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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. 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.

  3. 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.

  4. 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…

  5. 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

  6. 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

  7. 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

  8. 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.

  9. 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

  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. 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

  12. 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)

  13. 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.

  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. 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.)

  16. 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;…

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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...

  4. 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

  5. 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.

  6. 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...

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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.

  15. 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,…

  16. 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…

  17. 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.

  18. 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

  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. 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

  1. 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…

  2. 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.

  3. 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

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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

  9. 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)

  10. 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)

  11. 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...

  12. 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

  13. 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…

  14. 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

  15. 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

  16. 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.

  17. 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.

  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. 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

  20. 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

  1. 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...

  2. 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.

  3. 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.)

  4. 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...

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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…

  13. 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.

  14. 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

  15. 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

  16. 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.)

  17. 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.

  18. 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.)

  19. 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.

  20. 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.

  1. 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.

  2. 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.)

  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. 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.

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. 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

  10. 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.

  11. 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.

  12. 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.

  13. 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)

  14. 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

  15. 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.

  16. 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

  17. 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)

  18. 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…

  19. 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)

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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,…

  5. 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...

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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

  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. [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

  13. 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...

  14. 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.

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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.)

  2. 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…

  3. 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 ...

  4. 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

  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. 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...

  7. 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

  8. 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

  9. 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 ...

  10. 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.

  11. 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.

  12. 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,…

  13. 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…

  14. 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.

  15. Ultrasound-guided versus computed tomography-scan guided biopsy of pleural-based lung lesions.

    Science.gov (United States)

    Khosla, Rahul; McLean, Anna W; Smith, Jessica A

    2016-01-01

    Computed tomography (CT) guided biopsies have long been the standard technique to obtain tissue from the thoracic cavity and is traditionally performed by interventional radiologists. Ultrasound (US) guided biopsy of pleural-based lesions, performed by pulmonologists is gaining popularity and has the advantage of multi-planar imaging, real-time technique, and the absence of radiation exposure to patients. In this study, we aim to determine the diagnostic accuracy, the time to diagnosis after the initial consult placement, and the complications rates between the two different modalities. A retrospective study of electronic medical records was done of patients who underwent CT-guided biopsies and US-guided biopsies for pleural-based lesions between 2005 and 2014 and the data collected were analyzed for comparing the two groups. A total of 158 patients underwent 162 procedures during the study period. 86 patients underwent 89 procedures in the US group, and 72 patients underwent 73 procedures in the CT group. The overall yield in the US group was 82/89 (92.1%) versus 67/73 (91.8%) in the CT group (P = 1.0). Average days to the procedure was 7.2 versus 17.5 (P = 0.00001) in the US and CT group, respectively. Complication rate was higher in CT group 17/73 (23.3%) versus 1/89 (1.1%) in the US group (P guided biopsy is similar to that of CT-guided biopsy, with a lower complication rate and a significantly reduced time to the procedure.

  16. 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...

  17. 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...

  18. 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

  19. 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

  20. 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

  1. 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.

  2. BREATHING EXERCISE RELAXATION INCREASE PHSYCOLOGICAL RESPONSE PRESCHOOL CHILDREN

    Directory of Open Access Journals (Sweden)

    Yuni Sufyanti Arief

    2017-07-01

    Full Text Available Introduction: Being hospitalize will be made the children become stress. Hospitalization response of the child particularly is afraid sense regard to painfull procedure and increase to attack the invasive procedure. The aimed of this study was to describe the influence of breathing exercise relaxation technique regarded to phsycological receiving responses in the preeliminary school chidren while they were receiving invasive procedure. Method: A quasy experimental purposive sampling design was used in this study. There were 20 respondents who met to the inclusion criteria. The independent variable was the breathing exercise relaxation technique and the dependent variable was phsycological receiving responses. Data for phsylogical response were collected by using observation form then analyzed by using Wilcoxon Signed Rank Test and Mann Whitney U Test with significance level α≤0.05. Result :  The result showed that breathing exercise relaxation technique had significance influence to phsycological response (p=0.000. Discussion: It,s can be concluded that breathing exercise relaxation technique has an effect to increase pshycological response in preeliminary school children who received invasive procedure.

  3. 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.

  4. 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.

  5. 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)

  6. 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.

  7. 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

  8. 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.

  9. 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.)

  10. 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.)

  11. 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...

  12. Modernising the CERN Admin e-guide

    CERN Multimedia

    DG-RPC-PA (section des processus administratifs)

    2014-01-01

    In just a few years, the CERN Admin e-guide has become the essential guide for CERN's administrative procedures, intended not just for administrative services but for all members of the personnel of CERN. The guide is edited by the Administrative Process Section (DG-RPC-PA) and allows users to look up administrative procedures and forms relating to the application of the Staff Rules and Regulations easily in both French and English. Site visit statistics show that 5000 people on average consult the Admin e-guide each month. The most consulted procedures are those relating to green licence plates, taxes, Swiss and French cards and leave. The site has just been moved over to Drupal, which will make it easier to update the information provided and will improve content management. This system change meant migrating 220 procedures and more than 500 frequently asked questions. The structure has been revised for clarity, but the principles that made the guide so successful have not changed, namely the e...

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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)

  1. 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…

  2. 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

  3. 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)

  4. 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

  5. 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)

  6. [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.

  7. 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.

  8. Development on Guidance of Cyber Security Exercise for the Nuclear Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyundoo [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

    2016-10-15

    Cyber threats and attacks are increasing rapidly against infrastructure including energy and utilities industry over the world. Because of lack of human resource and incident response system to prevent or defend increased cyber threats, many governments and major national infrastructures perform cyber security exercises to improve capabilities of cyber security incident response. Accordingly there are exponential growth in the number of cyber security exercises over the past decade with the trend expecting to accelerate in the coming years. Even though there were many cyber security exercises in the Nuclear Facilities, this exercise was first which focused on mitigation and recovery of the system of the Nuclear Facility against cyber incident. So many insufficient items were deduced such as absence of a procedure for mitigation and recovery of cyber incident. These procedures should be developed and established through 3rd phase of Cyber Security Plan (CSP) and other technical complement actions under regulatory body’s guidance. Also developed and existed procedures should be regularly performed to make cyber incident response team and related people rapidly response against cyber incident through exercises or other training. The insufficient items come from the exercise should be reflected to developed and existed procedures by periods.

  9. Development on Guidance of Cyber Security Exercise for the Nuclear Facilities

    International Nuclear Information System (INIS)

    Kim, Hyundoo

    2016-01-01

    Cyber threats and attacks are increasing rapidly against infrastructure including energy and utilities industry over the world. Because of lack of human resource and incident response system to prevent or defend increased cyber threats, many governments and major national infrastructures perform cyber security exercises to improve capabilities of cyber security incident response. Accordingly there are exponential growth in the number of cyber security exercises over the past decade with the trend expecting to accelerate in the coming years. Even though there were many cyber security exercises in the Nuclear Facilities, this exercise was first which focused on mitigation and recovery of the system of the Nuclear Facility against cyber incident. So many insufficient items were deduced such as absence of a procedure for mitigation and recovery of cyber incident. These procedures should be developed and established through 3rd phase of Cyber Security Plan (CSP) and other technical complement actions under regulatory body’s guidance. Also developed and existed procedures should be regularly performed to make cyber incident response team and related people rapidly response against cyber incident through exercises or other training. The insufficient items come from the exercise should be reflected to developed and existed procedures by periods

  10. 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.

  11. 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)

  12. American National Standard: for radiological emergency-preparedness exercises for nuclear power plants

    International Nuclear Information System (INIS)

    Anon.

    1979-01-01

    The development of emergency plans and procedures should provide for testing and evaluating the emergency response organization and decision making processes. To test and evaluate emergency plans and procedures, realistic scenarios should be used for drills or exercises. Emergency exercises are training activities that require a substantial effort to plan and coordinate effectively. The exercise trains personnel who would be expected to participate in the emergency response. Emergency exercises should be conducted as realistically as possible. Insofar as possible, the participants should not be notified in advance except where necessary to assure that the exercise will not cause injuries or property damage. A real emergency will naturally impart stress on emergency response personnel and their organizations. Exercises should be designed to duplicate this sense of stress insofar as practical. An important element of testing the emergency response is to ensure that provisions have been made for observation, evaluation, and critiquing each exercise. These evaluations and critiques should be used to improve and revise emergency plans and procedures where required

  13. 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

  14. 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.

  15. 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.

  16. 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.)

  17. Ultrasound-guided genitourinary interventions: principles and techniques

    Directory of Open Access Journals (Sweden)

    Byung Kwan Park

    2017-10-01

    Full Text Available Ultrasound (US is often used to guide various interventional procedures in the genitourinary (GU tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  18. Ultrasound-guided genitourinary interventions: principles and techniques

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan [Dept. of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-10-15

    Ultrasound (US) is often used to guide various interventional procedures in the genitourinary (GU) tract because it can provide real-time imaging without any radiation hazard. Moreover, US can clearly visualize the pathway of an aspiration or biopsy needle to ensure the safety of the intervention. US guidance also helps clinicians to access lesions via the transabdominal, transhepatic, transvaginal, transrectal, and transperineal routes. Hence, US-guided procedures are useful for radiologists who wish to perform GU interventions. However, US-guided procedures and interventions are difficult for beginners because they involve a steep initial learning curve. The purpose of this review is to describe the basic principles and techniques of US-guided GU interventions.

  19. 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...

  20. Metabolic response to different glycemic indexes of pre-exercise meal

    Directory of Open Access Journals (Sweden)

    Valéria Cristina de Faria

    2015-08-01

    Full Text Available INTRODUCTION: To ensure performance and health, the type of food and the time of pre-exercise ingestion should be considered by practitioners of morning physical activity. Objective: This study assessed the metabolic response after pre-exercise meals with different glycemic indexes (GI and in the fasting state adopting different types of hydration.METHODS: Twelve men performed four experimental tests; two with pre-exercise meals of high GI (HGI and low GI (LGI, and two were performed in the fasting state with hydration: water (H2O and carbohydrate drink (CHO. Each test consisted of a pre-exercise rest period of 30 minutes followed by 60 minutes of cycle ergometer with continuous load equivalent to 60% of the extrapolated maximal oxygen consumption (VO2MaxExt. During the exercise, participants were hydrated every 15 minutes with 3mL per kg body weight. During each experimental test, venous blood samples were obtained for fasting and at 15-minute intervals during rest, and every 20 minutes during exercise. The gas analysis was carried out in periods of 5 minutes every 20 minutes of exercise.RESULTS: There was no difference in substrate oxidation. After 20 minutes of exercise, pre-exercise food intake procedures showed similar behavior, having only reduced blood glucose levels compared to fasting procedures (p<0.01. There was maintenance of blood glucose at stable and higher levels during exercise in relation to the other tests in the fast procedure with CHO.CONCLUSION: The data suggest that despite the similar metabolic behavior between LGI and HGI meals, the adoption of a LGI meal before the morning exercise seems to be a more suitable feeding practice due to higher tendency of rebound hypoglycemia after HGI meal and when morning exercise is performed on fasting, hydration with CHO seems to minimize the hypoglycemic risk arising from that state.

  1. 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...

  2. 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.

  3. 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.

  4. 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

  5. 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

  6. 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

  7. 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.

  8. PET/CT-guided Interventions: Personnel Radiation Dose

    Energy Technology Data Exchange (ETDEWEB)

    Ryan, E. Ronan, E-mail: ronan@ronanryan.com; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States); Hsu, Meier [Memorial Sloan-Kettering Cancer Center, Department of Epidemiology and Biostatistics (United States); Quinn, Brian; Dauer, Lawrence T. [Memorial Sloan-Kettering Cancer Center, Department of Medical Physics (United States); Solomon, Stephen B. [Memorial Sloan-Kettering Cancer Center, Department of Radiology (United States)

    2013-08-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0-0.13) mSv for the primary operator, 0.01 (range 0-0.05) mSv for the nurse anesthetist, and 0.02 (range 0-0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0-0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient.

  9. Effectiveness of inquiry-based learning in an undergraduate exercise physiology course

    DEFF Research Database (Denmark)

    Nybo, Lars; May, Michael

    2015-01-01

    (individual subject-specific tests and group interviews) were performed for a laboratory course in cardiorespiratory exercise physiology that was conducted in one year with a traditional step-by-step guided manual (traditional course) and the next year completed with an inquiry-based structure (I-based course......). The I-based course was a guided inquiry course where students had to design the experimental protocol and conduct their own study on the basis of certain predefined criteria (i.e., they should evaluate respiratory responses to submaximal and maximal exercise and provide indirect and direct measures...... of aerobic exercise capacity). The results indicated that the overall time spent on the experimental course as well as self-evaluated learning outcomes were similar across groups. However, students in the I-based course used more time in preparation (102 ± 5 min) than students in the traditional course (42...

  10. 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...

  11. 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.

  12. 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.

  13. 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)

  14. 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)

  15. 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…

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. Reliability and Validity of the Self-Efficacy for Exercise in Epilepsy and the Outcome Expectations for Exercise in Epilepsy Scales.

    Science.gov (United States)

    Dustin, Irene; Resnick, Barbara; Galik, Elizabeth; Klinedinst, N Jennifer; Michael, Kathleen; Wiggs, Edythe

    2017-04-01

    The purpose of this study was to test the psychometric properties of the revised Self-Efficacy for Exercise With Epilepsy (SEE-E) and Outcome Expectations for Exercise with Epilepsy (OEE-E) when used with people with epilepsy. The SEE-E and OEE-E were given in face-to-face interviews to 26 persons with epilepsy in an epilepsy clinic. There was some evidence of validity based on Rasch analysis INFIT and OUTFIT statistics. There was some evidence of reliability for the SEE-E and OEE-E based on person and item separation reliability indexes. These measures can be used to identify persons with epilepsy who have low self-efficacy and outcome expectations for exercise and guide design of interventions to strengthen these expectations and thereby improve exercise behavior.

  1. PET/CT-guided Interventions: Personnel Radiation Dose

    International Nuclear Information System (INIS)

    Ryan, E. Ronan; Thornton, Raymond; Sofocleous, Constantinos T.; Erinjeri, Joseph P.; Hsu, Meier; Quinn, Brian; Dauer, Lawrence T.; Solomon, Stephen B.

    2013-01-01

    PurposeTo quantify radiation exposure to the primary operator and staff during PET/CT-guided interventional procedures.MethodsIn this prospective study, 12 patients underwent PET/CT-guided interventions over a 6 month period. Radiation exposure was measured for the primary operator, the radiology technologist, and the nurse anesthetist by means of optically stimulated luminescence dosimeters. Radiation exposure was correlated with the procedure time and the use of in-room image guidance (CT fluoroscopy or ultrasound).ResultsThe median effective dose was 0.02 (range 0–0.13) mSv for the primary operator, 0.01 (range 0–0.05) mSv for the nurse anesthetist, and 0.02 (range 0–0.05) mSv for the radiology technologist. The median extremity dose equivalent for the operator was 0.05 (range 0–0.62) mSv. Radiation exposure correlated with procedure duration and with the use of in-room image guidance. The median operator effective dose for the procedure was 0.015 mSv when conventional biopsy mode CT was used, compared to 0.06 mSv for in-room image guidance, although this did not achieve statistical significance as a result of the small sample size (p = 0.06).ConclusionThe operator dose from PET/CT-guided procedures is not significantly different than typical doses from fluoroscopically guided procedures. The major determinant of radiation exposure to the operator from PET/CT-guided interventional procedures is time spent in close proximity to the patient

  2. Fast 3-T MR-guided transrectal prostate biopsy using an in-room tablet device for needle guide alignment: a feasibility study.

    Science.gov (United States)

    Overduin, Christiaan G; Heidkamp, Jan; Rothgang, Eva; Barentsz, Jelle O; de Lange, Frank; Fütterer, Jurgen J

    2018-05-22

    To assess the feasibility of adding a tablet device inside the scanner room to assist needle-guide alignment during magnetic resonance (MR)-guided transrectal prostate biopsy. Twenty patients with one cancer-suspicious region (CSR) with PI-RADS score ≥ 4 on diagnostic multiparametric MRI were prospectively enrolled. Two orthogonal scan planes of an MR fluoroscopy sequence (~3 images/s) were aligned to the CSR and needle-guide pivoting point. Targeting was achieved by manipulating the needle-guide under MR fluoroscopy feedback on the in-room tablet device. Technical feasibility and targeting success were assessed. Complications and biopsy procedure times were also recorded. Needle-guide alignment with the in-room tablet device was technically successful in all patients and allowed sampling after a single alignment step in 19/20 (95%) CSRs (median size 14 mm, range: 4-45). Biopsy cores contained cancer in 18/20 patients. There were no per-procedural or post-biopsy complications. Using the tablet device, the mean time to first biopsy was 5.8 ± 1.0 min and the mean total procedure time was 23.7 ± 4.1 min. Use of an in-room tablet device to assist needle-guide alignment was feasible and safe during MR-guided transrectal prostate biopsy. Initial experience indicates potential for procedure time reduction. • Performing MR-guided prostate biopsy using an in-room tablet device is feasible. • CSRs could be sampled after a single alignment step in 19/20 patients. • The mean procedure time for biopsy with the tablet device was 23.7 min.

  3. 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

  4. 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…

  5. 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.…

  6. Cardiopulmonary Exercise Testing in Patients with Asymptomatic or Equivocal Symptomatic Aortic Stenosis: Feasibility, Reproducibility, Safety and Information Obtained on Exercise Physiology.

    Science.gov (United States)

    van Le, Douet; Jensen, Gunnar Vagn Hagemann; Carstensen, Steen; Kjøller-Hansen, Lars

    2016-01-01

    The aim of this study was to determine the feasibility, reproducibility, safety and information obtained on exercise physiology from cardiopulmonary exercise testing (CPX) in patients with aortic stenosis. Patients with an aortic valve area (AVA) exercise, lower peak heart rate and FEV1, and higher VE/VCO2, but not by AVA index. Equivocal symptomatic status and a low gradient but high valvulo-arterial impedance were associated with a lower pVO2, but not with an inability to increase stroke volume. In total, 18 patients were referred for valve replacement. At 1 year, no cardiovascular deaths had occurred. CPX was feasible and reproducible and provided comprehensive data on exercise physiology. A CPX-guided treatment strategy was safe up to 1 year. © 2015 S. Karger AG, Basel.

  7. 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.

  8. 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

  9. Strategy for developing and conducting nuclear emergency exercises

    International Nuclear Information System (INIS)

    2007-01-01

    Emergency situations demand that actions be taken by responsible organisations and individuals at the site of the emergency and at the local, national and international levels to mitigate the impact on people and the environment. Effective emergency response requires development and implementation of emergency plans and procedures; established arrangements at the local, national and international levels; acquisition and maintenance of resources (funding, equipment and personnel); training of personnel; conduct of exercises; and a 'feedback programme' whereby improvements to the emergency management system are made based on lessons identified from exercises and actual events. A means for demonstrating the effectiveness of an emergency programme is through the conduct of exercises. Exercises demonstrate the effectiveness of plans, procedures, training and equipment; adequacy of response arrangements and resources; capabilities of response personnel in performing their assigned tasks; ability of individuals and organisations to work together; and provide a forum for exploring and testing revisions, modifications, and new and/or proposed changes to any emergency programme element in near realistic situations. Exercises may range in scope from small-scale drills to large-scale national or international exercises. There is clear benefit to organisations in supporting, developing and conducting well-managed exercises. Exercising is a resource-intensive tool; however, it is a critical tool for enhancing performance, testing arrangements and identifying areas for improvement. A thoroughly developed strategy should therefore be in place to ensure maximum value from an exercise programme. This report contributes to the good practice and management of exercise programmes by providing a strategy for improving the value of planning, conducting, participating in and/or supporting exercises. The OECD/NEA International Nuclear Emergency Exercise (INEX) series undertaken over the

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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.

  19. 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

  20. 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.

  1. Magneticresonanceimaging-guided percutaneouscryoablationofhepatocellular carcinomainspecialregions

    Institute of Scientific and Technical Information of China (English)

    Bin Wu; Yue-Yong Xiao; Xiao Zhang; Ai-Lian Zhang; Hong-Jun Li; Deng-Fa Gao

    2010-01-01

    BACKGROUND:Local cryoablation guided by CT or ultrasound has been widely applied in the treatment of hepatocellular carcinoma. However, it is still dififcult to apply this technique in certain regions such as the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. This study aimed to evaluate the safety and efifcacy of using magnetic resonance imaging (MRI)-guided percutaneous cryoablation as well as the effect of using an open MRI system in guiding and monitoring the treatment of hepatocellular carcinoma in these regions. METHODS:Cryoablation, guided by an open 0.35T MRI scanner and with the assistance of an MRI-compatible optical navigation system, was performed on 32 patients with hepatocellular carcinoma at the diaphragm dome, the ifrst hepatic hilum, and regions adjacent to the gallbladder. Each patient had one or two tumors. The total number of tumors treated was 36. The tumor diameters ranged from 2.5 to 10.0 cm (mean 4.7±1.8 cm). The cryosurgical system was MRI-compatible and equipped with cryoprobes 1.47 mm in outside diameter. Under the guidance of MRI in combination with the optical navigation system, the cryoprobes were introduced percutaneously into a tumor at the planned targeting points while critical organs or tissues were avoided. Each cryoablation procedure included two freezing-thawing cycles, and MRI images were acquired dynamically to monitor the ablation of the tumor from time to time during the operation. In order to investigate the therapeutic effects of a cryoablation procedure, AFP measurements and liver-enhanced MRI or CT-enhanced scans were performed at regular times. RESULTS:MRI and optical navigation system-guided cryo-ablation procedures were successfully performed on all 32 patients (36 tumor sites) and no serious complications occurred. The follow-up period ranged from 5 to 12 months. The 6-and 12-month overall survival rates were 96.8%and 90.6%, respectively. According to the diagnosis of liver

  2. Evaluation of cardiovascular risk-lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes.

    Science.gov (United States)

    Webb, R; Thompson, J E S; Ruffino, J-S; Davies, N A; Watkeys, L; Hooper, S; Jones, P M; Walters, G; Clayton, D; Thomas, A W; Morris, K; Llewellyn, D H; Ward, M; Wyatt-Williams, J; McDonnell, B J

    2016-01-01

    To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques. In studies 1-3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3. Because cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued

  3. 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.)

  4. Effectiveness of inquiry-based learning in an undergraduate exercise physiology course.

    Science.gov (United States)

    Nybo, Lars; May, Michael

    2015-06-01

    The present study was conducted to investigate the effects of changing a laboratory physiology course for undergraduate students from a traditional step-by-step guided structure to an inquiry-based approach. With this aim in mind, quantitative and qualitative evaluations of learning outcomes (individual subject-specific tests and group interviews) were performed for a laboratory course in cardiorespiratory exercise physiology that was conducted in one year with a traditional step-by-step guided manual (traditional course) and the next year completed with an inquiry-based structure (I-based course). The I-based course was a guided inquiry course where students had to design the experimental protocol and conduct their own study on the basis of certain predefined criteria (i.e., they should evaluate respiratory responses to submaximal and maximal exercise and provide indirect and direct measures of aerobic exercise capacity). The results indicated that the overall time spent on the experimental course as well as self-evaluated learning outcomes were similar across groups. However, students in the I-based course used more time in preparation (102 ± 5 min) than students in the traditional course (42 ± 3 min, P traditional course. Furthermore, students in the I-based course achieved a higher (P traditional course (31 ± 4%). Although students were unfamiliar with cardiorespiratory exercise physiology and the experimental methods before the course, it appears that an inquiry-based approach rather than one that provides students with step-by-step instructions may benefit learning outcomes in a laboratory physiology course. Copyright © 2015 The American Physiological Society.

  5. 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…

  6. Meditative Movement, Energetic, and Physical Analyses of Three Qigong Exercises: Unification of Eastern and Western Mechanistic Exercise Theory.

    Science.gov (United States)

    Klein, Penelope; Picard, George; Baumgarden, Joseph; Schneider, Roger

    2017-09-23

    Abstract : Qigong is the meditative movement and therapeutic exercise of Eastern medicine. A growing body of evidence is validating its health benefits leading to mechanistic questions of how it works. The purpose of this article is to explore mechanisms of action related to Qigong, with the intent of unifying Eastern and Western exercise theory and to present a model for Qigong exercise analysis. Three exercises from a standardized Qigong form: 'Plucking the Stars', 'Lotus Leaves Rustle in the Wind', and 'Pacing Forwards and Backwards' were selected for meditative, energetic, and physical analyses. Meditative aspects include relaxation response, interoception and exteroception. Energetic aspects include stimulation of meridians through mental intent, acupressure, and self-massage. Physical aspects include flexibility, strength, articular stimulation, neuro-integration, respiratory effect, fascial stretch, visceral massage, balance challenge CranioSacral pump, lymphatic and venous return and glandular stimulation, and physiologic response to relaxation. Knowledge of mechanisms of action for specific Qigong exercises can guide operational definition of Qigong, selection of outcomes assessment in future research, inform prescriptive practice addressing clinical health issues, and advance adoption of Qigong practice within integrative health care. The model of analysis demonstrated in this discussion may assist in these endeavors.

