WorldWideScience

Sample records for early test case

  1. Early diagnosis of acoustic neuroma by the vestibular test

    Energy Technology Data Exchange (ETDEWEB)

    Haid, T; Rettinger, G; Berg, M; Wigand, M E

    1981-11-01

    In a series of 390 cases with suspicion of acoustic neurinomas 78 such tumors could be diagnosed, including 12 early stage neurinomas. This relatively high detection quote of small neurinomas is due to a special diagnostical programme: Every patient with unilateral and sensoneural hearingloss, independent of vertigo anamnesis or of the result of X-rays must be further examined by a vestibular test. All 78 patients with acoustic neuroma had pathological vestibular findings. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the thermic test: 95% of the patients with a neuroma showed pathological findings in the positional test. Every patient suffering from an unidentified unilateral and sensoneural hearingloss combined with a pathological result in the positional test must be further checked by a cisternomeatography or computerized tomography using airinsufflation. Every fifth of these patients showed typical signs of an acoustic neuroma in the neuroradiological tests. 68 neuromas are operated today and verfied histologically, 10 patients are still waiting for surgical treatment.

  2. Histological distinction between early allergic and irritant patch test reactions

    DEFF Research Database (Denmark)

    Vestergaard, L; Clemmensen, Ole; Sørensen, Flemming Brandt

    1999-01-01

    no recognizable changes except a slight follicular spongiosis in 1 patient. The 2 pathologists agreed independently on the correct classification in 6 out of 7 cases (p=0.0156). We tested an optimized model, selecting non-irritant allergens and a well-known irritant. Further investigations are needed to elucidate......Comparative light microscopic studies have revealed subtle differences between allergic and irritant reactions in the skin. In the search for specific differences, we focussed on the early inflammatory response. This pilot study was conducted to test the hypothesis that follicular spongiosis can...... differentiate between early allergic and irritant patch test reactions. 8 patients with known contact allergy to either colophony or quarternium-15 participated in the study. In each patient, allergic and irritant patch tests reactions were elicited, and 4-mm punch biopsies were taken after 6 8 h from...

  3. Comparative Test Case Specification

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

     This document includes a definition of the comparative test cases DSF200_3 and DSF200_4, which previously described in the comparative test case specification for the test cases DSF100_3 and DSF200_3 [Ref.1]....... This document includes a definition of the comparative test cases DSF200_3 and DSF200_4, which previously described in the comparative test case specification for the test cases DSF100_3 and DSF200_3 [Ref.1]....

  4. Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report.

    Science.gov (United States)

    Tumminello, Richard; Glaspey, Lindsey; Bhamidipati, Anita; Sheehan, Patrick; Patel, Sundip

    2017-12-01

    Disseminated Lyme disease can be difficult to diagnose, as it begins with nonspecific signs and symptoms, which, if not treated correctly, can lead to atrioventricular conduction blocks and meningitis. In addition, the diagnosis can be further complicated by potentially false-positive test results. We report a case of early-disseminated Lyme disease presenting with Borrelia meningitis and concomitant Lyme carditis, which was misdiagnosed as mononucleosis. A young, previously healthy patient had been hiking in the woods of upstate New York and 4 weeks later developed fever, night sweats, and myalgias. He was diagnosed with mononucleosis via a positive rapid heterophile agglutination antibody test to the Epstein-Barr virus at a walk-in clinic and was started on medications, but then subsequently developed left hip pain, a facial droop, and a very long first-degree atrioventricular conduction block. He went to the Emergency Department, where he had testing that confirmed disseminated Lyme disease. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the difficulty in early diagnosis of disseminated Lyme disease and how a potentially false-positive laboratory test can lead to the complications of Borrelia meningitis and Lyme carditis in untreated young healthy patients. Emergency physicians need to consider Lyme disease in patients with nonspecific signs and symptoms, especially if they have been outdoors for prolonged periods of time in Lyme-endemic areas. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Early failure analysis of machining centers: a case study

    International Nuclear Information System (INIS)

    Wang Yiqiang; Jia Yazhou; Jiang Weiwei

    2001-01-01

    To eliminate the early failures and improve the reliability, nine ex-factory machining centers are traced under field conditions in workshops. Their early failure information throughout the ex-factory run-in test is collected. The field early failure database is constructed based on the collection of field early failure data and the codification of data. Early failure mode and effects analysis is performed to indicate the weak subsystem of a machining center or the troublemaker. The distribution of the time between early failures is analyzed and the optimal ex-factory run-in test time for machining center that may expose sufficiently the early failures and cost minimum is discussed. Suggestions how to arrange ex-factory run-in test and how to take actions to reduce early failures for machining center is proposed

  6. [Influence of early kinesitherapy on rehabilitation postoperative recovery in case of low extremity operations].

    Science.gov (United States)

    Tanović, Edina

    2009-01-01

    Arteriosclerosis is a disease effecting large elastic, elastic muscular and large muscular arteries. The primary pathological changes are found inside the arteries. Salient feature is atherosclerotic plaque. The main purpose of this paper is to determine whether early kinesitherapy with verticalization and mobilization can give better rehabilitation results with patients after lower extremities operation, in comparison to patients which were not mobilized early in this stage. In this paper we have analyzed two groups of 40 patients that were operatively treated for circulation obstruction to lower extremities. The first, tested group was treated with early kinesiotherapy with early verticalization and mobilization. The second, controlled group was treated with kinesitherapy in bed. All the patients were analyzed according to their gender, age, primary diagnosis, postoperative complications, as well as capabilities for everyday activities. For the evaluation of the everyday life activities we used the Barthel index at hospital admission and discharge. Both groups of patients were equable in gender and age. The most common age group within the tested groups was between 61-70 for males and 51-60 for woman.The most common type of obstruction in both groups was occlusion of femoral artery. The complications which occurred among the tested patients were thrombosis, ileus and contracture in 7.5% of cases, while 85% of patients did not have any complications. Within the controlled group, decubitus occurred in 7.5% of cases, as well as gangrene and ileus. Ulcus occurred in 5% of patients, thrombosis in 10%, and contracture in 4% of cases. 40% of patients in this group were without complications. Based on the results stated above we can conclude that early kinesitherapy with verticalization and mobilization of patients in postoperative phase after the treatment of lower extremities obstruction, have shown much better results in comparison to the patients which were only

  7. Accuracy of different diagnostic tests for early, delayed and late prosthetic joint infection.

    Science.gov (United States)

    Fernández-Sampedro, M; Fariñas-Alvarez, C; Garces-Zarzalejo, C; Alonso-Aguirre, M A; Salas-Venero, C; Martínez-Martínez, L; Fariñas, M C

    2017-08-25

    A combination of laboratory, histopathological and microbiological tests for diagnosis of prosthetic joint infection (PJI) have been strongly recommended. This study aims to characterize the accuracy of individual or group tests, such as culture of sonicate fluid, synovial fluid and peri-implant tissue, C-reactive protein (CRP) and histopathology for detection of early, delayed and late PJI. A prospective study of patients undergoing hip or knee arthroplasty from February 2009 to February 2014 was performed in a Spanish tertiary health care hospital. The diagnostic accuracy of the different methods was evaluated constructing receiver-operating-characteristic (ROC) curve areas. One hundred thirty consecutive patients were included: 18 (13.8%) early PJI, 35 (27%) delayed PJI and 77 (59.2%) late PJI. For individual parameters, the area under the ROC curve for peri-implant tissue culture was larger for early (0.917) than for delayed (0.829) and late PJI (0.778), p = 0.033. There was a significantly larger difference for ROC area in the synovial fluid culture for delayed (0.803) than for early (0.781) and late infections (0.679), p = 0.039. The comparison of the areas under the ROC curves for the two microbiological tests showed that sonicate fluid was significantly different from peri-implant tissue in delayed (0.951 vs 0.829, p = 0.005) and late PJI (0.901 vs 0.778, p = 0.000). The conjunction of preoperative parameters, synovial fluid culture and CRP, improved the accuracy for late PJI (p = 0.01). The conjunction of histopathology and sonicate fluid culture increased the area under ROC curve of sonication in early (0.917 vs 1.000); p = 0.06 and late cases (0.901 vs 0.999); p < 0.001. For early PJI, sonicate fluid and peri-implant tissue cultures achieve the same best sensitivity. For delayed and late PJI, sonicate fluid culture is the most sensitive individual diagnostic method. By combining histopathology and peri-implant tissue, all early, 97% of

  8. Automated Test Case Generation for an Autopilot Requirement Prototype

    Science.gov (United States)

    Giannakopoulou, Dimitra; Rungta, Neha; Feary, Michael

    2011-01-01

    Designing safety-critical automation with robust human interaction is a difficult task that is susceptible to a number of known Human-Automation Interaction (HAI) vulnerabilities. It is therefore essential to develop automated tools that provide support both in the design and rapid evaluation of such automation. The Automation Design and Evaluation Prototyping Toolset (ADEPT) enables the rapid development of an executable specification for automation behavior and user interaction. ADEPT supports a number of analysis capabilities, thus enabling the detection of HAI vulnerabilities early in the design process, when modifications are less costly. In this paper, we advocate the introduction of a new capability to model-based prototyping tools such as ADEPT. The new capability is based on symbolic execution that allows us to automatically generate quality test suites based on the system design. Symbolic execution is used to generate both user input and test oracles user input drives the testing of the system implementation, and test oracles ensure that the system behaves as designed. We present early results in the context of a component in the Autopilot system modeled in ADEPT, and discuss the challenges of test case generation in the HAI domain.

  9. Automation of Test Cases for Web Applications : Automation of CRM Test Cases

    OpenAIRE

    Seyoum, Alazar

    2012-01-01

    The main theme of this project was to design a test automation framework for automating web related test cases. Automating test cases designed for testing a web interface provide a means of improving a software development process by shortening the testing phase in the software development life cycle. In this project an existing AutoTester framework and iMacros test automation tools were used. CRM Test Agent was developed to integrate AutoTester to iMacros and to enable the AutoTester,...

  10. Business Case for Early Childhood Investments

    Science.gov (United States)

    America's Promise Alliance (NJ1), 2011

    2011-01-01

    America's Promise's ReadyNation initiative has released this brief, which "makes the case" to business leaders on why investing in early childhood should be important to them. The brief includes "how-to" tips, helpful statistics and more.

  11. A standard screening test for the early and rapid diagnosis of leptospirosis

    Directory of Open Access Journals (Sweden)

    Chandrasekaran S

    2004-01-01

    Full Text Available PURPOSE : To perform dark field microscopy (DFM for detection of Leptospira and to validate the results using Leptospira IgM antibody SERION ELISA test. METHODS : After differential centrifugation of Ruys, DFM was done to demonstrate Leptospira in the blood and SERION ELISA was done for Leptospira IgM antibody in single or paired serum samples. One hundred and eleven cases (39 adults and 72 children of suspected leptospirosis were included in the study. RESULTS : Anicteric cases accounted for 66.7% (26/39 of adults and complications involving brain, liver, kidney and eyes were seen in 33.3% (13/39. In children, 90.3% (65/72 were anicteric and involvement of brain and liver was seen in 9.7% (7/72 cases. On testing 60 single samples of blood from 23 adults and 37 children, DFM exhibited greater sensitivity of 93.3% (56/60 than that of SERION ELISA for Leptospira IgM antibody (33.3%, 20/60. It was observed that the positivity of DFM decreased from 100% (15/15 to 90.9% (10/11 with increase in the duration of infection for more than one week. ELISA for Leptospira IgM, done on 51 paired blood samples, was positive in 64.7% (33/51 cases when both (first and second samples were tested while in 45.1% (23/51 cases was positive with first sample alone. 58.8%(30/51 cases were positive by testing second sample. DFM results on paired blood samples showed persistence of Leptospira in 92.9% of cases. CONCLUSION : This study shows the validation of DFM results by SERION ELISA for Leptospira IgM antibody, based on which we recommend that DFM can serve as a standard screening test for early and rapid diagnosis of leptospirosis.

  12. Automatic Generation of Test Cases from UML Models

    Directory of Open Access Journals (Sweden)

    Constanza Pérez

    2018-04-01

    Full Text Available [Context] The growing demand for high-quality software has caused the industry to incorporate processes to enable them to comply with these standards, but increasing the cost of development. A strategy to reduce this cost is to incorporate quality evaluations from early stages of software development. A technique that facilitates this evaluation is the model-based testing, which allows to generate test cases at early phases using as input the conceptual models of the system. [Objective] In this paper, we introduce TCGen, a tool that enables the automatic generation of abstract test cases starting from UML conceptual models. [Method] The design and implementation of TCGen, a technique that applies different testing criteria to class diagrams and state transition diagrams to generates test cases, is presented as a model-based testing approach. To do that, TCGen uses UML models, which are widely used at industry and a set of algorithms that recognize the concepts in the models in order to generate abstract test cases. [Results] An exploratory experimental evaluation has been performed to compare the TCGen tool with traditional testing. [Conclusions] Even though the exploratory evaluation shows promising results, it is necessary to perform more empirical evaluations in order to generalize the results. Abstract (in Spanish: [Contexto] La creciente demanda de software de alta calidad ha provocado que la industria incorpore procesos para permitirles cumplir con estos estándares, pero aumentando el costo del desarrollo. Una estrategia para reducir este costo es incorporar evaluaciones de calidad desde las primeras etapas del desarrollo del software. Una técnica que facilita esta evaluación es la prueba basada en modelos, que permite generar casos de prueba en fases tempranas utilizando como entrada los modelos conceptuales del sistema. [Objetivo] En este artículo, presentamos TCGen, una herramienta que permite la generación automática de casos de

  13. Case Study: Testing with Case Studies

    Science.gov (United States)

    Herreid, Clyde Freeman

    2015-01-01

    This column provides original articles on innovations in case study teaching, assessment of the method, as well as case studies with teaching notes. This month's issue discusses using case studies to test for knowledge or lessons learned.

  14. Radiological evaluation of early gastric cancer: analysis of 104 cases

    International Nuclear Information System (INIS)

    Choi, Byung Ihn; Kim, Jae Hyung; Han, Man Chung

    1987-01-01

    During the two year period from January 1985 to December 1986, 161 cases were confirmed as early gastric cancer by pathologic mapping at Seoul National University Hospital. Among them, the authors reviewed 104 cases of early gastric cancer for the evaluation of diagnostic value of double contrast upper gastrointestinal series. Early gastric cancer was most common in 5th and 6th decade (64%) and male to female ratio was 2:1. Double contrast upper GI series could detect 97 out of 104 cases (93%). Among them, 62 cases were diagnosed as early gastric cancer, 32 as advanced gastric cancer and 3 as benign lesion. Detection rate according to the size was 100% in lesion larger than 2cm and 87% in lesion smaller than 2cm. Predictability of early gastric cancer according to size was 66% in lesion smaller than 3cm and 43% in lesion larger than 3cm. Detection rate according to the location of the tumor was almost similar between gastric body (94%) and antrum (93%), however was very low in anterior wall lesion (70%). Predictability of early gastric cancer was 69% in gastric body lesion, 52% in gastric antral lesion and 44% in greater curvature lesion. Detection rate according to the type of macrospecimen was 100% in type I, III and IIc+III. Type IIb showed the lowest detection rate (75%). Predictability of early gastric cancer was high in type IIc (68%) and low in type I (20%)

  15. A longitudinal evaluation of Treponema pallidum PCR testing in early syphilis

    Directory of Open Access Journals (Sweden)

    Shields Matt

    2012-12-01

    Full Text Available Abstract Background Syphilis is a growing public health problem among men who have sex with men (MSM globally. Rapid and accurate detection of syphilis is vital to ensure patients and their contacts receive timely treatment and reduce ongoing transmission. Methods We evaluated a PCR assay for the diagnosis of Treponema pallidum using swabs of suspected early syphilis lesions in longitudinally assessed MSM. Results We tested 260 MSM for T pallidum by PCR on 288 occasions: 77 (26.7% had early syphilis that was serologically confirmed at baseline or within six weeks, and 211 (73.3% remained seronegative for syphilis. Of 55 men with primary syphilis, 49 were PCR positive, giving a sensitivity of 89.1% (95% CI: 77.8%-95.9% and a specificity of 99.1% (95% CI: 96.5%-99.9%. Of 22 men with secondary syphilis, 11 were PCR positive, giving a sensitivity of 50% (95% CI: 28.2%-71.8% and a specificity of 100% (95% CI: 66.4%-71.8%. Of the 77 syphilis cases, 43 (56% were HIV positive and the sensitivity and specificity of the PCR test did not vary by HIV status. The PCR test was able to detect up to five (10% primary infections that were initially seronegative, including one HIV positive man with delayed seroconversion to syphilis (72 to 140 days and one HIV positive man who did not seroconvert to syphilis over 14 months follow-up. Both men had been treated for syphilis within a week of the PCR test. Conclusions T pallidum PCR is a potentially powerful tool for the early diagnosis of primary syphilis, particularly where a serological response has yet to develop.

  16. [A case report of early-onset Alzheimer's disease with multiple psychotic symptoms, finally diagnosed as APPV717I mutation by genetic testing].

    Science.gov (United States)

    Ishimaru, Takashi; Ochi, Shinichiro; Matsumoto, Teruhisa; Yoshida, Taku; Abe, Masao; Toyota, Yasutaka; Fukuhara, Ryuji; Tanimukai, Satoshi; Ueno, Shu-ichi

    2013-01-01

    It is difficult to confirm a diagnosis of early-onset Alzheimer's disease (EOAD) because patients sometimes have non-specific cortical features, such as psychiatric symptoms, executive functional impairment, and pyramidal symptoms, along with typical symptoms, such as recent memory impairment and disorientation. We encountered a patient with multiple psychotic symptoms, finally diagnosed with EOAD on genetic testing. A right-handed sixty-year-old man, whose mother was suspected of having dementia, developed memory impairment at the age of fifty, disorientation at the age of fifty-six, and both visual hallucination and dressing apraxia at the age of fifty-nine. After admission to a psychiatric hospital for treatment, his symptoms disappeared with antipsychotic medication. However, his ADL were declining and so he was referred to our university hospital. He had frontal lobe symptoms, pyramidal signs, and extrapyramidal signs with severe dementia. Neuropsychological examinations were not possible because of sedation. On brain MRI, he showed diffuse atrophy of the cerebral cortex and hippocampus. HMPO-SPECT showed hypoperfusion of cerebral cortices diffusely. We decided to perform genetic testing because he had both family and alcohol abuse histories. He showed EOAD with V717I mutation of the amyloid precursor protein gene. After the discontinuation of antipsychotics, excessive sedation and extrapyramidal signs disappeared. A dose of 10 mg of donepezil was effective to improve motivation and activity, and his mini mental examination score was calculable after recovery. The case supports usefulness of applying genetic testing for Alzheimer's disease to patients with early onset dementia, even when they do not have a family history.

  17. Case Report: HIV test misdiagnosis

    African Journals Online (AJOL)

    Case Study: HIV test misdiagnosis 124. Case Report: HIV ... A positive rapid HIV test does not require ... 3 College of Medicine - Johns Hopkins Research Project, Blantyre,. Malawi ... test results: a pilot study of three community testing sites.

  18. Theory testing using case studies

    DEFF Research Database (Denmark)

    Dissing Sørensen, Pernille; Løkke Nielsen, Ann-Kristina

    2006-01-01

    on the strengths of theory-testing case studies. We specify research paths associated with theory testing in case studies and present a coherent argument for the logic of theoretical development and refinement using case studies. We emphasize different uses of rival explanations and their implications for research...... design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive......Case studies may have different research goals. One such goal is the testing of small-scale and middle-range theories. Theory testing refers to the critical examination, observation, and evaluation of the 'why' and 'how' of a specified phenomenon in a particular setting. In this paper, we focus...

  19. A case of probable non-familial early onset Alzheimer dementia in a Hispanic male

    Directory of Open Access Journals (Sweden)

    Corey Ephrussi

    2012-07-01

    Full Text Available Background: Early onset Alzheimer's type dementia (EOAD is usually familial and associated with mutations in the Presenilin-1 (PSEN1, Presenilin-2 (PSEN2 or amyloid precursor protein (APP genes. It is rarely reported in patients of Hispanic descent. Case report: A 49-year-old Hispanic male developed significant cognitive impairment over a 4-year period. PET scan showed diminished metabolic activity in the posterior parietal/temporal lobes. Genetic testing revealed the presence of a PSEN1 gene mutation. Conclusion: Disparities in health care may account for an under-recognition of EOAD in the Hispanic population. Clinicians should test for EOAD in all patients with appropriate symptomatology, regardless of ethnicity. Early recognition and enrollment in clinical trials is vital to enhancing our understanding of the natural history and treatment of this condition.

  20. Automated Test Case Generation

    CERN Multimedia

    CERN. Geneva

    2015-01-01

    I would like to present the concept of automated test case generation. I work on it as part of my PhD and I think it would be interesting also for other people. It is also the topic of a workshop paper that I am introducing in Paris. (abstract below) Please note that the talk itself would be more general and not about the specifics of my PhD, but about the broad field of Automated Test Case Generation. I would introduce the main approaches (combinatorial testing, symbolic execution, adaptive random testing) and their advantages and problems. (oracle problem, combinatorial explosion, ...) Abstract of the paper: Over the last decade code-based test case generation techniques such as combinatorial testing or dynamic symbolic execution have seen growing research popularity. Most algorithms and tool implementations are based on finding assignments for input parameter values in order to maximise the execution branch coverage. Only few of them consider dependencies from outside the Code Under Test’s scope such...

  1. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Møller, Ann-Kristina Løkke; Dissing Sørensen, Pernille

    2014-01-01

    The appropriateness of case studies as a tool for theory testing is still a controversial issue, and discussions about the weaknesses of such research designs have previously taken precedence over those about its strengths. The purpose of the paper is to examine and revive the approach of theory...... testing using case studies, including the associated research goal, analysis, and generalisability. We argue that research designs for theory testing using case studies differ from theorybuilding case study research designs because different research projects serve different purposes and follow different...... research paths....

  2. Uniaxial Tension Test of Slender Reinforced Early Age Concrete Members

    Directory of Open Access Journals (Sweden)

    Wenbo Zhang

    2011-08-01

    Full Text Available The present study aims to obtain the tensile properties of early age concrete based on a uniaxial tension test employing RC slender members. First, the paper shows that concrete strain is equal to the strain of rebar at the mid-span of the RC member. The tensile Young’s modulus and the strain capacity of early age concrete are estimated using strain measurements. The experiment indicated that the tensile Young’s modulus at an early age is higher than the compressive modulus. This observation was similar to one found in a previous investigation which used a direct tension test of early age concrete. Moreover, the paper describes how an empirical equation for mature concrete can be applied to the relation between uniaxial tensile strength and splitting tensile strength even in early age concrete. Based on a uniaxial tension test, the paper proposes an empirical equation for the relationship between standard bond stresses and relative slip.

  3. Video Head Impulse Test for Early Diagnosis of Vestibular Neuritis Among Acute Vertigo.

    Science.gov (United States)

    Guan, Qiongfeng; Zhang, Lisan; Hong, Wenke; Yang, Yi; Chen, Zhaoying; Lu, Peilin; Zhang, Dan; Hu, Xingyue

    2017-09-01

    This study assesses the value of the video head impulse test (vHIT) for early diagnosis of vestibular neuritis (VN) among acute vertigo. Thirty-three cases of vestibular neuritis (VN), 96 patients with other acute vertigo (AV), and 50 cases of normal controls used vHIT to quantitatively test a pair of horizontal vestibulo-ocular reflection (VOR) gains, two pairs of vertical VOR gains, and the corresponding three pairs of VOR gain asymmetry. The peculiarity of VOR gains in VN and the differences between VN and other AV, normal controls by vHIT, were collected and analyzed. There were statistically significant differences in the three pairs of VOR gains asymmetry between VN and other AV, and normal controls (Pvertigo by vHIT. This study shows vHIT has advantages in the diagnosis of VN in acute vertigo with good sensitivity and specificity and indicates a widespread clinical application.

  4. Making the Case for Early Childhood Investments: Three Arguments

    Science.gov (United States)

    Neugebauer, Roger

    2011-01-01

    Tamar Manuelyan Atinc, vice president of The World Bank, introduces a World Bank report, "Investing in Young Children: An Early Childhood Development Guide for Policy Dialogue and Project Preparation". This report, which is a must for inclusion in every advocate's make the case for investing in early childhood services. It defines three arguments…

  5. Inversion Method for Early Detection of ARES-1 Case Breach Failure

    Science.gov (United States)

    Mackey, Ryan M.; Kulikov, Igor K.; Bajwa, Anupa; Berg, Peter; Smelyanskiy, Vadim

    2010-01-01

    A document describes research into the problem of detecting a case breach formation at an early stage of a rocket flight. An inversion algorithm for case breach allocation is proposed and analyzed. It is shown how the case breach can be allocated at an early stage of its development by using the rocket sensor data and the output data from the control block of the rocket navigation system. The results are simulated with MATLAB/Simulink software. The efficiency of an inversion algorithm for a case breach location is discussed. The research was devoted to the analysis of the ARES-l flight during the first 120 seconds after the launch and early prediction of case breach failure. During this time, the rocket is propelled by its first-stage Solid Rocket Booster (SRB). If a breach appears in SRB case, the gases escaping through it will produce the (side) thrust directed perpendicular to the rocket axis. The side thrust creates torque influencing the rocket attitude. The ARES-l control system will compensate for the side thrust until it reaches some critical value, after which the flight will be uncontrollable. The objective of this work was to obtain the start time of case breach development and its location using the rocket inertial navigation sensors and GNC data. The algorithm was effective for the detection and location of a breach in an SRB field joint at an early stage of its development.

  6. Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases

    OpenAIRE

    Marta Koper; Agnieszka B. Serwin; Anna Baran; Iwona Flisiak

    2015-01-01

    Introduction. Undiagnosed and untreated syphilis in pregnancy may result in subsequent complications: early fetal loss, stillbirth, low birth weight of infants and newborns with congenital syphilis. Objective. To analyze diagnostic and therapeutic dilemmas of positive results of serological tests for syphilis (STS) in pregnancy. Case reports. We present two cases of pregnant women, hospitalized in our department due to positive results of serological tests for syphilis, pe...

  7. Audit of the autoantibody test, EarlyCDT®-lung, in 1600 patients: an evaluation of its performance in routine clinical practice.

    Science.gov (United States)

    Jett, James R; Peek, Laura J; Fredericks, Lynn; Jewell, William; Pingleton, William W; Robertson, John F R

    2014-01-01

    EarlyCDT(®)-Lung may enhance detection of early stage lung cancer by aiding physicians in assessing high-risk patients through measurement of biological markers (i.e., autoantibodies). The test's performance characteristics in routine clinical practice were evaluated by auditing clinical outcomes of 1613 US patients deemed at high risk for lung cancer by their physician, who ordered the EarlyCDT-Lung test for their patient. Clinical outcomes for all 1613 patients who provided HIPAA authorization are reported. Clinical data were collected from each patient's treating physician. Pathology reports when available were reviewed for diagnostic classification. Staging was assessed on histology, otherwise on imaging. Six month follow-up for the positives/negatives was 99%/93%. Sixty-one patients (4%) were identified with lung cancer, 25 of whom tested positive by EarlyCDT-Lung (sensitivity=41%). A positive EarlyCDT-Lung test on the current panel was associated with a 5.4-fold increase in lung cancer incidence versus a negative. Importantly, 57% (8/14) of non-small cell lung cancers detected as positive (where stage was known) were stage I or II. EarlyCDT-Lung has been extensively tested and validated in case-control settings and has now been shown in this audit to perform in routine clinical practice as predicted. EarlyCDT-Lung may be a complementary tool to CT for detection of early lung cancer. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. A Case Report of Early Gastric Signet Ring Cell Carcinoma

    African Journals Online (AJOL)

    2018-02-07

    gmail.com. How to cite this article: Akabah PS, Mocan S, Molnar C, Dobru D. Importance of optical diagnosis in early gastric cancer: A case report of early gastric signet ring cell carcinoma. Niger J Clin Pract 2017;20:1342-5.

  9. Comparison between DOT EIA IgM and Widal Test as early diagnosis of typhoid fever.

    Science.gov (United States)

    Begum, Z; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahmud, M C; Ahsan, M M; Sumona, A A; Ahmed, S; Jahan, N A; Alam, M; Begum, A

    2009-01-01

    A recently developed DOT enzyme immunoassay known as "Typhidot" for detecting IgM antibody against 50 KDa OMP antigen of Salmonella typhi, was evaluated on 100 clinically suspected typhoid fever cases and 40 age-sex matched controls, in the Department of Microbiology, Mymensingh Medical College during, the period from June 2006 to July 2007. Blood culture, Widal test, and DOT EIA for IgM test were performed in all patients. Among 100 clinically suspected typhoid fever cases, 35 were subsequently confirmed on the basis of positive blood culture for S. typhi and/or significant rising titre of Widal test. The DOT EIA IgM test could produce results within 1 hour. The result of the DOT EIA IgM test showed a good diagnostic value for typhoid fever. The sensitivity, specificity, positive and negative predictive value of the test was found as 91.42%, 90.00%, 88.88% and 92.30% respectively. On the other hand corresponding values for Widal test were of 42.85%, 85.00%, 71.42% and 62.96% respectively. Thus, The DOT EIA IgM seems to be a practical alternative to Widal test for early diagnosis of typhoid fever.

  10. [Clinical study of induced abortion of early-early pregnancy: an analysis of 10, 404 cases].

    Science.gov (United States)

    Kang, Jian; Wang, Xue-fen; Zhang, Li; Liu, Jian-hua

    2012-01-03

    To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA). A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA). The amount of hemorrhage and operative duration, degree of pain, rate of induced-abortion syndrome, rate of incomplete abortion, menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups. The average age, ratio of parous cases, ratio of the cases of first-pregnancy induced abortion were not different between 2 groups (P > 0.05). The amount of hemorrhage bleeding ((4.9 ± 3.2) ml), operative duration ((90.3 ± 12.4) s), degree of pain, rate of induced-abortion syndrome, menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P abortion (0.44%) in the EPIA group was significantly higher than that (0.21%) in the CIA group (P abortion stays high.

  11. Use Case Evaluation (UCE): A Method for Early Usability Evaluation in Software Development

    DEFF Research Database (Denmark)

    Stage, Jan; Høegh, Rune Thaarup; Hornbæk, K.

    2007-01-01

    t is often argued that usability problems should be identified as early as possible during software development, but many usability evaluation methods do not fit well in early development activities. We propose a method for usability evaluation of use cases, a widely used representation of design...... ideas produced early in software development processes. The method proceeds by systematic inspection of use cases with reference to a set of guidelines for usable design. To validate the method, four evaluators inspected a set of use cases for a health care application....

  12. [Validation of three screening tests used for early detection of cervical cancer].

    Science.gov (United States)

    Rodriguez-Reyes, Esperanza Rosalba; Cerda-Flores, Ricardo M; Quiñones-Pérez, Juan M; Cortés-Gutiérrez, Elva I

    2008-01-01

    to evaluate the validity (sensitivity, specificity, and accuracy) of three screening methods used in the early detection of the cervical carcinoma versus the histopathology diagnosis. a selected sample of 107 women attended in the Opportune Detection of Cervicouterine Cancer Program in the Hospital de Zona 46, Instituto Mexicano del Seguro Social in Durango, during the 2003 was included. The application of Papa-nicolaou, acetic acid test, and molecular detection of human papillomavirus, and histopatholgy diagnosis were performed in all the patients at the time of the gynecological exam. The detection and tipification of the human papillomavirus was performed by polymerase chain reaction (PCR) and analysis of polymorphisms of length of restriction fragments (RFLP). Histopathology diagnosis was considered the gold standard. The evaluation of the validity was carried out by the Bayesian method for diagnosis test. the positive cases for acetic acid test, Papanicolaou, and PCR were 47, 22, and 19. The accuracy values were 0.70, 0.80 and 0.99, respectively. since the molecular method showed a greater validity in the early detection of the cervical carcinoma we considered of vital importance its implementation in suitable programs of Opportune Detection of Cervicouterino Cancer Program in Mexico. However, in order to validate this conclusion, cross-sectional studies in different region of country must be carried out.

  13. Comparative Test Case Specification

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

    This document includes the specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. In the comp....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases. The comparative test cases include: ventilation, shading and geometry....

  14. A comparative study of the typhidot (Dot-EIA) and Widal tests in blood culture positive cases of typhoid fever.

    Science.gov (United States)

    Khoharo, Haji Khan

    2011-07-01

    Seventy-six blood culture positive typhoid cases and forty-eight controls were studied. The typhidot test was positive in 74 (97.36%) cases, with a sensitivity, specificity and positive predictive value of 96%, 89.5%, and 95%, respectively, compared to the Widal test which was positive in 56 (73.68%) cases with a sensitivity, specificity, and positive predictive value of 72%, 87%, and 87%, respectively (P = 0.001). In the control group, seven (14.5%) cases tested positive for the Widal test and two (4.16%) for the typhidot (P = 0.001), yielding the sensitivity and specificity for the Widal test and the typhidot test of 63% and 83%, and 85% and 97%, respectively. We conclude that the Dot-EIA (enzyme immunoassay; typhidot) is a more sensitive and specific test which is easy to perform and more reliable compared to the Widal test and that it is useful in early therapy.

  15. Integration testing through reusing representative unit test cases for high-confidence medical software.

    Science.gov (United States)

    Shin, Youngsul; Choi, Yunja; Lee, Woo Jin

    2013-06-01

    As medical software is getting larger-sized, complex, and connected with other devices, finding faults in integrated software modules gets more difficult and time consuming. Existing integration testing typically takes a black-box approach, which treats the target software as a black box and selects test cases without considering internal behavior of each software module. Though it could be cost-effective, this black-box approach cannot thoroughly test interaction behavior among integrated modules and might leave critical faults undetected, which should not happen in safety-critical systems such as medical software. This work anticipates that information on internal behavior is necessary even for integration testing to define thorough test cases for critical software and proposes a new integration testing method by reusing test cases used for unit testing. The goal is to provide a cost-effective method to detect subtle interaction faults at the integration testing phase by reusing the knowledge obtained from unit testing phase. The suggested approach notes that the test cases for the unit testing include knowledge on internal behavior of each unit and extracts test cases for the integration testing from the test cases for the unit testing for a given test criteria. The extracted representative test cases are connected with functions under test using the state domain and a single test sequence to cover the test cases is produced. By means of reusing unit test cases, the tester has effective test cases to examine diverse execution paths and find interaction faults without analyzing complex modules. The produced test sequence can have test coverage as high as the unit testing coverage and its length is close to the length of optimal test sequences. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Early Onset Squamous Cell Carcinoma In A Case Of Lichen Planus

    Directory of Open Access Journals (Sweden)

    Singh Shri Nath

    1998-01-01

    Full Text Available Lichen planus, which is a very common condition, is being presented. However, the uncommon feature in this cases is its early onset and equally early development of squamous cell carcinoma on a lesion on the right thigh.

  17. Development and psychometric testing of the 'Motivation and Self-Efficacy in Early Detection of Skin Lesions' index.

    Science.gov (United States)

    Dyson, Judith; Cowdell, Fiona

    2014-12-01

    To develop and psychometrically test the Motivation and Self-Efficacy in Early Detection of Skin Lesions Index. Skin cancer is the most frequently diagnosed cancer worldwide. The primary strategy used to prevent skin cancer is promotion of sun avoidance and the use of sun protection. However, despite costly and extensive campaigns, cases of skin cancer continue to increase. If found and treated early, skin cancer is curable. Early detection is, therefore, very important. The study was conducted in 2013. Instrument Development. A literature review and a survey identified barriers (factors that hinder) and levers (factors that help) to skin self-examination. These were categorized according to a the Theoretical Domains Framework and this formed the basis of an instrument, which was tested for validity and reliability using confirmatory factor analysis and Cronbach's alpha respectively. A five-factor 20-item instrument was used that tested well for reliability and construct validity. Test-retest reliability was good for all items and domains. The five factors were: (i) Outcome expectancies; (ii) Intention; (iii) Self-efficacy; (iv) Social influences; (v) Memory. The Motivation and Self-Efficacy in Early Detection of Skin Lesions Index provides a reliable and valid method of assessing barriers and levers to skin self-examination. The next step is to design a theory-based intervention that can be tailored according to individual determinants to behaviour change identified by this instrument. © 2014 John Wiley & Sons Ltd.

  18. Early Phonological Development: Creating an Assessment Test

    Science.gov (United States)

    Stoel-Gammon, Carol; Williams, A. Lynn

    2013-01-01

    This paper describes a new protocol for assessing the phonological systems of two-year-olds with typical development and older children with delays in vocabulary acquisition. The test (Profiles of Early Expressive Phonological Skills ("PEEPS"), Williams & Stoel-Gammon, in preparation) differs from currently available assessments in…

  19. Code cases for implementing risk-based inservice testing in the ASME OM code

    International Nuclear Information System (INIS)

    Rowley, C.W.

    1996-01-01

    Historically inservice testing has been reasonably effective, but quite costly. Recent applications of plant PRAs to the scope of the IST program have demonstrated that of the 30 pumps and 500 valves in the typical plant IST program, less than half of the pumps and ten percent of the valves are risk significant. The way the ASME plans to tackle this overly-conservative scope for IST components is to use the PRA and plant expert panels to create a two tier IST component categorization scheme. The PRA provides the quantitative risk information and the plant expert panel blends the quantitative and deterministic information to place the IST component into one of two categories: More Safety Significant Component (MSSC) or Less Safety Significant Component (LSSC). With all the pumps and valves in the IST program placed in MSSC or LSSC categories, two different testing strategies will be applied. The testing strategies will be unique for the type of component, such as centrifugal pump, positive displacement pump, MOV, AOV, SOV, SRV, PORV, HOV, CV, and MV. A series of OM Code Cases are being developed to capture this process for a plant to use. One Code Case will be for Component Importance Ranking. The remaining Code Cases will develop the MSSC and LSSC testing strategy for type of component. These Code Cases are planned for publication in early 1997. Later, after some industry application of the Code Cases, the alternative Code Case requirements will gravitate to the ASME OM Code as appendices

  20. Code cases for implementing risk-based inservice testing in the ASME OM code

    Energy Technology Data Exchange (ETDEWEB)

    Rowley, C.W.

    1996-12-01

    Historically inservice testing has been reasonably effective, but quite costly. Recent applications of plant PRAs to the scope of the IST program have demonstrated that of the 30 pumps and 500 valves in the typical plant IST program, less than half of the pumps and ten percent of the valves are risk significant. The way the ASME plans to tackle this overly-conservative scope for IST components is to use the PRA and plant expert panels to create a two tier IST component categorization scheme. The PRA provides the quantitative risk information and the plant expert panel blends the quantitative and deterministic information to place the IST component into one of two categories: More Safety Significant Component (MSSC) or Less Safety Significant Component (LSSC). With all the pumps and valves in the IST program placed in MSSC or LSSC categories, two different testing strategies will be applied. The testing strategies will be unique for the type of component, such as centrifugal pump, positive displacement pump, MOV, AOV, SOV, SRV, PORV, HOV, CV, and MV. A series of OM Code Cases are being developed to capture this process for a plant to use. One Code Case will be for Component Importance Ranking. The remaining Code Cases will develop the MSSC and LSSC testing strategy for type of component. These Code Cases are planned for publication in early 1997. Later, after some industry application of the Code Cases, the alternative Code Case requirements will gravitate to the ASME OM Code as appendices.

  1. Histological distinction between early allergic and irritant patch test reactions

    DEFF Research Database (Denmark)

    Vestergaard, L; Clemmensen, Ole; Sørensen, Flemming Brandt

    1999-01-01

    Comparative light microscopic studies have revealed subtle differences between allergic and irritant reactions in the skin. In the search for specific differences, we focussed on the early inflammatory response. This pilot study was conducted to test the hypothesis that follicular spongiosis can...... differentiate between early allergic and irritant patch test reactions. 8 patients with known contact allergy to either colophony or quarternium-15 participated in the study. In each patient, allergic and irritant patch tests reactions were elicited, and 4-mm punch biopsies were taken after 6 8 h from...... clinically equipotent reactions. Paired sets of slides were assessed blindly by 2 pathologists. 1 patient showing a pityrosporum folliculitis was excluded from the study. All biopsies from allergic patch tests were characterized by follicular spongiosis, while biopsies from irritant patch tests showed...

  2. Casing pull tests for directionally drilled environmental wells

    International Nuclear Information System (INIS)

    Staller, G.E.; Wemple, R.P.; Layne, R.R.

    1994-11-01

    A series of tests to evaluate several types of environmental well casings have been conducted by Sandia National Laboratories (SNL) and it's industrial partner, The Charles Machine Works, Inc. (CMW). A test bed was constructed at the CMW test range to model a typical shallow, horizontal, directionally drilled wellbore. Four different types of casings were pulled through this test bed. The loads required to pull the casings through the test bed and the condition of the casing material were documented during the pulling operations. An additional test was conducted to make a comparison of test bed vs actual wellbore casing pull loads. A directionally drilled well was emplaced by CMW to closely match the test bed. An instrumented casing was installed in the well and the pull loads recorded. The completed tests are reviewed and the results reported

  3. Casing pull tests for directionally drilled environmental wells

    Energy Technology Data Exchange (ETDEWEB)

    Staller, G.E.; Wemple, R.P. [Sandia National Labs., Albuquerque, NM (United States); Layne, R.R. [Charles Machine Works, Inc., Perry, OK (United States)

    1994-11-01

    A series of tests to evaluate several types of environmental well casings have been conducted by Sandia National Laboratories (SNL) and it`s industrial partner, The Charles Machine Works, Inc. (CMW). A test bed was constructed at the CMW test range to model a typical shallow, horizontal, directionally drilled wellbore. Four different types of casings were pulled through this test bed. The loads required to pull the casings through the test bed and the condition of the casing material were documented during the pulling operations. An additional test was conducted to make a comparison of test bed vs actual wellbore casing pull loads. A directionally drilled well was emplaced by CMW to closely match the test bed. An instrumented casing was installed in the well and the pull loads recorded. The completed tests are reviewed and the results reported.

  4. Some early cases of aphasia and the capacity to sing.

    Science.gov (United States)

    Johnson, Julene K; Graziano, Amy B

    2015-01-01

    This chapter examines early cases of aphasia that include observations of the capacity to sing. Although the majority of these cases were published in the late nineteenth century, earlier reports exist and provide insights into the early thinking about the capacity to sing in aphasia, a topic that continues to the present day. The observation that some patients with aphasia and limited speech output were able to sing the texts of songs inspired scholars to examine the relationship between music and language. Early ideas about the capacity to sing were provided by well-known neurologists, such as John Hughlings Jackson and Adolf Kussmaul. The work of Herbert Spencer about the origins and function of music heavily influenced Jackson and others in their thinking about aphasia. This work also led to an increased interest in understanding music abilities in persons with aphasia and, later, in the brain mechanisms of music. The chapter provides a background as to why there was an interest in the capacity to sing in persons with aphasia and what influenced early thinking on this topic. © 2015 Elsevier B.V. All rights reserved.

  5. Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.

    Science.gov (United States)

    Toulis, Konstantinos A; Goulis, Dimitrios G; Tsolakidou, Konstantina; Hilidis, Ilias; Fragkos, Marios; Polyzos, Stergios A; Gerofotis, Antonios; Kita, Marina; Bili, Helen; Vavilis, Dimitrios; Daniilidis, Michail; Tarlatzis, Basil C; Papadimas, Ioannis

    2013-08-01

    We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.

  6. Usability Testing: Too Early? Too Much Talking? Too Many Problems?

    DEFF Research Database (Denmark)

    Hertzum, Morten

    2016-01-01

    Usability testing has evolved in response to a search for tests that are cheap, early, easy, and fast. In addition, it accords with a situational definition of usability, such as the one propounded by ISO. By approaching usability from an organizational perspective, this author argues that usabil......Usability testing has evolved in response to a search for tests that are cheap, early, easy, and fast. In addition, it accords with a situational definition of usability, such as the one propounded by ISO. By approaching usability from an organizational perspective, this author argues...... that usability should (also) be evaluated late, that usability professionals should be wary of thinking aloud, and that they should focus more on effects achievement than problem detection....

  7. Early pregnancy peripheral blood gene expression and risk of preterm delivery: a nested case control study

    Directory of Open Access Journals (Sweden)

    Muhie Seid Y

    2009-12-01

    Full Text Available Abstract Background Preterm delivery (PTD is a significant public health problem associated with greater risk of mortality and morbidity in infants and mothers. Pathophysiologic processes that may lead to PTD start early in pregnancy. We investigated early pregnancy peripheral blood global gene expression and PTD risk. Methods As part of a prospective study, ribonucleic acid was extracted from blood samples (collected at 16 weeks gestational age from 14 women who had PTD (cases and 16 women who delivered at term (controls. Gene expressions were measured using the GeneChip® Human Genome U133 Plus 2.0 Array. Student's T-test and fold change analysis were used to identify differentially expressed genes. We used hierarchical clustering and principle components analysis to characterize signature gene expression patterns among cases and controls. Pathway and promoter sequence analyses were used to investigate functions and functional relationships as well as regulatory regions of differentially expressed genes. Results A total of 209 genes, including potential candidate genes (e.g. PTGDS, prostaglandin D2 synthase 21 kDa, were differentially expressed. A set of these genes achieved accurate pre-diagnostic separation of cases and controls. These genes participate in functions related to immune system and inflammation, organ development, metabolism (lipid, carbohydrate and amino acid and cell signaling. Binding sites of putative transcription factors such as EGR1 (early growth response 1, TFAP2A (transcription factor AP2A, Sp1 (specificity protein 1 and Sp3 (specificity protein 3 were over represented in promoter regions of differentially expressed genes. Real-time PCR confirmed microarray expression measurements of selected genes. Conclusions PTD is associated with maternal early pregnancy peripheral blood gene expression changes. Maternal early pregnancy peripheral blood gene expression patterns may be useful for better understanding of PTD

  8. Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.

    Science.gov (United States)

    Creswell, Jacob; Codlin, Andrew J; Andre, Emmanuel; Micek, Mark A; Bedru, Ahmed; Carter, E Jane; Yadav, Rajendra-Prasad; Mosneaga, Andrei; Rai, Bishwa; Banu, Sayera; Brouwer, Miranda; Blok, Lucie; Sahu, Suvanand; Ditiu, Lucica

    2014-01-02

    The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the

  9. Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools

    Science.gov (United States)

    Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather

    2016-01-01

    This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…

  10. Automating Test Activities: Test Cases Creation, Test Execution, and Test Reporting with Multiple Test Automation Tools

    OpenAIRE

    Loke Mun Sei

    2015-01-01

    Software testing has become a mandatory process in assuring the software product quality. Hence, test management is needed in order to manage the test activities conducted in the software test life cycle. This paper discusses on the challenges faced in the software test life cycle, and how the test processes and test activities, mainly on test cases creation, test execution, and test reporting is being managed and automated using several test automation tools, i.e. Jira, ...

  11. Urinary hepcidin level as an early predictor of iron deficiency in children: A case control study

    Directory of Open Access Journals (Sweden)

    Gharib Amal F

    2011-08-01

    Full Text Available Abstract Background The ideal screening test would be capable of identifying iron deficiency in the absence of anemia. We tried to detect role of urinary hepcidin-25 level in early prediction of iron deficiency in children. Methods This is a case control study performed on 100 children in Hematology Unit of Pediatric Department, Zagazig University Hospital, Egypt. Our study included 25 cases of iron deficiency (ID stage-1 (iron depletion, 25 cases ID stage-2 (iron-deficient erythropoiesis, 25 cases ID stage-3 (iron deficiency anemia and 25 healthy children as a control group. Estimation of iron status parameters was done. Urinary hepcidin-25 level was detected. Results Urinary hepcidin-25 level was significantly lower in all stages of iron deficiency than in control group, more significant reduction in its level was observed with the progress in severity of iron deficiency. Urinary hepcidin showed significant positive correlation with hemoglobin, mean corpuscular volume, hematocrit value, serum iron and ferritin and transferrin saturation. In contrary, it showed significant negative correlation with serum transferrin and total iron binding capacity. Urinary hepcidin at cutoff point ≤0.94 nmol/mmol Cr could Predict ID stage-1 with sensitivity 88% and specificity 88%. Cutoff point ≤0.42 nmol/mmol Cr could predict ID stage-2 with sensitivity 96% and specificity 92%. Cutoff point ≤0.08 nmol/mmol Cr could Predict ID stage-3 with Sensitivity 96% and specificity 100%. Conclusions We can conclude that detection of urinary hepcidin-25 level was a simple and non invasive test and could predict iron deficiency very early, before appearance of hematological affections.

  12. Conversion (dissociative) symptoms as a presenting feature in early onset bipolar disorder: a case series

    OpenAIRE

    Ghosal, Malay Kumar; Guha, Prathama; Sinha, Mausumi; Majumdar, Debabrata; Sengupta, Payel

    2009-01-01

    We present three cases of early onset bipolar disorder where dissociative (conversion) symptoms preceded the onset of mania. This case series underscores the significance of dissociative/conversion symptoms as an early atypical presentation in juvenile bipolar disorder.

  13. Early Onset Marfan Syndrome: Atypical Clinical Presentation of Two Cases

    Directory of Open Access Journals (Sweden)

    Ozyurt Abdullah

    2015-06-01

    Full Text Available Early onset Marfan Syndrome (eoMFS is a rare, severe form of Marfan Syndrome (MFS. The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system.

  14. Earthquake Early Warning ShakeAlert System: Testing and certification platform

    Science.gov (United States)

    Cochran, Elizabeth S.; Kohler, Monica D.; Given, Douglas; Guiwits, Stephen; Andrews, Jennifer; Meier, Men-Andrin; Ahmad, Mohammad; Henson, Ivan; Hartog, Renate; Smith, Deborah

    2017-01-01

    Earthquake early warning systems provide warnings to end users of incoming moderate to strong ground shaking from earthquakes. An earthquake early warning system, ShakeAlert, is providing alerts to beta end users in the western United States, specifically California, Oregon, and Washington. An essential aspect of the earthquake early warning system is the development of a framework to test modifications to code to ensure functionality and assess performance. In 2016, a Testing and Certification Platform (TCP) was included in the development of the Production Prototype version of ShakeAlert. The purpose of the TCP is to evaluate the robustness of candidate code that is proposed for deployment on ShakeAlert Production Prototype servers. TCP consists of two main components: a real‐time in situ test that replicates the real‐time production system and an offline playback system to replay test suites. The real‐time tests of system performance assess code optimization and stability. The offline tests comprise a stress test of candidate code to assess if the code is production ready. The test suite includes over 120 events including local, regional, and teleseismic historic earthquakes, recentering and calibration events, and other anomalous and potentially problematic signals. Two assessments of alert performance are conducted. First, point‐source assessments are undertaken to compare magnitude, epicentral location, and origin time with the Advanced National Seismic System Comprehensive Catalog, as well as to evaluate alert latency. Second, we describe assessment of the quality of ground‐motion predictions at end‐user sites by comparing predicted shaking intensities to ShakeMaps for historic events and implement a threshold‐based approach that assesses how often end users initiate the appropriate action, based on their ground‐shaking threshold. TCP has been developed to be a convenient streamlined procedure for objectively testing algorithms, and it has

  15. Focal cortical malformations in children with early infantile epilepsy and PCDH19 mutations: case report.

    Science.gov (United States)

    Kurian, Mary; Korff, Christian M; Ranza, Emmanuelle; Bernasconi, Andrea; Lübbig, Anja; Nangia, Srishti; Ramelli, Gian Paolo; Wohlrab, Gabriele; Nordli, Douglas R; Bast, Thomas

    2018-01-01

    In this case report we assess the occurrence of cortical malformations in children with early infantile epilepsy associated with variants of the gene protocadherin 19 (PCDH19). We describe the clinical course, and electrographic, imaging, genetic, and neuropathological features in a cohort of female children with pharmacoresistant epilepsy. All five children (mean age 10y) had an early onset of epilepsy during infancy and a predominance of fever sensitive seizures occurring in clusters. Cognitive impairment was noted in four out of five patients. Radiological evidence of cortical malformations was present in all cases and, in two patients, validated by histology. Sanger sequencing and Multiplex Ligation-dependent Probe Amplification analysis of PCDH19 revealed pathogenic variants in four patients. In one patient, array comparative genomic hybridization showed a microdeletion encompassing PCDH19. We propose molecular testing and analysis of PCDH19 in patients with pharmacoresistant epilepsy, with onset in early infancy, seizures in clusters, and fever sensitivity. Structural lesions are to be searched in patients with PCDH19 pathogenic variants. Further, PCDH19 analysis should be considered in epilepsy surgery evaluation even in the presence of cerebral structural lesions. Focal cortical malformations and monogenic epilepsy syndromes may coexist. Structural lesions are to be searched for in patients with protocadherin 19 (PCDH19) pathogenic variants with refractory focal seizures. © 2017 Mac Keith Press.

  16. Time-Optimal Real-Time Test Case Generation using UPPAAL

    DEFF Research Database (Denmark)

    Hessel, Anders; Larsen, Kim Guldstrand; Nielsen, Brian

    2004-01-01

    Testing is the primary software validation technique used by industry today, but remains ad hoc, error prone, and very expensive. A promising improvement is to automatically generate test cases from formal models of the system under test. We demonstrate how to automatically generate real...... test purposes or generated automatically from various coverage criteria of the model.......-time conformance test cases from timed automata specifications. Specifically we demonstrate how to fficiently generate real-time test cases with optimal execution time i.e test cases that are the fastest possible to execute. Our technique allows time optimal test cases to be generated using manually formulated...

  17. Early Pathologic Findings of Bronchiolitis Obliterans after Allogeneic Hematopoietic Stem Cell Transplantation: A Proposal from a Case

    Directory of Open Access Journals (Sweden)

    Rie Nakamoto-Matsubara

    2012-01-01

    Full Text Available Bronchiolitis obliterans (BO is one of the serious, noninfectious pulmonary complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT. Early diagnosis of BO is usually difficult because patients are often asymptomatic at an initial stage of the disease and pathologic findings are available mostly at the late stages. Therefore, the diagnosis of the disease is based on the pulmonary function test using the National Institute of Health consensus criteria. Here, we report a case of slowly progressive BO. A biopsy specimen at an early stage demonstrated alveolar destruction with lymphocyte infiltration in bronchial walls and mild narrowing of bronchioles without fibrosis, those were strongly indicative of initial pathologic changes of BO. Definitive BO followed, which was proven by both clinical course and autopsy. While alloreactive lymphocytes associated with chronic graft-versus-host disease are believed to initiate BO, we present a rare case that directly implies such a scenario.

  18. TEST FUSION IN ADULT FORAMINIFERA: A REVIEW WITH NEW OBSERVATIONS OF AN EARLY EOCENE NUMMULITES SPECIMEN

    Science.gov (United States)

    Ferràndez-Cañadell, Carles; Briguglio, Antonino; Hohenegger, Johann; Wöger, Julia

    2015-01-01

    In foraminifera, so-called “double tests” usually arise due to abnormal growth originating mainly from twinning, but may also be caused by irregularities in the early chambers and by regeneration after test injury that modifies the direction of growth. A fourth cause of double tests has only rarely been reported: the fusion of the tests of two adult individuals. We studied an early Eocene Nummulites double test consisting of two adult individuals that fused after an extended period of independent growth. The specimen was studied using computed tomography with micrometric resolution (micro-CT) that allowed bi- and three-dimensional visualization of the internal structure. Before fusion each individual test had 30–36 chambers, which, by comparison with growth rates in recent nummulitids, implies at least three months of independent growth. After fusion, the compound test grew in two spirals that fused after about one whorl and then continued in a single spiral. To fuse their tests, either adult individuals have to be forced to do so or the allorecognition (ability to distinguish between self and another individual) mechanisms must fail. A possible explanation for the merged Nummulites tests in this study is forced fusion in attached individuals after surviving ingestion and digestion by a metazoan. Alternatively, environmental stress could lead to a failure of allorecognition mechanisms and/or foraminiferal motility. Once fused, subsequent growth seems to be determined mainly by the relative orientation of individual tests. In any case, the frequency in which adult fusion occurs remains unknown. PMID:26166916

  19. Stages of syphilis in South China - a multilevel analysis of early diagnosis.

    Science.gov (United States)

    Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

    2017-01-31

    Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

  20. RSG Deployment Case Testing Results

    Energy Technology Data Exchange (ETDEWEB)

    Owsley, Stanley L.; Dodson, Michael G.; Hatchell, Brian K.; Seim, Thomas A.; Alexander, David L.; Hawthorne, Woodrow T.

    2005-09-01

    The RSG deployment case design is centered on taking the RSG system and producing a transport case that houses the RSG in a safe and controlled manner for transport. The transport case was driven by two conflicting constraints, first that the case be as light as possible, and second that it meet a stringent list of Military Specified requirements. The design team worked to extract every bit of weight from the design while striving to meet the rigorous Mil-Spec constraints. In the end compromises were made primarily on the specification side to control the overall weight of the transport case. This report outlines the case testing results.

  1. Choroidal metastasis from early rectal cancer: Case report and literature review.

    Science.gov (United States)

    Tei, Mitsuyoshi; Wakasugi, Masaki; Akamatsu, Hiroki

    2014-01-01

    Choroidal metastasis from colorectal cancer is rare, and there have been no reported cases of such metastasis from early colorectal cancer. We report a case of choroidal metastasis from early rectal cancer. A 61 year-old-man experienced myodesopsia in the left eye 2 years and 6 months after primary rectal surgery for early cancer, and was diagnosed with left choroidal metastasis and multiple lung metastases. Radiotherapy was initiated for the left eye and systemic chemotherapy is initiated for the multiple lung metastases. The patient is living 2 years and 3 months after the diagnosis of choroidal metastasis without signs of recurrence in the left eye, and continues to receive systemic chemotherapy for multiple lung metastases. Current literatures have few recommendations regarding the appropriate treatment of choroidal metastasis from colorectal cancer, but an aggressive multi-disciplinary approach may be effective in local regression. This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Positive results of serological tests for syphilis in pregnancy – diagnostic and therapeutic problems, report of two cases

    Directory of Open Access Journals (Sweden)

    Marta Koper

    2015-06-01

    Full Text Available Introduction. Undiagnosed and untreated syphilis in pregnancy may result in subsequent complications: early fetal loss, stillbirth, low birth weight of infants and newborns with congenital syphilis. Objective. To analyze diagnostic and therapeutic dilemmas of positive results of serological tests for syphilis (STS in pregnancy. Case reports. We present two cases of pregnant women, hospitalized in our department due to positive results of serological tests for syphilis, performed during the antenatal visit. On the basis of patients' history, physical examination and STS results, early latent syphilis was diagnosed in the first patient; biological false positive reactions were considered in the second one. Both patients received procaine penicillin treatment. Conclusions. Screening for syphilis in pregnancy as a part of antenatal care and appropriate treatment with penicillin are the most effective interventions to prevent complications of syphilis in pregnancy. It is also important to adapt modern European Guidelines for management of syphilis to Polish conditions.

  3. Baby or bathwater? Referrals of "non-cases" in a targeted early identification intervention for psychosis.

    Science.gov (United States)

    Jordan, Gerald; Kinkaid, Miriam; Iyer, Srividya N; Joober, Ridha; Goldberg, Karen; Malla, Ashok; Shah, Jai L

    2018-03-14

    To explore the unintended impact of a targeted case identification (TCI) campaign for first episode psychosis (FEP) on people not experiencing FEP ("non-cases") with respect to referral patterns and reasons for being a non-case. Sources of referral, reasons for being a non-case, and subsequent referral destinations of non-cases were examined before and after a TCI. Following the TCI, a greater proportion of non-cases lived outside the study catchment area. A smaller proportion was referred by the parent hospital's emergency room or had a substance-induced psychosis. TCIs for FEP may have unintended effects, with implications for early case identification and early intervention services.

  4. A tool for early workstation design for small and medium enterprises evaluated in five cases

    NARCIS (Netherlands)

    Hallbeck, M.S.; Bosch, T.; Rhijn, J.W.van; Krause, F.; Looze, M.P.de; Vink, P.

    2010-01-01

    Five case studies on production line design were described to study the effect of an early design support tool. Based on these case studies, the simple, interactive, real-time, medium-fidelity, mixed-reality methodology was not only found to be a good early design stage evaluative tool for

  5. Test case for a near-surface repository

    International Nuclear Information System (INIS)

    Elert, M.; Jones, C.; Nilsson, L.B.; Skagius, K.; Wiborgh, M.

    1998-01-01

    A test case is presented for assessment of a near-surface disposal facility for radioactive waste. The case includes waste characterization and repository design, requirements and constraints in an assessment context, scenario development, model description and test calculations

  6. Test case preparation using a prototype

    OpenAIRE

    Treharne, Helen; Draper, J.; Schneider, Steve A.

    1998-01-01

    This paper reports on the preparation of test cases using a prototype within the context of a formal development. It describes an approach to building a prototype using an example. It discusses how a prototype contributes to the testing activity as part of a lifecycle based on the use of formal methods. The results of applying the approach to an embedded avionics case study are also presented.

  7. Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study.

    Science.gov (United States)

    Reis, Rejane de Souza; Silva, Neimar de Paula; Santos, Marceli de Oliveira; Oliveira, Julio Fernando Pinto; Thuler, Luiz Claudio Santos; de Camargo, Beatriz; Pombo-de-Oliveira, Maria S

    The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  8. Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study,

    Directory of Open Access Journals (Sweden)

    Rejane de Souza Reis

    Full Text Available Abstract Objective: The population-based cancer registries (PBCR and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC] have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL in Brazil. Methods: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i characteristics of the child at birth and (ii characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR and 95% confidence interval (CI were calculated by logistic regression models. Results: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10 and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00. Conclusions: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide.

  9. A case of functional growth hormone deficiency and early growth retardation in a child with IFT172 mutations.

    Science.gov (United States)

    Lucas-Herald, Angela K; Kinning, Esther; Iida, Aritoshi; Wang, Zheng; Miyake, Noriko; Ikegawa, Shiro; McNeilly, Jane; Ahmed, S Faisal

    2015-04-01

    Ciliopathies are a group of rare conditions that present through a wide range of manifestations. Given the relative common occurrence of defects of the GH/IGF-I axis in children with short stature and growth retardation, the association between ciliopathies and these defects needs further attention. Our patient is a boy who was born at term and noted to have early growth retardation and weight gain within the first 18 months of life. Biochemical tests demonstrated low IGF-I but a normal peak GH on stimulation and an adequate increase in IGF-I on administration of recombinant human growth hormone (rhGH). A magnetic resonance imaging scan revealed pituitary hypoplasia and an ectopic posterior pituitary. His growth responded well to rhGH therapy. Subsequently he also developed a retinopathy of his rods and cones, metaphyseal dysplasia, and hypertension with renal failure requiring renal replacement therapy. Whole-exome sequencing demonstrated compound heterozygous mutations of IFT172, thus consistent with a ciliopathy. This is the first reported case of a child with a mutation in IFT172 who presented with growth retardation in early childhood and was initially managed as a case of functional GH deficiency that responded to rhGH therapy. This case highlights the importance of ciliary function in pituitary development and the link between early onset growth failure and ciliopathies.

  10. Early diagnosis of acoustic neuroma by quantitative neurootological and neuroradiological tests

    Energy Technology Data Exchange (ETDEWEB)

    Haid, C T

    1983-02-01

    Every patient with unilateral and sensoneural loss of hearing, independent of vertigo anamnesis or X-rays must be further examined by a vestibular test. Between 1974 and 1980, 80 acoustic neuromas could be diagnosed, including 12 early stage neuromas. This relatively high detection quote of small neuromas is due to a special diagnostical program: All 80 patients with acoustic neuroma had a pathological vestibular result. The positional test turned out to be the most sensitive examination in the early diagnosis of acoustic neuromas and yields a still higher incidence than the caloric test: 95% of the patients with a neurinoma showed a pathological result in the positional test. So every patient suffering from an unidentified unilateral and sensoneural hearing loss combined with a pathological result in the positional test must be further examined by a cisternomeatography or computerized tomography (using air-insufflation). Every fifth of these patients showed unique hints of an acoustic neuroma in the neuroradiological test.

  11. Early diagnosis of Gorlin-Goltz syndrome: case report.

    Science.gov (United States)

    Casaroto, Ana R; Loures, Daniela C N Rocha; Moreschi, Eduardo; Veltrini, Vanessa C; Trento, Cleverson L; Gottardo, Vilmar D; Lara, Vanessa S

    2011-01-25

    The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

  12. Test case for a near-surface repository

    Energy Technology Data Exchange (ETDEWEB)

    Elert, M.; Jones, C. [Kemakta Konsult AB, Stockholm (Sweden); Nilsson, L.B. [Swedish Nuclear Fuel and Waste Co, Stockholm (Sweden); Skagius, K.; Wiborgh, M. [Kemakta Konsult AB, Stockholm (Sweden)

    1998-09-01

    A test case is presented for assessment of a near-surface disposal facility for radioactive waste. The case includes waste characterization and repository design, requirements and constraints in an assessment context, scenario development, model description and test calculations 6 refs, 12 tabs, 16 figs

  13. Multianalyte Tests for the Early Detection of Cancer: Speedbumps and Barriers

    Directory of Open Access Journals (Sweden)

    Michael A. Tainsky

    2007-01-01

    Full Text Available It has become very clear that a single molecular event is inadequate to accurately predict the biology (or pathophysiology of cancer. Furthermore, using any single molecular event as a biomarker for the early detection of malignancy may not comprehensively identify the majority of individuals with that disease. Therefore, the fact that technologies have arisen that can simultaneously detect several, possibly hundreds, of biomarkers has propelled the field towards the development of multianalyte-based in vitro diagnostic early detection tests for cancer using body fl uids such as serum, plasma, sputum, saliva, or urine. These multianalyte tests may be based on the detection of serum autoantibodies to tumor antigens, the presence of cancer-related proteins in serum, or the presence of tumor-specific genomic changes that appear in plasma as free DNA. The implementation of non-invasive diagnostic approaches to detect early stage cancer may provide the physician with evidence of cancer, but the question arises as to how the information will affect the pathway of clinical intervention. The confirmation of a positive result from an in vitro diagnostic cancer test may involve relatively invasive procedures to establish a true cancer diagnosis. If in vitro diagnostic tests are proven to be both specific, i.e. rarely produce false positive results due to unrelated conditions, and sufficiently sensitive, i.e. rarely produce false negative results, then such screening tests offer the potential for early detection and personalized therapeutics using multiple disease-related targets with convenient and non-invasive means. Here we discuss the technical and regulatory barriers inherent in development of clinical multianalyte biomarker assays.

