducing off-fault deformation, the through-going fault maintains <1.5 cm structural irregularities (i.e., stepovers), which suggests that small (<3 km) stepovers may persist along mature, efficient faults in the crust.

  9. Application of Radar Reflectivity Factor in Initializing Cloud-Resolving Mesoscale Model. Part Ⅱ: Numerical Simulation Experiments

    Institute of Scientific and Technical Information of China (English)

    LIU Hongya; XU Haiming; XUE Jishan; HU Zhijin; SHEN Tongli

    2008-01-01

    Microphysics elements and vertical velocity retrieved were incorporated using the nudging method into the initial data assimilation of GRAPES (Global/Regional Assimilation and Prediction System) model.Simulation experiments indicated that nudging technique was effective in forcing the model forecast gradually consistent to the observations, yielding the thermodynamically and dynamically balanced analysis field. As viewed from the simulation results, water vapor is vital to precipitation, and it is a governing factor for the amount and duration of precipitation. The initial cloud water, rain water, and vertical velocity determine the strength distribution of convection and precipitation at the beginning time of forecast; the horizontal wind field steers the motion of the mesoscale weather system embedded in and impacts the position of precipitation zone to a large extent. The simulation experiments show that the influence of the initial retrieval data on prediction weakens with the increase of forecast time, and within the first hour of forecast, the retrieval data have an important impact on the evolution of the weather system, but its influence becomes trivial after the first three hours. Changing the nudging coefficient and the integral time-spacing of numerical model will bring some influences to the results. Herein only one radar reflectivity was used, the radar observations did not cover the whole model domain, and some empirical parameters were used in the retrieval method, therefore some differences still lie between simulation and observation to a certain extent, and further studies on several aspects are expected.

  10. Combined laparoscopic and thoracoscopic Ivor Lewis esophagectomy for esophageal cancer: initial experience from China

    Institute of Scientific and Technical Information of China (English)

    LI Hui; HU Bin; YOU Bin; MIAO Jin-bai; FU Yi-li; CHEN Qi-rui

    2012-01-01

    Background Minimally invasive lvor Lewis esophagectomy was usually performed with either hand-sewn or circular stapler anastomosis through a small thoracotomy or using a side-to-side stapler anastomotic technique.This study aimed to present our initial results of lvor Lewis esophagectomy using a circular-stapled anastomosis with transoral anvil technique.Methods Six patients with esophageal cancer underwent minimally invasive lvor Lewis esophagectomy with an intrathoracic circular-stapled end-to-end anastomosis.The abdominal portion was operated on laparoscopically,and the thoracic portion was done using thoracoscopic techniques.A 25 mm anvil connected to a 90 cm long delivery tube was introduced transorally to the esophageal stump in a tilted position,the anvil head was then connected to circular stapler.The anastomosis was completed under direct thoracoscopic view.Results A total of six patients in this report successfully underwent total laparoscopic and thoracoscopic lvor Lewis esophagectomy with a circular-stapled anastomosis using a transoral anvil.They were five male and one female patients,and had a mean age of 55 years (range,38-69 years).The thoracic and abdominal operations were successfully performed without any intraoperative complications or conversion to laparotomy or thoracotomy.The passage of the anvil head was technically easy and successful in all six cases.The mean overall operative time was (260±42) minutes (range,220-300 minutes),and the mean estimated blood loss was (520±160) ml (range,130-800 ml).Patients resumed a liquid oral diet on postoperative day seven.The median length of hospital stay was 17 days (range,9-25 days).The postoperative pathological diagnosis was esophageal squamous cell carcinoma in five patients and esophageal small cell carcinoma in one patient.Tumors were staged as T2N0M0 in three cases,T2N1M0 in one case,and T3N0M0 in two cases.During the mean follow-up of 2.5 months (range,2-4months),there were no intraoperative

  11. Intent at day case laparoscopic cholecystectomy in Owerri, Nigeria: Initial experiences

    Directory of Open Access Journals (Sweden)

    Christopher Nonso Ekwunife

    2013-01-01

    Full Text Available Background and Objective: Laparoscopic cholecystectomy has been the default operation for cholelithiasis at Federal Medical Centre, Owerri for the past 2 years and the outcomes have been good. The duration of post operative stay has been decreasing. We therefore initiated a preliminary 2-year prospective study in May 2010 to determine the feasibility of carrying out day case laparoscopic cholecystectomy in our hospital. Materials and Methods: Patients undergoing laparoscopic cholecystectomy were included in the study if they satisfied the following criteria: Age < 65 years, body mass index < 35 kg/m 2 , American Society of Anaesthesiology physical status class I and II, patient residence within 20 km radius of the hospital, patient acceptance of the procedure and absence of previous complicated upper abdominal surgery. Results: Twelve patients (10 females, 2 males were worked up with the intent of achieving same-day discharge of the patients. Five of the patients (41.7% were discharged on the day of operation. The reasons for overnight stay included inadequate pain control, insertion of drain and patient wishes. There was no conversion to open surgery, no major complications and no case of readmission to the hospital. Conclusions: Day case laparoscopic cholecystectomy in our environment could be safely promoted but will depend on improved facilities and patient enlightenment.

  12. Local Control of Perivascular Malignant Liver Lesions Using Percutaneous Irreversible Electroporation: Initial Experiences

    Energy Technology Data Exchange (ETDEWEB)

    Eller, Achim, E-mail: Achim.Eller@uk-erlangen.de; Schmid, Axel, E-mail: axel.schmid@uk-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Radiology (Germany); Schmidt, Joachim, E-mail: joachim.schmidt@kfa.imed.uni-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Anesthesiology (Germany); May, Matthias, E-mail: matthias.may@uk-erlangen.de; Brand, Michael, E-mail: michael.brand@uk-erlangen.de; Saake, Marc, E-mail: marc.saake@uk-erlangen.de; Uder, Michael, E-mail: michael.uder@uk-erlangen.de; Lell, Michael, E-mail: michael.lell@uk-erlangen.de [University Hospital Erlangen, University of Erlangen-Nuremberg, Department of Radiology (Germany)

    2015-02-15

    PurposeThis study was designed to assess efficacy and safety in the treatment of perivascular malignant liver lesions using percutaneous, computed tomography (CT)-guided irreversible electroporation (IRE).MethodsFourteen patients (mean age 58 ± 11 years) with 18 malignant liver lesions were consecutively enrolled in this study. IRE was performed in patients not eligible for surgery and lesions abutting large vessels or bile ducts. Follow-up exams were performed using multislice-CT (MS-CT) or MRI.ResultsMedium lesion diameter was 20 ± 5 mm. Ten of 14 (71 %) were successfully treated with no local recurrence to date (mean follow-up 388 ± 160 days). One case left initial tumor control unclear and additional RFA was performed 4 weeks after IRE. Complications occurred in 4 of 14 (29 %) cases. In one case, intervention was terminated and abdominal bleeding required laparotomy. In two cases, a postinterventional hematothorax required intervention. In another case, abdominal bleeding could be managed conservatively. No complications related to the bile ducts occurred.ConclusionsPercutaneous IRE seems to be effective in perivascular lesions but is associated with a higher complication rate compared with thermoablative techniques.

  13. [Telecommunication--a medium for improving prenatal diagnosis and gynecologic ultrasound diagnosis? Initial experiences].

    Science.gov (United States)

    Sohn, C; Beldermann, F; Wallwiener, D; Lepold, H; Bastert, G

    1997-01-01

    To establish the requirements for real-time transfer of an ultrasound examination via telecommunication network the following tests were performed: The ultrasound data were transferred from the video out of an ultrasound system to a basis terminal of the German Telekom. Simultaneously, an external video camera filmed the positioning and movements of the ultrasound transducer, and the verbal comments were recorded. These informations were transmitted to Karlsruhe and London, where they were rerouted to the examination room in Heidelberg. Here the informations were received on a Telecom reception unit/terminal and compared directly with the initial signal. The quality was sufficient if the moving ultrasound images and the camera image of the transducer as well as the oral comment were transmitted over 2 parallel ISDN lines. The delay to a real-time transmission of the examination process is only in the range of milliseconds. If only one ISDN line is used, the image quality is unsatisfactory, three parallel lines do not bring significant improvement of image quality. Telemedicine seems a new possibility to bring the knowledge of specialized centers to the practicing gynaecologists thus avoiding unnecessary referrals. Still unanswered, however, are the problem of liability, data protection and costs.

  14. Initial operating experience of the 12-MW La Ola photovoltaic system.

    Energy Technology Data Exchange (ETDEWEB)

    Ellis, Abraham; Lenox, Carl (SunPower Corporation, Richmond, CA); Johnson, Jay; Quiroz, Jimmy Edward; Schenkman, Benjamin L.

    2011-10-01

    The 1.2-MW La Ola photovoltaic (PV) power plant in Lanai, Hawaii, has been in operation since December 2009. The host system is a small island microgrid with peak load of 5 MW. Simulations conducted as part of the interconnection study concluded that unmitigated PV output ramps had the potential to negatively affect system frequency. Based on that study, the PV system was initially allowed to operate with output power limited to 50% of nameplate to reduce the potential for frequency instability due to PV variability. Based on the analysis of historical voltage, frequency, and power output data at 50% output level, the PV system has not significantly affected grid performance. However, it should be noted that the impact of PV variability on active and reactive power output of the nearby diesel generators was not evaluated. In summer 2011, an energy storage system was installed to counteract high ramp rates and allow the PV system to operate at rated output. The energy storage system was not fully operational at the time this report was written; therefore, analysis results do not address system performance with the battery system in place.

  15. Can we reduce the burden of depression? The Australian experience with beyondblue: the national depression initiative.

    Science.gov (United States)

    Hickie, Ian

    2004-01-01

    Throughout the Asia Pacific region, there is an urgent need to reduce the burden of depression by increasing depression awareness, reducing stigma and dismantling those social barriers that prevent full participation by people with depression. This paper describes the development and early achievements of the Australian depression initiative, beyondblue. A review of the key priorities of beyondblue and their impacts during the first three years of operation (2001-03). Key achievements include: the degree of national recognition of beyondblue; size and scope of media impact; growth in website utilisation; increased reporting of the community's recognition of people with depression; genuine reforms in life insurance and income protection; development of a new national consumer and carer organisation; establishment of major population-based preventative and early intervention programs; system-wide reform of primary care-based mental health services; national educational program uptake by general practitioners; and, development of key awareness and intervention programs for use in schools and the workplace. In its first three years of operation, beyondblue has had a major impact on depression awareness in Australia and demonstrable gains have been made in reducing stigma and major social barriers. A pre-existing national mental health policy and implementation plan, a substantial funding base and participation by key political, media and community leaders have been essential elements of its short-term success. Its longer-term impact will now depend on more sustainable community and business partnerships as well as the growth of a more influential consumer and carer voice.

  16. Intraoperative perfusion contrast echocardiography. Initial experience during coronary artery bypass grafting.

    Science.gov (United States)

    Kabas, J S; Kisslo, J; Flick, C L; Johnson, S H; Craig, D M; Stanley, T E; Smith, P K

    1990-03-01

    Intraoperative evaluation of the effectiveness of myocardial revascularization has been limited by an inability to assess regional myocardial perfusion. Microbubbles of sonicated diatrizoate sodium and diatrizoate meglumine (Renografin) have been an effective echocardiographic contrast agent and have been employed clinically during cardiac catheterization. This recent development in contrast-enhanced two-dimensional echocardiography permits real-time imaging of transmural myocardial blood flow but has not been evaluated in the operating room. This study represents the initial surgical application of this directed technique and was designed to evaluate the safety and efficacy of intraoperative perfusion contrast echocardiography in assessing the results of coronary artery bypass grafting. Twenty men with significant coronary artery disease ranging in age from 49 to 73 years were studied. Direct contrast agent injection into completed saphenous vein bypass grafts caused the myocardium supplied by each graft to be well delineated and provided a tomographic view of contrast distribution. The enhanced region was well correlated with the size and distribution of the native vessel. Rapid contrast washout (less than 20 seconds) indicated satisfactory regional perfusion. Contrast echocardiography prolonged the operation less than 10 minutes and did not result in any perioperative complications.

  17. Participation in ICZM initiatives: critical aspects and lessons learnt from the Mediterranean and Black Sea experiences.

    Science.gov (United States)

    Soriani, Stefano; Buono, Fabrizia; Tonino, Marco; Camuffo, Monica

    2015-03-15

    Public participation is recognized as a necessary tool to ensure a successful implementation of Integrated Coastal Zone Management (ICZM) strategies and plans. This paper, based on the experiences carried out in the Mediterranean and in the Black Sea within the EU FP7 project PEGASO, presents some critical aspects and lessons learnt regarding participation in ICZM projects. The research shows that data availability, the complexity of data interpretation, an inadequate legal and cultural framework and the difficulties in promoting integration of all the components of coastal management within short term projects are all elements that if not properly considered since the beginning of the participatory process may hinder public participation effectiveness. Moreover the definition of the spatial scale of coastal phenomenon as well as the discrepancy between the local scale of coastal governance and the complex multi-scale nature of coastal systems remain highly critical aspects to be addressed.

  18. EXPERIENCES INITIATING SOFTWARE PRODUCT LINE ENGINEERING IN SMALL TEAMS WITH PULSE

    DEFF Research Database (Denmark)

    Mærsk-Møller, Hans Martin; Jørgensen, Bo Nørregaard

    2010-01-01

    papers and collective results on Software Product Line Engineering (SPLE) in the context of small teams. This paper remedies this situation by providing experiences from a successful approach of applying software product line engineering in a small team. We conduct a transition from single......-system production to Software Product Line (SPL) in the domain of greenhouse climate control systems. The domain contains inherent variabilities and extensive commonalities between the products in scope, which makes it a prime candidate for SPLE - besides having good business prospects. The transitioning to SPLE...... an existing methodology, PuLSETM, drew advantages of NetBeans Rich Client Platform, and based the product line on the existing application....

  19. Significance of assessment experiences during initial teacher training in physical education

    Directory of Open Access Journals (Sweden)

    Wagner dos Santos

    2016-03-01

    Full Text Available Abstract This study investigates how students in the final semester of their teacher training program (licensure at the Center of Physical Education and Sports (CEFD, Espírito Santo Federal University, Brazil, (reinterpret their assessment experiences, an integral component of their teacher training. It employs the narrative as a theoretical and methodological perspective, and it utilizes student portfolios, as well as focus groups and semi-structured individual interviews as inputs for data generation. Ten students in their eighth, or final, semester participated in this study. These were the total respondents to a "call for volunteers" among the 2014 graduating class. The results suggest that the students believe the assessment processes of their teaching practices in physical education are disjointed. They feel that the disciplines that allow them to review their own performance during teacher training are more efficient and play a stronger role in their education.

  20. Intracoronary brachytherapy in the treatment of in-stent restenosis. Initial experience in Brazil

    Directory of Open Access Journals (Sweden)

    Fábio Sândoli de Brito Jr

    2001-09-01

    Full Text Available Intracoronary brachytherapy using beta or gamma radiation is currently the most efficient type of therapy for preventing the recurrence of coronary in-stent restenosis. Its implementation depends on the interaction among interventionists, radiotherapists, and physicists to assure the safety and quality of the method. The authors report the pioneering experience in Brazil of the treatment of 2 patients with coronary in-stent restenosis, in whom beta radiation was used as part of the international multicenter randomized PREVENT study (Proliferation REduction with Vascular ENergy Trial. The procedures were performed rapidly and did not require significant modifications in the traditional techniques used for conventional angioplasty. Alteration in the radiological protection devices of the hemodynamic laboratory were also not required, showing that intracoronary brachytherapy using beta radiation can be incorporated into the interventional tools of cardiology in our environment.

  1. Experimental warming delays autumn senescence in a boreal spruce bog: Initial results from the SPRUCE experiment

    Science.gov (United States)

    Richardson, Andrew; Furze, Morgan; Aubrecht, Donald; Milliman, Thomas; Nettles, Robert; Krassovski, Misha; Hanson, Paul

    2016-04-01

    Phenology is considered one of the most robust indicators of the biological impacts of global change. In temperate and boreal regions, long-term data show that rising temperatures are advancing spring onset (e.g. budburst and flowering) and delaying autumn senescence (e.g. leaf coloration and leaf fall) in a wide range of ecosystems. While warm and cold temperatures, day length and insolation, precipitation and water availability, and other factors, have all been shown to influence plant phenology, the future response of phenology to rising temperatures and elevated CO2 still remains highly uncertain because of the challenges associated with conducting realistic manipulative experiments to simulate future environmental conditions. At the SPRUCE (Spruce and Peatland Responses Under Climatic and Environmental Change) experiment in the north-central United States, experimental temperature (0 to +9° C above ambient) and CO2 (ambient and elevated) treatments are being applied to mature, and intact, Picea mariana-Sphagnum spp. bog communities in their native habitat through the use of ten large (approximately 12 m wide, 10 m high) open-topped enclosures. We are tracking vegetation green-up and senescence in these chambers, at both the individual and whole-community level, using repeat digital photography. Within each chamber, digital camera images are recorded every 30 minutes and uploaded to the PhenoCam (http://phenocam.sr.unh.edu) project web page, where they are displayed in near-real-time. Image processing is conducted nightly to extract quantitative measures of canopy color, which we characterize using Gcc, the green chromatic coordinate. Data from a camera mounted outside the chambers (since November 2014) indicate strong seasonal variation in Gcc for both evergreen shrubs and trees. Shrub Gcc rises steeply in May and June, and declines steeply in September and October. By comparison, tree Gcc rises gradually from March through June, and declines gradually from

  2. Simple electrical model and initial experiments for intra-body communications.

    Science.gov (United States)

    Gao, Y M; Pun, S H; Du, M; Mak, P U; Vai, M I

    2009-01-01

    Intra-Body Communication(IBC) is a short range "wireless" communication technique appeared in recent years. This technique relies on the conductive property of human tissue to transmit the electric signal among human body. This is beneficial for devices networking and sensors among human body, and especially suitable for wearable sensors, telemedicine system and home health care system as in general the data rates of physiologic parameters are low. In this article, galvanic coupling type IBC application on human limb was investigated in both its mathematical model and related experiments. The experimental results showed that the proposed mathematical model was capable in describing the galvanic coupling type IBC under low frequency. Additionally, the calculated result and experimental result also indicated that the electric signal induced by the transmitters of IBC can penetrate deep into human muscle and thus, provide an evident that IBC is capable of acting as networking technique for implantable devices.

  3. UNIX trademark in high energy physics: What we can learn from the initial experiences at Fermilab

    Energy Technology Data Exchange (ETDEWEB)

    Butler, J.N.

    1991-03-01

    The reasons why Fermilab decided to support the UNIX operating system are reviewed and placed in the content of an overall model for high energy physics data analysis. The strengths and deficiencies of the UNIX environment for high energy physics are discussed. Fermilab's early experience in dealing with a an open'' multivendor environment, both for computers and for peripherals, is described. The human resources required to fully exploit the opportunities are clearly growing. The possibility of keeping the development and support efforts within reasonable bounds may depend on our ability to collaborate or at least to share information even more effectively than we have in the past. 7 refs., 4 figs., 5 tabs.

  4. Hepatobilio-pancreatic robotic surgery: initial experience from a single center institute.

    Science.gov (United States)

    Quijano, Yolanda; Vicente, Emilio; Ielpo, Benedetto; Duran, Hipolito; Diaz, Eduardo; Fabra, Isabel; Malave, Luis; Ferri, Valentina; Plaza, Carlos; Lindemann, Jan Lammel; D'Andrea, Vito; Caruso, Riccardo

    2016-12-30

    The use of robotic surgery in the hepatobilio-pancreatic (HBP) field is still limited. Our aim is to present our early experience of robotic liver resection. A retrospective review of robotic pancreatic and liver resection was performed at Sanchinarro University hospital from October 2010 to April 2016. Since the beginning of the robotic program in our center, 22 hepatic procedures and 45 pancreatic robotic procedures have been performed. Of the 21 patients subjected to liver resection, 13 (65%) were for malignancy. There were two left hepatectomies, one right hepatectomy, one associated liver partition and portal vein ligation staged procedure (both steps by robotic approach), three bisegmentectomies and three segmentectomies, eight wedge resections, and three pericystectomies. The mean operating time was 282 min. The overall conversion rate and postoperative complication rate were 4.7 and 19%, respectively. The mean length of hospital stay was 13.4 days (range 4-64 days). Of the 45 patients subjected to pancreatic resection, 22 were male and 23 female. The average age of all patients was 62 years (range 31-82 years). The mean operating room (OR) time was 370 min (120-780 min). Among the procedures performed were 15 pancreatico-duodenectomies, 19 distal pancreatectomies, and 11 enucleations. All procedures in the HBP area were R0. Our early experience shows that robotic surgery is a safe and feasible procedure in the HBP area. The complication and mortality rates are comparable to those of open surgery, but with the advantages of minimally invasive surgery.

  5. Assessment of Initial Test Conditions for Experiments to Assess Irradiation Assisted Stress Corrosion Cracking Mechanisms

    Energy Technology Data Exchange (ETDEWEB)

    Busby, Jeremy T [ORNL; Gussev, Maxim N [ORNL

    2011-04-01

    Irradiation-assisted stress corrosion cracking is a key materials degradation issue in today s nuclear power reactor fleet and affects critical structural components within the reactor core. The effects of increased exposure to irradiation, stress, and/or coolant can substantially increase susceptibility to stress-corrosion cracking of austenitic steels in high-temperature water environments. . Despite 30 years of experience, the underlying mechanisms of IASCC are unknown. Extended service conditions will increase the exposure to irradiation, stress, and corrosive environment for all core internal components. The objective of this effort within the Light Water Reactor Sustainability program is to evaluate the response and mechanisms of IASCC in austenitic stainless steels with single variable experiments. A series of high-value irradiated specimens has been acquired from the past international research programs, providing a valuable opportunity to examine the mechanisms of IASCC. This batch of irradiated specimens has been received and inventoried. In addition, visual examination and sample cleaning has been completed. Microhardness testing has been performed on these specimens. All samples show evidence of hardening, as expected, although the degree of hardening has saturated and no trend with dose is observed. Further, the change in hardening can be converted to changes in mechanical properties. The calculated yield stress is consistent with previous data from light water reactor conditions. In addition, some evidence of changes in deformation mode was identified via examination of the microhardness indents. This analysis may provide further insights into the deformation mode under larger scale tests. Finally, swelling analysis was performed using immersion density methods. Most alloys showed some evidence of swelling, consistent with the expected trends for this class of alloy. The Hf-doped alloy showed densification rather than swelling. This observation may be

  6. Endoscopic endonasal skull base approach for parasellar lesions: Initial experiences, results, efficacy, and complications

    Directory of Open Access Journals (Sweden)

    Shigetoshi Yano

    2014-01-01

    Full Text Available Background: Endoscopic surgery is suitable for the transsphenoidal approach; it is minimally invasive and provides a well-lit operative field. The endoscopic skull base approach through the large opening of the sphenoid sinus through both nostrils has extended the surgical indication for various skull base lesions. In this study, we describe the efficacy and complications associated with the endoscopic skull base approach for extra- or intradural parasellar lesions based on our experiences. Methods: Seventy-four cases were treated by an endoscopic skull base approach. The indications for these procedures included 55 anterior extended approaches, 10 clival approaches, and 9 cavernous approaches. The operations were performed through both the nostrils using a rigid endoscope. After tumor removal, the skull base was reconstructed by a multilayered method using a polyglactin acid (PGA sheet. Results: Gross total resection was achieved in 82% of pituitary adenomas, 68.8% of meningiomas, and 60% of craniopharyngiomas in anterior extended approach and in 83.3% of chordomas in clival approach, but only in 50% of the tumors in cavernous approach. Tumor consistency, adhesion, and/or extension were significant limitations. Visual function improvements were achieved in 37 of 41 (90.2% cases. Cerebrospinal fluid (CSF leakage (9.5%, infections (5.4%, neural injuries (4.1%, and vascular injuries (2.7% were the major complications. Conclusions: Our experiences show that the endoscopic skull base approach is a safe and effective procedure for various parasellar lesions. Selection of patients who are unlikely to develop complications seems to be an important factor for procedure efficacy and good outcome.

  7. Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing

    Directory of Open Access Journals (Sweden)

    Bruno Monteiro Tavares Pereira

    Full Text Available CONTEXT AND OBJECTIVE: Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. DESIGN AND SETTING: Retrospective study at Universidade Estadual de Campinas. METHODS: Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. RESULTS: A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3 teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7, or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. CONCLUSION: Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.

  8. Initial experience at a university teaching hospital from using telemedicine to promote education through video conferencing.

    Science.gov (United States)

    Pereira, Bruno Monteiro Tavares; Calderan, Thiago Rodrigues Araújo; Silva, Marcos Tadeu Nolasco da; Silva, Antonio Carlos da; Marttos, Antonio Carlos; Fraga, Gustavo Pereira

    2012-01-01

    Telehealth and telemedicine services are advancing rapidly, with an increasing spectrum of information and communication technologies that can be applied broadly to the population's health, and to medical education. The aim here was to report our institution's experience from 100 videoconferencing meetings between five different countries in the Americas over a one-year period. Retrospective study at Universidade Estadual de Campinas. Through a Microsoft Excel database, all conferences in all specialties held at our institution from September 2009 to August 2010 were analyzed retrospectively. A total of 647 students, physicians and professors participated in telemedicine meetings. A monthly mean of 8.3 (± 4.3) teleconferences were held over the analysis period. Excluding holidays and the month of inaugurating the telemedicine theatre, our teleconference rate reached a mean of 10.3 (± 2.7), or two teleconferences a week, on average. Trauma surgery and meetings on patient safety were by far the most common subjects discussed in our teleconference meetings, accounting for 22% and 21% of the total calls. Our experience with telemedicine meetings has increased students' interest; helped our institution to follow and discuss protocols that are already accepted worldwide; and stimulated professors to promote telemedicine-related research in their own specialties and keep up-to-date. These high-technology meetings have shortened distances in our vast country, and to other reference centers abroad. This virtual proximity has enabled discussion of international training with students and residents, to increase their overall knowledge and improve their education within this institution.

  9. The Role of Model and Initial Condition Error in Numerical Weather Forecasting Investigated with an Observing System Simulation Experiment

    Science.gov (United States)

    Prive, Nikki C.; Errico, Ronald M.

    2013-01-01

    A series of experiments that explore the roles of model and initial condition error in numerical weather prediction are performed using an observing system simulation experiment (OSSE) framework developed at the National Aeronautics and Space Administration Global Modeling and Assimilation Office (NASA/GMAO). The use of an OSSE allows the analysis and forecast errors to be explicitly calculated, and different hypothetical observing networks can be tested with ease. In these experiments, both a full global OSSE framework and an 'identical twin' OSSE setup are utilized to compare the behavior of the data assimilation system and evolution of forecast skill with and without model error. The initial condition error is manipulated by varying the distribution and quality of the observing network and the magnitude of observation errors. The results show that model error has a strong impact on both the quality of the analysis field and the evolution of forecast skill, including both systematic and unsystematic model error components. With a realistic observing network, the analysis state retains a significant quantity of error due to systematic model error. If errors of the analysis state are minimized, model error acts to rapidly degrade forecast skill during the first 24-48 hours of forward integration. In the presence of model error, the impact of observation errors on forecast skill is small, but in the absence of model error, observation errors cause a substantial degradation of the skill of medium range forecasts.

  10. Initial Surgical Experience with Aortic Valve Repair: Clinical and Echocardiographic Results

    Science.gov (United States)

    da Costa, Francisco Diniz Affonso; Colatusso, Daniele de Fátima Fornazari; da Costa, Ana Claudia Brenner Affonso; Balbi Filho, Eduardo Mendel; Cavicchioli, Vinicius Nesi; Lopes, Sergio Augusto Veiga; Ferreira, Andrea Dumsch de Aragon; Collatusso, Claudinei

    2016-01-01

    Introduction Due to late complications associated with the use of conventional prosthetic heart valves, several centers have advocated aortic valve repair and/or valve sparing aortic root replacement for patients with aortic valve insufficiency, in order to enhance late survival and minimize adverse postoperative events. Methods From March/2012 thru March 2015, 37 patients consecutively underwent conservative operations of the aortic valve and/or aortic root. Mean age was 48±16 years and 81% were males. The aortic valve was bicuspid in 54% and tricuspid in the remaining. All were operated with the aid of intraoperative transesophageal echocardiography. Surgical techniques consisted of replacing the aortic root with a Dacron graft whenever it was dilated or aneurysmatic, using either the remodeling or the reimplantation technique, besides correcting leaflet prolapse when present. Patients were sequentially evaluated with clinical and echocardiographic studies and mean follow-up time was 16±5 months. Results Thirty-day mortality was 2.7%. In addition there were two late deaths, with late survival being 85% (CI 95% - 68%-95%) at two years. Two patients were reoperated due to primary structural valve failure. Freedom from reoperation or from primary structural valve failure was 90% (CI 95% - 66%-97%) and 91% (CI 95% - 69%-97%) at 2 years, respectively. During clinical follow-up up to 3 years, there were no cases of thromboembolism, hemorrhage or endocarditis. Conclusions Although this represents an initial series, these data demonstrates that aortic valve repair and/or valve sparing aortic root surgery can be performed with satisfactory immediate and short-term results. PMID:27556321

  11. Reflectance confocal microscopy-guided laser ablation of basal cell carcinomas: initial clinical experience.

    Science.gov (United States)

    Sierra, Heidy; Yélamos, Oriol; Cordova, Miguel; Chen, Chih-Shan Jason; Rajadhyaksha, Milind

    2017-08-01

    Laser ablation offers a procedure for precise, fast, and minimally invasive removal of superficial and early nodular basal cell carcinomas (BCCs). However, the lack of histopathological confirmation has been a limitation toward widespread use in the clinic. A reflectance confocal microscopy (RCM) imaging-guided approach offers cellular-level histopathology-like feedback directly on the patient, which may then guide and help improve the efficacy of the ablation procedure. Following an ex vivo benchtop study (reported in our earlier papers), we performed an initial study on 44 BCCs on 21 patients in vivo, using a pulsed erbium:ytterbium aluminum garnet laser and a contrast agent (aluminum chloride). In 10 lesions on six patients, the RCM imaging-guided detection of either presence of residual tumor or complete clearance was immediately confirmed with histopathology. Additionally, 34 BCCs on 15 patients were treated with RCM imaging-guided laser ablation, with immediate confirmation for clearance of tumor (no histopathology), followed by longer-term monitoring, currently in progress, with follow-up imaging (again, no histopathology) at 3, 6, and 18 months. Thus far, the imaging resolution appears to be sufficient and consistent for monitoring efficacy of ablation in the wound, both immediately postablation and subsequently during recovery. The efficacy results appear to be promising, with observed clearance in 19 cases of 22 cases with follow-ups ranging from 6 to 21 months. An additional 12 cases with 1 to 3 months of follow-ups has shown clearance of tumor but a longer follow-up time is required to establish conclusive results. Further instrumentation development will be necessary to cover larger areas with a more automatically controlled instrument for more uniform, faster, and deeper imaging of margins. (2017) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  12. Initial clinical experience with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO).

    Science.gov (United States)

    Tuan, J; Vischioni, B; Fossati, P; Srivastava, A; Vitolo, V; Iannalfi, A; Fiore, M R; Krengli, M; Mizoe, J E; Orecchia, R

    2013-07-01

    We report the initial toxicity data with scanned proton beams at the Italian National Center for Hadrontherapy (CNAO). In September 2011, CNAO commenced patient treatment with scanned proton beams within two prospective Phase II protocols approved by the Italian Health Ministry. Patients with chondrosarcoma or chordoma of the skull base or spine were eligible. By October 2012, 21 patients had completed treatment. Immobilization was performed using rigid non-perforated thermoplastic-masks and customized headrests or body-pillows as indicated. Non-contrast CT scans with immobilization devices in place and MRI scans in supine position were performed for treatment-planning. For chordoma, the prescribed doses were 74 cobalt grey equivalent (CGE) and 54 CGE to planning target volume 1 (PTV1) and PTV2, respectively. For chondrosarcoma, the prescribed doses were 70 CGE and 54 CGE to PTV1 and PTV2, respectively. Treatment was delivered five days a week in 35-37 fractions. Prior to treatment, the patients' positions were verified using an optical tracking system and orthogonal X-ray images. Proton beams were delivered using fixed-horizontal portals on a robotic couch. Weekly MRI incorporating diffusion-weighted-imaging was performed during the course of proton therapy. Patients were reviewed once weekly and acute toxicities were graded with the Common Terminology Criteria for Adverse Events (CTCAE). Median age of patients = 50 years (range, 21-74). All 21 patients completed the proton therapy without major toxicities and without treatment interruption. Median dose delivered was 74 CGE (range, 70-74). The maximum toxicity recorded was CTCAE Grade 2 in four patients. Our preliminary data demonstrates the clinical feasibility of scanned proton beams in Italy.

  13. Conversion to sirolimus immunosuppression in liver transplantation recipients with hepatocellular carcinoma: Report of an initial experience

    Institute of Scientific and Technical Information of China (English)

    Jian Zhou; Yi-Feng He; Yu-Qi Wang; Zhao-You Tang; Jia Fan; Zheng Wang; Zhi-Quan Wu; Shuang-Jian Qiu; Xiao-Wu Huang; Yao Yu; Jian Sun; Yong-Sheng Xiao

    2006-01-01

    AIM: To report a retrospective analysis of preliminary results of 36 patients who received sirolimus (SRL, Rapamune(R), rapamycin) in a consecutive cohort of 248 liver allograft recipients.METHODS: Thirty-six liver transplant patients with hepatocellular carcinoma (HCC) who were switched to SRL-based immunosuppression therapy from tacrolimus were enrolled in this study. The patients who were diagnosed as advanced HCC before orthotopic liver transplantation (OLT) were divided into group A (n = 11), those who were found to have HCC recurrence and/or metastasis after OLT were assigned to group B (n = 18), and those who developed renal insufficiency caused by calcineurin inhibitor (CNI) were assigned to group C (n = 7) after OLT.RESULTS: The patients were followed up for a median of 10.4 mo (range, 3.8-19.1 mo) after conversion to SRL therapy and 12.3 mo (range, 5.1-34.4 mo) after OLT.Three patients developed mild acute cellular rejection 2 wk after initiating SRL therapy, which was fully reversed after prednisolone pulse therapy. In group A, only 1 patient was found to have HCC recurrence and metastasis 12 mo after OLT. In group B, 66.7% (12/18) patients (2 with progressive tumor, 7 with stable tumor and 3 without tumor) were still alive due to conversing to SRL and/or resection for HCC recurrence at the end of a median follow-up of 6.8 mo post conversion and 10.7 mo posttransplant. In group C, no HCC recurrence was demonstrated in 7 patients, and renal function became normal after SRL therapy. Thrombocytopenia (n = 2), anemia (n = 8), and oral aphthous ulcers (n = 7) found in our cohort were easily manageable.CONCLUSION: The conversion to SRL-based immunosuppression may inhibit the recurrence and metastasis of HCC and improve CNI-induced renal insufficiency in OLT patients with HCC.

  14. Conceptual design of initial opacity experiments on the national ignition facility

    Energy Technology Data Exchange (ETDEWEB)

    Heeter, R.  F.; Bailey, J.  E.; Craxton, R.  S.; DeVolder, B.  G.; Dodd, E.  S.; Garcia, E.  M.; Huffman, E.  J.; Iglesias, C.  A.; King, J.  A.; Kline, J.  L.; Liedahl, D.  A.; McKenty, P.  W.; Opachich, Y.  P.; Rochau, G.  A.; Ross, P.  W.; Schneider, M.  B.; Sherrill, M.  E.; Wilson, B.  G.; Zhang, R.; Perry, T.  S.

    2017-01-09

    Accurate models of X-ray absorption and re-emission in partly stripped ions are necessary to calculate the structure of stars, the performance of hohlraums for inertial confinement fusion and many other systems in high-energy-density plasma physics. Despite theoretical progress, a persistent discrepancy exists with recent experiments at the Sandia Z facility studying iron in conditions characteristic of the solar radiative–convective transition region. The increased iron opacity measured at Z could help resolve a longstanding issue with the standard solar model, but requires a radical departure for opacity theory. To replicate the Z measurements, an opacity experiment has been designed for the National Facility (NIF). The design uses established techniques scaled to NIF. A laser-heated hohlraum will produce X-ray-heated uniform iron plasmas in local thermodynamic equilibrium (LTE) at temperatures${\\geqslant}150$ eV and electron densities${\\geqslant}7\\times 10^{21}~\\text{cm}^{-3}$. The iron will be probed using continuum X-rays emitted in a${\\sim}200$ ps,${\\sim}200~\\unicode[STIX]{x03BC}\\text{m}$diameter source from a 2 mm diameter polystyrene (CH) capsule implosion. In this design

  15. Initial experience in 115 patients with the retrievable Cook Celect vena cava filter.

    Science.gov (United States)

    Doody, O; Given, M F; Kavnoudias, H; Street, M; Thomson, K R; Lyon, S M

    2009-02-01

    The aim of this study was to evaluate our experience with the retrievable Cook Celect inferior vena cava (IVC) filter (William Cook, Europe) with regard to insertion, efficiency, ease of retrieval, and any associated complications. A retrospective review was performed of 115 patients (41 female, 74 male, mean age 47.97 years) who underwent Cook Celect IVC filter insertion between December 2005 and October 2007. Filter insertion was successful in all patients. Of the 115 filters inserted, 57 have been successfully retrieved (49.6%) to date. The successful retrieval rate from attempted retrieval was 93.4%. The mean dwell time of successfully retrieved filters was 114.9 days (range 14-267 days). Failed retrievals were due to a thrombosed vena cava (n = 1) and endothelialisation of the filter (n = 3). In the failed retrieval group the mean implantation time was 142 days (range 78-211 days). While this is the first retrospective clinical study on the Cook Celect filter, results to date are promising. We demonstrated an efficacious filter with a high successful retrieval rate of 93.4% and a low complication rate. The filter was assessed with extended dwell times (range 14-267 days). Failed retrieval secondary to hook endothelialisation continues to be an issue with this filter. We recognize that a limitation of our study was the lack of systematic follow-up for clinically silent complications. Further studies to evaluate longer term outcomes and effectiveness of this filter are warranted.

  16. [A new balloon-expandable plastic endoprosthesis. Initial report of experience with the malleable thermostent].

    Science.gov (United States)

    Beck, A

    1990-07-01

    A new system of balloon-expandable stents for different purposes is presented. A special plastic material that can be shaped by a hot balloon technique or other internal or external heating modalities has been developed. The plastic material - a distant derivative of polyurethane - is caprolactone, which is soft from 52 degrees C to 70 degrees C. Using balloon techniques, the "thermo-stent" can be modeled to suit the form of the vessels, the bile ducts or the bronchial tree, as required. The balloon can be heated simply by means of a warm NaCl solution, electric matter in the balloon itself or microwaves. The plastic material can even be heated directly, which is especially beneficial if the stent needs to be thicker, e.g. in the bronchial tree, by an electric network within the plastic material, which heats the material to the necessary temperature by electric current. When the balloon is cooled after the dilatation the new form, the plastic has been modeled to is maintained exactly. The advantages of this thermo-stent will be the perfect adaptation to every individual situation in the intraluminal vessels, the bile ducts, and even the bronchi. The problems encountered hitherto with conventional metallic stents, e.g. high thrombogenicity, risk of metal intoxication or metallic rupture of filaments, have not be seen so far in animal experiments.

  17. Initial SAM Calibration Gas Experiments on Mars: Quadrupole Mass Spectrometer Results and Implications

    Science.gov (United States)

    Franz, Heather B.; Trainer, Melissa G.; Malespin, Charles A.; Mahaffy, Paul R.; Atreya, Sushil K.; Becker, Richard H,; Benna, Mehdi; Conrad, Pamela G.; Eigenbrode, Jennifer L.; Freissinet, Caroline; hide

    2017-01-01

    The Sample Analysis at Mars (SAM) instrument suite of the Mars Science Laboratory (MSL) Curiosity rover is equipped to analyze both martian atmospheric gases and volatiles released by pyrolysis of solid surface materials, with target measurements including chemical and isotopic composition (Mahaffy et al., 2012). To facilitate assessment of instrument performance and validation of results obtained on Mars, SAM houses a calibration cell containing CO2, Ar, N2, Xe, and several fluorinated hydrocarbon compounds (Franz et al., 2014; Mahaffy et al., 2012). This report describes the first two experiments utilizing this calibration cell on Mars and gives results from analysis of data acquired with the SAM Quadrupole Mass Spectrometer (QMS). These data support the accuracy of isotope ratios obtained with the QMS (Conrad et al., 2016; Mahaffy et al., 2013) and provide ground-truth for reassessment of analytical constants required for atmospheric measurements, which were reported in previous contributions (Franz et al., 2015, 2014). The most significant implication of the QMS data involves reinterpretation of pre-launch contamination previously believed to affect only CO abundance measurements (Franz et al., 2015) to affect N2 abundances, as well. The corresponding adjustment to the N2 calibration constant presented here brings the atmospheric volume mixing ratios for Ar and N2 retrieved by SAM into closer agreement with those reported by the Viking mission (Owen et al., 1977; Oyama and Berdahl, 1977).

  18. Use of natural user interfaces for image navigation during laparoscopic surgery: initial experience.

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    Sánchez-Margallo, Francisco M; Sánchez-Margallo, Juan A; Moyano-Cuevas, José L; Pérez, Eva María; Maestre, Juan

    2017-03-28

    Surgical environments require special aseptic conditions for direct interaction with the preoperative images. We aim to test the feasibility of using a set of gesture control sensors combined with voice control to interact in a sterile manner with preoperative information and an integrated operating room (OR) during laparoscopic surgery. Two hepatectomies and two partial nephrectomies were performed by three experienced surgeons in a porcine model. The Kinect, Leap Motion, and MYO armband in combination with voice control were used as natural user interfaces (NUIs). After surgery, surgeons completed a questionnaire about their experience. Surgeons required <10 min training with each NUI. They stated that NUIs improved the access to preoperative patient information and kept them more focused on the surgical site. The Kinect system was reported as the most physically demanding NUI and the MYO armband in combination with voice commands as the most intuitive and accurate. The need to release one of the laparoscopic instruments in order to use the NUIs was identified as the main limitation. The presented NUIs are feasible to directly interact in a more intuitive and sterile manner with the preoperative images and the integrated OR functionalities during laparoscopic surgery.

  19. Initial SAM calibration gas experiments on Mars: Quadrupole mass spectrometer results and implications

    Science.gov (United States)

    Franz, Heather B.; Trainer, Melissa G.; Malespin, Charles A.; Mahaffy, Paul R.; Atreya, Sushil K.; Becker, Richard H.; Benna, Mehdi; Conrad, Pamela G.; Eigenbrode, Jennifer L.; Freissinet, Caroline; Manning, Heidi L. K.; Prats, Benito D.; Raaen, Eric; Wong, Michael H.

    2017-04-01

    The Sample Analysis at Mars (SAM) instrument suite of the Mars Science Laboratory (MSL) Curiosity rover is equipped to analyze both martian atmospheric gases and volatiles released by pyrolysis of solid surface materials, with target measurements including chemical and isotopic composition (Mahaffy et al., 2012). To facilitate assessment of instrument performance and validation of results obtained on Mars, SAM houses a calibration cell containing CO2, Ar, N2, Xe, and several fluorinated hydrocarbon compounds (Franz et al., 2014; Mahaffy et al., 2012). This report describes the first two experiments utilizing this calibration cell on Mars and gives results from analysis of data acquired with the SAM Quadrupole Mass Spectrometer (QMS). These data support the accuracy of isotope ratios obtained with the QMS (Conrad et al., 2016; Mahaffy et al., 2013) and provide ground-truth for reassessment of analytical constants required for atmospheric measurements, which were reported in previous contributions (Franz et al., 2015, 2014). The most significant implication of the QMS data involves reinterpretation of pre-launch contamination previously believed to affect only CO abundance measurements (Franz et al., 2015) to affect N2 abundances, as well. The corresponding adjustment to the N2 calibration constant presented here brings the atmospheric volume mixing ratios for Ar and N2 retrieved by SAM into closer agreement with those reported by the Viking mission (Owen et al., 1977; Oyama and Berdahl, 1977).