  7. 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…

  8. Effect of guided relaxation and imagery on falls self-efficacy: a randomized controlled trial.

    Science.gov (United States)

    Kim, Bang Hyun; Newton, Roberta A; Sachs, Michael L; Glutting, Joseph J; Glanz, Karen

    2012-06-01

    To examine the effects of guided relaxation and imagery (GRI) on improvement in falls self-efficacy in older adults who report having a fear of falling. Randomized, controlled trial with allocation to GRI or guided relaxation with music of choice. General community. Ninety-one men and women aged 60 to 92. Participants were randomized to listen to a GRI audio compact disk (intervention group) or a guided relaxation audio compact disk and music of choice (control group) twice a week for 6 weeks for 10 minutes per session. Primary outcome measure was the Short Falls Efficacy Scale-International (FES-I). Secondary outcome measures were the Leisure Time Exercise Questionnaire (LTEQ) and the Timed Up and Go (TUG) mobility test. GRI participants reported greater improvements on the Short FES-I (P = .002) and LTEQ (P = .001) scores and shorter time on the TUG (P = .002) than the guided relaxation and music-of-choice group. GRI was more effective at increasing falls self-efficacy and self-reported leisure time exercise and reducing times on a simple mobility test than was guided relaxation with music of choice. GRI is an effective, simple, low-cost tool for older adults to improve falls self-efficacy and leisure time exercise behaviors. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  9. 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

  10. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F. [Charite University Medicine Berlin (Germany). Dept. of Diagnostic and Interventional Radiology; Bretschneider, T. [Magdeburg Univ. (Germany). Dept. of Radiology and Nuclear Medicine; Hartwig, T.; Disch, A.C. [Charite University Medicine Berlin (Germany). Center for Musculoskeletal Surgery

    2014-06-15

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  11. MRI-guided and CT-guided cervical nerve root infiltration therapy. A cost comparison

    International Nuclear Information System (INIS)

    Maurer, M.H.; Froeling, V.; Roettgen, R.; Bucourt, M. de; Hamm, B.; Streitparth, F.; Bretschneider, T.; Hartwig, T.; Disch, A.C.

    2014-01-01

    Purpose: To evaluate and compare the costs of MRI-guided and CT-guided cervical nerve root infiltration for the minimally invasive treatment of radicular neck pain. Materials and Methods: Between September 2009 and April 2012, 22 patients (9 men, 13 women; mean age: 48.2 years) underwent MRI-guided (1.0 Tesla, Panorama HFO, Philips) single-site periradicular cervical nerve root infiltration with 40 mg triamcinolone acetonide. A further 64 patients (34 men, 30 women; mean age: 50.3 years) were treated under CT fluoroscopic guidance (Somatom Definition 64, Siemens). The mean overall costs were calculated as the sum of the prorated costs of equipment use (purchase, depreciation, maintenance, and energy costs), personnel costs and expenditure for disposables that were identified for MRI- and CT-guided procedures. Additionally, the cost of ultrasound guidance was calculated. Results: The mean intervention time was 24.9 min. (range: 12-36 min.) for MRI-guided infiltration and 19.7 min. (range: 5-54 min.) for CT-guided infiltration. The average total costs per patient were EUR 240 for MRI-guided interventions and EUR 124 for CT-guided interventions. These were (MRI/CT guidance) EUR 150/60 for equipment use, EUR 46/40 for personnel, and EUR 44/25 for disposables. The mean overall cost of ultrasound guidance was EUR 76. Conclusion: Cervical nerve root infiltration using MRI guidance is still about twice as expensive as infiltration using CT guidance. However, since it does not involve radiation exposure for patients and personnel, MRI-guided nerve root infiltration may become a promising alternative to the CT-guided procedure, especially since a further price decrease is expected for MRI devices and MR-compatible disposables. In contrast, ultrasound remains the less expensive method for nerve root infiltration guidance. (orig.)

  12. 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.

  13. 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…

  14. 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…

  15. 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…

  16. 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...

  17. Pericardial Tamponade Following CT-Guided Lung Biopsy

    International Nuclear Information System (INIS)

    Mitchell, Michael J.; Montgomery, Mark; Reiter, Charles G.; Culp, William C.

    2008-01-01

    While not free from hazards, CT-guided biopsy of the lung is a safe procedure, with few major complications. Despite its safety record, however, potentially fatal complications do rarely occur. We report a case of pericardial tamponade following CT-guided lung biopsy. Rapid diagnosis and therapy allowed for complete patient recovery. Physicians who perform this procedure should be aware of the known complications and be prepared to treat them appropriately.

  18. Validation of EOPs/FRGs Procedures Using LOHS Scenario

    International Nuclear Information System (INIS)

    Bajs, T.; Konjarek, D.; Vukovic, J.

    2012-01-01

    Validation of EOPs (Emergency Operating Procedures) and FRGs (Function Restoration Guidelines) can be achieved either through plant full scope simulator or on desk top exercises. The desk top exercise is conducted when for the given scenario plant full scope simulator is not suitable. In either verification cases predefined scenario should be evaluated and possible branching foreseen. The scenario presented is LOHS, with bleed and feed procedure initiated. Best estimate light water reactor transient analysis code RELAP5/mod3.3 was used in calculation. Standardized detailed plant model was used. Operator actions were modelled from beginning of the scenario to its termination.(author).

  19. 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...

  20. 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...

  1. 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…

  2. Computerized Italian criticality guide, description and validation

    International Nuclear Information System (INIS)

    Carotenuto, M.; Landeyro, P.A.

    1988-10-01

    Our group is developing an 'expert system' for collecting engineering know-how on back-end nuclear plant design. An expert system is the most suitable software tool for our problem. During the analysis, the design process was divided into different branches. At each branch of the design process the Expert System relates a computerized design procedure. Any design procedure is composed of a set of design methods, together with their condition of application and reliability limits. In the framework of this expert system, the nuclear criticality safety analysis procedure was developed, in the form of a computerized criticality guide, attempting to reproduce the designer's normal 'reasoning' process. The criticality guide is composed of two parts: A computerized text, including theory, a description of the accidents occurred in the past and a description of the italian design experience; An interactive computer aided calculation module, containing a graphical facility for critical parameter curves. In the present report are presented the criticality guide (computerized Italian Criticality Guide) and its validation test. (author)

  3. Computerized Italian criticality guide, description and validation

    Energy Technology Data Exchange (ETDEWEB)

    Carotenuto, M; Landeyro, P A [ENEA - Dipartimento Ciclo del Combustibile, Centro Ricerche Energia, Casaccia (Italy)

    1988-10-15

    Our group is developing an 'expert system' for collecting engineering know-how on back-end nuclear plant design. An expert system is the most suitable software tool for our problem. During the analysis, the design process was divided into different branches. At each branch of the design process the Expert System relates a computerized design procedure. Any design procedure is composed of a set of design methods, together with their condition of application and reliability limits. In the framework of this expert system, the nuclear criticality safety analysis procedure was developed, in the form of a computerized criticality guide, attempting to reproduce the designer's normal 'reasoning' process. The criticality guide is composed of two parts: A computerized text, including theory, a description of the accidents occurred in the past and a description of the italian design experience; An interactive computer aided calculation module, containing a graphical facility for critical parameter curves. In the present report are presented the criticality guide (computerized Italian Criticality Guide) and its validation test. (author)

  4. 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.

  5. 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

  6. 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…

  7. Results of the reliability benchmark exercise and the future CEC-JRC program

    International Nuclear Information System (INIS)

    Amendola, A.

    1985-01-01

    As a contribution towards identifying problem areas and for assessing probabilistic safety assessment (PSA) methods and procedures of analysis, JRC has organized a wide-range Benchmark Exercise on systems reliability. This has been executed by ten different teams involving seventeen organizations from nine European countries. The exercise has been based on a real case (Auxiliary Feedwater System of EDF Paluel PWR 1300 MWe Unit), starting from analysis of technical specifications, logical and topological layout and operational procedures. Terms of references included both qualitative and quantitative analyses. The subdivision of the exercise into different phases and the rules adopted allowed assessment of the different components of the spread of the overall results. It appeared that modelling uncertainties may overwhelm data uncertainties and major efforts must be spent in order to improve consistency and completeness of qualitative analysis. After successful completion of the first exercise, CEC-JRC program has planned separate exercises on analysis of dependent failures and human factors before approaching the evaluation of a complete accident sequence

  8. Lecture-free biochemistry: A Process Oriented Guided Inquiry Approach.

    Science.gov (United States)

    Minderhout, Vicky; Loertscher, Jennifer

    2007-05-01

    Biochemistry courses at Seattle University have been taught exclusively using process oriented guided inquiry learning (POGIL) without any traditional lecture component since 1997. In these courses, students participate in a structured learning environment, which includes a preparatory assignment, an in-class activity, and a follow-up skill exercise. Instructor-designed learning activities provide the content of the course while the cooperative learning structure provides the content-free procedures that promote development of critical process skills needed for learning. This format enables students to initially explore a topic independently, work together in groups to construct and refine knowledge, and eventually develop deep understanding of the essential concepts. These stages of exploration and concept development form the foundation for application to high level biochemical problems. At the end of this course, most students report feeling confident in their knowledge of biochemistry and report substantial gains in independence, critical thinking, and respect for others. Copyright © 2007 International Union of Biochemistry and Molecular Biology, Inc.

  9. MCTS Microsoft Windows 7 Configuration Study Guide Exam 70-680

    CERN Document Server

    Panek, William

    2011-01-01

    A fully updated study guide for MCTS exam 70-680 Demand for experienced, qualified Windows 7 administrators remains high. IT professionals seeking certification in Windows 7 administration will find everything they need to learn to pass the MCTS exam (70-680) in this complete Sybex Study Guide. Updated to cover the most recent version of the exam, this comprehensive guide examines all the exam objectives, using real-world scenarios, hands-on exercises, and challenging review questions.Certification in Windows 7 administration is highly prized by IT professionals and employers; this comprehensi

  10. 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)

  11. 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 ...

  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. 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…

  14. Action at sea: Transport security exercise conducted off the coast of Sweden

    International Nuclear Information System (INIS)

    Isaksson, Stig; Jawerth, Nicole

    2015-01-01

    As in an action movie, ships, helicopters and uniformed people set the scene off the coast of Sweden on 6 May 2015 when national authorities conducted an exercise on security while transporting spent nuclear fuel. The exercise was part of a joint project with the IAEA to test and evaluate a new IAEA guide on planning, conducting and evaluating transport security exercises. The test subject and model was the security framework of Sweden’s national nuclear transport system, which regularly ships used fuel from power plants along the coast to the country’s interim storage facility for spent nuclear fuel.

  15. A Single-Institution Experience in Percutaneous Image-Guided Biopsy of Malignant Pleural Mesothelioma

    International Nuclear Information System (INIS)

    Welch, B. T.; Eiken, P. W.; Atwell, T. D.; Peikert, T.; Yi, E. S.; Nichols, F.; Schmit, G. D.

    2017-01-01

    PurposeMesothelioma has been considered a difficult pathologic diagnosis to achieve via image-guided core needle biopsy. The purpose of this study was to assess the diagnostic sensitivity of percutaneous image-guided biopsy for diagnosis of pleural mesothelioma.Materials and MethodsRetrospective review was performed to identify patients with a confirmed diagnosis of pleural mesothelioma and who underwent image-guided needle biopsy between January 1, 2002, and January 1, 2016. Thirty-two patients with pleural mesothelioma were identified and included for analysis in 33 image-guided biopsy procedures. Patient, procedural, and pathologic characteristics were recorded. Complications were characterized via standardized nomenclature [Common Terminology for Clinically Adverse Events (CTCAE)].ResultsPercutaneous image-guided biopsy was associated with an overall sensitivity of 81%. No CTCAE clinically significant complications were observed. No image-guided procedures were complicated by pneumothorax or necessitated chest tube placement. No patients had tumor seeding of the biopsy tract.ConclusionPercutaneous image-guided biopsy can achieve high sensitivity for pathologic diagnosis of pleural mesothelioma with a low procedural complication rate, potentially obviating need for surgical biopsy.

  16. A Single-Institution Experience in Percutaneous Image-Guided Biopsy of Malignant Pleural Mesothelioma

    Energy Technology Data Exchange (ETDEWEB)

    Welch, B. T., E-mail: Welch.brian@mayo.edu; Eiken, P. W.; Atwell, T. D. [Mayo Clinic, Department of Radiology (United States); Peikert, T. [Mayo Clinic, Department of Pulmonary and Critical Care Medicine (United States); Yi, E. S. [Mayo Clinic, Department of Pathology (United States); Nichols, F. [Mayo Clinic, Department of Thoracic Surgery (United States); Schmit, G. D. [Mayo Clinic, Department of Radiology (United States)

    2017-06-15

    PurposeMesothelioma has been considered a difficult pathologic diagnosis to achieve via image-guided core needle biopsy. The purpose of this study was to assess the diagnostic sensitivity of percutaneous image-guided biopsy for diagnosis of pleural mesothelioma.Materials and MethodsRetrospective review was performed to identify patients with a confirmed diagnosis of pleural mesothelioma and who underwent image-guided needle biopsy between January 1, 2002, and January 1, 2016. Thirty-two patients with pleural mesothelioma were identified and included for analysis in 33 image-guided biopsy procedures. Patient, procedural, and pathologic characteristics were recorded. Complications were characterized via standardized nomenclature [Common Terminology for Clinically Adverse Events (CTCAE)].ResultsPercutaneous image-guided biopsy was associated with an overall sensitivity of 81%. No CTCAE clinically significant complications were observed. No image-guided procedures were complicated by pneumothorax or necessitated chest tube placement. No patients had tumor seeding of the biopsy tract.ConclusionPercutaneous image-guided biopsy can achieve high sensitivity for pathologic diagnosis of pleural mesothelioma with a low procedural complication rate, potentially obviating need for surgical biopsy.

  17. 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…

  18. Postoperative effects of neuromuscular exercise prior to hip or knee arthroplasty

    DEFF Research Database (Denmark)

    Villadsen, Allan; Overgaard, Søren; Holsgaard-Larsen, Anders

    2014-01-01

    neuromuscular exercise prior to total joint arthroplasty (TJA) of the hip or knee did not confer additional benefits 3 months postoperatively compared with TJA alone. However, the intervention group experienced a statistically significant short-term benefit in ADL and pain, suggesting an earlier onset......OBJECTIVE: To investigate the postoperative efficacy of a supervised programme of neuromuscular exercise prior to hip or knee arthroplasty. METHODS: In this assessor-blinded randomised controlled trial, we included 165 patients scheduled for hip or knee arthroplasty due to severe osteoarthritis (OA......). An 8-week preoperative neuromuscular supervised exercise programme was delivered twice a week for 1 h as adjunct treatment to the standard arthroplasty procedure and compared with the standard arthroplasty procedure alone. The primary outcome was self-reported physical function measured...

  19. 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.

  20. 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

  1. Endoscopic Ultrasound-guided Drainage of Pancreatic Pseudocysts

    DEFF Research Database (Denmark)

    Ng, Pui Yung; Nytoft Rasmussen, Ditlev; Vilmann, Peter

    2013-01-01

    or by telephonic interview. RESULTS: A total of 61 procedures were performed. The symptoms that indicated drainage were abdominal pain (n = 43), vomiting (n = 7) and jaundice (n = 5). The procedure was technically successful in 57 of the 61 procedures (93%). The immediate complication rate was 5%. At a mean follow......-up of 45 weeks, the treatment success was 75%. The medium term complications appeared in 25% of cases, which included three cases each of stent clogging, stent migration, infection and six cases of recurrence. There was no mortality. CONCLUSION: EUS-guided drainage is an effective treatment for PPC...... with a successful outcome in most of patients. Most of the complications require minimal invasive surgical treatment or repeated EUS-guided drainage procedures....

  2. 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

  3. 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.

  4. 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.

  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. 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...

  7. Use of a paper-cut as an adjunct to teaching the Whipple procedure by video.

    Science.gov (United States)

    Mann, B D; Heath, C M; Gracely, E; Seidman, A; Nieman, L Z; Sachdeva, A K

    1998-10-01

    Medical students often experience difficulty comprehending anatomic relationships of complex operations to which they are exposed during surgical clerkship. Pancreaticoduodenectomy, the Whipple procedure, is one such operation. Although video recordings are available to facilitate the learning of the Whipple procedure, commercially available tapes are not self-explanatory to the uninitiated. Since we have previously demonstrated that third-year medical students could learn the operative steps of inguinal herniorraphy by a paper-cutting exercise, we set out to determine whether an exercise of similar design could enhance a student's comprehension of the Whipple procedure. Using Adobe Illustrator 5.5 for MacIntosh, an exercise was developed on a 8.5 x 11-inch paper that could be distributed to students for self-administration. The exercise was performed using a #15 scalpel or an iris scissors. Thirty-seven students were randomized into two groups. Each student received a pretest of questions focusing on the Whipple procedure. Group I was shown an 18-minute commercially available teaching video on the Whipple procedure. Group II was given the Whipple origami exercise, which required 20 minutes to complete. A first posttest was administered to each group. Next, the groups switched exercises, and a second posttest was administered. There was no significant difference between the groups' pretest scores (two-tailed t test, P = 0.290). Group I improved its score from an average of 64.21 (SD 14.27) to 67.89 (SD 13.16) after watching the video, and further to 77.89 (SD 14.37) after completing the paper-cut exercise. Group II improved from 60.00 (SD 9.43) to 78.95 (SD 11.00) after performing the paper-cut, but derived no additional measurable benefit from watching the video, average score 74.74 (SD 18.37). After the first exercise, students who performed the paper-cut showed a significantly greater improvement in test scores compared with students who saw the video (P = 0

  8. 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.

  9. 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.

  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. 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

  12. 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

  13. 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

  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. The linear algebra survival guide illustrated with Mathematica

    CERN Document Server

    Szabo, Fred

    2015-01-01

    The Linear Algebra Survival Guide is a reference book with a free downloadable Mathematica notebook containing all of interactive code to make the content of the book playable in Mathematica and the Mathematica Player. It offers a concise introduction to the core topics of linear algebra which includes numerous exercises that will accompany a first or second course in linear algebra. This book will guide you through the powerful graphic displays and visualization of Mathematica that make the most abstract theories seem simple-- allowing you to tackle realistic problems using simple mathematic

  16. CEH certified ethical hacker : version 8 : study guide

    CERN Document Server

    Oriyano, Sean-Philip

    2014-01-01

    Prepare for the new Certified Ethical Hacker version 8 exam with this Sybex guide Security professionals remain in high demand. The Certified Ethical Hacker is a one-of-a-kind certification designed to give the candidate a look inside the mind of a hacker. This study guide provides a concise, easy-to-follow approach that covers all of the exam objectives and includes numerous examples and hands-on exercises. Coverage includes cryptography, footprinting and reconnaissance, scanning networks, enumeration of services, gaining access to a system, Trojans, viruses, worms, covert channels, and muc

  17. 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.

  18. 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

  19. Biased Decision Making in Realistic Extra-Procedural Nuclear Control Room Scenarios

    DEFF Research Database (Denmark)

    Andersen, Emil; Kozin, Igor; Maier, Anja

    In normal operations and emergency situations, operators of nuclear control rooms rely on procedures to guide their decision making. However, in emergency situations, where several interacting problems can cause unpredictable adverse effects, these procedures may be insufficient in guiding...... improve safety by creating procedures that bear the risks of these biases in mind, or by specifically aiming to debias the users. Avenues for debiasing through design are discussed....

  20. Acute metabolic response to fasted and postprandial exercise

    Directory of Open Access Journals (Sweden)

    Lima FD

    2015-08-01

    Full Text Available Filipe Dinato de Lima,1,2 Ana Luiza Matias Correia,1 Denilson da Silva Teixeira,2 Domingos Vasco da Silva Neto,2 Ítalo Sávio Gonçalves Fernandes,2 Mário Boratto Xavier Viana,2 Mateus Petitto,2 Rodney Antônio da Silva Sampaio,2 Sandro Nobre Chaves,2 Simone Teixeira Alves,2 Renata Aparecida Elias Dantas,2 Márcio Rabelo Mota2 1University of Brasília, Brasília, DF, Brazil; 2Universitary Center of Brasília (UniCEUB, Brasília, DF, BrazilAbstract: The aim of this study was to analyze the acute metabolic response to exercise in fasting and postprandial. For this, ten individuals were submitted to an incremental treadmill test, with an initial speed of 5 and 1 km/h increments every minute, with no inclination, and a body composition assessment. After this 1st day, all volunteers were submitted to two experimental procedures (fasting and postprandial, with an aerobic exercise performed for 36 minutes at 65% of maximal oxygen consumption. At postprandial procedure, all subjects ingested a breakfast containing 59.3 g of carbohydrate (76.73%, 9.97 g of protein (12.90%, 8.01 g of lipids (10.37%, with a total energy intake of 349.17 kcal. An analysis of plasma concentration of triglycerides, lactate, and glucose was performed in two stages: before and after exercise. The Shapiro–Wilk test was used to verify the normality of the data. For analysis of glucose concentration, plasma lactate, and triglycerides, we used a repeated measures analysis of variance factorial 2×2, with Bonferroni multiple comparison test. The significance level of P<0.05 was adopted. The results indicated a maintenance level of glucose at fasting and a decrease in glucose concentration at postprandial exercise. Both conditions increase plasma lactate. Triglycerides also increased in the two experimental conditions; however, after exercise fasting, the increase was significantly higher than in the postprandial exercise. These data suggest that both exercises could increase

  1. Effects of home-based pulmonary rehabilitation with a metronome-guided walking pace in chronic obstructive pulmonary disease.

    Science.gov (United States)

    Lee, Sung-soon; Kim, Changhwan; Jin, Young-Soo; Oh, Yeon-Mok; Lee, Sang-Do; Yang, Yun Jun; Park, Yong Bum

    2013-05-01

    Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.

  2. 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.

  3. 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.

  4. Self-determined to exercise? Leisure-time exercise behavior, exercise motivation, and exercise dependence in youth.

    Science.gov (United States)

    Symons Downs, Danielle; Savage, Jennifer S; DiNallo, Jennifer M

    2013-02-01

    Scant research has examined the determinants of primary exercise dependence symptoms in youth. Study purposes were to examine sex differences across leisure-time exercise behavior, motivation, and primary exercise dependence symptoms in youth and the extent to which exercise behavior and motivation predicted exercise dependence within the Self-Determination Theory framework. Adolescents (N = 805; mean age = 15 years; 46% girls) completed measures of exercise behavior, motivation, and exercise dependence in health/PE classes. One-way ANOVA revealed boys scored higher than girls on leisure-time exercise behavior, exercise dependence symptoms, and most of the exercise motivation subscales. Hierarchical regression analyses indicated a) sex, exercise behavior, motivation, and their interaction terms explained 39% of the variance in primary exercise dependence; b) Integrated Regulation and Introjected Regulation were important determinants of exercise dependence; and c) sex moderated the contributions of External Regulation for predicting exercise dependence such that boys in the high and low external regulation groups had higher symptoms than girls in the high and low external regulation groups. These preliminary findings support the controlled dimensions of Integrated Regulation (boys, girls), Introjected Regulation (boys, girls), and External Regulation (boys only) are important determinants of primary exercise dependence symptoms.

  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. Progressive high-load strength training compared with general low-load exercises in patients with rotator cuff tendinopathy

    DEFF Research Database (Denmark)

    Ingwersen, Kim G; Christensen, Robin; Sørensen, Lilli

    2015-01-01

    of this trial is to compare the efficacy of progressive high-load exercises with traditional low-load exercises in patients with rotator cuff tendinopathy. Methods/Design: The current study is a randomised, participant- and assessor-blinded, controlled multicentre trial. A total of 260 patients with rotator...... cuff tendinopathy will be recruited from three outpatient shoulder departments in Denmark, and randomised to either 12 weeks of progressive high-load strength training or to general low-load exercises. Patients will receive six individually guided exercise sessions with a physiotherapist and perform...

  7. 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...

  8. 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)

  9. Engine Tune-Up Service. Unit 5: Fuel and Carburetion Systems. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Goodson, Ludy

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 5, Fuel and Carburetion Systems, available separately as CE 031 217. Focus of the exercises and pretests is inspecting and servicing the fuel and carburetion systems. Pretests and performance checklists are provided for each of the…

  10. Engine Tune-Up Service. Unit 1: Battery and Cranking System. Review Exercise Book. Automotive Mechanics Curriculum.

    Science.gov (United States)

    Goodson-Roberts, Ludy; And Others

    This book of pretests and review exercises is designed to accompany the Engine Tune-Up Service Student Guide for Unit 1, Battery and Cranking System. Focus of the exercises and pretests is testing the battery and cranking system. Pretests and performance checklists are provided for each of the four performance objectives contained in the unit.…

  11. 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 ...

