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Sample records for exercise procedural guide

  1. The 1991 Department of the Army Service Response Force exercise: Procedural Guide SRFX-91

    Energy Technology Data Exchange (ETDEWEB)

    Madore, M.A.; Thomson, R.S.; Haffenden, R.A.; Baldwin, T.E.; Meleski, S.A.

    1991-09-01

    This procedural guide was written to assist the US Army in planning for a chemical emergency exercise at Tooele Army Depot in Utah. The roles of various members of the emergency response community are described for various accident scenarios, and the relationships between the various responders are identified. For the June 1991 exercise at Tooele, the emergency response community includes the command structure at Tooele Army Depot; the US Army Service Response Force and other Department of Defense agencies; emergency response personnel from Tooele, Salt Lake, and Utah counties and municipal governments; the Utah Comprehensive Emergency Management Agency and other state agencies; and various federal agencies.

  2. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    In addition to a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry, this booklet includes information about radiation protection procedures for brachytherapy

  3. FFTF operations procedures preparation guide. Revision 2

    International Nuclear Information System (INIS)

    1976-12-01

    The Guide is intended to provide guidelines for the initial preparation of FFTF Operating Procedures. The Procedures Preparation Guide was developed from the plan presented and approved in the FFTF Reactor Plant Procedures Plan, PC-1, Revision 3

  4. Probabilistic safety analysis procedures guide

    International Nuclear Information System (INIS)

    Papazoglou, I.A.; Bari, R.A.; Buslik, A.J.

    1984-01-01

    A procedures guide for the performance of probabilistic safety assessment has been prepared for interim use in the Nuclear Regulatory Commission programs. The probabilistic safety assessment studies performed are intended to produce probabilistic predictive models that can be used and extended by the utilities and by NRC to sharpen the focus of inquiries into a range of tissues affecting reactor safety. This guide addresses the determination of the probability (per year) of core damage resulting from accident initiators internal to the plant and from loss of offsite electric power. The scope includes analyses of problem-solving (cognitive) human errors, a determination of importance of the various core damage accident sequences, and an explicit treatment and display of uncertainties for the key accident sequences. Ultimately, the guide will be augmented to include the plant-specific analysis of in-plant processes (i.e., containment performance) and the risk associated with external accident initiators, as consensus is developed regarding suitable methodologies in these areas. This guide provides the structure of a probabilistic safety study to be performed, and indicates what products of the study are essential for regulatory decision making. Methodology is treated in the guide only to the extent necessary to indicate the range of methods which is acceptable; ample reference is given to alternative methodologies which may be utilized in the performance of the study

  5. INDUSTRIAL RADIOGRAPHY STUDENT GUIDE AND LABORATORY EXERCISES.

    Science.gov (United States)

    Bureau of Adult, Vocational, and Technical Education (DHEW/OE), Washington, DC. Div. of Vocational and Technical Education.

    THIS INSTRUCTOR'S GUIDE TO AN 80-HOUR COURSE IN INDUSTRIAL RADIOGRAPHY IS COORDINATED WITH LESSONS IN THE STUDENT GUIDE AND LABORATORY EXERCISES AND IS BASED ON MATERIAL IN THE COURSE MANUAL, INDUSTRIAL RADIOGRAPHY. THE COURSE IS INTENDED TO TRAIN HIGH SCHOOL GRADUATES AS BEGINNING RADIOGRAPHERS WHO ARE EXPECTED TO BE ABLE TO EXTEND THEIR…

  6. Manual on brachytherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to brachytherapy: its application and procedures guides

  7. Procedures of Exercise Physiology Laboratories

    Science.gov (United States)

    Bishop, Phillip A.; Fortney, Suzanne; Greenisen, Michael; Siconolfi, Steven F.; Bamman, Marcas M.; Moore, Alan D., Jr.; Squires, William

    1998-01-01

    This manual describes the laboratory methods used to collect flight crew physiological performance data at the Johnson Space Center. The Exercise Countermeasures Project Laboratory is a standard physiology laboratory; only the application to the study of human physiological adaptations to spaceflight is unique. In the absence of any other recently published laboratory manual, this manual should be a useful document staffs and students of other laboratories.

  8. Image-guided procedures in brain biopsy.

    Science.gov (United States)

    Fujita, K; Yanaka, K; Meguro, K; Narushima, K; Iguchi, M; Nakai, Y; Nose, T

    1999-07-01

    Image-guided procedures, such as computed tomography (CT)-guided stereotactic and ultrasound-guided methods, can assist neurosurgeons in localizing the relevant pathology. The characteristics of image-guided procedures are important for their appropriate use, especially in brain biopsy. This study reviewed the results of various image-guided brain biopsies to ascertain the advantages and disadvantages. Brain biopsies assisted by CT-guided stereotactic, ultrasound-guided, Neuronavigator-guided, and the combination of ultrasound and Neuronavigator-guided procedures were carried out in seven, eight, one, and three patients, respectively. Four patients underwent open biopsy without a guiding system. Twenty of 23 patients had a satisfactory diagnosis after the initial biopsy. Three patients failed to have a definitive diagnosis after the initial procedure, one due to insufficient volume sampling after CT-guided procedure, and two due to localization failure by ultrasound because the lesions were nonechogenic. All patients who underwent biopsy using the combination of ultrasound and Neuronavigator-guided methods had a satisfactory result. The CT-guided procedure provided an efficient method of approaching any intracranial target and was appropriate for the diagnosis of hypodense lesions, but tissue sampling was sometimes not sufficient to achieve a satisfactory diagnosis. The ultrasound-guided procedure was suitable for the investigation of hyperdense lesions, but was difficult to localize nonechogenic lesions. The combination of ultrasound and Neuronavigator methods improved the diagnostic accuracy even in nonechogenic lesions such as malignant lymphoma. Therefore, it is essential to choose the most appropriate guiding method for brain biopsy according to the radiological nature of the lesions.

  9. Writer`s guide for technical procedures

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-12-01

    A primary objective of operations conducted in the US Department of Energy (DOE) complex is safety. Procedures are a critical element of maintaining a safety envelope to ensure safe facility operation. This DOE Writer`s Guide for Technical Procedures addresses the content, format, and style of technical procedures that prescribe production, operation of equipment and facilities, and maintenance activities. The DOE Writer`s Guide for Management Control Procedures and DOE Writer`s Guide for Emergency and Alarm Response Procedures are being developed to assist writers in developing nontechnical procedures. DOE is providing this guide to assist writers across the DOE complex in producing accurate, complete, and usable procedures that promote safe and efficient operations that comply with DOE orders, including DOE Order 5480.19, Conduct of Operations for DOE Facilities, and 5480.6, Safety of Department of Energy-Owned Nuclear Reactors.

  10. WSSDA's Guide to Parliamentary Procedures. Revised

    Science.gov (United States)

    Randolph, Mary

    2004-01-01

    This guide to parliamentary procedures is presented by the Washington State School Directors' Association (WSSDA) for use by local school boards within the State of Washington. Parliamentary law and parliamentary procedure is the key to order and to provide justice and fairness to all. Through both formal and informal parliamentary procedures,…

  11. Guide for External Beam Radiotherapy. Procedures 2007

    International Nuclear Information System (INIS)

    Ardiet, Jean-Michel; Bourhis, Jean; Eschwege, Francois; Gerard, Jean-Pierre; Martin, Philippe; Mazeron, Jean-Jacques; Barillot, Isabelle; Bey, Pierre; Cosset, Jean-Marc; Thomas, Olivier; Bolla, Michel; Bourguignon, Michel; Godet, Jean-Luc; Krembel, David; Valero, Marc; Bara, Christine; Beauvais-March, Helene; Derreumaux, Sylvie; Vidal, Jean-Pierre; Drouard, Jean; Sarrazin, Thierry; Lindecker-Cournil, Valerie; Robin, Sun Hee Lee; Thevenet, Nicolas; Depenweiller, Christian; Le Tallec, Philippe; Ortholan, Cecile; Aimone, Nicole; Baldeschi, Carine; Cantelli, Andree; Estivalet, Stephane; Le Prince, Cyrille; QUERO, Laurent; Costa, Andre; Gerard, Jean-Pierre; Ardiet, Jean-Michel; Bensadoun, Rene-Jean; Bourhis, Jean; Calais, Gilles; Lartigau, Eric; Ginot, Aurelie; Girard, Nicolas; Mornex, Francoise; Bolla, Michel; Chauvet, Bruno; Maingon, Philippe; Martin, Etienne; Azria, David; Gerard, Jean-Pierre; Grehange, Gilles; Hennequin, Christophe; Peiffert, Didier; Toledano, Alain; Belkacemi, Yazid; Courdi, Adel; Belliere, Aurelie; Peignaux, Karine; Mahe, Marc; Bondiau, Pierre-Yves; Kantor, Guy; Lepechoux, Cecile; Carrie, Christian; Claude, Line

    2007-01-01

    In order to optimize quality and security in the delivery of radiation treatment, the French SFRO (Societe francaise de radiotherapie oncologique) is publishing a Guide for Radiotherapy. This guide is realized according to the HAS (Haute Autorite de sante) methodology of 'structured experts consensus'. This document is made of two parts: a general description of external beam radiation therapy and chapters describing the technical procedures of the main tumors to be irradiated (24). For each procedure, a special attention is given to dose constraints in the organs at risk. This guide will be regularly updated

  12. Guide to Alabama Court Procedures.

    Science.gov (United States)

    Alabama Administrative Office of Courts, Montgomery.

    Designed to assist the public in understanding the judicial system and judicial process in Alabama, this handbook (1) presents an overview of Alabama's courts and their jurisdictions, (2) identifies the officers of the courts and the contributions each makes to the judicial process, and (3) narrates in general terms the procedures most common to…

  13. Guide to oil spill exercise planning

    International Nuclear Information System (INIS)

    1996-01-01

    The International Convention on Oil Pollution Preparedness, Response and Cooperation (OPRC Convention) foresees a future in which all at risk states have national oil spill preparedness and response plans. The Convention also encourages the idea that national plans be developed in cooperation with oil and shipping industries. The ultimate test of any contingency plan is measured by performance in a real emergency. It is vital, therefore, that any programme for developing a national contingency plan must include an ongoing programme to test the plan through realistic exercises. An exercise programme must progressively prepare the Oil Spill Energy Response Team to perform effectively in realistic representations of the risks that the contingency plan has been designed to meet. This report has been designed to guide all those in government or industry who are faced with the responsibility of developing and managing oil spill response exercises at all levels. It carries with it the authority that derives from peer review by many centres of oil spill response excellence around the world. It is well-illustrated with brief case histories of exercises that have been carried out by many IPIECA member companies. Each of those companies has indicated its preparedness to share more information by providing contact name and address details within this report. (author)

  14. A simplified hazard audit procedures guide

    International Nuclear Information System (INIS)

    Harrison, D.G.; Tabatabai, A.S.; Scott, W.B.; Murphy, K.J.

    1991-02-01

    As part of on-going technical support services to the US Department of Energy (DOE), Battelle Pacific Northwest Laboratory (PNL) has developed a simplified hazard audit procedures guide which enables cost-effective and timely assessment and characterization of the DOE nuclear (reactor and nonreactor) and non-nuclear facilities safety profile

  15. Manual on gamma radiography. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    This booklet contains information about radiation protection procedures for gamma radiography as well as a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry

  16. Manual on nuclear gauges. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    In addition to a basic guide to the principles of production of ionizing radiation and to the methods of radiation protection and dosimetry, this booklet considers the procedures that should be employed when using nuclear gauges. Applications for such gauges are described and radiation protection procedures discussed

  17. Guide of external radiotherapy procedures 2007

    International Nuclear Information System (INIS)

    Anon.

    2008-01-01

    This work aims at participating in the permanent optimization of the returned medical service and the ratio profit-risk. This first version of the guide of external radiotherapy procedures 2007 processes only techniques of external radiotherapy, by opposition to the techniques of brachytherapy which use radioactive sources (iridium 192 , iodine 125 , cesium 137 ) placed in the contact of the tumor to be irradiated. Only, also, will be considered the irradiations of the most frequent cunning(malignant) tumors with the exception of the radiotherapy of the mild pathologies and the re-irradiations after a first radiotherapy. The first part is shared in eight chapters as follow: introduction, the steps of a treatment by radiotherapy, infrastructure, equipment and human resources, radiobiology mechanism of action of ionising radiations in radiotherapy, dose in radiotherapy, quality of treatment and radiation protection of patients in radiotherapy, prevention and risk management in radiotherapy, quality assurance and radiation protection for the pediatrics cancers and the case of pregnant women. The second part gives the tumoral localizations and the procedures; the third part is a glossary and different annexes such regulations and legislative texts. (N.C.)

  18. Manual on therapeutic uses of iodine-131. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    This booklet contains information about procedures to protect hospital staff and visitors and families of patients treated with iodine 131 from exposure to radiation from I-131. It also includes a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry

  19. Diagnostic procedures in cardiology: A clinician's guide

    International Nuclear Information System (INIS)

    Warren, J.V.; Lewis, R.P.

    1985-01-01

    This book contains 31 papers. Some of the titles are: Cardiovascular radiology; Nuclear cardiology; echocardiography; The use and conduct of exercise tests; Lipid studies in cardiology; and The practice of cardiology in an era of high technology

  20. Manual on panoramic gamma irradiators (categories 2 and 4). Incorporating: Applications guide, procedures guide, basics guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    The document is the first revision of a previous one published in 1993 to provide guidance on the safe use and regulation of self-contained gamma irradiators (Co-60 or Cs-137 sources) in different fields of application. It includes three parts: Applications Guide, which describes the main applications of self-contained gamma irradiators, the type of equipment, including safety systems, operation and maintenance, and how to deal with incidents. Procedures Guide, which gives step by step instructions on how to carry out the practice. Basics Guide, which explains the fundamentals of radiation, the system of units, interaction of radiation with matter radiation detection, etc. The manual is aimed primarily at persons handling such radiation sources on a daily routine basis, as well as at the competent authorities for training of workers in radiation protection or for setting up local radiation protection rules.

  1. Manual on panoramic gamma irradiators (categories 2 and 4). Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    The document is the first revision of a previous one published in 1993 to provide guidance on the safe use and regulation of self-contained gamma irradiators (Co-60 or Cs-137 sources) in different fields of application. It includes three parts: Applications Guide, which describes the main applications of self-contained gamma irradiators, the type of equipment, including safety systems, operation and maintenance, and how to deal with incidents. Procedures Guide, which gives step by step instructions on how to carry out the practice. Basics Guide, which explains the fundamentals of radiation, the system of units, interaction of radiation with matter radiation detection, etc. The manual is aimed primarily at persons handling such radiation sources on a daily routine basis, as well as at the competent authorities for training of workers in radiation protection or for setting up local radiation protection rules

  2. Manual on gamma radiography. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to gamma radiography: its application and procedures guides

  3. Manual on therapeutic uses of iodine-131. Incorporating: Applications guide, procedures guide, basics guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to therapeutic uses of Iodine-131: its application and procedures guides.

  4. Manual on high energy teletherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to high energy radiotherapy: its application and procedures guides

  5. Manual on shielded enclosures. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to shielding enclosures: their application and procedures guides

  6. Manual on therapeutic uses of iodine-131. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to therapeutic uses of Iodine-131: its application and procedures guides

  7. Manual on nuclear gauges. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    This publication is part of practical radiation safety manual series for different fields of application aimed primarily at persons handling radiation sources on a daily routine basis, which could at same time be used by the competent authorities, supporting their efforts in the radiation protection training of workers or medical assistance personnel or helping on-site management to set up local radiation protection rules. It is dedicated to nuclear gauges: their application and procedures guides

  8. Procedures minimally invasive image-guided

    International Nuclear Information System (INIS)

    Mora Guevara, Alejandro

    2011-01-01

    A literature review focused on minimally invasive procedures, has been performed at the Department of Radiology at the Hospital Calderon Guardia. A multidisciplinary team has been raised for decision making. The materials, possible complications and the available imaging technique such as ultrasound, computed tomography, magnetic resonance imaging, have been determined according to the procedure to be performed. The revision has supported medical interventions didactically enjoying the best materials, resources and conditions for a successful implementation of procedures and results [es

  9. Multimodality imaging to guide cardiac interventional procedures

    NARCIS (Netherlands)

    Tops, Laurens Franciscus

    2010-01-01

    In recent years, a number of new cardiac interventional procedures have been introduced. Catheter ablation procedures for atrial fibrillation (AF) have been refined and are now considered a good treatment option in patients with drug-refractory AF. In cardiac pacing, cardiac resynchronization

  10. Radiation dose to the operator during fluoroscopically guided spine procedures

    Energy Technology Data Exchange (ETDEWEB)

    Roccatagliata, Luca; Pravata, Emanuele; Cianfoni, Alessandro [Department of Neuroradiology, Neurocenter of Southern Switzerland, Ospedale Regionale di Lugano, Lugano (Switzerland); Presilla, Stefano [Unita di Fisica Medica, Ente Ospedaliero Cantonale (EOC), Bellinzona (Switzerland)

    2017-09-15

    Fluoroscopy is widely used to guide diagnostic and therapeutic spine procedures. The purpose of this study was to quantify radiation incident on the operator (operator Air Kerma) during a wide range of fluoroscopy-guided spine procedures and its correlation with the amount of radiation incident on the patient (Kerma Area Product - KAP). We retrospectively included 57 consecutive fluoroscopically guided spine procedures. KAP [Gy cm{sup 2}] and total fluoroscopy time were recorded for each procedure. An electronic dosimeter recorded the operator Air Kerma [μGy] for each procedure. Operator Air Kerma for each procedure, correlation between KAP and operator Air Kerma, and between KAP and fluoroscopy time was obtained. Operator Air Kerma was widely variable across procedures, with median value of 6.4 μGy per procedure. Median fluoroscopy time and median KAP per procedure were 2.6 min and 4.7 Gy cm{sup 2}, respectively. There was correlation between operator Air Kerma and KAP (r{sup 2} = 0.60), with a slope of 1.6 μGy Air Kerma per unit Gy cm{sup 2} KAP incident on the patient and between fluoroscopy time and KAP (r{sup 2} = 0.63). Operator Air Kerma during individual fluoroscopy-guided spine procedures can be approximated from the commonly and readily available information of the total amount of radiation incident on the patient, measured as KAP. (orig.)

  11. Interim Reliability Evaluation Program procedures guide

    International Nuclear Information System (INIS)

    Carlson, D.D.; Gallup, D.R.; Kolaczkowski, A.M.; Kolb, G.J.; Stack, D.W.; Lofgren, E.; Horton, W.H.; Lobner, P.R.

    1983-01-01

    This document presents procedures for conducting analyses of a scope similar to those performed in Phase II of the Interim Reliability Evaluation Program (IREP). It documents the current state of the art in performing the plant systems analysis portion of a probabilistic risk assessment. Insights gained into managing such an analysis are discussed. Step-by-step procedures and methodological guidance constitute the major portion of the document. While not to be viewed as a cookbook, the procedures set forth the principal steps in performing an IREP analysis. Guidance for resolving the problems encountered in previous analyses is offered. Numerous examples and representative products from previous analyses clarify the discussion

  12. Carpentry and Finishing Procedures. Building Maintenance. Module II. Instructor's Guide.

    Science.gov (United States)

    Hawk, Sam; Brunk, Art

    This curriculum guide, keyed to the building maintenance competency profile developed by industry and education professionals, provides three units on carpentry and finishing procedures. The first unit, Exterior Carpentry, contains the following lessons: carpentry safety procedures, ladder and scaffolding safety, door installation/repair,…

  13. Naval Justice School Procedure Study Guide. Revision

    Science.gov (United States)

    1990-01-01

    negligence, incompetency, nel, dependents, or Department of the Navy em. improper accounting procedures, of intervention of ployees occurring on a Navy...suffered from a condition known as dyslexia ; a person with dyslexia , who has not had proper special education, cannot read. The recruiter was advised of...martial. However, in United States v. Blaylock, 15 M.J. 190 (C.M.A. 1983), the court repudiated Hardy insofar as the intervention in a court-martial

  14. PSYCHOLOGICAL ASSESSMENT IN EXERCISE: AN INTERVIEW GUIDE FOR EXERCISERS AND INSTRUCTORS

    OpenAIRE

    Gomes, Rui

    2013-01-01

    Abstract: The practice of physical activity is associated to psychological, physical and social benefits. However, in the general population sport practice is still very low and the levels of dropout are very significant (Dishman, 1994; “Global strategy on diet, physical activity and health”, 2004). So it becomes important to understand the factors that can cause these problems. This paper proposes two interview guides for exercisers and instructors that facilitate a deeper analysis of the ps...

  15. Alignment Adjustment Procedures. Automotive Mechanics. Steering & Suspension. Instructor's Guide [and] Student Guide.

    Science.gov (United States)

    Spignesi, B.

    This instructional package, one in a series of individualized instructional units on automotive steering and suspension, consists of a student guide and an instructor guide dealing with automobile alignment and adjustment procedures. Covered in the module are identifying positive and negative cambers, positive and negative casters, and toe-ins;…

  16. Masonry Procedures. Building Maintenance. Module V. Instructor's Guide.

    Science.gov (United States)

    Eck, Francis

    This curriculum guide, one of six modules keyed to the building maintenance competency profile developed by industry and education professionals, provides materials for a masonry procedures unit containing eight lessons. Lesson topics are masonry safety practices; set forms; mix concrete; patch and/or repair concrete; pour and finish concrete; mix…

  17. Manual on high energy teletherapy. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    Apart from a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dose measurements, this booklet contains information about radiation protection measures for high-energy teletherapy

  18. EUS-Guided Vascular Procedures: A Literature Review

    Directory of Open Access Journals (Sweden)

    Tomislav Bokun

    2013-01-01

    Full Text Available Endoscopic ultrasound (EUS is continuously stepping into the therapeutic arena, simultaneously evolving in different directions, such as the management of pancreatic and biliary diseases, celiac neurolysis, delivering local intratumoral therapy, and EUS-guided endosurgery. EUS-guided vascular procedures are also challenging, considering the variety of vascular pathology, proximity of the vascular structures to the GI tract wall, high resolution, and real-time guidance offering an attractive access route and precise delivery of the intervention. The literature on vascular therapeutic EUS demonstrates techniques for the management of upper GI variceal and nonvariceal bleeding, pseudoaneurysms, and coiling and embolization procedures, as well as the creation of intrahepatic portosystemic shunts. The paucity of studies, diversity of study designs, and the number of animal model studies hamper a systematic approach to the conclusion and decision making important to clinicians and healthcare policy makers. Nevertheless, theoretical benefits and findings up to date concerning technical feasibility, efficacy, and safety of the procedures drive further research and development in this rather young therapeutic arena.

  19. Patient radiation dose audits for fluoroscopically guided interventional procedures

    International Nuclear Information System (INIS)

    Balter, Stephen; Rosenstein, Marvin; Miller, Donald L.; Schueler, Beth; Spelic, David

    2011-01-01

    Purpose: Quality management for any use of medical x-ray imaging should include monitoring of radiation dose. Fluoroscopically guided interventional (FGI) procedures are inherently clinically variable and have the potential for inducing deterministic injuries in patients. The use of a conventional diagnostic reference level is not appropriate for FGI procedures. A similar but more detailed quality process for management of radiation dose in FGI procedures is described. Methods: A method that takes into account both the inherent variability of FGI procedures and the risk of deterministic injuries from these procedures is suggested. The substantial radiation dose level (SRDL) is an absolute action level (with regard to patient follow-up) below which skin injury is highly unlikely and above which skin injury is possible. The quality process for FGI procedures collects data from all instances of a given procedure from a number of facilities into an advisory data set (ADS). An individual facility collects a facility data set (FDS) comprised of all instances of the same procedure at that facility. The individual FDS is then compared to the multifacility ADS with regard to the overall shape of the dose distributions and the percent of instances in both the ADS and the FDS that exceed the SRDL. Results: Samples of an ADS and FDS for percutaneous coronary intervention, using the dose metric of reference air kerma (K a,r ) (i.e., the cumulative air kerma at the reference point), are used to illustrate the proposed quality process for FGI procedures. Investigation is warranted whenever the FDS is noticeably different from the ADS for the specific FGI procedure and particularly in two circumstances: (1) When the facility's local median K a,r exceeds the 75th percentile of the ADS and (2) when the percent of instances where K a,r exceeds the facility-selected SRDL is greater for the FDS than for the ADS. Conclusions: Analysis of the two data sets (ADS and FDS) and of the

  20. Manual on shielded enclosures. Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1992-01-01

    This booklet contains a basic guide to the principles of the production of ionizing radiation and to methods of radiation protection and dosimetry, and a discussion of the need for shielded enclosures. Shielding materials and the design of the enclosures are described

  1. Ultrasound-Guided Percutaneous Electrolysis and Eccentric Exercises for Subacromial Pain Syndrome: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    José L. Arias-Buría

    2015-01-01

    Full Text Available Objective. To compare effects of ultrasound- (US- guided percutaneous electrolysis combined with an eccentric exercise program of the rotator cuff muscles in subacromial pain syndrome. Methods. Thirty-six patients were randomized and assigned into US-guided percutaneous electrolysis (n=17 group or exercise (n=19 group. Patients were asked to perform an eccentric exercise program of the rotator cuff muscles twice every day for 4 weeks. Participants assigned to US-guided percutaneous electrolysis group also received the application of galvanic current through acupuncture needle on each session once a week (total 4 sessions. Shoulder pain (NPRS and disability (DASH were assessed at baseline, after 2 sessions, and 1 week after the last session. Results. The ANOVA revealed significant Group∗Time interactions for shoulder pain and disability (all, P<0.01: individuals receiving US-guided percutaneous electrolysis combined with the eccentric exercises experienced greater improvement than those receiving eccentric exercise alone. Conclusions. US-guided percutaneous electrolysis combined with eccentric exercises resulted in small better outcomes at short term compared to when only eccentric exercises were applied in subacromial pain syndrome. The effect was statistically and clinically significant for shoulder pain but below minimal clinical difference for function. Future studies should investigate the long-term effects and potential placebo effect of this intervention.

  2. Patient doses from fluoroscopically guided cardiac procedures in pediatrics

    Science.gov (United States)

    Martinez, L. C.; Vano, E.; Gutierrez, F.; Rodriguez, C.; Gilarranz, R.; Manzanas, M. J.

    2007-08-01

    Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for <1 year; 52 for 1-<5 years; 25 for 5-<10 years and 13 for 10-<16 years. Median values of KAP were 1.9, 2.9, 4.5 and 15.4 Gy cm2 respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers.

  3. Patient doses from fluoroscopically guided cardiac procedures in pediatrics

    International Nuclear Information System (INIS)

    Martinez, L C; Vano, E; Gutierrez, F; Rodriguez, C; Gilarranz, R; Manzanas, M J

    2007-01-01

    Infants and children are a higher risk population for radiation cancer induction compared to adults. Although some values on pediatric patient doses for cardiac procedures have been reported, data to determine reference levels are scarce, especially when compared to those available for adults in diagnostic and therapeutic procedures. The aim of this study is to make a new contribution to the scarce published data in pediatric cardiac procedures and help in the determination of future dose reference levels. This paper presents a set of patient dose values, in terms of air kerma area product (KAP) and entrance surface air kerma (ESAK), measured in a pediatric cardiac catheterization laboratory equipped with a biplane x-ray system with dynamic flat panel detectors. Cardiologists were properly trained in radiation protection. The study includes 137 patients aged between 10 days and 16 years who underwent diagnostic catheterizations or therapeutic procedures. Demographic data and technical details of the procedures were also gathered. The x-ray system was submitted to a quality control programme, including the calibration of the transmission ionization chamber. The age distribution of the patients was 47 for 2 respectively for the four age bands. These KAP values increase by a factor of 8 when moving through the four age bands. The probability of a fatal cancer per fluoroscopically guided cardiac procedure is about 0.07%. Median values of ESAK for the four age bands were 46, 50, 56 and 163 mGy, which lie far below the threshold for deterministic effects on the skin. These dose values are lower than those published in previous papers

  4. Manual on self-contained gamma irradiators (categories 1 and 3). Incorporating: Applications guide, procedures guide, basics guide

    International Nuclear Information System (INIS)

    1996-01-01

    The document is the first revision of a previous one published in 1993 to provide guidance on the safe use and regulation of panoramic gamma irradiators (Co-60 or Cs-137 sources) in different fields of application. It includes three parts: Applications Guide, which describes the main applications of panoramic gamma irradiators, the type of equipment, including safety systems, operation and maintenance, and how to deal with incidents. Procedures Guide, which gives step by step instructions on how to carry out the practice. Basics Guide, which explains the fundamentals of radiation, the system of units, interaction of radiation with matter radiation detection, etc. and which is common to all documents in the series. The manual is aimed primarily at persons handling such radiation sources on a daily routine basis, as well as at the competent authorities for training of workers in radiation protection or for setting up local radiation protection rules

  5. Utility of CT-guided abdominal aspiration procedures

    International Nuclear Information System (INIS)

    Sundaram, M.; Wolverson, M.K.; Heiberg, E.; Pilla, T.; Vas, W.G.; Shields, J.B.

    1982-01-01

    Over 200 consecutive diagnostic needle aspiration procedures of the abdomen were performed under computed tomographic (CT) guidance. Biopsies were done of the liver in 88 patients, the pancreas in 28, the kidney in 20, and the retroperitoneum in 32; 30 underwent an aspiration procedure for characterization of an intraabdominal fluid collection. Accuracy of diagnosis was very high for hepatic (99%) and renal (100%) biopsies and in characterization of fluid collections (100%). Accuracy for retroperitoneal biopsy was 87.5% and for pancreatic biopsy 82%. Overall accuracy for all sites was 95%. There were one false-negative diagnosis for the liver and five false-negative diagnoses for the pancreas. Insufficient material was obtained for diagnosis in four instances of retroperitoneal biopsy. There were no false positives. The technique is facilitated by rapid CT scan time, large aperture gantry, and rapid CT image reconstruction. Twenty gauge needles were used more frequently than 22 gauge needles because of their greater rigidity and ease of control. CT-guided diagnostic aspiration procedures are particularly useful for diagnosis of small, deep-seated lesions and in evaluation of lesions found in severely ill patients. An experienced cytologist is essential to the success of the technique

  6. Methodological aspects to elaborate the management and procedure guides of severe accidents

    International Nuclear Information System (INIS)

    Gonzalez Gonzalez, F.; Jimenez Fernandez, A.

    1995-01-01

    The management guides in severe accidents are very important to know the procedures in these accidents. The present articles summarizes the methodological aspects to elaborate the management guides, in order to prevent the severe accidents

  7. In-situ burn operational procedures development exercises

    International Nuclear Information System (INIS)

    Bitting, K.; Gynther, J.; Drieu, M.; Tidemann, A.; Martin, R.

    2001-01-01

    The United States Coast Guard, the Texas General Land Office and the National Response Corporation conducted three at-sea oil spill exercises in 1999 and 2000 to test and evaluate a variety of methods to perform in-situ burning (ISB) operations at sea. ISB is seldom used during actual responses, particularly in offshore environments because there is no detailed ISB operation plan for specific regional response teams. There is also a lack of sufficient ISB resources, both equipment and trained personnel, that can be mobilized within the limited ISB window-of-opportunity. There is also a misconception regarding the costs and benefits of ISB. For these exercises, the oil slick was simulated with several tons of oranges. The primary objective was to examine the safe, effective and efficient implementation of ISB. The exercises involved the use of actual response vessels, water-cooled fire booms, helicopters and helitorches. Specific manoeuvres were conducted and particular activities were measured. The experimental data was recorded for future use as a planning and training tool. The exercises demonstrated that ISB is a viable and efficient response tool if it is used in the right situation. The biggest short fall of these exercises was the inability to burn real oil on the water (the oranges did not provide enough data). It was concluded that ISB is not always the best tool for every situation. Dispersants and mechanical recovery are also viable options. 1 tab., 6 figs

  8. [Ultrasonography-guided therapeutic procedures in the neck region].

    Science.gov (United States)

    Brzac, Hrvojka Tomić

    2009-12-01

    Minimally invasive therapeutic procedures in medicine have become very popular because of the reduced risk compared to classic surgical treatment, speed of recovery, little or no side effects, and frequently lower cost. One of these methods is ultrasonography-guided percutaneous injection of 95% ethanol (PEIT, percutaneous ethanol injection therapy), which is especially suitable for the neck region. Other methods like laser photocoagulation (ILP) or radiofrequency ablation (RFA) are more aggressive and expensive. The procedure of sterile 95% ethanol injecting is performed on an outpatient basis, without preparation. A specific amount of alcohol is injected into the lesion using a thin spinal needle, under ultrasonography guidance. The amount of alcohol depends on the size of the lesion. Complications are rare and the procedure can be repeated several times. PEIT is used in the treatment of parathyroid glands, especially secondary hyperparathyroidism, thyroid nodules (toxic adenoma, goiters and cysts), other cysts on the neck, and cervical metastases of thyroid cancer. Direct ethanol injection into the tissue causes cellular dehydration and protein denaturation, followed by the development of necrosis, fibrosis, and thrombosis of the small blood vessels. In this way, reduction or disappearance of the nodes can be achieved, along with functional normalization (for parathyroid glands and toxic adenoma), with longer or shorter disease remission or complete recovery. Today, PEIT is mostly used in dialyzed patients with secondary hyperparathyroidism. The treatment gives best results in combination with vitamin D analogs, if 1-2 parathyroid glands are enlarged, and for residual parathyroid gland after parathyroidectomy. A success rate of 50%-70% has been reported, depending on the number of enlarged parathyroid glands. Therapeutic effect is manifested in the size reduction or complete fibrozation of the gland, reduction or disappearance of vascularization, and a decrease

  9. 12 CFR 550.140 - Must I adopt and follow written policies and procedures in exercising fiduciary powers?

    Science.gov (United States)

    2010-01-01

    ... procedures in exercising fiduciary powers? 550.140 Section 550.140 Banks and Banking OFFICE OF THRIFT SUPERVISION, DEPARTMENT OF THE TREASURY FIDUCIARY POWERS OF SAVINGS ASSOCIATIONS Exercising Fiduciary Powers § 550.140 Must I adopt and follow written policies and procedures in exercising fiduciary powers? You...

  10. New Jersey's experience with implementing Protective Action Guides during the 1988 Salem ingestion pathway exercise

    International Nuclear Information System (INIS)

    White, Duncan

    1989-01-01

    On November 30 and December 1, 1988, the New Jersey Department of Environmental Protection (DEP) and three other State agencies (Health, Agriculture and State Police) participated in the ingestion pathway portion of the 1988 Salem Nuclear Generating Station Emergency Exercise. The purpose of this phase of the exercise was to demonstrate the ingestion pathway components of the State's Radiological Emergency Response Plan (RERP) to the Federal Emergency Management Agency (FEMA). The intent of this paper is to provide a summary of difficulties and some lessons learned in implementing the DEP's ingestion pathway Protective Action Guides (PAGs) during the exercise as well as during the preparation of a total population dose estimate (TPDE)

  11. New Jersey's experience with implementing Protective Action Guides during the 1988 Salem ingestion pathway exercise

    Energy Technology Data Exchange (ETDEWEB)

    White, Duncan [New Jersey Department of Environmental Protection, Trenton, NJ (United States)

    1989-09-01

    On November 30 and December 1, 1988, the New Jersey Department of Environmental Protection (DEP) and three other State agencies (Health, Agriculture and State Police) participated in the ingestion pathway portion of the 1988 Salem Nuclear Generating Station Emergency Exercise. The purpose of this phase of the exercise was to demonstrate the ingestion pathway components of the State's Radiological Emergency Response Plan (RERP) to the Federal Emergency Management Agency (FEMA). The intent of this paper is to provide a summary of difficulties and some lessons learned in implementing the DEP's ingestion pathway Protective Action Guides (PAGs) during the exercise as well as during the preparation of a total population dose estimate (TPDE)

  12. Manual for guided home exercises for osteoarthritis of the knee

    Directory of Open Access Journals (Sweden)

    Nilza Aparecida de Almeida Carvalho

    2010-06-01

    Full Text Available INTRODUCTION: Physiotherapy is one of the most important components of therapy for osteoarthritis of the knee. The objective of this prospective case series was to assess the efficiency of a guidance manual for patients with osteoarthritis of the knee in relation to pain, range of movement , muscle strength and function, active goniometry, manual strength test and function. METHODS: Thirty-eight adults with osteoarthritis of the knee (> 45 years old who were referred to the physiotherapy service at the university hospital (Santa Casa de Misericórdia de São Paulo were studied. Patients received guidance for the practice of specific physical exercises and a manual with instructions on how to perform the exercises at home. They were evaluated for pain, range of movement, muscle strength and function. These evaluations were performed before they received the manual and three months later. Patients were seen monthly regarding improvements in their exercising abilities. RESULTS: The program was effective for improving muscle strength, controlling pain, maintaining range of movement of the knee joint, and reducing functional incapacity. DISCUSSION: A review of the literature showed that there are numerous clinical benefits to the regular practice of physical therapy exercises by patients with osteoarthritis of the knee(s in a program with appropriate guidance. This study shows that this guidance can be attained at home with the use of a proper manual. CONCLUSIONS: Even when performed at home without constant supervision, the use of the printed manual for orientation makes the exercises for osteoarthritis of the knee beneficial.

  13. A Guided-Inquiry pH Laboratory Exercise for Introductory Biological Science Laboratories

    Science.gov (United States)

    Snodgrass, Meagan A.; Lux, Nicholas; Metz, Anneke M.

    2011-01-01

    There is a continuing need for engaging inquiry-based laboratory experiences for advanced high school and undergraduate biology courses. The authors describe a guided-inquiry exercise investigating the pH-dependence of lactase enzyme that uses an inexpensive, wide-range buffering system, lactase dietary supplement, over-the-counter glucose test…

  14. The protective effects of acute cardiovascular exercise on the interference of procedural memory.

    Science.gov (United States)

    Jo, J S; Chen, J; Riechman, S; Roig, M; Wright, D L

    2018-04-10

    Numerous studies have reported a positive impact of acute exercise for procedural skill memory. Previous work has revealed this effect, but these findings are confounded by a potential contribution of a night of sleep to the reported exercise-mediated reduction in interference. Thus, it remains unclear if exposure to a brief bout of exercise can provide protection to a newly acquired motor memory. The primary objective of the present study was to examine if a single bout of moderate-intensity cardiovascular exercise after practice of a novel motor sequence reduces the susceptibility to retroactive interference. To address this shortcoming, 17 individuals in a control condition practiced a novel motor sequence that was followed by test after a 6-h wake-filled interval. A separate group of 17 individuals experienced practice with an interfering motor sequence 45 min after practice with the original sequence and were then administered test trials 6 h later. One additional group of 12 participants was exposed to an acute bout of exercise immediately after practice with the original motor sequence but prior to practice with the interfering motor sequence and the subsequent test. In comparison with the control condition, increased response times were revealed during the 6-h test for the individuals that were exposed to interference. The introduction of an acute bout of exercise between the practice of the two motor sequences produced a reduction in interference from practice with the second task at the time of test, however, this effect was not statistically significant. These data reinforce the hypothesis that while there may be a contribution from exercise to post-practice consolidation of procedural skills which is independent of sleep, sleep may interact with exercise to strengthen the effects of the latter on procedural memory.

  15. A Modular Set of Mixed Reality Simulators for Blind and Guided Procedures

    Science.gov (United States)

    2017-08-01

    AWARD NUMBER: W81XWH-14-1-0113 TITLE: A modular set of mixed reality simulators for blind and guided procedures PRINCIPAL INVESTIGATOR...2017 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER A modular set of mixed reality simulators for blind and guided procedures 5b. GRANT NUMBER W81XWH...A Modular Set of Mixed Reality Simulators for “Blind” and Guided Procedures Award W81XWH-14-1-0113 Reporting Period: 8/1/2016 – 7/31/2017 (Year 3

  16. Patients exposure from fluoroscopic guided pacemaker implantation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Alkhorayef, M.; Babikir, E. [King Saud University, College of Applied Sciences, Radiological Sciences Department, P. O. Box 10219, Riyadh 11433 (Saudi Arabia); Sulieman, A. [Prince Sattam bin Abdulaziz University, College of Applied Medical Sciences, Radiology and Medical Imaging Department, P. O. Box 422, Alkharj 11942 (Saudi Arabia); Daar, E. [University of Jordan, Faculty of Science, Department of Physics, Amman 11942 (Jordan); Alnaaimi, M.; Alduaij, M. [Kuwait Cancer Control Centre, Department of Nuclear Medicine, Shwiekh (Kuwait); Bradley, D., E-mail: malkhorayef@ksu.edu.sa [University of Surrey, Centre for Nuclear and Radiation Physics, Guildford, Surrey, GU2 7XH (United Kingdom)

    2016-10-15

    A pacemaker, which is used for heart re synchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of the pacemaker implantation procedures increased 50% worldwide. During this procedure, patients and staff can be exposed to excessive radiation exposure. Wide range of doses was reported in previous studies, suggesting that optimization of this procedure is not fulfilled yet. This study aims to evaluate the patient and staff radiation doses during cardiac pacemaker procedure and quantify the patient effective dose. A total of 145 procedures were performed for five pacemakers procedures (VVI, VVIR, VVD, VVDR and DDDR) two hospitals were evaluated. Patients doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from National Radiological Protection Board. The effective dose values were used to estimate the cancer risk from pacemaker procedure. Patients demographic data, exposure parameters for both fluoroscopy and radiography were quantified. The mean patients doses (Gy. cm{sup 2}) for VVI, VVIR, VVD, VVDR and DDDR was 1.52±0.13 (1.43-1.61), 3.28±2.34 (0.29-8.73), 3.04±1.67 (1.57-4.86), 6.04±2.326 and 19.2±3.6 (5.43-30.2), respectively, per procedure. The overall patients effective dose is 1.1 mSv per procedure. (Author)

  17. Patients exposure from fluoroscopic guided pacemaker implantation procedures

    International Nuclear Information System (INIS)

    Alkhorayef, M.; Babikir, E.; Sulieman, A.; Daar, E.; Alnaaimi, M.; Alduaij, M.; Bradley, D.

    2016-10-01

    A pacemaker, which is used for heart re synchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of the pacemaker implantation procedures increased 50% worldwide. During this procedure, patients and staff can be exposed to excessive radiation exposure. Wide range of doses was reported in previous studies, suggesting that optimization of this procedure is not fulfilled yet. This study aims to evaluate the patient and staff radiation doses during cardiac pacemaker procedure and quantify the patient effective dose. A total of 145 procedures were performed for five pacemakers procedures (VVI, VVIR, VVD, VVDR and DDDR) two hospitals were evaluated. Patients doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from National Radiological Protection Board. The effective dose values were used to estimate the cancer risk from pacemaker procedure. Patients demographic data, exposure parameters for both fluoroscopy and radiography were quantified. The mean patients doses (Gy. cm 2 ) for VVI, VVIR, VVD, VVDR and DDDR was 1.52±0.13 (1.43-1.61), 3.28±2.34 (0.29-8.73), 3.04±1.67 (1.57-4.86), 6.04±2.326 and 19.2±3.6 (5.43-30.2), respectively, per procedure. The overall patients effective dose is 1.1 mSv per procedure. (Author)

  18. Design procedures for heat-straightening repair : an engineering guide.

    Science.gov (United States)

    1992-12-01

    This report summarizes over four years of research on heat-straightening repairs and provides a prototype engineering guide for the application of heat-straightening to bridge structures. It is based on the research results detailed in a companion re...

  19. A Modular Set of Mixed Reality Simulators for Blind and Guided Procedures

    Science.gov (United States)

    2016-08-01

    presented the mixed reality simulator among other technologies at a lecture at the University of Southern California Institute of Creative Technologies (ICT...AWARD NUMBER: W81XWH-14-1-0113 TITLE: A Modular Set of Mixed Reality Simulators for “blind” and Guided Procedures PRINCIPAL INVESTIGATOR...2015 – 07/31/2016 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER A Modular Set of Mixed Reality Simulators for “Blind” and Guided Procedures 5b

  20. Biofeedback-guided pelvic floor exercise therapy for obstructive defecation: An effective alternative

    Science.gov (United States)

    ba-bai-ke-re, Ma-Mu-Ti-Jiang A; Wen, Ni-Re; Hu, Yun-Long; Zhao, Liang; Tuxun, Tuerhongjiang; Husaiyin, Aierhati; Sailai, Yalikun; Abulimiti, Alimujiang; Wang, Yun-Hai; Yang, Peng

    2014-01-01

    AIM: To compare biofeedback-guided pelvic floor exercise therapy (BFT) with the use of oral polyethylene glycol (PEG) for the treatment of obstructive defecation. METHODS: A total of 88 subjects were assigned to treatment with either BFT (n = 44) or oral PEG (n = 44). Constipation symptoms (including difficult evacuation, hard stool, digitation necessity, incomplete emptying sensation, laxative dependence, perianal pain at defecation, and constipation satisfaction), Wexner Scores, and quality of life scores were assessed after 1, 3, and 6 mo. RESULTS: At the 6 mo follow-up, the symptoms of the BFT group patients showed significantly greater improvements compared with the PEG group regarding difficult evacuation, hard stools, digitation necessity, laxative dependence, perianal pain at defecation, constipation satisfaction, Wexner Constipation Score, and quality of life score (P biofeedback-guided pelvic floor exercise training is superior to oral polyethylene glycol therapy for obstructive defecation. PMID:25083090

  1. Electrical Procedures and Environmental Control Systems. Building Maintenance. Module IV. Instructor's Guide.

    Science.gov (United States)

    Sloan, Garry

    This curriculum guide, one of six modules keyed to the building maintenance competency profile developed by industry and education professionals, provides materials for two units on electrical procedures and environmental control systems. Unit 1, on electrical procedures, includes the following lessons: electrical safety; troubleshooting and…

  2. Changes in corticospinal excitability during consolidation predict acute exercise-induced off-line gains in procedural memory

    DEFF Research Database (Denmark)

    Ostadan, Fatemeh; Centeno, Carla; Daloze, Jean-Felix

    2016-01-01

    A single bout of cardiovascular exercise performed immediately after practicing a motor task improves the long-term retention of the skill through an optimization of memory consolidation. However, the specific brain mechanisms underlying the effects of acute cardiovascular exercise on procedural...... exercise correlated with the magnitude of off-line gains in skill level assessed in a retention test performed 8h after motor practice. A single bout of exercise modulates short-term neuroplasticity mechanisms subserving consolidation processes that predict off-line gains in procedural memory....... memory are poorly understood. We sought to determine if a single bout of exercise modifies corticospinal excitability (CSE) during the early stages of memory consolidation. In addition, we investigated if changes in CSE are associated with exercise-induced off-line gains in procedural memory...

  3. Guided imagery targeting exercise, food cravings, and stress: a multi-modal randomized feasibility trial.

    Science.gov (United States)

    Giacobbi, Peter; Long, Dustin; Nolan, Richard; Shawley, Samantha; Johnson, Kelsey; Misra, Ranjita

    2018-02-01

    The purpose of this randomized wait-list controlled trial was to test the feasibility and preliminary efficacy of a guided imagery based multi-behavior intervention intended to address psychological stress, food cravings, and physical activity. Personalized guided imagery scripts were created and participants were instructed to practice guided imagery every day for 35 consecutive days. Of 48 women who enrolled, we report comparisons between 16 randomized to treatment with 19 who were wait-listed (overall M age  = 45.50; M bodymassindex  = 31.43). Study completers reported 89% compliance with practicing guided imagery during the intervention. A significant time-by-group interaction was observed with reductions in food cravings and increases in physical activity compared with wait-list controls. Telephone-based multi-behavior interventions that utilize guided imagery to address food cravings and exercise behavior appear to be acceptable for overweight and obese women. Future phone-based guided imagery research testing this skill to address multiple health behaviors is justified.

  4. 77 FR 36017 - Regulatory Guide 7.3, Procedures for Picking Up and Receiving Packages of Radioactive Material

    Science.gov (United States)

    2012-06-15

    ... NUCLEAR REGULATORY COMMISSION [NRC-2012-0139] Regulatory Guide 7.3, Procedures for Picking Up and... Guide (RG) 7.3, ``Procedures for Picking Up and Receiving Packages of Radioactive Material.'' The guide..., please contact the NRC's Public Document Room (PDR) reference staff at 1-800-397-4209, or 301-415-4737...

  5. Precision of guided scanning procedures for full-arch digital impressions in vivo.

    Science.gov (United States)

    Zimmermann, Moritz; Koller, Christina; Rumetsch, Moritz; Ender, Andreas; Mehl, Albert

    2017-11-01

    System-specific scanning strategies have been shown to influence the accuracy of full-arch digital impressions. Special guided scanning procedures have been implemented for specific intraoral scanning systems with special regard to the digital orthodontic workflow. The aim of this study was to evaluate the precision of guided scanning procedures compared to conventional impression techniques in vivo. Two intraoral scanning systems with implemented full-arch guided scanning procedures (Cerec Omnicam Ortho; Ormco Lythos) were included along with one conventional impression technique with irreversible hydrocolloid material (alginate). Full-arch impressions were taken three times each from 5 participants (n = 15). Impressions were then compared within the test groups using a point-to-surface distance method after best-fit model matching (OraCheck). Precision was calculated using the (90-10%)/2 quantile and statistical analysis with one-way repeated measures ANOVA and post hoc Bonferroni test was performed. The conventional impression technique with alginate showed the lowest precision for full-arch impressions with 162.2 ± 71.3 µm. Both guided scanning procedures performed statistically significantly better than the conventional impression technique (p Cerec Omnicam Ortho were 74.5 ± 39.2 µm and for group Ormco Lythos 91.4 ± 48.8 µm. The in vivo precision of guided scanning procedures exceeds conventional impression techniques with the irreversible hydrocolloid material alginate. Guided scanning procedures may be highly promising for clinical applications, especially for digital orthodontic workflows.

  6. Application of insights from the IREP analyses to the IREP procedures guide

    International Nuclear Information System (INIS)

    Carlson, D.D.; Murphy, J.A.; Young, J.

    1982-01-01

    One of the objectives of the Interim Reliability Evaluation Program (IREP) was to prepare a set of procedures based on experience gained in the study for use in future IREP-type analyses. The current analyses used a set of procedures and, over the course of the program, a concerted effort was made to develop insights which could improve these procedures. Insights have been gained into the organization and content of th procedures guide, into the performance and management of an IREP analysis, and into the methods to be used in the analysis

  7. A Clinician Guide to Altitude Training for Optimal Endurance Exercise Performance at Sea Level.

    Science.gov (United States)

    Constantini, Keren; Wilhite, Daniel P; Chapman, Robert F

    2017-06-01

    Constantini, Keren, Daniel P. Wilhite, and Robert F. Chapman. A clinician guide to altitude training for optimal endurance exercise performance at sea level. High Alt Med Biol. 18:93-101, 2017.-For well over 50 years, endurance athletes have been utilizing altitude training in an effort to enhance performance in sea level competition. This brief review will offer the clinician a series of evidence-based best-practice guidelines on prealtitude and altitude training considerations, which can ultimately maximize performance improvement outcomes.

  8. Percutaneous CT-guided interventional procedures in musculoskeletal system (our experience)

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas E-mail: loutharad@yahoo.com; Mylona, Sophia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos

    2004-06-01

    Percutaneous interventional procedures include a broad spectrum of minimal invasive techniques, which are a useful diagnostic and therapeutic tool. In this study we present our experience in CT-guided percutaneous musculoskeletal biopsies, drainages of musculoskeletal abscesses, facet and sacroiliac joint injection and radiofrequency thermal ablation of painful metastases or osteoid osteomas.

  9. Value of Artisanal Simulators to Train Veterinary Students in Performing Invasive Ultrasound-Guided Procedures

    Science.gov (United States)

    Hage, Maria Cristina F. N. S.; Massaferro, Ana Beatriz; Lopes, Érika Rondon; Beraldo, Carolina Mariano; Daniel, Jéssika

    2016-01-01

    Pericardial effusion can lead to cardiac tamponade, which endangers an animal's life. Ultrasound-guided pericardiocentesis is used to remove abnormal liquid; however, it requires technical expertise. In veterinary medical education, the opportunity to teach this procedure to save lives during emergencies is rare; therefore, simulators are…

  10. Grounds Maintenance Equipment and Procedures. Building Maintenance. Module VI. Instructor's Guide.

    Science.gov (United States)

    Crank, Virgil

    This curriculum guide, one of six modules keyed to the building maintenance competency profile developed by industry and education professionals, provides materials for two units on grounds maintenance equipment and procedures. The first unit deals with grounds maintenance equipment and includes the following lessons: safety; changing oil/filter…

  11. Outcomes of trocar-guided Gynemesh PS™ versus single-incision trocarless Polyform™ transvaginal mesh procedures.

    Science.gov (United States)

    Larouche, Maryse; Merovitz, Lisa; Correa, José A; Walter, Jens-Erik

    2015-01-01

    The aim of the study was to compare rates of success, mesh exposure, and surgical re-intervention after trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh procedures. We conducted a retrospective cohort study of all transvaginal mesh procedures performed at our centers between January 2008 and May 2012. Multiple logistic regression models were used to explore the binary outcomes of objective and subjective success rates, as well as mesh exposure and re-intervention rates, between the two procedures after adjustment for patient's age, parity, body mass index, smoking status, previous hysterectomy, previous prolapse surgery, and follow-up time. We included 103 transvaginal mesh procedures (47 trocar-guided Gynemesh PS™ and 56 trocarless Polyform™). In both groups, Pelvic Organ Prolapse Quantification (POP-Q) scores were significantly improved after the procedure. Median follow-up was 340 days and interquartile range (IQR) 152-644. Objective success rates were 55.3 % (26/47) in the trocar group and 60.7 % (34/56) in the trocarless group (p = 0.9), whereas subjective success was 83.0 % (39/47) and 94.6 % (53/56), respectively (p = 0.1). The adjusted odds of developing mesh exposure were significantly less after trocarless transvaginal mesh procedures compared to trocar-guided ones [odds ratio (OR) 0.16, 95 % confidence interval (CI) 0.03-0.97]. Surgical re-interventions, aimed mostly at treating recurrent prolapse, mesh exposure, and latent stress urinary incontinence, were also significantly less frequent after trocarless procedures [5 patients (8.9 %) requiring re-intervention versus 15 (31.9 %), respectively, adjusted OR 0.15, 95 % CI 0.04-0.60]. Trocar-guided Gynemesh PS™ and trocarless Polyform™ transvaginal mesh systems result in similar objective and subjective success rates. The newer Polyform™ mesh results in significantly fewer mesh exposures and surgical re-interventions.