  20. Initial experience with a group presentation of study results to research participants

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    Bent Stephen

    2008-03-01

    Full Text Available Abstract Background Despite ethical imperatives, informing research participants about the results of the studies in which they take part is not often performed. This is due, in part, to the costs and burdens of communicating with each participant after publication of the results. Methods Following the closeout and publication of a randomized clinical trial of saw palmetto for treatment of symptoms of benign prostatic hyperplasia, patients were invited back to the research center to participate in a group presentation of the study results. Results Approximately 10% of participants attended one of two presentation sessions. Reaction to the experience of the group presentation was very positive among the attendees. Conclusion A group presentation to research participants is an efficient method of communicating study results to those who desire to be informed and was highly valued by those who attended. Prospectively planning for such presentations and greater scheduling flexibility may result in higher attendance rates. Trial Registration Number Clinicaltrials.gov #NCT00037154

  1. Safety of autologous bone marrow aspiration concentrate transplantation: initial experiences in 101 patients

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    Christian Hendrich

    2009-12-01

    Full Text Available The clinical application of cellular based therapies with ex vivo cultivation for the treatment of diseases of the musculoskeletal system has until now been limited. In particular, the advanced laboratory and technical effort necessary, regulatory issues as well as high costs are major obstacles. On the other hand, newly developed cell therapy systems permit intra-operative enrichment and application of mesenchymal and progenitor stem cells from bone marrow aspirate concentrate (BMAC in one single operative session. The objective of the present clinical surveillance study was to evaluate new bone formation after the application of BMAC as well as to record any possible therapy-specific complications For this purpose, the clinical-radiological progress of a total of 101 patients with various bone healing disturbances was documented (surveillance study. The study included 37 necrosis of the head of the femur, 32 avascular necroses/bone marrow edema of other localization, 12 non-unions, 20 other defects. The application of BMAC was performed in the presence of osteonecrosis via a local injection as part of a core decompression (n=72 or by the local adsorption of intra-operative cellular bone substitution material (scaffold incubated with BMAC during osteosynthesis (n=17 or in further surgery (n=12. After an average of 14 months (2-24 months, the patients were re-examined clinically and radiologically and interviewed. Further surgery was necessary in 2 patients within the follow-up period. These were due to a progression of a collapsed head of the femur with initial necrosis in ARCO Stage III, as well as inadequate new bone formation with secondary loss of correction after periprosthetic femoral fracture. The latter healed after repeated osteosynthesis plus BMAC application without any consequences. Other than these 2 patients, no further complications were observed. In particular, no infections, no excessive new bone formation, no induction of

  2. Establishing a health demographic surveillance site in Bhaktapur district, Nepal: initial experiences and findings

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    Aryal Umesh

    2012-09-01

    Full Text Available Abstract Background A health demographic surveillance system (HDSS provides longitudinal data regarding health and demography in countries with coverage error and poor quality data on vital registration systems due to lack of public awareness, inadequate legal basis and limited use of data in health planning. The health system in Nepal, a low-income country, does not focus primarily on health registration, and does not conduct regular health data collection. This study aimed to initiate and establish the first HDSS in Nepal. Results We conducted a baseline survey in Jhaukhel and Duwakot, two villages in Bhaktapur district. The study surveyed 2,712 households comprising a total population of 13,669. The sex ratio in the study area was 101 males per 100 females and the average household size was 5. The crude birth and death rates were 9.7 and 3.9/1,000 population/year, respectively. About 11% of births occurred at home, and we found no mortality in infants and children less than 5 years of age. Various health problems were found commonly and some of them include respiratory problems (41.9%; headache, vertigo and dizziness (16.7%; bone and joint pain (14.4%; gastrointestinal problems (13.9%; heart disease, including hypertension (8.8%; accidents and injuries (2.9%; and diabetes mellitus (2.6%. The prevalence of non-communicable disease (NCD was 4.3% (95% CI: 3.83; 4.86 among individuals older than 30 years. Age-adjusted odds ratios showed that risk factors, such as sex, ethnic group, occupation and education, associated with NCD. Conclusion Our baseline survey demonstrated that it is possible to collect accurate and reliable data in a village setting in Nepal, and this study successfully established an HDSS site. We determined that both maternal and child health are better in the surveillance site compared to the entire country. Risk factors associated with NCDs dominated morbidity and mortality patterns.

  3. Extracorporeal Shock-wave Lithotripsy Success Rate and Complications: Initial Experience at Sultan Qaboos University Hospital

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    Mohammed S. Al-Marhoon

    2013-07-01

    Full Text Available Objective: To assess the efficacy and safety of extracorporeal shock wave lithotripsy with Modularis Vario Siemens in the management of patients with renal and ureteral stones.Methods: Between 2007 and 2009, 225 outpatients were treated with Siemens Modularis Vario lithotripter at Sultan Qaboos University Hospital. Stone size, location, total number of shockwaves, stone-free rate, complications and adjunctive interventions were investigated. Chi-Square and Logistic Regression analyses were used, with p<0.05 set as the level of significance.Results: Of the 225 initial consecutive patients who underwent extracorporeal shock wave lithotripsy, 192 (85% had renal stones and 33 (15% had ureteric stones. The mean±SD stone size was 11.3 ± 4.5 mm, while the mean age of the patients was 39.9 ± 12.8 years with 68.5% males. The mean renal stone size was 11.6 ± 4.7 mm; a mean of 1.3 sessions was required. The mean ureteric stone size was 9.9 ± 3 mm; and a mean of 1.3 sessions was required. Treatment success (defined as complete clearance of ureteric stones, stone-free or clinically insignificant residual fragments of <4 mm for renal stones was 74% for renal stones and 88% for ureteric stones. Additional extracorporeal shock wave lithotripsy and ureteroscopy were the most adjunctive procedures used for stone clearance. Complications occurred in 74 patients (38.5% with renal stones and 13 patients (39.4% with uretetric stones. The most common complication was loin pain (experienced by 16.7% with renal stones and 21% with ureteric stones. Severe renal colic mandating admission occurred in 2% of patients with renal stones and 6% of patients with ureteric stones. In patients with renal stone, steinstrasse occurred in 3.6% and infection post extracorporeal shock wave lithotripsy in 0.5%. Using Multivariate Logistic Regression analysis, factors found to have significant effect on complete stone clearance were serum creatinine (p=0.004 and the number of

  4. Documentation of polio eradication initiative best practices: Experience from WHO African Region.

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    Okeibunor, Joseph; Nshimirimana, Deo; Nsubuga, Peter; Mutabaruka, Evariste; Tapsoba, Leonard; Ghali, Emmanuel; Kabir, Shaikh Humayun; Gassasira, Alex; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    The African Region is set to achieving polio eradication. During the years of operations, the Polio Eradication Initiative [PEI] in the Region mobilized and trained tremendous amount of manpower with specializations in surveillance, social mobilization, supplementary immunization activities [SIAs], data management and laboratory staff. Systems were put in place to accelerate the eradication of polio in the Region. Standardized, real-time surveillance and response capacity were established. Many innovations were developed and applied to reaching people in difficult and security challenged terrains. All of these resulted in accumulation of lessons and best practices, which can be used in other priority public health intervention if documented. The World Health Organization Regional Office for Africa [WHO/AFRO] developed a process for the documentation of these best practices, which was pretested in Uganda. The process entailed assessment of three critical elements [effectiveness, efficiency and relevance] five aspects [ethical soundness, sustainability, involvement of partners, community involvement, and political commitment] of best practices. A scored card which graded the elements and aspects on a scale of 0-10 was developed and a true best practice should score >50 points. Independent public health experts documented polio best practices in eight countries in the Region, using this process. The documentation adopted the cross-sectional design in the generation of data, which combined three analytical designs, namely surveys, qualitative inquiry and case studies. For the selection of countries, country responses to earlier questionnaire on best practices were screened for potential best practices. Another criterion used was the level of PEI investment in the countries. A total of 82 best practices grouped into ten thematic areas were documented. There was a correlation between the health system performances with DPT3 as proxy, level of PEI investment in countries

  5. Kidney Transplantation From Brain-Dead Donors: Initial Experience in China.

    Science.gov (United States)

    Li, Y; Li, J; Fu, Q; Chen, L; Fei, J; Deng, S; Qiu, J; Chen, G; Huang, G; Wang, C

    2016-10-01

    Experience with kidney transplantation from brain-dead donors remains limited in China. Our objective was to evaluate the outcomes of kidney transplantation from brain-dead donors (group 1), compared with those from living ones of the same age (group 2). Clinical data of kidney transplantation from brain-dead donors and living donors in the same age range (18-45 years) performed between May 2007 and December 2011 were analyzed retrospectively. Recipients were analyzed for posttransplantation serum creatinine, creatinine clearance (calculated by the Cockcroft-Gault formula), the number of acute rejection episodes and delayed graft function, and patient/graft survival. Mean donor age was comparable between the 2 groups (31.9 ± 6.5 vs 32.8 ± 7.0 years; P = .268). The terminal serum creatinine level of donors was 125.5 ± 63.5 μmol/L in group 1 (n = 30) and 65.1 ± 13.7 μmol/L in group 2 (n = 110; P = .000). Recipient creatinine clearance was comparable between the 2 groups 1 month posttransplantation and thereafter. Acute rejection episodes were seen in 7 cases in recipients of group 1 (15.9%) and in 15 cases in recipients of group 2 (13.6%; P = .716). The incidence of delayed graft function was higher in recipients of group 1 (18.2%) than that of group 2 (3.6%; P = .002). The 1-, 3-, and 5-year patient/graft survival rate was comparable between the 2 groups. Our study demonstrated kidney transplantation from brain-dead donors achieved acceptable graft function and patient/graft survival in the 5-year follow-up, encouraging the use of this approach. Copyright © 2016. Published by Elsevier Inc.

  6. Initial Clinical Experience: Symmetric-Tip Dialysis Catheter with Helical Flow Characteristics Improves Patient Outcomes.

    Science.gov (United States)

    Clark, Timothy W I; Redmond, Jonas W; Mantell, Mark P; Nadolski, Gregory J; Mondschein, Jeffrey I; Dowd, Michael F; Dagli, Mandeep S; Sudheendra, Deepak; Shlansky-Goldberg, Richard D; Cohen, Raphael D

    2015-10-01

    To report preliminary clinical experience with a new symmetric-tip dialysis catheter compared with a conventional split-tip catheter. Over a 5-month period, patients requiring a tunneled catheter for hemodialysis or undergoing exchange of a dysfunctional dialysis catheter at a tertiary academic medical center were retrospectively analyzed. Patients underwent placement of a VectorFlow or Ash Split Cath catheter at the discretion of the inserting interventional radiologist. Patient demographics, catheter patency, mean blood flow rate, and arterial and venous pressures were compared according to catheter type. Catheter failure was analyzed based on clinical and anatomic variables by using a multivariate Cox proportional-hazards model. A total of 33 VectorFlow and 46 Ash Split Cath catheters were placed. Patients in the VectorFlow group had significantly higher body mass index (P = .013) and Charlson Comorbidity Index (P = .049), as well as more non-internal jugular vein placements. At 120 days, 89% of VectorFlow catheters remained functional, compared with 45% of Ash Split Cath catheters (P = .046). The VectorFlow catheter was associated with 16% lower arterial pressures during dialysis (P = .009); mean blood flow rate was equivalent. On multivariate analysis, the risk of catheter failure was 13.3 times higher in the Ash Split Cath group compared with the VectorFlow group (P = .004). Left-sided catheters were also predictive of catheter failure (relative risk = 5.5; P = .02). The VectorFlow catheter was associated with a significant increase in intervention-free catheter patency compared with the Ash Split Cath catheter, with equivalent flow at lower arterial pressures during dialysis. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  7. Digital storytelling and teacher education: an experience in initial teacher training

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    Marco Lazzari

    2016-07-01

    Full Text Available A group of pre-service teachers experienced the digital storytelling as part of their e-learning duties. We describe the structure of the project-work carried out by the students and discuss the results of a questionnaire they filled out after the end of the course, aiming to gather their opinions. The students claim to have enjoyed the proposal and most of them are likely to repeat it in their school, either by developing digital stories themselves or by involving their future students as designers and developers. By questionnaire and interviews with the participants, it is clear that the development experience has changed their attitude towards educational technology, enhanced their digital skills, and increased their self-esteem.Digital storytelling nella formazione iniziale degli insegnanti: un’esperienza nel Tirocinio Formativo AttivoUn gruppo di aspiranti insegnanti iscritti al Tirocinio Formativo Attivo ha affrontato un’esperienza di digital storytelling come parte dei compiti di didattica a distanza. Viene qui descritta la struttura del lavoro svolto dai corsisti e si riflette sui risultati di un questionario sottoposto al termine del corso per rilevarne le opinioni. I corsisti dichiarano di aver gradito la proposta e buona parte di loro ritiene probabile ripeterla a scuola, anche coinvolgendo gli studenti nel progetto e nella realizzazione di narrazioni digitali multimediali. Da questionario e colloqui con i corsisti si deduce che l’esperienza di sviluppo ha mutato il loro atteggiamento verso le tecnologie didattiche, aumentato la loro efficacia come comunicatori digitali e accresciuto la loro autostima.

  8. Robotic-assisted modified retroauricular cervical approach: initial experience in Latin America.

    Science.gov (United States)

    Chulam, Thiago Celestino; Lira, Renan Bezerra; Kowalski, Luiz Paulo

    2016-01-01

    to evaluate the thickness of the gastric wall at the time of intra gastric balloon (IGB) placement, at the time of its withdrawal and one month after withdrawal. fifteen morbidly obese patients underwent the introduction of IGB under general anesthesia. In all patients, there was infusion of 500ml of distilled water in the balloon for the test. Measurements of the thickness of the gastric wall were made in the antrum, body and proximal body, using a radial echoendoscope with a frequency of 12MHz and maximum zoom, and its own balloon inflated with 5ml of distilled water. the presence of IGB led to increased wall thickness of the gastric body by expanding the muscle layer. These changes were apparently transient, since 30 days after the balloon withdrawal there was a tendency to return of the wall thickness values ​​observed before the balloon insertion. the use of intragastric balloon for the treatment of obesity determines transient increase in the wall thickness of the gastric body caused by expanded muscle layer. A preocupação com a melhoria dos resultados estéticos e funcionais sem comprometimento dos resultados oncológicos na cirurgia de cabeça e pescoço tem aumentado significativamente. Os procedimentos minimamente invasivos e principalmente aqueles que utilizam a tecnologia robótica permitiram o desenvolvimento de novas abordagens, incluindo o acesso retroauricular, que agora é usado rotineiramente, especialmente na Coréia do Sul. A presente nota irá ilustrar a técnica e a experiência inicial na América Latina, demonstrando que esta abordagem é viável, segura e eficaz oncologicamente, podendo ser utilizada em casos selecionados com um benefício estético evidente.

  9. Initial experience of treating anal fistula with the Surgisis anal fistula plug.

    Science.gov (United States)

    Chan, S; McCullough, J; Schizas, A; Vasas, P; Engledow, A; Windsor, A; Williams, A; Cohen, C R

    2012-06-01

    Complex anal fistulas remain a challenge for the colorectal surgeon. The anal fistula plug has been developed as a simple treatment for fistula-in-ano. We present and evaluate our experience with the Surgisis anal fistula plug from two centres. Data were prospectively collected and analysed from consecutive patients undergoing insertion of a fistula plug between January 2007 and October 2009. Fistula plugs were inserted according to a standard protocol. Data collected included patient demographics, fistula characteristics and postoperative outcome. Forty-four patients underwent insertion of 62 plugs (27 males, mean age 45.6 years), 25 of whom had prior fistula surgery. Mean follow-up was 10.5 months Twenty-two patients (50%) had successful healing following the insertion of plug with an overall success rate of 23 out of 62 plugs inserted (35%). Nineteen out of 29 patients healed following first-time plug placement, whereas repeated plug placement was successful in 3 out of 15 patients (20%; p = 0.0097). There was a statistically significant difference in the healing rate between patients who had one or less operations prior to plug insertion (i.e. simple fistulas) compared with patients who needed multiple operations (18 out of 24 patients vs. 4 out of 20 patients; p = 0.0007). Success of treatment with the Surgisis anal fistula plug relies on the eradication of sepsis prior to plug placement. Plugs inserted into simple tracts have a higher success rate, and recurrent insertion of plugs following previous plug failure is less likely to be successful. We suggest the fistula plug should remain a first-line treatment for primary surgery and simple tracts.

  10. Simpatectomia cervicotoracica por videotoracoscopia: experiência inicial Thoracoscopic cervicodorsal sympathectomy: initial results

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    Paulo Kauffman

    1998-08-01

    Full Text Available O objetivo do presente trabalho é avaliar os resultados iniciais obtidos com a simpatectomia cervicotorácica videotoracoscópica. De outubro de 1995 a outubro de 1997 foram realizados 24 procedimentos em 14 pacientes: dez homens e quatro mulheres, com idades que variaram de 16 a 56 anos, média de 30 anos. Indicações para a operação foram: hiperidrose palmar em dez pacientes, isquemia de mão em três e causalgia em um. Nos casos de hiperidrose, a ressecção da cadeia simpática incluiu T2 e T3. Nos portadores de isquemia e causalgia também o gânglio estrelado foi ressecado. Vinte e três das 24 extremidades mostraram excelente resposta imediata à simpatectomia. Somente uma extremidade de paciente com hiperidrose permaneceu inalterada devido a procedimento incompleto, tendo sido desnervada pela mesma técnica em reoperação posterior, com bom resultado. Pneumotórax residual pós-operatório ocorreu em uma paciente com resolução espontânea. Treze pacientes tiveram seguimento que variou de dois a 18 meses, com média de 11 meses. Não houve mortalidade nessa série, e a principal complicação tardia observada nos pacientes operados por hiperidrose foi a hiperidrose compensatória, que ocorreu, em grau variado, nos nove pacientes com seguimento, sendo que em 30% deles esta manifestação foi significativa. Concluímos tratar-se de procedimento simples, seguro, eficiente e de melhor aceitação por parte dos pacientes do que a operação convencional.This report analyzes the initial results of thoracoscopic cervicodorsal sympathectomy. From October 1995 to October 1997, 24 procedures were accomplished in 14 patients. Ten were males and four were females ranging in age from 16 to 56 (mean 30. Surgical indications were: palmar hyperhidrosis in ten, ischemia of the hand in three and causalgia in one. Resection of the sympathetic chain in hyperhidrosis included T2 and T3. In those with ischemia and causalgia the stellate ganglion was

  11. Motion-Corrected Real-Time Cine Magnetic Resonance Imaging of the Heart: Initial Clinical Experience.

    Science.gov (United States)

    Rahsepar, Amir Ali; Saybasili, Haris; Ghasemiesfe, Ahmadreza; Dolan, Ryan S; Shehata, Monda L; Botelho, Marcos P; Markl, Michael; Spottiswoode, Bruce; Collins, Jeremy D; Carr, James C

    2017-08-29

    Free-breathing real-time (RT) imaging can be used in patients with difficulty in breath-holding; however, RT cine imaging typically experiences poor image quality compared with segmented cine imaging because of low resolution. Here, we validate a novel unsupervised motion-corrected (MOCO) reconstruction technique for free-breathing RT cardiac images, called MOCO-RT. Motion-corrected RT uses elastic image registration to generate a single heartbeat of high-quality data from a free-breathing RT acquisition. Segmented balanced steady-state free precession (bSSFP) cine images and free-breathing RT images (Cartesian, TGRAPPA factor 4) were acquired with the same spatial/temporal resolution in 40 patients using clinical 1.5 T magnetic resonance scanners. The respiratory cycle was estimated using the reconstructed RT images, and nonrigid unsupervised motion correction was applied to eliminate breathing motion. Conventional segmented RT and MOCO-RT single-heartbeat cine images were analyzed to evaluate left ventricular (LV) function and volume measurements. Two radiologists scored images for overall image quality, artifact, noise, and wall motion abnormalities. Intraclass correlation coefficient was used to assess the reliability of MOCO-RT measurement. Intraclass correlation coefficient showed excellent reliability (intraclass correlation coefficient ≥ 0.95) of MOCO-RT with segmented cine in measuring LV function, mass, and volume. Comparison of the qualitative ratings indicated comparable image quality for MOCO-RT (4.80 ± 0.35) with segmented cine (4.45 ± 0.88, P = 0.215) and significantly higher than conventional RT techniques (3.51 ± 0.41, P cine (1.51 ± 0.90, P = 0.088 and 1.23 ± 0.45, P = 0.182) were not different. Wall motion abnormality ratings were comparable among different techniques (P = 0.96). The MOCO-RT technique can be used to process conventional free-breathing RT cine images and provides comparable quantitative assessment of LV function and volume

  12. [Initial clinical experience with deep sclerectomy in ambulatory surgery in glaucoma].

    Science.gov (United States)

    Pitrová, S; Pesková, H; Lesták, J

    1999-01-01

    Deep sclerectomy is a non-perforating filtering operation used in surgical treatment of open angle glaucomas. The advantage of the operation is the creation of gradual filtration due to the thin trabecular Descement membrane which reduces markedly the risk of development of postoperative complications typical for perforating antiglaucomatous operations. The authors operated at the out-patient department 10 eyes of 8 patients (age 46-81 years). Indications for deep sclerectomy was seven times primary open angle glaucoma (POAG), once capsular glaucoma and twice normotensive glaucoma (NTG). In all eyes deep sclerectomy was indicated because of decompensation of the intraocular pressure with maximum tolerated therapy before surgery. None of the eyes were operated previously. The mean value of intraocular pressure before surgery was 25.1 +/- 6.5 mm Hg. From the results ensues that in nine operated eyes the intraocular pressure at the end of the 6-month follow-up period was compensated without supplementary therapy, only in one eye beta-blockers were prescribed one month after surgery. The cause of failure of filtration was the development of superficial adherence at the site of microperforatiion of the trabecular Descemet membrane which developed during operation. The mean intraocular pressure values at the end of the investigation period were 14.3 +/- 2.8 mm Hg. In two eyes haemorrhage into the anterior chamber was observed on the first day after surgery, the blood was absorbed within 24 hours. Hypotonia in two eyes was only transient and was not associated with a change in the depth of the anterior chamber or other complications. In none of the patients a decline of visual acuity was observed. In three operated eyes a change of refraction was necessary due to discontinuation of miotics after surgery. Deep sclerectomy is a delicate microsurgical technique which calls for experience and skill of the surgeon. The most complicated task is to prevent perforation of the

  13. Single-port video-assisted thoracic surgery for early lung cancer: initial experience in Japan

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    Takeuchi, Shingo; Usuda, Jitsuo

    2016-01-01

    Background Single-port video-assisted thoracic surgery (SPVATS) emerged several years ago as a new, minimally invasive surgery for diseases in the field of respiratory surgery, and is increasingly becoming a subject of interest for some thoracic surgeons in Europe and Asia. However, the adoption rate of this procedure in the United States and Japan remains low. We herein reviewed our experience of SPVATS for early lung cancer in our center, and evaluated the safety and minimal invasiveness of this technique. Methods We retrospectively analyzed patients who had undergone SPVATS for pathological stage I lung cancer in Nippon Medical School Chiba Hokusoh Hospital between September 2012 and October 2015. In SPVATS, an approximately 4-cm incision was made at the 4th or 5th intercostal space between the anterior and posterior axillary lines. A rib spreader was not used at the incision site, and surgical manipulation was performed very carefully in order to avoid contact between surgical instruments and the intercostal nerves. The same surgeon performed surgery on all patients, and analyzed laboratory data before and after surgery. Results Eighty-four patients underwent anatomical lung resection for postoperative pathological stage I lung cancer. The mean wound length was 4.2 cm. Eighty-four patients underwent lobectomy and segmentectomy, respectively. The mean preoperative forced expiratory volume in 1 second (FEV1%) was 1.85%±0.36%. Our patients consisted of 49 men (58.3%) and 35 women (41.7%), with 64, 18, 1, and 1 having adenocarcinoma, squamous cell carcinoma, adenosquamous carcinoma, and small-cell lung cancer, respectively. The mean operative time was 175±21 min, operative blood loss 92±18 mL, and duration of drain placement 1.9±0.6 days. The duration of the postoperative hospital stay was 7.1±1.7 days, numeric rating scale (NRS) 1 week after surgery 2.8±0.6, and occurrence rate of allodynia 1 month after surgery 10.7%. No patient developed serious

  14. Initial clinical experience with a radiation oncology dedicated open 1.0T MR-simulation.

    Science.gov (United States)

    Glide-Hurst, Carri K; Wen, Ning; Hearshen, David; Kim, Joshua; Pantelic, Milan; Zhao, Bo; Mancell, Tina; Levin, Kenneth; Movsas, Benjamin; Chetty, Indrin J; Siddiqui, M Salim

    2015-03-08

    The purpose of this study was to describe our experience with 1.0T MR-SIM including characterization, quality assurance (QA) program, and features necessary for treatment planning. Staffing, safety, and patient screening procedures were developed. Utilization of an external laser positioning system (ELPS) and MR-compatible couchtop were illustrated. Spatial and volumetric analyses were conducted between CT-SIM and MR-SIM using a stereotactic QA phantom with known landmarks and volumes. Magnetic field inhomogeneity was determined using phase difference analysis. System-related, in-plane distortion was evaluated and temporal changes were assessed. 3D distortion was characterized for regions of interest (ROIs) 5-20 cm away from isocenter. American College of Radiology (ACR) recommended tests and impact of ELPS on image quality were analyzed. Combined ultrashort echotime Dixon (UTE/Dixon) sequence was evaluated. Amplitude-triggered 4D MRI was implemented using a motion phantom (2-10 phases, ~ 2 cm excursion, 3-5 s periods) and a liver cancer patient. Duty cycle, acquisition time, and excursion were evaluated between maximum intensity projection (MIP) datasets. Less than 2% difference from expected was obtained between CT-SIM and MR-SIM volumes, with a mean distance of 3D geometric distortion was 0.59 ± 0.32 mm (maximum = 1.65 mm) and increased 10-15 cm from isocenter (mean = 1.57 ± 1.06 mm, maximum = 6.26 mm). ELPS interference was within the operating frequency of the scanner and was characterized by line patterns and a reduction in signal-to-noise ratio (4.6-12.6% for TE = 50-150 ms). Image quality checks were within ACR recommendations. UTE/Dixon sequences yielded detectability between bone and air. For 4D MRI, faster breathing periods had higher duty cycles than slow (50.4% (3 s) and 39.4% (5 s), p < 0.001) and ~fourfold acquisition time increase was measured for ten-phase versus two-phase. Superior-inferior object extent was underestimated 8% (6 mm) for two

  15. RM de cuerpo entero, experiencia inicial Whole body MRI, initial experience

    Directory of Open Access Journals (Sweden)

    Ezequiel Rombolá

    2008-09-01

    Full Text Available Objetivo: Exponer y compartir nuestra experiencia en resonancia magnética de cuerpo entero (RMCE. Material y métodos: Se realizó estudio prospectivo entre octubre de 2005 y mayo de 2007 sobre 165 RMCE. Edad de los pacientes: 21 y 85 años, media de 51,64. Se utilizó equipo de 1,5 Tesla de campo magnético y tabla deslizable. El protocolo de estudio estuvo integrado por cortes coronales multicontraste (T1, T2 y STIR, axiales y sagitales en T2. Resultados: Se obtuvieron 140 (84,84 % estudios con hallazgos relevantes y 25 (15,15 % sin alteraciones. Se halló predominancia de enfermedades degenerativas articulares del esqueleto axial en 94 pacientes (56,96% sin diferencias significativas entre sexos. Trece pacientes realizaron controles oncológicos demostrándose diseminación a distancia en 6 estudios. En 1 examen se registró la distribución de polimiositis. Conclusiones: La RMCE no representa solamente una innovadora herramienta diagnóstica, sino también ostenta el potencial de competir con metodologías preexistentes en aplicaciones oncológicas y no oncológicas. La sensibilidad y especificidad del método están probadas, pero su aplicación se encuentra limitada por el alto costo y la falta de inclusión en protocolos diagnósticos de estadificación tumoral.Objective: To expose and share our experience in whole-body MRI. Material and methods: A prospective study of 165 whole-body MRI was made from october 2005 to may 2007. The age range was between 21 to 85 years old, with a mean age of 51, 64. A 1.5 Tesla MRI scan was utilized with a table-top movement. Multicontrast coronal scans (T1, T2 and STIR, sagittal and axial T2 compose the study protocol. Results: 140 (84,84 % scans with relevant results and 25 (15,15 % without abnormalities were found. The axial skeletal articular degenerative disease prevalence on 94 (56,96 % cases, without significant difference. Six MRI scans showed secondary dissemination of the oncology disease in a

  16. Ultrasound-guided Breast Biopsy in the Resource-limited Setting: An Initial Experience in Rural Uganda

    Directory of Open Access Journals (Sweden)

    Christopher R. Stark

    2017-06-01

    Full Text Available Purpose: To describe the methodology and initial experience behind creation of an ultrasoundguided percutaneous breast core biopsy program in rural Uganda. Methods and Materials: Imaging the World Africa (ITWA is the registered non-governmental organization division of Imaging the World (ITW, a not-for-profit organization whose primary aim is the integration of affordable high-quality ultrasound into rural health centers. In 2013, ITWA began the pilot phase of an IRB-approved breast care protocol at a rural health center in Uganda. As part of the protocol’s diagnostic arm, an ultrasound-guided percutaneous breast core biopsy training curriculum was implemented in tandem with creation of regionally supplied biopsy kits. Results: A surgeon at a rural regional referral hospital was successfully trained and certified to perform ultrasound-guided percutaneous breast core biopsies. Affordable and safe biopsy kits were created using locally available medical supplies with the cost of each kit totaling $10.62 USD. Conclusion: Successful implementation of an ultrasound-guided percutaneous breast core biopsy program in the resource-limited setting is possible and can be made sustainable through incorporation of local health care personnel and regionally supplied biopsy materials. Our hope is that ITWA’s initial experience in rural Uganda can serve as a model for similar programs in the future.

  17. Image guided respiratory gated hypofractionated Stereotactic Body Radiation Therapy (H-SBRT) for liver and lung tumors: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Wurm, R.E.; Gum, F.; Erbel, S. [Charite Campus Mitte, Berlin (Germany). Dept. of Radiation Oncology

    2006-09-15

    To evaluate our initial experience with image guided respiratory gated H-SBRT for liver and lung tumors. The system combines a stereoscopic x-ray imaging system (ExacTrac{sup R} X-Ray 6D) with a dedicated conformal stereotactic radiosurgery and radiotherapy linear accelerator (Novalis) and ExacTrac{sup R} Adaptive Gating for dynamic adaptive treatment. Moving targets are located and tracked by x-ray imaging of implanted fiducial markers defined in the treatment planning computed tomography (CT). The marker position is compared with the position in verification stereoscopic x-ray images, using fully automated marker detection software. The required shift for a correct, gated set-up is calculated and automatically applied. We present our acceptance testing and initial experience in patients with liver and lung tumors. For treatment planning CT and Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) as well as magnetic resonance imaging (MRI) taken at free breathing and expiration breath hold with internal and external fiducials present were used. Patients were treated with 8-11 consecutive fractions to a dose of 74.8-79.2 Gy. Phantom tests demonstrated targeting accuracy with a moving target to within {+-}1 mm. Inter- and intrafractional patient set-up displacements, as corrected by the gated set-up and not detectable by a conventional set-up, were up to 30 mm. Verification imaging to determine target location during treatment showed an average marker position deviation from the expected position of up to 4 mm on real patients. This initial evaluation shows the accuracy of the system and feasibility of image guided real-time respiratory gated H-SBRT for liver and lung tumors.

  18. CORRELATION OF CRISES, CRISIS EXPERIENCES AND ORIENTATION OF TIME PERSPECTIVE AT THE INITIAL STAGE OF TRAINING IN HIGHER EDUCATION INSTITUTION

    Directory of Open Access Journals (Sweden)

    Irina A. Kurus

    2016-01-01

    Full Text Available The purpose of article is identification of an actual problem of psychological science: correlation of crises and a crisis experiences with and orientation of time perspective at the initial stage of training in institution of higher education.Methods. During the research the following psychodiagnostic methods are applied: the questionnaire of crisis experiences for student by V. R. Manukyan; a questionnaire of time perspective by F. Zimbardo in adaptation of A. Syrtsova, E. T. Sokolova, O. V. Mitina (ZTPI.Results and scientific novelty. Data on interrelation of crises and crisis experiences with an orientation of temporary prospect are obtained and analysed on the basis of representative selection of students in Novosibirsk State Medical University. Gender distinctions of crises behaviour of students are shown. It is established that temporary prospects «The negative past» and «The fatalistic present» correlate with all the crisis experiences of students at the initial stage of training in higher education institution. The temporary prospect «Future» has the return correlation with crisis experience «absence of the appreciably attractive purposes in the future», and the interrelation with crises is absent. In this regard the author proposes the correction procedure of psychological escort of first-year students.Practical significance. The research findings can be used by educational psychologists for psychological diagnostics of pupils, to search the reasons of their poor progress, during the developing and correction of programs of psychology and pedagogical escort of first-year students, in particular when writing the program of adaptive training in the centers of psychosocial maintenance of the trainees. Guidelines for a choice of the techniques and methods promoting overcoming of the problems connected with crisis of identity and biographic crises are given.

  19. Reactor physics studies for the Advanced Fuel Cycle Initiative (AFCI) Reactor-Accelerator Coupling Experiments (RACE) Project

    Science.gov (United States)

    Stankovskiy, Evgeny Yuryevich

    In the recently completed RACE Project of the AFCI, accelerator-driven subcritical systems (ADS) experiments were conducted to develop technology of coupling accelerators to nuclear reactors. In these experiments electron accelerators induced photon-neutron reactions in heavy-metal targets to initiate fission reactions in ADS. Although the Idaho State University (ISU) RACE ADS was constructed only to develop measurement techniques for advanced experiments, many reactor kinetics experiments were conducted there. In the research reported in this dissertation, a method was developed to calculate kinetics parameters for measurement and calculation of the reactivity of ADS, a safety parameter that is necessary for control and monitoring of power production. Reactivity is measured in units of fraction of delayed versus prompt neutron from fission, a quantity that cannot be directly measured in far-subcritical reactors such as the ISU RACE configuration. A new technique is reported herein to calculate it accurately and to predict kinetic behavior of a far-subcritical ADS. Experiments conducted at ISU are first described and experimental data are presented before development of the kinetic theory used in the new computational method. Because of the complexity of the ISU ADS, the Monte-Carlo method as applied in the MCNP code is most suitable for modeling reactor kinetics. However, the standard method of calculating the delayed neutron fraction produces inaccurate values. A new method was developed and used herein to evaluate actual experiments. An advantage of this method is that its efficiency is independent of the fission yield of delayed neutrons, which makes it suitable for fuel with a minor actinide component (e.g. transmutation fuels). The implementation of this method is based on a correlated sampling technique which allows the accurate evaluation of delayed and prompt neutrons. The validity of the obtained results is indicated by good agreement between experimental

  20. INITIAL COOLING EXPERIMENT (ICE)

    CERN Multimedia

    1978-01-01

    ICE was built in 1977, in a record time of 9 months, using the modified bending magnets of the g-2 muon storage ring. Its purpose was to verify the validity of stochastic and electron cooling for the antiproton project, to be launched in 1978. Already early in 1978, stochastic cooling proved a resounding success, such that the antiproton (p-pbar)project was entirely based on it. Tests of electron cooling followed later: protons of 46 MeV kinetic energy were cooled with an electron beam of 26 kV and 1.3 A. The cage seen prominently in the foreground houses the HV equipment, adjacent to the "cooler" installed in a straight section of the ring. With some modifications, the cooler was later transplanted into LEAR (Low Energy Antiproton Ring) and then, with further modifications, into the AD (Antiproton Decelerator), where it cools antiprotons to this day (2006). See also: 7711282, 7802099, 7908242.

  1. Initial experience of dual-energy lung perfusion CT using a dual-source CT system in children

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Hyun Woo [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center, Songpa-gu, Seoul (Korea)

    2010-09-15

    Initial experience of dual-source dual-energy (DE) lung perfusion CT in children is described. In addition to traditional identification of pulmonary emboli, the assessment of lung perfusion is technically feasible with dual-source DE CT in children with acceptable radiation dose. This article describes how to perform dual-source DE lung perfusion CT in children, including the optimization of intravenous injection method and CT dose parameters. How to produce weighted-average CT images for the assessment of pulmonary emboli and colour-coded perfusion maps for the assessment of regional lung perfusion is also detailed. Lung perfusion status can then be evaluated on perfusion maps by means of either qualitative or quantitative analysis. Potential advantages and disadvantages of this emerging CT technique compared to lung perfusion scintigraphy and cardiac MRI are discussed. (orig.)

  2. Initial results of a model rotor higher harmonic control (HHC) wind tunnel experiment on BVI impulsive noise reduction

    Science.gov (United States)

    Splettstoesser, W. R.; Lehmann, G.; van der Wall, B.

    1989-09-01

    Initial acoustic results are presented from a higher harmonic control (HHC) wind tunnel pilot experiment on helicopter rotor blade-vortex interaction (BVI) impulsive noise reduction, making use of the DFVLR 40-percent-scaled BO-105 research rotor in the DNW 6m by 8m closed test section. Considerable noise reduction (of several decibels) has been measured for particular HHC control settings, however, at the cost of increased vibration levels and vice versa. The apparently adverse results for noise and vibration reduction by HHC are explained. At optimum pitch control settings for BVI noise reduction, rotor simulation results demonstrate that blade loading at the outer tip region is decreased, vortex strength and blade vortex miss-distance are increased, resulting altogether in reduced BVI noise generation. At optimum pitch control settings for vibration reduction adverse effects on blade loading, vortex strength and blade vortex miss-distance are found.

  3. Multimedia materials for education, training, and advocacy in international health: experiences with the Schistosomiasis Control Initiative CD-ROM

    Directory of Open Access Journals (Sweden)

    TJ Beanland

    2006-10-01

    Full Text Available We describe an innovative use of multimedia materials to support training and advocacy within a schistosomiasis control programme. The Schistosomiasis Control Initiative (SCI at Imperial College London works with selected sub-Saharan African countries to develop schistosomiasis control programmes. Two elements of the SCI programme were supported by multimedia materials developed at the Wellcome Trust in collaboration with the SCI: (1 training of programme managers, district health officers, and those delivering practical elements of the programme; and (2 advocacy targeted at decision-makers and donors. Evaluation of the materials revealed high reported ratings for both user satisfaction and impact from use of the product. From this experience we draw out several general messages about development of multimedia materials and how these will play a growing future role in promoting training within international health.

  4. Multimedia materials for education, training, and advocacy in international health: experiences with the Schistosomiasis Control Initiative CD-ROM.

    Science.gov (United States)

    Beanland, T J; Lacey, S D; Melkman, D D; Palmer, S; Stothard, J R; Fleming, F; Fenwick, A

    2006-09-01

    We describe an innovative use of multimedia materials to support training and advocacy within a schistosomiasis control programme. The Schistosomiasis Control Initiative (SCI) at Imperial College London works with selected sub-Saharan African countries to develop schistosomiasis control programmes. Two elements of the SCI programme were supported by multimedia materials developed at the Wellcome Trust in collaboration with the SCI: (1) training of programme managers, district health officers, and those delivering practical elements of the programme; and (2) advocacy targeted at decision-makers and donors. Evaluation of the materials revealed high reported ratings for both user satisfaction and impact from use of the product. From this experience we draw out several general messages about development of multimedia materials and how these will play a growing future role in promoting training within international health.

  5. The mediating effect of depressive symptoms on the relationship between traumatic childhood experiences and drug use initiation.

    Science.gov (United States)

    Fishbein, Diana; Novak, Scott P; Krebs, Christopher; Warner, Tara; Hammond, Jane

    2011-05-01

    Stressful experiences such as childhood trauma and depressive symptoms have both been implicated in the initiation of drug use; however, longitudinal designs have not yet been used to elucidate their respective roles to better understand the causal sequence. In the present study, a sensitivity analysis was conducted using two mediation strategies to examine how this sequence may differ by various levels of statistical control, including (1) the standard mediational model in which the effect of lifetime traumatic stressors (Year 1) on the onset of drug use (Years 3 and 4) is mediated by levels of depressive symptoms (Year 2); and (2) a stronger test of causality such that the effect of lifetime traumatic stressors (Year 1) on the onset of drug use (Years 3 and 4) was mediated by changes in depressive symptoms (Year 1 to 2), measured by a residualized change score that controlled for levels in Year 1. Two types of trauma were studied in a community-based study of 489 Hispanic preadolescents (aged 10-12): (a) the number of lifetime traumatic stressors and (b) seven specific lifetime stressors. We also controlled for new onset traumatic stressors occurring between Years 1 and 2. Primary findings indicate that drug use initiation during early adolescence (e.g., ages 14-16) may not be tied to immediate proximal perturbations in risk factors, such as traumatic experiences and depressive symptoms. Rather, the effects of trauma on depression in this sample appear to be established earlier in childhood (ages 10-14 or younger) and persist in a relatively stable manner into middle adolescence when the risk for drug use may be heightened. Copyright © 2011 Elsevier Ltd. All rights reserved.

  6. The initial magnetic susceptibility of polydisperse ferrofluids: A comparison between experiment and theory over a wide range of concentration

    Science.gov (United States)

    Solovyova, Anna Y.; Goldina, Olga A.; Ivanov, Alexey O.; Lebedev, Aleksandr V.; Elfimova, Ekaterina A.

    2016-08-01

    Temperature dependencies of the static initial magnetic susceptibility for ferrofluids at various concentrations are studied using experiment and statistical-mechanical theories. Magnetic susceptibility measurements are carried out for twelve samples of magnetite-based fluids stabilized with oleic acid over a wide range of temperatures (210 K ≲T ≲ 390 K); all samples have the same granulometric composition but different volume ferroparticle concentrations (0.2 ≲ φ ≲ 0.5). Experimental results are analyzed using three theories: the second-order modified mean-field theory (MMF2) [A. O. Ivanov and O. B. Kuznetsova, Phys. Rev. E 64, 41405 (2001)]; its correction for polydisperse ferrofluids arising from Mayer-type cluster expansion and taking into account the first terms of the polydisperse second virial coefficient [A. O. Ivanov and E. A. Elfimova, J. Magn. Magn. Mater 374, 327 (2015)]; and a new theory based on MMF2 combined with the first terms of the polydisperse second and third virial contributions to susceptibility. It turns out that the applicability of each theory depends on the experimental sample density. If twelve ferrofluid samples are split into three groups of strong, moderate, and low concentrated fluids, the temperature dependences of the initial magnetic susceptibility in each group are very precisely described by one of the three theories mentioned above. The determination of a universal formula predicting a ferrofluid susceptibility over a broad range of concentrations and temperatures remains as a challenge.

  7. The Joint Experiment for Crop Assessment and Monitoring (JECAM) Initiative: Developing methods and best practices for global agricultural monitoring

    Science.gov (United States)

    Champagne, C.; Jarvis, I.; Defourny, P.; Davidson, A.

    2014-12-01

    Agricultural systems differ significantly throughout the world, making a 'one size fits all' approach to remote sensing and monitoring of agricultural landscapes problematic. The Joint Experiment for Crop Assessment and Monitoring (JECAM) was established in 2009 to bring together the global scientific community to work towards a set of best practices and recommendations for using earth observation data to map, monitor and report on agricultural productivity globally across an array of diverse agricultural systems. These methods form the research and development component of the Group on Earth Observation Global Agricultural Monitoring (GEOGLAM) initiative to harmonize global monitoring efforts and increase market transparency. The JECAM initiative brings together researchers from a large number of globally distributed, well monitored agricultural test sites that cover a range of crop types, cropping systems and climate regimes. Each test site works independently as well as together across multiple sites to test methods, sensors and field data collection techniques to derive key agricultural parameters, including crop type, crop condition, crop yield and soil moisture. The outcome of this project will be a set of best practices that cover the range of remote sensing monitoring and reporting needs, including satellite data acquisition, pre-processing techniques, information retrieval and ground data validation. These outcomes provide the research and development foundation for GEOGLAM and will help to inform the development of the GEOGLAM "system of systems" for global agricultural monitoring. The outcomes of the 2014 JECAM science meeting will be discussed as well as examples of methods being developed by JECAM scientists.