  12. EXERCISE WITH BAD FAITH OF SUBJECTIVE CIVIL RIGHTS

    Directory of Open Access Journals (Sweden)

    NICOLAE GRADINARU

    2012-05-01

    Full Text Available The abuse of rights is qualified as civil offence and it may not be different from that of aquilian responsibility, the purpose of its sanction is to protect the victim and not to punish the author. In the Romanian legal doctrine, the abuse of rights was defined as “the exercise of a civil subjective right by breaching the principles of its exercise.” The Constitutional Court held that the person exercising in bad faith and abusively his/her subjective or procedural rights is punishable by appropriate penalties, such as: dismissal of his/her legal action, obligation to bear the costs, application of certain court fines, etc.

  13. Strategy Feedback in an E-learning Tool for Mathematical Exercises

    NARCIS (Netherlands)

    Jeuring, J.T.; Pasman, W.

    2007-01-01

    Exercises in mathematics are often solved using a standard procedure, such as for example solving a system of linear equations by subtracting equations from top to bottom, and then substituting variables from bottom to top. Students have to practice such procedural skills: they have to learn how

  14. A study on CT-guided stereotactic technique for functional neurosurgery

    International Nuclear Information System (INIS)

    Uetsuhara, Koichi; Asakura, Tetsuhiko; Hirahara, Kazuho; Gondo, Masazumi; Oda, Hiroshige

    1987-01-01

    Recently, CT-guided stereotactic surgery has become of major interest, and some authors have discussed its potential in functional neurosurgery. The following is a comparative study of the CT-guided stereotactic technique and the conventional roentogenographic stereotactic technique. The Brown-Roberts-Wells apparatus was used for both types of procedures. 37 stereotactic procedures were performed on 35 patients under local anesthesia; 16 for stereotactic biopsy and 21 for stereotactic functional neurosurgery. Target points for stereotactic biopsy were determined by the CT-guided technique and target points for functional neurosurgery were determined by the conventional roentogenographic technique. The correlation with the position of target point determined by both techniques was investigated in the 21 functional neurosurgical procedures. On these occasions the authors used the reformatted horizontal and sagittal CT through the anterior and posterior commissure to determine the position of target point by the CT-guided technique. Results: It was found that the AC-PC line crossed with Reid's base line at angle of 11 ± 1 deg, and therefore it is important to obtain a CT images including AC-PC line at this angle. When applying the CT guided stereotactic procedure for functional surgery, it should be known that there could be a discrepancy within 2 mm from the conventional target determination. (author)

  15. Proactive error analysis of ultrasound-guided axillary brachial plexus block performance.

    LENUS (Irish Health Repository)

    O'Sullivan, Owen

    2012-07-13

    Detailed description of the tasks anesthetists undertake during the performance of a complex procedure, such as ultrasound-guided peripheral nerve blockade, allows elements that are vulnerable to human error to be identified. We have applied 3 task analysis tools to one such procedure, namely, ultrasound-guided axillary brachial plexus blockade, with the intention that the results may form a basis to enhance training and performance of the procedure.

  16. 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...

  17. Comparative analysis of diagnostic accuracy of different brain biopsy procedures.

    Science.gov (United States)

    Jain, Deepali; Sharma, Mehar Chand; Sarkar, Chitra; Gupta, Deepak; Singh, Manmohan; Mahapatra, A K

    2006-12-01

    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. The present study was carried out to examine the reliability of the diagnoses made on tumor sample obtained via different stereotactic and ultrasound-guided brain biopsy procedures. A retrospective analysis was conducted of all brain biopsies (frame-based and frameless stereotactic and ultrasound-guided) performed in a single tertiary care neurosciences center between 1995 and 2005. The overall diagnostic accuracy achieved on histopathology and correlation with type of biopsy technique was evaluated. A total of 130 cases were included, which consisted of 82 males and 48 females. Age ranged from 4 to 75 years (mean age 39.5 years). Twenty per cent (27 patients) were in the pediatric age group, while 12% (16 patients) were >or= 60-years of age. A definitive histological diagnosis was established in 109 cases (diagnostic yield 80.2%), which encompassed 101 neoplastic and eight nonneoplastic lesions. Frame-based, frameless stereotactic and ultrasound-guided biopsies were done in 95, 15 and 20 patients respectively. Although the numbers of cases were small there was trend for better yield with frameless image-guided stereotactic biopsy and maximum diagnostic yield was obtained i.e, 87% (13/15) in comparison to conventional frame-based CT-guided stereotactic biopsy and ultrasound-guided biopsy. Overall, a trend of higher diagnostic yield was seen in cases with frameless image-guided stereotactic biopsy. Thus, this small series confirms that frameless neuronavigator-guided stereotactic procedures represent the lesion sufficiently in order to make histopathologic diagnosis.

  18. 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…

  19. Determining procedures for simulation-based training in radiology: a nationwide needs assessment.

    Science.gov (United States)

    Nayahangan, Leizl Joy; Nielsen, Kristina Rue; Albrecht-Beste, Elisabeth; Bachmann Nielsen, Michael; Paltved, Charlotte; Lindorff-Larsen, Karen Gilboe; Nielsen, Bjørn Ulrik; Konge, Lars

    2018-01-09

    New training modalities such as simulation are widely accepted in radiology; however, development of effective simulation-based training programs is challenging. They are often unstructured and based on convenience or coincidence. The study objective was to perform a nationwide needs assessment to identify and prioritize technical procedures that should be included in a simulation-based curriculum. A needs assessment using the Delphi method was completed among 91 key leaders in radiology. Round 1 identified technical procedures that radiologists should learn. Round 2 explored frequency of procedure, number of radiologists performing the procedure, risk and/or discomfort for patients, and feasibility for simulation. Round 3 was elimination and prioritization of procedures. Response rates were 67 %, 70 % and 66 %, respectively. In Round 1, 22 technical procedures were included. Round 2 resulted in pre-prioritization of procedures. In round 3, 13 procedures were included in the final prioritized list. The three highly prioritized procedures were ultrasound-guided (US) histological biopsy and fine-needle aspiration, US-guided needle puncture and catheter drainage, and basic abdominal ultrasound. A needs assessment identified and prioritized 13 technical procedures to include in a simulation-based curriculum. The list may be used as guide for development of training programs. • Simulation-based training can supplement training on patients in radiology. • Development of simulation-based training should follow a structured approach. • The CAMES Needs Assessment Formula explores needs for simulation training. • A national Delphi study identified and prioritized procedures suitable for simulation training. • The prioritized list serves as guide for development of courses in radiology.

  20. 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

  1. 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.

  2. Emergency Response Resources guide for nuclear power plant emergencies

    International Nuclear Information System (INIS)

    1992-07-01

    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 was this guide for understanding the responsibilities and obtaining resources for specific needs from the various participants, particularly from those organizations within the Federal Government. This first revision of that guide broadens the focus of the original document. Also, new information defines the major Federal response facilities. This guide should assist State and local government organizations with identifying and obtaining those resources for the post-emergency response when their resources have been exhausted

  3. 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.)

  4. 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.)

  5. Exercises and problems in mathematical methods of physics

    CERN Document Server

    Cicogna, Giampaolo

    2018-01-01

    This book presents exercises and problems in the mathematical methods of physics with the aim of offering undergraduate students an alternative way to explore and fully understand the mathematical notions on which modern physics is based. The exercises and problems are proposed not in a random order but rather in a sequence that maximizes their educational value. Each section and subsection starts with exercises based on first definitions, followed by groups of problems devoted to intermediate and, subsequently, more elaborate situations. Some of the problems are unavoidably "routine", but others bring to the forenontrivial properties that are often omitted or barely mentioned in textbooks. There are also problems where the reader is guided to obtain important results that are usually stated in textbooks without complete proofs. In all, some 350 solved problems covering all mathematical notions useful to physics are included. While the book is intended primarily for undergraduate students of physics, students...

  6. Three-dimensional plotting and printing of an implant drilling guide: simplifying guided implant surgery.

    Science.gov (United States)

    Flügge, Tabea Viktoria; Nelson, Katja; Schmelzeisen, Rainer; Metzger, Marc Christian

    2013-08-01

    To present an efficient workflow for the production of implant drilling guides using virtual planning tools. For this purpose, laser surface scanning, cone beam computed tomography, computer-aided design and manufacturing, and 3-dimensional (3D) printing were combined. Intraoral optical impressions (iTero, Align Technologies, Santa Clara, CA) and digital 3D radiographs (cone beam computed tomography) were performed at the first consultation of 1 exemplary patient. With image processing techniques, the intraoral surface data, acquired using an intraoral scanner, and radiologic 3D data were fused. The virtual implant planning process (using virtual library teeth) and the in-office production of the implant drilling guide was performed after only 1 clinical consultation of the patient. Implant surgery with a computer-aided design and manufacturing produced implant drilling guide was performed during the second consultation. The production of a scan prosthesis and multiple preoperative consultations of the patient were unnecessary. The presented procedure offers another step in facilitating the production of drilling guides in dental implantology. Four main advantages are realized with this procedure. First, no additional scan prosthesis is needed. Second, data acquisition can be performed during the first consultation. Third, the virtual planning is directly transferred to the drilling guide without a loss of accuracy. Finally, the treatment cost and time required are reduced with this facilitated production process. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. 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

  8. 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)

  9. Business and Office Education: Accounting, Clerk. Instructor's Manual [and] Student Learning Activity Guide. Kit No. 204.

    Science.gov (United States)

    Cliatt, Katherine H.

    This learning activity guide and instructor's manual provide information and exercises for an exploratory activity in accounting. Instructional objectives covered in the guide are for the students to learn (1) reasons for studying accounting and related job descriptions, (2) definitions for accounting terms, (3) the accounting equation, (4) how to…

  10. 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

  11. 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

  12. 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.

  13. 21 CFR 886.4300 - Intraocular lens guide.

    Science.gov (United States)

    2010-04-01

    ...) MEDICAL DEVICES OPHTHALMIC DEVICES Surgical Devices § 886.4300 Intraocular lens guide. (a) Identification. An intraocular lens guide is a device intended to be inserted into the eye during surgery to direct... lenses, the device is exempt from the premarket notification procedures in subpart E of part 807 of this...

  14. Image-guided robotic surgery.

    Science.gov (United States)

    Marescaux, Jacques; Solerc, Luc

    2004-06-01

    Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

  15. Relaxation Therapy with Guided Imagery for Postoperative Pain Management: An Integrative Review.

    Science.gov (United States)

    Felix, Márcia Marques Dos Santos; Ferreira, Maria Beatriz Guimarães; da Cruz, Luciana Falcão; Barbosa, Maria Helena

    2017-12-14

    To identify the evidence in the literature about relaxation therapy with guided imagery for postoperative pain management. Integrative review. PubMed, Lilacs, Cochrane, Embase, Web of Science, Scopus and Cinahl, between August 2006 and December 2016. Descriptors: Postoperative Pain, Imagery (Psychotherapy) and Guided Imagery. original studies published in English, Spanish and Portuguese. 291 studies were identified and eight were selected. Descriptive data analysis, presented in detail, with a summary of the knowledge produced in each study. In the primary studies included, the use of guided imagery associated with other complementary therapies was highlighted: hand and foot "M" technique, education on postoperative pain management with analgesic drugs, relaxation exercises, respiration exercises, meditation, soothing biorhythmic music combined with positive and encouraging assertions and music with nature sounds. The knowledge synthesis resulting from this study indicates that evidence could be identified on the use of guided imagery associated with relaxation therapy as a complementary approach to drug analgesia in postoperative pain control strengthens its indication for nursing practice. This evidence, however, demonstrates that the quality of the use of this therapy is limited, and it is necessary to carry out new randomized clinical studies to fill the existing gaps in this topic. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  16. High-intensity interval exercise and cerebrovascular health: curiosity, cause, and consequence.

    Science.gov (United States)

    Lucas, Samuel J E; Cotter, James D; Brassard, Patrice; Bailey, Damian M

    2015-06-01

    Exercise is a uniquely effective and pluripotent medicine against several noncommunicable diseases of westernised lifestyles, including protection against neurodegenerative disorders. High-intensity interval exercise training (HIT) is emerging as an effective alternative to current health-related exercise guidelines. Compared with traditional moderate-intensity continuous exercise training, HIT confers equivalent if not indeed superior metabolic, cardiac, and systemic vascular adaptation. Consequently, HIT is being promoted as a more time-efficient and practical approach to optimize health thereby reducing the burden of disease associated with physical inactivity. However, no studies to date have examined the impact of HIT on the cerebrovasculature and corresponding implications for cognitive function. This review critiques the implications of HIT for cerebrovascular function, with a focus on the mechanisms and translational impact for patient health and well-being. It also introduces similarly novel interventions currently under investigation as alternative means of accelerating exercise-induced cerebrovascular adaptation. We highlight a need for studies of the mechanisms and thereby also the optimal dose-response strategies to guide exercise prescription, and for studies to explore alternative approaches to optimize exercise outcomes in brain-related health and disease prevention. From a clinical perspective, interventions that selectively target the aging brain have the potential to prevent stroke and associated neurovascular diseases.

  17. 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

  18. 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.

  19. Borders and Identity: A Resource Guide for Teachers = Identidad y Fronteras: Una Guia para Maestros.

    Science.gov (United States)

    Belauus, Betty; Botein, Emily; Cadaval, Olivia

    The materials in this resource guide include a four-part video, a poster-size cultural map with additional exercises, and the five sections of this guide. The unit, presented in English and Spanish, intends to introduce students to the peoples and cultures of the U.S.-Mexico border, to explore the concept of borders in their own communities, to…

  20. Guide for: environmental radiological surveillance at US Department of Energy installations

    International Nuclear Information System (INIS)

    Corley, J.P.; Denham, D.H.; Jaquish, R.E.; Michels, D.E.; Olsen, A.R.; Waite, D.A.

    1981-07-01

    This second edition of the Guide, originally published in 1977, is presented as an interim revision and does not contain major changes in content. The original objectives and scope of the Guide have not changed. The Guide is intended to: provide recommended methods, procedures, and performance criteria to bring greater comparability to DOE environmental monitoring and reporting systems; provide DOE management, particularly the Headquarters' Operational and Environmental Safety Division (OESD) and field offices, with a broad review of accepted radiological surveillance practices for use in the evaluation of environmental surveillance programs at DOE facilities; and delineate the capabilities and limitations of the various environmental monitoring systems for radioactivity currently used at DOE sites, including technical areas where there is either an inadequate basis for procedural selection or where further development work may be warranted. The document is intended as a guide, not a manual of detailed mandatory procedure

  1. Cardiopulmonary exercise testing – effective method for evaluation and recommendation of individualized exercise training in patients with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2011-12-01

    Full Text Available The present study aims to emphasize the role of cardiopulmonary exercise training (CPET in evaluation and recommendation of individualized exercise training in patients with a metabolic syndrome. Methods: We performed a prospective longitudinal study of 9 months. The study group consisted of 28 young patients (21.3±3.1 years old without contraindications to exercise, previously diagnosed with metabolic syndrome according to NCEP-ATPIII criteria. All patients were evaluating at baseline and after 3 months of intervention and at the end of the study (after 9 months. The evaluation consists in performing a CPET on bicycle ergometer in which subjects were monitored in terms of cardiac and respiratory parameters. The CPET results allow us to establish the range of effort intensity in which the patient should exercise in order to burn calories and achieve the maximum fat oxidation rate. All patients benefit from an intensive interval exercise training programme, supervised and guided by a physical therapist. Exercise training consisted in 50 minutes sessions, 3 times per week, at intensive endurance training zone (in the range of anaerobic threshold, completed by 1 minute interval in the range between anaerobic threshold (AT and respiratory compensation point (RCP, for every 5 minutes of training. Results: After 9 months of intervention we noticed an improvement of abdominal obesity (waist circumference decreased from 98.98±10.14 cm to 89.54±12.32 cm, p<0.001, physical fitness (V’O2peak increased from 1.83±0.33 l/min to 2.13±0.4 l/min, p<0.001 and endurance (Oxygen uptake in the range of anaerobic treshold increase from 1.27±0.27 l/min to 1.55±0.31 l/min, p<0.001. Conclusions: Cardiopulmonary exercise testing together with training zones determinations is a useful tool for assessing the exercise capacity and drawing up individual workouts. Active and closely monitored intervention by individualized exercise training programmes leads to

  2. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    Energy Technology Data Exchange (ETDEWEB)

    Yegul, I. E-mail: iyegul@med.ege.edu.tr; Erhan, E. E-mail: elvanerhan@yahoo.com

    2003-11-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures.

  3. Bilateral CT-guided percutaneous cordotomy for cancer pain relief

    International Nuclear Information System (INIS)

    Yegul, I.; Erhan, E.

    2003-01-01

    AIM: CT-guided percutaneous cordotomy is a useful procedure for treating unilateral cancer pain, however, bilateral cordotomy can be required on some occasions. We evaluated the effectiveness and complications of bilateral cordotomy. MATERIALS AND METHODS: Two hundred and thirty-four patients who suffered from unilateral cancer pain underwent CT-guided percutaneous cordotomy. The procedure was repeated in 22 patients, and nine patients had bilateral cordotomy. Effectiveness and complications were recorded after each procedure. RESULTS: Of nine patents (three women and six men) having bilateral percutaneous cordotomy in our study, four patients had mirror pain after the first procedure. In the remaining five patients the contralateral pain was due to new pain sites. The pain scores before and after the first procedure were 9.3 (range 7-10) and 1.2 (range 0-3), respectively. After the first procedure complete or satisfactory pain relief was achieved in all patients. The duration between the two procedures ranged from 7-243 days (mean 59.8 days). The pain scores before and after the second procedure were 8.4 (range 5-10) and 1.6 (range 0-4), respectively. After the second procedure complete or satisfactory pain relief was reported in all patients. There were no complications in four patients. One patient developed transient motor deficit after the first procedure. Other complications (nausea/vomiting, headache, ipsilateral neck pain, postcordotomy dysesthesia) were mild and transient. CONCLUSION: CT-guided percutaneous cordotomy is a useful procedure for the treatment of severe unilateral cancer pain syndromes. The procedure can be repeated on the other side at least 1 week later. These results show that the success on the second side appears to be similar to the first side with low complication rate for both procedures

  4. System analysis procedures for conducting PSA of nuclear power plants

    International Nuclear Information System (INIS)

    Lee, Yoon Hwan; Jeong, Won Dae; Kim, Tae Un; Kim, Kil You; Han, Sang Hoon; Chang, Seung Chul; Sung, Tae Yong; Yang, Jun Eon; Kang, Dae Il; Park, Jin Hee; Hwang, Mi Jeong; Jin, Young Ho.

    1997-03-01

    This document, the Probabilistic Safety Assessment(PSA) procedures guide for system analysis, is intended to provide the guidelines to analyze the target of system consistently and technically in the performance of PSA for nuclear power plants(NPPs). The guide has been prepared in accordance with the procedures and techniques for fault tree analysis(FTA) used in system analysis. Normally the main objective of system analysis is to assess the reliability of system modeled by Event Tree Analysis(ETA). A variety of analytical techniques can be used for the system analysis, however, FTA method is used in this procedures guide. FTA is the method used for representing the failure logic of plant systems deductively using AND, OR or NOT gates. The fault tree should reflect all possible failure modes that may contribute to the system unavailability. This should include contributions due to the mechanical failures of the components, Common Cause Failures (CCFs), human errors and outages for testing and maintenance. After the construction of fault tree is completed, system unavailability is calculated with the CUT module of KIRAP, and the qualitative and quantitative analysis is performed through the process as above stated. As above mentioned, the procedures for system analysis is based on PSA procedures and methods which has been applied to the safety assessments of constructing NPPs in the country. Accordingly, the method of FTA stated in this procedures guide will be applicable to PSA for the NPPs to be constructed in the future. (author). 6 tabs., 11 figs., 7 refs

  5. System analysis procedures for conducting PSA of nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yoon Hwan; Jeong, Won Dae; Kim, Tae Un; Kim, Kil You; Han, Sang Hoon; Chang, Seung Chul; Sung, Tae Yong; Yang, Jun Eon; Kang, Dae Il; Park, Jin Hee; Hwang, Mi Jeong; Jin, Young Ho

    1997-03-01

    This document, the Probabilistic Safety Assessment(PSA) procedures guide for system analysis, is intended to provide the guidelines to analyze the target of system consistently and technically in the performance of PSA for nuclear power plants(NPPs). The guide has been prepared in accordance with the procedures and techniques for fault tree analysis(FTA) used in system analysis. Normally the main objective of system analysis is to assess the reliability of system modeled by Event Tree Analysis(ETA). A variety of analytical techniques can be used for the system analysis, however, FTA method is used in this procedures guide. FTA is the method used for representing the failure logic of plant systems deductively using AND, OR or NOT gates. The fault tree should reflect all possible failure modes that may contribute to the system unavailability. This should include contributions due to the mechanical failures of the components, Common Cause Failures (CCFs), human errors and outages for testing and maintenance. After the construction of fault tree is completed, system unavailability is calculated with the CUT module of KIRAP, and the qualitative and quantitative analysis is performed through the process as above stated. As above mentioned, the procedures for system analysis is based on PSA procedures and methods which has been applied to the safety assessments of constructing NPPs in the country. Accordingly, the method of FTA stated in this procedures guide will be applicable to PSA for the NPPs to be constructed in the future. (author). 6 tabs., 11 figs., 7 refs.

  6. CT-guided interventions in children

    International Nuclear Information System (INIS)

    Honnef, D.; Wildberger, J.E.; Schubert, H.; Hohl, C.; Guenther, R.W.; Mahnken, A.

    2007-01-01

    In pediatric CT-guided interventions specific features have to be taken into account. Due to a lack of cooperation or limited ability to cooperate, procedures are often performed using analgosedation or general anesthesia. To provide radiation protection, justified indication for CT-guided intervention is necessary and sonography and MRI are to be preferred whenever possible. CT examinations also need to be dose-adapted with sequential scanning and a tube voltage and tube current reduction compared to pediatric diagnostic CT studies must be ensured. Gonad shields are recommended for male patients. Biopsy device selection depends on the assumed tumor entity since histology and also immunohistochemical, molecular pathological and cytogenetical analysis are necessary to differentiate pediatric tumors (small, round, blue cell tumors). In addition to diagnostic procedures, therapeutic interventions (drainage, injection therapies, neurolysis, and radiofrequency ablation) can also be used in children and can provide an alternative to surgery in selected cases. With justified indications and precise performance, CT-guided interventions can be successful in pediatric patients with limited risks. (orig.)

  7. 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.

  8. Self-Regulated Learning Strategies of Engineering College Students While Learning Electric Circuit Concepts with Enhanced Guided Notes

    Science.gov (United States)

    Lawanto, Oenardi; Santoso, Harry

    2013-01-01

    The current study evaluated engineering college students' self-regulated learning (SRL) strategies while learning electric circuit concepts using enhanced guided notes (EGN). Our goal was to describe how students exercise SRL strategies and how their grade performance changes after using EGN. Two research questions guided the study: (1) To what…

  9. 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 ...

  10. System administrator`s guide to CDPS. Version 1.0

    Energy Technology Data Exchange (ETDEWEB)

    Didier, B.T.; Portwood, M.H.

    1994-05-01

    The System Administrator`s Guide to CDPS is intended for those responsible for setting up and maintaining the hardware and software of a Common Mapping Standard (CMS) Date Production System (CDPS) installation. This guide assists the system administrator in performing typical administrative functions. It is not intended to replace the Ultrix Documentation Set that should be available for a DCPS installation. The Ultrix Documentation Set will be required to provide details on referenced Ultrix commands as well as procedures for performing Ultrix maintenance functions. There are six major sections in this guide. Section 1 introduces the system administrator to CDPS and describes the assumptions that are made by this guide. Section 2 describes the CDPS platform configuration. Section 3 describes the platform preparation that is required to install the CDPS software. Section 4 describes the CPS software and its installation procedures. Section 5 describes the CDS software and its installation procedures. Section 6 describes various operation and maintenance procedures. Four appendices are also provided. Appendix A contains a list of used acronyms. Appendix B provides a terse description of common Ultrix commands that are used in administrative functions. Appendix C provides sample CPS and CDS configuration files. Appendix D provides a required list and a recommended list of Ultrix software subsets for installation on a CDPS platform.