  12. Operational limits and conditions and operating procedures for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    This Safety Guide was prepared as part of the Agency's programme for establishing safety standards relating to nuclear power plants. The present Safety Guide supersedes the IAEA Safety Guide on Operational Limits and Conditions for Nuclear Power Plants which was issued in 1979 as Safety Series No. 50-SG-O3. For a nuclear power plant to be operated in a safe manner, the provisions made in the final design and subsequent modifications shall be reflected in limitations on plant operating parameters and in the requirements on plant equipment and personnel. Under the responsibility of the operating organization, these shall be developed during the design safety evaluation as a set of operational limits and conditions (OLCs). A major contribution to compliance with the OLCs is made by the development and utilization of operating procedures (OPs) that are consistent with and fully implement the OLCs. The requirements for the OLCs and OPs are established in Section 5 of the IAEA Safety Requirements publication Safety of Nuclear Power Plants: Operation, which this Safety Guide supplements. The purpose of this Safety Guide is to provide guidance on the development, content and implementation of OLCs and OPs. The Safety Guide is directed at both regulators and owners/operators. This Safety Guide covers the concept of OLCs, their content as applicable to land based stationary power plants with thermal neutron reactors, and the responsibilities of the operating organization regarding their establishment, modification, compliance and documentation. The OPs to support the implementation of the OLCs and to ensure their observance are also within the scope of this Safety Guide. The particular aspects of the procedures for maintenance, surveillance, in-service inspection and other safety related activities in connection with the safe operation of nuclear power plants are outside the scope of this Safety Guide but can be found in other IAEA Safety Guides. Section 2 indicates the

  13. Operational limits and conditions and operating procedures for nuclear power plants. Safety guide

    International Nuclear Information System (INIS)

    2000-01-01

    This Safety Guide was prepared as part of the Agency's programme for establishing safety standards relating to nuclear power plants. The present Safety Guide supersedes the IAEA Safety Guide on Operational Limits and Conditions for Nuclear Power Plants which was issued in 1979 as Safety Series No. 50-SG-O3. For a nuclear power plant to be operated in a safe manner, the provisions made in the final design and subsequent modifications shall be reflected in limitations on plant operating parameters and in the requirements on plant equipment and personnel. Under the responsibility of the operating organization, these shall be developed during the design safety evaluation as a set of operational limits and conditions (OLCs). A major contribution to compliance with the OLCs is made by the development and utilization of operating procedures (OPs) that are consistent with and fully implement the OLCs. The requirements for the OLCs and OPs are established in Section 5 of the IAEA Safety Requirements publication Safety of Nuclear Power Plants: Operation, which this Safety Guide supplements. The purpose of this Safety Guide is to provide guidance on the development, content and implementation of OLCs and OPs. The Safety Guide is directed at both regulators and owners/operators. This Safety Guide covers the concept of OLCs, their content as applicable to land based stationary power plants with thermal neutron reactors, and the responsibilities of the operating organization regarding their establishment, modification, compliance and documentation. The OPs to support the implementation of the OLCs and to ensure their observance are also within the scope of this Safety Guide. The particular aspects of the procedures for maintenance, surveillance, in-service inspection and other safety related activities in connection with the safe operation of nuclear power plants are outside the scope of this Safety Guide but can be found in other IAEA Safety Guides. Section 2 indicates the

  14. Use of Low-Fidelity Simulation Laboratory Training for Teaching Radiology Residents CT-Guided Procedures.

    Science.gov (United States)

    Picard, Melissa; Nelson, Rachel; Roebel, John; Collins, Heather; Anderson, M Bret

    2016-11-01

    To determine the benefit of the addition of low-fidelity simulation-based training to the standard didactic-based training in teaching radiology residents common CT-guided procedures. This was a prospective study involving 24 radiology residents across all years in a university program. All residents underwent standard didactic lecture followed by low-fidelity simulation-based training on three common CT-guided procedures: random liver biopsy, lung nodule biopsy, and drain placement. Baseline knowledge, confidence, and performance assessments were obtained after the didactic session and before the simulation training session. Approximately 2 months later, all residents participated in a simulation-based training session covering all three of these procedures. Knowledge, confidence, and performance data were obtained afterward. These assessments covered topics related to preprocedure workup, intraprocedure steps, and postprocedure management. Knowledge data were collected based on a 15-question assessment. Confidence data were obtained based on a 5-point Likert-like scale. Performance data were obtained based on successful completion of predefined critical steps. There was significant improvement in knowledge (P = .005), confidence (P simulation-based training to the standard didactic curriculum for all procedures. This study suggests that the addition of low-fidelity simulation-based training to a standard didactic-based curriculum is beneficial in improving resident knowledge, confidence, and tested performance of common CT-guided procedures. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  15. MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

    Science.gov (United States)

    Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

    2017-07-01

    The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

  16. Ultrasound-guided procedures around the wrist and hand: How to do

    International Nuclear Information System (INIS)

    Orlandi, Davide; Corazza, Angelo; Silvestri, Enzo; Serafini, Giovanni; Savarino, Edoardo Vincenzo; Garlaschi, Giacomo; Mauri, Giovanni; Cimmino, Marco Amedeo; Sconfienza, Luca Maria

    2014-01-01

    Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand

  17. Ultrasound-guided procedures around the wrist and hand: How to do

    Energy Technology Data Exchange (ETDEWEB)

    Orlandi, Davide; Corazza, Angelo [Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Silvestri, Enzo [Diagnostica per Immagini, Ospedale Evangelico Internazionale, Corso Solferino 29A, 16100 Genova (Italy); Serafini, Giovanni [Dipartimento di Diagnostica per Immagini, Ospedale Santa Corona, Via XXV Aprile 38, 17037 Pietra Ligure, Savona (Italy); Savarino, Edoardo Vincenzo [Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Università degli Studi di Padova, Via Giustiniani, Padova (Italy); Garlaschi, Giacomo [Dipartimento di Scienze per la Salute, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Mauri, Giovanni [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Cimmino, Marco Amedeo [Dipartimento di Medicina Interna, Università degli Studi di Genova, Via L.B. Alberti 4, 16132 Genova (Italy); Sconfienza, Luca Maria, E-mail: io@lucasconfienza.it [Servizio di Radiologia, IRCCS Policlinico San Donato, Piazza Malan 2, San Donato Milanese, Milano (Italy); Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Piazza Malan 2, San Donato Milanese, Milano (Italy)

    2014-07-15

    Ultrasound has emerged as a low-cost, radiation-free and effective imaging technique to detect joint abnormalities and to guide percutaneous procedures. Being superficial, wrist and hand tendons and joints represent a good target to perform such procedures using ultrasound guidance. This kind of approach allows for a clear and real-time visualization of the needles during their whole path. In this setting, the knowledge of technical aspects and tips is essential to act in the most accurate way on target tissues that can be as small as a few millimetres. The aim of this review is to summarize the local treatments of inflammatory and degenerative disease described in literature (such as treatment of De Quervain's tenosynovitis, trigger finger, trapezio-metacarpal joint osteoarthritis, etc.), emphasizing precautions and tricks based on day-by-day experience that may help to improve the outcome of percutaneous ultrasound-guided procedures around the wrist and hand.

  18. Smartphone-Guided Needle Angle Selection During CT-Guided Procedures.

    Science.gov (United States)

    Xu, Sheng; Krishnasamy, Venkatesh; Levy, Elliot; Li, Ming; Tse, Zion Tsz Ho; Wood, Bradford John

    2018-01-01

    In CT-guided intervention, translation from a planned needle insertion angle to the actual insertion angle is estimated only with the physician's visuospatial abilities. An iPhone app was developed to reduce reliance on operator ability to estimate and reproduce angles. The iPhone app overlays the planned angle on the smartphone's camera display in real-time based on the smartphone's orientation. The needle's angle is selected by visually comparing the actual needle with the guideline in the display. If the smartphone's screen is perpendicular to the planned path, the smartphone shows the Bull's-Eye View mode, in which the angle is selected after the needle's hub overlaps the tip in the camera. In phantom studies, we evaluated the accuracies of the hardware, the Guideline mode, and the Bull's-Eye View mode and showed the app's clinical efficacy. A proof-of-concept clinical case was also performed. The hardware accuracy was 0.37° ± 0.27° (mean ± SD). The mean error and navigation time were 1.0° ± 0.9° and 8.7 ± 2.3 seconds for a senior radiologist with 25 years' experience and 1.5° ± 1.3° and 8.0 ± 1.6 seconds for a junior radiologist with 4 years' experience. The accuracy of the Bull's-Eye View mode was 2.9° ± 1.1°. Combined CT and smart-phone guidance was significantly more accurate than CT-only guidance for the first needle pass (p = 0.046), which led to a smaller final targeting error (mean distance from needle tip to target, 2.5 vs 7.9 mm). Mobile devices can be useful for guiding needle-based interventions. The hardware is low cost and widely available. The method is accurate, effective, and easy to implement.

  19. Effectiveness of ultrasound-guided injections combined with shoulder exercises in the treatment of subacromial adhesive bursitis.

    Science.gov (United States)

    Gasparre, Giuseppe; Fusaro, Isabella; Galletti, Stefano; Volini, Silvia; Benedetti, Maria Grazia

    2012-05-01

    The aim of this study was to evaluate whether the association of exercises for the shoulder with ultrasound-guided injection into the bursa significantly improves the treatment outcome in adhesive bursitis. Two groups of 35 patients, one treated with ultrasound-guided injection (UGI) and the other one with ultrasound-guided injection and home exercise program (UGI-exercise) for 1 month, were assessed for pain and shoulder function before treatment, 1 and 3 months post-treatment. Fourteen patients in UGI group and 23 patients in the UGI-exercises group were completely free of pain after 1 month (p = 0.031). At 3 months' follow-up, patients in the UGI-exercise group showed a significant improvement with respect to the other group (p = 0.005). No differences were found in function assessment. The UGI combined with shoulder exercises in the treatment of subacromial adhesive bursitis is effective to ensure a more frequent complete pain relief in the medium term.

  20. CT-guided procedures: evaluation of a phantom system to teach accurate needle placement

    International Nuclear Information System (INIS)

    Dimmick, S.; Jones, M.; Challen, J.; Iedema, J.; Wattuhewa, U.; Coucher, J.

    2007-01-01

    Aim: To evaluate the use of a phantom system to help teach the basic techniques of accurate CT-guided needle placement, thereby avoiding the risks associated with teaching on patients. Materials and Methods: Gelatine phantoms with five, 1.9 cm embedded spherical wooden targets were constructed. Four trainee operators performed 15 simulated biopsy procedures on the targets (series one) and repeated identical procedures 2 weeks later (series two). Statistical analysis of accuracy of needle placement and subject confidence were performed. Results: Significant sequential improvement in axial plane angular error was noted with the average error decreasing by 0.33 degrees after every five procedures performed (95% CI: -0.58 to -0.08, p = 0.01). Operator confidence indicated significant improvement both within each series and from series one to series two (95% CI: 0.08 to 1.17, p = 0.025 and 95% CI: 0.00 to 0.58, p = 0.05) respectively. However, variability in operator performance made statistically significant improvement in other variables unproven. Conclusion: Despite the study comprising a relatively small number of participants and procedures, it clearly demonstrated the effectiveness of teaching operators to perform CT-guided procedures using a phantom system. Needle placement accuracy significantly improved, with a reduction in axial angular error, and improved operator confidence without the risks associated with training on patients. Three of the operators in this study had never performed a CT-guided procedure previously, and their proficiency, after a relatively short but intense period of training, was impressive. The use of phantoms should be considered routinely for basic training of CT-guided needle placement

  1. Imaging guided interventional procedures in paediatric uroradiology--a case based overview

    Energy Technology Data Exchange (ETDEWEB)

    Riccabona, M. E-mail: michael.riccabona@kfunigraz.ac.at; Sorantin, E.; Hausegger, K

    2002-08-01

    Objective: To describe the potential and application of interventional image guided procedures in the paediatric urinary tract. Patients and methods: The different techniques are illustrated using case reports. The examples comprise established indications such as percutaneous nephrostomy for compromised kidneys in obstructive uropathy and infection, sonographic guided renal biopsy including monitoring or treatment of complications after biopsy, and evaluation and balloon dilatation of childhood renal artery stenosis. There are new applications such as treatment of stenosis in cutaneous ureterostomy or sonographically guided catheterism for deployment of therapeutic agents. Results: Generally, the procedures are safe and successful. However, complications may occur, and peri-/post-interventional monitoring is mandatory to insure early detection and adequate management. Sometimes additional treatment such as percutaneous embolisation of a symptomatic post biopsy arterio-venous fistula, or a second biopsy for recurrent disease may become necessary. Conclusion: Imaging guided interventional procedures are performed successfully in a variety of diseases of the paediatric urinary tract. They can be considered a valuable additional modality throughout infancy and childhood.

  2. Imaging guided interventional procedures in paediatric uroradiology--a case based overview

    International Nuclear Information System (INIS)

    Riccabona, M.; Sorantin, E.; Hausegger, K.

    2002-01-01

    Objective: To describe the potential and application of interventional image guided procedures in the paediatric urinary tract. Patients and methods: The different techniques are illustrated using case reports. The examples comprise established indications such as percutaneous nephrostomy for compromised kidneys in obstructive uropathy and infection, sonographic guided renal biopsy including monitoring or treatment of complications after biopsy, and evaluation and balloon dilatation of childhood renal artery stenosis. There are new applications such as treatment of stenosis in cutaneous ureterostomy or sonographically guided catheterism for deployment of therapeutic agents. Results: Generally, the procedures are safe and successful. However, complications may occur, and peri-/post-interventional monitoring is mandatory to insure early detection and adequate management. Sometimes additional treatment such as percutaneous embolisation of a symptomatic post biopsy arterio-venous fistula, or a second biopsy for recurrent disease may become necessary. Conclusion: Imaging guided interventional procedures are performed successfully in a variety of diseases of the paediatric urinary tract. They can be considered a valuable additional modality throughout infancy and childhood

  3. PET/CT-guided interventional procedures: rationale, justification, initial study, and research plan

    Energy Technology Data Exchange (ETDEWEB)

    Wong, K.; Rahill, J.; Cleary, K. [Computer Aided Interventions and Medical Robotics (CAIMR), Imaging Science and Information Systems (ISIS) Center, Georgetown Univ. Medical Center, Washington, DC (United States); Petrillo, S.; Earl-Graef, D. [Dept. of Radiology, Georgetown Univ. Hospital, MedStar Health, Washington, DC (United States); Banovac, F.; Levy, E. [Computer Aided Interventions and Medical Robotics (CAIMR), Imaging Science and Information Systems (ISIS) Center, Georgetown Univ. Medical Center, Washington, DC (United States); Dept. of Radiology, Georgetown Univ. Hospital, MedStar Health, Washington, DC (United States); Shekhar, R. [Dept. of Radiology, Univ. of Maryland Medical Center, Baltimore, MD (United States)

    2007-06-15

    Positron-emission tomography (PET) and PET/CT (computed tomography) are becoming increasingly important for diagnosis and treatment of cancer. Clinically relevant changes can sometimes be seen on PET that are not seen on other imaging modalities. However, PET is not suitable for guiding biopsy as the images are not obtained in real-time. Therefore, our research group has begun developing a concept for PET/CT-guided interventional procedures. This paper presents the rationale for this concept, outlines our research plan, and includes an initial study to evaluate the relative sensitivity of CT and PET/CT in detecting suspicious lesions. (orig.)

  4. Multifunctional nanoparticles as a tissue adhesive and an injectable marker for image-guided procedures

    Science.gov (United States)

    Shin, Kwangsoo; Choi, Jin Woo; Ko, Giho; Baik, Seungmin; Kim, Dokyoon; Park, Ok Kyu; Lee, Kyoungbun; Cho, Hye Rim; Han, Sang Ihn; Lee, Soo Hong; Lee, Dong Jun; Lee, Nohyun; Kim, Hyo-Cheol; Hyeon, Taeghwan

    2017-07-01

    Tissue adhesives have emerged as an alternative to sutures and staples for wound closure and reconnection of injured tissues after surgery or trauma. Owing to their convenience and effectiveness, these adhesives have received growing attention particularly in minimally invasive procedures. For safe and accurate applications, tissue adhesives should be detectable via clinical imaging modalities and be highly biocompatible for intracorporeal procedures. However, few adhesives meet all these requirements. Herein, we show that biocompatible tantalum oxide/silica core/shell nanoparticles (TSNs) exhibit not only high contrast effects for real-time imaging but also strong adhesive properties. Furthermore, the biocompatible TSNs cause much less cellular toxicity and less inflammation than a clinically used, imageable tissue adhesive (that is, a mixture of cyanoacrylate and Lipiodol). Because of their multifunctional imaging and adhesive property, the TSNs are successfully applied as a hemostatic adhesive for minimally invasive procedures and as an immobilized marker for image-guided procedures.

  5. Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures

    International Nuclear Information System (INIS)

    Sommer, C.M.; Huber, J.; Radeleff, B.A.; Hosch, W.; Stampfl, U.; Loenard, B.M.; Hallscheidt, P.; Haferkamp, A.; Kauczor, H.U.; Richter, G.M.

    2011-01-01

    Aim: To report our experience of combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures. Patients and methods: Eighteen patients (23 kidneys) with non-obstructive uropathy due to urine leaks underwent combined CT- and fluoroscopy-guided nephrostomy. All procedures were indicated as second-line interventions after failed ultrasound-guided nephrostomy. Thirteen males and five females with an age of 62.3 ± 8.7 (40–84) years were treated. Urine leaks developed in majority after open surgery, e.g. postoperative insufficiency of ureteroneocystostomy (5 kidneys). The main reasons for failed ultrasound-guided nephrostomy included anatomic obstacles in the puncture tract (7 kidneys), and inability to identify pelvic structures (7 kidneys). CT-guided guidewire placement into the collecting system was followed by fluoroscopy-guided nephrostomy tube positioning. Procedural success rate, major and minor complication rates, CT-views and needle passes, duration of the procedure and radiation dose were analyzed. Results: Procedural success was 91%. Major and minor complication rates were 9% (one septic shock and one perirenal abscess) and 9% (one perirenal haematoma and one urinoma), respectively. 30-day mortality rate was 6%. Number of CT-views and needle passes were 9.3 ± 6.1 and 3.6 ± 2.6, respectively. Duration of the complete procedure was 87 ± 32 min. Dose-length product and dose-area product were 1.8 ± 1.4 Gy cm and 3.9 ± 4.3 Gy cm 2 , respectively. Conclusions: Combined CT- and fluoroscopy-guided nephrostomy in patients with non-obstructive uropathy due to urine leaks in cases of failed ultrasound-guided procedures was feasible with high technical success and a tolerable complication rate.

  6. Hydrophilic polymer-coated microcatheter-guide wire system for superselective angiographic procedures

    International Nuclear Information System (INIS)

    Kobayashi, Hisashi; Hiraki, Yoshiyuki; Nishimoto, Hidetou; Miyazono, Nobuaki; Satake, Mitsuo; Shinohara, Shinji

    1988-01-01

    A hydrophilic polymer-coated microcatheter-guide wire device has been newly developed for superselective angiography and interventional procedures. The injection rate of this microcatheter was estimated at 2.0 ml/sec. on the maximum pressure of 300 psi when used a non-ionic low osmolar contrast medium, Iopamidol 300. In two of three cases this catheter could make easy insertion into the peripheral branches of the right hepatic artery which were approximately 1 mm in vascular diameter. (author)

  7. Outcomes following implementation of a pediatric procedural sedation guide for referral to general anesthesia for magnetic resonance imaging studies.

    Science.gov (United States)

    Grunwell, Jocelyn R; Marupudi, Neelima K; Gupta, Rohan V; Travers, Curtis D; McCracken, Courtney E; Williamson, Julie L; Stockwell, Jana A; Fortenberry, James D; Couloures, Kevin; Cravero, Joseph; Kamat, Pradip P

    2016-06-01

    Guidelines for referral of children to general anesthesia (GA) to complete MRI studies are lacking. We devised a pediatric procedural sedation guide to determine whether a pediatric procedural sedation guide would decrease serious adverse events and decrease failed sedations requiring rescheduling with GA. We constructed a consensus-based sedation guide by combining a retrospective review of reasons for referral of children to GA (n = 221) with published risk factors associated with the inability to complete the MRI study with sedation. An interrupted time series analysis of 11 530 local sedation records from the Pediatric Sedation Research Consortium between July 2008 and March 2013, adjusted for case-mix differences in the pre- and postsedation guide cohorts, evaluated whether a sedation guide resulted in decreased severe adverse events (SAE) and failed sedation rates. A significant increase in referrals to GA following implementation of a sedation guide occurred (P pediatric procedural sedation services. © 2016 John Wiley & Sons Ltd.

  8. Failed common bile duct cannulation during pregnancy: Rescue with endoscopic ultrasound guided rendezvous procedure.

    Science.gov (United States)

    Singla, Vikas; Arora, Anil; Tyagi, Pankaj; Sharma, Praveen; Bansal, Naresh; Kumar, Ashish

    2016-01-01

    Common bile duct (CBD) stones can lead to serious complications and require intervention with either endoscopic retrograde cholangiopancreatography (ERCP) or laparoscopic techniques for urgent relief. On an average 10%-20% of the patients with gall bladder stones can have associated CBD stones. CBD stones during pregnancy can be associated with hazardous complications for both the mother and the fetus. Failed cannulation while performing ERCP during pregnancy is a technically demanding situation, which requires immediate rescue with special techniques. Conventional rescue techniques may not be feasible and can be associated with hazardous consequences. Endoscopic ultrasound (EUS) guided rendezvous technique has now emerged as a safe alternative, and in one of our patients, this technique was successfully attempted. To the best of our knowledge, this is the first case report in the literature on EUS-guided rendezvous procedure during pregnancy.

  9. A Guide for Developing Standard Operating Job Procedures for the Screening & Grinding Process Wastewater Treatment Facility. SOJP No. 1.

    Science.gov (United States)

    Deal, Gerald A.; Montgomery, James A.

    This guide describes standard operating job procedures for the screening and grinding process of wastewater treatment facilities. The objective of this process is the removal of coarse materials from the raw waste stream for the protection of subsequent equipment and processes. The guide gives step-by-step instructions for safety inspection,…

  10. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    Energy Technology Data Exchange (ETDEWEB)

    Nattenmüller, Johanna, E-mail: johanna.nattenmueller@med.uni-heidelberg.de; Filsinger, Matthias, E-mail: Matthias_filsinger@web.de; Bryant, Mark, E-mail: mark.bryant@med.uni-heidelberg.de; Stiller, Wolfram, E-mail: Wolfram.Stiller@med.uni-heidelberg.de; Radeleff, Boris, E-mail: boris.radeleff@med.uni-heidelberg.de; Grenacher, Lars, E-mail: lars.grenacher@med.uni-heidelberg.de; Kauczor, Hans-Ullrich, E-mail: hu.kauczor@med.uni-heidelberg.de; Hosch, Waldemar, E-mail: waldemar.hosch@urz.uni-heidelberg.de [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology (Germany)

    2013-06-19

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only.

  11. Complications in CT-guided Procedures: Do We Really Need Postinterventional CT Control Scans?

    International Nuclear Information System (INIS)

    Nattenmüller, Johanna; Filsinger, Matthias; Bryant, Mark; Stiller, Wolfram; Radeleff, Boris; Grenacher, Lars; Kauczor, Hans-Ullrich; Hosch, Waldemar

    2014-01-01

    PurposeThe aim of this study is twofold: to determine the complication rate in computed tomography (CT)-guided biopsies and drainages, and to evaluate the value of postinterventional CT control scans.MethodsRetrospective analysis of 1,067 CT-guided diagnostic biopsies (n = 476) and therapeutic drainages (n = 591) in thoracic (n = 37), abdominal (n = 866), and musculoskeletal (ms) (n = 164) locations. Severity of any complication was categorized as minor or major. To assess the need for postinterventional CT control scans, it was determined whether complications were detected clinically, on peri-procedural scans or on postinterventional scans only.ResultsThe complication rate was 2.5 % in all procedures (n = 27), 4.4 % in diagnostic punctures, and 1.0 % in drainages; 13.5 % in thoracic, 2.0 % in abdominal, and 3.0 % in musculoskeletal procedures. There was only 1 major complication (0.1 %). Pneumothorax (n = 14) was most frequent, followed by bleeding (n = 9), paresthesia (n = 2), material damage (n = 1), and bone fissure (n = 1). Postinterventional control acquisitions were performed in 65.7 % (701 of 1,067). Six complications were solely detectable in postinterventional control acquisitions (3 retroperitoneal bleeds, 3 pneumothoraces); all other complications were clinically detectable (n = 4) and/or visible in peri-interventional controls (n = 21).ConclusionComplications in CT-guided interventions are rare. Of these, thoracic interventions had the highest rate, while pneumothoraces and bleeding were most frequent. Most complications can be detected clinically or peri-interventionally. To reduce the radiation dose, postinterventional CT controls should not be performed routinely and should be restricted to complicated or retroperitoneal interventions only

  12. Probabilistic safety analysis procedures guide, Sections 8-12. Volume 2, Rev. 1

    International Nuclear Information System (INIS)

    McCann, M.; Reed, J.; Ruger, C.; Shiu, K.; Teichmann, T.; Unione, A.; Youngblood, R.

    1985-08-01

    A procedures guide for the performance of probabilistic safety assessment has been prepared for interim use in the Nuclear Regulatory Commission programs. It will be revised as comments are received, and as experience is gained from its use. The probabilistic safety assessment studies performed are intended to produce probabilistic predictive models that can be used and extended by the utilities and by NRC to sharpen the focus of inquiries into a range of issues affecting reactor safety. The first volume of the guide describes the determination of the probability (per year) of core damage resulting from accident initiators internal to the plant (i.e., intrinsic to plant operation) and from loss of off-site electric power. The scope includes human reliability analysis, a determination of the importance of various core damage accident sequences, and an explicit treatment and display of uncertainties for key accident sequences. This second volume deals with the treatment of the so-called external events including seismic disturbances, fires, floods, etc. Ultimately, the guide will be augmented to include the plant-specific analysis of in-plant processes (i.e., containment performance). This guide provides the structure of a probabilistic safety study to be performed, and indicates what products of the study are valuable for regulatory decision making. For internal events, methodology is treated in the guide only to the extent necessary to indicate the range of methods which is acceptable; ample reference is given to alternative methodologies which may be utilized in the performance of the study. For external events, more explicit guidance is given

  13. Probabilistic safety analysis procedures guide. Sections 1-7 and appendices. Volume 1, Revision 1

    International Nuclear Information System (INIS)

    Bari, R.A.; Buslik, A.J.; Cho, N.Z.

    1985-08-01

    A procedures guide for the performance of probabilistic safety assessment has been prepared for interim use in the Nuclear Regulatory Commission programs. It will be revised as comments are received, and as experience is gained from its use. The probabilistic safety assessment studies performed are intended to produce probabilistic predictive models that can be used and extended by the utilities and by NRC to sharpen the focus of inquiries into a range of issues affecting reactor safety. This first volume of the guide describes the determination of the probability (per year) of core damage resulting from accident initiators internal to the plant (i.e., intrinsic to plant operation) and from loss of off-site electric power. The scope includes human reliability analysis, a determination of the importance of various core damage accident sequences, and an explicit treatment and display of uncertainties for key accident sequences. The second volume deals with the treatment of the so-called external events including seismic disturbances, fires, floods, etc. Ultimately, the guide will be augmented to include the plant-specific analysis of in-plant processes (i.e., containment performance). This guide provides the structure of a probabilistic safety study to be performed, and indicates what products of the study are valuable for regulatory decision making. For internal events, methodology is treated in the guide only to the extent necessary to indicate the range of methods which is acceptable; ample reference is given to alternative methodologies which may be utilized in the performance of the study. For external events, more explicit guidance is given

  14. Introducing an on-line adaptive procedure for prostate image guided intensity modulate proton therapy.

    Science.gov (United States)

    Zhang, M; Westerly, D C; Mackie, T R

    2011-08-07

    With on-line image guidance (IG), prostate shifts relative to the bony anatomy can be corrected by realigning the patient with respect to the treatment fields. In image guided intensity modulated proton therapy (IG-IMPT), because the proton range is more sensitive to the material it travels through, the realignment may introduce large dose variations. This effect is studied in this work and an on-line adaptive procedure is proposed to restore the planned dose to the target. A 2D anthropomorphic phantom was constructed from a real prostate patient's CT image. Two-field laterally opposing spot 3D-modulation and 24-field full arc distal edge tracking (DET) plans were generated with a prescription of 70 Gy to the planning target volume. For the simulated delivery, we considered two types of procedures: the non-adaptive procedure and the on-line adaptive procedure. In the non-adaptive procedure, only patient realignment to match the prostate location in the planning CT was performed. In the on-line adaptive procedure, on top of the patient realignment, the kinetic energy for each individual proton pencil beam was re-determined from the on-line CT image acquired after the realignment and subsequently used for delivery. Dose distributions were re-calculated for individual fractions for different plans and different delivery procedures. The results show, without adaptive, that both the 3D-modulation and the DET plans experienced delivered dose degradation by having large cold or hot spots in the prostate. The DET plan had worse dose degradation than the 3D-modulation plan. The adaptive procedure effectively restored the planned dose distribution in the DET plan, with delivered prostate D(98%), D(50%) and D(2%) values less than 1% from the prescription. In the 3D-modulation plan, in certain cases the adaptive procedure was not effective to reduce the delivered dose degradation and yield similar results as the non-adaptive procedure. In conclusion, based on this 2D phantom

  15. Evaluation of Kerma rate in the skin entrance in interventional procedures guided by fluoroscopy

    International Nuclear Information System (INIS)

    Medeiros, Regina Bitelli; Alves, Fatima Faloppa Rodrigues; Ruberti Filha, Eny M.

    2005-01-01

    Interventional therapeutic procedures guided by fluoroscopy are responsible for delayed exposure to radiation of professionals and patients. The technology employed on generation of the pulsed fluoroscopy can be an important tool of protection used for reducing the exposure time. It generates constant width and varied frequency pulse or width pulse or varied frequency for a constant frequency. The typical doses into the skin and its relationship with the quality of the images in the various technical and operational conditions should be known by the professionals so that they can optimize them. Generated radiation doses were evaluated using the Toshiba Infinitix equipment used in invasive cardiology procedures and electrophysiological studies through the Kerma rate at the entrance of the patient's skin measured throughout the year of 2004. With these information shall be set out the criteria for the decision of the technical-operational conditions that allow minimizing of dose

  16. Procedure guide of design, construction of prototypes, calibration and sure operation of nucleonic control systems

    International Nuclear Information System (INIS)

    Banados Perez, H.; Griffith Martinez, J.; Desdin Garcia, L.F.; Rodriguez Cardona, R.L.; Molina, G.; Sebastian Calvo, C.

    1999-01-01

    This Guide was elaborated in the mark of the project RLA/8/024 ARCAL XLII 'Industrial Applications of the Tracer Technology and Nucleonic Control Systems'. Its objective is to establish the approaches for the design, the construction, the selection and the procedures for the sure operation of the Nucleonic Control Systems (NCS) in the industry. The NCS is used to control processes to high speeds, materials with extreme conditions or with noxious chemical properties, susceptible materials of being damaged by contact and packed products. In this document is defined the scope of the procedure. The SCN are classified according to: type of radiations, the mobility of the components, the degree of the beams collimation; and in function of the security. The design and construction criteria of the nuclear meters and of the systems of control nucleonic are exposed

  17. An assessment of methods for monitoring entrance surface dose in fluoroscopically guided interventional procedures

    International Nuclear Information System (INIS)

    Waite, J.C.; Fitzgerald, M.

    2001-01-01

    In the light of a growing awareness of the risks of inducing skin injuries as a consequence of fluoroscopically guided interventional procedures (FGIPs), this paper compares three methods of monitoring entrance surface dose (ESD). It also reports measurements of ESDs made during the period August 1998 to June 1999 on 137 patients undergoing cardiac, neurological and general FGIPs. Although the sample is small, the results reinforce the need for routine assessments to be made of ESDs in FGIPs. At present, the most reliable and accurate form of ESD measurement would seem to be arrays of TLDs. However, transducer based methods, although likely to be less accurate, have considerable advantages in relation to a continuous monitoring programme. It is also suggested that there may be the potential locally for threshold dose area product (DAP) values to be set for specific procedures. These could be used to provide early warning of the potential for skin injuries. (author)

  18. Performing MR-guided biopsies in clinical routine: factors that influence accuracy and procedure time

    International Nuclear Information System (INIS)

    Hoffmann, Ruediger; Thomas, Christoph; Rempp, Hansjoerg; Schmidt, Diethard; Claussen, Claus D.; Clasen, Stephan; Pereira, Philippe L.

    2012-01-01

    To assess the accuracy, the duration and factors that influence the duration of MRI-guided liver or soft-tissue biopsies. Nineteen liver biopsies and 19 soft-tissue biopsies performed using 1.5T-MRI guidance were retrospectively analysed. Diagnostic performance and complications were assessed. Intervention time was subdivided into preparation period, puncture period and control period. Correlation between procedure time and target size, skin-to-target-distance, used sequences and interventionalists' experience were analysed. Overall sensitivity, specificity and accuracy were 0.86, 1.0 and 0.92, respectively. Two minor complications occurred. Overall median procedure time was 103.5 min. Liver biopsies lasted longer than soft-tissue biopsies (mean [soft-tissue] : 73.0 min, mean [liver] : 134.1 min, P [liver] = 0.048, P [soft-tissue] = 0.005) was significantly prolonged for longer skin-to-target-distances. Lower numbers of image acquisitions (P [liver] = 0.0007, P [soft-tissue] = 0.0012) and interventionalists' experience reduces the procedure duration significantly (P < 0.05), besides all false-negative results appeared during the first five biopsies of each individual radiologist. The interventionalists' experience, skin-to-target-distances and number of image acquisition influence the procedure time significantly. (orig.)

  19. Exercise

    Science.gov (United States)

    ... decreased bone density with an increased risk of fracture, and shallow, inefficient breathing. An exercise program needs ... and-Soul (Feb. 2013 issue) (.pdf) Download Document Rehabilitation: Recommendations for Persons with MS (.pdf) Download Brochure ...

  20. Using probability density function in the procedure for recognition of the type of physical exercise

    Directory of Open Access Journals (Sweden)

    Cakić Nikola

    2017-01-01

    Full Text Available This paper presents a method for recognition of physical exercises, using only a triaxial accelerometer of a smartphone. The smartphone itself is free to move inside subject's pocket. Exercises for leg muscle strengthening from subject's standing position squat, right knee rise and lunge with right leg were analyzed. All exercises were performed with the accelerometric sensor of a smartphone placed in the pocket next to the leg used for exercises. In order to test the proposed recognition method, the knee rise exercise of the opposite leg with the same position of the sensor was randomly selected. Filtering of the raw accelerometric signals was carried out using Butterworth tenth-order low-pass filter. The filtered signals from each of the three axes were described using three signal descriptors. After the descriptors were calculated, a probability density function was constructed for each of the descriptors. The program that implemented the proposed recognition method was executed online within an Android application of the smartphone. Signals from two male and two female subjects were considered as a reference for exercise recognition. The exercise recognition accuracy was 94.22% for three performed exercises, and 85.33% for all four considered exercises.

  1. Comparison of transhepatic and extrahepatic routes for EUS-guided rendezvous procedure for distal CBD obstruction.

    Science.gov (United States)

    Dhir, Vinay; Bhandari, Suryaprakash; Bapat, Mukta; Joshi, Nitin; Vivekanandarajah, Suhirdan; Maydeo, Amit

    2013-04-01

    EUS-guided rendezvous procedure (EUS-RV) can be done by the transhepatic (TH) or the extrahepatic (EH) route. There is no data on the preferred access route when both routes are available. To compare the success, complications, and duration of hospitalization for patients undergoing EUS-RV by the TH or the EH route. Patients with distal common bile duct (CBD) obstruction, who failed selective cannulation, underwent EUS-RV by the TH route through the stomach or the EH route through the duodenum. A total of 35 patients were analysed (17 TH, 18 EH). The mean procedure time was significantly longer for the TH group (34.4 vs. 25.7 min; p = 0.0004). There was no difference in the technical success (94.1 vs. 100%). However, the TH group had a higher incidence of post-procedure pain (44.1 vs. 5.5%; p = 0.017), bile leak (11.7 vs. 0; p = 0.228), and air under diaphragm (11.7 vs. 0; p = 0.228). All bile leaks were small and managed conservatively. Duration of hospitalization was significantly higher for the TH group (2.52 vs. 0.17 days; p = 0.015). EUS-RV has similar success rate by the TH or the EH route. However, the TH route has higher post-procedure pain, longer procedure time, and longer duration of hospitalization. The EH route should be preferred for EUS-RV in patients with distal CBD obstruction when both access routes are technically feasible.

  2. Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit.

    Science.gov (United States)

    Pedicelli, Alessandro; Verdolotti, Tommaso; Pompucci, Angelo; Desiderio, Flora; D'Argento, Francesco; Colosimo, Cesare; Bonomo, Lorenzo

    2011-12-01

    The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180° and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of "CT-like" MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room.

  3. Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit

    International Nuclear Information System (INIS)

    Pedicelli, Alessandro; Verdolotti, Tommaso; Desiderio, Flora; D'Argento, Francesco; Colosimo, Cesare; Bonomo, Lorenzo; Pompucci, Angelo

    2011-01-01

    The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180 and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of ''CT-like'' MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room. (orig.)

  4. Interventional spinal procedures guided and controlled by a 3D rotational angiographic unit

    Energy Technology Data Exchange (ETDEWEB)

    Pedicelli, Alessandro; Verdolotti, Tommaso; Desiderio, Flora; D' Argento, Francesco; Colosimo, Cesare; Bonomo, Lorenzo [Catholic University of Rome, A. Gemelli Hospital, Department of Bioimaging and Radiological Sciences, Rome (Italy); Pompucci, Angelo [Catholic University of Rome, A. Gemelli Hospital, Department of Neurotraumatology, Rome (Italy)

    2011-12-15

    The aim of this paper is to demonstrate the usefulness of 2D multiplanar reformatting images (MPR) obtained from rotational acquisitions with cone-beam computed tomography technology during percutaneous extra-vascular spinal procedures performed in the angiography suite. We used a 3D rotational angiographic unit with a flat panel detector. MPR images were obtained from a rotational acquisition of 8 s (240 images at 30 fps), tube rotation of 180 and after post-processing of 5 s by a local work-station. Multislice CT (MSCT) is the best guidance system for spinal approaches permitting direct tomographic visualization of each spinal structure. Many operators, however, are trained with fluoroscopy, it is less expensive, allows real-time guidance, and in many centers the angiography suite is more frequently available for percutaneous procedures. We present our 6-year experience in fluoroscopy-guided spinal procedures, which were performed under different conditions using MPR images. We illustrate cases of vertebroplasty, epidural injections, selective foraminal nerve root block, facet block, percutaneous treatment of disc herniation and spine biopsy, all performed with the help of MPR images for guidance and control in the event of difficult or anatomically complex access. The integrated use of ''CT-like'' MPR images allows the execution of spinal procedures under fluoroscopy guidance alone in all cases of dorso-lumbar access, with evident limitation of risks and complications, and without need for recourse to MSCT guidance, thus eliminating CT-room time (often bearing high diagnostic charges), and avoiding organizational problems for procedures that need, for example, combined use of a C-arm in the CT room. (orig.)

  5. CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael Bernhard; Herber, Sascha; Koch, Ulrike; Oberholzer, Katja; Dueber, Christoph [Johannes Gutenberg-University of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Drees, Philip [University Hospital, Johannes Gutenberg-University of Mainz, Department of Orthopedic Surgery, Mainz (Germany)

    2008-11-15

    The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 {+-} 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 {+-} 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 {+-} 0.75 (range 1-6) and 1.01 {+-} 0.10, respectively. The amount of PMMA cement was 4.5 {+-} 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow

  6. CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures

    International Nuclear Information System (INIS)

    Pitton, Michael Bernhard; Herber, Sascha; Koch, Ulrike; Oberholzer, Katja; Dueber, Christoph; Drees, Philip

    2008-01-01

    The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 ± 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 ± 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 ± 0.75 (range 1-6) and 1.01 ± 0.10, respectively. The amount of PMMA cement was 4.5 ± 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow-up (15

  7. Eye lens dosimetry for fluoroscopically guided clinical procedures: practical approaches to protection and dose monitoring

    International Nuclear Information System (INIS)

    Martin, Colin J.

    2016-01-01

    Doses to the eye lenses of clinicians undertaking fluoroscopically guided procedures can exceed the dose annual limit of 20 mSv, so optimisation of radiation protection is essential. Ceiling-suspended shields and disposable radiation absorbing pads can reduce eye dose by factors of 2-7. Lead glasses that shield against exposures from the side can lower doses by 2.5-4.5 times. Training in effective use of protective devices is an essential element in achieving good protection and acceptable eye doses. Effective methods for dose monitoring are required to identify protection issues. Dosemeters worn adjacent to the eye provide the better option for interventional clinicians, but an unprotected dosemeter worn at the neck will give an indication of eye dose that is adequate for most interventional staff. Potential requirements for protective devices and dose monitoring can be determined from risk assessments using generic values for dose linked to examination workload. (author)

  8. Greater physician involvement improves coding outcomes in endobronchial ultrasound-guided transbronchial needle aspiration procedures.

    Science.gov (United States)

    Pillai, Anilkumar; Medford, Andrew R L

    2013-01-01

    Correct coding is essential for accurate reimbursement for clinical activity. Published data confirm that significant aberrations in coding occur, leading to considerable financial inaccuracies especially in interventional procedures such as endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Previous data reported a 15% coding error for EBUS-TBNA in a U.K. service. We hypothesised that greater physician involvement with coders would reduce EBUS-TBNA coding errors and financial disparity. The study was done as a prospective cohort study in the tertiary EBUS-TBNA service in Bristol. 165 consecutive patients between October 2009 and March 2012 underwent EBUS-TBNA for evaluation of unexplained mediastinal adenopathy on computed tomography. The chief coder was prospectively electronically informed of all procedures and cross-checked on a prospective database and by Trust Informatics. Cost and coding analysis was performed using the 2010-2011 tariffs. All 165 procedures (100%) were coded correctly as verified by Trust Informatics. This compares favourably with the 14.4% coding inaccuracy rate for EBUS-TBNA in a previous U.K. prospective cohort study [odds ratio 201.1 (1.1-357.5), p = 0.006]. Projected income loss was GBP 40,000 per year in the previous study, compared to a GBP 492,195 income here with no coding-attributable loss in revenue. Greater physician engagement with coders prevents coding errors and financial losses which can be significant especially in interventional specialties. The intervention can be as cheap, quick and simple as a prospective email to the coding team with cross-checks by Trust Informatics and against a procedural database. We suggest that all specialties should engage more with their coders using such a simple intervention to prevent revenue losses. Copyright © 2013 S. Karger AG, Basel.

  9. Navigation for fluoroscopy-guided cryo-balloon ablation procedures of atrial fibrillation

    Science.gov (United States)

    Bourier, Felix; Brost, Alexander; Kleinoeder, Andreas; Kurzendorfer, Tanja; Koch, Martin; Kiraly, Attila; Schneider, Hans-Juergen; Hornegger, Joachim; Strobel, Norbert; Kurzidim, Klaus

    2012-02-01

    Atrial fibrillation (AFib), the most common arrhythmia, has been identified as a major cause of stroke. The current standard in interventional treatment of AFib is the pulmonary vein isolation (PVI). PVI is guided by fluoroscopy or non-fluoroscopic electro-anatomic mapping systems (EAMS). Either classic point-to-point radio-frequency (RF)- catheter ablation or so-called single-shot-devices like cryo-balloons are used to achieve electrically isolation of the pulmonary veins and the left atrium (LA). Fluoroscopy-based systems render overlay images from pre-operative 3-D data sets which are then merged with fluoroscopic imaging, thereby adding detailed 3-D information to conventional fluoroscopy. EAMS provide tracking and visualization of RF catheters by means of electro-magnetic tracking. Unfortunately, current navigation systems, fluoroscopy-based or EAMS, do not provide tools to localize and visualize single shot devices like cryo-balloon catheters in 3-D. We present a prototype software for fluoroscopy-guided ablation procedures that is capable of superimposing 3-D datasets as well as reconstructing cyro-balloon catheters in 3-D. The 3-D cyro-balloon reconstruction was evaluated on 9 clinical data sets, yielded a reprojected 2-D error of 1.72 mm +/- 1.02 mm.

  10. Quality assurance procedure for a gamma guided stereotactic breast biopsy system.

    Science.gov (United States)

    Welch, Benjamin L; Brem, Rachel; Black, Rachel; Majewski, Stan

    2006-01-01

    A quality assurance procedure has been developed for a prototype gamma-ray guided stereotactic biopsy system. The system consists of a compact small-field-of-view gamma-ray camera mounted to the rotational arm of a Lorad stereotactic biopsy system. The small-field-of-view gamma-ray camera has been developed for clinical applications where mammographic X-ray localization is not possible. Marker sources that can be imaged with the gamma-camera have been designed and built for quality assurance testing and to provide a fiducial reference mark. An algorithm for determining the three dimensional location of a region of interest, such as a lesion, relative to the fiducial mark has been implemented into the software control of the camera. This system can be used to determine the three-dimensional location of a region of interest from a stereo pair of images and that information can be used to guide a biopsy needle to that site. Point source phantom tests performed with the system have demonstrated that the camera can be used to localize a point of interest to within 1 mm, which is satisfactory for its use in needle localization.

  11. Exercise

    DEFF Research Database (Denmark)

    Idorn, Manja; thor Straten, Eivind Per

    2016-01-01

    We recently demonstrated that voluntary exercise leads to an influx of immune cells in tumors and a greater than 60% reduction in tumor incidence and growth across several mouse models. Improved immunological control of tumor progression may have important clinical implications in the prevention...

  12. moBeat: Using Interactive Music to Guide and Motivate Users During Aerobic Exercising

    NARCIS (Netherlands)

    Vlist, van der B.J.J.; Bartneck, C.; Mäueler, S.

    2011-01-01

    An increasing number of people are having trouble staying fit and maintaining a healthy bodyweight because of lack of physical activity. Getting people to exercise is crucial. However, many struggle with developing healthy exercising habits, due to hurdles like having to leave the house and the

  13. MO-F-CAMPUS-I-02: Occupational Conceptus Doses From Fluoroscopically-Guided Interventional Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, J; Perisinakis, K; Solomou, G [University of Crete (Greece); Stratakis, J [University of Crete, Heraklion, Crete (Greece)

    2015-06-15

    Purpose: The aim of this method was to provide dosimetric data on conceptus dose for the pregnant employee who participates in fluoroscopically-guided interventional procedures. Methods: Scattered air-kerma dose rates were obtained for 17 fluoroscopic projections involved in interventional procedures. These projections were simulated on an anthropomorphic phantom placed on the examination table supine. The operating theater was divided into two grids relative to the long table sides. Each grid consisted of 33 cells spaced 0.50 m apart. During the simulated exposures, at each cell, scatter air-kerma rate was measured at 110 cm from the floor i.e. at the height of the waist of the pregnant worker. Air-kerma rates were divided by the dose area product (DAP) rate of each exposure to obtain normalized data. For each projection, measurements were performed for 3 kVp and 3 filtration values i.e. for 9 different x-ray spectra. All measurements were performed by using a modern C-arm angiographic system (Siemens Axiom Artis, Siemens, Germany) and a radiation meter equipped with an ionization chamber. Results: The results consist of 153 iso-dose maps, which show the spatial distribution of DAP-normalized scattered air-kerma doses at the waist level of a pregnant worker. Conceptus dose estimation is possible using air-kerma to embryo/fetal dose conversion coefficients published in a previous study (J Cardiovasc Electrophysiol, Vol. 16, pp. 1–8, July 2005). Using these maps, occupationally exposed pregnant personnel may select a working position for a certain projection that keeps abdominal dose as low as reasonably achievable. Taking into consideration the regulatory conceptus dose limit for occupational exposure, determination of the maximum workload allowed for the pregnant personnel is also possible. Conclusion: Data produced in this work allow for the anticipation of conceptus dose and the determination of the maximum workload for a pregnant worker from any

  14. MO-F-CAMPUS-I-02: Occupational Conceptus Doses From Fluoroscopically-Guided Interventional Procedures

    International Nuclear Information System (INIS)

    Damilakis, J; Perisinakis, K; Solomou, G; Stratakis, J

    2015-01-01

    Purpose: The aim of this method was to provide dosimetric data on conceptus dose for the pregnant employee who participates in fluoroscopically-guided interventional procedures. Methods: Scattered air-kerma dose rates were obtained for 17 fluoroscopic projections involved in interventional procedures. These projections were simulated on an anthropomorphic phantom placed on the examination table supine. The operating theater was divided into two grids relative to the long table sides. Each grid consisted of 33 cells spaced 0.50 m apart. During the simulated exposures, at each cell, scatter air-kerma rate was measured at 110 cm from the floor i.e. at the height of the waist of the pregnant worker. Air-kerma rates were divided by the dose area product (DAP) rate of each exposure to obtain normalized data. For each projection, measurements were performed for 3 kVp and 3 filtration values i.e. for 9 different x-ray spectra. All measurements were performed by using a modern C-arm angiographic system (Siemens Axiom Artis, Siemens, Germany) and a radiation meter equipped with an ionization chamber. Results: The results consist of 153 iso-dose maps, which show the spatial distribution of DAP-normalized scattered air-kerma doses at the waist level of a pregnant worker. Conceptus dose estimation is possible using air-kerma to embryo/fetal dose conversion coefficients published in a previous study (J Cardiovasc Electrophysiol, Vol. 16, pp. 1–8, July 2005). Using these maps, occupationally exposed pregnant personnel may select a working position for a certain projection that keeps abdominal dose as low as reasonably achievable. Taking into consideration the regulatory conceptus dose limit for occupational exposure, determination of the maximum workload allowed for the pregnant personnel is also possible. Conclusion: Data produced in this work allow for the anticipation of conceptus dose and the determination of the maximum workload for a pregnant worker from any

  15. Developing an automated database for monitoring ultrasound- and computed tomography-guided procedure complications and diagnostic yield.

    Science.gov (United States)

    Itri, Jason N; Jones, Lisa P; Kim, Woojin; Boonn, William W; Kolansky, Ana S; Hilton, Susan; Zafar, Hanna M

    2014-04-01

    Monitoring complications and diagnostic yield for image-guided procedures is an important component of maintaining high quality patient care promoted by professional societies in radiology and accreditation organizations such as the American College of Radiology (ACR) and Joint Commission. These outcome metrics can be used as part of a comprehensive quality assurance/quality improvement program to reduce variation in clinical practice, provide opportunities to engage in practice quality improvement, and contribute to developing national benchmarks and standards. The purpose of this article is to describe the development and successful implementation of an automated web-based software application to monitor procedural outcomes for US- and CT-guided procedures in an academic radiology department. The open source tools PHP: Hypertext Preprocessor (PHP) and MySQL were used to extract relevant procedural information from the Radiology Information System (RIS), auto-populate the procedure log database, and develop a user interface that generates real-time reports of complication rates and diagnostic yield by site and by operator. Utilizing structured radiology report templates resulted in significantly improved accuracy of information auto-populated from radiology reports, as well as greater compliance with manual data entry. An automated web-based procedure log database is an effective tool to reliably track complication rates and diagnostic yield for US- and CT-guided procedures performed in a radiology department.

  16. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    Energy Technology Data Exchange (ETDEWEB)

    Goncalves, B., E-mail: belarmino.goncalves@gmail.com [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Ambrosio, C.; Serra, S. [Department of Rheumatology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal); Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F. [Department of Radiology, Hospitais da Universidade de Coimbra - HUC, Coimbra (Portugal)

    2011-09-15

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  17. US-guided interventional joint procedures in patients with rheumatic diseases-When and how we do it?

    International Nuclear Information System (INIS)

    Goncalves, B.; Ambrosio, C.; Serra, S.; Alves, F.; Gil-Agostinho, A.; Caseiro-Alves, F.

    2011-01-01

    Objective: To describe the main indications and the technical steps to perform ultrasound guided procedures in patients with rheumatic diseases. To access procedures accuracy, safety and effectiveness. Materials and methods: 27 patients with pain related to articular complications of rheumatic diseases and according to previous radiographic or US exam were submitted to several US-guided procedures. 42% of patients (n = 11) had rheumatoid arthritis, 11% (n = 3) spondyloarthropathies, 18% (n = 5) psoriatic arthritis, 15% (n = 4) undifferentiated arthritis, 3% (n = 1) Sjoegren syndrome and 11% (n = 3) had gout. Described procedures are synovial biopsies, intra-articular injections of corticosteroids, radiation synovectomy and synovial cysts drainage procedures. When a therapeutical procedure was made, patients were evaluated by 2 rheumatologists. Corticosteroids used were Prednisolone and Triamcinolone. Yttrium-90 was used for synovectomy. Results: In all cases success was achieved with correct needle placement inside the joint. After injection/aspiration symptoms successfully solved with all patients improving their health status. No complications were recorded during follow-up period. Conclusions: US-guidance is very reliable to afford a safety procedure always checking the injection, biopsy or aspiration. Guided-biopsy has high success rates obtaining several samples. Thus is also possible to use more powerful/long acting therapeutic drugs aggressive to extra-articular structures avoiding complications.

  18. Application of Real-Time 3D Navigation System in CT-Guided Percutaneous Interventional Procedures: A Feasibility Study

    Directory of Open Access Journals (Sweden)

    Priya Bhattacharji

    2017-01-01

    Full Text Available Introduction. To evaluate the accuracy of a quantitative 3D navigation system for CT-guided interventional procedures in a two-part study. Materials and Methods. Twenty-two procedures were performed in abdominal and thoracic phantoms. Accuracies of the 3D anatomy map registration and navigation were evaluated. Time used for the navigated procedures was recorded. In the IRB approved clinical evaluation, 21 patients scheduled for CT-guided thoracic and hepatic biopsy and ablations were recruited. CT-guided procedures were performed without following the 3D navigation display. Accuracy of navigation as well as workflow fitness of the system was evaluated. Results. In phantoms, the average 3D anatomy map registration error was 1.79 mm. The average navigated needle placement accuracy for one-pass and two-pass procedures, respectively, was 2.0±0.7 mm and 2.8±1.1 mm in the liver and 2.7±1.7 mm and 3.0±1.4 mm in the lung. The average accuracy of the 3D navigation system in human subjects was 4.6 mm ± 3.1 for all procedures. The system fits the existing workflow of CT-guided interventions with minimum impact. Conclusion. A 3D navigation system can be performed along the existing workflow and has the potential to navigate precision needle placement in CT-guided interventional procedures.

  19. Three-dimensional C-arm CT-guided transjugular intrahepatic portosystemic shunt placement: Feasibility, technical success and procedural time

    Energy Technology Data Exchange (ETDEWEB)

    Ketelsen, Dominik; Groezinger, Gerd; Maurer, Michael; Grosse, Ulrich; Horger, Marius; Nikolaou, Konstantin; Syha, Roland [University of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Lauer, Ulrich M. [University of Tuebingen, Internal Medicine I, Department of Gastroenterology, Hepatology and Infectious disease, Tuebingen (Germany)

    2016-12-15

    Establishment of transjugular intrahepatic portosystemic shunts (TIPS) constitutes a standard procedure in patients suffering from portal hypertension. The most difficult step in TIPS placement is blind puncture of the portal vein. This study aimed to evaluate three-dimensional mapping of portal vein branches and targeted puncture of the portal vein. Twelve consecutive patients suffering from refractory ascites by liver cirrhosis were included in this retrospective study to evaluate feasibility, technical success and procedural time of C-arm CT-targeted puncture of the portal vein. As a control, 22 patients receiving TIPS placement with fluoroscopy-guided blind puncture were included to compare procedural time. Technical success could be obtained in 100 % of the study group (targeted puncture) and in 95.5 % of the control group (blind puncture). Appropriate, three-dimensional C-arm CT-guided mapping of the portal vein branches could be achieved in all patients. The median number of punctures in the C-arm CT-guided study group was 2 ± 1.3 punctures. Procedural time was significantly lower in the study group (14.8 ± 8.2 min) compared to the control group (32.6 ± 22.7 min) (p = 0.02). C-arm CT-guided portal vein mapping is technically feasible and a promising tool for TIPS placement resulting in a significant reduction of procedural time. (orig.)

  20. Can the diagnostic accuracy of radionuclide ventriculography during exercise be improved by means of a step-up loading procedure?

    International Nuclear Information System (INIS)

    Ruegenberg, T.

    1985-01-01

    34 patients (31 of whom were coronary heart disease sufferers as proven by angiography) and further 3 patients failing to show symptoms of this disorder were subjected to radionuclide ventriculography carried out with the aid of 99m Tc-labelled erythrocytes in such a way that examinations at rest were directly followed by maximum loading tests. In a second series of examinations a step-up procedure was adopted where initial recordings at rest were followed by preliminary exercise tests using only 25% of the maximum load. The parameters chosen to evaluate the results were heart rate, ejection fraction, maximum velocity of changes in volume, endsystolic and enddiastolic volumes (ESV and EDV) as well as cardiac output. In 23 patients the preliminary exercise test revealed an insufficient increase or even decrease of the ejection fraction that was associated with delayed volume changes, increases in ESV and EDV as well as reductions in cardiac output and in 21 patients it became evident during those examinations that the onset of stenocardiac complaints was preceded by markedly pronounced function disorders in the left ventricle. It was concluded from these findings that the step-up procedure followed here may in some patients provide additional information on the level of myocardial performance. It can thus be assumed to contribute considerably to higher diagnostic accuracy, although it requires no more time than conventional exercise tests and is not associated with additional radiation exposure. (TRV) [de

  1. THE VALUE OF REMOVING DAILY OBSTACLES VIA EVERYDAY PROBLEM SOLVING THEORY: DEVELOPING AN APPLIED NOVEL PROCEDURE TO INCREASE SELF-EFFICACY FOR EXERCISE

    Directory of Open Access Journals (Sweden)

    Daniele eArtistico

    2013-01-01

    Full Text Available The objective of the study was to develop a novel procedure to increase self-efficacy for exercise. Gains in one’s ability to resolve day-to-day obstacles for entering an exercise routine were expected to cause an increase in self-efficacy for exercise. Fifty-five sedentary participants (did not exercise regularly for at least 4 months prior to the study who expressed an intention to exercise in the near future were selected for the study. Participants were randomly assigned to one of three conditions: 1 an Experimental Group in which they received a problem-solving training session to learn new strategies for solving day-to-day obstacles that interfere with exercise, 2 a Control Group with Problem Solving Training which received a problem solving training session focused on a typical day-to-day problem unrelated to exercise, or 3 a Control Group which did not receive any problem-solving training. Assessment of obstacles to exercise and perceived self-efficacy for exercise were conducted at baseline; perceived self-efficacy for exercise was reassessed post-intervention (one week later. No differences in perceived challenges posed by obstacles to exercise or self-efficacy for exercise were observed across groups at baseline. The Experimental Group reported greater improvement in self-efficacy for exercise compared to the Control Group with Training (p < 0.01 and the Control Group (p < 0.01. Results of this study suggest that a novel procedure that focuses on removing obstacles to intended planned fitness activities is effective in increasing self-efficacy to engage in exercise among sedentary adults. Implications of these findings for use in applied settings and treatment studies are discussed.