  14. [Heart failure as early manifestation of neonatal hyperthyroidism. Case report].

    Science.gov (United States)

    Alvarado S, Jorge Luis; Fernández V, Zhirly Andrea

    2014-04-01

    Neonatal hyperthyroidism is usually a self-limited condition frequently associated with transplacental passage of thyroid stimulating antibodies secondary to maternal autoimmune disorders. To timely detect mothers with this medical antecedents decreases the risk for fetal adverse events. To report a case of neonatal hyperthyroidism associated with intrauterine growth restriction and heart failure. A 36 week-old newborn with birth weight of 1,240 g. Symptoms were tachycardia, distal coldness, exophthalmos, hepatomegaly and tremors. Echocardiogram ruled out structural heart disorders. Due to maternal symptoms suggestive of hyperthyroidism, TSH tests were performed showing 0.01 ulU/ml, free T4 7.7 ng/dl, so the diagnosis of neonatal hyperthyroidism was confirmed. It was treated with methimazole and propanol, alleviating the symptoms and decreasing the levels of free T4. To know the maternal history helps identify and manage neonatal complications of hyperthyroidism. Heart failure and other cardiopulmonary disorders are determinants of mortality during early neonatal period. High-risk newborns should receive follow up assessments.

  15. Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis

    OpenAIRE

    Michálková, Kateřina

    2013-01-01

    Title of bachelor's thesis: Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis. Summary: The bachelor thesis deals with polyarthritis disease with early rheumatoid arthritis and its physiotherapy care. It consists of two parts. The general part contains a general joint anatomy, deals with the major problems of disease and polyarthritis rheumatoid arthritis, its diagnosis, treatment and physiotherapy care. Special part includes a case repor...

  16. The feasibility of ambitious climate agreements. Norway as an early test case

    Energy Technology Data Exchange (ETDEWEB)

    Andresen, Steinar; Kolshus, Hans H.; Torvanger, Asbjoern

    2002-09-01

    There are considerable differences between developed countries as to how difficult it will be to meet their commitments under the Kyoto Protocol. 'High-cost abatement countries' are particularly interesting as they can be seen as 'test-cases' for other nations in more ambitious climate policy agreements. We assume that a country's objective is to develop an efficient climate policy, achieving cost effectiveness and environmental effectiveness, and that also is politically feasible. Norway is among the countries that will have a hard time in meeting their obligations. Our study suggests that Norway's climate policy has emphasized an international approach, whereas the domestic performance on cost effectiveness has been more moderate. An obvious reason for this is the lower cost associated with the international approach. A 'political cost' associated with such a policy can be criticism from environmental NGOs and other countries. At least in the near term there is little reason to expect 'climate enthusiasm' from the public or many countries of the world. Therefore, just like Norway, they will want emissions reductions carried out as cheaply as possible, which could imply extensive international quota trading, whereas compromises with regard to cost effectiveness are struck at the domestic scene for political feasibility reasons. (author)

  17. Endoscopic mucosal resection for early gastric cancer. A case report.

    Science.gov (United States)

    Gheorghe, Cristian; Sporea, Ioan; Becheanu, Gabriel; Gheorghe, Liana

    2002-03-01

    European experience in endoscopic mucosal resection (EMR) for early gastric cancer is still relatively low, since early stomach cancer is diagnosed at a much lower rate in Europe than in Japan and generally operable patients are referred to surgery for radical resection. Endoscopic mucosal resection or mucosectomy was developed as a promising technology to diagnose and treat mucosal lesions in the esophagus, stomach and colon. In contrast to surgical resection, EMR allows "early cancers" to be removed with a minimal cost, morbidity and mortality. We present the case of a patient with hepatic cirrhosis incidentally diagnosed with an elevated-type IIa early gastric cancer. Echoendoscopy was performed in order to assess the depth of invasion into the gastric wall confirming the only mucosal involvement. We performed an EMR using "cup and suction" method. After the procedure, the patient experienced an acute upper gastrointestinal bleeding from the ulcer bed requiring argon plasma coagulation. The histopathological examination confirmed an early cancer, without involvement of muscularis mucosae. The patient has had an uneventful evolution being well at six months after the procedure

  18. Measuring Test Case Similarity to Support Test Suite Understanding

    NARCIS (Netherlands)

    Greiler, M.S.; Van Deursen, A.; Zaidman, A.E.

    2012-01-01

    Preprint of paper published in: TOOLS 2012 - Proceedings of the 50th International Conference, Prague, Czech Republic, May 29-31, 2012; doi:10.1007/978-3-642-30561-0_8 In order to support test suite understanding, we investigate whether we can automatically derive relations between test cases. In

  19. Validation test case generation based on safety analysis ontology

    International Nuclear Information System (INIS)

    Fan, Chin-Feng; Wang, Wen-Shing

    2012-01-01

    Highlights: ► Current practice in validation test case generation for nuclear system is mainly ad hoc. ► This study designs a systematic approach to generate validation test cases from a Safety Analysis Report. ► It is based on a domain-specific ontology. ► Test coverage criteria have been defined and satisfied. ► A computerized toolset has been implemented to assist the proposed approach. - Abstract: Validation tests in the current nuclear industry practice are typically performed in an ad hoc fashion. This study presents a systematic and objective method of generating validation test cases from a Safety Analysis Report (SAR). A domain-specific ontology was designed and used to mark up a SAR; relevant information was then extracted from the marked-up document for use in automatically generating validation test cases that satisfy the proposed test coverage criteria; namely, single parameter coverage, use case coverage, abnormal condition coverage, and scenario coverage. The novelty of this technique is its systematic rather than ad hoc test case generation from a SAR to achieve high test coverage.

  20. The Couplex test cases: models and lessons

    International Nuclear Information System (INIS)

    Bourgeat, A.; Kern, M.; Schumacher, S.; Talandier, J.

    2003-01-01

    The Couplex test cases are a set of numerical test models for nuclear waste deep geological disposal simulation. They are centered around the numerical issues arising in the near and far field transport simulation. They were used in an international contest, and are now becoming a reference in the field. We present the models used in these test cases, and show sample results from the award winning teams. (authors)

  1. Science of Materials: A Case Study of Intentional Teaching in the Early Years

    Science.gov (United States)

    Hackling, Mark; Barratt-Pugh, Caroline

    2012-01-01

    Australia's Early Years Learning Framework and leading international researchers argue for more intentional and purposeful teaching of science in the early years. This case study of exemplary practice illustrates intentional teaching of science materials which opened-up learning opportunities in literacy and number. Student-led hands-on…

  2. Early diagnosis of Gorlin-Goltz syndrome: case report

    Directory of Open Access Journals (Sweden)

    Trento Cleverson L

    2011-01-01

    Full Text Available Abstract The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS, is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

  3. Early treatment of congenital syngnathia. A case report

    Directory of Open Access Journals (Sweden)

    Eduardo Alfredo Duro

    2018-02-01

    Full Text Available Congenital syngnathia is a rare malformation. The synechia or synostosis of the maxilla and the mandible may be partial or complete and also be associated with other malformations. The syngnathia can be developed between the upper and lower alveolar ridges with a wide spectrum and range of severity documented in case reports. The authors report a newborn with complete syngnathia and discuss the management during the first days of life. Our goal is to help attending physicians understand anatomic and functional implications of syngnathia, and become familiar with strategies used in the early caring of a newborn with congenital syngnathia. Literature reveals results of different patients with poorly documented follow-up and different management. The priority is a safe airway and early nutrition with human milk to avoid the risk of aspiration pneumonia, malnutrition, and poor growth.

  4. Development of an alternative testing strategy for the fish early life-stage (FELS) test using the AOP framework

    Science.gov (United States)

    Currently, the fish early life-stage (FELS) test (OECD 210) is the primary guideline used to estimate chronic toxicity of regulated chemicals. Although already more cost-efficient than adult fish tests, the FELS test has some important drawbacks. Both industry and regulatory inst...

  5. Intramuscular Olanzapine – a UK case series of early cases

    Directory of Open Access Journals (Sweden)

    Taylor Mark

    2007-04-01

    Full Text Available Abstract Background Clinical trials assessing efficacy and safety of Intramuscular (IM Olanzapine in acute schizophrenia and acute mania have previously been undertaken in studies required for drug registration in patients who were required to give informed consent. These patients may have less severe forms of psychosis than patients treated in routine practice. Data derived from naturalistic practice following the launch of IM olanzapine may be helpful for clinicians in assessing efficacy and safety of IM olanzapine. The PANSS-EC scale used in the clinical studies may represent a tool that could be used in routine clinical practice. Case presentation We report on an early unselected case series of 7 patients who received IM olanzapine in routine clinical practice settings in the UK. In this case series, olanzapine IM was generally effective, and no adverse events were reported. Adjunctive benzodiazepines were given concomitantly in 1 of the 7 subjects. This is relevant as concomitant benzodiazepines are not recommended for a minimum of 1 hour post IM olanzapine administration. PANSS-EC data was collected in 2 of the 7 subjects. Conclusion Although patients had greater severity of psychosis than clinical trial patients there were no unexpected findings. In addition the PANSS-EC scale is a scale that may be useful in assessing the efficacy of IM antipsychotics in routine clinical practice.

  6. Stages of syphilis in South China – a multilevel analysis of early diagnosis

    Directory of Open Access Journals (Sweden)

    Ngai Sze Wong

    2017-01-01

    Full Text Available Abstract Background Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. Methods In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015 accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21, adjusted for age at diagnosis and gender. Results Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. Conclusions To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

  7. Image processing of early gastric cancer cases

    International Nuclear Information System (INIS)

    Inamoto, Kazuo; Umeda, Tokuo; Inamura, Kiyonari

    1992-01-01

    Computer image processing was used to enhance gastric lesions in order to improve the detection of stomach cancer. Digitization was performed in 25 cases of early gastric cancer that had been confirmed surgically and pathologically. The image processing consisted of grey scale transformation, edge enhancement (Sobel operator), and high-pass filtering (unsharp masking). Grey scale transformation improved image quality for the detection of gastric lesions. The Sobel operator enhanced linear and curved margins, and consequently, suppressed the rest. High-pass filtering with unsharp masking was superior to visualization of the texture pattern on the mucosa. Eight of 10 small lesions (less than 2.0 cm) were successfully demonstrated. However, the detection of two lesions in the antrum, was difficult even with the aid of image enhancement. In the other 15 lesions (more than 2.0 cm), the tumor surface pattern and margin between the tumor and non-pathological mucosa were clearly visualized. Image processing was considered to contribute to the detection of small early gastric cancer lesions by enhancing the pathological lesions. (author)

  8. Radiotherapy in fascial fibromatosis: a case series, literature review and considerations for treatment of early-stage disease

    International Nuclear Information System (INIS)

    Grenfell, Solveig; Borg, Martin

    2014-01-01

    Palmar and plantar fascial fibromatoses are benign hyperproliferative disorders of the deep fascia of the palm and sole. This study seeks to examine the role of radiotherapy in the management of fascial fibromatosis. Six consecutive cases of early-stage fascial fibromatosis treated with radiotherapy at the Adelaide Radiotherapy Centre between July 2008 and May 2011 were analysed. The results of the case series were compared with a systematic review of the literature. All six cases regressed or showed a reduction of symptoms following radiotherapy. Treatment was well tolerated with minor toxicities. Median follow-up for the case series was 38.5 months. The systematic review identified seven studies describing the use of radiotherapy as primary treatment for fascial fibromatosis between 1946 and 2013. The literature indicates that radiotherapy can prevent disease progression and improve symptoms for early-stage disease, with low likelihood of significant toxicities. Early results from our case series are consistent with the literature, showing that radiotherapy can provide an effective management option for patients with early-stage fascial fibromatosis, and justify consideration of radiotherapy as a primary treatment for early-stage disease.

  9. Early onset polymyalgia rheumatica: two rare cases under age of 50

    International Nuclear Information System (INIS)

    Park, Jinyoung; Sung, Duk Hyun

    2017-01-01

    Polymyalgia rheumatica (PMR) is almost an exclusive disease of adults over the age of 50, and only a few cases have been reported. Two 46-year-old females visited our locomotor pain clinic with multiple joint pain with increased acute phase reactants. Rheumatologic markers, and HLA-B27 were checked. Serum protein electrophoresis and serum immunofixation electrophoresis, imaging studies including plane image, sonography, and magnetic resonance image was done. "1"8F-Fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed characteristic findings of PMR, without evidences of sacroiliitis. Since PMR can develop in mid 40s, a high index of suspicion is necessary in younger patients presenting the bilateral pain in shoulders, hips, and back, with elevated acute phase reactants. Furthermore, in addition to the previous case reports, FDG-PET/CT is helpful in making early differential diagnosis of PMR in patients under the age of 50. Here we present two cases of PMR onset in the mid-40s emphasizing the importance of diagnostic imaging for early differential diagnosis in PMR. (orig.)

  10. Early onset polymyalgia rheumatica: two rare cases under age of 50

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jinyoung [Yonsei University College of Medicine, Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Seoul (Korea, Republic of); Sung, Duk Hyun [Samsung Medical Center, Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul (Korea, Republic of)

    2017-06-15

    Polymyalgia rheumatica (PMR) is almost an exclusive disease of adults over the age of 50, and only a few cases have been reported. Two 46-year-old females visited our locomotor pain clinic with multiple joint pain with increased acute phase reactants. Rheumatologic markers, and HLA-B27 were checked. Serum protein electrophoresis and serum immunofixation electrophoresis, imaging studies including plane image, sonography, and magnetic resonance image was done. {sup 18}F-Fludeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) showed characteristic findings of PMR, without evidences of sacroiliitis. Since PMR can develop in mid 40s, a high index of suspicion is necessary in younger patients presenting the bilateral pain in shoulders, hips, and back, with elevated acute phase reactants. Furthermore, in addition to the previous case reports, FDG-PET/CT is helpful in making early differential diagnosis of PMR in patients under the age of 50. Here we present two cases of PMR onset in the mid-40s emphasizing the importance of diagnostic imaging for early differential diagnosis in PMR. (orig.)

  11. Early Stage Prurigo Pigmentosa : A Case Report

    Directory of Open Access Journals (Sweden)

    Emel ONAYGİL

    2018-05-01

    Full Text Available Prurigo pigmentosa is a rare inflammatory dermatosis that primarily affects adolescents and young adults. Even though it is most commonly seen in Japanese women, other countries have reported cases with increasing frequency. It is characterized by erythematous papules and macules on the trunk, neck and chest that resolve leaving a reticulate hyperpigmentation. Some endogenous factors related with ketosis like fasting, diet, diabetes, pregnancy and exogenous agents like chrome, nickel, para-amino compounds have been accused of playing a role in etiology. Here we would like to present a case of a 16-year-old female patient who was referred to our clinic with pruritic lesions on the trunk and neck, consistent with the initial phase of prurigo pigmentosa, after a period of strict diet. Prurigo pigmentosa is a disease with distinctive histologic and clinical features. Due to its rare occurrence, an accurate diagnosis may be particularly challenging. Clinicopathological correlation is therefore crucial in the diagnosis of the disease in its early phase.

  12. [Experience with Pregnosticon-planotest, a 2-minute immunologic pregnancy test].

    Science.gov (United States)

    Hancsók, M; Huber, G; Páhoki, I; Czeizel, E

    1969-08-23

    Pregnosticon-Planotest (PPT), produced by N.V. Organon, is an immunological latex-suspension pregnancy test that can be read in 2 minutes (or up to 60 minutes) and requires no special equipment such as centrifuges. Parallel pregnancy tests, using PPT and the biological Galli-Mainin Reaction (GMR) were carried out on 381 women for a total of 407 tests. The cases included 334 possible early pregnancies, 38 supected extrauterine pregnancies, and 35 suspected fetal deaths. The 2 tests agreed in 93.9% of the cases, and of 23 cases on which results differed, the PPT reading proved correct for 21 cases. Both tests gave false-negative readings for 36 early pregnancies and 1 extrauterine pregnancy. However, PPT results were correct for 80% of the extrauterine pregnancies (where production of human chorionic gonadotropin, the substance tested for, is low); the GMR was correct in 68.8% of these cases. The sensitivity of PPT was also shown in its early detection of pregnancies - 3.3-4 days earlier than with GMR. PPT is thus judged to be a sensitive, reliable, simple, and quick pregnancy test.

  13. Feeding problems in infancy and early childhood: A case study of ...

    African Journals Online (AJOL)

    Feeding problems in infancy and early childhood: A case study of selected ... of feeding problems among children 6 to 24 months of age in Ibadan, Nigeria. ... from four selected Primary Health Centres in Ibadan North Local Government Area.

  14. EARLY RECURRENCE OF WELL-DIFFERENTIATED ENDOMETRIAL CANCER (A CASE REPORT

    Directory of Open Access Journals (Sweden)

    N. E. Levchrnko

    2017-01-01

    Full Text Available Endometrial cancer is the 6-th most common malignancy in women worldwide, accounting for about 4.8 % of all female cancers. The treatment of recurrent endometrial cancer remains a major challenge. Some endometrial cancer recurrences, for example vaginal stump recurrence, are reported to be effectively treated with surgical resection and radiation therapy. Early recurrence of early-stage well-differentiated endometrial cancer is uncommon. Case report. Herein we report a rare case of recurrent well-differentiated endometrial cancer in a 65-year-old woman. The patient had recurrence 10 months after laparoscopic hysterectomy with bilateral salpingo-oophorectomy. Recurrent endometrial tumor with extension into the rectosigmoid colon, urinary bladder and the right ureter manifested itself clinically with severe pain requiring the use of opioids. The recurrent tumor was removed. Resection of the bladder, left ureter and upper ampular rectum was followed by anastomosis. The patient received multiple cycles of chemotherapy. Conclusion. Compliance with the principles of ablastics during the laparoscopic or laparotomic surgery helps to avoid recurrence in patients with prognostically favorable cancer. In case of recurrence, combined operations are the only possible chance of improving survival of patients with locally advanced or recurrent tumors, which are insensitive to chemoradiotherapy.

  15. Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

    Directory of Open Access Journals (Sweden)

    Neeraj Raizada

    Full Text Available Diagnosis of pulmonary tuberculosis (PTB in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India.The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU, with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm.4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8 pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2 of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4 who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV for rifampicin resistance detection was high (98%, CI 90.1-99.9, with no statistically significant variation with respect to past history of treatment.Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising

  16. Flow Test to Predict Early Hypotony and Hypertensive Phase After Ahmed Glaucoma Valve (AGV) Surgical Implantation.

    Science.gov (United States)

    Cheng, Jason; Beltran-Agullo, Laura; Buys, Yvonne M; Moss, Edward B; Gonzalez, Johanna; Trope, Graham E

    2016-06-01

    To assess the validity of a preimplantation flow test to predict early hypotony [intraocular pressure (IOP)≤5 mm Hg on 2 consecutive visits and hypertensive phase (HP) (IOP>21 mm Hg) after Ahmed Glaucoma Valve (AGV) implantation. Prospective interventional study on patients receiving an AGV. A preimplantation flow test using a gravity-driven reservoir and an open manometer was performed on all AGVs. Opening pressure (OP) and closing pressure (CP) were defined as the pressure at which fluid was seen to flow or stop flowing through the AGV, respectively. OP and CP were measured twice per AGV. Patients were followed for 12 weeks. In total, 20 eyes from 19 patients were enrolled. At 12 weeks the mean IOP decreased from 29.2±9.1 to 16.8±5.2 mm Hg (P<0.01). The mean AGV OP was 17.5±5.4 mm Hg and the mean CP was 6.7±2.3 mm Hg. Early (within 2 wk postoperative) HP occurred in 37% and hypotony in 16% of cases. An 18 mm Hg cutoff for the OP gave a sensitivity of 0.71, specificity of 0.83, positive predictive value of 0.71, and negative predictive value of 0.83 for predicting an early HP. A 7 mm Hg cutoff for the CP yielded a sensitivity of 1.0, specificity of 0.38, positive predictive value of 0.23, and negative predictive value of 1.0 for predicting hypotony. Preoperative OP and CP may predict early hypotony or HP and may be used as a guide as to which AGV valves to discard before implantation surgery.

  17. Identifying economic hurdles to early adoption of preventative practices: The case of trunk diseases in California winegrape vineyards

    Directory of Open Access Journals (Sweden)

    Jonathan Kaplan

    2016-12-01

    Full Text Available Despite the high likelihood of infection and substantial yield losses from trunk diseases, many California practitioners wait to adopt field-tested, preventative practices (delayed pruning, double pruning, and application of pruning-wound protectants until after disease symptoms appear in the vineyard at around 10 years old. We evaluate net benefits from adoption of these practices before symptoms appear in young Cabernet Sauvignon vineyards and after they become apparent in mature vineyards to identify economic hurdles to early adoption. We simulate winegrape production in select counties of California and find widespread benefits from early adoption, increasing vineyard profitable lifespans, in some cases, by close to 50%. However, hurdles may result from uncertainty about the cost and returns from adoption, labor constraints, long time lags in benefits from early adoption, growers’ perceived probabilities of infection, and their discount rate. Development of extension resources communicating benefits and potential hurdles to growers likely reduces uncertainty, increasing early adoption. Improvements in efficacy of preventative practices, perhaps by detecting when pathogen spores are released into the vineyard, will increase early adoption. Lastly, practice cost reductions will increase early adoption too, especially when the time it takes for adoption to payoff and infection uncertainty are influential in adoption decisions.

  18. Psychiatric Symptomatology in Early-Onset Binswanger’s Disease: Two Case Reports

    Directory of Open Access Journals (Sweden)

    R. M. Lawrence

    1995-01-01

    Full Text Available We describe two cases of Binswanger's disease of pre-senile onset which presented with affective and psychotic symptoms well before the appearance of cognitive deterioration and neurological signs, initially evading an accurate diagnosis. Psychiatrists should be aware of white matter disease and its role in the pathogenesis of psychiatric illness. Particular attention should be given to a history of hypertension as a risk factor in the early identification of these cases.

  19. The Significance of Isolated Reactive Treponemal Enzyme Immunoassay in the Diagnosis of Early Syphilis.

    Science.gov (United States)

    Caswell, Rachel J; Hathorn, Emma; Manavi, Kaveh

    2016-06-01

    The Treponemal test algorithm for syphilis screening is widely used. A diagnostic challenge between identifying early syphilis versus a false positive signal occurs in cases where the treponemal enzyme immunoassay (EIA) is reactive and confirmatory T. pallidum particle agglutination assay is negative. We investigated the diagnostic outcome of isolated reactive EIA in patients attending a sexual health clinic. Results of syphilis serology tests carried out at Birmingham Whittall Street Clinic between August 10, 2010, and November 31, 2014, were reviewed. Cases with isolated EIA were routinely invited for repeat syphilis serology. Outcomes of patients with isolated EIA were reviewed and the proportion with confirmed positive syphilis serology on their repeat test identified. The number of isolated EIA cases needed to retest to identify 1 case of early syphilis was calculated. A total of 121,724 syphilis screening tests were performed. Among the 1561 individual patients with reactive EIA sera, 316 (20% of total reactive tests) had isolated reactive EIA. Repeat syphilis serology results of 163 patients were reviewed; 106 patients remained with isolated reactive EIA, 50 had negative EIA test and 7 (4.3%) had confirmed reactive EIA. Of the 7 patients, 2 had evidence of early syphilis infection. The number of isolated EIA needed to retest to identify 1 case of early syphilis was 81.5 (95% confidence interval, 22.9-671.4). Routine recall of patients with isolated EIA sera is not warranted. Risk of acquisition or presence of early syphilis should be assessed independently and irrespective of a negative syphilis screening test or isolated EIA.

  20. Case for a wet, warm climate on early Mars

    International Nuclear Information System (INIS)

    Pollack, J.B.; Kasting, J.F.; Richardson, S.M.; Poliakoff, K.

    1987-01-01

    Arguments are presented in support of the idea that Mars possessed a dense CO 2 atmosphere and a wet, warm climate early in its history. The plausibility of a CO 2 greenhouse is tested by formulating a simple model of the CO 2 geochemical cycle on early Mars. By scaling the rate of silicate weathering on Earth, researchers estimated a weathering time constant of the order of several times 10 to the 7th power years for early Mars. Thus, a dense atmosphere could have existed for a geologically significant time period (approx. 10 to the 9th power years) only if atmospheric CO 2 was being continuously resupplied. The most likely mechanism by which this could have been accomplished is the thermal decomposition of carbonate rocks induced directly or indirectly by intense, global scale volcanism

  1. Test case prioritization using Cuscuta search

    Directory of Open Access Journals (Sweden)

    Mukesh Mann

    2014-12-01

    Full Text Available Most companies are under heavy time and resource constraints when it comes to testing a software system. Test prioritization technique(s allows the most useful tests to be executed first, exposing faults earlier in the testing process. Thus makes software testing more efficient and cost effective by covering maximum faults in minimum time. But test case prioritization is not an easy and straightforward process and it requires huge efforts and time. Number of approaches is available with their proclaimed advantages and limitations, but accessibility of any one of them is a subject dependent. In this paper, artificial Cuscuta search algorithm (CSA inspired by real Cuscuta parasitism is used to solve time constraint prioritization problem. We have applied CSA for prioritizing test cases in an order of maximum fault coverage with minimum test suite execution and compare its effectiveness with different prioritization ordering. Taking into account the experimental results, we conclude that (i The average percentage of faults detection (APFD is 82.5% using our proposed CSA ordering which is equal to the APFD of optimal and ant colony based ordering whereas No ordering, Random ordering and Reverse ordering has 76.25%, 75%, 68.75% of APFD respectively.

  2. A Case Study of Idea Work in the Early Phases of Product Development

    DEFF Research Database (Denmark)

    Gish, Liv; Clausen, Christian; Hansen, Claus Thorp

    2009-01-01

    development. Based on our case we will point out four central findings: 1) Early idea work is a complex process and interlinked with many other activities both inside and outside the organization. 2) Ideas evolve,combine and change over time. 3) Idea work involves a wide range of actors. 4) Carrying ideas......Focus in this paper is on the early innovation activities, in particular idea work. Based on a case study from industrial practice on the development of a new circulator (the Alpha Pro circulator) we aim at getting a better understanding of the work with ideas in the early phases of product...... through demands continuous mobilization of support among a range of actors. We suggest that the actors involved in idea work and their interaction such as negotiating different understandings of what constitutes a qualified idea as well as the continuous mobilization of support to their ideas among...

  3. [Early macular edema after phacoemulsification and suspected overdose of cefuroxime: report of six cases].

    Science.gov (United States)

    Le Dû, B; Pierre-Kahn, V

    2014-03-01

    Antibiotic prophylaxis by intracameral cefuroxime injection, 1mg/0.1 mL after cataract surgery is increasing in popularity. Several cases of early postoperative macular edema have recently been reported after cefuroxime injection, most of them due to accidental cefuroxime overdose. We report six additional cases of macular involvement after cataract surgery, with intracameral cefuroxime injection imputed to cause retinal toxicity. Formal proof of cefuroxime overdose has never been possible, due to rapid wash-out in a few hours and the diagnosis of the macular edema the day after surgery or within a few days. Thus, this strong suspicion is based on clinical, pharmacokinetic, tomographic and retinographic criteria. In our series of six cases, the first four patients involved the same surgeon in the same hospital, and two of them on the same day. For the sixth case, the diagnosis was made retrospectively and based on history and medium-term tomographic characteristics. All the patients underwent optical coherence tomography (OCT) relatively early. As early as day one after surgery, there is macular edema predominantly in the outer retinal layers associated with serous retinal detachment, similar to the cases described in the literature. In the late stage, three patients had functional impairment related to photoreceptor damage on OCT. Three cases are described with additional retinal imaging (angiography, autofluorescence) to better characterize this macular toxicity associated with cefuroxime. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  4. Test Automation Process Improvement A case study of BroadSoft

    OpenAIRE

    Gummadi, Jalendar

    2016-01-01

    This master thesis research is about improvement of test automation process at BroadSoft Finland as a case study. Test automation project recently started at BroadSoft but the project is not properly integrated in to existing process. Project is about converting manual test cases to automation test cases. The aim of this thesis is about studying existing BroadSoft test process and studying different test automation frameworks. In this thesis different test automation process are studied ...

  5. HYBRID DATA APPROACH FOR SELECTING EFFECTIVE TEST CASES DURING THE REGRESSION TESTING

    OpenAIRE

    Mohan, M.; Shrimali, Tarun

    2017-01-01

    In the software industry, software testing becomes more important in the entire software development life cycle. Software testing is one of the fundamental components of software quality assurances. Software Testing Life Cycle (STLC)is a process involved in testing the complete software, which includes Regression Testing, Unit Testing, Smoke Testing, Integration Testing, Interface Testing, System Testing & etc. In the STLC of Regression testing, test case selection is one of the most importan...

  6. Early prenatal syphilis

    Directory of Open Access Journals (Sweden)

    Santosh Rathod

    2010-01-01

    Full Text Available Syphilis in pregnancy still remains a challenge despite the availability of adequate diagnostic tests for serological screening and penicillin therapy. We report a case of 2 month old female infant who presented with runny nose, papulosquamous lesions over both palms and soles and perianal erosions since 1 month after birth. Cutaneous examination revealed moist eroded areas in the perianal region and fine scaly lesions over palms and soles. Radiograph of both upper limbs and limbs revealed early periosteal changes in lower end of humerus and lower end of tibia. Diagnosis of early pre-natal syphilis was confirmed by Child′s Serum Rapid Plasma Reagin Antibody test [S.RPR] being positive with 1:64 dilution while that of mother was 1:8.

  7. Endogenous steroid hormone levels in early pregnancy and risk of testicular cancer in the offspring: a nested case-referent study.

    Science.gov (United States)

    Holl, Katsiaryna; Lundin, Eva; Surcel, Heljä-Marja; Grankvist, Kjell; Koskela, Pentti; Dillner, Joakim; Hallmans, Göran; Wadell, Göran; Olafsdottir, Gudridur H; Ogmundsdottir, Helga M; Pukkala, Eero; Lehtinen, Matti; Stattin, Pär; Lukanova, Annekatrin

    2009-06-15

    According to the leading hypothesis on testicular cancer (TC) etiology exposure to a specific pattern of steroid hormones in utero, in particular, to high levels of estrogens and low levels of androgens is the major determinant of TC risk in the offspring. We performed a case-referent study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of maternal endogenous steroid hormones with regard to the risk of TC. TC cases and referents were aged between 0 and 25 years. For each case-index mother pair, three or four matched referent-referent mother pairs were identified using national population registries. First trimester or early second trimester sera were retrieved from the index mothers of 73 TC cases and 286 matched referent mothers, and were tested for dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG). Offspring of mothers with high DHEAS levels had a significantly decreased risk of TC (OR for highest vs. lowest DHEAS quartile, 0.18 (95% CI 0.06-0.58). In contrast, offspring of mothers with high androstenedione levels had an increased risk of TC (OR 4.1; 95% CI 1.2-12.0). High maternal total estradiol level also tended to be associated with an increased risk of TC in the offspring (OR 32; 95% CI 0.98-1,090). We report the first direct evidence that interplay of maternal steroid hormones in the early pregnancy is important in the etiology of TC in the offspring. Copyright 2008 UICC.

  8. The International intraval project. Phase 1 test cases

    International Nuclear Information System (INIS)

    1992-01-01

    This report contains a description of the test cases adopted in Phase 1 of the international cooperation project INTRAVAL. Seventeen test cases based on bench-scale experiments in laboratory, field tests and natural analogue studies, have been included in the study. The test cases are described in terms of experimental design and types of available data. In addition, some quantitative examples of available data are given as well as references to more extensive documentation of the experiments on which the test cases are based. Fithteen test cases examples are given: 1 Mass transfer through clay by diffusion and advection. 2 Uranium migration in crystalline bore cores, small scale pressure infiltration experiments. 3 Radionuclide migration in single natural fractures in granite. 4 Tracer tests in a deep basalt flow top. 5 Flow and tracer experiment in crystalline rock based on the Stripa 3-D experiment. 6 Tracer experiment in a fracture zone at the Finnsjon research area. 7 Synthetic data base, based on single fracture migration experiments in Grimsel rock laboratory. 8 Natural analogue studies at Pocos de Caldas, Minais Gerais, Brazil. Redox-front and radionuclide movement in an open pit uranium mine. 9 Natural analogue studies at the Koongarra site in the Alligator Rivers area of the Northern Territory, Australia. 10 Large block migration experiments in a block of crystalline rock. 11 Unsaturated flow and transport experiments performed at Las Cruces, New Mexico. 12 Flow and transport experiment in unsaturated fractured rock performed at the Apache Leap Tuff site, Arizona. 13 Experiments in partially saturated tuffaceous rocks performed in the G-tunnel underground facility at the Nevada Test site, USA. 14 Experimental study of brine transport in porous media. 15 Groundwater flow in the vicinity of the Gorleben Salt Dome, Federal Republic of Germany

  9. Contributions to early HIV diagnosis among patients linked to care vary by testing venue

    Directory of Open Access Journals (Sweden)

    Trott Alexander T

    2008-06-01

    Full Text Available Abstract Objective Early HIV diagnosis reduces transmission and improves health outcomes; screening in non-traditional settings is increasingly advocated. We compared test venues by the number of new diagnoses successfully linked to the regional HIV treatment center and disease stage at diagnosis. Methods We conducted a retrospective cohort study using structured chart review of newly diagnosed HIV patients successfully referred to the region's only HIV treatment center from 1998 to 2003. Demographics, testing indication, risk profile, and initial CD4 count were recorded. Results There were 277 newly diagnosed patients meeting study criteria. Mean age was 33 years, 77% were male, and 46% were African-American. Median CD4 at diagnosis was 324. Diagnoses were earlier via partner testing at the HIV treatment center (N = 8, median CD4 648, p = 0.008 and with universal screening by the blood bank, military, and insurance companies (N = 13, median CD4 483, p = 0.05 than at other venues. Targeted testing by health care and public health entities based on patient request, risk profile, or patient condition lead to later diagnosis. Conclusion Test venues varied by the number of new diagnoses made and the stage of illness at diagnosis. To improve the rate of early diagnosis, scarce resources should be allocated to maximize the number of new diagnoses at screening venues where diagnoses are more likely to be early or alter testing strategies at test venues where diagnoses are traditionally made late. Efforts to improve early diagnosis should be coordinated longitudinally on a regional basis according to this conceptual paradigm.

  10. Case studies in ultrasonic testing

    International Nuclear Information System (INIS)

    Prasad, V.; Satheesh, C.; Varde, P.V.

    2015-01-01

    Ultrasonic testing is widely used Non Destructive Testing (NDT) method and forms the essential part of In-service inspection programme of nuclear reactors. Main application of ultrasonic testing is for volumetric scanning of weld joints followed by thickness gauging of pipelines and pressure vessels. Research reactor Dhruva has completed the first In Service Inspection programme in which about 325 weld joints have been volumetrically scanned, in addition to thickness gauging of 300 meters of pipe lines of various sizes and about 24 nos of pressure vessels. Ultrasonic testing is also used for level measurements, distance measurements and cleaning and decontamination of tools. Two case studies are brought out in this paper in which ultrasonic testing is used successfully for identification of butterfly valve opening status and extent of choking in pipe lines in Dhruva reactor systems

  11. Theory Testing Using Case Studies

    DEFF Research Database (Denmark)

    Sørensen, Pernille Dissing; Løkke, Ann-Kristina

    2006-01-01

    design. Finally, we discuss the epistemological logic, i.e., the value to larger research programmes, of such studies and, following Lakatos, conclude that the value of theory-testing case studies lies beyond naïve falsification and in their contribution to developing research programmes in a progressive...

  12. Laparoscopic hysterectomy with bilateral orchidectomy for Persistent Mullerian duct syndrome with seminoma testes: Case report

    Directory of Open Access Journals (Sweden)

    Senthilnathan Palanisamy

    2015-01-01

    Full Text Available Persistent Mullerian duct syndrome (PMDS is one of the three rare intersex disorders caused by defective anti-mullerian hormone or its receptor, characterized by undescended testes with presence of underdeveloped derivatives of mullerian duct in genetically male infant or adult with normal external genitals and virilization. This population will essentially have normal, 46(XY, phenotype. We hereby present a case of PMDS, presented with incarcerated left inguinal hernia associated with cryptorchidism and seminoma of right testes. Patient underwent laparoscopic hernia repair with bilateral orchidectomy and hysterectomy with uneventful postoperative recovery. Here we highlight the importance of minimal access approach for this scenario in terms of better visualization, less blood loss, combining multiple procedures along with early return to work and excellent cosmetic outcome.

  13. Empirical Test Case Specification

    DEFF Research Database (Denmark)

    Kalyanova, Olena; Heiselberg, Per

    This document includes the empirical specification on the IEA task of evaluation building energy simulation computer programs for the Double Skin Facades (DSF) constructions. There are two approaches involved into this procedure, one is the comparative approach and another is the empirical one. I....... In the comparative approach the outcomes of different software tools are compared, while in the empirical approach the modelling results are compared with the results of experimental test cases....

  14. Completed suicide in an autopsy-confirmed case of early onset Alzheimer's disease.

    Science.gov (United States)

    Hartzell, Jennifer Wiener; Geary, Richard; Gyure, Kymberly; Chivukula, Venkata Ravi; Haut, Marc W

    2018-04-01

    We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it. The case is discussed in the context of literature differentiating the neural circuitry propagating impulsive versus planned suicidal acts.

  15. Investigating Alternatives to the Fish Early Life-Stage Test: A Strategy for Discovering and Annotating Adverse Outcome Pathways for Early Fish Development

    Science.gov (United States)

    The fish early life-stage (FELS) test (OECD Test Guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an on-going effort to develop efficient and cost-effec...

  16. Test Reviews: Ginsburg, H., & Baroody, A. (2003). "Test of Early Mathematics Ability--Third Edition." Austin, TX: Pro-Ed

    Science.gov (United States)

    Bliss, Stacy

    2006-01-01

    The Test of Early Mathematics Ability--Third Edition (TEMA-3) is a norm-referenced parallel forms test intended to identify the level of mathematical ability for children aged 3 years 0 months through 8 years 11 months. According to the authors, the instrument can also be used as a criterion referenced or diagnostic tool for older students who are…

  17. EARLY TESTS OF DRUM TYPE PACKAGINGS - THE LEWALLEN REPORT

    Energy Technology Data Exchange (ETDEWEB)

    Smith, A.

    2010-07-29

    The need for robust packagings for radioactive materials (RAM) was recognized from the earliest days of the nuclear industry. The U.S. Department of Energy (DOE) Rocky Flats Plant developed a packaging for shipment of Pu in the early 1960's, which became the U.S. Department of Transportation (DOT) 6M specification package. The design concepts were employed in other early packagings. Extensive tests of these at Savannah River Laboratory (now Savannah River National Laboratory) were performed in 1969 and 1970. The results of these tests were reported in 'Drum and Board-Type Insulation Overpacks of Shipping Packages for Radioactive Materials', by E. E. Lewallen. The Lewallen Report was foundational to design of subsequent drum type RAM packaging. This paper summarizes this important early study of drum type packagings. The Lewallen Report demonstrated the ability packagings employing drum and insulation board overpacks and engineered containment vessels to meet the Type B package requirements. Because of the results of the Lewallen Report, package designers showed high concern for thermal protection of 'Celotex'. Subsequent packages addressed this by following strategies like those recommended by Lewallen and by internal metal shields and supplemental, encapsulated insulation disks, as in 9975. The guidance provide by the Lewallen Report was employed in design of a large number of drum size packagings over the following three decades. With the increased public concern over transportation of radioactive materials and recognition of the need for larger margins of safety, more sophisticated and complex packages have been developed and have replaced the simple packagings developed under the Lewallen Report paradigm.

  18. Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

    Science.gov (United States)

    Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

    2017-12-14

    This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

  19. Discovery Channel Telescope active optics system early integration and test

    Science.gov (United States)

    Venetiou, Alexander J.; Bida, Thomas A.

    2012-09-01

    The Discovery Channel Telescope (DCT) is a 4.3-meter telescope with a thin meniscus primary mirror (M1) and a honeycomb secondary mirror (M2). The optical design is an f/6.1 Ritchey-Chrétien (RC) with an unvignetted 0.5° Field of View (FoV) at the Cassegrain focus. We describe the design, implementation and performance of the DCT active optics system (AOS). The DCT AOS maintains collimation and controls the figure of the mirror to provide seeing-limited images across the focal plane. To minimize observing overhead, rapid settling times are achieved using a combination of feed-forward and low-bandwidth feedback control using a wavefront sensing system. In 2011, we mounted a Shack-Hartmann wavefront sensor at the prime focus of M1, the Prime Focus Test Assembly (PFTA), to test the AOS with the wavefront sensor, and the feedback loop. The incoming wavefront is decomposed using Zernike polynomials, and the mirror figure is corrected with a set of bending modes. Components of the system that we tested and tuned included the Zernike to Bending Mode transformations. We also started open-loop feed-forward coefficients determination. In early 2012, the PFTA was replaced by M2, and the wavefront sensor moved to its normal location on the Cassegrain instrument assembly. We present early open loop wavefront test results with the full optical system and instrument cube, along with refinements to the overall control loop operating at RC Cassegrain focus.

  20. The universe of ANA testing: a case for point-of-care ANA testing.

    Science.gov (United States)

    Konstantinov, Konstantin N; Rubin, Robert L

    2017-12-01

    Testing for total antinuclear antibodies (ANA) is a critical tool for diagnosis and management of autoimmune diseases at both the primary care and subspecialty settings. Repurposing of ANA from a test for lupus to a test for any autoimmune condition has driven the increase in ANA requests. Changes in ANA referral patterns include early or subclinical autoimmune disease detection in patients with low pre-test probability and use of negative ANA results to rule out underlying autoimmune disease. A positive result can lead to further diagnostic considerations. Currently, ANA tests are performed in centralized laboratories; an alternative would be ANA testing at the clinical point-of-care (POC). By virtue of its near real-time data collection capability, low cost, and ease of use, we believe the POC ANA has the potential to enable a new paradigm shift in autoimmune serology testing.

  1. Early universe cosmology and tests of fundamental physics

    International Nuclear Information System (INIS)

    Albrecht, Andreas; Frieman, Joshua A.; Trodden, Mark

    2002-01-01

    This is the report of the Working Group on Early Universe Cosmology and tests of Fundamental Physics, group P4.8 of the of the Snowmass 2001 conference. Here we summarize the impressive array of advances that have taken place in this field, and identify opportunities for even greater progress in the future. Topics include Dark Energy, Cosmic Acceleration, Inflation, Phase Transitions, Baryogenesis, and String/M-theory Cosmology. The introductory section gives an executive summary with six key open questions on which we can expect to make significant progress

  2. Increased Syphilis Testing of Men Who Have Sex With Men: Greater Detection of Asymptomatic Early Syphilis and Relative Reduction in Secondary Syphilis.

    Science.gov (United States)

    Chow, Eric P F; Callander, Denton; Fairley, Christopher K; Zhang, Lei; Donovan, Basil; Guy, Rebecca; Lewis, David A; Hellard, Margaret; Read, Phillip; Ward, Alison; Chen, Marcus Y

    2017-08-01

    Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  3. Case of early pelviolumeral progressive muscular dystrophy associated with marked heart affection

    International Nuclear Information System (INIS)

    Gor'kova, N.B.; Starykh, L.M.; Karpova, L.E.

    1991-01-01

    A case of early pelviolumeral progressive muscular dystrophy detected in childhood and associated with marked heart affection is described. Patient underwent multimodality examination, including ECG, ultrasonography, roentgenography. It is shown that patients with progressive muscular dystrophy should receive medical supervision and treatment of both neuropathologist and therapist

  4. Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests.

    Science.gov (United States)

    Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

    2013-07-27

    To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding variables included low data quality, alternative diagnoses, poor exclusion of important other causes, and comedication by drugs and herbs in 6/8 cases. More specifically, problems were evident in some cases regarding temporal association, daily doses, exact start and end dates of product use, actual data of laboratory parameters such as ALT, and exact dechallenge characteristics. Shortcomings included scattered exclusion of hepatitis A-C, cytomegalovirus and Epstein Barr virus infection with only globally presented or lacking parameters. Hepatitis E virus infection was considered in one single patient and found positive, infections by herpes simplex virus and varicella zoster virus were excluded in none. Only one case fulfilled positive reexposure test criteria in initially assumed Herbalife hepatotoxicity, with lower CIOMS based causality gradings for the other cases than hitherto proposed.

  5. Diagnostic challenges of early Lyme disease: Lessons from a community case series

    Directory of Open Access Journals (Sweden)

    Schwarzwalder Alison

    2009-06-01

    Full Text Available Abstract Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61% of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations.

  6. Relationship between postoperative erythromycin breath test and early morbidity in liver transplant recipients

    DEFF Research Database (Denmark)

    Schmidt, Lars E; Rasmussen, Allan; Kirkegaard, Preben

    2003-01-01

    of cyclosporine and tacrolimus nephrotoxicity, episodes of early graft rejection, early graft function, and graft survival. RESULTS: Cyclosporine and tacrolimus nephrotoxicity were associated with low postoperative ERMBT values (mean 0.63%+/-0.25% 14C/hr vs. 1.35%+/-0.84% 14C/hr, P=0.02). No significant...... association between early graft rejection and ERMBT values was demonstrated. There was a significant inverse correlation between postoperative ERMBT values and the time to normalization of international normalized ratio as a measure of early graft function (r=-0.78, PGraft loss was associated......BACKGROUND: Interindividual variability in dosage requirements of the calcineurin inhibitor immunosuppressive agents cyclosporine and tacrolimus after liver transplantation may result from differences in the CYP3A activity of the liver graft. Early postoperative erythromycin breath test (ERMBT...

  7. Turbine-missile casing exit tests

    International Nuclear Information System (INIS)

    Yoshimura, H.R.; Sliter, G.E.

    1978-01-01

    Nuclear power plant designers are required to provide safety-related components with adequate protection against hypothetical turbine-missile impacts. In plants with a ''peninsula'' arrangement, protection is provided by installing the turbine axis radially from the reactor building, so that potential missile trajectories are not in line with the plant. In plants with a ''non-peninsula'' arrangement (turbine axis perpendicular to a radius), designers rely on the low probability of a missile strike and on the protection provided by reinforced concrete walls in order to demonstrate an adequate level of protection USNRC Regulatory Guide 1.115). One of the critical first steps in demonstrating adequacy is the determination of the energy and spin of the turbine segments as they exit the turbine casing. The spin increases the probability that a subsequent impact with a protective barrier will be off-normal and therefore less severe than the normal impact assumed in plant designs. Two full-scale turbine-missile casing exit tests which were conducted by Sandia Laboratories at their rocket-sled facility in Albuquerque, New Mexico, are described. Because of wide variations in turbine design details, postulated failure conditions, and missile exit scenarios, the conditions for the two tests were carefully selected to be as prototypical as possible, while still maintaining the well-controlled and well-characterized test conditions needed for generating benchmark data

  8. Maternal hair testing for the assessment of fetal exposure to drug of abuse during early pregnancy: Comparison with testing in placental and fetal remains.

    Science.gov (United States)

    Falcon, M; Pichini, S; Joya, J; Pujadas, M; Sanchez, A; Vall, O; García Algar, O; Luna, A; de la Torre, R; Rotolo, M C; Pellegrini, M

    2012-05-10

    Drug use by pregnant women in the first trimester of pregnancy and subsequent fetal exposure during early gestation can be assessed only by repetitive/systematic maternal blood/urine analysis or segmental hair analysis. No evidence of any relationship between maternal/fetal exposure during this specific period of gestation has been demonstrated to date in a human model. To clarify drugs toxicokinetics and transplacental passage during early pregnancy, the presence of the most widely used recreational drugs of abuse and metabolites was investigated in the proximal 4cm hair segments of women undergoing voluntary termination of pregnancy (n=280) during the 12th week of gestation and the results were compared to those from placenta and fetal tissue samples in order to verify whether maternal hair testing can reflect fetal exposure and, if so, to what extent. Hair, placenta and fetal remains were analyzed by validated gas chromatography mass spectrometry assays. Eighty one positive hair samples were identified: 60 were positive for cannabis (74.1%), 28 for cocaine (34.6%), 7 for opiates (8.6%), 3 for MDMA (3.7%) and 18.5% were positive for more than one drug. The positive hair test results were confirmed in placenta/fetal tissues in 10 cases out of 60 for cannabis (16. 7%); in 7 out of 28 for cocaine (25%); and none for the 6 opiates positive cases and 3 MDMA cases, respectively. Drugs/metabolites in hair of pregnant women can be used as biomarkers of past drug use (repetitive or sporadic), although the use is not always reflected in fetal/placental tissues. There are several possible hypotheses to explain the results: (1) the use occurred before the start of pregnancy, (2) past sporadic consumption which could be measured in hair but not in fetal and placental remains because of the narrow window of drug detection in placental/fetal tissues; (3) the sensitivity of the analytical methods was not high enough for the detection of the minute amount of drugs of abuse and

  9. Test of TEDA, Tsunami Early Detection Algorithm

    Science.gov (United States)

    Bressan, Lidia; Tinti, Stefano

    2010-05-01

    Tsunami detection in real-time, both offshore and at the coastline, plays a key role in Tsunami Warning Systems since it provides so far the only reliable and timely proof of tsunami generation, and is used to confirm or cancel tsunami warnings previously issued on the basis of seismic data alone. Moreover, in case of submarine or coastal landslide generated tsunamis, which are not announced by clear seismic signals and are typically local, real-time detection at the coastline might be the fastest way to release a warning, even if the useful time for emergency operations might be limited. TEDA is an algorithm for real-time detection of tsunami signal on sea-level records, developed by the Tsunami Research Team of the University of Bologna. The development and testing of the algorithm has been accomplished within the framework of the Italian national project DPC-INGV S3 and the European project TRANSFER. The algorithm is to be implemented at station level, and it is based therefore only on sea-level data of a single station, either a coastal tide-gauge or an offshore buoy. TEDA's principle is to discriminate the first tsunami wave from the previous background signal, which implies the assumption that the tsunami waves introduce a difference in the previous sea-level signal. Therefore, in TEDA the instantaneous (most recent) and the previous background sea-level elevation gradients are characterized and compared by proper functions (IS and BS) that are updated at every new data acquisition. Detection is triggered when the instantaneous signal function passes a set threshold and at the same time it is significantly bigger compared to the previous background signal. The functions IS and BS depend on temporal parameters that allow the algorithm to be adapted different situations: in general, coastal tide-gauges have a typical background spectrum depending on the location where the instrument is installed, due to local topography and bathymetry, while offshore buoys are

  10. Generating custom test plans for CASE{sup *}Dictionary 5.0

    Energy Technology Data Exchange (ETDEWEB)

    Atkins, K.D. [Boeing Computer Services, Richland, WA (United States)

    1994-04-01

    Most database development organizations use a formal software development methodology that requires a certain amount of formal testing. The amount of formal testing that will be performed will vary from methodology to methodology and from site to site. If a very detailed formal test plan is required for each module in a system, the work involved to produce the test plan can be tedious and costly. After a system has been designed and developed using Oracle*CASE, there is much useful information in the CASE*Dictionary repository. If this information could be tied to specific test requirements, a test plan could be generated automatically, saving much time and resources. This paper shows how CASE*Dictionary can be used to store test plan information that can then be used to generate a specific test plan for each module based on it`s detailed data usage.

  11. Early MRI findings in stab wound of the cervical spine: two case reports

    Energy Technology Data Exchange (ETDEWEB)

    Alkan, A.; Baysal, T.; Sarac, K.; Sigirci, A.; Kutlu, R. [Inonu Universitesi Turgut Ozal Tip Merkezi, Radyoloji Anabilim Dali, Malatya (Turkey)

    2002-01-01

    MR imaging was found to be the most sensitive modality for the detection of spinal cord abnormalities in the acutely injured spine. Although it is reported that traumatic pneumomyelogram indicates a base-of-skull or middle cranial fossa fracture and is almost certainly associated with intracranial subarachnoid air, early MR imaging may demonstrate subarachnoid air in penetrating trauma of the spinal cord without head injury. We report two cervical-spine stab-wound cases, one of which had subarachnoid air on early MR findings. (orig.)

  12. Sensing the danger. Can tsunami early warning systems benefit from test ban monitoring?

    International Nuclear Information System (INIS)

    Zerbo, L.

    2005-01-01

    An editorial in the February 2005 edition of the Magazine for European Research pointed to the very issue of responsibility: Improvements are always possible, of course, but the very nature of a 'natural disaster' is that while not entirely absolving humans of responsibility it surpasses our means to deal with and even understand the forces at work. But science can help enhance our knowledge. For if there is one subject that the Asian tragedy has highlighted, it is the importance of putting in place coordinated early warning systems for earthquakes and, in particular, the absence of effective monitoring of tsunamis in the Indian Ocean. A concerted effort is now being made to develop a coordinated system of systems - bringing together organizations and initiatives that together can put in place an early warning system. The Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO), set-up to monitor adherence to the Comprehensive Nuclear-Test-Ban Treaty, is one organization seen to contribute to a coordinated early warning system

  13. GENERATING TEST CASES FOR PLATFORM INDEPENDENT MODEL BY USING USE CASE MODEL

    OpenAIRE

    Hesham A. Hassan,; Zahraa. E. Yousif

    2010-01-01

    Model-based testing refers to testing and test case generation based on a model that describes the behavior of the system. Extensive use of models throughout all the phases of software development starting from the requirement engineering phase has led to increased importance of Model Based Testing. The OMG initiative MDA has revolutionized the way models would be used for software development. Ensuring that all user requirements are addressed in system design and the design is getting suffic...

  14. The Early Start Denver Model: A Case Study of an Innovative Practice

    Science.gov (United States)

    Vismara, Laurie A.; Rogers, Sally J.

    2008-01-01

    Intervention was implemented with an infant identified at 9 months of age with a behavioral profile consistent with autistic spectrum disorder. The intervention approach, the Early Start Denver model, consisted of a 12-week, 1.5-hr-per-week individualized parent-child education program. Results of this case study demonstrated that the parent…

  15. Prioritizing Test Cases for Memory Leaks in Android Applications

    Institute of Scientific and Technical Information of China (English)

    Ju Qian; Di Zhou

    2016-01-01

    Mobile applications usually can only access limited amount of memory. Improper use of the memory can cause memory leaks, which may lead to performance slowdowns or even cause applications to be unexpectedly killed. Although a large body of research has been devoted into the memory leak diagnosing techniques after leaks have been discovered, it is still challenging to find out the memory leak phenomena at first. Testing is the most widely used technique for failure discovery. However, traditional testing techniques are not directed for the discovery of memory leaks. They may spend lots of time on testing unlikely leaking executions and therefore can be inefficient. To address the problem, we propose a novel approach to prioritize test cases according to their likelihood to cause memory leaks in a given test suite. It firstly builds a prediction model to determine whether each test can potentially lead to memory leaks based on machine learning on selected code features. Then, for each input test case, we partly run it to get its code features and predict its likelihood to cause leaks. The most suspicious test cases will be suggested to run at first in order to reveal memory leak faults as soon as possible. Experimental evaluation on several Android applications shows that our approach is effective.

  16. Early postoperative dislocation of the anterior Maverick lumbar disc prosthesis: report of 2 cases.

    Science.gov (United States)

    Gragnaniello, Cristian; Seex, Kevin A; Eisermann, Lukas G; Claydon, Matthew H; Malham, Gregory M

    2013-08-01

    The authors report on 2 cases of anterior dislocation of the Maverick lumbar disc prosthesis, both occurring in the early postoperative period. These cases developed after experience with more than 50 uneventful cases and were therefore thought to be unrelated to the surgeon's learning curve. No similar complications have been previously reported. The anterior Maverick device has a ball-and-socket design made of cobalt-chromium-molybdenum metal plates covered with hydroxyapatite. The superior and inferior endplates have keels to resist translation forces. The patient in Case 1 was a 52-year-old man with severe L4-5 discogenic pain; and in Case 2, a 42-year-old woman with disabling L4-5 and L5-S1 discogenic back pain. Both patients were without medical comorbidities and were nonsmokers with no risk factors for osteoporosis. Both had undergone uneventful retroperitoneal approaches performed by a vascular access surgeon. Computed tomography studies on postoperative Day 2 confirmed excellent prosthesis placement. Initial recoveries were uneventful. Two weeks postoperatively, after stretching (extension or hyperextension) in bed at home, each patient suffered the sudden onset of severe abdominal pain with anterior dislocation of the Maverick prosthesis. The patients were returned to the operating room and underwent surgery performed by the same spinal and vascular surgeons. Removal of the Maverick prosthesis and anterior interbody fusion with a separate cage and plate were performed. Both patients had recovered well with good clinical and radiological recovery at the 6- and 12-month follow-ups. Possible causes of the anterior dislocation of the Maverick prosthesis include the following: 1) surgeon error: In both cases the keel cuts were neat, and early postoperative CT confirmed good placement of the prosthesis; 2) equipment problem: The keel cuts may have been too large because the cutters were worn, which led to an inadequate press fit of the implants; 3) prosthesis

  17. [The early pregnancy factor (EPF) as an early marker of disorders in pregnancy].

    Science.gov (United States)

    Straube, W; Römer, T; Zeenni, L; Loh, M

    1995-01-01

    The early pregnancy factor (EPF) seems to be very helpful in clinical applications such as early detection of pregnancy, differential diagnosis of failure of fertilization or implementation and prognosis of a fertilized ovum. Our purpose was to investigate the diagnostic value of single and serial measurement of EPF, especially in the differential diagnosis of abortion and extrauterine pregnancy. Women with a history of 6-16 weeks amenorrhoea with/without vaginal bleeding were included in the prospective study. The EPF-test system was carried out by means of the rosette inhibition method. EPF proved to be always positive in normal pregnant women and always negative in nonpregnant controls. In case of threatened abortion the prognosis was good, when the EPF values were positive, and poor when they became negative. Patients suffering from spontaneous and missed abortion mostly showed negative EPF-values. This was also true in ectopic pregnancies. The sensitivity and specificity of EPF-test system were 83%. The positive predictive value was observed to be 54% and the negative predictive value 95%. The EPF as an early embryonic signal may be a suitable parameter for the clinical use detecting pregnancy disturbances very early.

  18. Automatic WSDL-guided Test Case Generation for PropEr Testing of Web Services

    Directory of Open Access Journals (Sweden)

    Konstantinos Sagonas

    2012-10-01

    Full Text Available With web services already being key ingredients of modern web systems, automatic and easy-to-use but at the same time powerful and expressive testing frameworks for web services are increasingly important. Our work aims at fully automatic testing of web services: ideally the user only specifies properties that the web service is expected to satisfy, in the form of input-output relations, and the system handles all the rest. In this paper we present in detail the component which lies at the heart of this system: how the WSDL specification of a web service is used to automatically create test case generators that can be fed to PropEr, a property-based testing tool, to create structurally valid random test cases for its operations and check its responses. Although the process is fully automatic, our tool optionally allows the user to easily modify its output to either add semantic information to the generators or write properties that test for more involved functionality of the web services.

  19. A Case of Uterine Prolapse Complicating Pregnancy in Early Second Trimester

    Directory of Open Access Journals (Sweden)

    Necmiye Döver

    2011-12-01

    estimate disease prevalence.But uterine prolapse is a rare condition during pregnancy which can be complicated with severe maternal and neonatal outcomes.We report a case of uterine prolapse and cervical alongation which is first diagnosed at the 17th week of gestation.After the recognation, the patent is administered by both conservative and then non-surgical(pessary managements. Unique part about our case is early gestastional age at the time of diagnosis and the fact that our patient had only one previous vaginal delivery and no more risk factors for a pelvic organ prolapse with new-onset uterine prolapse in her current(secondpregnancy.In majority of cases pregnancy is superimposed on a preexisting prolapse.Prolapse occurs as a result of relaxation and tearing down of the supportive structures.

  20. Development and feasibility of smartphone application for cognitive-behavioural case management of individuals with early psychosis.

    Science.gov (United States)

    Kim, Sung-Wan; Lee, Ga-Young; Yu, Hye-Young; Jung, Eun-I; Lee, Ju-Yeon; Kim, Seon-Young; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

    2017-05-18

    This article describes the development of the smartphone application for cognitive-behavioural case management of young individuals with early psychosis and examines the acceptance and potential clinical benefits of this application through a pilot survey. Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (Heal Your Mind [HYM]) for cognitive-behavioural case management and symptom monitoring. The HYM application for clients includes 6 main modules including thought record, symptom record, daily life record, official notices, communication and scales. The key module is the "thought record" for self-directed cognitive-behavioural treatment. When the client writes and sends the self-cognitive-behavioural therapy sheet to the case manager, the latter receives a notification and can provide feedback in real time. We conducted a survey to investigate the acceptance and feasibility of this approach among young clients with early psychosis. A total of 24 clients with early psychosis participated in this survey. More than 80% of participants reported that it was easy to learn to use this application, and no one described this application as very complicated or reported that they needed a long time to learn how to use it. About 80% of participants were satisfied with this application, and 70% reported that they received help as a result of using this application. This study suggests that this smartphone application is useful for young individuals with early psychosis and that it may contribute to the development of both young customer- and case manager-friendly systems for this clinical population. © 2017 John Wiley & Sons Australia, Ltd.

  1. Developing and testing an Early Warning System for Non Indigenous Species and Ballast Water Management

    Science.gov (United States)

    Magaletti, Erika; Garaventa, Francesca; David, Matej; Castriota, Luca; Kraus, Romina; Luna, Gian Marco; Silvestri, Cecilia; Forte, Cosmo; Bastianini, Mauro; Falautano, Manuela; Maggio, Teresa; Rak, Giulietta; Gollasch, Stephan

    2018-03-01

    This paper describes the methodological approach used for the development of an Early Warning System (EWS) for Non Indigenous Species (NIS) and ballast water management and summarizes the results obtained. The specific goals of the EWS are firstly to warn vessels to prevent loading of ballast water when critical biological conditions occur in ports and surrounding areas i.e. mass development or blooms of Harmful Aquatic Organisms and Pathogens (HAOP). Secondly, to warn environmental and health authorities when NIS or pathogens are present in ports or surrounding areas to enable an early response and an implementation of remediation measures. The EWS is designed to be used for implementing various parallel obligations, by taking into consideration different legal scopes, associated information and decision-making needs. The EWS was elaborated, tested in the Adriatic Sea and illustrated by two case studies. Although the EWS was developed with an Adriatic Sea focus, it is presented in a format so that it may be used as a model when establishing similar systems in other locations. The role of the various actors is discussed and recommendations on further developments of the EWS are presented. It was concluded that the EWS is a suitable tool to reduce the spread of potentially harmful and ballast water mediated species.

  2. Osteosarcoma of the mandible: A case report with an early radiographic manifestation

    Energy Technology Data Exchange (ETDEWEB)

    Samraj, Lavanya; Venkatapathy, Ramesh; Oza, Nirima [Dept. of Oral Pathology and Microbiology, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Pondicherry (India); Kaliamoorthy, Sriram [Dept. of Oral and Maxillofacial Pathology, Chettinad Dental College and Research Institute, Tamilnadu (India)

    2014-03-15

    Osteosarcoma is a classical malignant bone-forming neoplasm which usually presents with an aggressive clinical course. The current case is presented with the radiographic feature of widening of the periodontal ligament space of the involved teeth, which is considered to be the earliest radiographic manifestation of osteosarcoma involving the jaw bone. The main aim of this case report was to focus on the importance of early diagnosis of this tumor based on clinical and radiographic examinations, and confirmation by histopathology. Considering the rarity of the disease type and particularly taking into account the fast progression and aggressiveness of this neoplasm, it is clear that the presentation of a clinical case represents a major contribution to better understanding of osteosarcomas involving the jaw bone.

  3. Early Orthodontic Tooth Movement into Regenerative Bony Defects: A Case Report.

    Science.gov (United States)

    Tsai, Hui-Chen; Yao, Chung-Chen Jane; Wong, Man-Ying

    Early orthodontic tooth movement following regenerative surgery is controversial. In this case, during protraction of the maxillary right first premolar to substitute for the long-term missing maxillary right canine, Bio-Oss and Bio-Gide were used for lateral ridge augmentation at the area of the maxillary right lateral incisor and to cover the denuded surface at the buccal side of the first premolar. Orthodontic tooth movement (OTM) commenced 2 weeks after regenerative surgery. After 8 months, new bone formation was observed on the root surface of the first premolar during implant surgery. A cone beam computed tomography scan taken 1.5 years postsurgery revealed good maintenance of regenerative bone at the same site. This satisfactory outcome of early OTM following regenerative surgery suggests biomechanical stimulation may not jeopardize the regenerative effect.

  4. Effect of alpha amylase on early childhood caries: a matched case-control study

    OpenAIRE

    Mojarad, Farzad; Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan; Fazlollahifar, Samira; Department of Pediatric Dentistry, School of Dentistry, Hamadan University of Medical Sciences, Hamadan; Poorolajal, Jalal; Research Center for Health Sciences, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan; Hajilooi, Mehrdad; Department of Pathology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan

    2013-01-01

    Objectives: There are a few studies addressing the relationship between salivary alpha-amylase and dental caries. This study was implemented in order to investigate the effect of salivary alpha-amylase level on early childhood caries (ECC).Materials and Methods: In this matched case-control study, which was carried out from November 2011 to March 2012 in Hamadan City, the west of Iran, mean levels of salivary alpha-amylase of 84 ECC-active cases were compared to that of 84 ECC-free controls u...