  11. A manual therapy and exercise approach to meralgia paresthetica in pregnancy: a case report

    Science.gov (United States)

    Skaggs, Clayton D.; Winchester, Brett A.; Vianin, Michael; Prather, Heidi

    2006-01-01

    Abstract Objective To present a case of a pregnant patient with meralgia paresthetica who improved using manual therapy and exercise procedures. Clinical Features A 22-year-old patient in the sixteenth week of pregnancy had low back pain, bilateral anterolateral thigh paresthesia and groin pain for a duration of 1 month. She had no motor deficits in either lower extremity and her reflexes were intact. As a standard clinic procedure, a battery of functional tests were performed including: active straight leg raise, long dorsal ligament test, and the pelvic pain provocation procedure. Based on her clinical history and physical responses to the aforementioned functional tests, the diagnosis of meralgia paresthetica was deduced. Intervention and Outcome Treatment was provided at 6 visits over a 6-week period where the patient underwent evaluation, manual intervention, and exercise prescription. Active Release Technique (ART) was performed to the restricted right sacroiliac (SIJ) complex and quadratus lumborum muscles. ART and post-isometric relaxation were applied to the illiopsoas muscles. The home exercise program consisted of pelvic/low back mobility, stabilization and relaxation exercises. After 6 treatments, the patient reported complete resolution of low back pain and left lower extremity symptoms and a 90% improvement in the right thigh symptoms. At her one-year follow-up, the patient reported no further complications and the absence of pain. Conclusions Manual therapy and exercises may serve as an effective treatment protocol for pregnant patients experiencing low back pain complicated by paresthesia. Because these conservative procedures offer a low-risk intervention, additional clinical studies are warranted to further study this treatment. PMID:19674679

  12. 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)

  13. Unicorns and Dragons: Using Guided Imagery in the Classroom.

    Science.gov (United States)

    Stockard, William H.; Eccles, Frankie

    A variety of classroom activities are offered in this paper as ways of exercising children's imaginations. Following a discussion of the need for developing creative thinking in children, some ways to establish the freedom or atmosphere to begin fantasies are offered and a guided fantasy technique for classroom use is outlined. The second half of…

  14. 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

  15. The role of ultrasound-guided vacuum-assisted removal of gynecomastia

    Energy Technology Data Exchange (ETDEWEB)

    Kim, You Me [Dankook University Hospital, Cheonan (Korea, Republic of)

    2008-02-15

    To evaluate the role of performing ultrasound (US)-guided vacuum-assisted breast biopsies for the treatment (mammotome excision) of gynecomastia. Between November 2005 and December 2006, nine male patients underwent US-guided mammotome excision for eleven cases of true gynecomastia. The patient ages ranged from 14 to 55 years (mean age, 32.3 years). US-guided mammotome excision was performed with an 11-gauge needle in seven cases and an 8-gauge needle in four cases. After the procedure, the cigarette method using gauze packing was performed. The number of samples, procedure time and presence of complications were evaluated. Scheduled follow-up physical and US examinations were performed after three and six months. For 11 cases of US-guided mammotome excision of gynecomastia, the number of samples ranged from 12-126 (mean, 66) and the procedure time ranged from 10-42 minutes (mean time, 25.1 minutes). Clinical significant complications did not occur immediately after the procedure and complications were not seen after a follow-up examination in any of the cases. At the 3-and 6-month follow up examinations, all of the patients showed a normal male physical appearance on a physical examination and there was no evidence of hypoechoic glandular tissues as seen on ultrasonograms. US-guided mammotome excision is effective for the treatment of small, glandular true gynecomastia and is suggested as a new modality to replace the need for surgery or liposuction.

  16. 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...

  17. 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)

  18. 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

  19. Radiologically-guided catheter drainage of intrathoracic abscesses and empyemas

    International Nuclear Information System (INIS)

    Berger, H.; Steiner, W.; Bergman, C.; Anthuber, M.; Dienemann, H.

    1993-01-01

    Radiologically guided percutaneous catheter drainage was used in 38 patients to treat pleural empyemas (35 patients) and pulmonary abscesses (3 patients). Drainage was successful in 85.7% of empyemas including 11 cases with fistulous communications. Three percutaneously drained pulmonary abscesses required subsequent lobectomy. One patient died during the drainage procedure due to sepsis. No major complications related to the drainage procedure were observed. Guided percutaneous drainage proved to be a safe and successful alternative to closed drainage of pleural fluid collections. (orig.)

  20. 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,…

  1. Exercise body surface potential mapping in single and multiple coronary artery disease

    International Nuclear Information System (INIS)

    Montague, T.J.; Witkowski, F.X.; Miller, R.M.; Johnstone, D.E.; MacKenzie, R.B.; Spencer, C.A.; Horacek, B.M.

    1990-01-01

    Body surface ST integral maps were recorded in 36 coronary artery disease (CAD) patients at: rest; peak, angina-limited exercise; and, 1 and 5 min of recovery. They were compared to maps of 15 CAD patients who exercised to fatigue, without angina, and eight normal subjects. Peak exercise heart rates were similar (NS) in all groups. With exercise angina, patients with two and three vessel CAD had significantly (p less than 0.05) greater decrease in the body surface sum of ST integral values than patients with single vessel CAD. CAD patients with exercise fatigue, in the absence of angina, had decreased ST integrals similar (NS) to patients with single vessel CAD who manifested angina and the normal control subjects. There was, however, considerable overlap among individuals; some patients with single vessel CAD had as much exercise ST integral decrease as patients with three vessel CAD. All CAD patients had persistent ST integral decreases at 5 min of recovery and there was a direct correlation of the recovery and peak exercise ST changes. Exercise ST changes correlated, as well, with quantitative CAD angiographic scores, but not with thallium perfusion scores. These data suggest exercise ST integral body surface mapping allows quantitation of myocardium at ischemic risk in patients with CAD, irrespective of the presence or absence of ischemic symptoms during exercise. A major potential application of this technique is selection of CAD therapy guided by quantitative assessment of ischemic myocardial risk

  2. Efficacy of US-guided Hydrostatic Reduction in Children with Intussusception

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Min; Chung, Tae Woong; Yoon, Woong; Chang, Nam Kyu; Heo, Suk Hee; Shin, Sang Soo; Lim, Hyo Sun; Jeong, Yong Yeon; Kang, Heoung Keun [Chonnam National University Hospital, Gwangju (Korea, Republic of)

    2007-09-15

    To assess the success rate and efficacy of US-guided hydrostatic reduction in children with intussusception. We retrospectively evaluated the ultrasonographic findings and clinical features of 121 children (M:F=80:41, mean age= 18 months) who underwent US-guided hydrostatic reduction between November, 2002 and February, 2007 for the diagnosis and treatment of intussusception. The 121 patients underwent 147 procedures, including recurred cases. Successful reduction was achieved in 132 cases (89.8% success rate), as confirmed by post-procedure ultrasonography and clinical findings. Emergency operations were performed in the 10 (6.8%) cases of irreducible intussusceptions, 8 of ileocolic type and 2 of ileoileal type. Perforation occurred in 4 cases (2.7%), and seizure in 1 case during the procedure (0.7%). US-guided hydrostatic reduction is a safe and effective tool for the diagnosis and treatment of pediatric intussusception

  3. Robotic System for MRI-Guided Stereotactic Neurosurgery

    Science.gov (United States)

    Li, Gang; Cole, Gregory A.; Shang, Weijian; Harrington, Kevin; Camilo, Alex; Pilitsis, Julie G.; Fischer, Gregory S.

    2015-01-01

    Stereotaxy is a neurosurgical technique that can take several hours to reach a specific target, typically utilizing a mechanical frame and guided by preoperative imaging. An error in any one of the numerous steps or deviations of the target anatomy from the preoperative plan such as brain shift (up to 20 mm), may affect the targeting accuracy and thus the treatment effectiveness. Moreover, because the procedure is typically performed through a small burr hole opening in the skull that prevents tissue visualization, the intervention is basically “blind” for the operator with limited means of intraoperative confirmation that may result in reduced accuracy and safety. The presented system is intended to address the clinical needs for enhanced efficiency, accuracy, and safety of image-guided stereotactic neurosurgery for Deep Brain Stimulation (DBS) lead placement. The work describes a magnetic resonance imaging (MRI)-guided, robotically actuated stereotactic neural intervention system for deep brain stimulation procedure, which offers the potential of reducing procedure duration while improving targeting accuracy and enhancing safety. This is achieved through simultaneous robotic manipulation of the instrument and interactively updated in situ MRI guidance that enables visualization of the anatomy and interventional instrument. During simultaneous actuation and imaging, the system has demonstrated less than 15% signal-to-noise ratio (SNR) variation and less than 0.20% geometric distortion artifact without affecting the imaging usability to visualize and guide the procedure. Optical tracking and MRI phantom experiments streamline the clinical workflow of the prototype system, corroborating targeting accuracy with 3-axis root mean square error 1.38 ± 0.45 mm in tip position and 2.03 ± 0.58° in insertion angle. PMID:25376035

  4. 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.

  5. Attitudes towards health and exercise of overweight women.

    Science.gov (United States)

    Khanam, Salma; Costarelli, Vassiliki

    2008-01-01

    To investigate the attitudes and beliefs held by UK Bangladeshi women on health and exercise and explore possible ways of increasing levels of physical activity in this group. A survey based on an interview-guided questionnaire, with 25 British Bangladeshi females, 30-60 years old, from the Borough of Tower Hamlets, East London, who have been referred to a gym by their general practitioner (GP) in order to improve health. Main reasons for referral were: obesity, metabolic syndrome, risk of type 2 diabetes and high blood pressure. Forty per cent of the subjects were obese (BMI > 30 kg/m2) and the remaining 60% were overweight (BMI 25-30 kg/m2). The great majority of the subjects (96%) reported that they were only willing to take up exercise if they were referred to the gym by their GP as an alternative or additional treatment for their complaints. They would not exercise voluntarily. Even though all women in our sample were either overweight or obese, 16% of the subjects reported that they did not know if they were overweight and 20% thought that they were actually of normal weight. Most women identified swimming as the type of physical activity of preference, if they had to exercise, followed by slow walking, with running being the least enjoyed activity. Bangladeshi women take little regular exercise to improve their health, predominant because of certain cultural beliefs and attitudes. More needs to be done to encourage levels and types of exercise that would be more appropriate for this ethnic group.

  6. 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

  7. [Guided maxillofacial surgery: Simulation and surgery aided by stereolithographic guides and custom-made miniplates.

    Science.gov (United States)

    Philippe, B

    2013-08-05

    We present a new model of guided surgery, exclusively using computer assistance, from the preoperative planning of osteotomies to the actual surgery with the aid of stereolithographic cutting guides and osteosynthetic miniplates designed and made preoperatively, using custom-made titanium miniplates thanks to direct metal laser sintering. We describe the principles that guide the designing and industrial manufacturing of this new type of osteosynthesis miniplates. The surgical procedure is described step-by-step using several representative cases of dento-maxillofacial dysmorphosis. The encouraging short-term results demonstrate the wide range of application of this new technology for cranio-maxillofacial surgery, whatever the type of osteotomy performed, and for plastic reconstructive surgery. Copyright © 2013. Published by Elsevier Masson SAS.

  8. Results of the round robin exercise on IV-measurements of classic Si-solar cells

    Energy Technology Data Exchange (ETDEWEB)

    Van der Borg, N.J.C.M. [ECN Solar Energy, Petten (Netherlands)

    2012-12-15

    A round robin exercise was performed on IV measurements and spectral response measurements of solar cells. Seven partners participated in the exercise. The aim of the round robin was to enable the verification of their measurement facilities and procedures for IV-measurements on 'classic' Si-solar cells by comparing their measurement data with the other participants. In this way possible flaws in the equipment or procedures can be found and corrected for or the measurement uncertainties can be reassessed. The differences between the measurement results of the various partners were more or less within the expected measurement uncertainty although one or more partners may decide to use the results to reexamine their facilities or procedures.

  9. CT and fluoroscopy guided celiac ganglion block

    International Nuclear Information System (INIS)

    Lim, Sun Kyung; Kwon, Dae Ik; Ahn, Hyup; Kim, Jong Il; Kim, Byung Young; Lee, Jong Gil

    1994-01-01

    To evaluate the effects and usefulness of fluoroscopy guided celiac ganglion block after marking of needle path with CT scan. Celiac ganglion block with 100% ethyl alcohol was performed in 50 cancer patients who were inoperable and had intractable abdominal pain. Duration and degree of pain relief after the procedure and its complication were analyzed. Early pain relief was observed in 98% and long term relief in 68% without serious complication. Fluoroscopy guided celiac ganglion block after marking of needle path with CT scan was a safe and valuable procedure in relieving intractable pain in terminal cancer patients and reduced the time in the CT room

  10. 48 CFR 31.002 - Availability of accounting guide.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Availability of accounting... GENERAL CONTRACTING REQUIREMENTS CONTRACT COST PRINCIPLES AND PROCEDURES 31.002 Availability of accounting guide. Contractors needing assistance in developing or improving their accounting systems and procedures...

  11. MCSA Windows Server 2012 R2 configuring advanced services study guide exam 70-412

    CERN Document Server

    Panek, William

    2015-01-01

    The bestselling MCSA study guide, with expert instruction andhands-on practice MCSA Windows Server 2012 R2 Configuring Advanced ServicesStudy Guide provides focused preparation for exam 70-412 and isfully updated to align with the latest Windows Server 2012 R2objectives. This comprehensive guide covers 100 percent of all examobjective domains, and includes hundreds of practice questions andanswers. You get access to video demonstrations, electronicflashcards, and practice exams, and hands-on exercises based onreal-world scenarios allow you to apply your skills to everydaytasks. Organized by o

  12. Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis

    Science.gov (United States)

    Takenaka, Mamoru; Kamata, Ken; Yoshikawa, Tomoe; Nakai, Atsushi; Omoto, Shunsuke; Miyata, Takeshi; Yamao, Kentaro; Imai, Hajime; Sakamoto, Hiroki; Kitano, Masayuki; Kudo, Masatoshi

    2018-01-01

    The most common symptom in patients with advanced pancreatic cancer is abdominal pain. This has traditionally been treated with nonsteroidal anti-inflammatory drugs and opioid analgesics. However, these treatments result in inadequate pain control or drug-related adverse effects in some patients. An alternative pain-relief modality is celiac plexus neurolysis, in which the celiac plexus is chemically ablated. This procedure was performed percutaneously or intraoperatively until 1996, when endoscopic ultrasound (EUS)-guided celiac plexus neurolysis was first described. In this transgastric anterior approach, a neurolytic agent is injected around the celiac trunk under EUS guidance. The procedure gained popularity as a minimally invasive approach and is currently widely used to treat pancreatic cancer-associated pain. We focus on two relatively new techniques of EUS-guided neurolysis: EUS-guided celiac ganglia neurolysis and EUS-guided broad plexus neurolysis, which have been developed to improve efficacy. Although the techniques are safe and effective in general, some serious adverse events including ischemic and infectious complications have been reported as the procedure has gained widespread popularity. We summarize reported clinical outcomes of EUS-guided neurolysis in pancreatic cancer (from the PubMed and Embase databases) with a goal of providing information useful in developing strategies for pancreatic cancer-associated pain alleviation. PMID:29462851

  13. Ultrasound-Guided Percutaneous Dilational Tracheostomy: A Systematic Review of Randomized Controlled Trials and Meta-Analysis.

    Science.gov (United States)

    Gobatto, André L N; Besen, Bruno A M P; Cestari, Mino; Pelosi, Paolo; Malbouisson, Luiz M S

    2018-01-01

    Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications. A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark-guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I 2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I 2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I 2 = 0%). The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical

  14. 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…

  15. 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

  16. Improved staff procedure skills lead to improved managment skills: an observational study in an educational setting.

    Science.gov (United States)

    Rüter, Anders; Vikstrom, Tore

    2009-01-01

    Good staff procedure skills in a management group during incidents and disasters are believed to be a prerequisite for good management of the situation. However, this has not been demonstrated scientifically. Templates for evaluation results from performance indicators during simulation exercises have previously been tested. The aim of this study was to demonstrate the possibility that these indicators can be used as a tool for studying the relationship between good management skills and good staff procedure skills. Good and structured work (staff procedure skills) in a hospital management group during simulation exercises in disaster medicine is related to good and timely decisions (good management skills). Results from 29 consecutive simulation exercises in which staff procedure skills and management skills were evaluated using quantitative measurements were included. The statistical analysis method used was simple linear regression with staff procedure skills as the response variable and management skills as the predictor variable. An overall significant relationship was identified between staff procedure skills and management skills (p(2)0.05). This study suggests that there is a relationship between staff procedure skills and management skills in the educational setting used. Future studies are needed to demonstrate if this also can be observed during actual incidents.

  17. 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.)

  18. 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.)

  19. 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

  20. 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)

  1. Treatment of osteoid osteoma using CT-guided radiofrequency ablation versus MR-guided laser ablation: A cost comparison

    International Nuclear Information System (INIS)

    Maurer, M.H.; Gebauer, B.; Wieners, G.; De Bucourt, M.; Renz, D.M.; Hamm, B.; Streitparth, F.

    2012-01-01

    Objective: To compare the costs of CT-guided radiofrequency ablation (RFA) and MR-guided laser ablation (LA) for minimally invasive percutaneous treatment of osteoid osteoma. Materials and methods: Between November 2005 and October 2011, 20 patients (14 males, 6 females, mean age 20.3 ± 9.1 years) underwent CT-guided RFA and 24 patients (18 males, 6 females; mean age, 23.8 ± 13.8 years) MR-guided LA (open 1.0 Tesla, Panorama HFO, Philips, Best, Netherlands) for osteoid osteoma diagnosed on the basis of clinical presentation and imaging findings. Prorated costs of equipment use (purchase, depreciation, and maintenance), staff costs, and expenditure for disposables were identified for CT-guided RFA and MR-guided LA procedures. Results: The average total costs per patient were EUR 1762 for CT-guided RFA and EUR 1417 for MR-guided LA. These were (RFA/LA) EUR 92/260 for equipment use, EUR 149/208 for staff, and EUR 870/300 for disposables. Conclusion: MR-guided LA is less expensive than CT-guided RFA for minimally invasive percutaneous ablation of osteoid osteoma. The higher costs of RFA are primarily due to the higher price of the disposable RFA probes.

  2. Performance appraisal and advancement exercise 2006

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement 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 1 December 2005 to 31 March 2006. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisal 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 December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. Human Resources Department Tel. 73566

  3. 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

  4. Training Requirements and Information Management System. Software user guide

    Energy Technology Data Exchange (ETDEWEB)

    Cillan, T.F.; Hodgson, M.A.

    1992-05-01

    This is the software user`s guide for the Training Requirements and Information Management System. This guide defines and describes the software operating procedures as they apply to the end user of the software program. This guide is intended as a reference tool for the user who already has an indepth knowledge of the Training Requirements and Information Management System functions and data reporting requirement.

  5. 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

  6. 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)…

  7. Perkembangan Terkini Membran Guided Tissue Regeneration/Guided Bone Regeneration sebagai Terapi Regenerasi Jaringan Periodontal

    Directory of Open Access Journals (Sweden)

    Cindy Cahaya

    2015-06-01

    kombinasi prosedur-prosedur di atas, termasuk prosedur bedah restoratif yang berhubungan dengan rehabilitasi oral dengan penempatan dental implan. Pada tingkat selular, regenerasi periodontal adalah proses kompleks yang membutuhkan proliferasi yang terorganisasi, differensiasi dan pengembangan berbagai tipe sel untuk membentuk perlekatan periodontal. Rasionalisasi penggunaan guided tissue regeneration sebagai membran pembatas adalah menahan epitel dan gingiva jaringan pendukung, sebagai barrier membrane mempertahankan ruang dan gigi serta menstabilkan bekuan darah. Pada makalah ini akan dibahas sekilas mengenai 1. Proses penyembuhan terapi periodontal meliputi regenerasi, repair ataupun pembentukan perlekatan baru. 2. Periodontal spesific tissue engineering. 3. Berbagai jenis membran/guided tissue regeneration yang beredar di pasaran dengan keuntungan dan kerugian sekaligus karakteristik masing-masing membran. 4. Perkembangan membran terbaru sebagai terapi regenerasi penyakit periodontal. Tujuan penulisan untuk memberi gambaran masa depan mengenai terapi regenerasi yang menjanjikan sebagai perkembangan terapi penyakit periodontal.   Latest Development of Guided Tissue Regeneration and Guided Bone Regeneration Membrane as Regenerative Therapy on Periodontal Tissue. Periodontitis is a patological state which influences the integrity of periodontal system that could lead to the destruction of the periodontal tissue and end up with tooth loss. Currently, there are so many researches and efforts to regenerate periodontal tissue, not only to stop the process of the disease but also to reconstruct the periodontal tissue. Periodontal regenerative therapy aims at directing the growth of new bone, cementum and periodontal ligament on the affected teeth. Regenerative procedures consist of soft tissue graft, bone graft, roots biomodification, guided tissue regeneration and combination of the procedures, including restorative surgical procedure that is

  8. Standard Guide for Identification of Fiber-Reinforced Polymer-Matrix Composite Materials in Databases

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2000-01-01

    1.1 This guide establishes essential and desirable data elements for fiber-reinforced composite materials for two purposes: to establish the material identification component of data-reporting requirements for test reporting and to provide information for the design of material property databases. 1.1.1 This guide is the first part of a two-part modular approach. The first part serves to identify the material and the second part serves to describe testing procedures and variables and to record results. 1.1.2 For mechanical testing, the related document is Guide E 1434. The interaction of this guide with Guide E 1434 is emphasized by the common numbering of data elements. Data Elements A1 through G13 are included in this guide, and numbering of data elements in Guide E 1434 begins with H1 for the next data element block. This guide is most commonly used in combination with a guide for reporting the test procedures and results such as Guide E 1434. 1.2 These guidelines are specific to fiber-reinforced polyme...

  9. Disinfection of a probe used in ultrasound-guided prostate biopsy.

    Science.gov (United States)

    Rutala, William A; Gergen, Maria F; Weber, David J

    2007-08-01

    Transrectal ultrasound (TRUS)-guided prostate biopsies are among the most common outpatient diagnostic procedures in urology clinics and carry the risk of introducing pathogens that may lead to infection. To investigate the effectiveness of procedures for disinfecting a probe used in ultrasound-guided prostate biopsy. The effectiveness of disinfection was determined by inoculating 10(7) colony forming units (cfu) of Pseudomonas aeruginosa at the following 3 sites on the probe: the interior lumen of the biopsy needle guide, the outside surface of the biopsy needle guide, and the interior lumen of the ultrasound probe where the needle guide passes through the transducer. Each site was investigated separately. After inoculation, the probe was immersed in 2% glutaraldehyde for 20 minutes and then assessed for the level of microbial contamination. The results demonstrated that disinfection (ie, a reduction in bacterial load of greater than 7 log(10) cfu) could be achieved if the needle guide was removed from the probe. However, if the needle guide was left in the probe channel during immersion in 2% glutaraldehyde, disinfection was not achieved (ie, the reduction was approximately 1 log(10) cfu). Recommendations for probe disinfection are provided and include disassembling the device and immersing the probe and the needle guide separately in a high-level disinfectant.

  10. Computed tomography-guided percutaneous gastrostomy: initial experience at a cancer center

    International Nuclear Information System (INIS)

    Tyng, Chiang Jeng; Santos, Erich Frank Vater; Guerra, Luiz Felipe Alves; Bitencourt, Almir Galvao Vieira; Barbosa, Paula Nicole Vieira Pinto; Chojniak, Rubens; Universidade Federal do Espirito Santo

    2017-01-01

    Gastrostomy is indicated for patients with conditions that do not allow adequate oral nutrition. To reduce the morbidity and costs associated with the procedure, there is a trend toward the use of percutaneous gastrostomy, guided by endoscopy, fluoroscopy, or, most recently, computed tomography. The purpose of this paper was to review the computed tomography-guided gastrostomy procedure, as well as the indications for its use and the potential complications. (author)

  11. Computed tomography-guided percutaneous gastrostomy: initial experience at a cancer center

    Energy Technology Data Exchange (ETDEWEB)

    Tyng, Chiang Jeng; Santos, Erich Frank Vater; Guerra, Luiz Felipe Alves; Bitencourt, Almir Galvao Vieira; Barbosa, Paula Nicole Vieira Pinto; Chojniak, Rubens [A. C. Camargo Cancer Center, Sao Paulo, SP (Brazil); Universidade Federal do Espirito Santo (HUCAM/UFES), Vitoria, ES (Brazil). Hospital Universitario Cassiano Antonio de Morais. Radiologia e Diagnostico por Imagem

    2017-03-15

    Gastrostomy is indicated for patients with conditions that do not allow adequate oral nutrition. To reduce the morbidity and costs associated with the procedure, there is a trend toward the use of percutaneous gastrostomy, guided by endoscopy, fluoroscopy, or, most recently, computed tomography. The purpose of this paper was to review the computed tomography-guided gastrostomy procedure, as well as the indications for its use and the potential complications. (author)

  12. Bosentan Improves Exercise Capacity in Adolescents and Adults After Fontan Operation

    DEFF Research Database (Denmark)

    Hebert, Anders; Mikkelsen, Ulla Ramer; Thilen, Ulf

    2014-01-01

    a crucial role. Elevated pulmonary vascular resistance has been associated with raised levels of endothelin-1, which are common both before and after Fontan operations. Treatment with endothelin-1 receptor antagonists could theoretically improve cardiopulmonary hemodynamics and exercise capacity. The aim......BACKGROUND: The Fontan procedure has improved survival in children with functionally univentricular hearts. With time, however, complications such as reduced exercise capacity are seen more frequently. Exercise intolerance is multifactorial, but pulmonary vascular resistance probably plays...... of this study was therefore to examine the efficacy and safety of bosentan in Fontan patients. METHODS AND RESULTS: Seventy-five adolescents and adults were randomized 1:1 to 14 weeks of treatment with bosentan or placebo. Cardiopulmonary exercise test, functional class, blood samples, and quality...