  2. The Value of Removing Daily Obstacles via Everyday Problem-Solving Theory: Developing an Applied Novel Procedure to Increase Self-Efficacy for Exercise.

    Science.gov (United States)

    Artistico, Daniele; Pinto, Angela Marinilli; Douek, Jill; Black, Justin; Pezzuti, Lina

    2013-01-01

    The objective of the study was to develop a novel procedure to increase self-efficacy for exercise. Gains in one's ability to resolve day-to-day obstacles for entering an exercise routine were expected to cause an increase in self-efficacy for exercise. Fifty-five sedentary participants (did not exercise regularly for at least 4 months prior to the study) who expressed an intention to exercise in the near future were selected for the study. Participants were randomly assigned to one of three conditions: (1) an Experimental Group in which they received a problem-solving training session to learn new strategies for solving day-to-day obstacles that interfere with exercise, (2) a Control Group with Problem-Solving Training which received a problem-solving training session focused on a typical day-to-day problem unrelated to exercise, or (3) a Control Group which did not receive any problem-solving training. Assessment of obstacles to exercise and perceived self-efficacy for exercise were conducted at baseline; perceived self-efficacy for exercise was reassessed post-intervention (1 week later). No differences in perceived challenges posed by obstacles to exercise or self-efficacy for exercise were observed across groups at baseline. The Experimental Group reported greater improvement in self-efficacy for exercise compared to the Control Group with Training and the Control Group. Results of this study suggest that a novel procedure that focuses on removing obstacles to intended planned fitness activities is effective in increasing self-efficacy to engage in exercise among sedentary adults. Implications of these findings for use in applied settings and treatment studies are discussed.

  3. Patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures

    International Nuclear Information System (INIS)

    Ivanova, D.; Hristova-Popova, J.; Avramova-Cholakova, S.; Deyanova, Ts.; Dobrikov, R.

    2015-01-01

    Full text: The aim of this study is to evaluate patient and staff doses in fluoroscopically guided invasive diagnostic and interventional urology procedures. All the data were collected in the Emergency Hospital 'N. I. Pirogov'. While recording data for the patients, a real time dosimetry measurement of the medical staff was made. Air kerma-area product (KAP) was recorded for intravenous pyelogram (IVP), percutaneous nephrostomy (PN) and ureteral 'double-J' stenting. Patient data sex, age and weight were also taken. Staff doses were estimated with the system RaySafe i2. It contains four dosimeters, with a wireless connection to a real time display. The dosimeters were worn on the unprotected upper part of the body and measured the personal dose equivalent Hp(10). The mean KAP values for the procedures are: 3.21 Gy.cm 2 for IVP, 10.37 Gy.cm 2 for PN and 4.15 Gy.cm 2 for 'double-J' respectively. The highest staff dose for PN and 'double-J' is received by the urologist (160 μSv and 47.3 μSv, respectively), while for the IVP the radiographer has the highest exposure (20 μSv). Each member of the medical staff was on a different position in respect to the X-ray tube and the patient, which is the main reason for the differences in the staff doses. The variations in the mean patient and staff doses are mostly due to the interventions themselves, their complexity and the individual treatment of every patient. RaySafe i2 is very useful as guideline for making a choice of a better position and in the decreasing of radiation exposure to the staff

  4. Patient Dose Optimization in Fluoroscopically Guided Interventional Procedures. Final Report of a Coordinated Research Project

    International Nuclear Information System (INIS)

    2010-01-01

    In recent years, many surgical procedures have increasingly been replaced by interventional procedures that guide catheters into the arteries under X ray fluoroscopic guidance to perform a variety of operations such as ballooning, embolization, implantation of stents etc. The radiation exposure to patients and staff in such procedures is much higher than in simple radiographic examinations like X ray of chest or abdomen such that radiation induced skin injuries to patients and eye lens opacities among workers have been reported in the 1990's and after. Interventional procedures have grown both in frequency and importance during the last decade. This Coordinated Research Project (CRP) and TECDOC were developed within the International Atomic Energy Agency's (IAEA) framework of statutory responsibility to provide for the worldwide application of the standards for the protection of people against exposure to ionizing radiation. The CRP took place between 2003 and 2005 in six countries, with a view of optimizing the radiation protection of patients undergoing interventional procedures. The Fundamental Safety Principles and the International Basic Safety Standards for Protection against Ionizing Radiation (BSS) issued by the IAEA and co-sponsored by the Food and Agriculture Organization of the United Nations (FAO), the International Labour Organization (ILO), the World Health Organization (WHO), the Pan American Health Organization (PAHO) and the Nuclear Energy Agency (NEA), among others, require the radiation protection of patients undergoing medical exposures through justification of the procedures involved and through optimization. In keeping with its responsibility on the application of standards, the IAEA programme on Radiological Protection of Patients encourages the reduction of patient doses. To facilitate this, it has issued specific advice on the application of the BSS in the field of radiology in Safety Reports Series No. 39 and the three volumes on Radiation

  5. PRA Procedures Guide: a guide to the performance of probabilistic risk assessments for nuclear power plants. Final report, Volume 1 - Chapters 1-8

    International Nuclear Information System (INIS)

    1983-01-01

    This document, the Probabilistic Risk Assessment (PRA) Procedures Guide, is intended to provide an overview of the risk-assessment field as it exists today and to identify acceptable techniques for the systematic assessment of the risk from nuclear power plants. Topics discussed include: organization of PRA; accident-sequence definition and system modeling; human-reliability analysis; data-base development; accident-sequence quantification; physical processes of core-melt accidents; and radionuclide release and transport

  6. Verifying the buildingEXODUS through an emergency response procedure (ERP) exercise at an underground intervention shaft

    Science.gov (United States)

    Tajedi, Noor Aqilah A.; Sukor, Nur Sabahiah A.; Ismail, Mohd Ashraf M.; Shamsudin, Shahrul A.

    2017-10-01

    An Emergency Response Plan (ERP) is an essential safety procedure that needs to be taken into account for railway operations, especially for underground railway networks. Several parameters need to be taken into consideration in planning an ERP such as the design of tunnels and intervention shafts, and operation procedures for underground transportation systems. Therefore, the purpose of this paper is to observe and analyse the Emergency Response Procedure (ERP) exercise for the underground train network at the LRT Kelana Jaya Line. The exercise was conducted at one of the underground intervention shaft exits, where the height of the staircase from the bottom floor to the upper floor was 24.59 metres. Four cameras were located at selected levels of the shaft, and 71 participants were assigned for the evacuation exercise. The participants were tagged with a number at the front and back of their safety vests. Ten respondents were randomly selected to give details of their height and weight and, at the same time, they had to self-record the time taken for them to evacuate from the bottom to the top of the shaft. The video footages that were taken during the ERP were analysed, and the data were used for the verification process on the buildingEXODUS simulation software. It was found that the results of the ERP experiment were significantly similar to the simulation results, thereby successfully verifying the simulation. This verification process was important to ensure that the results of the simulation were in accordance with the real situation. Therefore, a further evacuation analysis made use of the results from this verification.

  7. Isolation of active constituents from cherry laurel (Laurocerasus officinalis Roem.) leaves through bioassay-guided procedures.

    Science.gov (United States)

    Akkol, Esra Küpeli; Kırmızıbekmez, Hasan; Küçükboyacı, Nurgün; Gören, Ahmet C; Yesilada, Erdem

    2012-01-31

    The fresh leaves of Laurocerasus officinalis Roem. (Rosaceae) are externally used against pain and feverish symptoms in Turkish folk medicine. Effects of the extracts, fractions and isolated compounds from the leaves of L. officinalis were investigated using in vivo models of inflammation and pain in mice. The crude ethanolic extract from the leaves of plant was sequentially fractionated into five subextracts; explicitly, n-hexane, chloroform, ethyl acetate (EtOAc), n-butanol, and remaining water extracts. Further studies were carried out on the most active EtOAc subextract was further subjected to fractionation through column chromatography. For the anti-inflammatory activity, carrageenan-induced hind paw edema and acetic acid-induced increase in capillary permeability models, and for the antinociceptive activity p-benzoquinone-induced writhing test in mice were employed. Ethanolic extract of the leaves was shown to possess significant inhibitory activity in the assay methods without inducing any gastric damage. Through bioassay-guided fractionation and isolation procedures three phenolic compounds, 2-O-β-D-glucopyranosyl-2-hydroxyphenyl-acetic acid (1), kaempferol-3-O-β-D-xylopyranosyl-(1→2)-O-β-D-glucopyranoside (2) and (+)-catechin (3) were isolated from the active fraction and their structures were elucidated by spectral techniques (1D and 2D NMR, ESIMS). The experimental data verified that Laurocerasus officinalis leaves displayed remarkable anti-inflammatory and antinociceptive activity. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  8. Occupational exposures during abdominal fluoroscopically guided interventional procedures for different patient sizes - A Monte Carlo approach.

    Science.gov (United States)

    Santos, William S; Belinato, Walmir; Perini, Ana P; Caldas, Linda V E; Galeano, Diego C; Santos, Carla J; Neves, Lucio P

    2018-01-01

    In this study we evaluated the occupational exposures during an abdominal fluoroscopically guided interventional radiology procedure. We investigated the relation between the Body Mass Index (BMI), of the patient, and the conversion coefficient values (CC) for a set of dosimetric quantities, used to assess the exposure risks of medical radiation workers. The study was performed using a set of male and female virtual anthropomorphic phantoms, of different body weights and sizes. In addition to these phantoms, a female and a male phantom, named FASH3 and MASH3 (reference virtual anthropomorphic phantoms), were also used to represent the medical radiation workers. The CC values, obtained as a function of the dose area product, were calculated for 87 exposure scenarios. In each exposure scenario, three phantoms, implemented in the MCNPX 2.7.0 code, were simultaneously used. These phantoms were utilized to represent a patient and medical radiation workers. The results showed that increasing the BMI of the patient, adjusted for each patient protocol, the CC values for medical radiation workers decrease. It is important to note that these results were obtained with fixed exposure parameters. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  9. moBeat: Using interactive music to guide and motivate users during aerobic exercising.

    Science.gov (United States)

    van der Vlist, Bram; Bartneck, Christoph; Mäueler, Sebastian

    2011-06-01

    An increasing number of people are having trouble staying fit and maintaining a healthy bodyweight because of lack of physical activity. Getting people to exercise is crucial. However, many struggle with developing healthy exercising habits, due to hurdles like having to leave the house and the boring character of endurance exercising. In this paper, we report on a design project that explores the use of audio to motivate and provide feedback and guidance during exercising in a home environment. We developed moBeat, a system that provides intensity-based coaching while exercising, giving real-time feedback on training pace and intensity by means of interactive music. We conducted a within-subject comparison between our moBeat system and a commercially available heart rate watch. With moBeat, we achieved a comparable success rate: our system has a significant, positive influence on intrinsic motivation and attentional focus, but we did not see significant differences with regard to either perceived exertion or effectiveness. Although promising, future research is needed.

  10. Patient and staff doses and relationships between them in fluoroscopically guided procedures

    International Nuclear Information System (INIS)

    Avramova-Cholakova, S.; Christova-Popova, Y.; Sagorska, A.

    2015-01-01

    Full text: Medical exposure has the main contribution to man-made sources of exposures to the population in developed countries. Fluoroscopically guided procedures in interventional cardiology, gastroenterology, urology, orthopaedics and others may be related to high doses to both patients and staff. The main risk for both groups is the radiation carcinogenesis and it is increasing with dose. However deterministic effects are also possible: severe patient skin injuries occur sometimes. There are such cases in Bulgarian radiological practice. For the medical staff, involved in the procedures, radiation induced cataract is observed occasionally. Learning objective: In many cases there is direct correlation between patient and staff doses. Several simple rules must be observed in order to decrease exposure. Rules related to patient: Patient dose (dose-area product (DAP), fluoroscopy time, number of series,number of images) should be recorded for every patient; The patient should be positioned as far away as possible from the x-ray tube and as closer as possible to the image intensifier/digital image receptor; Fluoroscopy time should be minimized; Pulsed fluoroscopy with the lowest dose rate and the lowest frame rate providing acceptable image quality should be used; Different skin areas should be exposed in different projections; Oblique projections increase the dose - they should be avoided; Magnification also increases the dose several times and should be avoided; The acquisition mode should be avoided; it delivers dozens of times higher doses. Minimal number of frames and cine runs should be used. Use of “last image hold” is encouraged; The x-ray beam should be collimated to the area of interest. Rules related to staff: The staff receives scattered radiation from patient’s body. Every measure to decrease patient’s dose decreases staff dose as well; Every available protective device should be used (lead apron, thyroid collar, lead glasses, screens). They

  11. Exercise therapy after ultrasound-guided corticosteroid injections in patients with subacromial pain syndrome

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Christensen, Robin; Rosager, Sara

    2016-01-01

    BACKGROUND: Subacromial pain syndrome (SAPS) accounts for around 50 % of all cases of shoulder pain. The most commonly used treatments are glucocorticosteroid (steroid) injections and exercise therapy; however, despite treatment SAPS patients often experience relapse of their symptoms. Therefore...... the clinical effect of combining steroid and exercise therapy is highly relevant to clarify. The aim of this randomized controlled trial was to investigate if exercise therapy added to steroid injection in patients with SAPS will improve the effect of the injection therapy on shoulder pain. METHODS......: In this two-arm randomized trial running over 26 weeks, patients with unilateral shoulder pain (> 4 weeks) and thickened subacromial bursa (> 2 mm on US) were included. At baseline all participants received two steroid injections into the painful shoulder with an interval of one week. Subsequently they were...

  12. Robust electromagnetically guided endoscopic procedure using enhanced particle swarm optimization for multimodal information fusion

    International Nuclear Information System (INIS)

    Luo, Xiongbiao; Wan, Ying; He, Xiangjian

    2015-01-01

    Purpose: Electromagnetically guided endoscopic procedure, which aims at accurately and robustly localizing the endoscope, involves multimodal sensory information during interventions. However, it still remains challenging in how to integrate these information for precise and stable endoscopic guidance. To tackle such a challenge, this paper proposes a new framework on the basis of an enhanced particle swarm optimization method to effectively fuse these information for accurate and continuous endoscope localization. Methods: The authors use the particle swarm optimization method, which is one of stochastic evolutionary computation algorithms, to effectively fuse the multimodal information including preoperative information (i.e., computed tomography images) as a frame of reference, endoscopic camera videos, and positional sensor measurements (i.e., electromagnetic sensor outputs). Since the evolutionary computation method usually limits its possible premature convergence and evolutionary factors, the authors introduce the current (endoscopic camera and electromagnetic sensor’s) observation to boost the particle swarm optimization and also adaptively update evolutionary parameters in accordance with spatial constraints and the current observation, resulting in advantageous performance in the enhanced algorithm. Results: The experimental results demonstrate that the authors’ proposed method provides a more accurate and robust endoscopic guidance framework than state-of-the-art methods. The average guidance accuracy of the authors’ framework was about 3.0 mm and 5.6° while the previous methods show at least 3.9 mm and 7.0°. The average position and orientation smoothness of their method was 1.0 mm and 1.6°, which is significantly better than the other methods at least with (2.0 mm and 2.6°). Additionally, the average visual quality of the endoscopic guidance was improved to 0.29. Conclusions: A robust electromagnetically guided endoscopy framework was

  13. Robust electromagnetically guided endoscopic procedure using enhanced particle swarm optimization for multimodal information fusion.

    Science.gov (United States)

    Luo, Xiongbiao; Wan, Ying; He, Xiangjian

    2015-04-01

    Electromagnetically guided endoscopic procedure, which aims at accurately and robustly localizing the endoscope, involves multimodal sensory information during interventions. However, it still remains challenging in how to integrate these information for precise and stable endoscopic guidance. To tackle such a challenge, this paper proposes a new framework on the basis of an enhanced particle swarm optimization method to effectively fuse these information for accurate and continuous endoscope localization. The authors use the particle swarm optimization method, which is one of stochastic evolutionary computation algorithms, to effectively fuse the multimodal information including preoperative information (i.e., computed tomography images) as a frame of reference, endoscopic camera videos, and positional sensor measurements (i.e., electromagnetic sensor outputs). Since the evolutionary computation method usually limits its possible premature convergence and evolutionary factors, the authors introduce the current (endoscopic camera and electromagnetic sensor's) observation to boost the particle swarm optimization and also adaptively update evolutionary parameters in accordance with spatial constraints and the current observation, resulting in advantageous performance in the enhanced algorithm. The experimental results demonstrate that the authors' proposed method provides a more accurate and robust endoscopic guidance framework than state-of-the-art methods. The average guidance accuracy of the authors' framework was about 3.0 mm and 5.6° while the previous methods show at least 3.9 mm and 7.0°. The average position and orientation smoothness of their method was 1.0 mm and 1.6°, which is significantly better than the other methods at least with (2.0 mm and 2.6°). Additionally, the average visual quality of the endoscopic guidance was improved to 0.29. A robust electromagnetically guided endoscopy framework was proposed on the basis of an enhanced particle swarm

  14. Robust electromagnetically guided endoscopic procedure using enhanced particle swarm optimization for multimodal information fusion

    Energy Technology Data Exchange (ETDEWEB)

    Luo, Xiongbiao, E-mail: xluo@robarts.ca, E-mail: Ying.Wan@student.uts.edu.au [Robarts Research Institute, Western University, London, Ontario N6A 5K8 (Canada); Wan, Ying, E-mail: xluo@robarts.ca, E-mail: Ying.Wan@student.uts.edu.au; He, Xiangjian [School of Computing and Communications, University of Technology, Sydney, New South Wales 2007 (Australia)

    2015-04-15

    Purpose: Electromagnetically guided endoscopic procedure, which aims at accurately and robustly localizing the endoscope, involves multimodal sensory information during interventions. However, it still remains challenging in how to integrate these information for precise and stable endoscopic guidance. To tackle such a challenge, this paper proposes a new framework on the basis of an enhanced particle swarm optimization method to effectively fuse these information for accurate and continuous endoscope localization. Methods: The authors use the particle swarm optimization method, which is one of stochastic evolutionary computation algorithms, to effectively fuse the multimodal information including preoperative information (i.e., computed tomography images) as a frame of reference, endoscopic camera videos, and positional sensor measurements (i.e., electromagnetic sensor outputs). Since the evolutionary computation method usually limits its possible premature convergence and evolutionary factors, the authors introduce the current (endoscopic camera and electromagnetic sensor’s) observation to boost the particle swarm optimization and also adaptively update evolutionary parameters in accordance with spatial constraints and the current observation, resulting in advantageous performance in the enhanced algorithm. Results: The experimental results demonstrate that the authors’ proposed method provides a more accurate and robust endoscopic guidance framework than state-of-the-art methods. The average guidance accuracy of the authors’ framework was about 3.0 mm and 5.6° while the previous methods show at least 3.9 mm and 7.0°. The average position and orientation smoothness of their method was 1.0 mm and 1.6°, which is significantly better than the other methods at least with (2.0 mm and 2.6°). Additionally, the average visual quality of the endoscopic guidance was improved to 0.29. Conclusions: A robust electromagnetically guided endoscopy framework was

  15. Delphi Method Validation of a Procedural Performance Checklist for Insertion of an Ultrasound-Guided Internal Jugular Central Line.

    Science.gov (United States)

    Hartman, Nicholas; Wittler, Mary; Askew, Kim; Manthey, David

    2016-01-01

    Placement of ultrasound-guided central lines is a critical skill for physicians in several specialties. Improving the quality of care delivered surrounding this procedure demands rigorous measurement of competency, and validated tools to assess performance are essential. Using the iterative, modified Delphi technique and experts in multiple disciplines across the United States, the study team created a 30-item checklist designed to assess competency in the placement of ultrasound-guided internal jugular central lines. Cronbach α was .94, indicating an excellent degree of internal consistency. Further validation of this checklist will require its implementation in simulated and clinical environments. © The Author(s) 2014.

  16. Self-rating level of perceived exertion for guiding exercise intensity during a 12-week cardiac rehabilitation programme and the influence of heart rate reducing medication

    DEFF Research Database (Denmark)

    Tang, Lars H.; Zwisler, Ann-Dorthe; Taylor, Rod S

    2016-01-01

    OBJECTIVES: To investigate whether self-rating level of perceived exertion can adequately guide exercise intensity during a 12-week cardiac rehabilitation programme. DESIGN: Linear regression analysis using rehabilitation data from two randomised controlled trials. METHODS: Patients undergoing ra......-led and self-regulated model using rating of perceived exertion can help guide exercise intensity in everyday clinical practice among patients with heart disease, irrespective if they are taking heart rate-reducing medication....... radiofrequency ablation for atrial fibrillation or following heart valve surgery and participating in exercise-based rehabilitation were included. The 12-week rehabilitation outpatient programme comprised three weekly training sessions, each consisting of 20min aerobic exercise divided into three steps. Patients...... were asked to base their exercise intensity for each step on a predefined rating of perceived exertion specified in a training diary. Exercise intensity was objectively measured by heart rate during the last 2min for each exercise step. Comparative analysis and linear regression of the rating...

  17. Preliminary assessment of the dose to the interventional radiologist in fluoro-CT-guided procedures

    International Nuclear Information System (INIS)

    Pereira, M. F.; Alves, J. G.; Sarmento, S.; Santos, J. A. M.; Sousa, M. J.; Gouvea, M.; Oliveira, A. D.; Cardoso, J. V.; Santos, L. M.

    2011-01-01

    A preliminary assessment of the occupational dose to the intervention radiologist received in fluoroscopy computerised tomography (CT) used to guide the collection of lung and bone biopsies is presented. The main aim of this work was to evaluate the capability of the reading system as well as of the available whole-body (WB) and extremity dosemeters used in routine monthly monitoring periods to measure per procedure dose values. The intervention radiologist was allocated 10 WB detectors (LiF: Mg, Ti, TLD-100) placed at chest and abdomen levels above and below the lead apron, and at both right and left arms, knees and feet. A special glove was developed with casings for the insertion of 11 extremity detectors (LiF:Mg, Cu, P, TLD-100H) for the identification of the most highly exposed fingers. The H p (10) dose values received above the lead apron (ranged 0.20-0.02 mSv) depend mainly on the duration of the examination and on the placement of physician relative to the beam, while values below the apron are relatively low. The left arm seems to receive a higher dose value. H p (0.07) values to the hand (ranged 36.30-0.06 mSv) show that the index, middle and ring fingers are the most highly exposed. In this study, the wrist dose was negligible compared with the finger dose. These results are preliminary and further studies are needed to better characterise the dose assessment in CT fluoroscopy. (authors)

  18. Ultrasound-Guided Application of Percutaneous Electrolysis as an Adjunct to Exercise and Manual Therapy for Subacromial Pain Syndrome: a Randomized Clinical Trial.

    Science.gov (United States)

    de-Miguel-Valtierra, Lorena; Salom-Moreno, Jaime; Fernández-de-Las-Peñas, César; Cleland, Joshua A; Arias-Buría, José L

    2018-05-16

    This randomized clinical trial compared the effects of adding US-guided percutaneous electrolysis into a program consisting of manual therapy and exercise on pain, related-disability, function and pressure sensitivity in subacromial pain syndrome. Fifty patients with subacromial pain syndrome were randomized into manual therapy and exercise or percutaneous electrolysis group. All patients received the same manual therapy and exercise program, one session per week for 5 consecutive weeks. Patients assigned to the electrolysis group also received the application of percutaneous electrolysis at each session. The primary outcome was Disabilities of the Arm, Shoulder and Hand (DASH). Secondary outcomes included pain, function (Shoulder Pain and Disability Index-SPADI) pressure pain thresholds (PPTs) and Global Rating of Change (GROC). They were assessed at baseline, post-treatment, and 3, and 6 months after treatment. Both groups showed similar improvements in the primary outcome (DASH) at all follow-ups (P=0.051). Subjects receiving manual therapy, exercise, and percutaneous electrolysis showed significantly greater changes in shoulder pain (P0.91) for shoulder pain and function at 3 and 6 months in favour of the percutaneous electrolysis group. No between-groups differences in PPT were found. The current clinical trial found that the inclusion of US-guided percutaneous electrolysis in combination with manual therapy and exercise resulted in no significant differences for related-disability (DASH) than the application of manual therapy and exercise alone in patients with subacromial pain syndrome. Nevertheless, differences were reported for some secondary outcomes such as shoulder pain and function (SPADI). Whether or not these effects are reliable should be addressed in future studies Perspective This study found that the inclusion of US-guided percutaneous electrolysis into a manual therapy and exercise program resulted in no significant differences for disability

  19. Teacher's Guide to Canal. The Middlesex Canal: A Role Playing Exercise.

    Science.gov (United States)

    Holmes, Cary W.; Tedesco, Paul H.

    The document consists of a role-playing game and related teacher's guide designed to illustrate decision-making processes leading to the building of the Middlesex Canal in Massachusetts in 1793. The primary educational objective is to involve students in the decision-making process through role play. The game is designed to facilitate…

  20. Effect of a procedural video CD and study guide on the practical fixed prosthodontic performance of Iranian dental students.

    Science.gov (United States)

    Nikzad, Sakineh; Azari, Abbas; Mahgoli, Hosseinali; Akhoundi, Nasrin

    2012-03-01

    Dental students in programs around the world typically pass preclinical courses before entering the clinic and working on actual patients. Since fixed prosthodontics is a preclinical course that requires a great deal of effort, students may experience a substantial amount of stress that may affect their self-confidence and/or clinical performance. In this study, an instructional video CD (VCD) and study guide depicting the step-by-step procedures involved in a metal-ceramic tooth preparation and provisional crown fabrication was prepared. Students at the Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran, were divided randomly into two groups. Group A students trained as usual with live patients, and Group B students were given a copy of the VCD and study guide following a lecture. The students in Group B were encouraged to read the study guide and watch the VCD after live demonstrations. Then, both groups practiced individually on mannequins. At the end of the course, the students completed a sixteen-item questionnaire about their stress level, self-confidence, and knowledge base. The results showed that the students exposed to the extra media performed significantly better on some practical phases, e.g., laboratory procedures. A moderate, insignificant correlation was detected between exposure to media and decreasing the students' stress and self-esteem. We concluded that supplementary teaching aids such as a VCD and study guide may improve the clinical performance of dental students to some extent, but the live demonstration is still preferred by students.

  1. El camino hacia la buena salud: Guia para el maestro. Cuaderno de ejercicios (The Road to Good Health: Teacher's Guide. Exercise Book).

    Science.gov (United States)

    Villarreal, Abelardo; And Others

    This Spanish language curriculum guide is divided into three parts: a teacher's guide consisting of eight units--"An Adequate Diet,""Brushing Your Teeth,""A Visit to the Dentist,""Is It Necessary to Sleep?", "Who Can Do Better?", "A Visit to the Doctor,""Resting,""Bathing"--with material and procedural suggestions and a variety of lessons in each…

  2. Workflow optimisation for multimodal imaging procedures: a case of combined X-ray and MRI-guided TACE.

    Science.gov (United States)

    Fernández-Gutiérrez, Fabiola; Wolska-Krawczyk, Malgorzata; Buecker, Arno; Houston, J Graeme; Melzer, Andreas

    2017-02-01

    This study presents a framework for workflow optimisation of multimodal image-guided procedures (MIGP) based on discrete event simulation (DES). A case of a combined X-Ray and magnetic resonance image-guided transarterial chemoembolisation (TACE) is presented to illustrate the application of this method. We used a ranking and selection optimisation algorithm to measure the performance of a number of proposed alternatives to improve a current scenario. A DES model was implemented with detail data collected from 59 TACE procedures and durations of magnetic resonance imaging (MRI) diagnostic procedures usually performed in a common MRI suite. Fourteen alternatives were proposed and assessed to minimise the waiting times and improve workflow. Data analysis observed an average of 20.68 (7.68) min of waiting between angiography and MRI for TACE patients in 71.19% of the cases. Following the optimisation analysis, an alternative was identified to reduce waiting times in angiography suite up to 48.74%. The model helped to understand and detect 'bottlenecks' during multimodal TACE procedures, identifying a better alternative to the current workflow and reducing waiting times. Simulation-based workflow analysis provides a cost-effective way to face some of the challenges of introducing MIGP in clinical radiology, highligthed in this study.

  3. Proposed recommended procedure for the use of OAEs in hearing conservation: A Delphi exercise: Presentation

    CSIR Research Space (South Africa)

    Edwards, A

    2013-10-01

    Full Text Available 6 Methodology • well suited as a method for consensus-building • designed as a group communication process • aims to achieve a convergence of opinion on a specific real- world issue • Techniques used - Conference telephonic calls... Recommended Procedure Interpretation guidelines If 3-5dBSPL reduction in emission from previous test at any frequency counsel client and warn of deterioration. Review other results on similar exposed workers. If similar or greater deterioration...

  4. Magnetic resonance tomography-guided interventional procedure for diagnosis of prostate cancer

    International Nuclear Information System (INIS)

    Schernthaner, M.; Helbich, T.H.; Fueger, B.J.; Memarsadeghi, M.; Stiglbauer, A.; Linhart, H.G.; Doan, A.; Pinker, K.; Brader, P.; Margreiter, M.

    2011-01-01

    In recent years magnetic resonance imaging (MRI) has been increasingly established in the diagnosis of prostate cancer in addition to transrectal ultrasonography (TRUS). The use of T2-weighted imaging allows an exact delineation of the zonal anatomy of the prostate and its surrounding structures. Other MR imaging tools, such as dynamic contrast-enhanced T1-weighted imaging or diffusion-weighted imaging allow an inference of the biochemical characteristics (multiparametric MRI). Prostate cancer, which could only be diagnosed using MR imaging or lesions suspected as being prostate cancer, which are localized in the anterior aspect of the prostate and were missed with repetitive TRUS biopsy, need to undergo MR guided biopsy. Recent studies have shown a good correlation between MR imaging and histopathology of specimens collected by MR-guided biopsy. Improved lesion targeting is therefore possible with MR-guided biopsy. So far data suggest that MR-guided biopsy of the prostate is a promising alternative diagnostic tool to TRUS-guided biopsy. (orig.) [de

  5. Dosimetric evaluation of the OneDoseTM MOSFET for measuring kilovoltage imaging dose from image-guided radiotherapy procedures.

    Science.gov (United States)

    Ding, George X; Coffey, Charles W

    2010-09-01

    The purpose of this study is to investigate the feasibility of using a single-use dosimeter, OneDose MOSFET designed for in vivo patient dosimetry, for measuring the radiation dose from kilovoltage (kV) x rays resulting from image-guided procedures. The OneDose MOSFET dosimeters were precalibrated by the manufacturer using Co-60 beams. Their energy response and characteristics for kV x rays were investigated by using an ionization chamber, in which the air-kerma calibration factors were obtained from an Accredited Dosimetry Calibration Laboratory (ADCL). The dosimetric properties have been tested for typical kV beams used in image-guided radiation therapy (IGRT). The direct dose reading from the OneDose system needs to be multiplied by a correction factor ranging from 0.30 to 0.35 for kilovoltage x rays ranging from 50 to 125 kVp, respectively. In addition to energy response, the OneDose dosimeter has up to a 20% reduced sensitivity for beams (70-125 kVp) incident from the back of the OneDose detector. The uncertainty in measuring dose resulting from a kilovoltage beam used in IGRT is approximately 20%; this uncertainty is mainly due to the sensitivity dependence of the incident beam direction relative to the OneDose detector. The ease of use may allow the dosimeter to be suitable for estimating the dose resulting from image-guided procedures.

  6. Assessment in Counseling: A Guide to the Use of Psychological Assessment Procedures. Third Edition.

    Science.gov (United States)

    Hood, Albert B.; Johnson, Richard W.

    This book presents information about various psychological assessment procedures that are specifically relevant for practicing counselors. It deals with the use of assessment procedures in the counseling process and emphasizes the selection, interpretation, and communication of psychological test results. The importance of integrating test results…

  7. Radiology of non-spinal pain procedures. A guide for the interventionalist

    International Nuclear Information System (INIS)

    Syed, Mubin I.; Shaikh, Azin

    2011-01-01

    Most interventionalists are not radiologists and most radiologists do not understand interventional pain procedures. Nevertheless, interventionalists order extensive diagnostic imaging in the workup prior to any intervention. Against this background, this handy, well-illustrated manual has been designed to meet the major need of interventional pain physicians to understand the radiologic imaging involved in the performance of non-spinal pain procedures. It provides information on such topics as radiologic anatomy, the radiologic manifestations of indications and contraindications to interventional procedures, and the radiologic appearance of complications that may arise from these procedures. In addition, it will be useful for the diagnostic radiologist, who may be unaware of many of the interventional pain procedures. The chosen format will ensure that the reader is quickly able to reference any given procedure. Sections are devoted to the head and neck, thorax, abdomen, pelvis, and the upper and lower extremities. As this is a guidebook, it does not encompass every single pathologic entity that may be encountered; however, the commonly performed non-spinal pain procedures are included. This text will prove essential for any interventionalist who does not have easy access to a radiologist and vice versa. (orig.)

  8. Radiology of non-spinal pain procedures. A guide for the interventionalist

    Energy Technology Data Exchange (ETDEWEB)

    Syed, Mubin I. [Dayton Interventional Radiology, Dayton, OH (United States); Shaikh, Azin

    2011-07-01

    Most interventionalists are not radiologists and most radiologists do not understand interventional pain procedures. Nevertheless, interventionalists order extensive diagnostic imaging in the workup prior to any intervention. Against this background, this handy, well-illustrated manual has been designed to meet the major need of interventional pain physicians to understand the radiologic imaging involved in the performance of non-spinal pain procedures. It provides information on such topics as radiologic anatomy, the radiologic manifestations of indications and contraindications to interventional procedures, and the radiologic appearance of complications that may arise from these procedures. In addition, it will be useful for the diagnostic radiologist, who may be unaware of many of the interventional pain procedures. The chosen format will ensure that the reader is quickly able to reference any given procedure. Sections are devoted to the head and neck, thorax, abdomen, pelvis, and the upper and lower extremities. As this is a guidebook, it does not encompass every single pathologic entity that may be encountered; however, the commonly performed non-spinal pain procedures are included. This text will prove essential for any interventionalist who does not have easy access to a radiologist and vice versa. (orig.)

  9. An exercise to establish optimum procedures for the characterisation of porosity in UO2 fuel pellets

    International Nuclear Information System (INIS)

    Small, G.J.

    1980-05-01

    A standard metallographic preparation technique for UO 2 is proposed. The criteria for choosing the optimum route are that the specimen should be scratch-free and that the pores inherent to any sintered UO 2 pellet should be neither enlarged nor filled-in during preparation. Having met these criteria one has a specimen suitable for quantitative metallography which can be used to monitor porosity changes due to in-pile sintering. A procedure for analysing the porosity is suggested. This consists of imaging the specimen surface over a range of magnifications using both optical and Scanning Electron Microscopy in order to cover the range of pore sizes of interest (0.1 μm to 10 μm diameter). These images are then analysed to obtain figures for the distribution of pores as a function of diameter. Two methods of pore-size analysis are reviewed, the manual Zeiss Particle Size Analyser and a more sophisticated electronic instrument - the Quantimet. A comparison is made between these two instruments on the basis of accuracy, reproducibility and ease of operation. (author)

  10. Operational limits and conditions and operating procedures for research reactors. Safety guide

    International Nuclear Information System (INIS)

    2008-01-01

    This publication provides practical guidance on all important aspects of developing, formulating and presenting the operational limits and conditions as well as the operating procedures for research reactors. It covers the concept of operational limits and conditions, their content, and the responsibilities of the operating organization with respect to their establishment, modification, documentation and compliance. The guidance also covers the training of operating personnel on performing periodic testing, established by the operational limits and conditions, and operating procedures

  11. Determination of optimal ultrasound planes for the initialisation of image registration during endoscopic ultrasound-guided procedures.

    Science.gov (United States)

    Bonmati, Ester; Hu, Yipeng; Gibson, Eli; Uribarri, Laura; Keane, Geri; Gurusami, Kurinchi; Davidson, Brian; Pereira, Stephen P; Clarkson, Matthew J; Barratt, Dean C

    2018-06-01

    Navigation of endoscopic ultrasound (EUS)-guided procedures of the upper gastrointestinal (GI) system can be technically challenging due to the small fields-of-view of ultrasound and optical devices, as well as the anatomical variability and limited number of orienting landmarks during navigation. Co-registration of an EUS device and a pre-procedure 3D image can enhance the ability to navigate. However, the fidelity of this contextual information depends on the accuracy of registration. The purpose of this study was to develop and test the feasibility of a simulation-based planning method for pre-selecting patient-specific EUS-visible anatomical landmark locations to maximise the accuracy and robustness of a feature-based multimodality registration method. A registration approach was adopted in which landmarks are registered to anatomical structures segmented from the pre-procedure volume. The predicted target registration errors (TREs) of EUS-CT registration were estimated using simulated visible anatomical landmarks and a Monte Carlo simulation of landmark localisation error. The optimal planes were selected based on the 90th percentile of TREs, which provide a robust and more accurate EUS-CT registration initialisation. The method was evaluated by comparing the accuracy and robustness of registrations initialised using optimised planes versus non-optimised planes using manually segmented CT images and simulated ([Formula: see text]) or retrospective clinical ([Formula: see text]) EUS landmarks. The results show a lower 90th percentile TRE when registration is initialised using the optimised planes compared with a non-optimised initialisation approach (p value [Formula: see text]). The proposed simulation-based method to find optimised EUS planes and landmarks for EUS-guided procedures may have the potential to improve registration accuracy. Further work will investigate applying the technique in a clinical setting.

  12. Risk evaluations of aging: Procedures guide for an age-dependent PSA with emphasis on prioritization and sensitivity studies

    International Nuclear Information System (INIS)

    Vesely, W.E.

    1991-01-01

    Based on the previous work which has been performed in the project, a procedures guide is being developed for carrying out an age-dependent probabilistic safety assessment (PSA) for evaluating the core damage frequency with aging effects explicitly treated. A PSA is basically a Level 1 Probabilistic Risk Assessment (PRA). The emphasis of the guide is on prioritization and sensitivity studies. Focus is also on active components although consideration of aging effects in passive components is also treated. The guide is intended to become a NUREG/CR and is the first of three volumes which are being developed. The following topics with demonstrations and applications are described in the presentation: (1) the age-dependent PSA versus the standard PSA; (2) component reliability models used in an age-dependent PSA; (3) approaches for transforming a PSA into an age-dependent PSA; (4) application of an age-dependent PSA; (5) using a PSA to evaluate the risk effects from aging passive components; (6) evaluation of the risk importance of passive components; (7) prioritizations of aging contributors; (8) evaluations of test and maintenance effectiveness; and (9) sensitivity studies and uncertainty analyses of aging effects

  13. Stereotaxic microsurgical procedures of cerebral intracranial tumors guided by image and attended by computer

    International Nuclear Information System (INIS)

    Lopez Flores, Gerardo; Guerra Figueredo, Eritk; Ochoa Zaldivar, Luis

    2000-01-01

    It is reported that spatial guidance during microsurgery is an essential element. This application of stereotaxic surgery is shown at the International Center of Neurological Restoration (Cirene) from May, 1994, to February, 1998, on describing the performance of 65 microsurgical procedures under stereotaxic conditions among 62 patients with cerebral intracranial tumors. The procedure was divided into 3 stages: image acquisition, Cat, surgical planning , with Stasis planning system, and microsurgical procedures that included the Leksell, Micromar and Esteroflex stereotaxic systems. 27 of the total of patients presented glial tumors; 33, non-glial; and only 2 non-neoplastic lesions of diverse localization and size. 30 total resections We're made. Surgical morbidity was minimum and there was no surgical mortality. The main advantages of this method are: exact localization of the craniotomy, easy spatial guidance, and the opportunity to distinguish the limits between the tumor and the sound tissue. The possibility to apply Esteroflex to cerebral microsurgery was demonstrated

  14. MO-F-CAMPUS-I-01: A System for Automatically Calculating Organ and Effective Dose for Fluoroscopically-Guided Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Xiong, Z; Vijayan, S; Rana, V; Rudin, S; Bednarek, D [Toshiba Stroke and Vascular Research Center, University at Buffalo, Buffalo, NY (United States)

    2015-06-15

    Purpose: A system was developed that automatically calculates the organ and effective dose for individual fluoroscopically-guided procedures using a log of the clinical exposure parameters. Methods: We have previously developed a dose tracking system (DTS) to provide a real-time color-coded 3D- mapping of skin dose. This software produces a log file of all geometry and exposure parameters for every x-ray pulse during a procedure. The data in the log files is input into PCXMC, a Monte Carlo program that calculates organ and effective dose for projections and exposure parameters set by the user. We developed a MATLAB program to read data from the log files produced by the DTS and to automatically generate the definition files in the format used by PCXMC. The processing is done at the end of a procedure after all exposures are completed. Since there are thousands of exposure pulses with various parameters for fluoroscopy, DA and DSA and at various projections, the data for exposures with similar parameters is grouped prior to entry into PCXMC to reduce the number of Monte Carlo calculations that need to be performed. Results: The software developed automatically transfers data from the DTS log file to PCXMC and runs the program for each grouping of exposure pulses. When the dose from all exposure events are calculated, the doses for each organ and all effective doses are summed to obtain procedure totals. For a complicated interventional procedure, the calculations can be completed on a PC without manual intervention in less than 30 minutes depending on the level of data grouping. Conclusion: This system allows organ dose to be calculated for individual procedures for every patient without tedious calculations or data entry so that estimates of stochastic risk can be obtained in addition to the deterministic risk estimate provided by the DTS. Partial support from NIH grant R01EB002873 and Toshiba Medical Systems Corp.

  15. Technical procedures for template-guided surgery for mandibular reconstruction based on digital design and manufacturing.

    Science.gov (United States)

    Liu, Yun-feng; Xu, Liang-wei; Zhu, Hui-yong; Liu, Sean Shih-Yao

    2014-05-23

    The occurrence of mandibular defects caused by tumors has been continuously increasing in China in recent years. Conversely, results of the repair of mandibular defects affect the recovery of oral function and patient appearance, and the requirements for accuracy and high surgical quality must be more stringent. Digital techniques--including model reconstruction based on medical images, computer-aided design, and additive manufacturing--have been widely used in modern medicine to improve the accuracy and quality of diagnosis and surgery. However, some special software platforms and services from international companies are not always available for most of researchers and surgeons because they are expensive and time-consuming. Here, a new technical solution for guided surgery for the repair of mandibular defects is proposed, based on general popular tools in medical image processing, 3D (3 dimension) model reconstruction, digital design, and fabrication via 3D printing. First, CT (computerized tomography) images are processed to reconstruct the 3D model of the mandible and fibular bone. The defect area is then replaced by healthy contralateral bone to create the repair model. With the repair model as reference, the graft shape and cutline are designed on fibular bone, as is the guide for cutting and shaping. The physical model, fabricated via 3D printing, including surgical guide, the original model, and the repair model, can be used to preform a titanium locking plate, as well as to design and verify the surgical plan and guide. In clinics, surgeons can operate with the help of the surgical guide and preformed plate to realize the predesigned surgical plan. With sufficient communication between engineers and surgeons, an optimal surgical plan can be designed via some common software platforms but needs to be translated to the clinic. Based on customized models and tools, including three surgical guides, preformed titanium plate for fixation, and physical models of

  16. Computed tomography guided needle biopsy: experience from 1,300 procedures

    Energy Technology Data Exchange (ETDEWEB)

    Chojniak, Rubens; Isberner, Rony Klaus; Viana, Luciana Marinho; Yu, Liao Shin; Aita, Alessandro Amorim; Soares, Fernando Augusto [Hospital do Cancer A.C. Camargo, Sao Paulo, SP (Brazil). Dept. de Radiologia e Patologia

    2006-01-15

    Context and objective: computed tomography (CT) guided biopsy is widely accepted as effective and safe for diagnosis in many settings. Accuracy depends on target organ and needle type. Cutting needles present advantages over fine needles. This study presents experience from CT guided biopsies performed at an oncology center. Design and setting: retrospective study at Hospital do Cancer A. C. Camargo, Sao Paulo.Methods: 1,300 consecutive CT guided biopsies performed between July 1994 and February 2000 were analyzed. Nodules or masses were suspected as primary malignancy in 845 cases (65%) or metastatic lesion in 455 (35%). 628 lesions were thoracic, 281 abdominal, 208 retroperitoneal, 134 musculoskeletal and 49 head/neck. All biopsies were performed by one radiologist or under his supervision: 765 (59%) with 22-gauge fine-needle/aspiration technique and 535 (41%) with automated 16 or 18-gauge cutting-needle biopsy. Results: adequate samples were obtained in 70-92% of fine-needle and 93-100% of cutting-needle biopsies. The specific diagnosis rates were 54-67% for fine-needle and 82-100% for cutting-needle biopsies, according to biopsy site. For any site, sample adequacy and specific diagnosis rate were always better for cutting-needle biopsy. Among 530 lung biopsies, there were 84 pneumothorax (16%) and two hemothorax (0.3%) cases, with thoracic drainage in 24 (4.9%). Among abdominal and retroperitoneal biopsies, there were two cases of major bleeding and one of peritonitis. Conclusion: both types of needle showed satisfactory results, but cutting-needle biopsy should be used when specific diagnosis is desired without greater incidence of complications. (author)

  17. Image-guided spinal injection procedures in open high-field MRI with vertical field orientation: feasibility and technical features

    Energy Technology Data Exchange (ETDEWEB)

    Streitparth, F.; Walter, T.; Wonneberger, U.; Wagner, M.; Hermann, K.G.; Hamm, B.; Teichgraeber, U. [Charite, Humboldt-Universitaet zu Berlin, Department of Radiology, Berlin (Germany); Chopra, S. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Department of General, Visceral, and Transplantation Surgery, Berlin (Germany); Wichlas, F. [Charite-Universitaetsmedizin Berlin, Campus Virchow Klinikum, Center for Musculoskeletal Surgery, Berlin (Germany)

    2010-02-15

    We prospectively evaluated the feasibility and technical features of MR-guided lumbosacral injection procedures in open high-field MRI at 1.0 T. In a CuSO{sub 4}.5H{sub 2}O phantom and five human cadaveric spines, fluoroscopy sequences (proton-density-weighted turbo spin-echo (PDw TSE), T1w TSE, T2w TSE; balanced steady-state free precession (bSSFP), T1w gradient echo (GE), T2w GE) were evaluated using two MRI-compatible 20-G Chiba-type needles. Artefacts were analysed by varying needle orientation to B{sub 0}, frequency-encoding direction and slice orientation. Image quality was described using the contrast-to-noise ratio (CNR). Subsequently, a total of 183 MR-guided nerve root (107), facet (53) and sacroiliac joint (23) injections were performed in 53 patients. In vitro, PDw TSE sequence yielded the best needle-tissue contrasts (CNR = 45, 18, 15, 9, and 8 for needle vs. fat, muscle, root, bone and sclerosis, respectively) and optimal artefact sizes (width and tip shift less than 5 mm). In vivo, PDw TSE sequence was sufficient in all cases. The acquisition time of 2 s facilitated near-real-time MRI guidance. Drug delivery was technically successful in 100% (107/107), 87% (46/53) and 87% (20/23) of nerve root, facet and sacroiliac joint injections, respectively. No major complications occurred. The mean procedure time was 29 min (range 19-67 min). MR-guided spinal injections in open high-field MRI are feasible and accurate using fast TSE sequence designs. (orig.)

  18. A Guide for Developing Standard Operating Job Procedures for the Tertiary Chemical Treatment - Lime Precipitation Process Wastewater Treatment Facility. SOJP No. 6.

    Science.gov (United States)

    Petrasek, Al, Jr.

    This guide describes the standard operating job procedures for the tertiary chemical treatment - lime precipitation process of wastewater treatment plants. Step-by-step instructions are given for pre-start up, start-up, continuous operation, and shut-down procedures. In addition, some theoretical material is presented along with some relevant…

  19. Experience of CT Guided Procedures in the Diagnosis of 55 patients ...

    African Journals Online (AJOL)

    All fine needle aspirations were performed with 20-gauge needles while core tissue biopsies were performed with 14 –gauge needles under CT guidance. The diagnostic yield of these procedures, complications, and patient's feedback were studied. Results: Diagnosis was malignant lesions in 18(32.1%), benign in ...

  20. A novel radiation protection drape reduces radiation exposure during fluoroscopy guided electrophysiology procedures.

    Science.gov (United States)

    Germano, Joseph J; Day, Gina; Gregorious, David; Natarajan, Venkataraman; Cohen, Todd

    2005-09-01

    The purpose of this study was to evaluate a novel disposable lead-free radiation protection drape for decreasing radiation scatter during electrophysiology procedures. In recent years, there has been an exponential increase in the number of electrophysiology (EP) procedures exposing patients, operators and laboratory staff to higher radiation doses. The RADPAD was positioned slightly lateral to the incision site for pectoral device implants and superior to the femoral vein during electrophysiology studies. Each patient served as their own control and dosimetric measurements were obtained at the examiner's elbow and hand. Radiation badge readings for the operator were obtained three months prior to RADPAD use and three months after introduction. Radiation dosimetry was obtained in twenty patients: 7 electrophysiology studies, 6 pacemakers, 5 catheter ablations, and 2 implantable cardioverter-defibrillators. Eleven women and nine men with a mean age of 63 +/- 4 years had an average fluoroscopy time of 2.5 +/- 0.42 minutes per case. Mean dosimetric measurements at the hand were reduced from 141.38 +/- 24.67 to 48.63 +/- 9.02 milliroentgen (mR) per hour using the protective drape (63% reduction; p < 0.0001). Measurements at the elbow were reduced from 78.78 +/- 7.95 mR per hour to 34.50 +/- 4.18 mR per hour using the drape (55% reduction; p < 0.0001). Badge readings for three months prior to drape introduction averaged 2.45 mR per procedure versus 1.54 mR per procedure for 3 months post-initiation (37% reduction). The use of a novel radiation protection surgical drape can significantly reduce scatter radiation exposure to staff and operators during a variety of EP procedures.

  1. Integration of intraoperative stereovision imaging for brain shift visualization during image-guided cranial procedures

    Science.gov (United States)

    Schaewe, Timothy J.; Fan, Xiaoyao; Ji, Songbai; Roberts, David W.; Paulsen, Keith D.; Simon, David A.

    2014-03-01

    Dartmouth and Medtronic Navigation have established an academic-industrial partnership to develop, validate, and evaluate a multi-modality neurosurgical image-guidance platform for brain tumor resection surgery that is capable of updating the spatial relationships between preoperative images and the current surgical field. A stereovision system has been developed and optimized for intraoperative use through integration with a surgical microscope and an image-guided surgery system. The microscope optics and stereovision CCD sensors are localized relative to the surgical field using optical tracking and can efficiently acquire stereo image pairs from which a localized 3D profile of the exposed surface is reconstructed. This paper reports the first demonstration of intraoperative acquisition, reconstruction and visualization of 3D stereovision surface data in the context of an industry-standard image-guided surgery system. The integrated system is capable of computing and presenting a stereovision-based update of the exposed cortical surface in less than one minute. Alternative methods for visualization of high-resolution, texture-mapped stereovision surface data are also investigated with the objective of determining the technical feasibility of direct incorporation of intraoperative stereo imaging into future iterations of Medtronic's navigation platform.

  2. Guide for Regional Integrated Assessments: Handbook of Methods and Procedures, Version 5.1. Appendix 1

    Science.gov (United States)

    Rosenzweig, Cynthia E.; Jones, James W.; Hatfield, Jerry; Antle, John; Ruane, Alex; Boote, Ken; Thorburn, Peter; Valdivia, Roberto; Porter, Cheryl; Janssen, Sander; hide

    2015-01-01

    The purpose of this handbook is to describe recommended methods for a trans-disciplinary, systems-based approach for regional-scale (local to national scale) integrated assessment of agricultural systems under future climate, bio-physical and socio-economic conditions. An earlier version of this Handbook was developed and used by several AgMIP Regional Research Teams (RRTs) in Sub-Saharan Africa (SSA) and South Asia (SA)(AgMIP handbook version 4.2, www.agmip.org/regional-integrated-assessments-handbook/). In contrast to the earlier version, which was written specifically to guide a consistent set of integrated assessments across SSA and SA, this version is intended to be more generic such that the methods can be applied to any region globally. These assessments are the regional manifestation of research activities described by AgMIP in its online protocols document (available at www.agmip.org). AgMIP Protocols were created to guide climate, crop modeling, economics, and information technology components of its projects.

  3. A guide to the emissions certification procedures for alternative fuel aftermarket conversions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-01-01

    Emissions certification is still relatively new to the aftermarket vehicle conversion industry. Many in the industry think that as soon as a vehicle is converted to operate on compressed natural gas (CNG) or liquefied petroleum gas (LFG), it automatically runs as clean as or cleaner than it did on the conventional fuel. However, recent studies have shown that aftermarket conversions may not always reduce emissions. To achieve emissions benefits, the conversion equipment must be designed and calibrated specifically for the engine and emissions control system on which it has been installed, and the installation and setup must be performed so as to not adversely affect the vehicle`s original emissions performance. The reason for certification, then, is to ensure that these criteria are met, that the vehicle continues to perform properly, and that it continues to satisfy all appropriate emissions standards throughout its useful life. The authors have prepared this guide to help equipment manufacturers, distributors, and installers understand the emissions certification process for aftermarket conversions. The guide gives an overview of the certification requirements established by the US EPA and by the state of California.

  4. Characterizing a porous road pavement using surface impedance measurement: a guided numerical inversion procedure.

    Science.gov (United States)

    Benoit, Gaëlle; Heinkélé, Christophe; Gourdon, Emmanuel

    2013-12-01

    This paper deals with a numerical procedure to identify the acoustical parameters of road pavement from surface impedance measurements. This procedure comprises three steps. First, a suitable equivalent fluid model for the acoustical properties porous media is chosen, the variation ranges for the model parameters are set, and a sensitivity analysis for this model is performed. Second, this model is used in the parameter inversion process, which is performed with simulated annealing in a selected frequency range. Third, the sensitivity analysis and inversion process are repeated to estimate each parameter in turn. This approach is tested on data obtained for porous bituminous concrete and using the Zwikker and Kosten equivalent fluid model. This work provides a good foundation for the development of non-destructive in situ methods for the acoustical characterization of road pavements.

  5. Guide and manual of frequent special radiological procedures pertaining frequent pediatric patient

    International Nuclear Information System (INIS)

    Quesada Rodriguez, Marco V.

    2012-01-01

    A set of instructions and / or recommendations are afforded, developed in a systematic way, whose purpose is to help treating doctors to make decisions about the mode of study appropriate for a specialized clinical circumstance. The instructions are aimed at radiologists, in order to facilitate the selection and realization of special studies in the pediatric patient images, so that in this way, guide of the best and most efficient way to the resolution of the cases before diagnostic doubts that seek to clarify the treating clinician. The studies most frequently requested are exposed, as well as those with their prompt realization will lead to a quick and timely medical care and / or surgical of a specific problem [es

  6. Minimal guided bone regeneration procedure for immediate implant placement in the esthetic zone

    Directory of Open Access Journals (Sweden)

    Nettemu Sunil Kumar

    2013-01-01

    Full Text Available The anterior maxilla presents a challenging milieu interior for ideal placement of implants because of the compromised bone quality. With the advent of intraoral bone harvesting and augmentation techniques, immediate implant placement into fresh extraction sockets have become more predictable. Immediate implant placement has numerous advantages compared to the delayed procedure including superior esthetic and functional outcomes, maintenance of soft and hard tissue integrity and increased patient compliance. This case report exhibits immediate implant placement in the maxillary esthetic zone by combining a minimal invasive autogenous block bone graft harvest technique for ensuring successful osseointegration of the implant at the extraction site.