  5. A case of short-coupled premature ventricular beat-induced ventricular fibrillation with early repolarization in the inferolateral leads

    Directory of Open Access Journals (Sweden)

    Hidekazu Kondo, MD

    2015-02-01

    Full Text Available This case report describes a 19-year-old man with early repolarization (ER in the inferolateral leads and a normal QT interval who survived a cardiac arrest that was likely related to polymorphic ventricular tachycardia (VT. Electrocardiograms (ECGs also showed unifocal premature ventricular beats (PVBs with a relatively narrow QRS duration. A Holter ECG documented occasional short-coupled PVBs following non-sustained VTs. Pharmacological stress testing was also performed to assess the effects of anti-arrhythmic drugs on ER (the J wave and PVBs. We performed successful radiofrequency catheter ablation to prevent the recurrence of ventricular fibrillation after cardioverter-defibrillator implantation.

  6. IgD, cyclooxygenase-2 and ribosomal protein S6-PS240 immune response in a case of early psoriasis

    Directory of Open Access Journals (Sweden)

    Ana Maria Abreu Velez

    2018-02-01

    Full Text Available Psoriasis is an inflammatory skin disease. Five classic types of psoriasis have been defined: plaque, inverse, pustular, guttate, and erythrodermic. The early psoriasis immunologic skin immune response is not well understood. Here we aim to show an immune and cell signaling response in a case of early psoriasis. A 56 year old female presented with a desquamative lesion on her right leg. A skin biopsy for hematoxylin and eosin (H&E and immunohistochemistry (IHC staining was taken. The diagnosis indicated early psoriasis, and IHC showed positive IgD staining in the epidermal corneal layer, as well as positive staining with ribosomal protein S6-pS240 (RIBO in the hyperproliferative epidermis. Cyclooxygenase-2 (COX-2 was also very positive in the granular layer in spots, at the basement membrane zone of the skin and in the inflammatory infiltrate in the dermis subjacent to hyperproliferative psoriatic areas. In an early case of psoriasis, we confirmed the presence of IgD, RIBO and COX-2. Each molecule seems to be playing a role in inflammation and intracellular signaling pathways in early psoriasis. The role of IgD is unknown, and this case brings to light the complexity of the pathologic changes occurring in early psoriatic lesions.

  7. An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study.

    Science.gov (United States)

    Norkuviene, Eleonora; Petraitis, Mykolas; Apanaviciene, Indre; Virviciute, Dalia; Baranauskaite, Asta

    2017-08-01

    Objective To identify the optimal sites for classification of early gout by ultrasonography. Methods Sixty patients with monosodium urate crystal-proven gout (25 with early gout [≤2-year symptom duration], 35 with late gout [>2-year symptom duration], and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign. Results Ultrasonographic sensitivity was lower in early than late gout. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint [odds ratio, 16.46] and the DC sign in the ankle [odds ratio, 25.18]) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). The inter-reader reliability kappa value for the DC sign and tophi was 0.712. Conclusions Four-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice.

  8. Sample test cases using the environmental computer code NECTAR

    International Nuclear Information System (INIS)

    Ponting, A.C.

    1984-06-01

    This note demonstrates a few of the many different ways in which the environmental computer code NECTAR may be used. Four sample test cases are presented and described to show how NECTAR input data are structured. Edited output is also presented to illustrate the format of the results. Two test cases demonstrate how NECTAR may be used to study radio-isotopes not explicitly included in the code. (U.K.)

  9. RELATIONAL HEALING OF EARLY AFFECT-CONFUSION - PART 3 OF A CASE STUDY TRILOGY

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2015-06-01

    Full Text Available Part 3 of a case study trilogy on early affect-confusion describes the use of therapeutic dialogue, relational presence and supportive age regression in the psychotherapy of a client who lived on a “borderline” of early affect confusion. The concepts and methods of an in-depth, integrative and relational psychotherapy include a sensitivity to the client’s physiological and emotional expressions of implicit and sub-symbolic memories, therapeutic inference, an awareness of the client’s relational-needs, the effective use of a developmental image, as well the identification of an introjected other and the use of therapeutic interposition.

  10. Early-onset baldness and the risk of aggressive prostate cancer: findings from a case-control study.

    Science.gov (United States)

    Papa, Nathan P; MacInnis, Robert J; English, Dallas R; Bolton, Damien; Davis, Ian D; Lawrentschuk, Nathan; Millar, Jeremy L; Severi, Gianluca; Hopper, John L; Giles, Graham G

    2018-01-01

    We aimed to evaluate the associations between androgenetic alopecia at a young age and subsequent development of aggressive prostate cancer (PC). Using a case-control design with self-administered questionnaire, we evaluated the association between aggressive PC and very early-onset balding at age 20, and early-onset balding at age 40 years in 1,941 men. Cases were men with high-grade and/or advanced stage cancer and controls were clinic based men who had undergone biopsy and were found to be histologically cancer negative. Additionally, for cases we assessed whether early-onset balding was associated with earlier onset of disease. Men with very early-onset balding at age 20 years were at increased risk for subsequent aggressive PC [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.07-2.12] after adjustment for age at baseline, family history of PC, smoking status, alcohol intake, body shape, timing of growth spurt and ejaculatory frequency. Additionally, these men were diagnosed with PC approximately 16 months earlier than cases without the exposure. The effect was present particularly for men with advanced stage pT3+ disease (OR 1.68, 95% CI 1.14-2.47) while men with organ-confined high-grade (8-10) PC did not exhibit the same relationship. No significant associations were observed for men who were balding at age 40 years, given no balding at age 20. Men with androgenetic alopecia at age 20 years are at increased risk of advanced stage PC. This small subset of men are potentially candidates for earlier screening and urological follow-up.

  11. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases

    Energy Technology Data Exchange (ETDEWEB)

    Miyata, Naoko, E-mail: n.miyata@scchr.jp [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Endo, Masahiro [Division of Diagnostic Radiology, Shizuoka Cancer Center Hospital (Japan); Nakajima, Takashi [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Kojima, Hideaki; Maniwa, Tomohiro; Takahashi, Shoji; Isaka, Mitsuhiro [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan); Kameya, Toru [Division of Pathology, Shizuoka Cancer Center Hospital (Japan); Ohde, Yasuhisa [Division of Thoracic Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi, Sunto-gun, Shizuoka 411-8777 (Japan)

    2015-05-15

    Highlights: • We clinicopathologically reviewed 22 cases of early mucinous adenocarcinoma. • Radiologically, all cases showed solid or part-solid nodules. • Lobular-bounded margins were observed in 7 cases. • The radiological features could be histologically attributed to mucin production. • One-third of the cases were preoperatively misdiagnosed as inflammatory nodules. - Abstract: Background: The pathological criteria of early-stage mucinous adenocarcinoma of the lung have recently been defined; however, its characteristic radiologic imaging findings are still poorly understood. Thus, this study aimed to clarify the radiologic and pathological findings of early-stage mucinous adenocarcinoma. Materials and methods: In this study, we clinicopathologically reviewed 22 cases of surgically resected mucinous adenocarcinoma in situ (AIS) and minimal invasive adenocarcinoma (MIA), and attempted to elucidate the characteristic radiologic features of early mucinous adenocarcinomas using high-resolution computed tomography (HRCT). Results: Radiologically, the mean value of the maximum diameter of 22 tumours was 2.1 cm (range, 1.0–2.9 cm). Based on the HRCT findings, the tumours were divided into part-solid ground glass nodules (n = 11) and solid nodules (n = 11). The mean CT attenuation value was 25.7 HU (range, 17–35 HU). All tumours, except 3 tumours pathologically diagnosed as AIS, showed air-containing features. According to the preoperative CT findings, 7 (35%) cases were diagnosed as inflammatory nodules. Of these, 4 cases had lobular-bounded margins, and 3 showed vaguely outlined ground glass shadows. Conclusion: The characteristic HRCT findings of mucinous AIS and MIA were solid or part-solid nodules with air-containing spaces. However, some AIS and MIA nodules showed lobular-bounded margins or marginally vaguely outlined ground glass shadows, and were difficult to differentiate from inflammatory nodules.

  12. High-resolution computed tomography findings of early mucinous adenocarcinomas and their pathologic characteristics in 22 surgically resected cases

    International Nuclear Information System (INIS)

    Miyata, Naoko; Endo, Masahiro; Nakajima, Takashi; Kojima, Hideaki; Maniwa, Tomohiro; Takahashi, Shoji; Isaka, Mitsuhiro; Kameya, Toru; Ohde, Yasuhisa

    2015-01-01

    Highlights: • We clinicopathologically reviewed 22 cases of early mucinous adenocarcinoma. • Radiologically, all cases showed solid or part-solid nodules. • Lobular-bounded margins were observed in 7 cases. • The radiological features could be histologically attributed to mucin production. • One-third of the cases were preoperatively misdiagnosed as inflammatory nodules. - Abstract: Background: The pathological criteria of early-stage mucinous adenocarcinoma of the lung have recently been defined; however, its characteristic radiologic imaging findings are still poorly understood. Thus, this study aimed to clarify the radiologic and pathological findings of early-stage mucinous adenocarcinoma. Materials and methods: In this study, we clinicopathologically reviewed 22 cases of surgically resected mucinous adenocarcinoma in situ (AIS) and minimal invasive adenocarcinoma (MIA), and attempted to elucidate the characteristic radiologic features of early mucinous adenocarcinomas using high-resolution computed tomography (HRCT). Results: Radiologically, the mean value of the maximum diameter of 22 tumours was 2.1 cm (range, 1.0–2.9 cm). Based on the HRCT findings, the tumours were divided into part-solid ground glass nodules (n = 11) and solid nodules (n = 11). The mean CT attenuation value was 25.7 HU (range, 17–35 HU). All tumours, except 3 tumours pathologically diagnosed as AIS, showed air-containing features. According to the preoperative CT findings, 7 (35%) cases were diagnosed as inflammatory nodules. Of these, 4 cases had lobular-bounded margins, and 3 showed vaguely outlined ground glass shadows. Conclusion: The characteristic HRCT findings of mucinous AIS and MIA were solid or part-solid nodules with air-containing spaces. However, some AIS and MIA nodules showed lobular-bounded margins or marginally vaguely outlined ground glass shadows, and were difficult to differentiate from inflammatory nodules

  13. Early testing of new sanitation technology for urban slums: The case of the Blue Diversion Toilet.

    Science.gov (United States)

    Tobias, Robert; O'Keefe, Mark; Künzle, Rahel; Gebauer, Heiko; Gründl, Harald; Morgenroth, Eberhard; Pronk, Wouter; Larsen, Tove A

    2017-01-15

    The toilets used most in informal urban settlements have detrimental consequences for the environment and human health due to the lack of proper collection and treatment of toilet waste. Concepts for safe, sustainable and affordable sanitation systems exist, but their feasibility and acceptance have to be investigated at an early stage of development, which is difficult due to the high costs of building working models. In this paper, we present an approach to estimate acceptance in a valid and representative form with only one working model, and apply it to test an innovative zero-emission toilet with recycling of wash water. Four basic principles were specified for investigation and nine hypotheses formulated to test the feasibility and acceptance of these principles: source separation of urine and feces with subsequent collection for resource recovery; provision of wash water in a separate cycle with on-site recovery through a membrane bioreactor; a convenient and attractive overall design; and a financially sustainable business plan. In Kampala (Uganda), in 2013, data was collected from 22 regular users, 308 one-time users and a representative sample of 1538 participants. Qualitative data was collected from the users, who evaluated their likes, perceived benefits, social norms and expected ease of use based on verbal and visual information. Most of the hypotheses were confirmed, indicating the feasibility and acceptance of the basic principles. Source separation and on-site water recovery were found to be feasible and accepted, provided users can be convinced that the emptying service and water recovery process work reliably. In the survey, the toilet was evaluated favorably and 51% of the participants agreed to be placed on a bogus waiting list. However, some design challenges were revealed, such as the size of the toilet, hiding feces from view and improving the separation of urine and water. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights

  14. DWPF PCCS version 2.0 test case

    International Nuclear Information System (INIS)

    Brown, K.G.; Pickett, M.A.

    1992-01-01

    To verify the operation of the Product Composition Control System (PCCS), a test case specific to DWPF operation was developed. The values and parameters necessary to demonstrate proper DWPF product composition control have been determined and are presented in this paper. If this control information (i.e., for transfers and analyses) is entered into the PCCS as illustrated in this paper, and the results obtained correspond to the independently-generated results, it can safely be said that the PCCS is operating correctly and can thus be used to control the DWPF. The independent results for this test case will be generated and enumerated in a future report. This test case was constructed along the lines of the normal DWPF operation. Many essential parameters are internal to the PCCS (e.g., property constraint and variance information) and can only be manipulated by personnel knowledgeable of the Symbolics reg-sign hardware and software. The validity of these parameters will rely on induction from observed PCCS results. Key process control values are entered into the PCCS as they would during normal operation. Examples of the screens used to input specific process control information are provided. These inputs should be entered into the PCCS database, and the results generated should be checked against the independent, computed results to confirm the validity of the PCCS

  15. [Diagnosis and monitoring of endangered early pregnancies with determination of oestrone, oestradiol 17beta, oestriol, progesterone and HPL in plasma and the pregnancy test in graduated dilutions of urine (author's transl)].

    Science.gov (United States)

    Strecker, J R; Negulescu, R; Dahlén, H; Musch, K

    1977-06-01

    Unconjugated oestrone (Oe1), oestradiol-17beta (Oe2), oestriol (Oe3), progesterone (P) and HPL in plasma were determined by radioimmunoassay and the immunological pregnancy-test in urine was carried out in 70 patients with normal pregnancy or imminent abortion from 4th-20th week of gestation. Oe2 and HPL showed the most pronounced rises, Oe3 increased especially after the first trimester. In cases with abortion symptoms and poor prognosis Oe2 and HPL gave the most reliable results concerning the endocrin function of early normal pregnancy. Oe1- and P-values in normal pregnancy did not differ so clearly from concentrations observed during normal menstrual cycles and were thus of less value. The pregnancy-test was positive (greater than 1000 IU/1) even in most cases of dead pregnancy and therefore not reliable. With increasing production of oestrogen precursors in the fetal adrenal cortex after the first trimester determination of Oe3 becomes more important. In cases with abortion symptoms in early pregnancy and subsequent normal development, plasma Oe2- and Oe3- values represented best criteria for a prognosis. -- For the diagnosis and control of the endangered early pregnancy we recommend, as a consequence of this study, determination of Oe2 up to the 13th week of pregnancy and thereafter Oe3 in maternal plasma.

  16. Is MSAFP still a useful test for detecting open neural tube defects and ventral wall defects in the era of first-trimester and early second-trimester fetal anatomical ultrasounds?

    Science.gov (United States)

    Roman, Ashley S; Gupta, Simi; Fox, Nathan S; Saltzman, Daniel; Klauser, Chad K; Rebarber, Andrei

    2015-01-01

    To evaluate whether maternal serum α-fetoprotein (MSAFP) improves the detection rate for open neural tube defects (ONTDs) and ventral wall defects (VWD) in patients undergoing first-trimester and early second-trimester fetal anatomical survey. A cohort of women undergoing screening between 2005 and 2012 was identified. All patients were offered an ultrasound at between 11 weeks and 13 weeks and 6 days of gestational age for nuchal translucency/fetal anatomy followed by an early second-trimester ultrasound at between 15 weeks and 17 weeks and 6 days of gestational age for fetal anatomy and MSAFP screening. All cases of ONTD and VWD were identified via query of billing and reporting software. Sensitivity and specificity for detection of ONTD/VWD were calculated, and groups were compared using the Fisher exact test, with p met the criteria for inclusion. Overall, 15 cases of ONTD and 17 cases of VWD were identified; 100% of cases were diagnosed by ultrasound prior to 18 weeks' gestation; none were diagnosed via MSAFP screening (p < 0.001). First-trimester and early second-trimester ultrasound had 100% sensitivity and 100% specificity for diagnosing ONTD/VWD. Ultrasound for fetal anatomy during the first and early second trimester detected 100% of ONTD/VWD in our population. MSAFP is not useful as a screening tool for ONTD and VWD in the setting of this ultrasound screening protocol. © 2014 S. Karger AG, Basel.

  17. Early Warning Signals of Social Transformation: A Case Study from the US Southwest.

    Directory of Open Access Journals (Sweden)

    Katherine A Spielmann

    Full Text Available Recent research in ecology suggests that generic indicators, referred to as early warning signals (EWS, may occur before significant transformations, both critical and non-critical, in complex systems. Up to this point, research on EWS has largely focused on simple models and controlled experiments in ecology and climate science. When humans are considered in these arenas they are invariably seen as external sources of disturbance or management. In this article we explore ways to include societal components of socio-ecological systems directly in EWS analysis. Given the growing archaeological literature on 'collapses,' or transformations, in social systems, we investigate whether any early warning signals are apparent in the archaeological records of the build-up to two contemporaneous cases of social transformation in the prehistoric US Southwest, Mesa Verde and Zuni. The social transformations in these two cases differ in scope and severity, thus allowing us to explore the contexts under which warning signals may (or may not emerge. In both cases our results show increasing variance in settlement size before the transformation, but increasing variance in social institutions only before the critical transformation in Mesa Verde. In the Zuni case, social institutions appear to have managed the process of significant social change. We conclude that variance is of broad relevance in anticipating social change, and the capacity of social institutions to mitigate transformation is critical to consider in EWS research on socio-ecological systems.

  18. Early Warning Signals of Social Transformation: A Case Study from the US Southwest.

    Science.gov (United States)

    Spielmann, Katherine A; Peeples, Matthew A; Glowacki, Donna M; Dugmore, Andrew

    2016-01-01

    Recent research in ecology suggests that generic indicators, referred to as early warning signals (EWS), may occur before significant transformations, both critical and non-critical, in complex systems. Up to this point, research on EWS has largely focused on simple models and controlled experiments in ecology and climate science. When humans are considered in these arenas they are invariably seen as external sources of disturbance or management. In this article we explore ways to include societal components of socio-ecological systems directly in EWS analysis. Given the growing archaeological literature on 'collapses,' or transformations, in social systems, we investigate whether any early warning signals are apparent in the archaeological records of the build-up to two contemporaneous cases of social transformation in the prehistoric US Southwest, Mesa Verde and Zuni. The social transformations in these two cases differ in scope and severity, thus allowing us to explore the contexts under which warning signals may (or may not) emerge. In both cases our results show increasing variance in settlement size before the transformation, but increasing variance in social institutions only before the critical transformation in Mesa Verde. In the Zuni case, social institutions appear to have managed the process of significant social change. We conclude that variance is of broad relevance in anticipating social change, and the capacity of social institutions to mitigate transformation is critical to consider in EWS research on socio-ecological systems.

  19. BEAT: A Web-Based Boolean Expression Fault-Based Test Case Generation Tool

    Science.gov (United States)

    Chen, T. Y.; Grant, D. D.; Lau, M. F.; Ng, S. P.; Vasa, V. R.

    2006-01-01

    BEAT is a Web-based system that generates fault-based test cases from Boolean expressions. It is based on the integration of our several fault-based test case selection strategies. The generated test cases are considered to be fault-based, because they are aiming at the detection of particular faults. For example, when the Boolean expression is in…

  20. Increasing STEM Exposure in K–5 Schools Through MakerSpace Use: A Multi-Site Early Success Case Study

    OpenAIRE

    Ortega, Veronica Inez

    2017-01-01

    Using Brinkerhoff’s success case methodology, this multi-site case study examined early models of MakerSpace implementation in K–5 schools in a single district. Specifically, this study examined the early use of MakerSpaces as well as the supports and barriers affecting teacher use of these spaces. The study also examined curricular connections and MakerSpace use as a conduit for purveying instruction in the soon-to-be-implemented Next Generation Science Standards. The findings of this stud...

  1. Presentation of Two Cases with Early Extracranial Metastases from Glioblastoma and Review of the Literature

    DEFF Research Database (Denmark)

    Johansen, Maria Dinche; Rochat, Per; Law, Ian

    2016-01-01

    Extracranial metastases from glioblastoma are rare. We report two patients with extracranial metastases from glioblastoma. Case 1 concerns a 59-year-old woman with multiple metastases that spread early in the course of disease. What makes this case unusual is that the tumor had grown into the fal...... and extensive bleeding during acute surgery with tumor removal, which might have induced extracranial seeding. The cases presented might have hematogenous spreading in common as an explanation to extracranial metastases from GBM....

  2. Management of Very Early-onset Fetal Growth Restriction: Results from 92 Consecutive Cases.

    Science.gov (United States)

    Hoellen, Friederike; Beckmann, Annika; Banz-Jansen, Constanze; Weichert, Jan; Rody, Achim; Bohlmann, Michael K

    2016-01-01

    To evaluate management of early-onset intrauterine growth restriction (IUGR) and to define outcome according to obstetric setting. During an 11-year period (2000-2011), data of patients presenting with IUGR and preterm delivery of less than 30 weeks of gestation at a tertiary perinatal center were retrospectively reviewed. A total of 92 pregnancies were investigated. Delivery was indicated for fetal reasons in 38 out of 92 patients. Sixteen children of our cohort died within one year post partum, out of which eight had suffered from severe early-onset IUGR causing iatrogenic preterm delivery. Concerning the fetal outcome, gestational age at delivery and antenatal exposure to corticosteroids were found to be crucial. In some cases, respiratory distress syndrome prophylaxis and a "wait and see" approach to management in favor of a prolongation of the pregnancy might be favorable. Randomized prospective trials in early-onset IUGR with threatened preterm deliveries are needed in order to define guidelines for an individually tailored management of early-onset preterm infants. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  3. Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

    Science.gov (United States)

    van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

    2013-01-01

    This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

  4. Supernumerary teeth in primary dentition and early intervention: a series of case reports.

    Science.gov (United States)

    Bahadure, Rakesh N; Thosar, Nilima; Jain, Eesha S; Kharabe, Vidhi; Gaikwad, Rahul

    2012-01-01

    Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stages. They are of great concern to the dentists and parents because of the eruption, occlusal, and esthetic problems they can cause. Supernumerary teeth occur more frequently in the permanent dentition but rarely in primary dentition. Mesiodens is the most common type of supernumerary teeth but rarely seen in lower arch. Early recognition and diagnosis of supernumerary teeth is important to prevent further complications in permanent dentition. Four cases of supernumerary teeth with mesiodens in upper and lower arch in primary dentition and their management have been discussed.

  5. Supernumerary Teeth in Primary Dentition and Early Intervention: A Series of Case Reports

    Directory of Open Access Journals (Sweden)

    Rakesh N. Bahadure

    2012-01-01

    Full Text Available Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stages. They are of great concern to the dentists and parents because of the eruption, occlusal, and esthetic problems they can cause. Supernumerary teeth occur more frequently in the permanent dentition but rarely in primary dentition. Mesiodens is the most common type of supernumerary teeth but rarely seen in lower arch. Early recognition and diagnosis of supernumerary teeth is important to prevent further complications in permanent dentition. Four cases of supernumerary teeth with mesiodens in upper and lower arch in primary dentition and their management have been discussed.

  6. Preoperative and early postoperative magnetic resonance imaging in two cases of childhood choroid plexus carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Connor, S.E.J.; Jarosz, J.M. [Department of Neuroradiology, King' s College Hospital, London (United Kingdom); Chandler, C. [Department of Neurosurgery, King' s College Hospital, London (United Kingdom); Bodi, I.; Robinson, S. [Department of Neuropathology, King' s College Hospital, London (United Kingdom)

    2002-04-01

    We present and illustrate the MRI appearances of two children with choroid plexus carcinoma. The MRI characteristics of these rare tumours are reviewed. Since total surgical resection is a significant prognostic factor, early postoperative MRI was performed in both cases to ensure surgical clearance. In one case a complete resection was documented and this patient remains well at short-term follow-up. Residual tumour was noted in the second case, but despite ''second look'' surgery there was subsequent local relapse. (orig.)

  7. A five-year model to assess the early cost-effectiveness of new diagnostic tests in the early diagnosis of rheumatoid arthritis.

    Science.gov (United States)

    Buisman, Leander R; Luime, Jolanda J; Oppe, Mark; Hazes, Johanna M W; Rutten-van Mölken, Maureen P M H

    2016-06-10

    There is a lack of information about the sensitivity, specificity and costs new diagnostic tests should have to improve early diagnosis of rheumatoid arthritis (RA). Our objective was to explore the early cost-effectiveness of various new diagnostic test strategies in the workup of patients with inflammatory arthritis (IA) at risk of having RA. A decision tree followed by a patient-level state transition model, using data from published literature, cohorts and trials, was used to evaluate diagnostic test strategies. Alternative tests were assessed as add-on to or replacement of the ACR/EULAR 2010 RA classification criteria for all patients and for intermediate-risk patients. Tests included B-cell gene expression (sensitivity 0.60, specificity 0.90, costs €150), MRI (sensitivity 0.90, specificity 0.60, costs €756), IL-6 serum level (sensitivity 0.70, specificity 0.53, costs €50) and genetic assay (sensitivity 0.40, specificity 0.85, costs €750). Patients with IA at risk of RA were followed for 5 years using a societal perspective. Guideline treatment was assumed using tight controlled treatment based on DAS28; if patients had a DAS28 >3.2 at 12 months or later patients could be eligible for starting biological drugs. The outcome was expressed in incremental cost-effectiveness ratios (€2014 per quality-adjusted life year (QALY) gained) and headroom. The B-cell test was the least expensive strategy when used as an add-on and as replacement in intermediate-risk patients, making it the dominant strategy, as it has better health outcomes and lower costs. As add-on for all patients, the B-cell test was also the most cost-effective test strategy. When using a willingness-to-pay threshold of €20,000 per QALY gained, the IL-6 and MRI strategies were not cost-effective, except as replacement. A genetic assay was not cost-effective in any strategy. Probabilistic sensitivity analysis revealed that the B-cell test was consistently superior in all strategies. When

  8. Mobile phone base stations and early childhood cancers: case-control study.

    Science.gov (United States)

    Elliott, Paul; Toledano, Mireille B; Bennett, J; Beale, L; de Hoogh, K; Best, N; Briggs, D J

    2010-06-22

    To investigate the risk of early childhood cancers associated with the mother's exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy. Case-control study. Cancer registry and national birth register data in Great Britain. 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case). Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin's lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing. Mean distance of registered address at birth from a macrocell base station, based on a national database of 76,890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (-30.3 (SD 21.7) dBm v -29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin's lymphoma (P=0.51 for trend). There is no association between risk of early childhood cancers and estimates of the mother's exposure to mobile phone base stations during pregnancy.

  9. Evaluation of continuing education of family health strategy teams for the early identification of suspected cases of cancer in children.

    Science.gov (United States)

    Costa, Ana Maria Aranha Magalhaes; Magluta, Cynthia; Gomes Junior, Saint Clair

    2017-09-07

    This study evaluated the influence of continuing education of family health strategy teams by the Ronald McDonald Institute program on the early diagnosis of cancer in children and adolescents. The study applied Habicht's model to evaluate the adequacy and plausibility of continuing education by using as outcome the number of children with suspected cancer who were referred to the hospital of references in the 1 year before and 1 year after intervention and the number of patients referred by intervention group and control group family health strategy teams. Medical records from each hospital of reference were used to collect information of suspect cases of cancer. Descriptive analyses were performed using frequencies and mean values. Chi-square tests were used to assess statistically significant differences between the groups and periods by using p-values family health strategy teams that underwent the intervention referred 3.6 times more number of children to hospital of references than did the control group. Only the intervention group showed an increase in the number of confirmed cases. This evaluation of a continuing education program for early identification of pediatric cancer showed that the program was adequate in achieving the established goals and that the results could be attributed to the program.

  10. OCL-BASED TEST CASE GENERATION USING CATEGORY PARTITIONING METHOD

    Directory of Open Access Journals (Sweden)

    A. Jalila

    2015-10-01

    Full Text Available The adoption of fault detection techniques during initial stages of software development life cycle urges to improve reliability of a software product. Specification-based testing is one of the major criterions to detect faults in the requirement specification or design of a software system. However, due to the non-availability of implementation details, test case generation from formal specifications become a challenging task. As a novel approach, the proposed work presents a methodology to generate test cases from OCL (Object constraint Language formal specification using Category Partitioning Method (CPM. The experiment results indicate that the proposed methodology is more effective in revealing specification based faults. Furthermore, it has been observed that OCL and CPM form an excellent combination for performing functional testing at the earliest to improve software quality with reduced cost.

  11. A prevalence-based association test for case-control studies.

    Science.gov (United States)

    Ryckman, Kelli K; Jiang, Lan; Li, Chun; Bartlett, Jacquelaine; Haines, Jonathan L; Williams, Scott M

    2008-11-01

    Genetic association is often determined in case-control studies by the differential distribution of alleles or genotypes. Recent work has demonstrated that association can also be assessed by deviations from the expected distributions of alleles or genotypes. Specifically, multiple methods motivated by the principles of Hardy-Weinberg equilibrium (HWE) have been developed. However, these methods do not take into account many of the assumptions of HWE. Therefore, we have developed a prevalence-based association test (PRAT) as an alternative method for detecting association in case-control studies. This method, also motivated by the principles of HWE, uses an estimated population allele frequency to generate expected genotype frequencies instead of using the case and control frequencies separately. Our method often has greater power, under a wide variety of genetic models, to detect association than genotypic, allelic or Cochran-Armitage trend association tests. Therefore, we propose PRAT as a powerful alternative method of testing for association.

  12. High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

    Science.gov (United States)

    Meiron, Oded; Gale, Rena; Namestnic, Julia; Bennet-Back, Odeya; David, Jonathan; Gebodh, Nigel; Adair, Devin; Esmaeilpour, Zeinab; Bikson, Marom

    2018-01-01

    Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy. HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring. There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study. These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

  13. Vertical parasagittal hemispherotomy for Sturge-Weber syndrome in early infancy: case report and literature review.

    Science.gov (United States)

    Liu, Xiangyu; Otsuki, Taisuke; Takahashi, Akio; Kaido, Takanobu

    2016-01-01

    The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH. The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy. At follow-up, the patient's neurodevelopmental status has been improved since the surgery. It is generally accepted that early-onset seizures in children with SWS are associated with worse neurological and developmental outcomes. However, when surgical treatment should be considered and how it should be performed remain a longstanding controversy. We promote early surgery in children with SWS and early-onset epilepsy. We suggest that VPH may be a useful adjuvant in the management of SWS with refractory epilepsy in early infancy and this procedure carries low neurological risk.

  14. Comparison of readmission rates between groups with early versus late discharge after vaginal or cesarean delivery: a retrospective analyzes of 14,460 cases.

    Science.gov (United States)

    Bostanci Ergen, Evrim; Ozkaya, Enis; Eser, Ahmet; Abide Yayla, Cigdem; Kilicci, Cetin; Yenidede, Ilter; Eser, Semra Kayatas; Karateke, Ates

    2018-05-01

    The aim of this retrospective analysis was to show the readmission rate of cases with and without early discharge following vaginal or cesarean delivery. After exclusion of cases with pregnancy, delivery and neonatal complications, a total of 14,460 cases who delivered at Zeynep Kamil Women and Children's Health Training and Research Hospital were retrospectively screened from hospital database. Subjects were divided into two groups as Group 1: early discharge (n = 6802) and Group 2: late discharge (n = 7658). Groups were compared in terms of readmission rates and indications for readmission. There were 6802 cases with early discharge whereas the remaining women were discharged after 24 h for vaginal delivery and 48 h following cesarean delivery on regular bases. Among cases with early discharge, 205 (3%) cases readmitted to emergency service with variable indications, while there were 216 (2.8%) readmitted women who were discharged on regular bases. Most common indication for readmission was wound infection in both groups. Neonatal sex distributions were similar between groups (p > .05), where as there was a higher rate of cesarean deliveries in Group 2 (p discharge (p discharges following vaginal or cesarean delivery without any mortality or permanent morbidity and cost analyses revealed 68 Turkish liras lower cost with early discharge.

  15. Hybridisation or Ousterisation? The Case of Local Accountability Policy in Finnish Early Childhood Education

    Science.gov (United States)

    Paananen, Maiju; Lipponen, Lasse; Kumpulainen, Kristiina

    2015-01-01

    Drawing on the analytic concept of imaginary, this study investigates policy hybridisation in the Finnish early childhood education. Specifically, it illuminates how the interplay between different imaginaries enabled the neoliberal imaginary to oust the social-democratic imaginary through a tripartite process in a case of local productivity…

  16. MR imaging and ultrasonography findings of early myositis ossificans: a case report

    International Nuclear Information System (INIS)

    Lee, Kyung Ryeol; Park, So Young; Jin, Wook; Won, Kyu Yeoun

    2016-01-01

    Myositis ossificans (MO) is a benign soft tissue lesion with non-neoplastic heterotopic bone formation. MO in the intermediate and mature stages can be easily diagnosed if characteristic imaging findings such as a peripheral zonal pattern of ossification with variable thickness is observed. However, it is difficult to correctly diagnose early MO because it can mimic malignancy clinically, radiologically, and histopathologically. We report a case of early pseudosarcomatous phase of non-traumatic MO with atypical imaging findings. A 59-year-old woman presented with pain followed by a mass in the left thigh within a week. MR imaging and ultrasonography showed an intramuscular lesion with preserved muscle fascicles in the vastus lateralis muscle. Intralesional ossification or calcification was not seen on ultrasonography. A diagnosis of myositis ossificans was made by ultrasonographically guided biopsy. (orig.)

  17. MR imaging and ultrasonography findings of early myositis ossificans: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Ryeol [Jeju National University Hospital, Department of Radiology, Jeju-si, Jeju Special Self-Governing Province (Korea, Republic of); Park, So Young; Jin, Wook [Kyung Hee University Hospital at Gangdong, Department of Radiology, Seoul (Korea, Republic of); Won, Kyu Yeoun [Kyung Hee University Hospital at Gangdong, Department of Pathology, Seoul (Korea, Republic of)

    2016-10-15

    Myositis ossificans (MO) is a benign soft tissue lesion with non-neoplastic heterotopic bone formation. MO in the intermediate and mature stages can be easily diagnosed if characteristic imaging findings such as a peripheral zonal pattern of ossification with variable thickness is observed. However, it is difficult to correctly diagnose early MO because it can mimic malignancy clinically, radiologically, and histopathologically. We report a case of early pseudosarcomatous phase of non-traumatic MO with atypical imaging findings. A 59-year-old woman presented with pain followed by a mass in the left thigh within a week. MR imaging and ultrasonography showed an intramuscular lesion with preserved muscle fascicles in the vastus lateralis muscle. Intralesional ossification or calcification was not seen on ultrasonography. A diagnosis of myositis ossificans was made by ultrasonographically guided biopsy. (orig.)

  18. Folie à Deux and its interaction with early life stress: a case report

    Directory of Open Access Journals (Sweden)

    Alessandra Vargas Alves Nunes

    2016-12-01

    Full Text Available Abstract Background Folie à deux is a very rare psychiatric syndrome in which a psychotic symptom is transmitted from one individual to another. We present a case of folie à deux occurring during childhood, which is not an usual presentation of this syndrome. In this case, the disorder is correlated with child abuse and neglect, which possibly had a role in the development of the symptoms in our case. Case presentation We present a case of folie à deux between an “induced” 9-year-old black Brazilian boy and the “inducer”, his grandmother. They were found to be sharing similar auditory and visual hallucinations and delusional beliefs. The boy was neglected by his parents and was being cared for by his grandmother, who had a history of mental disorder. Conclusions The close relationship between the boy and his grandmother, the family history of first-degree psychosis, and the child abuse and neglect suffered by the boy may have altered his vulnerability to early-onset psychosis and, in this case, folie à deux.

  19. Test cases for interface tracking methods: methodology and current status

    International Nuclear Information System (INIS)

    Lebaigue, O.; Jamet, D.; Lemonnier, E.

    2004-01-01

    Full text of publication follows:In the past decade, a large number of new methods have been developed to deal with interfaces in the numerical simulation of two-phase flows. We have collected a set of 36 test cases, which can be seen as a tool to help engineers and researchers selecting the most appropriate method(s) for their specific fields of application. This set can be use: - To perform an initial evaluation of the capabilities of available methods with regard to the specificity of the final application and the most important features to be recovered from the simulation. - To measure the maximum mesh size to be used for a given physical problem in order to obtain an accurate enough solution. - To assess and quantify the performances of a selected method equipped with its set of physical models. The computation of a well-documented test case allows estimating the error due to the numerical technique by comparison with reference solutions. This process is compulsory to gain confidence and credibility on the prediction capabilities of a numerical method and its physical models. - To broaden the capabilities of a given numerical technique. The test cases may be used to identify the need for improvement of the overall numerical scheme or to determine the physical part of the model, which is responsible for the observed limitations. Each test case falls within one of the following categories: - Analytical solutions of well-known sets of equations corresponding to simple geometrical situations. - Reference numerical solutions of moderately complex problems, produced by accurate methods (e.g., boundary Fitted coordinate method) on refined meshes. - Separate effects analytical experiments. The presentation will suggest how to use the test cases for assessing the physical models and the numerical methods. The expected fallout of using test cases is indeed on the one hand to identify the merits of existing methods and on the other hand to orient further research towards

  20. Dental complications of rickets in early childhood: case report on 2 young girls.

    Science.gov (United States)

    Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

    2014-04-01

    Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

  1. LIFE: The Case for Early Commercialization of Fusion Energy

    International Nuclear Information System (INIS)

    Anklam, T.; Simon, A.J.; Powers, S.; Meier, W.R.

    2011-01-01

    This paper presents the case for early commercialization of laser inertial fusion energy (LIFE). Results taken from systems modeling of the US electrical generating enterprise quantify the benefits of fusion energy in terms of carbon emission, nuclear waste and plutonium production avoidance. Sensitivity of benefits-gained to timing of market-entry is presented. These results show the importance of achieving market entry in the 2030 time frame. Economic modeling results show that fusion energy can be competitive with other low-carbon energy sources. The paper concludes with a description of the LIFE commercialization path. It proposes constructing a demonstration facility capable of continuous fusion operations within 10 to 15 years. This facility will qualify the processes and materials needed for a commercial fusion power plant.

  2. Non Nuclear Testing of Reactor Systems In The Early Flight Fission Test Facilities (EFF-TF)

    International Nuclear Information System (INIS)

    Van Dyke, Melissa; Martin, James

    2004-01-01

    The Early Flight Fission-Test Facility (EFF-TF) can assist in the design and development of systems through highly effective non-nuclear testing of nuclear systems when technical issues associated with near-term space fission systems are 'non-nuclear' in nature (e.g. system's nuclear operations are understood). For many systems, thermal simulators can be used to closely mimic fission heat deposition. Axial power profile, radial power profile, and fuel pin thermal conductivity can be matched. In addition to component and subsystem testing, operational and lifetime issues associated with the steady state and transient performance of the integrated reactor module can be investigated. Instrumentation at the EFF-TF allows accurate measurement of temperature, pressure, strain, and bulk core deformation (useful for accurately simulating nuclear behavior). Ongoing research at the EFF-TF is geared towards facilitating research, development, system integration, and system utilization via cooperative efforts with DOE laboratories, industry, universities, and other Nasa centers. This paper describes the current efforts for the latter portion of 2003 and beginning of 2004. (authors)

  3. Initial and follow-up MRI in a case of early diagnosed Reye's syndrome

    International Nuclear Information System (INIS)

    Ozdoba, C.; Pfenninger, J.; Schroth, G.

    1997-01-01

    Early MRI in a case of clinically established Reye's syndrome confirmed CT findings of compressed ventricles and additionally demonstrated signal alterations in the thalamus, mesencephalon and pons. On follow-up MRI the pontine lesion had vanished by 1 week later, while the thalamic lesion persisted for more than 2 months. The patient, however, recovered without neurological sequelae. (orig.). With 3 figs

  4. Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

    Science.gov (United States)

    van de Kant, Kim DG; Klaassen, Ester MM; Jöbsis, Quirijn; Nijhuis, Annedien J; van Schayck, Onno CP; Dompeling, Edward

    2009-01-01

    Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique) have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study), is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure) on basis of lung function assessments and current respiratory symptoms ('golden standard'). From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate), blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have consequences for the management of

  5. Experimental impact testing and analysis of composite fan cases

    Science.gov (United States)

    Vander Klok, Andrew Joe

    For aircraft engine certification, one of the requirements is to demonstrate the ability of the engine to withstand a fan blade-out (FBO) event. A FBO event may be caused by fatigue failure of the fan blade itself or by impact damage of foreign objects such as bird strike. An un-contained blade can damage flight critical engine components or even the fuselage. The design of a containment structure is related to numerous parameters such as the blade tip speed; blade material, size and shape; hub/tip diameter; fan case material, configuration, rigidity, etc. To investigate all parameters by spin experiments with a full size rotor assembly can be prohibitively expensive. Gas gun experiments can generate useful data for the design of engine containment cases at much lower costs. To replicate the damage modes similar to that on a fan case in FBO testing, the gas gun experiment has to be carefully designed. To investigate the experimental procedure and data acquisition techniques for FBO test, a low cost, small spin rig was first constructed. FBO tests were carried out with the small rig. The observed blade-to-fan case interactions were similar to those reported using larger spin rigs. The small rig has the potential in a variety of applications from investigating FBO events, verifying concept designs of rotors, to developing spin testing techniques. This rig was used in the developments of the notched blade releasing mechanism, a wire trigger method for synchronized data acquisition, high speed video imaging and etc. A relationship between the notch depth and the release speed was developed and verified. Next, an original custom designed spin testing facility was constructed. Driven by a 40HP, 40,000rpm air turbine, the spin rig is housed in a vacuum chamber of phi72inx40in (1829mmx1016mm). The heavily armored chamber is furnished with 9 viewports. This facility enables unprecedented investigations of FBO events. In parallel, a 15.4ft (4.7m) long phi4.1inch (105mm

  6. Evaluation of latex agglutination test (KAtex) for early diagnosis of kala-azar.

    Science.gov (United States)

    Ahsan, M M; Islam, M N; Mollah, A H; Hoque, M A; Hossain, M A; Begum, Z; Islam, M T

    2010-07-01

    Kala-azar is one of the major public health problem in Bangladesh. But the diagnosis of the problem often is difficult, unusual and time consuming, a simple, noninvasive, easy to perform, reliable and rapid diagnostic test has been a long-felt need of the clinicians. Therefore, the present study was conducted to see the sensitivity and specificity of Latex Agglutination test (KAtex) to detect leishmanial antigen from urine of kala-azar cases. The study was carried out in the department of Paediatrics, Mymensingh Medical College and Hospital, Bangladesh during July to December, 2008. A total of 100 urine samples were collected of which 50 were confirmed kala-azar cases and 50 were age and sex matched controls. Out of 50 kala-azar cases 47 showed positive result of KAtex. The test was also positive in 01 out of 30 healthy controls. None of the febrile controls was positive by KAtex. The sensitivity, specificity, positive predictive value and negative predictive value of the test using presence of LD bodies in splenic and/or bone marrow aspirate as gold standard were 94%, 98%, 97.91% and 94.23% respectively. KAtex is simple, noninvasive, easy to perform, rapid and reliable test for diagnosing kala-azar in endemic area and useful for small, less equipped laboratories as well as for the laboratories with better facilities.

  7. Findings concerning testis, vas deference, and epididymis in adult cases with nonpalpable testes

    Directory of Open Access Journals (Sweden)

    Coskun Sahin

    2011-12-01

    Full Text Available In this study, we aimed to state the relationship between testis, epididymis and vas deference, in adult cases with nonpalpable testis. Between January 1996 and December 2009, we evaluated 154 adult cases with nonpalpable testes. Mean age was 23 years (20-27 years. Explorations were performed by open inguinal incision, laparoscopy, and by inguinal incision and laparoscopy together on 22, 131 and 1 patient, respectively. Of all the unilateral cases, 32 were accepted as vanishing testis. In five of these cases, vas deference was ending inside the abdomen, and in the others, it was ending inside the scrotum. In the remaining 99 unilateral and 22 bilateral cases, 143 testes were found in total. Testes were found in the inguinal canal as atrophic in one case, at the right renal pedicle level with dysmorphic testis in one case, and anterior to the internal ring between the bladder and the common iliac vessels at a smaller than normal size in 119 cases. One (0.69% case did not have epididymis. While epididymis was attached to the testis only at the head and tail locations in 88 (61.53% cases, it was totally attached to the testis in 54 (37.76% cases. There is an obviously high incidence rate of testis and vas deference anomalies, where epididymis is the most frequent one. In cases with abdominal testes, this rate is highest for high localised abdominal testes.

  8. 30 CFR 250.522 - When do I have to repeat casing diagnostic testing?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When do I have to repeat casing diagnostic... Operations Casing Pressure Management § 250.522 When do I have to repeat casing diagnostic testing? Casing diagnostic testing must be repeated according to the following table: When * * * you must repeat diagnostic...

  9. A case of early detection of bisphosphonate-related osteonecrosis of the jaw

    OpenAIRE

    Mori, Miyu; Koide, Tetsuro; Matsui, Yuriyo; Matsuda, Toru

    2015-01-01

    Osteonecrosis of the jaws is an adverse reaction associated with the use of bisphosphonates. Although the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ) is based on symptomatology, it is often detected late because the patients become symptomatic only after osteonecrosis is well established. We describe a case of early oral BRONJ detected by magnetic resonance imaging (MRI) accidentally. Head MRI revealed low signal of T1-weight images in left mandibula. Patient had been...

  10. Intracavitary irradiation of early rectal cancer for cure. A series of 186 cases

    International Nuclear Information System (INIS)

    Papillon, J.

    1975-01-01

    If radical surgery is the only rational policy for most cases of rectal cancer, the problem of local treatment in poor surgical risk patients should be discussed in selected cases. Only limited, fairly-well-differentiated tumors, still confined to the rectal wall may have a sufficiently low probability of lymphatic spread to be amenable to local treatment. Rectal cancer, usually regarded as being slightly radiosensitive when treated by external irradiation, proves to be highly radiosensitive in the case of early cancer treated by intracavitary irradiation. This method is able to control a large amount of limited polypoid and ulcerative adenocarcinomas. In a series of 133 cases followed more than 5 years, the rate of death from cancer is only 9 percent, and the 5-year survival rate is 78 percent. As compared with local excision or electrocoagulation, intracavitary irradiation has several advantages. It does not require colostomy nor anesthesia. Contact x-ray therapy is an ambulatory treatment applicable even to elderly and fragile patients. There is no danger of fistula in the case of tumor of the anterior wall in female patients. It preserves all the chances of cure by subsequent surgery in case of failure. (auth)

  11. Infant titi monkey behavior in the open field test and the effect of early adversity.

    Science.gov (United States)

    Larke, Rebecca H; Toubiana, Alice; Lindsay, Katrina A; Mendoza, Sally P; Bales, Karen L

    2017-09-01

    The open field test is commonly used to measure anxiety-related behavior and exploration in rodents. Here, we used it as a standardized novel environment in which to evaluate the behavioral response of infant titi monkeys (Callicebus cupreus), to determine the effect of presence of individual family members, and to assess how adverse early experience alters infant behavior. Infants were tested in the open field for 5 days at ages 4 and 6 months in four successive 5 min trials on each day. A transport cage, which was situated on one side of the open field, was either empty (non-social control) or contained the father, mother, or sibling. Infant locomotor, vocalization, and exploratory behavior were quantified. Results indicated that age, sex, social condition, and early experience all had significant effects on infant behavior. Specifically, infants were generally more exploratory at 6 months and male infants were more exploratory than females. Infants distinguished between social and non-social conditions but made few behavioral distinctions between the attachment figure and other individuals. Infants which had adverse early life experience demonstrated greater emotional and physical independence, suggesting that early adversity led to resiliency in the novel environment. © 2017 Wiley Periodicals, Inc.

  12. Safety early warning research for highway construction based on case-based reasoning and variable fuzzy sets.

    Science.gov (United States)

    Liu, Yan; Yi, Ting-Hua; Xu, Zhen-Jun

    2013-01-01

    As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR), this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods' effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established.

  13. Safety Early Warning Research for Highway Construction Based on Case-Based Reasoning and Variable Fuzzy Sets

    Directory of Open Access Journals (Sweden)

    Yan Liu

    2013-01-01

    Full Text Available As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR, this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods’ effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established.

  14. Designing, developing, and testing an app for parents being discharged early postnatally

    DEFF Research Database (Denmark)

    Danbjørg, Dorthe Boe; Wagner, Lis; Clemensen, Jane

    2014-01-01

    In Denmark and internationally, earlier discharge of postnatal patients presents a challenge to find innovative ways of providing follow-up support to new mothers who may be discharged early. The purpose of this participatory design study is to describe the process of the design, development, and...... testing. •We designed, developed, and testet an app for the iPad.•The app was viable, but the app requires refinements and wider testing.•The app met the new families' needs for follow-up support.•There is a potential for ensuring postnatal security with the use of technology....

  15. Paternity tests in Mexico: Results obtained in 3005 cases.

    Science.gov (United States)

    García-Aceves, M E; Romero Rentería, O; Díaz-Navarro, X X; Rangel-Villalobos, H

    2018-04-01

    National and international reports regarding the paternity testing activity scarcely include information from Mexico and other Latin American countries. Therefore, we report different results from the analysis of 3005 paternity cases analyzed during a period of five years in a Mexican paternity testing laboratory. Motherless tests were the most frequent (77.27%), followed by trio cases (20.70%); the remaining 2.04% included different cases of kinship reconstruction. The paternity exclusion rate was 29.58%, higher but into the range reported by the American Association of Blood Banks (average 24.12%). We detected 65 mutations, most of them involving one-step (93.8% and the remaining were two-step mutations (6.2%) thus, we were able to estimate the paternal mutation rate for 17 different STR loci: 0.0018 (95% CI 0.0005-0.0047). Five triallelic patterns and 12 suspected null alleles were detected during this period; however, re-amplification of these samples with a different Human Identification (HID) kit confirmed the homozygous genotypes, which suggests that most of these exclusions actually are one-step mutations. HID kits with ≥20 STRs detected more exclusions, diminishing the rate of inconclusive results with isolated exclusions (Powerplex 21 kit (20 STRs) and Powerplex Fusion kit (22 STRs) offered similar PI (p = 0.379) and average number of exclusions (PE) (p = 0.339) when a daughter was involved in motherless tests. In brief, besides to report forensic parameters from paternity tests in Mexico, results describe improvements to solve motherless paternity tests using HID kits with ≥20 STRs instead of one including 15 STRs. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  16. Design and Testing of Braided Composite Fan Case Materials and Components

    Science.gov (United States)

    Roberts, Gary D.; Pereira, J. Michael; Braley, Michael S.; Arnold, William a.; Dorer, James D.; Watson, William R/.

    2009-01-01

    Triaxial braid composite materials are beginning to be used in fan cases for commercial gas turbine engines. The primary benefit for the use of composite materials is reduced weight and the associated reduction in fuel consumption. However, there are also cost benefits in some applications. This paper presents a description of the braided composite materials and discusses aspects of the braiding process that can be utilized for efficient fabrication of composite cases. The paper also presents an approach that was developed for evaluating the braided composite materials and composite fan cases in a ballistic impact laboratory. Impact of composite panels with a soft projectile is used for materials evaluation. Impact of composite fan cases with fan blades or blade-like projectiles is used to evaluate containment capability. A post-impact structural load test is used to evaluate the capability of the impacted fan case to survive dynamic loads during engine spool down. Validation of these new test methods is demonstrated by comparison with results of engine blade-out tests.

  17. Early Maternal Time Investment and Early Child Outcomes

    OpenAIRE

    Del Bono, Emilia; Francesconi, Marco; Kelly, Yvonne; Sacker, Amanda

    2014-01-01

    Using large longitudinal survey data from the UK Millennium Cohort Study, this paper estimates the relationship between maternal time inputs and early child development. We find that maternal time is a quantitatively important determinant of skill formation and that its effect declines with child age. There is evidence of long-term effects of early maternal time inputs on later outcomes, especially in the case of cognitive skill development. In the case of non-cognitive development, the evide...

  18. Class hierarchical test case generation algorithm based on expanded EMDPN model

    Institute of Scientific and Technical Information of China (English)

    LI Jun-yi; GONG Hong-fang; HU Ji-ping; ZOU Bei-ji; SUN Jia-guang

    2006-01-01

    A new model of event and message driven Petri network(EMDPN) based on the characteristic of class interaction for messages passing between two objects was extended. Using EMDPN interaction graph, a class hierarchical test-case generation algorithm with cooperated paths (copaths) was proposed, which can be used to solve the problems resulting from the class inheritance mechanism encountered in object-oriented software testing such as oracle, message transfer errors, and unreachable statement. Finally, the testing sufficiency was analyzed with the ordered sequence testing criterion(OSC). The results indicate that the test cases stemmed from newly proposed automatic algorithm of copaths generation satisfies synchronization message sequences testing criteria, therefore the proposed new algorithm of copaths generation has a good coverage rate.

  19. A Human Proximity Operations System test case validation approach

    Science.gov (United States)

    Huber, Justin; Straub, Jeremy

    A Human Proximity Operations System (HPOS) poses numerous risks in a real world environment. These risks range from mundane tasks such as avoiding walls and fixed obstacles to the critical need to keep people and processes safe in the context of the HPOS's situation-specific decision making. Validating the performance of an HPOS, which must operate in a real-world environment, is an ill posed problem due to the complexity that is introduced by erratic (non-computer) actors. In order to prove the HPOS's usefulness, test cases must be generated to simulate possible actions of these actors, so the HPOS can be shown to be able perform safely in environments where it will be operated. The HPOS must demonstrate its ability to be as safe as a human, across a wide range of foreseeable circumstances. This paper evaluates the use of test cases to validate HPOS performance and utility. It considers an HPOS's safe performance in the context of a common human activity, moving through a crowded corridor, and extrapolates (based on this) to the suitability of using test cases for AI validation in other areas of prospective application.

  20. An Extended Quadratic Frobenius Primality Test with Average Case Error Estimates

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Frandsen, Gudmund Skovbjerg

    2001-01-01

    We present an Extended Quadratic Frobenius Primality Test (EQFT), which is related to an extends the Miller-Rabin test and the Quadratic Frobenius test (QFT) by Grantham. EQFT takes time about equivalent to 2 Miller-Rabin tests, but has much smaller error probability, namely 256/331776t for t...... for the error probability of this algorithm as well as a general closed expression bounding the error. For instance, it is at most 2-143 for k = 500, t = 2. Compared to earlier similar results for the Miller-Rabin test, the results indicates that our test in the average case has the effect of 9 Miller......-Rabin tests, while only taking time equivalent to about 2 such tests. We also give bounds for the error in case a prime is sought by incremental search from a random starting point....

  1. A case of urinary retention in the early stages of herpes simplex virus type-1 encephalitis.

    Science.gov (United States)

    Fukuoka, Takuya; Nakazato, Yoshihiko; Miyake, Akifumi; Tamura, Naotoshi; Araki, Nobuo; Yamamoto, Toshimasa

    2017-06-01

    A 70-year-old man developed urinary retention in the early stages of herpes simplex virus (HSV) type-1 encephalitis. A nerve conduction study suggested latent myeloradiculitis. This is the first report of human herpes simplex virus-1 encephalitis followed by urinary retention at early stage from the onset like the Elsberg syndrome. Although relatively few similar cases have been reported, we consider that urinary retention is common in HSV-1 encephalitis, in which disturbances of consciousness usually require bladder catheterization from the onset. We further emphasize that urinary retention may occasionally occur in early stages of HSV-1 encephalitis, with a significant possibility of recovery. Copyright © 2017. Published by Elsevier B.V.

  2. Rethinking Instructional Technology to Improve Pedagogy for Digital Literacy: A Design Case in a Graduate Early Childhood Education Course

    Science.gov (United States)

    Langub, Lee Woodham; Lokey-Vega, Anissa

    2017-01-01

    Digital literacy is an important aspect to consider within teacher education as a way to address twenty-first century learner needs, particularly in early childhood contexts where developmental concerns should be paramount in making instructional design decisions. This article is a design case of a graduate level early childhood education…

  3. Tests of spinning turbine fragment impact on casing models

    International Nuclear Information System (INIS)

    Wilbeck, J.S.

    1984-01-01

    Ten 1/11-scale model turbine missile impact tests were conducted at a Naval spin chamber test facility to assess turbine missile effects in nuclear plant design. The objective of the tests was to determine the effects of missile spin, blade crush, and target edge conditions on the impact of turbine disk fragments on the steel casing. The results were intended for use in making realistic estimates for the initial conditions of fragments that might escape the casing in the event of a disk burst in a nuclear plant. The burst of a modified gas turbine rotor in a high-speed spin chamber provided three missiles with the proper rotational and translational velocities of actual steam turbine fragments. Tests of bladed, spinning missiles were compared with previous tests of unbladed, nonspinning missiles. The total residual energy of the spinning missiles, as observed from high-speed photographs of disk burst, was the same as that of the nonspinning missiles launched in a piercing orientation. Tests with bladed missiles showed that for equal burst speeds, the residual energy of bladed missiles is less than that of unbladed missiles. Impacts of missiles near the edge of targets resulted in residual missile velocities greater than for central impact. (orig.)

  4. Proper knowledge on toxicokinetics improves human hazard testing and subsequent health risk characterisation. A case study approach.

    Science.gov (United States)

    Bessems, Jos G M; Geraets, Liesbeth

    2013-12-01

    In the current EU legislative frameworks on chemicals safety, the requirements with respect to information on general kinetic parameters (absorption, distribution, metabolism and excretion or ADME) or integrated toxicokinetic parameters (TK, i.e. plasma concentration-time curve, area under the curve etcetera) in humans and experimental animals vary widely. For agrochemicals and cosmetics, there are regulatory requirements whereas for other frameworks, such as food ingredients, biocides, consumer products and high production volume chemicals (REACH) there are very little or no requirements. This paper presents case studies that illustrate the importance of ADME and TK data in regulatory risk characterisations. The examples were collected by interviewing regulatory risk assessors from various chemicals (non-pharmaceutical) frameworks. The case studies illustrate how (1) applying ADME/TK in an early phase of toxicity testing can be used to improve study design and support the 3R-goals and how (2) increased use of ADME/TK data can improve the final risk assessment. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Early Osteoarthritis and Osteoporosis Due to Spondyloepiphysial Dysplasia: A Case Report - Case Report

    Directory of Open Access Journals (Sweden)

    Asylbek Kaparov

    2009-12-01

    Full Text Available Spondyloepiphysial dysplasia (SED is a rare diseases which causes delayed growth, short statue and involves the centre of the vertebral epiphysis. SED congenita and SED tarda are two different clinical forms of this disease. SED tarda with progressive arthropathy is another rare clinical appearance. SED is more frequently seen in male patients due to a genetic recessive transmission by chromosome X. The disease is characterized by a delay in the formation of epipysis, shortness of spine and extremities, kyphoscoliosis, coxa vara and platyspondily. In this case report we aimed to discuss an adolescent male SED tarda patient with early onset of osteoarthritis and osteoporosis, who was diagnosed as Scheuerman disease in the orthopedics clinic and treated with growth hormone for growth retardation in the pediatric endocrinology clinic. Important findings and labotatory investigation methods for diagnosis and treatment of this diasese will be outlined. (From the World of Osteoporosis 2009;15:79-82

  6. 30 CFR 250.520 - When do I have to perform a casing diagnostic test?

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 2 2010-07-01 2010-07-01 false When do I have to perform a casing diagnostic... Operations Casing Pressure Management § 250.520 When do I have to perform a casing diagnostic test? (a) You must perform a casing diagnostic test within 30 days after first observing or imposing casing pressure...

  7. [A case of Neuro-Behçet's disease with early onset of bipolar mood disorder].

    Science.gov (United States)

    Nakano, Yuko; Hatanaka, Yuki; Ikebuchi, Emi; Shimizu, Teruo; Nanko, Shinichiro; Utsumii, Takeshi

    2004-01-01

    In this report, we describe a case of Neuro-Behçet's disease with early onset of bipolar mood disorder. A 53-year-old man with neuropathy including dysphasia and dyslalia developed bipolar mood disorder with anxiety, agitation, depressive mood, talkativeness, hyperkinesias, and appetite rise, and soon exhibited severe personality deterioration. Oral aphthae, cell proliferation and elevated IL-6 levels in spinal fluid, and the patient's clinical downhill course with remission and relapse in spite of good reaction to steroid preparation indicated the possibility of Neuro-Behçet's disease. Brain MRI showed clear swelling of the brain stem area, especially in the pons, in the active phase with low signal in T1-weighted images contrasting with clear high signal in T2-weighted images and FLAIR. At the time of remission, atrophy of the brain stem was shown. These findings were consistent with the view reported in recent years concerning the brain image of Neuro-Behçet's disease, which seemed to be useful for the differential diagnosis. This case manifested two outstanding clinical features. First, it showed bipolar mood swing or mixed state distinguishable from disinhibition or euphoria in deteriorated personality, which is common in this condition. A clear bipolar mood disorder has not been described until now in Neuro-Behçet's disease. Second, subclinical dysthymia or hypomanic phase occurred before clear onset of the disease. In Neuro-Behçet's disease, it is currently considered that psychiatric symptoms may appear in the early stage, but there is controversy as to whether they can precede the other symptoms. Our case indicated very early onset of psychiatric symptoms in this condition.

  8. A Method to Select Test Input Cases for Safety-critical Software

    International Nuclear Information System (INIS)

    Kim, Heeeun; Kang, Hyungook; Son, Hanseong

    2013-01-01

    This paper proposes a new testing methodology for effective and realistic quantification of RPS software failure probability. Software failure probability quantification is important factor in digital system safety assessment. In this study, the method for software test case generation is briefly described. The test cases generated by this method reflect the characteristics of safety-critical software and past inputs. Furthermore, the number of test cases can be reduced, but it is possible to perform exhaustive test. Aspect of software also can be reflected as failure data, so the final failure data can include the failure of software itself and external influences. Software reliability is generally accepted as the key factor in software quality since it quantifies software failures which can make a powerful system inoperative. In the KNITS (Korea Nuclear Instrumentation and Control Systems) project, the software for the fully digitalized reactor protection system (RPS) was developed under a strict procedure including unit testing and coverage measurement. Black box testing is one type of Verification and validation (V and V), in which given input values are entered and the resulting output values are compared against the expected output values. Programmable logic controllers (PLCs) were used in implementing critical systems and function block diagram (FBD) is a commonly used implementation language for PLC

  9. Rapid radioimmunological test for HCG in normal and disturbed early pregnancy

    International Nuclear Information System (INIS)

    Dericks-Tan, J.S.E.; Taubert, H.D.

    1979-01-01

    The clinical evaluation of a rapid radioimmunological test for HCG in serum showed that this method is as suitable as conventional radioimmunoassay or receptor methods in the diagnosis of normal and disturbed early pregnancy. Using a direct immunosorbent method total time requirements for the estimation could be reduced to half a working day. Sera of 314 women with normal pregnancies showed an exponential increase of HCG concentrations in serum during the first 8 weeks and thereafter steady levels for several weeks. As the anti-HCG serum used has only a slight cross reactivity with LH, false-positive results need hardly be expected in states if high LH levels in serum (menopause, polycystic ovaries, preovulatory LH peak). HCG concentrations in serum were clearly diminished in all pregnancies ending in abortion and in nearly all extrauterine pregnancies. Repeated estimations in early pregnancy enable a diagnosis of ectopic or disturbed intrauterine pregnancy to be made before symptoms of rupture, haemorrhage and similar complications occur. (orig.) [de

  10. Proteinuria in children with juvenile idiopathic arthritis: Making the case for early urinary screening

    Directory of Open Access Journals (Sweden)

    Anshuman Saha

    2017-01-01

    Full Text Available Systemic onset juvenile idiopathic arthritis (SOJIA can be associated with proteinuria due to various renal pathologies. We report two pediatric cases with SOJIA and nephrotic syndrome secondary to renal amyloidosis, a very rare complication in children. Once present, amyloidosis heralds a poor prognosis for the patient, though early detection may allow some improvement if the inflammatory arthritis is controlled.

  11. Early Loading of Single-Piece Implant for Partially Edentulous Posterior Arch: A Prospective One-Year Case Report

    Directory of Open Access Journals (Sweden)

    Amol Beldar

    2013-01-01

    Full Text Available Implant therapy is now well established, and there is an increasing need for shorter rehabilitation time. Original prerequisites of osseointegration have been reassessed to satisfy continuously increasing patient's expectation of reduced treatment time, improved esthetics, and increased comfort. Shorter healing time may be appropriate in some circumstances, and examples of early loading have been reported in animal and human studies. However, to date there are insufficient data to determine a universally acceptable opinion on early loading of implants for single-tooth replacement. This case report involves early loading, combined with construction of a restoration, inserted directly after 6 weeks of implant surgery and followup of one year.