  13. 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

  14. Medical and biohazardous waste generator's guide: Revision 1

    International Nuclear Information System (INIS)

    1994-09-01

    This Guide describes the procedures required to comply with all federal and state laws and regulations and Lawrence Berkeley Laboratory (LBL) policy applicable to medical and biohazardous waste. The members of the LBL Biological Safety Subcommittee participated in writing these policies and procedures. The procedures and policies in this Guide apply to LBL personnel who work with infectious agents or potentially infectious agents, publicly perceived infectious items or materials (e.g., medical gloves, culture dishes), and sharps (e.g., needles, syringes, razor blades). If medical or biohazardous waste is contaminated or mixed with a hazardous chemical or material, with a radioactive material, or with both, the waste will be handled in accordance with the applicable federal and State of California laws and regulations for hazardous, radioactive, or mixed waste

  15. What If?: Writing Exercises for Fiction Writers. Revised and Expanded Edition.

    Science.gov (United States)

    Bernays, Anne; Painter, Pamela

    This book is designed to be a how-to-write-fiction guide that is long on specifics and short on theoretical material. Each section of the book deals with a separate element of fiction--characterization, dialogue, point of view, plot, etc. Every exercise in the book is introduced in an opening paragraph, followed by instructions for completing the…

  16. 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

  17. Ultrasound guided electrochemotherapy for the treatment of a clear ...

    African Journals Online (AJOL)

    Ultrasound guided biopsy yielded a diagnosis of clear cell thymoma upon histopathology. After complete staging procedures, the owner elected to treat the cat with electrochemotherapy (ECT) using systemic bleomycin. Two sessions of ultrasound guided ECT were performed at two week intervals with trains of biphasic ...

  18. Ultrasound-guided Interventions for Core and Hip Injuries in Athletes.

    Science.gov (United States)

    McCarthy, Eoghan; Hegazi, Tarek M; Zoga, Adam C; Morrison, William B; Meyers, William C; Poor, Alex E; Nevalainen, Mika T; Roedl, Johannes B

    2016-09-01

    Trauma and the mechanical strain of high-energy activity predispose athletes to pelvic injuries. Magnetic resonance imaging remains the primary modality for diagnosing these conditions, but ultrasonography-guided interventions are important in the management of core muscle, hip, and other pelvic conditions. This article reviews ultrasonography-guided interventions for injuries at the core, including the pelvis and hips. It reviews common injuries, procedure optimization, medication preparation, clinical evidence behind injections, tenotomy, and platelet-rich plasma. These interventions are especially important in athletes, because ultrasonography-guided procedures are often undertaken early in the treatment process, paralleling conservative rehabilitation to facilitate a faster return to play. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. 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

  20. 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

  1. 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

  2. CompTIA Security+ Deluxe Study Guide Exam SY0-301

    CERN Document Server

    Dulaney, Emmett

    2011-01-01

    Get a host of extras with this Deluxe version including a Security Administration Simulator!  Prepare for CompTIA's new Security+ exam SY0-301 with this Deluxe Edition of our popular CompTIA Security+ Study Guide, 5th Edition. In addition to the 100% coverage of all exam essentials and study tools you'll find in the regular study guide, the Deluxe Edition gives you over additional hands-on lab exercises and study tools, three additional practice exams, author videos, and the exclusive Security Administration simulator. This book is a CompTIA Recommended product. Provides 100% coverage of all e

  3. Therapeutic impact of CT-guided percutaneous catheter drainage in treatment of deep tissue abscesses

    International Nuclear Information System (INIS)

    Asai, Nobuhiro; Ohkuni, Yoshihiro; Kaneko, Norihiro; Aoshima, Masahiro; Yamazaki, Ikuo; Kawamura, Yasutaka

    2013-01-01

    Combination therapy of CT-guided percutaneous drainage and antibiotics is the first-line treatment for abscesses. Its effectiveness has been demonstrated. However, the therapeutic impact of this procedure for infection treatment has never been reported. We retrospectively analyzed all 47 patients who received CT-guided percutaneous drainage for infection treatment. Patients' characteristics, pathogens isolated, antibiotics administered, technical and clinical outcomes, complications related to this procedure and therapeutic impacts were investigated. Patients were 26 males and 21 females. The mean age was 63.5 years (±18.7). The diseases targeted were 19 retroperitoneal abscesses, 18 intraabdominal abscesses, three pelvic abscesses, and seven others. As for technical outcomes, all of the 54 procedures (100%) were successful. As for clinical outcomes, 44 (93.6%) were cured and three patients (6.4%) died. No complications related to this procedure were found in this study. A total of 42 patients (88%) had a change in the management of their infection as a result of CT-guided percutaneous drainage, such as selection and discontinuation of antibiotics. In conclusion, CT-guided percutaneous drainage is a safe and favorable procedure in the treatment of deep tissue abscesses. Therapeutic impact of these procedures helped physicians make a rational decision for antibiotics selection. (author)

  4. Therapeutic impact of CT-guided percutaneous catheter drainage in treatment of deep tissue abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Asai, Nobuhiro; Ohkuni, Yoshihiro; Kaneko, Norihiro; Aoshima, Masahiro; Yamazaki, Ikuo; Kawamura, Yasutaka, E-mail: nobuhiro0204@hotmail.com [Kameda Medical Center, Chiba (Japan)

    2013-03-15

    Combination therapy of CT-guided percutaneous drainage and antibiotics is the first-line treatment for abscesses. Its effectiveness has been demonstrated. However, the therapeutic impact of this procedure for infection treatment has never been reported. We retrospectively analyzed all 47 patients who received CT-guided percutaneous drainage for infection treatment. Patients' characteristics, pathogens isolated, antibiotics administered, technical and clinical outcomes, complications related to this procedure and therapeutic impacts were investigated. Patients were 26 males and 21 females. The mean age was 63.5 years ({+-}18.7). The diseases targeted were 19 retroperitoneal abscesses, 18 intraabdominal abscesses, three pelvic abscesses, and seven others. As for technical outcomes, all of the 54 procedures (100%) were successful. As for clinical outcomes, 44 (93.6%) were cured and three patients (6.4%) died. No complications related to this procedure were found in this study. A total of 42 patients (88%) had a change in the management of their infection as a result of CT-guided percutaneous drainage, such as selection and discontinuation of antibiotics. In conclusion, CT-guided percutaneous drainage is a safe and favorable procedure in the treatment of deep tissue abscesses. Therapeutic impact of these procedures helped physicians make a rational decision for antibiotics selection. (author)

  5. 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.

  6. Patients' mental models and adherence to outpatient physical therapy home exercise programs.

    Science.gov (United States)

    Rizzo, Jon

    2015-05-01

    Within physical therapy, patient adherence usually relates to attending appointments, following advice, and/or undertaking prescribed exercise. Similar to findings for general medical adherence, patient adherence to physical therapy home exercise programs (HEP) is estimated between 35 and 72%. Adherence to HEPs is a multifactorial and poorly understood phenomenon, with no consensus regarding a common theoretical framework that best guides empirical or clinical efforts. Mental models, a construct used to explain behavior and decision-making in the social sciences, may serve as this framework. Mental models comprise an individual's tacit thoughts about how the world works. They include assumptions about new experiences and expectations for the future based on implicit comparisons between current and past experiences. Mental models play an important role in decision-making and guiding actions. This professional theoretical article discusses empirical research demonstrating relationships among mental models, prior experience, and adherence decisions in medical and physical therapy contexts. Specific issues related to mental models and physical therapy patient adherence are discussed, including the importance of articulation of patients' mental models, assessment of patients' mental models that relate to exercise program adherence, discrepancy between patient and provider mental models, and revision of patients' mental models in ways that enhance adherence. The article concludes with practical implications for physical therapists and recommendations for further research to better understand the role of mental models in physical therapy patient adherence behavior.

  7. Systems reliability Benchmark exercise part 1-Description and results

    International Nuclear Information System (INIS)

    Amendola, A.

    1986-01-01

    The report describes aims, rules and results of the Systems Reliability Benchmark Exercise, which has been performed in order to assess methods and procedures for reliability analysis of complex systems and involved a large number of European organizations active in NPP safety evaluation. The exercise included both qualitative and quantitative methods and was structured in such a way that separation of the effects of uncertainties in modelling and in data on the overall spread was made possible. Part I describes the way in which RBE has been performed, its main results and conclusions

  8. Gadolinium Use in Spine Pain Management Procedures for Patients with Contrast Allergies: Results in 527 Procedures

    International Nuclear Information System (INIS)

    Safriel, Yair; Ang, Roberto; Ali, Muhammed

    2008-01-01

    Introduction. To review the safety and efficacy of gadolinium in spine pain management procedures in patients at high risk for a contrast reaction and who are not suitable candidates for the use of standard non-ionic contrast. Methods. We reviewed records over a 61-month period of all image-guided spinal pain management procedures where patients had allergies making them unsuitable candidates for standard non-ionic contrast and where gadolinium was used to confirm needle tip placement prior to injection of medication. Results. Three hundred and four outpatients underwent 527 procedures. A spinal needle was used in all but 41 procedures. Gadolinium was visualized using portable C-arm fluoroscopy in vivo allowing for confirmation of needle tip location. The gadolinium dose ranged from 0.2 to 10 ml per level. The highest dose received by one patient was 15.83 ml intradiscally during a three-level discogram. Three hundred and one patients were discharged without complication or known delayed complications. One patient had documented intrathecal injection but without sequelae and 2 patients who underwent cervical procedures experienced seizures requiring admission to the intensive care unit. Both the latter patients were discharged without any further complications. Conclusion. Based on our experience we recommend using gadolinium judiciously for needle tip confirmation. We feel more confident using gadolinium in the lumbar spine and in cervical nerve blocks. Gadolinium should probably not be used as an injectate volume expander. The indications for gadolinium use in cervical needle-guided spine procedures are less clear and use of a blunt-tipped needle should be considered

  9. 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)

  10. 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)

  11. Development of Handcraft Exercise Courses that Bring Out Student's Creativity

    Science.gov (United States)

    Senda, Shinkoh; Yamamoto, Koji; Fukumori, Tutom; Matsuura, Hideo; Sato, Kazuo

    We have developed a new type of handcraft exercise program that aims to stimulate student's creativity on the way of design and fabrication of the subject machines. Conventional handicraft exercise program used to aim at letting students learn procedures of machining operation in accordance with a designated manual. Students having experienced our conventional exercise did not fully satisfied at those programs because of the lack in a room for their idea and creativity. Authors, a group of both technical and academic staffs, have developed and started the new type of program since 2003 at the Creation Plaza in Nagoya University. Developed program is classified into grades according to the difference in technical contents required for students.

  12. Exercising multi-jurisdictional response to bioterrorism in Canada

    International Nuclear Information System (INIS)

    Jones, M. S.; Marchione, A.; MacDonald, S.; Vidosa, D.

    2009-01-01

    Throughout 2007, the CRTI Biological Cluster conducted a series of biological terrorism exercises within a project entitled Bi-Ex West. The overall purpose of Bi-Ex West was to determine how the federal science and technology community could assist responders in a bio-terrorism attack involving a zoonotic agent. Bi-Ex West consisted of three immersive electronic tabletop exercises, which culminated into a two-day full-scale field exercise involving more than 200 players distributed throughout six sites. Participants represented 18 agencies, including agricultural, health and emergency management organizations at the federal, provincial and municipal levels, as well as first responders from the law enforcement and fire rescue communities. These exercises were conducted in a learning environment that fostered knowledge sharing between local, provincial and federal agencies and enabled participants to exercise their roles, responsibilities and procedures when responding to a biological terrorist event. It also provided agencies with an opportunity to gain a better understanding of how to integrate their various response plans to improve coordination. Observations and recommendations were collected from evaluators and participants over the course of the exercise. The resulting 70 recommendations have been grouped under the following categories: Roles and Responsibilities; Communication; Training, Education and Planning; Resources and Equipment; Security and; Exercise Design. In addition to action items attached to the recommendations, a number of CBRNE activities resulted from Bi-Ex West increasing the capacity of resources within the Federal Government and the Province of British Columbia.(author)

  13. Endoscope-guided pneumatic dilation for treatment of esophageal achalasia

    Science.gov (United States)

    Chuah, Seng-Kee; Wu, Keng-Liang; Hu, Tsung-Hui; Tai, Wei-Chen; Changchien, Chi-Sin

    2010-01-01

    Pneumatic dilation (PD) is considered to be the first line nonsurgical therapy for achalasia. The principle of the procedure is to weaken the lower esophageal sphincter by tearing its muscle fibers by generating radial force. The endoscope-guided procedure is done without fluoroscopic control. Clinicians usually use a low-compliance balloon such as Rigiflex dilator to perform endoscope-guided PD for the treatment of esophageal achalasia. It has the advantage of determining mucosal injury during the dilation process, so that a repeat endoscopy is not needed to assess the mucosal tearing. Previous studies have shown that endoscope-guided PD is an efficient and safe nonsurgical therapy with results that compare well with other treatment modalities. Although the results may be promising, long-term follow-up is required in the near future. PMID:20101764

  14. EUS-guided biliary rendezvous using a short hydrophilic guidewire.

    Science.gov (United States)

    Dhir, Vinay; Kwek, Boon Eu Andrew; Bhandari, Suryaprakash; Bapat, Mukta; Maydeo, Amit

    2011-10-01

    BACKGROUND AND STUDY AIMS: EUS-guided rendezvous technique for biliary access requires expert manipulation of the guidewire across the downstream stricture or papilla. Published literature reports usage of the long-wire system to prevent loss of wire during scope exchange. We studied the efficacy of using a short hydrophilic guidewire in EUS-guided rendezvous. PATIENTS AND METHODS: This is a retrospective study conducted in a tertiary care referral centre. 15 patients underwent EUS-guided biliary rendezvous with short wire. EUS-guided transduodenal/transgastric puncture of the biliary system was performed, followed by anterograde placement of a hydrophilic short-wire (260 cm) across the downstream stricture and/or papilla. Retrograde access was then achieved by retrieving the trans-papillary wire, followed by standard ERCP intervention. Main outcome measurements were rates of procedural success and complications. RESULTS: EUS-guided biliary rendezvous was successful in 14 patients (93.3%). Failure was seen in one patient due to a tight malignant biliary stricture. One patient had peri-choledochal bile tracking which did not require any specific treatment. CONCLUSIONS: Short-wire system in EUS-guided biliary rendezvous is highly effective and safe. It is a useful salvage procedure for biliary cannulation in patients with accessible papilla.

  15. Methodological guide: management of industrial sites potentially contaminated by radioactive substances; Guide methodologique: gestion des sites industriels potentiellement contamines par des substances radioactives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    At the request of the Ministries of Health and the Environment, IPSN is preparing and publishing the first version of the methodological guide devoted to managing industrial sites potentially contaminated by radioactive substances. This guide describes a procedure for defining and choosing strategies for rehabilitating such industrial sites. (author)

  16. Value of MR contrast media in image-guided body interventions.

    Science.gov (United States)

    Saeed, Maythem; Wilson, Mark

    2012-01-28

    In the past few years, there have been multiple advances in magnetic resonance (MR) instrumentation, in vivo devices, real-time imaging sequences and interventional procedures with new therapies. More recently, interventionists have started to use minimally invasive image-guided procedures and local therapies, which reduce the pain from conventional surgery and increase drug effectiveness, respectively. Local therapy also reduces the systemic dose and eliminates the toxic side effects of some drugs to other organs. The success of MR-guided procedures depends on visualization of the targets in 3D and precise deployment of ablation catheters, local therapies and devices. MR contrast media provide a wealth of tissue contrast and allows 3D and 4D image acquisitions. After the development of fast imaging sequences, the clinical applications of MR contrast media have been substantially expanded to include pre- during- and post-interventions. Prior to intervention, MR contrast media have the potential to localize and delineate pathologic tissues of vital organs, such as the brain, heart, breast, kidney, prostate, liver and uterus. They also offer other options such as labeling therapeutic agents or cells. During intervention, these agents have the capability to map blood vessels and enhance the contrast between the endovascular guidewire/catheters/devices, blood and tissues as well as direct therapies to the target. Furthermore, labeling therapeutic agents or cells aids in visualizing their delivery sites and tracking their tissue distribution. After intervention, MR contrast media have been used for assessing the efficacy of ablation and therapies. It should be noted that most image-guided procedures are under preclinical research and development. It can be concluded that MR contrast media have great value in preclinical and some clinical interventional procedures. Future applications of MR contrast media in image-guided procedures depend on their safety, tolerability

  17. AVS user's guide on the basis of practice

    International Nuclear Information System (INIS)

    Masuko, Kenji; Kato, Katsumi; Kume, Etsuo; Fujii, Minoru.

    1997-07-01

    The special guides for the use of visualization software AVS have been developed at Japan Atomic Energy Research Institute (JAERI). The purpose of these guides is to help the AVS users understand easily the use of the one, due to the fact that it is so difficult for beginners to understand the original manuals. In this report, 'Transportation Evacuation Simulation' is taken up as an object of visualization, and the procedure of visualization and images recording by using the AVS are described. By using the AVS according to this report, a series of the procedure which are necessary for use of the AVS can be acquired. (author)

  18. 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.

  19. 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…

  20. The Politics of Revolution; A Film Course Study Guide.

    Science.gov (United States)

    Kernan, Margot

    This study guide for high school and college students examines selected, revolutionary political films made by Godard, Rocha, Solanas, Sanjines, and others, notably Czech and Cuban film-makers. This guide stresses an aesthetic, auteuristic approach and touches upon film production procedures. The films recommended for study range in technique from…

  1. A Telephone Communication Skills Exercise for Veterinary Students: Experiences, Challenges, and Opportunities.

    Science.gov (United States)

    Grevemeyer, Bernard; Betance, Larry; Artemiou, Elpida

    2016-01-01

    Evidence from human medicine shows a rise in telephone communication in support of after-hours services and in providing medical advice, follow-up information, etc. While specific training programs are continuously being developed for human medical education, limited publications are available on training veterinary students in telephone communication. Presented is our method of introducing a telephone communication skills exercise to third-year veterinary students. The exercise progressed over three phases and currently follows the principles of the Calgary-Cambridge Guide. Challenges and improvements on implementing a telephone communication exercise are discussed. Within veterinary communication curricula, attention should be given to the specific communication skills required for successful telephone consultations. In the absence of visual nonverbal cues and prompts during a telephone interaction, communication skills must be applied with greater intent and attention to achieve an effective consultation outcome.

  2. Development of In-pile Plug Assembly and Primary Shutter for Cold Neutron Guide System

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Jin Won; Cho, Yeong Garp; Ryu, Jeong Soo; Lee, Jung Hee [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2008-12-15

    The HANARO, a 30 MW multi-purpose research reactor in Korea, will be equipped with a neutron guide system, in order to transport cold neutrons from the neutron source to the neutron scattering instruments in the neutron guide hall near the reactor building. The neutron guide system of HANARO consists of the in-pile plug assembly with in-pile guides, the primary shutter with in-shutter guides, the neutron guides in the guide shielding room with dedicated secondary shutters, and the neutron guides connected to the instruments in the neutron guide hall. The functions of the in-pile plug assembly are to shield the reactor environment from a nuclear radiation and to support the neutron guides and maintain them precisely oriented. The primary shutter is a mechanical device to be installed just after the in-pile plug assembly, which stops neutron flux on demand. This report describes the mechanical design, fabrication, and installation procedure of the in-pile plug assembly and the primary shutter for the neutron guide system at HANARO. A special tool and procedure for a replacement of in-pile plug and guide cassette is also presented with the interface condition in the reactor hall.

  3. Radio-guided thoracoscopic surgery (RGTS) of small pulmonary nodules.

    Science.gov (United States)

    Ambrogi, Marcello Carlo; Melfi, Franca; Zirafa, Carmelina; Lucchi, Marco; De Liperi, Annalisa; Mariani, Giuliano; Fanucchi, Olivia; Mussi, Alfredo

    2012-04-01

    The demand for adequate tissue sampling to determine individual tumor behavior is increasing the number of lung nodule resections, even when the diagnosis is already recognized. Video-assisted thoracic surgery (VATS) is the procedure of choice for diagnosis and treatment of small pulmonary nodules. Difficulties in localizing smaller and deeper nodules have been approached with different techniques. Herein we report our 13-years' experience with radio-guided thoracoscopic resection. Patients with pulmonary nodules smaller than 1 cm and/or deeper than 1 cm, below the visceral pleura, underwent computed tomography (CT)-guided injection of a solution, composed of 0.2 ml (99)Tc-labeled human serum albumin microspheres and 0.1 ml nonionic contrast, into the nodule. During the VATS procedure, an 11-mm-diameter collimated probe connected to a gamma ray detector was introduced to scan the lung surface. The area of major radioactivity, which matched with the area of the nodule, was resected. From 1997 to 2009, 573 patients underwent thoracoscopic resection of small pulmonary nodules, 211 with the radio-guided technique. There were 159 men and 52 women, with an average age of 60.6 years (range = 12-83). The mean duration of the surgical procedure was 41 min (range = 20-100). The procedure was successful in 208/211 cases. Three patients (0.5%) required conversion to a minithoracotomy. The mean length of pleural drainage and hospital stay was 2.3 and 3.7 days, respectively. Histological examination showed 98 benign lesions and 113 malignant lesions (61 metastases and 52 primary lung cancers). This study confirms that radio-guided localization of small pulmonary nodules is a feasible, safe, and quick procedure, with a high rate of success. The spread of the sentinel lymph node technique has increased the availability of technology required for RGTS.

  4. United Kingdom procedures in case of nuclear accidents

    International Nuclear Information System (INIS)

    Chalfont, L.

    1988-01-01

    From the United Kingdom experience, general principles for establishing emergency plans are drawn. Every country with nuclear plant should have such emergency arrangements capable of dealing with the largest scale that can be envisaged as a practical possibility. While the effects of accidents cannot be anticipated in detail these plans should form a good flexible basis for providing the resources, communications and procedures that are likely to be needed. They encompass the administrative infrastructure of the area surrounding the nuclear installation and involve co-ordination with the police, fire services and ambulance services, the local and county authorities, the authorities responsible for food, agriculture, fisheries and water, and the health authorities including hospitals and medical services. Special training and procedures have to be established for the personnel that are involved and exercises graduating from the exercising of special procedures to large scale simulated accidents need to be carried out periodically. Good communication systems have to be established between the nuclear installations, the operational support centres or equivalent, the field and headquarters units of the relevant organizations, and the central government departments so that whatever additional resources and support are needed can be marshalled quickly and efficiently. (author)

  5. 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

  6. 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 ...

  7. Physiotherapy exercise programmes: are instructional exercise sheets effective?

    Science.gov (United States)

    Smith, Jo; Lewis, Jeremy; Prichard, Diana

    2005-01-01

    Effective compliance with physiotherapy exercises is only possible if patients remember the exercises accurately. The purpose of this study was to assess how well elderly in-patients remembered simple physiotherapy exercises, by comparing the ability to accurately reproduce a set of exercises in a group of patients that had received a written exercise sheet, with a group that had not. The study also aimed to investigate the relationship between memory for exercises and cognition. Sixty-four in-patients in an acute hospital were taught 3 exercises. Half of the subjects were randomised to receive exercise sheets to reinforce the teaching (Group 1). The rest of the subjects did not receive this memory aid (Group 2). Two to three days later subjects were asked to demonstrate their exercises. The accurate recall of the exercises was scored using a new assessment scale with a maximum score of 24. The mean exercise score was 17.19 for group 1 (SD = 5.91) and 16.24 for Group 2 (SD = 6.01). There was no significant difference in exercise score between groups (Mann Whitney U test p = 0.44). There was a statistically significant small positive correlation between exercise score and cognition (tau = 0.263). The study showed that older adult in-patients do not remember physiotherapy exercises effectively after a single teaching session and that their memory is not significantly improved by provision of an exercise sheet.