  8. Initial Experience with Percutaneous Needle Aspiration of Paraspinal Lesions Using XperGuide Cone-Beam CT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Si Lip; Park, Hee Jin; Lee, So Yeon; Chung, Eun Chul; Paark, Hae Won; Kook, Shin Ho; Rho, Myung Ho [Dept. of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2013-03-15

    The aim of this study is to report our initial experience using XperGuide cone-beam computed tomography (CBCT) for percutaneous needle aspiration of the paraspinal lesions. Between September 2011 and September 2012, 12 patients who underwent percutaneous needle aspiration of the paraspinal lesions for suspected pyogenic spondylitis, tuberculous spondylitis, or metastasis were included. The procedure was performed on the XperGuide CBCT. Based on the initial CBCT, target points and entrance were determined, using dedicated guidance software (XperGuide), and the needle pathway was visualized in various reconstructed images. Needle aspiration was performed using Westcott needle and correct needle positioning was confirmed with the second CBCT. The technical success was defined as the needle tip reached within 5 mm of the target point. Culture, smear, and polymerase chain reaction of obtained samples were performed. In all twelve patients, target areas could be determined based on XperCT data and achieved 100% technical success. Diagnosis could be made in 91.7% of cases and the median interventional procedure time was 27.8 minutes. There was no major complication in all patients. Percutaneous needle aspiration of paraspinal lesions using XperGuide CBCT is easy, accurate, safe, and useful in determining the treatment of direction.

  9. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal carcinomatosis: initial experience in Oaxaca, Mexico.

    Science.gov (United States)

    García-Matus, Rolando; Hernández-Hernández, Carlos Alberto; Leyva-García, Omar; Vásquez-Ciriaco, Sergio; Flores-Ayala, Guillermo; Navarro-Hernández, Quetzalli; Pérez-Bustamante, Gerardo; Valencia-Mijares, Norma Miriam; Esquivel, Jesus

    2012-09-01

    Peritoneal carcinomatosis (PC) has been traditionally considered a terminal disease with median survivals reported in the literature of 6 to 12 months. Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) are playing an ever increasing role in the treatment of these patients. Excellent results have been achieved in well-selected patients but there is a very steep learning curve when starting a new program. A program for peritoneal surface malignancies in which patients with PC of gastrointestinal or gynecological origin were treated using multimodality therapy with combinations of systemic therapy, cytoreductive surgery (CRS), and HIPEC was initiated in December 2007 at "Hospital Regional de Alta Especialidad de Oaxaca," Mexico. We present the results of our initial experience. From December 2007 to February 2011, 26 patients were treated with CRS and HIPEC. There were 21 female patients. Most common indication (46%) was recurrent ovarian cancer. Mean duration of surgery was 260 minutes. Mean Peritoneal Cancer Index was 9. Twenty-three (88.5%) patients had a complete cytoreduction. Major morbidity and mortality rates were 19.5 and 3.8 per cent, respectively. Mean hospital stay was 8 days. At a mean follow-up of 20 months, median survival has not been reached. Rigorous preoperative workup, strict selection criteria, and mentoring from an experienced cytoreductive surgeon are mandatory and extremely important when starting a center for PC.

  10. An experimental investigation of the dynamics of submarine leveed channel initiation as sediment-laden density currents experience sudden unconfinement

    Energy Technology Data Exchange (ETDEWEB)

    Rowland, Joel C [Los Alamos National Laboratory; Hilley, George E [STANFORD UNIV; Fildani, Andrea [CHEVRON ETC

    2009-01-01

    Leveed submarine channels play a critical role in the transfer of sediment from the upper continental slopes to interslope basins and ultimately deepwater settings. Despite a reasonable understanding of how these channels grow once established, how such channels initiate on previously unchannelized portions of the seafloor remains poorly understood. We conducted a series of experiments that elucidate the influence of excess density relative to flow velocity on the dynamics of, and depositional morphologies arising from, density currents undergoing sudden unconfinement across a sloped bed. Experimental currents transported only suspended sediment across a non-erodible substrate. Under flow conditions ranging from supercritical to subcritical (bulk Richardson numbers of 0.02 to 1.2) our experiments failed to produce deposits resembling or exhibiting the potential to evolve into self-formed leveed channels. In the absence of excess density, a submerged sediment-laden flow produced sharp crested lateral deposits bounding the margins of the flow for approximately a distance of two outlet widths down basin. These lateral deposits terminated in a centerline deposit that greatly exceeded marginal deposits in thickness. As excess density increased relative to the outlet velocity, the rate of lateral spreading of the flow increased relative to the downstream propagation of the density current, transitioning from a narrow flow aligned with the channel outlet to a broad radially expanding flow. Coincident with these changes in flow dynamics, the bounding lateral deposits extended for shorter distances, had lower, more poorly defined crests that were increasingly wider in separation than the initial outlet, and progressively became more oblong rather than linear. Based on our results, we conclude that leveed channels cannot initiate from sediment-laden density currents under strictly depositional conditions. Partial confinement of these currents appears to be necessary to

  11. Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia

    Directory of Open Access Journals (Sweden)

    Chinsembu Kazhila C

    2009-10-01

    Full Text Available Abstract Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD, and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia.

  12. Model and experiences of initiating collaboration with traditional healers in validation of ethnomedicines for HIV/AIDS in Namibia.

    Science.gov (United States)

    Chinsembu, Kazhila C

    2009-10-23

    Many people with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in Namibia have access to antiretroviral drugs but some still use traditional medicines to treat opportunistic infections and offset side-effects from antiretroviral medication. Namibia has a rich biodiversity of indigenous plants that could contain novel anti-HIV agents. However, such medicinal plants have not been identified and properly documented. Various ethnomedicines used to treat HIV/AIDS opportunistic infections have not been scientifically validated for safety and efficacy. These limitations are mostly attributable to the lack of collaboration between biomedical scientists and traditional healers. This paper presents a five-step contextual model for initiating collaboration with Namibian traditional healers in order that candidate plants that may contain novel anti-HIV agents are identified, and traditional medicines used to treat HIV/AIDS opportunistic infections are subjected to scientific validation. The model includes key structures and processes used to initiate collaboration with traditional healers in Namibia; namely, the National Biosciences Forum, a steering committee with the University of Namibia (UNAM) as the focal point, a study tour to Zambia and South Africa where other collaborative frameworks were examined, commemorations of the African Traditional Medicine Day (ATMD), and consultations with stakeholders in north-eastern Namibia. Experiences from these structures and processes are discussed. All traditional healers in north-eastern Namibia were willing to collaborate with UNAM in order that their traditional medicines could be subjected to scientific validation. The current study provides a framework for future collaboration with traditional healers and the selection of candidate anti-HIV medicinal plants and ethnomedicines for scientific testing in Namibia.

  13. Initial experience with live three-dimensional image overlay for ductal stenting in hypoplastic left heart syndrome.

    Science.gov (United States)

    Goreczny, Sebastian; Morgan, Gareth J; Dryzek, Pawel; Moll, Jadwiga A; Moszura, Tomasz

    2016-12-20

    Precise visualisation of ductal morphology and adjacent vessels is crucial for accurate stent choice and placement during hybrid palliation of hypoplastic left heart syndrome (HLHS). We aimed to describe our initial experience with live three-dimensional reconstruction overlay derived from rotational angiography (RA) for ductal stenting in HLHS. We carried out a retrospective review of ductal stenting in 18 newborns with HLHS, including six patients with 3D reconstruction overlay used to guide the intervention. The median age at the intervention was 20 days (range 13-31 days) and the median weight was 3.25 kg (range 3-4 kg). Eleven RA runs were performed, pre and post stent implantation in five patients and before the intervention in one patient. 3D reconstructions from all RA runs had sufficient image quality to allow stent placement without additional contrast injections. Comparison with 2D angiography-guided ductal stenting showed similar contrast usage, with the 2D angiography patients receiving a higher radiation dose. Three-dimensional rotational angiography provides accurate visualisation of the ductal morphology and nearby structures. Three-dimensional reconstruction overlay with clear landing points enabled precise stent implantation with no additional contrast injections and lower radiation doses than conventional angiography in our patients.

  14. Initial Experience with Balloon-Occluded Trans-catheter Arterial Chemoembolization (B-TACE) for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Maruyama, Mitsunari, E-mail: mitunari@med-shimane.u.ac.jp; Yoshizako, Takeshi, E-mail: yosizako@med.shimane-u.ac.jp; Nakamura, Tomonori, E-mail: t-naka@med.shimane-u.ac.jp; Nakamura, Megumi, E-mail: megumi@med.shimane-u.ac.jp; Yoshida, Rika, E-mail: yoshidar@med.shimane-u.ac.jp; Kitagaki, Hajime, E-mail: kitagaki@med.shimane-u.ac.jp [Shimane University Faculty of Medicine, Department of Radiology (Japan)

    2016-03-15

    PurposeThis study was performed to evaluate the accumulation of lipiodol emulsion (LE) and adverse events during our initial experience of balloon-occluded trans-catheter arterial chemoembolization (B-TACE) for hepatocellular carcinoma (HCC) compared with conventional TACE (C-TACE).MethodsB-TACE group (50 cases) was compared with C-TACE group (50 cases). The ratio of the LE concentration in the tumor to that in the surrounding embolized liver parenchyma (LE ratio) was calculated after each treatment. Adverse events were evaluated according to the Common Terminology Criteria for Adverse Effects (CTCAE) version 4.0.ResultsThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). Only elevation of alanine aminotransferase was more frequent in the B-TACE group, showing a statistically significant difference (Mann–Whitney test: P < 0.05). While B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation, there was no statistically significant difference in incidence between the groups. Multivariate logistic regression analysis suggested that the significant risk factor for liver abscess/infarction was bile duct dilatation (P < 0.05).ConclusionThe LE ratio at the level of subsegmental showed a statistically significant difference between the groups (t test: P < 0.05). B-TACE caused severe adverse events (liver abscess and infarction) in patients with bile duct dilatation.

  15. In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience

    Science.gov (United States)

    Vieira, Alexandre R.; Bayram, Merve; Seymen, Figen; Sencak, Regina C.; Lippert, Frank; Modesto, Adriana

    2017-01-01

    We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel. PMID:28275354

  16. Initial Operative Experience and Short-term Hearing Preservation Results With a Mid-scala Cochlear Implant Electrode Array.

    Science.gov (United States)

    Svrakic, Maja; Roland, J Thomas; McMenomey, Sean O; Svirsky, Mario A

    2016-12-01

    To describe our initial operative experience and hearing preservation results with the Advanced Bionics (AB) Mid Scala Electrode (MSE). Retrospective review. Tertiary referral center. Sixty-three MSE implants in pediatric and adult patients were compared with age- and sex-matched 1j electrode implants from the same manufacturer. All patients were severe to profoundly deaf. Cochlear implantation with either the AB 1j electrode or the AB MSE. The MSE and 1j electrodes were compared in their angular depth of insertion and pre to postoperative change in hearing thresholds. Hearing preservation was analyzed as a function of angular depth of insertion. Secondary outcome measures included operative time, incidence of abnormal intraoperative impedance and telemetry values, and incidence of postsurgical complications. Depth of insertion was similar for both electrodes, but was more consistent for the MSE array and more variable for the 1j array. Patients with MSE electrodes had better hearing preservation. Thresholds shifts at four audiometric frequencies ranging from 250 to 2000 Hz were 10, 7, 2, and 6 dB smaller for the MSE electrode than for the 1j (p Hearing preservation at low frequencies was worse with deeper insertion, regardless of array. Secondary outcome measures were similar for both electrodes. The MSE electrode resulted in more consistent insertion depth and somewhat better hearing preservation than the 1j electrode. Differences in other surgical outcome measures were small or unlikely to have a meaningful effect.

  17. Dual-energy CT of the heart for diagnosing coronary artery stenosis and myocardial ischemia-initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Ruzsics, Balazs; Costello, Philip [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Lee, Heon [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Seoul Medical Center, Department of Radiology, Seoul (Korea); Zwerner, Peter L.; Schoepf, U.J. [Medical University of South Carolina, Department of Radiology, Charleston, SC (United States); Medical University of South Carolina, Division of Cardiology, Charleston, SC (United States); Gebregziabher, Mulugeta [Medical University of South Carolina, Department of Biostatistics, Bioinformatics, and Epidemiology, Charleston, SC (United States)

    2008-11-15

    We aimed to evaluate the feasibility of diagnosing coronary stenosis and myocardial ischemia with a single dual-energy CT (DECT) acquisition. Thirty-five patients underwent contrast-enhanced, ECG-gated DECT of the heart while independently operating the two tubes of a dual-source CT system at high- and low-energy X-ray spectra. From the same raw data, coronary CTA (cCTA) studies were reconstructed for stenosis detection, and the myocardial blood-pool was analyzed by determining the tissue iodine content. Two independent observers analyzed all studies for stenosis and myocardial blood-pool deficits. Results were correlated with SPECT, coronary catheterization and cCTA on a segmental basis. cCTA had 98% sensitivity, 88% specificity and 92% accuracy for detection of >50% stenosis. DECT detected myocardial ischemia with 84% sensitivity, 94% specificity and 92% accuracy. Our initial experience may warrant further exploration of DECT as a possibly feasible single imaging investigation for the comprehensive diagnosis of coronary stenosis and myocardial ischemia. (orig.)

  18. In vivo proton magnetic resonance spectroscopic imaging of the healthy human brain at 9.4 T: initial experience.

    Science.gov (United States)

    Chadzynski, Grzegorz L; Pohmann, Rolf; Shajan, Gunamony; Kolb, Rupert; Bisdas, Sotirios; Klose, Uwe; Scheffler, Klaus

    2015-06-01

    In this study, the feasibility of in vivo proton magnetic resonance spectroscopic imaging ((1)H MRSI) of the healthy human brain at a field strength of 9.4 T, using conventional acquisition techniques, is examined and the initial experience is summarized. MRSI measurements were performed on a 9.4 T MR scanner (Siemens, Erlangen, Germany) equipped with head-only gradient insert (AC84, Siemens) and custom-developed, 8-channel transmit/24-channel receive, and 16-channel transmit/31-channel receive coils. Spectra were acquired from the superior part of the human brain with a modified STEAM sequence. Spectral quantification was done with LCModel software. Reasonable quality and signal-to-noise ratio of the acquired spectra allowed reliable quantification of 12 metabolites (Cramer-Rao lower bounds < 20 %), some of which may be difficult to quantify at field strengths below 7 T due to overlapping resonances or low concentrations. While further developments are necessary to minimize chemical shift displacement and homogeneity of the transmit field, it is demonstrated that in vivo (1)H MRSI at a field strength of 9.4 T is possible. However, further studies applying up-to-date techniques to overcome high-field specific problems are needed in order to assess the potential gain in sensitivity that may be offered by MRSI at 9.4 T.

  19. In Vitro Acid-Mediated Initial Dental Enamel Loss Is Associated with Genetic Variants Previously Linked to Caries Experience.

    Science.gov (United States)

    Vieira, Alexandre R; Bayram, Merve; Seymen, Figen; Sencak, Regina C; Lippert, Frank; Modesto, Adriana

    2017-01-01

    We have previously shown that AQP5 and BTF3 genetic variation and expression in whole saliva are associated with caries experience suggesting that these genes may have a functional role in protecting against caries. To further explore these results, we tested ex vivo if variants in these genes are associated with subclinical dental enamel mineral loss. DNA and enamel samples were obtained from 53 individuals. Enamel samples were analyzed for Knoop hardness of sound enamel, integrated mineral loss after subclinical carious lesion creation, and change in integrated mineral loss after remineralization. DNA samples were genotyped for single nucleotide polymorphisms using TaqMan chemistry. Chi-square and Fisher's exact tests were used to compare individuals above and below the mean sound enamel microhardness of the cohort with alpha of 0.05. The A allele of BTF3 rs6862039 appears to be associated with harder enamel at baseline (p = 0.09), enamel more resistant to demineralization (p = 0.01), and enamel that more efficiently regain mineral and remineralize (p = 0.04). Similarly, the G allele of AQP5 marker rs3759129 and A allele of AQP5 marker rs296763 are associated with enamel more resistant to demineralization (p = 0.03 and 0.05, respectively). AQP5 and BTF3 genetic variations influence the initial subclinical stages of caries lesion formation in the subsurface of enamel.

  20. Collision Experiment of an Arched Plasma-Filled Flux Rope and a Target Cloud of Initially Neutral Gas

    Science.gov (United States)

    Wongwaitayakornkul, Pakorn; Bellan, Paul; Li, Hui; Li, Shengtai

    2016-10-01

    Shocks occur in the co-rotating interaction regions just beyond the solar corona, in the corona during CME events, and when the solar wind impacts Earth's magnetosphere. The Caltech solar loop experiment investigates shock physics by creating an arched plasma-filled flux rope that expands to collide with a pre-injected, initially-neutral gas. We focus the investigation on the situation of a heavy-gas plasma (Argon) impacting a much lighter neutral gas cloud (Hydrogen). The neutral gas target cloud ionizes immediately upon being impacted and plasma-induced shock waves propagate in the target cloud away from the impact region. Analysis of data from magnetic probes, Langmuir probes, a fast camera, and spectroscopic measurements will be presented. The measurements suggest that a thin, compressed, ionized layer of hydrogen is formed just downstream of the Argon plasma loop and that thin, supersonic shocks form further downstream and propagate obliquely away from the plasma loop. Numerical simulation of an ideal MHD plasma is underway to enable comparison of the measurements with the predictions of MHD theory.

  1. EXPERIMENTS ON ASSIMILATION OF INITIAL VALUES IN NUMERICAL PREDICTION OF A WARM-SECTOR PRECIPITATION IN SOUTH CHINA

    Institute of Scientific and Technical Information of China (English)

    ZHANG Cheng-zhong; WAN Qi-lin; HUANG Yan-yan; CHEN Zi-tong; DING Wei-yu

    2009-01-01

    In order to understand the impact of initial conditions upon prediction accuracy of short-term forecast and nowcast of precipitation in South China,four experiments i.e. a control,an assimilation of conventional sounding and surthce data,testing with nudging rainwater data and the assimilation of radar-derived radial wind,are respectively conducted to simulate a case of warm-sector heavy rainfall that occurred over South China,by using the GRAPES MESO model. The results show that (I) assimilating conventional surface and sounding observations helps improve the 24-h rainfall forecast in both the area and order of magnitude; (2) nudging rainwater contributes to a significant improvement of nowcast,and (3)the assimilation of radar-derived radial winds distinctly improves the 24-h rainfall forecast in both the area and order of magnitude. These results serve as signiticant technical reference for the study on short-term forecast and nowcast of precipitation over South China in the thture.

  2. Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

    Directory of Open Access Journals (Sweden)

    Karan Madan

    2014-01-01

    Full Text Available Background and Aim: Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure. Materials and Methods: A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India. Results: Thirty-eight rigid bronchoscopies (50 procedures were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65 min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal. Conclusions: Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

  3. Experiência inicial com operações cardíacas minimamente invasivas Initial experience with minimally invasive cardiac operations

    Directory of Open Access Journals (Sweden)

    Francisco Costa

    2012-09-01

    initial experience with minimally invasive operations, with emphasis on technical aspects and the learning curve. METHODS: Between July 2009 and March 2012, 95 patients were operated using minimally invasive operations. Mean age was 55 ± 15 years and 53% were females. The operations performed were atrial septal defect closure (25, aortic valve replacement (32, mitral valve repair (23, mitral valve replacement (12, excision of atrial myxoma (2 and resection of subaortic membrane (1. The incision was a mini right thoracotomy in 87 cases and ministernotomy in 8. RESULTS: Early mortality was 4.2%. Mean size of the incision was 6.3 ±1.2 cm. Extension of the original thoracotomy was necessary in only one case. Two patients suffered a stroke, and the mean total blood loss was 470 ± 277 ml. There were no cases of incision infection and 67% the patients had no major morbidity. CONCLUSIONS: Our initial results with minimally invasive operations demonstrated that it was safe and with good clinical results. Patient satisfaction is quite high. After the learning phase has been transversed, minimally invasive operations may be an excellent alternative for many patients with congenital and acquired diseases.

  4. Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study.

    Science.gov (United States)

    de'Angelis, Nicola; Alghamdi, Salah; Renda, Andrea; Azoulay, Daniel; Brunetti, Francesco

    2015-10-09

    Robotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon's psychological stress and physical pain. The study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon's stress and pain were assessed before and after surgery on a 0-100-mm visual analog scale. The demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon's stress was

  5. Initial experiences and innovations in supervising community health workers for maternal, newborn, and child health in Morogoro region, Tanzania.

    Science.gov (United States)

    Roberton, Timothy; Applegate, Jennifer; Lefevre, Amnesty E; Mosha, Idda; Cooper, Chelsea M; Silverman, Marissa; Feldhaus, Isabelle; Chebet, Joy J; Mpembeni, Rose; Semu, Helen; Killewo, Japhet; Winch, Peter; Baqui, Abdullah H; George, Asha S

    2015-04-09

    Supervision is meant to improve the performance and motivation of community health workers (CHWs). However, most evidence on supervision relates to facility health workers. The Integrated Maternal, Newborn, and Child Health (MNCH) Program in Morogoro region, Tanzania, implemented a CHW pilot with a cascade supervision model where facility health workers were trained in supportive supervision for volunteer CHWs, supported by regional and district staff, and with village leaders to further support CHWs. We examine the initial experiences of CHWs, their supervisors, and village leaders to understand the strengths and challenges of such a supervision model for CHWs. Quantitative and qualitative data were collected concurrently from CHWs, supervisors, and village leaders. A survey was administered to 228 (96%) of the CHWs in the Integrated MNCH Program and semi-structured interviews were conducted with 15 CHWs, 8 supervisors, and 15 village leaders purposefully sampled to represent different actor perspectives from health centre catchment villages in Morogoro region. Descriptive statistics analysed the frequency and content of CHW supervision, while thematic content analysis explored CHW, supervisor, and village leader experiences with CHW supervision. CHWs meet with their facility-based supervisors an average of 1.2 times per month. CHWs value supervision and appreciate the sense of legitimacy that arises when supervisors visit them in their village. Village leaders and district staff are engaged and committed to supporting CHWs. Despite these successes, facility-based supervisors visit CHWs in their village an average of only once every 2.8 months, CHWs and supervisors still see supervision primarily as an opportunity to check reports, and meetings with district staff are infrequent and not well scheduled. Supervision of CHWs could be strengthened by streamlining supervision protocols to focus less on report checking and more on problem solving and skills development

  6. Initial experience of percutaneous transthoracic needle biopsy of lung nodules using C-arm cone-beam CT systems

    Energy Technology Data Exchange (ETDEWEB)

    Jin, Kwang Nam; Goo, Jin Mo; Lee, Hyun Ju; Lee, Youkyung; Kim, Jung Im; Choi, So Young; Kim, Hyo-Cheol [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea); Park, Chang Min [Seoul National University Hospital, Department of Radiology, Seoul (Korea); Seoul National University College of Medicine, Department of Radiology, Seoul (Korea); Seoul National University Medical Research Center, Institute of Radiation Medicine, Seoul (Korea)

    2010-09-15

    To describe our initial experience with percutaneous transthoracic biopsy (PCNB) of lung nodules using C-arm cone-beam CT (CBCT). Seventy-one consecutive patients with lung nodules of 30 mm or smaller underwent CBCT-guided PCNB using a coaxial cutting needle. We evaluated the procedure time, coaxial introducer dwell time, the numbers of pleural passages, coaxial introducer repositionings and CT acquisitions, as well as the technical success rate and radiation doses. Diagnostic accuracy, sensitivity, specificity and incidence of complications were also evaluated. PCNB was performed for 71 nodules: 63 solid, 6 part-solid and 2 ground-glass nodules. The procedure time, coaxial introducer dwell time, numbers of pleural passages, coaxial introducer repositionings and CT acquisitions were 17.9 {+-} 5.9 min, 8.7 {+-} 3.8 min, 1.1 {+-} 0.4, 0.2 {+-} 0.5 and 2.9 {+-} 0.7, respectively. The technical success rate was 100% and the radiation dose was 272 {+-} 116 mGy. Thirty-six nodules (50.7%) were diagnosed as malignant, 25 (35.2%) as benign and 10 (14.1%) as indeterminate. Diagnostic accuracy, sensitivity, specificity and incidence of complications were 98.4%, 97%, 100% and 38%, respectively. Complications included pneumothorax in 18 patients (25.4%), haemoptysis in 10 (14.1%) and chest pain in one (1.4%). Under CBCT guidance, PCNB of lung nodules can be performed accurately, providing both real-time fluoroscopic guidance and CT imaging capabilities. (orig.)

  7. Adoption of an integrated radiology reading room within a urologic oncology clinic: initial experience in facilitating clinician consultations.

    Science.gov (United States)

    Rosenkrantz, Andrew B; Lepor, Herbert; Taneja, Samir S; Recht, Michael P

    2014-05-01

    The authors describe their initial experience in implementing an integrated radiology reading room within a urologic oncology clinic, including the frequency and nature of clinician consultations and the perceived impact on patient management by clinicians. A radiology reading room was established within an office-based urologic oncology clinic in proximity to the surgeon's work area. A radiologist was present in this reading room for a 3-hour shift each day. The frequency and nature of consultations during these shifts were recorded. Also, the clinic's staff completed a survey assessing perceptions of the impact of the integrated reading room on patient management. One hundred two consultations occurred during 57 included dates (average, 1.8 consultations per shift): 52% for review of external cases brought in by patients on discs, 43% for review of internal cases, and 5% for direct review by the radiologist of imaging with patients. The maximum number of consultations during a single shift was 8. All of the clinic's urologists indicated that >90% of consultations benefited patient care. The clinicians indicated tendencies to view consultations as affecting management in the majority of cases, to be more likely to seek consultation for outside imaging when the radiologist was on site, and to be less likely to repeat outside imaging when the radiologist was on site. The integrated reading room within the clinic has potential to improve the quality of care, for instance by facilitating increased review of outside imaging studies and thereby potentially reducing duplicate ordering and by enabling occasional direct image review with patients by radiologists. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  8. Left atrial appendage closure using the Amulet device: an initial experience with the second generation amplatzer cardiac plug.

    Science.gov (United States)

    Lam, Simon Cheung Chi; Bertog, Stefan; Gafoor, Sameer; Vaskelyte, Laura; Boehm, Patrick; Ho, Raymond Wei Jian; Franke, Jennifer; Hofmann, Ilona; Sievert, Horst

    2015-02-01

    Aim of this study was to demonstrate the feasibility, safety, and short-term outcome of left atrial appendage (LAA) closure with a new generation LAA closure device. The Amulet device (AGA, St Jude Medical, Minneapolis, MN) is a new generation of the amplatzer cardiac plug (ACP), specifically designed for LAA closure. This new version is designed to facilitate the implantation process and minimize procedural or device-related complications. The device was implanted in 17 patients with nonvalvular atrial fibrillation (AF). Clinical data were obtained at baseline, during the procedure, at discharge, at 30 and 90 days. All devices were implanted successfully. Device sizes ranged from 20 mm to 31 mm. A 12 French (Fr) or 14 Fr delivery sheath was used depending on the selected device size. Full and partial recapture was performed in 1 case and 3 cases, respectively. There was 1 procedure-related pericardial effusion successfully managed with pericardiocentesis. There was no device embolization. The mean length of stay was 2.1 ± 0.3 days. At 90 days, there were no deaths, strokes, systemic thromboembolism, or bleeding complications. There was no device-related thrombus or pericardial effusion at 90-day TEE. In 2 of the 17 patients minimal peridevice flow (smaller than 2 mm) was present. The Amulet device, which has new novel features as compared with the first generation ACP, is a feasible option for LAA closure. From our initial experience, implantation of the Amulet is associated with high success rate and good short-term outcome. © 2014 Wiley Periodicals, Inc.

  9. Initiatives on early detection and intervention to proactively identify health and social problems in older people : Experiences from the Netherlands

    NARCIS (Netherlands)

    Lette, Manon; Baan, C.A.; van den Berg, Matthijs; de Bruin, Simone R.

    2015-01-01

    Background Over the last years, several initiatives on early detection and intervention have been put in place to proactively identify health and social problems in (frail) older people. An overview of the initiatives currently available in the Netherlands is lacking, and it is unknown whether they

  10. Oclusão percutânea das comunicações interventriculares: experiência inicial Interventricular septal defects percutaneous occlusion: initial experiment

    Directory of Open Access Journals (Sweden)

    Francisco José Araújo Chamié de Queiróz

    2005-09-01

    Full Text Available OBJETIVO: Avaliar a experiência inicial com o fechamento percutâneo das comunicações interventriculares (CIV, em especial, das CIV perimembranosas (CIVPM com a nova prótese de Amplatzer. MÉTODOS: Foram submetidos ao procedimento onze pacientes, seis com CIV perimembranosas (CIVPM e cinco com CIV musculares (CIVM. Dois apresentavam infecções repetidas do trato respiratório e tinham baixo ganho ponderal. Um apresentou história prévia de endocardite infecciosa. Os demais eram assintomáticos e foram selecionados pela ecocardiografia transtorácica (ETT. RESULTADOS: No grupo das CIVM (n=5, um paciente tinha uma CIV apical, dois tinham defeitos médio-septais e dois pacientes apresentavam defeitos múltiplos. Neste grupo, foi utilizada uma prótese de comunicação interatrial (CIA (Amplatzer Septal Occluder® e cinco próteses para CIVM (Amplatzer VSD-MUSC Occluder®, sendo que uma mesma paciente recebeu dois dispositivos. Todos os implantes foram bem sucedidos e transcorreram sem complicações. No grupo das CIVPM (n=6, dois tinham aneurismas de septo membranoso. Em 5, identificamos dois pertuitos com angiografia seletiva. Utilizamos próteses de Amplatzer para canal arterial (PCA (Amplatzer Duct Occluder® em 1 paciente e próteses específicas para CIVPM nos demais (Amplatzer VSD-MEMB Occluder®. Um oclusor perimembranoso migrou imediatamente depois de liberado, sendo retirado da aorta descendente. Outro paciente apresentou bloqueio atrioventricular total (BAVT, que reverteu após corticoterapia. CONCLUSÃO: O procedimento é tecnicamente complexo e deve ser executado apenas em centros especializados. Apesar disso, mostrou-se seguro e eficaz nos casos selecionados, e pode ser oferecido como alternativa ao tratamento cirúrgico tradicional.OBJECTIVE: To assess the initial experiment with percutaneous closure of interventricular septal defects (IVSD, especially perimembranous IVSD (PMIVSD with the new Amplatzer prosthesis. METHODS

  11. If I Experience Formative Assessment Whilst Studying at University, Will I Put It into Practice Later as a Teacher? Formative and Shared Assessment in Initial Teacher Education (ITE)

    Science.gov (United States)

    Hamodi, Carolina; López-Pastor, Víctor Manuel; López-Pastor, Ana Teresa

    2017-01-01

    The aim of this article is to analyse whether having experience of formative assessment during their initial teacher education courses (ITE) influences graduates' subsequent practice as teachers. That is, if the assessment methods that university students are subject to during their learning process are then actually employed by them during their…

  12. A parametric study of variables that affect fiber microbuckling initiation in composite laminates. I - Analyses. II - Experiments

    Science.gov (United States)

    Guynn, E. G.; Ochoa, Ozden O.; Bradley, Walter L.

    1992-01-01

    The effects of the stacking sequence (orientation of plies adjacent to the 0-deg plies), free surfaces, fiber/matrix interfacial bond strength, initial fiber waviness, resin-rich regions, and nonlinear shear constitutive behavior of the resin on the initiation of fiber microbuckling in thermoplastic composites were investigated using nonlinear geometric and nonlinear 2D finite-element analyses. Results show that reductions in the resin shear tangent modulus, large amplitudes of the initial fiber waviness, and debonds each cause increases in the localized matrix shear strains; these increases lead in turn to premature initiation of fiber microbuckling. The numerical results are compared to experimental data obtained using three thermoplastic composite material systems: (1) commercial APC-2, (2) QUADRAX Unidirectional Interlaced Tape, and AU4U/PEEK.

  13. Initial Experience with Electronic Tracking of Specific Tumor Sites in Men Undergoing Active Surveillance of Prostate Cancer

    Science.gov (United States)

    Sonn, Geoffrey A.; Filson, Christopher P.; Chang, Edward; Natarajan, Shyam; Margolis, Daniel J.; Macairan, Malu; Lieu, Patricia; Huang, Jiaoti; Dorey, Frederick J.; Reiter, Robert E.; Marks, Leonard S.

    2014-01-01

    Objectives Targeted biopsy, using magnetic resonance (MR) – ultrasound (US) fusion, may allow tracking of specific cancer sites in the prostate. We aimed to evaluate initial use of the technique to follow tumor sites in men on active surveillance of prostate cancer. Methods and Materials Fifty-three men with prostate cancer (all T1c) underwent re-biopsy of 74 positive biopsy sites, which were tracked and targeted using the Artemis MR-US fusion device (Eigen, Grass Valley, CA, USA) from March 2010 through January 2013. The initial biopsy included 12 cores from a standard template (mapped by software) and directed biopsies from regions of interest seen on MRI. In the repeat biopsy, samples were taken from sites containing cancer at the initial biopsy. Outcomes of interest at second MR-US biopsy included (a) presence of any cancer and (b) presence of clinically significant cancer. Results All cancers on initial biopsy were either Gleason score 3+3=6 (N=63) or 3+4=7 (N=11). At initial biopsy, 23 cancers were within an MRI target, and 51 were found on systematic biopsy. Cancer detection rate on repeat biopsy (29/74, 39%) was independent of Gleason score on initial biopsy (p=NS) but directly related to initial cancer core length (CCL) (pbiopsies were positive. An increase of Gleason score was uncommon (9/74, 12%). Conclusions Monitoring of specific prostate cancer-containing sites may be achieved in some men using an electronic tracking system. The chances of finding tumor on repeat specific-site sampling was directly related to the length of tumor in the initial biopsy core and presence of tumor within an MRI target; upgrading of Gleason score was uncommon. Further research is required to evaluate the potential utility of site-specific biopsy tracking for prostate cancer patients on active surveillance. PMID:25027689

  14. The effectiveness of active travel initiatives in Irish provincial towns: an evaluation of a quasi-experimental natural experiment

    OpenAIRE

    Lambe, Barry

    2015-01-01

    Ireland is a car dependent country with low levels of active travel and also low levels of total physical activity. There is a paucity of studies, internationally, that have evaluated active travel initiatives in a real world setting. This thesis contributes new knowledge to the evidence base on the implementation, effectiveness and design of active travel initiatives at the community level and their impact on physical activity. This thesis is comprised of a series of quasi-experimental de...

  15. Prevalence of Sexual Experience and Initiation of Sexual Intercourse Among Adolescents, Rakai District, Uganda, 1994-2011

    DEFF Research Database (Denmark)

    Santelli, John S; Song, Xiaoyu; Larsen Holden, Inge Kristine

    2015-01-01

    PURPOSE: The purpose of the study was to identify risk factors and time trends for sexual experience and sexual debut in rural Uganda. METHODS: Using population-based, longitudinal data from 15- to 19-year olds in Rakai, Uganda, we examined temporal trends in the prevalence of sexual experience...... youth in Rakai was associated with social factors particularly school enrollment. Changes in these social factors also appear to influence change over time in sexual experience....

  16. 实验过程中调动学生自主性的探索%Exploration on Mobilizing Students' Self-initiative in the Experiment

    Institute of Scientific and Technical Information of China (English)

    喻冬秀

    2012-01-01

    Designing experiment substituted for verification experiment was used in order to mobilize students' sell-initiative. The designing experiment about the ginger oil extraction rate by steam distillation was put forward. The result showed that the designing experiment not only could improve the students' abilities of designing experiment and solving problems, but also effectively inspire the students' interest to do experiments and mobilize students' self-initiative in the experiment.%针对学生在实验过程中自主性不足,采用设计性实验代替验证性实验的方法,以水蒸气提取姜油试验为例,实施结果表明,设计性实验不仅可提高学生自己设计实验、解决问题的能力,且可有效激发学生做实验的兴趣,调动学生参与实验的自主性。

  17. Young Women's Adolescent Experiences of Oral Sex: Relation of Age of Initiation to Sexual Motivation, Sexual Coercion, and Psychological Functioning

    Science.gov (United States)

    Fava, Nicole M.; Bay-Cheng, Laina Y.

    2012-01-01

    Research examining oral sex during adolescence tends to investigate only potential negative consequences without considering its place in sexual development or distinctions between cunnilingus and fellatio. Using retrospective reports from 418 undergraduate women, we examined the relations among young women's ages of initiation of both cunnilingus…

  18. Race Differences in Family Experience and Early Sexual Initiation: Dynamic Models of Family Structure and Family Change.

    Science.gov (United States)

    Wu, Lawrence L.; Thomson, Elizabeth

    2001-01-01

    Examines the effects of family structure on age at first sexual intercourse before marriage for a recent cohort of women. For neither White nor Black women are results consistent with hypotheses positing earlier initiation of sexual activity for women with prolonged exposure to a single-mother or father-absent family. (BF)

  19. Birthing support and breastfeeding initiation in Somaliland: experiences at the Edna Adan Maternity Hospital in Hargeisa, Somaliland.

    Science.gov (United States)

    Holder, Kelly

    2011-03-01

    Research has identified a relationship between birthing practices and breastfeeding initiation Continuous support during labor and delivery is a key component to increasing breastfeeding initiation. The purpose of this project was to assess the impact of labor support on breastfeeding initiation in a setting in which women receive traditional birthing support from female family members. Research was conducted at the Edna Adan Maternity Hospital in Hargeisa, Somaliland using the grounded theory method of qualitative research. Semi-structured interviews, direct observations and participant observations were conducted. A purposeful, non-statistical sample was chosen: ten women, five family members, six health care providers and five birth observations were included. The CDC EZ-Text, a software program developed by the Center for Disease Control and Prevention for use in qualitative research, was used in managing and analyzing the data. Data analysis and interpretation was conducted using micro-analysis, open, axial and selective coding procedures. The results indicated that due to cultural influences, contradictory beliefs and practices, lack of critical thinking and lack of long term planning, traditional birthing support was not always indicative of immediate breastfeeding initiation. The presence of a labor companion is a low-cost, preventative intervention that is consistent with the cultural practices of Somaliland. Breastfeeding education and support should, therefore, include a tertiary approach which includes pregnant and birthing women, labor support persons or family members and health care providers.

  20. The Sensed Presence Questionnaire (SenPQ: initial psychometric validation of a measure of the “Sensed Presence” experience

    Directory of Open Access Journals (Sweden)

    Joseph M. Barnby

    2017-03-01

    Full Text Available Background The experience of ‘sensed presence’—a feeling or sense that another entity, individual or being is present despite no clear sensory or perceptual evidence—is known to occur in the general population, appears more frequently in religious or spiritual contexts, and seems to be prominent in certain psychiatric or neurological conditions and may reflect specific functions of social cognition or body-image representation systems in the brain. Previous research has relied on ad-hoc measures of the experience and no specific psychometric scale to measure the experience exists to date. Methods Based on phenomenological description in the literature, we created the 16-item Sensed Presence Questionnaire (SenPQ. We recruited participants from (i a general population sample, and; (ii a sample including specific selection for religious affiliation, to complete the SenPQ and additional measures of well-being, schizotypy, social anxiety, social imagery, and spiritual experience. We completed an analysis to test internal reliability, the ability of the SenPQ to distinguish between religious and non-religious participants, and whether the SenPQ was specifically related to positive schizotypical experiences and social imagery. A factor analysis was also conducted to examine underlying latent variables. Results The SenPQ was found to be reliable and valid, with religious participants significantly endorsing more items than non-religious participants, and the scale showing a selective relationship with construct relevant measures. Principal components analysis indicates two potential underlying factors interpreted as reflecting ‘benign’ and ‘malign’ sensed presence experiences. Discussion The SenPQ appears to be a reliable and valid measure of sensed presence experience although further validation in neurological and psychiatric conditions is warranted.

  1. The Sensed Presence Questionnaire (SenPQ): initial psychometric validation of a measure of the "Sensed Presence" experience.

    Science.gov (United States)

    Barnby, Joseph M; Bell, Vaughan

    2017-01-01

    The experience of 'sensed presence'-a feeling or sense that another entity, individual or being is present despite no clear sensory or perceptual evidence-is known to occur in the general population, appears more frequently in religious or spiritual contexts, and seems to be prominent in certain psychiatric or neurological conditions and may reflect specific functions of social cognition or body-image representation systems in the brain. Previous research has relied on ad-hoc measures of the experience and no specific psychometric scale to measure the experience exists to date. Based on phenomenological description in the literature, we created the 16-item Sensed Presence Questionnaire (SenPQ). We recruited participants from (i) a general population sample, and; (ii) a sample including specific selection for religious affiliation, to complete the SenPQ and additional measures of well-being, schizotypy, social anxiety, social imagery, and spiritual experience. We completed an analysis to test internal reliability, the ability of the SenPQ to distinguish between religious and non-religious participants, and whether the SenPQ was specifically related to positive schizotypical experiences and social imagery. A factor analysis was also conducted to examine underlying latent variables. The SenPQ was found to be reliable and valid, with religious participants significantly endorsing more items than non-religious participants, and the scale showing a selective relationship with construct relevant measures. Principal components analysis indicates two potential underlying factors interpreted as reflecting 'benign' and 'malign' sensed presence experiences. The SenPQ appears to be a reliable and valid measure of sensed presence experience although further validation in neurological and psychiatric conditions is warranted.

  2. Influence of Initial Texture, Temperature and Total Strain on the Texture Development of Polycrystalline Pyrrhotite Ores in Deformation Experiments

    OpenAIRE

    Niederschlag, Elke; Siemes, Heinrich

    1996-01-01

    The development of the crystallographic preferred orientation (texture) of polycrystalline pyrrhotite from Sullivan mine, Canada, and Cerro de Pasco, Peru was determined by neutron texture analyses before and after experimental deformation. The pyrrhotite ore from Sullivan has an initial texture with a distinct c-axis maximum perpendicular to the foliation whereas the ore from Cerro de Pasco shows a weak and moreover inhomogeneous texture within the specimen.The deformation texture and deform...

  3. Initial CT-guided needle biopsy of extremity skeletal lesions: Diagnostic performance and experience of a tertiary musculoskeletal center

    Energy Technology Data Exchange (ETDEWEB)

    Nouh, Mohamed Ragab, E-mail: mragab73@yahoo.com [Department of Radiology, Faculty of Medicine, Alexandria University (Egypt); Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait); Abu Shady, Hamdy Mohamed, E-mail: hamdi_abushadi@yahoo.com [Department of Radiology, Al-Razi Hospital, Sulibikhate 13001 (Kuwait)

    2014-02-15

    Introduction: Appendicular long bones are the target for a wide spectrum of bony lesions with variable clinical presentations. Biopsy procedures are needed for subsequent proper patient's management. Most of the available literature globally assessed musculoskeletal biopsies with inclusion of repeat biopsy results. We thought to retrospectively assess the diagnostic performance of initial CT-guided percutaneous core needle biopsy (PCNB) of extremity long bone lesions in a tertiary musculoskeletal referral center. Patients and methods: We retrospectively analyzed the outcome of initial CT-guided PCNB of 49 patients who presented with extremity long bone lesions which were biopsied in our hospital during a 36 months’ time period. The diagnostic performance was assessed in terms of diagnostic yield and accuracy. Results: There were 34 males and 15 females with a mean age of 33.69 years (range from 4 to 77 years). The overall diagnostic yield of initial biopsies was 87.75% with a diagnostic accuracy of 82.85% derived from the surgically proven cases. The higher diagnostic yield was recorded with malignancy, presence of extra-osseous soft-tissue component as well as mixed and sclerotic lesions. The pathologies of the non-diagnostic biopsies included large-cell lymphoma, giant-cell tumor, langerhans cell histiocytosis, osteoid osteoma and a non-ossifying fibroma. Conclusion: Initial CT-guided PCNB in extremities’ long bones lesions showed high diagnostic performance in malignant, mixed and/or sclerotic lesions as well as lesions with extra-osseous exophytic tissue growth. Lack of extra-osseous components, benign and lytic lesions all had worse diagnostic performance.