  12. Developing a dengue early warning system using time series model: Case study in Tainan, Taiwan

    Science.gov (United States)

    Chen, Xiao-Wei; Jan, Chyan-Deng; Wang, Ji-Shang

    2017-04-01

    Dengue fever (DF) is a climate-sensitive disease that has been emerging in southern regions of Taiwan over the past few decades, causing a significant health burden to affected areas. This study aims to propose a predictive model to implement an early warning system so as to enhance dengue surveillance and control in Tainan, Taiwan. The Seasonal Autoregressive Integrated Moving Average (SARIMA) model was used herein to forecast dengue cases. Temporal correlation between dengue incidences and climate variables were examined by Pearson correlation analysis and Cross-correlation tests in order to identify key determinants to be included as predictors. The dengue surveillance data between 2000 and 2009, as well as their respective climate variables were then used as inputs for the model. We validated the model by forecasting the number of dengue cases expected to occur each week between January 1, 2010 and December 31, 2015. In addition, we analyzed historical dengue trends and found that 25 cases occurring in one week was a trigger point that often led to a dengue outbreak. This threshold point was combined with the season-based framework put forth by the World Health Organization to create a more accurate epidemic threshold for a Tainan-specific warning system. A Seasonal ARIMA model with the general form: (1,0,5)(1,1,1)52 is identified as the most appropriate model based on lowest AIC, and was proven significant in the prediction of observed dengue cases. Based on the correlation coefficient, Lag-11 maximum 1-hr rainfall (r=0.319, Pclimate variables. Comparing the four multivariate models(i.e.1, 4, 9 and 13 weeks ahead), we found that including the climate variables improves the prediction RMSE as high as 3.24%, 10.39%, 17.96%, 21.81% respectively, in contrast to univariate models. Furthermore, the ability of the four multivariate models to determine whether the epidemic threshold would be exceeded in any given week during the forecasting period of 2010-2015 was

  13. 30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

    Science.gov (United States)

    2010-07-01

    ... and diagnostic tests? 250.523 Section 250.523 Mineral Resources MINERALS MANAGEMENT SERVICE... casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing diagnostic test for each casing...

  14. Making System Dynamics Cool IV : Teaching & Testing with Cases & Quizzes

    NARCIS (Netherlands)

    Pruyt, E.

    2012-01-01

    This follow-up paper presents cases and multiple choice questions for teaching and testing System Dynamics modeling. These cases and multiple choice questions were developed and used between January 2012 and April 2012 a large System Dynamics course (250+ 2nd year BSc and 40+ MSc students per year)

  15. Making System Dynamics Cool III : New Hot Teaching & Testing Cases

    NARCIS (Netherlands)

    Pruyt, E.

    2011-01-01

    This follow-up paper presents seven actual cases for testing and teaching System Dynamics developed and used between January 2010 and January 2011 for one of the largest System Dynamics courses (250+ students per year) at Delft University of Technology in the Netherlands. The cases presented in this

  16. Diagnostic yield of hair and urine toxicology testing in potential child abuse cases.

    Science.gov (United States)

    Stauffer, Stephanie L; Wood, Stephanie M; Krasowski, Matthew D

    2015-07-01

    Detection of drugs in a child may be the first objective finding that can be reported in cases of suspected child abuse. Hair and urine toxicology testing, when performed as part of the initial clinical evaluation for suspected child abuse or maltreatment, may serve to facilitate the identification of at-risk children. Furthermore, significant environmental exposure to a drug (considered by law to constitute child abuse in some states) may be identified by toxicology testing of unwashed hair specimens. In order to determine the clinical utility of hair and urine toxicology testing in this population we performed a retrospective chart review on all children for whom hair toxicology testing was ordered at our academic medical center between January 2004 and April 2014. The medical records of 616 children aged 0-17.5 years were reviewed for injury history, previous medication and illicit drug use by caregiver(s), urine drug screen result (if performed), hair toxicology result, medication list, and outcome of any child abuse evaluation. Hair toxicology testing was positive for at least one compound in 106 cases (17.2%), with unexplained drugs in 82 cases (13.3%). Of these, there were 48 cases in which multiple compounds (including combination of parent drugs and/or metabolites within the same drug class) were identified in the sample of one patient. The compounds most frequently identified in the hair of our study population included cocaine, benzoylecgonine, native (unmetabolized) tetrahydrocannabinol, and methamphetamine. There were 68 instances in which a parent drug was identified in the hair without any of its potential metabolites, suggesting environmental exposure. Among the 82 cases in which hair toxicology testing was positive for unexplained drugs, a change in clinical outcome was noted in 71 cases (86.5%). Urine drug screens (UDS) were performed in 457 of the 616 reviewed cases. Of these, over 95% of positive UDS results could be explained by iatrogenic drug

  17. Cell-mediated immunity as an early diagnostic test for osteosarcoma in human radium cases

    International Nuclear Information System (INIS)

    Lloyd, E.L.; Menon, M.; Mitchen, J.L.

    1976-01-01

    Lymphocytes from patients carrying a body burden greater than 0.3 μCi of 226 Ra have been tested for specific cytotoxicity to four different osteosarcoma cell lines as well as to normal human fibroblasts. Cytotoxicity indexes (defined as the ratio of the number of target cells remaining, after treatment with the patients' lymphocytes, relative to the values obtained with normal control subjects) have been calculated. With one exception no cytotoxicity was observed. This is in agreement with the fact that no fresh osteosarcomas were diagnosed. The patient in whom cytotoxicity was found was suffering from an inflammatory lesion involving bone as the result of a foreign-body reaction at the time of the first test. When the test was repeated 10 months later, no cytotoxicity was observed. No significant nonspecific cytotoxicity was observed when lymphocytes from normal control subjects were interacted with any of the target cell lines

  18. Palaeoclimate significance of speleothems in crystalline rocks: a test case from the Late Glacial and early Holocene (Vinschgau, northern Italy)

    Science.gov (United States)

    Koltai, Gabriella; Cheng, Hai; Spötl, Christoph

    2018-03-01

    Partly coeval flowstones formed in fractured gneiss and schist were studied to test the palaeoclimate significance of this new type of speleothem archive on a decadal-to-millennial timescale. The samples encompass a few hundred to a few thousand years of the Late Glacial and the early Holocene. The speleothem fabric is primarily comprised of columnar fascicular optic calcite and acicular aragonite, both indicative of elevated Mg / Ca ratios in the groundwater. Stable isotopes suggest that aragonite is more prone to disequilibrium isotope fractionation driven by evaporation and prior calcite/aragonite precipitation than calcite. Changes in mineralogy are therefore attributed to these two internal fracture processes rather than to palaeoclimate. Flowstones formed in the same fracture show similar δ18O changes on centennial scales, which broadly correspond to regional lacustrine δ18O records, suggesting that such speleothems may provide an opportunity to investigate past climate conditions in non-karstic areas. The shortness of overlapping periods in flowstone growth and the complexity of in-aquifer processes, however, render the establishment of a robust stacked δ18O record challenging.

  19. Intraoperative iodinated contrast swallow with CT-scan delayed control for detection of early complications in laparoscopic gastric bypass: A case series of 260 cases

    Directory of Open Access Journals (Sweden)

    Vincenzo Consalvo, M.D.

    2017-01-01

    Conclusions: This study gives a contribute to the existing issue of fast track in bariatric surgery for the early diagnosis of complications and patients' readmission or non-discharge. In conclusion, the use of intraoperative iodinated water soluble contrast swallow and abdominal CT-scan at 48 h was a safe and accurate test in order to detect and treat any potential early surgical complication in LRYGB.

  20. An epidemiological investigation of the early phase of the porcine epidemic diarrhea (PED) outbreak in Canadian swine herds in 2014: A case-control study.

    Science.gov (United States)

    Perri, Amanda M; Poljak, Zvonimir; Dewey, Cate; Harding, John C S; O'Sullivan, Terri L

    2018-02-01

    The first case of porcine epidemic diarrhea (PED) in Canada was diagnosed in January 2014 in Ontario, approximately 9 months after PED emerged in the United States. An early investigation of the Canadian outbreak suspected that the probable source of the virus was contaminated feed. The objective of this study was to evaluate the role of feed and other possible factors in the early phase of the PED outbreak in Canadian swine herds. The study period of interest for this case-control study was January 22nd to March 1st, 2014. A case herd was defined as a swine herd with a confirmed positive laboratory diagnostic test (RT-PCR) results for PED virus, along with pigs exhibiting typical clinical signs at the herd level during the study period. A questionnaire was administered to participating producers from the 22 Canadian swine herds enrolled (n = 9 case and n = 13 control herds). Case herd producers were asked to provide information from the initial day of onset of clinical signs and 30 days prior to that day. Control herds were matched to a case herd on the basis of province, herd type and approximate size. The period of interest for a control herd was matched to the initial day of clinical signs of PED for the case herd, along with the 30 days prior to this day. The questionnaire questions focused on herd demographics, biosecurity protocols, live animal movements onto and off sites, deadstock movements, feed and people movements for both the case and control herds. The questionnaire for control herds were based on their matched case's period of interest, and together with case herds formed a matched stratum. Multivariable exact conditional logistic regression and mixed multivariable logistic regression models, with the matched stratum as a random effect, were used to assess the association between various risk factors and the odds of PED introduction into a herd. After adjusting for biosecurity practices, the odds of a PED occurrence was 38.1 (95% CI: 2

  1. Oxygen restriction as challenge test reveals early high-fat-diet-induced changes in glucose and lipid metabolism

    NARCIS (Netherlands)

    Duivenvoorde, L.P.M.; Schothorst, van E.M.; Derous, D.; Stelt, van der I.; Masania, J.; Rabbani, N.; Thornalley, P.J.; Keijer, J.

    2015-01-01

    Challenge tests stress homeostasis and may reveal deviations in health that remain masked under unchallenged conditions. Ideally, challenge tests are non-invasive and applicable in an early phase of an animal experiment. Oxygen restriction (OxR; based on ambient, mild normobaric hypoxia) is a

  2. Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

    Science.gov (United States)

    Paliwoda, Michelle; New, Karen; Bogossian, Fiona

    2016-09-01

    All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of

  3. Application of a high throughput method of biomarker discovery to improvement of the EarlyCDT(®-Lung Test.

    Directory of Open Access Journals (Sweden)

    Isabel K Macdonald

    Full Text Available BACKGROUND: The National Lung Screening Trial showed that CT screening for lung cancer led to a 20% reduction in mortality. However, CT screening has a number of disadvantages including low specificity. A validated autoantibody assay is available commercially (EarlyCDT®-Lung to aid in the early detection of lung cancer and risk stratification in patients with pulmonary nodules detected by CT. Recent advances in high throughput (HTP cloning and expression methods have been developed into a discovery pipeline to identify biomarkers that detect autoantibodies. The aim of this study was to demonstrate the successful clinical application of this strategy to add to the EarlyCDT-Lung panel in order to improve its sensitivity and specificity (and hence positive predictive value, (PPV. METHODS AND FINDINGS: Serum from two matched independent cohorts of lung cancer patients were used (n = 100 and n = 165. Sixty nine proteins were initially screened on an abridged HTP version of the autoantibody ELISA using protein prepared on small scale by a HTP expression and purification screen. Promising leads were produced in shake flask culture and tested on the full assay. These results were analyzed in combination with those from the EarlyCDT-Lung panel in order to provide a set of re-optimized cut-offs. Five proteins that still displayed cancer/normal differentiation were tested for reproducibility and validation on a second batch of protein and a separate patient cohort. Addition of these proteins resulted in an improvement in the sensitivity and specificity of the test from 38% and 86% to 49% and 93% respectively (PPV improvement from 1 in 16 to 1 in 7. CONCLUSION: This is a practical example of the value of investing resources to develop a HTP technology. Such technology may lead to improvement in the clinical utility of the EarlyCDT--Lung test, and so further aid the early detection of lung cancer.

  4. A case of Becker muscular dystrophy with early manifestation of cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ki Hyun Doo

    2012-09-01

    Full Text Available An 18-year-old boy was admitted with chest discomfort, nausea, and dyspnea at rest. At the age of 3 years, he underwent muscle biopsy and dystrophin gene analysis owing to an enlarged calf muscle and elevated serum kinase level (6,378 U/L without overt weakness; based on the results, Becker muscular dystrophy (BMD was diagnosed. The dystrophin gene showed deletion of exons 45 to 49. He remained ambulant and could step upstairs without significant difficulties. A chest roentgenogram showed cardiomegaly (cardiothoracic ratio, 54%, and his electrocardiogram (ECG showed abnormal ST-T wave, biatrial enlargement, and left ventricular hypertrophy. The 2-dimensional and M-mode ECGs showed a severely dilated left ventricular cavity with diffuse hypokinesis. The systolic indices were reduced, including fractional shortening (9% and ejection fraction (19%. Despite receiving intensive medical treatment, he died from congestive heart failure 5 months after the initial cardiac symptoms. We report a case of BMD with early-onset dilated cardiomyopathy associated with deletion of exons 45 to 49. Early cardiomyopathy can occur in BMD patients with certain genotypes; therefore, careful follow-up is required even in patients with mild phenotypes of BMD.

  5. Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care.

    Science.gov (United States)

    Duggan, A E; Elliott, C A; Miller, P; Hawkey, C J; Logan, R F A

    2009-01-01

    Early endoscopy, Helicobacter pylori eradication and empirical acid suppression are commonly used dyspepsia management strategies in primary care but have not been directly compared in a single trial. To compare endoscopy, H. pylori test and refer, H. pylori test and treat and empirical acid suppression for dyspepsia in primary care. Patients presenting to their general practitioner with dyspepsia were randomized to endoscopy, H. pylori'test and treat', H. pylori test and endoscope positives, or empirical therapy with symptoms, patient satisfaction, healthcare costs and cost effectiveness at 12 months being the outcomes. At 2 months, the proportion of patients reporting no or minimal dyspeptic symptoms ranged from 74% for those having early endoscopy to 55% for those on empirical therapy (P = 0.009), but at 1 year, there was little difference among the four strategies. Early endoscopy was associated with fewer subsequent consultations for dyspepsia (P = 0.003). 'Test and treat' resulted in fewer endoscopies overall and was most cost-effective over a range of cost assumptions. Empirical therapy resulted in the lowest initial costs, but the highest rate of subsequent endoscopy. Gastro-oesophageal cancers were found in four patients randomized to the H. pylori testing strategies. While early endoscopy offered some advantages 'Test and treat' was the most cost-effective strategy. In older patients, early endoscopy may be an appropriate strategy in view of the greater risk of malignant disease. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

  6. BALANCING ON THE BORDERLINE OF EARLY AFFECT-CONFUSION - PART 2 OF A CASE STUDY TRILOGY

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2013-05-01

    Full Text Available Part 2 of a case study trilogy on early affect-confusion describes the psychotherapy relationship between an angry/helpless client and the psychotherapist’s skill in balancing the “borderline” between behavioral management and affect attunement, historical inquiry and normalization, validation and shame. The therapeutic use of bifurcated questions and juxtaposition reactions is illustrated.

  7. Highly Automated Agile Testing Process: An Industrial Case Study

    Directory of Open Access Journals (Sweden)

    Jarosław Berłowski

    2016-09-01

    Full Text Available This paper presents a description of an agile testing process in a medium size software project that is developed using Scrum. The research methods used is the case study were as follows: surveys, quantifiable project data sources and qualitative project members opinions were used for data collection. Challenges related to the testing process regarding a complex project environment and unscheduled releases were identified. Based on the obtained results, we concluded that the described approach addresses well the aforementioned issues. Therefore, recommendations were made with regard to the employed principles of agility, specifically: continuous integration, responding to change, test automation and test driven development. Furthermore, an efficient testing environment that combines a number of test frameworks (e.g. JUnit, Selenium, Jersey Test with custom-developed simulators is presented.

  8. Automatic Model-Based Generation of Parameterized Test Cases Using Data Abstraction

    NARCIS (Netherlands)

    Calamé, Jens R.; Ioustinova, Natalia; Romijn, J.M.T.; Smith, G.; van de Pol, Jan Cornelis

    2007-01-01

    Developing test suites is a costly and error-prone process. Model-based test generation tools facilitate this process by automatically generating test cases from system models. The applicability of these tools, however, depends on the size of the target systems. Here, we propose an approach to

  9. Performance Evaluation of Commercial Dengue Diagnostic Tests for Early Detection of Dengue in Clinical Samples

    Directory of Open Access Journals (Sweden)

    Tuan Nur Akmalina Mat Jusoh

    2017-01-01

    Full Text Available The shattering rise in dengue virus infections globally has created a need for an accurate and validated rapid diagnostic test for this virus. Rapid diagnostic test (RDT and reverse transcription-polymerase chain reaction (RT-PCR diagnostic detection are useful tools for diagnosis of early dengue infection. We prospectively evaluated the diagnostic performance of nonstructural 1 (NS1 RDT and real-time RT-PCR diagnostic kits in 86 patient serum samples. Thirty-six samples were positive for dengue NS1 antigen while the remaining 50 were negative when tested with enzyme-linked immunosorbent assay (ELISA. Commercially available RDTs for NS1 detection, RTK ProDetect™, and SD Bioline showed high sensitivity of 94% and 89%, respectively, compared with ELISA. GenoAmp® Trioplex Real-Time RT-PCR and RealStar® Dengue RT-PCR tests presented a comparable kappa agreement with 0.722. The result obtained from GenoAmp® Real-Time RT-PCR Dengue test showed that 14 samples harbored dengue virus type 1 (DENV-1, 8 samples harbored DENV-2, 2 samples harbored DENV-3, and 1 sample harbored DENV-4. 1 sample had a double infection with DENV-1 and DENV-2. The NS1 RDTs and real-time RT-PCR tests were found to be a useful diagnostic for early and rapid diagnosis of acute dengue and an excellent surveillance tool in our battle against dengue.

  10. Does provider-initiated HIV testing and counselling lead to higher HIV testing rate and HIV case finding in Rwandan clinics?

    NARCIS (Netherlands)

    Kayigamba, Felix R.; van Santen, Daniëla; Bakker, Mirjam I.; Lammers, Judith; Mugisha, Veronicah; Bagiruwigize, Emmanuel; de Naeyer, Ludwig; Asiimwe, Anita; Schim van der Loeff, Maarten F.

    2016-01-01

    Provider-initiated HIV testing and counselling (PITC) is promoted as a means to increase HIV case finding. We assessed the effectiveness of PITC to increase HIV testing rate and HIV case finding among outpatients in Rwandan health facilities (HF). PITC was introduced in six HFs in 2009-2010. HIV

  11. Full scale turbine-missile casing exit tests

    International Nuclear Information System (INIS)

    Yoshimura, H.R.; Schamaun, J.T.; Sliter, G.E.

    1979-01-01

    Two full-scale tests have simulated the impact of a fragment from a failed turbine disk upon the steel casing of a low-pressure steam turbine with the objective of providing data for making more realistic assessments of turbine missile effects for nuclear power plant designers. Data were obtained on both the energy-absorbing mechanisms of the impact process and the post-impact trajectory of the fragment. (orig.)

  12. Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

    Science.gov (United States)

    Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

    2018-02-26

    Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

  13. KRAS early testing: consensus initiative and cost-effectiveness evaluation for metastatic colorectal patients in an Italian setting.

    Directory of Open Access Journals (Sweden)

    Carlo Barone

    Full Text Available KRAS testing is relevant for the choice of the most appropriate first-line therapy of metastatic colorectal cancer (CRC. Strategies for preventing unequal access to the test should be implemented, but their relevance in the practice is related to economic sustainability. The study adopted the Delphi technique to reach a consensus on several topics. Issues related to execution of KRAS testing were identified by an expert's board and proposed to 108 Italian oncologists and pathologists through two subsequent questionnaires. The emerging proposal was evaluated by decision analyses models employed by technology assessment agencies in order to assess cost-effectiveness. Alternative therapeutic strategies included most commonly used chemotherapy regimens alone or in combination with cetuximab or bevacizumab. The survey indicated that time interval for obtaining KRAS test should not exceed 15 days, 10 days being an optimal interval. To assure the access to proper treatment, a useful strategy should be to anticipate the test after radical resection in patients at high risk of relapse. Early KRAS testing in high risk CRC patients generates incremental cost-effectiveness ratios between 6,000 and 13,000 Euro per quality adjusted life year (QALY gained. In extensive sensitivity analyses ICER's were always below 15,000 Euro per QALY gained, far within the threshold of 60,000 Euro/QALY gained accepted by regulatory institutions in Italy. In metastatic CRC a time interval higher than 15 days for result of KRAS testing limits access to therapeutic choices. Anticipating KRAS testing before the onset of metastatic disease in patients at high risk does not affect the sustainability and cost-effectiveness profile of cetuximab in first-line mCRC. Early KRAS testing may prevent this inequality in high-risk patients, whether they develop metastases, and is a cost-effective strategy. Based on these results, present joined recommendations of Italian societies of

  14. The applied observation of ultrasonography on before and after anti-early pregnancy with mifepristone (reports of 660 cases)

    International Nuclear Information System (INIS)

    Liu Qinglan; Li Yan; Li Julian; He Lihong

    2004-01-01

    Objective: To estimate the clinical significance of ultrasonography on before and after anti-early pregnancy with mifepristone. Methods: 660 cases of premedical abortion were ultrasonic diagnosed to know the status of inner-uterus pregnancy and exclude the taboo of medical abortion; after-medical abortion ultrasonic were performed to find rudimental embryo in uterus, recuperation of uterus, etc. Results: 88.18% of cases are full abortion; 10.15% of cases are semi-abortion; 1.7% of cases are unsuccessful abortion. Conclusions: It is a quick and safe method to use ultrasonography before and after medical abortion. (authors)

  15. Metamorphic Testing Integer Overflow Faults of Mission Critical Program: A Case Study

    Directory of Open Access Journals (Sweden)

    Zhanwei Hui

    2013-01-01

    Full Text Available For mission critical programs, integer overflow is one of the most dangerous faults. Different testing methods provide several effective ways to detect the defect. However, it is hard to validate the testing outputs, because the oracle of testing is not always available or too expensive to get, unless the program throws an exception obviously. In the present study, the authors conduct a case study, where the authors apply a metamorphic testing (MT method to detect the integer overflow defect and alleviate the oracle problem in testing critical program of Traffic Collision Avoidance System (TCAS. Experimental results show that, in revealing typical integer mutations, compared with traditional safety property testing method, MT with a novel symbolic metamorphic relation is more effective than the traditional method in some cases.

  16. A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients.

    Science.gov (United States)

    Myers, Ronald E; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C; Waldman, Scott A

    2016-10-03

    We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption. We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results. Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using the new prognostic test. Multivariable analyses showed that physicians in academic medical centers were significantly more receptive to molecular test use than those in non-academic settings. Forty-one percent of respondents were ready to act on abnormal molecular test results. Physicians who viewed current staging methods as inaccurate and were confident in their capacity to incorporate molecular testing in practice were more likely to say they would act on abnormal test results. Physician receptivity to molecular diagnostic testing for early-stage colon cancer patients is likely to be influenced by practice setting and perceptions related to delivering quality care to patients. ClinicalTrials.gov Identifier: NCT01972737.

  17. Predictors of early neurological deterioration after ischaemic stroke: a case-control study.

    Science.gov (United States)

    Barber, Mark; Wright, Fiona; Stott, David J; Langhorne, Peter

    2004-01-01

    Early neurological deterioration after ischaemic stroke (stroke in progression) is reported to be common and associated with poor outcome or death. The causes of progressing stroke are, however, uncertain. To determine whether prior drug treatment (with anticoagulant or antiplatelet agents) or early adverse physiological features (pyrexia, hypoxia, dehydration or hyperglycaemia) are associated with progressing ischaemic stroke. The study used a case-control design. From a database of 873 consecutive acute stroke admissions, 196 cases of progressing ischaemic stroke (defined by point deterioration in components of the Scandinavian Stroke Scale or death over the first 72 h after hospital admission) were matched to 196 controls on the basis of age and stroke type. Univariate and conditional logistic regression techniques were used to explore predictors of progressing stroke. Cases and controls were well matched for baseline stroke severity. Warfarin use prior to admission was associated with a reduced risk of progressing stroke [odds ratio (OR) 0.10, p = 0.005]. Prior antiplatelet use was not related. A previous history of diabetes (OR 2.11, p = 0.039) and elevated systolic blood pressure on admission (OR 1.01 for each 1 mm Hg rise, p = 0.017) predicted progressing stroke. Although there were no differences in time to presentation or to brain imaging, a visible causative lesion on CT scanning was more common in the progressing stroke group (OR 2.30, p = 0.022). We found no evidence that adverse physiological features were associated with progressing stroke. Outcomes were worse in the progressing stroke group with 70% being dead or dependent by 30 days compared to 55% in the control group (p = 0.002). Prior warfarin use may be protective against progressing ischaemic stroke. A previous history of diabetes along with elevated admission systolic blood pressure predict deterioration. We found no evidence for an association between adverse physiological features and

  18. Early diagnosis of sub-clinical stage of diabetic retinopathy

    Directory of Open Access Journals (Sweden)

    Xing-Hui Xu

    2014-12-01

    Full Text Available AIM: To evaluate the early diagnosis of sub-clinic stage of diabetic retinopathy.METHODS: This was cross sectional study,multifocal retina electroretinogram(mf-ERG, contrast sensitivity(CSand central retinal artery color Doppler examination were recorded from 30 cases(30 eyesmatched control subjects, 35 cases(35 eyeswith type 2 diabetes mellitus(DMwithout diabetic retinopathy(NDRand 38 cases(38 eyeswith non-prolifera tive diabetic retinopathy(NPDR. One-way ANOVA and SNK-q test were used for data analysis.RESULTS: P1 response density of NDR patients were found decrease, N1 implicit time were delayed. Which were related with the degree of retinopathy(PPPP>0.05, The differences between normal group, NDR group and NPDR group were found statistically significant(PCONCLUSION: mf-ERG and CS are sensitive indexes for early evaluation of visual function in patients with diabetes mellitus, with development of the disease, CRA blood flow also appears to decline.

  19. Precursors of adolescent substance use from early childhood and early adolescence: testing a developmental cascade model.

    Science.gov (United States)

    Sitnick, Stephanie L; Shaw, Daniel S; Hyde, Luke W

    2014-02-01

    This study examined developmentally salient risk and protective factors of adolescent substance use assessed during early childhood and early adolescence using a sample of 310 low-income boys. Child problem behavior and proximal family risk and protective factors (i.e., parenting and maternal depression) during early childhood, as well as child and family factors and peer deviant behavior during adolescence, were explored as potential precursors to later substance use during adolescence using structural equation modeling. Results revealed that early childhood risk and protective factors (i.e., child externalizing problems, mothers' depressive symptomatology, and nurturant parenting) were indirectly related to substance use at the age of 17 via risk and protective factors during early and middle adolescence (i.e., parental knowledge and externalizing problems). The implications of these findings for early prevention and intervention are discussed.

  20. Giant deep orbital dermoid cyst presenting early in infancy in a Nigerian child: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Fasina Oluyemi

    2012-09-01

    Full Text Available Abstract Introduction Dermoid cysts are the most common orbital cystic lesions seen in children. While superficial orbital dermoid cysts present early in life, deep dermoid cysts remain clinically occult until adolescence or adulthood. We here present a case of a deep orbital dermoid cyst in a Nigerian child that became symptomatic early in infancy. Case presentation A female Nigerian infant of Yoruba ethnicity presented at three months of age with left non-axial proptosis and a hazy cornea. A superotemporal cystic orbital mass was seen on ultrasonography, and her parents were counseled for simple tumor excision. They however defaulted, only for their child to re-present two years later with gradually progressive proptosis, an enlarged orbit and keratinized ocular surface, necessitating orbital exenteration. Conclusion Deep orbital dermoid cysts may be symptomatic from birth. Late presentation may result in an irreversible loss of vision, as demonstrated in our case. The need for public enlightenment on early presentation and prompt management of such benign lesions is emphasized.

  1. Endoscopic Treatment of Early Gastric Obstruction After Sleeve Gastrectomy: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Mariana Nuno Costa

    2016-01-01

    Full Text Available Morbid obesity is an epidemic and complex disease which imposes a multidisciplinary approach. Laparoscopic sleeve gastrectomy has become a frequent procedure given its efficacy and safety compared to other surgical options. However, it isn’t free from complications. Lax gastric fixation or incorrect positioning of the stomach during surgery can result in early gastric outlet obstruction caused by a volvulus-like mechanism by rotation of the stomach around its anatomic axes. This report refers to two cases of post sleeve gastric torsion resulting in persisting vomiting after initiating oral intake. The diagnosis was confirmed by upper gastrointestinal-contrast study and gastroscopy. In both cases, a fully covered self-expandable metallic stent was inserted which prompted the gastric lumen to become permeable resulting in symptomatic resolution. The stents were removed endoscopically after two and three months. Beyond more than three years of follow-up, the patients remain asymptomatic and no recurring “stenosis” was noticed. In these cases the use of fully covered self-expandable metallic stents demonstrated to be effective and safe in the treatment of post sleeve gastric torsion.

  2. Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.

    Science.gov (United States)

    Namikawa, Tsutomu; Kawanishi, Yasuhiro; Fujisawa, Kazune; Munekage, Eri; Munekage, Masaya; Sugase, Takahito; Maeda, Hiromichi; Kitagawa, Hiroyuki; Kumon, Tatsuya; Hiroi, Makoto; Kobayashi, Michiya; Hanazaki, Kazuhiro

    2017-08-29

    The metastasis of malignant tumors to the spleen is rare, and only a small percentage of cases can be treated surgically, as splenic metastases generally occur in the context of multivisceral metastatic cancer at a terminal stage. We report a rare case of metachronous solitary splenic metastasis arising from early gastric cancer. A 75-year-old man was initially referred to our hospital for examination of gastric cancer, diagnosed at a medical check-up. Esophagogastroduodenoscopy showed a slightly elevated lesion with a central irregular depression in the upper-third of the stomach. Biopsy specimens of the lesion showed a moderately-differentiated adenocarcinoma, and abdominal computed tomography showed no evidence of distant metastases. Endoscopic submucosal dissection was performed, with histological confirmation of a moderately-differentiated adenocarcinoma invading the submucosal layer. The patient subsequently underwent laparoscopic total gastrectomy with regional lymph node dissection, resulting in no residual carcinoma and no lymph node metastasis. Computed tomography, 28 months later, showed a well-defined mass measuring 4.2 cm in diameter in the spleen, and the patient underwent a splenectomy, since there was no evidence of further metastatic lesions in any other organs. Histological examination confirmed the diagnosis of a poorly-differentiated adenocarcinoma originating from the previous gastric cancer. The patient was alive 2 months after surgical resection of the splenic metastasis without any recurrence. To the best of our knowledge, this is only the second case of a solitary splenic metastasis from early gastric cancer to be reported in the English literature. The present case suggests surgical resection may be the preferred treatment of choice for patients with a solitary splenic metastasis from gastric cancer.

  3. FARO base case post-test analysis by COMETA code

    Energy Technology Data Exchange (ETDEWEB)

    Annunziato, A.; Addabbo, C. [Joint Research Centre, Ispra (Italy)

    1995-09-01

    The paper analyzes the COMETA (Core Melt Thermal-Hydraulic Analysis) post test calculations of FARO Test L-11, the so-called Base Case Test. The FARO Facility, located at JRC Ispra, is used to simulate the consequences of Severe Accidents in Nuclear Power Plants under a variety of conditions. The COMETA Code has a 6 equations two phase flow field and a 3 phases corium field: the jet, the droplets and the fused-debris bed. The analysis shown that the code is able to pick-up all the major phenomena occurring during the fuel-coolant interaction pre-mixing phase.

  4. Music therapy for early cognitive rehabilitation post-childhood TBI: an intrinsic mixed methods case study.

    Science.gov (United States)

    Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen

    2014-10-01

    The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

  5. Atypical manifestations of early syphilis

    Directory of Open Access Journals (Sweden)

    R V Koranne

    1990-01-01

    Full Text Available A study of 36 untreated patients with early syphilis revealed atypical variations namely; long incubation period of 101 days in I patient, more than 3 chancres in 1, undermined margin of the chancre along with tenderness in 1 and moderate to severe tenderness of the ulcers in 2 cases. In 3 patients there was no indurations of the ulcers. Three patients with primary syphilis had unilateral lymphadenitis, and in I case the lymph nodes were not only tender but showed tendency towardsmatingawell. Insecondarysyphilis, 11 out of 16 patients having condylomata lata had no other muco-cutaneous lesions. Concomitant presence of other venereal disease to account for the atypical manifestations was discounted- by appropriate laboratory tests, response to therapeutic agents and follow up.

  6. The role of ability, motivation, and opportunity to work in the transition from work to early retirement--testing and optimizing the Early Retirement Model.

    Science.gov (United States)

    de Wind, Astrid; Geuskens, Goedele A; Ybema, Jan Fekke; Bongers, Paulien M; van der Beek, Allard J

    2015-01-01

    Determinants in the domains health, job characteristics, skills, and social and financial factors may influence early retirement through three central explanatory variables, namely, the ability, motivation, and opportunity to work. Based on the literature, we created the Early Retirement Model. This study aims to investigate whether data support the model and how it could be improved. Employees aged 58-62 years (N=1862), who participated in the first three waves of the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) were included. Determinants were assessed at baseline, central explanatory variables after one year, and early retirement after two years. Structural equation modeling was applied. Testing the Early Retirement Model resulted in a model with good fit. Health, job characteristics, skills, and social and financial factors were related to the ability, motivation and/or opportunity to work (significant β range: 0.05-0.31). Lower work ability (β=-0.13) and less opportunity to work (attitude colleagues and supervisor about working until age 65: β=-0.24) predicted early retirement, whereas the motivation to work (work engagement) did not. The model could be improved by adding direct effects of three determinants on early retirement, ie, support of colleagues and supervisor (β=0.14), positive attitude of the partner with respect to early retirement (β=0.15), and not having a partner (β=-0.13). The Early Retirement Model was largely supported by the data but could be improved. The prolongation of working life might be promoted by work-related interventions focusing on health, work ability, the social work climate, social norms on prolonged careers, and the learning environment.

  7. Effectiveness of test driven development and continuous integration - a case study

    NARCIS (Netherlands)

    Amrit, Chintan; Meijberg, Yoni

    2018-01-01

    In this article we describe the implementation of hybrid agile practices, namely Test Driven Development (TDD) and Continuous Integration (CI) at a Dutch SME. The quality and productivity outcomes of the case study were compared to a performance baseline set by a reference case, a preceding

  8. Learning to Learn: An Analysis of Early Learning Behaviours Demonstrated by Young Deaf/Hard-of-Hearing Children with High/Low Mathematics Ability

    Science.gov (United States)

    Pagliaro, Claudia M.; Kritzer, Karen L.

    2010-01-01

    Using a multiple case-study design, this study compares the early learning behaviours of young deaf/hard-of-hearing (d/hh) children with high/low mathematics ability (as defined by test score on the Test of Early Mathematics Ability-3). Children's simultaneous use of multiple learning behaviours was also examined as were contributing adult…

  9. Brief Report: Impact of Early Antiretroviral Therapy on the Performance of HIV Rapid Tests and HIV Incidence Assays.

    Science.gov (United States)

    Fogel, Jessica M; Piwowar-Manning, Estelle; Debevec, Barbara; Walsky, Tamara; Schlusser, Katherine; Laeyendecker, Oliver; Wilson, Ethan A; McCauley, Marybeth; Gamble, Theresa; Tegha, Gerald; Soko, Dean; Kumwenda, Johnstone; Hosseinipour, Mina C; Chen, Ying Q; Cohen, Myron S; Eshleman, Susan H

    2017-08-01

    Antiretroviral therapy (ART) can downregulate antibody responses to HIV infection. We evaluated the impact of early vs. delayed ART on the performance of HIV diagnostic and incidence assays. Samples were obtained from 207 participants in the HPTN 052 trial, who were stably suppressed on ART for ≥4 years [Malawi sites; pre-ART CD4 cell count 350-550 cells/mm (early ART arm, N = 180) or ART arm, N = 27)]. Samples were tested with 2 HIV rapid tests and 2 HIV incidence assays; selected samples were also tested with two fourth-generation immunoassays and a Western blot (WB) assay. A pre-ART sample was analyzed if the follow-up sample had a false-negative or weakly-reactive rapid test result, or had an incidence assay result indicative of recent infection (false-recent result). Ten (4.8%) samples had a nonreactive or weakly-reactive rapid test result (7/180 early ART arm, 3/27 delayed ART arm, P = 0.13); one sample had nonreactive fourth-generation assay results and 3 had indeterminate WBs. Forty (18.9%) samples had a false-recent incidence assay result; 16 (7.8%) had false-recent results with both incidence assays. Baseline samples had stronger rapid test and WB bands, higher fourth-generation assay signal-to-cutoff values, and fewer HIV incidence assay results indicative of recent infection. False-negative/weakly-reactive HIV rapid tests and false-recent HIV incidence assay results were observed in virally-suppressed individuals, regardless of pre-ART CD4 cell count. Downregulation of the antibody response to HIV infection in the setting of ART may impact population-level surveys of HIV prevalence and incidence.

  10. Early detection of Alzheimer disease: methods, markers, and misgivings.

    Science.gov (United States)

    Green, R C; Clarke, V C; Thompson, N J; Woodard, J L; Letz, R

    1997-01-01

    There is at present no reliable predictive test for most forms of Alzheimer disease (AD). Although some information about future risk for disease is available in theory through ApoE genotyping, it is of limited accuracy and utility. Once neuroprotective treatments are available for AD, reliable early detection will become a key component of the treatment strategy. We recently conducted a pilot survey eliciting attitudes and beliefs toward an unspecified and hypothetical predictive test for AD. The survey was completed by a convenience sample of 176 individuals, aged 22-77, which was 75% female, 30% African-American, and of which 33% had a family member with AD. The survey revealed that 69% of this sample would elect to obtain predictive testing for AD if the test were 100% accurate. Individuals were more likely to desire predictive testing if they had an a priori belief that they would develop AD (p = 0.0001), had a lower educational level (p = 0.003), were worried that they would develop AD (p = 0.02), had a self-defined history of depression (p = 0.04), and had a family member with AD (p = 0.04). However, the desire for predictive testing was not significantly associated with age, gender, ethnicity, or income. The desire to obtain predictive testing for AD decreased as the assumed accuracy of the hypothetical test decreased. A better short-term strategy for early detection of AD may be computer-based neuropsychological screening of at-risk (older aged) individuals to identify very early cognitive impairment. Individuals identified in this manner could be referred for diagnostic evaluation and early cases of AD could be identified and treated. A new self-administered, touch-screen, computer-based, neuropsychological screening instrument called Neurobehavioral Evaluation System-3 is described, which may facilitate this type of screening.

  11. A case of early-onset radiation retinopathy

    International Nuclear Information System (INIS)

    Sato, Yoko; Den, Seika; Shimizu, Kazuhiro; Ikeda, Tsunehiko

    2001-01-01

    We encountered a 27-year-old male early caused by radiation retinopathy five months after radiotherapy (51 Gy) for astrocytoma. The retinopathy was the proliferative retinopathy, with several dot and blot hemorrhages, hard and soft exudate, increased capillary permeability, macula edema and avasucular areas. So it was treated with panretial photocoagulation like diabetic retinopathy. Now hemorrhage, exudate, edema and avascular areas were improved. Photocoagulation treatment is effective to stop the progression of radiation retinopathy. Radiation retinopathy is sometimes early caused, therefore long-term follow up is recommended on starting radiotherapy. (author)

  12. A case of early-onset radiation retinopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Yoko; Den, Seika; Shimizu, Kazuhiro; Ikeda, Tsunehiko [Osaka Medical Coll., Takatsuki (Japan)

    2001-12-01

    We encountered a 27-year-old male early caused by radiation retinopathy five months after radiotherapy (51 Gy) for astrocytoma. The retinopathy was the proliferative retinopathy, with several dot and blot hemorrhages, hard and soft exudate, increased capillary permeability, macula edema and avasucular areas. So it was treated with panretial photocoagulation like diabetic retinopathy. Now hemorrhage, exudate, edema and avascular areas were improved. Photocoagulation treatment is effective to stop the progression of radiation retinopathy. Radiation retinopathy is sometimes early caused, therefore long-term follow up is recommended on starting radiotherapy. (author)

  13. Epidural Brain Metastases in a Patient with Early Onset Pancreatic Cancer: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Aibek E. Mirrakhimov

    2012-01-01

    Full Text Available We present a case of early onset pancreatic cancer related extra-axial brain metastases. A 46-year-old Caucasian non-Jewish nonobese male with a history of PC diagnosed 3 months ago with metastases to the liver, omentum, malignant ascites, and a history of a pulmonary embolism was admitted to the hospital because of a new onset headache, nausea, and vomiting which started 2 days prior to the encounter. Brain MRI was ordered, which showed acute bihemispheric subdural hematomas and left hemispheric extra-axial heterogeneously enhancing lesions consisting with metastatic disease. The patient was started on ondansentron, metoclopramide, and dexamethasone. The cranial irradiation was started, and the patient’s headache and nausea significantly improved. There are only 9 published reports of extra-axial brain metastases related to the pancreatic cancer, whereas our paper is the first such case reported on a patient with epidural metastases and early onset pancreatic cancer.

  14. Use of combinatorial pharmacogenomic testing in two cases from community psychiatry

    Directory of Open Access Journals (Sweden)

    Fields ES

    2016-08-01

    Full Text Available Eve S Fields,1 Raymond A Lorenz,2 Joel G Winner2 1Northwest Center for Community Mental Health, Reston, VA, USA; 2Assurex Health, Mason, OH, USA Abstract: This report describes two cases in which pharmacogenomic testing was utilized to guide medication selection for difficult to treat patients. The first patient is a 29-year old male with bipolar disorder who had severe akathisia due to his long acting injectable antipsychotic. The second patient is a 59-year old female with major depressive disorder who was not ­responding to her medication. In both cases, a proprietary combinatorial pharmacogenomic test was used to inform medication changes and improve patient outcomes. The first patient was switched to a long acting injectable that was not affected by his genetic profile and his adverse effects abated. The second patient had her medications discontinued due to the results of the genetic testing and more intense psychotherapy initiated. While pharmacogenomic testing may be ­helpful in cases such as these presented here, it should never serve as a proxy for a comprehensive biopsychosocial approach. The pharmacogenomic information may be selectively added to this comprehensive approach to support medication treatment. Keywords: pharmacogenomics, adverse effects, risperidone, nortriptyline, paliperidone

  15. Predictive value of vaginal IL-6 and TNFα bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes.

    Science.gov (United States)

    Kayem, Gilles; Batteux, Frederic; Girard, Noémie; Schmitz, Thomas; Willaime, Marion; Maillard, Francoise; Jarreau, Pierre Henri; Goffinet, Francois

    2017-04-01

    Examine the predictive value for maternal-fetal infection of routine bedside tests detecting the proinflammatory cytokines, TNFα and IL-6, in the vaginal secretions of women with premature rupture of the membranes (PROM). This prospective two-center cohort study included all women hospitalized for PROM over a 2-year period. A bedside test assessed IL-6 and TNFα in vaginal secretions. Both centers routinely tested CRP and leukocytes, assaying both in maternal serum, and analyzed vaginal bacterial flora; all samples were repeated twice weekly until delivery. The study included 689 women. In cases of preterm PROM (PPROM) before 37 weeks (n=184), a vaginal sample positive for one or more bacteria was the only marker associated with early neonatal infection (OR 5.6, 95%CI; 2.0-15.7). Its sensitivity was 82% (95%CI; 62-94) and its specificity 56% (95%CI; 47-65). All positive markers of infection were associated with the occurrence of chorioamnionitis. In cases of PROM from 37 weeks onward (n=505), only CRP >5mg/dL was associated with early neonatal infection (OR=8.3, 95%CI; 1.1-65.4) or clinical chorioamnionitis (OR=6.8, 95%CI; 1.5-30.0). The sensitivity of CRP >5mg/dL was 91% (95%CI; 59-100) and its specificity 45% (95%CI; 40-51) for predicting early neonatal infection, and 89% (95%CI; 65-99) and 46% (95%CI; 41-51), respectively, for predicting clinical chorioamnionitis. The association of vaginal cytokines with maternal-fetal infection is weak and thus prevents their use as a good predictor of maternal-fetal infection. CRP and vaginal samples may be useful for identifying a group of women at low risk of infection. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Concept Test of a Smoking Cessation Smart Case.

    Science.gov (United States)

    Comello, Maria Leonora G; Porter, Jeannette H

    2018-04-05

    Wearable/portable devices that unobtrusively detect smoking and contextual data offer the potential to provide Just-In-Time Adaptive Intervention (JITAI) support for mobile cessation programs. Little has been reported on the development of these technologies. To address this gap, we offer a case report of users' experiences with a prototype "smart" cigarette case that automatically tracks time and location of smoking. Small-scale user-experience studies are typical of iterative product design and are especially helpful when proposing novel ideas. The purpose of the study was to assess concept acceptability and potential for further development. We tested the prototype case with a small sample of potential users (n = 7). Participants used the hardware/software for 2 weeks and reconvened for a 90-min focus group to discuss experiences and provide feedback. Participants liked the smart case in principle but found the prototype too bulky for easy portability. The potential for the case to convey positive messages about self also emerged as a finding. Participants indicated willingness to pay for improved technology (USD $15-$60 on a one-time basis). The smart case is a viable concept, but design detail is critical to user acceptance. Future research should examine designs that maximize convenience and that explore the device's ability to cue intentions and other cognitions that would support cessation. This study is the first to our knowledge to report formative research on the smart case concept. This initial exploration provides insights that may be helpful to other developers of JITAI-support technology.

  17. Early detection of interstitial pneumonia by WXGa-citrate scintigraphy. Cases of abnormal pulmonary WXGa uptake with normal chest radiographs

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Shinsaku; Mikami, Riichiro; Ryujin, Yoshitada

    1985-04-01

    In this paper we report our recent experience indicating usefulness of WXGa-citrate scintigraphy in 4 cases with inflammatory pulmonary diseases. These cases showed abnormal pulmonary WXGa uptake with normal chest radiographs. The first case with malignant lymphoma and the second one with lung cancer suffered from pulmonary infection following secondary immuno-insufficiency due to radiotherapy and chemotherapy. Pneumocystis carinii was suspected as causative agent in the first case, and gram negative bacilli in the second case. The third case with lung cancer developed radiation pneumonia after radiotherapy. The fourth case with acute bronchitis developed drug induced interstitial pneumonia presumably due to minocycline administration. It is concluded that WXGa-citrate scintigraphy is more sensitive for early detection of interstitial pneumonia than routine chest radiography.

  18. Early Experience with Laparoscopic Management of Nonpalpable Undescended Testes.

    Science.gov (United States)

    Ekwunife, Okechukwu Hyginus; Modekwe, Victor Ifeanyichukwu; Ugwu, Jideofor Okechukwu; Ugwunne, Chuka Abunike

    2017-01-01

    Nonpalpable undescended testes (NPT) constitute 20%-30% of undescended testes, and its management has been a challenge both in diagnosis and treatment. Worldwide, laparoscopy is the current gold standard of management. In Nigeria, the management of NPT has largely been by open surgery with consequent high morbidity. In Nigeria, the trend is changing from a largely open management with its attendant high morbidity, to laparoscopic management which is the current worldwide gold standard of care. This study aims to classify the laparoscopic features of NPT and determine the outcome of managed cases in our center. Prospective data were collected from consecutive patients who had laparoscopy for NPT at the Paediatric Surgical Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from June 2014 to July 2016. A total of 15 patients with 23 testes were treated. There were eight patients with bilateral NPT; four had left and the remaining three right NPT. The age ranged from 1.2 to 29 years with a median of 5 years. Eleven out of the 22 internal inguinal rings were open. The position of the testes was canalicular (2), peeping (2), low abdominal (6), high abdominal (6), blind-ended vas (1), absent vas and vessels (5). No further intervention was needed for the six agenetic/atrophic testes. Standard open orchiopexy was done for the two canalicular testes. Eight testes were brought down by one stage laparoscopic orchiopexy while four were brought down by staged laparoscopic Fowler-Stephens procedure. Laparoscopic orchiectomy was done in two patients (a grossly dysmorphic testes [nubbin] and a high abdominal testis in a 29-year-old). Orchiopexy was successful in 11 out of 15 fixed testes. Of the unsuccessful ones, three testes were atrophic (volume less than what it was initially) while two were high scrotal (one testes has both complications). There was no conversion to open abdominal surgery. All patients were discharged within 24 h of surgery. Laparoscopy

  19. Early experience with laparoscopic management of nonpalpable undescended testes

    Directory of Open Access Journals (Sweden)

    Okechukwu Hyginus Ekwunife

    2017-01-01

    Full Text Available Background: Nonpalpable undescended testes (NPT constitute 20%–30% of undescended testes, and its management has been a challenge both in diagnosis and treatment. Worldwide, laparoscopy is the current gold standard of management. In Nigeria, the management of NPT has largely been by open surgery with consequent high morbidity. In Nigeria, the trend is changing from a largely open management with its attendant high morbidity, to laparoscopic management which is the current worldwide gold standard of care. Aim: This study aims to classify the laparoscopic features of NPT and determine the outcome of managed cases in our center. Methodology: Prospective data were collected from consecutive patients who had laparoscopy for NPT at the Paediatric Surgical Unit of Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria from June 2014 to July 2016. Results: A total of 15 patients with 23 testes were treated. There were eight patients with bilateral NPT; four had left and the remaining three right NPT. The age ranged from 1.2 to 29 years with a median of 5 years. Eleven out of the 22 internal inguinal rings were open. The position of the testes was canalicular (2, peeping (2, low abdominal (6, high abdominal (6, blind-ended vas (1, absent vas and vessels (5. No further intervention was needed for the six agenetic/atrophic testes. Standard open orchiopexy was done for the two canalicular testes. Eight testes were brought down by one stage laparoscopic orchiopexy while four were brought down by staged laparoscopic Fowler-Stephens procedure. Laparoscopic orchiectomy was done in two patients (a grossly dysmorphic testes [nubbin] and a high abdominal testis in a 29-year-old. Orchiopexy was successful in 11 out of 15 fixed testes. Of the unsuccessful ones, three testes were atrophic (volume less than what it was initially while two were high scrotal (one testes has both complications. There was no conversion to open abdominal surgery. All patients were

  20. The Long-Term Cognitive Consequences of Early Childhood Malnutrition: The Case of Famine in Ghana

    OpenAIRE

    Samuel K. Ampaabeng; Chih Ming Tang

    2012-01-01

    We examine the role of early childhood health in human capital accumulation. Using a unique data set from Ghana with comprehensive information on individual, family, community, school quality characteristics and a direct measure of intelligence together with test scores, we examine the long-term cognitive effects of the 1983 famine on survivors. We show that differences in intelligence test scores can be robustly explained by the differential impact of the famine in different parts of the cou...

  1. The Influence of Test-Based Accountability Policies on Early Elementary Teachers: School Climate, Environmental Stress, and Teacher Stress

    Science.gov (United States)

    Saeki, Elina; Segool, Natasha; Pendergast, Laura; von der Embse, Nathaniel

    2018-01-01

    This study examined the potential influence of test-based accountability policies on school environment and teacher stress among early elementary teachers. Structural equation modeling of data from 541 kindergarten through second grade teachers across three states found that use of student performance on high-stakes tests to evaluate teachers…

  2. Gitelman syndrome manifesting in early childhood and leading to delayed puberty: a case report

    Directory of Open Access Journals (Sweden)

    Raza Farhan

    2012-10-01

    Full Text Available Abstract Introduction Gitelman syndrome is an inherited autosomal recessive renal salt-wasting disorder. It presents with variable clinical symptoms including muscle weakness and fatigue, and the diagnosis is based on metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. It is usually diagnosed incidentally in early adulthood. There are rare cases of Gitelman syndrome presenting in early childhood; however, to the best of our knowledge it has not previously been associated with delayed puberty. Case presentation A 17-year-old South Asian man with recurrent episodes of generalized muscle weakness, fatigue and cramps from the age of two years was admitted for further workup. Before the age of 12 years, the episodes had been mild, but they then got progressively worse. Other symptoms include polyuria, polydipsia, nocturia, paresthesia and occasional watery diarrhea. He also had a history of short stature, poor weight gain and delayed developmental landmarks. His family history was unremarkable except for the consanguineous marriage of his parents. An examination revealed a thin and lean man with blood pressure of 95/60mmHg. His height and weight were below the third percentile and his sexual development was at Tanner Stage II. Laboratory work revealed serum sodium of 124mmol/L, potassium 2.4mmol/L, calcium 6.5mmol/L and magnesium of 1.2mg/dL. His testosterone level was low (0.85ng/mL, normal for his age 2.67 to 10.12ng/mL with normal levels of luteinizing hormone and follicle-stimulating hormone. The sex hormone findings were attributed to delayed puberty. A 24-hour urinary analysis revealed decreased excretion of calcium (25.9mg/24 hours. Based on the findings of hypokalemic metabolic alkalosis without hypertension, severe hypomagnesemia and hypocalciuria, a diagnosis of Gitelman syndrome was made. Treatment was started with oral supplementation of potassium, magnesium and calcium along with spironolactone and liberal salt intake

  3. An Extended Quadratic Frobenius Primality Test with Average and Worst Case Error Estimates

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Frandsen, Gudmund Skovbjerg

    2003-01-01

    We present an Extended Quadratic Frobenius Primality Test (EQFT), which is related to an extends the Miller-Rabin test and the Quadratic Frobenius test (QFT) by Grantham. EQFT takes time about equivalent to 2 Miller-Rabin tests, but has much smaller error probability, namely 256/331776t for t...... for the error probability of this algorithm as well as a general closed expression bounding the error. For instance, it is at most 2-143 for k = 500, t = 2. Compared to earlier similar results for the Miller-Rabin test, the results indicates that our test in the average case has the effect of 9 Miller......-Rabin tests, while only taking time equivalent to about 2 such tests. We also give bounds for the error in case a prime is sought by incremental search from a random starting point....

  4. An Extended Quadratic Frobenius Primality Test with Average- and Worst-Case Error Estimate

    DEFF Research Database (Denmark)

    Damgård, Ivan Bjerre; Frandsen, Gudmund Skovbjerg

    2006-01-01

    We present an Extended Quadratic Frobenius Primality Test (EQFT), which is related to an extends the Miller-Rabin test and the Quadratic Frobenius test (QFT) by Grantham. EQFT takes time about equivalent to 2 Miller-Rabin tests, but has much smaller error probability, namely 256/331776t for t...... for the error probability of this algorithm as well as a general closed expression bounding the error. For instance, it is at most 2-143 for k = 500, t = 2. Compared to earlier similar results for the Miller-Rabin test, the results indicates that our test in the average case has the effect of 9 Miller......-Rabin tests, while only taking time equivalent to about 2 such tests. We also give bounds for the error in case a prime is sought by incremental search from a random starting point....

  5. Optimized periodic verification testing blended risk and performance-based MOV inservice test program an application of ASME code case OMN-1

    Energy Technology Data Exchange (ETDEWEB)

    Sellers, C.; Fleming, K.; Bidwell, D.; Forbes, P. [and others

    1996-12-01

    This paper presents an application of ASME Code Case OMN-1 to the GL 89-10 Program at the South Texas Project Electric Generating Station (STPEGS). Code Case OMN-1 provides guidance for a performance-based MOV inservice test program that can be used for periodic verification testing and allows consideration of risk insights. Blended probabilistic and deterministic evaluation techniques were used to establish inservice test strategies including both test methods and test frequency. Described in the paper are the methods and criteria for establishing MOV safety significance based on the STPEGS probabilistic safety assessment, deterministic considerations of MOV performance characteristics and performance margins, the expert panel evaluation process, and the development of inservice test strategies. Test strategies include a mix of dynamic and static testing as well as MOV exercising.

  6. Optimized periodic verification testing blended risk and performance-based MOV inservice test program an application of ASME code case OMN-1

    International Nuclear Information System (INIS)

    Sellers, C.; Fleming, K.; Bidwell, D.; Forbes, P.

    1996-01-01

    This paper presents an application of ASME Code Case OMN-1 to the GL 89-10 Program at the South Texas Project Electric Generating Station (STPEGS). Code Case OMN-1 provides guidance for a performance-based MOV inservice test program that can be used for periodic verification testing and allows consideration of risk insights. Blended probabilistic and deterministic evaluation techniques were used to establish inservice test strategies including both test methods and test frequency. Described in the paper are the methods and criteria for establishing MOV safety significance based on the STPEGS probabilistic safety assessment, deterministic considerations of MOV performance characteristics and performance margins, the expert panel evaluation process, and the development of inservice test strategies. Test strategies include a mix of dynamic and static testing as well as MOV exercising

  7. The early clinical features of dengue in adults: challenges for early clinical diagnosis.

    Directory of Open Access Journals (Sweden)

    Jenny G H Low

    Full Text Available BACKGROUND: The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis. METHODOLOGY/PRINCIPAL FINDINGS: We structured a prospective study of adults (≥ 18 years of age presenting with acute febrile illness within 72 hours from illness onset upon informed consent. Patients were followed up over a 3-4 week period to determine the clinical outcome. A total of 2,129 adults were enrolled in the study, of which 250 (11.7% had dengue. Differences in the rates of dengue-associated symptoms resulted in high sensitivities when the WHO 1997 or 2009 classification schemes for probable dengue fever were applied to the cohort. However, when the cases were stratified into age groups, fewer older adults reported symptoms such as myalgia, arthralgia, retro-orbital pain and mucosal bleeding, resulting in reduced sensitivity of the WHO classification schemes. On the other hand, the risks of severe dengue and hospitalization were not diminished in older adults, indicating that this group of patients can benefit from early diagnosis, especially when an antiviral drug becomes available. Our data also suggests that older adults who present with fever and leukopenia should be tested for dengue, even in the absence of other symptoms. CONCLUSION: Early clinical diagnosis based on previously defined symptoms that are associated with dengue, even when used in the schematics of both the WHO 1997 and 2009 classifications, is difficult in older adults.

  8. An Iterative Procedure for Efficient Testing of B2B: A Case in Messaging Service Tests

    Energy Technology Data Exchange (ETDEWEB)

    Kulvatunyou, Boonserm [ORNL

    2007-03-01

    Testing is a necessary step in systems integration. Testing in the context of inter-enterprise, business-to-business (B2B) integration is more difficult and expensive than intra-enterprise integration. Traditionally, the difficulty is alleviated by conducting the testing in two stages: conformance testing and then interoperability testing. In conformance testing, systems are tested independently against a reference system. In interoperability testing, they are tested simultaneously against one another. In the traditional approach for testing, these two stages are performed sequentially with little feedback between them. In addition, test results and test traces are left only to human analysis or even discarded if the solution passes the test. This paper proposes an approach where test results and traces from both the conformance and interoperability tests are analyzed for potential interoperability issues; conformance test cases are then derived from the analysis. The result is that more interoperability issues can be resolved in the lower-cost conformance testing mode; consequently, time and cost required for achieving interoparble solutions are reduced.

  9. Alcohol intake and early-onset basal cell carcinoma in a case-control study.

    Science.gov (United States)

    Zhang, Y; Ferrucci, L M; Cartmel, B; Molinaro, A M; Leffell, D J; Bale, A E; Mayne, S T

    2014-12-01

    Previous epidemiological studies of overall alcohol intake and basal cell carcinoma (BCC) are inconsistent, with some evidence for differences by type of alcoholic beverage. While alcohol may enhance the carcinogenicity of ultraviolet (UV) radiation, this has not been evaluated in existing epidemiological studies. To evaluate alcohol intake in relation to early-onset BCC, and explore potential interactions with UV exposure. Basal cell carcinoma cases (n = 380) and controls with benign skin conditions (n = 390) under 40 years of age were identified through Yale Dermatopathology. Participants provided information on lifetime alcohol intake, including type of beverage, during an in-person interview. Self-reported data on indoor tanning and outdoor sunbathing were used to categorize UV exposure. We calculated odds ratios (OR) and 95% confidence intervals (CIs) using unconditional multivariate logistic regression in the full sample and in women only. There was no statistically significant association between lifetime alcohol intake and early-onset BCC overall [above median intake vs. no regular alcohol intake (OR 1·10, 95% CI 0·69-1·73)] or in women only (OR 1·21, 95% CI 0·73-2·01). Similarly, intake of red wine, white wine, beer or spirits and mixed drinks was not associated with early-onset BCC. In exploratory analyses, we saw limited evidence for an interaction (P(interaction) = 0·003), with highest risk for high alcohol and high UV exposures, especially in women, but subgroup risk estimates had wide and overlapping CIs. Overall, we did not observe any clear association between lifetime alcohol intake and early-onset BCC. © 2014 British Association of Dermatologists.

  10. 2-tiered antibody testing for early and late Lyme disease using only an immunoglobulin G blot with the addition of a VlsE band as the second-tier test.

    Science.gov (United States)

    Branda, John A; Aguero-Rosenfeld, Maria E; Ferraro, Mary Jane; Johnson, Barbara J B; Wormser, Gary P; Steere, Allen C

    2010-01-01

    Standard 2-tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second-tier IgG blot that performs well throughout the infection. Separate serum sets from LD patients and control subjects were tested independently at 2 medical centers using whole-cell enzyme immunoassays and IgM and IgG immunoblots, with recombinant VlsE added to the IgG blots. The results from both centers were combined, and a new second-tier IgG algorithm was developed. With standard 2-tiered IgM and IgG testing, 31% of patients with active erythema migrans (stage 1), 63% of those with acute neuroborreliosis or carditis (stage 2), and 100% of those with arthritis or late neurologic involvement (stage 3) had positive results. Using new IgG criteria, in which only the VlsE band was scored as a second-tier test among patients with early LD (stage 1 or 2) and 5 of 11 IgG bands were required in those with stage 3 LD, 34% of patients with stage 1, 96% of those with stage 2, and 100% of those with stage 3 infection had positive responses. Both new and standard testing achieved 100% specificity. Compared with standard IgM and IgG testing, the new IgG algorithm (with VlsE band) eliminates the need for IgM testing; it provides comparable or better sensitivity, and it maintains high specificity.

  11. Early diagnosis of the Spondyloarthropathies

    International Nuclear Information System (INIS)

    Gonzalez Naranjo, Luis Alonso; Londono, John D; Valle, Rafael Raul

    2005-01-01

    Spondyloarthropathies are a cluster of chronic inflammatory diseases that primarily include ankylosing spondylitis, reactive arthritis, psoriatic arthritis; arthritis associated with inflammatory bowel diseases and undifferentiated spondyloarthropathies. The most common subgroups of spondyloarthropathies are ankylosing spondylitis and undifferentiated spondyloarthropathy. The diagnosis of ankylosing spondylitis is mainly based on unequivocal radiographic sacroiliitis of at least grade 2 bilaterally or grade 3 unilaterally. How ever, in the early phase of disease, conventional radiographs are often too insensitive to show sacroiliitis and it usually takes several years for definite radiographic sacroiliitis to evolve. Thus, the diagnosis of ankylosing spondylitis is a commonly delayed by 8 to 11 years after the onset of symptoms. As a result, diagnosing axial spondyloarthropathy in the absence of radiographic sacroiliitis is very difficult to rheumatologists. In the early phase of disease, HLA B27 test and magnetic resonance imaging of sacroiliac joints may be helpful to the early diagnosis. In the presence of chronic low back pain the probability of axial spondyloarthropathy is about 5% and is about 14% if the back pain is inflammatory. The presence of = 3 features of spondyloarthropathy (heel pain, uveitis, dactylitis, positive family history, alternating buttock pain, psoriasis, inflammatory bowel disease, asymmetrical arthritis, positive response to anti-inflammatory drugs) increase the probability of axial spondyloarthropathy to 90%. Both, the positive HLA B27 and magnetic resonance imaging with signs of sacroiliitis increase the probability of spondyloarthropathy, particularly in patients without spondyloarthropathies features or with only 1 or 2 features. Since ankylosing spondylitis in association with psoriasis and inflammatory bowel disease is often HLA B27 negative, this test is of limited value under theses circumstances. Is important to consider that

  12. To what extent does climate explain variations in reported malaria cases in early 20th century Uganda?

    Directory of Open Access Journals (Sweden)

    Adrian M. Tompkins

    2016-03-01

    Full Text Available Malaria case statistics were analysed for the period 1926 to 1960 to identify inter-annual variations in malaria cases for the Uganda Protectorate. The analysis shows the mid-to-late 1930s to be a period of increased reported cases. After World War II, malaria cases trend down to a relative minimum in the early 1950s, before increasing rapidly after 1953 to the end of the decade. Data for the Western Province confirm these national trends, which at the time were attributed to a wide range of causes, including land development and management schemes, population mobility, interventions and misdiagnosis. Climate was occasionally proposed as a contributor to enhanced case numbers, and unusual precipitation patterns were held responsible; temperature was rarely, if ever, considered. In this study, a dynamical malaria model was driven with available precipitation and temperature data from the period for five stations located across a range of environments in Uganda. In line with the historical data, the simulations produced relatively enhanced transmission in the 1930s, although there is considerable variability between locations. In all locations, malaria transmission was low in the late 1940s and early 1950s, steeply increasing after 1954. Results indicate that past climate variability explains some of the variations in numbers of reported malaria cases. The impact of multiannual variability in temperature, while only on the order of 0.5°C, was sufficient to drive some of the trends observed in the statistics and thus the role of climate was likely underestimated in the contemporary reports. As the elimination campaigns of the 1960s followed this partly climate-driven increase in malaria, this emphasises the need to account for climate when planning and evaluating intervention strategies.

  13. Negative Exercise Stress Test: Does it Mean Anything? Case study

    Directory of Open Access Journals (Sweden)

    Hassan A. Mohamed

    2007-01-01

    Full Text Available Despite its low sensitivity and specificity (67% and 72%, respectively, exercise testing has remained one of the most widely used noninvasive tests to determine the prognosis in patients with suspected or established coronary disease.As a screening test for coronary artery disease, the exercise stress test is useful in that it is relatively simple and inexpensive. It has been considered particularly helpful in patients with chest pain syndromes who have moderate probability for coronary artery disease, and in whom the resting electrocardiogram (ECG is normal. The following case presentation and discussion will question the predictive value of a negative stress testing in patients with moderate probability for coronary artery disease.

  14. Making System Dynamics Cool II : New Hot Teaching and Testing Cases of Increasing Complexity

    NARCIS (Netherlands)

    Pruyt, E.