  8. 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…

  9. Application of CT-guided percutaneous thyroid biopsy in basic study of interventional therapy for Graves disease

    International Nuclear Information System (INIS)

    Yi Genfa; Zhao Wei; Hu Jihong; Jin Cangzheng; Yang Huiying

    2007-01-01

    Objective: To evaluate the value of application of CT-guided percutaneous thyroid biopsy in basic study of interventional treatment for Graves disease. Methods: Fifteen patients of hyperthyroidism caused by Graves' disease had been undertaken transcathter arterial embolizsation with PVA micropheres including 52 core needle biopsy(CNB)of pre-or post-interventional procedure. All procedures were divided into 2 groups according to the size of the thyroid enlargement: (1) II degree enlargement (n=19)under palpation puncture. (2) No enlargement or under II degree enlargement (n=33)with palpation and CT-guided puncture. Results: In group (1), 17 of the 19 procedures with palpation puncture were succeeded, reaching a successful rate of 89.5%. For group (2), the successful rate of CT-guided puncture was 91.7%. The difference between the successful rate of two groups showed statistical significance (P<0.05). No complication occurred during procedures in all cases. Conclusions: CT-guided thyroid core needle biopsy is an accurate, safe and high successful procedure providing the basic study for post-interventional treatment of Graves disease. (authors)

  10. Standard guide for preparation of plastics and polymeric specimens for microstructural examination

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2004-01-01

    1.1 This guide covers recommended procedures and guidelines for the preparation of plastic and polymeric specimens for microstructural examination by light and electron microscopy. 1.2 This guide is applicable to most semi-rigid and rigid plastics, including engineering plastics. This guide is also applicable to some non-rigid plastics. 1.3 The procedures and guidelines presented in this guide are those which generally produce satisfactory specimens. This guide does not describe the variations in techniques required to solve individual problems. 1.4 Many detailed descriptions of grinding and polishing of plastics and polymers are available (1-7). 1.5 This standard does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this standard to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  11. MCSA Windows Server 2012 R2 administration study guide exam 70-411

    CERN Document Server

    Panek, William

    2015-01-01

    Complete exam coverage, hands-on practice, and interactive studytools for the MCSA: Administering Windows Server 2012 R2 exam70-411 MCSA: Windows Server 2012 R2 Administration Study Guide: Exam70-411 provides comprehensive preparation for exam 70-411:Administering Windows Server 2012 R2. With full coverage of allexam domains, this guide contains everything you need to know to befully prepared on test day. Real-world scenarios illustrate thepractical applications of the lessons, and hands-on exercises allowyou to test yourself against everyday tasks. You get access to aninteractive practice te

  12. Comparison between Steroid Injection and Stretching Exercise on the Scalene of Patients with Upper Extremity Paresthesia: Randomized Cross-Over Study.

    Science.gov (United States)

    Kim, Yong Wook; Yoon, Seo Yeon; Park, Yongbum; Chang, Won Hyuk; Lee, Sang Chul

    2016-03-01

    To compare the therapeutic effects on upper extremity paresthesia of intra-muscular steroid injections into the scalene muscle with those of stretching exercise only. Twenty patients with upper extremity paresthesia who met the criteria were recruited to participate in this single-blind, crossover study. Fourteen of 20 patients were female. The average age was 45.0 ± 10.5 years and duration of symptom was 12.2 ± 8.7 months. Each participant completed one injection and daily exercise program for 2 weeks. After randomization, half of all patients received ultrasound-guided injection of scalene muscles before exercise, while the other was invested for the other patients. After two weeks, there was a significant decrease of the visual analog scale score of treatment effect compared with baseline in both groups (6.90 to 2.85 after injection and 5.65 to 4.05 after stretching exercise, p50% reduction in post-treatment visual analog scale, was 18 of 20 (90.0%) after injection, compared to 5 of 20 (25.0%) after stretching exercise. There were no cases of unintended brachial plexus block after injection. Ultrasound-guided steroid injection or stretching exercise of scalene muscles led to reduced upper extremity paresthesia in patients who present with localized tenderness in the scalene muscle without electrodiagnostic test abnormalities, although injection treatment resulted in more improvements. The results suggest that symptoms relief might result from injection into the muscle alone not related to blockade of the brachial plexus.

  13. Aerobic exercise decreases the positive-reinforcing effects of cocaine.

    Science.gov (United States)

    Smith, Mark A; Schmidt, Karl T; Iordanou, Jordan C; Mustroph, Martina L

    2008-11-01

    Aerobic exercise can serve as an alternative, non-drug reinforcer in laboratory animals and has been recommended as a potential intervention for substance abusing populations. Unfortunately, relatively little empirical data have been collected that specifically address the possible protective effects of voluntary, long-term exercise on measures of drug self-administration. The purpose of the present study was to examine the effects of chronic exercise on sensitivity to the positive-reinforcing effects of cocaine in the drug self-administration procedure. Female rats were obtained at weaning and immediately divided into two groups. Sedentary rats were housed individually in standard laboratory cages that permitted no exercise beyond normal cage ambulation; exercising rats were housed individually in modified cages equipped with a running wheel. After 6 weeks under these conditions, rats were surgically implanted with venous catheters and trained to self-administer cocaine on a fixed-ratio schedule of reinforcement. Once self-administration was acquired, cocaine was made available on a progressive ratio schedule and breakpoints were obtained for various doses of cocaine. Sedentary and exercising rats did not differ in the time to acquire cocaine self-administration or responding on the fixed-ratio schedule of reinforcement. However, on the progressive ratio schedule, breakpoints were significantly lower in exercising rats than sedentary rats when responding was maintained by both low (0.3mg/kg/infusion) and high (1.0mg/kg/infusion) doses of cocaine. In exercising rats, greater exercise output prior to catheter implantation was associated with lower breakpoints at the high dose of cocaine. These data indicate that chronic exercise decreases the positive-reinforcing effects of cocaine and support the possibility that exercise may be an effective intervention in drug abuse prevention and treatment programs.

  14. Extra Luminal Entrapment of Guide Wire; A Rare Complication of Central Venous Catheter Placement in Right Internal Jugular Vein.

    Science.gov (United States)

    Ansari, Md Abu Masud; Kumar, Naveen; Kumar, Shailesh; Kumari, Sarita

    2016-10-01

    Central venous Catheterization (CVC) is a commonly performed procedure for venous access. It is associated with several complications. We report a rare case of extra luminal entrapment of guide wire during CVC placement in right jugular vein. We report a case of 28 years old female patient presented in our emergency with history of entrapped guide wire in right side of neck during CVC. X-ray showed coiling of guide wire in neck. CT Angiography showed guide wire coursing in between common carotid artery and internal jugular vein (IJV), closely abutting the wall of both vessels. The guide wire was coiled with end coursing behind the esophageal wall. Guide wire was removed under fluoroscopic guide manipulation under local anesthesia. We want to emphasize that even though CVC placement is common and simple procedure, serious complication can occur in hands of untrained operator. The procedure should be performed under supervision, if done by trainee. Force should never be applied to advance the guide wire if resistance is encountered.

  15. Ultrasound-guided central venous access using Google Glass.

    Science.gov (United States)

    Wu, Teresa S; Dameff, Christian J; Tully, Jeffrey L

    2014-12-01

    The use of ultrasound during invasive bedside procedures is quickly becoming the standard of care. Ultrasound machine placement during procedures often requires the practitioner to turn their head during the procedure to view the screen. Such turning has been implicated in unintentional hand movements in novices. Google Glass is a head-mounted computer with a specialized screen capable of projecting images and video into the view of the wearer. Such technology may help decrease unintentional hand movements. Our aim was to evaluate whether or not medical practitioners at various levels of training could use Google Glass to perform an ultrasound-guided procedure, and to explore potential advantages of this technology. Forty participants of varying training levels were randomized into two groups. One group used Google Glass to perform an ultrasound-guided central line. The other group used traditional ultrasound during the procedure. Video recordings of eye and hand movements were analyzed. All participants from both groups were able to complete the procedure without difficulty. Google Glass wearers took longer to perform the procedure at all training levels (medical student year 1 [MS1]: 193 s vs. 77 s, p > 0.5; MS4: 197s vs. 91s, p ≤ 0.05; postgraduate year 1 [PGY1]: 288s vs. 125 s, p > 0.5; PGY3: 151 s vs. 52 s, p ≤ 0.05), and required more needle redirections (MS1: 4.4 vs. 2.0, p > 0.5; MS4: 4.8 vs. 2.8, p > 0.5; PGY1: 4.4 vs. 2.8, p > 0.5; PGY3: 2.0 vs. 1.0, p > 0.5). In this study, it was possible to perform ultrasound-guided procedures with Google Glass. Google Glass wearers, on average, took longer to gain access, and had more needle redirections, but less head movements were noted. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Standard guide to In-Plant performance evaluation of Hand-Held SNM monitors

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    1999-01-01

    1.1 This guide is one of a series on the application and evaluation of special nuclear material (SNM) monitors. Other guides in the series are listed in Section 2, and the relationship of in-plant performance evaluation to other procedures described in the series is illustrated in Fig. 1. Hand-held SNM monitors are described in of Guide C1112, and performance criteria illustrating their capabilities can be found in Appendix X1. 1.2 The purpose of this guide to in-plant performance evaluation is to provide a comparatively rapid procedure to verify that a hand-held SNM monitor performs as expected for detecting SNM or alternative test sources or to disclose the need for repair. The procedure can be used as a routine operational evaluation or it can be used to verify performance after a monitor is calibrated. 1.3 In-plant performance evaluations are more comprehensive than daily functional tests. They take place less often, at intervals ranging from weekly to once every three months, and derive their result fr...

  17. Comparison of angiography, prone renography, and exercise renography for treatment planning in hypertension

    International Nuclear Information System (INIS)

    Clorius, J.H.; Strauss, L.G.; Allenberg, J.; Hupp, T.; Schmidlin, P.; Irngartinger, G.

    1987-01-01

    Fifteen hypertensives with unilateral vascular stenosis had selective renal angiograms, prone-position gamma camera hippurate renograms, and upright exercise renograms. The exercise renograms were used to identify renal vasomotor dysfunction. Each procedure was assessed for its value to predict cure of hypertension. Therapy included one nephrectomy, and angioplasty, and 13 surgical revascularizations. Neither the extent of vascular lumen reduction as assessed with angiography nor the unilateral function impairment documented with a prone-position renogram contained useful prognostic data. Exercise renography correctly predicted the posttherapy blood pressure status in 14 of 15 hypertensives. Exercise renography can identify a newly recognized function response of the vasculature of the kidney, a pathologic response that shows promise in the investigation of hypertension

  18. Performing better nuclear emergency management exercises in Belgium

    International Nuclear Information System (INIS)

    Sohier, A.

    2006-01-01

    The recently revised Royal Decree of 17 October 2003 (the Belgian Monitor of 22 November 2003) stipulating the nuclear emergency plan for radiological risks on the Belgian territory aims at reducing the impact of a radiological or nuclear accident to the population. It describes the organisation, tasks and necessary interactions between the different participating entities at the federal, provincial and communal level. It also foresees that each major nuclear installation holds regularly exercises with the different off-site entities to test and improve the response procedures. Under contract with the Ministry of Interior, and in consortium with AVN and IRE, SCK-CEN has been assigned as co-ordinator for the improvement of the methodology for emergency exercises, and to apply this for the 2005 exercises of the nuclear installations of Doel and Tihange. The main objective of this project is to define a methodology allowing to conduct exercises in a more efficient way. The methodology is based on the IAEA EPR-EXERCISE (2005) publication. This should in turn (1) allow the principal actors to train the different aspects of a nuclear crisis, (2) allow easier detection of deficiencies in the emergency plan and its application, and (3) result in the necessary corrective actions to improve future responses to crises

  19. Lessons learned from the CEOG generic accident management guidelines confirmation (validation) exercise

    International Nuclear Information System (INIS)

    Khalil, Y.F.; Schneider, R.E.; Greene, M.A.

    1996-01-01

    In July 1995, the CE Owner's Group completed and issued Revision 0 of the Generic Accident Management Guidelines (AMG's) to the owners group task participants. This guidance provides a structured mechanism for the plant staff at CE utilities to respond to accidents that beyond the plant design basis and, possibly, the Emergency Operating Procedures. Prior to final issue of the generic AMGs, the CEOG conducted an AMG Confirmation Exercise to establish the ability of the AMGs to fulfill this important role. The specific objectives of the AMG Confirmation Exercise were to (1) clarify the interactions and transitions between the AMG/Technical Support Center (TSC) and the EOPS/Operations Personnel (2) validate the adequacy of the AMG data collection and plant condition diagnostic evaluation process and (3) assess the feasibility of the mechanical material and recommendations contained in the AMG's. The purpose of paper is to provide a detailed description of the AMG Confirmation Exercise as well as important lessons learned during the planning and implementation of the exercise. In addition, a discussion will be presented pertaining to the relationship between the AMG's (incumbent to the Technical Support Center) and the plants Emergency Operating Procedures (incumbent to the Control Room Operations Staff)

  20. Medical and biohazardous waste generator`s guide: Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    1994-09-01

    This Guide describes the procedures required to comply with all federal and state laws and regulations and Lawrence Berkeley Laboratory (LBL) policy applicable to medical and biohazardous waste. The members of the LBL Biological Safety Subcommittee participated in writing these policies and procedures. The procedures and policies in this Guide apply to LBL personnel who work with infectious agents or potentially infectious agents, publicly perceived infectious items or materials (e.g., medical gloves, culture dishes), and sharps (e.g., needles, syringes, razor blades). If medical or biohazardous waste is contaminated or mixed with a hazardous chemical or material, with a radioactive material, or with both, the waste will be handled in accordance with the applicable federal and State of California laws and regulations for hazardous, radioactive, or mixed waste.

  1. 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.

  2. The Medical Examiner/Coroner's Guide for Contaminated Deceased Body Management.

    Science.gov (United States)

    Hanzlick, Randy; Nolte, Kurt; deJong, Joyce

    2009-12-01

    In the past few years, a number of publications and other resources have appeared concerning the management of mass fatality incidents. Some are geared toward the general management of incidents while others cover more specific topics such as decontamination procedures. Still others cover selected agents, including chemical, biologic, or radiologic ones. Few publications have been written specifically for medical examiners and coroners. The Medical Examiner and Coroner's Guide for Contaminated Deceased Body Management is written specifically for the medical examiner or coroner who will be in charge of investigations of fatalities that result from terrorism or other events that result in contaminated remains. In some such cases, agents may be used that will require mitigation of environmental hazards and decontamination of human bodies. To that end, this Guide provides information and suggestions that may be useful in understanding the principles involved in decontamination procedures, recognizing that it may not be the medical examiner or coroner staff who actually conducts decontamination procedures. The suggestions in this guide may differ slightly from those in other publications. However, those who have contributed to this guide believe that the recommendations are practical, workable, have a scientific basis, and do not differ much in substance when compared with other relevant publications. The contents of this Guide may be reproduced for practical use but the Guide may not be sold and it may not be cited for advertisement purposes. Reference to specific commercial products is for informational purposes only and does not constitute endorsement of the product or company which produces the product. The recommendations contained in this Guide are not mandated nor are they required by federal, state, or local law. Rather, the recommendations are intended to assist medical examiners and coroners for the purposes of planning and providing a set of reasonable

  3. A randomized trial of individual versus group-format exercise and self-management in individuals with Parkinson’s disease and comorbid depression

    Directory of Open Access Journals (Sweden)

    Sajatovic M

    2017-05-01

    Full Text Available Martha Sajatovic,1,2 Angela L Ridgel,3 Ellen M Walter,1,4 Curtis M Tatsuoka,1,2 Kari Colón-Zimmermann,2 Riane K Ramsey,2 Elisabeth Welter,2 Steven A Gunzler,1,4 Christina M Whitney,1,4 Benjamin L Walter1,4 1Department of Neurology, Case Western Reserve University School of Medicine, 2Neurological and Behavioral Outcomes Center, University Hospitals Cleveland Medical Center, Cleveland, 3Department of Exercise Physiology, Kent State University, Kent, 4Movement Disorders Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA Background: Depression is common in people with Parkinson’s disease (PD, and exercise is known to improve depression and PD. However, lack of motivation and low self-efficacy can make exercise difficult for people with PD and comorbid depression (PD-Dep. A combined group exercise and chronic disease self-management (CDSM program may improve the likelihood that individuals will engage in exercise and will show a reduction in depression symptoms. The purpose of this study was to compare changes in depression in PD-Dep between individual versus group exercise plus CDSM and to examine participant adherence and perception of the interventions.Methods: Participants (N=30 were randomized to either Enhanced EXerCisE thErapy for PD (EXCEED; group CDSM and exercise or self-guided CDSM plus exercise. Outcomes were change in depression assessed with the Montgomery–Asberg Depression Rating Scale (MADRS, cognition, apathy, anxiety, sleep, quality of life, motor function, self-efficacy, and patient satisfaction.Results: Both groups showed significant improvement in MADRS (P<0.001 with no significant group difference. Individuals in EXCEED group enjoyed the group dynamics but noted difficulty with the fixed-time sessions.Conclusion: Both group CDSM plus exercise and self-guided CDSM plus exercise can improve depression in PD-Dep. These findings suggest that development of a remotely delivered group-based CDSM format

  4. Southern forest inventory and analysis volume equation user’s guide

    Science.gov (United States)

    Christopher M. Oswalt; Roger C. Conner

    2011-01-01

    Reliable volume estimation procedures are fundamental to the mission of the Forest Inventory and Analysis (FIA) program. Moreover, public access to FIA program procedures is imperative. Here we present the volume estimation procedures used by the southern FIA program of the U.S. Department of Agriculture Forest Service Southern Research Station. The guide presented...

  5. The PISC exercise: a discussion of its relevance to ultrasonic inspection of pressure vessels

    International Nuclear Information System (INIS)

    Whittle, M.J.; Coffey, J.M.

    1981-01-01

    The value of the European Plate Inspection Steering Committee (PISC) exercise for determining the reliability of ultrasonic inspection of pressure vessels is discussed. It is argued that the particular ultrasonic procedure assessed in the exercise was a poor one whose failure was predictable. In addition the test blocks were sufficiently unrealistic that the value of the results would have been diminished even if all the defects had been found. Consequently the report maintains that the outcome of the exercise is largely irrelevant to the wider question of the reliability of more thorough ultrasonic procedures. A more general discussion is given of the role of test block studies in ultrasonics. Statistical arguments are used to show that it is impracticable to produce a sufficient number of defects to demonstrate a high reliability and have a high confidence in such a result. Some important points for planning future programmes are emphasised. (author)

  6. Military Exercises in Korea: A Provocation or a Deterrent to War?

    National Research Council Canada - National Science Library

    Chu, John S

    2006-01-01

    ...), have conducted a warfighting exercise called Ulchi Focus Lens (UFL) to evaluate and improve joint and combined procedures, plans, and systems used in the event of conflict with the Democratic People's Republic of Korea (DPRK...

  7. Image-guided surgery and therapy: current status and future directions

    Science.gov (United States)

    Peters, Terence M.

    2001-05-01

    Image-guided surgery and therapy is assuming an increasingly important role, particularly considering the current emphasis on minimally-invasive surgical procedures. Volumetric CT and MR images have been used now for some time in conjunction with stereotactic frames, to guide many neurosurgical procedures. With the development of systems that permit surgical instruments to be tracked in space, image-guided surgery now includes the use of frame-less procedures, and the application of the technology has spread beyond neurosurgery to include orthopedic applications and therapy of various soft-tissue organs such as the breast, prostate and heart. Since tracking systems allow image- guided surgery to be undertaken without frames, a great deal of effort has been spent on image-to-image and image-to- patient registration techniques, and upon the means of combining real-time intra-operative images with images acquired pre-operatively. As image-guided surgery systems have become increasingly sophisticated, the greatest challenges to their successful adoption in the operating room of the future relate to the interface between the user and the system. To date, little effort has been expended to ensure that the human factors issues relating to the use of such equipment in the operating room have been adequately addressed. Such systems will only be employed routinely in the OR when they are designed to be intuitive, unobtrusive, and provide simple access to the source of the images.

  8. Exercise accelerates wound healing among healthy older adults: a preliminary investigation.

    Science.gov (United States)

    Emery, Charles F; Kiecolt-Glaser, Janice K; Glaser, Ronald; Malarkey, William B; Frid, David J

    2005-11-01

    Older adults are likely to experience delayed rates of wound healing, impaired neuroendocrine responsiveness, and increased daily stress. Exercise activity has been shown to have a positive effect on physiological functioning and psychological functioning among older adults. This study evaluated the effect of a 3-month exercise program on wound healing, neuroendocrine function, and perceived stress among healthy older adults. Twenty-eight healthy older adults (mean age 61.0 +/- 5.5 years) were assigned randomly to an exercise activity group (n = 13) or to a nonexercise control group (n = 15). One month following baseline randomization, after exercise participants had acclimated to the exercise routine, all participants underwent an experimental wound procedure. Wounds were measured 3 times per week until healed to calculate rate of wound healing. All participants completed assessments of exercise endurance, salivary cortisol, and self-reported stress prior to randomization and at the conclusion of the intervention. Exercise participants achieved significant improvements in cardiorespiratory fitness, as reflected by increased oxygen consumption (VO(2)max) and exercise duration. Wound healing occurred at a significantly faster rate in the exercise group [mean = 29.2 (9.0) days] than in the nonexercise group [38.9 (7.4) days; p =.012]. Exercise participants also experienced increased cortisol secretion during stress testing following the intervention. Group differences in wound healing and neuroendocrine responsiveness were found despite low levels of self-reported stress. A relatively short-term exercise intervention is associated with enhanced rates of wound healing among healthy older adults. Thus, exercise activity may be an important component of health care to promote wound healing.

  9. Management of Severe Rhabdomyolysis and Exercise-Associated Hyponatremia in a Female with Anorexia Nervosa and Excessive Compulsive Exercising

    Directory of Open Access Journals (Sweden)

    Marwan El Ghoch

    2016-01-01

    Full Text Available This case report describes the management of a 49-year-old female with restricting-type anorexia nervosa and excessive compulsive exercising associated with rhabdomyolysis, high levels of serum creatine kinase (CK (3,238 U/L, and marked hyponatremia (Na+: 123 mEq/L in the absence of purging behaviours or psychogenic polydipsia; it is the first case report to describe exercise-associated hyponatremia in a patient with anorexia nervosa. The patient, who presented with a body mass index (BMI of 13.4 kg/m2, was successfully treated by means of an adapted inpatient version of an enhanced form of cognitive behavioural therapy (CBT-E. Within a few days, careful water restriction, solute refeeding, and the specific cognitive behavioural strategies and procedures used to address the patient’s excessive compulsive exercising and undereating produced a marked reduction in CK levels, which normalised within one week. Exercise-associated hyponatremia also gradually improved, with serum sodium levels returning to normal within two weeks. The patient thereby avoided severe complications such as cerebral or pulmonary oedema or acute renal failure and was discharged after 20 weeks of treatment with a BMI of 19.0 kg/m2 and improved eating disorder psychopathology.

  10. Management of Severe Rhabdomyolysis and Exercise-Associated Hyponatremia in a Female with Anorexia Nervosa and Excessive Compulsive Exercising.

    Science.gov (United States)

    El Ghoch, Marwan; Calugi, Simona; Dalle Grave, Riccardo

    2016-01-01

    This case report describes the management of a 49-year-old female with restricting-type anorexia nervosa and excessive compulsive exercising associated with rhabdomyolysis, high levels of serum creatine kinase (CK) (3,238 U/L), and marked hyponatremia (Na + : 123 mEq/L) in the absence of purging behaviours or psychogenic polydipsia; it is the first case report to describe exercise-associated hyponatremia in a patient with anorexia nervosa. The patient, who presented with a body mass index (BMI) of 13.4 kg/m 2 , was successfully treated by means of an adapted inpatient version of an enhanced form of cognitive behavioural therapy (CBT-E). Within a few days, careful water restriction, solute refeeding, and the specific cognitive behavioural strategies and procedures used to address the patient's excessive compulsive exercising and undereating produced a marked reduction in CK levels, which normalised within one week. Exercise-associated hyponatremia also gradually improved, with serum sodium levels returning to normal within two weeks. The patient thereby avoided severe complications such as cerebral or pulmonary oedema or acute renal failure and was discharged after 20 weeks of treatment with a BMI of 19.0 kg/m 2 and improved eating disorder psychopathology.

  11. Soil sampling intercomparison exercise by selected laboratories of the ALMERA Network

    International Nuclear Information System (INIS)

    2009-01-01

    The IAEA's Seibersdorf Laboratories in Austria have the programmatic responsibility to provide assistance to Member State laboratories in maintaining and improving the reliability of analytical measurement results, both in radionuclide and trace element determinations. This is accomplished through the provision of reference materials of terrestrial origin, validated analytical procedures, training in the implementation of internal quality control, and through the evaluation of measurement performance by the organization of worldwide and regional interlaboratory comparison exercises. The IAEA is mandated to support global radionuclide measurement systems related to accidental or intentional releases of radioactivity in the environment. To fulfil this obligation and ensure a reliable, worldwide, rapid and consistent response, the IAEA coordinates an international network of analytical laboratories for the measurement of environmental radioactivity (ALMERA). The network was established by the IAEA in 1995 and makes available to Member States a world-wide network of analytical laboratories capable of providing reliable and timely analysis of environmental samples in the event of an accidental or intentional release of radioactivity. A primary requirement for the ALMERA members is participation in the IAEA interlaboratory comparison exercises, which are specifically organized for ALMERA on a regular basis. These exercises are designed to monitor and demonstrate the performance and analytical capabilities of the network members, and to identify gaps and problem areas where further development is needed. In this framework, the IAEA organized a soil sampling intercomparison exercise (IAEA/SIE/01) for selected laboratories of the ALMERA network. The main objective of this exercise was to compare soil sampling procedures used by different participating laboratories. The performance evaluation results of the interlaboratory comparison exercises performed in the framework of

  12. Feasibility and effectiveness of image-guided percutaneous biopsy of the urinary bladder.

    Science.gov (United States)

    Butros, Selim Reha; McCarthy, Colin James; Karaosmanoğlu, Ali Devrim; Shenoy-Bhangle, Anuradha S; Arellano, Ronald S

    2015-08-01

    To evaluate the indications, technique, results, and complications of image-guided percutaneous biopsy of the urinary bladder. This retrospective study included 15 patients (10 male, 5 female) who underwent image-guided percutaneous biopsy of the urinary bladder between January 1999 and December 2013. The medical records, imaging studies, procedural details, and long-term follow-up of each patient were reviewed in detail to assess the feasibility of percutaneous bladder biopsy. Ten patients had focal bladder masses and 5 patients had asymmetric or diffuse bladder wall thickening. Eleven patients had either negative or unsatisfactory cystoscopies prior to the biopsy. Percutaneous biopsies were performed under computed tomography guidance in 12 patients and ultrasound in 3 patients. All procedures were technically successful and there were no procedural complications. Malignancy was confirmed in 8 patients, among whom 6 had transitional cell carcinoma, 1 cervical cancer, and 1 prostate cancer metastasis. Seven patients had a benign diagnosis, including 3 that were later confirmed by pathology following surgery and 2 patients with a false-negative result. The overall sensitivity was 80% and accuracy was 87%. Image-guided percutaneous biopsy of the urinary bladder is a safe and technically feasible procedure with a high sensitivity and accuracy rate. Although image-guided bladder biopsy is an uncommon procedure, it should be considered in selected cases when more traditional methods of tissue sampling are either not possible or fail to identify abnormalities detected by cross-sectional imaging.