  7. AIChe equipment testing procedure centrifugal compressors : a guide to performance evaluation and site testing

    CERN Document Server

    AIChE

    2013-01-01

    With its engineer-tested procedures and thorough explanations, Centrifugal Compressors is an essential text for anyone engaged in implementing new technology in equipment design, identifying process problems, and optimizing equipment performance.  This condensed book presents a step by step approach to preparing for, planning, executing, and analyzing tests of centrifugal compressors, with an emphasis on methods that can be conducted on-site and with an acknowledgement of the strengths and limitations of these methods. The book opens with an extensive and detailed section offering definitions

  8. Image-guided automatic triggering of a fractional CO2 laser in aesthetic procedures.

    Science.gov (United States)

    Wilczyński, Sławomir; Koprowski, Robert; Wiernek, Barbara K; Błońska-Fajfrowska, Barbara

    2016-09-01

    Laser procedures in dermatology and aesthetic medicine are associated with the need for manual laser triggering. This leads to pulse overlapping and side effects. Automatic laser triggering based on image analysis can provide a secure fit to each successive doses of radiation. A fractional CO2 laser was used in the study. 500 images of the human skin of healthy subjects were acquired. Automatic triggering was initiated by an application together with a camera which tracks and analyses the skin in visible light. The tracking algorithm uses the methods of image analysis to overlap images. After locating the characteristic points in analysed adjacent areas, the correspondence of graphs is found. The point coordinates derived from the images are the vertices of graphs with respect to which isomorphism is sought. When the correspondence of graphs is found, it is possible to overlap the neighbouring parts of the image. The proposed method of laser triggering owing to the automatic image fitting method allows for 100% repeatability. To meet this requirement, there must be at least 13 graph vertices obtained from the image. For this number of vertices, the time of analysis of a single image is less than 0.5s. The proposed method, applied in practice, may help reduce the number of side effects during dermatological laser procedures resulting from laser pulse overlapping. In addition, it reduces treatment time and enables to propose new techniques of treatment through controlled, precise laser pulse overlapping. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Improving needle tip identification during ultrasound-guided procedures in anaesthetic practice.

    Science.gov (United States)

    Scholten, H J; Pourtaherian, A; Mihajlovic, N; Korsten, H H M; A Bouwman, R

    2017-07-01

    Ultrasound guidance is becoming standard practice for needle-based interventions in anaesthetic practice, such as vascular access and peripheral nerve blocks. However, difficulties in aligning the needle and the transducer can lead to incorrect identification of the needle tip, possibly damaging structures not visible on the ultrasound screen. Additional techniques specifically developed to aid alignment of needle and probe or identification of the needle tip are now available. In this scoping review, advantages and limitations of the following categories of those solutions are presented: needle guides; alterations to needle or needle tip; three- and four-dimensional ultrasound; magnetism, electromagnetic or GPS systems; optical tracking; augmented (virtual) reality; robotic assistance; and automated (computerised) needle detection. Most evidence originates from phantom studies, case reports and series, with few randomised clinical trials. Improved first-pass success and reduced performance time are the most frequently cited benefits, whereas the need for additional and often expensive hardware is the greatest limitation to widespread adoption. Novice ultrasound users seem to benefit most and great potential lies in education. Future research should focus on reporting relevant clinical parameters to learn which technique will benefit patients most in terms of success and safety. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  10. Towards an Ultrasonic Guided Wave Procedure for Health Monitoring of Composite Vessels: Application to Hydrogen-Powered Aircraft.

    Science.gov (United States)

    Yaacoubi, Slah; McKeon, Peter; Ke, Weina; Declercq, Nico F; Dahmene, Fethi

    2017-09-19

    This paper presents an overview and description of the approach to be used to investigate the behavior and the defect sensitivity of various ultrasonic guided wave (UGW) modes propagating specifically in composite cylindrical vessels in the framework of the safety of hydrogen energy transportation such as hydrogen-powered aircrafts. These structures which consist of thick and multi-layer composites are envisioned for housing hydrogen gas at high pressures. Due to safety concerns associated with a weakened structure, structural health monitoring techniques are needed. A procedure for optimizing damage detection in these structural types is presented. It is shown that a finite element method can help identify useful experimental parameters including frequency range, excitation type, and receiver placement.

  11. Towards an Ultrasonic Guided Wave Procedure for Health Monitoring of Composite Vessels: Application to Hydrogen-Powered Aircraft

    Directory of Open Access Journals (Sweden)

    Slah Yaacoubi

    2017-09-01

    Full Text Available This paper presents an overview and description of the approach to be used to investigate the behavior and the defect sensitivity of various ultrasonic guided wave (UGW modes propagating specifically in composite cylindrical vessels in the framework of the safety of hydrogen energy transportation such as hydrogen-powered aircrafts. These structures which consist of thick and multi-layer composites are envisioned for housing hydrogen gas at high pressures. Due to safety concerns associated with a weakened structure, structural health monitoring techniques are needed. A procedure for optimizing damage detection in these structural types is presented. It is shown that a finite element method can help identify useful experimental parameters including frequency range, excitation type, and receiver placement.

  12. SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Chen, L; Chen, X; Wang, B; Gupta, R; Ma, C [Fox Chase Cancer Center, Philadelphia, PA (United States)

    2014-06-01

    Purpose: The purpose of this work is to develop and verify our quality assurance (QA) procedures to ensure the safety and efficacy of MR-guided focused ultrasound (MRgFUS) treatment of bone metastases. Methods: A practical QA program was developed. Monthly and daily QA (DQA) procedures were performed. The major QA items included the checks of the machine hardware, software and patient safety features. Briefly, these checks/tests include: 1) the cooling system reservoir and treatment table; 2) power to the treatment table; 3) the MR coil; 4) the transducer position with MRI; 5) image display on the treatment work station; 6) the effective focal spot in 3 directions using MR thermometry; and 7) all the safety devices including a sonication lamp, and the emergency stop-sonication switches. In order to avoid patient skin burn, it is important to remove gas bubbles in the interfaces between the treatment table and the gel pad, and the gel pad and patients skin during the patient setup. Our QA procedures have been verified and evaluated through patient treatments. Seven patients with scapula, humeral head, sacrum, ilium, pubic ramus and acetabular bone metastases were treated using MRgFUS. Results: Our study showed that all seven patients tolerated the MRgFUS treatment well. No skin toxicity or other complications were observed. The pain score (0–10) using the visual analog scale (VAS) was significantly reduced from 8.0 ± 1.1 before treatment to 4.7 ± 3.0, 3.0 ± 1.5, 3.2 ± 2.8 and 3.4 ± 1.5 at one day, one month, two months and three months after the MRgFUS treatment, respectively. Conclusion: We demonstrated that with the appropriate QA procedures, MRgFUS is a safe, effective and noninvasive treatment modality for palliation of bone metastases.

  13. SU-E-J-162: Quality Assurance Procedures for MR Guided Focused Ultrasound Treatment of Bone Metastasis

    International Nuclear Information System (INIS)

    Chen, L; Chen, X; Wang, B; Gupta, R; Ma, C

    2014-01-01

    Purpose: The purpose of this work is to develop and verify our quality assurance (QA) procedures to ensure the safety and efficacy of MR-guided focused ultrasound (MRgFUS) treatment of bone metastases. Methods: A practical QA program was developed. Monthly and daily QA (DQA) procedures were performed. The major QA items included the checks of the machine hardware, software and patient safety features. Briefly, these checks/tests include: 1) the cooling system reservoir and treatment table; 2) power to the treatment table; 3) the MR coil; 4) the transducer position with MRI; 5) image display on the treatment work station; 6) the effective focal spot in 3 directions using MR thermometry; and 7) all the safety devices including a sonication lamp, and the emergency stop-sonication switches. In order to avoid patient skin burn, it is important to remove gas bubbles in the interfaces between the treatment table and the gel pad, and the gel pad and patients skin during the patient setup. Our QA procedures have been verified and evaluated through patient treatments. Seven patients with scapula, humeral head, sacrum, ilium, pubic ramus and acetabular bone metastases were treated using MRgFUS. Results: Our study showed that all seven patients tolerated the MRgFUS treatment well. No skin toxicity or other complications were observed. The pain score (0–10) using the visual analog scale (VAS) was significantly reduced from 8.0 ± 1.1 before treatment to 4.7 ± 3.0, 3.0 ± 1.5, 3.2 ± 2.8 and 3.4 ± 1.5 at one day, one month, two months and three months after the MRgFUS treatment, respectively. Conclusion: We demonstrated that with the appropriate QA procedures, MRgFUS is a safe, effective and noninvasive treatment modality for palliation of bone metastases

  14. A Bayesian nonrigid registration method to enhance intraoperative target definition in image-guided prostate procedures through uncertainty characterization

    International Nuclear Information System (INIS)

    Pursley, Jennifer; Risholm, Petter; Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Wells, William M. III; Tempany, Clare M.; Cormack, Robert A.

    2012-01-01

    Purpose: This study introduces a probabilistic nonrigid registration method for use in image-guided prostate brachytherapy. Intraoperative imaging for prostate procedures, usually transrectal ultrasound (TRUS), is typically inferior to diagnostic-quality imaging of the pelvis such as endorectal magnetic resonance imaging (MRI). MR images contain superior detail of the prostate boundaries and provide substructure features not otherwise visible. Previous efforts to register diagnostic prostate images with the intraoperative coordinate system have been deterministic and did not offer a measure of the registration uncertainty. The authors developed a Bayesian registration method to estimate the posterior distribution on deformations and provide a case-specific measure of the associated registration uncertainty. Methods: The authors adapted a biomechanical-based probabilistic nonrigid method to register diagnostic to intraoperative images by aligning a physician's segmentations of the prostate in the two images. The posterior distribution was characterized with a Markov Chain Monte Carlo method; the maximum a posteriori deformation and the associated uncertainty were estimated from the collection of deformation samples drawn from the posterior distribution. The authors validated the registration method using a dataset created from ten patients with MRI-guided prostate biopsies who had both diagnostic and intraprocedural 3 Tesla MRI scans. The accuracy and precision of the estimated posterior distribution on deformations were evaluated from two predictive distance distributions: between the deformed central zone-peripheral zone (CZ-PZ) interface and the physician-labeled interface, and based on physician-defined landmarks. Geometric margins on the registration of the prostate's peripheral zone were determined from the posterior predictive distance to the CZ-PZ interface separately for the base, mid-gland, and apical regions of the prostate. Results: The authors observed

  15. Custom-Machined Miniplates and Bone-Supported Guides for Orthognathic Surgery: A New Surgical Procedure.

    Science.gov (United States)

    Brunso, Joan; Franco, Maria; Constantinescu, Thomas; Barbier, Luis; Santamaría, Joseba Andoni; Alvarez, Julio

    2016-05-01

    Several surgical strategies exist to improve accuracy in orthognathic surgery, but ideal planning and treatment have yet to be described. The purpose of this study was to present and assess the accuracy of a virtual orthognathic positioning system (OPS), based on the use of bone-supported guides for placement of custom, highly rigid, machined titanium miniplates produced using computer-aided design and computer-aided manufacturing technology. An institutional review board-approved prospective observational study was designed to evaluate our early experience with the OPS. The inclusion criteria were as follows: adult patients who were classified as skeletal Class II or III patients and as candidates for orthognathic surgery or who were candidates for maxillomandibular advancement as a treatment for obstructive sleep apnea. Reverse planning with computed tomography and modeling software was performed. Our OPS was designed to avoid the use of intermaxillary fixation and occlusal splints. The minimum follow-up period was 1 year. Six patients were enrolled in the study. The custom OPS miniplates fit perfectly with the anterior buttress of the maxilla and the mandible body surface intraoperatively. To evaluate accuracy, the postoperative 3-dimensional reconstructed computed tomography image and the presurgical plan were compared. In the maxillary fragments that underwent less than 6 mm of advancement, the OPS enabled an SD of 0.14 mm (92% within 1 mm) at the upper maxilla and 0.34 mm (86% within 1 mm) at the mandible. In the case of great advancements of more than 10 mm, the SD was 1.33 mm (66% within 1 mm) at the upper maxilla and 0.67 mm (73% within 1 mm) at the mandibular level. Our novel OPS was safe and well tolerated, providing positional control with considerable surgical accuracy. The OPS simplified surgery by being independent of support from the opposite maxilla and obviating the need for classic intermaxillary occlusal splints. Copyright © 2016

  16. Evaluation of occupational dose from the special procedures guided by fluoroscopy: cardiac catheterism

    International Nuclear Information System (INIS)

    Silva, Amanda Juliene da

    2011-01-01

    The purpose of this study was to evaluate the dose received by health professionals in the hemodynamic sector of a university hospital in Sao Paulo city. A self-applied questionnaire was used to delineate the profile of health professionals, taking into account sociodemographic variables and variables related to the work with ionizing radiation. The assessment of occupational doses was performed by consulting of the individual dose records of the institution database from 2000 to 2009. A total of 240 records was evaluated, corresponding to 38 active professionals (2009), divided in different professional category: physician, nurses, radiologic technologists and nursing assistants. The annual doses were compared with the limits established by national regulatory authorities. Based on the effective doses received and recorded during the studied period, experimental measures were performed with TL dosimeters in five physicians to evaluate the equivalent dose, in the left hand, during hemodynamic procedures. In addition, the radioprotection measures adopted by health professionals were verified. This study allowed delineating the profile of medical staff that integrates the hemodynamic service as well as knowing the distribution of their doses in relation to limits over the years. (author)

  17. Ultrasound-Guided Regional Anesthesia for Procedures of the Upper Extremity

    Directory of Open Access Journals (Sweden)

    Farheen Mirza

    2011-01-01

    Full Text Available Anesthesia options for upper extremity surgery include general and regional anesthesia. Brachial plexus blockade has several advantages including decreased hemodynamic instability, avoidance of airway instrumentation, and intra-, as well as post-operative analgesia. Prior to the availability of ultrasound the risks of complications and failure of regional anesthesia made general anesthesia a more desirable option for anesthesiologists inexperienced in the practice of regional anesthesia. Ultrasonography has revolutionized the practice of regional anesthesia. By visualizing needle entry throughout the procedure, the relationship between the anatomical structures and the needle can reduce the incidence of complications. In addition, direct visualization of the spread of local anesthesia around the nerves provides instant feedback regarding the likely success of the block. This review article outlines how ultrasound has improved the safety and success of brachial plexus blocks. The advantages that ultrasound guidance provides are only as good as the experience of the anesthesiologist performing the block. For example, in experienced hands, with real time needle visualization, a supraclavicular brachial plexus block has changed from an approach with the highest risk of pneumothorax to a block with minimal risks making it the ideal choice for most upper extremity surgeries.

  18. Identifying indications for percutaneous (PTC) vs. endoscopic ultrasound (EUS)- guided "rendezvous" procedure in biliary obstruction and incomplete endoscopic retrograde cholangiography (ERC).

    Science.gov (United States)

    Albert, J G; Finkelmeier, F; Friedrich-Rust, M; Kronenberger, B; Trojan, J; Zeuzem, S; Sarrazin, C

    2014-10-01

    The variety of rendezvous (RV) procedures has recently been extended by EUS- and PTCD-guided procedures as a complementary means to conventional ERCP. We have identified indication criteria and the potential of biliary PTCD-guided vs. EUS-guided RV. Consecutive patients with bile duct obstruction who underwent RV were included. In all, ERCP alone was unable to achieve treatment success. Indication, technical success, and outcome in PTCD- vs. EUS-guided RV were retrospectively compared to identify criteria that indicate preference of RV technique. Site of obstruction, clinical scenario (stenosis with abscess vs. no abscess) and reason for previous failure of ERC were evaluated. In 32 patients, three different indications for RV procedures were identified: First, a one-step access to assist in failed ERCP (type 1, intra-ductal RV); second, temporary drainage for prolonged treatment of complex biliary disease (type 2, intra-ductal RV), and drainage of cholangio-abscess with re-establishing bile outflow (type 3, intra-abscess RV). Indication of PTCD- vs. EUS-guided rendezvous was competitive in type 1, but exclusive in favor of PTCD in types 2 and 3. The site of biliary obstruction indicated the anatomic location of RV procedures. This classification may help to define inclusion criteria for prospective studies on biliary RV procedures. Choice of therapeutic strategy depends on the anatomic location of the biliary obstruction and the type of the biliary lesion. PTCD-guided RV might improve outcome in cholangio-abscess. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Two-dimensional mapping of needle visibility with linear and curved array for ultrasound-guided interventional procedure

    Science.gov (United States)

    Susanti, Hesty; Suprijanto, Kurniadi, Deddy

    2018-02-01

    Needle visibility in ultrasound-guided technique has been a crucial factor for successful interventional procedure. It has been affected by several factors, i.e. puncture depth, insertion angle, needle size and material, and imaging technology. The influences of those factors made the needle not always well visible. 20 G needles of 15 cm length (Nano Line, facet) were inserted into water bath with variation of insertion angles and depths. Ultrasound measurements are performed with BK-Medical Flex Focus 800 using 12 MHz linear array and 5 MHz curved array in Ultrasound Guided Regional Anesthesia mode. We propose 3 criteria to evaluate needle visibility, i.e. maximum intensity, mean intensity, and the ratio between minimum and maximum intensity. Those criteria were then depicted into representative maps for practical purpose. The best criterion candidate for representing the needle visibility was criterion 1. Generally, the appearance pattern of the needle from this criterion was relatively consistent, i.e. for linear array, it was relatively poor visibility in the middle part of the shaft, while for curved array, it is relatively better visible toward the end of the shaft. With further investigations, for example with the use of tissue-mimicking phantom, the representative maps can be built for future practical purpose, i.e. as a tool for clinicians to ensure better needle placement in clinical application. It will help them to avoid the "dead" area where the needle is not well visible, so it can reduce the risks of vital structures traversing and the number of required insertion, resulting in less patient morbidity. Those simple criteria and representative maps can be utilized to evaluate general visibility patterns of the needle in vast range of needle types and sizes in different insertion media. This information is also important as an early investigation for future research of needle visibility improvement, i.e. the development of beamforming strategies and

  20. Evaluation of the Most Reliable Procedure of Determining Jump Height During the Loaded Countermovement Jump Exercise: Take-Off Velocity vs. Flight Time.

    Science.gov (United States)

    Pérez-Castilla, Alejandro; García-Ramos, Amador

    2018-07-01

    Pérez-Castilla, A and García-Ramos, A. Evaluation of the most reliable procedure of determining jump height during the loaded countermovement jump exercise: Take-off velocity vs. flight time. J Strength Cond Res 32(7): 2025-2030, 2018-This study aimed to compare the reliability of jump height between the 2 standard procedures of analyzing force-time data (take-off velocity [TOV] and flight time [FT]) during the loaded countermovement (CMJ) exercise performed with a free-weight barbell and in a Smith machine. The jump height of 17 men (age: 22.2 ± 2.2 years, body mass: 75.2 ± 7.1 kg, and height: 177.0 ± 6.0 cm) was tested in 4 sessions (twice for each CMJ type) against external loads of 17, 30, 45, 60, and 75 kg. Jump height reliability was comparable between the TOV (coefficient of variation [CV]: 6.42 ± 2.41%) and FT (CV: 6.53 ± 2.17%) during the free-weight CMJ, but it was higher for the FT when the CMJ was performed in a Smith machine (CV: 11.34 ± 3.73% for TOV and 5.95 ± 1.12% for FT). Bland-Altman plots revealed trivial differences (≤0.27 cm) and no heteroscedasticity of the errors (R ≤ 0.09) for the jump height obtained by the TOV and FT procedures, whereas the random error between both procedures was higher for the CMJ performed in the Smith machine (2.02 cm) compared with the free-weight barbell (1.26 cm). Based on these results, we recommend the FT procedure to determine jump height during the loaded CMJ performed in a Smith machine, whereas the TOV and FT procedures provide similar reliability during the free-weight CMJ.

  1. Influenza pandemic planning guide

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2006-11-15

    An influenza pandemic will have serious economic impacts on the natural gas industry due to absenteeism as well as downstream effects due to supply disruption.This guide was prepared to assist gas distribution companies in planning for an influenza epidemic. The guide aimed to minimize the risks that an influenza pandemic might pose to the health and safety of employees and the continuity of business operations. The guide discussed 5 critical aspects of emergency planning: (1) prevention and threat mitigation; (2) preparedness; (3) response; (4) business continuity; and (5) communication. The legal context of the emergency plans were discussed. The plans were also discussed to other essential infrastructure emergency response plans. Recommendations were presented for infection control, decentralization and access restriction. Outlines for pandemic response planning teams and training and exercise programs were provided. Issues related to alert, mobilization, and response procedures were also discussed. 10 refs., 3 tabs., 1 fig.

  2. Exercise: Benefits for Body and Mind. Teacher's Guide. Health Promotion for Adult Literacy Students: An Empowering Approach.

    Science.gov (United States)

    Hudson River Center for Program Development, Glenmont, NY.

    This teaching guide is part of a series of materials developed, with input from adult learners, to aid adult literacy teachers in incorporating health education into the curriculum. This guide aims to help teachers to provide adult students with information about good fitness habits and positive health behaviors that will substantially reduce the…

  3. From Guided Surgery to Final Prosthesis with a Fully Digital Procedure: A Prospective Clinical Study on 15 Partially Edentulous Patients

    Directory of Open Access Journals (Sweden)

    Giorgio Andrea Dolcini

    2016-01-01

    Full Text Available Scope. To demonstrate guided implant placement and the application of fixed, implant-supported prosthetic restorations with a fully digital workflow. Methods. Over a 2-year period, all patients with partial edentulism of the posterior maxilla, in need of fixed implant-supported prostheses, were considered for inclusion in this study. The protocol required intraoral scanning and cone beam computed tomography (CBCT, the superimposition of dental-gingival information on bone anatomy, surgical planning, 3D-printed teeth-supported surgical templates, and modelling and milling of polymethylmethacrylate (PMMA temporaries for immediate loading. After 3 months, final optical impression was taken and milled zirconia frameworks and 3D-printed models were fabricated. The frameworks were veneered with ceramic and delivered to the patients. Results. Fifteen patients were selected for this study. The surgical templates were stable. Thirty implants were placed (BTK Safe®, BTK, Vicenza, Italy and immediately loaded with PMMA temporaries. After 3 months, the temporaries were replaced by the final restorations in zirconia-ceramic, fabricated with a fully digital process. At 6 months, none of the patients reported any biological or functional problems with the implant-supported prostheses. Conclusions. The present procedure for fully digital planning of implants and short-span fixed implant-supported restorations has been shown to be reliable. Further studies are needed to validate these results.

  4. Efficacy of CT-guided biopsies of the spine in patients with spondylitis – an analysis of 164 procedures

    International Nuclear Information System (INIS)

    Heyer, Christoph M.; Brus, Lisa-Johanna; Peters, Soeren A.; Lemburg, Stefan P.

    2012-01-01

    Objective: To evaluate efficacy of CT-guided spinal biopsy (CTSB) in patients with spondylitis considering patient characteristics, technical issues, antibiotic therapy, histopathological, and microbiological findings. Materials and methods: All CTSB procedures performed between 1995 and 2009 in patients with proven spondylitis were re-evaluated. Patient sex and age, antibiotic treatment, biopsy approach, number of specimens, length of needle path, laboratory results (CRP, WBC), and histopathological/microbiological findings were documented and compared to the final diagnosis of spondylitis. Statistical analysis was performed using Chi-square test and Student's t-test. The p-value was set to 5%. Results: 164 CTSB procedures were performed in 159 patients (mean age 65 years, 60% men) in which spondylitis was histopathologically verified in 95%. Neither patient sex nor age, positioning, localization of the spinal lesion, bioptic approach, number of specimens, or depth of the needle showed significant impact on the rate of positive histopathological findings. A causative germ was identified in 40/127 biopsies (32%) with Staphylococcus aureus being identified in 50%. Tuberculous spondylitis was diagnosed in ten cases (6%). CRP significantly correlated with bacterial growth (13.3 ± 12.2 mg/dl versus 8.8 ± 7.6 mg/dl; p = .015) whereas administration of antibiotics did not show any significant impact on bacterial growth (29% versus 36% in patients without antibiotics; p = 0.428). Patients with histopathological signs of active spondylitis showed a significantly higher CRP (16.5 ± 15.8 mg/dl versus 8.9 ± 8.0 mg/dl, p < .001). Complication rate was 0.6% (one focal bleeding). Conclusion: CTSB of the spine in suspected spondylitis is an effective and safe procedure for establishing final histopathological diagnosis. However, microbiological yield is low regardless of technical issues and antibiotic therapy. Other than CRP values, laboratory investigations added little

  5. Procedure Study Guide (Revision)

    Science.gov (United States)

    1997-04-01

    dismissed eight days after the accused enlisted.) In Russo, the accused suffered from dyslexia . The recruiter was advised of the accused’s inability...v. Blaylock, 15 M.J. 190 (C.M.A. 1983), the court repudiated Hardy insofar as the intervention in a court-martial by a superior officer might give

  6. Procedure Study Guide

    Science.gov (United States)

    1998-08-01

    accused enlisted.) In Russo, the accused suffered from dyslexia . The recruiter was advised of the accused’s inability to read, a nonwaivable bar to...C.M.A. 1983), the court repudiated Hardy insofar as the intervention in a court-martial by a superior officer might give rise to a jurisdictional...punishment imposed under Article 15, UCMJ, for minor offenses, without the intervention of a court-martial. Naval Justice School Rev. 8/98

  7. Human Engineering Procedures Guide

    Science.gov (United States)

    1981-09-01

    Research Laboratory AFETR Air Force Eastern Test Range AFFTC Air Force Flight Test Center AFHRL Air Force Human Resources Laboratory AFR Air Force...performance requirements through the most effective use of man’s performance capability. 13 Human Engineering is one of five elements in the Human...applied judiciously and tailored to fit * the program or program phase and the acquisition strategy to achieve cost effective acquisition and life cycle

  8. Work-rate-guided exercise testing in patients with incomplete spinal cord injury using a robotics-assisted tilt-table.

    Science.gov (United States)

    Laubacher, Marco; Perret, Claudio; Hunt, Kenneth J

    2015-01-01

    Robotics-assisted tilt-table (RTT) technology allows neurological rehabilitation therapy to be started early thus alleviating some secondary complications of prolonged bed rest. This study assessed the feasibility of a novel work-rate-guided RTT approach for cardiopulmonary training and assessment in patients with incomplete spinal cord injury (iSCI). Three representative subjects with iSCI at three distinct stages of primary rehabilitation completed an incremental exercise test (IET) and a constant load test (CLT) on a RTT augmented with integrated leg-force and position measurement and visual work rate feedback. Feasibility assessment focused on: (i) implementation, (ii) limited efficacy testing, (iii) acceptability. (i) All subjects were able follow the work rate target profile by adapting their volitional leg effort. (ii) During the IETs, peak oxygen uptake above rest was 304, 467 and 1378 ml/min and peak heart rate (HR) was 46, 32 and 65 beats/min above rest (subjects A, B and C, respectively). During the CLTs, steady-state oxygen uptake increased by 42%, 38% and 162% and HR by 12%, 20% and 29%. (iii) All exercise tests were tolerated well. The novel work-rate guided RTT intervention is deemed feasible for cardiopulmonary training and assessment in patients with iSCI: substantial cardiopulmonary responses were observed and the approach was found to be tolerable and implementable. Implications for Rehabilitation Work-rate guided robotics-assisted tilt-table technology is deemed feasible for cardiopulmonary assessment and training in patients with incomplete spinal cord injury. Robotics-assisted tilt-tables might be a good way to start with an active rehabilitation as early as possible after a spinal cord injury. During training with robotics-assisted devices the active participation of the patients is crucial to strain the cardiopulmonary system and hence gain from the training.

  9. Next Indefinite Contract review exercise

    CERN Multimedia

    2013-01-01

    Dear Colleagues, We are pleased to inform you that the 2013 LD2IC exercise (selection process for the conversion of limited-duration contracts to indefinite contracts) was officially launched last week.  The vacancy notices for posts opened with a view to the award of indefinite contracts will be published on 9 August 2013 for a period of four weeks (until 8 September 2013). The CERN Contract Review Boards (candidate interviews) will be held between the end of September and mid-November. The LD to IC procedure, Frequently Asked Questions and a calendar for the exercise are now available in the Admin e-guide. In addition, general information sessions on the procedure will be organised for candidates on the following dates: Information on the location of these sessions will be provided in due course on the CERN announcements page. HR Department

  10. An exploration of fluoroscopically guided spinal steroid injections in patients with non-specific exercise-related lower-limb pain

    Directory of Open Access Journals (Sweden)

    Leon Neve

    2010-09-01

    Full Text Available Leon Neve1, John Orchard2, Nathan Gibbs3, Willem van Mechelen4, Evert Verhagen4, Ken Sesel5, Ian Burgess6, Brett Hines61VU University, Amsterdam, The Netherlands; 2School of Public Health, University of Sydney, Sydney, NSW, Australia; 3South Sydney Sports Medicine, Sydney, NSW, Australia; 4EMGO, VU University, Amsterdam, The Netherlands; 5Sydney X-ray Centre, Sydney, NSW, Australia; 6Mater Imaging, Sydney, NSW, AustraliaBackground: Fluoroscopically guided lumbar cortisone injections have been proven useful in cases of lower-limb pain caused by lumbar disc prolapse (with evidence levels ll-1/ll-2. These injections are also sometimes used clinically in sports medicine for patients with non-specific exercise-related lower-limb pain, where no prolapse or other obvious cause of nerve-impingement is diagnosed via magnetic resonance imaging (MRI or computed tomography (CT, even though this treatment scenario has not been adequately studied for this last diagnosis.Objectives: To explore whether fluoroscopically guided transforaminal lumbar cortisone injections may be a valid treatment method for non-specific exercise-related lower-limb pain.Study design: Retrospective case series.Methods: Patients were selected from databases at two sports clinics and divided into two groups: Group D, with back-related lower-limb pain and disc prolapse proven on CT or MR; and Group N, with non-specific exercise-related lower-limb pain. Patients were sent a questionnaire regarding: symptoms, improvement, effect of injections, satisfaction, side effects and other used treatments. Outcomes were compared between Group D and N.Results: 153 patients were eligible for the study (Group D: 93/Group N: 60. Eventually 110 patients responded (Group D: 67/Group N: 43. Twelve percent of Group D and 14% of Group N indicated that the injections had fully cured their symptoms. Altogether, 27% of Group D and 24% of Group N were certain the injections had improved their symptoms in the

  11. Retrospective analysis of technical success rate and procedure-related complications of 867 percutaneous CT-guided needle biopsies of lung lesions.

    Science.gov (United States)

    Mills, M; Choi, J; El-Haddad, G; Sweeney, J; Biebel, B; Robinson, L; Antonia, S; Kumar, A; Kis, B

    2017-12-01

    To investigate the technical success rate and procedure-related complications of computed tomography (CT)-guided needle biopsy of lung lesions and to identify the factors that are correlated with the occurrence of procedure-related complications. This was a single- institution retrospective study of 867 consecutive CT-guided needle biopsies of lung lesions performed on 772 patients in a tertiary cancer centre. The technical success rate and complications were correlated with patient, lung lesion, and procedure-related variables. The technical success rate was 87.2% and the mortality rate was 0.12%. Of the 867 total biopsies 25.7% were associated with pneumothorax, and 6.5% required chest tube drainage. The haemothorax rate was 1.8%. There was positive correlation between the development of pneumothorax and smaller lesion diameter (ptechnical success and a low rate of major complications. The present study has revealed several variables that can be used to identify high-risk procedures. A post-procedural chest X-ray within hours after the procedure is highly recommended to identify high-risk patients who require chest tube placement. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. Procedures can be learned on the Web: a randomized study of ultrasound-guided vascular access training.

    Science.gov (United States)

    Chenkin, Jordan; Lee, Shirley; Huynh, Thien; Bandiera, Glen

    2008-10-01

    Web-based learning has several potential advantages over lectures, such as anytime-anywhere access, rich multimedia, and nonlinear navigation. While known to be an effective method for learning facts, few studies have examined the effectiveness of Web-based formats for learning procedural skills. The authors sought to determine whether a Web-based tutorial is at least as effective as a didactic lecture for learning ultrasound-guided vascular access (UGVA). Participating staff emergency physicians (EPs) and junior emergency medicine (EM) residents with no UGVA experience completed a precourse test and were randomized to either a Web-based or a didactic group. The Web-based group was instructed to use an online tutorial and the didactic group attended a lecture. Participants then practiced on simulators and live models without any further instruction. Following a rest period, participants completed a four-station objective structured clinical examination (OSCE), a written examination, and a postcourse questionnaire. Examination results were compared using a noninferiority data analysis with a 10% margin of difference. Twenty-one residents and EPs participated in the study. There were no significant differences in mean OSCE scores (absolute difference = -2.8%; 95% confidence interval [CI] = -9.3% to 3.8%) or written test scores (absolute difference = -1.4%; 95% CI = -7.8% to 5.0%) between the Web group and the didactic group. Both groups demonstrated similar improvements in written test scores (26.1% vs. 25.8%; p = 0.95). Ninety-one percent (10/11) of the Web group and 80% (8/10) of the didactic group participants found the teaching format to be effective (p = 0.59). Our Web-based tutorial was at least as effective as a traditional didactic lecture for teaching the knowledge and skills essential for UGVA. Participants expressed high satisfaction with this teaching technology. Web-based teaching may be a useful alternative to didactic teaching for learning procedural

  13. Evaluation of methods to produce an image library for automatic patient model localization for dose mapping during fluoroscopically guided procedures

    Science.gov (United States)

    Kilian-Meneghin, Josh; Xiong, Z.; Rudin, S.; Oines, A.; Bednarek, D. R.

    2017-03-01

    The purpose of this work is to evaluate methods for producing a library of 2D-radiographic images to be correlated to clinical images obtained during a fluoroscopically-guided procedure for automated patient-model localization. The localization algorithm will be used to improve the accuracy of the skin-dose map superimposed on the 3D patient- model of the real-time Dose-Tracking-System (DTS). For the library, 2D images were generated from CT datasets of the SK-150 anthropomorphic phantom using two methods: Schmid's 3D-visualization tool and Plastimatch's digitally-reconstructed-radiograph (DRR) code. Those images, as well as a standard 2D-radiographic image, were correlated to a 2D-fluoroscopic image of a phantom, which represented the clinical-fluoroscopic image, using the Corr2 function in Matlab. The Corr2 function takes two images and outputs the relative correlation between them, which is fed into the localization algorithm. Higher correlation means better alignment of the 3D patient-model with the patient image. In this instance, it was determined that the localization algorithm will succeed when Corr2 returns a correlation of at least 50%. The 3D-visualization tool images returned 55-80% correlation relative to the fluoroscopic-image, which was comparable to the correlation for the radiograph. The DRR images returned 61-90% correlation, again comparable to the radiograph. Both methods prove to be sufficient for the localization algorithm and can be produced quickly; however, the DRR method produces more accurate grey-levels. Using the DRR code, a library at varying angles can be produced for the localization algorithm.

  14. Guided graded exercise self-help plus specialist medical care versus specialist medical care alone for chronic fatigue syndrome (GETSET): a pragmatic randomised controlled trial.

    Science.gov (United States)

    Clark, Lucy V; Pesola, Francesca; Thomas, Janice M; Vergara-Williamson, Mario; Beynon, Michelle; White, Peter D

    2017-07-22

    Graded exercise therapy is an effective and safe treatment for chronic fatigue syndrome, but it is therapist intensive and availability is limited. We aimed to test the efficacy and safety of graded exercise delivered as guided self-help. In this pragmatic randomised controlled trial, we recruited adult patients (18 years and older) who met the UK National Institute for Health and Care Excellence criteria for chronic fatigue syndrome from two secondary-care clinics in the UK. Patients were randomly assigned to receive specialist medical care (SMC) alone (control group) or SMC with additional guided graded exercise self-help (GES). Block randomisation (randomly varying block sizes) was done at the level of the individual with a computer-generated sequence and was stratified by centre, depression score, and severity of physical disability. Patients and physiotherapists were necessarily unmasked from intervention assignment; the statistician was masked from intervention assignment. SMC was delivered by specialist doctors but was not standardised; GES consisted of a self-help booklet describing a six-step graded exercise programme that would take roughly 12 weeks to complete, and up to four guidance sessions with a physiotherapist over 8 weeks (maximum 90 min in total). Primary outcomes were fatigue (measured by the Chalder Fatigue Questionnaire) and physical function (assessed by the Short Form-36 physical function subscale); both were self-rated by patients at 12 weeks after randomisation and analysed in all randomised patients with outcome data at follow-up (ie, by modified intention to treat). We recorded adverse events, including serious adverse reactions to trial interventions. We used multiple linear regression analysis to compare SMC with GES, adjusting for baseline and stratification factors. This trial is registered at ISRCTN, number ISRCTN22975026. Between May 15, 2012, and Dec 24, 2014, we recruited 211 eligible patients, of whom 107 were assigned to the

  15. Topography-guided transepithelial PRK after intracorneal ring segments implantation and corneal collagen CXL in a three-step procedure for keratoconus.

    Science.gov (United States)

    Coskunseven, Efekan; Jankov, Mirko R; Grentzelos, Michael A; Plaka, Argyro D; Limnopoulou, Aliki N; Kymionis, George D

    2013-01-01

    To present the results of topography-guided transepithelial photorefractive keratectomy (PRK) after intracorneal ring segments implantation followed by corneal collagen cross-linking (CXL) for keratoconus. In this prospective case series, 10 patients (16 eyes) with progressive keratoconus were included. All patients underwent topography-guided transepithelial PRK after Keraring intracorneal ring segments (Mediphacos Ltda) implantation, followed by CXL treatment. The follow-up period was 6 months after the last procedure for all patients. Time interval between both intracorneal ring segments implantation and CXL and between CXL and topography-guided transepithelial PRK was 6 months. LogMAR mean uncorrected distance visual acuity and mean corrected distance visual acuity were significantly improved (PPRK with intracorneal ring segments implantation and CXL in a three-step procedure seems to be an effective, promising treatment sequence offering patients a functional visual acuity and ceasing progression of the ectatic disorder. A longer follow-up and larger case series are necessary to thoroughly evaluate safety, stability, and efficacy of this innovative procedure. Copyright 2013, SLACK Incorporated.

  16. Evaluation of the impact of a system for real-time visualisation of occupational radiation dose rate during fluoroscopically guided procedures

    International Nuclear Information System (INIS)

    Sandblom, V; Almén, A; Cederblad, A.; Båth, M; Lundh, C; Mai, T; Rystedt, H

    2013-01-01

    Optimisation of radiological protection for operators working with fluoroscopically guided procedures has to be performed during the procedure, under varying and difficult conditions. The aim of the present study was to evaluate the impact of a system for real-time visualisation of radiation dose rate on optimisation of occupational radiological protection in fluoroscopically guided procedures. Individual radiation dose measurements, using a system for real-time visualisation, were performed in a cardiology laboratory for three cardiologists and ten assisting nurses. Radiation doses collected when the radiation dose rates were not displayed to the staff were compared to radiation doses collected when the radiation dose rates were displayed. When the radiation dose rates were displayed to the staff, one cardiologist and the assisting nurses (as a group) significantly reduced their personal radiation doses. The median radiation dose (H p (10)) per procedure decreased from 68 to 28 μSv (p = 0.003) for this cardiologist and from 4.3 to 2.5 μSv (p = 0.001) for the assisting nurses. The results of the present study indicate that a system for real-time visualisation of radiation dose rate may have a positive impact on optimisation of occupational radiological protection. In particular, this may affect the behaviour of staff members practising inadequate personal radiological protection. (paper)

  17. User`s guide for the Augmented Computer Exercise for Inspection Training (ACE-IT), Version 2.0 software

    Energy Technology Data Exchange (ETDEWEB)

    Dobranich, P.R. [Sandia National Labs., Albuquerque, NM (United States); Horak, K.E.; Evanko, D.A. [Excel Tactical Staffing, Albuquerque, NM (United States)] [and others

    1998-04-01

    The on-site inspection provisions in many current and proposed arms control agreements require extensive preparation and training on the part of both the Inspection Teams (inspectors) and Inspected Parties (hosts). Traditional training techniques include lectures, table-top inspections, and practice inspections. The Augmented Computer Exercise for Inspection Training (ACE-IT), an interactive computer training tool, increases the utility of table-top inspections. ACE-IT is used for training both inspectors and hosts to conduct a hypothetical challenge inspection under the Chemical Weapons Convention (CWC). The training covers the entire sequence of events in the challenge inspection regime, from initial notification of an inspection through post-inspection activities. The primary emphasis of the training tool is on conducting the inspection itself, and in particular, implementing the concept of managed access. (Managed access is a technique used to assure the inspectors that the facility is in compliance with the CWC, while at the same time protecting sensitive information unrelated to the CWC.) Information for all of the activities is located in the electronic {open_quotes}Exercise Manual.{close_quotes} In addition, interactive menus are used to negotiate access to each room and to alternate information during the simulated inspection. ACE-IT also demonstrates how various inspection provisions impact compliance determination and the protection of sensitive information.

  18. OXFORD HANDBOOK OF SPORT AND EXERCISE MEDICINE

    Directory of Open Access Journals (Sweden)

    Domhnall MacAuley

    2007-03-01

    Full Text Available DESCRIPTION This flexicover handbook presents a user-friendly overview into the evolving discipline of sports medicine. The growing scientific and research base is summarised and essential views on treatment, preventive strategies, and optimal exercise recommendation are discussed briefly in the relevant chapters. This book has been designed for everyday use for the practitioners working in this medical field. It also has blank pages for the readers' own updates. PURPOSE This guide book aims to display the common problems and diagnoses in sports and exercise medicine and to concentrate on the up-to-date approaches, management plans, and evidence-based procedures of treatment at the same time. AUDIENCE As a comprehensive basic text this guide book could be useful for lecturers, teachers, practitioners and students of exercise and sports medicine as well as GPs, nurses and others who are especially interested in this field. FEATURES This handbook is partitioned into 24 chapters focusing on the needs of the patient and offering an immediate guide to all aspects of diagnosis and treatment, epidemiology, exercise benefits and physiological issues. The chapters are: 1. Immediate care, 2. Sports injury, 3. Benefits of exercise, 4. Physiothrepy and rehabilitation, 5. Hip and pelvis, 6. Knee, 7. Ankle and lower leg, 8. Foot, 9. Shoulder, 10. Elbow and forearm, 11. Wrist and hand, 12. Head and face, 13. Spine, 14. Cardiorespiratory, 15. Abdomen, 16. Infectious disease, 17. Arthritis, 18. Dermatology, 19. Disability, 20. Physiology, 21. Metabolic, 22. Women, 23. Aids to performance, 24. The team physician. ASSESSMENT This is a must-have handbook for all medics practising in sports and exercise medicine, as well as anyone who has a special interest in this area, especially GPs, nurses, physiotherapists; even coaches, trainers, biomechanical experts. I believe they will enjoy making use of this guide book as it is right to the point, easy to read and

  19. International comparison of interpolation procedures for the efficiency of germanium gamma-ray spectrometers (GAM83 exercise)

    International Nuclear Information System (INIS)

    Zijp, W.L.; Polle, A.N.; Nolthenius, H.J.

    1986-01-01

    Results are presented for the outcome of an international intercomparison of a particular gamma-ray spectrometric procedure. Laboratories were asked to determine full energy peak efficiencies and activities by means of their own procedures, starting from supplied peak-efficiency data. Four data sets for four different conditions of germanium detectors were distributed. The sets comprised: a high accuracy- (uncertainty > 1%) data set with a relatively large number of measured data (SET 1); a low accuracy- (uncertainty 3-5%) data set with a relatively small number of measured data (SET 2); a low energy-data set (SET 3); a high accuracy-data set with a relatively small number of measured data (SET 4). The intercomparison (coded GAM83) was organized and analyzed under auspices of the International Committee for Radionuclide Metrology (ICRM). The results comprise the analysis of the contributions of 41 participants

  20. Implementation to the guide and regulatory procedures elaborated in mark the ARCAL XX project for the teletherapy practices

    International Nuclear Information System (INIS)

    Peres Reyes, Y.; Betancourt Hernandez, L.A.; De la Fuente Punch, A.

    1998-01-01

    From the beginning of ARCAL XX, the activities have been guided to homogenize the conditions the radiological security in the different ones you practice associated to the ionizing radiations uses, on the fundamental base to the adoption that the International Basic Standards on Radiation Protection for the ionizing radiation and the Security to the Radiation sources

  1. SU-G-IeP3-05: Effects of Image Receptor Technology and Dose Reduction Software On Radiation Dose Estimates for Fluoroscopically-Guided Interventional (FGI) Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Merritt, Z; Dave, J; Eschelman, D; Gonsalves, C [Thomas Jefferson University, Philadelphia, PA (United States)

    2016-06-15

    Purpose: To investigate the effects of image receptor technology and dose reduction software on radiation dose estimates for most frequently performed fluoroscopically-guided interventional (FGI) procedures at a tertiary health care center. Methods: IRB approval was obtained for retrospective analysis of FGI procedures performed in the interventional radiology suites between January-2011 and December-2015. This included procedures performed using image-intensifier (II) based systems which were subsequently replaced, flat-panel-detector (FPD) based systems which were later upgraded with ClarityIQ dose reduction software (Philips Healthcare) and relatively new FPD system already equipped with ClarityIQ. Post procedure, technologists entered system-reported cumulative air kerma (CAK) and kerma-area product (KAP; only KAP for II based systems) in RIS; these values were analyzed. Data pre-processing included correcting typographical errors and cross-verifying CAK and KAP. The most frequent high and low dose FGI procedures were identified and corresponding CAK and KAP values were compared. Results: Out of 27,251 procedures within this time period, most frequent high and low dose procedures were chemo/immuno-embolization (n=1967) and abscess drainage (n=1821). Mean KAP for embolization and abscess drainage procedures were 260,657, 310,304 and 94,908 mGycm{sup 2}, and 14,497, 15,040 and 6307 mGycm{sup 2} using II-, FPD- and FPD with ClarityIQ- based systems, respectively. Statistically significant differences were observed in KAP values for embolization procedures with respect to different systems but for abscess drainage procedures significant differences were only noted between systems with FPD and FPD with ClarityIQ (p<0.05). Mean CAK reduced significantly from 823 to 308 mGy and from 43 to 21 mGy for embolization and abscess drainage procedures, respectively, in transitioning to FPD systems with ClarityIQ (p<0.05). Conclusion: While transitioning from II- to FPD- based

  2. Percutaneous Management of Accidentally Retained Foreign Bodies During Image-Guided Non-vascular Procedures: Novel Technique Using a Large-Bore Biopsy System

    Energy Technology Data Exchange (ETDEWEB)

    Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr; Thénint, Marie-Aude, E-mail: marie-aude.thenint@chru-strasbourg.fr; Rao, Pramod, E-mail: pramodrao@me.com; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr; Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

    2016-07-15

    ObjectiveTo describe a novel percutaneous image-guided technique using a large-bore biopsy system to retrieve foreign bodies (FBs) accidentally retained during non-vascular interventional procedures.Materials and MethodsBetween May 2013 and October 2015, five patients underwent percutaneous retrieval of five iatrogenic FBs, including a biopsy needle tip in the femoral head following osteoblastoma biopsy and radiofrequency ablation (RFA); a co-axial needle shaft within a giant desmoid tumour following cryoablation; and three post-vertebroplasty cement tails within paraspinal muscles. All FBs were retrieved immediately following original procedures under local or general anaesthesia, using combined computed tomography (CT) and fluoroscopic guidance. The basic technique involved positioning a 6G trocar sleeve around the FB long axis and co-axially advancing an 8G biopsy needle to retrieve the FB within the biopsy core. Retrospective chart review facilitated analysis of procedures, FBs, technical success, and complications.ResultsMean FB size was 23 mm (range 8–74 mm). Four FBs were located within 10 mm of non-vascular significant anatomic structures. The basic technique was successful in 3 cases; 2 cases required technical modifications including using a stiff guide-wire to facilitate retrieval in the case of the post-cryoablation FB; and using the central mandrin of the 6G trocar to push a cement tract back into an augmented vertebra when initial retrieval failed. Overall technical success (FB retrieval or removal to non-hazardous location) was 100 %, with no complications.ConclusionPercutaneous image-guided retrieval of iatrogenic FBs using a large-bore biopsy system is a feasible, safe, effective, and versatile technique, with potential advantages over existing methods.

  3. Kegel Exercises

    Science.gov (United States)

    ... exercised my pelvic muscles ____ times. I spent ____ minutes exercising. At each exercise session, I squeezed my pelvic ... exercised my pelvic muscles ____ times. I spent ____ minutes exercising. At each exercise session, I squeezed my pelvic ...

  4. Prevention: Exercise

    Medline Plus

    Full Text Available ... Core! Stretching/Flexibility Aerobic Exercise Cervical Exercise Strength Training for the Elderly ... Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ...

  5. Morphological and health-related changes associated with a 12-week self-guided exercise programme in overweight adults: a pilot study.

    Science.gov (United States)

    Stewart, Arthur D; Rolland, Catherine; Gryka, Ania; Findlay, Sally; Smith, Sara; Jones, Jacklyn; Davidson, Isobel M

    2014-01-01

    Over 12 weeks, supervised physical activity (PA) interventions have demonstrated improvements in morphological and health parameters, whereas community walking programmes have not. The present study piloted a self-guided programme for promoting PA and reducing sedentary behaviour in overweight individuals and measured its effect on a range of health outcomes. Six male and 16 female sedentary adults aged 48.5 ± 5.5 years with body mass index (BMI) 33.4 ± 6.3 kg m(-2) were assessed for anthropometric variables, blood pressure, functional capacity, well-being and fatigue. After an exercise consultation, participants pursued their own activity and monitored PA points weekly. At baseline, mid-point and 12 weeks, eight participants wore activity monitors, and all participants undertook a 5-day food diary to monitor dietary intake. In 17 completers, mass, BMI, sit-to-stand, physical and general fatigue had improved by 6 weeks. By 12 weeks, waist, sagittal abdominal diameter (SAD), diastolic blood pressure, well-being and most fatigue dimensions had also improved. Throughout the intervention, PA was stable, energy intake and lying time decreased and standing time increased; thus, changes in both energy intake and expenditure explain the health-related outcomes. Observed changes in function, fatigue and quality of life are consistent with visceral fat loss and can occur at levels of weight loss which may not be considered clinically significant.

  6. Can a Drill Guide Improve the Coracoid Graft Placement During the Latarjet Procedure? A Prospective Comparative Study With the Freehand Technique.

    Science.gov (United States)

    Barth, Johannes; Boutsiadis, Achilleas; Neyton, Lionel; Lafosse, Laurent; Walch, Gilles

    2017-10-01

    One of the factors that can affect the success of the Latarjet procedure is accurate coracoid graft (CG) placement. The use of a guide can improve placement of the CG and screw positioning in the sagittal and axial planes as compared with the classic open ("freehand") technique. Cohort study; Level of evidence, 2. A total of 49 patients who underwent a Latarjet procedure for the treatment of recurrent anterior shoulder instability were prospectively included; the procedure was performed with the freehand technique in 22 patients (group 1) and with use of a parallel drill guide during screw placement in 27 patients (group 2). All patients underwent a postoperative computed tomography scan with the same established protocol. The scans were used to evaluate and compare the position of the CG in the sagittal and axial planes, the direction of the screws (α angle), and overall contact of the graft with the anterior surface of the glenoid after the 2 surgical techniques. The CG was placed >60% below the native glenoid equator in 23 patients (85.2%) in group 2, compared with 14 patients (63.6%) in group 1 ( P = .004). In the axial plane, the position of the CG in group 2 patients was more accurate (85.2% and 88.9% flush) at the inferior and middle quartiles of the glenoid surface ( P = .012 and .009), respectively. Moreover, with the freehand technique (group 1), the graft was in a more lateral position in the inferior and middle quartiles ( P = .012 and .009, respectively). No differences were found between groups 1 and 2 regarding the mean α angle of the superior (9° ± 4.14° vs 11° ± 6.3°, P = .232) and inferior (9.5° ± 6° vs 10° ± 7.5°, P = .629) screws. However, the mean contact angle (angle between the posterior coracoid and the anterior glenoid surface) with the freehand technique (3.8° ± 6.8°) was better than that of the guide (8.55° ± 8°) ( P = .05). Compared with the classic freehand operative technique, the parallel drill guide can ensure

  7. Nuclear electronic equipment for control and monitoring panel. Procedure guide for on-site tests of nuclear reactor instruments

    International Nuclear Information System (INIS)

    1975-10-01

    By the use of a procedure for on-site testing of nuclear reactor instruments it should be possible to judge their ability to guarantee the reactor safety and availability at the moment of divergence or during operation. Such a procedure must therefore be created as a work implement for the quick and reliable installation of electronic devices necessary for nuclear reactor control and supervision. A standard document is proposed for this purpose, allowing a ''test programme'' to be set up before the equipment is installed on the site [fr

  8. 77 FR 40385 - Withdrawal of Regulatory Guide 7.3; Procedures for Picking Up and Receiving Packages of...

    Science.gov (United States)

    2012-07-09

    ... Picking Up and Receiving Packages of Radioactive Material AGENCY: Nuclear Regulatory Commission. ACTION.... Nuclear Regulatory Commission (NRC or Commission) is withdrawing RG 7.3, ``Procedures for Picking Up and... Public Document Room (PDR) reference staff at 1-800-397-4209, or 301-415-4737, or by email at PDR...

  9. Evaluation of the UF/NCI hybrid computational phantoms for use in organ dosimetry of pediatric patients undergoing fluoroscopically guided cardiac procedures

    Science.gov (United States)

    Marshall, Emily L.; Borrego, David; Tran, Trung; Fudge, James C.; Bolch, Wesley E.

    2018-03-01

    Epidemiologic data demonstrate that pediatric patients face a higher relative risk of radiation induced cancers than their adult counterparts at equivalent exposures. Infants and children with congenital heart defects are a critical patient population exposed to ionizing radiation during life-saving procedures. These patients will likely incur numerous procedures throughout their lifespan, each time increasing their cumulative radiation absorbed dose. As continued improvements in long-term prognosis of congenital heart defect patients is achieved, a better understanding of organ radiation dose following treatment becomes increasingly vital. Dosimetry of these patients can be accomplished using Monte Carlo radiation transport simulations, coupled with modern anatomical patient models. The aim of this study was to evaluate the performance of the University of Florida/National Cancer Institute (UF/NCI) pediatric hybrid computational phantom library for organ dose assessment of patients that have undergone fluoroscopically guided cardiac catheterizations. In this study, two types of simulations were modeled. A dose assessment was performed on 29 patient-specific voxel phantoms (taken as representing the patient’s true anatomy), height/weight-matched hybrid library phantoms, and age-matched reference phantoms. Two exposure studies were conducted for each phantom type. First, a parametric study was constructed by the attending pediatric interventional cardiologist at the University of Florida to model the range of parameters seen clinically. Second, four clinical cardiac procedures were simulated based upon internal logfiles captured by a Toshiba Infinix-i Cardiac Bi-Plane fluoroscopic unit. Performance of the phantom library was quantified by computing both the percent difference in individual organ doses, as well as the organ dose root mean square values for overall phantom assessment between the matched phantoms (UF/NCI library or reference) and the patient

  10. Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures.

    Science.gov (United States)

    Waki, Tomonori; Kan, Joseph Y K

    2016-01-01

    Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations.

  11. Rapid fusion of 2D X-ray fluoroscopy with 3D multislice CT for image-guided electrophysiology procedures

    Science.gov (United States)

    Zagorchev, Lyubomir; Manzke, Robert; Cury, Ricardo; Reddy, Vivek Y.; Chan, Raymond C.

    2007-03-01

    Interventional cardiac electrophysiology (EP) procedures are typically performed under X-ray fluoroscopy for visualizing catheters and EP devices relative to other highly-attenuating structures such as the thoracic spine and ribs. These projections do not however contain information about soft-tissue anatomy and there is a recognized need for fusion of conventional fluoroscopy with pre-operatively acquired cardiac multislice computed tomography (MSCT) volumes. Rapid 2D-3D integration in this application would allow for real-time visualization of all catheters present within the thorax in relation to the cardiovascular anatomy visible in MSCT. We present a method for rapid fusion of 2D X-ray fluoroscopy with 3DMSCT that can facilitate EP mapping and interventional procedures by reducing the need for intra-operative contrast injections to visualize heart chambers and specialized systems to track catheters within the cardiovascular anatomy. We use hardware-accelerated ray-casting to compute digitally reconstructed radiographs (DRRs) from the MSCT volume and iteratively optimize the rigid-body pose of the volumetric data to maximize the similarity between the MSCT-derived DRR and the intra-operative X-ray projection data.

  12. Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures.

    Directory of Open Access Journals (Sweden)

    Chiara Gardin

    Full Text Available The combination of bone grafting materials with guided bone regeneration (GBR membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM. In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications.

  13. VALIDATION OF ANALYTICAL METHODS AND INSTRUMENTATION FOR BERYLLIUM MEASUREMENT: REVIEW AND SUMMARY OF AVAILABLE GUIDES, PROCEDURES, AND PROTOCOLS

    Energy Technology Data Exchange (ETDEWEB)

    Ekechukwu, A.