    2010-01-01

    This follow-up paper presents several actual cases for testing and teaching System Dynamics. The cases were developed between April 2009 and January 2010 for the Introductory System Dynamics courses at Delft University of Technology in the Netherlands. They can be used for teaching and testing

  15. A Method to Select Software Test Cases in Consideration of Past Input Sequence

    International Nuclear Information System (INIS)

    Kim, Hee Eun; Kim, Bo Gyung; Kang, Hyun Gook

    2015-01-01

    In the Korea Nuclear I and C Systems (KNICS) project, the software for the fully-digitalized reactor protection system (RPS) was developed under a strict procedure. Even though the behavior of the software is deterministic, the randomness of input sequence produces probabilistic behavior of software. A software failure occurs when some inputs to the software occur and interact with the internal state of the digital system to trigger a fault that was introduced into the software during the software lifecycle. In this paper, the method to select test set for software failure probability estimation is suggested. This test set reflects past input sequence of software, which covers all possible cases. In this study, the method to select test cases for software failure probability quantification was suggested. To obtain profile of paired state variables, relationships of the variables need to be considered. The effect of input from human operator also have to be considered. As an example, test set of PZR-PR-Lo-Trip logic was examined. This method provides framework for selecting test cases of safety-critical software

  16. Integrating non-animal test information into an adaptive testing strategy - skin sensitization proof of concept case.

    Science.gov (United States)

    Jaworska, Joanna; Harol, Artsiom; Kern, Petra S; Gerberick, G Frank

    2011-01-01

    There is an urgent need to develop data integration and testing strategy frameworks allowing interpretation of results from animal alternative test batteries. To this end, we developed a Bayesian Network Integrated Testing Strategy (BN ITS) with the goal to estimate skin sensitization hazard as a test case of previously developed concepts (Jaworska et al., 2010). The BN ITS combines in silico, in chemico, and in vitro data related to skin penetration, peptide reactivity, and dendritic cell activation, and guides testing strategy by Value of Information (VoI). The approach offers novel insights into testing strategies: there is no one best testing strategy, but the optimal sequence of tests depends on information at hand, and is chemical-specific. Thus, a single generic set of tests as a replacement strategy is unlikely to be most effective. BN ITS offers the possibility of evaluating the impact of generating additional data on the target information uncertainty reduction before testing is commenced.

  17. Factors influencing behavioral intention to undergo Papanicolaou testing in early adulthood: Comparison of Japanese and Korean women.

    Science.gov (United States)

    Kang, Kyung-Ah; Kim, Shin-Jeong; Kaneko, Noriyo

    2017-12-01

    In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. © 2017 John Wiley & Sons Australia, Ltd.

  18. The Role of NGAL in Peritoneal Dialysis Effluent in Early Diagnosis of Peritonitis: Case-Control Study in Peritoneal Dialysis Patients.

    Science.gov (United States)

    Martino, Francesca; Scalzotto, Elisa; Giavarina, Davide; Rodighiero, Maria Pia; Crepaldi, Carlo; Day, Sonya; Ronco, Claudio

    2015-01-01

    Peritoneal dialysis (PD) is frequently complicated by high rates of peritonitis, which result in hospitalization, technique failure, transfer to hemodialysis, and increased mortality. Early diagnosis, and identification of contributing factors are essential components to increasing effectiveness of care. In previous reports, neutrophil gelatinase-associated lipocalin (NGAL), a lipocalin which is a key player in innate immunity and rapidly detectable in peritoneal dialysis effluent (PDE), has been demonstrated to be a useful tool in the early diagnosis of peritonitis. This study investigates predictive value of PDE NGAL concentration as a prognostic indicator for PD-related peritonitis. A case-control study with 182 PD patients was conducted. Plasma and PDE were analyzed for the following biomarkers: C-reactive protein (CRP), blood procalcitonin (PCT), leucocytes and NGAL in PDE. The cases consisted of patients with suspected peritonitis, while controls were the patients who came to our ambulatory clinic for routine visits without any sign of peritonitis. The episodes of peritonitis were defined in agreement with International Society for Peritoneal Dialysis guidelines. Continuous variables were presented as the median values and interquartile range (IQR). Mann-Whitney U test was used to compare continuous variables. Univariate and multivariate logistic regression were used to evaluate the association of biomarkers with peritonitis. Receiver operating characteristic (ROC) curve analysis was used to calculate area under curve (AUC) for biomarkers. Finally we evaluated sensitivity, and specificity for each biomarker. All statistical analyses were performed with SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). During the 19-month study, of the 182 patients, 80 had a clinical diagnosis of peritonitis. C-reactive protein levels (p peritonitis. In univariate analysis, CRP (odds ratio [OR] 1,339; p = 0.001), PCT (OR 2,473; p peritonitis. In multivariate regression analysis

  19. Incidence of tuberculosis and the predictive value of ELISPOT and Mantoux tests in Gambian case contacts.

    Directory of Open Access Journals (Sweden)

    Philip C Hill

    2008-01-01

    Full Text Available Studies of Tuberculosis (TB case contacts are increasingly being utilised for understanding the relationship between M. tuberculosis and the human host and for assessing new interventions and diagnostic tests. We aimed to identify the incidence rate of new TB cases among TB contacts and to relate this to their initial Mantoux and ELISPOT test results.After initial Mantoux and ELISPOT tests and exclusion of co-prevalent TB cases, we followed 2348 household contacts of sputum smear positive TB cases. We visited them at 3 months, 6 months, 12 months, 18 months and 24 months, and investigated those with symptoms consistent with TB. Those who were diagnosed separately at a government clinic had a chest x-ray. Twenty six contacts were diagnosed with definite TB over 4312 person years of follow-up (Incidence rate 603/100,000 person years; 95% Confidence Interval, 370-830. Nine index and secondary case pairs had cultured isolates available for genotyping. Of these, 6 pairs were concordant and 3 were discordant. 2.5% of non-progressors were HIV positive compared to 12% of progressors (HR 6.2; 95% CI 1.7-22.5; p = 0.010. 25 secondary cases had initial Mantoux results, 14 (56% were positive ; 21 had initial ELISPOT results, 11 (52% were positive; 15 (71% of 21 tested were positive by one or the other test. Of the 6 contacts who had concordant isolates with their respective index case, 4 (67% were Mantoux positive at recruitment, 3 (50% were ELISPOT positive; 5 (83% were positive by one or other of the two tests. ELISPOT positive contacts, and those with discordant results, had a similar rate of progression to those who were Mantoux positive. Those negative on either or both tests had the lowest rate of progression.The incidence rate of TB disease in Gambian TB case contacts, after screening for co-prevalent cases, was 603/100,000 person years. Since initial ELISPOT test and Mantoux tests were each positive in only just over half of cases, but 71% were

  20. Personal experience in the early diagnosis of deep venous thrombosis with the /sup 135/I-fibrinogen test

    Energy Technology Data Exchange (ETDEWEB)

    Diaz, G P; Vicente, A B; Mestre, A P; Iglesias, R S; Irijoa, V; Garcia-Bengochea, J B

    1973-01-01

    The results in the early diagnosis of various surgical patients with a high rate of deep venous thrombosis, using the /sup 125/I Fibrinogen Test are presented. A 22 percent incidence of thrombosis was found, and certain limitations have been noticed which make the test only ideal for the venous system distal to the inguinal area and in legs without recent surgical wounds. The real value of the test, as the earliest method for detecting silent venous thrombosis of the legs is emphasized.

  1. Making System Dynamics Cool? Using Hot Testing & Teaching Cases

    NARCIS (Netherlands)

    Pruyt, E.

    2009-01-01

    This paper deals with the use of ‘hot’ real-world cases for both testing and teaching purposes such as in the Introductory System Dynamics course at Delft University of Technology in the Netherlands. The paper starts with a brief overview of the System Dynamics curriculum. Then the problem-oriented

  2. Curative resection by splenectomy for solitary splenic metastasis from early gastric cancer: a case report and literature review.

    Science.gov (United States)

    Yoshizawa, Junichi; Kubo, Naoki; Ishizone, Satoshi; Karasawa, Fumitoshi; Nakayama, Ataru

    2017-06-20

    Solitary metastasis of a malignancy to the spleen is rare, particularly for gastric cancer. Only a few case reports have documented isolated splenic metastasis from early gastric cancer. We describe a case of splenic metastasis from early gastric cancer. A 60-year-old man underwent a distal gastrectomy for early gastric cancer. It infiltrated the submucosa with pathological nodal involvement (pT1bN2M0, stage IIB). One year after the gastrectomy, an abdominal computed tomography scan showed a low-density lesion, 17 mm in diameter, at the upper pole of the spleen. Positron emission tomography/computed tomography showed focal accumulation of fluorine-18 fluorodeoxyglucose in the spleen without extrasplenic tumor dissemination or metastasis. We diagnosed splenic metastasis of gastric cancer, and performed a splenectomy. Histological examination confirmed moderately differentiated tubular adenocarcinoma and poorly differentiated adenocarcinoma (solid type) that was consistent with the features of the primary gastric cancer. The splenic tumor was pathologically and immunohistochemically diagnosed as a metastasis from the gastric carcinoma. More than 18 months after the splenectomy, the patient has had no evidence of recurrent gastric cancer. When solitary metastasis to the spleen is suspected during the postoperative follow-up of a patient with gastric cancer, a splenectomy is a potentially effective treatment.

  3. A case with atrophic autoimmune thyroiditis-related hypothyroidism causing multisystem involvement in early childhood.

    Science.gov (United States)

    Kurnaz, Erdal; Savaş-Erdeve, Şenay; Keskin, Melikşah; Doğan, Vehbi; Çetinkaya, Semra; Aycan, Zehra

    2016-01-01

    The most common reason of acquired hypothyroidism is autoimmune (Hashimoto) thyroiditis. Autoimmune thyroiditis can be atrophic or goitrogenic. Atrophic autoimmune thyroiditis (ATT) related acquired hypothyroidism causes interruption of growth, obesity, and bone age retardation in early ages while goitrogenic thyroiditis has a higher incidence rate and mostly presents with diffuse goiter. We discuss the effects of hypothyroidism on various systems through a case found to have pericardial effusion during the echocardiography performed after cardiac murmur was detected and later diagnosed with ATT related hypothyroidism.

  4. The clinical utility of naturalistic action test in differentiating mild cognitive impairment from early dementia in memory clinic.

    Science.gov (United States)

    Bruce, Irene; Ntlholang, Ontefetse; Crosby, Lisa; Cunningham, Conal; Lawlor, Brian

    2016-03-01

    This study aimed to examine the validity of the Naturalistic Action Test in differentiating Mild Cognitive Impairment from early dementia compared to clinical diagnosis and ascertain Naturalistic Action Test cut-off points. This was a cross-sectional study of 70 consecutive patients diagnosed with Mild Cognitive Impairment attending the memory clinic in St James's Hospital, Dublin, Ireland. Patients with a diagnosis of Mild Cognitive Impairment who attended for routine annual assessment were asked to participate in the study. The Naturalistic Action Test was carried out after the patient had completed their routine assessment in the clinic. The Area under the Curve, AUC ± SE was 0.808 ± 0.058, p Cognitive Impairment in our study (PPV 50%, NPV 91%, sensitivity 78%, specificity 73% and accuracy of 74%). There was discrepancy in 18 patients using the new cut-off point (≥11 for Mild Cognitive Impairment vs ≤10 for dementia). The Naturalistic Action Test is a useful tool that can increase diagnostic accuracy in differentiating Mild Cognitive Impairment from early dementia. Copyright © 2015 John Wiley & Sons, Ltd.

  5. Early-onset childhood sarcoidosis: a case report

    Directory of Open Access Journals (Sweden)

    Lai-San Wong

    2011-12-01

    Full Text Available Sarcoidosis is a multisystemic granulomatous disease of unknown etiology and it most commonly affects young adults. Childhood sarcoidosis is relatively rare; older children usually present a picture similar to that of adults, with frequent hilar lymphadenopathy and pulmonary infiltration. Early-onset (<4 years of age childhood sarcoidosis is a unique disease and has a different presentation. It is characterized by arthritis, uveitis, and cutaneous involvement. The prognosis of early-onset childhood sarcoidosis varies in different studies due to the rarity of the disease. The treatment of choice in systemic involvement of childhood sarcoidosis is corticosteroids. Methotrexate can also be considered in the long-term treatment due to its safety, effectiveness, and steroid-sparing effect in children.

  6. Reexpansion Pulmonary Edema following Laparoscopy-Assisted Distal Gastrectomy for a Patient with Early Gastric Cancer: A Case Report

    Directory of Open Access Journals (Sweden)

    Kazuhito Yajima

    2012-01-01

    Full Text Available We report here a case of reexpansion pulmonary edema following laparoscopy-assisted distal gastrectomy (LADG for early gastric cancer. A 57-year-old Japanese woman with no preoperative comorbidity was diagnosed with early gastric cancer. The patient underwent LADG using the pneumoperitoneum method. During surgery, the patient was unintentionally subjected to single-lung ventilation for approximately 247 minutes due to intratracheal tube dislocation. One hour after surgery, she developed severe dyspnea and produced a large amount of pink frothy sputum. Chest radiography results showed diffuse ground-glass attenuation and alveolar consolidation in both lungs without cardiomegaly. A diagnosis of pulmonary edema was made, and the patient was immediately intubated and received ventilatory support with high positive end-expiratory pressure. The patient gradually recovered and was weaned from the ventilatory support on the third postoperative day. This case shows that single-lung ventilation may be a risk factor for reexpansion pulmonary edema during laparoscopic surgery with pneumoperitoneum.

  7. Diagnostic capabilities of non-treponemal and treponemal reactions in the early forms of syphilis.

    OpenAIRE

    Zakharov, S. V.

    2017-01-01

    A comparative analysis of the sensitivity and specificity of immunoblotting against other non-treponemal and treponemal reactions was carried out in 215 patients with early forms of syphilis. A high diagnostic efficiency of immunoblotting in patients with early latent syphilis was established. It was found that only in case of primary syphilis, immunoblotting is inferior to Immunofluorescence reaction; this test can be used for differential diagnosis between hidden syphilis and false positive...

  8. Huntington's disease predictive testing: the case for an assessment approach to requests from adolescents.

    Science.gov (United States)

    Binedell, J; Soldan, J R; Scourfield, J; Harper, P S

    1996-01-01

    Adolescents who are actively requesting Huntington's predictive testing of their own accord pose a dilemma to those providing testing. In the absence of empirical evidence as regards the impact of genetic testing on minors, current policy and guidelines, based on the ethical principles of non-maleficence and respect for individual autonomy and confidentiality, generally exclude the testing of minors. It is argued that adherence to an age based exclusion criterion in Huntington's disease predictive testing protocols is out of step with trends in UK case law concerning minors' consent to medical treatment. Furthermore, contributions from developmental psychology and research into adolescents' decision making competence suggest that adolescents can make informed choices about their health and personal lives. Criteria for developing an assessment approach to such requests are put forward and the implications of a case by case evaluation of competence to consent in terms of clinicians' tolerance for uncertainty are discussed. PMID:8950670

  9. Testing objective measures of motor impairment in early Parkinson's disease: Feasibility study of an at-home testing device.

    Science.gov (United States)

    Goetz, Christopher G; Stebbins, Glenn T; Wolff, David; DeLeeuw, William; Bronte-Stewart, Helen; Elble, Rodger; Hallett, Mark; Nutt, John; Ramig, Lorraine; Sanger, Terence; Wu, Allan D; Kraus, Peter H; Blasucci, Lucia M; Shamim, Ejaz A; Sethi, Kapil D; Spielman, Jennifer; Kubota, Ken; Grove, Andrew S; Dishman, Eric; Taylor, C Barr

    2009-03-15

    We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson's disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5'' x 10'' computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the 6 month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range: 80-100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (P = 0.08), tremor (P = 0.06) and speech (P = 0.11). Change in tremor was a significant predictor of change in UPDRS (P = 0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document.

  10. HIV screening at health facilities and community pharmacies in Kenya : Enhancing test uptake and early diagnosis

    NARCIS (Netherlands)

    Mugo, P.M.

    2017-01-01

    Despite a tremendous scale-up of antiretroviral therapy, as many as 54% of HIV-infected persons globally remain undiagnosed hence are not on treatment. This thesis presents findings from a series of studies conducted in Coastal Kenya aiming to enhance HIV test uptake and early diagnosis. We found

  11. Discussions On Worst-Case Test Condition For Single Event Burnout

    Science.gov (United States)

    Liu, Sandra; Zafrani, Max; Sherman, Phillip

    2011-10-01

    This paper discusses the failure characteristics of single- event burnout (SEB) on power MOSFETs based on analyzing the quasi-stationary avalanche simulation curves. The analyses show the worst-case test condition for SEB would be using the ion that has the highest mass that would result in the highest transient current due to charge deposition and displacement damage. The analyses also show it is possible to build power MOSFETs that will not exhibit SEB even when tested with the heaviest ion, which have been verified by heavy ion test data on SEB sensitive and SEB immune devices.

  12. Parenting style and oral health practices in early childhood caries: a case-control study.

    Science.gov (United States)

    Dabawala, Suhel; Suprabha, Baranya S; Shenoy, Ramya; Rao, Arathi; Shah, Nachiket

    2017-03-01

    There is a need to carry out controlled investigations regarding risk factors for early childhood caries (ECC). To study the type of parenting style and oral health practices as risk factors among children with ECC in an Indian preschool population. Two hundred and eleven children with ECC and equal number of controls participated in this case-control study. A questionnaire was answered by parents regarding oral health practices such as oral hygiene methods, feeding habits, daily sugar intake, and dental attendance pattern along with socioeconomic and demographic status. The parenting style was determined using Parenting Styles Dimension Questionnaire (PSDQ) index. Data were statistically analyzed using chi-square test and multiple logistic regression analysis. Risk factors associated with ECC were higher birth order, lower socioeconomic status, non-use of fluoridated toothpaste, breast/bottle feeding for more than one year, presence of formula milk or milk with sugar in the feeding bottle while falling asleep, higher sweet scores in the diet chart, and visiting dentist only when a problem was perceived. Majority of parents of children with and without ECC had authoritative parenting style. Improper oral health practices are the risk factors for ECC. The association of parenting style with ECC could not be confirmed. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Revisiting and Reinforcing the Farmers Fox Theory: A Study (Test) of Three Cases in Cross-border Inbound Acquisitions

    OpenAIRE

    Reddy, Kotapati Srinivasa

    2015-01-01

    This paper aims to revisit and reinforce the early-development of Farmers Fox theory (Reddy et al. 2014a) through analyzing three cases in cross-border inbound acquisitions stream. A qualitative case method is adopted to explore findings from sampling cases include Vodafone-Hutchison telecom deal, Bharti Airtel-MTN broken telecom deal and Vedanta-Cairn India oil deal. We have highlighted discussions on organizational factors, due diligence issues, deal characteristics and country-specific det...

  14. A one-sided sequential test

    Energy Technology Data Exchange (ETDEWEB)

    Racz, A.; Lux, I. [Hungarian Academy of Sciences, Budapest (Hungary). Atomic Energy Research Inst.

    1996-04-16

    The applicability of the classical sequential probability ratio testing (SPRT) for early failure detection problems is limited by the fact that there is an extra time delay between the occurrence of the failure and its first recognition. Chien and Adams developed a method to minimize this time for the case when the problem can be formulated as testing the mean value of a Gaussian signal. In our paper we propose a procedure that can be applied for both mean and variance testing and that minimizes the time delay. The method is based on a special parametrization of the classical SPRT. The one-sided sequential tests (OSST) can reproduce the results of the Chien-Adams test when applied for mean values. (author).

  15. A thermal active restrained shrinkage ring test to study the early age concrete behaviour of massive structures

    International Nuclear Information System (INIS)

    Briffaut, M.; Benboudjema, F.; Torrenti, J.M.; Nahas, G.

    2011-01-01

    In massive concrete structures, cracking may occur during hardening, especially if autogenous and thermal strains are restrained. The concrete permeability due to this cracking may rise significantly and thus increase leakage (in tank, nuclear containment...) and reduce the durability. The restrained shrinkage ring test is used to study the early age concrete behaviour (delayed strains evolution and cracking). This test shows, at 20 o C and without drying, for a concrete mix which is representative of a French nuclear power plant containment vessel (w/c ratio equal to 0.57), that the amplitude of autogenous shrinkage (about 40 μm/m for the studied concrete mix) is not high enough to cause cracking. Indeed, in this configuration, thermal shrinkage is not significant, whereas this is a major concern for massive structures. Therefore, an active test has been developed to study cracking due to restrained thermal shrinkage. This test is an evolution of the classical restrained shrinkage ring test. It allows to take into account both autogenous and thermal shrinkages. Its principle is to create the thermal strain effects by increasing the temperature of the brass ring (by a fluid circulation) in order to expand it. With this test, the early age cracking due to restrained shrinkage, the influence of reinforcement and construction joints have been experimentally studied. It shows that, as expected, reinforcement leads to an increase of the number of cracks but a decrease of crack widths. Moreover, cracking occurs preferentially at the construction joint.

  16. Mathematical Basis and Test Cases for Colloid-Facilitated Radionuclide Transport Modeling in GDSA-PFLOTRAN

    Energy Technology Data Exchange (ETDEWEB)

    Reimus, Paul William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-07-31

    This report provides documentation of the mathematical basis for a colloid-facilitated radionuclide transport modeling capability that can be incorporated into GDSA-PFLOTRAN. It also provides numerous test cases against which the modeling capability can be benchmarked once the model is implemented numerically in GDSA-PFLOTRAN. The test cases were run using a 1-D numerical model developed by the author, and the inputs and outputs from the 1-D model are provided in an electronic spreadsheet supplement to this report so that all cases can be reproduced in GDSA-PFLOTRAN, and the outputs can be directly compared with the 1-D model. The cases include examples of all potential scenarios in which colloid-facilitated transport could result in the accelerated transport of a radionuclide relative to its transport in the absence of colloids. Although it cannot be claimed that all the model features that are described in the mathematical basis were rigorously exercised in the test cases, the goal was to test the features that matter the most for colloid-facilitated transport; i.e., slow desorption of radionuclides from colloids, slow filtration of colloids, and equilibrium radionuclide partitioning to colloids that is strongly favored over partitioning to immobile surfaces, resulting in a substantial fraction of radionuclide mass being associated with mobile colloids.

  17. Early Statin Use and the Progression of Alzheimer Disease: A Total Population-Based Case-Control Study.

    Science.gov (United States)

    Lin, Feng-Cheng; Chuang, Yun-Shiuan; Hsieh, Hui-Min; Lee, Tzu-Chi; Chiu, Kuei-Fen; Liu, Ching-Kuan; Wu, Ming-Tsang

    2015-11-01

    The protective effect of statin on Alzheimer disease (AD) is still controversial, probably due to the debate about when to start the use of statin and the lack of any large-scale randomized evidence that actually supports the hypothesis. The purpose of this study was to examine the protective effect of early statin use on mild-to-moderate AD in the total Taiwanese population.This was a total population-based case-control study, using the total population of Taiwanese citizens seen in general medical practice; therefore, the findings can be applied to the general population. The study patients were those with newly diagnosed dementia (ICD-9 290.x) and prescribed any acetylcholinesterase inhibitors (AChEI) from the Taiwan National Health Insurance dataset in 1997 to 2008. The newly diagnosed eligible mild-to-moderate AD patients were traced from the dates of their index dates, which was defined as the first day to receive any AChEI treatment, back to 1 year (exposure period) to categorize them into AD with early statin use and without early statin use. Early statin use was defined as patients using statin before AChEI treatment. Alzheimer disease patients with early statin use were those receiving any statin treatment during the exposure period. Then, we used propensity-score-matched strategy to match these 2 groups as 1:1. The matched study patients were followed-up from their index dates. The primary outcome was the discontinuation of AChEI treatment, indicating AD progression.There were 719 mild-to-moderate AD-paired patients with early statin use and without early statin use for analyses. Alzheimer disease progression was statistically lower in AD patients with early statin use than those without (P = 0.00054). After adjusting for other covariates, mild-to-moderate AD patients with early stain use exhibited a 0.85-risk (95% CI = 0.76-0.95, P = 0.0066) to have AD progression than those without.Early statin use was significantly associated with a reduction in AD

  18. Revised surveillance case definition for HIV infection--United States, 2014.

    Science.gov (United States)

    2014-04-11

    Following extensive consultation and peer review, CDC and the Council of State and Territorial Epidemiologists have revised and combined the surveillance case definitions for human immunodeficiency virus (HIV) infection into a single case definition for persons of all ages (i.e., adults and adolescents aged ≥13 years and children aged case now accommodate new multitest algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection. A confirmed case can be classified in one of five HIV infection stages (0, 1, 2, 3, or unknown); early infection, recognized by a negative HIV test within 6 months of HIV diagnosis, is classified as stage 0, and acquired immunodeficiency syndrome (AIDS) is classified as stage 3. Criteria for stage 3 have been simplified by eliminating the need to differentiate between definitive and presumptive diagnoses of opportunistic illnesses. Clinical (nonlaboratory) criteria for defining a case for surveillance purposes have been made more practical by eliminating the requirement for information about laboratory tests. The surveillance case definition is intended primarily for monitoring the HIV infection burden and planning for prevention and care on a population level, not as a basis for clinical decisions for individual patients. CDC and the Council of State and Territorial Epidemiologists recommend that all states and territories conduct case surveillance of HIV infection using this revised surveillance case definition.

  19. Real-Time Extended Interface Automata for Software Testing Cases Generation

    Science.gov (United States)

    Yang, Shunkun; Xu, Jiaqi; Man, Tianlong; Liu, Bin

    2014-01-01

    Testing and verification of the interface between software components are particularly important due to the large number of complex interactions, which requires the traditional modeling languages to overcome the existing shortcomings in the aspects of temporal information description and software testing input controlling. This paper presents the real-time extended interface automata (RTEIA) which adds clearer and more detailed temporal information description by the application of time words. We also establish the input interface automaton for every input in order to solve the problems of input controlling and interface covering nimbly when applied in the software testing field. Detailed definitions of the RTEIA and the testing cases generation algorithm are provided in this paper. The feasibility and efficiency of this method have been verified in the testing of one real aircraft braking system. PMID:24892080

  20. A history of the early days of personality testing in American industry: an obsession with adjustment.

    Science.gov (United States)

    Gibby, Robert E; Zickar, Michael J

    2008-08-01

    Objective personality testing began with Woodworth's Personal Data Sheet in 1917. That test was developed to identify soldiers prone to nervous breakdowns during enemy bombardment in World War I (WWI). Soon after, many competing personality tests were developed for use in industry. Many of these tests, like Woodworth's, focused on the construct of employee maladjustment and were deemed important in screening out applicants who would create workplace disturbances. In this article, the authors review the history of these early personality tests, especially the Bernreuter Personality Inventory and the Humm-Wadsworth Temperament Scale, and discuss the implications of personality testers' obsession with the construct of employee maladjustment. In addition, the authors discuss the industry's obsession with emotional maladjustment and how this obsession coincided with a cultural shift in norms relating to cultural expression.

  1. The early and long-term outcomes of completion pneumonectomy: report of 56 cases.

    Science.gov (United States)

    Pan, Xufeng; Fu, Shijie; Shi, Jianxin; Yang, Jun; Zhao, Heng

    2014-09-01

    The aim of this study was to analyse the early and long-term results of completion pneumonectomy (CP). A retrospective review of consecutive patients who underwent CP in the Shanghai Chest Hospital. Fifty-six CP were performed between January 2003 and July 2013. There were 45 conventional CP (CCP) and 11 rescue CP (RCP) cases. CCP was defined as resection of the remaining lung because of the occurrence of new lesions in patients with previous lung resection. RCP was defined as resection of the remaining lung because of severe complication after primary lung surgery. The mortality and morbidity rates of CCP were 4.4 and 33.3%, respectively. For CCP, the morbidity was significantly higher in benign cases than in malignant cases (80.0 vs 27.5%, P = 0.04). The mortality and morbidity rates of RCP were 27.3 and 90.9%, respectively. For RCP, advanced age (P = 0.046) and preoperative mechanical ventilation (P = 0.03) were related to higher postoperative mortality. The overall 5-year survival rate was 80% for benign cases, whereas for lung malignancy cases, it was 30%. Survival varied (median 60.0 vs 35.0 vs 10.0 months, I vs II vs III, P 2 years (median 60.0 vs 18.0 months, P RCP. Advanced age and mechanical ventilation before the operation were related to higher mortality in RCP. CCP of benign cases was related to higher postoperative risk, but with good survival. For lung malignancy, survival was better for a time interval (between primary surgery and occurrence of lesion) of >2 years. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. The Subtlety of Age, Gender, and Race Barriers: A Case Study of Early Career African American Female Principals

    Science.gov (United States)

    Jean-Marie, Gaetane

    2013-01-01

    While all educational leaders face challenges in achieving success, African American female principals often face a unique set of challenges associated with the complexity of their gender, race, and, as examined in this study, age. This case study investigates the experiences of two highly visible, early career African American female principals…

  3. Early port-site metastasis during neoadjuvant chemotherapy in advanced stage ovarian cancer: report of two cases

    OpenAIRE

    Özmen, Batuhan; Şükür, Yavuz Emre; Atabekoglu, Cem Somer; Heper, Aylin Okçu; Sönmezer, Murat; Güngör, Mete

    2011-01-01

    Port-site metastases in gynecological malignancies subsequent to laparoscopy have been reported with an incidence of 1.1-16%. These metastases tend to be disappearing after primary debulking surgery and subsequent primary chemotherapy. Local resection, chemotherapy and/or radiotherapy have been defined in the management of these metastases with enhanced clinical success. However, in extremely rare cases these metastases were also defined very early during neoadjuvant chemotherapy. Herein, we ...

  4. Roentgenographic diagnosis of early stomach cancer

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Jung Ho; Choi, Byung Sook; Choi, Heung Jai [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1970-10-15

    The most significant feature of early carcinoma, be defined as the gastric carcinoma confined in mucosa and submucosal regardless of its size and shape, is its excellent prognosis; 5 year survival rate after operation in early stomach carcinoma amounts to 93 percent in comparison with around 25 percent in advanced carcinoma, and so the detection of this early stomach carcinoma is most important subject to minimize the mortality from stomach carcinoma at the present time. For the diagnosis of the early stomach carcinoma the radiographic study, cytology and gastroscopic examination are practised, and of those the radiographic study has been revealed commonly best results, but by usual method of upper G-I study it is often difficult to diagnose accurately. Therefore, we have been employed the barium and air double contrast method by insertion of the gastric tube. This method is simple and by this method, the adequate amount of air may introduced into the stomach for the best visualization of the mucosal pattern and gastric juice may also aspirated in a case of which the stomach wall could not be coated by barium because of excessive gastric juice. Summary of the results of this studies of early carcinoma detection at the department of radiology, Severance Hospital during 6 months since May 1969 are as followings; of 1407 cases taken upper G-I study with double contrast method, 17 cases were diagnosed as possible early stomach carcinoma radiographically, and then only 6 cases had surgical resection of stomach. Of these 2 cases were confirmed pathologically and one was considered as precancerots lesion.

  5. Roentgenographic diagnosis of early stomach cancer

    International Nuclear Information System (INIS)

    Suh, Jung Ho; Choi, Byung Sook; Choi, Heung Jai

    1970-01-01

    The most significant feature of early carcinoma, be defined as the gastric carcinoma confined in mucosa and submucosal regardless of its size and shape, is its excellent prognosis; 5 year survival rate after operation in early stomach carcinoma amounts to 93 percent in comparison with around 25 percent in advanced carcinoma, and so the detection of this early stomach carcinoma is most important subject to minimize the mortality from stomach carcinoma at the present time. For the diagnosis of the early stomach carcinoma the radiographic study, cytology and gastroscopic examination are practised, and of those the radiographic study has been revealed commonly best results, but by usual method of upper G-I study it is often difficult to diagnose accurately. Therefore, we have been employed the barium and air double contrast method by insertion of the gastric tube. This method is simple and by this method, the adequate amount of air may introduced into the stomach for the best visualization of the mucosal pattern and gastric juice may also aspirated in a case of which the stomach wall could not be coated by barium because of excessive gastric juice. Summary of the results of this studies of early carcinoma detection at the department of radiology, Severance Hospital during 6 months since May 1969 are as followings; of 1407 cases taken upper G-I study with double contrast method, 17 cases were diagnosed as possible early stomach carcinoma radiographically, and then only 6 cases had surgical resection of stomach. Of these 2 cases were confirmed pathologically and one was considered as precancerots lesion

  6. Repeatability of an automated Landolt C test, compared with the early treatment of diabetic retinopathy study (ETDRS) chart testing.

    Science.gov (United States)

    Ruamviboonsuk, Paisan; Tiensuwan, Montip; Kunawut, Catleya; Masayaanon, Patcharapim

    2003-10-01

    To evaluate the repeatability of visual acuity scores from the automated test and compare them with the Early Treatment of Diabetic Retinopathy Study (ETDRS) chart. Instrument validation study based on a model of repeatability study in two observations. SMETHODS: a prospective, clinic-based, comparative study. A total of 206 participants without ocular diseases and refractive errors in their right eyes were randomly enrolled in the automated group in which 107 participants performed the automated test and the ETDRS group in which 99 participants read the ETDRS chart. All participants were tested with only their right eyes without corrections at 4 meters and came back to have the same tests 1 week later. The automated test used the Landolt rings as optotypes and was conducted by a low-ended personal computer with a 15-inch monitor and a wireless keyboard. The "letter" score calculated by counting every correct response to optotypes, and the "threshold curve" score interpreted from the optotype size at the midpoint of a visual acuity threshold curve. The 95% confidence interval of test-retest of visual acuity scores from the automated test are comparable to the ETDRS chart (.143 compared with.125 for letter scores,.145 compared with.122 for threshold curve scores). The score repeatabilities, calculated from the standard deviations of test-retest, from the automated test are also comparable to the ETDRS chart (.201 compared with.177 for letter scores,.206 compared with.172 for threshold curve scores). All comparisons demonstrated no statistical difference (P >.05). The automated testing system in this study enables practical measuring visual acuity by the Landolt rings. The system's repeatability, which is comparable to the ETDRS chart, supports its role as an alternative tool for measuring outcome in new clinical research. Its ability to practically generate visual acuity threshold curves may also be useful in future clinical research studies.

  7. Testing independence between two Poisson-generated multinomial variables in case-series and cohort studies.

    Science.gov (United States)

    Hocine, Mounia; Guillemot, Didier; Tubert-Bitter, Pascale; Moreau, Thierry

    2005-12-30

    In case-series or cohort studies, we propose a test of independence between the occurrences of two types of recurrent events (such as two repeated infections) related to an intermittent exposure (such as an antibiotic treatment). The test relies upon an extension of a recent method for analysing case-series data, in the presence of one type of recurrent event. The test statistic is derived from a bivariate Poisson generated-multinomial distribution. Simulations for checking the validity of the test concerning the type I error and the power properties are presented. The test is illustrated using data from a cohort on antibiotics bacterial resistance in schoolchildren. Copyright 2005 John Wiley & Sons, Ltd.

  8. [Management and Nursing care for a patient with Lynch syndrome: A case report].

    Science.gov (United States)

    Pacheco-Pérez, Luis Arturo; Guevara Valtier, Milton Carlos

    2016-01-01

    Colorectal cancer is one of the leading causes of death from cancer worldwide. Main interventions to reduce the impact are aimed to enhance prevention and early detection. Results of several studies show that tests such as the fecal occult blood test and colonoscopy are effective for early diagnosis. There are hereditary syndromes such as Lynch Syndrome that can lead to certain types of cancers, including bowel neoplasms, therefore early detection needs to be included as part of the treatment. In these cases, family genetic testing is recommended if the bowel cancer is diagnosed before 50 years old. A care plan including the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) was developed for a patient with suspected Lynch Syndrome. Nurses should be qualified to identify potential cases of cancer associated with this syndrome, and thus, reduce the likelihood that family members develop the disease, through genetic counseling and education of environmental risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  9. Targeting the initial investigation and management in cases of acute pulmonary embolism.

    Science.gov (United States)

    Moore, Nicholas; Hawkins, Peter

    2013-01-01

    It was noted by consultants in our hospital that the early investigation of suspected pulmonary embolism (PE) lacked structure. This was causing delays in definitive diagnosis and early management. The resulting unnecessary use of investigation was also wasting resources. In particular, the inappropriate use of serum d-dimer tests was causing concern. The National Institute of Clinical Excellence (NICE) guidelines recommend use of the 2-level Well's score to target investigation in suspected PE. A baseline audit against the NICE guideline revealed that Well's scores were rarely used (only calculated in 12% of cases) and confirmed the suspicion that early investigation was poorly targeted. This project intervened using educational talks promoting the use of Well's scores in cases of suspected PE. Well's score proformas were placed in the emergency department and emergency assessment unit for reference. Their availability was advertised. This significantly increased the use of Well's scores (46% vs 11%, p<0.001). Fewer patients underwent unnecessary d-dimer measurements in cases of likely PE (65% vs 86%). Initial investigation was more targeted in cases where a Well's score had been calculated than in cases without a Well's score. For example, significantly fewer unnecessary d-dimer tests were performed in these cases (45% vs 100%, p<0.05). The cost of unnecessary investigation in suspected PE is not only significant financially but also in the resulting delay in definitive diagnosis and management for the patient. The simple intervention used here was effective in addressing this problem.

  10. Alternatives to the Fish Early Life-Stage Test: A Research Strategy for Discovering and Annotating Adverse Outcome Pathways During Fish Development

    Science.gov (United States)

    The OECD 210 fish early life]stage (FELS) test is the primary guideline test used to estimate chronic fish toxicity, as well as support ecological risk assessments and chemical management programs around the world. As a step toward developing alternatives to the FELS test, a HES...

  11. Changes in pathology test ordering by early career general practitioners: a longitudinal study.

    Science.gov (United States)

    Magin, Parker J; Tapley, Amanda; Morgan, Simon; Henderson, Kim; Holliday, Elizabeth G; Davey, Andrew R; Ball, Jean; Catzikiris, Nigel F; Mulquiney, Katie J; van Driel, Mieke L

    2017-07-17

    To assess the number of pathology tests ordered by general practice registrars during their first 18-24 months of clinical general practice. Longitudinal analysis of ten rounds of data collection (2010-2014) for the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing, multicentre, cohort study of general practice registrars in Australia. The principal analysis employed negative binomial regression in a generalised estimating equations framework (to account for repeated measures on registrars).Setting, participants: General practice registrars in training posts with five of 17 general practice regional training providers in five Australian states. The registrar participation rate was 96.4%. Number of pathology tests requested per consultation. The time unit for analysis was the registrar training term (the 6-month full-time equivalent component of clinical training); registrars contributed data for up to four training terms. 876 registrars contributed data for 114 584 consultations. The number of pathology tests requested increased by 11% (95% CI, 8-15%; P pathology test ordering by general practice registrars increased significantly during their first 2 years of clinical practice. This causes concerns about overtesting. As established general practitioners order fewer tests than registrars, test ordering may peak during late vocational training and early career practice. Registrars need support during this difficult period in the development of their clinical practice patterns.

  12. Diagnostic capabilities of non-treponemal and treponemal reactions in the early forms of syphilis

    Directory of Open Access Journals (Sweden)

    Zakharov S.V.

    2017-12-01

    Full Text Available A comparative analysis of the sensitivity and specificity of immunoblotting against other non-treponemal and treponemal reactions was carried out in 215 patients with early forms of syphilis. A high diagnostic efficiency of immunoblotting in patients with early latent syphilis was established. It was found that only in case of primary syphilis, immunoblotting is inferior to Immunofluorescence reaction; this test can be used for differential diagnosis between hidden syphilis and false positive reactions to syphilis.

  13. Reduced benefit from mnemonic strategies in early-stage Alzheimer's disease: a brief testing-the-limits paradigm for clinical practice.

    Science.gov (United States)

    Uttner, Ingo; Schurig, Niklas; von Arnim, Christine A F; Lange-Asschenfeldt, Christian; Tumani, Hayrettin; Riepe, Matthias W

    2010-10-01

    Discriminating incipient Alzheimer's disease (AD) from major depression (MD) and age related memory decline is a challenge in clinical practice. Since AD is characterized by an early loss of neuronal and functional plasticity, a dynamic test strategy, such as the testing-the-limits (TtL) approach, that measures learning capacity can be a helpful diagnostic tool. To evaluate this, a short recognition paradigm consisting of a pre-test (baseline) and two post-test conditions with an interposed encoding instruction was developed and administered to individuals with incipient AD (n = 19; Mini Mental Status Examination (MMSE) 26.5), patients with depressive disorders (n = 11; MMSE 30), and healthy controls (n = 11; MMSE 30). In addition, participants completed a set of traditional neuropsychological tests that focused on the subjects' cognitive baseline performance. Intergroup comparisons (Kruskal-Wallis, U test) revealed significantly higher post-test failure rates in AD patients. Pre-test performance of MD and AD patients did not differ. Intra-group comparisons (Friedman, Wilcoxon test) showed that all three subject samples benefit from intervention in post-test 1. In contrast to MD and healthy individuals, who revealed significantly lower failure rates in post-test 2 compared to the pre-test, AD patients did not improve. Out of the 15 traditional test scores obtained, only two discriminated simultaneously between AD and each of the other groups. Our data confirm the finding of an impaired cognitive plasticity already present in very early stages of AD and illustrate the efficiency of a dynamic test approach in identifying incipient dementia.

  14. Intellectual disability, mental illness and offending behaviour: forensic cases from early twentieth-century Ireland.

    Science.gov (United States)

    Kelly, B D

    2010-09-01

    The history of institutional care for individuals with intellectual disability is under-researched, complex and troubling. To explore the experiences of women who may have had intellectual disability and/or mental illness and were admitted to forensic psychiatric care in early twentieth-century Ireland. All female case records at the Central Mental Hospital, Dublin from 1910 to 1948 (n = 42) were studied for evidence of possible intellectual disability and a series of five cases is presented in detail. These committals occurred in the context of adverse social conditions, over-crowding in asylums and a belief that rates of mental illness were rising. Particular challenges included diagnostic issues (especially in relation to intellectual disability), adjustment to asylum environments, mental illness and physical ill-health. The institutional experiences of individuals with intellectual disability represents an important area for further historical research, using larger and more varied forensic populations.

  15. Early Detection Of Cancer

    Directory of Open Access Journals (Sweden)

    V B Bhatnagar

    1987-04-01

    Full Text Available Farly detection of cancer is based upon three fundamental assumptions, firstly that the trea'ment of benign and precancerous lesions reduces the incidence of cancer, secondly, that the treatment of in situ cancers is conducive to total cure and thirdly that early diagnosis and management of invasive cancer ensures be.ter survival. When patient seeks medical advice for vague symptoms, which could however be due to a possible malignant tumour at a particular site, the alert clinician should investigate the patient immediately to exclude cancer. At this stage cancer is usually not significantly advanced. Currently the U. I. C. C. (International Union for Cancer Control} is studying the epidemiology of cancers in various countries The importance of this is two folds : Firstly by focussing attention on a section of population vulnerable to a particular cancer an early detection is facilitated Secondly by changing the causative factors responsible to a particular cancer, the incidence of that cancer can be reduced e. g. reduction in lung cancer following campaigns against ciguette smoking and reductioi in breast cancer after campaigns for advocating breast feeding of infants, lowering fat consumption and encouraging self palpation of breast regularly. Indeed early diagnosis of cancer implies diagnosis of cancer in almost a symptomatic stage It involves motiva’ion of the population towards acquisitio : of knowledge, attitude and practice.. Epidemiologies and clinicians should be able to recognise high risk cases exposed to particular neoplasia and knowledge of alarming symptoms should be pro- pogated for wide publicity through common available media and means. Probable cases should have regular clhrcal examination periodically and relevant investigations including radiological, imaging techniques and Bio-Chemical examination should be undertaken as and when desired Suspicious lesions should be investigated by specific tests including smear cytology

  16. Early Bronchus-Associated Lymphoid Tissue Lymphoma Diagnosed with Immunoglobulin Heavy Chain Molecular Testing

    Directory of Open Access Journals (Sweden)

    Pen Li

    2016-01-01

    Full Text Available When extranodal marginal zone B-cell lymphoma of mucosa associated lymphoid tissue (MALT, a low grade B-cell lymphoma, arises in the lung it is referred to as bronchus-associated lymphoid tissue (BALT lymphoma. We describe a patient with a history of Sjögren’s syndrome and rheumatoid arthritis with dyspnea and imaging consistent with lymphoid interstitial pneumonia (LIP. However, while histology and immunohistochemistry lacked definitive features of a lymphoma, immunoglobulin heavy chain (IgH polymerase chain reaction testing demonstrated B-cell monoclonality, consistent with an early BALT lymphoma.

  17. Simulation of VVER MCCI reactor test case with ASTEC V2/MEDICIS computer code

    International Nuclear Information System (INIS)

    Stefanova, A.; Grudev, P.; Gencheva, R.

    2011-01-01

    This paper presents an application of the ASTEC v2, module MEDICIS for simulation of VVER Molten core concrete interaction test (MCCI) case without water injection. The main purpose of performed calculation is verification and improvement of module MEDICIS/ASTECv2 for better simulation of core concrete interaction processes. The VVER-1000 reference nuclear power plant was chosen as SARNET2 benchmark MCCI test-case. The initial conditions for MCCI test are taken after SBO scenario calculated with ASTEC version 1.3R2 by INRNE. (authors)

  18. Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series

    Energy Technology Data Exchange (ETDEWEB)

    Cilloniz, Catia; Torres, Antoni [Servicio de Neumologia, Hospital Clinic de Barcelona, Ciber de Enfermedades Respiratorias (CIBERES), Instituto de Investigacion Biomedica Agusti Pi i Sunyer, Universidad de Barcelona (Spain); Rangel, Ernesto [Facultad de Medicina, Universidad Autonoma de Nayarit, Tepic (Mexico); Barlascini, Cornelius [Servizio di Igiene e Sanita Pubblica, Ospedale Generale di Sestri Levante, Sestri Levante (Italy); Piroddi, Ines Maria Grazia; Nicolini, Antonello, E-mail: antonellonicolini@gmail.com [Servizio di Pneumologia, Ospedale Generale di Sestri Levante, Sestri Levante (Italy)

    2015-07-15

    Objective: In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. Methods: We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. Results: In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. Conclusions: In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis. (author)

  19. Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series

    International Nuclear Information System (INIS)

    Cilloniz, Catia; Torres, Antoni; Rangel, Ernesto; Barlascini, Cornelius; Piroddi, Ines Maria Grazia; Nicolini, Antonello

    2015-01-01

    Objective: In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. Methods: We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. Results: In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. Conclusions: In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis. (author)

  20. Early user involvement and participation in employee self-service application deployment: theory and evidence from four Dutch governmental cases.

    NARCIS (Netherlands)

    Koopman, G.; Batenburg, R.

    2009-01-01

    This paper theoretically and empirically addresses the notion that user participation and involvement is one of the important factors for IS success. Different models and studies are reviewed to define and classify types of early end-user involvement and participation. Next, five case studies are

  1. Low dose CT in early lung cancer diagnosis: prevalence data

    International Nuclear Information System (INIS)

    Cardinale, Luciano; Cortese, Giancarlo; Ferraris, Fabrizio; Perotto, Fabio; Fava, Cesare; Borasio, Piero; Dogliotti, Luigi; Novello, Silvia; Scagliotti, Giorgio

    2005-01-01

    Purpose. Lung cancer has a high mortality rate and its prognosis largely depends on early detection. We report the prevalence data of the study on early detection of lung cancer with low-dose spiral CT underway at our hospital. Materials and methods. Since the beginning of 2001, 519 asymptomatic volunteers have undergone annual blood tests, sputum tests, urinalyses and low-dose spiral CT. The inclusion criteria were age (55 years old), a history of cigarette smoking and a negative history for previous neoplastic disease. The diagnostic workup varied depending on the size and CT features of the nodules detected. Results. At baseline, the CT scan detected nodules> 5 mm in 22% of subjects; the nodules were single in 42 and multiple in 71. In 53% of cases the findings were completely negative, while in 122 (23.4%) nodules with a diameter [it

  2. PedGenie: meta genetic association testing in mixed family and case-control designs

    Directory of Open Access Journals (Sweden)

    Allen-Brady Kristina

    2007-11-01

    Full Text Available Abstract Background- PedGenie software, introduced in 2006, includes genetic association testing of cases and controls that may be independent or related (nuclear families or extended pedigrees or mixtures thereof using Monte Carlo significance testing. Our aim is to demonstrate that PedGenie, a unique and flexible analysis tool freely available in Genie 2.4 software, is significantly enhanced by incorporating meta statistics for detecting genetic association with disease using data across multiple study groups. Methods- Meta statistics (chi-squared tests, odds ratios, and confidence intervals were calculated using formal Cochran-Mantel-Haenszel techniques. Simulated data from unrelated individuals and individuals in families were used to illustrate meta tests and their empirically-derived p-values and confidence intervals are accurate, precise, and for independent designs match those provided by standard statistical software. Results- PedGenie yields accurate Monte Carlo p-values for meta analysis of data across multiple studies, based on validation testing using pedigree, nuclear family, and case-control data simulated under both the null and alternative hypotheses of a genotype-phenotype association. Conclusion- PedGenie allows valid combined analysis of data from mixtures of pedigree-based and case-control resources. Added meta capabilities provide new avenues for association analysis, including pedigree resources from large consortia and multi-center studies.

  3. Real-Time Extended Interface Automata for Software Testing Cases Generation

    Directory of Open Access Journals (Sweden)

    Shunkun Yang

    2014-01-01

    Full Text Available Testing and verification of the interface between software components are particularly important due to the large number of complex interactions, which requires the traditional modeling languages to overcome the existing shortcomings in the aspects of temporal information description and software testing input controlling. This paper presents the real-time extended interface automata (RTEIA which adds clearer and more detailed temporal information description by the application of time words. We also establish the input interface automaton for every input in order to solve the problems of input controlling and interface covering nimbly when applied in the software testing field. Detailed definitions of the RTEIA and the testing cases generation algorithm are provided in this paper. The feasibility and efficiency of this method have been verified in the testing of one real aircraft braking system.

  4. High-dose calcium stimulation test in a case of insulinoma masquerading as hysteria.

    Science.gov (United States)

    Nakamura, Yoshio; Doi, Ryuichiro; Kohno, Yasuhiro; Shimono, Dai; Kuwamura, Naomitsu; Inoue, Koichi; Koshiyama, Hiroyuki; Imamura, Masayuki

    2002-11-01

    It is reported that some cases with insulinoma present with neuropsychiatric symptoms and are often misdiagnosed as psychosis. Here we report a case of insulinoma masquerading as hysteria, whose final diagnosis could be made using high-dose calcium stimulation test. A 28-yr-old woman was referred presenting with substupor, mutism, mannerism, restlessness, and incoherence. Laboratory examinations revealed hypoglycemia (33 mg/dL) and detectable insulin levels (9.7 microU/mL), suggesting the diagnosis of insulinoma. However, neither imaging studies nor selective arterial calcium injection (SACI) test with a conventional dose of calcium (0.025 mEq/kg) indicated the tumor. High-dose calcium injection (0.05 mEq/kg) evoked insulin secretion when injected into superior mesenteric artery. A solitary tumor in the head of the pancreas was resected, and her plasma glucose returned to normal. Postoperatively, iv injection of secretin resulted in a normal response of insulin, which was not found preoperatively. This case suggests the usefulness of the SACI test with high-dose of calcium in the case of insulinoma when the standard dose fails to detect such a tumor.

  5. Early Lyme disease with spirochetemia - diagnosed by DNA sequencing

    Directory of Open Access Journals (Sweden)

    Jones William

    2010-11-01

    Full Text Available Abstract Background A sensitive and analytically specific nucleic acid amplification test (NAAT is valuable in confirming the diagnosis of early Lyme disease at the stage of spirochetemia. Findings Venous blood drawn from patients with clinical presentations of Lyme disease was tested for the standard 2-tier screen and Western Blot serology assay for Lyme disease, and also by a nested polymerase chain reaction (PCR for B. burgdorferi sensu lato 16S ribosomal DNA. The PCR amplicon was sequenced for B. burgdorferi genomic DNA validation. A total of 130 patients visiting emergency room (ER or Walk-in clinic (WALKIN, and 333 patients referred through the private physicians' offices were studied. While 5.4% of the ER/WALKIN patients showed DNA evidence of spirochetemia, none (0% of the patients referred from private physicians' offices were DNA-positive. In contrast, while 8.4% of the patients referred from private physicians' offices were positive for the 2-tier Lyme serology assay, only 1.5% of the ER/WALKIN patients were positive for this antibody test. The 2-tier serology assay missed 85.7% of the cases of early Lyme disease with spirochetemia. The latter diagnosis was confirmed by DNA sequencing. Conclusion Nested PCR followed by automated DNA sequencing is a valuable supplement to the standard 2-tier antibody assay in the diagnosis of early Lyme disease with spirochetemia. The best time to test for Lyme spirochetemia is when the patients living in the Lyme disease endemic areas develop unexplained symptoms or clinical manifestations that are consistent with Lyme disease early in the course of their illness.

  6. An improved interim therapeutic restoration technique for management of anterior early childhood caries: report of two cases.

    Science.gov (United States)

    Nelson, Travis

    2013-01-01

    Early childhood caries presents unique treatment challenges that often require advanced behavior management techniques, such as general anesthesia or procedural sedation. In some cases, use of these pharmacologic adjuncts is undesirable or not possible. The interim therapeutic restoration is a treatment method that, while sometimes employed in such cases, can often produce unsatisfactory results in primary anterior teeth. This is often due to insufficient bulk of material and lack of retention. The purpose of this report was to describe a simple alternative technique (resin modified glass ionomer strip crowns) that may be employed to deliver esthetic anterior restorations to marginally cooperative children in the dental clinic setting and to report on two cases in which it was successfully used. \\\\\\Department of Pediatric Dentistry, University of Washington, Seattle, Wash., USA. tmnelson@uw.edu

  7. The Loss of Grammatical Gender and Case Features Between Old and Early Middle English: Its Impact on Simple Demonstratives and Topic Shift

    Directory of Open Access Journals (Sweden)

    Jurczyk Rafał

    2017-12-01

    Full Text Available In this paper we examine the relation between the loss of formal gender and Case features on simple demonstratives and the topic shifting property they manifest. The examination period spans between Old English and Early Middle English. While we argue that this loss has important discourse-pragmatic and derivational effects on demonstratives, we also employ the Strong Minimalist Hypothesis approach (Chomsky 2001 and feature valuation, as defined in Pesetsky & Torrego (2007, to display how their syntactic computation and pragmatic properties have come about. To account for the above innovations yielding the Early Middle English ϸe (‘the’, we first discuss the formal properties of the Old English demonstratives which distinguish number, gender, and Case features. This inflectional variety of forms allows the Old English demonstratives to be used independently and to show the anaphoric and discourse-linking properties of topics. Crucially, the same properties characterise also German and Dutch demonstratives that manifest Case and/or gender morphology overtly, which shows that the syntactic distribution of LIs and their morphological richness should be considered as intertwined. The above properties are then confronted with the determiner system in Early Middle English, whose forms undergo inflectional levelling producing the invariant ϸe/ðe form that loses its distributional independence and acquires the article status. The levelling process in question is argued to stimulate the shift of the [+ref/spec] feature from the formal to the semantic pole. This suggests that the Early Middle English ϸe form no longer counts as an appropriate anaphor in topic shift contexts owing to its indeterminacy of Case, gender, and φ-features, which means that it cannot satisfy the Full Interpretation requirement at the interfaces.

  8. Emergency department based HIV screening: An opportunity for early diagnosis in high prevalent areas

    Directory of Open Access Journals (Sweden)

    Teja V

    2008-01-01

    Full Text Available The Emergency Medicine Department (EMD is an ideal place for public health interventions and provides ready access to the health care system, offering a great opportunity for HIV testing and counselling. Between 2003 and 2005, rapid test was requested for 59.39% of 10,752 cases from EMD, where as ELISA was requested for 40.61%. Of the 317 HIV reactive cases, available medical records of 249 were reviewed for epidemiological and clinical information. Nearly 42% of total reactive cases detected in our Institute were from EMD. Three percent (317/10,752 were diagnosed as HIV reactive, 1.52% of the total samples were reactive by rapid test and the other 1.43% by ELISA. Two and half percent (163/6386 of those who had rapid testing and 3.53% (154/4366 who had ELISA testing, were identified as HIV reactive. All these cases were diagnosed within a mean EMD stay of 2.5 days. Eighty-five percent of HIV reactive individuals were unaware of their reactive status. Additional 53 cases of asymptomatic spouses were diagnosed as HIV reactive, thus making it possible to seek early treatment for HIV infection. The study emphasizes the importance of offering HIV testing to all patients who present to emergency department.

  9. The early diagnosis and management of mixed delirium in a patient placed on ECMO and with difficult sedation: A case report.

    Science.gov (United States)

    Acevedo-Nuevo, María; González-Gil, Maria Teresa; Romera-Ortega, Miguel Ángel; Latorre-Marco, Ignacio; Rodríguez-Huerta, Maria Dolores

    2018-02-01

    Delirium represents a serious problem that impacts the physical and cognitive prognosis of patients admitted to intensive care units and requires prompt diagnosis and management. This article describes the case and progress of a patient placed on Extracorporeal Membrane Oxygenation with difficult sedation criteria and an early diagnosis of mixed delirium. During the case report, we reflect on the pharmacological and non-pharmacological strategies employed to cope with delirium paying special attention to the non-use of physical restraint measures in order to preserve vital support devices (endotracheal tube or Extracorporeal Membrane Oxygenation cannula). The multimodal and multidisciplinary approach, focused on nursing interventions, strict Pain/Agitation/Delirium monitoring and pharmacological measures, as well as the implementation of measures according to the eCASH (early Comfort using Analgesia, minimal Sedatives and maximal Human Care) concept, were effective, resulting in a relatively short admission considering the severity of the patient's condition and the associated complications. Early independent ambulation was achieved prior to transfer to a hospitalisation unit. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. USE OF EXTENDED-RELEASE PRAMIPEXOLE IN EARLY-STAGE PARKINSON’S DISEASE: DESCRIPTION OF A CLINICAL CASE

    Directory of Open Access Journals (Sweden)

    N. V. Fedorova

    2014-11-01

    Full Text Available The paper considers a clinical case of early-stage mixed Parkinson’s disease (PD with significant affective disorders and restless legs syndrome. Once-daily extended-release pramipexole 3 mg significantly improved a patient’s status and led to regression of movement and affective disorders. The paper gives data on the efficacy of dopamine receptor agonists in treating PD and the benefits of their extended-release formulations.

  11. Sport-specific fitness testing and intervention for an adolescent with cerebral palsy: a case report.

    Science.gov (United States)

    Kenyon, Lisa K; Sleeper, Mark D; Tovin, Melissa M

    2010-01-01

    This case report describes the development, implementation, and outcomes of a fitness-related intervention program that addressed the sport-specific goals of an adolescent with cerebral palsy. The participant in this case was a 16-year-old African American male with spastic diplegia. The participant joined his high school wrestling team and asked to focus his physical therapy on interventions that would improve his wrestling performance. An examination was performed using the muscle power sprint test, the 10 x 5-m sprint test, strength tests, the 10-m shuttle run test, and the Gross Motor Function Measure. The intervention consisted of interval training, which focused on the demands of wrestling. Scores on all tests and measures were higher after the intervention. The outcomes of this case report seem to support the use of a fitness-related intervention program for addressing the sport-specific goals of an adolescent with cerebral palsy.

  12. Early detection of typhoid by polymerase chain reaction

    International Nuclear Information System (INIS)

    Haque, A.; Qureshi, Javed A.; Ahmed, J.

    1999-01-01

    Typhoid is a common problem in developing countries. Cultivation ofbacteria and serology (especially Widal test) gives unacceptable levels offalse-negative and false-positive results respectively. In this study, arecently introduced polymerase chain reaction based technique (which has 100%specificity for Salmonella typhi) was compared with blood culture and Widaltest during the first week of illness of 82 suspected cases of typhoid. Therespective figures of positivity for PCR, blood culture and Widal test were71.95%, 34.1% and 36.5%. A control group of 20 healthy persons gave figuresof 0%, 0% and 33.3%, respectively. We conclude that this PCR-based techniqueis not only absolutely specific, but also very sensitive and therefore muchsuperior to blood culture and, Widal test for the early diagnosis of typhoid.(author)

  13. Relationship between histopathological changes in post partum renal biopsies and renal function tests of African women with early onset pre-eclampsia.

    Science.gov (United States)

    Khedun, S M; Naicker, T; Moodley, J

    2000-05-01

    To improve the diagnostic accuracy of concurrent renal disease in hypertension of pregnancy, biopsy evaluation is essential. In addition, establishing underlying renal disease is important for prognosis on future pregnancies. We therefore designed a study to determine the diagnostic yield of postpartum renal biopsy and the nature and frequency of complications associated with this procedure. Also, to determine relationships, if any, between renal function tests and ultrastructural and histopathological findings. Fifty renal biopsies were performed in the immediate postpartum period in black African women with early onset pre-eclampsia. Each biopsy specimen was placed in a separate container and coded so that sampling was unknown to the electron microscopist. Each biopsy specimen was divided into three parts, and processed and stained for light, fluorescent and transmission electron microscopy using conventional techniques. Renal tissue biopsies were adequate for diagnostic purposes in all cases. There were no complications in any of the 50 patients studied. Ultrastructural examination confirmed the light microscopy findings. In addition the ultrastructural findings showed intramembranous deposits, foot process fusion and mesangial deposits. In 16 patients with normal renal function tests; the biopsies evaluation from these patients showed ultrastructural changes. In the remaining 34 patients with abnormal renal function tests of varying severity; biopsy evaluation from these patients showed both ultrastructural and histopathological changes. Renal biopsy procedure is safe, and ultrastructural and histological findings obtained from postpartum renal biopsies are more informative than the routine renal function tests.

  14. Heterozygous truncation mutations of the SMC1A gene cause a severe early onset epilepsy with cluster seizures in females: Detailed phenotyping of 10 new cases.

    Science.gov (United States)

    Symonds, Joseph D; Joss, Shelagh; Metcalfe, Kay A; Somarathi, Suresh; Cruden, Jamie; Devlin, Anita M; Donaldson, Alan; DiDonato, Nataliya; Fitzpatrick, David; Kaiser, Frank J; Lampe, Anne K; Lees, Melissa M; McLellan, Ailsa; Montgomery, Tara; Mundada, Vivek; Nairn, Lesley; Sarkar, Ajoy; Schallner, Jens; Pozojevic, Jelena; Parenti, Ilaria; Tan, Jeen; Turnpenny, Peter; Whitehouse, William P; Zuberi, Sameer M

    2017-04-01

    The phenotype of seizure clustering with febrile illnesses in infancy/early childhood is well recognized. To date the only genetic epilepsy consistently associated with this phenotype is PCDH19, an X-linked disorder restricted to females, and males with mosaicism. The SMC1A gene, which encodes a structural component of the cohesin complex is also located on the X chromosome. Missense variants and small in-frame deletions of SMC1A cause approximately 5% of Cornelia de Lange Syndrome (CdLS). Recently, protein truncating mutations in SMC1A have been reported in five females, all of whom have been affected by a drug-resistant epilepsy, and severe developmental impairment. Our objective was to further delineate the phenotype of SMC1A truncation. Female cases with de novo truncation mutations in SMC1A were identified from the Deciphering Developmental Disorders (DDD) study (n = 8), from postmortem testing of an affected twin (n = 1), and from clinical testing with an epilepsy gene panel (n = 1). Detailed information on the phenotype in each case was obtained. Ten cases with heterozygous de novo mutations in the SMC1A gene are presented. All 10 mutations identified are predicted to result in premature truncation of the SMC1A protein. All cases are female, and none had a clinical diagnosis of CdLS. They presented with onset of epileptic seizures between <4 weeks and 28 months of age. In the majority of cases, a marked preponderance for seizures to occur in clusters was noted. Seizure clusters were associated with developmental regression. Moderate or severe developmental impairment was apparent in all cases. Truncation mutations in SMC1A cause a severe epilepsy phenotype with cluster seizures in females. These mutations are likely to be nonviable in males. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  15. Dose Prediction for surface nuclear explosions: case studies for Semipalatinsk and Lop Nur tests

    International Nuclear Information System (INIS)

    Takada, Jun

    2008-01-01

    Dose prediction method RAPS after surface nuclear explosion has been developed by using the empirical dose function of USA nuclear test. This method which provides us external total dose, dose rate at any distant, at any time for any yield of nuclear explosion, is useful for radiation protection in case of nuclear events such as terrorism and nuclear war. The validity of RAPS has been confirmed by application to historical surface nuclear test explosions. The first test case study which was done for the first test explosion of the former USSR at the Semipalatinsk Nuclear Test Site on August 29th 1949, shows a good agreement with luminescence dosimetry on a brick. This dose prediction method was applied nuclear tests in Lop Nur. The results indicate dangerous nuclear radiation influences including fatal risk in the wide Uygur area. (author)

  16. Retaining early career registered nurses: a case study.

    Science.gov (United States)

    Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea

    2016-01-01

    A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs

  17. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Science.gov (United States)

    Mutanga, Jane N; Raymond, Juliette; Towle, Megan S; Mutembo, Simon; Fubisha, Robert Captain; Lule, Frank; Muhe, Lulu

    2012-01-01

    Provider-initiated testing and counselling (PITC) is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS) uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074), 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983), 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR) testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342), 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early infant diagnosis. The hospital's bolstered antiretroviral

  18. Airside HVAC BESTEST. Adaptation of ASHRAE RP 865 Airside HVAC Equipment Modeling Test Cases for ASHRAE Standard 140. Volume 1, Cases AE101-AE445

    Energy Technology Data Exchange (ETDEWEB)

    Neymark, J. [J. Neymark & Associates, Golden, CO (United States); Kennedy, M. [Mike D. Kennedy, Inc., Townsend, WA (United States); Judkoff, R. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Gall, J. [AAON, Inc., Tulsa, OK (United States); Knebel, D. [AAON, Inc., Tulsa, OK (United States); Henninger, R. [GARD Analytics, Inc., Arlington Heights, IL (United States); Witte, M. [GARD Analytics, Inc., Arlington Heights, IL (United States); Hong, T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); McDowell, T. [Thermal Energy System Specialists, Madison, WI (United States); Yan, D. [Tsinghua Univ., Beijing (China); Zhou, X. [Tsinghua Univ., Beijing (China)

    2016-03-01

    This report documents a set of diagnostic analytical verification cases for testing the ability of whole building simulation software to model the air distribution side of typical heating, ventilating and air conditioning (HVAC) equipment. These cases complement the unitary equipment cases included in American National Standards Institute (ANSI)/American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs, which test the ability to model the heat-transfer fluid side of HVAC equipment.