  4. The impact of user- and system-initiated personalization on the user experience at large sports events.

    Science.gov (United States)

    Sun, Xu; May, Andrew; Wang, Qingfeng

    2016-05-01

    This article describes an experimental study investigating the impact on user experience of two approaches of personalization of content provided on a mobile device, for spectators at large sports events. A lab-based experiment showed that a system-driven approach to personalization was generally preferable, but that there were advantages to retaining some user control over the process. Usability implications for a hybrid approach, and design implications are discussed, with general support for countermeasures designed to overcome recognised limitations of adaptive systems.

  5. Staff Experience and Attitudes towards Technology-Enhanced Learning Initiatives in One Faculty of Health and Life Sciences

    Science.gov (United States)

    Reed, Peter

    2014-01-01

    Further to earlier work carried out by the student union (SU) along with strategic discussions regarding technology-enhanced learning (TEL), this research aimed to identify the attitudes and experience of teaching staff in relation to specific uses of technology in learning and teaching. Data obtained through an online questionnaire (n = 100)…

  6. Conscious sedation as an anaesthetic technique in patients undergoing nonthoracotomy placement of automatic implantable cardioverter defibrillator : an initial experience.

    Directory of Open Access Journals (Sweden)

    Singh V

    2004-01-01

    Full Text Available Six adult patients with life threatening recurrent ventricular arrhythmias who underwent non- thoracotomy placement of automatic implantable cardioverter defibrillator under conscious sedation are reported. Our clinical experience, patient satisfaction, recovery profile, complications and cardiologist perception about the technique of conscious sedation is presented and discussed.

  7. Using narratives to understand the motivational factors and experience of being a self-initiated academic expatriate in South Africa

    Directory of Open Access Journals (Sweden)

    Tinashe T. Harry

    2017-01-01

    Full Text Available Orientation: A growing movement of foreign nationals is settling in South Africa. Given this, there is a need to understand not only those factors influencing foreign nationals to settle in South Africa but also their lived experiences as a basis for individual career development.Research purpose: To investigate the expatriation motivational factors and experiences of selfinitiated academic expatriates in South Africa.Motivation for the study: Calls have been made within the careers literature for more empirical focus on understanding career development using some of the neglected sample groups.Research approach, design and method: The interpretive paradigm was adopted to understand the main purpose of the study. Guided by study objectives, unstructured interviews were conducted using a sample of foreign academics working in South Africa (n = 25.Main findings: Individual stories and narratives highlighted that academics relocated for the following reasons: (1 individual preference, (2 economic meltdown and (3 political conditions. Furthermore, the lived experiences of the expatriates reflected discrimination within the workplace and the community of residences in South Africa.Practical and managerial implications: Research findings indicate that the human resources (HR function can come up with interventions that positively influence the lived experience and career development of foreign academics working in South Africa.Contribution: The expatriate experience framed in this study provides a picture of the career development processes of neglected sample groups in the extant literature. Such an understanding is key in advancing literature and proposing interventions. All this is important given the global trend on labour and skills movement added to the role South Africa plays in the international arena. 

  8. Bimaxillary Advancement as the Initial Treatment of Obstructive Sleep Apnea: Five Years Follow-Up of the Pori Experience

    Directory of Open Access Journals (Sweden)

    Antti Raunio

    2012-03-01

    Full Text Available Objectives: Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Material and Methods: Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS confirmed by polysomnography in whom ODI-4 (oxygen desaturation index was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS as initial therapy. Results: In the group A mean ODI-4 was 17.8 (SD 12 before treatment and 3.5 (SD 3.4 at 5-year follow-up (P = 0.018 in paired differences t-test. In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6 to 96.3% (SD 2, P = 0.115 and in group B from 96.3% (SD 1.2 to 97.8% (SD 1.7, P = 0.056 (in paired differences t-test. The static charge sensitive bed evaluation showed improvement in all patients except one. Conclusions: Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.

  9. Bimaxillary advancement as the initial treatment of obstructive sleep apnea: five years follow-up of the pori experience.

    Science.gov (United States)

    Raunio, Antti; Rauhala, Esa; Kiviharju, Minna; Lehmijoki, Ossi; Sándor, George K B; Oikarinen, Kyösti

    2012-01-01

    Bimaxillary advancement surgery has proven to be effective treatment of obstructive sleep apnea syndrome. According to the Stanford protocol upper airway soft tissue surgery or advancement of tongue by chin plastic surgery is first carried out and if obstructive sleep apnea persists, then bimaxillary advancement is done. This study describes the 5 year outcome of 13 obstructive sleep apnea patients in whom the Stanford protocol was omitted and bimaxillary advancement was carried out as initial surgical treatment. Patients were divided in two groups. Group A comprised patients with obstructive sleep apnea (OSAS) confirmed by polysomnography in whom ODI-4 (oxygen desaturation index) was 5 or more. Group B consisted of patients with occlusal problems needing orthognathic surgery and with OSAS symptoms but no clear disease on polysomnography, where the ODI-4 index was less than 5. Both groups were treated with bimaxillary advancement surgery (BAS) as initial therapy. In the group A mean ODI-4 was 17.8 (SD 12) before treatment and 3.5 (SD 3.4) at 5-year follow-up (P = 0.018 in paired differences t-test). In group B the ODI-4 remained below 5. In group A mean saturation improved from 94.3% (SD 1.6) to 96.3% (SD 2), P = 0.115 and in group B from 96.3% (SD 1.2) to 97.8% (SD 1.7), P = 0.056 (in paired differences t-test). The static charge sensitive bed evaluation showed improvement in all patients except one. Bimaxillary advancement surgery is safe and reliable as an initial surgical treatment of obstructive sleep apnea syndrome.

  10. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Science.gov (United States)

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  11. From the Experience of Revitalization of Ecological and Local Lore Student Initiatives of Izmail State University for Humanities

    Directory of Open Access Journals (Sweden)

    Gramatik N.V.

    2016-08-01

    Full Text Available The urgency of the problem of ecological education of students of local lore is its connection with the decision of the major problems of pedagogy, as the problem of the formation of personality, all its moral side, and including - a responsible attitude to nature. Ecological and local history education in the vocational training system, opens the future specialist the world with all the versatility of the complex nature of the relationship, it promotes the formation of personal qualities and values. In this regard, the main objective of the educational process in higher education is study ways to enhance eco-initiatives of local history students.

  12. Participatory approaches to improving safety and health under trade union initiative--experiences of POSITIVE training program in Asia.

    Science.gov (United States)

    Kawakami, Tsuyoshi; Kogi, Kazutaka; Toyama, Naoki; Yoshikawa, Toru

    2004-04-01

    The participatory, action-oriented training program in occupational safety and health named POSITIVE (Participation-Oriented Safety Improvements by Trade Union InitiatiVE) was established in Pakistan and extended to other countries in Asia. The steps taken in the development of the POSITIVE program included collecting local good examples in safety and health, developing an action-checklist, testing a participatory training program, and conducting follow-up activities to examine local achievements. Training manuals were compiled to provide workers with the practical, easy-to-understand information on safety and health improvements and on the positive roles of trade unions. Trade union trainers trained in the methodology conducted serial POSITIVE training workshops in Pakistan and then in Bangladesh, Mongolia, Nepal, the Philippines and Thailand and recently in China. These workshops resulted in many low-cost improvements at the workplace level. These improvements were carried out in the technical areas of materials handling, workstations, machine safety, physical environment, and welfare facilities. The trade union networks have been vital in reaching an increasing number of grass-root workplaces and in expanding the program to other countries. This included the visits to Mongolia and Thailand of Pakistani trade union trainers to demonstrate the POSITIVE training. The participatory training tools used in the POSITIVE program such as the action checklist and group discussion methods were commonly applied in different local situations. Participatory approaches adopted in the POSITIVE program have proven useful for providing practical problem-solving measures based on the local trade union initiative.

  13. Thyroglobulin fluctuations in patients with iodine-refractory differentiated thyroid carcinoma on lenvatinib treatment – initial experience

    Science.gov (United States)

    Werner, R. A.; Lückerath, K.; Schmid, J. S.; Higuchi, T.; Kreissl, M. C.; Grelle, I.; Reiners, C.; Buck, A. K.; Lapa, C.

    2016-01-01

    Tyrosine kinase inhibitors (TKI) have shown clinical effectiveness in iodine-refractory differentiated thyroid cancer (DTC). The corresponding role of serum thyroglobulin (Tg) in iodine-refractory DTC has not been investigated yet. 9 patients (3 female, 61 ± 8y) with progressive iodine-refractory DTC starting on lenvatinib were considered. Tumor restaging was performed every 2–3 months including contrast-enhanced computed tomography (CT, RECIST 1.1). Serum Tg was measured and compared to imaging findings. After treatment initiation, serum Tg levels dropped in all patients with a median reduction of 86.2%. During long-term follow-up (median, 25.2 months), fluctuations in Tg could be observed in 8/9 subjects. According to RECIST, 6/9 subjects achieved a partial response or stable disease with the remaining 3/9 experiencing progressive disease (2/3 with Tg levels rising above baseline). All of the patients with disease progression presented with a preceding continuous rise in serum Tg, whereas tumor marker oscillations in the subjects with controlled disease were only intermittent. Initiation of lenvatinib in iodine-refractory DTC patients is associated with a significant reduction in serum Tg levels as a marker of treatment response. In the course of treatment, transient Tg oscillations are a frequent phenomenon that may not necessarily reflect morphologic tumor progression. PMID:27306607

  14. Two-Person Technique of Peroral Endoscopic Myotomy for Achalasia with an Advanced Endoscopist and a Thoracic Surgeon: Initial Experience

    Directory of Open Access Journals (Sweden)

    Madhusudhan R. Sanaka

    2016-01-01

    Full Text Available Background and Aims. We initiated peroral endoscopic myotomy (POEM utilizing a two-person technique with combination of an advanced endoscopist and a thoracic surgeon with complementary skills. Our aim was to determine the feasibility and outcomes in initial 20 patients. Methods. In this observational study, main outcomes measured were therapeutic success in relieving symptoms (Eckardt score < 3, decrease in lower esophageal sphincter (LES pressures, improvement in emptying on timed barium esophagogram (TBE, and complications. Results. POEM was successful in all 20 patients with a mean operative time of 140.1+32.9 minutes. Eckardt symptom scores decreased significantly at two-month follow-up (6.4+2.9 versus 0.25+0.45, p<0.001. Both basal and residual LES pressures decreased significantly (28.2+14.1 mmHg versus 12.8+6.3 and 22.4+11.3 versus 6.3+3.4 mmHg, p=0.025 and <0.001, resp.. Barium column height at 5 minutes on TBE reduced from 6.8+4.9 cm to 2.3+2.9 cm (p=0.05. Two patients (10% had mucosal perforations and one had delayed bleeding (5%. Conclusions. Two-person technique of POEM with combination of an advanced endoscopist and a thoracic surgeon is highly successful with low risk of complications.

  15. Supplemental vibrational force does not reduce pain experience during initial alignment with fixed orthodontic appliances: a multicenter randomized clinical trial.

    Science.gov (United States)

    Woodhouse, Neil R; DiBiase, Andrew T; Papageorgiou, Spyridon N; Johnson, Nicola; Slipper, Carmel; Grant, James; Alsaleh, Maryam; Cobourne, Martyn T

    2015-11-27

    This prospective randomized trial investigated the effect of supplemental vibrational force on orthodontic pain during alignment with fixed-appliances. Eighty-one subjects analgesics reported slightly higher maximum-pain although this was not significant (P = 0.170). The effect of intervention was independent of analgesia (P = 0.883). At T1 and T2, a statistically and clinically significant increase in mean pain was seen at 4 and 24-hours, declining at 72-hours and becoming insignificant at 1-week. For mean alignment-rate, pain-intensity and use of analgesics, no significant differences existed between groups (P > 0.003). The only significant predictor for mean pain was time. Use of an AcceleDent vibrational device had no significant effect on orthodontic pain or analgesia consumption during initial alignment with fixed appliances.

  16. FROM PHENOMENA AND LAWS OF NATURE TO INITIAL DATA SYMMETRY PRINCIPLES (EXPERIENCE OF RELATIONSHIP OF NATURAL SCIENCE AND THEOLOGY

    Directory of Open Access Journals (Sweden)

    Victor Nikolaevich Pervushin

    2015-01-01

    Full Text Available The aim of the investigation is to show a role of principles of symmetry of the initial data in formation of the consistent physical theory in a context of the newest advances in cosmology and physics of elementary particles.Methods. Methodological problems of modernity are considered on the basis of the retrospective analysis of physical theories, history of theology, comparison and generalisation of knowledge, the facts and positions from scientific, philosophical and religious spheres.Results and scientific novelty. The problems of consistency and completeness of scientific knowledge and convergence of the maintenance of religious texts and the observant scientific data in the physics and cosmology are discussed by the example of modern cosmologic models of the description of the Universe. It is proved that such convergence is claimed and actual not only concerning classification of physical processes in the Universe, including its origin from vacuum, but also in area of ontology and at forming of logics of scientific researches.Former and newest scientific achievements in the physics and cosmology are reinterpreted in a context of Hilbert geometrodynamics, added with a choice of relative standards of lengths and principles measurement of conformal symmetry.Practical significance. The author sees the further prospect of development of the scientific theory in a priority of conformal symmetry of a totality of any initial research data. So, in accordance with conformal symmetry, elementary objects of space-time are twistors that mathematically equivalent to cubits or to quantum generalisations of bits – information units. The general theory of knowledge eventually conducts to the fundamental theory of the information which, probably, will accept the name of quantum informodynamics, by analogy with quantum chromodynamics.

  17. Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

    Directory of Open Access Journals (Sweden)

    Quigley DD

    2015-07-01

    Full Text Available Denise D Quigley,1 Peter J Mendel,1 Zachary S Predmore,2 Alex Y Chen,3 Ron D Hays41RAND Corporation, Santa Monica, CA, 2RAND Corporation, Boston, MA, 3AltaMed Health Services Corporation, 4Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, CA, USAObjective: To describe how practice leaders used Consumer Assessment of Healthcare Providers and Systems (CAHPS® Clinician and Group (CG-CAHPS data in transitioning toward a patient-centered medical home (PCMH.Study design: Interviews conducted at 14 primary care practices within a large urban Federally Qualified Health Center in California.Participants: Thirty-eight interviews were conducted with lead physicians (n=13, site clinic administrators (n=13, nurse supervisors (n=10, and executive leadership (n=2.Results: Seven themes were identified on how practice leaders used CG-CAHPS data for PCMH transformation. CAHPS® was used: 1 for quality improvement (QI and focusing changes for PCMH transformation; 2 to maintain focus on patient experience; 3 alongside other data; 4 for monitoring site-level trends and changes; 5 to identify, analyze, and monitor areas for improvement; 6 for provider-level performance monitoring and individual coaching within a transparent environment of accountability; and 7 for PCMH transformation, but changes to instrument length, reading level, and the wording of specific items were suggested.Conclusion: Practice leaders used CG-CAHPS data to implement QI, develop a shared vision, and coach providers and staff on performance. They described how CAHPS® helped to improve the patient experience in the PCMH model, including access to routine and urgent care, wait times, provider spending enough time and listening carefully, and courteousness of staff. Regular reporting, reviewing, and discussing of patient-experience data alongside other clinical quality and productivity measures at multilevels of the organization was critical in maximizing the

  18. [General practice continuing education--initial experiences with problem-based learning in a continuing education program].

    Science.gov (United States)

    Stiegler, I; Falck-Ytter, Y; Hupe, K

    1995-08-01

    In May 1994, the regional chamber of physicians of Westfalia/Lippe, Germany, introduced their qualifying course in family medicine with a new didactic approach: It changed from a more traditional lecture-based style to the emphasis of problem-based learning. The decision to do this was mainly driven by two reasons: firstly, the common experience of a declining attendance during regular whole day lectures and, secondly, the goal to implement regional quality-seminars following the course. In addition, the federal chamber of physicians published a guidebook with recommendations favoring a more problem-based approach to family medicine in order to implement changes. Although there is still much hesitance in Germany towards the implementation of problem-based learning, we think that this approach cannot only facilitate factual learning but also stimulates other important goals of medical education. Because of time restrictions, it was not possible to assess the outcome. However, participants valued their experience relatively high in a process-evaluation conducted during and after the course.

  19. The origin and implementation of the Broadening Experiences in Scientific Training programs: an NIH common fund initiative.

    Science.gov (United States)

    Meyers, Frederick J; Mathur, Ambika; Fuhrmann, Cynthia N; O'Brien, Theresa C; Wefes, Inge; Labosky, Patricia A; Duncan, D'Anne S; August, Avery; Feig, Andrew; Gould, Kathleen L; Friedlander, Michael J; Schaffer, Chris B; Van Wart, Audra; Chalkley, Roger

    2016-02-01

    Recent national reports and commentaries on the current status and needs of the U.S. biomedical research workforce have highlighted the limited career development opportunities for predoctoral and postdoctoral trainees in academia, yet little attention is paid to preparation for career pathways outside of the traditional faculty path. Recognizing this issue, in 2013, the U.S. National Institutes of Health (NIH) Common Fund issued a request for application titled "NIH Director's Biomedical Research Workforce Innovation Award: Broadening Experiences in Scientific Training (BEST)." These 5-yr 1-time grants, awarded to 17 single or partnering institutions, were designed to develop sustainable approaches to broaden graduate and postgraduate training, aimed at creating training programs that reflect the range of career options that trainees may ultimately pursue. These institutions have formed a consortium in order to work together to develop, evaluate, share, and disseminate best practices and challenges. This is a first report on the early experiences of the consortium and the scope of participating BEST programs. In this report, we describe the state of the U.S. biomedical workforce and development of the BEST award, variations of programmatic approaches to assist with program design without BEST funding, and novel approaches to engage faculty in career development programs. To test the effectiveness of these BEST programs, external evaluators will assess their outcomes not only over the 5 yr grant period but also for an additional 10 yr beyond award completion.

  20. Initial experiences in embedding core competency education in entry-level surgery residents through a nonclinical rotation.

    Science.gov (United States)

    Kahol, Kanav; Huston, Carrie; Hamann, Jessica; Ferrara, John J

    2011-03-01

    Health care continues to expand in scope and in complexity. In this changing environment, residents are challenged with understanding its intricacies and the impact it will have on their professional activities and careers. Embedding each of the competency elements in residents in a meaningful way remains a challenge for many surgery residency program directors. We established a nonclinical rotation to provide surgery postgraduate year-1 (PGY-1) residents with a structured, multifaceted, largely self-directed curriculum into which each of the 6 core competencies are woven. Posttesting strategies were established for most curricular experiences to ensure to the greatest possible extent that each resident will have achieved an acceptable level of understanding of each of the competency areas before being given credit for the rotation. By uniformly exceeding satisfactory scores on respective objective analyses, residents demonstrated an increased (at least short-term) understanding of each of the assessed competency areas. Our project sought to address a prior lack of opportunity for our residents to develop a sound foundation for our residents in systems-based practice. Our new rotation addresses systems-based practice in several different learning environments, including emergency medical service ride-along, sentinel event participation, and hospice visits. Several research projects have enhanced the overall learning program. Our experience shows that a rotation dedicated to competency training can provide an innovative and engaging means of teaching residents the value of each element.

  1. Using immersive healthcare simulation for physiology education: initial experience in high school, college, and graduate school curricula.

    Science.gov (United States)

    Oriol, Nancy E; Hayden, Emily M; Joyal-Mowschenson, Julie; Muret-Wagstaff, Sharon; Faux, Russell; Gordon, James A

    2011-09-01

    In the natural world, learning emerges from the joy of play, experimentation, and inquiry as part of everyday life. However, this kind of informal learning is often difficult to integrate within structured educational curricula. This report describes an educational program that embeds naturalistic learning into formal high school, college, and graduate school science class work. Our experience is based on work with hundreds of high school, college, and graduate students enrolled in traditional science classes in which mannequin simulators were used to teach physiological principles. Specific case scenarios were integrated into the curriculum as problem-solving exercises chosen to accentuate the basic science objectives of the course. This report also highlights the historic and theoretical basis for the use of mannequin simulators as an important physiology education tool and outlines how the authors' experience in healthcare education has been effectively translated to nonclinical student populations. Particular areas of focus include critical-thinking and problem-solving behaviors and student reflections on the impact of the teaching approach.

  2. Experience in initial training required for the recognition of the qualified RP expert in Spain; Experiencia en la formacion requerida para el reconocimiento del experto cualificado en Espana

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez Suarez, M.; Marco Arboli, M.; Menarguez, J.

    2003-07-01

    An important point of the actions inside the European framework to achieve the harmonisation of the training programmes and recognition was included in the European directive 96/29/Euratom which includes definition and specific tasks of the European Qualified Expert on Radiation Protection (RP). Basic syllabus for training of those experts was developed in the communication 98/C 133/03 concerning BSS applications. Although, in the Spanish education system, the training and recognition requirements of the high level qualified experts on RP was defined since 1977, until 2001, the figure of the Technical Qualified Expert on RP does not appear in the legal framework. In December 2002, a new regulation of the Spanish Regulatory Body, CSN, about qualifications to obtain the recognition of RP Expert in Spain (both high qualified and technical RP experts) was published. Concerning the qualified expert on RP, (RP Officer), responsible of the RP Service, which takes charge of the effective protection and advise radioactive and nuclear facilities in Rp aspects,has to be authorised by the regulatory body. to obtain the RP officer diploma, conceded by the CSN, an initial training of 300 hours and a three-year minimum experience are required (for X-ray installation a 6-month experience is enough). The technical qualified expert on RP is the worker who carried out the tasks in the a RP Service under the supervision of the RP officer. A Technician Qualified Expert on RP does not need an specific accreditation of the Regulatory Body, but an initial RP training and a three-month minimum experience are required and has hold a certificate by the RP officer. Continuous training is also required and as well has to receive a certificate from the RP officer. Since 1977, The Institute for energy Studies has been implementing specific training courses for those professionals who want to obtain the diploma of RP officer (high degree qualified RP expert), conceded by the CSN. Since then

  3. Intraoperative Scintigraphy Using a Large Field-of-View Portable Gamma Camera for Primary Hyperparathyroidism: Initial Experience

    Directory of Open Access Journals (Sweden)

    Nathan C. Hall

    2015-01-01

    Full Text Available Background. We investigated a novel technique, intraoperative 99 mTc-Sestamibi (MIBI imaging (neck and excised specimen (ES, using a large field-of-view portable gamma camera (LFOVGC, for expediting confirmation of MIBI-avid parathyroid adenoma removal. Methods. Twenty patients with MIBI-avid parathyroid adenomas were preoperatively administered MIBI and intraoperatively imaged prior to incision (neck and immediately following resection (neck and/or ES. Preoperative and intraoperative serum parathyroid hormone monitoring (IOPTH and pathology (path were also performed. Results. MIBI neck activity was absent and specimen activity was present in 13/20 with imaging after initial ES removal. In the remaining 7/20 cases, residual neck activity and/or absent ES activity prompted excision of additional tissue, ultimately leading to complete hyperfunctioning tissue excision. Postexcision LFOVGC ES imaging confirmed parathyroid adenoma resection 100% when postresection imaging qualitatively had activity (ES and/or no activity (neck. The mean ± SEM time saving using intraoperative LFOVGC data to confirm resection versus first IOPTH or path result would have been 22.0 ± 2 minutes (specimen imaging and 26.0 ± 3 minutes (neck imaging. Conclusion. Utilization of a novel real-time intraoperative LFOVGC imaging approach can provide confirmation of MIBI-avid parathyroid adenoma removal appreciably faster than IOPTH and/or path and may provide a valuable adjunct to parathyroid surgery.

  4. Initial experiments of a 128-channel FPGA and PC-based ultrasound imaging system for teaching and research activities.

    Science.gov (United States)

    Assef, Amauri Amorin; Maia, Joaquim Miguel; Tavares Costa, Eduardo

    2016-08-01

    Although widely employed in medical diagnostic applications, most of the available commercial ultrasound (US) scanners do not always fit the needs of research users. Access to raw US data, portability, flexibility and advanced user control are essential features to explore alternative biomedical signal and imaging processing algorithms. In this paper, we present the initial results of a reconfigurable, cost-effective and modular 128-channel FPGA and PC-based US system, specifically designed for teaching and medical imaging research. The proposed system exploits the advantages of the MD2131 (Microchip Technology Inc.) beamformer source driver to generate arbitrary waveforms and the analog front-end AFE5805 (Texas Instruments Inc.) to obtain the maximum flexibility and wide data access to the various US data streams. Two applications involving plane wave excitation and delay-and-sum (DAS) beamforming are discussed. The results show that the open platform can help biomedical students and researchers to develop and evaluate different imaging strategies for medical US imaging and nondestructive testing (NDT) techniques, among other applications.

  5. A flexible multichannel FPGA and PC-Based ultrasound system for medical imaging research: initial phantom experiments

    Directory of Open Access Journals (Sweden)

    Amauri Amorin Assef

    Full Text Available IntroductionIn this paper, we present the initial results of a fully programmable 128-channel FPGA and PC-based system that has been developed for medical ultrasound (US imaging research in our University laboratory (Federal University of Technology - Paraná, Brazil.MethodsIn order to demonstrate the feasibility of the US research system, two applications involving unfocused plane wave transmission and conventional B-mode beamforming were evaluated using a commercial tissue-mimicking phantom and a 3.2 MHz 128-element convex array transducer.ResultsTesting results show that the hardware platform is able to synthesize arbitrary pulses up to 100 Vpp with second order harmonic distortion below 80 dB. For the first application, a 41-tap digital FIR bandpass filter was applied to the acquired RF echoes, sampled at 40 MHz with 12-bit resolution, to improve the noise suppression. In the second application, after offline apodization weighting, filtering, delay-and-sum processing, envelope detection, log compression and scan conversion, the reconstructed B-mode image is displayed over a 50 dB range.DiscussionThe presented results indicate that the open US imaging system can be used to support different ultrasonic transmission and reception strategies, which typically cannot be implemented in conventional data flow architectures that are mainly based on hardware.

  6. Application of the GRAAL model to leaching experiments with SON68 nuclear glass in initially pure water

    Energy Technology Data Exchange (ETDEWEB)

    Frugier, P., E-mail: pierre.frugier@cea.f [CEA Marcoule, DTCD/SECM/LCLT, BP 17171, 30207 Bagnols-sur-Ceze Cedex (France); Chave, T. [ICSM Site de Marcoule, DEN/MAR/ICSM/LSFC, UMR 5257, BP 17171, 30207 Bagnols-sur-Ceze Cedex (France); Gin, S. [CEA Marcoule, DTCD/SECM/LCLT, BP 17171, 30207 Bagnols-sur-Ceze Cedex (France); Lartigue, J.-E. [CEA Cadarache, DEN/CAD/DTN/SMTM/LMTE, 13108 Saint-Paul-Lez-Durance Cedex (France)

    2009-08-01

    Based on a review of the current state of knowledge concerning the aqueous alteration of SON68 nuclear glass we have proposed a mechanistic model, GRAAL (Glass Reactivity with Allowance for the Alteration Layer) [P. Frugier, S. Gin, Y. Minet, T. Chave, B. Bonin, N. Godon, J.E. Lartigue, P. Jollivet, A. Ayral, L. De Windt, G. Santarini, J. Nucl. Mater. 380 (2008) 8]. This article describes how the GRAAL model hypotheses are solved using a calculation code coupling chemistry and transport. The geochemical solution of this model combines three major phenomena: chemical equilibria in solution, water and ion transport by convection or diffusion, and element diffusion through the passivating reactive interphase. The model results are compared with experimental data for SON68 glass leached in initially pure water both in a closed system and in renewed media. The comparison shows the model very satisfactorily accounts for variations in the pH and the element concentrations in solution as a function of time, the glass surface area in contact with solution, and the solution renewal rate. This success is due to the fact that the diffusion of elements through the alteration gel is taken into account in the model. This mechanism cannot be disregarded under most experimental conditions - if only to predict the solution pH - and must therefore be an integral part of the geochemical model.

  7. Ergonomics support for local initiative in improving safety and health at work: International Labour Organization experiences in industrially developing countries.

    Science.gov (United States)

    Kawakami, T; Kogi, K

    2005-04-15

    Ergonomics has played essential roles in the technical cooperation activities of the International Labour Organization (ILO) in occupational safety and health in industrially developing countries. Ergonomics support focusing on practical day-to-day needs at the grass-root workplace has strengthened the local initiative in improving safety and health. Practical action-tools such as ergonomics checklists, local good example photos and group discussions have assisted workers and employers in identifying feasible solutions using locally available resources. Direct participation of workers and employers has been promoted in ergonomics training aimed at immediate solutions. ILO Guidelines on Occupational Safety and Health Management Systems have played increasingly important roles in the systematic planning of local improvement actions. Policy-level programmes to develop network support mechanisms to the grass-root workplace were essential for following up and sustaining local achievements. Practical ergonomics support tools, such as action checklists and low-cost improvement guides, should be developed and widely applied so as to reach grass-root levels and help local people create safer and healthier workplaces.

  8. Regional Initiatives in Support of Surveillance in East Africa: The East Africa Integrated Disease Surveillance Network (EAIDSNet Experience

    Directory of Open Access Journals (Sweden)

    Maurice Ope

    2013-01-01

    Full Text Available The East African Integrated Disease Surveillance Network (EAIDSNet was formed in response to a growing frequency of cross-border malaria outbreaks in the 1990s and a growing recognition that fragmented disease interventions, coupled with weak laboratory capacity, were making it difficult to respond in a timely manner to the outbreaks of malaria and other infectious diseases. The East Africa Community (EAC partner states, with financial support from the Rockefeller Foundation, established EAIDSNet in 2000 to develop and strengthen the communication channels necessary for integrated cross-border disease surveillance and control efforts. The objective of this paper is to review the regional EAIDSNet initiative and highlight achievements and challenges in its implementation. Major accomplishments of EAIDSNet include influencing the establishment of a Department of Health within the EAC Secretariat to support a regional health agenda; successfully completing a regional field simulation exercise in pandemic influenza preparedness; and piloting a web-based portal for linking animal and human health disease surveillance. The strategic direction of EAIDSNet was shaped, in part, by lessons learned following a visit to the more established Mekong Basin Disease Surveillance (MBDS regional network. Looking to the future, EAIDSNet is collaborating with the East, Central and Southern Africa Health Community (ECSA-HC, EAC partner states, and the World Health Organization to implement the World Bank-funded East Africa Public Health Laboratory Networking Project (EAPHLNP. The network has also begun lobbying East African countries for funding to support EAIDSNet activities.

  9. Difficult diagnosis of gout: the benefit of dual energy computed tomography, initial experience in routine clinical practice

    Directory of Open Access Journals (Sweden)

    Vera Löckmann

    2013-09-01

    Full Text Available Gout, one of the most common inflammatory arthritides in humans, is still difficult to diagnose in challenging situations, when fluid for arthrocentesis or an apparent tophus are absent and, for example, an infection as differential diagnosis has to be ruled out. Dual energy computed tomography (DECT is an established tool for detection and characterisation of uric acid stones in the urinary tract and has recently been used to detect and display urate deposits. Our first experiences with DECT as a diagnostic tool in routine clinical practice show, that DECT is a promising imaging technique which allows the detection of monosodium urate deposits and benefits the routine diagnosis of tophaceous gout particularly in diffuse soft tissue swelling of the limbs, without the possibility of needle aspiration. However, DECT does not seem suitable to detect dissolved urate crystals, neither in vitro nor in vivo.

  10. Selective intraarterial radionuclide therapy with yttrium-90 (Y-90 microspheres for hepatic neuroendocrine metastases: Initial experience at a single center

    Directory of Open Access Journals (Sweden)

    Arslan Nuri

    2011-01-01

    Full Text Available Background/Aim. Selective intraarterial radionuclide therapy (SIRT with Yttrium-90 (Y-90 microspheres is also known as radioembolization and delivers high doses of radiation to hepatic tumors with minimum healthy liver exposure. The aim of this study was to present our preliminary experience in the role of liver directed radiotherapy with Y-90 microspheres for the treatment of unresectable hepatic metastases from neuroendocrine tumors (NET. Methods. The results of SIRT in 10 patients (5 males, 5 females; mean age 48.7 years; age range 24-73 years with metastatic liver disease from NETs during the period from April 2008 through August 2010 were reviewed. All patients had meticulous pre- and post-imaging studies as a part of their work-up procedure, as well as serologic tests of liver function to determine the extent of liver function damage. The patients who were eligible for SIRT had pretreatment visceral angiography to define and occlude non-target arteries. Results. The mean ± SD administered SIR-Spheres® activity was 1.49 ± 0.42 GBq (range 0.72-2.21 GBq in all the patients. These treatments delivered a dose of 99.73 ± 66.36 Gy (range 49- 420.8 Gy to the target tumors. The estimated dose to the lungs and normal liver was 4.45 ± 1.95 Gy (range 2.4-8.5 Gy and 26.73 ± 14.19 Gy (range 5-58.9 Gy, respectively. Overall response rate of 90% and patient tolerance was satisfactory for most patients. Conclusion. From our limited experience, we can conclude that SIRT with Y-90 microspheres is a safe and efficacious treatment option for patients with liver metastasis of NET without any serious side effects.

  11. Impact of initial and boundary conditions on regional winter climate over the Western Himalayas: A fixed domain size experiment

    Science.gov (United States)

    Maharana, P.; Dimri, A. P.

    2014-03-01

    The Western Himalayas during winter receives precipitation due to the eastward moving low pressure synoptic weather systems, called Western Disturbances (WDs) in Indian meteorological parlance. The complex Himalayan topography, sparse observational data, less understanding of physical processes, etc. form many interesting research questions over this region. One of the important research goals is to study the change in the winter (Dec., Jan. and Feb. - DJF) climate over the Himalayas. In the presented study with modelling efforts having varying initial and boundary conditions (ICBC) with same model physics option is attempted to provide a comment on important physical processes pertaining to precipitation and temperature fields. A 22 year (1980-2001) simulation with Regional Climate Model version 3 (RegCM3) forced with National Centre for Environmental Prediction/National Centre for Atmospheric Research (NCEP/NCAR) reanalysis 1 (NNRP1), NCEP/NCAR reanalysis 2 (NNRP2) and European Centre for Medium Range Weather Forecast 40 Year reanalysis (ERA40) as three different ICBC is carried out. The present study focuses on the winter climatology of the main meteorological parameters viz., temperature, precipitation and snow depth and interannual variability of winter seasonal precipitation. The model shows overestimation of seasonal average precipitation and underestimation of seasonal average temperature fields over the Western Himalayas in all the three model simulations. The interannual variability of precipitation and temperature over this region is nicely captured by the model. The model simulation with NNRP2 as the ICBC shows more realistic results. In addition the ensemble mean of the three simulations has shown improved results and is closer to the abovementioned simulation. Precipitation bias explained in terms of the higher vertical integrated moisture flux and transport shows strong convergence zone over and along the southern rim of the Indian Himalayas. The

  12. CT-guided biopsy of thoracic lesions with a novel wire-based needle guide device - initial experiences

    Energy Technology Data Exchange (ETDEWEB)

    Kroepil, Patric; Bilk, Philip; Quentin, Michael; Miese, Falk R; Lanzman, Rotem S; Scherer, Axel (Dept. of Radiology, Medical Faculty, Univ. Duesseldorf, Duesseldorf (Germany)), email: Patric.Kroepil@med.uni-duesseldorf.de

    2011-10-15

    Background Biopsies guided by computed tomography (CT) play an important role in clinical practice. A short duration, minimal radiation dose and complication rate are of particular interest. Purpose To evaluate the potential of a novel self-manufactured wire-based needle guide device for CT-guided thoracic biopsies with respect to radiation dose, intervention time and complication rate. Material and Methods Forty patients that underwent CT-guided biopsies of thoracic lesions were included in this study and assigned to two groups. Patients in group A (n = 20, mean age 69 +- 8.4 years) underwent biopsies with a novel wire-based needle guide device, while patients in group B (n = 20, mean age 68.4 +- 10.1 years) were biopsied without a needle guide device. The novel self-manufactured needle guide device consists of an iron/zinc wire modelled to a ring with a flexible arm and an eye at the end of the arm to stabilize the biopsy needle in the optimal position during intervention. Predefined parameters (radiation dose, number of acquired CT-slices, duration of intervention, complications) were compared between both groups. Results Mean radiation dose (CTDIvol 192 mGy versus 541 mGy; P = 0.001) and the number of acquired slices during intervention (n = 49 +- 33 vs. n = 126 +- 78; P = 0.001) were significantly lower in group A compared with group B. Intervention time in group A (13.1 min) was significantly lower than in group B (18.5 min, P < 0.01). A pneumothorax as peri-interventional complication was observed less frequent after device assisted biopsies (n = 4 vs. n = 8, n.s.). Conclusion The novel wire-based needle guide device is a promising tool to facilitate CT-guided thoracic biopsies reducing radiation dose, intervention time, and related complications. Further studies are mandatory to confirm these initial results

  13. Concurrent Chemotherapy and Pulsed High-Intensity Focused Ultrasound Therapy for the Treatment of Unresectable Pancreatic Cancer: Initial Experiences

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jae Young; Choi, Byung Ihn; Ryu, Ji Kon; Kim, Yong Tae; Kim, Se Hyung; Han, Joon Koo [Seoul National University Hospital, Seoul (Korea, Republic of); Hwang, Joo Ha [University of Washington Medical Center, Seattle (United States)

    2011-04-15

    This study was performed to evaluate the potential clinical value of concurrent chemotherapy and pulsed high intensity focused ultrasound (HIFU) therapy (CCHT), as well as the safety of pulsed HIFU, for the treatment of unresectable pancreatic cancer. Twelve patients were treated with HIFU from October 2008 to May 2010, and three of them underwent CCHT as the main treatment (the CCHT group). The overall survival (OS), the time to tumor progression (TTP), the complications and the current performance status in the CCHT and non-CCHT groups were analyzed. Nine patients in the non-CCHT group were evaluated to determine why CCHT could not be performed more than twice. The OS of the three patients in the CCHT group was 26.0, 21.6 and 10.8 months, respectively, from the time of diagnosis. Two of them were alive at the time of preparing this manuscript with an excellent performance status, and one of them underwent a surgical resection one year after the initiation of CCHT. The TTP of the three patients in the CCHT group was 13.4, 11.5 and 9.9 months, respectively. The median OS and TTP of the non-CCHT group were 10.3 months and 4.4 months, respectively. The main reasons why the nine patients of the non-CCHT group failed to undergo CCHT more than twice were as follows: pancreatitis (n = 1), intolerance of the pain during treatment (n = 4), palliative use of HIFU for pain relief (n = 1) and a poor physical condition due to disease progression (n = 3). No major complications were encountered except one case of pancreatitis. This study shows that CCHT is a potentially effective and safe modality for the treatment of unresectable pancreatic cancer

  14. Evaluation of intracranial aneurysms with 7 T versus 1.5 T time-of-flight MR angiography. Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Moenninghoff, C.; Maderwald, S.; Theysohn, J.M.; Kraff, O.; Ladd, S.C.; Ladd, M.E.; Forsting, M.; Quick, H.H.; Wanke, I. [Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Duisburg-Essen Univ. (Germany). Erwin-L.-Hahn Inst. fuer Magnetresonanz

    2009-01-15

    Purpose: The purpose of this study was to compare the depiction of intracranial aneurysms by 3D time-of-flight (TOF) magnetic resonance angiography (MRA) at 7 Tesla (T) with the clinical standard TOF MRA at 1.5 T and with digital subtraction angiography (DSA). Materials and Methods: 7 T and 1.5 T TOF MRA images optimized for both field strengths were compared in ten patients with an unruptured intracranial aneurysm. Two blinded neuroradiologists independently rated the image quality of the dome, the neck, and the vessel of origin of all aneurysms in MRA source and maximum intensity projection (MIP) images. DSA was obtained in all subjects and served as reference standard. The mean values of image quality were compared by Wilcoxon signed rank test. In all patients the number and location of the aneurysms was confirmed by DSA. Results: Both readers identified twelve aneurysms in ten patients in 7 T, 1.5 T TOF MRA and DSA. The image quality of the aneurysm dome was rated higher in 8 of 12 aneurysms and the image quality of the aneurysm neck was superior in 9 of 12 aneurysms at 7 T TOF MRA compared to 1.5 T TOF MRA. The depiction of the parent vessel was graded almost equally by both readers. Conclusion: Our initial results indicate that image quality of intracranial aneurysms may benefit from the increased spatial resolution of 7 T TOF MRA compared with 1.5 T TOF MRA. Tailored scan protocols and optimized radiofrequency head coils are needed to further improve the image quality of 7 T TOF MRA. (orig.)

  15. Efficacy and safety of Mitoxantrone, as an initial therapy, in multiple sclerosis: Experience in an Indian tertiary care setting

    Directory of Open Access Journals (Sweden)

    Singhal B

    2009-01-01

    Full Text Available Background and Purpose : Mitoxantrone is an approved disease modifying agent for treatment of multiple sclerosis (MS. The aim of the study was to assess its efficacy and safety in Indian MS patients. Materials and Methods : A total of 23 patients with clinically definite MS (Poser criteria were enrolled in an open label study. Of which, 21 satisfied the McDonald′s criteria for MS and two satisfied the diagnostic criteria of neuromyelitis optica (NMO. The numbers of relapses and expanded disability status scale (EDSS score were used as primary and secondary outcome measures. The patients were monitored for the adverse effects. Results : In 17 (15 MS and two NMO patients who completed one year of therapy, there was significant difference in the mean annual relapse rates [before 0.879±0.58; on mitoxantrone 0.091±0.17, (P=0.003]. Of the 17 patients, ten (MS 9 and NMO 1 completed therapy for two years. Annual relapse rates [before (1.024±0.59, on therapy (0.155±0.21, (P=0.0054] and EDSS score [before start of therapy 5.3, at the end of therapy 2.4, (P=0.001] showed significant benefit in the ten patients who completed two years therapy. This benefit persisted during the mean follow-up period of two and a half years after completion of therapy. The adverse events noted in the entire cohort were leucopenia in four patients and asymptomatic reversible decrease in cardiac ejection fraction in one patient. Leucopenia was severe in two patients requiring discontinuation of the therapy and mitoxantrone was also discontinued in the patient with cardiotoxicity. Conclusions : Mitoxantrone, as an initial therapy, decreases clinical exacerbations and disability progression, and has a reasonable safety profile in Indian patients with MS and NMO.

  16. Effect of Microgravity on Early Events of Biological Nitrogen Fixation in Medicago Truncatula: Initial Results from the SyNRGE Experiment

    Science.gov (United States)

    Stutte, Gary W.; Roberts, Michael S.