    2008-12-17

    This document proposes to provide a listing of available sources which can be used to validate analytical methods and/or instrumentation for beryllium determination. A literature review was conducted of available standard methods and publications used for method validation and/or quality control. A comprehensive listing of the articles, papers, and books reviewed is given in Appendix 1. Available validation documents and guides are listed in the appendix; each has a brief description of application and use. In the referenced sources, there are varying approaches to validation and varying descriptions of validation at different stages in method development. This discussion focuses on validation and verification of fully developed methods and instrumentation that have been offered up for use or approval by other laboratories or official consensus bodies such as ASTM International, the International Standards Organization (ISO) and the Association of Official Analytical Chemists (AOAC). This review was conducted as part of a collaborative effort to investigate and improve the state of validation for measuring beryllium in the workplace and the environment. Documents and publications from the United States and Europe are included. Unless otherwise specified, all documents were published in English.

  14. DOE program guide for universities and other research groups. Part I. DOE Research and Development Programs; Part II. DOE Procurement and Assistance Policies/Procedures

    Energy Technology Data Exchange (ETDEWEB)

    1980-03-01

    This guide addresses the DOE responsibility for fostering advanced research and development of all energy resources, both current and potential. It is intended to provide, in a single publication, all the fundamental information needed by an institution to develop a potential working relationship with DOE. Part I describes DOE research and development programs and facilities, and identifies areas of additional research needs and potential areas for new research opportunities. It also summarizes budget data and identifies the DOE program information contacts for each program. Part II provides researchers and research administrators with an introduction to the DOE administrative policies and procedures for submission and evaluation of proposals and the administration of resulting grants, cooperative agreements, and research contracts. (RWR)

  15. Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures

    Science.gov (United States)

    Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A.; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y. B.; Maydeo, Amit P.; Ho, Khek Yu

    2017-01-01

    Background and aims  EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures. Methods  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 – 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties. Results  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 – 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently. Conclusions  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures. PMID:29250585

  16. Evaluation of a novel, hybrid model (Mumbai EUS II) for stepwise teaching and training in EUS-guided biliary drainage and rendezvous procedures.

    Science.gov (United States)

    Dhir, Vinay; Itoi, Takao; Pausawasdi, Nonthalee; Khashab, Mouen A; Perez-Miranda, Manuel; Sun, Siyu; Park, Do Hyun; Iwashita, Takuji; Teoh, Anthony Y B; Maydeo, Amit P; Ho, Khek Yu

    2017-11-01

     EUS-guided biliary drainage (EUS-BD) and rendezvous (EUS-RV) are acceptable rescue options for patients with failed endoscopic retrograde cholangiopancreatography (ERCP). However, there are limited training opportunities at most centers owing to low case volumes. The existing models do not replicate the difficulties encountered during EUS-BD. We aimed to develop and validate a model for stepwise learning of EUS-BD and EUS-RV, which replicates the actual EUS-BD procedures.  A hybrid model was created utilizing pig esophagus and stomach, with a synthetic duodenum and biliary system. The model was objectively assessed on a grade of 1 - 4 by two experts. Twenty-eight trainees were given initial training with didactic lectures and live procedures. This was followed by hands-on training in EUS-BD and EUS-RV on the hybrid model. Trainees were assessed for objective criteria of technical difficulties.  Both the experts graded the model as very good or above for all parameters. All trainees could complete the requisite steps of EUS-BD and EUS-RV in a mean time of 11 minutes (8 - 18 minutes). Thirty-six technical difficulties were noted during the training (wrong scope position, 13; incorrect duct puncture, 12; guidewire related problems, 11). Technical difficulties peaked for EUS-RV, followed by hepaticogastrostomy (HGS) and choledochoduodenostomy (CDS) (20, 9, and 7, P  = 0.001). At 10 days follow-up, nine of 28 trainees had successfully performed three EUS-RV and seven EUS-BD procedures independently.  The Mumbai EUS II hybrid model replicates situations encountered during EUS-RV and EUS-BD. Stepwise mentoring improves the chances of success in EUS-RV and EUS-BD procedures.

  17. SU-E-I-42: Normalized Embryo/fetus Doses for Fluoroscopically Guided Pacemaker Implantation Procedures Calculated Using a Monte Carlo Technique

    Energy Technology Data Exchange (ETDEWEB)

    Damilakis, J; Stratakis, J; Solomou, G [University of Crete, Heraklion (Greece)

    2014-06-01

    Purpose: It is well known that pacemaker implantation is sometimes needed in pregnant patients with symptomatic bradycardia. To our knowledge, there is no reported experience regarding radiation doses to the unborn child resulting from fluoroscopy during pacemaker implantation. The purpose of the current study was to develop a method for estimating embryo/fetus dose from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all trimesters of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study. Three mathematical anthropomorphic phantoms representing the average pregnant patient at the first, second and third trimesters of gestation were generated using Bodybuilder software (White Rock science, White Rock, NM). The normalized embryo/fetus dose from the posteroanterior (PA), the 30° left-anterior oblique (LAO) and the 30° right-anterior oblique (RAO) projections were calculated for a wide range of kVp (50–120 kVp) and total filtration values (2.5–9.0 mm Al). Results: The results consist of radiation doses normalized to a) entrance skin dose (ESD) and b) dose area product (DAP) so that the dose to the unborn child from any fluoroscopic technique and x-ray device used can be calculated. ESD normalized doses ranged from 0.008 (PA, first trimester) to 2.519 μGy/mGy (RAO, third trimester). DAP normalized doses ranged from 0.051 (PA, first trimester) to 12.852 μGy/Gycm2 (RAO, third trimester). Conclusion: Embryo/fetus doses from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all stages of gestation can be estimated using the method developed in this study. This study was supported by the Greek Ministry of Education and Religious Affairs, General Secretariat for Research and Technology, Operational Program ‘Education and Lifelong Learning’, ARISTIA (Research project: CONCERT)

  18. SU-E-I-42: Normalized Embryo/fetus Doses for Fluoroscopically Guided Pacemaker Implantation Procedures Calculated Using a Monte Carlo Technique

    International Nuclear Information System (INIS)

    Damilakis, J; Stratakis, J; Solomou, G

    2014-01-01

    Purpose: It is well known that pacemaker implantation is sometimes needed in pregnant patients with symptomatic bradycardia. To our knowledge, there is no reported experience regarding radiation doses to the unborn child resulting from fluoroscopy during pacemaker implantation. The purpose of the current study was to develop a method for estimating embryo/fetus dose from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all trimesters of gestation. Methods: The Monte Carlo N-Particle (MCNP) radiation transport code was employed in this study. Three mathematical anthropomorphic phantoms representing the average pregnant patient at the first, second and third trimesters of gestation were generated using Bodybuilder software (White Rock science, White Rock, NM). The normalized embryo/fetus dose from the posteroanterior (PA), the 30° left-anterior oblique (LAO) and the 30° right-anterior oblique (RAO) projections were calculated for a wide range of kVp (50–120 kVp) and total filtration values (2.5–9.0 mm Al). Results: The results consist of radiation doses normalized to a) entrance skin dose (ESD) and b) dose area product (DAP) so that the dose to the unborn child from any fluoroscopic technique and x-ray device used can be calculated. ESD normalized doses ranged from 0.008 (PA, first trimester) to 2.519 μGy/mGy (RAO, third trimester). DAP normalized doses ranged from 0.051 (PA, first trimester) to 12.852 μGy/Gycm2 (RAO, third trimester). Conclusion: Embryo/fetus doses from fluoroscopically guided pacemaker implantation procedures performed on pregnant patients during all stages of gestation can be estimated using the method developed in this study. This study was supported by the Greek Ministry of Education and Religious Affairs, General Secretariat for Research and Technology, Operational Program ‘Education and Lifelong Learning’, ARISTIA (Research project: CONCERT)

  19. VALIDATION OF ANALYTICAL METHODS AND INSTRUMENTATION FOR BERYLLIUM MEASUREMENT: REVIEW AND SUMMARY OF AVAILABLE GUIDES, PROCEDURES, AND PROTOCOLS

    Energy Technology Data Exchange (ETDEWEB)

    Ekechukwu, A

    2009-05-27

    Method validation is the process of evaluating whether an analytical method is acceptable for its intended purpose. For pharmaceutical methods, guidelines from the United States Pharmacopeia (USP), International Conference on Harmonisation (ICH), and the United States Food and Drug Administration (USFDA) provide a framework for performing such valications. In general, methods for regulatory compliance must include studies on specificity, linearity, accuracy, precision, range, detection limit, quantitation limit, and robustness. Elements of these guidelines are readily adapted to the issue of validation for beryllium sampling and analysis. This document provides a listing of available sources which can be used to validate analytical methods and/or instrumentation for beryllium determination. A literature review was conducted of available standard methods and publications used for method validation and/or quality control. A comprehensive listing of the articles, papers and books reviewed is given in the Appendix. Available validation documents and guides are listed therein; each has a brief description of application and use. In the referenced sources, there are varying approches to validation and varying descriptions of the valication process at different stages in method development. This discussion focuses on valication and verification of fully developed methods and instrumentation that have been offered up for use or approval by other laboratories or official consensus bodies such as ASTM International, the International Standards Organization (ISO) and the Association of Official Analytical Chemists (AOAC). This review was conducted as part of a collaborative effort to investigate and improve the state of validation for measuring beryllium in the workplace and the environment. Documents and publications from the United States and Europe are included. Unless otherwise specified, all referenced documents were published in English.

  20. SPORT AND EXERCISE PHYSIOLOGY TESTING Volume one: Sport Testing Volume two: Exercise and Clinical Testing

    Directory of Open Access Journals (Sweden)

    Edward M. Winter

    2007-03-01

    Full Text Available DESCRIPTION The objective of the book is to discuss the theoretical and practical aspects of physiological testing in exercise and sports which is essential to evaluate and monitor developing exercise performance for athletes and public health, and improving quality of life for patients.A board of leading sport and exercise physiologists and scientists are gathered to discuss physiological assessments that have proven validity and reliability, both in sport and health relevant issues. Incidentally, it updates the reader about the current subjects of physiological exertion testing in both research and clinical procedures. Both volumes individually cover the increasing number of available research and review publications, and theoretical explanations are supported by practical examples. A step-by-step and/or checklist method is used in appropriate sections which make the guides more user-friendly than most. PURPOSE The first volume is designed to help readers develop an understanding of the essential concepts of sport specific testing whereas the second volume aims at making the exercise and clinical specific testing comprehensible, dealing with both technical terms and the theories underlying the importance of these tests. AUDIENCE As Guidelines books of the British Association of Sport and Exercise Sciences, it will be of interest to a wide range of students, researchers and practitioners in the sport and exercise disciplines whether they work in the laboratory or in the field. FEATURES The first volume features immediate practical requirements particularly in sport testing. It is composed of five parts with detailed sub-sections in all of them. The topics of the parts are: i general principles, ii methodological issues, iii general procedures, iv sport specific procedures, v special populations.The second volume is also presented in five parts, again with sub-sections in all of them, but considering the requirements in clinical and exercise

  1. MRI-guided procedures in various regions of the body using a robotic assistance system in a closed-bore scanner: preliminary clinical experience and limitations.

    Science.gov (United States)

    Moche, Michael; Zajonz, Dirk; Kahn, Thomas; Busse, Harald

    2010-04-01

    To present the clinical setup and workflow of a robotic assistance system for image-guided interventions in a conventional magnetic resonance imaging (MRI) environment and to report our preliminary clinical experience with percutaneous biopsies in various body regions. The MR-compatible, servo-pneumatically driven, robotic device (Innomotion) fits into the 60-cm bore of a standard MR scanner. The needle placement (n = 25) accuracy was estimated by measuring the 3D deviation between needle tip and prescribed target point in a phantom. Percutaneous biopsies in six patients and different body regions were planned by graphically selecting entry and target points on intraoperatively acquired roadmap MR data. For insertion depths between 29 and 95 mm, the average 3D needle deviation was 2.2 +/- 0.7 mm (range 0.9-3.8 mm). Patients with a body mass index of up to approximately 30 kg/m(2) fitted into the bore with the device. Clinical work steps and limitations are reported for the various applications. All biopsies were diagnostic and could be completed without any major complications. Median planning and intervention times were 25 (range 20-36) and 44 (36-68) minutes, respectively. Preliminary clinical results in a standard MRI environment suggest that the presented robotic device provides accurate guidance for percutaneous procedures in various body regions. Shorter procedure times may be achievable by optimizing technical and workflow aspects. (c) 2010 Wiley-Liss, Inc.

  2. No More Waits and Delays: Streamlining Workflow to Decrease Patient Time of Stay for Image-guided Musculoskeletal Procedures.

    Science.gov (United States)

    Cheung, Yvonne Y; Goodman, Eric M; Osunkoya, Tomiwa O

    2016-01-01

    Long wait times limit our ability to provide the right care at the right time and are commonly products of inefficient workflow. In 2013, the demand for musculoskeletal (MSK) procedures increased beyond our department's ability to provide efficient and timely service. We initiated a quality improvement (QI) project to increase efficiency and decrease patient time of stay. Our project team included three MSK radiologists, one senior resident, one technologist, one administrative assistant/scheduler, and the lead technologist. We adopted and followed the Lean Six Sigma DMAIC (define, measure, analyze, improve, and control) approach. The team used tools such as voice of the customer (VOC), along with affinity and SIPOC (supplier, input, process, output, customer) diagrams, to understand the current process, identify our customers, and develop a project charter in the define stage. During the measure stage, the team collected data, created a detailed process map, and identified wastes with the value stream mapping technique. Within the analyze phase, a fishbone diagram helped the team to identify critical root causes for long wait times. Scatter plots revealed relationships among time variables. Team brainstorming sessions generated improvement ideas, and selected ideas were piloted via plan, do, study, act (PDSA) cycles. The control phase continued to enable the team to monitor progress using box plots and scheduled reviews. Our project successfully decreased patient time of stay. The highly structured and logical Lean Six Sigma approach was easy to follow and provided a clear course of action with positive results. (©)RSNA, 2016.

  3. Spatial Distortion in MRI-Guided Stereotactic Procedures: Evaluation in 1.5-, 3- and 7-Tesla MRI Scanners.

    Science.gov (United States)

    Neumann, Jan-Oliver; Giese, Henrik; Biller, Armin; Nagel, Armin M; Kiening, Karl

    2015-01-01

    Magnetic resonance imaging (MRI) is replacing computed tomography (CT) as the main imaging modality for stereotactic transformations. MRI is prone to spatial distortion artifacts, which can lead to inaccuracy in stereotactic procedures. Modern MRI systems provide distortion correction algorithms that may ameliorate this problem. This study investigates the different options of distortion correction using standard 1.5-, 3- and 7-tesla MRI scanners. A phantom was mounted on a stereotactic frame. One CT scan and three MRI scans were performed. At all three field strengths, two 3-dimensional sequences, volumetric interpolated breath-hold examination (VIBE) and magnetization-prepared rapid acquisition with gradient echo, were acquired, and automatic distortion correction was performed. Global stereotactic transformation of all 13 datasets was performed and two stereotactic planning workflows (MRI only vs. CT/MR image fusion) were subsequently analysed. Distortion correction on the 1.5- and 3-tesla scanners caused a considerable reduction in positional error. The effect was more pronounced when using the VIBE sequences. By using co-registration (CT/MR image fusion), even a lower positional error could be obtained. In ultra-high-field (7 T) MR imaging, distortion correction introduced even higher errors. However, the accuracy of non-corrected 7-tesla sequences was comparable to CT/MR image fusion 3-tesla imaging. MRI distortion correction algorithms can reduce positional errors by up to 60%. For stereotactic applications of utmost precision, we recommend a co-registration to an additional CT dataset. © 2015 S. Karger AG, Basel.

  4. Performance of intra-procedural 18-fluorodeoxyglucose PET/CT-guided biopsies for lesions suspected of malignancy but poorly visualized with other modalities

    International Nuclear Information System (INIS)

    Cornelis, F.; Silk, M.; Takaki, H.; Durack, J.C.; Erinjeri, J.P.; Sofocleous, C.T.; Siegelbaum, R.H.; Maybody, M.; Solomon, S.B.; Schoder, H.

    2014-01-01

    We sought to evaluate the safety and the diagnostic success rate of percutaneous biopsies performed under intra-procedural 18 F-deoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) guidance for lesions difficult to see with conventional cross-sectional imaging. From 2011 to 2013, consecutive clinically indicated percutaneous PET/CT-guided biopsies of 106 masses (mean size, 3.3 cm; range, 0.7-15.9 cm; SD, 2.9 cm) in bones (n = 33), liver (n = 26), soft tissues (n = 18), lung (n = 15) and abdomen (n = 14) were reviewed. The biopsy procedures were performed following injection of a mean of 255 MBq (SD, 74) FDG. Mean maximal standardized uptake value (SUV) of lesions was 8.8 (SD, 6.3). A systematic review of the histopathological results and outcomes was performed. Biopsies were positive for malignancy in 76 cases (71.7 %, 76/106) and for benign tissue in 30 cases (28.3 %, 30/106). Immediate results were considered adequate for 100 PET/CT biopsies (94.3 %, 100/106) requiring no further exploration, and for the six others (5.7 %, 6/106) benign diagnoses were confirmed after surgery (n = 4) or follow-up (n = 2). The consequent overall sensitivity and the diagnostic success of biopsy were therefore 100 %. No significant differences in terms of detection of malignancy were observed between the different locations. Lesions > 2 cm or with SUV > 4 were not significantly more likely to be malignant. Complications occurred after four biopsies (3.7 %, 4/106). Intra-procedural PET/CT guidance appears as a safe and effective method and allows high diagnostic success of percutaneous biopsies for metabolically active lesions. (orig.)

  5. Next Indefinite Contract review exercise

    CERN Multimedia

    2015-01-01

    Dear Colleagues, We are pleased to inform you that the 2015 LD2IC exercise (selection process for the conversion of limited-duration contracts into indefinite contracts) has been officially launched. The vacancy notices for posts opened with a view to the award of indefinite contracts will be published on 3 August 2015 for a period of four weeks (until 31 August 2015). The CERN Contract Review Boards (candidate interviews) will be held between the end of September and mid-November. The LD to IC procedure, Frequently Asked Questions (FAQ) and a calendar for the exercise are now available in the Admin e-guide. In addition, general information sessions on the procedure will be organised for candidates on the following dates: We would like to remind you that all staff members holding a limited-duration contract who have successfully completed their probation period at the time of application and who meet the eligibility criteria in the vacancy notices (VNs) are eligible to apply for posts for the awa...

  6. Next Indefinite Contract review exercise

    CERN Multimedia

    HR Department

    2015-01-01

    Dear Colleagues, We are pleased to inform you that the 2015 LD2IC exercise (selection process for the conversion of limited-duration contracts into indefinite contracts) has been officially launched. The vacancy notices for posts opened with a view to the award of indefinite contracts will be published on 3 August 2015 for a period of four weeks (until 31 August 2015). The CERN Contract Review Boards (candidate interviews) will be held between the end of September and mid-November. The LD to IC procedure, Frequently Asked Questions (FAQ) and a calendar for the exercise are now available in the Admin e-guide. In addition, general information sessions on the procedure will be organised for candidates on the following dates: We would like to remind you that all staff members holding a limited-duration contract who have successfully completed their probation period at the time of application and who meet the eligibility criteria in the vacancy notices (VNs) are eligible to apply for posts for the award of a...

  7. CT-Guided Microwave Ablation of 45 Renal Tumors: Analysis of Procedure Complexity Utilizing a Percutaneous Renal Ablation Complexity Scoring System.

    Science.gov (United States)

    Mansilla, Alberto V; Bivins, Eugene E; Contreras, Francisco; Hernandez, Manuel A; Kohler, Nathan; Pepe, Julie W

    2017-02-01

    To develop a scoring system that stratifies complexity of percutaneous ablation of renal tumors. Analysis was performed of 36 consecutive patients (mean age, 64 y; range, 30-89 y) who underwent CT-guided microwave (MW) ablation of 45 renal tumors (mean tumor diameter, 2.4 cm; range, 1.2-4.0 cm). Technical success and effectiveness were determined based on intraprocedural and follow-up imaging studies. The RENAL score and the proposed percutaneous renal ablation complexity (P-RAC) score were calculated for each tumor. Technical success was 93.3% (n = 42). Biopsy of 38 of 45 renal tumors revealed 23 renal cell carcinomas. Median follow-up period was 9.7 months (range, 2.9-46.8 months). There were no tumor recurrences. One major complication, ureteropelvic junction stricture, occurred (2.6%). The P-RAC score was found to differ statistically from the RENAL score (t = 3.754, df = 44, P = .001). A positive correlation was found between the P-RAC score and number of antenna insertions (r = .378, n = 45, P = .011) and procedure duration (r = .328, n = 45, P = .028). No correlation was found between the RENAL score and number of MW antenna insertions (r = .110, n = 45, P = .472) or procedure duration (r = .263, n = 45, P = .081). Hydrodissection was significantly more common in the P-RAC high-complexity category than in low-complexity category (χ 2 = 12.073, df = 2, P = .002). The P-RAC score may be useful in stratifying percutaneous renal ablation complexity. Further studies with larger sample sizes are necessary to validate the P-RAC score and to determine if it can predict risk of complications. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  8. Exercise and Pulmonary Hypertension (PH)

    Science.gov (United States)

    ... Situations Find a Doctor PH Care Centers PHA Classroom PHA Registry Insurance Guide Specialty Pharmacy Other Resources ... no published data in the medical literature regarding routine exercise in patients with PAH. However, there are ...

  9. Method for automatic localization of MR-visible markers using morphological image processing and conventional pulse sequences: feasibility for image-guided procedures.

    Science.gov (United States)

    Busse, Harald; Trampel, Robert; Gründer, Wilfried; Moche, Michael; Kahn, Thomas

    2007-10-01

    To evaluate the feasibility and accuracy of an automated method to determine the 3D position of MR-visible markers. Inductively coupled RF coils were imaged in a whole-body 1.5T scanner using the body coil and two conventional gradient echo sequences (FLASH and TrueFISP) and large imaging volumes up to (300 mm(3)). To minimize background signals, a flip angle of approximately 1 degrees was used. Morphological 2D image processing in orthogonal scan planes was used to determine the 3D positions of a configuration of three fiducial markers (FMC). The accuracies of the marker positions and of the orientation of the plane defined by the FMC were evaluated at various distances r(M) from the isocenter. Fiducial marker detection with conventional equipment (pulse sequences, imaging coils) was very reliable and highly reproducible over a wide range of experimental conditions. For r(M) guided procedures. (c) 2007 Wiley-Liss, Inc.

  10. Therapeutic laryngoscopy during exercise: A novel non-surgical therapy for refractory EILO.

    Science.gov (United States)

    Olin, J Tod; Deardorff, Emily H; Fan, Elizabeth M; Johnston, Kristina L; Keever, Valerie L; Moore, Camille M; Bender, Bruce G

    2017-06-01

    Exercise-induced laryngeal obstruction (EILO) may affect as many as 6% of the adolescent population, with some patients experiencing symptoms refractory to conservative interventions. This report describes therapeutic laryngoscopy during exercise, a novel, non-surgical intervention that harnesses real-time laryngoscopy video as biofeedback to control laryngeal aperture during high-intensity exercise. Additionally, we quantitate patient-reported perceptions of procedure safety, tolerability, learning value, and effectiveness. Clinical EILO patients with symptoms refractory to conventional respiratory retraining and other therapies were referred for the procedure which features laryngoscopy video as biofeedback during serial physician-guided 1-min exercise sprints. We quantify perceptions of procedure safety, tolerability, learning value, and effectiveness through questionnaires offered to all patients as well as observers of the procedure. Forty-one patients and 37 parent observers were approached for feedback; 88% of patients and 95% of observers consented to participation. Patients and observers reported perceptions of safety and tolerability (81% and 86%, respectively), learning value (78% and 91%, respectively), and effectiveness (58% and 80%, respectively) with patient age predicting some responses. Seventy-five percent of patients noted that "Since the procedure, my breathing during exercise has improved," and 85% of this group noted that therapeutic laryngoscopy during exercise was "the most important therapy leading to my breathing improvement." The procedure also provided insight into the psychological experience of patients, a domain not clinically apparent prior to the procedure. Our data support further study of therapeutic laryngoscopy during exercise as a possible intervention for patients with refractory EILO. Pediatr Pulmonol. 2017;52:813-819. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  11. Eye bank procedures: donor selection criteria.

    Science.gov (United States)

    Sousa, Sidney Júlio de Faria E; Sousa, Stella Barretto de Faria E

    2018-01-01

    Eye banks use sterile procedures to manipulate the eye, antiseptic measures for ocular surface decontamination, and rigorous criteria for donor selection to minimize the possibility of disease transmission due to corneal grafting. Donor selection focuses on analysis of medical records and specific post-mortem serological tests. To guide and standardize procedures, eye bank associations and government agencies provide lists of absolute and relative contraindications for use of the tissue based on donor health history. These lists are guardians of the Hippocratic principle "primum non nocere." However, each transplantation carries risk of transmission of potentially harmful agents to the recipient. The aim of the procedures is not to eliminate risk, but limit it to a reasonable level. The balance between safety and corneal availability needs to be maintained by exercising prudence without disproportionate rigor.

  12. Exercising the federal radiological emergency response plan

    International Nuclear Information System (INIS)

    Gant, K.S.; Adler, M.V.; Wolff, W.F.

    1986-01-01

    Multiagency exercises were an important part of the development of the Federal Radiological Emergency Response Plan. This paper concentrates on two of these exercises, the Federal Field Exercise in March 1984 and the Relocation Tabletop Exercise in December 1985. The Federal Field Exercise demonstrated the viability and usefulness of the draft plan; lessons learned from the exercise were incorporated into the published plan. The Relocation Tabletop Exercise examined the federal response in the postemergency phase. This exercise highlighted the change over time in the roles of some agencies and suggested response procedures that should be developed or revised. 8 refs

  13. Prevention: Exercise

    Medline Plus

    Full Text Available ... A SPECIALIST Prevention Strengthening Exercise Committee Exercise Committee Core Strengthening Many popular forms of exercise focus on ... acute pain, you should stop doing it. Transverse Core Strengthening This strengthens the muscles that cross from ...

  14. Prevention: Exercise

    Medline Plus

    Full Text Available ... Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic Exercise Cervical Exercise Strength Training for the Elderly Other Back Pack Safety Pregnancy ...

  15. Multimodal Guided Self-Help Exercise Program to Prevent Speech, Swallowing, and Shoulder Problems Among Head and Neck Cancer Patients : A Feasibility Study

    NARCIS (Netherlands)

    Cnossen, Ingrid C.; van Uden-Kraan, Cornelia F.; Rinkel, Rico N. P. M.; Aalders, IJke J.; de Goede, Cees J. T.; de Bree, Remco; Doornaert, Patricia; Rietveld, Derek H. F.; Langendijk, Johannes A.; Witte, Birgit I.; Leemans, C. Rene; Verdonck-de Leeuw, Irma M.

    Background: During a 6-week course of (chemo) radiation many head and neck cancer patients have to endure radiotherapy-induced toxicity, negatively affecting patients' quality of life. Pretreatment counseling combined with self-help exercises could be provided to inform patients and possibly prevent

  16. Multimodal guided self-help exercise program to prevent speech, swallowing, and shoulder problems among head and neck cancer patients: a feasibility study.

    NARCIS (Netherlands)

    Cnossen, I.C.; van Uden-Kraan, C.F.; Rinkel, R.N.; Aalders, I.J.; de Goede, C.J.T.; de Bree, R.; Doornaert, P.; Rietveld, D.H.F.; Langendijk, J.A.; Witte, B.I.; Leemans, C.R.; de Leeuw, I.M.

    2014-01-01

    Background: During a 6-week course of (chemo)radiation many head and neck cancer patients have to endure radiotherapy-induced toxicity, negatively affecting patients' quality of life. Pretreatment counseling combined with self-help exercises could be provided to inform patients and possibly prevent

  17. Flouroscopically–guided transhepatic puncture for difficult TIPS re-do procedures utilizing the En Snare retrieval device: A new approach to occluded TIPS in patients with recurrent ascites

    International Nuclear Information System (INIS)

    Stambo, Glenn W.; Berlet, Matthew H.

    2012-01-01

    Portal hypertension and variceal bleeding are complications due to cirrhosis. Transjugular Intraphepatic Portosystemic shunt (TIPS) procedure is a well-established treatment for recurrent ascites and variceal bleeding related to portal hypertension. After a TIPS has been placed, the potential of TIPS occlusion or stenosis is high. A TIPS re-do procedure has been used in treatment of progressive clinical symptoms. The standard approach is via the jugular route to recannulate the TIPS shunt. Rarely, it cannot be performed from the jugular approach. Therefore, a fluoroscopically -guided transhepatic approach has been devised for these difficult situations. This case describes the use of the transhepatic route through an indwelling Viatorr covered stent utilizing an En-Snare device to help complete the TIPS re-do procedure. With this newer approach to TIPS re-do procedures, endovascular specialists can achieve TIPS patency despite difficult venous anatomical challenges and the various types of available TIPS stents presently on the market.

  18. Rethinking exercise identity

    DEFF Research Database (Denmark)

    Adamsen, Lis; Andersen, Christina; Lillelund, Christian

    2017-01-01

    Objective: To explore physically inactive breast and colon cancer patients’ prediagnosis exercise history and attitudes to physical activity (PA) and experiences in initiating PA while undergoing adjuvant chemotherapy. Design: An explorative qualitative study guided the interpretive analysis...... age 49 years: 25 patients with breast cancer and 8 with colon cancer, 72% with a low cardiac respiratory fitness level and the majority with a high level of education. Patients received adjuvant chemotherapy, oncologist’s PA recommendation and exercise, cancer nurse specialist’s counselling prior...... to allocation to PA interventions or waitlist control group. Results: Prediagnosis exercise had been excluded from patients’ daily lives due to perceptions of exercise as boring, lack of discipline and stressful work conditions for both genders. Recommendations from oncologists and nurses inspired the patients...

  19. The American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies Joint Committee recommendations for education and training in ultrasound-guided interventional pain procedures.

    Science.gov (United States)

    Narouze, Samer N; Provenzano, David; Peng, Philip; Eichenberger, Urs; Lee, Sang Chul; Nicholls, Barry; Moriggl, Bernhard

    2012-01-01

    The use of ultrasound in pain medicine for interventional axial, nonaxial, and musculoskeletal pain procedures is rapidly evolving and growing. Because of the lack of specialty-specific guidelines for ultrasonography in pain medicine, an international collaborative effort consisting of members of the Special Interest Group on Ultrasonography in Pain Medicine from the American Society of Regional Anesthesia and Pain Medicine, the European Society of Regional Anaesthesia and Pain Therapy, and the Asian Australasian Federation of Pain Societies developed the following recommendations for education and training in ultrasound-guided interventional pain procedures. The purpose of these recommendations is to define the required skills for performing ultrasound-guided pain procedures, the processes for appropriate education, and training and quality improvement. Training algorithms are outlined for practice- and fellowship-based pathways. The previously published American Society of Regional Anesthesia and Pain Medicine and European Society of Regional Anaesthesia and Pain Therapy education and teaching recommendations for ultrasound-guided regional anesthesia served as a foundation for the pain medicine recommendations. Although the decision to grant ultrasound privileges occurs at the institutional level, the committee recommends that the training guidelines outlined in this document serve as the foundation for educational training and the advancement of the practice of ultrasonography in pain medicine.

  20. Comparison of the performance of natural latex membranes prepared with different procedures and PTFE membrane in guided bone regeneration (GBR) in rabbits.

    Science.gov (United States)

    Moura, Jonas M L; Ferreira, Juliana F; Marques, Leonardo; Holgado, Leandro; Graeff, Carlos F O; Kinoshita, Angela

    2014-09-01

    This work assessed the performance of membranes made of natural latex extracted from Hevea brasiliensis prepared with three different methods: polymerized immediately after collection without the use of ammonia (L1); polymerized after preservation in ammonia solution (L2); and polymerized after storage in ammonia, followed by Soxhlet technique for the extraction of substances (L3). Polytetrafluoroethylene (PTFE) membrane was used as control. Two 10-mm diameter bone defects were surgically made in the calvaria of thirty adult male New Zealand rabbits. Defects (total n = 60) were treated with guided bone regeneration (GBR) using L1, L2, L3 or PTFE membranes (n = 15 for each membrane). Ten animals were euthanized after 7, 20 and 60 days postoperatively so that five samples (n = 5) of each treatment were collected at each time, and bone regeneration was assessed microscopically. The microscopic analysis revealed defects filled with blood clot and new bone formation at the margins of the defect in all 7-day samples, while 20-day defects were mainly filled with fibrous connective tissue. After 60 days defects covered with L1 membranes showed a significantly larger bone formation area in comparison to the other groups (P PTFE membranes was also investigated in six additional rabbits. The animals were subjected to the same surgical procedure for the confection of one 10-mm diameter bone defect that was treated with L1 (n = 3) or PTFE (n = 3). Fifty-three days later, a second surgery was performed to make a second defect, which was treated with the same type of membrane used in the first surgery. Seven days later, the animals were euthanized and samples analyzed. No differences among L1 and PTFE samples collected from sensitized and non-sensitized animals were found (P > 0.05, Kruskal-Wallis). Therefore, the results demonstrated that latex membranes presented performance comparable to PTFE membranes, and that L1 membranes induced higher bone formation. L1 and

  1. Automatic evaluations and exercise setting preference in frequent exercisers.

    Science.gov (United States)

    Antoniewicz, Franziska; Brand, Ralf

    2014-12-01

    The goals of this study were to test whether exercise-related stimuli can elicit automatic evaluative responses and whether automatic evaluations reflect exercise setting preference in highly active exercisers. An adapted version of the Affect Misattribution Procedure was employed. Seventy-two highly active exercisers (26 years ± 9.03; 43% female) were subliminally primed (7 ms) with pictures depicting typical fitness center scenarios or gray rectangles (control primes). After each prime, participants consciously evaluated the "pleasantness" of a Chinese symbol. Controlled evaluations were measured with a questionnaire and were more positive in participants who regularly visited fitness centers than in those who reported avoiding this exercise setting. Only center exercisers gave automatic positive evaluations of the fitness center setting (partial eta squared = .08). It is proposed that a subliminal Affect Misattribution Procedure paradigm can elicit automatic evaluations to exercising and that, in highly active exercisers, these evaluations play a role in decisions about the exercise setting rather than the amounts of physical exercise. Findings are interpreted in terms of a dual systems theory of social information processing and behavior.

  2. Assisted Medical Procedures (AMP)

    Data.gov (United States)

    National Aeronautics and Space Administration — DOCUMENTATION, DEVELOPMENT, AND PROGRESS The AMP was initially being developed as part the Advanced Integrated Clinical System (AICS)-Guided Medical Procedure System...

  3. Procedure guide for the implementation of quality management program in products and services link with the utilization of tracers technology (TT) and Nucleonic Control System

    International Nuclear Information System (INIS)

    Maggio Noldor, E.; Banados Perez, H.; Longo, G.; Kohnenkamp O, I.; Rodriguez Cardona, R.L.; Sebastian Calvo, C.; Vitart, X.

    1999-01-01

    This Guide was elaborated in the mark of the project RLA/8/024 ARCAL XLII 'Industrial Applications of the Tracer Technology and Nucleonic Control Systems'. Its objective is to establish the approaches for the implementation of quality management system in Tracer Techniques and Nucleonic Control System. The industry application of both techniques are increasing every day in Latin America, so it become in a necessity the implementation of quality control. This paper have 7 chapter. I. Introduction, II. General concepts, III. Proposal of the guide, IV. Verification process about the adhesion all the countries to the quality system; V. Requirement of the system; VI. Term and levels of implementation; VII. Glossary

  4. Prevention: Exercise

    Medline Plus

    Full Text Available ... body. Pilates, yoga and martial arts all provide well-rounded core strengthening programs. Simple exercises can be done at home as well. Some specific core strengthening exercises are described below. ...

  5. Compulsive Exercise

    Science.gov (United States)

    ... negative thinking and low self-esteem. Why Is Exercising Too Much a Bad Thing? We all know ... spent with friends. Warning Signs Someone may be exercising compulsively if he or she: won't skip ...

  6. Prevention: Exercise

    Medline Plus

    Full Text Available ... prescribe an exercise program that matches your abilities. Neck Press This is an isometric exercise to strengthen your neck. Press your palm against your forehead, then use ...

  7. Exercise Headaches

    Science.gov (United States)

    ... headaches may require emergency medical attention. Symptoms Primary exercise headaches These headaches: Are usually described as throbbing ... sides of the head in most cases Secondary exercise headaches These headaches may cause: The same symptoms ...

  8. Prevention: Exercise

    Medline Plus

    Full Text Available ... programs. Simple exercises can be done at home as well. Some specific core strengthening exercises are described ... times... Abdominal Crunch Draw abdominal wall inward, exhale as you lift chest area. This can be done ...

  9. Prevention: Exercise

    Medline Plus

    Full Text Available ... provide well-rounded core strengthening programs. Simple exercises can be done at home as well. Some specific ... benefit from this exercise... Sagittal Core Strengthening You can stretch and strengthen the low back muscles that ...

  10. Prevention: Exercise

    Medline Plus

    Full Text Available ... Disc Replacement (ADR) Bone Graft Alternatives Bone Morphogenetic Proteins (BMP) Cervical Disc Replacement Cervical Laminoplasty Lumbar (Open) ... Flexibility Aerobic Exercise Cervical Exercise Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back ...

  11. Staff supplement to the draft report on human engineering guide to control room evaluation: response to comments, sample checklist, draft systems review guidelines, and evaluation procedures

    International Nuclear Information System (INIS)

    1981-03-01

    This staff supplement to Draft Report NUREG/CR-1580, Human Engineering Guide to Control Room Evaluation, provides staff responses to comments on the draft report and supplemental material not provided in the draft report. The supplemental material includes new draft guidelines for the systems review of nuclear power plant control rooms and sample checklists and corresponding human engineering guidelines

  12. Exercise Habit

    Science.gov (United States)

    ... chunks of time. Exercise has so many health benefits that any amount is better than none. Try exercising for 10 minutes at a time throughout your ... second hand. Most people will get the greatest benefit and lower their risks if ... rate when exercising. To figure out your maximum heart rate, subtract ...

  13. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years.

    Science.gov (United States)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong

    2017-08-01

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. • CT-guided core needle biopsy is an accurate technique for diagnosing mediastinal nodes. • The rates of complications are similar to those for pulmonary lesion biopsy. • Pneumothorax risk factors include distance from pleura to target lesion and number of visceral pleura. • Distance from pleura to target lesion is the risk factor for hemoptysis. • CT-guided core needle biopsy is an important diagnostic method for mediastinal nodes.

  14. Magnetic resonance tomography-guided interventional procedure for diagnosis of prostate cancer; MRT-gezielte interventionelle Verfahren zur Abklaerung des Prostatakarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Schernthaner, M.; Helbich, T.H.; Fueger, B.J.; Memarsadeghi, M.; Stiglbauer, A.; Linhart, H.G.; Doan, A.; Pinker, K.; Brader, P. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Division fuer Molekulare und Gender-Bildgebung, Wien (Austria); Margreiter, M. [Medizinische Universitaet Wien, Univ.-Klinik fuer Urologie, Wien (Austria)

    2011-11-15

    In recent years magnetic resonance imaging (MRI) has been increasingly established in the diagnosis of prostate cancer in addition to transrectal ultrasonography (TRUS). The use of T2-weighted imaging allows an exact delineation of the zonal anatomy of the prostate and its surrounding structures. Other MR imaging tools, such as dynamic contrast-enhanced T1-weighted imaging or diffusion-weighted imaging allow an inference of the biochemical characteristics (multiparametric MRI). Prostate cancer, which could only be diagnosed using MR imaging or lesions suspected as being prostate cancer, which are localized in the anterior aspect of the prostate and were missed with repetitive TRUS biopsy, need to undergo MR guided biopsy. Recent studies have shown a good correlation between MR imaging and histopathology of specimens collected by MR-guided biopsy. Improved lesion targeting is therefore possible with MR-guided biopsy. So far data suggest that MR-guided biopsy of the prostate is a promising alternative diagnostic tool to TRUS-guided biopsy. (orig.) [German] Neben dem transrektalen Ultraschall (TRUS) hat sich in den letzten Jahren die MRT als nichtinvasive Methode zur Bildgebung von Prostatatumoren etabliert. Mittels T2-gewichteter Sequenzen ist eine exakte anatomische Darstellung der Prostata und ihrer umliegenden Strukturen moeglich. Andere MRT-Techniken ermoeglichen Rueckschluesse auf das biologische Verhalten des Tumors: dynamische kontrastmittelverstaerkte T1-gewichtete Sequenzen zur Darstellung der Angiogenese, diffusionsgewichtete Aufnahmen zur Beurteilung der Zelldichte und die Spektroskopie zur Bestimmung von Gewebemetaboliten wie Cholin und Kreatin (multiparametrische Bildgebung). Prostatatumoren, die nur mittels MRT nachweisbar sind oder verdaechtige Tumoren, die hauptsaechlich anterior in der Prostata lokalisiert sind und in wiederholten TRUS-gezielten Biopsien verfehlt wurden, benoetigen eine MRT-gezielte Biopsie zur Diagnosesicherung. Die bisherigen

  15. Computerized procedures system

    Science.gov (United States)

    Lipner, Melvin H.; Mundy, Roger A.; Franusich, Michael D.

    2010-10-12

    An online data driven computerized procedures system that guides an operator through a complex process facility's operating procedures. The system monitors plant data, processes the data and then, based upon this processing, presents the status of the current procedure step and/or substep to the operator. The system supports multiple users and a single procedure definition supports several interface formats that can be tailored to the individual user. Layered security controls access privileges and revisions are version controlled. The procedures run on a server that is platform independent of the user workstations that the server interfaces with and the user interface supports diverse procedural views.

  16. International exercise in Spain INEX-4

    International Nuclear Information System (INIS)

    Almodovar, A.; Granada, M. J.; Parages, C.; Garcia, J. P.; Calvin, M.; Vega, R. de la

    2012-01-01

    The INEX exercises are designed to test the procedures and arrangements in emergencies and have proved useful to try to investigate and improve procedures and agreements necessary to respond to nuclear accidents and radiological emergencies at national and international level.

  17. Exercise addiction

    DEFF Research Database (Denmark)

    Lichtenstein, Mia Beck; Christiansen, Erik; Elklit, Ask

    2014-01-01

    Exercise addiction is characterized by excessive exercise patterns with potential negative consequences such as overuse injuries. The aim of this study was to compare eating disorder symptoms, quality of life, personality traits and attachments styles in exercisers with and without indications...... of exercise addiction. A case-control study with 121 exercisers was conducted. The exercisers were categorized into an addiction group (n=41) or a control group (n=80) on the basis of their responses to the Exercise Addiction Inventory. The participants completed the Eating Disorder Inventory 2, the Short......-Form 36, the NEO Personality Inventory Revised and the Adult Attachment Scale. The addiction group scored higher on eating disorder symptoms, especially on perfectionism but not as high as eating disorder populations. The characteristic personality traits in the addiction group were high levels...

  18. Procedure guide of design, construction of prototypes, calibration and sure operation of nucleonic control systems; Guia de procedimientos de diseno, construccion de prototipos, calibracion y operacion segura de sistemas de control nucleonico

    Energy Technology Data Exchange (ETDEWEB)

    Banados Perez, H [Instituto de Pesquizas Energia Nuclear, Sao Paulo (Brazil); Griffith Martinez, J [Instituto de Investigaciones de la Cana de Azucar, La Habana (Cuba); Desdin Garcia, L F [Centro de Estudios Aplicados al Desarrollo Nuclear, La Habana (Cuba); Rodriguez Cardona, R L [Agencia de Energia Nuclear, La Habana (Cuba); Molina, G [Instituto de Investigaciones Nucleares, Mexico City (Mexico); Sebastian Calvo, C [Instituto Peruano de Energia Nuclear, Lima (Peru)

    1999-09-24

    This Guide was elaborated in the mark of the project RLA/8/024 ARCAL XLII 'Industrial Applications of the Tracer Technology and Nucleonic Control Systems'. Its objective is to establish the approaches for the design, the construction, the selection and the procedures for the sure operation of the Nucleonic Control Systems (NCS) in the industry. The NCS is used to control processes to high speeds, materials with extreme conditions or with noxious chemical properties, susceptible materials of being damaged by contact and packed products. In this document is defined the scope of the procedure. The SCN are classified according to: type of radiations, the mobility of the components, the degree of the beams collimation; and in function of the security. The design and construction criteria of the nuclear meters and of the systems of control nucleonic are exposed.

  19. Collegiate Drug Management Guide.

    Science.gov (United States)

    Janosik, Steven M.; Anderson, David S.

    A checklist to help colleges and universities reevaluate their policies and procedures regarding drug use among college students is presented. It is designed to supplement the "Collegiate Alcohol Risk Assessment Guide." In this guide drugs other than alcohol are of concern, although alcohol is viewed by many as the "drug of choice" among college…

  20. Exercise addiction.

    Science.gov (United States)

    Landolfi, Emilio

    2013-02-01

    This article examines the nature of exercise addiction. It presents a broad, congruent and discerning narrative literature review with the aim of providing a deeper understanding of the condition 'exercise addiction', including symptoms and options for treatment. In addition, guidelines are provided with respect to 'healthy' levels of exercise. Criteria used for determining the eligibility of studies evaluated in the review included the provision of relevant information in studies identified using pertinent search terms. The review highlights some of the key distinctions between healthy levels of exercise and exercise addiction. The findings suggest that an individual who is addicted to exercise will continue exercising regardless of physical injury, personal inconvenience or disruption to other areas of life including marital strain, interference with work and lack of time for other activities. 'Addicted' exercisers are more likely to exercise for intrinsic rewards and experience disturbing deprivation sensations when unable to exercise. In contrast, 'committed' exercisers engage in physical activity for extrinsic rewards and do not suffer severe withdrawal symptoms when they cannot exercise. Exercisers must acquire a sense of life-balance while embracing an attitude conducive to sustainable long-term physical, psychological and social health outcomes. Implementation of recommendations by the Canadian Society for Exercise Physiology, which states that all apparently healthy adults between 18 and 64 years of age should accumulate at least 150 minutes of moderate (5 or 6 on a scale of 0-10) to vigorous (7 or 8 on a scale of 0-10) intensity aerobic physical activity per week in bouts of 10 minutes or more, also expressed as 30 minutes per day distributed over 5 days per week, would be a good start.

  1. CT-guided core needle biopsy of mediastinal nodes through a transpulmonary approach: retrospective analysis of the procedures conducted over six years

    Energy Technology Data Exchange (ETDEWEB)

    Yin, Zhongyuan; Liang, Zhiwen; Li, Pengcheng; Wang, Qiong [Huazhong University of Science and Technology, Cancer Center, Union Hospital, Tongji Medical College, Wuhan (China)

    2017-08-15

    To retrospectively evaluate the diagnostic performance and complications of a CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach. From January 2009 to December 2014, we used a coaxial positioning system and an 18G cutting-type biopsy device to perform CT-guided percutaneous transpulmonary needle biopsies of mediastinal nodes for 127 patients. The diagnostic performance, complication rate, influencing factors, distribution of mediastinal nodes and pathological diagnoses were investigated. Among 127 patients, pathologic analyses showed that all of the biopsies were technically successful. The sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. As for complications, the ratios for pneumothorax and hemoptysis were 33.9% and 4.7%, respectively. Multivariate analyses revealed that the distance from the pleura to the target lesion (P = 0.008) and the numbers of visceral pleura injuries (P = 0.006) were the two most significant risk factors for pneumothorax, and that the distance from the pleura to the target lesion (P = 0.004) was the most significant risk factor for hemoptysis. CT-guided core needle cutting biopsy of mediastinal nodes through a transpulmonary approach is a safe and efficient diagnostic method. (orig.)

  2. Technical success, technique efficacy and complications of minimally-invasive imaging-guided percutaneous ablation procedures of breast cancer: A systematic review and meta-analysis.

    Science.gov (United States)

    Mauri, Giovanni; Sconfienza, Luca Maria; Pescatori, Lorenzo Carlo; Fedeli, Maria Paola; Alì, Marco; Di Leo, Giovanni; Sardanelli, Francesco

    2017-08-01

    To systematically review studies concerning imaging-guided minimally-invasive breast cancer treatments. An online database search was performed for English-language articles evaluating percutaneous breast cancer ablation. Pooled data and 95% confidence intervals (CIs) were calculated. Technical success, technique efficacy, minor and major complications were analysed, including ablation technique subgroup analysis and effect of tumour size on outcome. Forty-five studies were analysed, including 1,156 patients and 1,168 lesions. Radiofrequency (n=577; 50%), microwaves (n=78; 7%), laser (n=227; 19%), cryoablation (n=156; 13%) and high-intensity focused ultrasound (HIFU, n=129; 11%) were used. Pooled technical success was 96% (95%CI 94-97%) [laser=98% (95-99%); HIFU=96% (90-98%); radiofrequency=96% (93-97%); cryoablation=95% (90-98%); microwave=93% (81-98%)]. Pooled technique efficacy was 75% (67-81%) [radiofrequency=82% (74-88); cryoablation=75% (51-90); laser=59% (35-79); HIFU=49% (26-74)]. Major complications pooled rate was 6% (4-8). Minor complications pooled rate was 8% (5-13%). Differences between techniques were not significant for technical success (p=0.449), major complications (p=0.181) or minor complications (p=0.762), but significant for technique efficacy (p=0.009). Tumour size did not impact on variables (p>0.142). Imaging-guided percutaneous ablation techniques of breast cancer have a high rate of technical success, while technique efficacy remains suboptimal. Complication rates are relatively low. • Imaging-guided ablation techniques for breast cancer are 96% technically successful. • Overall technique efficacy rate is 75% but largely inhomogeneous among studies. • Overall major and minor complication rates are low (6-8%).

  3. Development approach on usage of radiation and inspection of QA according to the change of approval procedure of safety regulatory guides

    International Nuclear Information System (INIS)

    Oh, B. J.; Ahn, H. Z.; Kim, S. W.; Yoo, S. O.; Kang, S. C.; Yang, S. H.; Han, S. J.; Kim, H. S.; Kim, H. J.

    2002-01-01

    In accordance with 2001 amendment of the Atomic Energy Act(AEA), KINS also amended its internal 'Regulation on Implementation of Entrusted AEA-related Work'. Up to now the nuclear safety-specialized institute has used its internally developed guidelines in the safety regulation. From now on, however, the institute will enhance the objectivity and transparency by having the instruments approved by the Ministry of Science ad Technology. In this paper, we introduced the major points and directions to be considered to the development of the safety regulatory guides on Inspection for the quality assurance of the nuclear reactor facilities and the use of radioisotopes, and review and inspection for dosimeter reading

  4. Exercise Dependence

    Directory of Open Access Journals (Sweden)

    Erdal Vardar

    2012-06-01

    Full Text Available Exercise dependence define a condition in which a person performs excessive exercise resulting in deterioration of his or her physical and mental health wellness. Despite many clinical research studies on exercise dependence, exact diagnostic criteria has not been developed yet. Clinical evidences concerning etiology, epidemiology, underlying mechanisms and treatment of exercise dependence are still not sufficient. Moreover, evaluation of this clinical disorder within dependency perspective is a fairly new concept. Recent studies have shown that exercise dependence has similar features like chemical substance dependence with regards to withdrawal and tolerance symptoms. The aim of this review was to briefly evaluate diagnostic and clinical features of exercise dependence. [Archives Medical Review Journal 2012; 21(3.000: 163-173

  5. Development of nuclear emergency exercise programme (NEEP) in Korea

    International Nuclear Information System (INIS)

    Shin, H. K.; Kim, J. Y.; Kim, M. K.; Kim, S. H.

    2011-01-01

    The nuclear emergency exercise programme (NEEP) is a PC-based application intended for design and planning emergency preparedness and response (EP and R) exercises for a potential nuclear emergency in Korea. The application programme allows EP and R staff to create and edit exercise scenarios based on information customised for a specific nuclear power plant's emergency plans. NEEP includes the following features: (1) step-by-step guide to developing new exercise scenario according to emergency alarm level and potential accident type, (2) database of specific plant's field exercise scenarios that can be easily modified by users, (3) generating master scenario events list and messages of exercise participants and (4) allowing the quantitative evaluation of exercise participants from the view of exercise objectives and evaluator guides. NEEP also features tools for queries, reports and visualisation that can be used to create documentation during the scenario planning and exercise evaluation processes. (authors)

  6. Introduction of a MR-compatible system for extracorporal perfusion of vital organs for MR-guided procedures. First-experiences

    International Nuclear Information System (INIS)

    Gaffke, Gunnar; Nagel, Stefan; Hegemann, Olaf; Speck, Ulrich; Grosse-Siestrup, Christian; Jungnickel, Kerstin; Stroszczynski, Christian

    2009-01-01

    Purpose:To represent a MRI-compatible perfusion-system for extracorporeal perfusion of vital organs which permits the realisation of realistic experiments in a MR scanner. Material and methods: We performed MR examinations of explanted porcine livers and MR-guided interventions in porcine livers. Explanted organs were hemo-perfused under physiological conditions during the experiments. MR-sequences for diagnostic and interventional examinations were used. Results:The evaluated system was MRI-compatible. The achieved image quality of the used sequences showed excellent anatomical resolution. Planned experiments can be carried out with relatively low expenditure. Diagnostic as well as interventional investigations can be carried out. The used organs showed a stable function within physiological parameters up to 4 hours. Conclusion:It is possible to perform ex vivo experiments under in vivo conditions with this system. With the used MR-compatible system MR-guided experimental interventions and thermal ablations can be carried out in explanted organs under in vivo conditions. (orig.)

  7. Prevention: Exercise

    Medline Plus

    Full Text Available ... Steroid Injections Lumbar Zygapophysical (Facet) Joint Injections PREVENTION Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen ...

  8. Exercise as a Counseling Intervention.

    Science.gov (United States)

    Okonski, Verna O.

    2003-01-01

    The focus of wellness counseling is to guide individuals to live a healthy life in which body, mind, and spirit are integrated in order to experience fulfillment and happiness. The purpose of this article is to provide counselors steps to follow when using exercise as a counseling intervention and to provide techniques that will encourage exercise…

  9. The cardiovascular system after exercise

    Science.gov (United States)

    Romero, Steven A.; Minson, Christopher T.

    2017-01-01

    Recovery from exercise refers to the time period between the end of a bout of exercise and the subsequent return to a resting or recovered state. It also refers to specific physiological processes or states occurring after exercise that are distinct from the physiology of either the exercising or the resting states. In this context, recovery of the cardiovascular system after exercise occurs across a period of minutes to hours, during which many characteristics of the system, even how it is controlled, change over time. Some of these changes may be necessary for long-term adaptation to exercise training, yet some can lead to cardiovascular instability during recovery. Furthermore, some of these changes may provide insight into when the cardiovascular system has recovered from prior training and is physiologically ready for additional training stress. This review focuses on the most consistently observed hemodynamic adjustments and the underlying causes that drive cardiovascular recovery and will highlight how they differ following resistance and aerobic exercise. Primary emphasis will be placed on the hypotensive effect of aerobic and resistance exercise and associated mechanisms that have clinical relevance, but if left unchecked, can progress to symptomatic hypotension and syncope. Finally, we focus on the practical application of this information to strategies to maximize the benefits of cardiovascular recovery, or minimize the vulnerabilities of this state. We will explore appropriate field measures, and discuss to what extent these can guide an athlete’s training. PMID:28153943

  10. Emergency procedures

    International Nuclear Information System (INIS)

    Abd Nasir Ibrahim; Azali Muhammad; Ab Razak Hamzah; Abd Aziz Mohamed; Mohammad Pauzi Ismail

    2004-01-01

    The following subjects are discussed - Emergency Procedures: emergency equipment, emergency procedures; emergency procedure involving X-Ray equipment; emergency procedure involving radioactive sources

  11. 3D accuracy of implant positions in template-guided implant placement as a function of the remaining teeth and the surgical procedure: a retrospective study.

    Science.gov (United States)

    Schnutenhaus, Sigmar; Edelmann, Cornelia; Rudolph, Heike; Dreyhaupt, Jens; Luthardt, Ralph G

    2018-01-22

    The aim of this study was to investigate differences between the virtually planned and clinically achieved implant positions in completely template-guided implantations as a function of the type of edentulous space, the residual natural dentition, and the surgical implementation. Fifty-six patient cases with a total of 122 implants were evaluated retrospectively. The implantations were completely template-based. The data of the planned implant positions were overlaid with the actual clinical implant positions, followed by measurements of the 3D deviations in terms of coronal (x c ) and apical distance, height (x h ), and angulation (ang) and statistical analysis. The mean x c was 1.2 mm (SD 0.7 mm); the mean x a was 1.8 mm (SD 0.9 mm), the mean x h was 0.8 mm (SD 0.7 mm); and the mean ang was 4.8° (SD 3.1). The type of edentulous space and the jaw (maxilla/mandible) had no significant effect on the results in terms of implant positions. The presence of an adjacent natural tooth at the time of implantation had a significant influence on x h (p = 0.04) and ang (p = 0.05). No significant differences were found regarding the surgical approach for any of the parameters examined. The results of our study are in the same range as those of other studies. Template-guided implantation offers a high degree of accuracy even in the presence of different configurations of the residual dentition or different surgical approaches. A clinical benefit is therefore present, especially from a prosthetic point of view. The clinically achievable accuracy can be described as sufficient for further prosthetic treatment, given the intrinsic and methodological tolerances, making prosthetic rehabilitation safe and predictable.