  19. Graphs as a Managerial Tool: A Case Study of Du Pont's Use of Graphs in the Early Twentieth Century.

    Science.gov (United States)

    Yates, JoAnne

    1985-01-01

    Sketches the development of business graphs in America. Examines their early use at Du Pont and the origin of the chart room around 1920, an important factor in the executive control systems at Du Pont. Draws lessons from this case study for managers and teachers of business communication. (PD)

  20. RESPONSE TO THE RICHARD ERSKINES ARTICLE RELATIONAL HEALING OF EARLY AFFECT-CONFUSION - PART 3 OF A CASE STUDY TRILOGY

    Directory of Open Access Journals (Sweden)

    Maša Žvelc

    2013-10-01

    Full Text Available This article provides four responses from senior psychotherapists and supervisors to Erskine’s articleRelational Healing of Early Affect-Confusion. The authors approach the third part of case study trilogy from their particular perspective and provide both challenge and respect for the author’s work.

  1. PREDICTABILITY OF FINANCIAL CRISES: TESTING K.R.L. MODEL IN THE CASE OF TURKEY

    Directory of Open Access Journals (Sweden)

    Zeynep KARACOR

    2012-06-01

    Full Text Available The aim of this study is to test predictability of 2007 Global Economic Crisis which hit Turkey by the help of macroeconomic data of Turkey. K.R.L. model is used to test the predictability. By the method of analyzing various leading early warning indicators, the success of the model in forecasting the crises is surveyed. The findings do not support K.R.L. models. Possible reasons for this are stated at the article.

  2. Vignettes of scholars: A case study of black male students at a STEM early college high school

    Science.gov (United States)

    Adams, Tempestt Richardson

    Ensuring students graduate high school ready to enter college or the workforce has become a prime focus within secondary education. High school graduates are often ill-prepared for college-level work and often have to register for remedial courses before they can take standard college level courses (Southern Regional Education Board, 2010). Serving as both a solution to this concern and an alternative to traditional high schools, early college high schools were created to focus on increasing the number of students graduating from high school and enrolling in college. Early college high schools seek to serve students who have traditionally underperformed in school and those who are underrepresented in higher education including students of color, first-generation college students, students from low socioeconomic backgrounds, and English language learners (Barnett, Bucceri, Hindo, Kim, 2013; "Overview & FAQS," 2013). In efforts to learn more about how early colleges are meeting the needs of students, this dissertation examines the experiences, identity construction, and perceptions of Black male students at a science, technology, engineering, and mathematics (STEM) based early college high school. Using a qualitative case study design, participants were eight Black male upperclassmen enrolled in a STEM early college high school, located on the campus of a four-year university. Data was collected through focus groups and individual interviews and data was analyzed thematically. Findings suggest students in this study have largely positive experiences at their early college high school. Despite some challenges, the early college high school environment helps facilitate scholar identities, and the STEM focus of the school helps students learn more about their strengths and weaknesses. The implications of the research, recommendations for educational stakeholders, and recommendations for future research are discussed.

  3. Early Detection of Alzheimer's Disease Based on the Patient's Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method.

    Science.gov (United States)

    Heymann, Petra; Gienger, Regine; Hett, Andreas; Müller, Stephan; Laske, Christoph; Robens, Sibylle; Ostermann, Thomas; Elbing, Ulrich

    2018-01-01

    Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

  4. Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder.

    Science.gov (United States)

    DiGuiseppi, Carolyn G; Daniels, Julie L; Fallin, Daniele M; Rosenberg, Steven A; Schieve, Laura A; Thomas, Kathleen C; Windham, Gayle C; Goss, Cynthia W; Soke, Gnakub N; Currie, Dustin W; Singer, Alison B; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A; Miller, Lisa A; Pinto-Martin, Jennifer A; Young, Lisa M; Schendel, Diana E

    2016-07-01

    The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Gifted and Talented Education: A National Test Case in Peoria.

    Science.gov (United States)

    Fetterman, David M.

    1986-01-01

    This article presents a study of a program in Peoria, Illinois, for the gifted and talented that serves as a national test case for gifted education and minority enrollment. It was concluded that referral, identification, and selection were appropriate for the program model but that inequalities resulted from socioeconomic variables. (Author/LMO)

  6. Case management after long-term absence from work in China: a case report.

    Science.gov (United States)

    Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

    2011-03-01

    Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

  7. Report of a Case of Primary Abdominal Pregnancy

    Directory of Open Access Journals (Sweden)

    Sh Beigi

    2006-01-01

    Full Text Available Ectopic pregnancy (EP is a potentially life-threatening condition in which the embryo implants outside the uterine endometrial cavity. Abdominal pregnancy is an atypical site wherein the product of conception lies totally outside the reproductive tract. Primary abdominal pregnancy is a very rare condition with a high mortality rate. Diagnosis is often late or misdiagnosed. The aim of introducing this case report is to present a new case of early primary abdominal pregnancy. Despite regular menstrual bleeding and contraception with IUD (intrauterine device, this pregnancy occurred in a 24-year old woman. Emergency laparotomy was performed because of abdominal pain, unstable condition and positive urine pregnancy test. It revealed more than 1500 ml of blood in the abdominal cavity. The uterus, both fallopian tubes and ovaries were completely intact. A 3X4 cm mass lateral to the left utersacral ligament was observed and resected. Since IUD strings could not be identified, endometrial currettage was performed and then the IUD was removed. Histological report of the mass and tissue of uterine cavity was placental villi and secretory endometrium, respectively, which according to Studdifords criteria is a new case of early primary abdominal pregnancy. To reduce maternal mortality and morbidity, early recognition of ectopic pregnancy is critical. According to review of the literature and the case report, a high index of suspicion is vital for the early diagnosis of ectopic pregnancy because the signs and symptoms of EP overlap with many surgical and gynecologic conditions. With early diagnosis of EP, we can suggest many therapeutic options and also retain fertility (if desired by patient, while minimizing disease and treatment-related morbidity.

  8. Early detection of venous thromboses of the lower limb in traumatology using labelled fibrinogen

    International Nuclear Information System (INIS)

    Pasteyer, J.; Lanata, E.; Bonnard, P.; Jean, N.; Kher, A.; Patel, A.

    1975-01-01

    In emergency traumatology, the iodine 125 labelled fibrinogen test is useful in the early detection of phlebitis in patients in whom the routine use of heparin is not possible: fractures of the cervical spine, severe cranial trauma, elderly subjects. It makes possible the institution of appropriate heparin therapy, whithout waiting for clinical signs to become evident. Isotopic venous thromboses occured very frequently and very early and clinical signs, when present (50% of cases) occured 24 to 48 hours after the appearance of isotopic signs [fr

  9. Effect of mercury and cadmium on early life stages of Java medaka (Oryzias javanicus): A potential tropical test fish

    International Nuclear Information System (INIS)

    Ismail, Ahmad; Yusof, Shahrizad

    2011-01-01

    Research highlights: → Early life stages of Java medaka show high sensitivity to Cd and Hg. → Exposure of the early life stages caused several developmental impairments. → Java medaka is suitable to be established as test organism for ecotoxicology. → Results of testing using this fish reflect the environment of the tropical region. - Abstract: Several organisms have been used as indicators, bio-monitoring agents or test organisms in ecotoxicological studies. A close relative of the well established Japanese medaka, the Java medaka (Oryzias javanicus), has the potential to be a test organism. The fish is native to the estuaries of the Malaysian Peninsula, Thailand, Indonesia and Singapore. In this study, newly fertilised eggs were exposed to different concentrations of Cd and Hg. Observations were done on the development of the embryos. Exposure to low levels of Cd and Hg (0.01-0.05 ppm) resulted in several developmental disorders that led to death. Exposure to ≥1.0 ppm Cd resulted in immediate developmental arrest. The embryos of Java medaka showed tolerance to a certain extent when exposed to ≥1.0 ppm Hg compared to Cd. Based on the sensitivity of the embryos, Java medaka is a suitable test organism for ecotoxicology in the tropical region.

  10. Economic evaluation of medical tests at the early phases of development: a systematic review of empirical studies.

    Science.gov (United States)

    Frempong, Samuel N; Sutton, Andrew J; Davenport, Clare; Barton, Pelham

    2018-02-01

    There is little specific guidance on the implementation of cost-effectiveness modelling at the early stage of test development. The aim of this study was to review the literature in this field to examine the methodologies and tools that have been employed to date. Areas Covered: A systematic review to identify relevant studies in established literature databases. Five studies were identified and included for narrative synthesis. These studies revealed that there is no consistent approach in this growing field. The perspective of patients and the potential for value of information (VOI) to provide information on the value of future research is often overlooked. Test accuracy is an essential consideration, with most studies having described and included all possible test results in their analysis, and conducted extensive sensitivity analyses on important parameters. Headroom analysis was considered in some instances but at the early development stage (not the concept stage). Expert commentary: The techniques available to modellers that can demonstrate the value of conducting further research and product development (i.e. VOI analysis, headroom analysis) should be better utilized. There is the need for concerted efforts to develop rigorous methodology in this growing field to maximize the value and quality of such analysis.

  11. Location tests for biomarker studies: a comparison using simulations for the two-sample case.

    Science.gov (United States)

    Scheinhardt, M O; Ziegler, A

    2013-01-01

    Gene, protein, or metabolite expression levels are often non-normally distributed, heavy tailed and contain outliers. Standard statistical approaches may fail as location tests in this situation. In three Monte-Carlo simulation studies, we aimed at comparing the type I error levels and empirical power of standard location tests and three adaptive tests [O'Gorman, Can J Stat 1997; 25: 269 -279; Keselman et al., Brit J Math Stat Psychol 2007; 60: 267- 293; Szymczak et al., Stat Med 2013; 32: 524 - 537] for a wide range of distributions. We simulated two-sample scenarios using the g-and-k-distribution family to systematically vary tail length and skewness with identical and varying variability between groups. All tests kept the type I error level when groups did not vary in their variability. The standard non-parametric U-test performed well in all simulated scenarios. It was outperformed by the two non-parametric adaptive methods in case of heavy tails or large skewness. Most tests did not keep the type I error level for skewed data in the case of heterogeneous variances. The standard U-test was a powerful and robust location test for most of the simulated scenarios except for very heavy tailed or heavy skewed data, and it is thus to be recommended except for these cases. The non-parametric adaptive tests were powerful for both normal and non-normal distributions under sample variance homogeneity. But when sample variances differed, they did not keep the type I error level. The parametric adaptive test lacks power for skewed and heavy tailed distributions.

  12. Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease

    Science.gov (United States)

    Weiner, Zachary P.; Crew, Rebecca M.; Brandt, Kevin S.; Ullmann, Amy J.; Schriefer, Martin E.; Molins, Claudia R.

    2015-01-01

    Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. PMID:26376927

  13. Evaluation of Selected Borrelia burgdorferi lp54 Plasmid-Encoded Gene Products Expressed during Mammalian Infection as Antigens To Improve Serodiagnostic Testing for Early Lyme Disease.

    Science.gov (United States)

    Weiner, Zachary P; Crew, Rebecca M; Brandt, Kevin S; Ullmann, Amy J; Schriefer, Martin E; Molins, Claudia R; Gilmore, Robert D

    2015-11-01

    Laboratory testing for the diagnosis of Lyme disease is performed primarily by serologic assays and is accurate for detection beyond the acute stage of the infection. Serodiagnostic assays to detect the early stages of infection, however, are limited in their sensitivity, and improvement is warranted. We analyzed a series of Borrelia burgdorferi proteins known to be induced within feeding ticks and/or during mammalian infection for their utility as serodiagnostic markers against a comprehensive panel of Lyme disease patient serum samples. The antigens were assayed for IgM and IgG reactivity in line immunoblots and separately by enzyme-linked immunosorbent assay (ELISA), with a focus on reactivity against early Lyme disease with erythema migrans (EM), early disseminated Lyme neuroborreliosis, and early Lyme carditis patient serum samples. By IgM immunoblotting, we found that recombinant proteins BBA65, BBA70, and BBA73 reacted with early Lyme EM samples at levels comparable to those of the OspC antigen used in the current IgM blotting criteria. Additionally, these proteins reacted with serum samples from patients with early neuroborreliosis and early carditis, suggesting value in detecting early stages of this disease progression. We also found serological reactivity against recombinant proteins BBA69 and BBA73 with early-Lyme-disease samples using IgG immunoblotting and ELISA. Significantly, some samples that had been scored negative by the Centers for Disease Control and Prevention-recommended 2-tiered testing algorithm demonstrated positive reactivity to one or more of the antigens by IgM/IgG immunoblot and ELISA. These results suggest that incorporating additional in vivo-expressed antigens into the current IgM/IgG immunoblotting tier in a recombinant protein platform assay may improve the performance of early-Lyme-disease serologic testing. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  14. Large block migration experiments: INTRAVAL phase 1, Test Case 9

    Energy Technology Data Exchange (ETDEWEB)

    Gureghian, A.B.; Noronha, C.J. (Battelle, Willowbrook, IL (USA). Office of Waste Technology Development); Vandergraaf, T.T. (Atomic Energy of Canada Ltd., Ottawa, ON (Canada))

    1990-08-01

    The development of INTRAVAL Test Case 9, as presented in this report, was made possible by a past subsidiary agreement to the bilateral cooperative agreement between the US Department of Energy (DOE) and Atomic Energy of Canada Limited (AECL) encompassing various aspects of nuclear waste disposal research. The experimental aspect of this test case, which included a series of laboratory experiments designed to quantify the migration of tracers in a single, natural fracture, was undertaken by AECL. The numerical simulation of the results of these experiments was performed by the Battelle Office of Waste Technology Development (OWTD) by calibrating an in-house analytical code, FRACFLO, which is capable of predicting radionuclide transport in an idealized fractured rock. Three tracer migration experiments were performed, using nonsorbing uranine dye for two of them and sorbing Cs-137 for the third. In addition, separate batch experiments were performed to determine the fracture surface and rock matrix sorption coefficients for Cs-137. The two uranine tracer migration experiment were used to calculate the average fracture aperture and to calibrate the model for the fracture dispersivity and matrix diffusion coefficient. The predictive capability of the model was then tested by simulating the third, Cs-137, tracer test without changing the parameter values determined from the other experiments. Breakthrough curves of both the experimental and numerical results obtained at the outlet face of the fracture are presented for each experiment. The reported spatial concentration profiles for the rock matrix are based solely on numerical predictions. 22 refs., 12 figs., 8 tabs.

  15. Construction of a case for expert judgement of uncertainty in early health effects models

    International Nuclear Information System (INIS)

    Grupa, J.

    1997-11-01

    The contribution of ECN to a joint study of the European Commission (EC) and the US Nuclear Regulatory Commission (NRC), in which the uncertainty in risks and consequences of severe accidents at nuclear power plants are evaluated, is described. The procedure used to obtain these uncertainties is called expert judgement. In a formal expert judgement procedure a panel of experts has provided quantitative information about the uncertainty in given observables: a quantity that describes an observation concerning the phenomenon of interest, in this paper the relation between dose and health effects, without information or assumptions about any model describing this phenomenon. The observables are defined in a case structure, a questionnaire provided to all experts. ECN has contributed to the selection of the experts for the early health effects panel, and provided assistance for drafting the case structure for this panel. This paper describes the radiological information provided by ECN and the analyses necessary for constructing the case structure. The deliverables of the expert elicitation are uncertainty distributions of the observables requested in the case structure. The results are intended to be unbiased, i.e. it should be applicable to any model describing the relation between dose and health effects. They will be published by the project team in a joint publication of the NRC and the EC. In this way the resulting uncertainty distributions are available for further work in the joint project and available to a more general public. 2 figs., 4 refs

  16. Avoiding pitfalls in molecular genetic testing: case studies of high-resolution array comparative genomic hybridization testing in the definitive diagnosis of Mowat-Wilson syndrome.

    Science.gov (United States)

    Kluk, Michael Joseph; An, Yu; James, Philip; Coulter, David; Harris, David; Wu, Bai-Lin; Shen, Yiping

    2011-05-01

    The molecular testing options available for the diagnosis of genetic disorders are numerous and include a variety of different assay platforms. The consultative input of molecular pathologists and cytogeneticists, working closely with the ordering clinicians, is often important for definitive diagnosis. Herein, we describe two patients who had long histories of unexplained signs and symptoms with a high clinical suspicion of an underlying genetic etiology. Initial molecular testing in both cases was negative, but the application of high-resolution array comparative genomic hybridization technology lead to definitive diagnosis in both cases. We summarize the clinical findings and molecular testing in each case, discuss the differential diagnoses, and review the clinical and pathological findings of Mowat-Wilson syndrome. This report highlights the importance for those involved in molecular testing to know the nature of the underlying genetic abnormalities associated with the suspected diagnosis, to recognize the limitations of each testing platform, and to persistently pursue repeat testing using high-resolution technologies when indicated. This concept is applicable to both germline and somatic molecular genetic testing. Copyright © 2011 American Society for Investigative Pathology and the Association for Molecular Pathology. Published by Elsevier Inc. All rights reserved.

  17. [X-linked adrenoleukodystrophy: a report of three cases. The importance of early diagnosis].

    Science.gov (United States)

    López Úbeda, Marta; de Arriba Muñoz, Antonio; Ferrer Lozano, Marta; Labarta Aizpún, José I; García Jiménez, María C

    2017-10-01

    X-linked adrenoleukodystrophy is the most common peroxisomal disorder. This disease is caused by a defect in the ABCD1 gen. Saturated very long chain fatty acids are accumulated in serum, adrenal cortex and central nervous system white matter. The clinical spectrum is characterized by progressive neurological dysfunction and adrenal insufficiency with a devastating prognosis. We report a first case of X-linked adrenoleukodystrophy with fatal evolution which identified two asymptomatic family members and established a preventive treatment. Although there is no definitive cure, we stress the importance of family study and evaluation of the individual in situation of risk to establish an early preventive treatment and to give in each particular situation suitable professional advice. Sociedad Argentina de Pediatría.

  18. The outcome of rectal cancer after early salvage TME following TEM compared with primary TME: a case-matched study.

    Science.gov (United States)

    Levic, K; Bulut, O; Hesselfeldt, P; Bülow, S

    2013-08-01

    Transanal endoscopic microsurgery (TEM) allows locally complete resection of early rectal cancer as an alternative to conventional radical surgery. In case of unfavourable histology after TEM, or positive resection margins, salvage surgery can be performed. However, it is unclear if the results are equivalent to primary treatment with total mesorectal excision (TME). The aim of this retrospective study was to determine whether there is a difference in outcome between patients who underwent early salvage resection with TME after TEM, and those who underwent primary TME for rectal cancer. From 1997 to 2011, early salvage surgery with TME after TEM was performed in 25 patients in our institution. These patients were compared with 25 patients who underwent primary TME, matched according to gender, age (±2 years), cancer stage and operative procedure. Data were obtained from the patients' charts and reviewed retrospectively. No patients received preoperative chemotherapy. Perioperative data and oncological outcome were analysed. The Mann-Whitney U-test and Fisher's exact test were used to compare the results between the two groups. There was no significant difference between the two groups in median operating time (P = 0.39), median blood loss (P = 0.19) or intraoperative complications (P = 1.00). The 30-day mortality was 8 % (n = 2) among patients who underwent salvage TME after TEM, and no patients died in the primary TME group (P = 0.49). There was no significant difference between two groups of patients in the median number of harvested lymph nodes (P = 0.34), median circumferential resection margin (CRM) (P = 0.99) or the completeness of the mesorectal fascia plane. No local recurrences occurred among the patients with salvage TME, and there were 2 patients (8 %) with local recurrences among the patients with primary TME (P = 0.49). Distant metastasis occurred in one patient (4 %) after salvage TME and in 3 patients (12 %) with primary TME (P = 0.61). The median

  19. Acute HIV Infection in Pregnancy: The Case for Third Trimester Rescreening

    Directory of Open Access Journals (Sweden)

    Jocelyn Wertz

    2011-01-01

    Full Text Available Combination testing with anti-HIV Elisa and Western blot is both sensitive and specific for diagnosis of established HIV-1 infection but could not detect acute HIV infection (AHI. AHI is a time of extremely high viral load, which may correlate to increased risk of horizontal or vertical transmission. Thus, early identification of AHI could allow for interventions to decrease transmission. However, recognition of AHI can be challenging as symptoms could be absent or nonspecific, therefore, AHI is often not detected, particularly in pregnancy. We present a case report of AHI in a pregnant woman who presented with headache and fever. She tested negative for HIV in the first trimester and at time of AHI at 26 3/7 weeks by anti-HIV Elisa, but was diagnosed with AHI based on an HIV RNA viral load of 434,000 copies/mL. This report presents a case for improved awareness of AHI in pregnancy, and the need for repeat HIV testing in late pregnancy, and highlighted that early detection of AHI might be possible with adding HIV RNA testing at time of standard anti-HIV Elisa screening test in pregnancy. Novel laboratory approaches including pooling of sera for HIV RNA could reduce the cost of HIV RNA testing.

  20. Testing the snake-detection hypothesis: larger early posterior negativity in humans to pictures of snakes than to pictures of other reptiles, spiders and slugs

    OpenAIRE

    Van Strien, Jan W.; Franken, Ingmar H. A.; Huijding, Jorg

    2014-01-01

    According to the snake detection hypothesis (Isbell, 2006), fear specifically of snakes may have pushed evolutionary changes in the primate visual system allowing pre-attentional visual detection of fearful stimuli. A previous study demonstrated that snake pictures, when compared to spiders or bird pictures, draw more early attention as reflected by larger early posterior negativity (EPN). Here we report two studies that further tested the snake detection hypothesis. In Study, 1 we tested whe...

  1. [Laparoscopic radical trachelectomy for preservation of fertility in early cervical cancer. A case report].

    Science.gov (United States)

    Isla Ortiz, David; Montalvo-Esquivel, Gonzalo; Chanona-Vilchis, José Gregorio; Herrera Gómez, Ángel; Ñamendys Silva, Silvio Antonio; Pareja Franco, Luis René

    2016-01-01

    Radical hysterectomy is the standard treatment for patients with early-stage cervical cancer. However, for women who wish to preserve fertility, radical trachelectomy is a safe and viable option. To present the first case of laparoscopic radical trachelectomy performed in the National Cancer Institute, and published in Mexico. Patient, 34 years old, gravid 1, caesarean 1, stage IB1 cervical cancer, squamous, wishing to preserve fertility. She underwent a laparoscopic radical trachelectomy and bilateral dissection of the pelvic lymph nodes. Operation time was 330minutes, and the estimated blood loss was 100ml. There were no intraoperative or postoperative complications. The final pathology reported a tumour of 15mm with infiltration of 7mm, surgical margins without injury, and pelvic nodes without tumour. After a 12 month follow-up, the patient is having regular periods, but has not yet tried to get pregnant. No evidence of recurrence. Laparoscopic radical trachelectomy and bilateral pelvic lymphadenectomy is a safe alternative in young patients who wish to preserve fertility with early stage cervical cancer. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

  2. Predictors of early stent occlusion among plastic biliary stents.

    Science.gov (United States)

    Khashab, Mouen A; Kim, Katherine; Hutfless, Susan; Lennon, Anne Marie; Kalloo, Anthony N; Singh, Vikesh K

    2012-09-01

    A major disadvantage of plastic biliary stents is their short patency rates. The aim of this study was to identify predictors of early stent occlusion among patients receiving conventional plastic biliary stents. Early stent occlusion was defined as worsening cholestatic liver test results of a severity sufficiently significant to warrant ERCP with stent exchange prior to the planned stent exchange, or as symptoms of cholangitis. The association of cumulative stent diameter, demographics, stricture location, procedure indication, Charlson comorbidity index, history of prior early stent occlusion, presence of gallbladder, and performance of sphincteromy with the occurrence of early stent occlusion was studied using logistic regression and multivariate analysis. Our patient cohort comprised 343 patients (mean age 59.3 years) who underwent 561 ERCP procedures with the placement of one or more plastic biliary stents (mean number of stents per procedure 1.2, mean total diameter of stents per procedure 12 Fr). Early stent occlusion occurred in 73 (13 %) procedures. Female gender was protective against early stent occlusion (adjusted OR 0.54, 95 % CI 0.32-0.90, p = 0.02), while hilar stricture location was independently associated with a significantly increased risk of early stent occlusion (adjusted OR 3.41, 95 % CI 1.68-6.90, p = 0.0007). Early occlusion of conventional biliary stents occurred in 13 % of cases. While female gender decreased the risk of early stent occlusion, hilar stricture location was a significant predictor of early stent occlusion. Our results suggest that physicians should consider early elective stent exchange in patients with hilar strictures.

  3. Chromium Toxicity Test for Fall Chinook Salmon (Oncorhynchus tshawytscha) Using Hanford Site Groundwater: Onsite Early Life-Stage Toxicity Evaluation

    International Nuclear Information System (INIS)

    Patton, Gregory W; Dauble, Dennis D; Chamness, Mickie A; Abernethy, Cary S; McKinstry, Craig A

    2001-01-01

    The objective of this study was to evaluate site-specific effects for early life-stage (eyed eggs to free swimming juveniles) fall chinook salmon that might be exposed to hexavalent chromium from Hanford groundwater sources. Our exposure conditions included hexavalent chromium obtained from Hanford groundwater wells near the Columbia River, Columbia River water as the diluent, and locally adapted populations of fall chinook salmon. This report describes both a 96-hr pretest using rainbow trout eggs and an early life-stage test beginning with chinook salmon eggs

  4. ANALYSIS OF SERUM URIC ACID LEVELS IN EARLY SECOND TRIMESTER AS AN EARLY PREDICTOR FOR PREECLAMPSIA

    Directory of Open Access Journals (Sweden)

    Ratna Bulusu

    2017-01-01

    Full Text Available BACKGROUND Hypertensive disorders complicate 5-10% of all pregnancies. Screening for these factors in the second trimester of pregnancy will help in early detection of hypertensive disorders of pregnancy, thus enabling. 1. Early identification of patients at risk of developing preeclampsia and eclampsia. 2. Prophylactic medication to prevent hypertension or to reduce its severity. 3. Proper antenatal care. The aim of the study is to study the accuracy of serum uric acid levels in early second trimester (14-20 weeks as early predictor of preeclampsia. MATERIALS AND METHODS 100 pregnant normotensive women between 14-20 weeks gestation with singleton pregnancy irrespective of parity were selected randomly and serum levels of uric acid was estimated. Regular follow up of the cases was done till delivery. Number of cases developing preeclampsia was noted. Results were analysed statistically. RESULTS Out of the 100 patients enrolled in the study, 11 developed preeclampsia while rest 89 remained normotensive. Mean value of uric acid in preeclampsia cases was 6.28±0.86 mg/dL while that in normotensive cases was 3.42±0.94 mg/dL. This result was statistically significant. CONCLUSION Serum uric acid level at 14-20 weeks of gestation was significantly raised in the cases who developed preeclampsia as compared to those who remained normotensive. Hence, serum uric acid estimation at 14-20 weeks of gestation could be used as an effective parameter for predicting preeclampsia.

  5. Genetic Testing for Type 2 Diabetes in High-Risk Children: the Case for Primordial Prevention

    Directory of Open Access Journals (Sweden)

    Jennifer Wessel

    2017-09-01

    Full Text Available Extensive research now demonstrates that lifestyle modification can significantly lower risk of developing type 2 diabetes (T2D in high-risk adults. In children, the evidence for lifestyle modification is not as robust, but the rapidly rising rate of obesity in children coupled with the substantial difficulty in changing behaviors later in life illuminates the need to implement prevention efforts early in the life course of children. Genetic data can now be used early in the life course to identify children at high-risk of developing T2D before traditional clinical measures can detect the presence of prediabetes; a metabolic condition associated with obesity that significantly increases risk for developing T2D.  Such early detection of risk may enable the promotion of “primordial prevention” in which parents implement behavior change for their at risk children.  Young children with genetic risk are a novel target population.  Here we review the literature on genetic testing for prevention as it relates to chronic diseases and specifically use T2D as a model. We discuss the history of primordial prevention, the need for primordial prevention of T2D and the role genetic testing has in primordial prevention of high-risk families.

  6. The Lifetime Economic Burden of Inaccurate HER2 Testing: Estimating the Costs of False-Positive and False-Negative HER2 Test Results in US Patients with Early-Stage Breast Cancer.

    Science.gov (United States)

    Garrison, Louis P; Babigumira, Joseph B; Masaquel, Anthony; Wang, Bruce C M; Lalla, Deepa; Brammer, Melissa

    2015-06-01

    Patients with breast cancer whose tumors test positive for human epidermal growth factor receptor 2 (HER2) are treated with HER2-targeted therapies such as trastuzumab, but limitations with HER2 testing may lead to false-positive (FP) or false-negative (FN) results. To develop a US-level model to estimate the effect of tumor misclassification on health care costs and patient quality-adjusted life-years (QALYs). Decision analysis was used to estimate the number of patients with early-stage breast cancer (EBC) whose HER2 status was misclassified in 2012. FP results were assumed to generate unnecessary trastuzumab costs and unnecessary cases of trastuzumab-related cardiotoxicity. FN results were assumed to save money on trastuzumab, but with a loss of QALYs and greater risk of disease recurrence and its associated costs. QALYs were valued at $100,000 under a net monetary benefit approach. Among 226,870 women diagnosed with EBC in 2012, 3.12% (n = 7,070) and 2.18% (n = 4,955) were estimated to have had FP and FN test results, respectively. Approximately 8400 QALYs (discounted, lifetime) were lost among women not receiving trastuzumab because of FN results. The estimated incremental per-patient lifetime burden of FP or FN results was $58,900 and $116,000, respectively. The implied incremental losses to society were $417 million and $575 million, respectively. HER2 tests result in misclassification and nonoptimal treatment of approximately 12,025 US patients with EBC annually. The total economic societal loss of nearly $1 billion suggests that improvements in HER2 testing accuracy are needed and that further clinical and economic studies are warranted. Copyright © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  7. Clinical effect of vitamin A palmitate eye gel on early ocular surface reconstruction after thermal or chemical injuries

    Directory of Open Access Journals (Sweden)

    Fen-Dui Zhang

    2015-11-01

    Full Text Available AIM: To evaluate the clinical effect of vitamin A palmitate eye gel on early ocular surface reconstruction after thermal or chemical injuries. METHODS: Seventy-eight cases with thermal or chemical injuries to eyes were selected and divided into two groups by randomized, double-blind, positive drug parallel controlled method: group A(40 cases were treated with vitamin A palmitate eye geland group B \\〖38 cases were treated with basic fibroblast growth factor(bFGF\\〗. The bFGF and vitamin A palmitate eye gel were used 4 times a day. The treatment course was 14d. Restoration of epithelial defect, Schirmer's test values, tear break-up time(BUT, and subjective assessment of symptoms and signs were observed on D1, D3, D5, D7, D10 and D14.RESULTS: In group A, 31 cases were cured, 5 cases were effective, with the cure rate of 76% and efficiency 90%. In group B, 32 cases were cured, 3 cases were effective, with the cure rate of 84% and efficiency 92%. There were no significant differences between the two groups(P>0.05. However, there were significant differences on the results of Schirmer's test and BUT(PPCONCLUSION: Vitamin A palmitate eye gel is valuable and safe on early ocular surface reconstruction of the eyes suffered from thermal or chemical injuries.

  8. Computer-aided detection of early interstitial lung diseases using low-dose CT images

    Energy Technology Data Exchange (ETDEWEB)

    Park, Sang Cheol; Kim, Soo Hyung [School of Electronics and Computer Engineering, Chonnam National University, Gwangju 500-757 (Korea, Republic of); Tan, Jun; Wang Xingwei; Lederman, Dror; Leader, Joseph K; Zheng Bin, E-mail: zhengb@upmc.edu [Department of Radiology, University of Pittsburgh, Pittsburgh, PA 15213 (United States)

    2011-02-21

    This study aims to develop a new computer-aided detection (CAD) scheme to detect early interstitial lung disease (ILD) using low-dose computed tomography (CT) examinations. The CAD scheme classifies each pixel depicted on the segmented lung areas into positive or negative groups for ILD using a mesh-grid-based region growth method and a multi-feature-based artificial neural network (ANN). A genetic algorithm was applied to select optimal image features and the ANN structure. In testing each CT examination, only pixels selected by the mesh-grid region growth method were analyzed and classified by the ANN to improve computational efficiency. All unselected pixels were classified as negative for ILD. After classifying all pixels into the positive and negative groups, CAD computed a detection score based on the ratio of the number of positive pixels to all pixels in the segmented lung areas, which indicates the likelihood of the test case being positive for ILD. When applying to an independent testing dataset of 15 positive and 15 negative cases, the CAD scheme yielded the area under receiver operating characteristic curve (AUC = 0.884 {+-} 0.064) and 80.0% sensitivity at 85.7% specificity. The results demonstrated the feasibility of applying the CAD scheme to automatically detect early ILD using low-dose CT examinations.

  9. Excess cases of prostate cancer and estimated overdiagnosis associated with PSA testing in East Anglia

    Science.gov (United States)

    Pashayan, N; Powles, J; Brown, C; Duffy, S W

    2006-01-01

    This study aimed to estimate the extent of ‘overdiagnosis' of prostate cancer attributable to prostate-specific antigen (PSA) testing in the Cambridge area between 1996 and 2002. Overdiagnosis was defined conceptually as detection of prostate cancer through PSA testing that otherwise would not have been diagnosed within the patient's lifetime. Records of PSA tests in Addenbrookes Hospital were linked to prostate cancer registrations by NHS number. Differences in prostate cancer registration rates between those receiving and not receiving prediagnosis PSA tests were calculated. The proportion of men aged 40 years or over with a prediagnosis PSA test increased from 1.4 to 5.2% from 1996 to 2002. The rate of diagnosis of prostate cancer was 45% higher (rate ratios (RR)=1.45, 95% confidence intervals (CI) 1.02–2.07) in men with a history of prediagnosis PSA testing. Assuming average lead times of 5 to 10 years, 40–64% of the PSA-detected cases were estimated to be overdiagnosed. In East Anglia, from 1996 to 2000, a 1.6% excess of cases was associated with PSA testing (around a quarter of the 5.3% excess incidence cases observed in East Anglia from 1996 to 2000). Further quantification of the overdiagnosis will result from continued surveillance and from linkage of incidence to testing in other hospitals. PMID:16832417

  10. Reactor protection system software test-case selection based on input-profile considering concurrent events and uncertainties

    International Nuclear Information System (INIS)

    Khalaquzzaman, M.; Lee, Seung Jun; Cho, Jaehyun; Jung, Wondea

    2016-01-01

    Recently, the input-profile-based testing for safety critical software has been proposed for determining the number of test cases and quantifying the failure probability of the software. Input-profile of a reactor protection system (RPS) software is the input which causes activation of the system for emergency shutdown of a reactor. This paper presents a method to determine the input-profile of a RPS software which considers concurrent events/transients. A deviation of a process parameter value begins through an event and increases owing to the concurrent multi-events depending on the correlation of process parameters and severity of incidents. A case of reactor trip caused by feedwater loss and main steam line break is simulated and analyzed to determine the RPS software input-profile and estimate the number of test cases. The different sizes of the main steam line breaks (e.g., small, medium, large break) with total loss of feedwater supply are considered in constructing the input-profile. The uncertainties of the simulation related to the input-profile-based software testing are also included. Our study is expected to provide an option to determine test cases and quantification of RPS software failure probability. (author)

  11. Early detection of fatigue cracks by means of nondestructive testing, NDT; Tidig detektering av utmattningssprickor genom ofoerstoerande provning, OFP

    Energy Technology Data Exchange (ETDEWEB)

    Broddegaard, Mattias [Siemens Industrial Turbines, Finspaang (Sweden)

    2004-12-01

    Components in gas turbines, steam turbines and boilers are subjected to both high and low cycle fatigue. The lifetime of components is established by calculations based on conservative assumptions and safety factors, which means that most components will have a real life far exceeding the calculated. Conventional nondestructive testing is aimed at detecting macroscopic defects, such as cracks, inclusions and other discontinuities in the material. By having the possibility of detecting damage at a microscopic level, the risk of fractures in components subjected to fatigue can be reduced and the interval between testing occasions can be extended. The project goal has been to establish knowledge about possibilities and limitations for early detection of low and high cycle fatigue damage, by a literature survey and by practical experiments on low cycle fatigue specimens in 12% Cr-steel, for the following nondestructive testing methods: MWM (Meandering Winding Magnetometer) eddy current testing; and Nonlinear ultrasonics, both classical (second harmonic) and non-classical (crack closure). The project started with a literature survey. This resulted in a proposal for specimen design and selection of testing techniques and project partners. Manufacturing of specimens in 12% Cr-steel, designation X22CrMoV12-1, and low cycle fatigue testing at 300 deg C testing temperature was carried out at Siemens Industrial Turbines in Finspaang. Specimens with 0, 25, 50, 75 and 100% consumed life, based on the number of cycles to presence of macroscopic cracks, were produced. MWM eddy current testing was carried out by Jentek Sensors Inc. in the USA. Measurements with nonlinear ultrasonics were carried out by Siemens Corporate Technology in Munich and at Blekinge Univ. The specimens were finally examined in SEM and light optical microscope in Finspaang. In the literature, results showing that early detection of fatigue damage by nondestructive testing is possible, can be found. By

  12. Indentifying Latent Classes and Testing Their Determinants in Early Adolescents' Use of Computers and Internet for Learning

    Science.gov (United States)

    Heo, Gyun

    2013-01-01

    The purpose of the present study was to identify latent classes resting on early adolescents' change trajectory patterns in using computers and the Internet for learning and to test the effects of gender, self-control, self-esteem, and game use in South Korea. Latent growth mixture modeling (LGMM) was used to identify subpopulations in the Korea…

  13. The long-term cognitive consequences of early childhood malnutrition: the case of famine in Ghana.

    Science.gov (United States)

    Ampaabeng, Samuel K; Tan, Chih Ming

    2013-12-01

    We examine the role of early childhood health in human capital accumulation. Using a unique data set from Ghana with comprehensive information on individual, family, community, school quality characteristics and a direct measure of intelligence together with test scores, we examine the long-term cognitive effects of the 1983 famine on survivors. We show that differences in intelligence test scores can be robustly explained by the differential impact of the famine in different parts of the country and the impacts are most severe for children under two years of age during the famine. We also account for model uncertainty by using Bayesian Model Averaging. Copyright © 2013 Elsevier B.V. All rights reserved.

  14. The radiographic diagnosis of early attacking congenital syphilis of bone

    International Nuclear Information System (INIS)

    Ji Yaping; Zhuge Moyi

    2005-01-01

    Objective: To explore the method of radiological diagnosis of early attacking congenital syphilis. Methods: Seven cases of early attacking congenital syphilis of bone were retrospectively analyzed, diagnosed serologically, and were taken X-rays of the long bones. Results: Bone radiographs abnormalities were identified in 6 of 7 cases. Five cases suffered periotities, six cases metaphysitis, and three cases combined with diaphysitis. Seven cases had swollen soft tissue. The vertebraes, craniums and epiphysitis were not found abnormal in 7 cases. Diffusion, multiple and symmetric metaphysitis, periosteitis and osteitis were the radiological characters of congenital syphilis of bone. Conclusion: Radiography can affirm the diagnose of early attacking congenital syphilis and definite the arrange and depth. Radiographs of the extremities should be routinely taken in suspected infants. (authors)

  15. Couplex1 test case nuclear - Waste disposal far field simulation

    International Nuclear Information System (INIS)

    2001-01-01

    This first COUPLEX test case is to compute a simplified Far Field model used in nuclear waste management simulation. From the mathematical point of view the problem is of convection diffusion type but the parameters are highly varying from one layer to another. Another particularity is the very concentrated nature of the source, both in space and in time. (author)

  16. Parent and Peer Predictors of Physical Dating Violence Perpetration in Early Adolescence: Tests of Moderation and Gender Differences

    Science.gov (United States)

    Miller, Shari; Gorman-Smith, Deborah; Sullivan, Terri; Orpinas, Pamela; Simon, Thomas R.

    2009-01-01

    This study examined parenting and peer predictors of physical dating violence perpetration during early adolescence and tested moderation among these predictors and gender. Participants were 2,824 ethnically diverse sixth-grade students with a recent boyfriend/girlfriend who was part of a multisite, longitudinal investigation of the development…

  17. Early Vitrectomy for Vitreous Hemorrhage Associated With Retinal Tears

    NARCIS (Netherlands)

    Tan, H. Stevie; Mura, Marco; Bijl, Heico M.

    2010-01-01

    PURPOSE: To evaluate outcome of early surgery in vitreous hemorrhage, presumably associated with retinal tears. DESIGN: Retrospective, noncomparative interventional case series. METHODS: We included 40 consecutive cases in 39 patients treated with early vitrectomy for vitreous hemorrhage. Main

  18. Case Management Reduces Length of Stay, Charges, and Testing in Emergency Department Frequent Users

    Directory of Open Access Journals (Sweden)

    Jameel Sughair

    2018-02-01

    Full Text Available Introduction: Case management is an effective, short-term means to reduce emergency department (ED visits in frequent users of the ED. This study sought to determine the effectiveness of case management on frequent ED users, in terms of reducing ED and hospital length of stay (LOS, accrued costs, and utilization of diagnostic tests. Methods: The study consisted of a retrospective chart review of ED and inpatient visits in our hospital’s ED case management program, comparing patient visits made in the one year prior to enrollment in the program, to the visits made in the one year after enrollment in the program. We examined the LOS, use of diagnostic testing, and monetary charges incurred by these patients one year prior and one year after enrollment into case management. Results: The study consisted of 158 patients in case management. Comparing the one year prior to enrollment to the one year after enrollment, ED visits decreased by 49%, inpatient admissions decreased by 39%, the use of computed tomography imaging decreased 41%, the use of ultrasound imaging decreased 52%, and the use of radiographs decreased 38%. LOS in the ED and for inpatient admissions decreased by 39%, reducing total LOS for these patients by 178 days. ED and hospital charges incurred by these patients decreased by 5.8 million dollars, a 41% reduction. All differences were statistically significant. Conclusion: Case management for frequent users of the ED is an effective method to reduce patient visits, the use of diagnostic testing, length of stay, and cost within our institution.

  19. Rapid molecular detection of rifampicin resistance facilitates early diagnosis and treatment of multi-drug resistant tuberculosis: case control study.

    Directory of Open Access Journals (Sweden)

    Philly O'Riordan

    2008-09-01

    Full Text Available Multi-drug resistant tuberculosis (MDR-TB is a major public health concern since diagnosis is often delayed, increasing the risk of spread to the community and health care workers. Treatment is prolonged, and the total cost of treating a single case is high. Diagnosis has traditionally relied upon clinical suspicion, based on risk factors and culture with sensitivity testing, a process that can take weeks or months. Rapid diagnostic molecular techniques have the potential to shorten the time to commencing appropriate therapy, but have not been put to the test under field conditions.This retrospective case-control study aimed to identify risk factors for MDR-TB, and analyse the impact of testing for rifampicin resistance using RNA polymerase B (rpoB mutations as a surrogate for MDR-TB. Forty two MDR-TB cases and 84 fully sensitive TB controls were matched by date of diagnosis; and factors including demographics, clinical presentation, microbiology findings, management and outcome were analysed using their medical records. Conventionally recognised risk factors for MDR-TB were absent in almost half (43% of the cases, and 15% of cases were asymptomatic. A significant number of MDR-TB cases were identified in new entrants to the country. Using rpoB mutation testing, the time to diagnosis of MDR-TB was dramatically shortened by a median of 6 weeks, allowing patients to be commenced on appropriate therapy a median of 51days earlier than those diagnosed by conventional culture and sensitivity testing.MDR-TB is frequently an unexpected finding, may be asymptomatic, and is particularly prevalent among TB infected new entrants to the country. Molecular resistance testing of all acid fast bacilli positive specimens has the potential to rapidly identify MDR-TB patients and commence them on appropriate therapy significantly earlier than by conventional methods.

  20. Unstandardized Measures: A Cross-Case Analysis of Test Prep in Two Urban

    Science.gov (United States)

    Kesler, Ted

    2013-01-01

    This article presents a cross-case analysis of two fourth-grade teachers' instruction while preparing their students for an English language arts test. Both teachers taught in high-needs urban public schools and were

  1. Life cycle assessment based environmental impact estimation model for pre-stressed concrete beam bridge in the early design phase

    International Nuclear Information System (INIS)

    Kim, Kyong Ju; Yun, Won Gun; Cho, Namho; Ha, Jikwang

    2017-01-01

    The late rise in global concern for environmental issues such as global warming and air pollution is accentuating the need for environmental assessments in the construction industry. Promptly evaluating the environmental loads of the various design alternatives during the early stages of a construction project and adopting the most environmentally sustainable candidate is therefore of large importance. Yet, research on the early evaluation of a construction project's environmental load in order to aid the decision making process is hitherto lacking. In light of this dilemma, this study proposes a model for estimating the environmental load by employing only the most basic information accessible during the early design phases of a project for the pre-stressed concrete (PSC) beam bridge, the most common bridge structure. Firstly, a life cycle assessment (LCA) was conducted on the data from 99 bridges by integrating the bills of quantities (BOQ) with a life cycle inventory (LCI) database. The processed data was then utilized to construct a case based reasoning (CBR) model for estimating the environmental load. The accuracy of the estimation model was then validated using five test cases; the model's mean absolute error rates (MAER) for the total environmental load was calculated as 7.09%. Such test results were shown to be superior compared to those obtained from a multiple-regression based model and a slab area base-unit analysis model. Henceforth application of this model during the early stages of a project is expected to highly complement environmentally friendly designs and construction by facilitating the swift evaluation of the environmental load from multiple standpoints. - Highlights: • This study is to develop the model of assessing the environmental impacts on LCA. • Bills of quantity from completed designs of PSC Beam were linked with the LCI DB. • Previous cases were used to estimate the environmental load of new case by CBR model. • CBR

  2. Life cycle assessment based environmental impact estimation model for pre-stressed concrete beam bridge in the early design phase

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyong Ju, E-mail: kjkim@cau.ac.kr; Yun, Won Gun, E-mail: ogun78@naver.com; Cho, Namho, E-mail: nhc51@cau.ac.kr; Ha, Jikwang, E-mail: wlrhkd29@gmail.com

    2017-05-15

    The late rise in global concern for environmental issues such as global warming and air pollution is accentuating the need for environmental assessments in the construction industry. Promptly evaluating the environmental loads of the various design alternatives during the early stages of a construction project and adopting the most environmentally sustainable candidate is therefore of large importance. Yet, research on the early evaluation of a construction project's environmental load in order to aid the decision making process is hitherto lacking. In light of this dilemma, this study proposes a model for estimating the environmental load by employing only the most basic information accessible during the early design phases of a project for the pre-stressed concrete (PSC) beam bridge, the most common bridge structure. Firstly, a life cycle assessment (LCA) was conducted on the data from 99 bridges by integrating the bills of quantities (BOQ) with a life cycle inventory (LCI) database. The processed data was then utilized to construct a case based reasoning (CBR) model for estimating the environmental load. The accuracy of the estimation model was then validated using five test cases; the model's mean absolute error rates (MAER) for the total environmental load was calculated as 7.09%. Such test results were shown to be superior compared to those obtained from a multiple-regression based model and a slab area base-unit analysis model. Henceforth application of this model during the early stages of a project is expected to highly complement environmentally friendly designs and construction by facilitating the swift evaluation of the environmental load from multiple standpoints. - Highlights: • This study is to develop the model of assessing the environmental impacts on LCA. • Bills of quantity from completed designs of PSC Beam were linked with the LCI DB. • Previous cases were used to estimate the environmental load of new case by CBR model. • CBR

  3. Scenery Picture Memory Test: A new type of quick and effective screening test to detect early stage Alzheimer’s disease patients

    Science.gov (United States)

    Takechi, Hajime; Dodge, Hiroko H

    2010-01-01

    Aim It is highly desirable to develop a neuropsychological screening test which is sensitive to the early stage of Alzheimer’s disease (AD), and is easy to administer at the primary care physician’s (PCP’s) office. Methods Participants were 128 AD patients and 54 healthy volunteers. Brief cognitive screening tests were administered to the participants including the Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), Verbal Fluency Test (VFT), a Verbal Category Cued Memory test (CCMT) and the Scenery Picture Memory Test (SPMT). In the SPMT, a scenery picture of a living room containing 23 familiar objects was used. The administration of the SPMT comprised the first shallow memory session (Pict 1) and the second deep memory session (Pict 2). The area under the receiver–operator curve (AUC) was used to compare the efficacy of SPMT with other cognitive tests. Results Pict 1, which requires less than 2 min to complete, had the same AUC as Pict 2, and showed significantly larger AUC than MMSE, CDT and VFT for all (MMSE 19–23) and very mild (MMSE ≥ 24) AD patients. When we conducted the similar analysis separately for those younger than 75 years and those aged 75 years or older, we obtained the same results as above among the older age group. Pict 1 showed larger AUC than CCMT in overall sample and also in the older age group, although the difference was not statistically significant. Conclusion The SPMT could be useful for detection of mild and very mild AD in settings even where time is limited. PMID:20446933

  4. Wealth-related inequality in early uptake of HIV testing among pregnant women: an analysis of data from a national cross-sectional survey, South Africa

    Science.gov (United States)

    Ngandu, Nobubelo Kwanele; Van Malderen, Carine; Goga, Ameena; Speybroeck, Niko

    2017-01-01

    Objectives Wealth-related inequality across the South African antenatal HIV care cascade has not been considered in detail as a potential hindrance to eliminating mother-to-child HIV transmission (EMTCT). We aimed to measure wealth-related inequality in early (before enrolling into antenatal care) uptake of HIV testing and identify the contributing determinants. Design Cross-sectional survey. Settings South African primary public health facilities in 2012. Participants A national-level sample of 8618 pregnant women. Outcome measures Wealth-related inequality in early uptake of HIV testing was measured using the Erreygers concentration index (CI) further adjusted for inequality introduced by predicted healthcare need (ie, need-standardised). Determinants contributing to the observed inequality were identified using the Erreygers and Wagstaff decomposition methods. Results Participants were aged 13 to 49 years. Antenatal HIV prevalence was 33.2%, of which 43.7% came from the lowest 40% wealth group. A pro-poor wealth-related inequality in early HIV testing was observed. The need-standardised concentration index was −0.030 (95% confidence interval −0.038 to −0.022). The proportion of early HIV testing was significantly better in the lower 40% wealth group compared with the higher 40% wealth group (p value=0.040). The largest contributions to the observed inequality were from underlying inequalities in province (contribution, 65.27%), age (−44.38%), wealth group (24.73%) and transport means (21.61%). Conclusions Our results on better early uptake of HIV testing among the poorer subpopulation compared with the richer highlights inequity in uptake of HIV testing in South Africa. This socioeconomic difference could contribute to fast-tracking EMTCT given the high HIV prevalence among the lower wealth group. The high contribution of provinces and age to inequality highlights the need to shift from reliance on national-level estimates alone but identify subregional

  5. Wealth-related inequality in early uptake of HIV testing among pregnant women: an analysis of data from a national cross-sectional survey, South Africa.

    Science.gov (United States)

    Ngandu, Nobubelo Kwanele; Van Malderen, Carine; Goga, Ameena; Speybroeck, Niko

    2017-07-12

    Wealth-related inequality across the South African antenatal HIV care cascade has not been considered in detail as a potential hindrance to eliminating mother-to-child HIV transmission (EMTCT). We aimed to measure wealth-related inequality in early (before enrolling into antenatal care) uptake of HIV testing and identify the contributing determinants. Cross-sectional survey. South African primary public health facilities in 2012. A national-level sample of 8618 pregnant women. Wealth-related inequality in early uptake of HIV testing was measured using the Erreygers concentration index (CI) further adjusted for inequality introduced by predicted healthcare need (ie, need-standardised). Determinants contributing to the observed inequality were identified using the Erreygers and Wagstaff decomposition methods. Participants were aged 13 to 49 years. Antenatal HIV prevalence was 33.2%, of which 43.7% came from the lowest 40% wealth group. A pro-poor wealth-related inequality in early HIV testing was observed. The need-standardised concentration index was -0.030 (95% confidence interval -0.038 to -0.022). The proportion of early HIV testing was significantly better in the lower 40% wealth group compared with the higher 40% wealth group (p value=0.040). The largest contributions to the observed inequality were from underlying inequalities in province (contribution, 65.27%), age (-44.38%), wealth group (24.73%) and transport means (21.61%). Our results on better early uptake of HIV testing among the poorer subpopulation compared with the richer highlights inequity in uptake of HIV testing in South Africa. This socioeconomic difference could contribute to fast-tracking EMTCT given the high HIV prevalence among the lower wealth group. The high contribution of provinces and age to inequality highlights the need to shift from reliance on national-level estimates alone but identify subregional-specific and age-specific bottlenecks. Future interventions need to be context

  6. A test case of the deformation rate analysis (DRA) stress measurement method

    Energy Technology Data Exchange (ETDEWEB)

    Dight, P.; Hsieh, A. [Australian Centre for Geomechanics, Univ. of WA, Crawley (Australia); Johansson, E. [Saanio and Riekkola Oy, Helsinki (Finland); Hudson, J.A. [Rock Engineering Consultants (United Kingdom); Kemppainen, K.

    2012-01-15

    As part of Posiva's site and ONKALO investigations, the in situ rock stress has been measured by a variety of techniques, including hydraulic fracturing, overcoring, and convergence measurements. All these techniques involve direct measurements in a drillhole or at the rock surface. An alternative method is to test drillhole core in a way that enables estimation of the magnitudes and orientations of the in situ rock stress. The Kaiser Effect (KE) and Deformation Rate Analysis (DRA) are two ways to do this. In the work reported here, a 'blind' DRA test was conducted on core obtained from the POSE (Posiva's Olkiluoto Spalling Experiment) niche in the ONKALO. The term 'blind' means that the two first authors of this report, who conducted the tests at the Australian Centre for Geomechanics, did not know the depths below surface at which the cores had been obtained. The results of this DRA Test Case are presented, together with an explanation of the DRA procedure. Also, additional information that would help in such DRA testing and associated analysis is explained. One of the problems in comparing the DRA results with the known Olkiluoto stress field is that the latter is highly variable across the site, as experienced by the previous in situ stress measurements and as predicted by numerical analysis. The variability is mainly caused by the presence of the large brittle deformation zones which perturb the local stress state. However, this variability reduces with depth and the stress field becomes more stable at the {approx} 350 m at which the drillhole cores were obtained. Another compounding difficulty is that the stress quantity, being a second order tensor, requires six independent components for its specification. In other words, comparison of the DRA results and the known stress field requires comparison of six different quantities. In terms of the major principal stress orientation, the DRA results predict an orientation completely

  7. A test case of the deformation rate analysis (DRA) stress measurement method

    International Nuclear Information System (INIS)

    Dight, P.; Hsieh, A.; Johansson, E.; Hudson, J.A.; Kemppainen, K.

    2012-01-01

    As part of Posiva's site and ONKALO investigations, the in situ rock stress has been measured by a variety of techniques, including hydraulic fracturing, overcoring, and convergence measurements. All these techniques involve direct measurements in a drillhole or at the rock surface. An alternative method is to test drillhole core in a way that enables estimation of the magnitudes and orientations of the in situ rock stress. The Kaiser Effect (KE) and Deformation Rate Analysis (DRA) are two ways to do this. In the work reported here, a 'blind' DRA test was conducted on core obtained from the POSE (Posiva's Olkiluoto Spalling Experiment) niche in the ONKALO. The term 'blind' means that the two first authors of this report, who conducted the tests at the Australian Centre for Geomechanics, did not know the depths below surface at which the cores had been obtained. The results of this DRA Test Case are presented, together with an explanation of the DRA procedure. Also, additional information that would help in such DRA testing and associated analysis is explained. One of the problems in comparing the DRA results with the known Olkiluoto stress field is that the latter is highly variable across the site, as experienced by the previous in situ stress measurements and as predicted by numerical analysis. The variability is mainly caused by the presence of the large brittle deformation zones which perturb the local stress state. However, this variability reduces with depth and the stress field becomes more stable at the ∼ 350 m at which the drillhole cores were obtained. Another compounding difficulty is that the stress quantity, being a second order tensor, requires six independent components for its specification. In other words, comparison of the DRA results and the known stress field requires comparison of six different quantities. In terms of the major principal stress orientation, the DRA results predict an orientation completely different to the NW-SE regional

  8. [Comparison of Preferential Hyperacuity Perimeter (PHP) test and Amsler grid test in the diagnosis of different stages of age-related macular degeneration].

    Science.gov (United States)

    Kampmeier, J; Zorn, M M; Lang, G K; Botros, Y T; Lang, G E

    2006-09-01

    Age-related macular degeneration (ARMD) is the leading cause of blindness in people over 65 years of age. A rapid loss of vision occurs especially in cases with choroidal neovascularisation. Early detection of ARMD and timely treatment are mandatory. We have prospectively studied the results of two diagnostic self tests for the early detection of metamorphopsia and scotoma, the PHP test and the Amsler grid test, in different stages of ARMD. Patients with ARMD and best corrected visual acuity of 6/30 or better (Snellen charts) were examined with a standardised protocol, including supervised Amsler grid examination and PHP, a new device for metamorphopsia or scotoma measurement, based on the hyperacuity phenomenon in the central 14 degrees of the visual field. The stages of ARMD were independently graded in a masked fashion by stereoscopic ophthalmoscopy, stereoscopic fundus colour photographs, fluorescein angiography, and OCT. The patients were subdivided into 3 non-neovascular groups [early, late (RPE atrophy > 175 microm) and geographic atrophy], a neovascular group (classic and occult CNV) and an age-matched control group (healthy volunteers). 140 patients, with ages ranging from 50 to 90 years (median 68 years), were included in the study. Best corrected visual acuity ranged from 6/30 to 6/6 with a median of 6/12. 95 patients were diagnosed as non-neovascular ARMD. Thirty eyes had early ARMD (9 were tested positive by the PHP test and 9 by the Amsler grid test), and 50 late ARMD (positive: PHP test 23, Amsler grid test 26). The group with geographic atrophy consisted of 15 eyes (positive: PHP test 13, Amsler grid test 10). Forty-five patients presented with neovascular ARMD (positive: PHP test 38, Amsler grid test 36), 34 volunteers served as control group (positive: PHP test 1, Amsler grid test 5). The PHP and Amsler grid tests revealed comparable results detecting metamorphopsia and scotoma in early ARMD (30 vs. 30 %) and late ARMD (46 vs. 52 %). However, the

  9. Serum auto-antibody testing for early diagnosis of breast cancer

    International Nuclear Information System (INIS)

    Parvez, S.

    2012-01-01

    The aim of this thesis is generate prototype-tests suitable for randomized prospective validation of auto-antibody based diagnostic testing using serum samples. Tumours can stimulate the production of auto-antibodies against autologous cellular proteins known as TAAs (tumour associated antigens). This discovery has lead to a possibility of using the auto-antibodies as serological tools for the early diagnosis and management of breast cancer. The recombinant proteins expressed by the SEREX clones, identified from screenings of brain and lung tumour, were used for the production of the protein microarrays and macroarrays. The protein microarrays showed better correlation between the replicates of the serum samples used. The optimized protocols were used for the subsequent experiments. A sizable panel of 642 clone-proteins was selected by marker-screening on protein macroarrays with 38000 clones. These 642 clone-proteins were used to generate protein microarrays that differentiated serum samples from breast cancer patients and controls. Antigenic peptide motifs were identified by in-silico analysis of 642 clone-proteins and peptide arrays were generated using synthetically generated peptides. Comparative studies between protein microarrays and peptide microarrays were done using breast cancer and healthy control samples. Simultaneously, SEREX strategy was used for the identification of the immunogenic TAAs. I identified 192 cDNA expression clones derived from breast cancer tissue samples and the selection was done using breast cancer sera. The genes corresponding to these clones were found over-represented for the pathways that are known to be associated with cancers. These genes showed typical features of TAAs, like over-expression, mutations and fusion genes. (author)

  10. Proposal of early retreatment with iloprost in partially responsive patients with bone marrow edema syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Simone Meini

    2012-12-01

    Full Text Available Background Avascular Necrosis (AVN is defined as the cellular death of bone components due to an alteration of the blood supply, resulting in Edema of the Bone Marrow (BME, structural collapse and bone destruction. In advanced stages, AVN requires surgery. One emerging medical treatment for supporting osseous perfusion is the administration of iloprost.Materials and methods A 38-year-old woman presented with severe BME of the left hip (primary, persisting for 6 weeks. She was treated with iloprost iv at 2 ng/kg/min for 6 hours/day for 5 days, and after 4 weeks, the treatment was repeated at 1.5 ng/kg/min for 6 hours for 5 days because she exhibited only a partial response to the first treatment. Complete remission was obtained, documented clinically and on Magnetic Resonance Imaging (MRI. Her Harris Hip Score (HHS increased from 29.90 to 97. No significant adverse events related to iloprost were registered. No surgical procedures were necessary.Conclusions In most cases, iloprost is administered in a single cycle of treatment over 5 days at 1-2 ng/kg/min for 6 hours/day, but no research has investigated the effectiveness of early retreatment after the first cycle results in only a partially response. Only a few studies examining small numbers of patients have evaluated iloprost in AVN/BME, preferring, in most cases, the dose of 1 ng/kg/min and obtaining clinical improvement both in BME and in AVN in times comparable to surgical core decompression. This case report demonstrates the safety and effectiveness of early repetition of the maximal dose of iloprost before BME evolves into AVN, as well as in cases initially appearing serious and requiring surgical procedures.

  11. Children's Participation Rights in Early Childhood Education and Care: The Case of Early Literacy Learning and Pedagogy

    Science.gov (United States)

    Dunphy, Elizabeth

    2012-01-01

    This position article argues that educators' knowledge of young children's perspectives on aspects of early learning, including literacy learning, and subsequent interpretations of the ways that these perspectives can inform and shape pedagogy are key to promoting children's participation rights in early childhood education and care. Drawing on…

  12. Institutionalizing provider-initiated HIV testing and counselling for children: an observational case study from Zambia.

    Directory of Open Access Journals (Sweden)

    Jane N Mutanga

    Full Text Available BACKGROUND: Provider-initiated testing and counselling (PITC is a priority strategy for increasing access for HIV-exposed children to prevention measures, and infected children to treatment and care interventions. This article examines efforts to scale-up paediatric PITC at a second-level hospital located in Zambia's Southern Province, and serving a catchment area of 1.2 million people. METHODS AND PRINCIPAL FINDINGS: Our retrospective case study examined best practices and enabling factors for rapid institutionalization of PITC in Livingstone General Hospital. Methods included clinical observations, key informant interviews with programme management, and a desk review of hospital management information systems (HMIS uptake data following the introduction of PITC. After PITC roll-out, the hospital experienced considerably higher testing uptake. In a 36-month period following PITC institutionalization, of total inpatient children eligible for PITC (n = 5074, 98.5% of children were counselled, and 98.2% were tested. Of children tested (n = 4983, 15.5% were determined HIV-infected; 77.6% of these results were determined by DNA polymerase chain reaction (PCR testing in children under the age of 18 months. Of children identified as HIV-infected in the hospital's inpatient and outpatient departments (n = 1342, 99.3% were enrolled in HIV care, including initiation on co-trimoxazole prophylaxis. A number of good operational practices and enabling factors in the Livingstone General Hospital experience can inform rapid PITC institutionalization for inpatient and outpatient children. These include the placement of full-time nurse counsellors at key areas of paediatric intake, who interface with patients immediately and conduct testing and counselling. They are reinforced through task-shifting to peer counsellors in the wards. Nurse counsellor capacity to draw specimen for DNA PCR for children under 18 months has significantly enhanced early

  13. JAK2V617F mutation in chronic myeloid leukemia predicts early disease progression

    International Nuclear Information System (INIS)

    Pahore, Z.A.A.; Shamsi, T.S.; Taj, M.; Farzana, T.; Ansari, S.H.; Nadeem, M.; Ahmad, M.; Naz, A.

    2011-01-01

    Objective: To determine the association of JAK2V617F mutation along with BCR-ABL translocation or Philadelphia chromosome in chronic myeloid leukemia with early disease progression to advanced stages (accelerated phase or blast crisis) and poor outcome. Study Design: Case series. Place and Duration of Study: National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, from February 2008 to August 2009. Methodology: All the newly diagnosed cases of BCR-ABL or Philadelphia positive CML were tested for JAK2V617F mutation by Nested PCR. Demographic data, spleen size, hemoglobin levels, white blood cell and platelet counts were recorded. Independent sample t-test was used for age, haemoglobin level and spleen size. Fisher's exact test was applied to compare disease progression in JAK2V617F mutation positive and negative cases. Results: Out of 45 newly diagnosed cases of CML, 40 were in chronic phase, 01 in accelerated phase and 04 in blast crisis. JAK2V617F mutation was detected in 12 (26.7%) patients; 09 (22.5%) in chronic phase, none in accelerated phase and 03 (75%) in blast crisis. During a mean follow-up of 8 months, 03 patients in chronic phase transformed in blast crisis and 02 into accelerated phase. Overall 08 out of 11 (73%) JAK2V617F positive patients either had advanced disease or showed disease progression. Only 2 of 20 (10%) available patients, negative for the mutation, showed disease progression by transforming into blast crisis (p < 0.001). No statistically significant difference was seen in the age, spleen size, haemoglobin levels, white blood cells and platelets counts in JAK2V617F positive patients. Conclusion: JAK2V617F mutation was detected in 26.7% cases of chronic myeloid leukemia. A significant proportion of them showed early disease progression. (author)

  14. Design and Development of a Miniaturized Percutaneously Deployable Wireless Left Ventricular Assist Device: Early Prototypes and Feasibility Testing.