  13. 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

  14. Relocation tabletop exercise: federal radiological response in the post-accident phase

    International Nuclear Information System (INIS)

    Grant, K.; Adler, M.V.; Wolff, W.F.

    1986-01-01

    The federal Radiological Emergency Response Plan (FRERP) was developed to provide the framework for coordinating federal radiological assistance to states and to local authorities faced with a large radiological accident. The Relocation Tabletop Exercise was conducted on December 9-11, 1985 at the Beaver Valley Power Station, the site of the simulated accident. The exercise scenario had postulated a substantial release of radioactive materials from a fuel handling accident at the Beaver Valley Power Station in Shippingport, Pennsylvania, leaving radioactive materisls deposited over part of the surrounding area. The exercise was structured as a sequential series of nice mini-scenarios, each of which focused on one problems. The exercise was intended to identify issues and problems which needed consideration or procedures which might need to be developed for this post-accident phase. It was a ''no-fault'' excercise

  15. National Environmental Policy Act (NEPA) Compliance Guide, Sandia National Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, R.P. [Hansen Environmental Consultants, Englewood, CO (United States)

    1995-08-01

    This report contains a comprehensive National Environmental Policy Act (NEPA) Compliance Guide for the Sandia National Laboratories. It is based on the Council on Environmental Quality (CEQ) NEPA regulations in 40 CFR Parts 1500 through 1508; the US Department of Energy (DOE) N-EPA implementing procedures in 10 CFR Part 102 1; DOE Order 5440.1E; the DOE ``Secretarial Policy Statement on the National Environmental Policy Act`` of June 1994- Sandia NEPA compliance procedures-, and other CEQ and DOE guidance. The Guide includes step-by-step procedures for preparation of Environmental Checklists/Action Descriptions Memoranda (ECL/ADMs), Environmental Assessments (EAs), and Environmental Impact Statements (EISs). It also includes sections on ``Dealing With NEPA Documentation Problems`` and ``Special N-EPA Compliance Issues.``

  16. Reference Dose Rates for Fluoroscopy Guided Interventions

    International Nuclear Information System (INIS)

    Geleijns, J.; Broerse, J.J.; Hummel, W.A.; Schalij, M.J.; Schultze Kool, L.J.; Teeuwisse, W.; Zoetelief, J.

    1998-01-01

    The wide diversity of fluoroscopy guided interventions which have become available in recent years has improved patient care. They are being performed in increasing numbers, particularly at departments of cardiology and radiology. Some procedures are very complex and require extended fluoroscopy times, i.e. longer than 30 min, and radiation exposure of patient and medical staff is in some cases rather high. The occurrence of radiation-induced skin injuries on patients has shown that radiation protection for fluoroscopy guided interventions should not only be focused on stochastic effects, i.e. tumour induction and hereditary risks, but also on potential deterministic effects. Reference dose levels are introduced by the Council of the European Communities as an instrument to achieve optimisation of radiation protection in radiology. Reference levels in conventional diagnostic radiology are usually expressed as entrance skin dose or dose-area product. It is not possible to define a standard procedure for complex interventions due to the large inter-patient variations with regard to the complexity of specific interventional procedures. Consequently, it is not realistic to establish a reference skin dose or dose-area product for complex fluoroscopy guided interventions. As an alternative, reference values for fluoroscopy guided interventions can be expressed as the entrance dose rates on a homogeneous phantom and on the image intensifier. A protocol has been developed and applied during a nationwide survey of fluoroscopic dose rate during catheter ablations. From this survey reference entrance dose rates of respectively 30 mGy.min -1 on a polymethylmethacrylate (PMMA) phantom with a thickness of 21 cm, and of 0.8 μGy.s -1 on the image intensifier have been derived. (author)

  17. Recommendations for fluorescence instrument qualification: the new ASTM Standard Guide.

    Science.gov (United States)

    DeRose, Paul C; Resch-Genger, Ute

    2010-03-01

    Aimed at improving quality assurance and quantitation for modern fluorescence techniques, ASTM International (ASTM) is about to release a Standard Guide for Fluorescence, reviewed here. The guide's main focus is on steady state fluorometry, for which available standards and instrument characterization procedures are discussed along with their purpose, suitability, and general instructions for use. These include the most relevant instrument properties needing qualification, such as linearity and spectral responsivity of the detection system, spectral irradiance reaching the sample, wavelength accuracy, sensitivity or limit of detection for an analyte, and day-to-day performance verification. With proper consideration of method-inherent requirements and limitations, many of these procedures and standards can be adapted to other fluorescence techniques. In addition, procedures for the determination of other relevant fluorometric quantities including fluorescence quantum yields and fluorescence lifetimes are briefly introduced. The guide is a clear and concise reference geared for users of fluorescence instrumentation at all levels of experience and is intended to aid in the ongoing standardization of fluorescence measurements.

  18. Improving the health of mental health staff through exercise interventions: a systematic review.

    Science.gov (United States)

    Fibbins, Hamish; Ward, Philip B; Watkins, Andrew; Curtis, Jackie; Rosenbaum, Simon

    2018-04-01

    Exercise interventions are efficacious in reducing cardiometabolic risk and improving symptoms in people with severe mental illness, yet evidence guiding the implementation and scalability of such efforts is lacking. Given increasing efforts to address the disparity in physical health outcomes facing people with a mental illness, novel approaches to increasing adoption of effective interventions are required. Exercise interventions targeting mental health staff may improve staff health while also creating more positive attitudes towards the role of lifestyle interventions for people experiencing mental illness. We aimed to determine the feasibility, acceptability and effectiveness of exercise interventions delivered to staff working in mental health services. A systematic review was conducted from database inception, until November 2017. Studies recruiting staff participants to receive an exercise intervention were eligible for inclusion. Five studies met the inclusion criteria. Physical health interventions for mental health staff were feasible and acceptable with low dropout rates. Reductions in anthropometric measures and work-related stress were reported. Limited evidence suggests that exercise interventions targeting mental health staff are feasible and acceptable. Further research is required to determine the efficacy of such interventions and the impact such strategies may have on staff culture and patient outcomes.

  19. Percutaneous CT-guided cryoablation for the treatment of refractory pudendal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D.; Williams, Roger [Emory University Hospital, Department of Radiology and Imaging Sciences Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Lin, Roger C. [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States)

    2015-05-01

    To evaluate the safety and efficacy of percutaneous CT-guided cryoablation of the pudendal nerve for the treatment of refractory pudendal neuralgia. Eleven patients were selected to undergo percutaneous CT-guided cryoablation of the pudendal nerve based on established diagnostic criteria. Brief Pain Inventory questionnaires were administered prior to the procedure, during the immediate 24 h post procedure, and 45 days and 6 months following the procedure. Prior to treatment, the average level of pain on a scale from 0 (no pain) to 10 (worst pain imaginable) was 7.6, with pain described as ''burning'' (80%), ''pulling'' (37.5%), ''crushing'' (50%), ''pressure'' (84.5%), ''throbbing'' (50%), ''knife-life'' (52%), and ''other'' (60%). At 24 h, 45 days, and 6 months post-treatment, pain intensity dropped to 2.6, 3.5, and 3.1, respectively (p < 0.005). There were no procedure-related complications. CT-guided percutaneous cryoablation may represent a safe and efficacious option for selected patients with refractory pudendal neuralgia. (orig.)

  20. Body-mounted robotic instrument guide for image-guided cryotherapy of renal cancer

    Science.gov (United States)

    Hata, Nobuhiko; Song, Sang-Eun; Olubiyi, Olutayo; Arimitsu, Yasumichi; Fujimoto, Kosuke; Kato, Takahisa; Tuncali, Kemal; Tani, Soichiro; Tokuda, Junichi

    2016-01-01

    Purpose: Image-guided cryotherapy of renal cancer is an emerging alternative to surgical nephrectomy, particularly for those who cannot sustain the physical burden of surgery. It is well known that the outcome of this therapy depends on the accurate placement of the cryotherapy probe. Therefore, a robotic instrument guide may help physicians aim the cryotherapy probe precisely to maximize the efficacy of the treatment and avoid damage to critical surrounding structures. The objective of this paper was to propose a robotic instrument guide for orienting cryotherapy probes in image-guided cryotherapy of renal cancers. The authors propose a body-mounted robotic guide that is expected to be less susceptible to guidance errors caused by the patient’s whole body motion. Methods: Keeping the device’s minimal footprint in mind, the authors developed and validated a body-mounted, robotic instrument guide that can maintain the geometrical relationship between the device and the patient’s body, even in the presence of the patient’s frequent body motions. The guide can orient the cryotherapy probe with the skin incision point as the remote-center-of-motion. The authors’ validation studies included an evaluation of the mechanical accuracy and position repeatability of the robotic instrument guide. The authors also performed a mock MRI-guided cryotherapy procedure with a phantom to compare the advantage of robotically assisted probe replacements over a free-hand approach, by introducing organ motions to investigate their effects on the accurate placement of the cryotherapy probe. Measurements collected for performance analysis included accuracy and time taken for probe placements. Multivariate analysis was performed to assess if either or both organ motion and the robotic guide impacted these measurements. Results: The mechanical accuracy and position repeatability of the probe placement using the robotic instrument guide were 0.3 and 0.1 mm, respectively, at a depth

  1. Effect of exercise order on the number of repeats and training volume in the tri-set training method

    Directory of Open Access Journals (Sweden)

    Waynne Ferreira de Faria

    2016-05-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2016v18n2p187   Although the tri-set system is widely adopted by athletes and experienced weight training practitioners aimed at optimizing the metabolic overload, there are still few works in literature on the effect of exercise order manipulation on this training system. Therefore, this work was aimed at investigating the effect of exercise order manipulation on the number of repeats and training volume using the tri-set system for lower limbs. This is a randomized cross-over design study. The experimental group consisted of 14 healthy men (23.53 ± 5.40 years; 24.51 ± 2.96 kg/m2. Subjects were submitted to two experimental sessions at different exercise order for lower limbs: Sequence A: squat on guided bar, leg press 45° and bilateral leg extension; sequence B: bilateral leg extension, leg press 45° and squat on guided bar. Three sets to volitional fatigue in all exercises were performed, with intensity of 75% 1RM. Superiority for sequence B in the total number of repeats (70.14 ± 13 vs 60.93 ± 7.94 repeats, p = 0.004 and total training volume (9129.64 ± 2830.05 vs 8238.29 ± 2354.20 kg, p = 0.014 was observed. Based on the above, the performance of single-joint exercises before multi-joint exercises in the tri-set system adopted for lower limbs induced higher number of repeats and total training volume.

  2. 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...

  3. Exercise identity as a risk factor for exercise dependence.

    Science.gov (United States)

    Murray, Aja L; McKenzie, Karen; Newman, Emily; Brown, Erin

    2013-05-01

    The aim of the study was to explore the relationship between exercise identity and exercise dependence. We hypothesized that stronger exercise identities would be associated with greater odds of experiencing exercise dependence symptoms. Logistic regression was used to assess the extent of association between exercise identity and the risk of experiencing exercise dependence symptoms. Participants (101) were recruited online via sports clubs and social networking sites and were asked to complete online measures of exercise identity and exercise dependence. The overall model fit was a significant improvement on the baseline model, but only the exercise beliefs factor was significantly associated with the odds of dependence symptoms, with higher scores on the belief scale predicting greater odds of experiencing dependence symptoms. Exercise role identity, in contrast, was not significantly associated with odds of experiencing dependence symptoms. Per cent correct classification was 55.9% for asymptomatic and 88.2% for symptomatic individuals and the overall per cent correct classification was 77.5%. The relation between identity and dependence could represent both a fruitful research avenue and a potential therapeutic target for those experiencing dependence symptoms; although our findings only showed a relationship between one of the two factors of the exercise identity measure and dependence. Longitudinal research is required to examine the relationship between identity and dependence in the context of other variables to better understand why some individuals become exercise dependent whereas others do not. What is already known on this subject? Exercise identity has been identified as an important determinant of exercise behaviour and studies within the exercise identity framework have proven elucidative with respect to the psychological processes that may underpin commitment to exercise. It has separately been established that some individuals may become

  4. 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 ...

  5. Septic bursitis after ultrasound-guided percutaneous treatment of rotator cuff calcific tendinopathy.

    Science.gov (United States)

    Sconfienza, Luca Maria; Randelli, Filippo; Sdao, Silvana; Sardanelli, Francesco; Randelli, Pietro

    2014-08-01

    Calcific tendinopathy of the rotator cuff is a common condition. Ultrasound-guided percutaneous aspiration is one of several options to treat this condition. The main advantages of this procedure are short duration, good outcome, and low cost. Furthermore, only minor complications have been reported in the literature, namely, vagal reactions during the procedure and mild postprocedural pain. We report the first case of septic bursitis after ultrasound-guided percutaneous treatment of calcific tendinopathy. Although this is generally considered a very safe procedure, a risk of infection should be taken into account. Copyright © 2014 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  6. Distribution and predictors of exercise habits among pregnant women in the Danish National Birth Cohort.

    Science.gov (United States)

    Juhl, M; Madsen, M; Andersen, A-M N; Andersen, P K; Olsen, J

    2012-02-01

    Physical activity is recommended during pregnancy, although strong evidence on reproductive health is lacking. We present exercise habits and predictors of exercise during pregnancy. From the Danish National Birth Cohort (1996-2002), 88,200 singleton pregnancies were analyzed in logistic regression. About one-third of the women exercised in early/mid pregnancy and slightly less in late pregnancy. Bicycling, swimming, and low-impact activities were most common. Exercising more than three times per week was strongly correlated with older age, being a student or out of work, eating disorders, moderate alcohol consumption, and a healthy diet. Multiparity, a normal or less good self-rated health, smoking, and a less health conscious diet were the strongest predictors of not doing exercise. Women of 25 years or older, with metabolic or psychiatric disorders, or who had received subfecundity treatment were more likely to increase their activity level substantially from early to late pregnancy than comparison groups. In conclusion, exercising during pregnancy correlated with a number of maternal characteristics. The findings may be used to identify pregnant women not likely to exercise, to target activities that may fit their needs, and, for research purposes, to identify adjustment variables or guide sensitivity analyses when data on confounders are lacking. © 2010 John Wiley & Sons A/S.

  7. Wheel running exercise attenuates vulnerability to self-administer nicotine in rats.

    Science.gov (United States)

    Sanchez, Victoria; Lycas, Matthew D; Lynch, Wendy J; Brunzell, Darlene H

    2015-11-01

    Preventing or postponing tobacco use initiation could greatly reduce the number of tobacco-related deaths. While evidence suggests that exercise is a promising treatment for tobacco addiction, it is not clear whether exercise could prevent initial vulnerability to tobacco use. Thus, using an animal model, we examined whether exercise attenuates vulnerability to the use and reinforcing effects of nicotine, the primary addictive chemical in tobacco. Initial vulnerability was assessed using an acquisition procedure wherein exercising (unlocked running wheel, n=10) and sedentary (locked or no wheel, n=12) male adolescent rats had access to nicotine infusions (0.01-mg/kg) during daily 21.5-h sessions beginning on postnatal day 30. Exercise/sedentary sessions (2-h/day) were conducted prior to each of the acquisition sessions. The effects of exercise on nicotine's reinforcing effects were further assessed in separate groups of exercising (unlocked wheel, n=7) and sedentary (no wheel, n=5) rats responding for nicotine under a progressive-ratio schedule with exercise/sedentary sessions (2-h/day) conducted before the daily progressive-ratio sessions. While high rates of acquisition of nicotine self-administration were observed among both groups of sedentary controls, acquisition was robustly attenuated in the exercise group with only 20% of exercising rats meeting the acquisition criterion within the 16-day testing period as compared to 67% of the sedentary controls. Exercise also decreased progressive-ratio responding for nicotine as compared to baseline and to sedentary controls. Exercise may effectively prevent the initiation of nicotine use in adolescents by reducing the reinforcing effects of nicotine. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. 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

  9. CT guided percutaneous needle biopsy of the chest: initial experience

    African Journals Online (AJOL)

    The objective of this article is to report our first experience of CT guided percutaneous thoracic biopsy and to demonstrate the accuracy and safety of this procedure. This was a retrospective study of 28 CT-Guided Percutaneous Needle Biopsies of the Chest performed on 24 patients between November 2014 and April 2015.

  10. [McArdle disease revealed by exercise intolerance associated with severe rhabdomyolysis].

    Science.gov (United States)

    Amezyane, T; El Kharras, A; Abouzahir, A; Fatihi, J; Bassou, D; Mahassin, F; Ghafir, D; Ohayon, V

    2009-12-01

    McArdle's disease (MAD) is a rare hereditary myopathy secondary to a deficit in myophosphorylase, an essential enzyme for the use of muscular glycogen reserves. Exercise intolerance to a variable degree is the fundamental manifestation. Muscular enzymes are usually normal or slightly elevated, except during episodes of rhabdomyolysis. Generally, the electromyogram has poor sensitivity for the diagnosis of exercise myopathies. The muscular biopsy can be misleadingly normal. The role of MRI in the diagnosis of MAD is not well clarified in the literature. We report the case of a 16-year-old patient, hospitalized in July 2008 for exercise intolerance. On admission, he was asymptomatic and the physical examination was non contributive. Serum creatine kinase levels and renal function measures were normal. Cycloergometer exercise testing unmasked the disease. EMG and muscular biopsies were normal. During the second hospitalization, this time for rhabdomyolysis, T2 weighted MRI of the thighs showed high intensity signals from the gracilis muscles. The control MRI, made after 2 weeks of rest, was normal. Right gracilis muscle biopsy demonstrated excess glycogen with myophosphorylase deficiency, establishing the diagnosis of MAD. MAD is a rare metabolic myopathy to consider in patients with a history of exercise intolerance. The muscle biopsy can be misleadingly normal and should be, to our opinion, be guided by MRI findings.

  11. PET/CT-guided interventions: Indications, advantages, disadvantages and the state of the art.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Koch, Guillaume; Tsoumakidou, Georgia; Caudrelier, Jean; Addeo, Pietro; Bachellier, Philippe; Namer, Izzie Jacques; Gangi, Afshin

    2018-02-01

    Positron emission tomography/computed tomography (PET/CT) represents an emerging imaging guidance modality that has been applied to successfully guide percutaneous procedures such as biopsies and tumour ablations. The aim of the present narrative review is to report the indications, advantages and disadvantages of PET/CT-guided procedures in the field of interventional oncology and to briefly describe the experience gained with this new emerging technique while performing biopsies and tumor ablations.

  12. DOE assessment guide for safeguards and security

    International Nuclear Information System (INIS)

    Bennett, C.A.; Christorpherson, W.E.; Clark, R.J.; Martin, F.; Hodges, Jr.

    1978-04-01

    DOE operations are periodically assessed to assure that special nuclear material, restricted data, and other classified information and DOE facilities are executed toward continuing the effectiveness of the International Atomic Energy Agency safeguards. A guide to describe the philosophy and mechanisms through which these assessments are conducted is presented. The assessment program is concerned with all contractor, field office, and Headquarters activities which are designed to assure that safeguards and security objectives are reached by contractors at DOE facilities and operations. The guide takes into account the interlocking relationship between many of the elements of an effective safeguards and security program. Personnel clearance programs are a part of protecting classified information as well as nuclear materials. Barriers that prevent or limit access may contribute to preventing theft of government property as well as protecting against sabotage. Procedures for control and surveillance need to be integrated with both information systems and procedures for mass balance accounting. Wherever possible, assessment procedures have been designed to perform integrated inspection, evaluation, and follow-up for the safeguards and security program

  13. 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 ...

  14. Final report on the REAL-84 exercise

    International Nuclear Information System (INIS)

    Zijp, W.L.; Nolthenius, H.J.

    1988-11-01

    The main aim of the REAL-84 exercise, organized by the International Atomic Energy Agency in Vienna, was to improve the assessment of accuracies in radiation damage predictions by various laboratories using good quality input data and proper calculation methods. The emphasis was concentrated on radiation damage characterization to reactor pressure vessels and related neutron technology. The long term aim of this exercise was to strive towards the establishment of standardized metrology procedures and recommended nuclear data for use in spectrum adjustment and damage parameter calculations. In this calculation exercise dealing with seven different neutron spectra the best available input data were used. Also some utility programs were included to facilitate the preparation of input data for the adjustment codes. This final report presents a discussion on the 44 sets of adjustment results received from 12 laboratories. The comparison of the results of the various spectra showed in most cases a relatively large and unexpected interlaboratory spread. Attention is given to this phenomenon. Also the quality of the input data set and a characterization of covariance matrices is summarized

  15. Nordic nuclear emergency exercises. Final report of the BER-5 project

    International Nuclear Information System (INIS)

    Bennerstedt, T.; Stranden, E.; Salo, A.

    1994-05-01

    In all Nordic countries, nuclear emergency provisions have been revised following the Chernobyl accident. Local and national exercises are carried out regularly in each of the countries. Several actions have been taken to harmonize the approaches of individual Nordic countries. In order to further promote similar decision making procedures in an emergency situation, two Nordic exercises were conducted in 1993. It was important to see if all five countries (Denmark, Finland, Iceland, Norway and Sweden) responded in a similar way to a given situation, as far as risk assessment and countermeasures were concerned. The exercises were mainly aimed at decision makers and advisers of the five national emergency organizations. Thus, the exercises did not include comparison of underlying calculations on, e.g., atmospheric trajectories or transfer of radioactive material from air to ground. Such functions were tested separately in drills that formed part of the overall Nordic emergency preparedness program. It turned out that considerable effort is required to prepare exercises of this kind and magnitude. In each country, a national exercise leader was appointed. A Nordic evaluation team was set up. Common rules for the simulated inputs during the exercise and for the evaluators were decided on. The scenarios were prepared by an independent group. An essential planning item is the coordination of the Nordic exercises with those performed on a more routine basis in each country. The exercises included an acute-phase situation (NORA), and a late-phase situation (ODIN)

  16. A Study on Guide Sign Validity in Driving Simulator

    Directory of Open Access Journals (Sweden)

    Wei Zhonghua

    2011-12-01

    Full Text Available The role of guide sign to inform road user about the information of network is important. How to design and locate guide sign to increase traffic operation efficiency is a key point for traffic engineers. Driving simulator is useful devised to study guide sign in the process and system control. For the purpose of studying guide signs using the tool of driving simulator, guide sign's validity in driving simulator was studied. Results of this experiment are the foundation of further study on guide sign. Simulator calibration procedure for guide sign was set up in this study. Legibility distance as measure of performance was used to evaluate the validity of guide sign in driving simulator. Thirty two participants were recruited. Results indicated legibility distance and speed were inversely related with the method of data mining. Legibility distance and text height of guide sign were positive related. When speed is 20km/h, 30km/h, 40km/h, magnifying power of text height is 4.3, 4.1, 3.8, while guide signs are absolute validity in driving simulator.

  17. A Pilot Study of an Exercise-Based Patient Education Program in People with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Stephanie Kersten

    2014-01-01

    Full Text Available There is increasing evidence that physical exercise leads to numerous positive effects in PwMS. However, long-term effects of exercise may only be achievable if training is implemented in daily routine. Enabling patients to exercise regularly, we developed a patient education program focused on evidence-based information of training. PwMS were educated in neurophysiological effects of physical exercise, exercise-induced benefits for PwMS, and risk factors (e.g., weather. Fifteen PwMS were analyzed before (T0 and after (T1 a 12-week patient education. Afterwards, participants performed their exercises autonomously for 32 weeks and were tested in sustainability tests (T2. Guided interviews were carried out, additionally. Significant improvements from T0 to T1 were found in 6MWT, gait velocity, TUG, fatigue, and quality of life. Significant results of TUG and gait velocity from T1 to T2 demonstrated that participants kept few effects after the 32-week training phase. Qualitative analyses showed improved self-confidence and identified training strategies and barriers. This pilot study provides evidence that PwMS are able to acquire good knowledge about physical exercise and apply this knowledge successfully in training management. One might conclude that this exercise-based patient education seems to be a feasible option to maintain or improve patients’ integral constitution concerning physical and mental health.