  12. Simulated Exercise Physiology Laboratories.

    Science.gov (United States)

    Morrow, James R., Jr.; Pivarnik, James M.

    This book consists of a lab manual and computer disks for either Apple or IBM hardware. The lab manual serves as "tour guide" for the learner going through the various lab experiences. The manual contains definitions, proper terminology, and other basic information about physiological principles. It is organized so a step-by-step procedure may be…

  13. Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System.

    Directory of Open Access Journals (Sweden)

    Harald Busse

    Full Text Available MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out" in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators.Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators - attending (AR and resident radiologists (RR as well as medical students (MS - performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm. Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0.Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81% were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec differed significantly (p<0.01. Mean overall rating was 4.2. The average operator would use the system again (4.8 and stated that the outcome justifies the extra effort (4.4. Lowest agreement was reported for the robustness against external perturbations (2.8.The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between groups with different expertise there were

  14. Targeting Accuracy, Procedure Times and User Experience of 240 Experimental MRI Biopsies Guided by a Clinical Add-On Navigation System.

    Science.gov (United States)

    Busse, Harald; Riedel, Tim; Garnov, Nikita; Thörmer, Gregor; Kahn, Thomas; Moche, Michael

    2015-01-01

    MRI is of great clinical utility for the guidance of special diagnostic and therapeutic interventions. The majority of such procedures are performed iteratively ("in-and-out") in standard, closed-bore MRI systems with control imaging inside the bore and needle adjustments outside the bore. The fundamental limitations of such an approach have led to the development of various assistance techniques, from simple guidance tools to advanced navigation systems. The purpose of this work was to thoroughly assess the targeting accuracy, workflow and usability of a clinical add-on navigation solution on 240 simulated biopsies by different medical operators. Navigation relied on a virtual 3D MRI scene with real-time overlay of the optically tracked biopsy needle. Smart reference markers on a freely adjustable arm ensured proper registration. Twenty-four operators - attending (AR) and resident radiologists (RR) as well as medical students (MS) - performed well-controlled biopsies of 10 embedded model targets (mean diameter: 8.5 mm, insertion depths: 17-76 mm). Targeting accuracy, procedure times and 13 Likert scores on system performance were determined (strong agreement: 5.0). Differences in diagnostic success rates (AR: 93%, RR: 88%, MS: 81%) were not significant. In contrast, between-group differences in biopsy times (AR: 4:15, RR: 4:40, MS: 5:06 min:sec) differed significantly (p<0.01). Mean overall rating was 4.2. The average operator would use the system again (4.8) and stated that the outcome justifies the extra effort (4.4). Lowest agreement was reported for the robustness against external perturbations (2.8). The described combination of optical tracking technology with an automatic MRI registration appears to be sufficiently accurate for instrument guidance in a standard (closed-bore) MRI environment. High targeting accuracy and usability was demonstrated on a relatively large number of procedures and operators. Between groups with different expertise there were

  15. Crisis exercises at AREVA

    International Nuclear Information System (INIS)

    Chanson, D.

    2016-01-01

    AREVA being an operator of nuclear facilities has to organize crisis exercises regularly. About 100 crisis exercises are performed each year in AREVA installations. These exercises allow the training of the staff, the assessing of material and humane means and the checking of the quality of the interfaces between all the participants (other AREVA teams or Nuclear Safety Authority or...). The management of nuclear crisis is based on anticipation and relies on 3 pillars: a referential gathering all the useful documents (emergency plans, procedures,...), the training and practice of AREVA staff in specific domains to cope with emergency situations, and various crisis exercises to keep fit all the teams. The basis emergency exercise lasts 2 hours and is organized into modules. First module: detecting abnormal conditions, alerting, rescuing and limiting the consequences; second module: launching the emergency plan; third module: understanding the situation and limiting the consequences; fourth module: communicating with other actors that intervene in a nuclear crisis (nuclear safety authority, state or local officials, the media...); and fifth module: anticipating the end of the emergency phase to prepare post-accidental management. (A.C.)

  16. Key-Feature-Probleme zum Prüfen von prozeduralem Wissen: Ein Praxisleitfaden [Key Feature Problems for the assessment of procedural knowledge: a practical guide

    Directory of Open Access Journals (Sweden)

    Kopp, Veronika

    2006-08-01

    Full Text Available [english] After assigning the different examination formats to the diverse terms of Miller's pyramide of knowledge, this paper provides a short presentation of the key feature approach by giving the definition and an example for clarification. Afterwards, a practical guide to writing key feature problems is given consisting of the following steps: define the domain, choose a clinical situation, define the key features, develop a test case scenario, write questions, select a preferred response format, define the scoring key, and validation. Finally, we present the evaluation results of this practical guide. In sum, the participants were very pleased with it. The differences between the estimations of their knowledge before and after the workshop concerning key features were significant. The key feature approach is an innovative tool for assessing clinical decision-making skills, also for electronical examinations. Substituting the write-in format for the long-menu format allows an automatic data analysis. [german] Im vorliegenden Beitrag wird - nach der Zuordnung unterschiedlicher Prüfungsformen zu den verschiedenen Wissensarten der Wissenspyramide von Miller - der Key-Feature (KF Ansatz vorgestellt. Nachdem anhand der Definition und einem Beispiel erklärt wurde, was ein KF ist, wird im Anschluss eine Anleitung für die Erstellung eines KF-Problems gegeben. Diese besteht aus folgenden Schritten: Definition des Kontextes, Wahl der klinischen Situation, Identifikation der KFs des klinischen Problems, Schreiben des klinischen Szenarios (Fallvignette, Schreiben der einzelnen KF-Fragen, Auswahl des Antwortformates, Bewertungsverfahren und Inhaltsvalidierung. Am Ende werden die Ergebnisse einer Evaluation dieser Anleitung, die im Rahmen eines KF-Workshops gewonnen wurden, präsentiert. Die Teilnehmer waren mit dieser Workshopeinheit sehr zufrieden und gaben an, sehr viel gelernt zu haben. Die subjektive Einschätzung ihres Wissensstands vor und nach

  17. An exercise in safety

    CERN Multimedia

    CERN Bulletin

    2014-01-01

    On 14 October, a large-scale evacuation exercise took place. Ten buildings (1-2-3-4-50-51-52-53-58-304), with a total capacity of almost 1900 people, were successfully evacuated.   The exercise, which for the first time involved all of the central buildings on the Meyrin site, was organised by the PH Department in collaboration with the HSE Unit, the GS Department and the safety officers of all the various departments involved. On the day, around 400 people were evacuated in just a few minutes.  “It took us three months to prepare for the exercise,” explains Niels Dupont, safety officer for the PH Department, who organised the exercise. “Around 100 people: safety officers, firefighters, emergency guides, observers, representatives from the control centre, etc. attended four preparatory meetings and five training sessions. We also purchased equipment such as evacuation chairs, high-visibility vests and signs to mark the evacuation route.” The dec...

  18. Development of image-guided operation system having integrated information of the patient for procedure of endoscopic surgery of digestive tracts

    International Nuclear Information System (INIS)

    Hattori, Asaki; Suzuki, Naoki; Tanoue, Kazuo; Ieiri, Satoshi; Konishi, Kozo; Tomikawa, Morimasa; Kenmotsu, Hajime; Hashizume, Makoto

    2010-01-01

    This study reports the development of patient's integrated information-displaying system at image-guided, robotic peroral endoscopic operation of digestive tracts as well as the actual operative field for the operator not to look aside. The peroral endoscope has, at its top, a magnetic position sensor and 2 robotic manipulative forceps at right and left side to navigate the surgery through following 3 windows of superimposing display: the inner peritoneal 3D structure of the real operative field reconstructed from preoperative CT and MR images by volume rendering, presentation of the robot top tip in the structure above and in the preoperative CT or MR image as an ordinary navigation. Furthermore, the robot has a function to measure softness of its grabbing tissue which is displayed in the corresponding right and left superimposing windows, and signs like the real-time blood pressure and heart rate are also given in another window. All of the patient's integrated information-displaying can be handled at will during the operation. Improvement of user interface and of navigation display is further to be conducted. (T.T.)

  19. A comparison of the dose of anesthetic agents and the effective interval from the block procedure to skin incision for ultrasound-guided supraclavicular brachial plexus block in upper extremity surgery.

    Science.gov (United States)

    Nakayama, Masanori; Sakuma, Yu; Imamura, Hitoshi; Yano, Koichiro; Kodama, Takao; Ikari, Katsunori

    2017-12-01

    The aim of this study was to review and evaluate the selection and dose of anesthetic agents and the interval from the block procedure to skin incision for supraclavicular brachial plexus block in upper extremity surgery. We reviewed our cases that underwent upper extremity surgery using only ultrasound-guided supraclavicular brachial plexus block in our hospital between 2011 and 2016. Adverse events during surgery were evaluated. Receiver operating characteristic (ROC) curves were constructed to investigate the relationship between the time from the end of the block procedure to skin incision and the use of local anesthesia on the surgical site. There were 255 patients who were divided into three groups according to the anesthetic agents used: group 1, 1% lidocaine (L) 10 ml + 0.75% ropivacaine (R) 20 ml (n = 62); group 2, L 20 ml + R 10 ml (n = 93); and group 3, L 10 ml + R 15 ml (n = 100). The rate of use of local anesthesia on the surgical site was significantly higher in group 3 than in the other two groups. There were no significant differences in the other evaluated items among the three groups. ROC curve analysis indicated that ≥24 min from the end of the block procedure to skin incision might reduce the use of local anesthesia. The total volume of anesthetic agents had an important influence on the rate of the addition of local anesthesia for surgical pain; however, the combined dose of agents did not influence the evaluation items. For effective analgesia, ≥24 min should elapse from the end of the block procedure to skin incision. Copyright © 2017. Published by Elsevier B.V.

  20. Exercise and Posture

    Science.gov (United States)

    ... About Spondylitis › Treatment Information › Exercise & Posture Print Page Exercise Exercise is an integral part of any spondylitis ... For First Responders For Chiropractors Research Article Archive Exercise Guidelines Having an exercise program that accomplishes your ...

  1. CT-guided core biopsy and percutaneous fiducial seed placement in the lung: Can these procedures be combined without an increase in complication rate or decrease in technical success?

    Energy Technology Data Exchange (ETDEWEB)

    Mendiratta-Lala, Mishal [Henry Ford Hospital, Department of Radiology, Abdominal Interventional Radiology, 2799 West Grand Blvd, Detroit, MI 48202 (United States); Sheiman, Robert, E-mail: rsheiman@bidmc.harvard.edu [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Brook, Olga R. [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States); Gourtsoyianni, Sofia [King' s College London, St Thomas’ Hospital, Lambeth Palace Road, SE1 7EH London (United Kingdom); Mahadevan, Anand [Beth Israel Deaconess Hospital, Radiation Oncology, One Deaconess Road, Boston, MA 02215 (United States); Siewert, Bettina [Beth Israel Deaconess Hospital, Department of Radiology, Abdominal Imaging, One Deaconess Road, Boston, MA 02215 (United States)

    2014-04-15

    Objective: To determine if concomitant CT-guided biopsy and percutaneous fiducial seed placement in the lung can be performed in a selective patient population without increased complication or decreased success rates compared to either procedure alone. Materials and methods: An IRB approved retrospective analysis of 285 consecutive patients that underwent CT-guided placement of fiducial seeds in the lung alone (N = 63), with concomitant core biopsy (N = 53) or only core biopsy (N = 169) was performed. Variables compared included: patient demographics, lesion size, depth from pleura, needle size, number of passes through pleura, number and size of core biopsies, number of seeds placed and technical success rates. Statistical analysis was performed using univariate and multivariate pair-wise comparisons. Results: A pathologic diagnosis of malignancy was confirmed in all cases undergoing seed placement alone and seed placement with concurrent biopsy, and in 144 of the biopsy alone lesions. On univariate analysis, major complication rates were similar for all three groups as were lesion size, depth, number of pleural passes, and technical success. Pair-wise comparisons of the remaining variables demonstrated a significant younger age and smaller needle size in the biopsy only group, and less minor complications in the fiducial only group. Overall there were 80/285 (28.1%) minor and 29/285 (10.2%) major complications. All major complications leading to admission consisted of either pneumothorax or hemothorax, while minor complications included asymptomatic stable or resolving pneumothoraces, transient hemoptysis or small hemothoraces. Conclusions: A combined procedure of percutaneous pulmonary core biopsy and stereotactic seed placement can be performed without additional risk of a major complication when compared to performing these separately.

  2. Ultrasound-controlled neuronavigator-guided brain surgery.

    Science.gov (United States)

    Koivukangas, J; Louhisalmi, Y; Alakuijala, J; Oikarinen, J

    1993-07-01

    The development of a unique neurosurgical navigator is described and a preliminary series of seven cases of intracerebral lesions approached with the assistance of this neuronavigation system under ultrasound control is presented. The clinical series included five low-grade astrocytomas, one chronic intracerebral hematoma, and one porencephalic cyst. Management procedures included biopsy in all cases, drainage of the hematoma, and endoscopy and fenestration for the cyst. The features of the neuronavigation system are interactive reconstructions of preoperative computerized tomography and magnetic resonance imaging data, corresponding intraoperative ultrasound images, versatility of the interchangeable end-effector instruments, graphic presentation of instruments on the reconstructed images, and voice control of the system. The principle of a common axis in the reconstructed images served to align the navigational pointer, biopsy guide, endoscope guide, ultrasound transducer, and surgical microscope to the brain anatomy. Intraoperative ultrasound imaging helped to verify the accuracy of the neuronavigator and check the results of the procedures. The arm of the neuronavigation system served as a holder for instruments, such as the biopsy guide, endoscope guide, and ultrasound transducer, in addition to functioning as a navigational pointer. Also, the surgical microscope was aligned with the neuronavigator for inspection and biopsy of the hematoma capsule to rule out tumor etiology. Voice control freed the neurosurgeon from manual exercises during start-up and calibration of the system.

  3. Crew Exercise

    Science.gov (United States)

    Rafalik, Kerrie K.

    2017-01-01

    Johnson Space Center (JSC) provides research, engineering, development, integration, and testing of hardware and software technologies for exercise systems applications in support of human spaceflight. This includes sustaining the current suite of on-orbit exercise devices by reducing maintenance, addressing obsolescence, and increasing reliability through creative engineering solutions. Advanced exercise systems technology development efforts focus on the sustainment of crew's physical condition beyond Low Earth Orbit for extended mission durations with significantly reduced mass, volume, and power consumption when compared to the ISS.

  4. Exercise KATRINE

    International Nuclear Information System (INIS)

    Clahane, Darren; Burgoyne, William

    1995-01-01

    Based on a hypothetical incident at the Scottish Nuclear Ltd Torness AGR nuclear power station, Exercise KATRINE was the 1994 national civil nuclear exercise and the biggest simulation of a nuclear accident to take place in Britain last year. The exercise, held on 17 and 18 November, was based on a series of postulated faults which resulted in an uncontrolled release of radioactivity. It commenced at 07.00 on Thursday and continued for about 33 hours, until around 15.30 on Friday. Activity focused on the Torness Off-site Centre (TOSC), in Cockenzie near Edinburgh, and the brand new Torness Media Briefing Centre (TMBC) located nearby. (author)

  5. Bronchial or Laryngeal Obstruction Induced by Exercise?

    Directory of Open Access Journals (Sweden)

    Ayoub Bey

    2017-06-01

    Full Text Available A child suspected of exercise-induced laryngeal obstruction and asthma is examined by laryngoscopy and respiratory resistance (Rrs after exercise challenge. Immediately at exercise cessation, the visualized adduction of the larynx in inspiration is reflected in a paroxystic increase in Rrs. While normal breathing has apparently resumed later on during recovery from exercise, the pattern of Rrs in inspiration is observed to reoccur following a deep breath or swallowing. The procedure may thus help diagnosing the site of exercise-induced obstruction when laryngoscopy is not available and identify re-inducers of laryngeal dysfunction.

  6. Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR): Guide to data processing and revision: Part 2, Human error probability data entry and revision procedures

    International Nuclear Information System (INIS)

    Gilmore, W.E.; Gertman, D.I.; Gilbert, B.G.; Reece, W.J.

    1988-11-01

    The Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) is an automated data base management system for processing and storing human error probability (HEP) and hardware component failure data (HCFD). The NUCLARR system software resides on an IBM (or compatible) personal micro-computer. Users can perform data base searches to furnish HEP estimates and HCFD rates. In this manner, the NUCLARR system can be used to support a variety of risk assessment activities. This volume, Volume 3 of a 5-volume series, presents the procedures used to process HEP and HCFD for entry in NUCLARR and describes how to modify the existing NUCLARR taxonomy in order to add either equipment types or action verbs. Volume 3 also specifies the various roles of the administrative staff on assignment to the NUCLARR Clearinghouse who are tasked with maintaining the data base, dealing with user requests, and processing NUCLARR data. 5 refs., 34 figs., 3 tabs

  7. Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR): Guide to data processing and revision: Part 3, Hardware component failure data entry and revision procedures

    International Nuclear Information System (INIS)

    Gilmore, W.E.; Gertman, D.I.; Gilbert, B.G.; Reece, W.J.

    1988-11-01

    The Nuclear Computerized Library for Assessing Reactor Reliability (NUCLARR) is an automated data base management system for processing and storing human error probability (HEP) and hardware component failure data (HCFD). The NUCLARR system software resides on an IBM (or compatible) personal micro-computer. Users can perform data base searches to furnish HEP estimates and HCFD rates. In this manner, the NUCLARR system can be used to support a variety of risk assessment activities. This volume, Volume 3 of a 5-volume series, presents the procedures used to process HEP and HCFD for entry in NUCLARR and describes how to modify the existing NUCLARR taxonomy in order to add equipment types of action verbs. Volume 3 also specifies the various roles of the administrative staff on assignment to the NUCLARR Clearinghouse who are tasked with maintaining the data base, dealing with user requests, and processing NUCLARR data

  8. MRI-guided vacuum-assisted breast biopsy: comparison with stereotactically guided and ultrasound-guided techniques

    Energy Technology Data Exchange (ETDEWEB)

    Imschweiler, Thomas; Freiwald, Bianka; Kubik-Huch, Rahel A. [Kantonspital Baden AG, Institute for Radiology, Baden (Switzerland); Haueisen, Harald [Kantonspital Aarau AG, Institute for Radiology, Aarau (Switzerland); Kampmann, Gert [Clinica Sant' Anna, Lugano, Sorengo (Switzerland); Rageth, Luzi [Adjumed Services AG, Zurich (Switzerland); Seifert, Burkhardt [Institute for Social and Preventive Medicine, University of Zurich, Division of Biostatistics, Zuerich (Switzerland); Rageth, Christoph [Breast Centre, Zurich (Switzerland)

    2014-01-15

    To analyse the development of MRI-guided vacuum-assisted biopsy (VAB) in Switzerland and to compare the procedure with stereotactically guided and ultrasound-guided VAB. We performed a retrospective analysis of VABs between 2009 and 2011. A total of 9,113 VABs were performed. Of these, 557 were MRI guided. MRI-guided VAB showed the highest growth rate (97 %) of all three procedures. The technical success rates for MRI-guided, stereotactically guided and ultrasound-guided VAB were 98.4 % (548/557), 99.1 % (5,904/5,960) and 99.6 % (2,585/2,596), respectively. There were no significant differences (P = 0.12) between the MRI-guided and the stereotactically guided procedures. The technical success rate for ultrasound-guided VAB was significantly higher than that for MRI-guided VAB (P < 0.001). There were no complications using MRI-guided VAB requiring open surgery. The malignancy diagnosis rate for MRI-guided VAB was similar to that for stereotactically guided VAB (P = 0.35). MRI-guided VAB is a safe and accurate procedure that provides insight into clinical breast findings. (orig.)

  9. Cookbook Procedures in MBL Physics Exercises.

    Science.gov (United States)

    Royuk, Brent; Brooks, David W.

    2003-01-01

    Presents results of a controlled experiment comparing the conceptual mechanics learning gains as measured by the Force Concept Inventory (FCI) between two laboratory groups. One group completed cookbook labs while the other completed Interactive-Engagement (IE) labs in RealTime Physics. Suggests that laboratory activities should engage students in…

  10. Prevention: Exercise

    Medline Plus

    Full Text Available ... support for your body. Pilates, yoga and martial arts all provide well-rounded core strengthening programs. Simple ... use progressively heavier balls, you will experience more benefit from this exercise... Sagittal Core Strengthening You can ...

  11. Prevention: Exercise

    Medline Plus

    Full Text Available ... Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic ... Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back Pain Preventing Osteoporosis Back Pain ...

  12. Intercomparison exercises

    International Nuclear Information System (INIS)

    Arunachalam, J.

    2007-01-01

    Intercomparison exercises are vital to many a national programmes. These are only tools available with the laboratories to prove their competence to an international audience and also for the accrediting agencies to assess a laboratory

  13. Compulsive exercise

    DEFF Research Database (Denmark)

    Lichtenstein, Mia Beck; Hinze, Cecilie Juul; Emborg Jannsen, Bolette

    2017-01-01

    found that compulsive exercise is associated with eating disorder pathology, perfectionism, neuroticism, narcissism, and obsessive compulsive traits. The most prominent negative consequences were injuries, social impairment, and depression, but more research is needed to uncover the potential......Compulsive exercise is a condition described since 1970s. It is characterized by a craving for physical training, resulting in uncontrollable excessive exercise behavior with harmful consequences, such as injuries and impaired social relations. It has not been accepted as a mental disorder...... dysfunction resulting from compulsive exercise. As the condition is not recognized as a psychiatric disorder, studies on treatment interventions are sparse. Problems with compliance have been reported; therefore, motivational interviewing has been proposed as a treatment approach, in combination...

  14. Prevention: Exercise

    Medline Plus

    Full Text Available ... Physical Therapy Postural Training Traction Watchful Waiting and Education Injection Treatments for ... Core Strengthening Many popular forms of exercise focus on core strengthening, or building the muscles that provide ...

  15. Prevention: Exercise

    Medline Plus

    Full Text Available ... following suggested exercises increases your back pain after five repetitions, or causes acute pain, you should stop ... 10 seconds working towards 30 seconds. Repeat 1-5 times or to fatigue... Prone Bridge/Plank Prop ...

  16. Prevention: Exercise

    Medline Plus

    Full Text Available ... Lifestyle Choices 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! ... in a straight line. Hold for 10 seconds working towards 30 seconds. Repeat 1-5 times or ...

  17. Prevention: Exercise

    Medline Plus

    Full Text Available ... Chronic Low Back Pain SI Joint Pain Other Scoliosis Back Pain and Emotional Distress Muscle Spasms Pinched ... DC Directional Exercises Electrothermal Modalities Ergonomic Changes Hydrotherapy Manual Therapy Physical Therapy Postural Training Traction Watchful Waiting and ...

  18. Prevention: Exercise

    Medline Plus

    Full Text Available ... weights (hand-held or training machines) or using isometric techniques. Common household items (like small canned goods) ... matches your abilities. Neck Press This is an isometric exercise to strengthen your neck. Press your palm ...

  19. Prevention: Exercise

    Medline Plus

    Full Text Available ... 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility ... Pain Preventing Osteoporosis Back Pain Basics Book RESOURCES Patient Information Feature Articles Patient Q&A Success Stories ...

  20. Prevention: Exercise

    Medline Plus

    Full Text Available ... slow full movements. Repeat 10-15 times, to fatigue... Abdominal Exercise Lay on your back with both ... Return leg and extend other leg. Repeat to fatigue, about 10-15 repetitions at a slow and ...

  1. Prevention: Exercise

    Medline Plus

    Full Text Available ... 15 repetitions at a slow and controlled pace... Resistance Training Resistance training is exercise done against something providing resistance. It can be done with weights (hand-held ...

  2. Prevention: Exercise

    Medline Plus

    Full Text Available ... legs to touch the wall, keeping hips and knees bent. Use your hips to push your body ... Abdominal Exercise Lay on your back with both knees bent. Draw abdominal wall in. Maintaining abdominal wall ...

  3. Applications for a hybrid operating room in thoracic surgery: from multidisciplinary procedures to --image-guided video-assisted thoracoscopic surgery.

    Science.gov (United States)

    Terra, Ricardo Mingarini; Andrade, Juliano Ribeiro; Mariani, Alessandro Wasum; Garcia, Rodrigo Gobbo; Succi, Jose Ernesto; Soares, Andrey; Zimmer, Paulo Marcelo

    2016-01-01

    The concept of a hybrid operating room represents the union of a high-complexity surgical apparatus with state-of-the-art radiological tools (ultrasound, CT, fluoroscopy, or magnetic resonance imaging), in order to perform highly effective, minimally invasive procedures. Although the use of a hybrid operating room is well established in specialties such as neurosurgery and cardiovascular surgery, it has rarely been explored in thoracic surgery. Our objective was to discuss the possible applications of this technology in thoracic surgery, through the reporting of three cases. RESUMO O conceito de sala híbrida traduz a união de um aparato cirúrgico de alta complexidade com recursos radiológicos de última geração (ultrassom, TC, radioscopia e/ou ressonância magnética), visando a realização de procedimentos minimamente invasivos e altamente eficazes. Apesar de bem estabelecido em outras especialidades, como neurocirurgia e cirurgia cardiovascular, o uso da sala hibrida ainda é pouco explorado na cirurgia torácica. Nosso objetivo foi discutir as aplicações e as possibilidades abertas por essa tecnologia na cirurgia torácica através do relato de três casos.

  4. Emergency department management of pain and anxiety related to orthopedic fracture care: a guide to analgesic techniques and procedural sedation in children.

    Science.gov (United States)

    Kennedy, Robert M; Luhmann, Jan D; Luhmann, Scott J

    2004-01-01

    Orthopedic fractures and joint dislocations are among the most painful pediatric emergencies. Safe and effective management of fracture-related pain and anxiety in the emergency department reduces patient distress during initial evaluation and often allows definitive management of the fracture. No consensus exists on which pharmacologic regimens for procedural sedation/analgesia are safest and most effective. For some children, control of fracture pain is the primary goal, whereas for others, relief from anxiety is an additionally important objective. Furthermore, strategies for the management of fracture pain may vary by fracture location and patient characteristics; thus, no single regimen is likely to provide the best means of analgesia and anxiolysis for all patients. Effective analgesia can be provided by local or regional anesthesia, such as hematoma, Bier, or nerve blocks. Alternatively, induction of deep sedation with analgesic agents such as ketamine or fentanyl, often combined with sedative-anxiolytic agents such as midazolam, may be used to manage distress associated with fracture reduction. A combination of local anesthesia with moderate sedation, for example nitrous oxide, is another attractive option.

  5. SU-F-BRA-01: A Procedure for the Fast Semi-Automatic Localization of Catheters Using An Electromagnetic Tracker (EMT) for Image-Guided Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Damato, A; Viswanathan, A; Cormack, R [Brigham and Women’s Hospital, Boston, MA (United States)

    2015-06-15

    Purpose: To evaluate the feasibility of brachytherapy catheter localization through use of an EMT and 3D image set. Methods: A 15-catheter phantom mimicking an interstitial implantation was built and CT-scanned. Baseline catheter reconstruction was performed manually. An EMT was used to acquire the catheter coordinates in the EMT frame of reference. N user-identified catheter tips, without catheter number associations, were used to establish registration with the CT frame of reference. Two algorithms were investigated: brute-force registration (BFR), in which all possible permutation of N identified tips with the EMT tips were evaluated; and signature-based registration (SBR), in which a distance matrix was used to generate a list of matching signatures describing possible N-point matches with the registration points. Digitization error (average of the distance between corresponding EMT and baseline dwell positions; average, standard deviation, and worst-case scenario over all possible registration-point selections) and algorithm inefficiency (maximum number of rigid registrations required to find the matching fusion for all possible selections of registration points) were calculated. Results: Digitization errors on average <2 mm were observed for N ≥5, with standard deviation <2 mm for N ≥6, and worst-case scenario error <2 mm for N ≥11. Algorithm inefficiencies were: N = 5, 32,760 (BFR) and 9900 (SBR); N = 6, 360,360 (BFR) and 21,660 (SBR); N = 11, 5.45*1010 (BFR) and 12 (SBR). Conclusion: A procedure was proposed for catheter reconstruction using EMT and only requiring user identification of catheter tips without catheter localization. Digitization errors <2 mm were observed on average with 5 or more registration points, and in any scenario with 11 or more points. Inefficiency for N = 11 was 9 orders of magnitude lower for SBR than for BFR. Funding: Kaye Family Award.

  6. Gender differences in the variables of exercise treadmill test in type ...

    African Journals Online (AJOL)

    Background: Exercise capacity, like some other variables of exercise stress test, is a strong predictor of cardiovascular and overall ..... plan, and guide cardiac rehabilitation. .... peripheral vascular disease, peripheral neuropathy, physical ...

  7. Acute exercise and motor memory consolidation

    DEFF Research Database (Denmark)

    Thomas, Richard; Korsgaard Johnsen, Line; Geertsen, Svend Sparre

    2016-01-01

    where low to moderate intensities may be more suitable. The aim of this study was to investigate the role of intensity in mediating the effects of acute cardiovascular exercise on motor skill learning. We investigated the effects of different exercise intensities on the retention (performance score...... an important role in modulating the effects that a single bout of cardiovascular exercise has on the consolidation phase following motor skill learning. There appears to be a dose-response relationship in favour of higher intensity exercise in order to augment off-line effects and strengthen procedural memory.......A single bout of high intensity aerobic exercise (~90% VO2peak) was previously demonstrated to amplify off-line gains in skill level during the consolidation phase of procedural memory. High intensity exercise is not always a viable option for many patient groups or in a rehabilitation setting...

  8. The emergency plan implementing procedures for HANARO facility

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong Tai; Khang, Byung Oui; Lee, Goan Yup; Lee, Moon [Korea Atomic Energy Research Institute, Taejon (Korea)

    1999-04-01

    The radiological emergency plan implementing procedures of HANARO (High-flux Advanced Neutron Application Reactor) facility is prepared based on the Korea Atomic Law, the Civil Defence Law, Disaster Protection Law and the emergency related regulatory guides such as Guidance for Evolution of Radiation Emergency Plans in Nuclear Research Facilities (KAERI/TR-956/98, Feb.1998) and the emergency plan of HANARO. These procedures is also prepared to ensure adequate response activities to the rediological events which would cause a significant risk to the KAERI staffs and the public nea to the site. Periodic trainning and exercise for the reactor operators and emergency staffs will reduce accident risks and the release of radioactivities to the environment. 61 refs., 81 tabs. (Author)

  9. CT-guided puncture

    International Nuclear Information System (INIS)

    Noeldge, G.; Richter, G.M.; Grenacher, L.; Brado, M.; Kauffmann, G.W.

    1996-01-01

    Sonographic and CT-guided punctures allow the evaluation of suspected lesions in the head, thorax, abdomen, retroperitoneum and skeletal system. The size of the lesion to be evaluated determines the size and the diameter of the puncture needle. The quantity of the material obtained will be defined by the diameter of the needle, i.e. fine-needle biopsy is more adequate for cytological than for histological evaluation. Strict adherence to the indications and contraindications for puncture and painstaking performance of the procedure go a long why towards minimizing the complications. The advantage of CT-guided puncture, in contrast to an ultrasound-guided procedure, is visualization during the puncture procedure free from overshadowing. This permits punctures of lesions located deep in the thorax or the abdomen which are overshadowed by the lungs, by air in the small or large bowel or by bone structures. Moreover, this technique yields much more information about the tissues and organs surrounding the suspected lesion. This information is much more investigator-related with ultrasoundguided puncture. Therefore, the CT-guided puncture has become mandatory in the evaluation of suspected lesions. Moreover, using the same technique, percutaneous drainage of fluids in the interpleural space, abscesses in organs, hematomas, lymphoceles and urinomas; ablation of metastases; and sympathicolysis can be carried out. CT-guided puncture thus changes from a minimally invasive diagnostic procedure to a minimally invasive therapy. (orig./MG) [de

  10. RENEB accident simulation exercise.

    Science.gov (United States)

    Brzozowska, Beata; Ainsbury, Elizabeth; Baert, Annelot; Beaton-Green, Lindsay; Barrios, Leonardo; Barquinero, Joan Francesc; Bassinet, Celine; Beinke, Christina; Benedek, Anett; Beukes, Philip; Bortolin, Emanuela; Buraczewska, Iwona; Burbidge, Christopher; De Amicis, Andrea; De Angelis, Cinzia; Della Monaca, Sara; Depuydt, Julie; De Sanctis, Stefania; Dobos, Katalin; Domene, Mercedes Moreno; Domínguez, Inmaculada; Facco, Eva; Fattibene, Paola; Frenzel, Monika; Monteiro Gil, Octávia; Gonon, Géraldine; Gregoire, Eric; Gruel, Gaëtan; Hadjidekova, Valeria; Hatzi, Vasiliki I; Hristova, Rositsa; Jaworska, Alicja; Kis, Enikő; Kowalska, Maria; Kulka, Ulrike; Lista, Florigio; Lumniczky, Katalin; Martínez-López, Wilner; Meschini, Roberta; Moertl, Simone; Moquet, Jayne; Noditi, Mihaela; Oestreicher, Ursula; Orta Vázquez, Manuel Luis; Palma, Valentina; Pantelias, Gabriel; Montoro Pastor, Alegria; Patrono, Clarice; Piqueret-Stephan, Laure; Quattrini, Maria Cristina; Regalbuto, Elisa; Ricoul, Michelle; Roch-Lefevre, Sandrine; Roy, Laurence; Sabatier, Laure; Sarchiapone, Lucia; Sebastià, Natividad; Sommer, Sylwester; Sun, Mingzhu; Suto, Yumiko; Terzoudi, Georgia; Trompier, Francois; Vral, Anne; Wilkins, Ruth; Zafiropoulos, Demetre; Wieser, Albrecht; Woda, Clemens; Wojcik, Andrzej

    2017-01-01

    The RENEB accident exercise was carried out in order to train the RENEB participants in coordinating and managing potentially large data sets that would be generated in case of a major radiological event. Each participant was offered the possibility to activate the network by sending an alerting email about a simulated radiation emergency. The same participant had to collect, compile and report capacity, triage categorization and exposure scenario results obtained from all other participants. The exercise was performed over 27 weeks and involved the network consisting of 28 institutes: 21 RENEB members, four candidates and three non-RENEB partners. The duration of a single exercise never exceeded 10 days, while the response from the assisting laboratories never came later than within half a day. During each week of the exercise, around 4500 samples were reported by all service laboratories (SL) to be examined and 54 scenarios were coherently estimated by all laboratories (the standard deviation from the mean of all SL answers for a given scenario category and a set of data was not larger than 3 patient codes). Each participant received training in both the role of a reference laboratory (activating the network) and of a service laboratory (responding to an activation request). The procedures in the case of radiological event were successfully established and tested.

  11. Whipple Procedure

    Science.gov (United States)

    ... and Care Surgical Treatment Laparoscopic Surgery Vaccine Radiation Therapy Chemotherapy Clinical Trials Pain Management Nutrition and Exercise Holistic Care Pathology Intraductal Papillary Mucinous Neoplasms Islet Cell ...

  12. Adolescent test or procedure preparation

    Science.gov (United States)

    ... someone else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... effects the test may cause. Older teens may benefit from videos that show adolescents of the same age explaining ...

  13. Study guide for applied finite mathematics

    CERN Document Server

    Macri, Nicholas A

    1982-01-01

    Study Guide for Applied Finite Mathematics, Third Edition is a study guide that introduces beginners to the fundamentals of finite mathematics and its various realistic and relevant applications. Some applications of probability, game theory, and Markov chains are given. Each chapter includes exercises, and each set begins with basic computational ""drill"" problems and then progresses to problems with more substance.Comprised of 10 chapters, this book begins with exercises related to set theory and concepts such as the union and intersection of sets. Exercises on Cartesian coordinate

  14. Laboratory Exercise to Evaluate Hay Preservatives.

    Science.gov (United States)

    McGraw, R. L.; And Others

    1990-01-01

    Presented is a laboratory exercise designed to demonstrate the effects of moisture on hay preservation products in a manner that does not require large amounts of equipment or instructor time. Materials, procedures, and probable results are discussed. (CW)

  15. Study guide for college algebra

    CERN Document Server

    Snow, James W; Shapiro, Arnold

    1981-01-01

    Study Guide for College Algebra is a supplemental material for the basic text, College Algebra. Its purpose is to make the learning of college algebra and trigonometry easier and enjoyable.The book provides detailed solutions to exercises found in the text. Students are encouraged to use the study guide as a learning tool during the duration of the course, a reviewer prior to an exam, a reference book, and as a quick overview before studying a section of the text. The Study Guide and Solutions Manual consists of four major components: basic concepts that should be learned from each unit, what

  16. Exercise at Home

    Science.gov (United States)

    ... Home Health Insights Exercise & Weight Exercise at Home Exercise at Home Make an Appointment Ask a Question ... with the movement and contact your provider. Posture Exercises Better posture means better breathing and movement. Axial ...

  17. Is the Cardiovascular Response Equivalent Between a Supervised Center-Based Setting and a Self-care Home-Based Setting When Rating of Perceived Exertion Is Used to Guide Aerobic Exercise Intensity During a Cardiac Rehabilitation Program?

    DEFF Research Database (Denmark)

    Tang, Lars H.; Zwisler, Ann Dorthe; Kikkenborg Berg, Selina

    2017-01-01

    and atrial fibrillation post–radiofrequency ablation) participating in exercise-based rehabilitation were included. Patients performed a 12-week program in either a center- or a home-based setting. Using RPE, patients recorded their exercise intensity 3 times during an aerobic training phase. Exercise...... intensity was objectively measured using heart rate (HR) monitors. RESULTS: A total of 2622 RPE values with corresponding HR data were available. There was no difference in the level of association (interaction P = 0.51) between HR and RPE seen in the center-based setting (mean of 6.1 beats/min per 1...

  18. Interventional management of intractable sympathetically mediated pain by computed tomography-guided catheter implantation for block and neuroablation of the thoracic sympathetic chain: technical approach and review of 322 procedures.

    Science.gov (United States)

    Agarwal-Kozlowski, K; Lorke, D E; Habermann, C R; Schulte am Esch, J; Beck, H

    2011-08-01

    We retrospectively evaluated the safety and efficacy of computed tomography-guided placement of percutaneous catheters in close proximity to the thoracic sympathetic chain by rating pain intensity and systematically reviewing charts and computed tomography scans. Interventions were performed 322 times in 293 patients of mean (SD) age 59.4 (17.0) years, and male to female ratio 105:188, with postherpetic neuralgia (n = 103, 35.1%), various neuralgias (n = 88, 30.0%), complex regional pain syndrome (n = 69, 23.6%), facial pain (n = 17, 5.8%), ischaemic limb pain (n = 7, 2.4%), phantom limb pain (n = 4, 1.4%), pain following cerebrovascular accident (n = 2, 0.7%), syringomyelia (n = 2, 0.7%) and palmar hyperhidrosis (n = 1, 0.3%). The interventions were associated with a total of 23 adverse events (7.1% of all procedures): catheter dislocation (n = 9, 2.8%); increase in pain intensity (n = 8, 2.5%); pneumothorax (n = 3, 0.9%); local infection (n = 2, 0.6%); and puncture of the spinal cord (n = 1, 0.3%). Continuous infusion of 10 ml.h(-1) ropivacaine 0.2% through the catheters decreased median (IQR [range]) pain scores from 8 (6-9 [2-10]) to 2 (1-3 [0-10]) (p < 0.0001). Chemical neuroablation was necessary in 137 patients (46.8%). We conclude that this procedure leads to a significant reduction of pain intensity in otherwise obstinate burning or stabbing pain and is associated with few hazards. © 2011 The Authors. Anaesthesia © 2011 The Association of Anaesthetists of Great Britain and Ireland.

  19. Prevention: Exercise

    Medline Plus

    Full Text Available ... abdominal wall inward, exhale as you lift chest area. This can be done with quick short movements, or slow full movements. Repeat 10-15 times, to fatigue... Abdominal Exercise Lay on your back with both knees ... © 2018 North ...

  20. Prevention: Exercise

    Medline Plus

    Full Text Available ... 10 Tips for a Healthy Back Smoking Weight Patient Safety Exercise Strengthening Strengthen Your Core! Stretching/Flexibility Aerobic ... Strength Training for the Elderly Other Back Pack Safety Pregnancy and Back ... Patient Information Feature Articles Patient Q&A Success Stories ...

  1. Evacuation exercise

    CERN Multimedia

    AUTHOR|(CDS)2094367

    2017-01-01

    In the event of an emergency, it is important that staff and visitors are evacuated safely and efficiently. Hence CERN organises regularly emergency response and evacuation exercise (also known as an ‘evacuation drill’) in different buildings across the sites.

  2. Compulsive Exercise

    Science.gov (United States)

    ... compulsive habit when it is done for the wrong reasons. Some people start exercising with weight loss as their main ... developing normally. This is especially true if the person also has an eating disorder. Girls who overexercise and restrict their eating ...

  3. Prevention: Exercise

    Medline Plus

    Full Text Available ... Information Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine Specialists Videos 9 for Spine Epidural Steroid Injections Exercise: The Backbone of Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Prevention ...

  4. Why Exercise?

    Science.gov (United States)

    ... strength, boosts energy, and can help you reduce stress. It can also help you maintain a healthy body weight and curb ... well-being and help treat depression. Help relieve stress and anxiety. Increase ... Can anyone exercise? Everyone can benefit from physical activity. ...

  5. Prevention: Exercise

    Medline Plus

    Full Text Available ... Feature Articles Patient Q&A Success Stories Definitions Anatomy of the Spine Definitions A-Z Spine ... Strengthening Many popular forms of exercise focus on core strengthening, or building the muscles that provide support for your body. Pilates, yoga ...

  6. Exercise Hypertension.

    Science.gov (United States)

    Schultz, Martin G; Sharman, James E

    2014-05-01

    Irrespective of apparent 'normal' resting blood pressure (BP), some individuals may experience an excessive elevation in BP with exercise (i.e. systolic BP ≥210 mm Hg in men or ≥190 mm Hg in women or diastolic BP ≥110 mm Hg in men or women), a condition termed exercise hypertension or a 'hypertensive response to exercise' (HRE). An HRE is a relatively common condition that is identified during standard exercise stress testing; however, due to a lack of information with respect to the clinical ramifications of an HRE, little value is usually placed on such a finding. In this review, we discuss both the clinical importance and underlying physiological contributors of exercise hypertension. Indeed, an HRE is associated with an increased propensity for target organ damage and also predicts the future development of hypertension, cardiovascular events and mortality, independent of resting BP. Moreover, recent work has highlighted that some of the elevated cardiovascular risks associated with an HRE may be related to high-normal resting BP (pre-hypertension) or ambulatory 'masked' hypertension and that an HRE may be an early warning signal of abnormal BP control that is otherwise undetected with clinic BP. Whilst an HRE may be amenable to treatment via pharmacological and lifestyle interventions, the exact physiological mechanism of an HRE remains elusive, but it is likely a manifestation of multiple factors including large artery stiffness, increased peripheral resistance, neural circulatory control and metabolic irregularity. Future research focus may be directed towards determining threshold values to denote the increased risk associated with an HRE and further resolution of the underlying physiological factors involved in the pathogenesis of an HRE.

  7. Predictive Accuracy of Exercise Stress Testing the Healthy Adult.

    Science.gov (United States)

    Lamont, Linda S.

    1981-01-01

    Exercise stress testing provides information on the aerobic capacity, heart rate, and blood pressure responses to graded exercises of a healthy adult. The reliability of exercise tests as a diagnostic procedure is discussed in relation to sensitivity and specificity and predictive accuracy. (JN)

  8. Are the surgeon's movements repeatable? An analysis of the feasibility and expediency of implementing support procedures guiding the surgical tools and increasing motion accuracy during the performance of stereotypical movements by the surgeon.

    Science.gov (United States)

    Podsędkowski, Leszek Robert; Moll, Jacek; Moll, Maciej; Frącczak, Łukasz

    2014-03-01

    The developments in surgical robotics suggest that it will be possible to entrust surgical robots with a wider range of tasks. So far, it has not been possible to automate the surgery procedures related to soft tissue. Thus, the objective of the conducted studies was to confirm the hypothesis that the surgery telemanipulator can be equipped with certain routines supporting the surgeon in leading the surgical tools and increasing motion accuracy during stereotypical movements. As the first step in facilitating the surgery, an algorithm will be developed which will concurrently provide automation and allow the surgeon to maintain full control over the slave robot. The algorithm will assist the surgeon in performing typical movement sequences. This kind of support must, however, be preceded by determining the reference points for accurately defining the position of the stitched tissue. It is in relation to these points that the tool's trajectory will be created, along which the master manipulator will guide the surgeon's hand. The paper presents the first stage, concerning the selection of movements for which the support algorithm will be used. The work also contains an analysis of surgical movement repeatability. The suturing movement was investigated in detail by experimental research in order to determine motion repeatability and verify the position of the stitched tissue. Tool trajectory was determined by a motion capture stereovision system. The study has demonstrated that the suturing movement could be considered as repeatable; however, the trajectories performed by different surgeons exhibit some individual characteristics.

  9. NPAS Users Guide

    International Nuclear Information System (INIS)

    1984-01-01

    This NPAS Users Guide is primarily intended as a source of information about policies, procedures, and facilities appropriate for users in the program of Nuclear Physics at SLAC (NPAS). General policies and practices are described, the preparation of proposals is discussed, and the services for users is outlined. SLAC experimental facilities are described, and contacts are listed

  10. The role of age, gender, mood states and exercise frequency on exercise dependence.

    Science.gov (United States)

    Costa, Sebastiano; Hausenblas, Heather A; Oliva, Patrizia; Cuzzocrea, Francesca; Larcan, Rosalba

    2013-12-01

    The purpose of our study was to explore the prevalence, and the role of mood, exercise frequency, age, and gender differences of exercise dependence. Regular exercisers (N = 409) completed a socio-demographic questionnaire, the Exercise Dependence Scale, and the Profile of Mood States. For data analyses, the participants were stratified for sex and age (age ranges = young adults: 18-24 years, adults: 25-44 years, and middle-aged adults: 45-64 years). We found that: (a) 4.4% of the participants were classified as at-risk for exercise dependence; (b) the men and the two younger groups (i.e., young adults and adults) had higher exercise dependence scores; and (c) age, gender, exercise frequency, and mood state were related to exercise dependence. Our results support previous research on the prevalence of exercise dependence and reveal that adulthood may be the critical age for developing exercise dependence. These findings have practical implication for identifying individuals at-risk for exercise dependence symptoms, and may aid in targeting and guiding the implementation of prevention program for adults.

  11. Kinetic Analysis of Horizontal Plyometric Exercise Intensity.

    Science.gov (United States)

    Kossow, Andrew J; Ebben, William P

    2018-05-01

    Kossow, AJ, DeChiara, TG, Neahous, SM, and Ebben, WP. Kinetic analysis of horizontal plyometric exercise intensity. J Strength Cond Res 32(5): 1222-1229, 2018-Plyometric exercises are frequently performed as part of a strength and conditioning program. Most studies assessed the kinetics of plyometric exercises primarily performed in the vertical plane. The purpose of this study was to evaluate the multiplanar kinetic characteristics of a variety of plyometric exercises, which have a significant horizontal component. This study also sought to assess sex differences in the intensity progression of these exercises. Ten men and 10 women served as subjects. The subjects performed a variety of plyometric exercises including the double-leg hop, standing long jump, single-leg standing long jump, bounding, skipping, power skipping, cone hops, and 45.72-cm hurdle hops. Subjects also performed the countermovement jump for comparison. All plyometric exercises were evaluated using a force platform. Dependent variables included the landing rate of force development and landing ground reaction forces for each exercise in the vertical, frontal, and sagittal planes. A 2-way mixed analysis of variance with repeated-measures for plyometric exercise type demonstrated main effects for exercise type for all dependent variables (p ≤ 0.001). There was no significant interaction between plyometric exercise type and sex for any of the variable assessed. Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the dependent variables assessed (p ≤ 0.05). These findings should be used to guide practitioners in the progression of plyometric exercise intensity, and thus program design, for those who require significant horizontal power in their sport.

  12. Terrain Analysis Procedural Guide for Climate,

    Science.gov (United States)

    1980-09-01

    days a year at many locations. D. HUMID MICROTHERMAL CLIMATES. The humid microthermal climate occurs in the Northern Hemisphere northward from the...subarctic are the principal types of microthermal climate. 71 1. Humid Continental Climates. These climates border the marine west coast climatic regions...frequently occur during summer in prairie regions. Regions on the southern margin of microthermal climates have long, hot and humid summers lasting from

  13. Microelectronics Failure Analysis Techniques. A Procedural Guide

    Science.gov (United States)

    1980-01-01

    0.26 0.60 0. 142 0.33 Nitrogen 0.48 0. 143 Oxygen 0. 15 0. 144 Fluorine 0.11 0.146 Neon 0. 006 0. 148 Sodium 0.099 0.097 0. 150 0.15 Magnesium 0.093 0...urethane; silicones; varnishes Dynasolve 100 Dynaloy, Inc. Removal of potting epoxies Dynasolve 160 Dynaloy, Inc. Removal of some potting epoxies J-300...elements below fluorine without very restrictive windowless detectors. There are other important differences, partic- ularly in research applications, and

  14. Naval Justice Procedure Study Guide. Revised

    Science.gov (United States)

    1994-05-01

    The civilian charges had been dismissed eight days after the accused enlisted.) In Russo, the accused suffered from a condition known as dyslexia ; a...person with dyslexia , who has not had proper special education, cannot read. The recruiter was advised of the accused’s inability to read, a nonwaivable...15 M.J. 190 (C.M.A. 1983), the court repudiated Hardy insofar as the intervention in a court-martial by a superior officer might give rise to a

  15. Interdepartmental circular on nuclear and radiological emergency exercises

    International Nuclear Information System (INIS)

    2011-01-01

    This document deals with the planning of nuclear and radiological emergency exercises for 2012 in France. It discusses the return on experience of these exercises, identifies the national objectives for 2012, and indicates the exercise agenda for 2012 and predictions for 2013. The appendix is a guide for the preparation and assessment of these exercises. It indicates the concerned references and regulations, describes the classification of these exercises, and indicates how they must be prepared, performed and reported, how they must be assessed, and the different aspects which must be addressed in terms of return on experience

  16. Eccentric exercise

    DEFF Research Database (Denmark)

    Kjaer, Michael; Heinemeier, Katja Maria

    2014-01-01

    to differences in type and/or amount of mechanical stimulus with regard to expression of collagen, regulatory factors for collagen, and cross-link regulators. In overused (tendinopathic) human tendon, eccentric exercise training has a beneficial effect, but the mechanism by which this is elicited is unknown......Eccentric exercise can influence tendon mechanical properties and matrix protein synthesis. mRNA for collagen and regulatory factors thereof are upregulated in animal tendons, independent of muscular contraction type, supporting the view that tendon, compared with skeletal muscle, is less sensitive......, and slow concentric loading appears to have similar beneficial effects. It may be that tendinopathic regions, as long as they are subjected to a certain magnitude of load at a slow speed, independent of whether this is eccentric or concentric in nature, can reestablish their normal tendon fibril alignment...

  17. How to prescribe physical exercise in rheumatology

    Directory of Open Access Journals (Sweden)

    S. Maddali Bongi

    2011-06-01

    Full Text Available Physical exercise, aiming to improve range of movement, muscle strength and physical well being, lately substituted the immobilization previously prescribed in rheumatic diseases. International guidelines, recommendations of Scientific Societies, and structured reviews regard physical exercise as of pivotal importance in treating rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, fibromyalgia syndrome, osteoporosis, and to be considered in connective tissue diseases. Therapeutic exercise should: aim to improve firstly local symptoms and then general health; respect the pain threshold; be a part of a treatment including pharmacological therapies and other rehabilitation techniques, be administered by skilled physiotherapist under the guide of a rheumatologist, be different according to different diseases, disease phases and patient expectations.

  18. Neuromuscular Exercise Post Partial Medial Meniscectomy

    DEFF Research Database (Denmark)

    Hall, Michelle; Hinman, Rana S; Wrigley, Tim V

    2015-01-01

    PURPOSE: To evaluate the effects of a 12-week, home-based, physiotherapist-guided neuromuscular exercise program on the knee adduction moment (an indicator of mediolateral knee load distribution) in people with a medial arthroscopic partial meniscectomy within the past 3-12 months. METHODS......: An assessor-blinded, randomised controlled trial including people aged 30-50 years with no to mild pain following medial arthroscopic partial meniscectomy was conducted. Participants were randomly allocated to either a 12-week neuromuscular exercise program that targeted neutral lower limb alignment...... or a control group with no exercise. The exercise program included eight individual sessions with one of seven physiotherapists in private clinics, together with home exercises. Primary outcomes were the peak external knee adduction moment during normal pace walking and during a one-leg sit-to-stand. Secondary...

  19. National staff exercise in the Netherlands

    International Nuclear Information System (INIS)

    Bergman, L.J.W.M.; Dal, A.H.

    1993-01-01

    In mid 1990, with the implementation of the National Plan for Nuclear Emergency Planning and Response in its final phase, it was decided to conduct a National Staff Exercise (NSE) on 14th November 1991, focused on an accident at the nuclear power plant in Borssele. In preparing the exercise a workplan was developed and a task force was formed. The task force was responsible for implementing all activities listed in the workplan. Approximately 450 persons participated in the exercise, including an extensive control organization. For evaluation purposes several evaluation reports were drawn up. An international group of experts observed the exercise, visited several participating locations and evaluated the performance of participants. In general the exercise was judged as realistic and successful. Both participants as well as controllers expressed opinions that it was a very instructive exercise and the scenario contained enough elements to perform their tasks as well as provide a realistic assessment of the plan and the procedures

  20. Ultrasonography-guided core needle biopsy for the thyroid nodule: does the procedure hold any benefit for the diagnosis when fine-needle aspiration cytology analysis shows inconclusive results?

    Science.gov (United States)

    Hahn, S Y; Han, B-K; Ko, E Y; Ko, E S

    2013-01-01

    Objective: We evaluated the diagnostic role of ultrasonography-guided core needle biopsy (CNB) according to ultrasonography features of thyroid nodules that had inconclusive ultrasonography-guided fine-needle aspiration (FNA) results. Methods: A total of 88 thyroid nodules in 88 patients who underwent ultrasonography-guided CNB because of previous inconclusive FNA results were evaluated. The patients were classified into three groups based on ultrasonography findings: Group A, which was suspicious for papillary thyroid carcinoma (PTC); Group B, which was suspicious for follicular (Hurthle cell) neoplasm; and Group C, which was suspicious for lymphoma. The final diagnoses of the thyroid nodules were determined by surgical confirmation or follow-up after ultrasonography-guided CNB. Results: Of the 88 nodules, the malignant rate was 49.1% in Group A, 12.0% in Group B and 90.0% in Group C. The rates of conclusive ultrasonography-guided CNB results after previous incomplete ultrasonography-guided FNA results were 96.2% in Group A, 64.0% in Group B and 90.0% in Group C (p=0.001). 12 cases with inconclusive ultrasonography-guided CNB results were finally diagnosed as 8 benign lesions, 3 PTCs and 1 lymphoma. The number of previous ultrasonography-guided FNA biopsies was not significantly different between the conclusive and the inconclusive result groups of ultrasonography-guided CNB (p=0.205). Conclusion: Ultrasonography-guided CNB has benefit for the diagnosis of thyroid nodules with inconclusive ultrasonography-guided FNA results. However, it is still not helpful for the differential diagnosis in 36% of nodules that are suspicious for follicular neoplasm seen on ultrasonography. Advances in knowledge: This study shows the diagnostic contribution of ultrasonography-guided CNB as an alternative to repeat ultrasonography-guided FNA or surgery. PMID:23564885

  1. Software Package with Exercises for Therapy of Children with Dyslalia

    OpenAIRE

    Schipor, Ovidiu Andrei; Belciug, Felicia Giza; Pentiuc, Stefan-Gheorghe; Belciug, Cristian Eduard; Nestor, Marian

    2014-01-01

    In this paper we present a consistent set of exercises for children with dyslalia (dyslalia is a speech disorder that affect pronunciation of one ore many sounds). The achievement has gone from "Therapeutic Guide" made available by the team of researchers led by Professor Mrs. Iolanda TOBOLCEA from the "Alexandru Ioan Cuza" University of Iasi. The specifications of the "Therapeutic Guide" have been fully complied with, such exercises being adapted both age and level of children. To achieve th...