    Science.gov (United States)

    Letzen, Brian; Park, Jiheum; Tuzun, Zeynep; Bonde, Pramod

    The current left ventricular assist devices (LVADs) are limited by a highly invasive implantation procedure in a severely unstable group of advanced heart failure patients. Additionally, the current transcutaneous power drive line acts as a nidus for infection resulting in significant morbidity and mortality. In an effort to decrease this invasiveness and eliminate drive line complications, we have conceived a wireless miniaturized percutaneous LVAD, capable of being delivered endovascularly with a tether-free operation. The system obviates the need for a transcutaneous fluid purge line required in existing temporary devices by utilizing an incorporated magnetically coupled impeller for a complete seal. The objective of this article was to demonstrate early development and proof-of-concept feasibility testing to serve as the groundwork for future formalized device development. Five early prototypes were designed and constructed to iteratively minimize the pump size and improve fluid dynamic performance. Various magnetic coupling configurations were tested. Using SolidWorks and ANSYS software for modeling and simulation, several geometric parameters were varied. HQ curves were constructed from preliminary in vitro testing to characterize the pump performance. Bench top tests showed no-slip magnetic coupling of the impeller to the driveshaft up to the current limit of the motor. The pump power requirements were tested in vitro and were within the appropriate range for powering via a wireless energy transfer system. Our results demonstrate the proof-of-concept feasibility of a novel endovascular cardiac assist device with the potential to eventually offer patients an untethered, minimally invasive support.

  15. Ballistic and Cyclic Rig Testing of Braided Composite Fan Case Structures

    Science.gov (United States)

    Watson, William R.; Roberts, Gary D.; Pereira, J. Michael; Braley, Michael S.

    2015-01-01

    FAA fan blade-out certification testing on turbofan engines occurs very late in an engine's development program and is very costly. It is of utmost importance to approach the FAA Certification engine test with a high degree of confidence that the containment structure will not only contain the high-energy debris, but that it will also withstand the cyclic loads that occur with engine spooldown and continued rotation as the non-running engine maintains a low rotor RPM due to forced airflow as the engine-out aircraft returns to an airport. Accurate rig testing is needed for predicting and understanding material behavior of the fan case structure during all phases of this fan blade-out event.

  16. Evaluation of the observation of breast glands condition in mammographic early detection programme

    International Nuclear Information System (INIS)

    Kleszczewska, J.; Zomer-Drozda, J.; Tarlowska, L.; Romejko, M.

    1993-01-01

    The results of mammography tests were evaluated for 542 female employees of higher schools during an observation continued over 1 to 7.5 years, and they were compared with the results of the first test. Among 22 cancers detected and confirmed by macroscopic examination, mammography result turned out to be false negative in 2 cases. A positive error occurred in 7 cases. Cancer developed during observation in 8 women, that is, in 4 women from the group of 365 who earlier had correct mammography results (1.1%) and another 4 in the group of 154 women originally showing benign changes in their breast glands (2.6%). This work confirms the importance of regular checkups in the mammographic early detection programme. (author)

  17. Early deprivation increases high-leaning behavior, a novel anxiety-like behavior, in the open field test in rats.

    Science.gov (United States)

    Kuniishi, Hiroshi; Ichisaka, Satoshi; Yamamoto, Miki; Ikubo, Natsuko; Matsuda, Sae; Futora, Eri; Harada, Riho; Ishihara, Kohei; Hata, Yoshio

    2017-10-01

    The open field test is one of the most popular ethological tests to assess anxiety-like behavior in rodents. In the present study, we examined the effect of early deprivation (ED), a model of early life stress, on anxiety-like behavior in rats. In ED animals, we failed to find significant changes in the time spent in the center or thigmotaxis area of the open field, the common indexes of anxiety-like behavior. However, we found a significant increase in high-leaning behavior in which animals lean against the wall standing on their hindlimbs while touching the wall with their forepaws at a high position. The high-leaning behavior was decreased by treatment with an anxiolytic, diazepam, and it was increased under intense illumination as observed in the center activity. In addition, we compared the high-leaning behavior and center activity under various illumination intensities and found that the high-leaning behavior is more sensitive to illumination intensity than the center activity in the particular illumination range. These results suggest that the high-leaning behavior is a novel anxiety-like behavior in the open field test that can complement the center activity to assess the anxiety state of rats. Copyright © 2017 Elsevier Ireland Ltd and Japan Neuroscience Society. All rights reserved.

  18. An Unusual Case of Rapidly Progressive Hyperbilirubinemia

    Directory of Open Access Journals (Sweden)

    Kimberly M. Thornton

    2013-01-01

    Full Text Available We present an unusual case of hyperbilirubinemia with rapid early progression leading to bilirubin encephalopathy in a term neonate. Despite early recognition and intervention, the total serum bilirubin reached a maximum level of 39 mg/dL at 32 hours of life. Prior to an emergent exchange transfusion, the patient’s diagnostic evaluation was significant for Coombs-negative microangiopathic hemolytic anemia and thrombocytopenia. Further testing revealed a deficiency of ADAMTS13 protein, or von Willebrand factor-cleaving protease, a finding diagnostic of congenital thrombotic thrombocytopenic purpura, or Upshaw-Schulman syndrome. This rare disease is often misdiagnosed, especially in the newborn period.

  19. Clinical Utility of Short Social Cognitive Tests in Early Differentiation of Behavioral Variant Frontotemporal Dementia from Alzheimer’s Disease

    DEFF Research Database (Denmark)

    Buhl, Christian; Stokholm, Jette; Gade, Anders

    2013-01-01

    Traditional cognitive tests used in clinical practice may not be sensitive enough for the early differentiation of behavioral variant frontotemporal dementia (bvFTD) from Alzheimer's disease (AD). A growing body of literature has shown that deficits in various aspects of social cognition can be f...

  20. Identification and testing of early indicators for N leaching from urine patches.

    Science.gov (United States)

    Vogeler, Iris; Cichota, Rogerio; Snow, Val

    2013-11-30

    Nitrogen leaching from urine patches has been identified as a major source of nitrogen loss under intensive grazing dairy farming. Leaching is notoriously variable, influenced by management, soil type, year-to-year variation in climate and timing and rate of urine depositions. To identify early indicators for the risk of N leaching from urine patches for potential usage in a precision management system, we used the simulation model APSIM (Agricultural Production Systems SIMulator) to produce an extensive N leaching dataset for the Waikato region of New Zealand. In total, nearly forty thousand simulation runs with different combinations of soil type and urine deposition times, in 33 different years, were done. The risk forecasting indicators were chosen based on their practicality: being readily measured on farm (soil water content, temperature and pasture growth) or that could be centrally supplied to farms (such as actual and forecast weather data). The thresholds of the early indicators that are used to forecast a period for high risk of N leaching were determined via classification and regression tree analysis. The most informative factors were soil temperature, pasture dry matter production, and average soil water content in the top soil over the two weeks prior to the urine N application event. Rainfall and air temperature for the two weeks following urine deposition were also important to fine-tune the predictions. The identified early indicators were then tested for their potential to predict the risk of N leaching in two typical soils from the Waikato region in New Zealand. The accuracy of the predictions varied with the number of indicators, the soil type and the risk level, and the number of correct predictions ranged from about 45 to over 90%. Further expansion and fine-tuning of the indicators and the development of a practical N risk tool based on these indicators is needed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Non-reactive HIV-1 Rapid Tests after Sustained Viral Suppression Following Antiretroviral Therapy Initiation During Primary Infection.

    Science.gov (United States)

    Stefic, Karl; Novelli, Sophie; Mahjoub, Nadia; Seng, Remonie; Molina, Jean-Michel; Cheneau, Christine; Barin, Francis; Chaix, Marie-Laure; Meyer, Laurence; Delaugerre, Constance

    2018-03-02

    We assessed the impact of early antiretroviral treatment (ART) on HIV antibody detection by rapid tests in 44 individuals after several years of successful ART. HIV self-tests and point-of-care tests were negative in respectively 30% and 7-9% of cases. These data reinforce the message that patients should never be retested after entering HIV care.

  2. Radiotherapy of early breast cancer in scleroderma patients: our experience with four cases and a short review of the literature

    Directory of Open Access Journals (Sweden)

    Kyrgias G

    2012-01-01

    Full Text Available George Kyrgias1,2, Kiki Theodorou3,4, Anna Zygogianni1, Konstantinos Tsanadis2, Stefanos Zervoudis5, John Tzitzikas6, Michael Koukourakis71Academic Radiotherapy, University of Thessaly, Medical School, Greece; 2Radiation Oncology Department, University Hospital of Larissa, Greece; 3Academic Medical Physics, University of Thessaly, Medical School, Greece; 4Medical Physics Department, University Hospital of Larissa, 5Breast Unit, REA Hospital, Athens, Greece; 6Radiation Oncology Department, AHEPA University Hospital of Thessaloniki, Greece; 7Radiotherapy-Oncology Department, University Hospital of Alexandroupolis, GreecePurpose: Connective vascular diseases (CVD, including scleroderma, are reported to represent for some researchers a relative contraindication and for others absolute contraindication for radiotherapy. The purpose of our study is to add four new cases to the existing body of international literature and to determine whether women with pre-existing scleroderma who have been surgically treated for early breast cancer could undergo postsurgical radiotherapy without serious early and late complications.Patients and methods: From May 1998 to November 2010, we irradiated for early breast cancer four patients suffering from pre-existing scleroderma; after conservative surgery, we performed whole breast postoperative radiotherapy of 50.4 Gy total dose to the whole breast plus a 9 Gy boost to the tumor bed. We reviewed the records of all four patients and evaluated the early and late reactions using acute radiation morbidity scoring criteria (Radiation Therapy Oncology Group [RTOG], American College of Radiology, Philadelphia, PA and late radiation morbidity scoring scheme (European Organisation for Research and Treatment of Cancer [EORTC], Brussels, Belgium and RTOG.Results: After a median follow-up of 105 months (range 12–155 months the early and late toxicity concerning the skin, the subcutaneous tissues, the lungs, and the heart have

  3. TESTING INFORMATIONAL EFFICIENCY: THE CASE OF U.E. AND BRIC EMERGENT MARKETS

    OpenAIRE

    OPREAN Camelia

    2012-01-01

    Empirical finance has brought together a considerable number of studies in determining the market efficiency in terms of information in the case of an emerging financial market. Conflicting results have been generated by these researches in efficient market hypothesis (EMH), so efficiency tests in the emerging financial markets are rarely definitive in reaching a conclusion about the existence of informational efficiency. This paper tests weak-form market efficiency of eight emerging markets:...

  4. Relational Constraint Driven Test Case Synthesis for Web Applications

    Directory of Open Access Journals (Sweden)

    Xiang Fu

    2010-09-01

    Full Text Available This paper proposes a relational constraint driven technique that synthesizes test cases automatically for web applications. Using a static analysis, servlets can be modeled as relational transducers, which manipulate backend databases. We present a synthesis algorithm that generates a sequence of HTTP requests for simulating a user session. The algorithm relies on backward symbolic image computation for reaching a certain database state, given a code coverage objective. With a slight adaptation, the technique can be used for discovering workflow attacks on web applications.

  5. "Pre-emptive strike"-the case for early treatment of hepatic sinusoidal obstruction syndrome with defibrotide.

    Science.gov (United States)

    Rajagopal, Revathi; Phillips, Marianne B; Gottardo, Nicholas G

    2018-07-01

    The initial signs of hepatic sinusoidal obstruction syndrome (HSOS) can be challenging to recognize in children, especially outside the hematopoietic stem cell transplantation setting. To assist clinicians to promptly identify HSOS, the European Society for Blood and Marrow Transplantation has proposed pediatric HSOS diagnostic criteria which emphasize unexplained consumptive and transfusion-refractory thrombocytopenia. To highlight the importance of these "bellwether" early signs of HSOS and the efficacy of pre-emptive treatment with defibrotide, we describe the case of a child with a right 11th rib primitive neuroectodermal tumor who developed HSOS following focal radiotherapy and actinomycin-D treatment. © 2018 The Authors. Pediatric Blood & Cancer Published by Wiley Periodicals, Inc.

  6. [18F]-Fluoro-Deoxy-Glucose Positron Emission Tomography Scan Should Be Obtained Early in Cases of Autoimmune Encephalitis

    Directory of Open Access Journals (Sweden)

    C. R. Newey

    2016-01-01

    Full Text Available Introduction. Autoimmune encephalitis (AE is a clinically challenging diagnosis with nonspecific neurological symptoms. Prompt diagnosis is important and often relies on neuroimaging. We present a case series of AE highlighting the importance of an early [18F]-fluoro-deoxy-glucose positron emission tomography (FDG-PET scan. Methods. Retrospective review of seven consecutive cases of autoimmune encephalitis. Results. All patients had both magnetic resonance imaging (MRI and FDG-PET scans. Initial clinical presentations included altered mental status and/or new onset seizures. Six cases had serum voltage-gated potassium channel (VGKC antibody and one had serum N-methyl-D-aspartate (NMDA antibody. MRI of brain showed mesial temporal lobe hyperintensity in five cases of VGKC. The other two patients with VGKC or NMDA AE had restiform body hyperintensity on MRI brain or a normal MRI, respectively. Mesial temporal lobe hypermetabolism was noted in three cases on FDG-PET, despite initial unremarkable MRI. Malignancy workup was negative in all patients. Conclusion. A high index of suspicion for AE should be maintained in patients presenting with cognitive symptoms, seizures, and limbic changes on neuroimaging. In cases with normal initial brain MRI, FDG-PET can be positive. Additionally, extralimbic hyperintensity on MRI may also be observed.

  7. [18F]-Fluoro-Deoxy-Glucose Positron Emission Tomography Scan Should Be Obtained Early in Cases of Autoimmune Encephalitis

    Science.gov (United States)

    Sarwal, A.; Hantus, S.

    2016-01-01

    Introduction. Autoimmune encephalitis (AE) is a clinically challenging diagnosis with nonspecific neurological symptoms. Prompt diagnosis is important and often relies on neuroimaging. We present a case series of AE highlighting the importance of an early [18F]-fluoro-deoxy-glucose positron emission tomography (FDG-PET) scan. Methods. Retrospective review of seven consecutive cases of autoimmune encephalitis. Results. All patients had both magnetic resonance imaging (MRI) and FDG-PET scans. Initial clinical presentations included altered mental status and/or new onset seizures. Six cases had serum voltage-gated potassium channel (VGKC) antibody and one had serum N-methyl-D-aspartate (NMDA) antibody. MRI of brain showed mesial temporal lobe hyperintensity in five cases of VGKC. The other two patients with VGKC or NMDA AE had restiform body hyperintensity on MRI brain or a normal MRI, respectively. Mesial temporal lobe hypermetabolism was noted in three cases on FDG-PET, despite initial unremarkable MRI. Malignancy workup was negative in all patients. Conclusion. A high index of suspicion for AE should be maintained in patients presenting with cognitive symptoms, seizures, and limbic changes on neuroimaging. In cases with normal initial brain MRI, FDG-PET can be positive. Additionally, extralimbic hyperintensity on MRI may also be observed. PMID:27559482

  8. CONFIDENCE LEVELS AND/VS. STATISTICAL HYPOTHESIS TESTING IN STATISTICAL ANALYSIS. CASE STUDY

    Directory of Open Access Journals (Sweden)

    ILEANA BRUDIU

    2009-05-01

    Full Text Available Estimated parameters with confidence intervals and testing statistical assumptions used in statistical analysis to obtain conclusions on research from a sample extracted from the population. Paper to the case study presented aims to highlight the importance of volume of sample taken in the study and how this reflects on the results obtained when using confidence intervals and testing for pregnant. If statistical testing hypotheses not only give an answer "yes" or "no" to some questions of statistical estimation using statistical confidence intervals provides more information than a test statistic, show high degree of uncertainty arising from small samples and findings build in the "marginally significant" or "almost significant (p very close to 0.05.

  9. Lexically-based learning and early grammatical development.

    Science.gov (United States)

    Lieven, E V; Pine, J M; Baldwin, G

    1997-02-01

    Pine & Lieven (1993) suggest that a lexically-based positional analysis can account for the structure of a considerable proportion of children's early multiword corpora. The present study tests this claim on a second, larger sample of eleven children aged between 1;0 and 3;0 from a different social background, and extends the analysis to later in development. Results indicate that the positional analysis can account for a mean of 60% of all the children's multiword utterances and that the great majority of all other utterances are defined as frozen by the analysis. Alternative explanations of the data based on hypothesizing underlying syntactic or semantic relations are investigated through analyses of pronoun case marking and of verbs with prototypical agent-patient roles. Neither supports the view that the children's utterances are being produced on the basis of general underlying rules and categories. The implications of widespread distributional learning in early language development are discussed.

  10. Trends of reporTed ouTpaTienT malaria cases To assess The TesT ...

    African Journals Online (AJOL)

    Background: kenya reports over six million malaria cases annually. in 2012 the country adopted the Test, Treat and Track (T3) policy to ensure that all suspected .... cases increased by about half in all ages (50% in + 5 ...

  11. Mothers Who Kill Their Offspring: Testing Evolutionary Hypothesis in a 110-Case Italian Sample

    Science.gov (United States)

    Camperio Ciani, Andrea S.; Fontanesi, Lilybeth

    2012-01-01

    Objectives: This research aimed to identify incidents of mothers in Italy killing their own children and to test an adaptive evolutionary hypothesis to explain their occurrence. Methods: 110 cases of mothers killing 123 of their own offspring from 1976 to 2010 were analyzed. Each case was classified using 13 dichotomic variables. Descriptive…

  12. Early Development of Squamous Cell Carsinoma in Two Sister Cases with pidermodysplasia Verruciformis

    Directory of Open Access Journals (Sweden)

    Ömer Çalka

    2010-06-01

    Full Text Available Epidermodysplasia verruciformis (Lewandowsky-Lutz syndrome is an uncommon disease characterized by multiple plane warts, pityriasis versicolor-like lesions, defects of cell-mediated immunity, and tendency to develop skin malignancies, primarily on sun-exposed areas. Most commonly it is inherited as an autosomal recessive trait. Squamous cell carcinoma is the most common type of skin cancer found in patient with epidermodysplasia verruciformis. Human papilloma virus 5, 8, and 47 are found in more than 90% of epidermodysplasia verruciformis skin cancers. Treatment for epidermodysplasia verruciformis consists largely of preventive measures. Photoprotection remains essential for management. In this report, two sister case of epidermodisplasia verruciformis with plane warts, pityriasis versicolor-like lesions, and squamous cell carcinomas on sun-exposed areas of skin was presented for it is a rarely encountered disease and associated with early development of malignancy.

  13. Early diagnosis of slipped capital femoral epiphysis on magnetic resonance imaging: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Sanjay M Khaladkar

    2015-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common hip condition occurring in adolescents, with a prevalence of 10 cases per 100,000 children. It usually affects younger age group from 10 to 17 years. The condition is usually found to be coexistent with various other conditions such as obesity, growth surges, and endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and pan-hypopituitarism. Patients present with limping and a poorly localized pain in the hip, groin, thigh, or knee. Diagnosis of the condition is often delayed due to its nonassociation with trauma and hence increases the chances of developing various complications such as avascular necrosis, chondrolysis and deformity. Majority of researches of SCFE are from Europe and North America, while studies in Asian populations are rare. Delay in diagnosis of SCFE is usually due to patients presenting with knee pain. Imaging can thus aid in early diagnosis and appropriate treatment of the disease, which in turn reduces incidence of deformity and disability in the affected children. Bilateral hip radiography - anteroposterior and frog′s-leg lateral views and magnetic resonance imaging (MRI are the radiological techniques that help in early diagnosis. MRI detects early physeal changes of both preslip and SCFE even when radiographs and computed tomography are normal. MRI should be routinely used to diagnose early SCFE in preslip stage to avoid further complications.

  14. Herpes Simplex Virus Hepatitis: A Presentation of Multi-Institutional Cases to Promote Early Diagnosis and Management of the Disease

    Directory of Open Access Journals (Sweden)

    Ashwinee Natu

    2017-01-01

    Full Text Available Objective. To compare three cases of Herpes simplex virus (HSV hepatitis to increase early diagnosis of the disease. Case  1. A 23-year-old man with Crohn’s disease and oral HSV. HSV hepatitis was diagnosed clinically and he improved with acyclovir. Case  2. An 18-year-old G1P0 woman with transaminitis. Despite early empiric acyclovir therapy, she died due to fulminant liver failure. Case  3. A 65-year-old woman who developed transaminitis after liver transplant. Diagnosis was confirmed by biopsy and she had resolution of acute liver failure with acyclovir. Conclusion. It is imperative that clinicians be aware of patients at high risk for developing HSV hepatitis to increase timely diagnosis and prevent morbidity and fatality.

  15. Systemic reaction after performing a food prick-to-prick test. A case report

    Directory of Open Access Journals (Sweden)

    Karen Estefanía Hernández-Moreno

    2017-02-01

    Full Text Available Background: Skin prick test is the most widely used test for the diagnosis of IgE-mediated conditions. Commercial extracts are used for its performance, but in the case of fruits and vegetables it is preferable using fresh food. Although both tests possess a good safety profile, hypersensitivity reactions have been recorded. Clinical case: Forty-seven-year old woman with a history of persistent allergic rhinitis, sensitized to the pollen of grasses, olive and salsola; she was referred to an allergology department due to anaphylaxis triggered by the consumption of avocado, cantaloupe, carrots and watermelon. Minutes after skin prick test with standardized extract and skin prick with fresh foods, she developed dyspnea, pruritus, erythema, dizziness and sibilance; she was administered 0.5 mg of intramuscular adrenalin and 4 salbutamol inhalations and placed in the Trendelemburg position. Dyspnea persisted, and vital signs monitoring showed heart and respiratory rates increase and, hence, salbutamol was applied again, together with 2 L/min of oxygen delivered by nasal cannula, intravenous fluids and 100 mg intravenous hydrocortisone; improvement was observed at 40 minutes. The patient was hospitalized for 48 hours. Conclusions: Although skin tests are safe, the risk of hypersensitivity and anaphylactic reactions should not be ruled out, especially in susceptible patients.

  16. Atlantoaxial subluxation as an early manifestation in an adolescent with undifferentiated spondyloarthritis: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Jea Andrew

    2011-07-01

    Full Text Available Abstract Introduction Atlantoaxial instability has been described as a manifestation of ankylosing spondylitis (juvenile and adult onset, reactive arthritis, juvenile idiopathic arthritis, and rheumatoid arthritis; however, it has rarely been reported as an early manifestation of these disorders. We present this case report to increase awareness of the condition in the hope that earlier recognition of this disease may prevent further serious injury. Case presentation We report the case of a 17-year-old Hispanic adolescent woman who was initially diagnosed with undifferentiated spondyloarthritis due to peripheral arthritis, enthesitis, a positive human leukocyte antigen B27 result, and inflammatory spinal pain lasting two months. Our patient experienced persistent and worsening occipitocervical pain and signs of myelopathy three months after diagnosis; consequently, we found atlantoaxial instability along with cervical spine bone erosion and pannus formation. She was treated surgically with a C1-2 posterior instrumented fusion and at six weeks post-operatively was started on tumor necrosis factor α blockade. Her occipitocervical symptoms subsided following surgery and initiation of immunomodulation. Conclusions Our report serves to emphasize to pediatric and adult general practitioners, pediatricians, internists, family physicians, pediatric and adult rheumatologists and spine surgeons that atlantoaxial subluxation may be an early manifestation of spondyloarthritis, and that the condition is treatable by surgical intervention and immunomodulation.

  17. Evidence of the presence of the Zika virus in Mexico since early 2015.

    Science.gov (United States)

    Díaz-Quiñonez, José Alberto; López-Martínez, Irma; Torres-Longoria, Belem; Vázquez-Pichardo, Mauricio; Cruz-Ramírez, Edith; Ramírez-González, José Ernesto; Ruiz-Matus, Cuitláhuac; Kuri-Morales, Pablo

    2016-12-01

    To assess the possible circulation of Zika virus (ZIKV) prior to the first documented case in Mexico, we reanalyzed the stored samples from the states of Veracruz and Yucatán, which were originally collected to test for dengue (DENV) and chikungunya (CHIKV) but were negative for these viruses despite the symptomatology. The samples were originally collected between the 30 and 46 epidemiological weeks (EW) when the ZIKV was not yet declared as a Public Health Emergency of International Concern (PHEIC). From the total 4016 negative samples, a total of one hundred samples, 50 from Veracruz (CHIK - DENV - ) and 50 from Yucatán (4 CHIK - DENV - and 46 CHIK - or DENV - ), were tested for Zika virus by using RT-PCR. Results showed that in Veracruz and Yucatán, 20 % (10/50) and 70 % (35/50) were, respectively, ZIKV positive, indicating unequivocally the presence of ZIKV at least since July 2015. We also tested non-confirmed suspect measles cases from early 2015 for ZIKV by RT-PCR. Remarkably in 11 Mexican states, 86 % (18/21) were positive with the earlier symptoms onset as early as May 2015. Finally, RT-PCR analyses on RNA extracted from Aedes aegypti mosquitoes captured from January to March 2015 showed the presence of ZIKV, strongly suggesting that the vector was already carrying the virus at the start of 2015.

  18. Trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of extrapulmonary tuberculosis cases in referral hospitals in northern India

    Directory of Open Access Journals (Sweden)

    A K Maurya

    2012-01-01

    Full Text Available Background: Drug-resistant tuberculosis is one of major current challenges to global public health. The transmission of resistant strains is increasing as a burden of multidrug-resistant tuberculosis (MDR-TB patients in extra pulmonary tuberculosis (EPTB cases in India. Aim and Objectives: The aim was to study trends of anti-tuberculosis drug resistance pattern in new cases and previously treated cases of EPTB in referral hospitals in northern India. Study Design and Setting: A prospectively observational study and referral medical institutions in northern India. Materials and Methods: All EPTB specimens were processed for Ziehl Neelsen staining, BACTEC culture and BACTEC NAP test for Mycobacterium tuberculosis complex. All M. tuberculosis complex isolates were performed for radiometric-based drug susceptibility pattern against streptomycin, isoniazid, rifampicin and ethambutol using the 1% proportion method. Results: We found that 165/756 (20.5% isolates were identified as M. tuberculosis complex by the NAP test. We observed that 39.9% were resistant to first-line antitubercular drugs. The resistance rate was higher in previously treated patients: H (30.3%, R (16.3%, E (15.7% and S (16.3%. MDR-TB was observed in 13.4%, but, in new cases, this was 11.4% and 19.1% of the previously treated patients (P<0.05. Conclusion: MDR-TB is gradually increased in EPTB cases and predominant resistance to previous treated cases of EPTB. The molecular drug sensitivity test (DST method can be an early decision for chemotherapy in MDR-TB patients. The International Standards of TB Care need to be used by the RNTCP and professional medical associations as a tool to improve TB care in the country.

  19. Early Gender Test Score Gaps across OECD Countries

    Science.gov (United States)

    Bedard, Kelly; Cho, Insook

    2010-01-01

    The results reported in this paper contribute to the debate about gender skill gaps in at least three ways. First, we document the large differences in early gender gaps across developed countries using a large scale, modern, representative data source. Second, we show that countries with pro-female sorting, countries that place girls in classes…

  20. EARLY AFFECT-CONFUSION: THE BORDERLINE BETWEEN DESPAIR AND RAGE - PART 1 OF A CASE STUDY TRILOGY

    Directory of Open Access Journals (Sweden)

    Richard G. Erskine

    2012-12-01

    Full Text Available This three part case study illustrates the principles, theoretical concepts, and relational methods of Integrative Psychotherapy in the treatment of a client who continually experienced early affect-confusion and lived on a “borderline” between intense neediness and rage, despair and self-reliance, impulsivity and manipulation. Part 1 describes the behavioral dynamics of a 38 year old female client who required a two-part treatment approach that emphasized an inter-subjective relationship, consistency, and respect while helping her to acknowledge and value her relational-needs and to engage in a relationally contactful form of anger.

  1. Pathologic features of early inflammatory bowel disease.

    Science.gov (United States)

    Finkelstein, Sydney D; Sasatomi, Eizaburo; Regueiro, Miguel

    2002-03-01

    Often the pathologic changes of IBD are subtle and may not be present in a proportion of biopsy specimens. In cases of early disease, the changes may be missed, and additional specimens should be taken after a period of time. Modifying factors, such as prebiopsy treatment and coexisting disease, should be considered. A forum to review cases and allow for communication between gastroenterologists and pathologists is especially useful for clinicopathologic correlation and assignment of a working diagnosis to each case. Careful attention to the pathologic features of early UC and CD would be most useful when evaluating new therapies for IBD.

  2. Teachers' Beliefs on Foreign Language Teaching Practices in Early Childhood Education: A case study

    Directory of Open Access Journals (Sweden)

    Mustafa Caner

    2010-01-01

    Full Text Available The purpose of the study was to examine whether teacher beliefs would play a role in their actual practices while teaching target language in early phases of primary education, principally, in kindergarten and first grades in a state school. As it is a very broad research area, the researchers exclusively analyzed teaching practices and teaching activities of two teachers and their beliefs about teaching English to young children within the frame of early childhood education principles. One of the data gathering instruments in this case study was a questionnaire that inquires the participants beliefs related to the classroom practices and how these beliefs influence their classroom practices in early childhood education. In addition to the questionnaire, semi structured interviews with participants were held to examine their beliefs in detail. Finally, in order to see whether participants’ beliefs matched with their actual practices in their classrooms or not, the sample courses of the participants were observed and video-recorded for triangulation for the data. The classroom observations of the courses as well as video recordings of those courses were also examined by the researchers, and the findings were verified by another co-rater in order to increase the trustworthiness of the data. The analysis of responses of participants to the questionnaire, video-recorded classroom observations and interviews were presented qualitatively in the findings section. The results showed that both of the teachers took into account how their students could learn best with regards to their age, level and interest through using different activities and materials suitable for teaching English to young learners. It was also observed that teachers placed room for repetition, role-play, singing songs, picture drawings and coloring in their classes with young learners

  3. Test of thermal shields for early warning station detectors

    DEFF Research Database (Denmark)

    Petersen, Jesper

    1997-01-01

    The properties of thermal shields around NaI crystal scintillators for early warning stations have been checked in order to assure that external temperature variations cannot influence the stability of the measurements....

  4. Validation of new CFD release by Ground-Coupled Heat Transfer Test Cases

    Directory of Open Access Journals (Sweden)

    Sehnalek Stanislav

    2017-01-01

    Full Text Available In this article is presented validation of ANSYS Fluent with IEA BESTEST Task 34. Article stars with outlook to the topic, afterward are described steady-state cases used for validation. Thereafter is mentioned implementation of these cases on CFD. Article is concluded with presentation of the simulated results with a comparison of those from already validated simulation software by IEA. These validation shows high correlation with an older version of tested ANSYS as well as with other main software. The paper ends by discussion with an outline of future research.

  5. Individual responsibility in early detection of prostate gland cancer

    International Nuclear Information System (INIS)

    Nodal Laugart, Ramon Lemay; Rodriguez Ardi, Maricel; Tamayo Tamayo, Iser

    2011-01-01

    Starting from the point that morbidity and mortality rate due to prostate gland cancer has increased in Santiago de Cuba, the authors of this work decided to analyze the relation to individual responsibility in order to early detect the aforementioned condition. Therefore, 48 men over 50 years old belonging to the health area of Frank Pais Garcia University Polyclinic in Santiago de Cuba were surveyed during the first months of the year 2011 to determine the factors that influenced on the low risk perception. Results showed the urgent need of carrying out actions of health promotion and disease prevention in order to achieve the individual feels more responsible of his health care. Of the case material, 85,4 % participants admitted they did not have the tests to guarantee the early diagnosis or detect this tumor.(author)

  6. Early postnatal diagnosis of hereditary spherocytosis by combining light microscopy, acidified glycerol lysis test and eosin-5'-maleimide binding assay.

    Science.gov (United States)

    Andres, Oliver; Eber, Stefan; Speer, Christian P

    2015-12-01

    Exact diagnosis of hereditary spherocytosis (HS) is widely considered unreliable around birth. However, early postnatal diagnosis at the beginning of congenital hemolysis may be essential for managing neonatal anemia and hemolytic icterus, identifying those at high risk for severe hyperbilirubinemia, irreversible kernicterus, or sudden need for red cell transfusion. We analyzed 37 blood samples from neonates or infants up to six weeks of life that had been collected in-house or shipped to our laboratory due to suspected red cell membrane disorder. By combining assessment of red cell morphology, acidified glycerol lysis test (AGLT), and eosin-5'-maleimide (EMA) binding assay, we were able to clearly exclude HS in 22 and confirm HS in 10 patients, of which one had undergone red cell transfusion prior to blood sampling. Assessment of red cell morphology and normal test results allowed diagnosis of infantile pyknocytosis or Heinz body anemia in three neonates. Re-evaluation of five patients with inconsistent results of AGLT and EMA binding led to confirmation of HS in two cases. Automated analysis of hematologic parameters revealed elevated proportion of hyperdense cells to be a highly significant indicator for HS in neonatal infants. We showed that assessment of red cell morphology in combination with AGLT and EMA binding assay is a reliable basis for confirming or rejecting suspected diagnosis of HS even in neonates. Our data underline the necessity for blood sampling and laboratory exploration in suspected red cell membrane or enzyme defects at the earliest occasion.

  7. Evidence of the preferential use of disease prototypes over case exemplars among early year one medical students prior to and following diagnostic training.

    Science.gov (United States)

    Papa, Frank J; Li, Feiming

    2015-12-01

    Two core dual processing theory (DPT) System I constructs (Exemplars and Prototypes) were used to: 1) formulate a training exercise designed to improve diagnostic performance in year one medical students, and 2) explore whether any observed performance improvements were associated with preferential use of exemplars or prototypes. With IRB approval, 117 year one medical students participated in an acute chest pain diagnostic training exercise. A pre- and post-training test containing the same 27 case vignettes was used to determine if the subjects' diagnostic performance improved via training in both exemplars and prototypes. Exemplar and Prototype theory was also used to generate a unique typicality estimate for each case vignette. Because these estimates produce different performance predictions, differences in the subjects' observed performance would make it possible to infer whether subjects were preferentially using Exemplars or Prototypes. Pre- vs. post-training comparison revealed a significant performance improvement; t=14.04, pmid typical vignettes: t=4.94, pleast typical: t=5.16, pmid typical: t=2.94, pleast typical: t=6.64, ptheory than Exemplar theory. DPT is useful in designing and evaluating the utility of new approaches to diagnostic training, and, investigating the cognitive factors driving diagnostic capabilities among early medical students.

  8. Holistic care patient with Early Childhood Caries (ECC: A case report

    Directory of Open Access Journals (Sweden)

    Intan Maulani

    2016-06-01

    Full Text Available Early Childhood Caries (ECC is a specific form of severe dental caries that affects infants and young children. ECC progresses rapidly in those who are at high risk, and often goes untreated. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both primary and permanent dentitions. This case showed management holistic care for children with ECC.A five year old boy patient accompanied with her parents were reported to the Pedodontic Clinic Padjadjaran University Dental Hospital with a chief complaint of decayed upper anterior teeth and pain in the molar teeth. Clinical examinations found dental caries almost all teeth in the maxilla and mandible. Based on panoramic radiograph, treatments that can be done are strip crown glass ionomer restorations, pulp treatments, extractions and fixed space maintainer. Patients diagnosed with severe ECC, patient and parents described on this type of caries. During treatment the patient was given oral hygiene instruction and recommend daily use of tooth mouse. After all treatment were completed, fluoride topical, and fissure sealants, recall check up after three months was scheduled. Holistic care needed in handling children with ECC.

  9. Geoethical considerations in early warning of flooding and landslides: Case study from Norway

    Science.gov (United States)

    Devoli, Graziella; Kleivane Krøgli, Ingeborg; Dahl, Mads Peter; Colleuille, Hervé; Nykjær Boje, Søren; Sund, Monica

    2015-04-01

    The Norwegian Water Resources and Energy Directorate (NVE) runs the national early warning systems (EWS) for flooding and shallow landslides in Norway. The two EWSs have been operational since the late 1980s and 2013 respectively, and are based on weather forecasts, various hydro-meteorological prognosis and expert evaluation. Daily warning levels and related information to the public is prepared and presented through custom build internet platforms. In natural hazards sciences, the risk of a specific threat is defined as the product of hazard and consequence. In this context an EWS is intended to work as a mitigation measure in lowering the consequence and thus the risk of the threat. One of several factors determining the quality of such an EWS, is how warnings are communicated to the public. In contrary to what is common practice in some other countries, experts working with EWS in Norway cannot be held personally responsible for consequences of warnings being issued or not. However, the communication of warnings for flooding and landslides at NVE still implies many considerations of geoethical kind. Which are the consequences today for the forecasters when erroneous warning messages are sent because based on a poorly documented analysis? What is for example the most responsible way to describe uncertainties in warnings issued? What is the optimal compromise between avoiding false alarms and not sending out a specific warning? Is it responsible to rely on a "gut feeling"? Some authorities complain in receiving warning messages too often. Is it responsible to begin notifying these, only in cases of "high hazard level" and no longer in cases of "moderate hazard level"? Is it acceptable to issue general warnings for large geographical areas without being able to pinpoint the treat on local scale? What responsibility lies within the EWS in recommending evacuation or other practical measures to local authorities? By presenting how early warnings of flooding and

  10. Gitelman syndrome manifesting in early childhood and leading to delayed puberty: a case report.

    Science.gov (United States)

    Raza, Farhan; Sultan, Mubashar; Qamar, Khola; Jawad, Ali; Jawa, Ali

    2012-10-02

    Gitelman syndrome is an inherited autosomal recessive renal salt-wasting disorder. It presents with variable clinical symptoms including muscle weakness and fatigue, and the diagnosis is based on metabolic alkalosis, hypokalemia, hypomagnesemia and hypocalciuria. It is usually diagnosed incidentally in early adulthood. There are rare cases of Gitelman syndrome presenting in early childhood; however, to the best of our knowledge it has not previously been associated with delayed puberty. A 17-year-old South Asian man with recurrent episodes of generalized muscle weakness, fatigue and cramps from the age of two years was admitted for further workup. Before the age of 12 years, the episodes had been mild, but they then got progressively worse. Other symptoms include polyuria, polydipsia, nocturia, paresthesia and occasional watery diarrhea. He also had a history of short stature, poor weight gain and delayed developmental landmarks. His family history was unremarkable except for the consanguineous marriage of his parents. An examination revealed a thin and lean man with blood pressure of 95/60mmHg. His height and weight were below the third percentile and his sexual development was at Tanner Stage II. Laboratory work revealed serum sodium of 124mmol/L, potassium 2.4mmol/L, calcium 6.5mmol/L and magnesium of 1.2mg/dL. His testosterone level was low (0.85ng/mL, normal for his age 2.67 to 10.12ng/mL) with normal levels of luteinizing hormone and follicle-stimulating hormone. The sex hormone findings were attributed to delayed puberty. A 24-hour urinary analysis revealed decreased excretion of calcium (25.9mg/24 hours). Based on the findings of hypokalemic metabolic alkalosis without hypertension, severe hypomagnesemia and hypocalciuria, a diagnosis of Gitelman syndrome was made. Treatment was started with oral supplementation of potassium, magnesium and calcium along with spironolactone and liberal salt intake. Diagnosis of Gitelman syndrome is usually made incidentally

  11. Syringe test screening of microbial gas production activity: Cases denitrification and biogas formation.

    Science.gov (United States)

    Østgaard, Kjetill; Kowarz, Viktoria; Shuai, Wang; Henry, Ingrid A; Sposob, Michal; Haugen, Hildegunn Hegna; Bakke, Rune

    2017-01-01

    Mass produced plastic syringes may be applied as vessels for cheap, simple and large scale batch culture testing. As illustrated for the cases of denitrification and of biogas formation, metabolic activity was monitored by direct reading of the piston movement due to the gas volume formed. Pressure buildup due to friction was shown to be moderate. A piston pull and slide back routine can be applied before recording gas volume to minimize experimental errors due to friction. Inoculum handling and activity may be conveniently standardized as illustrated by applying biofilm carriers. A robust set of positive as well as negative controls ("blanks") should be included to ensure quality of the actual testing. The denitrification test showed saturation response at increasing amounts of inoculum in the form of adapted moving bed biofilm reactor (MBBR) carriers, with well correlated nitrate consumption vs. gas volume formed. As shown, the denitrification test efficiently screened different inocula at standardized substrates. Also, different substrates were successfully screened and compared at standardized inocula. The biogas potential test showed efficient screening of different substrates with effects of relative amounts of carbohydrate, protein, fat. A second case with CO 2 capture reclaimer waste as substrate demonstrated successful use of co-feeding to support waste treatment and how temperature effects on kinetics and stoichiometry can be observed. In total, syringe test screening of microbial gas production seems highly efficient at a low cost when properly applied. Copyright © 2016 Elsevier B.V. All rights reserved.

  12. Risk Identification in the Early Design Stage Using Thermal Simulations—A Case Study

    Directory of Open Access Journals (Sweden)

    Seyed Masoud Sajjadian

    2018-01-01

    Full Text Available The likely increasing temperature predicted by UK Climate Impacts Program (UKCIP underlines the risk of overheating and potential increase in cooling loads in most of UK dwellings. This could also increase the possibility of failure in building performance evaluation methods and add even more uncertainty to the decision-making process in a low-carbon building design process. This paper uses a 55-unit residential unit project in Cardiff, UK as a case study to evaluate the potential of thermal simulations to identify risk in the early design stage. Overheating, increase in energy loads, carbon emissions, and thermal bridges are considered as potential risks in this study. DesignBuilder (DesignBuilder Software Ltd., Stroud, UK was the dynamic thermal simulation software used in this research. Simulations compare results in the present, 2050, and 2080 time slices and quantifies the overall cooling and heating loads required to keep the operative temperature within the comfort zone. Overall carbon emissions are also calculated and a considerable reduction in the future is predicted. Further analysis was taken by THERM (Lawrence Berkeley National Laboratory, Berkeley, CA, USA and Psi THERM (Passivate, London, UK to evaluate the thermal bridge risk in most common junctions of the case study and the results reveal the potential of thermal assessment methods to improve design details before the start of construction stage.

  13. Should all suspected tuberculosis cases in high income countries be tested with GeneXpert?

    Science.gov (United States)

    Vella, Venanzio; Broda, Agnieszka; Drobniewski, Francis

    2018-05-01

    In countries with a low incidence of multidrug-resistant tuberculosis (MDR-TB), universal testing with GeneXpert might not be always cost-effective. This study provides hospital managers in low MDR-TB incidence countries with criteria on when decentralised universal GeneXpert testing would make sense. The alternatives taken into consideration include: universal microbiological culture and drug susceptibility testing (DST) only (comparator); as above but with concurrent centralized GeneXpert in a referral laboratory vs a decentralized GeneXpert system in every hospital to test smear-positive cases only; as above but testing all samples with GeneXpert regardless of smear status. The parameters were from the national TB statistics for England and from a systematic review. Decentralised GeneXpert to test any suspected TB case was the most cost-effective option when 6% or more TB patients belonged to the high-risk group, defined as previous TB diagnosis and or being born in countries with a high MDR-TB incidence. Hospital managers in England and other low MDR-TB incidence countries could use these findings to decide when to invest in GeneXpert or other molecular diagnostics with similar performance criteria for TB diagnostics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. The Development of case based Early Warning and Response System (EWRS for communicable diseases with diarrhea (2008, Turkey

    Directory of Open Access Journals (Sweden)

    Sema Sevken

    2010-08-01

    Full Text Available AIM: Routine surveys do not detect early waterborn and foodborn infections which are mostly observed during the summer. This is a pilot project that is being implemented in Kocaeli, Malatya and Trabzon cities to detect and control diarrhoeal illnesses in the early stages. The aim of the project is to develop an applicable Early Warning System (EWRS that can be implemented throughout the country. METHOD: This research is a partial report of the diarrhoeal illnesses that were indicated in between 01/08/2008 – 01/10/2008. The weekly cases were calculated by moving averages of three week time in the same period of time in 2007. Then the results were converted to daily counts after adding 10% (threshold value of the average of weekly observed counts. The daily expected case counts were collected from public hospitals and public village clinics in the same period of time by using the diagnosis which was defined as ICD10 code in advance. Having analysised the data in SPSS 15.0 programme, descriptive and pearson’s correlative statistics were done. RESULTS: The findings fromKocaeli andr Trabzon were analysed by the pearson’s correlation and there was not a meaningful relationship between getting over the threshold and the precaution components. In Malatya, 206 warnings were recorded. The rate of the incidence was 0.2 – 23.2 per 1000 population in per week. The rate of the invasive E.coli outbreak which was experienced in Battalgazi was 22.1 per 1000 population. With the help of the EWRS, the risk of epidemi was determined 18 days in advance, then retrospectively EARS_X programme has statisticly confirmed the case as an “epidemi”. It was also confirmed that there was an intermediate level, a positive and statistical significant relationship between the weekly measured amount of chlorine residue and the threshold with pearson’s correlation.(r = 0,45; p< 0,001. The correlation between number of bacterial samples and thresholds were also similar

  15. [Prader-Willi syndrome case with proliferative diabetic retinopathy in both eyes treated by early vitrectomy under local anesthesia].

    Science.gov (United States)

    Hori, Hideyuki; Sato, Yukihiro; Nakashima, Motohiro; Nakajima, Motohiro

    2012-02-01

    Although patients with Prader-Willi syndrome have a high rate of diabetes, to date, there have been only 4 reported cases (6 eyes) undergoing vitrectomy for proliferative diabetic retinopathy. Herein, we report a case of Prader-Willi syndrome with proliferative diabetic retinopathy that was treated by early vitrectomy OU under local anesthesia. A 30-year-old man was diagnosed as having Prader-Willi syndrome at the age of 2 years and diabetes at age 17. He was referred to our hospital as diabetic retinopathy had been detected in his first ophthalmological examination at age 29. Visual acuity was 0.6 bilaterally. Proliferative retinopathy, with cataract and macular edema, was identified in both eyes. Panretinal photocoagulation was performed on both eyes. However, proliferative membranes developed bilaterally, and vitreous hemorrhage occurred OS. Visual acuity decreased to 0.3 OU. The patient was hospitalized at our internal medicine department for blood glucose control. Subsequently, with an anesthesiologist on standby, a hypnotic sedative was injected intramuscularly, achieving retro-bulbar anesthesia. Combined cataract and vitreous surgery was performed on the left eye. One week later, a similar operation was performed on the right eye. The patient was discharged four days later. In the two years since these operation, visual acuity has been maintained at 0.8 OU. Patients with Prader-Willi syndrome should be examined for early detection and treatment of diabetic retinopathy.

  16. Predictive validity of the Biomedical Admissions Test: an evaluation and case study.

    Science.gov (United States)

    McManus, I C; Ferguson, Eamonn; Wakeford, Richard; Powis, David; James, David

    2011-01-01

    There has been an increase in the use of pre-admission selection tests for medicine. Such tests need to show good psychometric properties. Here, we use a paper by Emery and Bell [2009. The predictive validity of the Biomedical Admissions Test for pre-clinical examination performance. Med Educ 43:557-564] as a case study to evaluate and comment on the reporting of psychometric data in the field of medical student selection (and the comments apply to many papers in the field). We highlight pitfalls when reliability data are not presented, how simple zero-order associations can lead to inaccurate conclusions about the predictive validity of a test, and how biases need to be explored and reported. We show with BMAT that it is the knowledge part of the test which does all the predictive work. We show that without evidence of incremental validity it is difficult to assess the value of any selection tests for medicine.

  17. 37 CFR 1.219 - Early publication.

    Science.gov (United States)

    2010-07-01

    ... 37 Patents, Trademarks, and Copyrights 1 2010-07-01 2010-07-01 false Early publication. 1.219... COMMERCE GENERAL RULES OF PRACTICE IN PATENT CASES National Processing Provisions Publication of Applications § 1.219 Early publication. Applications that will be published under § 1.211 may be published...

  18. Policing, massive street drug testing and poly-substance use chaos in Georgia - a policy case study.

    Science.gov (United States)

    Otiashvili, David; Tabatadze, Mzia; Balanchivadze, Nino; Kirtadze, Irma

    2016-01-16

    Since early 2000, intensive policing, wide scale street drug testing, and actions aimed at limiting the availability of specific drugs have been implemented in Georgia. Supporters of this approach argue that fear of drug testing and resulting punishment compels drug users to stop using and prevents youth from initiating drug use. It has been also stated that reduction in the availability of specific drugs should be seen as an indication of the overall success of counter-drug efforts. The aim of the current review is to describe the drug-related law enforcement response in Georgia and its impact on illicit drug consumption and drug-related harm. We reviewed relevant literature that included peer-reviewed scientific articles, stand-alone research reports, annual drug situation reports, technical reports and program data. This was also supplemented by the review of relevant legislation and judicial practices for the twelve year period between 2002 and 2014. Every episode of reduced availability of any "traditional" injection drug was followed by the discovery/introduction of a new injection preparation. The pattern of drug consumption was normally driven by users' attempts to substitute their drug of choice through mixing together available alternative substances. Chaotic poly-substance use and extensive utilization of home-made injection drugs, prepared from toxic precursors, became common. Massive random street drug testing had little or no effect on the prevalence of problem drug use. Intensive harassment of drug users and exclusive focus on reducing the availability of specific drugs did not result in reduction of the prevalence of injecting drug use. Repressive response of Georgian anti-drug authorities relied heavily on consumer sanctions, which led to shifts in drug users' behavior. In most cases, these shifts were associated with the introduction and use of new toxic preparations and subsequent harm to the physical and mental health of drug consumers.

  19. Testing the Suitability of Mediation of Child Support Orders in Title IV-D Cases

    Science.gov (United States)

    Schraufnagel, Scot; Li, Quan

    2010-01-01

    Objectives: The purpose of this study is to test mediation versus a traditional court process for the establishment or modification of child support orders. The intention is to determine which dispute resolution process is associated with greater client satisfaction and compliance. An auxiliary objective is to test the type of cases which are most…

  20. Early postoperative erythromycin breath test correlates with hepatic cytochrome P4503A activity in liver transplant recipients

    DEFF Research Database (Denmark)

    Schmidt, L E; Olsen, A K; Stentoft, K

    2001-01-01

    BACKGROUND: Interindividual variation in the pharmacokinetics of the immunosuppressive agents cyclosporine (INN, ciclosporin) and tacrolimus may result from differences in the activity of cytochrome P4503A (CYP3A). The erythromycin breath test is an in vivo assay of hepatic CYP3A activity......, but the method has never been directly validated. The aim of the study was to investigate whether an early postoperative erythromycin breath test correlated with the hepatic CYP3A protein level and catalytic activity in liver transplant recipients. METHODS: In 18 liver transplant recipients, the erythromycin...... breath test was performed within 2 hours after transplantation. A graft biopsy was obtained during surgery and analyzed for the CYP3A protein level by Western blotting and for CYP3A activity with erythromycin demethylation and testosterone 6beta- hydroxylation assays. RESULTS: The erythromycin breath...

  1. Retrospective testing and case series study of porcine delta coronavirus in U.S. swine herds.

    Science.gov (United States)

    McCluskey, Brian J; Haley, Charles; Rovira, Albert; Main, Rodger; Zhang, Yan; Barder, Sunny

    2016-01-01

    Porcine deltacoronavirus (PDCoV) was first reported in the United States (US) in February 2014. This was the second novel swine enteric coronavirus detected in the US since May 2013. In this study, we conducted retrospective testing of samples submitted to three veterinary diagnostic laboratories where qualifying biological samples were derived from previously submitted diagnostic case submissions from US commercial swine farms with a clinical history of enteric disease or from cases that had been previously tested for transmissible gastroenteritis virus, PEDV, or rotavirus. Overall, 2286 banked samples were tested from 27 States. Samples were collected in 3 separate years and in 17 different months. Test results revealed 4 positive samples, 3 collected in August 2013 and 1 collected in October 2013. In addition, a case series including 42 operations in 10 States was conducted through administration of a survey. Survey data collected included information on characteristics of swine operations that had experienced PDCoV clinical signs. Special emphasis was placed on obtaining descriptive estimates of biosecurity practices and disease status over time of each operation. Clinical signs of PDCoV were reported to be similar to those of PEDV. The average number of animals on each operation exhibiting clinical signs (morbidity) and the average number of case fatalities was greatest for suckling and weaned pigs. Average operation-level weaned pig morbidity was greatest in the first week of the outbreak while average operation-level suckling pig case fatality was greatest in the second week of the outbreak. The survey included questions regarding biosecurity practices for visitors and operation employees; trucks, equipment and drivers; and feed sources. These questions attempted to identify a likely pathway of introduction of PDCoV onto the operations surveyed. Published by Elsevier B.V.

  2. RILEM technical committee 195-DTD recommendation for test methods for AD and TD of early age concrete Round Robin documentation report : program, test results and statistical evaluation

    CERN Document Server

    Bjøntegaard, Øyvind; Krauss, Matias; Budelmann, Harald

    2015-01-01

    This report presents the Round-Robin (RR) program and test results including a statistical evaluation of the RILEM TC195-DTD committee named “Recommendation for test methods for autogenous deformation (AD) and thermal dilation (TD) of early age concrete”. The task of the committee was to investigate the linear test set-up for AD and TD measurements (Dilation Rigs) in the period from setting to the end of the hardening phase some weeks after. These are the stress-inducing deformations in a hardening concrete structure subjected to restraint conditions. The main task was to carry out an RR program on testing of AD of one concrete at 20 °C isothermal conditions in Dilation Rigs. The concrete part materials were distributed to 10 laboratories (Canada, Denmark, France, Germany, Japan, The Netherlands, Norway, Sweden and USA), and in total 30 tests on AD were carried out. Some supporting tests were also performed, as well as a smaller RR on cement paste. The committee has worked out a test procedure recommenda...

  3. Eye and hand motor interactions with the Symbol Digit Modalities Test in early multiple sclerosis.

    Science.gov (United States)

    Nygaard, Gro O; de Rodez Benavent, Sigrid A; Harbo, Hanne F; Laeng, Bruno; Sowa, Piotr; Damangir, Soheil; Bernhard Nilsen, Kristian; Etholm, Lars; Tønnesen, Siren; Kerty, Emilia; Drolsum, Liv; Inge Landrø, Nils; Celius, Elisabeth G

    2015-11-01

    Eye and hand motor dysfunction may be present early in the disease course of relapsing-remitting multiple sclerosis (RRMS), and can affect the results on visual and written cognitive tests. We aimed to test for differences in saccadic initiation time (SI time) between RRMS patients and healthy controls, and whether SI time and hand motor speed interacted with the written version of the Symbol Digit Modalities Test (wSDMT). Patients with RRMS (N = 44, age 35.1 ± 7.3 years), time since diagnosis < 3 years and matched controls (N = 41, age 33.2 ± 6.8 years) were examined with ophthalmological, neurological and neuropsychological tests, as well as structural MRI (white matter lesion load (WMLL) and brainstem lesions), visual evoked potentials (VEP) and eye-tracker examinations of saccades. SI time was longer in RRMS than controls (p < 0.05). SI time was not related to the Paced Auditory Serial Addition Test (PASAT), WMLL or to the presence of brainstem lesions. 9 hole peg test (9HP) correlated significantly with WMLL (r = 0.58, p < 0.01). Both SI time and 9HP correlated negatively with the results of wSDMT (r = -0.32, p < 0.05, r = -0.47, p < 0.01), but none correlated with the results of PASAT. RRMS patients have an increased SI time compared to controls. Cognitive tests results, exemplified by the wSDMT, may be confounded by eye and hand motor function. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  4. Huntington disease: a case study of early onset presenting as depression.

    Science.gov (United States)

    Duesterhus, Pia; Schimmelmann, Benno Graf; Wittkugel, Oliver; Schulte-Markwort, Michael

    2004-10-01

    Huntington disease is a dominantly inherited, neurodegenerative disease characterized by choreiform movement disturbances and dementia, usually with adult onset. The rare juvenile-onset Huntington disease differs from the adult phenotype. A case presenting twice, at age 10 with all the signs of a major depression and age 14 with mutism and rigidity, is reported. Meanwhile, the father developed the adult variant of Huntington disease. The boy's diagnosis was confirmed by molecular genetic analysis and magnetic resonance imaging. It is important to be aware of hereditary conditions such as Huntington disease and to provide family counseling before genetic testing and after the diagnosis is confirmed.

  5. Morphological and histomorphological structures of testes and ovaries in early developmental stages of the silkworm, Bombyx mori.

    Science.gov (United States)

    Sakai, Hiroki; Kirino, Yohei; Katsuma, Susumu; Aoki, Fugaku; Suzuki, Masataka G

    2016-01-01

    The gonad develops as a testis in male or an ovary in female. In the silkworm, B. mori , little is known about testis and ovary in the embryonic stages and early larval stages. In this study, we performed morphological and histomorphological observations of ovaries and testes from the late embryonic stage to the 1st instar larval stage. Results obtained with lack of accurate information on sex of examined individuals may be misleading, thus we performed phenotypic observations of gonads by utilizing sex-limited strain that enables us to easily discriminate female embryos from male ones based on those egg colors. In testis, four testicular follicles were clearly observed in the testis at the first instar larval stage, and boundary layers were formed between the testicular follicles. At the late embryonic stage, the testis consisted of four testicular follicles, while the boundary layers were still obscure. In ovary, four ovarioles were easily recognizable in the ovary at the first instar larval stage, and boundary layers were formed between the ovarioles. However, in the late embryonic stage, it was quite difficult to identify four ovarioles. Morphological characteristics were almost similar between testis and ovary in early developmental stages. Our present study demonstrates that the most reliable difference between testis and ovary in early developmental stages is the attaching point of the duct. Formation and development of the duct may be sensitive to the sex-determining signal and display sexual dimorphism in early embryonic stages.

  6. A rare case of os odontoideum from an Early Intermediate period tomb at the Huacas de Moche, Peru.

    Science.gov (United States)

    Titelbaum, A R; Castillo, S Uceda

    2015-12-01

    Os odontoideum is an uncommon vertebral anomaly where there is a smoothly corticated ossicle independent from a shortened odontoid peg. An example of os odontoideum was observed in an Early Intermediate period skeleton excavated from the Huacas de Moche (Moche IV, AD 400-700), Peru. The affected individual is a middle adult male who presents additional minor developmental anomalies of the axial skeleton. This individual was interred with a middle adult female who also has developmental anomalies of the axial skeleton, including block cervical vertebra (Klippel-Feil). Os odontoideum is infrequently reported in the medical literature and there continues to be debate about whether it is acquired or congenital. Unlike clinical cases, archaeological cases present an opportunity to examine the entirety of the skeleton. In the present case, there does not appear to be macroscopic or radiographic evidence for a healed fracture, and since the individual has multiple minor axial developmental anomalies, a congenital etiology is plausible. This case is the first to be described from the archaeological context of South America and one of few paleopathological examples worldwide. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. Idealized tropical cyclone simulations of intermediate complexity: A test case for AGCMs

    Directory of Open Access Journals (Sweden)

    Kevin Reed

    2012-04-01

    Full Text Available The paper introduces a moist, deterministic test case of intermediate complexity for Atmospheric General Circulation Models (AGCMs. We suggest pairing an AGCM dynamical core with simple physical parameterizations to test the evolution of a single, idealized, initially weak vortex into a tropical cyclone. The initial conditions are based on an initial vortex seed that is in gradient-wind and hydrostatic balance. The suggested ``simple-physics'' package consists of parameterizations of bulk aerodynamic surface fluxes for moisture, sensible heat and momentum, boundary layer diffusion, and large-scale condensation. Such a configuration includes the important driving mechanisms for tropical cyclones, and leads to a rapid intensification of the initial vortex over a forecast period of ten days. The simple-physics test paradigm is not limited to tropical cyclones, and can be universally applied to other flow fields. The physical parameterizations are described in detail to foster model intercomparisons.The characteristics of the intermediate-complexity test case are demonstrated with the help of four hydrostatic dynamical cores that are part of the Community Atmosphere Model version 5 (CAM 5 developed at the National Center for Atmospheric Research (NCAR. In particular, these are the Finite-Volume, Spectral Element, and spectral transform Eulerian and semi-Lagrangian dynamical cores that are coupled to the simple-physics suite. The simulations show that despite the simplicity of the physics forcings the models develop the tropical cyclone at horizontal grid spacings of about 55 km and finer. The simple-physics simulations reveal essential differences in the storm's structure and strength due to the choice of the dynamical core. Similar differences are also seen in complex full-physics aqua-planet experiments with CAM 5 which serve as a motivator for this work. The results suggest that differences in complex full-physics simulations can be, at least

  8. Investigating alternatives to the fish early-life stage test: a strategy for discovering and annotating adverse outcome pathways for early fish development.

    Science.gov (United States)

    Villeneuve, Daniel; Volz, David C; Embry, Michelle R; Ankley, Gerald T; Belanger, Scott E; Léonard, Marc; Schirmer, Kristin; Tanguay, Robert; Truong, Lisa; Wehmas, Leah

    2014-01-01

    The fish early-life stage (FELS) test (Organisation for Economic Co-operation and Development [OECD] test guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an ongoing effort to develop efficient and cost-effective alternatives to the FELS test, there is a need to identify and describe potential adverse outcome pathways (AOPs) relevant to FELS toxicity. To support this endeavor, the authors outline and illustrate an overall strategy for the discovery and annotation of FELS AOPs. Key events represented by major developmental landmarks were organized into a preliminary conceptual model of fish development. Using swim bladder inflation as an example, a weight-of-evidence-based approach was used to support linkage of key molecular initiating events to adverse phenotypic outcomes and reduced young-of-year survival. Based on an iterative approach, the feasibility of using key events as the foundation for expanding a network of plausible linkages and AOP knowledge was explored and, in the process, important knowledge gaps were identified. Given the scope and scale of the task, prioritization of AOP development was recommended and key research objectives were defined relative to factors such as current animal-use restrictions in the European Union and increased demands for fish toxicity data in chemical management programs globally. The example and strategy described are intended to guide collective efforts to define FELS-related AOPs and develop resource-efficient predictive assays that address the toxicological domain of the OECD 210 test. © 2013 The Authors. Environmental Toxicology and Chemistry published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).

  9. Modeling screening, prevention, and delaying of Alzheimer's disease: an early-stage decision analytic model

    Directory of Open Access Journals (Sweden)

    Siemers Eric R

    2010-04-01

    Full Text Available Abstract Background Alzheimer's Disease (AD affects a growing proportion of the population each year. Novel therapies on the horizon may slow the progress of AD symptoms and avoid cases altogether. Initiating treatment for the underlying pathology of AD would ideally be based on biomarker screening tools identifying pre-symptomatic individuals. Early-stage modeling provides estimates of potential outcomes and informs policy development. Methods A time-to-event (TTE simulation provided estimates of screening asymptomatic patients in the general population age ≥55 and treatment impact on the number of patients reaching AD. Patients were followed from AD screen until all-cause death. Baseline sensitivity and specificity were 0.87 and 0.78, with treatment on positive screen. Treatment slowed progression by 50%. Events were scheduled using literature-based age-dependent incidences of AD and death. Results The base case results indicated increased AD free years (AD-FYs through delays in onset and a reduction of 20 AD cases per 1000 screened individuals. Patients completely avoiding AD accounted for 61% of the incremental AD-FYs gained. Total years of treatment per 1000 screened patients was 2,611. The number-needed-to-screen was 51 and the number-needed-to-treat was 12 to avoid one case of AD. One-way sensitivity analysis indicated that duration of screening sensitivity and rescreen interval impact AD-FYs the most. A two-way sensitivity analysis found that for a test with an extended duration of sensitivity (15 years the number of AD cases avoided was 6,000-7,000 cases for a test with higher sensitivity and specificity (0.90,0.90. Conclusions This study yielded valuable parameter range estimates at an early stage in the study of screening for AD. Analysis identified duration of screening sensitivity as a key variable that may be unavailable from clinical trials.

  10. Modeling screening, prevention, and delaying of Alzheimer's disease: an early-stage decision analytic model.

    Science.gov (United States)

    Furiak, Nicolas M; Klein, Robert W; Kahle-Wrobleski, Kristin; Siemers, Eric R; Sarpong, Eric; Klein, Timothy M

    2010-04-30

    Alzheimer's Disease (AD) affects a growing proportion of the population each year. Novel therapies on the horizon may slow the progress of AD symptoms and avoid cases altogether. Initiating treatment for the underlying pathology of AD would ideally be based on biomarker screening tools identifying pre-symptomatic individuals. Early-stage modeling provides estimates of potential outcomes and informs policy development. A time-to-event (TTE) simulation provided estimates of screening asymptomatic patients in the general population age > or =55 and treatment impact on the number of patients reaching AD. Patients were followed from AD screen until all-cause death. Baseline sensitivity and specificity were 0.87 and 0.78, with treatment on positive screen. Treatment slowed progression by 50%. Events were scheduled using literature-based age-dependent incidences of AD and death. The base case results indicated increased AD free years (AD-FYs) through delays in onset and a reduction of 20 AD cases per 1000 screened individuals. Patients completely avoiding AD accounted for 61% of the incremental AD-FYs gained. Total years of treatment per 1000 screened patients was 2,611. The number-needed-to-screen was 51 and the number-needed-to-treat was 12 to avoid one case of AD. One-way sensitivity analysis indicated that duration of screening sensitivity and rescreen interval impact AD-FYs the most. A two-way sensitivity analysis found that for a test with an extended duration of sensitivity (15 years) the number of AD cases avoided was 6,000-7,000 cases for a test with higher sensitivity and specificity (0.90,0.90). This study yielded valuable parameter range estimates at an early stage in the study of screening for AD. Analysis identified duration of screening sensitivity as a key variable that may be unavailable from clinical trials.