    2011-01-01

    SyNRGE (Symbiotic Nodulation in a Reduced Gravity Environment) was a sortie mission on STS-135 in the Biological Research in Canisters (BRIC) hardware to study the effect of microgravity on a plant-microbe symbiosis resulting in biological nitrogen fixation. Medicago truncatula, a model species of the legume family, was inoculated with its bacterial symbiont, Sinorhizobium meliloti, to observe early events associated with infection and nodulation in Petri Dish Fixation Units (PDFUs). Two sets of experiments were conducted in orbit and in 24-hour delayed ground controls. Experiment one was designed to determine if S. meliloti infect M. truncatula and initiate physiological changes associated with nodule formation. Roots of five-day-old M. truncatula cultivar Jemalong A17 (Enodll::gus) were inoculated 24 hr before launch with either S. meliloti strain 1021 or strain ABS7 and integrated into BRIC-PDFU hardware placed in a 4 C Cold Bag for launch on Atlantis. Inoculated plants and uninoculated controls were maintained in the dark at ambient temperature in the middeck of STS-135 for 11 days before fixation in RNAlater(tM) by crew activation of the PDFU. Experiment two was designed to determine if microgravity altered the process of bacterial infection and host plant nodule formation. Seeds of two M. truncatula cultivar Jemalong A17 lines, the Enodll::gus used in experiment 1, and SUNN, a super-nodulating mutant of A17, were germinated on orbit for 11 days in the middeck cabin and returned to Earth alive inside of BRIC-PDFU's at 4 C. S. meliloti strains 1021 and ABS7 were cultivated separately in broth culture on orbit and also returned to Earth alive. After landing, flight- and groundgrown plants and bacteria were transferred from BRIC-PDFU's into Nunc(tm) 4-well plates for reciprocity crosses. Rates of plant growth and nodule development on Buffered Nodulation Medium (lacking nitrogen) were measured for 14 days. Preliminary analysis' of Experiment 1 confirms that

  17. Initial results of simultaneous PET/MRI experiments with an MRI-compatible silicon photomultiplier PET scanner.

    Science.gov (United States)

    Yoon, Hyun Suk; Ko, Guen Bae; Kwon, Sun Il; Lee, Chan Mi; Ito, Mikiko; Chan Song, In; Lee, Dong Soo; Hong, Seong Jong; Lee, Jae Sung

    2012-04-01

    The most investigated semiconductor photosensor for MRI-compatible PET detectors is the avalanche photodiode (APD). However, the silicon photomultiplier (SiPM), also called the Geiger-mode APD, is gaining attention in the development of the next generation of PET/MRI systems because the SiPM has much better performance than the APD. We have developed an MRI-compatible PET system based on multichannel SiPM arrays to allow simultaneous PET/MRI. The SiPM PET scanner consists of 12 detector modules with a ring diameter of 13.6 cm and an axial extent of 3.2 cm. In each detector module, 4 multichannel SiPM arrays (with 4 × 4 channels arranged in a 2 × 2 array to yield 8 × 8 channels) were coupled with 20 × 18 Lu(1.9)Gd(0.1)SiO(5):Ce crystals (each crystal is 1.5 × 1.5 × 7 mm) and mounted on a charge division network for multiplexing 64 signals into 4 position signals. Each detector module was enclosed in a shielding box to reduce interference between the PET and MRI scanners, and the temperature inside the box was monitored for correction of the temperature-dependent gain variation of the SiPM. The PET detector signal was routed to the outside of the MRI room and processed with a field programmable gate array-based data acquisition system. MRI compatibility tests and simultaneous PET/MRI acquisitions were performed inside a 3-T clinical MRI system with 4-cm loop receiver coils that were built into the SiPM PET scanner. Interference between the imaging systems was investigated, and phantom and mouse experiments were performed. No radiofrequency interference on the PET signal or degradation in the energy spectrum and flood map was shown during simultaneous PET/MRI. The quality of the MRI scans acquired with and without the operating PET showed only slight degradation. The results of phantom and mouse experiments confirmed the feasibility of this system for simultaneous PET/MRI. Simultaneous PET/MRI was possible with a multichannel SiPM-based PET scanner, with no

  18. I Knew I Would Be Safer. Experiences of Kenyan HIV Serodiscordant Couples Soon After Pre-Exposure Prophylaxis (PrEP) Initiation.

    Science.gov (United States)

    Ngure, Kenneth; Heffron, Renee; Curran, Kathyrn; Vusha, Sophie; Ngutu, Mariah; Mugo, Nelly; Celum, Connie; Baeten, Jared M

    2016-02-01

    Pre-exposure prophylaxis (PrEP) for HIV-uninfected persons is highly efficacious for HIV prevention. Understanding how people at risk for HIV will use PrEP is important to inform PrEP scale-up and implementation. We used qualitative methods to gather insights into couples' early experiences with PrEP use within the Partners Demonstration Project, an open-label implementation study evaluating integrated delivery of PrEP and antiretroviral therapy (ART). PrEP is offered to HIV uninfected partners until the HIV-infected partner initiates and sustains ART use (i.e., PrEP as a "bridge" to ART initiation and viral suppression). From August 2013 to March 2014 we conducted 20 in-depth dyadic interviews (n = 40) with heterosexual HIV serodiscordant couples participating at the Thika, Kenya study site, exploring how couples make decisions about using PrEP for HIV prevention. We developed and applied deductive and inductive codes to identify key themes related to experiences of PrEP initiation and use of time-limited PrEP. Couples reported that PrEP offered them an additional strategy to reduce the risk of HIV transmission, meet their fertility desires, and cope with HIV serodiscordance. Remaining HIV negative at follow-up visits reinforced couples' decisions and motivated continued adherence to PrEP. In addition, confidence in their provider's advice and client-friendly services were critical to their decisions to initiate and continue use of PrEP. Strategies for wide-scale PrEP delivery for HIV serodiscordant couples in low resource settings may include building capacity of health providers to counsel on PrEP adoption while addressing couples' concerns and barriers to adoption and continued use.

  19. How to Recondition Ex Vivo Initially Rejected Donor Lungs for Clinical Transplantation: Clinical Experience from Lund University Hospital

    Directory of Open Access Journals (Sweden)

    Sandra Lindstedt

    2011-01-01

    Full Text Available A major problem in clinical lung transplantation is the shortage of donor lungs. Only about 20% of donor lungs are accepted for transplantation. We have recently reported the results of the first six double lung transplantations performed with donor lungs reconditioned ex vivo that had been deemed unsuitable for transplantation by the Scandiatransplant, Eurotransplant, and UK Transplant organizations because the arterial oxygen pressure was less than 40 kPa. The three-month survival of patients undergoing transplant with these lungs was 100%. One patient died due to sepsis after 95 days, and one due to rejection after 9 months. Four recipients are still alive and well 24 months after transplantation, with no signs of bronchiolitis obliterans syndrome. The donor lungs were reconditioned ex vivo in an extracorporeal membrane oxygenation circuit using STEEN solution mixed with erythrocytes, to dehydrate edematous lung tissue. Functional evaluation was performed with deoxygenated perfusate at different inspired fractions of oxygen. The arterial oxygen pressure was significantly improved in this model. This ex vivo evaluation model is thus a valuable addition to the armamentarium in increasing the number of acceptable lungs in a donor population with inferior arterial oxygen pressure values, thereby, increasing the lung donor pool for transplantation. In the following paper we present our clinical experience from the first six patients in the world. We also present the technique we used in detail with flowchart.

  20. The Incorporation of an Advanced Donation Program Into Kidney Paired Exchange: Initial Experience of the National Kidney Registry.

    Science.gov (United States)

    Flechner, S M; Leeser, D; Pelletier, R; Morgievich, M; Miller, K; Thompson, L; McGuire, S; Sinacore, J; Hil, G

    2015-10-01

    The continued growth of kidney paired donation (KPD) to facilitate transplantation for otherwise incompatible or suboptimal living kidney donors and recipients has depended on a balance between the logistics required for patients and the collaborating transplant centers. The formation of chains for KPD and the shipping of kidneys have permitted networks such as the National Kidney Registry (NKR) to offer KPD to patients over a transcontinental area. However, over the last 3 years, we have encountered patient requests for a more flexible experience in KPD to meet their individual needs often due to rigid time constraints. To accommodate these requests, we have developed an Advanced Donation Program (ADP) in which the donor desires to donate by a specific date, but their paired recipient has not yet been matched to a specific donor or scheduled for surgery. After obtaining careful informed consent from both the donor and paired recipient, 10 KPD chains were constructed using an ADP donor. These 10 ADP donors have facilitated 47 transplants, and thus far eight of their paired recipients have received a kidney within a mean of 178 (range 10-562) days. The ADP is a viable method to support time limited donors in a KPD network.

  1. Microbial borehole observatories deployed within the oceanic crust: Design considerations and initial results from long-term colonization experiments (Invited)

    Science.gov (United States)

    Orcutt, B. N.; Bach, W.; Becker, K.; Fisher, A. T.; Hulme, S.; Toner, B. M.; Wheat, C. G.; Edwards, K. J.; Iodp Expedition 327 Shipboard Party

    2010-12-01

    Borehole observatories developed for long-term sampling and monitoring in the subseafloor of the deep ocean must satisfy design and operation requirements that are similar to systems deployed on land. Many of these systems are used to achieve simultaneous hydrologic, geochemical and microbiological goals, requiring innovative design, installation, and operation. There are major logistical challenges for subseafloor observatories, the foremost being having to remotely access sites kilometers underwater using multiple oceanographic platforms (drill ship, surface ship, submersible, remotely-operated vehicle) and reliance on autonomous devices that are serviced only after several years. Contamination of the analytical environment is probable during installation operations, requiring vigilance during analysis for interpretation. Subseafloor observatories also require self-contained and robust instrumentation that can withstand long-term exposure to seawater at high pressures, elevated temperatures, a variety of redox conditions, and little to no access to external power. Although subseafloor borehole observatories have been in development for hydrologic monitoring for two decades, the inclusion of experimentation to examine the deep biosphere in the marine subsurface has only recently been developed. Results from some of the first microbial colonization experiments in young basaltic rocks on the eastern flank of the Juan de Fuca Ridge demonstrate in situ microbial-mineral interactions that can be identified using complementary geochemical and microbiological techniques. Mineral surfaces were first colonized by iron oxidizing bacteria, and as fluid composition changed, the microbial community became dominated by Firmicutes bacteria, some of which are phylogenetically similar to microbial communities observed in the terrestrial deep biosphere.

  2. Initial clinical experience with a new pulsed dye laser device in angioplasty of limb ischemia and shunt fistula obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Zwaan, M.; Weiss, H.D.; Kagel, H.; Gmelin, E.; Rinast, E. (Medical University of Luebeck (Germany). Department of Radiology); Goethlin, J.H. (Sahlgrenska Sjukhuset, Goeteborg (Sweden)); Kummer, D. (Medical University of Luebeck (Germany). Department of Angiology and Geriatry); Scheu, M. (Medical Laser Center Luebeck (Germany))

    Selective plaque ablation with laser radiation at 405-530 nm in vitro has been reported. The possibilities are investigated of a new pulsed dye laser device for in vivo recanalization of arteries in ischemic lower limbs and stenoses/occlusions of arterio-venous hemo-dialysis shunt fistulae. A specially designed 9F or 7F multifiber catheter was used for treatment of 10 patients with lower limb artery obliterations and 11 patients with malfunctioning hemodialysis access fistulae (HAF). The recanalization technical success was 5/5 in the iliac arteries (IA), 4/5 in the superficial femoral arteries (SFA), and 11/11 in the HAF. Early re-occlusions occurred in one SFA and IA, respectively, caused by very bad run-off. There was one clinically insignificant SFA perforation. Additional balloon angioplasty was considered necessary in 10/16 lesions. Mean ankle-arm index increased from 0.68 to 0.97. With two exceptions all HAF patients were re-integrated in the dialysis program. Pulsed dye laser angioplasty promises to be an effective and fast method for plaque ablation debulking. The first clinical experience confirms previous in vitro results. In particular laser recanalization may become the method of choice for treatment of rigid HAF obstructions and it seems to be superior to vascular surgery or balloon angioplasty alone. (author). 15 refs.; 2 figs.

  3. Robot-assisted nerve-sparing radical prostatectomy using near-infrared fluorescence technology and indocyanine green: initial experience.

    Science.gov (United States)

    Mangano, Mario S; De Gobbi, Alberto; Beniamin, Francesco; Lamon, Claudio; Ciaccia, Matteo; Maccatrozzo, Luigino

    2017-05-23

    Indocyanine green (ICG) is a fluorescent molecule that provokes detectable photon emission. The use of ICG with near-infrared (NIR) imaging system (Akorn, Lake Forest, IL) has been described during robotic partial nephrectomy (RAPN) as an adjunctive means of identifying renal artery and parenchymal perfusion.We propose the use of the ICG with NIR fluorescence during laparoscopic robot-assisted radical prostatectomy (RARP), to identify the benchmark artery improving the preservation of neurovascular bundle and to improve the visualization of the vascularization and then the hemostasis. From April 2015 to February 2016, 62 patients underwent to RARP in our Urology Unit. In 26 consecutive patients, in the attempt to have a better visualization of neurovascular bundles, we used to inject ICG during the procedure. We evaluated the percentage of identification of neurovascular bundles using NIR fluorescence. Then, we evaluated complications related to injection of ICG and operative time differences between RARP with and without ICG injection performed by the same surgeons. We identified prostatic arteries and neurovascular bundles using NIR fluorescence technology in all patients (100%). There was not any increase in the operative time compared with RARP without ICG injection performed by the same surgeons. Complications related to injection of ICG did not occurred. In our experience, even if on a limited number of patients, the application of ICG with NIR fluorescence during RARP is helpful to identify the benchmark artery of neurovascular bundle.

  4. Introduction: The Pan-Eurasian Experiment (PEEX) - multidisciplinary, multiscale and multicomponent research and capacity-building initiative

    Science.gov (United States)

    Kulmala, M.; Lappalainen, H. K.; Petäjä, T.; Kurten, T.; Kerminen, V.-M.; Viisanen, Y.; Hari, P.; Sorvari, S.; Bäck, J.; Bondur, V.; Kasimov, N.; Kotlyakov, V.; Matvienko, G.; Baklanov, A.; Guo, H. D.; Ding, A.; Hansson, H.-C.; Zilitinkevich, S.

    2015-11-01

    The Pan-Eurasian Experiment (PEEX) is a multidisciplinary, multiscale and multicomponent research, research infrastructure and capacity-building program. PEEX has originated from a bottom-up approach by the science communities and is aiming at resolving the major uncertainties in Earth system science and global sustainability issues concerning the Arctic and boreal pan-Eurasian regions, as well as China. The vision of PEEX is to solve interlinked, global grand challenges influencing human well-being and societies in northern Eurasia and China. Such challenges include climate change; air quality; biodiversity loss; urbanization; chemicalization; food and freshwater availability; energy production; and use of natural resources by mining, industry, energy production and transport sectors. Our approach is integrative and supra-disciplinary, recognizing the important role of the Arctic and boreal ecosystems in the Earth system. The PEEX vision includes establishing and maintaining long-term, coherent and coordinated research activities as well as continuous, comprehensive research and educational infrastructure and related capacity-building across the PEEX domain. In this paper we present the PEEX structure and summarize its motivation, objectives and future outlook.

  5. The South India Precambrian crust and shallow lithospheric mantle: Initial results from the India Deep Earth Imaging Experiment (INDEX)

    Indian Academy of Sciences (India)

    S S Rai; Kajaljyoti Borah; Ritima Das; Sandeep Gupta; Shalivahan Srivastava; K S Prakasam; K Sivaram; Sudesh Kumar; Rishikesh Meena

    2013-12-01

    We present here the most comprehensive study of the thickness and composition (/ ratio) of the South India Precambrian crust and the nature of shallower mantle inferred from analysis of teleseismic receiver functions from 70 broad-band seismic stations operated as a part of the India Deep Earth Imaging Experiment (INDEX). South India could be broadly divided into regions with thin crust (32–38 km) and thick crust (38–54 km). Thin crust domains include the East Dharwar Craton (EDC), Cuddapah basin and Madurai/Kerala Khondalite Block. The thicker crust domain includes the Western Dharwar Craton (WDC) and northern part of Southern Granulite Terrain. The WDC shows progressive increase in thickness from 38 km in north to 46–54 km in south, compared to an almost flat Moho beneath the EDC. Compositionally, most of the crustal domains are felsic to intermediate (/ ∼ 1.69–1.75) except the mid Archean block in the southern WDC where it is mafic (/ < 1.81). Considering erosion depth in the WDC, we argue for Himalaya like ∼70 km thick crust beneath it during the Archean. Variation in crustal thickness does not have a first-order influence on regional topography in South India and suggests significant role for the crustal composition. We also present evidence of mid-lithospheric low velocity at ∼85–100 km beneath South India.

  6. Reconstruction of medial patellofemoral ligament using quadriceps tendon combined with reconstruction of medial patellotibial ligament using patellar tendon: initial experience

    Directory of Open Access Journals (Sweden)

    Betina Bremer Hinckel

    2016-02-01

    Full Text Available ABSTRACT OBJECTIVE: To describe a surgical technique for anatomical reconstruction of the medial patellofemoral ligament using the quadriceps tendon, combined with reconstruction of the medial patellotibial ligament using the patellar tendon; and to present the initial results from a case series. METHOD: The proposed technique was used on a series of cases of patients with diagnoses of patellofemoral instability and indications for surgical treatment, who were attended by the Knee Group of HC-IOT, University of São Paulo. The following were evaluated before and after the operation: range of motion (ROM, apprehension test, lateral translation test, patellar inclination test, inverted J sign, subluxation upon extension, pain from compression of the patella and pain from contraction of the quadriceps. After the operation, the patients were asked whether any new episode of dislocation had occurred, what their degree of satisfaction with the surgery was (on a scale from 0 to 10 and whether they would be prepared to go through this operation again. RESULTS: Seven knees were operated, in seven patients, with a mean follow-up of 5.46 months (±2.07. Four patients who presented apprehension before the operation did not show this after the operation. The lateral translation test became normal for all the patients, while the patellar inclination test remained positive for two patients. The patients with an inverted J sign continued to be positive for this sign. Five patients were positive for subluxation upon extension before the operation, but all patients were negative for this after the operation. None of the patients presented any new episode of dislocation of the patella. All of them stated that they were satisfied: five gave a satisfaction score of 9 and two, a score of 10. All of them said that they would undergo the operation again. Only one patient presented a postoperative complication: dehiscence of the wound. CONCLUSION: Reconstruction of the

  7. The INTERBALL-Tail ELECTRON experiment: initial results on the low-latitude boundary layer of the dawn magnetosphere

    Directory of Open Access Journals (Sweden)

    J.-A. Sauvaud

    Full Text Available The Toulouse electron spectrometer flown on the Russian project INTERBALL-Tail performs electron measurements from 10 to 26 000 eV over a 4 solid angle in a satellite rotation period. The INTERBALL-Tail probe was launched on 3 August 1995 together with a subsatellite into a 65° inclination orbit with an apogee of about 30 RE. The INTERBALL mission also includes a polar spacecraft launched in August 1996 for correlated studies of the outer magnetosphere and of the auroral regions. We present new observations concerning the low-latitude boundary layers (LLBL of the magnetosphere obtained near the dawn magnetic meridian. LLBL are encountered at the interface between two plasma regimes, the magnetosheath and the dayside extension of the plasma sheet. Unexpectedly, the radial extent of the region where LLBL electrons can be sporadically detected as plasma clouds can reach up to 5 RE inside the magnetopause. The LLBL core electrons have an average energy of the order of 100 eV and are systematically field-aligned and counterstreaming. As a trend, the temperature of the LLBL electrons increases with decreasing distance to Earth. Along the satellite orbit, the apparent time of occurrence of LLBL electrons can vary from about 5 to 20 min from one pass to another. An initial first comparison between electron- and magnetic-field measurements indicates that the LLBL clouds coincide with a strong increase in the magnetic field (by up to a factor of 2. The resulting strong magnetic field gradient can explain why the plasma-sheet electron flux in the keV range is strongly depressed in LLBL occurrence regions (up to a factor of sim10. We also show that LLBL electron encounters are related to field-aligned current structures and that wide LLBL correspond to northward interplanetary magnetic field. Evidence for LLBL/plasma-sheet electron leakage into the magnetosheath during southward IMF is also presented.

  8. El comienzo de la lactancia: experiencias de madres primerizas Initiating breastfeeding: experiences of first-time mothers

    Directory of Open Access Journals (Sweden)

    M. Belintxon-Martín

    2011-12-01

    establishment. Methods. A qualitative study with a descriptive phenomenological approach was used. Twelve first-time mothers were interviewed in-depth on two occasions: once a few days after childbirth, and another time one month from giving birth. The data were recorded and transcribed verbatim. Giorgi´s method was used for the analysis. Results. The essential meaning of the experience undergone by the mothers who took part in this study can be described by the following five themes: an idealization of breastfeeding; uncertainty over the difficulties; a desire for privacy during breastfeeding; shared responsibility with the child for breastfeeding to succeed; and, finally, disruption to the women´s lives and changes in their role. Conclusions. This study allowed access to the experiences of first-time mothers during the establishment of breastfeeding. This information will facilitate the design of tailored interventions taking into account the mothers´ reports. Health professionals should: consider women´s expectations and how they face their new role, provide practical and emotional support, be consistent and avoid giving conflicting advice, and acknowledge the importance of the fathers´ support.

  9. Perioperative outcome of initial 190 cases of robot-assisted laparoscopic radical prostatectomy - A single-center experience

    Directory of Open Access Journals (Sweden)

    P N Dogra

    2012-01-01

    Full Text Available Objective: To analyze the perioperative outcome of the first 190 cases of robot-assisted laparoscopic radical prostatectomy performed at our center from July 2006 to December 2010. Materials and Methods: Operative and recovery data for men with localized prostate cancer undergoing robot-assisted radical prostatectomy at our center were reviewed. All surgeries were performed using the 4-arm da Vinci-S surgical robot. Preoperative data included age, body mass index (BMI, prostate specific antigen (PSA level, prostate weight, biopsy Gleason score and TNM staging, while operative and recovery data included total operative time, estimated blood loss, complications, hospital stay and catheter time. These parameters were evaluated for the safety and efficacy of this procedure in our center. Results: The mean age of our patients was 65 ± 1.2 years. The mean BMI was 25.20 ± 2.88 and the median PSA was 14.8 ng/ml. Majority of our patients belonged to clinical stage T2 (51.58%. The mean total operative time was 166.44 ± 11.5 min. Six patients required conversion to open procedure and there was one rectal injury. The median estimated blood loss was 302 ± 14.45 ml and the median duration of hospital stay was 4 days. The overall margin positivity rate was 12.63%. Conclusion: Despite our limited robotic surgery experience, our perioperative outcome and complication rate is comparable to most contemporary series. Robot-assisted laparoscopic prostatectomy (RALP is easy to learn and provides the patient with the benefits of minimally invasive surgery with minimal perioperative morbidity.

  10. Initial clinical experience with the Medtronic Micro Vascular Plug™ in transcatheter occlusion of PDAs in extremely premature infants.

    Science.gov (United States)

    Sathanandam, Shyam; Justino, Henri; Waller, B Rush; Radtke, Wolfgang; Qureshi, Athar M

    2017-05-01

    To describe the early multicenter, clinical experience with the Medtronic Micro Vascular Plug™ (MVP) for the occlusion of patent ductus arteriosus (PDA) in premature infants. The MVP is a large diameter plug that can be delivered through a microcatheter for occlusion of abnormal blood vessels. A Retrospective review of PDA embolization procedures performed in two centers using the MVP was performed. Fifteen premature infants underwent attempted PDA occlusion using the MVP. The gestational age and birth weight were 25.6 ± 2.5 weeks and 735 ± 251 g, respectively. The median weight and age at the time of the procedure were 1,210 g (700-3,500 g) and 4.5 weeks (2-12 weeks), respectively. Median procedure and fluoroscopy times were 45 and 6.5 min, respectively. The median radiation and contrast doses were 19.7 mGy and 2.4 mL/kg, respectively. Antegrade occlusion was successfully achieved in 13 patients 2 kg had arterial access and attempted retrograde occlusion; one of which was unsuccessful due to the PDA being short and wide. Complete closure was observed in 13 of 14 successful procedures (93%), with one patient having a small residual shunt that was not seen on follow-up. There were no complications related to the procedure or noted during follow-up (Median 11 months). The MVP is a new, large-diameter vascular embolization device that may be useful for the occlusion of PDA in extremely small, premature infants. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Telerobotic-assisted laparoscopic operation performed at a remote site: initial experience Cirurgia laparoscópica robotizada a distância: experiência inicial

    Directory of Open Access Journals (Sweden)

    Cássio Andreoni

    2004-06-01

    Full Text Available Robotic surgery is an option to laparoscopy that may offer some benefits including the possibility of performing surgery when the surgeon is geographically away from the patient and faster tireless repetitive movements with greater precision. At present, robot-assisted surgery has been done routinely in several institutions around the world, however, to the best of our knowledge, it is the first time such procedure is performed in our academic environment and herein is reported the first telerobotic-assisted laparoscopic cystectomy performed in a domestic pig at our institution using the Zeus®robotic system (Computer Motion, EUA. The procedure was performed using two different operating rooms geographically apart from each other. The assistant was in an operating room that was set with the operating table and the pig as well as with the Zeus® robotic arms. In the other operating room, the surgeon was seated in the control console with a three-dimensional imaging five meters away from the operating table connected with electric cables. The assistant surgeon established the pneumoperitoneum and five trocars were placed in a fan configuration. The surgeon started performing the surgery using three out of the five ports taking control of the laparoscope (voice control and manual control of laparoscopic instruments connected to the robotic arms using the joysticks. The other two ports were used by the assistant for traction and clips placement that was also necessary for exchanging the many laparoscopic instruments connected to the robot. The laparoscopic total cystectomy was successfully performed in 25 minutes with no complications. The truly benefits as well as the cost-effectiveness of the robotic surgery in our environment is yet to be determined after experience acquisition with telerobotic before start performing such procedures routinely in humans. The present report shows the technical feasibility of telerobotic surgery in a developing

  12. First-Year Students’ Initial Motivational Beliefs at University: Predicted by Motivational Beliefs Derived from Within and Out-of-School Experience and Malleable Regardless of the Extent of Students’ Out-of-School Experience

    Science.gov (United States)

    Gorges, Julia

    2017-01-01

    The present study tested how academic self-concept of ability (ASC) and intrinsic task value (ITV) transpose onto novel university programs that depart from traditional subject areas within the framework of expectancy-value theory. The study focused on two potential sources of information used to anticipate one’s ASC and ITV regarding new learning content (here: business administration). First, students’ experiences from secondary school, especially their ASCs and ITVs established in a school subject they consider similar to business administration—mathematics—should predict their business administration-specific ASC and ITV. Second, students may have gained relevant experience in out-of-school settings such as internships with business companies or commercial vocational training prior to entering higher education. ASC and ITV developed from out-of-school experiences was hypothesized to predict students’ business administration-specific ASC and ITV as well. However, the likely mismatch between anticipated and actual experience with new contents should lead to revisions of ASC and ITV after entering university reflected in a presumably lower stability compared to secondary school settings. In addition, the extent of students’ out-of-school experience might act as a moderator. Data were collected from 341 first-year students in higher education in Germany before they began their study program and again 3–4 months later. Confirmatory factor analyses support the discriminant validity of the measures used in the study. Results from structural equation modeling show that students’ ASC/ITV derived from relevant out-of-school experience make an important contribution to their initial business administration-specific ASC and ITV beyond their mathematics-specific ASC/ITV. Furthermore, both business administration-specific ASC and ITV showed significantly lower stability coefficients over the initial study phase than research from secondary school indicating

  13. Tratamento cirúrgico da fibrilação atrial: procedimento do "labirinto": experiência inicial Surgical treatment of atrial fibrillation with "maze" procedure: initial experience

    Directory of Open Access Journals (Sweden)

    Adib D Jatene

    1992-06-01

    complicações infecciosas. Os pacientes restantes obtiveram alta hospitalar sem drogas antiarrítmicas. Em um período de um a dez meses (M = 5,4, os pacientes estão assintomáticos e o Holter mostra presença de ritmo atrial irregular permanente (com FC média de 70 a 80 bpm com condução AV preservada; o ecodoppler mostra presença de contração atrial eficiente. Não houve recorrências de FA e nenhum dos pacientes. Em conclusão, podemos admitir que, a curto prazo, a técnica do "labirinto" na FA em reumáticos restaurou a contração atrial organizada e controlou a FC. Assim, pode contribuir para redução de fenômenos trombo-embólicos. Maior número de pacientes deve ser observado durante tempo prolongado para avaliação da eficácia do procedimento.The "maze" procedure for surgical treatment of chronic atrial fibrillation (AF described by Cox was performed in 9 patients from July 91 to May 92; 7 were female and the ages range from 37 to 63y (51,4y. Eight patients had surgical rheumatic valve disfunction (mitral stenosis in 6; mitral double disfunction in 2 being 1 with associated tricuspid regurgitation and 1 had recurrent paroxicistic AF with no valve disfunction. Surgical treatment was performed following the technique described by Cox and the surgery was completed with 6 mitral comissurotomies and 2 mitral valve replacements. Three patients had left atrial thrombosis. There were no immediate deaths and 1 patient died in the 45th day with infeccious complications. The first patient required reoperation for bleeding review. Second and 3rd patients presented transitory atrial tachycardia in 3rd and 5th day, controlled with intravenous amiodarone. No other complications were observed. In a mean follow up period of 5,4m (1 to 10 m, all patients were in regular atrial rhythm without antiarrhythmic drugs. Effective atrial contraction was demonstrated by ECHO in all patients and no one returned to AF. In conclusion, this initial follow up showed good results in

  14. Treatment effect expressed as the novel Delay of Event measure is associated with high willingness to initiate preventive treatment - A randomized survey experiment comparing effect measures.

    Science.gov (United States)

    Berglund, Erik; Westerling, Ragnar; Sundström, Johan; Lytsy, Per

    2016-12-01

    This study aimed to investigate patients' willingness to initiate a preventive treatment and compared two established effect measures to the newly developed Delay of Events (DoE) measure that expresses treatment effect as a gain in event-free time. In this cross-sectional, randomized survey experiment in the general Swedish population,1079 respondents (response rate 60.9%) were asked to consider a preventive cardiovascular treatment. Respondents were randomly allocated to one of three effect descriptions: DoE, relative risk reduction (RRR), or absolute risk reduction (ARR). Univariate and multivariate analyses were performed investigating willingness to initiate treatment, views on treatment benefit, motivation and importance to adhere and willingness to pay for treatment. Eighty-one percent were willing to take the medication when the effect was described as DoE, 83.0% when it was described as RRR and 62.8% when it was described as ARR. DoE and RRR was further associated with positive views on treatment benefit, motivation, importance to adhere and WTP. Presenting treatment effect as DoE or RRR was associated with a high willingness to initiate treatment. An approach based on the novel time-based measure DoE may be of value in clinical communication and shared decision making. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. CORDEX Flagship Pilot Study "LUCAS - Land Use & Climate Across Scales" - a new initiative on coordinated regional land use change and climate experiments for Europe

    Science.gov (United States)

    Rechid, Diana; Davin, Edouard; de Noblet-Ducoudré, Nathalie; Katragkou, Eleni

    2017-04-01

    The new project LUCAS (Land Use & Climate Across Scales) was initiated jointly by EURO-CORDEX and LUCID (Land-Use and Climate, IDentification of robust impacts) and has been endorsed by WCRP CORDEX as a flagship pilot study. The overall objective of LUCAS is to identify robust biophysical impacts of land use changes on climate across regional to local spatial scales and at various time scales from extreme events to multiple decades. In this context, land use changes (LUC) refer to anthropogenic land cover conversions as well as land management practises. We identified major science questions to be addressed: • How large is the relative contribution of LUC to detected past and potential future climate trends? • How do land use practices modulate climate variability? Can local LUC reduce or amplify extreme climate conditions? • What is the effect of spatial resolution on the magnitude and robustness of LUC-induced climate changes? • How sensitive are the regional climate models to LUC and how is this interrelated to land-atmosphere coupling in different regions among the suite of models? In order to derive robust answers, we initiate a new era of coordinated regional climate model (RCM) ensemble LUC experiments on high spatial resolutions based on consistent land use dynamics for the past and the future. We include a new generation of RCMs which couple regional atmosphere interactively with further components of the regional earth system, e.g. terrestrial biosphere and hydrosphere. Land use pathways will be chosen in cooperation with land use modelling experts. The multi-model experiments will be conducted over multiple gridded nests to refine the continental simulations down to resolutions below 5 km. Simulated variables and fine-scale processes will be evaluated against multi-variable observations from flux towers, satellite sensors and new airborne and spaceborn radar techniques. In this conference contribution, we will present the overall framework of the

  16. THE INITIAL COOLING EXPERIMENT (ICE)

    CERN Multimedia

    CERN PhotoLab

    1977-01-01

    ICE was built during 1977, in a record time of 9 months, using the modified bending magnets of the g-2 muon storage ring (see 7405430). ICE was a proton and antiproton storage ring, built to verify the validity of stochastic and electron cooling for the antiproton project to be launched in 1978. More on the ICE experimental programme with 7802099. See also 7809081, 7908242.

  17. Measuring trauma and stressful events in childhood and adolescence among patients with first-episode psychosis: initial factor structure, reliability, and validity of the Trauma Experiences Checklist.

    Science.gov (United States)

    Cristofaro, Sarah L; Cleary, Sean D; Ramsay Wan, Claire; Broussard, Beth; Chapman, Colby; Haggard, Patrick J; Jananeh, Sara; Myers, Neely L; Compton, Michael T

    2013-12-15

    Past trauma and stressful events, especially in childhood and adolescence, are common among individuals with serious mental illnesses like schizophrenia. Traumatic experiences are thought to be a socio-environmental risk factor not only for poorer outcomes, but also potentially for the onset of these disorders. Because improved measurement tools are needed, we developed and studied, among 205 first-episode psychosis patients, the factor structure, internal consistency reliability, and initial validity of the Trauma Experiences Checklist (TEC), our measure of trauma and stressful events during childhood/adolescence. We assessed validity of subscales using correlations with Childhood Trauma Questionnaire-Short Form, Parental Harsh Discipline, Violence Exposure, and TEC-Informant Version scores. Exploratory factor analysis resulted in two internally consistent subscales (Cronbach's α=0.79 and 0.80, respectively), interpersonal abuse and family stress, and violence, death, and legal involvement. Scores from the former subscale were substantially associated with CTQ-SF physical, emotional, and sexual abuse (r=0.42-0.57, all p<0.001) and Violence Exposure (r=0.49, p<0.001). On the other hand, violence, death, and legal involvement scores were most highly correlated with Violence Exposure (r=0.49, p<0.001), and not with most CTQ-SF subscales. The TEC is a potentially useful tool in assessing diverse traumatic life events across various social contexts during childhood and adolescence.

  18. PAN EURASIAN EXPERIMENT (PEEX - A RESEARCH INITIATIVE MEETING THE GRAND CHALLENGES OF THE CHANGING ENVIRONMENT OF THE NORTHERN PAN-EURASIAN ARCTIC-BOREAL AREAS

    Directory of Open Access Journals (Sweden)

    Hanna K. Lappalainen

    2014-01-01

    Full Text Available The Pan-Eurasian Experiment (PEEX is a new multidisciplinary, global change research initiative focusing on understanding biosphere-ocean-cryosphere-climate interactions and feedbacks in Arctic and boreal regions in the Northern Eurasian geographical domain. PEEX operates in an integrative way and it aims at solving the major scientific and society relevant questions in many scales using tools from natural and social sciences and economics. The research agenda identifies the most urgent large scale research questions and topics of the land-atmosphere-aquatic-anthropogenic systems and interactions and feedbacks between the systems for the next decades. Furthermore PEEX actively develops and designs a coordinated and coherent ground station network from Europe via Siberia to China and the coastal line of the Arctic Ocean together with a PEEX-modeling platform. PEEX launches a program for educating the next generation of multidisciplinary researcher and technical experts. This expedites the utilization of the new scientific knowledge for producing a more reliable climate change scenarios in regional and global scales, and enables mitigation and adaptation planning of the Northern societies. PEEX gathers together leading European, Russian and Chinese research groups. With a bottom-up approach, over 40 institutes and universities have contributed the PEEX Science Plan from 18 countries. In 2014 the PEEX community prepared Science Plan and initiated conceptual design of the PEEX land-atmosphere observation network and modeling platform. Here we present the PEEX approach as a whole with the specific attention to research agenda and preliminary design of the PEEX research infrastructure.

  19. Initial experience with circumferential pulmonary vein isolation guided by Overlay Ref and CartoMerge in the treatment of paroxysmal atrial fibrillation.

    Science.gov (United States)

    Tang, Kai; Zhao, Dong-dong; Zhang, Jing-ying; Chen, Yan-qing; Xu, Ya-wei

    2010-05-20

    CartoMerge has been widely used in guiding circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF). However, the procedure of landmarks selection varies among operators according to their experience. Techniques have to be established to standardize this procedure. We propose that Overlay Ref could facilitate this procedure. This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF. Fifty-nine patients with PAF were enrolled in this study. Using Overlay Ref technique, a reference image (inverted) was faded into the live fluoroscopic image. Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins (PVs) and the bottom of inferior PVs guided by Overlay Ref image. Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge. All patients were successfully mapped by CartoMerge guided by Overlay Ref. The distance between the mapping points and the CT surfaces was (1.42 +/- 0.67) mm for the patients as a whole. This led to a successful rate of 96% for isolation of pulmonary veins. Duration of ablation procedure was (92 +/- 17) minutes. And the total duration of procedure was (139 +/- 32) minutes. CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto. Then, the total duration of procedure could be shortened to (115 +/- 38) minutes. Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.

  20. Initial experience with circumferential pulmonary vein isolation guided by Overlay Ref and CartoMerge in the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    TANG Kai; ZHAO Dong-dong; ZHANG Jing-ying; CHEN Yan-qing; XU Ya-wei

    2010-01-01

    Background CartoMerge has been widely used in guiding circumferential pulmonary vein isolation (CPVI) for the treatment of paroxysmal atrial fibrillation (PAF).However, the procedure of landmarks selection varies among operators according to their experience.Techniques have to be established to standardize this procedure.We propose that Overlay Ref could facilitate this procedure.This paper aimed to report our initial experience with CPVI guided by Overlay Ref and CartoMerge for the treatment of PAF.Methods Fifty-nine patients with PAF were enrolled in this study.Using Overlay Ref technique, a reference image (inverted) was faded into the live fluoroscopic image.Landmarks of CartoMerge were selected from anatomic points of the top of superior pulmonary veins (PVs) and the bottom of inferior PVs guided by Overlay Ref image.Overlay Ref images were also used to guide the ablation procedure combining with CartoMerge.Results All patients were successfully mapped by CartoMerge guided by Overlay Ref.The distance between the mapping points and the CT surfaces was (1.42±0.67) mm for the patients as a whole.This led to a successful rate of 96%for isolation of pulmonary veins.Duration of ablation procedure was (92±17) minutes.And the total duration of procedure was (139±32) minutes.CartoMerge could also be performed just with 3 paries to 4 paries selected landmarks guided by Overlay Ref without a full anatomic model constructed by Carto.Then, the total duration of procedure could be shortened to (115±38) minutes.Conclusions Overlay Ref technique can facilitate the catheter ablation of PAF and can help to standardize the procedure of landmarks selection.

  1. Perfusion measurement of the whole upper abdomen of patients with and without liver diseases: Initial experience with 320-detector row CT

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori, E-mail: k_a@hotmail.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yoshikawa, Takeshi, E-mail: yoshikaw@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Ohno, Yoshiharu, E-mail: yosirad@kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Fujisawa, Yasuko, E-mail: yasuko1.fujisawa@toshiba.co.jp [Toshiba Medical Systems Co., 1385 Shimoishigami, Otawara 324-0036 (Japan); Kanata, Naoki, E-mail: takikina12345@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yamaguchi, Masato, E-mail: masato03310402@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Seo, Yasushi, E-mail: yseo@med.kobe-u.ac.jp [Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate, School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yano, Yoshihiko, E-mail: yanoyo@med.kobe-u.ac.jp [Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate, School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Koyama, Hisanobu, E-mail: hkoyama@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Kitajima, Kazuhiro, E-mail: kazu10041976@yahoo.co.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Takenaka, Daisuke, E-mail: daisuket@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); and others

    2012-10-15

    Objectives: To report initial experience of upper abdominal perfusion measurement with 320-detector row CT (CTP) for assessment of liver diseases and therapeutic effects. Materials and methods: Thirty-eight patients who were suspected of having a liver disease underwent CTP. There were two patients with liver metastases, two with hemangiomas, and four with cirrhosis (disease group). CTP was repeated for four patients with cirrhosis or hepatocellular carcinoma (HCC) after therapy. Hepatic arterial and portal perfusion (HAP and HPP) and arterial perfusion fraction (APF), and arterial perfusion (AP) of pancreas, spleen, stomach, and intra-portal HCC were calculated. For disease-free patients (normal group), the values were compared among liver segments and among pancreatic and gastric parts. The values were compared between groups and before and after therapy. Results: No significant differences were found in the normal group except between APFs for liver segments 3 and 5, and fundus and antrum. Mean HAP and APF for the disease group were significantly higher than for the normal group. APF increased after partial splenic embolization or creation of a transjugular intrahepatic portosystemic shunt. HPP increased and AP of intra-portal HCC decreased after successful radiotherapy. Conclusions: 320-Detector row CT makes it possible to conduct perfusion measurements of the whole upper abdomen. Our preliminary results suggested that estimated perfusion values have the potential to be used for evaluation of hepatic diseases and therapeutic effects.

  2. Synchronous Aberrant Cerebellar and Opercular Development in Fetuses and Neonates with Congenital Heart Disease: Correlation with Early Communicative Neurodevelopmental Outcomes, Initial Experience.

    Science.gov (United States)

    Wong, A; Chavez, T; O'Neil, S; Votava-Smith, J; Miller, D; delCastillo, S; Panigrahy, A; Paquette, L

    2017-01-01

    Patients with congenital heart disease (CHD) demonstrate multidomain cognitive delays. Cingulo-opercular and cerebellar brain networks are critical to language functions. This is a description of our initial experience aiming to identify an anatomic correlate for CHD patients with expressive language delays. Fetal CHD patients, prospectively enrolled, underwent serial fetal (1.5T), postnatal pre- and postoperative (3T) MRI. Non-CHD patients were enrolled retrospectively from the same epoch. Comparable fetal and neonatal T2 contrast was used for manual linear cross-sectional measurement. Multivariable analysis was used for adjustments and curve fitting. Neurodevelopment was assessed with Battelle Developmental Inventory, 2nd ed. between 9 and 36 months of age. This interim analysis included patients from our longitudinal CHD study who had fetal, postnatal imaging and neurodevelopmental data-yielding a total of 62 mothers (11 CHD fetuses and 51 non-CHD fetuses). Altered brain trajectories were seen in selected cerebellar and opercular measurements in CHD patients compared with the non-CHD group. Smaller inferior cerebellar vermis measurements were associated with multiple communication-related abnormalities. Altered early structural development of the cerebellum and operculum is present in patients with CHD, which correlates with specific neurodevelopmental abnormalities.