  2. Mind racing: The influence of exercise on long-term memory consolidation.

    Science.gov (United States)

    McNerney, M Windy; Radvansky, Gabriel A

    2015-01-01

    Over time, regular exercise can lower the risk for age-related decline in cognition. However, the immediate effects of exercise on memory consolidation in younger adults have not been fully investigated. In two experiments, the effects of exercise were assessed on three different memory tasks. These included paired-associate learning, procedural learning and text memory. Results indicate that performance on procedural learning and situation model memory was increased with exercise, regardless of if participants exercised before or after encoding. No benefit of exercise was found for paired-associate learning. These findings suggest that intense exercise may benefit certain types of memory consolidation.

  3. Kinetic quantification of plyometric exercise intensity.

    Science.gov (United States)

    Ebben, William P; Fauth, McKenzie L; Garceau, Luke R; Petushek, Erich J

    2011-12-01

    Ebben, WP, Fauth, ML, Garceau, LR, and Petushek, EJ. Kinetic quantification of plyometric exercise intensity. J Strength Cond Res 25(12): 3288-3298, 2011-Quantification of plyometric exercise intensity is necessary to understand the characteristics of these exercises and the proper progression of this mode of exercise. The purpose of this study was to assess the kinetic characteristics of a variety of plyometric exercises. This study also sought to assess gender differences in these variables. Twenty-six men and 23 women with previous experience in performing plyometric training served as subjects. The subjects performed a variety of plyometric exercises including line hops, 15.24-cm cone hops, squat jumps, tuck jumps, countermovement jumps (CMJs), loaded CMJs equal to 30% of 1 repetition maximum squat, depth jumps normalized to the subject's jump height (JH), and single leg jumps. All plyometric exercises were assessed with a force platform. Outcome variables associated with the takeoff, airborne, and landing phase of each plyometric exercise were evaluated. These variables included the peak vertical ground reaction force (GRF) during takeoff, the time to takeoff, flight time, JH, peak power, landing rate of force development, and peak vertical GRF during landing. A 2-way mixed analysis of variance with repeated measures for plyometric exercise type demonstrated main effects for exercise type and all outcome variables (p ≤ 0.05) and for the interaction between gender and peak vertical GRF during takeoff (p ≤ 0.05). Bonferroni-adjusted pairwise comparisons identified a number of differences between the plyometric exercises for the outcome variables assessed (p ≤ 0.05). These findings can be used to guide the progression of plyometric training by incorporating exercises of increasing intensity over the course of a program.

  4. A New Resource for College Distance Education Astronomy Laboratory Exercises

    Science.gov (United States)

    Vogt, Nicole P.; Cook, Stephen P.; Muise, Amy Smith

    2013-01-01

    This article introduces a set of distance education astronomy laboratory exercises for use by college students and instructors and discusses first usage results. This General Astronomy Education Source exercise set contains eight two-week projects designed to guide students through both core content and mathematical applications of general…

  5. A Sport and Exercise Psychology Perspective on Stress.

    Science.gov (United States)

    Gill, Diane L.

    1994-01-01

    Introduces psychological perspectives on stress, noting conceptual models that guide sport and exercise psychology. After presenting key aspects of Lazarus' stress model, the paper reviews major lines of research related to stress within sport and exercise psychology. Lazarus suggests more information can be gained by considering emotion along…

  6. Pneumatic conveying design guide

    CERN Document Server

    Mills, David

    1990-01-01

    Pneumatic Conveying Design Guide is a guide for the design of pneumatic conveying systems and includes detailed data and information on the conveying characteristics of a number of materials with a wide range of properties. This book includes logic diagrams for design procedures and scaling parameters for the conveying line configuration. It also explains how to improve the performance of pneumatic conveyors by optimizing, uprating, and extending the system or adapting it for a change of material. This book consists of 15 chapters divided into three sections and opens with an overview of the s

  7. Exercise interventions for smoking cessation.

    Science.gov (United States)

    Ussher, Michael H; Taylor, Adrian H; Faulkner, Guy E J

    2014-08-29

    Taking regular exercise may help people give up smoking by moderating nicotine withdrawal and cravings, and by helping to manage weight gain. To determine whether exercise-based interventions alone, or combined with a smoking cessation programme, are more effective than a smoking cessation intervention alone. We searched the Cochrane Tobacco Addiction Group Specialized Register in April 2014, and searched MEDLINE, EMBASE, PsycINFO, and CINAHL Plus in May 2014. We included randomized trials which compared an exercise programme alone, or an exercise programme as an adjunct to a cessation programme, with a cessation programme (which we considered the control in this review). Studies were required to recruit smokers or recent quitters and have a follow-up of six months or more. Studies that did not meet the full inclusion criteria because they only assessed the acute effects of exercise on smoking behaviour, or because the outcome was smoking reduction, are summarised but not formally included. We extracted data on study characteristics and smoking outcomes. Because of differences between studies in the characteristics of the interventions used we summarized the results narratively, making no attempt at meta-analysis. We assessed risk of selection and attrition bias using standard methodological procedures expected by The Cochrane Collaboration. We identified 20 trials with a total of 5,870 participants. The largest study was an internet trial with 2,318 participants, and eight trials had fewer than 30 people in each treatment arm. Studies varied in the timing and intensity of the smoking cessation and exercise programmes offered. Only one included study was judged to be at low risk of bias across all domains assessed. Four studies showed significantly higher abstinence rates in a physically active group versus a control group at end of treatment. One of these studies also showed a significant benefit for exercise versus control on abstinence at the three-month follow

  8. Physical Exercise and Individuals with Autism Spectrum Disorders: A Systematic Review

    Science.gov (United States)

    Lang, Russell; Koegel, Lynn Kern; Ashbaugh, Kristen; Regester, April; Ence, Whitney; Smith, Whitney

    2010-01-01

    Studies involving physical exercise and individuals with autism spectrum disorders (ASD) were reviewed. Systematic search procedures identified 18 studies meeting predetermined inclusion criteria. These studies were evaluated in terms of: (a) participant characteristics, (b) type of exercise, (c) procedures used to increase exercise, (d) outcomes,…

  9. Assessing the Diet, Exercise, Body Image, and Weight of Adolescents: A Guide for Out-of-School Time Program Practitioners. Research-to-Results Brief. Publication #2007-06

    Science.gov (United States)

    Martin, Laurie; Milot, Alyssa

    2007-01-01

    This brief discusses diet, exercise, body image, and weight and also provides information for practitioners on how to measure these factors among youth in their program. It summarizes (1) what it means to be overweight; (2) what are body image and eating disorders; (3) what to do if you suspect that someone in your program is suffering from an…

  10. Do nonexercisers also share the positive exerciser stereotype?: An elicitation and comparison of beliefs about exercisers.

    Science.gov (United States)

    Rodgers, Wendy M; Hall, Craig R; Wilson, Philip M; Berry, Tanya R

    2009-02-01

    The purpose of this research was to examine whether exercisers and nonexercisers are rated similarly on a variety of characteristics by a sample of randomly selected regular exercisers, nonexercisers who intend to exercise, and nonexercisers with no intention to exercise. Previous research by Martin Ginis et al. (2003) has demonstrated an exerciser stereotype that advantages exercisers. It is unknown, however, the extent to which an exerciser stereotype is shared by nonexercisers, particularly nonintenders. Following an item-generation procedure, a sample of 470 (n=218 men; n=252 women) people selected using random digit dialing responded to a questionnaire assessing the extent to which they agreed that exercisers and nonexercisers possessed 24 characteristics, such as "happy," "fit," "fat," and "lazy." The results strongly support a positive exerciser bias, with exercisers rated more favorably on 22 of the 24 items. The degree of bias was equivalent in all groups of respondents. Examination of the demographic characteristics revealed no differences among the three groups on age, work status, or child-care responsibilities, suggesting that there is a pervasive positive exerciser bias.

  11. Exercise and immunity

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/007165.htm Exercise and immunity To use the sharing features on ... take a daily walk or follow a simple exercise routine a few times a week. Exercise helps ...

  12. Quantization Procedures

    International Nuclear Information System (INIS)

    Cabrera, J. A.; Martin, R.

    1976-01-01

    We present in this work a review of the conventional quantization procedure, the proposed by I.E. Segal and a new quantization procedure similar to this one for use in non linear problems. We apply this quantization procedures to different potentials and we obtain the appropriate equations of motion. It is shown that for the linear case the three procedures exposed are equivalent but for the non linear cases we obtain different equations of motion and different energy spectra. (Author) 16 refs

  13. Examining physiotherapist use of structured aerobic exercise testing to decrease barriers to aerobic exercise.

    Science.gov (United States)

    Foster B Sc, Evan; Fraser, Julia E; Inness PhD, Elizabeth L; Munce, Sarah; Biasin, Louis; Poon, Vivien; Bayley, Mark

    2018-04-03

    To determine the frequency of physiotherapist-administered aerobic exercise testing/training, the proportion of physiotherapists who administer this testing/training, and the barriers that currently exist across different practice environments. A secondary objective is to identify the learning needs of physiotherapists for the development of an education curriculum in aerobic exercise testing and training with electrocardiograph (ECG) administration and interpretation. National, cross-sectional survey. Registered physiotherapists practicing in Canada. Out of 137 participants, most (75%) physiotherapists prescribed aerobic exercise on a regular basis (weekly); however, 65% had never conducted an aerobic exercise test. There were no significant differences in frequency of aerobic exercise testing across different practice environments or across years of physiotherapy experience. Physiotherapists perceived the main barriers to aerobic exercise testing as being a lack of equipment/space (78%), time (65%), and knowledge (56%). Although most (82%) were uncomfortable administering 12-lead ECG-monitored aerobic exercise tests, 60% stated they would be interested in learning more about ECG interpretation. This study found that physiotherapists are regularly implementing aerobic exercise. This exercise was infrequently guided by formal aerobic exercise testing, which could increase access to safe and effective exercise within the optimal aerobic training zone. As well, this could facilitate training in patients with cardiovascular diagnoses that require additional testing for medical clearance. Increased ECG training and access to equipment for physiotherapists may augment pre-screening aerobic exercise testing. This training should include learning the key arrhythmias for aerobic exercise test termination as defined by the American College of Sports Medicine.

  14. Exercise Equipment: Neutral Buoyancy

    Science.gov (United States)

    Shackelford, Linda; Valle, Paul

    2016-01-01

    Load Bearing Equipment for Neutral Buoyancy (LBE-NB) is an exercise frame that holds two exercising subjects in position as they apply counter forces to each other for lower extremity and spine loading resistance exercises. Resistance exercise prevents bone loss on ISS, but the ISS equipment is too massive for use in exploration craft. Integrating the human into the load directing, load generating, and motion control functions of the exercise equipment generates safe exercise loads with less equipment mass and volume.

  15. Exercise rehabilitation for smartphone addiction.

    Science.gov (United States)

    Kim, Hyunna

    2013-12-31

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.

  16. Emergency procedures in London

    International Nuclear Information System (INIS)

    Cree, D.

    1984-01-01

    This chapter discusses the following: emergency services (fire brigade, ambulance and police) that would be involved in dealing with an accident to a nuclear fuel flask in transport through London, with special reference to procedures used by the Metropolitan Police; geographical area covered by Metropolitan Police; initiation of action; decision whether to evacuate the area of the accident; examples of action taken to deal with non-radiation accidents (in absence of any example of relevant radiation accident); specific instructions, or advice, to police relating to the movement of irradiated fuel; training exercises. (U.K.)

  17. Exercise and Sports Science Australia position statement on exercise and falls prevention in older people.

    Science.gov (United States)

    Tiedemann, Anne; Sherrington, Catherine; Close, Jacqueline C T; Lord, Stephen R

    2011-11-01

    Falls affect a significant number of older Australians and present a major challenge to health care providers and health systems. The purpose of this statement is to inform and guide exercise practitioners and health professionals in the safe and effective prescription of exercise for older community-dwelling people with the goal of preventing falls. Falls in older people are not random events but can be predicted by assessing a number of risk factors. Of particular importance are lower limb muscle strength, gait and balance, all of which can be improved with appropriate exercise. There is now extensive evidence to demonstrate that many falls are preventable, with exercise playing a crucial role in prevention. Research evidence has identified that programs which include exercises that challenge balance are more effective in preventing falls than those which do not challenge balance. It is important for exercise to be progressively challenging, ongoing and of sufficient dose to maximise its benefits in reducing falls. Other (non-exercise) interventions are necessary for certain people with complex medical conditions or recent hospitalisation and risk factors relating to vision and the use of psychotropic medications. Qualified exercise professionals are well placed to implement the research evidence and to prescribe and supervise specific exercise aimed at preventing falls in both healthy older community-dwelling people and those with co-morbidities. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  18. Guided labworks

    DEFF Research Database (Denmark)

    Jacobsen, Lærke Bang

    For the last 40 years physics education research has shown poor learning outcomes of guided labs. Still this is found to be a very used teaching method in the upper secodary schools. This study explains the teacher's choice of guided labs throught the concept of redesign as obstacle dislodgement...

  19. Can exercise mimetics substitute for exercise?

    DEFF Research Database (Denmark)

    Richter, Erik; Kiens, Bente; Wojtaszewski, Jørgen

    2008-01-01

    Exercise leads to changes in muscle phenotype with important implications for exercise performance and health. A recent paper in Cell by Narkar et al. (2008) shows that many of the adaptations in muscle phenotype elicited by exercise can be mimicked by genetic manipulation and drug treatment...

  20. Intradialytic Exercise is Medicine for Hemodialysis Patients.

    Science.gov (United States)

    Parker, Kristen

    2016-01-01

    When a person's kidneys fail, hemodialysis (HD) is the most common treatment modality. With a growing number of patients requiring this life-sustaining treatment, and with evidence illustrating the significant physical dysfunction of this population, encouraging exercise is essential. The use of intradialytic exercise, as a novel and efficient use of time during HD, is well established in Australia and some European nations; however, it is slower to start in North America. While a large number of small studies have demonstrated numerous benefits and safe delivery of intradialytic exercise training for patients with end-stage kidney disease, intradialytic exercise is rarely delivered as standard of care. It is of utmost importance for health care staff to overcome barriers and bring theory into practice. Included in this report are current recommendations from governing bodies, expert opinion, as well as established policies and procedures from a successful intradialytic exercise program in Canada.

  1. Using the Entrustable Professional Activities Framework in the Assessment of Procedural Skills.

    Science.gov (United States)

    Pugh, Debra; Cavalcanti, Rodrigo B; Halman, Samantha; Ma, Irene W Y; Mylopoulos, Maria; Shanks, David; Stroud, Lynfa

    2017-04-01

    The entrustable professional activity (EPA) framework has been identified as a useful approach to assessment in competency-based education. To apply an EPA framework for assessment, essential skills necessary for entrustment to occur must first be identified. Using an EPA framework, our study sought to (1) define the essential skills required for entrustment for 7 bedside procedures expected of graduates of Canadian internal medicine (IM) residency programs, and (2) develop rubrics for the assessment of these procedural skills. An initial list of essential skills was defined for each procedural EPA by focus groups of experts at 4 academic centers using the nominal group technique. These lists were subsequently vetted by representatives from all Canadian IM training programs through a web-based survey. Consensus (more than 80% agreement) about inclusion of each item was sought using a modified Delphi exercise. Qualitative survey data were analyzed using a framework approach to inform final assessment rubrics for each procedure. Initial lists of essential skills for procedural EPAs ranged from 10 to 24 items. A total of 111 experts completed the national survey. After 2 iterations, consensus was reached on all items. Following qualitative analysis, final rubrics were created, which included 6 to 10 items per procedure. These EPA-based assessment rubrics represent a national consensus by Canadian IM clinician educators. They provide a practical guide for the assessment of procedural skills in a competency-based education model, and a robust foundation for future research on their implementation and evaluation.

  2. HBR guides

    CERN Document Server

    Duarte, Nancy; Dillon, Karen

    2015-01-01

    Master your most pressing professional challenges with this seven-volume set that collects the smartest best practices from leading experts all in one place. "HBR Guide to Better Business Writing" and "HBR Guide to Persuasive Presentations" help you perfect your communication skills; "HBR Guide to Managing Up and Across" and "HBR Guide to Office Politics" show you how to build the best professional relationships; "HBR Guide to Finance Basics for Managers" is the one book you'll ever need to teach you about the numbers; "HBR Guide to Project Management" addresses tough questions such as how to manage stakeholder expectations and how to manage uncertainty in a complex project; and "HBR Guide to Getting the Right Work Done" goes beyond basic productivity tips to teach you how to prioritize and focus on your work. This specially priced set of the most popular books in the series makes a perfect gift for aspiring leaders looking for trusted advice. Arm yourself with the advice you need to succeed on the job, from ...

  3. Effect of exercise intensity on exercise and post exercise energy ...

    African Journals Online (AJOL)

    The aim of this study was to determine if exercise and post exercise energy expenditure are affected by the intensity of exercise during a set distance of 4km walking and/or jogging. Subjects for this study were 12 moderately obese females with mean fat percentage of 31.7±6.3% and mean age of 38.2±4.6 years. For the low ...

  4. Emergency exercise scenario tools

    International Nuclear Information System (INIS)

    Sjoeblom, K.

    1998-03-01

    Nuclear power plant emergency exercises require a realistically presented accident situation which includes various aspects: plant process, radioactivity, radiation, weather and people. Experiences from nuclear power plant emergency exercises show that preparing accident scenarios even for relatively short exercises is tedious. In the future modern computer technology and past experience could be used for making exercise planning more effective. (au)

  5. Exercise and Fatigue

    NARCIS (Netherlands)

    Ament, Wim; Verkerke, Gijsbertus J.

    2009-01-01

    Physical exercise affects the equilibrium of the internal environment. During exercise the contracting muscles generate force or power and heat. So physical exercise is in fact a form of mechanical energy. This generated energy will deplete the energy stocks within the body. During exercise,

  6. Exercise-Induced Asthma

    Science.gov (United States)

    ... Videos for Educators Search English Español Exercise-Induced Asthma KidsHealth / For Parents / Exercise-Induced Asthma What's in ... Exercise-Induced Asthma Print What Is Exercise-Induced Asthma? Most kids and teens with asthma have symptoms ...

  7. RECREATIONAL ACTIVITIES AND BODY EXERCISE AMONG SECONDARY SCHOOL STUDENTS IN KWARA STATE, NIGERIA

    OpenAIRE

    Olaitan; Olukunmi ‘Lanre; Bakinde; Surajudeen Tosho; Ibraheem; Tajudeen Olanrewaju

    2012-01-01

    This paper investigated the influence of recreational activities and body exercise among secondary school students in Kwara State. This paper explores types of exercise, benefits of physical exercise, risk of physical exercise and well as health and recreation. Four research questions and four research hypotheses were raised and generated to guide the study.This researcher employed a descriptive research survey method. The population consists of all secondary school students in Kwara State. T...

  8. Medication Guide

    Science.gov (United States)

    ... Size Small Text Medium Text Large Text Contrast Dark on Light Light on Dark Donate Search Menu Donate What is Glaucoma? Care ... Low Vision Resources Medication Guide Resources on the Web » See All Articles Where the Money Goes Have ...

  9. Safety guides development process in Spain

    International Nuclear Information System (INIS)

    Butragueno, J.L.; Perello, M.

    1979-01-01

    Safety guides have become a major factor in the licensing process of nuclear power plants and related nuclear facilities of the fuel cycle. As far as the experience corroborates better and better engineering methodologies and procedures, the results of these are settled down in form of standards, guides, and similar issues. This paper presents the actual Spanish experience in nuclear standards and safety guides development. The process to develop a standard or safety guide is shown. Up to date list of issued and on development nuclear safety guides is included and comments on the future role of nuclear standards in the licensing process are made. (author)

  10. Running from fear: Exercise modulation of fear extinction.

    Science.gov (United States)

    Tanner, Margaret K; Hake, Holly S; Bouchet, Courtney A; Greenwood, Benjamin N

    2018-03-31

    Extinction-based exposure therapy is the most common behavioral therapy for anxiety and trauma-related disorders, but fear tends to resurface even after successful extinction. Identification of novel strategies to enhance fear extinction and reduce fear relapse is of paramount importance to mental health. Exercise can enhance cognitive function, but it is not yet well understood whether exercise can be an effective augmentation strategy for fear extinction. In the current review, we present the current state of knowledge on the effects of exercise on fear extinction. Effects of exercise duration, explanations for conflicting results, and potential mechanisms, focusing on a hypothesized role for dopamine, are all discussed. We also provide new data suggesting that the timing in which acute exercise occurs relative to fear extinction, is a crucial variable in determining whether exercise can enhance fear extinction. Clinical implications and ideas to guide future research endeavors in this area are provided. Copyright © 2018 Elsevier Inc. All rights reserved.

  11. Trunk stabilization exercises for healthy individuals

    Directory of Open Access Journals (Sweden)

    Francisco J Vera-Garcia

    2014-01-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2014v16n2p200   The aim of this study was to analyze the trunk muscular response during different variations of some of the most popular stabilization exercises: front-bridge, back-bridge, side-bridge, and bird-dog. Surface electromyography was bilaterally re-corded from rectus abdominis, external and internal oblique and erector spinae during 25 variations of the aforementioned exercises. Compared to the conventional form of the front- and side-bridge, performing these exercises kneeling on a bench or with elbows extended reduced the muscular challenge. Conversely, performing the back-bridge with elbows extended elicited higher muscular activation than the conventional exercise. While bridge exercises with double leg support produced the highest activation levels in those muscles that counteracted gravity, single leg support while bridging increased the activation of the trunk rotators, especially internal oblique. The highest activation levels were found in three exercises: sagittal walkout in a front-bridge position, rolling from right side-bridge into front-bridge position, and side-bridge with single leg support on a BOSUTMbalance trainer. Although the exercises performed on unstable surfaces usu-ally enhanced the muscle activation, performing the exercises on the BOSUTMbalance trainer did not always increase the trunk muscle activity. Overall, this information may be useful to guide fitness instructors and clinicians when establishing stabilization exercise progressions for the trunk musculature.

  12. Exercisers' identities and exercise dependence: the mediating effect of exercise commitment.

    Science.gov (United States)

    Lu, Frank Jing-Horng; Hsu, Eva Ya-Wen; Wang, Junn-Ming; Huang, Mei-Yao; Chang, Jo-Ning; Wang, Chien-Hsin

    2012-10-01

    The purpose of this study was to examine the associations of exercise identity, exercise commitment, exercise dependence, and, particularly, the mediating effects of exercise commitment on the relationship between exercise identity and exercise dependence. 253 Taiwanese regular exercisers completed measures, including the Exercise Dependence Scale-Revised, the Exercise Identity Scale, the Exercise Commitment Scale, and the Godin Leisure Time Exercise Questionnaire. Results showed that exercise identity, exercise dependence, and two types of exercise commitment were moderately to highly correlated. Furthermore, structural equation modelling indicated that a "have to" commitment partially mediated the relationship between exercise identity and exercise dependence. Based on the mediating role of a "have to" commitment, the findings are particularly informative to exercise instructors and for exercise program managers.

  13. Choosing the Future You Prefer. A Goal Setting Guide.

    Science.gov (United States)

    Lindaman, Edward B.; Lippitt, Ronald O.

    The guide, intended for group and organization leaders, presents activities and exercises to aid in personal and group goal-setting and planning for the future. The objective is to help groups choose goals which are sensitive to and oriented toward the evolving future with its rapid rate of change. The guide is presented in eight chapters.…

  14. Effects of exercise on insulin binding to human muscle

    International Nuclear Information System (INIS)

    Bonen, A.; Tan, M.H.; Clune, P.; Kirby, R.L.

    1985-01-01

    A procedure was developed to measure insulin binding to human skeletal muscle obtained via the percutaneous muscle biopsy technique. With this method the effects of exercise on insulin binding were investigated. Subjects (n = 9) exercised for 60 min on a bicycle ergometer at intensities ranging from 20-86% maximum O 2 consumption (VO 2 max). Blood samples were obtained before, during, and after exercise and analyzed for glucose and insulin. Muscle samples (250 mg) for the vastus lateralis were obtained 30 min before exercise, at the end of exercise, and 60 min after exercise. Two subjects rested during the experimental period. There was no linear relationship between exercise intensities and the changes in insulin binding to human muscle. At rest (n = 2) and at exercise intensities below 60% VO 2 max (n = 5) no change in insulin binding occurred (P greater than 0.05). However, when exercise occurred at greater than or equal to 69% VO 2 max (n = 4), a pronounced decrement in insulin binding (30-50%) was observed (P less than 0.05). This persisted for 60 min after exercise. These results indicate that insulin binding in human muscle is not altered by 60 min of exercise at less than or equal to 60% VO 2 max but that a marked decrement occurs when exercise is greater than or equal to 69% VO 2 max

  15. Bodie State Historic Park. Teacher's Guide.

    Science.gov (United States)

    California State Dept. of Parks and Recreation, Sacramento.

    This guide is intended to assist teachers in organizing and preparing a field trip to Bodie State Historic Park (California). Although it is intended to assist in the trip to Bodie, it also provides information for organizing group tours or family outings to other areas. Activities include before, during, and after visit exercises focusing on the…

  16. Exercise in Pregnancy.

    Science.gov (United States)

    Gregg, Vanessa H; Ferguson, James E

    2017-10-01

    Routine exercise should be recommended to healthy pregnant women after consultation with an obstetric provider. Even pregnant women who have not been exercising regularly can gradually increase their exercise during pregnancy. Regular exercise during pregnancy promotes overall wellness and helps maintain appropriate gestational weight gain and appropriate fetal weight gain. Exercise in pregnancy may also reduce hypertensive disorders of pregnancy and gestational diabetes, and may be associated with shorter first stage of labor and decreased risk for cesarean section. Exercise in pregnancy is safe for pregnant women and their fetuses and can have multiple health benefits. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. The comparative study of CT guided and ultrasound guided percutaneous ethanol injection in the treatment of intra-abdominal cyst

    International Nuclear Information System (INIS)

    Li Heping; Yang Jianyong; Chen Wei; Zhuang Wenquan; Huang Yulian; Chen Jianye

    2005-01-01

    Objective: An comparative study of the interventional approach of CT guided and ultiasound guided percutaneous ethanol injection(PEI) in the treatment of intra-abdominal cyst. Methods: CT guided PEI was performed in the treatment of intra-abdominal cyst in 38 patients while ultrasound guided PEI was performed in 45 cases. Results: The puncture procedure of CT guided PEI was totally performed 83 times in treating 56 intra-abdominal cysts in 38 patients and CT guided PEI was unsuccessful in 6 patients. The puncture procedure of ultrasound guided PEI were performed 87 times in treating 71 intra-abdominal cysts in 55 patients and ultrasound guided PEI only failed only in 1 patient. Conclusion: Ultrasound guided PEI is superior to CT guided PEI in the treatment of intra-abdominal cyst. (authors)

  18. Guide device

    International Nuclear Information System (INIS)

    Brammer, C.M. Jr.

    1977-01-01

    Disclosed is a fuel handling guide tube centering device for use in nuclear reactors during fuel assembly handling operations. The device comprises an outer ring secured to the flange of a nuclear reactor pressure vessel, a rotatable table rotatably coupled to the outer ring, and a plurality of openings through the table. Truncated locating cones are positioned in each of the openings in the table, and the locating cones center the guide tube during fuel handling operations. The openings in the table are located such that each fuel assembly in the nuclear core may be aligned with one of the openings by a suitable rotation of the table. The locating cones thereby provide alignment between the fuel handling mechanism located in the guide tube and the individual fuel assemblies of the cone. The need for a device to provide alignment is especially critical for floating nuclear power plants, where wave motion may exist during fuel handling operations. 5 claims, 4 figures

  19. Metabolic, respiratory, and cardiological measurements during exercise and rest

    Science.gov (United States)

    1971-01-01

    Low concentration effects of CO2 on metabolic respiration and circulation were measured during work and at rest. The relationship between heart rate and metabolic rate is examined, as well as calibration procedures, and rate measurement during submaximal and standard exercise tests. Alterations in acid base and electrolytes were found during exhaustive exercise, including changes in ECG and metabolic alkalosis effects.

  20. A Faith-Based and Cultural Approach to Promoting Self-Efficacy and Regular Exercise in Older African American Women

    Science.gov (United States)

    Quinn, Mary Ellen; Guion, W. Kent

    2010-01-01

    The health benefits of regular exercise are well documented, yet there has been limited success in the promotion of regular exercise in older African American women. Based on theoretical and evidence-based findings, the authors recommend a behavioral self-efficacy approach to guide exercise interventions in this high-risk population. Interventions…

  1. Brakes. Auto Mechanics Curriculum Guide. Module 6. Instructor's Guide.

    Science.gov (United States)

    Allain, Robert

    This module is the sixth of nine modules in the competency-based Missouri Auto Mechanics Curriculum Guide. Eight units cover: introduction to automotive brake systems; disc and drum brake system components and how they operate; properties of brake fluid and procedures for bleeding the brake system; diagnosing and determining needed repairs on…

  2. Exercising is like flogging a dead horse

    International Nuclear Information System (INIS)

    Molhoek, W.

    2003-01-01

    Full text: To explore the international aspects of nuclear accidents, the OECD Nuclear Energy Agency initiated and established an international nuclear emergency 'exercise culture', starting with the INEX 1 table-top exercise, the first international nuclear emergency exercise in 1993, followed by the series of real time command-post exercises INEX 2 and INEX 2000 (five exercises between 1996 - 2001). Deficiencies in the area of communication and information exchange were the most significant findings of the INEX 2 series and corrective actions represent a major step forward in nuclear emergency management. The development of a new communication and information exchange strategy, which is currently implemented by various countries as well as by the international community, has strengthened our preparedness and response to nuclear emergencies. In addition, one of these exercises explored for the first time third party liability procedures and compensation after a nuclear accident. Regarding the role of international organizations, the INEX 2 series contributed to a better clarification regarding the roles of relevant international organizations, their obligations and responsibilities, and how their response in the case of a nuclear emergency are co-ordinated and harmonized. On the national level, many countries participating in INEX 1 and INEX 2 exercises used the experiences and lessons learned to modify and improve national procedures for nuclear emergency preparedness and management. Countries also used the outcome of the exercises to update bilateral agreements and arrangements. As an important follow-up of the lessons learned, an OECD/NEA-working group established the report: monitoring and data management strategies for nuclear emergencies. To test the implementation of the features of the outcome of the report, e.g. the effectiveness of developed data matrix and the effectiveness of proposed communication strategies employing new technologies, the INEX-2000

  3. Human factors reliability Benchmark exercise

    International Nuclear Information System (INIS)

    Poucet, A.

    1989-06-01

    The Joint Research Centre of the European Commission has organized a Human Factors Reliability Benchmark Exercise (HF-RBE) with the aim of assessing the state of the art in human reliability modelling and assessment. Fifteen teams from eleven countries, representing industry, utilities, licensing organisations and research institutes, participated in the HF-RBE. The HF-RBE was organized around two study cases: (1) analysis of routine functional Test and Maintenance (T and M) procedures: with the aim of assessing the probability of test induced failures, the probability of failures to remain unrevealed and the potential to initiate transients because of errors performed in the test; (2) analysis of human actions during an operational transient: with the aim of assessing the probability that the operators will correctly diagnose the malfunctions and take proper corrective action. This report contains the final summary reports produced by the participants in the exercise

  4. Endoscopic Ultrasound-Guided Biliary Drainage

    International Nuclear Information System (INIS)

    Artifon, Everson L.A.; Ferreira, Fla'vio C.; Sakai, Paulo

    2012-01-01

    To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage. Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews. EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.

  5. Endoscopic Ultrasound-Guided Biliary Drainage

    Energy Technology Data Exchange (ETDEWEB)

    Artifon, Everson L.A.; Ferreira, Fla& #x27; vio C.; Sakai, Paulo [University of Saeo Paulo, Saeo Paulo (Brazil)

    2012-02-15

    To demonstrate a comprehensive review of published articles regarding endoscopic ultrasound (EUS)-guided biliary drainage. Review of studies regarding EUS-guided biliary drainage including case reports, case series and previous reviews. EUS-guided hepaticogastrostomy, coledochoduodenostomy and choledoantrostomy are advanced biliary and pancreatic endoscopy procedures, and together make up the echo-guided biliary drainage. Hepaticogastrostomy is indicated in cases of hilar obstruction, while the procedure of choice is the coledochoduodenostomy or choledochoantrostomy in distal lesions. Both procedures must be performed only after unsuccessful ERCPs. The indication of these procedures must be made under a multidisciplinary view while sharing information with the patient or legal guardian. Hepaticogastrostomy and coledochoduodenostomy or choledochoantrostomy are feasible when performed by endoscopists with expertise in biliopancreatic endoscopy. Advanced echo-endoscopy should currently be performed under a rigorous protocol in educational institutions.

  6. Classification guide: Paralympic Games London 2012

    OpenAIRE

    2013-01-01

    The London 2012 Paralympic Games Classification Guide is designed to provide National Paralympic Committees (NPCs) and International Paralympic Sport Federations (IPSFs) with information about the classification policies and procedures that will apply to the London 2012 Paralympic Games.

  7. Classification guide: Sochi 2014 Paralympic Winter Games

    OpenAIRE

    2014-01-01

    The Sochi 2014 Paralympic Winter Games classification guide is designed to provide National Paralympic Committees (NPCs) and International Federations (IFs) with information about the classification policies and procedures that will apply to the Sochi 2014 Paralympic Winter Games.

  8. Environmental Compliance Guide

    International Nuclear Information System (INIS)

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects

  9. Environmental Compliance Guide

    Energy Technology Data Exchange (ETDEWEB)

    None

    1981-02-01

    The Guide is intended to assist Department of Energy personnel by providing information on the NEPA process, the processes of other environmental statutes that bear on the NEPA process, the timing relationships between the NEPA process and these other processes, as well as timing relationships between the NEPA process and the development process for policies, programs, and projects. This information should be helpful not only in formulating environmental compliance plans but also in achieving compliance with NEPA and various other environmental statutes. The Guide is divided into three parts with related appendices: Part I provides guidance for developing environmental compliance plans for DOE actions; Part II is devoted to NEPA with detailed flowcharts depicting the compliance procedures required by CEQ regulations and Department of Energy NEPA Guidelines; and Part III contains a series of flowcharts for other Federal environmental requirements that may apply to DOE projects.

  10. Arrhythmia and exercise intolerance in Fontan patients

    DEFF Research Database (Denmark)

    Idorn, L; Juul, K; Jensen, A S

    2013-01-01

    BACKGROUND: Long-term survival after the Fontan procedure shows excellent results but is associated with a persistent risk of arrhythmias and exercise intolerance. We aimed to analyze the current burden of clinically relevant arrhythmia and severe exercise intolerance in Danish Fontan patients...... and estimated to 99.1% per year. Prevalence of clinically relevant arrhythmia and severe exercise intolerance increased significantly with age and was found in 32% and 85% of patients ≥20years, respectively. Thus, from survival data and logistic regression models the future prevalence of patients, clinically...... relevant arrhythmia and severe exercise intolerance were estimated, revealing a considerable augmentation. Furthermore, resting and maximum cardiac index, resting stroke volume index and pulmonary diffusing capacity decreased significantly with age while diastolic and systolic ventricular function...

  11. Exercise and children's cognition: The role of exercise characteristics and a place for metacognition

    Directory of Open Access Journals (Sweden)

    Phillip D. Tomporowski

    2015-03-01

    Full Text Available Definitive conclusions concerning the impact of exercise interventions on children's mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was conducted to evaluate the role of two types of exercise interventions on children's cognition. Acute and chronic exercise interventions were classified as quantitative or qualitative on the basis of manipulations of task complexity and, by inference, mental engagement. Both types of interventions enhance aspects of children's cognition; however, their effects on metacognitive processes are unknown. The role of metacognitive processes and their regulation of children's behavior and academic performance are highlighted.

  12. Exercise After Pregnancy

    Science.gov (United States)

    ... 2 days a week. When can I start exercising after pregnancy? If you had a healthy pregnancy ... some guidelines I can follow when I begin exercising after pregnancy? Aim to stay active for 20– ...

  13. Benefits of Exercise

    Science.gov (United States)

    ... activity into your life. To get the most benefit, you should try to get the recommended amount ... likely even live longer. What are the health benefits of exercise? Regular exercise and physical activity may ...

  14. Experience in exercise evaluations

    Energy Technology Data Exchange (ETDEWEB)

    Bickerton, George E [Office of Emergency Planning, Food Safety and Inspection Service, United States Department of Agriculture, Washington, DC (United States)

    1989-09-01

    This summary outline presents environmental ingestion exposure pathways exercise evaluations that should be followed by state and local governments. It includes environmental monitoring, food, feeds and monitoring of organisms as well as emergency planning and execution exercises.

  15. Muscle glycogenolysis during exercise

    DEFF Research Database (Denmark)

    Richter, Erik; Ruderman, N B; Gavras, H

    1982-01-01

    glycogenolysis during exercise: contractions principally stimulate glycogenolysis early in exercise, and a direct effect of epinephrine on muscle is needed for continued glycogenolysis. In addition, epinephrine increased oxygen consumption and glucose uptake in both resting and electrically stimulated...

  16. Fight Cravings with Exercise

    Science.gov (United States)

    ... run up and down the stairs. Fact: Exercise boosts your endorphins, gives you time to clear your ... I find gardening really helps me keep my mind off smoking. It’s relaxing and good exercise, too!" - ...

  17. Experience in exercise evaluations

    International Nuclear Information System (INIS)

    Bickerton, George E.

    1989-01-01

    This summary outline presents environmental ingestion exposure pathways exercise evaluations that should be followed by state and local governments. It includes environmental monitoring, food, feeds and monitoring of organisms as well as emergency planning and execution exercises

  18. Eating and Exercise

    Science.gov (United States)

    ... recovery smoothie Turkey on whole-grain bread with vegetables Don't forget to drink fluids. You need adequate fluids before, during and after exercise to help prevent dehydration. To stay well-hydrated for exercise, the American ...

  19. Exercise during Pregnancy

    Science.gov (United States)

    ... wear loose-fitting clothing, and exercise in a temperature-controlled room. Do not exercise outside when it ... breathing. There are even prenatal yoga and Pilates classes designed for pregnant women. These classes often teach ...

  20. Aerobic exercise (image)

    Science.gov (United States)

    Aerobic exercise gets the heart working to pump blood through the heart more quickly and with more ... must be oxygenated more quickly, which quickens respiration. Aerobic exercise strengthens the heart and boosts healthy cholesterol ...

  1. Isometric exercise (image)

    Science.gov (United States)

    Isometric exercise works muscles and strengthens bone. Increased muscle mass elevates metabolism, which in turn burns fat. Strength training is also called anaerobic exercise, as opposed to aerobic, because increased oxygen production is not ...

  2. Exercise and Asthma

    Science.gov (United States)

    ... Español Text Size Email Print Share Exercise and Asthma Page Content Article Body Almost every child (and ... of Pediatrics about asthma and exercise. What is asthma Asthma is the most common chronic medical problem ...

  3. Clinical Applications for Exercise.

    Science.gov (United States)

    Goldstein, David

    1989-01-01

    Patients with chronic conditions such as coronary artery disease, hypertension, diabetes, and obesity might benefit from prescribed exercise. Although exercise does not reverse pathologic changes, it may play a role in disease management. (JD)

  4. Exercise-Induced Bronchoconstriction (EIB)

    Science.gov (United States)

    ... Conditions & Treatments ▸ Conditions Dictionary ▸ Exercise-Induced Bronchoconstriction Share | Exercise-Induced Bronchoconstriction (EIB) « Back to A to Z Listing Exercise-Induced Bronchoconstriction, (EIB), often known as exercise-induced ...

  5. Dengue and Chikungunya Vector Control Pocket Guide

    Science.gov (United States)

    This technical guide consolidates information and procedures for surveillance and control of mosquitoes that transmit dengue and chikungunya viruses. The guide focuses on mosquitoes that transmit dengue but also makes reference to chikungunya and yellow fever because the pathogens that cause these ...

  6. Homebuyer's Guide.

    Science.gov (United States)

    Sindt, Roger P.; Harris, Jack

    Designed to assist prospective buyers in making such important decisions as whether to buy a new or older home and within what price range, the guide provides information on the purchase process. Discussion of the purchase process covers the life-cycle costs (recurring homeownership costs that must be met every month); selection of a home;…

  7. Exercise in Pregnancy

    OpenAIRE

    Hinman, Sally K.; Smith, Kristy B.; Quillen, David M.; Smith, M. Seth

    2015-01-01

    Context: Health professionals who care for pregnant women should discuss potential health benefits and harms of exercise. Although most pregnant women do not meet minimal exercise recommendations, there are a growing number of physically active women who wish to continue training throughout pregnancy. Evidence Acquisition: A search of the Web of Science database of articles and reviews available in English through 2014. The search terms exercise pregnancy, strenuous exercise pregnancy, and vi...

  8. Exercise and cancer

    DEFF Research Database (Denmark)

    Idorn, Manja; thor Straten, Per

    2017-01-01

    Exercise improves functional capacity and patient-reported outcomes across a range of cancer diagnoses. The mechanisms behind this protection have been largely unknown, but exercise-mediated changes in body composition, sex hormone levels, systemic inflammation, and immune cell function have been...... hypothesize that this link between exercise and the immune system can be exploited in cancer therapy in particular in combination with immunotherapy. Thus, we believe that exercise may not just be “healthy” but may in fact be therapeutic....

  9. Exercise and Your Heart.

    Science.gov (United States)

    National Heart and Lung Inst. (DHHS/NIH), Bethesda, MD.

    This pamphlet presents information on the effects of physical activity on the heart and practical guidelines for starting and staying on an exercise program. The following topics are discussed: (1) the benefits of getting sufficient exercise; (2) possible risks in exercising compared to benefits; (3) when to seek doctor's advice and prevention of…

  10. WOMEN AND EXERCISE

    OpenAIRE

    Tarran, Leanne

    1995-01-01

    This paper examines the social attitudes and expectations that limit women's freedom to move in the world. The history of gendered attitudes to exercise, current gendered differences in patterns of exercise and issues of body image and ageing are discussed. The importance of these issues when considering exercise as a preventative health measure is emphasised.

  11. Sleep, Exercise, and Nutrition.

    Science.gov (United States)

    Harrelson, Orvis A.; And Others

    The first part of this booklet concerns why sleep and exercise are necessary. It includes a discussion of what occurs during sleep and what dreams are. It also deals with the benefits of exercise, fatigue, posture, and the correlation between exercise and personality. The second part concerns nutrition and the importance of food. This part covers…

  12. Selected exercises in particle and nuclear physics

    CERN Document Server

    Bianchini, Lorenzo

    2018-01-01

    This book presents more than 300 exercises, with guided solutions, on topics that span both the experimental and the theoretical aspects of particle physics. The exercises are organized by subject, covering kinematics, interactions of particles with matter, particle detectors, hadrons and resonances, electroweak interactions and flavor physics, statistics and data analysis, and accelerators and beam dynamics. Some 200 of the exercises, including 50 in multiple-choice format, derive from exams set by the Italian National Institute for Nuclear Research (INFN) over the past decade to select its scientific staff of experimental researchers. The remainder comprise problems taken from the undergraduate classes at ETH Zurich or inspired by classic textbooks. Whenever appropriate, in-depth information is provided on the source of the problem, and readers will also benefit from the inclusion of bibliographic details and short dissertations on particular topics. This book is an ideal complement to textbooks on experime...

  13. Emergency preparedness and its enhancement in Japan: From perspectives of infrastructure preparation, and exercise enhancement

    International Nuclear Information System (INIS)

    Funahashi, T.

    2010-01-01

    The organizational structure, procedures and infrastructures for the nuclear emergency response were established in Japan in the aftermath of the JCO accident and have been improved through exercises, drills and training. This paper overviews the infrastructure for the emergency response prepared by JNES and exercises implemented or supported by JNES for nuclear emergency preparedness. Approaches to feeding back exercise results are also addressed. (author)

  14. Environmental procedures

    International Nuclear Information System (INIS)

    1992-01-01

    The European Bank has pledged in its Agreement to place environmental management at the forefront of its operations to promote sustainable economic development in central and eastern Europe. The Bank's environmental policy is set out in the document titled, Environmental Management: The Bank's Policy Approach. This document, Environmental Procedures, presents the procedures which the European Bank has adopted to implement this policy approach with respect to its operations. The environmental procedures aim to: ensure that throughout the project approval process, those in positions of responsibility for approving projects are aware of the environmental implications of the project, and can take these into account when making decisions; avoid potential liabilities that could undermine the success of a project for its sponsors and the Bank; ensure that environmental costs are estimated along with other costs and liabilities; and identify opportunities for environmental enhancement associated with projects. The review of environmental aspects of projects is conducted by many Bank staff members throughout the project's life. This document defines the responsibilities of the people and groups involved in implementing the environmental procedures. Annexes contain Environmental Management: The Bank's Policy Approach, examples of environmental documentation for the project file and other ancillary information

  15. Early Option Exercise

    DEFF Research Database (Denmark)

    Heje Pedersen, Lasse; Jensen, Mads Vestergaard

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  16. Early Option Exercise

    DEFF Research Database (Denmark)

    Jensen, Mads Vestergaard; Heje Pedersen, Lasse

    2016-01-01

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  17. Acute Exercise and Motor Memory Consolidation: The Role of Exercise Timing

    Directory of Open Access Journals (Sweden)

    Richard Thomas

    2016-01-01

    Full Text Available High intensity aerobic exercise amplifies offline gains in procedural memory acquired during motor practice. This effect seems to be evident when exercise is placed immediately after acquisition, during the first stages of memory consolidation, but the importance of temporal proximity of the exercise bout used to stimulate improvements in procedural memory is unknown. The effects of three different temporal placements of high intensity exercise were investigated following visuomotor skill acquisition on the retention of motor memory in 48 young (24.0 ± 2.5 yrs, healthy male subjects randomly assigned to one of four groups either performing a high intensity (90% Maximal Power Output exercise bout at 20 min (EX90, 1 h (EX90+1, 2 h (EX90+2 after acquisition or rested (CON. Retention tests were performed at 1 d (R1 and 7 d (R7. At R1 changes in performance scores after acquisition were greater for EX90 than CON (p<0.001 and EX90+2 (p=0.001. At R7 changes in performance scores for EX90, EX90+1, and EX90+2 were higher than CON (p<0.001, p=0.008, and p=0.008, resp.. Changes for EX90 at R7 were greater than EX90+2 (p=0.049. Exercise-induced improvements in procedural memory diminish as the temporal proximity of exercise from acquisition is increased. Timing of exercise following motor practice is important for motor memory consolidation.

  18. Every exercise bout matters

    DEFF Research Database (Denmark)

    Dethlefsen, Christine; Pedersen, Katrine Seide; Hojman, Pernille

    2017-01-01

    Cumulative epidemiological evidence shows that regular exercise lowers the risk of developing breast cancer and decreases the risk of disease recurrence. The causality underlying this relation has not been fully established, and the exercise recommendations for breast cancer patients follow...... the general physical activity guidelines, prescribing 150 min of exercise per week. Thus, elucidations of the causal mechanisms are important to prescribe and implement the most optimal training regimen in breast cancer prevention and treatment. The prevailing hypothesis on the positive association within...... exercise oncology has focused on lowering of the basal systemic levels of cancer risk factors with exercise training. However, another rather overlooked systemic exercise response is the marked acute increases in several potential anti-cancer components during each acute exercise bout. Here, we review...

  19. Diabetes, insulin and exercise

    DEFF Research Database (Denmark)

    Richter, Erik; Galbo, H

    1986-01-01

    The metabolic and hormonal adaptations to single exercise sessions and to exercise training in normal man and in patients with insulin-dependent as well as non-insulin-dependent diabetes mellitus are reviewed. In insulin-dependent (type I) diabetes good metabolic control is best obtained...... by a regular pattern of life which will lead to a fairly constant demand for insulin from day to day. Exercise is by nature a perturbation that makes treatment of diabetes difficult: Muscle contractions per se tend to decrease the plasma glucose concentration whereas the exercise-induced response of the so......-called counter-regulatory hormones tend to increase plasma glucose by increasing hepatic glucose production and adipose tissue lipolysis. If the pre-exercise plasma insulin level is high, hypoglycaemia may develop during exercise whereas hyperglycaemia and ketosis may develop if pre-exercise plasma insulin...

  20. A pilot randomised trial to assess the methods and procedures for evaluating the clinical effectiveness and cost-effectiveness of Exercise Assisted Reduction then Stop (EARS) among disadvantaged smokers.

    Science.gov (United States)

    Taylor, Adrian H; Thompson, Tom P; Greaves, Colin J; Taylor, Rod S; Green, Colin; Warren, Fiona C; Kandiyali, Rebecca; Aveyard, Paul; Ayres, Richard; Byng, Richard; Campbell, John L; Ussher, Michael H; Michie, Susan; West, Robert

    2014-01-01

    There have been few rigorous studies on the effects of behavioural support for helping smokers to reduce who do not immediately wish to quit. While reduction may not have the health benefits of quitting, it may lead smokers to want to quit. Physical activity (PA) helps to reduce cravings and withdrawal symptoms, and also reduces weight gain after quitting, but smokers may be less inclined to exercise. There is scope to develop and determine the effectiveness of interventions to support smoking reduction and increase physical activity, for those not ready to quit. To conduct a pilot randomised controlled trial (RCT) [Exercise Assisted Reduction then Stop (EARS) smoking study] to (1) design and evaluate the feasibility and acceptability of a PA and smoking-reduction counselling intervention [for disadvantaged smokers who do not wish to quit but do want to reduce their smoking (to increase the likelihood of quitting)], and (2) to inform the design of a large RCT to determine the clinical effectiveness and cost-effectiveness of the intervention. A single-centre, pragmatic, pilot trial with follow-up up to 16 weeks. A mixed methods approach assessed the acceptability and feasibility of the intervention and trial methods. Smokers were individually randomised to intervention or control arms. General practices, NHS buildings, community venues, and the Stop Smoking Service (SSS) within Plymouth, UK. Aged > 18 years, smoking ≥ 10 cigarettes per day (for ≥ 2 years) who wished to cut down. We excluded individuals who were contraindicated for moderate PA, posed a safety risk to the research team, wished to quit immediately or use Nicotine Replacement Therapy, not registered with a general practitioner, or did not converse in English. We designed a client-centred, counselling-based intervention designed to support smoking reduction and increases in PA. Support sessions were delivered by trained counsellors either face to face or by telephone. Both intervention

  1. Radiochemical procedures

    International Nuclear Information System (INIS)

    Lyon, W.S.

    1982-01-01

    The modern counting instrumentation has largely obviated the need for separation processes in the radiochemical analysis but problems in low-level radioactivity measurement, environmental-type analyses, and special situations caused in the last years a renaissance of the need for separation techniques. Most of the radiochemical procedures, based on the classic works of the Manhattan Project chemists of the 1940's, were published in the National Nuclear Energy Series (NNES). Improvements such as new solvent extraction and ion exchange separations have been added to these methods throughout the years. Recently the Los Alamos Group have reissued their collected Radiochemical Procedures containing a short summary and review of basic inorganic chemistry - 'Chemistry of the Elements on the Basis of Electronic Configuration'. (A.L.)

  2. Procedures Manual: A Guide to Uniform Grant and Contract Management Standards and The Common Rule for Uniform Administrative Requirements for Grants and Cooperative Agreements to State and Local Governments.

    Science.gov (United States)

    Conable, Sharon R.

    This manual has been compiled to provide consistent grant application and administrative procedures for state agencies which award grants or contracts to local governments. It provides a conceptual framework of information concerning the reporting, financial, contractual, and auditing requirements for recipients of Texas State Library grants…

  3. Planning for exercises of the Federal Radiological Monitoring and Assessment Plan

    International Nuclear Information System (INIS)

    Adler, M.V.

    1985-11-01

    This report is to be used in planning radiological emergency exercises to test the Federal Radiological Monitoring and Assessment Plan (FRMAP). Although developed for this specific purpose, the document also contains material that may be useful for planning other types of exercises. This report describes the types of exercises that might be used, the steps in planning and conducting the exercises, and the special considerations required for exercises to test the FRMAP. FRMAP exercises typically involve several federal and state agencies. General and specific objectives that could guide these exercises, as well as the possible activities of all the participants - players, controllers, and evaluators - are discussed. The resources that each participating federal agency might provide during an exercise are listed

  4. Acute exercise and motor memory consolidation

    DEFF Research Database (Denmark)

    Thomas, Richard; Beck, Mikkel Malling; Lind, Rune Rasmussen

    2016-01-01

    High intensity aerobic exercise amplifies offline gains in procedural memory acquired during motor practice. This effect seems to be evident when exercise is placed immediately after acquisition, during the first stages of memory consolidation, but the importance of temporal proximity...... of the exercise bout used to stimulate improvements in procedural memory is unknown. The effects of three different temporal placements of high intensity exercise were investigated following visuomotor skill acquisition on the retention of motor memory in 48 young (24.0 ± 2.5 yrs), healthy male subjects randomly...... assigned to one of four groups either performing a high intensity (90% Maximal Power Output) exercise bout at 20 min (EX90), 1 h (EX90+1), 2 h (EX90+2) after acquisition or rested (CON). Retention tests were performed at 1 d (R1) and 7 d (R7). At R1 changes in performance scores after acquisition were...

  5. Factors Influencing Amount of Weekly Exercise Time in Colorectal Cancer Survivors.

    Science.gov (United States)

    Chou, Yun-Jen; Lai, Yeur-Hur; Lin, Been-Ren; Liang, Jin-Tung; Shun, Shiow-Ching

    Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.

  6. 42 CFR 405.1202 - Expedited determination procedures.

    Science.gov (United States)

    2010-10-01

    ... Reconsiderations of Provider Service Terminations, and Procedures for Inpatient Hospital Discharges § 405.1202... exercise the right to an expedited determination must submit a request for a determination to the QIO in...

  7. 75 FR 12804 - Withdrawal of Regulatory Guide 8.6

    Science.gov (United States)

    2010-03-17

    ... ``Regulatory Guides'' in the NRC's Electronic Reading Room at http://www.nrc.gov/reading-rm/doc-collections... NUCLEAR REGULATORY COMMISSION [NRC-2010-0103] Withdrawal of Regulatory Guide 8.6 AGENCY: Nuclear Regulatory Commission. ACTION: Withdrawal of Regulatory Guide 8.6, ``Standard Test Procedure for Geiger-M...

  8. Regulations and guides for nuclear power plants

    International Nuclear Information System (INIS)

    1984-01-01

    The purpose of the present Guide is to provide information, guidance and recommendations to assist the regulatory body of a Member State in establishing its own regulations and guides. It discusses the purpose, the method and procedure of establishment, and the content and legal status of these documents, and it explains how to use the Codes of Practice and Safety Guides issued by the IAEA under the Nuclear Safety Standards (NUSS) programme. Certain aspects of how to use other international standards and appropriate regulations and guides from other countries are discussed

  9. EPRI's pumped storage planning and evaluation guide

    International Nuclear Information System (INIS)

    Chen, H.H.

    1991-01-01

    EPRI's Hydropower Pumped Storage Planning and Evaluation Guide was published in 1990. The Guide provides step-by-step procedures to: evaluate pumped-storage operation in a utility system, establish site development concept, estimate capital cost, and conduct economic analysis. The Guide provides a floppy diskette containing a production costing model simulating the chronologic operation of pumped storage in a generating system. It provides a series of estimating curves for the preparation of capital cost estimates. The paper presents how the Guide was organized and prepared, and highlights its contents

  10. THE RARE CAUSE OF THE ANAPHYLAXIS: EXERCISE

    Directory of Open Access Journals (Sweden)

    Sami OZTURK

    2005-02-01

    Full Text Available Introduction: Exercise-induced anaphylaxis (EIA is a rare syndrome. We described two patients experienced anaphylaxis after exercise. Case 1: A 24 -year-old male patient, recruited to army as a private 6 months ago. The medical history was suggestive of an anaphylactic reaction which was developed about 30 minute after a vigorous exercise. Case 2: A 42-year old female, was referred to our clinic because of the recurrent episodes of generalized pruritus, nausea, vomiting, swelling on extremities and breathing difficultly. She was experienced with symptoms after moderate exercises which were performed to losing weight. Evaluation: The complete diagnostic procedures including skin tests with foods and inhalant allergens were performed. In Case 2, positive skin test results were detected in food allergens (apricot, tomato, vanilla and inhalant allergens (house-dust mites and cockroach. Management: In Case 1, he was first experienced EIA symptoms with the military training. For this reason, he exempted from vigorous exercises during his remaining compulsory military service and self-injectable epinephrine kit and antihistamine were prescribed him. In Case 2, she advised to avoid from vigorous exercises. Conclusion: EIA should be considered in cases of anaphylaxis with uncertain etiology. [TAF Prev Med Bull 2005; 4(1.000: 46-49

  11. ARGX-87: Accident Response Group Exercise, 1987: A Broken Arrow mini exercise

    International Nuclear Information System (INIS)

    Schuld, E.P.; Cruff, D.F.