  11. WHO HAS TO UNDERGO CANCER GENETIC TESTING? A PERSPECTIVE.

    Directory of Open Access Journals (Sweden)

    Carmen Rinaldi

    2017-10-01

    Full Text Available Genetic testing is a medical tool employed to screen changes in genes linked to cancer and other genetic diseases. Genetic tests are available for breast, ovarian, colon, thyroid, and some other cancers and they represent the main tool for early identification of the “risk” subjects. The choice to undergo genetic testing by a healthy or affected cancer patient with family history of the cancer has to be the fruit of a careful and prudent assessment of the advantages and disadvantages discussed during oncogenetic counselling. The latter, in turn, in the case of a patient's positive and informed choice, must constantly affiliate the genetic testing, in order to preserve the prediction and information role of the test as much as possible.

  12. Evaluation of a fast single-photon avalanche photodiode for measurement of early transmitted photons through diffusive media.

    Science.gov (United States)

    Mu, Ying; Valim, Niksa; Niedre, Mark

    2013-06-15

    We tested the performance of a fast single-photon avalanche photodiode (SPAD) in measurement of early transmitted photons through diffusive media. In combination with a femtosecond titanium:sapphire laser, the overall instrument temporal response time was 59 ps. Using two experimental models, we showed that the SPAD allowed measurement of photon-density sensitivity functions that were approximately 65% narrower than the ungated continuous wave case at very early times. This exceeds the performance that we have previously achieved with photomultiplier-tube-based systems and approaches the theoretical maximum predicted by time-resolved Monte Carlo simulations.

  13. Concurrent colonic mucosa-associated lymphoid tissue lymphoma and adenoma diagnosed after a positive fecal occult blood test: a case report.

    Science.gov (United States)

    Lin, Pei-Chiang; Chen, Jinn-Shiun; Deng, Po; Wang, Chih-Wei; Huang, Chiung-Huei; Tang, Reiping; Chiang, Jy-Ming; Yeh, Chien-Yuh; Hsieh, Pao-Shiu; Tsai, Wen-Sy; Chiang, Sum-Fu

    2016-01-27

    Colonic lymphoma is an uncommon presentation of extranodal lymphoma. Colonic mucosa-associated lymphoid tissue lymphoma is a different entity from gastric mucosa-associated lymphoid tissue lymphoma, and very rare. The presentation and management of colonic mucosa-associated lymphoid tissue are highly variable in the literature. We report the case of a 59-year-old Taiwanese man who underwent a colonoscopy after a positive test for fecal occult blood. His past history included hypertension and hyperthyroidism. The colonoscopy revealed an adenomatous polyp and mucosa-associated lymphoid tissue lymphoma. We successfully performed a polypectomy and endoscopic mucosal resection. The lymphoma was staged according to the Ann Arbor system modified by Musshoff as E-I. Our patient showed no lymphoma recurrence over a 3-year follow-up. Endoscopic mucosal resection for colonic mucosa-associated lymphoid tissue lymphoma without disseminated disease may be feasible. We successfully used colonoscopic treatment without adjuvant therapy to treat early-stage pathogen-free colonic mucosa-associated lymphoid tissue lymphoma.

  14. Early adolescent music preferences and minor delinquency

    NARCIS (Netherlands)

    ter Bogt, T.F.M.; Keijsers, L.G.M.T.; Meeus, W.H.J.

    2013-01-01

    Objectives: To test Music Marker Theory (MMT) positing that early adolescents’ preferences for nonmainstream types of popular music indicate concurrent and later minor delinquency. Methods: MMT was tested in a 4-year longitudinal study (n = 309). Results: The results showed that early fans of

  15. Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study

    Directory of Open Access Journals (Sweden)

    Rejane de Souza Reis

    2017-11-01

    Full Text Available Objective: The population-based cancer registries (PBCR and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC] have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL in Brazil. Methods: A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i characteristics of the child at birth and (ii characteristics of maternal exposure during pregnancy. The case–control ratio was 1:4. Linkage was performed using R software; odds ratio (OR and 95% confidence interval (CI were calculated by logistic regression models. Results: EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16–4.10 and with birth defects (adjOR: 3.62, 95% CI: 1.19–11.00. Conclusions: The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide. Resumo: Objetivos: Os registros de câncer de base populacional (RCBP e o Sistema Nacional de Nascidos Vivos (SINASC possuem informações que possibilitam testar hipóteses sobre fatores de riscos associados às leucemias. O objetivo principal deste projeto é identificar quais as características ao nascimento das crianças que estariam associadas ao risco de desenvolver Leucemia Aguda (LA na primeira infância. Métodos: Foram utilizadas informações de 12 RCBP e do Sistema de Informação de Nascidos Vivos das mesmas localidades. Foram elegíveis 272 casos e 1.088 controles no período de 1996 a 2010. As associações de riscos de LA foram agrupadas em, (i caracter

  16. Non-pathological complete paternal uniparental isodisomy of chromosome 2 revealed in a maternity testing case.

    Science.gov (United States)

    Chen, Man; Jiang, Jian; Li, Chen; Ren, He; Chen, Wei; Liu, Zhiyong; Cheng, Feng; Zhao, Jing; Chen, Tong; Chen, Chuguang; Yan, Jiangwei

    2018-05-25

    We present a duo paternity test case to assess the biological relationship between a woman and her female child. After analyzing 57 autosomal and 19 X-chromosomal short tandem repeat loci, mother-daughter exclusions were discovered at four loci, which were all located on chromosome 2. Further testing of whole-genome single nucleotide polymorphisms confirmed that the daughter had complete uniparental disomy (UPD) of chromosome 2. This study presents a cautionary case demonstrating that hasty decisions of parentage exclusion should not be made when genetic markers on the same chromosome do not conform to Mendel's laws due to UPD.

  17. Tests in Print II: An Index to Tests, Test Reviews, and the Literature on Specific Tests.

    Science.gov (United States)

    Buros, Oscar K., Ed.

    Tests in Print II is a comprehensive, annotated bibliography of all in-print tests published as separates for use with English-speaking subjects. The 1,155 two-column pages list 2,467 tests in print as of early 1974; 16,574 references through 1971 on specific tests; a reprinting of the 1974 APA-AERA-NCME Standards for Educational andPsychological…

  18. The Role of Occupational Therapists and Physical Therapists in Elementary School System Early Intervening Services and Response to Intervention: A Case Report

    Science.gov (United States)

    Reeder, Deborah L.; Arnold, Sandra H.; Jeffries, Lynn M.; McEwen, Irene R.

    2011-01-01

    The Individuals with Disabilities Improvement Act and No Child Left Behind Act broadened the roles of occupational therapists (OTs) and physical therapists (PTs) to include therapist participation in early intervening services including response to intervention (RTI). This case report describes one school district's inclusion of OT and PT in the…

  19. How Should Clinicians Counsel a Woman with a Strong Family History of Early-Onset Alzheimer's Disease about Her Pregnancy?

    Science.gov (United States)

    Mapes, Marianna V; O'Brien, Barbara M; King, Louise P

    2017-07-01

    Counseling patients regarding the benefits, harms, and dilemmas of genetic testing is one of the greatest ethical challenges facing reproductive medicine today. With or without test results, clinicians grapple with how to communicate potential genetic risks as patients weigh their reproductive options. Here, we consider a case of a woman with a strong family history of early-onset Alzheimer's disease (EOAD). She is early in her pregnancy and unsure about learning her own genetic status. We address the ethical ramifications of each of her options, which include genetic testing, genetic counseling, and termination versus continuation of the pregnancy. Our analysis foregrounds clinicians' role in helping to ensure autonomous decision making as the patient reflects on these clinical options in light of her goals and values. © 2017 American Medical Association. All Rights Reserved.

  20. Fluorescence photodiagnosis of early stage lung cancer

    International Nuclear Information System (INIS)

    Kato, H.; Sakai, H.; Konaka, C.; Okunaka, T.; Furukawa, K.; Saito, Y.; Aizawa, K.; Hayata, Y.

    1992-01-01

    Sputum cytology examination is the most effective method to detect early stage central type squamous cell carcinoma. As sputum-positive early stage lung cancer usually does not show any abnormal findings on chest X-ray film, fiberoptic bronchoscopy is subsequently performed for localization. However, sometimes cases do not show any abnormal findings of cancer endoscopically because they are very early stage cases. For the purpose of localization of invisible lesions the photodynamic reaction was employed in this study. Photodynamic reaction is achieved by transfer of energy of an excited photo-sensitizer induced by photoradiation of light. This phenomenon was already recognized in the beginning of this century. Study of tumor localization of the bronchial tree using hematoporphyrin derivative (HpD) and a mercury arc lamp was first performed in the Mayo Clinic in 1960s. In 1978, krypton laser was used first as a light source by Profio and Doiron. Authors have been doing research on early localization of such endoscopically occult early lung cancer since 1978. They recently developed an image processing system using an excimer dye laser for early localization of lung cancer. (author). 5 refs., 4 figs., 1 tab

  1. Effects of child development accounts on early social-emotional development: an experimental test.

    Science.gov (United States)

    Huang, Jin; Sherraden, Michael; Kim, Youngmi; Clancy, Margaret

    2014-03-01

    This study, based on Oklahoma's statewide Child Development Accounts (CDAs) program, presents findings from the first experimental test of the hypothesis that creating lifelong savings accounts for children at birth promotes their long-term well-being. To examine the effects of CDAs, an innovative social policy to encourage lifelong saving and asset building for long-term development, on parent-reported social-emotional development in early childhood. A statewide randomized experiment of CDAs was conducted in 2008, drawing a probability sample of 7328 children from all infants born in two 3-month periods in Oklahoma (April 1 through June 30 and August 1 through October 31, 2007). After agreeing to participate in the experiment, caregivers of 2704 infants completed a baseline survey and were randomly assigned to treatment (n = 1358) and control groups (n = 1346). Approximately 84% of participants completed a follow-up survey in the spring of 2011. The intervention offered CDAs, built on the existing Oklahoma 529 college-savings plan, to treatment participants. It also provided additional financial incentives and information. The primary outcome-child social-emotional development-is measured by scores from a 17-item version of the Ages and Stages Questionnaire: Social-Emotional. Caregivers completed it in the 3-year follow-up survey. Lower scores indicate better functioning. The CDAs have positive effects on social-emotional development for children at approximately age 4 years. The nonweighted treatment-control difference is -1.56 (90% CI, -2.87 to -0.22; P = .06), but the weighted difference is nonsignificant. The effects appear to be greater for disadvantaged subsamples, such as low-income households (weighted mean difference, -2.21; 90% CI, -4.01 to -0.42; P = .04). As a complement to other early education and health interventions, CDAs may improve social-emotional development in early childhood. Their effects may be explained as a mediating

  2. Robust Tests for Additive Gene-Environment Interaction in Case-Control Studies Using Gene-Environment Independence

    DEFF Research Database (Denmark)

    Liu, Gang; Lee, Seunggeun; Lee, Alice W

    2018-01-01

    test with case-control data. Our simulation studies suggest that the EB approach uses the gene-environment independence assumption in a data-adaptive way and provides power gain compared to the standard logistic regression analysis and better control of Type I error when compared to the analysis......There have been recent proposals advocating the use of additive gene-environment interaction instead of the widely used multiplicative scale, as a more relevant public health measure. Using gene-environment independence enhances the power for testing multiplicative interaction in case......-control studies. However, under departure from this assumption, substantial bias in the estimates and inflated Type I error in the corresponding tests can occur. This paper extends the empirical Bayes (EB) approach previously developed for multiplicative interaction that trades off between bias and efficiency...

  3. Sensitivity analysis methods and a biosphere test case implemented in EIKOS

    Energy Technology Data Exchange (ETDEWEB)

    Ekstroem, P.A.; Broed, R. [Facilia AB, Stockholm, (Sweden)

    2006-05-15

    Computer-based models can be used to approximate real life processes. These models are usually based on mathematical equations, which are dependent on several variables. The predictive capability of models is therefore limited by the uncertainty in the value of these. Sensitivity analysis is used to apportion the relative importance each uncertain input parameter has on the output variation. Sensitivity analysis is therefore an essential tool in simulation modelling and for performing risk assessments. Simple sensitivity analysis techniques based on fitting the output to a linear equation are often used, for example correlation or linear regression coefficients. These methods work well for linear models, but for non-linear models their sensitivity estimations are not accurate. Usually models of complex natural systems are non-linear. Within the scope of this work, various sensitivity analysis methods, which can cope with linear, non-linear, as well as non-monotone problems, have been implemented, in a software package, EIKOS, written in Matlab language. The following sensitivity analysis methods are supported by EIKOS: Pearson product moment correlation coefficient (CC), Spearman Rank Correlation Coefficient (RCC), Partial (Rank) Correlation Coefficients (PCC), Standardized (Rank) Regression Coefficients (SRC), Sobol' method, Jansen's alternative, Extended Fourier Amplitude Sensitivity Test (EFAST) as well as the classical FAST method and the Smirnov and the Cramer-von Mises tests. A graphical user interface has also been developed, from which the user easily can load or call the model and perform a sensitivity analysis as well as uncertainty analysis. The implemented sensitivity analysis methods has been benchmarked with well-known test functions and compared with other sensitivity analysis software, with successful results. An illustration of the applicability of EIKOS is added to the report. The test case used is a landscape model consisting of several

  4. Sensitivity analysis methods and a biosphere test case implemented in EIKOS

    International Nuclear Information System (INIS)

    Ekstroem, P.A.; Broed, R.

    2006-05-01

    Computer-based models can be used to approximate real life processes. These models are usually based on mathematical equations, which are dependent on several variables. The predictive capability of models is therefore limited by the uncertainty in the value of these. Sensitivity analysis is used to apportion the relative importance each uncertain input parameter has on the output variation. Sensitivity analysis is therefore an essential tool in simulation modelling and for performing risk assessments. Simple sensitivity analysis techniques based on fitting the output to a linear equation are often used, for example correlation or linear regression coefficients. These methods work well for linear models, but for non-linear models their sensitivity estimations are not accurate. Usually models of complex natural systems are non-linear. Within the scope of this work, various sensitivity analysis methods, which can cope with linear, non-linear, as well as non-monotone problems, have been implemented, in a software package, EIKOS, written in Matlab language. The following sensitivity analysis methods are supported by EIKOS: Pearson product moment correlation coefficient (CC), Spearman Rank Correlation Coefficient (RCC), Partial (Rank) Correlation Coefficients (PCC), Standardized (Rank) Regression Coefficients (SRC), Sobol' method, Jansen's alternative, Extended Fourier Amplitude Sensitivity Test (EFAST) as well as the classical FAST method and the Smirnov and the Cramer-von Mises tests. A graphical user interface has also been developed, from which the user easily can load or call the model and perform a sensitivity analysis as well as uncertainty analysis. The implemented sensitivity analysis methods has been benchmarked with well-known test functions and compared with other sensitivity analysis software, with successful results. An illustration of the applicability of EIKOS is added to the report. The test case used is a landscape model consisting of several linked

  5. A case of deep venous thrombosis following protracted catatonic immobility recovered with electroconvulsive therapy: the relevance for an early intervention.

    Science.gov (United States)

    Medda, Pierpaolo; Fornaro, Michele; Fratta, Sara; Callari, Antonio; Manzo, Valerio; Ciaponi, Benedetta; Perugi, Giulio

    2012-01-01

    Catatonic patients often experience prolonged inactivity and dehydration, thus being prone to venous stasis leading to life-threatening thrombosis and pulmonary embolism (PE). When this occurs, the prescription of electroconvulsive therapy (ECT), actually irreplaceable in most life-threatening cases, remains controversial essentially due to an increased risk for PE and cerebral haemorrhage, with timing clinical decisions being as crucial as difficult to take. We report the case of a catatonic patient affected by malnutrition, deep venous thrombosis, severe pressure ulcers and septic syndrome resulting from previous untimely management, successfully treated with 16 well-tolerated ECT applications upon intensive supportive care. Although anecdotal, cases like this remind the relevance of early ECT to reduce the risk for potentially life-threatening complications due to prolonged catatonic inactivity, especially to those clinicians substantially disregarding this practice. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. Sprites and Early ionospheric VLF perturbations

    Science.gov (United States)

    Haldoupis, Christos; Amvrosiadi, Nino; Cotts, Ben; van der Velde, Oscar; Chanrion, Olivier; Neubert, Torsten

    2010-05-01

    Past studies have shown a correlation between sprites and early VLF perturbations, but the reported correlation varies widely from ~ 50% to 100%. The present study resolves these large discrepancies by analyzing several case studies of sprite and narrowband VLF observations, in which multiple transmitter-receiver VLF links with great circle paths (GCPs) passing near a sprite-producing thunderstorm were available. In this setup, the multiple links act in a complementary way that makes the detection of early VLF perturbations much more probable compared to a single VLF link that can miss several of them, a fact that was overlooked in past studies. The evidence shows that sprites are accompanied by early VLF perturbations in a one-to-one correspondence. This implies that the sprite generation mechanism may cause also sub-ionospheric conductivity disturbances that produce early VLF events. However, the one-to-one "sprite to early" event relationship, if viewed conversely as "early to sprite", appears not to be always reciprocal. This is because the number of early events detected in some cases was considerably larger than the number of sprites. Since the great majority of the early events not accompanied by sprites was caused by positive cloud to ground (+CG) lightning discharges, it is possible that sprites or sprite halos were concurrently present in these events as well but were missed by the sprite-watch detection system. In order for this option to be resolved we need more studies using highly sensitive optical systems capable of detecting weaker sprites, sprite halos and elves.

  7. Using a fuzzy comprehensive evaluation method to determine product usability: A test case.

    Science.gov (United States)

    Zhou, Ronggang; Chan, Alan H S

    2017-01-01

    In order to take into account the inherent uncertainties during product usability evaluation, Zhou and Chan [1] proposed a comprehensive method of usability evaluation for products by combining the analytic hierarchy process (AHP) and fuzzy evaluation methods for synthesizing performance data and subjective response data. This method was designed to provide an integrated framework combining the inevitable vague judgments from the multiple stages of the product evaluation process. In order to illustrate the effectiveness of the model, this study used a summative usability test case to assess the application and strength of the general fuzzy usability framework. To test the proposed fuzzy usability evaluation framework [1], a standard summative usability test was conducted to benchmark the overall usability of a specific network management software. Based on the test data, the fuzzy method was applied to incorporate both the usability scores and uncertainties involved in the multiple components of the evaluation. Then, with Monte Carlo simulation procedures, confidence intervals were used to compare the reliabilities among the fuzzy approach and two typical conventional methods combining metrics based on percentages. This case study showed that the fuzzy evaluation technique can be applied successfully for combining summative usability testing data to achieve an overall usability quality for the network software evaluated. Greater differences of confidence interval widths between the method of averaging equally percentage and weighted evaluation method, including the method of weighted percentage averages, verified the strength of the fuzzy method.

  8. ROSA-II test data report, 11

    International Nuclear Information System (INIS)

    1978-02-01

    Results of the ROSA-II tests simulating a loss-of-coolant accident (LOCA) and effects of an emergency core cooling system (ECCS) in a pressurized water reactor (PWR) are presented including the test conditions and interpretations of the data in test runs 327,328,329 and 330. Each test was performed with large double-ended hot leg break and effect of the break area distribution (break diameter are 25.0 mm at one end and 37.5 mm at the other end of break) and of pump circulation upon coolant flow in the core were studied. The following are the results: In the case of a smaller break on the steam generator side, core cooling was achieved due to upward coolant flow in the core and early reflooding by ACC water injected into the cold leg. In the case of a smaller break area on the vessel side, on the other hand, coolant flow in the core was stagnant and the heater rods were mostly exposed to steam, so that core cooling was not as good. Effect of the coolant circulation by acting pump on the core cooling during a blowdown was not significant except that in a steam generator side small break the core cooling was improved. (auth.)

  9. Alexander's disease in a neurologically normal child: a case report

    International Nuclear Information System (INIS)

    Guthrie, Scott O.; Knowles, Paul; Marshall, Robert; Burton, Edward M.

    2003-01-01

    We report the clinical and MRI findings of symmetric hyperintensity involving the deep and subcortical white matter of the frontal lobes in a neurologically normal child with macrocephaly. In this patient, a serum test for mutations in glial fibrillary acidic protein, used to diagnose Alexander's disease (AD), was positive. This case indicates an extraordinarily mild or early form of juvenile-onset AD. (orig.)

  10. SMAP Impact Analysis of Early Adopter Research-Two Case studies on the scientific and societal benefits of SMAP data

    Science.gov (United States)

    Escobar, V. M.; Wu, H. T.; Moran, S.; O'Neill, P. E.

    2016-12-01

    To document and evaluate the use of SMAP science products in applications, the SMAP Phase E Applications Plan proposes to "conduct case studies to address a basic question: How are SMAP science products used in decision support systems and how does the new data stream affect the system performance?" The objective is to determine the value of SMAP data to the six categories of applications based on Early Adopters' experiences, where value is defined as the scientific and/or societal benefit. Since SMAP is the first mission with a pre-launch Early Adopter Program, the post-launch case study is also unprecedented. In this talk, we will show some results of the SMAP Early Adopters, with focus on the two case studies in the applications of agriculture and weather forecasting, respectively. For agriculture, we will show the work of USDA/NASS (National Agriculture Statistics Service) scientists (Zhengwei Yang and Rick Mueller). Using SMAP soil moisture products, they have been working on the establishment of a visualization, analytics, and dissemination tool to support and improve US national crop condition monitoring. Scientifically, this study will improve our understanding on the impact of crop canopy on the SMAP SM retrieval and on the mapping relation between SMAP SM and NASS soil moisture survey results. Socio-economically, the use of SMAP data and web-based tool will improve the consistency, reliability, objectivity, and efficiency of cropland soil moisture monitoring and assessment, which will benefit the current end users of the NASS weekly report including farmers, insurance companies, and financial institutes. For weather, we will show the work of NOAA scientists (Xiwu Zhan, Weizhong Zheng, and Mike Ek) on the transition of NASA SMAP research products to NOAA operational numerical weather and seasonal climate predictions and research hydrological forecasts. Results of initial analyses and validation of the assimilation of SMAP soil moisture in NOAA's Global

  11. [Septic thrombophlebitis of the portal vein (pylephlebitis): diagnosis and management of three cases].

    Science.gov (United States)

    Arteche, E; Ostiz, S; Miranda, L; Caballero, P; Jiménez López de Oñate, G

    2005-01-01

    Pylephlebitis is thrombophlebitis of the portal vein and/or of its branches; it is acute and generally arises as a complication of inflammatory intra-abdominal processes or of surgical interventions in patients with blood discrasies. As its clinical picture is fairly non-specific, radiological findings, while not pathognomonic, are of great use in early diagnosis and improved vital prognosis of these patients. The aims of this study are to review the pathophysiology of this entity and its clinical and radiological presentation, which allow for early clinical suspicion. Three cases of pylephlebitis are presented, two of them post-surgical, in which the only common clinical data for suspicion were the febricula and leucocytosis. Diagnosis was obtained from the finding of helicoidal computer tomography with IV contrast - Somaton Siemens - and abdominal echography - Ellegra Siemens - carried out on the three. The result of these tests was decisive for an early diagnosis, efficient treatment and satisfactory evolution in the three cases. We wish to emphasize the importance of clinical suspicion and early radiology for an early diagnosis of this entity, which make it possible to establish an efficient treatment.

  12. DiagTest3Grp: An R Package for Analyzing Diagnostic Tests with Three Ordinal Groups

    Directory of Open Access Journals (Sweden)

    Jingqin Luo

    2012-10-01

    Full Text Available Medical researchers endeavor to identify potentially useful biomarkers to develop marker-based screening assays for disease diagnosis and prevention. Useful summary measures which properly evaluate the discriminative ability of diagnostic markers are critical for this purpose. Literature and existing software, for example, R packages nicely cover summary measures for diagnostic markers used for the binary case (e.g., healthy vs. diseased. An intermediate population at an early disease stage usually exists between the healthy and the fully diseased population in many disease processes. Supporting utilities for three-group diagnostic tests are highly desired and important for identifying patients at the early disease stage for timely treatments. However, application packages which provide summary measures for three ordinal groups are currently lacking. This paper focuses on two summary measures of diagnostic accuracy—volume under the receiver operating characteristic surface and the extended Youden index, with three diagnostic groups. We provide the R package DiagTest3Grp to estimate, under both parametric and nonparametric assumptions, the two summary measures and the associated variances, as well as the optimal cut-points for disease diagnosis. An omnibus test for multiple markers and a Wald test for two markers, on independent or paired samples, are incorporated to compare diagnostic accuracy across biomarkers. Sample size calculation under the normality assumption can be performed in the R package to design future diagnostic studies. A real world application evaluating the diagnostic accuracy of neuropsychological markers for Alzheimer’s disease is used to guide readers through step-by-step implementation of DiagTest3Grp to demonstrate its utility.

  13. Post-mortem diagnostics in cases of sepsis. Part 1. Aetiology, epidemiology and microbiological tests

    Directory of Open Access Journals (Sweden)

    Marta Rorat

    2015-03-01

    Full Text Available Clinical practice has an effective methodology of diagnostic procedures to be followed in cases of sepsis. However, there are as yet no corresponding standards of action in post-mortem diagnostics. The scope of examinations is limited to an autopsy and histopathological tests. This situation may lead to errors in medico-legal opinions on the cause of death and in the assessment of appropriateness of medical procedures. In cases of suspected sepsis, medico-legal investigations require obtaining detailed information about the circumstances of death (including symptoms and results of intravital examinations before autopsy is performed, as well as sterile collection of specimens for microbiological tests and interpretation of their results on the basis of knowledge of epidemiology, pathophysiology and clinical progression of sepsis.

  14. Genetic Testing Confirmed the Early Diagnosis of X-Linked Hypophosphatemic Rickets in a 7-Month-Old Infant

    Directory of Open Access Journals (Sweden)

    Kok Siong Poon BSc

    2015-08-01

    Full Text Available Loss-of-function mutations in the p hosphate regulating gene with h omologies to e ndopeptidases on the X -chromosome ( PHEX have been causally associated with X-linked hypophosphatemic rickets (XLHR. The early diagnosis of XLHR in infants is challenging when it is based solely on clinical features and biochemical findings. We report a 7-month-old boy with a family history of hypophosphatemic rickets., who demonstrated early clinical evidence of rickets, although serial biochemical findings could not definitively confirm rickets. A sequencing assay targeting the PHEX gene was first performed on the mother’s DNA to screen for mutations in the 5′UTR, 22 coding exons, and the exon-intron junctions. Targeted mutation analysis and mRNA studies were subsequently performed on the boys’ DNA to investigate the pathogenicity of the identified mutation. Genetic screening of the PHEX gene revealed a novel mutation, c.1080-2A>C, at the splice acceptor site in intron 9. The detection of an aberrant mRNA transcript with skipped (loss of exon 10 establishes its pathogenicity and confirms the diagnosis of XLHR in this infant. Genetic testing of the PHEX gene resulted in early diagnosis of XLHR, thus enabling initiation of therapy and prevention of progressive rachitic changes in the infant.

  15. Blueprint of quartz crystal microbalance biosensor for early detection of breast cancer through salivary autoantibodies against ATP6AP1.

    Science.gov (United States)

    Arif, Sania; Qudsia, Syeda; Urooj, Samina; Chaudry, Nazia; Arshad, Aneeqa; Andleeb, Saadia

    2015-03-15

    Breast cancer represents a significant health problem because of its high prevalence. Tests like mammography, which are used abundantly for the detection of breast cancer, suffer from serious limitations. Mammography correctly detects malignancy about 80-90% of the times, failing in places when (1) the tumor is small at early stage, (2) breast tissue is dense or (3) in women of less than 40 years. Serum-based detection of biomarkers involves risk of disease transfer, along with other concerns. These techniques compromise in the early detection of breast cancer. Early detection of breast cancer is a crucial factor to enhance the survival rate of patient. Development of regular screening tests for early diagnosis of breast cancer is a challenge. This review highlights the design of a handy and household biosensor device aimed for self-screening and early diagnosis of breast cancer. The design makes use of salivary autoantibodies for specificity to develop a noninvasive procedure, breast cancer specific biomarkers for precision for the development of device, and biosensor technology for sensitivity to screen the early cases of breast cancer more efficiently. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Pulsar perimetry in the diagnosis of early glaucoma.

    Science.gov (United States)

    Zeppieri, Marco; Brusini, Paolo; Parisi, Lucia; Johnson, Chris A; Sampaolesi, Roberto; Salvetat, Maria Letizia

    2010-01-01

    To assess the ability of Pulsar perimetry (Pulsar) in detecting early glaucomatous visual field (VF) damage in comparison with Frequency Doubling Technology (FDT), Scanning Laser Polarimetry (SLP, GDx VCC), and Heidelberg Retina Tomography (HRT). Prospective observational cross-sectional case study. This multicenter study included: 87 ocular hypertensives (OHT); 67 glaucomatous optic neuropathy (GON) patients; 75 primary open-angle glaucoma (POAG) patients; and 90 normals. All patients underwent standard automated perimetry (SAP) HFA 30-2, Pulsar T30W, FDT N-30, HRT II, and GDx VCC. Area under Receiver Operating Characteristic Curves (AROCs) for discriminating between healthy and glaucomatous eyes and agreement among instruments were determined. The best parameters for Pulsar, FDT, HRT, and GDx were, respectively: loss variance square root; no. of areas with PPulsar (AROC, 0.90) appeared comparable with FDT (0.89) and significantly better than HRT (0.82) and GDx (0.79). For GON, Pulsar ability (0.74) was higher than GDx (0.69) and lower than FDT (0.80) and HRT (0.83). The agreement among instruments ranged from 0.12 to 0.56. Pulsar test duration was significantly shorter than SAP and FDT (PPulsar T30W test is a rapid and easy perimetric method, showing higher sensitivity than SAP in detecting early glaucomatous VF loss. Its diagnostic ability is good for detecting early perimetric POAG eyes and fair for GON eyes. Pulsar performance was comparable with FDT, HRT, and GDx, even if the agreement between instruments was poor to fair. Copyright 2010 Elsevier Inc. All rights reserved.

  17. Typhidot M and Diazo test vis-à-vis blood culture and Widal test in the early diagnosis of typhoid fever in children in a resource poor setting.

    Science.gov (United States)

    Beig, Farzana K; Ahmad, Faraz; Ekram, Mohd; Shukla, Indu

    2010-01-01

    Typhoid fever is a major public health problem. A test which is simple, reliable and can be carried out in small laboratories is the need of the hour. We prospectively evaluated typhidot M and Diazo tests vis-à-vis blood culture and Widal test in children. Patients aged 6 months to 12 years, having fever of more than four days duration with clinical suspicion of typhoid fever were enrolled. Patients in whom other diagnosis was made served as control. The tests under scrutiny were validated against blood culture and then all the four tests were evaluated among patients who presented in the first week of illness. Blood culture was positive in only 27.3% of the cases. Among these culture positive cases, typhidot M test had the highest sensitivity, specificity, PPV and NPV of 90% (95% CI = 74.4-96.5), 100% (95% CI = 90.1-100), 100% (95% CI = 87.5-100), and 92.1% (95% CI = 79.2-97.3) respectively. Diazo test ranked next with sensitivity, specificity, PPV and NPV of 86.7% (95% CI = 70.3-94.7), 85.7% (95% CI = 70.6-93.7), 83.9% (95% CI = 67.4-92.9), 88.2% (95% CI = 73.4-95.3) respectively. Among clinically suspected typhoid cases, the overall sensitivity, of blood culture, Widal, typhidot M, Diazo was 27.3% (95% CI = 19.8- 36.3), 64.6% (95% CI = 55.3-72.9), 89.1% (95% CI = 81.9-93.7), 80.9% (95% CI = 72.6-87.2) respectively. In the first week of illness, typhidot M showed the best sensitivity [86.2% (95% CI = 69.4-94.5)] followed by Diazo [79% (95% CI = 61.6-90.2)], Widal [41.4% (95% CI = 25.5-59.3)] and blood culture [31% (95% CI = 17.3-49.2)]. Both Typhidot M and Diazo are good screening tests for the diagnosis of typhoid fever. Typhidot M is superior to Diazo but the latter is more suitable to resource poor settings being economic and easy to perform.

  18. Early life stress paradigms in rodents: potential animal models of depression?

    Science.gov (United States)

    Schmidt, Mathias V; Wang, Xiao-Dong; Meijer, Onno C

    2011-03-01

    While human depressive illness is indeed uniquely human, many of its symptoms may be modeled in rodents. Based on human etiology, the assumption has been made that depression-like behavior in rats and mice can be modulated by some of the powerful early life programming effects that are known to occur after manipulations in the first weeks of life. Here we review the evidence that is available in literature for early life manipulation as risk factors for the development of depression-like symptoms such as anhedonia, passive coping strategies, and neuroendocrine changes. Early life paradigms that were evaluated include early handling, separation, and deprivation protocols, as well as enriched and impoverished environments. We have also included a small number of stress-related pharmacological models. We find that for most early life paradigms per se, the actual validity for depression is limited. A number of models have not been tested with respect to classical depression-like behaviors, while in many cases, the outcome of such experiments is variable and depends on strain and additional factors. Because programming effects confer vulnerability rather than disease, a number of paradigms hold promise for usefulness in depression research, in combination with the proper genetic background and adult life challenges.

  19. Utility of Post-Mortem Genetic Testing in Cases of Sudden Arrhythmic Death Syndrome

    NARCIS (Netherlands)

    Lahrouchi, Najim; Raju, Hariharan; Lodder, Elisabeth M.; Papatheodorou, Efstathios; Ware, James S.; Papadakis, Michael; Tadros, Rafik; Cole, Della; Skinner, Jonathan R.; Crawford, Jackie; Love, Donald R.; Pua, Chee J.; Soh, Bee Y.; Bhalshankar, Jaydutt D.; Govind, Risha; Tfelt-Hansen, Jacob; Winkel, Bo G.; van der Werf, Christian; Wijeyeratne, Yanushi D.; Mellor, Greg; Till, Jan; Cohen, Marta C.; Tome-Esteban, Maria; Sharma, Sanjay; Wilde, Arthur A. M.; Cook, Stuart A.; Bezzina, Connie R.; Sheppard, Mary N.; Behr, Elijah R.

    2017-01-01

    Sudden arrhythmic death syndrome (SADS) describes a sudden death with negative autopsy and toxicological analysis. Cardiac genetic disease is a likely etiology. This study investigated the clinical utility and combined yield of post-mortem genetic testing (molecular autopsy) in cases of SADS and

  20. Influenza outbreak during Sydney World Youth Day 2008: the utility of laboratory testing and case definitions on mass gathering outbreak containment.

    Directory of Open Access Journals (Sweden)

    Sebastiaan J van Hal

    Full Text Available BACKGROUND: Influenza causes annual epidemics and often results in extensive outbreaks in closed communities. To minimize transmission, a range of interventions have been suggested. For these to be effective, an accurate and timely diagnosis of influenza is required. This is confirmed by a positive laboratory test result in an individual whose symptoms are consistent with a predefined clinical case definition. However, the utility of these clinical case definitions and laboratory testing in mass gathering outbreaks remains unknown. METHODS AND RESULTS: An influenza outbreak was identified during World Youth Day 2008 in Sydney. From the data collected on pilgrims presenting to a single clinic, a Markov model was developed and validated against the actual epidemic curve. Simulations were performed to examine the utility of different clinical case definitions and laboratory testing strategies for containment of influenza outbreaks. Clinical case definitions were found to have the greatest impact on averting further cases with no added benefit when combined with any laboratory test. Although nucleic acid testing (NAT demonstrated higher utility than indirect immunofluorescence antigen or on-site point-of-care testing, this effect was lost when laboratory NAT turnaround times was included. The main benefit of laboratory confirmation was limited to identification of true influenza cases amenable to interventions such as antiviral therapy. CONCLUSIONS: Continuous re-evaluation of case definitions and laboratory testing strategies are essential for effective management of influenza outbreaks during mass gatherings.

  1. A Modified Murine Embryonic Stem Cell Test for Evaluating the Teratogenic Effects of Drugs on Early Embryogenesis.

    Directory of Open Access Journals (Sweden)

    Ruoxing Yu

    Full Text Available Mammalian fetal development is easily disrupted by exogenous agents, making it essential to test new drug candidates for embryotoxicity and teratogenicity. To standardize the testing of drugs that might be used to treat pregnant women, the U.S. Food and Drug Administration (FDA formulated special grade categories, labeled A, B, C, D and X, that define the level of risk associated with the use of a specific drug during pregnancy. Drugs in categories (Cat. D and X are those with embryotoxic and/or teratogenic effects on humans and animals. However, which stages of pregnancy are affected by these agents and their molecular mechanisms are unknown. We describe here an embryonic stem cell test (EST that classifies FDA pregnancy Cat.D and Cat.X drugs into 4 classes based on their differing effects on primitive streak formation. We show that ~84% of Cat.D and Cat.X drugs target this period of embryogenesis. Our results demonstrate that our modified EST can identify how a drug affects early embryogenesis, when it acts, and its molecular mechanism. Our test may thus be a useful addition to the drug safety testing armamentarium.

  2. Strategy for a Rock Mechanics Site Descriptive Model. A test case based on data from the Aespoe HRL

    International Nuclear Information System (INIS)

    Hudson, John A

    2002-06-01

    In anticipation of the SKB Site Investigations for radioactive waste disposal, an approach has been developed for the Rock Mechanics Site Descriptive Model. This approach was tested by predicting the rock mechanics properties of a 600 m x 180 m x 120 m rock volume at the Aespoe Hard Rock Laboratory (HRL) using limited borehole data of the type typically obtained during a site investigation. These predicted properties were then compared with 'best estimate' properties obtained from a study of the test rock volume using additional information, mainly tunnel data. The exercise was known as the Test Case, and is the subject of this Report. Three modelling techniques were used to predict the rock properties: the 'empirical approach' - the rock properties were estimated using rock mass classification schemes and empirical correlation formulae; the 'theoretical approach' - the rock properties were estimated using numerical modelling techniques; and the 'stress approach' - the rock stress state was estimated using primary data and numerical modelling. These approaches are described separately and respectively. Following an explanation of the context for the Test Case within the strategy for developing the Rock Mechanics Site Descriptive Model, conditions at the Aespoe HRL are described in Chapter 2. The Test Case organization and the suite of nine Protocols used to ensure that the work was appropriately guided and co-ordinated are described in Chapter 3. The methods for predicting the rock properties and the rock stress, and comparisons with the 'best estimate' properties of the actual conditions, are presented in Chapters 4 and 5. Finally, the conclusions from this Test Case exercise are given in Chapter 6. General recommendations for the management of this type of Test Case are also included

  3. Strategy for a Rock Mechanics Site Descriptive Model. A test case based on data from the Aespoe HRL

    Energy Technology Data Exchange (ETDEWEB)

    Hudson, John A (ed.) [Rock Engineering Consultants, Welwyn Garden City (United Kingdom)

    2002-06-01

    In anticipation of the SKB Site Investigations for radioactive waste disposal, an approach has been developed for the Rock Mechanics Site Descriptive Model. This approach was tested by predicting the rock mechanics properties of a 600 m x 180 m x 120 m rock volume at the Aespoe Hard Rock Laboratory (HRL) using limited borehole data of the type typically obtained during a site investigation. These predicted properties were then compared with 'best estimate' properties obtained from a study of the test rock volume using additional information, mainly tunnel data. The exercise was known as the Test Case, and is the subject of this Report. Three modelling techniques were used to predict the rock properties: the 'empirical approach' - the rock properties were estimated using rock mass classification schemes and empirical correlation formulae; the 'theoretical approach' - the rock properties were estimated using numerical modelling techniques; and the 'stress approach' - the rock stress state was estimated using primary data and numerical modelling. These approaches are described separately and respectively. Following an explanation of the context for the Test Case within the strategy for developing the Rock Mechanics Site Descriptive Model, conditions at the Aespoe HRL are described in Chapter 2. The Test Case organization and the suite of nine Protocols used to ensure that the work was appropriately guided and co-ordinated are described in Chapter 3. The methods for predicting the rock properties and the rock stress, and comparisons with the 'best estimate' properties of the actual conditions, are presented in Chapters 4 and 5. Finally, the conclusions from this Test Case exercise are given in Chapter 6. General recommendations for the management of this type of Test Case are also included.

  4. Maternal separation with early weaning: a novel mouse model of early life neglect

    Directory of Open Access Journals (Sweden)

    Elwafi Hani M

    2010-09-01

    Full Text Available Abstract Background Childhood adversity is associated with increased risk for mood, anxiety, impulse control, and substance disorders. Although genetic and environmental factors contribute to the development of such disorders, the neurobiological mechanisms involved are poorly understood. A reliable mouse model of early life adversity leading to lasting behavioral changes would facilitate progress in elucidating the molecular mechanisms underlying these adverse effects. Maternal separation is a commonly used model of early life neglect, but has led to inconsistent results in the mouse. Results In an effort to develop a mouse model of early life neglect with long-lasting behavioral effects in C57BL/6 mice, we designed a new maternal separation paradigm that we call Maternal Separation with Early Weaning (MSEW. We tested the effects of MSEW on C57BL/6 mice as well as the genetically distinct DBA/2 strain and found significant MSEW effects on several behavioral tasks (i.e., the open field, elevated plus maze, and forced swim test when assessed more than two months following the MSEW procedure. Our findings are consistent with MSEW causing effects within multiple behavioral domains in both strains, and suggest increased anxiety, hyperactivity, and behavioral despair in the MSEW offspring. Analysis of pup weights and metabolic parameters showed no evidence for malnutrition in the MSEW pups. Additionally, strain differences in many of the behavioral tests suggest a role for genetic factors in the response to early life neglect. Conclusions These results suggest that MSEW may serve as a useful model to examine the complex behavioral abnormalities often apparent in individuals with histories of early life neglect, and may lead to greater understanding of these later life outcomes and offer insight into novel therapeutic strategies.

  5. Origin of honeycombs: Testing the hydraulic and case hardening hypotheses

    Science.gov (United States)

    Bruthans, Jiří; Filippi, Michal; Slavík, Martin; Svobodová, Eliška

    2018-02-01

    Cavernous weathering (cavernous rock decay) is a global phenomenon, which occurs in porous rocks around the world. Although honeycombs and tafoni are considered to be the most common products of this complex process, their origin and evolution are as yet not fully understood. The two commonly assumed formation hypotheses - hydraulic and case hardening - were tested to elucidate the origin of honeycombs on sandstone outcrops in a humid climate. Mechanical and hydraulic properties of the lips (walls between adjacent pits) and backwalls (bottoms of pits) of the honeycombs were determined via a set of established and novel approaches. While the case hardening hypothesis was not supported by the determinations of either tensile strength, drilling resistance or porosity, the hydraulic hypothesis was clearly supported by field measurements and laboratory tests. Fluorescein dye visualization of capillary zone, vapor zone, and evaporation front upon their contact, demonstrated that the evaporation front reaches the honeycomb backwalls under low water flow rate, while the honeycomb lips remain dry. During occasional excessive water flow events, however, the evaporation front may shift to the lips, while the backwalls become moist as a part of the capillary zone. As the zone of evaporation corresponds to the zone of potential salt weathering, it is the spatial distribution of the capillary and vapor zones which dictates whether honeycombs are created or the rock surface is smoothed. A hierarchical model of factors related to the hydraulic field was introduced to obtain better insights into the process of cavernous weathering.

  6. Comparative evaluation of two rapid Salmonella-IgM tests and blood culture in the diagnosis of enteric fever.

    Science.gov (United States)

    Prasad, K J; Oberoi, J K; Goel, N; Wattal, C

    2015-01-01

    Enteric fever is a major public health problem in developing countries like India. An early and accurate diagnosis is necessary for a prompt and effective treatment. We have evaluated the diagnostic accuracy of two Rapid Salmonella-IgM tests (Typhidot-IgM and Enteroscreen-IgM) as compared to blood culture in rapid and early diagnosis of enteric fever. A total of 2,699 patients' serum samples were tested by Rapid Salmonella-IgM tests and blood culture. Patients were divided into two groups. Test group - patients with enteric fever and blood culture positives for Salmonella Typhi; and three types of Controls, i.e. patients with non-enteric fever illnesses, normal healthy controls and patients positive for S. Paratyphi- A. In addition to this we have also evaluated the significance of positive Salmonella-IgM tests among blood culture-negative cases. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the Typhidot-IgM test and Enteroscreen-IgM test considering blood culture as gold standard were 97.29% and 88.13%, 97.40% and 87.83%, 98.18% and 92.03%, 96.15% and 82.27%, respectively. Typhidot-IgM test was found to be significantly more sensitive and specific as compared to Enteroscreen-IgM. Among blood culture-negative patients, Rapid Salmonella-IgM tests detected 72.25% additional cases of enteric fever. Although the Rapid Salmonella-IgM tests are meant to diagnose S. Typhi only, but these tests detect S. Paratyphi- A also. Thirty-eight patients who were blood culture-positive for S. Paratyphi- A were also positive by Rapid Salmonella-IgM tests. Rapid Salmonella-IgM tests offer an advantage of increased sensitivity, rapidity, early diagnosis and simplicity over blood culture.

  7. Informed Choice in Direct-to-Consumer Genetic Testing for Alzheimer and Other Diseases: Lessons from Two Cases.

    Science.gov (United States)

    Messner, Donna A

    2011-01-01

    Health-related direct-to-consumer (DTC) genetic testing has been a controversial practice. Especially problematic is predictive testing for Alzheimer disease (AD), since the disease is incurable, prevention is inconclusive, and testing does not definitively predict an individual's future disease status. In this paper, I examine two contrasting cases of subjects who learn through genetic testing that they have an elevated risk of developing AD later in life. In these cases, the subject's emotional response to the result is related to how well prepared she was for the real-life personal implications of possible test results. Analysis leads to the conclusion that when groups of health-related genetic tests are offered as packages by DTC companies, informed consumer choice is rendered impossible. Moreover, I argue, this marketing approach contravenes U.S. Federal Trade Commission policies for non-deceptive commercial communications. I conclude by suggesting ways to improve the prospects for informed consumer choice in DTC testing.

  8. Emergency Preparedness. HERCA-Approach for a better cross-border coordination of protective actions during the response in the early phase of a nuclear accident; development and practical testing

    International Nuclear Information System (INIS)

    Aaltonen, Hannele; Kuusi, Antero; Bijlholt, Jette; Calvaro, Jose-Manuel Martin; Mozas Garcia, Alfredo; Constantinou, Costas; Janssens, Augustin; ); Degueldre, Didier; Vandecasteele, Christian; Willems, Petra; Djounova, Jana; Fueloep, Nandor; Gering, Florian; Lieser, Joachim; Halldorsson, Oskar; Haywood, Stephanie; Hofer, Peter; Holo, Eldri; Hubbard, Lynn; Lindh, Karin; Isnard, Olivier; Kuhlen, Johannes; Rother, Wolfram; Lachaume, Jean-Luc; Perrin, Marie-Line; Xicluna, Delphine; Majerus, Patrick; McMahon, Ciara; Murith, Christophe; Nizamska, Marina; Rauber, Dominique; Rusch, Ronald; Stahl, Thorsten; Stephen, Patrick; Tkavc, Marjan; Van Gelder, Iris

    2014-06-01

    The HERCA-Approach on emergencies relies on the following principles: mutual understanding, coordination and mutual trust. It does not aim at proposing a uniform cross border framework to deal with such situations. The main strategy is to aim at an alignment of the response between neighbouring countries, or neighbouring territories. The HERCA-Approach comprises mechanisms of early information exchanges allowing neighbouring countries to align measures for protective actions by using as far as possible the existing dedicated bilateral and international arrangements. The HERCA-Approach is divided into 3 steps, the preparedness phase, the early phase and the later phase (development of a common situation report). The approach contains the main principles and leaves necessary margins of freedom for detailed implementation: - In preparedness the aim is to achieve and maintain a shared understanding of the existing national emergency arrangements through the improvement of bilateral or multilateral arrangements, the testing of these arrangements and the implementation of improvements. - In the early phase of an accident, the proposed HERCA-Approach foresees rapid information exchanges by using as far as possible the existing dedicated bilateral and international arrangements, including the exchange of liaison officers as appropriate. If the response is thought consistent, the neighbouring countries can recommend to their governments to follow these recommendations, i.e. adopt the principle that in the first hours, 'we do the same as the accident country'. - In the later phase a common situation report, accepted by all impacted countries, will further support coordinated protective actions. The HERCA-Approach has been tested and validated against concrete and realistic accident scenarios in NPPs that are close enough to national borders. Therefore a workshop was organized in September 2013. The workshop showed that in case of a sufficient information exchange most

  9. Seismic waveform inversion best practices: regional, global and exploration test cases

    Science.gov (United States)

    Modrak, Ryan; Tromp, Jeroen

    2016-09-01

    Reaching the global minimum of a waveform misfit function requires careful choices about the nonlinear optimization, preconditioning and regularization methods underlying an inversion. Because waveform inversion problems are susceptible to erratic convergence associated with strong nonlinearity, one or two test cases are not enough to reliably inform such decisions. We identify best practices, instead, using four seismic near-surface problems, one regional problem and two global problems. To make meaningful quantitative comparisons between methods, we carry out hundreds of inversions, varying one aspect of the implementation at a time. Comparing nonlinear optimization algorithms, we find that limited-memory BFGS provides computational savings over nonlinear conjugate gradient methods in a wide range of test cases. Comparing preconditioners, we show that a new diagonal scaling derived from the adjoint of the forward operator provides better performance than two conventional preconditioning schemes. Comparing regularization strategies, we find that projection, convolution, Tikhonov regularization and total variation regularization are effective in different contexts. Besides questions of one strategy or another, reliability and efficiency in waveform inversion depend on close numerical attention and care. Implementation details involving the line search and restart conditions have a strong effect on computational cost, regardless of the chosen nonlinear optimization algorithm.

  10. Bottom-up laboratory testing of the DKIST Visible Broadband Imager (VBI)

    Science.gov (United States)

    Ferayorni, Andrew; Beard, Andrew; Cole, Wes; Gregory, Scott; Wöeger, Friedrich

    2016-08-01

    The Daniel K. Inouye Solar Telescope (DKIST) is a 4-meter solar observatory under construction at Haleakala, Hawaii [1]. The Visible Broadband Imager (VBI) is a first light instrument that will record images at the highest possible spatial and temporal resolution of the DKIST at a number of scientifically important wavelengths [2]. The VBI is a pathfinder for DKIST instrumentation and a test bed for developing processes and procedures in the areas of unit, systems integration, and user acceptance testing. These test procedures have been developed and repeatedly executed during VBI construction in the lab as part of a "test early and test often" philosophy aimed at identifying and resolving issues early thus saving cost during integration test and commissioning on summit. The VBI team recently completed a bottom up end-to-end system test of the instrument in the lab that allowed the instrument's functionality, performance, and usability to be validated against documented system requirements. The bottom up testing approach includes four levels of testing, each introducing another layer in the control hierarchy that is tested before moving to the next level. First the instrument mechanisms are tested for positioning accuracy and repeatability using a laboratory position-sensing detector (PSD). Second the real-time motion controls are used to drive the mechanisms to verify speed and timing synchronization requirements are being met. Next the high-level software is introduced and the instrument is driven through a series of end-to-end tests that exercise the mechanisms, cameras, and simulated data processing. Finally, user acceptance testing is performed on operational and engineering use cases through the use of the instrument engineering graphical user interface (GUI). In this paper we present the VBI bottom up test plan, procedures, example test cases and tools used, as well as results from test execution in the laboratory. We will also discuss the benefits realized

  11. Onset and relapse of psychiatric disorders following early breast cancer: a case-control study.

    Science.gov (United States)

    Gandubert, Catherine; Carrière, Isabelle; Escot, Chantal; Soulier, Maryvonne; Hermès, Aziz; Boulet, Patrick; Ritchie, Karen; Chaudieu, Isabelle

    2009-10-01

    Our objective is to evaluate the mental status of primary early breast cancer survivors according to DSM-IV criteria, distinguishing new psychiatric diagnosis, which started after the cancer diagnosis from relapse. A comparative study of 144 breast cancer survivors and 125 women without previous history of cancer was carried out. Neuropsychiatric symptomatology was assessed retrospectively using standardized psychiatric examinations (Mini International Neuropsychiatric Interview, Watson's Post-Traumatic Stress Disorder Inventory) over three successive periods, 'before cancer' (from childhood to 3 years before the interview), 'around the cancer event' (the last 3 years including the time of diagnosis and treatment), and 'currently' (the last 2 weeks). Increased rates of anxiety and mood disorders were observed following a diagnosis of breast cancer compared with controls (generalized anxiety disorder (GAD) and major depressive disorder (MDD); 10.4 vs 1.6% and 19.4 vs 8.8%, respectively). The cancer disease promoted the development of dysthymia (n=4 new cases/6 two-year prevalent cases) and PTSD (7/7) and the re-emergence of MDD (n=21 relapses/28 three-year prevalent cases) and GAD (10/15). No improvement in serious mood disorders such as MDD (16.0 vs 7.2%) and dysthymia (4.2 vs 0%) was reported at the time of interview, more than 1.75 years (median time) after the cancer surgery, the prevalence being 2-4 times greater in breast cancer survivors than in controls. Despite significant advances in treatment, a diagnosis of breast cancer is highly associated with various forms of psychopathology, regardless of psychiatric history, with symptoms persisting after treatment. These results may assist clinicians in planning mental healthcare for women with breast cancer.

  12. Uncertainties in Early-Stage Capital Cost Estimation of Process Design – A Case Study on Biorefinery Design

    International Nuclear Information System (INIS)

    Cheali, Peam; Gernaey, Krist V.; Sin, Gürkan

    2015-01-01

    Capital investment, next to the product demand, sales, and production costs, is one of the key metrics commonly used for project evaluation and feasibility assessment. Estimating the investment costs of a new product/process alternative during early-stage design is a challenging task, which is especially relevant in biorefinery research where information about new technologies and experience with new technologies is limited. A systematic methodology for uncertainty analysis of cost data is proposed that employs: (a) bootstrapping as a regression method when cost data are available; and, (b) the Monte Carlo technique as an error propagation method based on expert input when cost data are not available. Four well-known models for early-stage cost estimation are reviewed and analyzed using the methodology. The significance of uncertainties of cost data for early-stage process design is highlighted using the synthesis and design of a biorefinery as a case study. The impact of uncertainties in cost estimation on the identification of optimal processing paths is indeed found to be profound. To tackle this challenge, a comprehensive techno-economic risk analysis framework is presented to enable robust decision-making under uncertainties. One of the results using order-of-magnitude estimates shows that the production of diethyl ether and 1,3-butadiene are the most promising with the lowest economic risks (among the alternatives considered) of 0.24 MM$/a and 4.6 MM$/a, respectively.

  13. Uncertainties in Early Stage Capital Cost Estimation of Process Design – A case study on biorefinery design

    Directory of Open Access Journals (Sweden)

    Gurkan eSin

    2015-02-01

    Full Text Available Capital investment, next to the product demand, sales and production costs, is one of the key metrics commonly used for project evaluation and feasibility assessment. Estimating the investment costs of a new product/process alternative during early stage design is a challenging task. This is especially important in biorefinery research, where available information and experiences with new technologies is limited. A systematic methodology for uncertainty analysis of cost data is proposed that employs (a Bootstrapping as a regression method when cost data is available and (b the Monte Carlo technique as an error propagation method based on expert input when cost data is not available. Four well-known models for early stage cost estimation are reviewed an analyzed using the methodology. The significance of uncertainties of cost data for early stage process design is highlighted using the synthesis and design of a biorefinery as a case study. The impact of uncertainties in cost estimation on the identification of optimal processing paths is found to be profound. To tackle this challenge, a comprehensive techno-economic risk analysis framework is presented to enable robust decision making under uncertainties. One of the results using an order-of-magnitude estimate shows that the production of diethyl ether and 1,3-butadiene are the most promising with economic risks of 0.24 MM$/a and 4.6 MM$/a due to uncertainties in cost estimations, respectively.

  14. Uncertainties in Early-Stage Capital Cost Estimation of Process Design – A Case Study on Biorefinery Design

    Energy Technology Data Exchange (ETDEWEB)

    Cheali, Peam; Gernaey, Krist V.; Sin, Gürkan, E-mail: gsi@kt.dtu.dk [Department of Chemical and Biochemical Engineering, Technical University of Denmark, Lyngby (Denmark)

    2015-02-06

    Capital investment, next to the product demand, sales, and production costs, is one of the key metrics commonly used for project evaluation and feasibility assessment. Estimating the investment costs of a new product/process alternative during early-stage design is a challenging task, which is especially relevant in biorefinery research where information about new technologies and experience with new technologies is limited. A systematic methodology for uncertainty analysis of cost data is proposed that employs: (a) bootstrapping as a regression method when cost data are available; and, (b) the Monte Carlo technique as an error propagation method based on expert input when cost data are not available. Four well-known models for early-stage cost estimation are reviewed and analyzed using the methodology. The significance of uncertainties of cost data for early-stage process design is highlighted using the synthesis and design of a biorefinery as a case study. The impact of uncertainties in cost estimation on the identification of optimal processing paths is indeed found to be profound. To tackle this challenge, a comprehensive techno-economic risk analysis framework is presented to enable robust decision-making under uncertainties. One of the results using order-of-magnitude estimates shows that the production of diethyl ether and 1,3-butadiene are the most promising with the lowest economic risks (among the alternatives considered) of 0.24 MM$/a and 4.6 MM$/a, respectively.

  15. Phonological-Lexical Feedback during Early Abstract Encoding: The Case of Deaf Readers.

    Directory of Open Access Journals (Sweden)

    Manuel Perea

    Full Text Available In the masked priming technique, physical identity between prime and target enjoys an advantage over nominal identity in nonwords (GEDA-GEDA faster than geda-GEDA. However, nominal identity overrides physical identity in words (e.g., REAL-REAL similar to real-REAL. Here we tested whether the lack of an advantage of the physical identity condition for words was due to top-down feedback from phonological-lexical information. We examined this issue with deaf readers, as their phonological representations are not as fully developed as in hearing readers. Results revealed that physical identity enjoyed a processing advantage over nominal identity not only in nonwords but also in words (GEDA-GEDA faster than geda-GEDA; REAL-REAL faster than real-REAL. This suggests the existence of fundamental differences in the early stages of visual word recognition of hearing and deaf readers, possibly related to the amount of feedback from higher levels of information.

  16. Research and field tests of staged fracturing technology for casing deformation sections in horizontal shale gas wells

    Directory of Open Access Journals (Sweden)

    Shimeng Liao

    2018-02-01

    Full Text Available Horizontal shale gas well fracturing is mostly carried out by pumping bridge plugs. In the case of casing deformation, the bridge plug can not be pumped down to the designated position, so the hole sections below the deformation could not be stimulated according to the design program. About 30% of horizontal shale gas wells in the Changning and Weiyuan Blocks, Sichuan Basin, suffer various casing deformation after fracturing. Previously, the hole sections which could not be stimulated due to casing deformation were generally abandoned. As a result, the resources controlled by shale gas wells weren't exploited effectively and the fracturing effect was impacted greatly. There are a lot of difficulties in investigating casing deformation, such as complex mechanisms, various influencing factors and unpredictable deformation time. Therefore, it is especially important to seek a staged fracturing technology suitable for the casing deformation sections. In this paper, the staged fracturing technology with sand plugs inside fractures and the staged fracturing technology with temporary plugging balls were tested in casing deformation wells. The staged fracturing technology with sand plugs inside fractures was carried out in the mode of single-stage perforation and single-stage fracturing. The staged fracturing technology with temporary plugging balls was conducted in the mode of single perforation, continuous fracturing and staged ball dropping. Then, two kinds of technologies were compared in terms of their advantages and disadvantages. Finally, they were tested on site. According to the pressure response, the pressure monitoring of the adjacent wells and the microseismic monitoring in the process of actual fracturing, both technologies are effective in the stimulation of the casing deformation sections, realizing well control reserves efficiently and guaranteeing fracturing effects. Keywords: Shale gas, Horizontal well, Casing deformation, Staged

  17. Understanding minds: early cochlear implantation and the development of theory of mind in children with profound hearing impairment.

    Science.gov (United States)

    Sundqvist, Annette; Lyxell, Björn; Jönsson, Radoslava; Heimann, Mikael

    2014-03-01

    The present study investigates how auditory stimulation from cochlear implants (CI) is associated with the development of Theory of Mind (ToM) in severely and profoundly hearing impaired children with hearing parents. Previous research has shown that deaf children of hearing parents have a delayed ToM development. This is, however, not always the case with deaf children of deaf parents, who presumably are immersed in a more vivid signing environment. Sixteen children with CI (4.25 to 9.5 years of age) were tested on measures of cognitive and emotional ToM, language and cognition. Eight of the children received their first implant relatively early (before 27 months) and half of them late (after 27 months). The two groups did not differ in age, gender, language or cognition at entry of the study. ToM tests included the unexpected location task and a newly developed Swedish social-emotional ToM test. The tests aimed to test both cognitive and emotional ToM. A comparison group of typically developing hearing age matched children was also added (n=18). Compared to the comparison group, the early CI-group did not differ in emotional ToM. The late CI-group differed significantly from the comparison group on both the cognitive and emotional ToM tests. The results revealed that children with early cochlear implants solved ToM problems to a significantly higher degree than children with late implants, although the groups did not differ on language or cognitive measures at baseline. The outcome suggests that early cochlear implantation for deaf children in hearing families, in conjunction with early social and communicative stimulation in a language that is native to the parents, can provide a foundation for a more normalized ToM development. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Systemic non-albicans infections presented as meningitis in chronic hepatitis B patient: a case report

    Directory of Open Access Journals (Sweden)

    Wen-Jing Lv

    2014-12-01

    Full Text Available Non-albicans candida meningitis is a relatively rare disease, with nonspecific clinical manifestation, which makes the misdiagnosis occur sometimes, especially in the early stage of the disease. Abuse of broad-spectrum antibiotics, corticosteroids, central vein cannulas, senility, big operation, malignancy, and total parenteral alimentation were all the susceptible factors of non-albicans candida infection. We present a case of this type of non-albicans infection in a 42-year-old woman who was early misdiagnosed as tuberculous meningitis and was treated with antibiotics and antituberculosis agents. The diagnosis of non-albicans infection was confirmed by fungus culture of the cerebrospinal fluid (CSF with a low detectable rate. This case reminds us that the non-albicans candida meningitis had a nonspecific clinical presentations and laboratory data, and was difficult to differentiate from tuberculosis meningitis. Hence, we should highly suspect this disease if central nervous system infections with uncertain pathogens. Test cell counts; protein and fungus culture of CSF should be used to confirm the diagnosis. Once the diagnosis was established, the patients should receive antifungal treatment based on drug sensitivity tests as early as possible.

  19. Dengue NS1 Antigen - for Early Detection of Dengue Virus Infection

    Directory of Open Access Journals (Sweden)

    Amol Hartalkar

    2015-08-01

    Full Text Available Objectives: To evaluate the efficacy of NS1 antigen assay for early diagnosis of dengue virus infection in a tertiary care hospital. Methods: This cross sectional study was carried out in department of Medicine from August to December 2013. Total 100 patients with dengue fever were included. Complete blood count, alanine aminotransferase (ALT, aspartate aminotransferase (AST, Dengue NS1 antigen and IgM and IgG antibodies of dengue virus were done in all cases. Results: Of the 100 sera tested, 75% were positive for dengue virus infection based on dengue NS1 antigen, IgM antibody and IgG antibody. Dengue NS1 antigen and IgM, IgG antibody were able to detect dengue virus infection between day 1 to day 8 in 92% of samples, 86.7% of samples and 82.6% of samples respectively. Sixty nine percent (69% were found positive for dengue NS1 antigen, 65% were IgM positive and 62% were IgG positive. Based on the dengue NS1 antigen and IgM antibody combination, 74% were positive for dengue virus infections. Sensitivity of Dengue NS1 antigen was 92.3% and specificity of 74.28% in comparison to IgM antibody. Detection rate increased to 75%, based on the antigen and IgG antibody combination. Sensitivity of dengue NS1 antigen was 90.3% and specificity of 65.8% in comparison to IgG antibody. Conclusion: Dengue NS1 antigen is a useful, sensitive and specific test for early diagnosis of dengue virus infection and it improves diagnostic efficiency in combination with antibody test. Key words: Dengue fever, NS1 antigen. Introduction: Dengue fever (DF is the most common arboviral illness in humans. Each year, an estimated 50-100 million cases of dengue fever and 500,000 cases of dengue hemorrhagic fever occur worldwide, with 30000 deaths (mainly in children. Globally 2.5-3 billion people in approximately 112 tropical and subtropical countries are at risk of dengue.of samples respectively. Sixty nine percent (69% were found positive for dengue NS1 antigen, 65% were Ig

  20. A practical model-based statistical approach for generating functional test cases: application in the automotive industry

    OpenAIRE

    Awédikian , Roy; Yannou , Bernard

    2012-01-01

    International audience; With the growing complexity of industrial software applications, industrials are looking for efficient and practical methods to validate the software. This paper develops a model-based statistical testing approach that automatically generates online and offline test cases for embedded software. It discusses an integrated framework that combines solutions for three major software testing research questions: (i) how to select test inputs; (ii) how to predict the expected...