  3. SU-C-16A-01: In Vivo Source Position Verification in High Dose Rate (HDR) Prostate Brachytherapy Using a Flat Panel Imager: Initial Clinical Experience

    Energy Technology Data Exchange (ETDEWEB)

    Franich, R; Smith, R; Millar, J [RMIT University, Melbourne, Victoria (Australia); The Alfred Hospital, Melbourne, Victoria (Australia); Haworth, A [RMIT University, Melbourne, Victoria (Australia); Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Taylor, M [RMIT University, Melbourne, Victoria (Australia); Australian Federal Police, Canberra, ACT (Australia); McDermott, L [RMIT University, Melbourne, Victoria (Australia)

    2014-06-15

    Purpose: We report our initial clinical experience with a novel position-sensitive source-tracking system based on a flat panel imager. The system has been trialled with 4 prostate HDR brachytherapy patients (8 treatment fractions) in this initial study. Methods: The flat panel imaging system was mounted under a customised carbon fibre couch top assembly (Figure 1). Three gold fiducial markers were implanted into the prostate of each patient at the time of catheter placement. X-ray dwell position markers were inserted into three catheters and a radiograph acquired to locate the implant relative to the imaging device. During treatment, as the HDR source dwells were delivered, images were acquired and processed to determine the position of the source in the patient. Source positions measured by the imaging device were compared to the treatment plan for verification of treatment delivery. Results: Measured dwell positions provided verification of relative dwell spacing within and between catheters, in the coronal plane. Measurements were typically within 2.0mm (0.2mm – 3.3mm, s.d. 0.8mm) of the planned positions over 60 dwells (Figure 2). Discrimination between larger dwell intervals and catheter differentiation were clear. This confirms important delivery attributes such as correct transfer tube connection, source step size, relative catheter positions and therefore overall correct plan selection and delivery. The fiducial markers, visible on the radiograph, provided verification of treatment delivery to the correct anatomical location. The absolute position of the dwells was determined by comparing the measured dwell positions with the x-ray markers from the radiograph, validating the programmed treatment indexer length. The total impact on procedure time was less than 5 minutes. Conclusion: The novel, noninvasive HDR brachytherapy treatment verification system was used clinically with minor impact on workflow. The system allows verification of correct treatment

  4. The ion experiment onboard the Interball-Aurora satellite; initial results on velocity-dispersed structures in the cleft and inside the auroral oval

    Directory of Open Access Journals (Sweden)

    J. A. Sauvaud

    Full Text Available The Toulouse ION experiment flown on the Russian Interball-Aurora mission performs simultaneous ion and electron measurements. Two mass spectrometers looking in opposing directions perpendicular to the satellite spin axis, which points toward the sun, measure ions in the mass and energy ranges 1–32 amu and ~0–14 000 eV. Two electron spectrometers also looking in opposing directions perform measurements in the energy range ~10 eV–20 000 eV. The Interball-Aurora spacecraft was launched on 29 August 1996 into a 62.8° inclination orbit with an apogee of ~3 RE. The satellite orbital period is 6 h, so that every four orbits the satellite sweeps about the same region of the auroral zone; the orbit plane drifts around the pole in ~9 months. We present a description of the ION experiment and discuss initial measurements performed in the cusp near noon, in the polar cleft at dusk, and inside the proton aurora at dawn. Ion-dispersed energy structures resulting from time-of-flight effects are observed both in the polar cleft at ~16 hours MLT and in the dawnside proton aurora close to 06 hours MLT. Magnetosheath plasma injections in the polar cleft, which appear as overlapping energy bands in particle energy-time spectrograms, are traced backwards in time using a particle trajectory model using 3D electric and magnetic field models. We found that the cleft ion source is located at distances of the order of 18 RE from the earth at about 19 MLT, i.e., on the flank of the magnetopause. These observations are in agreement with flux transfer events (FTE occurring not only on the front part of the magnetopause but also in a region extending at least to dusk. We also show that, during quiet magnetic conditions, time-of-flight ion dispersions can also be measured inside the dawn proton aurora. A method similar to that used for the cleft is applied to these auroral energy dispersion signatures. Unexpectedly, the ion source is found to be

  5. Initial experience with locoregional radioimmunotherapy using {sup 131}I-labelled monoclonal antibodies against tenascin (BC-4) for treatment of glioma (WHO III and IV)

    Energy Technology Data Exchange (ETDEWEB)

    Poepperl, G.; Gildehaus, F.J.; Hahn, K.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin, Klinikum Grosshadern, Muenchen (Germany); Goetz, C.; Reulen, H.J. [Klinik und Poliklinik fuer Neurochirurgie, Klinikum Grosshadern, Muenchen (Germany); Yousry, T.A. [Inst. fuer Neuroradiologie der LMU Muenchen, Klinikum Grosshadern, Muenchen (Germany)

    2002-06-01

    Aim: None of the established treatments (surgery, radiotherapy, chemotherapy) for malignant glioma has improved its very poor prognosis. Adjuvant locoregional radioimmunotherapy (RIT) represents a new therapeutic approach. We present our initial experience with this therapeutic tool with respect to adverse effects, biokinetics and clinical follow-up. Methods: Following surgery and radiotherapy, 12 patients with glioma (4, WHO stage III; 8, WHO stage IV) underwent 1-5 RIT-cycles (average dose 1100 MBq {sup 131}labelled monoclonal BC-4 antibodies) at six week intervals. Follow-up included serial FDG-PET and MRI investigations. Evaluation of biokinetics included whole body scans, together with analysis of blood, urine and fluid from the tumor cavity. Results: Following RIT, four patients experienced temporary seizures, which, in one case, were associated with temporary aphasia. Eight patients developed HAMA (human anti-mouse anti-bodies) during follow-up. Mean biologic half-life of the radiopharmaceutical in the resection cavity was 3.9 d (range: 1.0-10.2 d) and remained stable intraindividually during further RIT-cycles. The antibody/radionuclide conjugate remain stable in the tumor cavity for at least 5 d. Median survival presently stands at 18.5 months compared to 9.7 months in a historical patient group (n=89) undergoing conventional therapeutic strategies. Five patients show no signs of recurrence. In three patients with post-surgical evidence of residual tumor, one patient showed partial remission, one stable disease, and one progressive disease during RIT. Four patients without evidence of residual tumor mass at the beginning of RIT developed recurrence during therapy. Conclusions: Initial experience demonstrates that locoregional RIT is a well tolerated treatment modality that may represent a promising new approach in the management of patients with malignant glioma. Advantages of local application include passage of the blood-brain barrier, high concentration

  6. Numerical Simulation Study on the Experiments of the Initiation of Debris Flow%泥石流启动试验的数值模拟研究∗

    Institute of Scientific and Technical Information of China (English)

    周健; 杜强; 于仕才

    2015-01-01

    This paper used Particle Flow Code (PFC3D )to simulate the model experiment of the process of the initiation of debris flow.Based on the previous simulation studies and considering the unsaturated features of sand soil,it simulated water with small granules in the numerical simulation of the initiation phase of sandy debris flow,and set a bond model to simulate the matrix suction between soil particles. Compared with the results of the numerical simulation with laboratory model tests,the result of the study shows that the start of debris flow forms with rear soil pushing the front soil rapid decline.Under the con-dition of unsaturated,the matrix suction between soil particles provides soil strength.When the penetra-tion and gravity are beyond the bond force between particles,soil turns from unsaturated to saturated and debris flow will start.Compared with the results in the simulated method which does not consider the con-dition of unsaturated,the method of considering the unsaturated is suitable to simulate the initiation process and failure mode of flow-slip mudslides.%采用离散元颗粒流程序 PFC3D (Particle Flow Code)对泥石流启动过程的模型试验进行数值模拟研究。考虑泥石流启动过程中砂土的非饱和特性,在前期研究的基础上对模型进行改进,利用微小颗粒模拟水团,并通过设置黏结模型模拟土颗粒间的基质吸力。将数值模拟结果与室内模型试验进行对比分析,分析得出泥石流的启动表现为后部土体推挤前部土体快速下滑。非饱和状态下,颗粒间的基质吸力提供了一定的土体强度,当渗透力和重力引起的下滑力克服这种颗粒间的黏结力时,土体由非饱和状态逐渐转变为饱和状态,泥石流才会启动。与原有未考虑非饱和特性的数值模拟方法对比,结果表明,使用 PFC3D 并考虑土体非饱和特性,可以更接近地模拟流滑型泥石流的破坏形态和启动过程。

  7. Percutaneous computed tomography-guided high-dose-rate brachytherapy ablation of breast cancer liver metastases: initial experience with 80 lesions.

    Science.gov (United States)

    Collettini, Federico; Golenia, Mascha; Schnapauff, Dirk; Poellinger, Alexander; Denecke, Timm; Wust, Peter; Riess, Hanno; Hamm, Bernd; Gebauer, Bernhard

    2012-05-01

    To analyze initial experience with computed tomography-guided high-dose-rate brachytherapy (CT-HDRBT) ablation of breast cancer liver metastases (BCLM). Between January 2008 and December 2010, 37 consecutive women with 80 liver metastases were treated with CT-HDRBT in 56 sessions. Mean age was 58.6 years (range, 34-83 y). Treatment was performed by CT-guided applicator placement and high-dose-rate brachytherapy with an iridium-192 source. The mean radiation dose was 18.57 Gy (standard deviation 2.27). Tumor response was evaluated by gadoxetic acid-enhanced liver magnetic resonance (MR) imaging performed before treatment, 6 weeks after treatment, and every 3 months thereafter. Two patients were lost to follow-up; the remaining 35 patients were available for MR imaging evaluation for a mean follow-up time of 11.6 months (range 3-32 mo). Mean tumor diameter was 25.5 mm (range 8-74 mm). Two (2.6%) local recurrences were observed after local tumor control for 10 months and 12 months. Both local progressions were successfully retreated. Distant tumor progression (new metastases or enlargement of nontreated metastases) occurred during the follow-up period in 11 (31.4%) patients. Seven (20%) patients died during the follow-up period. Overall survival ranged from 3-39 months (median 18 months). CT-HDRBT is a safe and effective ablative therapy, providing a high rate of local tumor control in patients with BCLM. Copyright © 2012 SIR. Published by Elsevier Inc. All rights reserved.

  8. Radioactive seed localization with 125I for nonpalpable lesions prior to breast lumpectomy and/or excisional biopsy: methodology, safety, and experience of initial year.

    Science.gov (United States)

    Dauer, Lawrence T; Thornton, Cynthia; Miodownik, Daniel; Boylan, Daniel; Holahan, Brian; King, Valencia; Brogi, Edi; Morrow, Monica; Morris, Elizabeth A; St Germain, Jean

    2013-10-01

    The use of radioactive seed localization (RSL) as an alternative to wire localizations (WL) for nonpalpable breast lesions is rapidly gaining acceptance because of its advantages for both the patient and the surgical staff. This paper examines the initial experience with over 1,200 patients seen at a comprehensive cancer center. Radiation safety procedures for radiology, surgery, and pathology were implemented, and radioactive material inventory control was maintained using an intranet-based program. Surgical probes allowed for discrimination between 125I seed photon energies from 99mTc administered for sentinel node testing. A total of 1,127 patients (median age of 57.2 y) underwent RSL procedures with 1,223 seeds implanted. Implanted seed depth ranged from 10.3-107.8 mm. The median length of time from RSL implant to surgical excision was 2 d. The median 125I activity at time of implant was 3.1 MBq (1.9 to 4.6). The median dose rate from patients with a single seed was 9.5 µSv h-1 and 0.5 µSv h-1 at contact and 1 m, respectively. The maximum contact dose rate was 187 µSv h-1 from a superficially placed seed. RSL performed greater than 1 d before surgery is a viable alternative to WL, allowing flexibility in scheduling, minimizing day of surgery procedures, and improving workflow in breast imaging and surgery. RSL has been shown to be a safe and effective procedure for preoperative localization under mammographic and ultrasound guidance, which can be managed with the use of customized radiation protection controls.

  9. High intensity focused ultrasound with Focal-One(®) device: Prostate-specific antigen impact and morbidity evaluation during the initial experience.

    Science.gov (United States)

    Perez-Reggeti, J I; Sanchez-Salas, R; Sivaraman, A; Linares Espinos, E; de Gracia-Nieto, A E; Barret, E; Galiano, M; Rozet, F; Fregeville, A; Renard-Penna, R; Cathala, N; Mombet, A; Prapotnich, D; Cathelineau, X

    2016-12-01

    We report our initial experience in the treatment of prostate cancer (PCa) with high-intensity focused ultrasound (HIFU) using the Focal-One(®) device. Retrospective review of the prospectively populated database. Between June 2014 to October 2015, 85 patients underwent HIFU (focal/whole-gland) treatment for localized PCa. Preoperative cancer localization was done with multiparametric magnetic resonance imaging (mpMRI) and transperineal mapping biopsies. Treatment was carried out using the Focal-One(®) device under general anesthesia. Oncological follow-up: PSA measurement and control biopsy with mpMRI according to protocol. Questionnaire-based functional outcome assessment was done. Complications were reported using Clavien classification. The median PSA was 7.79ng/ml (IQR 6.32-9.16), with a median prostate volume of 38cc (IQR: 33-49.75). Focal and whole-gland therapy was performed in 64 and 21 patients respectively. Ten patients received salvage HIFU. Complications were encountered in 15% of cases, all Clavien 2 graded. Mean hospital stay was 1.8 days (0-7) and bladder catheter was removed on day 2 (1-6). Mean percentage reduction of PSA was 54%. Median follow-up was 3 months (IQR: 2-8). Functional outcomes: All patients were continents at 3 months and potency was maintained in 83% of the preoperatively potent. Focal-One(®) HIFU treatment appears to be a safe procedure with few complications. Functional outcomes proved no urinary incontinence and sexual function were maintained in 83%. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  10. Experiência inicial no fechamento percutâneo da comunicação interatrial com a prótese de Amplatzer Initial experience in percutaneous occlusion of atrial septal defects with the Amplatzer device

    Directory of Open Access Journals (Sweden)

    Valmir F. Fontes

    1998-03-01

    Full Text Available OBJETIVO: Analisar a experiência inicial no fechamento percutâneo da comunicação interatrial ostium secundum (CIA OS com a prótese de Amplatzer. MÉTODOS: Sete pacientes foram submetidos ao procedimento através da via venosa anterógrada, orientados pela ecocardiografia transesofágica (ETE e sob anestesia geral. Uma criança era portadora de 2 CIA e de canal arterial (CA. As CIA medidas pelo ETE variaram de 8,7 a 20mm. Um ecocardiograma transtorácico foi realizado na manhã seguinte do procedimento. RESULTADOS: Oito próteses foram implantadas nos 7 pacientes com sucesso. Em um paciente, o CA foi ocluído na mesma sessão com mola de Gianturco, tendo surgido taquicardia supraventricular durante a oclusão de uma das CIA, controlada com adenosina. Todos receberam alta hospitalar na manhã seguinte, com oclusão total dos defeitos. CONCLUSÃO: O procedimento mostrou-se seguro, eficaz e versátil, podendo ser considerado como uma alternativa terapêutica inicial em pacientes selecionados com CIA OS.PURPOSE: To evaluate our initial experience with percutaneous closure of secundum type atrial septal defects (ASD with the Amplatzer septal occluder. METHODS: Seven patients underwent occlusion by anterograde approach, under general anesthesia and transesophageal echocardiography (TEE guidance. One child had 2 ASD and a patent ductus arteriosus (PDA. The ASD size ranged from 8,7 to 20mm as measured by TEE. A transthoracic echocardiogram was performed in the morning after the procedure. RESULTS: Eight devices were successfully implanted in 7 patients and the PDA was occluded with a Gianturco coil at the same session. In this patient, there was an episode of supraventricular tachycardia during the occlusion of one ASD which was reverted with adenosin. All patients were discharged the day after, with complete occlusion of all defects. CONCLUSION: The procedure is safe, effective and versatile. It can be applied as an initial alternative to the

  11. Efficiency, safety, and long-term follow-up of retrograde approach for CTO recanalization: initial (Belgrade) experience with international proctorship.

    Science.gov (United States)

    Stojkovic, Sinisa; Sianos, George; Katoh, Osamu; Galassi, Alfredo R; Beleslin, Branko; Vukcevic, Vladan; Nedeljkovic, Milan; Stankovic, Goran; Orlic, Dejan; Dobric, Milan; Tomasevic, Miloje; Ostojic, Miodrag

    2012-12-01

     Retrograde approach increases the success rate for percutaneous recanalization of complex chronic total occlusion (CTO) of coronary arteries.  The purpose of this study was to describe our initial experience of retrograde percutaneous coronary intervention for CTO program, focusing on its safety and feasibility, and long-term clinical follow-up.  The study was a single center retrospective registry which included a total of 40 patients, of 590 CTO treated patients (6.7%), between January 2008 and October 2011, who underwent retrograde approach for CTO recanalization.  Mean occlusion duration was 37.8 ± 40.3 months. Overall success recanalization rate was 87.5% (35/40). Septal collaterals were used to access the occlusion in all cases (100%). Retrograde guidewire crossing of collateral channels was successful in 36/40 (90.0%) patients with success rate of CTO recanalization in these patients of 97.2%. Retrograde approach as the primary strategy was applied in 23/40 (57.5%) patients, retrograde approach immediately after antegrade failure attempt was performed in 8/40 (20.0%) patients, and retrograde approach as elective procedure, after previously failed antegrade attempt, was performed in 9/40 (22.5%) patients. The success rate of these strategies was: 87.0% (20/23 patients) for primary, 87.5% (7/8 patients) for retrograde immediately after antegrade failure, and 88.9% (8/9 patients) for retrograde after previous failed antegrade attempt, respectively. Total in-hospital major adverse cardiac events (MACE) rate was 5.0% (2 non-Q-wave myocardial infarctions). The MACE free survival at median follow-up of 20 months was 89% (95% CI: 78-100%).  This study has demonstrated that adequate training and international proctorship for this complex and demanding technique is a necessity and prerequisite to achieve high overall success rates, with acceptable complication rates and excellent long-term survival rate. ©2012, Wiley Periodicals, Inc.

  12. Robot-assisted laparoscopic approach for artificial urinary sphincter implantation in 11 women with urinary stress incontinence: surgical technique and initial experience.

    Science.gov (United States)

    Biardeau, Xavier; Rizk, Jérôme; Marcelli, François; Flamand, Vincent

    2015-05-01

    Artificial urinary sphincter (AUS) implantation is recommended for women suffering urinary stress incontinence. Robot-assisted laparoscopy allows improved dexterity and visibility compared to traditional laparoscopy, potentially providing significant advantages for deep pelvic surgery. To report our surgical technique and initial experience in transperitoneal robot-assisted laparoscopic AUS implantation in women with urinary stress incontinence. Eleven eligible patients with AUS implantation or revision using robot-assisted laparoscopy for urinary stress incontinence were included between January 2012 and February 2014 at Department of Urology, Lille University Hospital. Procedures were performed with the assistance of a four-arm da Vinci robot. The urethrovaginal space was dissected after transperitoneal access to the Retzius space. An 11-mm port placed in the right iliac fossa allowed introduction of the AUS device. The cuff and balloon tubes were externalised via a 5-mm suprapubic incision. The peritoneum was finally sutured. Clinical data were prospectively collected before, during, and after the procedure. Results were classified as complete continence (no leakage and no pad usage), social continence (leakage and/or pad usage with no impact on social life), or failure (leakage and/or pad usage impacting social life). After mean follow-up of 17.6 mo (interquartile range 10.8-26 mo), eight patients (72.7%) had a successful AUS implantation, of whom seven (87.5%) reported complete continence and one had social continence. Two vaginal injuries and two bladder injuries occurred intraoperatively. Two patients experienced early minor postoperative complications and two had a major postoperative complication. Robot-assisted laparoscopic AUS implantation is a feasible procedure. Further studies will better assess the place of robot-assisted laparoscopy in AUS implantation. We investigated the treatment of 11 patients with stress urinary incontinence using robot

  13. Linac-based extracranial radiosurgery with Elekta volumetric modulated arc therapy and an anatomy-based treatment planning system: Feasibility and initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Cilla, Savino, E-mail: savinocilla@gmail.com [Medical Physics Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso (Italy); Deodato, Francesco; Macchia, Gabriella; Digesù, Cinzia [Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso (Italy); Ianiro, Anna; Viola, Pietro; Craus, Maurizio [Medical Physics Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso (Italy); Valentini, Vincenzo [Radiotherapy Unit, Fondazione di Ricerca e Cura “Giovanni Paolo II”, Università Cattolica del Sacro Cuore, Campobasso (Italy); Radiation Oncology Unit, Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, Roma (Italy); Piermattei, Angelo [Medical Physics Unit, Policlinico Universitario “A. Gemelli”, Università Cattolica del Sacro Cuore, Roma (Italy); Morganti, Alessio G. [Radiation Oncology Unit, Department of Experimental, Diagnostic and Specialty Medicine-DIMES, S. Orsola-Malpighi Hospital, University of Bologna, Bologna (Italy)

    2016-07-01

    We reported our initial experience in using Elekta volumetric modulated arc therapy (VMAT) and an anatomy-based treatment planning system (TPS) for single high-dose radiosurgery (SRS-VMAT) of liver metastases. This study included a cohort of 12 patients treated with a 26-Gy single fraction. Single-arc VMAT plans were generated with Ergo++ TPS. The prescription isodose surface (IDS) was selected to fulfill the 2 following criteria: 95% of planning target volume (PTV) reached 100% of the prescription dose and 99% of PTV reached a minimum of 90% of prescription dose. A 1-mm multileaf collimator (MLC) block margin was added around the PTV. For a comparison of dose distributions with literature data, several conformity indexes (conformity index [CI], conformation number [CN], and gradient index [GI]) were calculated. Treatment efficiency and pretreatment dosimetric verification were assessed. Early clinical data were also reported. Our results reported that target and organ-at-risk objectives were met for all patients. Mean and maximum doses to PTVs were on average 112.9% and 121.5% of prescribed dose, respectively. A very high degree of dose conformity was obtained, with CI, CN, and GI average values equal to 1.29, 0.80, and 3.63, respectively. The beam-on-time was on average 9.3 minutes, i.e., 0.36 min/Gy. The mean number of monitor units was 3162, i.e., 121.6 MU/Gy. Pretreatment verification (3%-3 mm) showed an optimal agreement with calculated values; mean γ value was 0.27 and 98.2% of measured points resulted with γ < 1. With a median follow-up of 16 months complete response was observed in 12/14 (86%) lesions; partial response was observed in 2/14 (14%) lesions. No radiation-induced liver disease (RILD) was observed in any patients as well no duodenal ulceration or esophagitis or gastric hemorrhage. In conclusion, this analysis demonstrated the feasibility and the appropriateness of high-dose single-fraction SRS-VMAT in liver metastases performed with Elekta

  14. Padronização da técnica para cirurgia cardíaca videoassistida: experiência inicial Standardization of video-assisted cardiac surgery technique: initial experience

    Directory of Open Access Journals (Sweden)

    Jeronimo Antonio Fortunato Júnior

    2008-06-01

    procedure such as valves, coronary and congenital surgery. OBJECTIVE: To demonstrate our first works with noninvasive cardiac surgery by mean of the experience gained with general and thoracic surgery. METHODS: Whenever possible to carry out a minimally invasive cardiac surgery, this was the approach of choice. The left thoracoscopy was used in four cases: (1 symptomatic coronary-pulmonary fistula ligation; (2 implant of an epicardial electrode into the left ventricle for resynchronization; (3 excision of pericardial giant lipoma in the left atrium, and (4 resection of hemangiolipoma in the mediastinum. Right thoracoscopy with extracorporeal circulation through cardiopulmonary bypass via femoral vein and artery and cardiac arrest in ventricular fibrillation with moderate hypothermia were carried out in the following cases: (5 patient with mitral stenosis after surgical repair with Carpentier ring 12 years before. An anterior and posterior commissurotomy without thoracotomy was successfully made; (6 patient with idiopathic dilated cardiomyopathy, high-response atrial fibrillation, and severe mitral insufficiency, underwent mitral repair surgery with Gregori's ring and ablation of the pulmonary veins with radio-frequency catheter. (MAZZE modified. RESULT: No death occurred in this series and the surgical result in all cases was highly satisfactory. All patients were discharged from hospital with a mean time of 5.5 ± 5 days after intervention. CONCLUSION: Our initial experience in this field proves the effectiveness and the viability in introducing this type of technique.

  15. Experiência inicial com o uso de adesivo tissular contendo trombina para tratamento do pseudo-aneurisma femoral Treatment of femoral pseudoaneurysm with thrombin tissue adhesive: initial experience

    Directory of Open Access Journals (Sweden)

    Daniel Mendes Pinto

    2006-03-01

    Full Text Available O pseudo-aneurisma (PSA após cateterização femoral tem sido diagnosticado com regularidade em serviços com grande movimento de intervenções percutâneas, com incidência variando de 0,05 a 6%. PSA femorais pequenos podem ser acompanhados até a resolução espontânea. As opções de tratamento são: compressão guiada por ultra-som, injeção de trombina para trombose do PSA e tratamento cirúrgico. A injeção percutânea de trombina tem a vantagem de ser um procedimento indolor e rápido. Podem ser utilizados trombina isolada ou preparados contendo trombina associada a fibrinogênio e fatores de coagulação. A experiência inicial dos autores de cinco casos tratados com injeção de adesivo tissular contendo trombina mostrou resultado satisfatório em quatro; um caso necessitou tratamento cirúrgico. Não houve sucesso com uso isolado de trombina humana, porém, ocorreu trombose imediata após injeção de preparado de trombina associada a fibrinogênio/fator XIII. Neste artigo, são discutidas as opções de tratamento dos PSA femorais e a técnica do uso de trombina percutânea.Pseudoaneurysms caused by femoral artery catheterization have been regularly diagnosed in medical units with a great number of percutaneous interventions, with a documented incidence between 0.05 and 6%. Small femoral pseudoaneurysms undergo spontaneous resolution. Treatment options are: ultrasound-guided compression, thrombin injection to induce pseudoaneurysm thrombosis and surgical treatment. Percutaneous thrombin injection has the advantage of being a fast and painless procedure. Both isolated thrombin and thrombin preparations with fibrinogen and coagulation factors can be used. The authors' initial experience with five cases treated with thrombin tissue adhesive showed successful results in four; one case required surgery. There was no success with isolated human thrombin, but immediate thrombosis was achieved after injection of thrombin associated to

  16. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

    Directory of Open Access Journals (Sweden)

    Randal Henrique de Oliveira

    2000-03-01

    Full Text Available Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL e a histerectomia total abdominal (HTA, relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve diferença estat��stica entre os grupos quanto à idade, paridade e cirurgia abdominal prévia. A principal indicação cirúrgica para ambos os grupos foi leiomiomatose uterina. O grupo das HVAL apresentou tempo de internação menor, com mediana de 1 dia e o das HTA, de 2 dias (pPurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH and total abdominal hysterectomy (TAH, reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient's records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01. LAVH showed to be 40.2% more expensive than TAH (p<0.01. Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002. Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better

  17. Growth and form of Quercus robur and Fraxinus excelsior respond distinctly different to initial growing space: results from 24-year-old Nelder experiments

    Institute of Scientific and Technical Information of China (English)

    Christian Kuehne; Edgar Kublin; Patrick Pyttel; Jürgen Bauhus

    2013-01-01

    Initial growing space is of critical importance to growth and quality development of individual trees.We investigated how mortality,growth (diameter at breast height,total height),natural pruning (height to first dead and first live branch and branchiness) and stem and crown form of 24-year-old pedunculate oak (Quercus robur [L.]) and European ash (Fraxinus excelsior [L.]) were affected by initial spacing.Data were recorded from two replicate single-species Nelder wheels located in southern Germany with eight initial stocking regimes varying from 1,020to 30,780 seedlings·ha-1.Mortality substantially decreased with increasing initial growing space but significantly differed among the two species,averaging 59% and 15% for oak and ash plots,respectively.In contrast to oak,the low self-thinning rate found in the ash plots over the investigated study period resulted in a high number of smaller intermediate or suppressed trees,eventually retarding individual tree as well as overall stand development.As a result,oak gained greater stem dimensions throughout all initial spacing regimes and the average height of ash significantly increased with initial growing space.The survival of lower crown class ashes also appeared to accelerate self-pruning dynamics.In comparison to oak,we observed less dead and live primary branches as well as a smaller number of epicormic shoots along the first 6 m of the lower stem of dominant and co-dominant ashes in all spacing regimes.Whereas stem form of both species was hardly affected by initial growing space,the percentage of brushy crowns significantly increased with initial spacing in oak and ash.Our findings suggest that initial stockings of ca.12,000seedlings per hectare in oak and 2,500 seedlings per hectare in ash will guarantee a sufficient number of at least 300 potential crop trees per hectare in pure oak and ash plantations at the end of the self-thinning phase,respectively.If the problem of epicormic shoots and inadequate self

  18. The association of specific traumatic experiences with cannabis initiation and transition to problem use: Differences between African-American and European-American women.

    Science.gov (United States)

    Werner, K B; McCutcheon, V V; Agrawal, A; Sartor, C E; Nelson, E C; Heath, A C; Bucholz, K K

    2016-05-01

    To examine the contribution of trauma exposure to cannabis initiation and transition to first cannabis use disorder (CUD) symptom in African-American (AA) and European-American (EA) emerging adults. Data are from the Missouri Adolescent Female Twins Study [(N=3787); 14.6% AA; mean age=21.7 (SD 3.8)]. Trauma exposures (e.g. sexual abuse, physical abuse, witnessing another person being killed or injured, experiencing an accident, and experiencing a disaster) were modeled as time-varying predictors of cannabis initiation and transition to CUD symptom using Cox proportional hazards regression. Other substance involvement and psychiatric disorders were considered as time-varying covariates. Analyses revealed different trauma-related and psychiatric predictors for cannabis use supporting racially distinct etiologic models of cannabis involvement. For AA women, history of witnessing injury/death or experiencing a life-threatening accident was associated with cannabis initiation across the complete emerging adult risk period while sexual abuse predicted cannabis initiation only before 15 years old. For EA women, history of sexual or physical abuse and major depressive disorder (MDD) predicted cannabis initiation and physical abuse and MDD predicted transition from initiation to first CUD symptom. No association was discovered between trauma exposures and transition to first CUD symptom in AA women. Results reveal trauma exposures as important contributors to cannabis initiation and to a lesser extent transition to CUD symptom, with different trauma types conferring risk for cannabis involvement in AA and EA women. Findings suggest the importance of considering racial/ethnic differences when developing etiologic models of cannabis involvement. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Initial experience in adult-to-adult living donor liver transplantation%成人活体肝移植的早期经验

    Institute of Scientific and Technical Information of China (English)

    董家鸿; 纪文斌; 段伟东; 史宪杰; 王彦斌; 冷建军; 王宏光; 黄志强

    2008-01-01

    目的 总结成人活体肝移植的早期经验,提高活体肝移植效果.方法 回顾性分析解放军总医院肝移植中心2006年6月至2008年2月31例成人活体肝移植资料.结果 31例中慢性乙型肝炎肝硬化失代偿期8例,急性肝功能衰竭7例,肝细胞肝癌12例,肝脏紫癜病2例,肝门部胆管癌1例和Wilson 病1例.含肝中静脉(middle hepatic vein,MHV)的右半肝移植25例,不含MHV的右半肝移植3例,双供肝为含MHV的右半肝+左外叶和含MHV的右半肝+左半肝各1例,左半肝辅助性原位肝移植1例.33例供者中5例发生并发症6例次.9例受者发生并发症11例次,其中胆道并发症4例,血管并发症3例,感染性并发症3例,切口延迟愈合1例.2例肺部感染和1例全身多处曲霉菌感染者死亡.结论 活体肝移植已成为拓展供肝来源的有效途径,合理的供、受者评估,手术方式和术后处理是关键.%Objective To summarize the initial experience in adult-to-adult living donor liver transplantation(ALDLT),so as to improve the efficacy of ALDLT.Methods The clinical data of 31 adult patients who undelwent ALDLT from June 2006 to February 2008 were retrospectively analyzed.Results Of all the patients,8 was with decompensated cirrhosis,7 with acute liver failure,12 with hepatocellular carcinoma,2 with purpura of liver,1 with hilar cholangiocarcinoma,and 1 with Wilson disease.The liver grafts included 25 right lobes with middle hepatic vein(MHV),3 right lobes without MHV,1 right lobe with MHV+left lateral lobe,1 right lobe with MHV+left lobe.The remaining 1 patient underwent auxiliary partial orthotopic liver transplantation with left lobe graft.Six post-transplantation complications occurred in 5 donors. Eleven post-transplantation complications occurred in 9 recipients,including 4 biliary complications,3 vascular complications,3 infection complications and 1 delayed healing of the incision.After ALDLT,2 recipients died of pulmonary infection and 1 of

  20. Initial experience of transumbilical single incision laparoscopic splenectomy%经脐单切口腹腔镜脾切除术

    Institute of Scientific and Technical Information of China (English)

    于增文; 牛忠; 李索林; 孙驰; 许书清; 李英超; 马亚贞

    2011-01-01

    目的 总结儿童经脐单切口腹腔镜脾切除术的初步经验,并探讨其可行性和安全性.方法 回顾分析2010年4月至2011年1月期间5例脾相关疾病儿童经脐单切口入路腹腔镜脾切除术的临床资料,男3例,女2例,年龄4~12岁,包括遗传性球形红细胞增多症3例和特发性血小板减少性紫癜2例.我们使用自行改进的三通道套管和弯曲器械,超声刀切断脾周围韧带,切割钉合器或生物夹处理脾蒂,脾脏从单切口取出.结果 5例腹腔镜脾切除术均经脐单切口入路获得成功,没有中转常规腹腔镜手术.手术时间125~220 min,估计术中出血量10~30 ml,无围手术期并发症,术后5~8 d痊愈出院.随访3~12个月,5例患儿均生长发育良好,贫血得到纠正,血小板计数正常.结论 经脐单切口腹腔镜脾切除术较常规腹腔镜脾切除术对腹壁创伤更小、美容效果更好,可在儿童安全实施;但需要更多数量和进一步前瞻性研究来评价其真正益处.%Objective To review our initial experience of transumbilical single incision laparoscopic splenectomy in children and to assess the feasibility and safety of this laparoscopic procedures.Methods Clinical data of 5 children who underwent laparoscopic splenectomy via a single umbilical incision between April 2010 and January 2011 were reviewed. There were 3 boys and 2 girls. The age ranged from 4 to 12 years. Of them,3 cases suffered from hereditary spherocytosis and 2 cases from idiopathic thrombocytopenic purpura. We used the Tri-port and self-modified curved instruments. The splenic attachments were taken down using the harmonic scalpel,and the hilum was clipped with Hemo-lok or transected with Endo-GIA. The spleen was removed from the abdomen via the single incision.Results All of the laparoscopic splenectomies were completed successfully with transumbilical single incision approach without conversion to conventional laparoscopic surgery. The operation

  1. Investigating Sophomore Student Success: The National Survey of Sophomore-Year Initiatives and the Sophomore Experiences Survey, 2014. Research Reports on College Transitions No. 6

    Science.gov (United States)

    Young, Dallin George; Schreiner, Laurie A.; McIntosh, Eric J.

    2015-01-01

    Less is known about the second college year compared to other transition points, and fewer high-impact initiatives and curricular programs tend to be offered to sophomores. To increase our knowledge of this important, but sometimes neglected, year on the collegiate journey, "Investigating Sophomore Student Success" presents findings from…

  2. Investigating Sophomore Student Success: The National Survey of Sophomore-Year Initiatives and the Sophomore Experiences Survey, 2014. Research Reports on College Transitions No. 6

    Science.gov (United States)

    Young, Dallin George; Schreiner, Laurie A.; McIntosh, Eric J.

    2015-01-01

    Less is known about the second college year compared to other transition points, and fewer high-impact initiatives and curricular programs tend to be offered to sophomores. To increase our knowledge of this important, but sometimes neglected, year on the collegiate journey, "Investigating Sophomore Student Success" presents findings from…

  3. Bilateral testicular germ cell tumours in patients with initial stage I disease : Prevalence and prognosis - a single centre's 30 years' experience

    NARCIS (Netherlands)

    Sonneveld, DJA; Sleijfer, DT; Hoekstra, HJ; Schraffordt Koops, H.

    1998-01-01

    Development of second testicular tumours, i.e. bilateral testicular cancer, is influenced by systemic chemotherapy for the first tumour. The prevalence of bilateral testicular cancer was studied in patients with initial stage I disease, in which no systemic treatment was given after orchidectomy. Al

  4. Bilateral testicular germ cell tumours in patients with initial stage I disease : Prevalence and prognosis - a single centre's 30 years' experience

    NARCIS (Netherlands)

    Sonneveld, DJA; Sleijfer, DT; Hoekstra, HJ; Schraffordt Koops, H.

    1998-01-01

    Development of second testicular tumours, i.e. bilateral testicular cancer, is influenced by systemic chemotherapy for the first tumour. The prevalence of bilateral testicular cancer was studied in patients with initial stage I disease, in which no systemic treatment was given after orchidectomy. Al

  5. Initial Discussion of Teaching Reform in Analytical Chemistry Experiment%分析化学实验教学改革初探

    Institute of Scientific and Technical Information of China (English)

    欧丽娟

    2013-01-01

    The traditional teaching of analytical chemistry experi-ment has many disadvantages and needs to reform. According to teaching practice, a series of reform and exploration for analytical chemistry experiment are carried out in Hunan Institute of Tech-nology, which includes the content of experiment, the teaching method, and the testing system. The results are remarkable.%  传统的分析化学实验教学存在诸多弊端,亟须改革。结合教学实践,湖南工学院从实验内容、教学方法和考核方式等方面对分析化学实验教学进行了积极的改革与探索,取得了良好的成效。

  6. Experiência inicial com a técnica de Buttonhole em um centro de hemodiálise Brasileiro Initial experience with the Buttonhole technique in a Brazilian hemodialysis center

    Directory of Open Access Journals (Sweden)

    Geni dos Santos Teles Silva

    2010-09-01

    Full Text Available INTRODUÇÃO: A técnica de punção de fístulas arteriovenosas para hemodiálise mais comumente utilizada é a de alternância de sítios de punção. Uma técnica opcional (buttonhole vem-se popularizando, pois os sítios de punção são constantes, oferecendo vantagens para pacientes com características especiais. OBJETIVO: Avaliar experiência inicial do serviço com a técnica de buttonhole e determinar sua utilidade. PACIENTES E MÉTODOS: 21 pacientes com fístulas curtas, tortuosas, de difícil punção ou dolorosas foram puncionados pela primeira vez utilizando-se agulhas apropriadas para a técnica buttonhole. RESULTADOS: Não foram observados sangramentos intra- ou pós-hemodiálise, assim como não houve hematomas. Observou-se dor de intensidade leve e mesmo ausência de dor em alguns pacientes (15%. Houve perda de duas fístulas arteriovenosas (9,5% e 47,6% dos pacientes apresentaram coágulos em algum momento, situações essas relacionadas com a troca de puncionador. Um paciente apresentou abscesso paravertebral, admitindo-se a disseminação via fístula arteriovenosa. DISCUSSÃO E CONCLUSÃO: As vantagens de menor dor, menor erro de punção e hematoma são contrabalançadas por aumento do risco de infecção e perda do acesso quando ocorre quebra da técnica ou mais de um puncionador está envolvido. É técnica útil para pacientes selecionados.INTRODUCTION: The most commonly used technique of arteriovenous fistula cannulation for hemodialysis is the rope-ladder technique with alternation of the cannulation site. An alternative technique, the buttonhole (BH technique, has become popular because its constant cannulation sites are advantageous for patients with special characteristics. OBJECTIVE: To assess the initial experience of our service with the BH technique and determine its usefulness. PATIENTS AND METHODS: Twenty-one patients with short, tortuous, painful fistulae of difficult cannulation were submitted to the BH

  7. Decreased health care utilization and health care costs in the inpatient and emergency department setting following initiation of ketogenic diet in pediatric patients: The experience in Ontario, Canada.

    Science.gov (United States)

    Whiting, Sharon; Donner, Elizabeth; RamachandranNair, Rajesh; Grabowski, Jennifer; Jetté, Nathalie; Duque, Daniel Rodriguez

    2017-03-01

    To assess the change in inpatient and emergency department utilization and health care costs in children on the ketogenic diet for treatment of epilepsy. Data on children with epilepsy initiated on the ketogenic diet (KD) Jan 1, 2000 and Dec 31, 2010 at Ontario pediatric hospitals were linked to province wide inpatient, emergency department (ED) data at the Institute for Clinical Evaluative Sciences. ED and inpatient visits and costs for this cohort were compared for a maximum of 2 years (730days) prior to diet initiation and for a maximum of 2 years (730days) following diet initiation. KD patient were compared to matched group of children with epilepsy who did not receive the ketogenic diet (no KD). Children on the KD experienced a mean decrease in ED visits of 2.5 visits per person per year [95% CI (1.5-3.4)], and a mean decrease of 0.8 inpatient visits per person per year [95% CI (0.3-1.3)], following diet initiation. They had a mean decrease in ED costs of $630 [95% CI (249-1012)] per person per year and a median decrease in inpatient costs of $1059 [IQR: 7890; pdiet experienced a mean reduction of 2.1 ED visits per child per year [95% CI (1.0-3.2)] and a mean decrease of 0.6 [95% CI (0.1-1.1)] inpatient visits per child per year. Patients on the KD experienced a reduction of $442 [95% CI (34.4-850)] per child per year more in ED costs than the matched group. The ketogenic diet group had greater median decrease in inpatient costs per child per year than the matched group [pketogenic diet, experienced decreased ED and inpatient visits as well as costs following diet initiation in Ontario, Canada. Copyright © 2017 Elsevier B.V. All rights reserved.

  8. End-to-End Simulation for a Forest-Dedicated Full-Waveform Lidar Onboard a Satellite Initialized from Airborne Ultraviolet Lidar Experiments

    OpenAIRE

    Xiaoxia Shang; Patrick Chazette

    2015-01-01

    In order to study forests at the global scale, a detailed link budget for a lidar system onboard satellite is presented. It is based on an original approach coupling airborne lidar observations and an end-to-end simulator. The simulator is initialized by airborne lidar measurements performed over temperate and tropical forests on the French territory, representing a wide range of forests ecosystems. Considering two complementary wavelengths of 355 and 1064 nm, the end-to-end simulator compute...

  9. Swimming Upstream: Faculty and Staff Members From Urban Middle Schools in Low-Income Communities Describe Their Experience Implementing Nutrition and Physical Activity Initiatives

    Directory of Open Access Journals (Sweden)

    Katherine W. Bauer, SM

    2006-03-01

    Full Text Available Introduction Addressing childhood overweight has become a top priority in the United States. Modification of school policies and practices has been used in an attempt to address the overweight epidemic among children and adolescents. Culturally diverse urban schools in low-income communities attempting to improve nutrition and increase physical activity may face unique challenges in the school environment. A better understanding is needed about school environments and how they may affect the implementation, efficacy, and sustainability of initiatives designed to improve nutrition and physical activity. Methods We carried out a qualitative study in five urban middle schools in low-income communities that had recently implemented Planet Health, a nutrition and physical activity intervention, to assess which aspects of the schools’ physical, social, and policy environments were facilitating or impeding the implementation of health promotion initiatives. Thirty-five faculty and staff members participated. We conducted one focus group per school, with an average of seven participants per group. We analyzed focus group transcripts using the thematic analysis technique to identify key concepts, categories, and themes. Results Teachers and staff members in our study identified many school-related environmental barriers to successful implementation of nutrition and physical activity initiatives in their schools. School personnel recommended that classroom-based nutrition interventions such as Planet Health be coordinated with school food services so that the healthy messages taught in the classroom are reinforced by the availability of healthy, culturally appropriate cafeteria food. They identified household food insufficiency and overly restrictive eligibility criteria of the federally subsidized meal program as critical barriers to healthy nutritional behaviors. They also identified weight-related teasing and bullying and unhealthy weight

  10. First-Year Students’ Initial Motivational Beliefs at University: Predicted by Motivational Beliefs Derived from Within and Out-of-School Experience and Malleable Regardless of the Extent of Students’ Out-of-School Experience

    National Research Council Canada - National Science Library

    Julia Gorges

    2017-01-01

    ...: business administration). First, students’ experiences from secondary school, especially their ASCs and ITVs established in a school subject they consider similar to business administration—mathematics...

  11. The Si Huan Playgroup: An Initiative to Provide Non-Formal Early Childhood Education Experiences to Children of Migrants in Beijing

    Science.gov (United States)

    Nyland, Berenice; Nyland, Chris; Gao, Yang; Ng, Josephine; Zeng, Xiaodong

    2016-01-01

    This paper is about an experiment in non-formal early childhood education for migrant children in Beijing. The Si Huan Playgroup was set up by a group of volunteers in 2004 and is built on ideas of early childhood pedagogy, equity, life-long learning and non-formal education. Non-formal education has implications for policy makers as this is a…

  12. Experiences of Parents with the Reading to Learn Approach: A Randomised Control Trial Initiative to Improve Literacy and Numeracy in Kenya and Uganda

    Science.gov (United States)

    Abuya, Benta A.; Oketch, Moses; Ngware, Moses W.; Mutisya, Maurice; Musyoka, Peter K.