    1987-07-01

    A Broken Arrow mini exercise dubbed ''Accident Response Group Exercise - 1987'' (ARGX-87) was conducted on June 1, 1987 at the Lawrence Livermore National Laboratory (LLNL) and Sandia National Laboratories, Livermore (SNLL). The exercise started at 0445 PDT with a call from the Department of Energy (DOE) - EOC in Washington, DC, to the Albuquerque Operations (AL - ) - EOC. AL, in turn, called the Laboratory off-hour emergency number (Fire Dispatcher), who called the Laboratory Emergency Duty Officer (LEDO). The LEDO then contacted the Accident Response Group (ARG) Senior Scientific Advisor. Calls were placed to assemble appropriate members of the ARG in the ALERT Center. No phone number for SNLL was available at the Albuquerque Operations EOC, so a controller injected a message to SNLL to get them involved in the exercise. The messages received at the Laboratory identified the Air Force line item weapon system involved in the accident and the accident location. As people arrived at the ALERT Center they began discussing the details of the accident. They also started working the deployment logistics and other issues. Travel arrangements for the HOT SPOT equipment and ARG personnel were made for immediate deployment to the accident site in North Dakota. The exercise was terminated at 0840 as planned. While certain procedural deficiencies were noted, the exercise was considered a valuable learning experience. The results and observations from this experience will be used to refine the operating procedures and the training program

  12. Formal Verification of Computerized Procedure with Colored Petri Nets

    International Nuclear Information System (INIS)

    Kim, Yun Goo; Shin, Yeong Cheol

    2008-01-01

    Computerized Procedure System (CPS) supports nuclear power plant operators in performing operating procedures which are instructions to guide in monitoring, decision making and controlling nuclear power plants. Computerized Procedure (CP) should be loaded to CPS. Due to its execution characteristic, computerized procedure acts like a software in CPS. For example, procedure flows are determined by operator evaluation and computerized procedure logic which are pre-defined. So the verification of Computerized Procedure logic and execution flow is needed before computerized procedures are installed in the system. Formal verification methods are proposed and the modeling of operating procedures with Coloured Petri Nets(CP-nets) is presented

  13. Comparative analysis of diagnostic accuracy of different brain biopsy procedures

    OpenAIRE

    Jain Deepali; Sharma Mehar; Sarkar Chitra; Gupta Deepak; Singh Manmohan; Mahapatra A

    2006-01-01

    Background: Image-guided procedures such as computed tomography (CT) guided, neuronavigator-guided and ultrasound-guided methods can assist neurosurgeons in localizing the intraparenchymal lesion of the brain. However, despite improvements in the imaging techniques, an accurate diagnosis of intrinsic lesion requires tissue sampling and histological verification. Aims: The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different s...

  14. Ultrasound- and MRI-Guided Prostate Biopsy

    Science.gov (United States)

    ... assistance of a nurse and an MR imaging technologist. As with the ultrasound procedure, you may receive antibiotics, sedatives and pain medication before the biopsy. The MRI-guided procedure may use contrast ... A nurse or technologist will insert an intravenous (IV) catheter into a ...

  15. Food Products Procurement, Receiving and Storage Guide.

    Science.gov (United States)

    Kansas Association of School Business Officials, Haysville.

    This guide is intended as a resource document for the beginner in food services and food purchasing. The publication is divided topically by (1) purchasing procedures, (2) specifications and evaluation, (3) sources for purchasing food products, (4) storage of food products and inventory procedures, (5) type of food service management, and (6)…

  16. Plumbing. Building Maintenance. Module III. Instructor's Guide.

    Science.gov (United States)

    Brunk, Art

    This curriculum guide, one of six modules keyed to the building maintenance competency profile developed by industry and education professionals, provides materials for a plumbing procedures unit of seven lessons. Lesson topics are: safety procedures, joining pipes, water systems, fixtures and appliances, maintenance and repair, drainage systems,…

  17. Comparisons of Positron Emission Tomography/Computed Tomography and Ultrasound Imaging for Detection of Internal Mammary Lymph Node Metastases in Patients With Breast Cancer and Pathologic Correlation by Ultrasound-Guided Biopsy Procedures.

    Science.gov (United States)

    An, Yeong Yi; Kim, Sung Hun; Kang, Bong Joo; Lee, Ah Won

    2015-08-01

    To compare the diagnostic performance of [(18)F]fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) and ultrasound imaging (US) with pathologic results obtained by US-guided biopsy and to evaluate the role of US in detecting internal mammary lymph node (LN) metastases in patients with breast cancer. Between January 2008 and December 2012, 37 patients with breast cancer (median age, 51.4 years; range, 40-79 years) underwent US-guided biopsy for suspected internal mammary LN metastases. Medical records, radiologic images, and reports were reviewed and correlated with pathologic results. The positive internal mammary LN metastasis rate was 78.4%. All biopsies were performed safely without major complications. Only 8.1% of obtained samples were unsatisfactory. There were statistically significant differences in lesion size (P = .0002), standardized uptake value on PET/CT (P = .0015), biopsy methods (P = .002), and specimen adequacy (P = .007) between metastatic and benign groups. Of the clinical factorsreviewed, only concurrent distant metastasis was correlated with internal mammary LN metastasis (P< .0001). Sensitivities for detecting internal mammary LN metastases were 76.7%, 96.7%, and 92.9% for initial US examinations, initial US combined with second-look US for initially missed cases, and PET/CT, respectively (P= .017). In a subgroup analysis, the only significant difference found was in sensitivities between initial and combined US (P = .019). In a receiver operating characteristic curve analysis, the area under the curve for PET/CT using standardized uptake criteria (0.87) was higher than that for US using size criteria (0.83); however, this difference was not significant. Although PET/CT is the best noninvasive method for evaluating internal mammary LN metastases, US is also useful if internal mammary LN evaluation is routine during standard US surveillance of patients with breast cancer. Additionally, US-guided biopsies could be

  18. Expert Guide

    DEFF Research Database (Denmark)

    Heiselberg, Per

    , their benefits and limitations, economical feasibility and impact on energy savings, company image, comfort, productivity, building functionality and flexibility and gives guidance on design of these concepts, including integration of responsive building elements and HVAC-systems and build examples......This guide summarizes the work of Subtask B of IEA-ECBCS Annex 44 “Integrating Environmentally Responsive Elements in Buildings” and is based on the contributions from the participating countries. The publication is an official Annex report. With a focus on innovative building concepts...

  19. Dietary antioxidants and exercise.

    Science.gov (United States)

    Powers, Scott K; DeRuisseau, Keith C; Quindry, John; Hamilton, Karyn L

    2004-01-01

    Muscular exercise promotes the production of radicals and other reactive oxygen species in the working muscle. Growing evidence indicates that reactive oxygen species are responsible for exercise-induced protein oxidation and contribute to muscle fatigue. To protect against exercise-induced oxidative injury, muscle cells contain complex endogenous cellular defence mechanisms (enzymatic and non-enzymatic antioxidants) to eliminate reactive oxygen species. Furthermore, exogenous dietary antioxidants interact with endogenous antioxidants to form a cooperative network of cellular antioxidants. Knowledge that exercise-induced oxidant formation can contribute to muscle fatigue has resulted in numerous investigations examining the effects of antioxidant supplementation on human exercise performance. To date, there is limited evidence that dietary supplementation with antioxidants will improve human performance. Furthermore, it is currently unclear whether regular vigorous exercise increases the need for dietary intake of antioxidants. Clearly, additional research that analyses the antioxidant requirements of individual athletes is needed.

  20. Exercise therapy for fibromyalgia.

    Science.gov (United States)

    Busch, Angela J; Webber, Sandra C; Brachaniec, Mary; Bidonde, Julia; Bello-Haas, Vanina Dal; Danyliw, Adrienne D; Overend, Tom J; Richards, Rachel S; Sawant, Anuradha; Schachter, Candice L

    2011-10-01

    Fibromyalgia syndrome, a chronic condition typically characterized by widespread pain, nonrestorative sleep, fatigue, cognitive dysfunction, and other somatic symptoms, negatively impacts physical and emotional function and reduces quality of life. Exercise is commonly recommended in the management of people with fibromyalgia, and interest in examining exercise benefits for those with the syndrome has grown substantially over the past 25 years. Research supports aerobic and strength training to improve physical fitness and function, reduce fibromyalgia symptoms, and improve quality of life. However, other forms of exercise (e.g., tai chi, yoga, Nordic walking, vibration techniques) and lifestyle physical activity also have been investigated to determine their effects. This paper highlights findings from recent randomized controlled trials and reviews of exercise for people with fibromyalgia, and includes information regarding factors that influence response and adherence to exercise to assist clinicians with exercise and physical activity prescription decision-making to optimize health and well-being.

  1. DIABETES AND EXERCISE

    Directory of Open Access Journals (Sweden)

    Aydın BALCI

    2015-09-01

    Full Text Available Diabetes is a crucial health problem due to its incidence and serious complications. Physical inactivity is one of the risk factors associated with it. Therapeutic exercises are beneficial in the treatment and prevention of diabetes. There are several studies about the effects of exercise type and intensity on glycemic control. The exercise programs should be prepared individually after a comprehensive medical evaluation. There are some regulations to prevent acute complications before, after and during the exercises. The importance of regular exercise for public health should be pointed out and physical activity should be urged. The present review discusses issues concerning the prevention and treatment of diabetes through exercise, and the possible risks, in view of current literature.

  2. Engine Tune-up Service. Unit 6: Emission Control Systems. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 6, Emission Control Systems, available separately as CE 031 220. Focus of the exercises and pretests is inspecting, testing, and servicing emission control systems. Pretests and performance checklists are provided for each of the…

  3. Engine Tune-Up Service. Unit 3: Primary Circuit. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 3, Primary Circuit, available separately as CE 031 211. Focus of the exercises and pretests is testing the primary ignition circuit. Pretests and performance checklists are provided for each of the eight performance objectives…

  4. Engine Tune-up Service. Unit 2: Charging System. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Richardson, Roger L.; Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 2, Charging System, available separately as CE 031 208. Focus of the exercises and pretests is testing the charging system. Pretests and performance checklists are provided for each of the three performance objectives contained in…

  5. Engine Tune-up Service. Unit 4: Secondary Circuit. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Bacon, E. Miles

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 4, Secondary Circuit, available separately as CE 031 214. Focus of the exercises and pretests is testing and servicing the secondary ignition circuit. Pretests and performance checklists are provided for each of the seven…

  6. Interventional chest procedures in pregnancy.

    LENUS (Irish Health Repository)

    Morgan, Ross K

    2012-02-01

    Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

  7. Interventional chest procedures in pregnancy.

    LENUS (Irish Health Repository)

    Morgan, Ross K

    2011-03-01

    Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for which these interventions have a role are malignant and nonmalignant airway disease, pleural effusion, pneumothorax, and artificial airways. There are no data from well-designed prospective trials to guide recommendations for interventional pulmonary procedures in pregnancy. The recommendations provided in this article are based on critical review of reported case series, opinion from recognized experts, and personal observations.

  8. Guide to the declaration procedure and coding system for criteria concerning significant events related to safety, radiation protection or the environment, applicable to basic nuclear installations and the transport of radioactive materials

    International Nuclear Information System (INIS)

    Lacoste, Andre-Claude

    2005-01-01

    This guide notably contains various forms associated with the declaration of significant events, and explanations to fill them in: significant event declaration form for a basic nuclear installation, significant event declaration form for radioactive material transport, significant event report for a basic nuclear installation, significant event report for radioactive material transport, declaration criteria for significant events related to the safety of non-PWR basic nuclear installations, declaration criteria for significant events related to PWR safety, significant events declared further to events resulting in group 1 unavailability and non-compliance with technical operating specifications, declaration criteria for significant events concerning radiation protection for basic nuclear installations, declaration criteria for significant events concerning environmental protection, applicable to basic nuclear installations, and declaration criteria for significant events concerning radioactive material transport

  9. Exercise for midlife women.

    Science.gov (United States)

    Shangold, M M; Sherman, C

    1998-12-01

    Exercise is good for everyone, but it's more important than ever when you reach midlife. While regular exercise may not eliminate symptoms like hot flushes, it can improve your general well-being and increase your strength and stamina in daily life. If you want to lose fat or maintain a healthy weight, exercise is far more effective than diet alone. A physically active lifestyle, along with good nutrition and estrogen therapy, will also help protect you against heart disease, overweight, and osteoporosis.

  10. Exercise-induced rhabdomyolysis.

    Science.gov (United States)

    Lee, George

    2014-11-03

    Exercise-induced rhabdomyolysis, or exertional rhabdomyolysis (ER), is a clinical entity typically considered when someone presents with muscle stiffness, swelling, and pain out of proportion to the expected fatigue post exercise. The diagnosis is confirmed by myoglobinuria, and an elevated serum Creatinine Phosphokinase (CPK) level, usually 10 times the normal range. However, an elevation in CPK is seen in most forms of strenuous exercise, up to 20 times the upper normal range. Therefore, there is no definitive pathologic CPK cut-off. Fortunately the dreaded complication of acute renal failure is rare compared to other forms rhabdomyolysis. We review the risks, diagnosis, clinical course and treatment for exercise- induced rhabdomyolysis.

  11. University Policies and Procedures on Sexual Harassment.

    Science.gov (United States)

    McIntyre, Jerilyn S.

    Sexual harassment complaints are challenges to the abuse of power in certain kinds of communicative relationships, and sexual harassment policies and procedures are ways of defining the responsible exercise of power and providing the means to address grievances that result from irresponsible and potentially harmful uses of power in those…

  12. Demonstration and practical exercises on radiation curing technology

    International Nuclear Information System (INIS)

    Nik Ghazali Nik Salleh

    1993-01-01

    The contents are Part I : Demonstration - substrate, coating materials, experimental procedures; Part II: Practical exercises - coating and characterization, the report, testing; procedure to use i. automatic reverse roller coater, ii. flow/curtain coater; description and technical data of IST-UV irradiator (including safety precautions); low energy electron beam accelerator (Cureton) model EBC-200-20-15

  13. Demonstration and practical exercises on radiation curing technology

    Energy Technology Data Exchange (ETDEWEB)

    Nik Salleh, Nik Ghazali [Nuclear Energy Unit, Bangi, Selangor (Malaysia)

    1994-12-31

    The contents are Part I : Demonstration - substrate, coating materials, experimental procedures; Part II: Practical exercises - coating and characterization, the report, testing; procedure to use i. automatic reverse roller coater, ii. flow/curtain coater; description and technical data of IST-UV irradiator (including safety precautions); low energy electron beam accelerator (Cureton) model EBC-200-20-15.

  14. Developing Mathematical Fluency: Comparing Exercises and Rich Tasks

    Science.gov (United States)

    Foster, Colin

    2018-01-01

    Achieving fluency in important mathematical procedures is fundamental to students' mathematical development. The usual way to develop procedural fluency is to practise repetitive exercises, but is this the only effective way? This paper reports three quasi-experimental studies carried out in a total of 11 secondary schools involving altogether 528…

  15. HAL-RAR (Doppler guided haemorrhoid artery ligation with recto-anal repair) is a safe and effective procedure for haemorrhoids. Results of a prospective study after two-years follow-up.

    Science.gov (United States)

    Hoyuela, Carlos; Carvajal, Fernando; Juvany, Montserrat; Troyano, Daniel; Trias, Miquel; Martrat, Antoni; Ardid, Jordi; Obiols, Joan

    2016-04-01

    To analyse prospectively results of HAL-RAR technique by evaluating pain, perioperative complications and clinical outcome after two years followup. A prospective study design including 30 consecutive patients with haemorrhoids grade III-IV treated from June 2012. After discharge, patients received a specific questionnaire to record postoperative pain, delayed complications, evolution/disappearance of the symptoms that led to the surgical intervention (bleeding, prolapse, itching, pain and soiling). A visual analog scale (VAS) was used to measure pain. Outpatient follow-up was carried out at 7 days, and 1, 6 and 12 months and annually thereafter. Pre, intra and postoperative data (including physical examination) had been recorded prospectively. The median operating time (range) was 40 (26-60) minutes. Average hospital stay (range) was 11 (3-25) hours. No postoperative complications were observed in 29 cases (96.6%). Median follow-up was 26 (12-36) months. All the patients attended the follow-up. Mean postoperative pain was VAS = 1.7 on the seventh day and it was practically non-existent (VAS = 0.7) 1 month after the procedure. 87.5% of patients confirmed complete relief of symptoms after 30 days and 93% of patients feel free of symptoms 6 months after the procedure. No patient has experienced late complications as dyschezia, urgency, soiling or faecal incontinence. After 24 months follow-up, recurrence of bleeding and prolapse was observed in only 1 patient; 93% of patients have considered results of HAL-RAR as very good or excellent. HAL-RAR is safe and almost painless technique and it has very good results in the control of haemorrhoidal symptoms. This procedure should be considered as an effective first treatment option for haemorrhoids. Copyright © 2016 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  16. Women, 'madness' and exercise.

    Science.gov (United States)

    Hardes, Jennifer Jane

    2018-03-21

    The positive relationship between exercise and mental health is often taken for granted in today's society, despite the lack of academic literature evidencing this symbiosis. Gender is considered a significant determinant in a number of mental health diagnoses. Indeed, women are considered twice as likely as men to experience the most pervasive mental health condition, depression. Exercise for women's mental health is promoted through various macrolevel charity, as well as microlevel, campaigns that influence government healthcare policy and National Health Service guidelines. Indeed, 'exercise prescriptions' in the treatment of depression is not uncommon. Yet, this link between exercise as a treatment for women's mental health has not always been so pervasive. In fact, an examination of asylum reports and medical journals from the late 19th century highlights a significant shift in attitude towards the role of exercise in the treatment of women's emotional states and mental health. This paper specifically examines how this treatment of women's mental health through exercise has moved from what might be regarded as a focus on exercise as a 'cause' of women's mental ailments to exercise promoted as a 'cure'. Unpacking the changing medical attitudes towards exercise for women in line with larger sociopolitical and historic contexts reveals that while this shift towards exercise promotion might prima facie appear as a less essentialist view of women and their mental and physical states, it inevitably remains tied to larger policy and governance agendas. New modes of exercise 'treatment' for women's mental health are not politically neutral and, thus, what appear to emerge as forms of liberation are, in actuality, subtler forms of regulation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  17. Study guide for college algebra and trigonometry

    CERN Document Server

    Snow, James W; Shapiro, Arnold

    1981-01-01

    Study Guide for College Algebra and Trigonometry is a supplement material to the basic text, College Algebra and Trigonometry. It is written to assist the student in learning mathematics effectively.The book provides detailed solutions to exercises found in the text. Students are encouraged to use these solutions to find a way to approach a problem. The Study Guide and Solutions Manual consists of four major components: basic concepts that should be learned from each unit, what was learned upon completion of each unit, solutions to selected problems, and a short chapter quiz, including the ans

  18. Post-emergency response resources guide

    International Nuclear Information System (INIS)

    1991-07-01

    On August 28 and September 18, 1990, the States of Louisiana and Mississippi, Gulf States Utilities, five local parishes, six Federal agencies, and the American Nuclear Insurers participated in a post-emergency TABLETOP exercise in Baton Rouge, Louisiana. One of the products developed from that experience is this guide for understanding the responsibilities and obtaining resources for specific needs from the various participants, particularly those organizations within the federal government. This guide should assist state and local government organizations with identifying and obtaining those resources for the post-emergency response when theirs have been exhausted

  19. Assessment of the impact of NUC accreditation exercise on ...

    African Journals Online (AJOL)

    This is a survey research aimed at determining the impact of National Universities Commission's accreditation exercise on personnel in the business education programmes of the universities in the South-east Geopolitical Zone of Nigeria. One research question and one null hypothesis guided the study. The population ...

  20. An Exercise in Desktop Publishing: Using the "Newsroom."

    Science.gov (United States)

    Kiteka, Sebastian F.

    This guide provides a description and step-by-step instructions for the use of "Newsroom," a desktop-publishing program for the Apple II series of microcomputers produced by Springboard Software Inc. Based on the 1984 version of the program, this two-hour exercise focuses on the design and production of a newsletter with text and…

  1. Launch of the new CERN Admin e-guide

    CERN Multimedia

    Laëtitia Pedroso

    2010-01-01

    The CERN Admin e-guide is a new guide to the Organization's administrative procedures, which has been drawn up for the benefit of members of the personnel and the various administrative services alike and replaces the old "Administrative Procedures Manual". All the different procedures currently available on separate department sites will henceforth be accessible at a single website.   Home page of the new CERN Admin e-guide. The goal of creating a compendium of CERN's administrative procedures, available at a single website and accessible with a simple click of the mouse, has now been realised.  "It had become difficult to know where to find the relevant up-to-date information on administrative procedures", says Yaël Grange-Lavigne of the HR-SPS-OP Section (Organisation and Procedures), coordinator of the working group that compiled the e-guide. The team, which comprised members of the HR Department, observers from other department...

  2. Summative Mass Analysis of Algal Biomass - Integration of Analytical Procedures: Laboratory Analytical Procedure (LAP)

    Energy Technology Data Exchange (ETDEWEB)

    Laurens, Lieve M. L.

    2016-01-13

    This procedure guides the integration of laboratory analytical procedures to measure algal biomass constituents in an unambiguous manner and ultimately achieve mass balance closure for algal biomass samples. Many of these methods build on years of research in algal biomass analysis.

  3. Exercises to Improve Gait Abnormalities

    Science.gov (United States)

    ... Articles Directories Videos Resources Contact Exercises to Improve Gait Abnormalities Home » Article Categories » Exercise and Fitness Font Size: A A A A Exercises to Improve Gait Abnormalities Next Page The manner of how a ...

  4. Exercise for Your Bone Health

    Science.gov (United States)

    ... FAQs Breadcrumb Home Exercise for Your Bone Health Exercise for Your Bone Health Vital at every age ... A Complete Osteoporosis Program For Your Information Why Exercise? Like muscle, bone is living tissue that responds ...

  5. Exercise through Menopause.

    Science.gov (United States)

    Stuhr, Robyn M.

    2002-01-01

    Menopause is associated with many different health effects and symptoms. This paper explains that regular exercise can play a critical role in protecting health and battling the increased risk of cardiovascular disease, osteoporosis, pelvic floor atrophy, and joint stiffness associated with menopause. Exercise programs for menopausal women should…

  6. EXERCISE-INDUCED ASTHMA

    African Journals Online (AJOL)

    Enrique

    to a repeat bout of intense exercise within 2 hours after an initial. EIA response. In this ... advantage of athletes, if the athlete then competes following a warm-up in this .... Diagnostic and therapeutic algorithm in the work-up of the athlete with EIA. .... Avoid exercise in excessively cold Reduced responsiveness of airways.

  7. Exercises in Computational Chemistry

    DEFF Research Database (Denmark)

    Spanget-Larsen, Jens

    2016-01-01

    A selection of HyperChem© PC-exercises in computational chemistry. Answers to most questions are appended (Roskilde University 2014-16).......A selection of HyperChem© PC-exercises in computational chemistry. Answers to most questions are appended (Roskilde University 2014-16)....

  8. CT-guided stereotactic neurosurgery

    International Nuclear Information System (INIS)

    Takizawa, Takaaki; Sato, Shoju; Matsumoto, Akira; Sano, Akira; Takahashi, Kazunori; Murakami, Yuji; Ohta, Kosuke

    1985-01-01

    Brown-Roberts-Wells stereotactic instruments were used for CT guided stereotactic surgery in 54 cases (65 operations). Stereotactic biopsy was done in 9 cases and successive regional chemotherapy was done in 3 cases. Stereotactic drainage was done in 2 cases of bacterial abcess, 3 cases of cystic neoplasm and 33 cases (43 operations) of intracerebral hematoma. CT guided stereotactic procedure was valuable for the correct cannulation to the center of the cavity. We tried to utilize CT image for the selection of targets for stereotactic functional neurosurgical procedures in 6 cases. In the cases of thalamotomy, the information derived from CT made the operation safer than that by contrast ventriculography alone. In all cases of electrode implantation for deep brain stimulation, accurate and precise electrode placement was achieved from CT images alone. This rapid and easy surgical technique was useful also for poor risk patients. (author)

  9. Value of senior level exercises in radiation protection

    International Nuclear Information System (INIS)

    Dickson, Howard; Landry, Steven

    2008-01-01

    The United States Department of Homeland Security (DHS) maintains the National Exercise Program (NEP) as one of the mechanisms to evaluate the preparation of the U.S. government (USG) to execute the full range of capabilities and responsibilities. The NEP is a national, interagency-wide program that prioritizes, focuses, and coordinates national security and homeland security preparedness-related exercise activities. Results from these exercises provide information that informs the policy process and ultimately improves the government's preparedness posture. Exercises are the primary tool available for evaluating the capability to perform in a crisis or emergency. The principal focus of the NEP is a program of capabilities-based exercises designed for the participation of heads of Federal Departments and Agencies and other top officials to examine and evaluate emerging national-level policy issues. TOPOFF (referring to 'Top Officials') is a national, biennial domestic counter terrorism exercise series consisting of a two-year planning endeavor, involving experts at all levels of government and the private sector. The TOPOFF 4 Full Scale Exercise (FSE), focused on radiological dispersal devices (RDD), was conducted in October 2007. The TOPOFF series of exercises are an important component of national preparedness, helping to build an integrated federal, state, territorial, local, and private sector capability to prevent terrorist attacks, and rapidly and effectively respond to, and recover from, any terrorist attack or major disaster that does occur. The full-scale exercises offer agencies and jurisdictions a way to test their plans and skills in a real-time, realistic environment and to gain the in-depth knowledge that only experience can provide. Participants also exercise prevention and intelligence gathering functions, which are critical to preventing terrorist attacks. Lessons learned from these exercises provide valuable insights to guide future planning for

  10. Pretreatment procedures

    International Nuclear Information System (INIS)

    Anon.

    1989-01-01

    It is frequently in the patient's best interest that radiation treatments are initiated soon after the decision to treat is made. However, it is essential to good radiation therapy that the patient's treatment course be planned and beam-modifying devices be fabricated with utmost care prior to treatment. The objectives of the treatment, along with the treatment parameters and techniques necessary to achieve these objectives, must be discussed prior to initiating planning procedures. Determination of the target volume is made by the radiation oncologist; this is based on knowledge of the history of the tumor, the patterns of spread of the disease, and on diagnostic findings during the work-up of each patient. It is then necessary to obtain several measurements of the patient and also to identify the position of the target volume and of adjacent normal organs with respect to known external skin marks before the actual treatment planning is begun. Such localization can be done through several methods. The two most commonly used methods are radiographic and computed tomography (CT), both of which are discussed in this chapter. The measurements often include contours of the patient's external surface, usually in the axial plane of the central axis of the beam, and often in multiple levels within the region to be treated. Three dimensional localization and treatment planning requires thorough understanding of geometry as well as of patient positioning and immobilization. This chapter attempts to clarify some of these complicated but essential preparations for treatment

  11. Forthcoming indefinite contract review procedure

    CERN Multimedia

    Human Resources Department

    2011-01-01

    The vacancy notices for posts opened with a view to the award of an indefinite contract will be published in early April 2011. In the meantime, the list of posts to be opened this spring is available at the following address: Indefinite contract posts - spring 2011 A second exercise will take place in autumn 2011 and, as of 2012, the indefinite contract award procedure will only be held once a year, in autumn. For more information please consult: https://hr-recruit.web.cern.ch/hr-recruit/staff/IndefiniteContracts.asp  

  12. Fat utilization during exercise

    DEFF Research Database (Denmark)

    Helge, Jørn Wulff; Watt, Peter W.; Richter, Erik

    2001-01-01

    1. This study was carried out to test the hypothesis that the greater fat oxidation observed during exercise after adaptation to a high-fat diet is due to an increased uptake of fat originating from the bloodstream. 2. Of 13 male untrained subjects, seven consumed a fat-rich diet (62 % fat, 21...... % carbohydrate) and six consumed a carbohydrate-rich diet (20 % fat, 65 % carbohydrate). After 7 weeks of training and diet, 60 min of bicycle exercise was performed at 68 +/- 1 % of maximum oxygen uptake. During exercise [1-(13)C]palmitate was infused, arterial and venous femoral blood samples were collected......, and blood flow was determined by the thermodilution technique. Muscle biopsy samples were taken from the vastus lateralis muscle before and after exercise. 3. During exercise, the respiratory exchange ratio was significantly lower in subjects consuming the fat-rich diet (0.86 +/- 0.01, mean +/- S.E.M.) than...

  13. Compliance with physical exercise

    DEFF Research Database (Denmark)

    Gram, Anne Sofie; Bønnelycke, Julie; Rosenkilde Larsen, Mads

    2014-01-01

    Aims: Sixty-one healthy, sedentary, moderately overweight young men participated in a randomised controlled trial to examine the effects of two different doses of endurance exercise on health behaviour and exercise compliance. Methods: Participants were randomised to a sedentary control group......), a post hoc thematic analysis was conducted to connect qualitative and quantitative data in a joint analysis. Results: Of the subjects interviewed, exercise compliance expressed as 95% CI was [96.8; 103%] in the MOD group and [82.9; 99.6%] in the HIGH group. The different doses of daily exercise equally...... or quantitative methodology alone. The preconditions of the TBP were fulfilled, and it represents a methodological model to explain the high degree of compliance and motivation to exercise....

  14. Exercise and reproductive dysfunction.

    Science.gov (United States)

    Chen, E C; Brzyski, R G

    1999-01-01

    To provide an overview of our current understanding of exercise-induced reproductive dysfunction and an approach to its evaluation and management. A MEDLINE search was performed to review all articles with title words related to menstrual dysfunction, amenorrhea, oligomenorrhea, exercise, and athletic activities from 1966 to 1998. The pathophysiology, proposed mechanisms, clinical manifestations, evaluation, and management of exercise-associated reproductive dysfunction were compiled. Exercise-induced menstrual irregularity appears to be multifactorial in origin and remains a diagnosis of exclusion. The underlying mechanisms are mainly speculative. Clinical manifestations range from luteal phase deficiency to anovulation, amenorrhea, and even delayed menarche. Evaluation should include a thorough history and a complete physical plus pelvic examination. Most cases are reversible with dietary and exercise modifications. Hormonal replacement in cases of a prolonged hypoestrogenic state with evidence of increased bone loss is recommended, although the long-term consequences of prolonged hormonal deficiency are ill-defined.

  15. Galois theory through exercises

    CERN Document Server

    Brzeziński, Juliusz

    2018-01-01

    This textbook offers a unique introduction to classical Galois theory through many concrete examples and exercises of varying difficulty (including computer-assisted exercises). In addition to covering standard material, the book explores topics related to classical problems such as Galois’ theorem on solvable groups of polynomial equations of prime degrees, Nagell's proof of non-solvability by radicals of quintic equations, Tschirnhausen's transformations, lunes of Hippocrates, and Galois' resolvents. Topics related to open conjectures are also discussed, including exercises related to the inverse Galois problem and cyclotomic fields. The author presents proofs of theorems, historical comments and useful references alongside the exercises, providing readers with a well-rounded introduction to the subject and a gateway to further reading. A valuable reference and a rich source of exercises with sample solutions, this book will be useful to both students and lecturers. Its original concept makes it particula...

  16. MR-guided lumbar sympathicolysis

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, Claudius W.; Schott, Ulrich G.; Pereira, Philippe L.; Truebenbach, Jochen; Claussen, Claus D.; Duda, Stephan H. [Department of Diagnostic Radiology, University of Tuebingen (Germany); Schneider, Wilke [Department of Vascular Surgery, University of Tuebingen (Germany)

    2002-06-01

    The aim of this study was to demonstrate the feasibility of MR-guided lumbar sympathicolysis (LSL) in a non-selected patient population. One hundred one MR-guided LSL procedures were performed in 89 patients according to Haaga's technique using a horizontally open clinical MR system (0.2 T) and non-ferromagnetic 20-G cannulas (neurolysis, n=93; blockade, n=8). Only gradient-recalled sequences in either single or multislice mode [fast imaging with steady-state precession (FISP) and fast low-angle shot] were applied for anatomical survey and needle guiding. Bupivacaine injection was monitored with MR fluoroscopically. Fluid distribution was subsequently documented in a CT scan in 65 patients. Ninety-one LSL procedures could be successfully completed. Ten patients were not treated using MR due to patient inconvenience, severe motion artifacts (n=4 each), excessive spondylophytes, and retroperitoneal hematoma (n=1 each). One case of ureteral necrosis occurred. Motion artifacts were rated less severe in single-slice FISP sequences and in obese patients. An average of 3.48 sequence measurements were required for definitive needle placement. Average table time was 32.3 min. An MR-guided LSL is feasible and can be performed with acceptable safety and time effort. It can be recommended for repeated sympathetic blockades in younger patients to avoid cumulative irradiation associated with CT guidance. (orig.)

  17. MR-guided lumbar sympathicolysis

    International Nuclear Information System (INIS)

    Koenig, Claudius W.; Schott, Ulrich G.; Pereira, Philippe L.; Truebenbach, Jochen; Claussen, Claus D.; Duda, Stephan H.; Schneider, Wilke

    2002-01-01

    The aim of this study was to demonstrate the feasibility of MR-guided lumbar sympathicolysis (LSL) in a non-selected patient population. One hundred one MR-guided LSL procedures were performed in 89 patients according to Haaga's technique using a horizontally open clinical MR system (0.2 T) and non-ferromagnetic 20-G cannulas (neurolysis, n=93; blockade, n=8). Only gradient-recalled sequences in either single or multislice mode [fast imaging with steady-state precession (FISP) and fast low-angle shot] were applied for anatomical survey and needle guiding. Bupivacaine injection was monitored with MR fluoroscopically. Fluid distribution was subsequently documented in a CT scan in 65 patients. Ninety-one LSL procedures could be successfully completed. Ten patients were not treated using MR due to patient inconvenience, severe motion artifacts (n=4 each), excessive spondylophytes, and retroperitoneal hematoma (n=1 each). One case of ureteral necrosis occurred. Motion artifacts were rated less severe in single-slice FISP sequences and in obese patients. An average of 3.48 sequence measurements were required for definitive needle placement. Average table time was 32.3 min. An MR-guided LSL is feasible and can be performed with acceptable safety and time effort. It can be recommended for repeated sympathetic blockades in younger patients to avoid cumulative irradiation associated with CT guidance. (orig.)

  18. Image guided percutaneous splenic interventions

    International Nuclear Information System (INIS)

    Kang, Mandeep; Kalra, Naveen; Gulati, Madhu; Lal, Anupam; Kochhar, Rohit; Rajwanshi, Arvind

    2007-01-01

    Aim: The objective of this study is to evaluate the efficacy and safety of image-guided percutaneous splenic interventions as diagnostic or therapeutic procedures. Materials and methods: We performed a retrospective review of our interventional records from July 2001 to June 2006. Ninety-five image-guided percutaneous splenic interventions were performed after informed consent in 89 patients: 64 men and 25 women who ranged in age from 5 months to 71 years (mean, 38.4 years) under ultrasound (n = 93) or CT (n = 2) guidance. The procedures performed were fine needle aspiration biopsy of focal splenic lesions (n = 78) and aspiration (n = 10) or percutaneous catheter drainage of a splenic abscess (n = 7). Results: Splenic fine needle aspiration biopsy was successful in 62 (83.78%) of 74 patients with benign lesions diagnosed in 43 (58.1%) and malignancy in 19 (25.67%) patients. The most common pathologies included tuberculosis (26 patients, 35.13%) and lymphoma (14 patients, 18.91%). Therapeutic aspiration or pigtail catheter drainage was successful in all (100%) patients. There were no major complications. Conclusions: Image-guided splenic fine needle aspiration biopsy is a safe and accurate technique that can provide a definitive diagnosis in most patients with focal lesions in the spleen. This study also suggests that image-guided percutaneous aspiration or catheter drainage of splenic abscesses is a safe and effective alternative to surgery

  19. Guide to Geometric Algebra in Practice

    CERN Document Server

    Dorst, Leo

    2011-01-01

    This highly practical "Guide to Geometric Algebra in Practice" reviews algebraic techniques for geometrical problems in computer science and engineering, and the relationships between them. The topics covered range from powerful new theoretical developments, to successful applications, and the development of new software and hardware tools. This title: provides hands-on review exercises throughout the book, together with helpful chapter summaries; presents a concise introductory tutorial to conformal geometric algebra (CGA) in the appendices; examines the application of CGA for the d

  20. Alarm management a comprehensive guide

    CERN Document Server

    Hollifield, Bill R

    2011-01-01

    In this second edition, Alarm Management: A Comprehensive Guide, various problems of alarm systems are covered with precise guidance on how they come about and how to effectively correct them. It is written by individuals with vast experience in the different plants, processes, and environments requiring effective alarm management. The second edition is filled with good examples and explanations of procedures, with practical lists and tips on how one should proceed. It is based on hundreds of successful projects.

  1. Using implicit attitudes of exercise importance to predict explicit exercise dependence symptoms and exercise behaviors.

    Science.gov (United States)

    Forrest, Lauren N; Smith, April R; Fussner, Lauren M; Dodd, Dorian R; Clerkin, Elise M

    2016-01-01

    "Fast" (i.e., implicit) processing is relatively automatic; "slow" (i.e., explicit) processing is relatively controlled and can override automatic processing. These different processing types often produce different responses that uniquely predict behaviors. In the present study, we tested if explicit, self-reported symptoms of exercise dependence and an implicit association of exercise as important predicted exercise behaviors and change in problematic exercise attitudes. We assessed implicit attitudes of exercise importance and self-reported symptoms of exercise dependence at Time 1. Participants reported daily exercise behaviors for approximately one month, and then completed a Time 2 assessment of self-reported exercise dependence symptoms. Undergraduate males and females (Time 1, N = 93; Time 2, N = 74) tracked daily exercise behaviors for one month and completed an Implicit Association Test assessing implicit exercise importance and subscales of the Exercise Dependence Questionnaire (EDQ) assessing exercise dependence symptoms. Implicit attitudes of exercise importance and Time 1 EDQ scores predicted Time 2 EDQ scores. Further, implicit exercise importance and Time 1 EDQ scores predicted daily exercise intensity while Time 1 EDQ scores predicted the amount of days exercised. Implicit and explicit processing appear to uniquely predict exercise behaviors and attitudes. Given that different implicit and explicit processes may drive certain exercise factors (e.g., intensity and frequency, respectively), these behaviors may contribute to different aspects of exercise dependence.

  2. Therapeutic exercises for the control of temporomandibular disorders

    Directory of Open Access Journals (Sweden)

    Alberto da Rocha Moraes

    2013-10-01

    Full Text Available INTRODUCTION: Temporomandibular disorder (TMD is a multifactorial disease. For this reason, it is difficult to obtain an accurate and correct diagnosis. In this context, conservative treatments, including therapeutic exercises classified as stretching, relaxation, coordination, strengthening and endurance, are oftentimes prescribed. OBJECTIVE: Thus, the aim of the present article was to conduct a literature review concerning the types of exercises available and the efficacy for the treatment of muscular TMD. METHODS: The review included researches carried out between 2000 and 2010, indexed on Web of Science, PubMed, LILACS and BBO. Moreover, the following keywords were used: Exercise, physical therapy, facial pain, myofascial pain syndrome, and temporomandibular joint dysfunction syndrome. Studies that did not consider the subject "TMD and exercises", used post-surgery exercises and did not use validated criteria for the diagnosis of TMD (RDC/TMD were not included. RESULTS: The results comprised seven articles which proved therapeutic exercises to be effective for the treatment of muscular TMD. However, these studies are seen as limited, since therapeutic exercises were not applied alone, but in association with other conservative procedures. In addition, they present some drawbacks such as: Small samples, lack of control group and no detailed exercise description which should have included intensity, repetition, frequency and duration. CONCLUSION: Although therapeutic exercises are considered effective in the management of muscular TMD, the development of randomized clinical trials is necessary, since many existing studies are still based on the clinical experience of professionals.

  3. Habitual exercise instigation (vs. execution) predicts healthy adults' exercise frequency.

    Science.gov (United States)

    Phillips, L Alison; Gardner, Benjamin

    2016-01-01

    Habit is thought to be conducive to health behavior maintenance, because habits prompt behavior with minimal cognitive resources. The precise role of habit in determining complex behavioral sequences, such as exercise, has been underresearched. It is possible that the habit process may initiate a behavioral sequence (instigation habit) or that, after instigation, movement through the sequence is automated (execution habit). We hypothesized that exercise instigation habit can be empirically distinguished from exercise execution habit and that instigation habit strength is most predictive of future exercise and reflective of longitudinal exercise behavior change. Further, we evaluated whether patterned exercise action-that is, engaging in the same exercise actions from session to session-can be distinct from exercise execution habit. Healthy adults (N = 123) rated their exercise instigation and execution habit strengths, patterned exercise actions, and exercise frequency in baseline and 1-month follow-up surveys. Participants reported exercise engagement via electronic daily diaries for 1 month. Hypotheses were tested with regression analyses and repeated-measures analyses of variance. Exercise instigation habit strength was the only unique predictor of exercise frequency. Frequency profiles (change from high to low or low to high, no change high, no change low) were associated with changes in instigation habit but not with execution habit or patterned exercise action. Results suggest that the separable components of exercise sessions may be more or less automatic, and they point to the importance of developing instigation habit for establishing frequent exercise. (c) 2015 APA, all rights reserved).

  4. Hot spot exercise: 1975 (HSX-75)

    International Nuclear Information System (INIS)

    Trolan, R.T.; Wilson, R.L.; Jessen, F.W.

    1976-01-01

    A special unannounced exercise, called HOT SPOT Exercise--1975 (HSX-75), was prepared to test the general capability of the LLL ALERT Program to activate and deploy the LLL and Sandia Laboratory, Livermore (SLL) component of the ERDA/ARG. The exercise activities were limited to the LLL facilities in Livermore and the Site 300 explosive test facility located approximately 15 miles southeast of Livermore. The exercise simulated an accident at a U.S. Army storage facility (Site 300). The simulated accident involved two LLL designed weapons (W-70). One weapon was dropped during unloading operations and ignited the gas tank of the weapon transporter. The subsequent fire caused a low-order detonation of the high explosive component. The fire caused dispersal of fissile material downwind from the site. A second weapon was damaged in the explosion by fragments from the first weapon. The extent of damage to the second weapon was initially unknown. The exercise was conducted on September 23, 1975. A complete description of the specific nature of the simulated accident is contained in the scenario. Umpires were assigned to evaluate and subsequently report on the effectiveness of the response. All test objectives were accomplished. The following appendices are included: operational safety procedures, photographs and site map, HOT SPOT equipment, atmospheric release advisory capability, personnel list, chronology of events, and critique comments

  5. Radiological field exercises for forensic investigators. Technical memorandum

    International Nuclear Information System (INIS)

    Larsson, C.L.; Clement, C.; Estan, D.; McDiarmid, C.; Tessier, M.

    2006-06-01

    A series of tabletop and field exercises were designed and executed to test traditional forensic investigation procedures in a crime scene with radioactive material present. This allowed for specific training needs of forensic identification specialists to be identified and revised procedures to be drafted. Two scenarios were exercised, first as tabletop discussions with the Royal Canadian Mounted Police (RCMP), the Canadian Nuclear Safety Commission (CNSC), and DRDC Ottawa, and then as field exercises with the participation of the RCMP and Ottawa Police Services (OPS) forensic investigators. These exercises produced a number of lessons learned with regard to protocols for forensic investigators and led to the development of a one-page fact sheet on performing forensic identification tasks in a radiation environment. (author)

  6. Mathematics for physicists and engineers fundamentals and interactive study guide

    CERN Document Server

    Weltner, Klaus; Weber, Wolfgang J; Schuster, Peter; Grosjean, Jean

    2014-01-01

    This textbook offers an accessible and highly approved approach which is characterized by the combination of the textbook with a detailed study guide available online at our repository extras.springer.com. This study guide divides the whole learning task into small units which the student is very likely to master successfully. Thus he or she is asked to read and study a limited section of the textbook and to return to the study guide afterwards. Working with the study guide his or her learning results are controlled, monitored and deepened by graded questions, exercises, repetitions and finally by problems and applications of the content studied. Since the degree of difficulties is slowly rising the students gain confidence and experience their own progress in mathematical competence thus fostering motivation. Furthermore in case of learning difficulties he or she is given supplementary explanations and in case of individual needs supplementary exercises and applications. So the sequence of the studies is ind...

  7. Human Reliability Analysis For Computerized Procedures

    International Nuclear Information System (INIS)

    Boring, Ronald L.; Gertman, David I.; Le Blanc, Katya

    2011-01-01

    This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

  8. Technical innovation: Wire guided ductography

    International Nuclear Information System (INIS)

    Aslam, Muhammad Ovais; Ramadan, Salwa; Al-Adwani, Muneera

    2012-01-01

    To introduce an easy and improved technique for performing ductography using inexpensive easily available intravenous cannula. Guide wire: Prolene/Surgipro 3-0 (Polypropylene mono filament non-absorbable surgical suture). A plastic 26 G intravenous cannula. Disposable syringe 2 ml. Non-ionic contrast (low density like Omnipaque 240 mg I/I). The guide wire (Prolene 3-0) is introduced into the orifice of the duct heaving discharge and 26 G intravenous plastic cannula is then passed over the guide wire. The cannula is advanced in the duct over guide wire by spinning around it. When the cannula is in place the guide wire is removed. Any air bubbles present in the hub of the cannula can be displaced by filling the hub from bottom upwards with needle attached to contrast filled syringe. 0.2–0.4 ml non-ionic contrast is gently injected. Injection is stopped if the patient has pain or burning. Magnified cranio-caudal view is obtained with cannula tapped in place and gentle compression is applied with the patient sitting. If duct filling is satisfactory a 90* lateral view is obtained. A successful adaptation of the technique for performing ductography is presented. The materials required for the technique are easily available in most radiology departments and are inexpensive, thus making the procedure comfortable for the patient and radiologist with considerable cost effectiveness.

  9. COATING ALTERNATIVES GUIDE (CAGE) USER'S GUIDE

    Science.gov (United States)

    The guide provides instructions for using the Coating Alternatives GuidE (CAGE) software program, version 1.0. It assumes that the user is familiar with the fundamentals of operating an IBM-compatible personal computer (PC) under the Microsoft disk operating system (MS-DOS). CAGE...

  10. Sugars, exercise and health.

    Science.gov (United States)

    Codella, Roberto; Terruzzi, Ileana; Luzi, Livio

    2017-12-15

    There is a direct link between a variety of addictions and mood states to which exercise could be relieving. Sugar addiction has been recently counted as another binge/compulsive/addictive eating behavior, differently induced, leading to a high-significant health problem. Regularly exercising at moderate intensity has been shown to efficiently and positively impact upon physiological imbalances caused by several morbid conditions, including affective disorders. Even in a wider set of physchiatric diseases, physical exercise has been prescribed as a complementary therapeutic strategy. A comprehensive literature search was carried out in the Cochrane Library and MEDLINE databases (search terms: sugar addiction, food craving, exercise therapy, training, physical fitness, physical activity, rehabilitation and aerobic). Seeking high-sugar diets, also in a reward- or craving-addiction fashion, can generate drastic metabolic derangements, often interpolated with affective disorders, for which exercise may represent a valuable, universal, non-pharmachological barrier. More research in humans is needed to confirm potential exercise-mechanisms that may break the bond between sugar over-consumption and affective disorders. The purpose of this review is to address the importance of physical exercise in reversing the gloomy scenario of unhealthy diets and sedentary lifestyles in our modern society. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. EXERCISE DURING PREGNANCY

    Directory of Open Access Journals (Sweden)

    Zrna Agačević

    2011-03-01

    Full Text Available Exercise has become a vital part of many women's lives. However, theoretic concerns have been raised about the safety of some forms of exercise during pregnancy. Because of the physiologic changes associated with pregnancy, as well as the hemodynamic response to exercise, some precautions should be observed. The physician should screen for any contraindications to exercise and encourage patients to avoid overly vigorous activity, especially in the third trimester, when most pregnant women have a decreased tolerance for weight-bearing exercise. Adequate hydration and appropriate ventilation are important in preventing the possible teratogenic effects of overheating. Pregnant women should avoid exercise that involves the risk of abdominal trauma, falls or excessive joint stress, as in contact sports and vigorous racquet sports. In the absence of any obstetric or medical complications, most women can maintain a regular exercise regimen during pregnancy. Some studies have found a greater sense of well-being, shorter labor and fewer obstetric interventions in physically wellconditioned women as compared with other women.

  12. Construction of group exercise sessions in geriatric inpatient rehabilitation.

    Science.gov (United States)

    Wallin, Marjo; Talvitie, Ulla; Cattan, Mima; Karppi, Sirkka-Liisa

    2008-01-01

    There is little knowledge about the ways geriatric physiotherapy is being carried out in practice and about the situational construction of formal policies for promoting physical activity. This article examines how professional physiotherapists and frail community-dwelling older adults as their clients use talk and action to construct a group exercise session in an inpatient rehabilitation setting in Finland. The analysis of 7 group exercise sessions with a total of 52 clients and 9 professional physiotherapists revealed 3 different practitioner approaches, which served different functions in older adults' empowerment and lifestyle activity change. The highly structured approach favored taciturn physical performances completed independently and successfully by frail older adults. The guided exercise approach with individualized guidance encouraged occasional coconstruction of shared understanding of learning the exercises. The circuit training approach facilitated occasional self-regulation by the clients. The results of this study indicate that a combination of different approaches is required to address the multifaceted needs of heterogeneous frail older adults.

  13. [Chronic fatigue syndrome--exercise and physical activity].

    Science.gov (United States)

    Greenberg, Shai; Frid, Mordechai

    2006-04-01

    One of the major symptoms of chronic fatigue syndrome (CFS) is reduced exercise and functional capacity and increased fatigue symptoms following physical effort. A review of the literature indicates that patients that suffer from CFS are characterized by: low aerobic capacity, higher heart rate during sub-maximal exercise, higher subjective effort prescription, reduced muscle strength, and prolonged recovery period. Although several symptoms are a result of lack of physical activity, several mechanisms were suggested to explain those symptoms: pathological heart rate control, reduced aerobic metabolic capacity, reduced blood supply to the working muscles and nerve system dysfunction. Participating in guided exercise programs was found to be the most effective treatment in improving exercise and functional capacity, reducing fatigue syndromes and improving patients' daily function.

  14. THE ETHICS OF SCIENTIFIC RESEARCH (WITH PARTICULAR EMPHASIS ON EXERCISE AND MOVEMENT SCIENCE (English translated version

    Directory of Open Access Journals (Sweden)

    Luis Fernando Aragón-Vargas

    2015-12-01

    Full Text Available This paper reviews how we arrived at the current state of affairs in the ethical practice of scientific research, discussing some issues that are particularly pertinent to the exercise scientist. The paper focuses on two major areas of ethics in science. The ethical principles for biomedical research involving human subjects are presented and discussed using the three basic principles from the Belmont Report (autonomy, beneficence, and justice as a guide. The ethical presentation and publication of data are discussed as an update or expanded comment on the ten topics covered by Roy Shephard in his Ethics in Exercise Science Research paper from 2002. The manuscript closes with a reflection on personal responsibility and its importance in every scientific endeavor: placing all responsibility for action on those scientists or physicians doing the experiments was not sufficient to prevent all types of human research abuses in the first half of the twentieth century. However, intricate and cumbersome external review and approval procedures generate the perception that the system should be more than enough to ensure good practices, a perception that may dangerously prevent the scientists from assuming their individual responsibility.

  15. Examining cerebral angiogenesis in response to physical exercise.

    Science.gov (United States)

    Berggren, Kiersten L; Kay, Jacob J M; Swain, Rodney A

    2014-01-01

    Capillary growth and expansion (angiogenesis) is a prerequisite for many forms of neural and behavioral plasticity. It is commonly observed in both brain and muscle of aerobically exercising animals. As such, several histological methods have been used to quantify capillary density, including perfusion with India ink, various Nissl stains, and immunohistochemistry. In this chapter, we will describe these histological procedures and describe the stereological analysis used to quantify vessel growth in response to aerobic exercise.

  16. "It's exercise or nothing": a qualitative analysis of exercise dependence

    Science.gov (United States)

    Bamber, D; Cockerill, I; Rodgers, S; Carroll, D

    2000-01-01

    Objectives—To explore, using qualitative methods, the concept of exercise dependence. Semistructured interviews were undertaken with subjects screened for exercise dependence and eating disorders. Methods—Female exercisers, four in each case, were allocated a priori to four groups: primary exercise dependent; secondary exercise dependent, where there was a coincidence of exercise dependence and an eating disorder; eating disordered; control, where there was no evidence of either exercise dependence or eating disorder. They were asked about their exercise and eating attitudes and behaviour, as well as about any history of psychological distress. Their narratives were taped, transcribed, and analysed from a social constructionist perspective using QSR NUD*IST. Results—Participants classified as primary exercise dependent either showed no evidence of exercise dependent attitudes and behaviour or, if they exhibited features of exercise dependence, displayed symptoms of an eating disorder. Only the latter reported a history of psychological distress, similar to that exhibited by women classified as secondary exercise dependent or eating disordered. For secondary exercise dependent and eating disordered women, as well as for controls, the narratives largely confirmed the a priori classification. Conclusions—Where exercise dependence was manifest, it was always in the context of an eating disorder, and it was this co-morbidity, in addition to eating disorders per se, that was associated with psychological distress. As such, these qualitative data support the concept of secondary, but not primary, exercise dependence. Key Words: exercise dependence; eating disorders; psychological distress; anorexia; bulimia PMID:11131229

  17. Performance appraisal and merit recognition exercise 2007

    CERN Multimedia

    HR Department

    2006-01-01

    The 2007 performance appraisal and merit recognition exercise will start in the usual way with annual interviews between staff and their supervisors. This year, these interviews should be held in the period from 8 January 2007 to 16 April 2007. Interconnection with the 5-yearly review, a number of modifications to the procedures relating to the performance appraisal and merit recognition are currently under study. Administrative Circular No. 26 (Procedures governing the Career Development of Staff Members) and the electronic MAPS form in EDH are being reviewed and will be available from January onwards. HR Department will shortly provide further information on this subject. Human Resources Department Tel. 73566

  18. Exercise as medicine

    DEFF Research Database (Denmark)

    Pedersen, Bente Klarlund; Saltin, Bengt

    2015-01-01

    disease, asthma, cystic fibrosis); musculo-skeletal disorders (osteoarthritis, osteoporosis, back pain, rheumatoid arthritis); and cancer. The effect of exercise therapy on disease pathogenesis and symptoms are given and the possible mechanisms of action are discussed. We have interpreted the scientific......This review provides the reader with the up-to-date evidence-based basis for prescribing exercise as medicine in the treatment of 26 different diseases: psychiatric diseases (depression, anxiety, stress, schizophrenia); neurological diseases (dementia, Parkinson's disease, multiple sclerosis...... literature and for each disease, we provide the reader with our best advice regarding the optimal type and dose for prescription of exercise....

  19. Automation of the guiding center expansion

    Energy Technology Data Exchange (ETDEWEB)

    Burby, J. W.; Squire, J. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Qin, H. [Princeton Plasma Physics Laboratory, Princeton, New Jersey 08543 (United States); Department of Modern Physics, University of Science and Technology of China, Hefei, Anhui 230026 (China)

    2013-07-15

    We report on the use of the recently developed Mathematica package VEST (Vector Einstein Summation Tools) to automatically derive the guiding center transformation. Our Mathematica code employs a recursive procedure to derive the transformation order-by-order. This procedure has several novel features. (1) It is designed to allow the user to easily explore the guiding center transformation's numerous non-unique forms or representations. (2) The procedure proceeds entirely in cartesian position and velocity coordinates, thereby producing manifestly gyrogauge invariant results; the commonly used perpendicular unit vector fields e{sub 1},e{sub 2} are never even introduced. (3) It is easy to apply in the derivation of higher-order contributions to the guiding center transformation without fear of human error. Our code therefore stands as a useful tool for exploring subtle issues related to the physics of toroidal momentum conservation in tokamaks.

  20. Planning, conduct and principal features of NPP emergency exercises in Switzerland

    International Nuclear Information System (INIS)

    Baggenstos, M.

    1993-01-01

    Emergency exercises for each NPP are required on a regular basis by the Swiss Nuclear Safety Inspectorate. The purpose of such exercises is to train the NPP staff and the on-site emergency organization in the application of the emergency procedures and the cooperation with off-site emergency teams and public authorities. The paper discusses the purpose of the emergency exercises and experiences made especially with bilateral exercises. The responsibilities for the preparation and execution of the different emergency exercises in Switzerland are explained