    2015-01-01

    Parental involvement in their children's schooling is in recognition that establishing the context in which a child attends school is important. Reading to Learn (RtL)was implemented in two districts of Kwale and Kinango in Kenya and of Amolatar and Dokolo in Uganda. This paper looks at parental involvement and their experiences with RtL. Data are…

  13. Fermentative hydrogen production in batch experiments using lactose, cheese whey and glucose: Influence of initial substrate concentration and pH

    Energy Technology Data Exchange (ETDEWEB)

    Davila-Vazquez, Gustavo; Alatriste-Mondragon, Felipe; Razo-Flores, Elias [Division de Ciencias Ambientales, Instituto Potosino de Investigacion Cientifica y Tecnologica, Camino a la Presa San Jose 2055, Lomas 4a seccion, C.P. 78216, San Luis Potosi, S.L.P (Mexico); de Leon-Rodriguez, Antonio [Division de Biologia Molecular, Instituto Potosino de Investigacion Cientifica y Tecnologica, Camino a la Presa San Jose 2055, Lomas 4a seccion, C.P. 78216, San Luis Potosi, S.L.P (Mexico)

    2008-10-15

    Biologically produced hydrogen using biomass and mixed bacterial cultures is one approach to generate renewable H{sub 2}. Response surface methodology (RSM) was used to study the effect of initial pH (3.88-8.12) and initial substrate concentration (0.86-29.14 g/L) on both hydrogen molar yield (HMY) and volumetric H{sub 2} production rate (VHPR). Lactose, cheese whey powder (CWP) and glucose were used as substrates and heat-treated anaerobic granular sludge as inoculum. For lactose, 3.6 mol H{sub 2}/mol lactose and 5.6 mmol H{sub 2}/L/h were found at pH 7.5 and 5 g lactose/L. CWP yielded 3.1 mol H{sub 2}/mol lactose at pH 6 and 15 g CWP/L while 8.1 mmol H{sub 2}/L/h were attained at pH 7.5 and 25 g CWP/L. Glucose yielded 1.46 mol H{sub 2}/mol substrate (pH 7.5, 5 g glucose/L), with a VHPR of 8.9 mmol H{sub 2}/L/h, at pH 8.12 and 15 g glucose/L. Acetic and butyric acids were the main organic metabolites detected. HMY and VHPR obtained in this study were found at initial pH above the reported optimum pH value for hydrogen production. These findings could be of significance when alkaline pretreatments are performed on organic feedstock by eliminating the need to lower the pH to acidic levels before fermentation start-up. (author)

  14. Preliminary Results of a U.S. Deep South Modeling Experiment Using NASA SPoRT Initialization Datasets for Operational National Weather Service Local Model Runs

    Science.gov (United States)

    Wood, Lance; Medlin, Jeffrey M.; Case, Jon

    2012-01-01

    A joint collaborative modeling effort among the NWS offices in Mobile, AL, and Houston, TX, and NASA Short-term Prediction Research and Transition (SPoRT) Center began during the 2011-2012 cold season, and continued into the 2012 warm season. The focus was on two frequent U.S. Deep South forecast challenges: the initiation of deep convection during the warm season; and heavy precipitation during the cold season. We wanted to examine the impact of certain NASA produced products on the Weather Research and Forecasting Environmental Modeling System in improving the model representation of mesoscale boundaries such as the local sea-, bay- and land-breezes (which often leads to warm season convective initiation); and improving the model representation of slow moving, or quasi-stationary frontal boundaries (which focus cold season storm cell training and heavy precipitation). The NASA products were: the 4-km Land Information System, a 1-km sea surface temperature analysis, and a 4-km greenness vegetation fraction analysis. Similar domains were established over the southeast Texas and Alabama coastlines, each with an outer grid with a 9 km spacing and an inner nest with a 3 km grid spacing. The model was run at each NWS office once per day out to 24 hours from 0600 UTC, using the NCEP Global Forecast System for initial and boundary conditions. Control runs without the NASA products were made at the NASA SPoRT Center. The NCAR Model Evaluation Tools verification package was used to evaluate both the positive and negative impacts of the NASA products on the model forecasts. Select case studies will be presented to highlight the influence of the products.

  15. Intratympanic steroids as primary initial treatment of idiopathic sudden sensorineural hearing loss. The Hospital Universitario Ramón y Cajal experience and review of the literature.

    Science.gov (United States)

    Labatut, Tomás; Daza, María José; Alonso, Antonio

    2013-11-01

    The objective of this study was to determine the effectiveness, dosage, safety and comfort of intratympanic steroids as primary initial treatment of idiopathic sudden sensorineural hearing loss (ISSHL). Prospective nonrandomized clinical practice study was performed in Tertiary referral center university hospital. A total of 35 consecutive patients suffering from newly diagnosed sudden sensorineural hearing loss with mean pure-tone average thresholds of 81 ± 21 dB were treated. No previous therapy had been undertaken. Intratympanic steroid injection as primary initial treatment was administered during 2 weeks on a twice a week schedule, between 2010 and 2011. Treatment was started on average within 2 days of symptoms onset. Pre and post-treatment audiometric evaluations were analyzed on follow-up as well as tolerance of the procedure and possible adverse effects. 66-85 % of patients achieved successful treatment according to the different outcome criteria used to evaluate hearing improvement (Furuhashi criteria/improvement of ≥10 dB in pure-tone average). Mean post-treatment improvement regarding pure-tone average was 34 ± 21 dB. A 48 ± 43 % improvement in speech discrimination score was observed. Patients received an average of 18 mg of methylprednisolone per injection and a total dose of 72 mg per treatment cycle. No serious adverse effects were noted. Intratympanic steroid injection is an effective, safe and well-tolerated office based-procedure for the treatment of ISSHL as primary initial treatment that can avoid the potential adverse effects of systemic steroids. A higher dose, schedule of administration as well as standardization of hearing recovery criteria still need to be established.

  16. Revascularização do miocárdio sem circulação extracorpórea: experiência e resultados iniciais Myocardial revascularization without cardiopulmonary bypass: experience and initial results

    Directory of Open Access Journals (Sweden)

    Luiz Antônio BRASIL

    2000-03-01

    insufficiency. OBJECTIVE: To present our experience with this procedure describing the technique used and our initial results. MATERIAL AND METHODS: Twenty-three patients were submitted to myocardial revascularization without CPB. The patients selected for this study had lesions in the coronary arteries of the anterodiaphragmatic cardiac region. The main surgical indication was chronic coronary insufficiency (78.3%. 65% of the patients were male, with age between 44-80 (mean - 59.6 years. The surgical approach in all patients was through median sternotomy. He grafts used were internal thoracic arteries, saphenous vein and radial artery. RESULTS: Mean surgical time was 3:15 hours. There were no intra-operative occurences. The number of grafts was 1 to 3 in each patient (mean 1.56 graft/patient out of a total of 36 grafts. The left internal thoracic artery was the most used graft (41.7%. The most frequently revascularized coronary arteries were the anterior interventricular branch (52.8% and the right coronary (30.5%. Hospital mortality and post-operative infarct were 4.3%. There were no neurological, pulmonary, renal, hemorragic or infectious complications. The mean hospital stay was 7 days. CONCLUSION: Myocardial revascularization without cardiopulmonary bypass is an effective and safe technique that can be utilized in selected cases with low morbidity and mortality, reducing costs and hospital stay.

  17. Initial experience with stapled hemorrhoidopexy for treatment of hemorrhoids Experiência inicial com o tratamento da doença hemorroidária pela técnica de grampeamento circular

    Directory of Open Access Journals (Sweden)

    Carlos Walter Sobrado

    2006-09-01

    Full Text Available BACKGROUND: Introduction of stapled hemorrhoidopexy by Longo in 1998 represented a radical change in the treatment of hemorrhoids. By avoiding multiple excisions and suture lines in the perianal region, stapled hemorrhoidopexy is intended to offer less postoperative pain than with conventional techniques. OBJECTIVE: To report and analyze the intra and postoperative results gained during initial experience with stapled hemorrhoidopexy. METHODS: One hundred and fifty five patients (67 males with average age of 39.5 years (21-67 years underwent stapled hemorrhoidopexy between June 2000 and December 2003 with symptomatic third-degree (n = 74 and fourth-degree (n = 81 hemorrhoids. Mean follow-up period was 20 months (14-60 months. RESULTS: Preoperative symptoms were prolapse (96.7% and anal bleeding (96.1%. Overall mean operative time was 23 minutes (16-48 minutes. We observed one case of stapler failure and one case of failure to introduce the stapler occurred in a patient with previous anal surgery. Additional sutures for hemostasis were required in 103 patients (66.5%. Resection of skin tags was performed in 45 cases (29%. Postoperatively scheduled analgesia with oral dipyrone and celecoxib was enough for pain control in 131 patients (84.5%. Rescue analgesia was necessary in 24 cases (15.5%. Five patients needed opiates for pain control. Hospital discharge took place on the first postoperative day in 140 patients (90.3%. First defecation without pain was reported by 118 patients (76.1%. Postoperative complications were anal bleeding (10.3%, severe pain (3.2%, urinary retention (3.9%, fever without any signs of perianal infection (1.9%, incontinence for flatus (1.9%, hemorrhoidal thrombosis (1.3%. Two patients presented symptoms of recurrent hemorrhoidal disease and were successfully treated by conventional hemorrhoidectomy. They were no cases of anal stenosis, permanent incontinence, chronic pain or deaths in this series. CONCLUSIONS

  18. Using multidetector-row CT in neonates with complex congenital heart disease to replace diagnostic cardiac catheterization for anatomical investigation: initial experiences in technical and clinical feasibility

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Tain; Tsai, I.C.; Chen, Min-Chi [Taichung Veterans General Hospital, 407 Department of Radiology, Taichung (Taiwan); Medical College of Chung Shan Medical University, Faculty of Medicine, Taichung (Taiwan); National Yang Ming University School of Medicine, Department of Medicine, Taipei (Taiwan); Fu, Yun-Ching; Jan, Sheng-Lin [Taichung Veterans General Hospital, Department of Paediatrics, Taichung (Taiwan); National Yang-Ming University, Institute of Clinical Medicine, Taipei (Taiwan); Wang, Chung-Chi; Chang, Yen [Taichung Veterans General Hospital, Section of Cardiovascular Surgery, Department of Surgery, Taichung (Taiwan)

    2006-12-15

    Echocardiography is the first-line modality for the investigation of neonatal congenital heart disease. Diagnostic cardiac catheterization, which has a small but recognized risk, is usually performed if echocardiography fails to provide a confident evaluation of the lesions. To verify the technical and clinical feasibilities of replacing diagnostic cardiac catheterization with multidetector-row CT (MDCT) in neonatal complex congenital heart disease. Over a 1-year period we prospectively enrolled all neonates with complex congenital heart disease referred for diagnostic cardiac catheterization after initial assessment by echocardiography. MDCT was performed using a 40-detector-row CT scanner with dual syringe injection. A multidisciplinary congenital heart disease team evaluated the MDCT images and decided if further diagnostic cardiac catheterization was necessary. The accuracy of MDCT in detecting separate cardiovascular anomalies and bolus geometry of contrast enhancement were calculated. A total of 14 neonates were included in the study. No further diagnostic cardiac catheterization was needed in any neonate. The accuracy of MDCT in diagnosing separate cardiovascular anomalies was 98% (53/54) with only one atrial septal defect missed in a patient with coarctation syndrome. The average cardiovascular enhancement in evaluated chambers was 471 HU. No obvious beam-hardening artefact was observed. The technical and clinical feasibility of MDCT in complex congenital heart disease in neonates is confirmed. After initial assessment with echocardiography, MDCT could probably replace diagnostic cardiac catheterization for further anatomical clarification in neonates. (orig.)

  19. "Ico-Alone" single nocturnal exchange to initiate peritoneal dialysis in patients with residual renal function-Five year, single centre experience

    Directory of Open Access Journals (Sweden)

    T Jeloka

    2013-01-01

    Full Text Available We analyzed the outcome of incremental dialysis with single nocturnal icodextrin exchange peritoneal dialysis (PD as the initial treatment for end-stage kidney failure in patients who have significant residual renal function. All adult patients opting for PD as renal replacement therapy, having residual renal function, and urinary KT/V of 1.0 were offered incremental dialysis with single nocturnal icodextrin exchange as initial treatment. Adequacy of dialysis was calculated at 1, 3, and 6 months and then 6 monthly. Patients were shifted to conventional PD if short of adequacy or if clinically indicated. Median period on "Ico-alone," peritonitis, exit site infection rates, and patient survival, while on this protocol, were calculated. These outcomes were compared with the cohort of contemporary patients on conventional PD. Thirteen patients were initiated on "Ico-alone" dialysis between October 2006 and October 2011. The baseline characteristics were similar when compared with cohort of conventional PD patients, except urine volume, which was more in "Ico-alone" group (1265 ± 316 vs. 551 ± 504, P = 0.000. Total KT/V at 3 months (1.63 ± 0.6 vs. 1.7 ± 0.2, P = 0.6 and at 1 year (1.64 ± 0.5 vs. 1.53 ± 0.3, P = 0.6 was similar to the cohort of conventional PD patients. Median period on "Ico-alone" was 9.6 months. Peritonitis rate was 1 episode in 56.22 vs 25.29 patient-months and exit site infection was 1 episode in 56.2 vs 189.71 patient-months in "Ico-alone" and conventional group, respectively. Patient survival was 42.84 months in "Ico-alone′ vs 25.29 months in conventional dialysis ( P = 0.01. In conclusion, single icodextrin exchange offers adequate dialysis in patients with residual renal function (KT/V = 1 for a median period of 9 months.

  20. “Ico-Alone” single nocturnal exchange to initiate peritoneal dialysis in patients with residual renal function–Five year, single centre experience

    Science.gov (United States)

    Jeloka, T.; Sanwaria, P.; Chaudhari, L.; Periera, A.

    2013-01-01

    We analyzed the outcome of incremental dialysis with single nocturnal icodextrin exchange peritoneal dialysis (PD) as the initial treatment for end-stage kidney failure in patients who have significant residual renal function. All adult patients opting for PD as renal replacement therapy, having residual renal function, and urinary KT/V of 1.0 were offered incremental dialysis with single nocturnal icodextrin exchange as initial treatment. Adequacy of dialysis was calculated at 1, 3, and 6 months and then 6 monthly. Patients were shifted to conventional PD if short of adequacy or if clinically indicated. Median period on “Ico-alone,” peritonitis, exit site infection rates, and patient survival, while on this protocol, were calculated. These outcomes were compared with the cohort of contemporary patients on conventional PD. Thirteen patients were initiated on “Ico-alone” dialysis between October 2006 and October 2011. The baseline characteristics were similar when compared with cohort of conventional PD patients, except urine volume, which was more in “Ico-alone” group (1265 ± 316 vs. 551 ± 504, P = 0.000). Total KT/V at 3 months (1.63 ± 0.6 vs. 1.7 ± 0.2, P = 0.6) and at 1 year (1.64 ± 0.5 vs. 1.53 ± 0.3, P = 0.6) was similar to the cohort of conventional PD patients. Median period on “Ico-alone” was 9.6 months. Peritonitis rate was 1 episode in 56.22 vs 25.29 patient-months and exit site infection was 1 episode in 56.2 vs 189.71 patient-months in “Ico-alone” and conventional group, respectively. Patient survival was 42.84 months in “Ico-alone” vs 25.29 months in conventional dialysis (P = 0.01). In conclusion, single icodextrin exchange offers adequate dialysis in patients with residual renal function (KT/V = 1) for a median period of 9 months. PMID:23960344

  1. "Ico-Alone" single nocturnal exchange to initiate peritoneal dialysis in patients with residual renal function-Five year, single centre experience.

    Science.gov (United States)

    Jeloka, T; Sanwaria, P; Chaudhari, L; Periera, A

    2013-07-01

    We analyzed the outcome of incremental dialysis with single nocturnal icodextrin exchange peritoneal dialysis (PD) as the initial treatment for end-stage kidney failure in patients who have significant residual renal function. All adult patients opting for PD as renal replacement therapy, having residual renal function, and urinary KT/V of 1.0 were offered incremental dialysis with single nocturnal icodextrin exchange as initial treatment. Adequacy of dialysis was calculated at 1, 3, and 6 months and then 6 monthly. Patients were shifted to conventional PD if short of adequacy or if clinically indicated. Median period on "Ico-alone," peritonitis, exit site infection rates, and patient survival, while on this protocol, were calculated. These outcomes were compared with the cohort of contemporary patients on conventional PD. Thirteen patients were initiated on "Ico-alone" dialysis between October 2006 and October 2011. The baseline characteristics were similar when compared with cohort of conventional PD patients, except urine volume, which was more in "Ico-alone" group (1265 ± 316 vs. 551 ± 504, P = 0.000). Total KT/V at 3 months (1.63 ± 0.6 vs. 1.7 ± 0.2, P = 0.6) and at 1 year (1.64 ± 0.5 vs. 1.53 ± 0.3, P = 0.6) was similar to the cohort of conventional PD patients. Median period on "Ico-alone" was 9.6 months. Peritonitis rate was 1 episode in 56.22 vs 25.29 patient-months and exit site infection was 1 episode in 56.2 vs 189.71 patient-months in "Ico-alone" and conventional group, respectively. Patient survival was 42.84 months in "Ico-alone" vs 25.29 months in conventional dialysis (P = 0.01). In conclusion, single icodextrin exchange offers adequate dialysis in patients with residual renal function (KT/V = 1) for a median period of 9 months.

  2. Initiating therapy or switching to biphasic insulin aspart improves glycaemic control in type 2 diabetes: an Indian experience from the A1chieve study.

    Science.gov (United States)

    Kumar, A; Sharma, S K; Rajput, R; Unnikrishnan, A G

    2013-01-01

    Biphasic insulin aspart 30 (BIAsp 30) has been used in patients for almost a decade; There is a wealth of knowledge from clinical trials to document its efficacy and safety and suggest that BIAsp 30 is an option for initiation and intensification of insulin therapy in patients with type 2 diabetes mellitus (T2DM). The A1chieve was a non-interventional study that explored the safety and effectiveness of initiating or switching to insulin analogues in routine clinical practice in more than 60,000 patients from 28 different countries. In this manuscript, we discuss the findings from the subgroup of the Indian cohort who were treated with BIAsp 30. In a cohort of 15287 who were on BIAsp 30, 12645 (83%) were insulin naive and 2642 (17%) had been on insulin therapy earlier. Glycaemic parameters were high at baseline. Mean (SD) HbA1c was 9.2% (1.3) in the these and was comparable in the insulin naive and insulin experienced groups. After 24 weeks of therapy with BIAsp 30, there were reductions in HbA1c in both the insulin naive group, [-1.8 (1.3)] and insulin experienced group [-1.6 (1.3)]. Fasting plasma glucose (FPG) and postprandial plasma glucose (PPG) levels were also reduced significantly from baseline [-3.4 (2.7) and -4.8 (3.8) mmol/L, respectively, p < 0.05). Overall, hypoglycaemia decreased from 1.33 events/patient years at baseline to 0.19 events/patient years at 24 weeks. There was also an increase in quality of life score as evaluated by EQ-5D questionnaire. Initiating insulin therapy with or switching to BIAsp 30 in patients with poor glycaemic control leads to an improvement in glycaemic profile with no major hypoglycaemia or clinically significant weight gain. Therapy with BIAsp 30 also improves the quality of life in patients with type 2 diabetes.

  3. Near-ultraviolet Incoherent Broadband Cavity Enhanced Absorption Spectroscopy for OClO and CH20 in Cl-initiated Photooxidation Experiment

    Institute of Scientific and Technical Information of China (English)

    Mei-li Dong; Wei-xiong Zhao; Ming-qiang Huang; Wei-dong Chen; Chang-jin Hu; Xue-jun Gu; Shi-xin Pei

    2013-01-01

    Chlorine dioxide (OClO) is an important indicator for Cl-activation.The monitoring of OClO appears to be crucial for understanding the chemistry of Cl-initialed oxidation and its impact on air quality in polluted coastal regions and industrialized areas.We report the development of a Xe arc lamp based near-ultraviolet (335-375 nm) incoherent broadband cavity enhanced absorption spectroscopy (IBBCEAS) spectrometer for quantitative assessment of OClO in an atmospheric simulation chamber.The important intermediate compound CH2O,and other key atmospheric trace species (NO2) were also simultaneously measured.The instrumental performance shows a strong potential of this kind of IBBCEAS instrument for field and laboratory studies of atmospheric halogen chemistry.

  4. Construction and operation of the flue gas desulphurization plant at Altbach/Deizisau power station, unit no. 5. Experience from commissioning and initial operating period

    Energy Technology Data Exchange (ETDEWEB)

    Maier, R.; Necker, P.; Strauss, J.; Hemming, H.; Landgraf, E.

    1987-04-01

    Since take-over the flue gas desulphurization plant has easily maintained the required level of desulphurisation. Caking-on and incrustation are substantially avoided. By redesigning the gypsum drying process an easily storable gypsum which can be used both in the gypsum and cement industry is produced. According to experience gained to date it is expected that the flue gas desulphurisation plant will not impair the availability of the power plant unit taking into account statutory regulations. In overall terms the plant has satisfactorily fulfilled the expectations of the operator.

  5. Self-initiated expatriates

    DEFF Research Database (Denmark)

    Selmer, Jan; Lauring, Jakob

    2014-01-01

    by further studies, this exploratory research project may contribute to the understanding of the adjustment of adult third-culture kids as well as the role of experience and multicultural abilities. Few, if any, prior studies, have examined adjustment of this group of self-initiated expatriates....

  6. The Initial Learning Curve for Robot-Assisted Sleeve Gastrectomy: A Surgeon's Experience While Introducing the Robotic Technology in a Bariatric Surgery Department.

    Science.gov (United States)

    Vilallonga, Ramon; Fort, José Manuel; Gonzalez, Oscar; Caubet, Enric; Boleko, Angeles; Neff, Karl John; Armengol, Manel

    2012-01-01

    Objective. Robot-assisted sleeve gastrectomy has the potential to treat patients with obesity and its comorbidities. To evaluate the learning curve for this procedure before undergoing Roux en-Y gastric bypass is the objective of this paper. Materials and Methods. Robot-assisted sleeve gastrectomy was attempted in 32 consecutive patients. A survey was performed in order to identify performance variables during completion of the learning curve. Total operative time (OT), docking time (DT), complications, and length of hospital stay were compared among patients divided into two cohorts according to the surgical experience. Scattergrams and continuous curves were plotted to develop a robotic sleeve gastrectomy learning curve. Results. Overall OT time decreased from 89.8 minutes in cohort 1 to 70.1 minutes in cohort 2, with less than 5% change in OT after case 19. Time from incision to docking decreased from 9.5 minutes in cohort 1 to 7.6 minutes in cohort 2. The time required to dock the robotic system also decreased. The complication rate was the same in the two cohorts. Conclusion. Our survey indicates that technique and outcomes for robot-assisted sleeve gastrectomy gradually improve with experience. We found that the learning curve for performing a sleeve gastrectomy using the da Vinci system is completed after about 20 cases.

  7. Intensified Local Resource Mobilization for the Polio Eradication Initiative: The Experience of World Health Organization in Nigeria During 2008-2015.

    Science.gov (United States)

    Yehualashet, Yared G; Horton, Janet; Mkanda, Pascal; Vaz, Rui G; Afolabi, Oluwole; Gashu, Sisay G; Banda, Richard; O'Malley, Helena; Nsubuga, Peter

    2016-05-01

    Since the World Health Assembly (WHA) resolved in 1988 to eradicate poliovirus, several rounds of immunization campaigns have been conducted by member states. By 2000, with the support of the Global Polio Eradication Initiative (GPEI) partners, the number of polio cases decreased by 99%. Eradicating the remaining 1% proved to be more challenging. Although the GPEI, being the largest public health project, required >$9 billion between 1988 and 2012, economic analysis showed the estimated incremental net benefits of $40 billion-$50 billion between 1988 and 2035. In 2012, the WHA declared that the completion of poliovirus eradication is a programmatic emergency for global public health. Nigeria, as one of 3 remaining polio-endemic countries, developed an emergency plan to interrupt the transmission of poliovirus. The plan included the introduction or scale-up of various new innovations and strategies, which had substantial financial implication. This is a retrospective study to document the intensified resource mobilization efforts made by the World Health Organization (WHO) in Nigeria to meet the increased financial requirements and bridge the remaining gap in funding. In addition to the established coordination platforms, the WHO Nigeria Country Office team directly engaged with national authorities, donors, and partners throughout the process of resource requirement analysis, project appraisals, proposal development, and implementation of activities, joint monitoring, and evaluation exercises. The office strengthened its capacity for direct funds disbursement and systematic implementation of a rigorous accountability framework. Between 2008 and May 2015, $538 million was mobilized locally, of which 82% was mobilized since 2012. The percentage of the total funding requirements that were locally mobilized averaged 31% between 2008 and 2011 and increased to 70% between 2012 and May 2015. During the same period, the WHO Nigeria Country Office team produced and

  8. Intensified Local Resource Mobilization for the Polio Eradication Initiative: The Experience of World Health Organization in Nigeria During 2008–2015

    Science.gov (United States)

    Yehualashet, Yared G.; Horton, Janet; Mkanda, Pascal; Vaz, Rui G.; Afolabi, Oluwole; Gashu, Sisay G.; Banda, Richard; O'Malley, Helena; Nsubuga, Peter

    2016-01-01

    Background. Since the World Health Assembly (WHA) resolved in 1988 to eradicate poliovirus, several rounds of immunization campaigns have been conducted by member states. By 2000, with the support of the Global Polio Eradication Initiative (GPEI) partners, the number of polio cases decreased by 99%. Eradicating the remaining 1% proved to be more challenging. Although the GPEI, being the largest public health project, required >$9 billion between 1988 and 2012, economic analysis showed the estimated incremental net benefits of $40 billion–$50 billion between 1988 and 2035. In 2012, the WHA declared that the completion of poliovirus eradication is a programmatic emergency for global public health. Nigeria, as one of 3 remaining polio-endemic countries, developed an emergency plan to interrupt the transmission of poliovirus. The plan included the introduction or scale-up of various new innovations and strategies, which had substantial financial implication. Methods. This is a retrospective study to document the intensified resource mobilization efforts made by the World Health Organization (WHO) in Nigeria to meet the increased financial requirements and bridge the remaining gap in funding. In addition to the established coordination platforms, the WHO Nigeria Country Office team directly engaged with national authorities, donors, and partners throughout the process of resource requirement analysis, project appraisals, proposal development, and implementation of activities, joint monitoring, and evaluation exercises. The office strengthened its capacity for direct funds disbursement and systematic implementation of a rigorous accountability framework. Results. Between 2008 and May 2015, $538 million was mobilized locally, of which 82% was mobilized since 2012. The percentage of the total funding requirements that were locally mobilized averaged 31% between 2008 and 2011 and increased to 70% between 2012 and May 2015. During the same period, the WHO Nigeria

  9. Positron emission tomography with 2-[18F]-Fluoro-2-Deoxy-D-Glucose for initial staging of hodgkin lymphoma: a single center experience in Brazil

    Directory of Open Access Journals (Sweden)

    Juliano Julio Cerci

    2009-06-01

    Full Text Available BACKGROUND: 2-[18F]-Fluoro-2-Deoxy-D-Glucose (FDG-PET is a well established functional imaging modality for the initial staging of Hodgkin lymphoma (HL in patients from Western Europe and North America. The reliability of FDG-PET in populations of different ethnic groups is unclear, as all investigations published to date have come from developed countries. PURPOSE: The aim of the present study was to investigate the effectiveness of FDG-PET in the initial staging of HL patients in a Brazilian population. METHODS: Eighty-two patients with newly diagnosed HL were prospectively included in the study. All patients were staged with both conventional clinical staging (CCS methods, including computed tomography (CT and whole-body FDG-PET methods. A standard of reference for the nodal regions and the extranodal organs was determined using all available information, including the CCS methods, FDG-PET, the diagnostic histology and the follow-up examinations. The results of the CCS were then compared to the FDG-PET results. RESULTS: The sensitivity of FDG-PET was higher for nodal staging than that of CT (87.8% vs. 61.6%, respectively. FDG-PET was also more sensitive than CT in regard to evaluating the extranodal organs for lymphomatous involvement (96.2% vs. 40.0%, respectively. FDG-PET detected all 16 patients who were characterized by a positive bone marrow biopsy and identified an additional 4 patients with bone marrow disease. The incorporation of FDG-PET coupled with CCS in the staging procedure upstaged 20% (17/82 of the patients and downstaged 11% (9/82 of the patients. As a result of these changes in staging, 15% (13/82 of the patients would have received a different therapeutic regimen. CONCLUSIONS: The FDG-PET method is superior to CT for the detection of nodal and extra-nodal HL. The observation that the FDG-PET method upstaged the disease was the most common result (20% of patients brought about by the addition of PET to the staging algorithm

  10. Interplay of demographic variables, birth experience, and initial reactions in the prediction of symptoms of posttraumatic stress one year after giving birth.

    Science.gov (United States)

    König, Julia; Schmid, Sabine; Löser, Eva; Neumann, Olaf; Buchholz, Stefan; Kästner, Ralph

    2016-01-01

    There has been increasing research on posttraumatic stress disorder (PTSD) following childbirth in the last two decades. The literature on predictors of who develops posttraumatic stress symptoms (PSS) suggests that both vulnerability and birth factors have an influence, but many studies measure predictors and outcomes simultaneously. In this context, we aimed to examine indirect and direct effects of predictors of PSS, which were measured longitudinally. We assessed women within the first days (n=353), 6 weeks, and 12 months (n=183) after having given birth to a healthy infant. The first assessment included questions on demographics, pregnancy, and birth experience. The second and third assessments contained screenings for postpartum depression, PTSD, and general mental health problems, as well as assessing social support and physical well-being. We analysed our data using structural equation modelling techniques (n=277). Our final model showed good fit and was consistent with a diathesis-stress model of PSS. Women who had used antidepressant medication in the 10 years before childbirth had higher PSS at 6 weeks, independent of birth experiences. Subjective birth experience was the early predictor with the highest total effect on later PSS. Interestingly, a probable migration background also had a small but significant effect on PSS via more episiotomies. The null results for social support may have been caused by a ceiling effect. Given that we measured predictors at different time points, our results lend important support to the etiological model, namely, that there is a vulnerability pathway and a stress pathway leading to PSS. PSS and other psychological measures stayed very stable between 6 weeks and 1 year postpartum, indicating that it is possible to identify women developing problems early. Our results are consistent with a diathesis-stress model: vulnerability (antidepressant use in the previous 10 years) influenced posttraumatic stress symptoms at 6

  11. Coronary CT angiography-derived fractional flow reserve correlated with invasive fractional flow reserve measurements - initial experience with a novel physician-driven algorithm

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, Stefan [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); University Medical Centre Mannheim (UMM), University of Heidelberg, First Department of Medicine, Faculty of Medicine Mannheim, Mannheim (Germany); Wang, Rui [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Beijing Anzhen Hospital, Capital Medical University, Department of Radiology, Beijing (China); Schoepf, U.J.; Steinberg, Daniel H.; Spearman, James V.; Bayer, Richard R. [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Hamm, Christian W. [Giessen University, Department of Internal Medicine I, Cardiology/Angiology, Giessen (Germany); Renker, Matthias [Medical University of South Carolina, Heart and Vascular Center, Charleston, SC (United States); Giessen University, Department of Internal Medicine I, Cardiology/Angiology, Giessen (Germany)

    2015-04-01

    The present study aimed to determine the feasibility of a novel fractional flow reserve (FFR) algorithm based on coronary CT angiography (cCTA) that permits point-of-care assessment, without data transfer to core laboratories, for the evaluation of potentially ischemia-causing stenoses. To obtain CT-based FFR, anatomical coronary information and ventricular mass extracted from cCTA datasets were integrated with haemodynamic parameters. CT-based FFR was assessed for 36 coronary artery stenoses in 28 patients in a blinded fashion and compared to catheter-based FFR. Haemodynamically relevant stenoses were defined by an invasive FFR ≤0.80. Time was measured for the processing of each cCTA dataset and CT-based FFR computation. Assessment of cCTA image quality was performed using a 5-point scale. Mean total time for CT-based FFR determination was 51.9 ± 9.0 min. Per-vessel analysis for the identification of lesion-specific myocardial ischemia demonstrated good correlation (Pearson's product-moment r = 0.74, p < 0.0001) between the prototype CT-based FFR algorithm and invasive FFR. Subjective image quality analysis resulted in a median score of 4 (interquartile ranges, 3-4). Our initial data suggest that the CT-based FFR method for the detection of haemodynamically significant stenoses evaluated in the selected population correlates well with invasive FFR and renders time-efficient point-of-care assessment possible. (orig.)

  12. The Medical Education Partnership Initiative (MEPI), a collaborative paradigm for institutional and human resources capacity building between high- and low- and middle-income countries: the Mozambique experience

    Science.gov (United States)

    Virgínia Noormahomed, Emília; Carrilho, Carla; Ismail, Mamudo; Noormahomed, Sérgio; Nguenha, Alcido; Benson, Constance A.; Mocumbi, Ana Olga; Schooley, Robert T.

    2017-01-01

    ABSTRACT Background: Collaborations among researchers based in lower and middle income countries (LMICs) and high income countries (HICs) have made major discoveries related to diseases disproportionately affecting LMICs and have been vital to the development of research communities in LMICs. Such collaborations have generally been scientifically and structurally driven by HICs. Objectives: In this report we outline a paradigm shift in collaboration, exemplified by the Medical Education Partnership Initiative (MEPI), in which the formulation of priorities and administrative infrastructure reside in the LMIC. Methods: This descriptive report outlines the critical features of the MEPI partnership. Results: In the MEPI, LMIC program partners translate broad program goals and define metrics into priorities that are tailored to local conditions. Program funds flow to a LMIC-based leadership group that contracts with peers from HICs to provide technical and scientific advice and consultation in a 'reverse funds flow' model. Emphasis is also placed on strengthening administrative capacity within LMIC institutions. A rigorous monitoring and evaluation process modifies program priorities on the basis of evolving opportunities to maximize program impact. Conclusions: Vesting LMIC partners with the responsibility for program leadership, and building administrative and fiscal capacity in LMIC institutions substantially enhances program relevance, impact and sustainability.

  13. Initial studies into the viability of using co-dopants in inorganic glass scintillators to develop a scintillating glass for applications in particle physics experiments

    CERN Document Server

    Brown, R M; Fu, J; Parker, J M

    2002-01-01

    Inorganic glasses are a potential source of affordable scintillators for particle physics; however, for application to calorimetry, dense glasses are required, and oxide glasses with the necessary characteristics have proved difficult to produce. Recent work has demonstrated that cerium-doped heavy metal fluoride (HMF) glasses have many of the required properties, although their performance is limited by the fact that CeF sub 3 emission is in the near ultraviolet, close to the band edge for transmission in the glass. The light yield from large blocks of glass is, therefore, reduced by self-absorption. The yield is further reduced when the material is exposed to ionising radiation, which causes the formation of colour centres, increasing absorption at short wavelengths. This work reports on initial studies into the addition of rare earth fluorides to Ce-doped HMF glasses as a means of moving the emission wavelength away from the absorption edge and some developments in the manufacture of dense oxide glasses. A...

  14. Percutaneous suture-mediated closure of femoral access sites deployed through the procedure sheath: initial clinical experience with a novel vascular closure device.

    Science.gov (United States)

    Eggebrecht, Holger; Naber, Christoph; Woertgen, Uta; Ringe, Sonia; Konorza, Thomas F M; Schmermund, Axel; von Birgelen, Clemens; Haude, Michael; Kroeger, Knut; Erbel, Raimund; Baumgart, Dietrich

    2003-03-01

    The objective of this study was to assess the initial safety and feasibility of a novel suture-mediated device for closure of femoral access sites immediately after diagnostic or interventional cardiac catheterization. In a prospective study, 150 patients (mean age, 61.5 years; 109 male) underwent femoral access closure with a novel suture closure device (Superstitch, Sutura) immediately after diagnostic (n = 106) or interventional (n = 44) catheterization procedures, independently of the coagulation status. All patients were monitored for 24 hr after the procedure. The closure device was successfully deployed in 92% of patients. Immediate hemostasis was achieved in 77% of patients with no differences between patients undergoing diagnostic catheterization or coronary interventions (79% vs. 73%; P = 0.659). After 2 min of additional light manual compression, hemostasis was achieved in 92% of patients. There was one major complication requiring vascular surgery (0.7%). The novel suture closure device is a safe and effective device that allows for immediate closure of femoral puncture sites after both diagnostic and interventional procedures with a low rate of major complications.

  15. Micro-dose hCG as luteal phase support without exogenous progesterone administration: mathematical modelling of the hCG concentration in circulation and initial clinical experience.

    Science.gov (United States)

    Andersen, C Yding; Fischer, R; Giorgione, V; Kelsey, Thomas W

    2016-10-01

    For the last two decades, exogenous progesterone administration has been used as luteal phase support (LPS) in connection with controlled ovarian stimulation combined with use of the human chorionic gonadotropin (hCG) trigger for the final maturation of follicles. The introduction of the GnRHa trigger to induce ovulation showed that exogenous progesterone administration without hCG supplementation was insufficient to obtain satisfactory pregnancy rates. This has prompted development of alternative strategies for LPS. Augmenting the local endogenous production of progesterone by the multiple corpora lutea has been one focus with emphasis on one hand to avoid development of ovarian hyper-stimulation syndrome and, on the other hand, to provide adequate levels of progesterone to sustain implantation. The present study evaluates the use of micro-dose hCG for LPS support and examines the potential advances and disadvantages. Based on the pharmacokinetic characteristics of hCG, the mathematical modelling of the concentration profiles of hCG during the luteal phase has been evaluated in connection with several different approaches for hCG administration as LPS. It is suggested that the currently employed LPS provided in connection with the GnRHa trigger (i.e. 1.500 IU) is too strong, and that daily micro-dose hCG administration is likely to provide an optimised LPS with the current available drugs. Initial clinical results with the micro-dose hCG approach are presented.

  16. Geomagnetic model investigations for 1980 - 1989: A model for strategic defense initiative particle beam experiments and a study in the effects of data types and observatory bias solutions

    Science.gov (United States)

    Langel, Robert A.; Sabaka, T. J.; Baldwin, R. T.

    1991-01-01

    Two suites of geomagnetic field models were generated at the request of Los Alamos National Lab. concerning Strategic Defense Initiative (SDI) research. The first is a progression of five models incorporating MAGSAT data and data from a sequence of batches as a priori information. The batch sequence is: post 1979.5 observatory data, post 1980 land survey and selected aeromagnetic and marine survey data, a special White Sands (NM) area survey by Project Magnet with some additional post 1980 marine survey data, and finally DE-2 satellite data. These models are of 13th deg and order in their main field terms, and deg and order 10 in their first derivative temporal terms. The second suite consists of four models based solely upon post 1983.5 observatory and survey data. They are of deg and order 10 in main field and 8 in a first deg Taylor series. A comprehensive error analysis was applied to both series, which accounted for error sources such as the truncated core and crustal fields, and the neglected Sq and low deg crustal fields. Comparison of the power spectrum of the MGST (10/81) model with those of this series show good agreement.

  17. Advancing the education in molecular diagnostics: the IFCC-Initiative "Clinical Molecular Biology Curriculum" (C-CMBC); a ten-year experience.

    Science.gov (United States)

    Lianidou, Evi; Ahmad-Nejad, Parviz; Ferreira-Gonzalez, Andrea; Izuhara, Kenji; Cremonesi, Laura; Schroeder, Maria-Eugenia; Richter, Karin; Ferrari, Maurizio; Neumaier, Michael

    2014-09-25

    Molecular techniques are becoming commonplace in the diagnostic laboratory. Their applications influence all major phases of laboratory medicine including predisposition/genetic risk, primary diagnosis, therapy stratification and prognosis. Readily available laboratory hardware and wetware (i.e. consumables and reagents) foster rapid dissemination to countries that are just establishing molecular testing programs. Appropriate skill levels extending beyond the technical procedure are required for analytical and diagnostic proficiency that is mandatory in molecular genetic testing. An international committee (C-CMBC) of the International Federation for Clinical Chemistry (IFCC) was established to disseminate skills in molecular genetic testing in member countries embarking on the respective techniques. We report the ten-year experience with different teaching and workshop formats for beginners in molecular diagnostics.

  18. Small dispersion limit of the Korteweg-de Vries equation with periodic initial conditions and analytical description of the Zabusky-Kruskal experiment

    Science.gov (United States)

    Deng, Guo; Biondini, Gino; Trillo, Stefano

    2016-10-01

    We study the small dispersion limit of the Korteweg-de Vries (KdV) equation with periodic boundary conditions and we apply the results to the Zabusky-Kruskal experiment. In particular, we employ a WKB approximation for the solution of the scattering problem for the KdV equation [i.e., the time-independent Schrödinger equation] to obtain an asymptotic expression for the trace of the monodromy matrix and thereby of the spectrum of the problem. We then perform a detailed analysis of the structure of said spectrum (i.e., band widths, gap widths and relative band widths) as a function of the dispersion smallness parameter ɛ. We then formulate explicit approximations for the number of solitons and corresponding soliton amplitudes as a function of ɛ. Finally, by performing an appropriate rescaling, we compare our results to those in the famous Zabusky and Kruskal's paper, showing very good agreement with the numerical results.

  19. Mid-Pliocene global climate simulation with MRI-CGCM2.3: set-up and initial results of PlioMIP Experiments 1 and 2

    Directory of Open Access Journals (Sweden)

    Y. Kamae

    2012-05-01

    Full Text Available The mid-Pliocene (3.3 to 3.0 million yr ago, a globally warm period before the Quaternary, is recently attracting attention as a new target for paleoclimate modelling and data-model synthesis. This paper reports set-ups and results of experiments proposed in Pliocene Model Intercomparison Project (PlioMIP using a global climate model, MRI-CGCM2.3. We conducted pre-industrial and mid-Pliocene runs by using the coupled atmosphere-ocean general circulation model (AOGCM and its atmospheric component (AGCM for the PlioMIP Experiments 2 and 1, respectively. In addition, we conducted two types of integrations in AOGCM simulation, with and without flux adjustments on sea surface. General characteristics of differences in the simulated mid-Pliocene climate relative to the pre-industrial in the three integrations are compared. In addition, patterns of predicted mid-Pliocene biomes resulting from the three climate simulations are compared in this study. Generally, difference of simulated surface climate between AGCM and AOGCM is larger than that between the two AOGCM runs, with and without flux adjustments. The simulated climate shows different pattern between AGCM and AOGCM particularly over low latitude oceans, subtropical land regions and high latitude oceans. The AOGCM simulations do not reproduce wetter environment in the subtropics relative to the present-day, which is suggested by terrestrial proxy data. The differences between the two types of AOGCM runs are small over the land, but evident over the ocean particularly in the North Atlantic and polar regions.

  20. Initial Study

    DEFF Research Database (Denmark)

    Torp, Kristian

    2009-01-01

    Congestion is a major problem in most cities and the problem is growing (Quiroga, 2000) (Faghri & Hamad, 2002). When the congestion level is increased the drivers notice this as delays in the traffic (Taylor, Woolley, & Zito, 2000), i.e., the travel time for the individual driver is simply...... increased. In the initial study presented here, the time it takes to pass an intersection is studied in details. Two major signal-controlled four-way intersections in the center of the city Aalborg are studied in details to estimate the congestion levels in these intersections, based on the time it takes...

  1. Final report: Initial ecosystem response of salt marshes to ditch plugging and pool creation: Experiments at Rachel Carson National Wildlife Refuge (Maine)

    Science.gov (United States)

    Adamowicz, S.C.; Roman, C.T.

    2002-01-01

    This study evaluates the response of three salt marshes, associated with the Rachel Carson National Wildlife Refuge (Maine), to the practice of ditch plugging. Drainage ditches, originally dug to drain the marsh for mosquito control or to facilitate salt hay farming, are plugged with marsh peat in an effort to impound water upstream of the plug, raise water table levels in the marsh, and increase surface water habitat. At two study sites, Moody Marsh and Granite Point Road Marsh, ditch plugs were installed in spring 2000. Monitoring of hydrology, vegetation, nekton and bird utilization, and marsh development processes was conducted in 1999, before ditch plugging, and then in 2000 and 2001 (all parameters except nekton), after ditch plugging. Each study site had a control marsh that was monitored simultaneously with the plugged marsh, and thus, we employed a BACI study design (before, after, control, impact). A third site, Marshall Point Road Marsh, was plugged in 1998. Monitoring of the plugged and control sites was conducted in 1999 and 2000, with limited monitoring in 2001, thus there was no ?before? plug monitoring. With ditch plugging, water table levels increased toward the marsh surface and the areal extent of standing water increased. Responding to a wetter substrate, a vegetation change from high marsh species (e.g., Spartina patens) to those more tolerant of flooded conditions (e.g., Spartina alterniflora) was noted at two of the three ditch plugged sites. Initial response of the nekton community (fishes and decapod crustaceans) was evaluated by monitoring utilization of salt marsh pools using a 1m2 enclosure trap. In general, nekton species richness, density, and community structure remained unchanged following ditch plugging at the Moody and Granite Point sites. At Marshall Point, species richness and density (number of individuals per m2) were significantly greater in the experimental plugged marsh than the control marsh (ditch plugging, bird species

  2. Pinatubo Emulation in Multiple Models (POEMs): planned co-ordinated experiments for the SPARC Stratospheric Sulphur and it's Role in Climate initiative (SSiRC)

    Science.gov (United States)

    Mann, Graham; Lee, Lindsay A.; Carslaw, Ken S.; Toohey, Matthew; Aquila, Valentina; Timmreck, Claudia; English, Jason M.; Neely, Ryan R., III

    2014-05-01

    The World Climate Research Program's SPARC initiative has a new international activity "Stratospheric Sulphur and its Role in Climate" (SSiRC) to better understand changes in stratospheric aerosol and precursor gaseous sulphur species. A powerful new technique to quantify and attribute sources of uncertainty in complex global models is described by Lee et al. (2011). This involves "conditioning" a Gaussian emulator to replicate (gridbox by gridbox) the results from an ensemble of runs with the full complex 3D model. Once trained on the ensemble, a Monte Carlo simulation with the fast emulator can be carried out for a full variance-based sensitivity analysis. For example, Carslaw et al., (2013, Nature) used the approach to quantify the uncertainty in indirect aerosol forcing from a 3D global chemistry-aerosol-microphysics model, decomposing the variance attributed to 28 uncertain emissions-types/processes-parameters/model-structures. One component of SSiRC involves an intercomparison of a new generation of Earth System Models that simulate the stratospheric aerosol layer interactively. Following the kick-off meeting for SSiRC in October 2013, one component of the SSiRC activity will be for each model to run "perturbed physics ensembles" (PPEs) of the Pinatubo eruption across several uncertain parameters. The Gaussian emulation approach will the be carried out on each model to characterise and intercompare the magnitude and uncertainty of simulated climate effects. In this poster presentation we will present the overall plan for this "POEMS" analysis including the outcome of an expert elicitation to finalise which uncertain parameters are to be varied and their uncertainty ranges.

  3. Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization.

    Science.gov (United States)

    Okeibunor, Joseph; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization METHODS: We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region. The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country. The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African

  4. SU-E-CAMPUS-T-06: Initial Experience of Patient-Specific QA Using a Pencil Beam Scanning Proton Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Piskulich, F; Zhang, Y; Perles, L; Mascia, A; Lepage, R; Giebeler, A; Dong, L [Scripps Proton Therapy Center, San Diego, CA (United States)

    2014-06-15

    Purpose: To illustrate patient QA results for the first 10 patients treated at Scripps Proton Center by comparing point dose measurement using an ion chamber and in-house developed secondary MU program, and the measurement of 2D dose distribution using an ion chamber array. Methods: At the time of writing, 10 patient plans were approved for treatment using Varian ProBeam pencil beam scanning system and Eclipse treatment planning software. We used the IBA CC04 0.04 cm3 ion chamber and PTW Unidos E electrometer for point dose measurement in a small water tank (Sun Nuclear 1D scanner). We developed independent MU check software based on measured pencil beam dose profiles for various energies. We used PTW Octavius 729 XDR array to evaluate 2D planar dose distribution. The 3D gamma at 3%/3 mm local dose was used to compare a 3D calculated dose plan with a 2D measured dose distribution using PTW Verisoft software. All fields were exported to a verification phantom plan and delivered at 0 degrees for simplicity. Results: Comparisons between the CC04 ion chamber measurement and calculated dose agree well within 1%. The PTW Octavius 729 XDR array exhibited some dose rate dependence in high dose rate pencil beam delivery. Nevertheless, the results, used as a relative measurement, passed the gamma criteria of 3%/3mm for greater than 90% of area in all patient fields. Visual inspection showed good agreement between ion chamber dose profile and the calculated plan. The in-house secondary check for MU agreed very well with the plan dose and measurement. The results will be updated with more patients treated. Conclusion: The initial patient specific QA results are encouraging for a new pencil beam scanning only proton therapy system.

  5. End-to-End Simulation for a Forest-Dedicated Full-Waveform Lidar Onboard a Satellite Initialized from Airborne Ultraviolet Lidar Experiments

    Directory of Open Access Journals (Sweden)

    Xiaoxia Shang

    2015-04-01

    Full Text Available In order to study forests at the global scale, a detailed link budget for a lidar system onboard satellite is presented. It is based on an original approach coupling airborne lidar observations and an end-to-end simulator. The simulator is initialized by airborne lidar measurements performed over temperate and tropical forests on the French territory, representing a wide range of forests ecosystems. Considering two complementary wavelengths of 355 and 1064 nm, the end-to-end simulator computes the performance of spaceborne lidar systems for different orbits. The analysis is based on forest structural (tree top height, quadratic mean canopy height and optical (forest optical thickness parameters. Although an ultraviolet lidar appears to be a good candidate for airborne measurements, our results show that the limited energy is not favorable for spaceborne missions with such a wavelength. A near infrared wavelength at 1064 nm is preferable, requiring ~100 mJ laser emitted energy, which is in agreement with current and future spaceborne missions involving a lidar. We find that the signal-to-noise ratio at the ground level to extract both the structural and optical parameters of forests must be larger than 10. Hence, considering the presence of clouds and aerosols in the atmosphere and assuming a stationary forest, a good detection probability of 99% can be reached when 4 or 5 satellite revisits are considered for a lidar system onboard the ISS or ICESat, respectively. This concerns ~90% of forest covers observed from the lidar, which have an optical thickness less than 3.

  6. Simultaneous multi-tear exclusion:an optimal strategy for type B thoracic aortic dissection initially proved by a single center's 8 years experience

    Institute of Scientific and Technical Information of China (English)

    YUAN Liang-xi; BAO Jun-min; ZHAO Zhi-qing; FENG Xiang; OU Le-feng; FENG Rui; LU Qing-sheng; MEI Zhi-jun; JING Zai-ping

    2007-01-01

    Background Endovascular stent-grafting is widely used to treat thoracic aortic dissection.However,little information is available regarding outcome following simultaneous exclusion of multiple tears.This report details eight years of experience using simultaneous multi-tear exclusion for treatment of Stanford type B thoracic aortic dissection resulting in successful aortic remodeling without adverse events.Methods From September 1998 to January 2006,29 type B thoracic aortic dissection patients(24 men,5 women;27 chronic,2 acute;mean age 58 years,range 45-77 years)were treated by simultaneous multi-tear exclusion in our center.Magnetic resonance angiography was used as the preoperative evaluation method.Different kinds of stent-grafts were used.The patients were followed up with contrast-enhanced spiral computed tomography at 6 months postoperatively and yearly thereafter.Results Twenty-nine surgeries were completed successfully using at least 2 stent-grafts per patient(range:2-6,mean:2.7).No major procedure-related complications,such as rupture,paraplegia,aortic branch ischemia or cerebral infarction,were observed.During follow-up,favorable remodeling of the aorta was observed.Conclusions The mid-term result of thoracic aortic dissection with simultaneous multi-tear exclusion was satisfactory.With the improvement of stent-grafts,simultaneous multi-tear exclusion should find wider application and become an optimal strategy for thoracic aortic dissection.

  7. Magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer: initial experience; Espectroscopia por ressonancia magnetica no diagnostico do cancer de prostata: experiencia inicial

    Energy Technology Data Exchange (ETDEWEB)

    Melo, Homero Jose de Farias e [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Escola Paulista de Medicina. Ciencias Radiologicas]. E-mail: homero.ddi@epm.br; Szejnfeld, Denis [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sp (Brazil). Dept. de Diagnostico por Imagem. Setor de Ressonancia Magnetica; Paiva, Cristiano Silveira [Universidade Federal do Amazonas (UFAM), Manaus, AM (Brazil); Abdala, Nitamar [Universidade Federal de Sao Paulo (UNIFESP/EPM), SP (Brazil). Dept. de Diagnostico por Imagem. Setor de Neuroradiologia; Arruda, Homero Oliveira de [Hospital do Servidor Publico Estadual de Sao Paulo (IAMSPE), SP (Brazil); Goldman, Suzan Menasce; Szejnfeld, Jacob [Universidade Federal de Sao Paulo (UNIFESP/EPM), Sp (Brazil). Escola Paulista de Medicina. Dept. de Diagnostico por Imagem

    2009-01-15

    Objective: to report an experiment involving the introduction of a protocol utilizing commercially available three-dimensional 1H magnetic resonance spectroscopy imaging (3D 1H MRSI) method in patients diagnosed with prostatic tumors under suspicion of neoplasm. Materials and methods: forty-one patients in the age range between 51 and 80 years (mean, 67 years) were prospectively evaluated. The patients were divided into two groups: patients with one or more biopsies negative for cancer and high specific-prostatic antigen levels (group A), and patients with cancer confirmed by biopsy (group B). The determination of the target area (group A) or the known cancer extent (group B) was based on magnetic resonance imaging and MRSI studies. Results: the specificity of MRSI in the diagnosis of prostate cancer was lower than the specificity reported in the literature (about 47%). On the other hand, for tumor staging, it corresponded to the specificity reported in the literature. Conclusion: the introduction and standardization of 3D 1H MRSI has allowed the obtention of a presumable diagnosis of prostate cancer, by a combined analysis of magnetic resonance imaging and metabolic data from 3D 1H MRSI. (author)

  8. The clinical utility of reduced-distortion readout-segmented echo-planar imaging in the head and neck region: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Koyasu, Sho; Iima, Mami; Umeoka, Shigeaki; Morisawa, Nobuko; Togashi, Kaori [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Sakyo-Ku, Kyoto (Japan); Porter, David A. [Siemens AG, MED MR PLM AW Neurology, Allee am Roethelheimpark 2, Erlangen (Germany); Ito, Juichi [Kyoto University, Department of Otolaryngology, Head and Neck Surgery, Graduate School of Medicine, Sakyo-Ku, Kyoto (Japan); Le Bihan, Denis [Kyoto University, Human Brain Research Center, Graduate School of Medicine, Sakyo-Ku, Kyoto (Japan); Neurospin, CEA-Saclay Center, Gif-sur-Yvette Cedex (France)

    2014-12-15

    To evaluate whether readout-segmented echo-planar imaging (RS-EPI) diffusion weighted image (DWI) can diminish image distortion in the head and neck area, compared with single-shot (SS)-EPI DWI. We conducted phantom and patient studies using 3 T magnetic resonance imaging (MRI) with a 16-channel coil. For the phantom study, we evaluated distortion and signal homogeneity in gel phantoms. For the patient study, 29 consecutive patients with clinically suspicious parotid lesions were prospectively enrolled. RS-EPI and SS-EPI DWI were evaluated by two independent readers for identification of organ/lesion and distortion, using semiquantitative scales and quantitative scores. Apparent diffusion coefficient (ADC) values and contrast-noise ratios of parotid tumours (if present; n = 15) were also compared. The phantom experiments showed that RS-EPI provided less distorted and more homogeneous ADC maps than SS-EPI. In the patient study, RS-EPI was found to provide significantly less distortion in almost all organs/lesions (p < 0.05), according to both semiquantitative scales and quantitative scores. There was no significant difference in ADC values and contrast-noise ratios between the two DWI techniques. The distortion in DWI was significantly reduced with RS-EPI in both phantom and patient studies. The RS-EPI technique provided more homogenous images than SS-EPI, and can potentially offer higher image quality in the head and neck area. (orig.)

  9. Balanced Steady State Free Precession for Arterial Spin Labeling MRI: Initial Experience for Blood Flow Mapping in Human Brain, Retina, and Kidney

    Science.gov (United States)

    Park, Sung-Hong; Wang, Danny J.J.; Duong, Timothy Q.

    2013-01-01

    We implemented pseudo-continuous ASL (pCASL) with 2D and 3D balanced steady state free precession (bSSFP) readout for mapping blood flow in the human brain, retina, and kidney, free of distortion and signal dropout, which are typically observed in the most commonly used echo-planar imaging acquisition. High resolution functional brain imaging in the human visual cortex was feasible with 3D bSSFP pCASL. Blood flow of the human retina could be imaged with pCASL and bSSFP in conjunction with a phase cycling approach to suppress the banding artifacts associated with bSSFP. Furthermore, bSSFP based pCASL enabled us to map renal blood flow within a single breath hold. Control and test-retest experiments suggested that the measured blood flow values in retina and kidney were reliable. Because there is no specific imaging tool for mapping human retina blood flow and the standard contrast agent technique for mapping renal blood flow can cause problems for patients with kidney dysfunction, bSSFP based pCASL may provide a useful tool for the diagnosis of retinal and renal diseases and can complement existing imaging techniques. PMID:23664680

  10. Initial ground experiments of silkworm cultures living on different feedstock for provision of high quality animal protein for human in space

    Science.gov (United States)

    Yang, Yunan; Tang, Liman; Tong, Ling; Liu, Yang; Liu, Hong; Li, Xiaomin

    2010-09-01

    Silkworm could be an alternative to provide edible animal protein in Controlled Ecological Life Support System (CELSS) for long-term manned space missions. Silkworms can consume non-edible plant residue and convert plant nutrients to high quality edible animal protein for astronauts. The preliminary investigation of silkworm culture was carried out in earth environment. The silkworms were fed with artificial silkworm diet and the leaves of stem lettuce ( Lactuca sativa L. var. angustana Irish) separately and the nutritional structure of silkworm was investigated and compared, The culture experiments showed that: (1) Stem lettuce leaves could be used as food of silkworm. The protein content of silkworm fed with lettuce leaves can reach 70% of dry mass. (2) The protein content of silkworm powder produced by the fifth instar silkworm larvae was 70%, which was similar to the protein content of silkworm pupae. The powder of the fifth instar silkworm larvae can be utilized by astronaut. (3) The biotransformation rate of silkworm larvae between the third instar and the fifth instar could reach above 70%. The biotransformation cycle of silkworm was determined as 24 days. (4) Using the stem lettuce leaves to raise silkworm, the coarse fiber content of silkworm excrements reached about 33%. The requirements of space silkworm culture equipment, feeding approaches and feeding conditions were also preliminarily designed and calculated. It is estimated that 2.2 m 3 of culture space could satisfy daily animal protein demand for seven astronauts.

  11. Introduction: The Pan-Eurasian Experiment (PEEX – multi-disciplinary, multi-scale and multi-component research and capacity building initiative

    Directory of Open Access Journals (Sweden)

    M. Kulmala

    2015-08-01

    Full Text Available The Pan-Eurasian Experiment (PEEX is a multi-disciplinary, multi-scale and multi-component research, research infrastructure and capacity building program. PEEX has originated from a bottom-up approach by the science communities, and is aiming at resolving the major uncertainties in Earth System Science and global sustainability issues concerning the Arctic and boreal Pan-Eurasian regions, as well as China. The vision of PEEX is to solve interlinked global grand challenges influencing human well-being and societies in northern Eurasia and China. Such challenges include climate change, air quality, biodiversity loss, urbanization, chemicalization, food and fresh water availability, energy production and use of natural resources by mining, industry, energy production and transport sectors. Our approach is integrative and supra-disciplinary, recognizing the important role of the Arctic and boreal ecosystems in the Earth system. The PEEX vision includes establishing and maintaining long-term, coherent and coordinated research activities as well as continuous, comprehensive research and educational infrastructures and related capacity building across the PEEX domain. In this paper we present the PEEX structure, summarize its motivation, objectives and future outlook.

  12. RHUM-RUM, a Large-Scale Effort to Seismologically Image a Mantle Plume Under the Reunion Hotspot: Experiment Presentation and Initial Results

    Science.gov (United States)

    Sigloch, K.; Barruol, G.

    2014-12-01

    RHUM-RUM is a German-French geophysical experiment based on the seafloor and on islands surrounding the hotspot of La Réunion, western Indian Ocean. Its primary objective is to clarify the presence or absence of a mantle plume beneath the Reunion hotspot, which is thought to have first pierced the surface 65 million years ago with the eruption of the Deccan Traps on India. RHUM-RUM's central component is a one-year deployment (Oct 2012 - Nov 2013) of 57 broadband ocean-bottom seismometers (OBS) and hydrophones on an area of 2000x2000 km2 surrounding the hotspot. All OBS have been successfully recovered. We also have been operating 37 land seismometers on the islands of La Réunion, Mauritius, Rodrigues, southern Seychelles, îles Eparses, and on Madagascar between 2011 and 2014. As the data collection stage is drawing to a close, we discuss data yield and quality with respect to RHUM-RUM's primary purpose (passive seismological imaging through all depth levels of the mantle) and secondary applications ("environmental seismology" in a sparsely instrumented area, e.g., tracking of tropical cyclones). We give an overview of the research questions investigated by the RHUM-RUM group, and present preliminary results.

  13. Introduction: The Pan-Eurasian Experiment (PEEX) - multi-disciplinary, multi-scale and multi-component research and capacity building initiative

    Science.gov (United States)

    Kulmala, M.; Lappalainen, H. K.; Petäjä, T.; Kurten, T.; Kerminen, V.-M.; Viisanen, Y.; Hari, P.; Bondur, V.; Kasimov, N.; Kotlyakov, V.; Matvienko, G.; Baklanov, A.; Guo, H. D.; Ding, A.; Hansson, H.-C.; Zilitinkevich, S.

    2015-08-01

    The Pan-Eurasian Experiment (PEEX) is a multi-disciplinary, multi-scale and multi-component research, research infrastructure and capacity building program. PEEX has originated from a bottom-up approach by the science communities, and is aiming at resolving the major uncertainties in Earth System Science and global sustainability issues concerning the Arctic and boreal Pan-Eurasian regions, as well as China. The vision of PEEX is to solve interlinked global grand challenges influencing human well-being and societies in northern Eurasia and China. Such challenges include climate change, air quality, biodiversity loss, urbanization, chemicalization, food and fresh water availability, energy production and use of natural resources by mining, industry, energy production and transport sectors. Our approach is integrative and supra-disciplinary, recognizing the important role of the Arctic and boreal ecosystems in the Earth system. The PEEX vision includes establishing and maintaining long-term, coherent and coordinated research activities as well as continuous, comprehensive research and educational infrastructures and related capacity building across the PEEX domain. In this paper we present the PEEX structure, summarize its motivation, objectives and future outlook.

  14. Case Experience of Radiofrequency Ablation for Benign Thyroid Nodules: From an Ex Vivo Animal Study to an Initial Ablation in Taiwan

    Directory of Open Access Journals (Sweden)

    Ming-Tsang Lee

    2016-03-01

    Full Text Available Radiofrequency ablation (RFA is a minimally invasive technique, used with ultrasound or computed tomography guidance, which can produce tissue coagulation necrosis in various kinds of tumors in the human body. In the past 10 years, numerous studies about RFA in benign thyroid nodules have been published. Reviewing these studies, we noticed that the effectiveness of ablation was higher when it was performed with the “moving-shot technique” via an internally cooled electrode. A consensus statement published from the Korean Society of Radiology also suggested the moving-shot technique as a standard ablation procedure for benign thyroid nodule ablation in Korea. In Taiwan, most symptomatic benign nodules are currently treated with surgical removal. RFA for mass lesions is primarily performed for the treatment of metastatic hepatic tumors. In our case, we have attempted to introduce RFA for benign thyroid nodules in Taiwan. Because endocrinologists in Taiwan were not familiar with this technique, we adopted a stepwise approach in learning how to perform RFA. We conducted ex vivo animal ablation exercises to gain experience in setting the radiofrequency generator for the right ablation mode and appropriate power output. The thyroid nodule volume reduction rate after 1 year of follow up was approximately 50% in this case. The most important thing we learned from this trial is that we confirmed the safety of thyroid nodule ablation. To the best of our knowledge, this is the first reported study of RFA of a thyroid nodule in Taiwan.

  15. Usefulness of 64-slice MDCT for follow-up of young children with coronary artery aneurysm due to Kawasaki disease: Initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Peng Yun [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)], E-mail: ppengyun@yahoo.com; Zeng Jinjin [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Du Zhongdong [Pediatric Cardiovascular Department, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Sun Guoqiang [Imaging Center, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China); Guo Huling [Pediatric Cardiovascular Department, Beijing Children' s Hospital Affiliated to Capital Medical University, 56, Nanlishi Road, Xicheng District, Beijing 100045 (China)

    2009-03-15

    To evaluate the initial application and value of 64-slice multidetector computed tomography as an alternative diagnostic modality in the follow-up of young children with coronary artery aneurysm due to Kawasaki disease. Twelve boys (mean age 5.1 years, range 1.8-7.8 years) for follow-up (time range from 1.1 to 5.1 years) of known Kawasaki disease and coronary artery aneurysm underwent 64-slice MDCT ECG-gated coronary angiography. All data were acquired without breath holding. Two pediatric radiologists independently assessed image quality and the diameter of all coronary segments were measured for each patient. The number, position, shape and size of each coronary artery aneurysm were observed and compared with those of ECHO performed previously. A total of 118/156 segments permitted visualization with diagnostic image quality, the CT measurements showed good inter-observer and intra-observer reliability, coefficients were 0.93 and 0.88, respectively. A total of 30 coronary artery aneurysms were identified with measured mean of 7.5 {+-} 3.8 mm in diameter, and of 12.4 {+-} 9.1 mm in longitudinal lengths.10 tumors were small, 8 tumors were medium and 12 tumors were giant aneurysm. The affected segments included LM7/12(58.3%), 9/12(75%) of LAD1, 4/12(33.3%) of LAD2, 2/12(16.7%) of LCX1; 6/12(50%) of RCA1, 9/12(75%) of RCA2 and 4/12(33.3%) of RCA3, including affected two segments in 9 tumors and three segments in 1 tumor. Calcifications were found in 5 aneurysms and 3/5 with thrombosis; six stenotic segments were found. ECHO failed to detect 8 tumors with 2/8 in LAD, 1/8 in LCX and 5/8 in RCA, and those included 4 small aneurysms. The use of 64-slice MDCT angiography proved valuable for monitoring young children with Kawasaki disease. However, further study is necessary to specify the sensitivity and specificity of MDCT in the follow-up.

  16. Acetazolamide-augmented dynamic BOLD (aczBOLD imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience

    Directory of Open Access Journals (Sweden)

    Junjie Wu

    2017-01-01

    Full Text Available The purpose of this study was to measure cerebrovascular reactivity (CVR in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ vasoreactivity (aczBOLD, to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM: 4.13% ± 1.16% vs. 4.90% ± 0.98%, P = 0.002; white matter (WM: 2.83% ± 1.23% vs. 3.50% ± 0.94%, P = 0.005. In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0–4.43 min for the GM and 1.80 min (time range above 95% of the maximum value: 1.40–3.53 min for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (Tmax (P = 0.008 for the WM and normalized cerebral blood flow (P = 0.003 for the GM, and P = 0.001 for the WM. AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

  17. SU-F-E-15: Initial Experience Implementing a Case Method Teaching Approach to Radiation Oncology Physics Residents, Graduate Students and Doctorate of Medical Physics Students

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, A [University of Texas Health Science Center San Antonio, San Antonio, TX (United States)

    2016-06-15

    Purpose: Case Method Teaching approach is a teaching tool used commonly in business school to challenge students with real-world situations—i.e. cases. The students are placed in the role of the decision maker and have to provide a solution based on the multitude of information provided. Specifically, students must develop an ability to quickly make sense of a complex problem, provide a solution incorporating all of the objectives (at time conflicting) and constraints, and communicate that solution in a succinct, professional and effective manner. The validity of the solution is highly dependent on the auxiliary information provided in the case and the basic didactic knowledge of the student. A Case Method Teaching approach was developed and implemented into an on-going course focused on AAPM Task Group reports at UTHSCSA. Methods: A current course at UTHSCSA reviews and discusses 15 AAPM Task Group reports per semester. The course is structured into three topic modules: Imaging QA, Stereotactic Radiotherapy, and Special Patient Measurements—i.e. pacemakers, fetal dose. After a topic module is complete, the students are divided into groups (2–3 people) and are asked to review a case study related to the module topic. Students then provide a solution presented in an executive summary and class presentation. Results: Case studies were created to address each module topic. Through team work and whole-class discussion, a collaborative learning environment was established. Students additionally learned concepts such vendor relations, financial negotiations, capital project management, and competitive strategy. Conclusion: Case Method Teaching approach is an effective teaching tool to further enhance the learning experience of radiation oncology physics students by presenting them with though-provoking dilemmas that require students to distinguish pertinent from peripheral information, formulate strategies and recommendations for action, and confront obstacles to

  18. An initial exploration of community mental health nurses' attitudes to and experience of sexuality-related issues in their work with people experiencing mental health problems.

    Science.gov (United States)

    Cort, E M; Attenborough, J; Watson, J P

    2001-12-01

    = 77) of respondents anticipated that people with mental health problems who are in relationships might experience sexual problems, and 52.4% (n = 64) agreed that a sexual history should be routinely included in assessment. Seventeen per cent (n = 21) had encountered clients becoming sexually aroused during the administration of a depot injection in the community. The authors identify this as an area of concern that warrants further investigation. The results indicate that although awareness of sexuality issues may be high there may be less agreement as to how such awareness should translate into CMHN practice.

  19. Choice of initial therapy

    Directory of Open Access Journals (Sweden)

    Manuel Battegay

    2014-11-01

    Full Text Available Current international and national treatment guidelines such as EACS, BHIVA, DHHS or IAS update regularly recommendations on the choice of initial combination antiretroviral treatment (cART regimens. Preferred cART regimens include a backbone with two nucleoside (nucleotide reverse transcriptase inhibitors combined either with one non-nucleoside reverse transcriptase inhibitor or one ritonavir boosted protease inhibitor or more recently one integrase inhibitor. Response rates according to viral load measurements increased in recent years, in particular due to better tolerability. The choice of initial therapy is flexible and influenced by several factors such as height of viral load, genotypic resistance testing, CD4 cell count, co-morbidities, interactions, potential adverse events, (potential for pregnancy, convenience, adherence, costs as well as physician's and patient's preferences. Diverse highly potent initial cART regimens exist. Following the many possibilities, the choice of a regimen is based on a mixture of evidence-informed data and individualized concepts, some of the latter only partly supported by strong evidence. For example, different perceptions and personal experiences exist about boosted protease inhibitors compared to non-nucleoside reverse transcriptase inhibitors or integrase inhibitors and vice versa which may influence the initial choice. This lecture will discuss choices of initial cART in view of international guidelines and the evidence for individualization of initial HIV therapy.

  20. Openness initiative

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, S.S. [Los Alamos National Lab., NM (United States)

    1995-12-31

    Although antinuclear campaigns seem to be effective, public communication and education efforts on low-level radioactive waste have mixed results. Attempts at public information programs on low-level radioactive waste still focus on influencing public opinion. A question then is: {open_quotes}Is it preferable to have a program focus on public education that will empower individuals to make informed decisions rather than trying to influence them in their decisions?{close_quotes} To address this question, a case study with both quantitative and qualitative data will be used. The Ohio Low-Level Radioactive Waste Education Program has a goal to provide people with information they want/need to make their own decisions. The program initiated its efforts by conducting a statewide survey to determine information needed by people and where they turned for that information. This presentation reports data from the survey and then explores the program development process in which programs were designed and presented using the information. Pre and post data from the programs reveal attitude and knowledge shifts.

  1. Rosmarinus officinalis vitroculture initiation

    Directory of Open Access Journals (Sweden)

    Liviu POP

    2007-05-01

    Full Text Available In this experiment we have initiated a Rosmarinus officinalis vitroculture, on different growth media. As biological material we used apexes, taken from an only plant. The development medium have consisted in Murashige and Skoog standard mixture, where growth regulators were added, resulting 4 experimental variants: V0 – control variant – basic medium (BM, V1 – BM + 2mg/l BA + 1mg/l IBA, V2 - BM + 2mg/l BA + 1mg/l IAA, V3 –BM + 2mg/l BA + 1mg/l NAA. The experiment lasted for 90 days. We have found that the initiation of Rosmarinus officinalis vitroculture is possible, the best growth medium for this purpose being the basic one (V0 - Murashige and Skoog without growth regulators.

  2. Remodelamento do ventrículo esquerdo pela técnica da endoventriculoplastia com exclusão septal: experiência inicial Endoventricular circular patch plasty with septal exclusion: initial experience

    Directory of Open Access Journals (Sweden)

    Rui Manuel Sequeira de ALMEIDA

    2000-12-01

    écnica para a melhoria da função e da nova geometria do VE, em casos de correção cirúrgica de Aneu VE.OBJECTIVE: The authors present the initial results, on the left ventricle (LV anterior aneurysms' treatment, by the Dor's technique of endoventricular circular patch plasty with septal exclusion. This work was initially based on Hutchins and Bulkley's (1980 concepts of left ventricle geometry and its' geometrical reconstruction, and on those of the circular reduction surgery by Jatene (1984. MATERIAL AND METHODS: Between April and October 1999, we performed six procedures for the surgical correction of LV aneurysms, by Dor's technique. Time between the anterior wall infarct and the surgical procedure varied between 8 days and 10 months, being 3 patients in functional class III, of the NYHA, 2 in class IV and 1 in class I. Four patients were males and the mean age was 58.3 years. On the pre-operative angiographic studies the global ejection fraction varied from 27 to 46% (mean 37.2%, the LV end systolic volume from 64.4 to 135.3 ml (mean 107.9 ml and the LV end diastolic volume from 132.9 to 236.4 ml (mean 183.8 ml. The procedure was associated with the resection of mural thrombus, in 3 cases, myocardial revascularization in 5 cases, using 10 venous and three arterial grafts (2.2 grafts/patient and 1 endarterectomy. The anterior wall was revascularized in 9 cases and the lateral and inferior in 2 each. The mean cross clamping and bypass time were, respectively, 44 and 110 minutes. RESULTS: The mean hospital post-operative time was 7.7 days. The patients were followed up for a period of 5 to 31 weeks, being all in functional class I. In 3 cases an angiography was performed, and on the other two a two dimension echocardiogram, to evaluate the global ejection fraction, which varied from 42.5 to 60% (mean 49.4, with an improvement of 32.8%. CONCLUSIONS: The authors believe, with these initial results, that this is another technique for the surgical correction of LV aneurysms

  3. Endoscopic mucosal resection of early gastric cancer: initial experience with two technical variants Mucosectomia endoscópica no câncer gástrico precoce: experiência inicial com duas variantes técnicas

    Directory of Open Access Journals (Sweden)

    Paulo Moacir de Oliveira Campoli

    2007-09-01

    Full Text Available BACKGROUND: When performed in carefully selected cases, the endoscopic treatment of early gastric cancer yields results which are comparable to the conventional surgical treatment, but with lower morbidity and mortality and better quality of life. Several technical options to perform endoscopic mucosal resection have been described and there is a large amount of accumulated experience with this procedure in eastern countries. In western countries, particularly in Brazil, technical limitations associated with the small number of cases of early gastric cancer reflect the little experience with this therapeutic mode. AIM: This study was carried out in order to assess the indications, pathological results and morbidity of a series of endoscopic mucosal resections using two technical variants in addition to investigating the safety and feasibility of the method. METHODS: Individuals with well-differentiated early gastric adenocarcinomas with up to 30 mm in diameter without scar or ulcer underwent endoscopic treatment. Two variants of the strip biopsy technique were used. The pathological study assessed the depth of the vertical invasion, lateral and basal margins as well as angio-lymphatic invasion. RESULTS: Thirteen tumors in 12 patients were resected between June 2002 and August 2005. The most common macroscopic types were IIa and IIa + IIc. Tumor size ranged from 10 to 30 mm (mean = 16.5 mm. En bloc resection was carried out in nine patients. Angio-lymphatic invasion was not observed; however, submucosal invasion was found in two cases. In four cases, the lateral margin was involved. Perforation occurred in two patients who then received conservative treatment. CONCLUSION: The relatively small series presented here suggests that the method is safe and feasible. Appropriate patient selection is the most important criteria. Long follow-up is required after treatment due to the risk of relapse.RACIONAL: O tratamento endoscópico do câncer g

  4. [Simplified laparoscopic gastric bypass. Initial experience].

    Science.gov (United States)

    Hernández-Miguelena, Luis; Maldonado-Vázquez, Angélica; Cortes-Romano, Pablo; Ríos-Cruz, Daniel; Marín-Domínguez, Raúl; Castillo-González, Armando

    2014-01-01

    Obesity surgery includes various gastrointestinal procedures. Roux-en-Y gastric bypass is the prototype of mixed procedures being the most practiced worldwide. A similar and novel technique has been adopted by Dr. Almino Cardoso Ramos and Dr. Manoel Galvao called "simplified bypass," which has been accepted due to the greater ease and very similar results to the conventional technique. The aim of this study is to describe the results of the simplified gastric bypass for treatment of morbid obesity in our institution. We performed a descriptive, retrospective study of all patients undergoing simplified gastric bypass from January 2008 to July 2012 in the obesity clinic of a private hospital in Mexico City. A total of 90 patients diagnosed with morbid obesity underwent simplified gastric bypass. Complications occurred in 10% of patients; these were more frequent bleeding and internal hernia. Mortality in the study period was 0%. The average weight loss at 12 months was 72.7%. Simplified gastric bypass surgery is safe with good mid-term results and a loss of adequate weight in 71% of cases.

  5. Percutaneous Cryotherapy of Vascular Malformation: Initial Experience

    Energy Technology Data Exchange (ETDEWEB)

    Cornelis, F., E-mail: francoiscornelis@hotmail.com [Institut Bergonie, Department of Radiology (France); Neuville, A. [Institut Bergonie, Department of Pathology (France); Labreze, C. [Pellegrin Hospital, Department of Pediatric Dermatology (France); Kind, M. [Institut Bergonie, Department of Radiology (France); Bui, B. [Institut Bergonie, Department of Oncology (France); Midy, D. [Pellegrin Hospital, Department of Vascular Surgery (France); Palussiere, J. [Institut Bergonie, Department of Radiology (France); Grenier, N. [Pellegrin Hospital, Department of Radiology (France)

    2013-06-15

    The present report describes a case of percutaneous cryotherapy in a 36-year-old woman with a large and painful pectoral venous malformation. Cryoablation was performed in a single session for this 9-cm mass with 24 h hospitalisation. At 2- and 6-month follow-up, the pain had completely disappeared, and magnetic resonance imaging demonstrated a significant decrease in size. Percutaneous cryoablation shows promise as a feasible and apparently safe method for local control in patients with symptomatic venous vascular malformations.

  6. [Initial experiences of an orthogeriatric unit].

    Science.gov (United States)

    Mesa-Lampré, M P; Canales-Cortés, V; Castro-Vilela, M E; Clerencia-Sierra, M

    2015-01-01

    To report the design and outcomes obtained during the first operational years of the Orthogeriatric Unit (OGU) established in the Zaragoza-1 (Spain) Health-Sector. A total of 494 patients >70 years old treated in the OGU from February 2009 to December 2012. An analysis was performed using the following variables: demography, previous functional level, comorbidities, surgical delay, fracture type and surgical technique, complications, hospital stay, functional outcomes, destination after hospital discharge, and short and long term mortality. Mean age 85.22 years. High incidence of comorbidities (Charlson Index): 24.3%. Dementia: 38.5%. Surgical delay: 2.57 days. Mean hospital stay between admission and discharge/transfer to convalescence unit, 20.9 days (Traumatology 6.45+OGU 14.49). More than a third (34.6%) of patients suffered from delirium. Mean functional improvement (Barthel index at hospital discharge-Barthel index at hospital admission): 27.25 points. Montebello index: 0.49. In-hospital mortality: 6.9%. Hip fracture is such a frequent and disabling pathology among the geriatric population that its treatment requires an interdisciplinary approach. This must be managed by the geriatrician, who has to assure the continuity and integration of the diverse treatment and care schedules, with the participation of the entire professional team in the decision-making process. We are very satisfied with the creation of our interdisciplinary Unit that enables us to report competitive outcomes. We believe that the progression of this Unit from providing subacute to acute care will improve the general outcomes in the future. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  7. Initial experience with heart and lung transplantation.

    Science.gov (United States)

    Reichenspurner, H; Odell, J A; Cooper, D K; Novitzky, D; Rose, A G; Klinner, W; Reichart, B

    1988-01-01

    Between February 1983 and July 1987, twelve patients underwent heart-lung transplantation at the University of Cape Town and the University of Munich. The patients included eight men and four women, whose ages ranged from 15 to 49 years (mean, 27 years). The underlying pathologic condition was idiopathic primary pulmonary hypertension in five cases, Eisenmenger's syndrome in four cases, idiopathic pulmonary fibrosis in one case, diffuse fibrosing alveolitis in one case, and chronic emphysema in one case. The immunosuppressive regimen consisted of cyclosporine A, azathioprine, and rabbit antithymocyte globulin (RATG) during the first 2 postoperative weeks; RATG was subsequently replaced by methylprednisolone. Pulmonary rejection frequently occurred in the absence of cardiac rejection; in one case, however, this situation was reversed. Two patients required retransplantation, which was undertaken for caseating pulmonary tuberculosis with obliterative bronchiolitis after 1 year in one case and for early pulmonary insufficiency after 2 days in the other case. There were no operative deaths, but three early deaths occurred, owing to respiratory insufficiency of unknown origin (10 days postoperatively), multiorgan failure (10 days postoperatively), and acute liver dystrophy (11 days postoperatively). Five weeks after operation, a fourth patient died of multi-organ failure. There were five late deaths, all of which resulted from infectious complications. Three patients, including one who underwent retransplantation, remain alive and well, 10 to 36 months postoperatively.

  8. Minilaparoscopic fundoplication: technical adaptations and initial experience

    Directory of Open Access Journals (Sweden)

    Daniellson Dimbarre

    2012-09-01

    Full Text Available CONTEXT: Gastroesophageal reflux diasease (GERD is a highly prevalent disease. Treatment is divided into lifestyle modifications, medical and surgical treatment. Surgical laparoscopy is the gold standard treatment. In the last decade, there were an extensive research on procedures, less aggressive than laparoscopy and with better esthetic results. Minilaparoscopy is "reemerging" as a safe, effective and with excellent cosmetic results in selected patients treated for gastroesophageal reflux diasease. We present a serie of 27 patients treated for GERD by minilaparoscopic laparoscopy. MATERIAL: Between October 2009July 2011 a total of 27 patients underwent fundoplication by minilaparoscopy. It is used one 10mm trocar, a telescope of 30 degrees and four 3 mm trocars at regular positions. Regular surgical steps are done with no modifications. Cardiac tape, suture needles, and eventually extracting bag, gauze, are placed and taked out through the umbilical port. With these technical adjustments, we can perform the procedure safely and effectively, similarly to standard laparoscopic technique. RESULTS: Of the 27 patients, 22 were female and 5 male. The average body mass index was 25.5 kg/m². Hiatal hernias were small (<3 cm in 24 patients. Mean operative time was 60 minutes. In all cases the hiatoplasty was performed with simple or 'x' stiches of 2.0 Ethibond. There was no need for conversion to standard laparoscopy or open surgery. The length of hospital stay was less than or equal to 24 hours in all patients. In this series of patients there were no postoperative complications. We did not observe any complication of the surgical wound. There were no evidence of recurrence of symptoms or endoscopic changes. CONCLUSION: Hiatoplasty associated with fundoplication using minilaparoscopic instruments is safe, feasible and effective. If compared to other "new access", has a spectacular esthetic results. Can be done with only minor technical adjustments, for any experienced laparoscopic surgeon, and is perfectly adaptable to our financial reality.

  9. Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty Experiência inicial com dispositivo de reversão de fluxo para proteção cerebral na angioplastia carotídea

    Directory of Open Access Journals (Sweden)

    Sidnei José Galego

    2013-03-01

    Full Text Available PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction and minor (hematoma adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II aortic arch was encountered in 62.5% of the patients and atherosclerotic lesion predominantly at the carotid bifurcation affecting the internal and common carotid arteries in 79.2%. Angiographic data revealed contralateral carotid arteries with OBJETIVO: Relatar os achados iniciais da utilização do GORE Flow Reversal System® (Sistema de Fluxo de Reversão, com foco em eventos adversos maiores/menores nos primeiros 30 dias do pós-operatório. MÉTODOS: Os primeiros 24 pacientes submetidos a angioplastia carotídea com a utilização do sistema GORE, de junho de 2010 a maio de 2012, foram avaliados retrospectivamente com relação a indicações, detalhes anatômicos, dificuldades técnicas e desfechos clínicos imediatos, incluindo eventos adversos maiores (acidente vascular cerebral, morte, infarto agudo do miocárdio e menores (hematoma. RESULTADOS: Hipertensão sistêmica estava presente em 100% dos pacientes, diabete melito em 58,3% e doença coronariana em 37,5%. Arco aórtico tipo II foi encontrado em 62,5% dos pacientes e lesão de aterosclerose predominantemente na bifurcação carotídea que afeta as artérias carótidas internas e comuns em 79,2%. Dados angiográficos revelaram artérias carótidas contralaterais com estenose <50% em 95,8% de casos e preservação de fluxo sanguíneo cerebral em 95,8%. Todos os

  10. Initial Critical Experiment and Zero Power Physical Experiments of YBW Critical Assembly after Technical Modification%YBW 临界装置技术改造后的首次临界试验和零功率物理试验

    Institute of Scientific and Technical Information of China (English)

    黄礼渊; 牛江; 付国恩; 魏东; 穆克亮

    2014-01-01

    It reports the initial critical experiment ,zero power physical experiments and the experimental results on YBW Critical Assembly after technical modification .The experiments show that the modified systems and de-vices of YBW Critical Assembly can perform their own functions , the protection system and reactivity control system satisfy the requirements , the reactor can operate safely , and the Assembly can be used for the reactor physical experiment researches .%报告了技术改造后的YBW临界装置首次临界试验和零功率物理试验及试验结果。试验表明:技术改造后,YBW临界装置的系统和设备能正常执行其功能,保护系统和堆芯反应性控制系统等符合设计要求,反应堆能够安全地正常运行。该装置可以用于开展反应堆物理实验研究。

  11. FIELD EXPERIMENTS FOR GROOVE-TYPE DEBRIS FLOW INITIATION WITH ARTIFICIAL RAINFALL%人工降雨条件下冲沟型泥石流起动试验研究

    Institute of Scientific and Technical Information of China (English)

    倪化勇

    2015-01-01

    下垫面以位于贡嘎山东坡的熊家沟为模型,开展了不同降雨强度条件下冲沟型泥石流起动的模拟试验,初步研究了冲沟型泥石流的形成机理和演化特征。试验研究表明:(1)在强降雨条件下,水体入渗速度、不同深度土体含水量变化与降雨强度呈反比例关系,降雨强度越大,越不利于水体入渗,而有利于坡面汇流、冲沟径流和下切侵蚀;(2)在强降雨和径流条件下,土体破坏方式、破坏程度以及泥石流形成机理表现出差异性。相对较小雨强降雨条件下,土体破坏方式以滑坡为主,泥石流形成模式表现为滑坡液化与转化起动,雨强较大降雨条件下,土体破坏方式以侵蚀垮塌为主,泥石流形成模式为洪流席卷垮塌体和沟床揭底;(3)起动试验中泥石流阵性特征明显。在强降雨条件下,雨强与泥石流的规模、黏度之间没有正相关性,雨强越大,泥石流黏度越小,试验中多出现的是高含砂洪流,而相对较小雨强作用下由土体液化转化形成的泥石流黏度较大。试验现象和结果与熊家沟泥石流起动、发生过程具有较高的一致性。%Debris flows can occur abruptly and rapidly in mountainous areas.It is difficult to observe their occurrence process.Therefore,field experiment becomes an important method to study debris flow initiation mechanism in recent years.This paper takes Xiongjia gully as an example and uses artificial rainfall experiment to study initiation of groove-type debris flow.Experimental results indicate some relations among rainfall intensity and gully erosion,slope stability and failure mode,debris flow initiation mechanism and characteristics.Conclusions are drawn as follows:(1 )Under strong precipitation,infiltration rate and soil water content at different depths are inversely proportional with rainfall intensity.Intense rainfall favors overland flow,gully runoff and

  12. Motility initiation in active gels

    CERN Document Server

    Recho, Pierre; Truskinovsky, Lev

    2015-01-01

    Motility initiation in crawling cells requires a symmetry breaking mechanism which transforms a symmetric state into a polarized state. Experiments on keratocytes suggest that polarization is triggered by increased contractility of motor proteins. In this paper we argue that contraction can be responsible not only for the symmetry breaking transition but also for the incipient translocation of the segment of an active gel mimicking the crawling cell. Our model suggests that when the contractility increases sufficiently far beyond the motility initiation threshold, the cell can stop and re-symmetrizes. The proposed theory reproduces the motility initiation pattern in fish keratocytes and the behavior of keratocytes prior to cell division.

  13. Authoring experience

    DEFF Research Database (Denmark)

    Knox, Jeanette Bresson Ladegaard; Svendsen, Mette Nordahl

    2015-01-01

    This article examines the storytelling aspect inphilosophizing with rehabilitating cancer patients in small Socratic dialogue groups (SDG). Recounting an experienceto illustrate a philosop