  18. Balance, dizziness and proprioception in patients with chronic whiplash associated disorders complaining of dizziness: A prospective randomized study comparing three exercise programs.

    Science.gov (United States)

    Treleaven, Julia; Peterson, Gunnel; Ludvigsson, Maria Landén; Kammerlind, Ann-Sofi; Peolsson, Anneli

    2016-04-01

    Dizziness and unsteadiness are common symptoms following a whiplash injury. To compare the effect of 3 exercise programs on balance, dizziness, proprioception and pain in patients with chronic whiplash complaining of dizziness. A sub-analysis of a randomized study. One hundred and forty subjects were randomized to either a physiotherapist-guided neck-specific exercise (NSE), physiotherapist-guided neck-specific exercise, with a behavioural approach (NSEB) or prescription of general physical activity (PPA) group. Pre intervention, 3, 6 and 12 months post baseline they completed the University of California Los Angeles Dizziness Questionnaire (UCLA-DQ), Visual Analogue Scales (VAS) for, dizziness at rest and during activity and physical measures (static and dynamic clinical balance tests and head repositioning accuracy (HRA)). There were significant time by group differences with respect to dizziness during activity and UCLA-Q favouring the physiotherapy led neck specific exercise group with a behavioural approach. Within group analysis of changes over time also revealed significant changes in most variables apart from static balance. Between and within group comparisons suggest that physiotherapist led neck exercise groups including a behavioural approach had advantages in improving measures of dizziness compared with the general physical activity group, although many still complained of dizziness and balance impairment. Future studies should consider exercises specifically designed to address balance, dizziness and cervical proprioception in those with persistent whiplash. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  19. 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

  20. Operating procedures for the Pajarito Site Critical Assembly Facility

    International Nuclear Information System (INIS)

    Malenfant, R.E.

    1983-03-01

    Operating procedures consistent with DOE Order 5480.2, Chapter VI, and the American National Standard Safety Guide for the Performance of Critical Experiments are defined for the Pajarito Site Critical Assembly Facility of the Los Alamos National Laboratory. These operating procedures supersede and update those previously published in 1973 and apply to any criticality experiment performed at the facility

  1. Magnetic-resonance-guided biopsy of focal liver lesions

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Ethan A. [University of Michigan Health System, Section of Pediatric Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Grove, Jason J. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); Der Spek, Abraham F.L.V. [University of Michigan Health System, Department of Anesthesiology, C.S. Mott Children' s Hospital, Ann Arbor, MI (United States); Jarboe, Marcus D. [University of Michigan Health System, Division of Interventional Radiology, C.S. Mott Children' s Hospital, Department of Radiology, Ann Arbor, MI (United States); University of Michigan Health System, Section of Pediatric Surgery, C.S. Mott Children' s Hospital, Department of Surgery, Ann Arbor, MI (United States)

    2017-05-15

    Image-guided biopsy techniques are widely used in clinical practice. Commonly used methods employ either ultrasound (US) or computed tomography (CT) for image guidance. In certain patients, US or CT guidance may be suboptimal, or even impossible, because of artifacts, suboptimal lesion visualization, or both. We recently began performing magnetic resonance (MR)-guided biopsy of focal liver lesions in select pediatric patients with lesions that are not well visualized by US or CT. This report describes our experience performing MR-guided biopsy of focal liver lesions, with case examples to illustrate innovative techniques and novel aspects of these procedures. (orig.)

  2. Outcomes of ultrasound guided renal mass biopsies.

    Science.gov (United States)

    Sutherland, Edward L; Choromanska, Agnieszka; Al-Katib, Sayf; Coffey, Mary

    2018-06-01

    The purpose of this study was to evaluate the rate of nondiagnostic ultrasound-guided renal mass biopsies (RMBs) at our institution and to determine what patient, procedural, and focal renal mass (FRM) factors were associated with nondiagnostic ultrasound-guided RMBs. Eighty-two ultrasound-guided renal mass biopsies performed between January 2014 and October 2016 were included in our study. Biopsy outcomes (diagnostic vs. nondiagnostic) and patient, procedural, and FRM characteristics were retrospectively reviewed and recorded. Univariate statistical analyses were performed to identify biopsy characteristics that were indicative of nondiagnostic biopsy. Ultrasound-guided RMBs were diagnostic in 70 out of 82 cases (85%) and non-diagnostic in 12 cases (15%). Among the diagnostic biopsies, 54 (77%) were malignant cases, 94% of which were renal cell carcinoma (RCC). Of the 12 nondiagnostic cases, the final diagnosis was RCC in 4 cases and angiomyolipoma in one case; seven of the nondiagnostic cases were lost to follow-up. A weak association (p = 0.04) was found between the number of needle passes and the biopsy outcome. None of the remaining collected RMB characteristics showed a significant correlation with a diagnostic or nondiagnostic RMB. Six patients (7%) experienced complications. Ultrasound-guided renal mass biopsy is a safe and effective method for the diagnosis of renal masses with a low rate of nondiagnostic outcomes. A nondiagnostic biopsy should not be treated as a surrogate for a diagnosis since a significant number of patients with nondiagnostic biopsies have subsequently been shown to have renal malignancies. Repeat biopsy should be considered in such cases.

  3. Mathematics for physicists and engineers fundamentals and interactive study guide

    CERN Document Server

    Weltner, Klaus; Grosjean, Jean; Schuster, Peter

    2009-01-01

    Mathematics is the basic language in physics and engineering. It is an essential tool which first and second year students have to master as soon as possible. A lack of competence in mathematics is the main reason for failure and drop out in the beginning periods of study. 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 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 progre...

  4. 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.

  5. 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.

  6. Ultrasound-guided versus fluoroscopy-guided sacroiliac joint intra-articular injections in the noninflammatory sacroiliac joint dysfunction: a prospective, randomized, single-blinded study.

    Science.gov (United States)

    Jee, Haemi; Lee, Ji-Hae; Park, Ki Deok; Ahn, Jaeki; Park, Yongbum

    2014-02-01

    To compare the short-term effects and safety of ultrasound (US)-guided sacroiliac joint (SIJ) injections with fluoroscopy (FL)-guided SIJ injections in patients with noninflammatory SIJ dysfunction. Prospective, randomized controlled trial. University hospital. Patients (N=120) with noninflammatory sacroiliac arthritis were enrolled. All procedures were performed using an FL or US apparatus. Subjects were randomly assigned to either the FL or US group. Immediately after the SIJ injections, fluoroscopy was applied to verify the correct placement of the injected medication and intravascular injections. Treatment effects and functional improvement were compared at 2 and 12 weeks after the procedures. The verbal numeric pain scale and Oswestry Disability Index improved at 2 and 12 weeks after the injections without statistical significances between groups. Of 55 US-guided injections, 48 (87.3%) were successful and 7 (12.7%) were missed. The FL-guided SIJ approach exhibited a greater accuracy (98.2%) than the US-guided approach. Vascularization around the SIJ was seen in 34 of 55 patients. Among the 34 patients, 7 had vascularization inside the joint, 23 had vascularization around the joint, and 4 had vascularization both inside and around the joint. Three cases of intravascular injections occurred in the FL group. The US-guided approach may facilitate the identification and avoidance of the critical vessels around or within the SIJ. Function and pain relief significantly improved in both groups without significant differences between groups. The US-guided approach was shown to be as effective as the FL-guided approach in treatment effects. However, diagnostic application in the SIJ may be limited because of the significantly lower accuracy rate (87.3%). Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  7. 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).

  8. Applying computer-based procedures in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Oliveira, Mauro V. de; Carvalho, Paulo V.R. de; Santos, Isaac J.A.L. dos; Grecco, Claudio H.S. [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Div. de Instrumentacao e Confiabilidade Humana], e-mail: mvitor@ien.gov.br, e-mail: paulov@ien.gov.br, e-mail: luquetti@ien.gov.br, e-mail: grecco@ien.gov.br; Bruno, Diego S. [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Escola Politecnica. Curso de Engenharia de Controle e Automacao], e-mail: diegosalomonebruno@gmail.com

    2009-07-01

    Plant operation procedures are used to guide operators in coping with normal, abnormal or emergency situations in a process control system. Historically, the plant procedures have been paper-based (PBP), with the digitalisation trend in these complex systems computer-based procedures (CBPs) are being developed to support procedure use. This work shows briefly the research on CBPs at the Human-System Interface Laboratory (LABIHS). The emergency operation procedure EOP-0 of the LABIHS NPP simulator was implemented in the ImPRO CBP system. The ImPRO system was chosen for test because it is available for download in the Internet. A preliminary operation test using the implemented procedure in the CBP system was realized and the results were compared to the operation through PBP use. (author)

  9. Simulated physical inventory verification exercise at a mixed-oxide fuel fabrication facility

    International Nuclear Information System (INIS)

    Reilly, D.; Augustson, R.

    1985-01-01

    A physical inventory verification (PIV) was simulated at a mixed-oxide fuel fabrication facility. Safeguards inspectors from the International Atomic Energy Agency (IAEA) conducted the PIV exercise to test inspection procedures under ''realistic but relaxed'' conditions. Nondestructive assay instrumentation was used to verify the plutonium content of samples covering the range of material types from input powders to final fuel assemblies. This paper describes the activities included in the exercise and discusses the results obtained. 5 refs., 1 fig., 6 tabs

  10. Methodological guide: management of industrial sites potentially contaminated by radioactive substances

    International Nuclear Information System (INIS)

    2001-01-01

    At the request of the Ministries of Health and the Environment, IPSN is preparing and publishing the first version of the methodological guide devoted to managing industrial sites potentially contaminated by radioactive substances. This guide describes a procedure for defining and choosing strategies for rehabilitating such industrial sites. (author)

  11. 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.

  12. Effects of acute exercise on gene expression in exercising and non-exercising human skeletal muscle

    NARCIS (Netherlands)

    Catoire, Milene; Mensink, Marco; Boekschoten, Mark; Hangelbroek, Roland; Muller, Michael; Schrauwen, Patricht; Kersten, Sander

    2012-01-01

    Background: Exercising is know to have an effect on exercising skeletal muscle, but unkown is the effect on non-exercising skeletal muscle. Gene expression changes in the non-exercising skeletal muscle would point to a signalling role of skeletal muscle

  13. Health Professionals' Perceptions of the Effects of Exercise on Joint Health in Rheumatoid Arthritis Patients.

    Science.gov (United States)

    Halls, Serena; Law, Rebecca-Jane; Jones, Jeremy G; Markland, David A; Maddison, Peter J; Thom, Jeanette M

    2017-09-01

    Although exercise is an important factor in the management of rheumatoid arthritis (RA), research indicates that patients perceive that health professionals (HPs) are uncertain about the place of exercise in treatment and its relationship with joint damage. The present study investigated the perceptions of HPs regarding the effects of exercise on joint health in RA patients. A questionnaire investigating perceptions of exercise and joint health was distributed via professional networks and websites. Confirmatory factor analysis (CFA) was used to analyse questionnaire data and develop a focus group interview guide. Focus groups were conducted with multidisciplinary teams (MDTs) of rheumatology HPs and analysed using framework analysis. A total of 137 rheumatology HPs (95 female; 27-65 years of age) completed questionnaires. CFA showed that a four-factor model provided a marginally acceptable fit. Analysis of four focus groups (n = 24; 19 female; 30-60 years of age) identified five themes relating to HPs' perceptions of exercise and joint health in RA patients: 'Exercise is beneficial', 'Concerns about damage to joints', 'Patients have barriers to exercise', 'HP knowledge differs' and 'Patients may think service delivery is vague'. HPs were highly aware of the benefits and importance of exercise for RA patients. However, to remove the patient perception that HPs lack certainty and clarity regarding exercise it is important to ensure: (i) consistent promotion of exercise across the whole MDT; (ii) clear provision of information regarding rest, joint protection and exercise; (iii) HP education to ensure consistent, accurate knowledge, and understanding of the potential for conflicting advice when promoting exercise as part of an MDT. Copy © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  14. On a Practical Exercise with OJE (On the Job Education)

    Science.gov (United States)

    Zako, Masaru; Narumi, Kunihiro; Sato, Takehiko; Yamamoto, Takao; Hama, Keisuke; Yanabu, Kouji; Shinohara, Hiroshi; Murata, Masato; Uenishi, Keisuke; Kaga, Atsuko; Matsumura, Nobuhiko; Nakagawa, Takashi; Kurashiki, Tetsusei

    The Department of Management of Industry and Technology, Graduate School of Engineering in Osaka University provides a new type of a leadership training program which took in an OJE (On the Job Education) method. The OJE is an autonomous education system from planning to problem solving through aggressive self-developments. This program composes of not only lectures and case studies, but also practical exercises for accumulating knowledge and experience in order to develop strong judgment and decisiveness of graduate students. The procedure of the activity, examples of the exercises and the educational effects are described in the paper.

  15. Use of Ultrasound Contrast Agents in Relation to Percutaneous Interventional Procedures

    DEFF Research Database (Denmark)

    Nolsøe, Christian Pállson; Nolsøe, Alexander Bjørneboe; Klubien, Jeanett

    2018-01-01

    The aim of this article is to provide an inventory of the use of contrast-enhanced ultrasound (CEUS) in relation to percutaneous interventional procedures. The article is structured into a systematic literature review followed by a clinical part relating to percutaneous CEUS-guided procedures...

  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. Outcome of percutaneous continuous drainage of psoas abscess: A clinically guided technique.

    Science.gov (United States)

    Dave, Bharat R; Kurupati, Ranganatha Babu; Shah, Dipak; Degulamadi, Devanand; Borgohain, Nitu; Krishnan, Ajay

    2014-01-01

    Percutaneous aspiration of abscesses under ultrasonography (USG) and computer tomography (CT) scan has been well described. With recurrence rate reported as high as 66%. The open drainage and percutaneous continuous drainage (PCD) has reduced the recurrence rate. The disadvantage of PCD under CT is radiation hazard and problems of asepsis. Hence a technique of clinically guided percutaneous continuous drainage of the psoas abscess without real-time imaging overcomes these problems. We describe clinically guided PCD of psoas abscess and its outcome. Twenty-nine patients with dorsolumbar spondylodiscitis without gross neural deficit with psoas abscess of size >5 cm were selected for PCD. It was done as a day care procedure under local anesthesia. Sequentially, aspiration followed by guide pin-guided trocar and catheter insertion was done without image guidance. Culture sensitivity was done and chemotherapy initiated and catheter kept till the drainage was drainage and ODI (Oswestry Disability Index) score at 2 years. PCD was successful in all cases. Back and radicular pain improved in all cases. Average procedure time was 24.30 minutes, drain output was 234.40 ml, and the drainage duration was 7.90 days. One patient required surgical stabilisation due to progression of the spondylodiscitis resulting in instability inspite of successful drainage of abscess. Problems with the procedure were noticed in six patients. Multiple attempts (n = 2), persistent discharge (n = 1) for 2 weeks, blocked catheter (n = 2) and catheter pull out (n = 1) occurred with no effect on the outcome. The average ODI score improved from 62.47 to 5.51 at 2 years. Clinically guided PCD is an efficient, safe and easy procedure in drainage of psoas abscess.

  18. "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

  19. Performance appraisal and advancement exercise 2006 (Rev)

    CERN Multimedia

    Human Resources Department

    2005-01-01

    The 2006 performance appraisal and advancement 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 1 December 2005 to 15 March 2006*. In this connection, a number of improvements to the procedures relating to the interviews and performance appraisals 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 December onwards. In the meantime supervisors can start the interview procedure. HR Department will shortly provide further information on this subject. The 2005 MAPS report can be retrieved for consultation at any time via EDH. * Instead of 31 March, as indicated in the electronic Bulletin No. 47 of 21 November 2005 Human Resources Department Tel. 73566

  20. "It's exercise or nothing": a qualitative analysis of exercise dependence.

    Science.gov (United States)

    Bamber, D; Cockerill, I M; Rodgers, S; Carroll, D

    2000-12-01

    To explore, using qualitative methods, the concept of exercise dependence. Semistructured interviews were undertaken with subjects screened for exercise dependence and eating disorders. 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. 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. Where exercise dependence was manifest, it was always in the context of an eating disorder, and it was this comorbidity, 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.

  1. 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.

  2. Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

    Energy Technology Data Exchange (ETDEWEB)

    Schouten, Martijn G. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); University Medical Centre Nijmegen, Department of Radiology, Nijmegen (Netherlands); Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J. [Radboud University Nijmegen Medical Centre, Department of Radiology, Nijmegen (Netherlands); Rothgang, Eva [Pattern Recognition Lab, Friedrich-Alexander-University of Erlangen-Nuremberg, Erlangen (Germany); Center for Applied Medical Imaging, Siemens Corporate Research (Germany); Center for Applied Medical Imaging, Siemens Corporate Research, Baltimore, MD (United States); Misra, Sarthak [University of Twente, MIRA-Institute of Biomedical Technology and Technical Medicine, Enschede (Netherlands)

    2012-02-15

    To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

  3. Evaluation of a robotic technique for transrectal MRI-guided prostate biopsies

    International Nuclear Information System (INIS)

    Schouten, Martijn G.; Bomers, Joyce G.R.; Yakar, Derya; Huisman, Henkjan; Bosboom, Dennis; Scheenen, Tom W.J.; Fuetterer, Jurgen J.; Rothgang, Eva; Misra, Sarthak

    2012-01-01

    To evaluate the accuracy and speed of a novel robotic technique as an aid to perform magnetic resonance image (MRI)-guided prostate biopsies on patients with cancer suspicious regions. A pneumatic controlled MR-compatible manipulator with 5 degrees of freedom was developed in-house to guide biopsies under real-time imaging. From 13 consecutive biopsy procedures, the targeting error, biopsy error and target displacement were calculated to evaluate the accuracy. The time was recorded to evaluate manipulation and procedure time. The robotic and manual techniques demonstrated comparable results regarding mean targeting error (5.7 vs 5.8 mm, respectively) and mean target displacement (6.6 vs 6.0 mm, respectively). The mean biopsy error was larger (6.5 vs 4.4 mm) when using the robotic technique, although not significant. Mean procedure and manipulation time were 76 min and 6 min, respectively using the robotic technique and 61 and 8 min with the manual technique. Although comparable results regarding accuracy and speed were found, the extended technical effort of the robotic technique make the manual technique - currently - more suitable to perform MRI-guided biopsies. Furthermore, this study provided a better insight in displacement of the target during in vivo biopsy procedures. (orig.)

  4. EnCE EnCase computer forensics : the official EnCase certified examiner : study guide

    CERN Document Server

    Bunting, Steve

    2012-01-01

    The official, Guidance Software-approved book on the newest EnCE exam! The EnCE exam tests that computer forensic analysts and examiners have thoroughly mastered computer investigation methodologies, as well as the use of Guidance Software's EnCase Forensic 7. The only official Guidance-endorsed study guide on the topic, this book prepares you for the exam with extensive coverage of all exam topics, real-world scenarios, hands-on exercises, up-to-date legal information, and sample evidence files, flashcards, and more. Guides readers through preparation for the newest EnCase Certified Examiner

  5. 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.

  6. Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain

    International Nuclear Information System (INIS)

    Wasserman, A.G.; Katz, R.J.; Varghese, P.J.; Leiboff, R.H.; Bren, G.G.; Schlesselman, S.; Varma, V.M.; Reba, R.C.; Ross, A.M.

    1984-01-01

    The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and 1.4 +/- 1%, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29%) and in 4 of the 20 without it (20%) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1%, in contrast to the patients without coronary disease, who had an increase of +/- 1% (P < 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48%), as compared with 3 of the 38 without it (8%) (P < 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain. 28 references, 2 figures, 3 tables

  7. Learner's Guide: Water Quality Monitoring. An Instructional Guide for the Two-Year Water Quality Monitoring Curriculum.

    Science.gov (United States)

    Glazer, Richard B.; And Others

    This learner's guide is designed to meet the training needs for technicians involved in monitoring activities related to the Federal Water Pollution Act and the Safe Drinking Water Act. In addition it will assist technicians in learning how to perform process control laboratory procedures for drinking water and wastewater treatment plant…

  8. Laser Guidance in C-Arm Cone-Beam CT-Guided Radiofrequency Ablation of Osteoid Osteoma Reduces Fluoroscopy Time

    Energy Technology Data Exchange (ETDEWEB)

    Kroes, Maarten W., E-mail: Maarten.Kroes@radboudumc.nl; Busser, Wendy M. H.; Hoogeveen, Yvonne L.; Lange, Frank de; Schultze Kool, Leo J. [Radboud University Medical Center, Department of Radiology and Nuclear Medicine (Netherlands)

    2017-05-15

    PurposeTo assess whether laser guidance can reduce fluoroscopy and procedure time of cone-beam computed tomography (CBCT)-guided radiofrequency (RF) ablations of osteoid osteoma compared to freehand CBCT guidance.Materials and Methods32 RF ablations were retrospectively analyzed, 17 laser-guided and 15 procedures using the freehand technique. Subgroup selection of 18 ablations in the hip–pelvic region with a similar degree of difficulty was used for a direct comparison. Data are presented as median (ranges).ResultsComparison of all 32 ablations resulted in fluoroscopy times of 365 s (193–878 s) for freehand and 186 s (75–587 s) for laser-guided procedures (p = 0.004). Corresponding procedure times were 56 min (35–97 min) and 52 min (30–85 min) (p = 0.355). The subgroup showed comparable target sizes, needle path lengths, and number of scans between groups. Fluoroscopy times were lower for laser-guided procedures, 215 s (75–413 s), compared to 384 s (193–878 s) for freehand (p = 0.012). Procedure times were comparable between groups, 51 min (30–72 min) for laser guidance and 58 min (35–79 min) for freehand (p = 0.172).ConclusionAdding laser guidance to CBCT-guided osteoid osteoma RF ablations significantly reduced fluoroscopy time without increasing procedure time.Level of EvidenceLevel 4, case series.

  9. 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

  10. Faculty staff-guided versus self-guided ultrasound training for internal medicine residents.

    Science.gov (United States)

    Alba, George A; Kelmenson, Daniel A; Noble, Vicki E; Murray, Alice F; Currier, Paul F

    2013-11-01

    Ultrasonography is of growing importance within internal medicine (IM), but the optimal method of training doctors to use it is uncertain. In this study, the authors provide the first objective comparison of two approaches to training IM residents in ultrasonography. In this randomised trial, a simulation-based ultrasound training curriculum was implemented during IM intern orientation at a tertiary care teaching hospital. All 72 incoming interns attended a lecture and were given access to online modules. Interns were then randomly assigned to a 4-hour faculty-guided (FG) or self-guided (SG) ultrasound training session in a simulation laboratory with both human and manikin models. Interns were asked to self-assess their competence in ultrasonography and underwent an objective structured clinical examination (OSCE) to assess their competence in basic and procedurally oriented ultrasound tasks. The primary outcome was the score on the OSCE. Faculty-guided training was superior to self-guided training based on the OSCE scores. Subjects in the FG training group achieved significantly higher OSCE scores on the two subsets of task completion (0.9-point difference, 95% confidence interval [CI] 0.27-1.54; p = 0.008) and ultrasound image quality (2.43-point difference, 95% CI 1.5-3.36; p training groups demonstrated an increase in self-assessed competence after their respective training sessions and there was little difference between the groups. Subjects rated the FG training group much more favourably than the SG training group. Both FG and SG ultrasound training curricula can improve the self-reported competence of IM interns in ultrasonography. However, FG training was superior to SG training in both skills acquisition and intern preference. Incorporating mandatory ultrasound training into IM residencies can address the perceived need for ultrasound training, improve confidence and procedural skills, and may enhance patient safety. However, the optimal training method

  11. Oscillation of tissue oxygen index in non-exercising muscle during exercise.

    Science.gov (United States)

    Yano, T; Afroundeh, R; Shirakawa, K; Lian, C-S; Shibata, K; Xiao, Z; Yunoki, T

    2015-09-01

    The purpose of the present study was to examine how oscillation of tissue oxygen index (TOI) in non-exercising exercise is affected during high-intensity and low-intensity exercises. Three exercises were performed with exercise intensities of 30% and 70% peak oxygen uptake (Vo(2)peak) for 12 min and with exercise intensity of 70% Vo(2)peak for 30 s. TOI in non-exercising muscle (biceps brachii) during the exercises for 12 min was determined by nearinfrared spectroscopy. TOI in the non-exercising muscle during the exercises was analyzed by fast Fourier transform (FFT) to obtain power spectra density (PSD). The frequency at which maximal PSD appeared (Fmax) during the exercise with 70% Vo(2)peak for 12 min (0.00477 ± 0.00172 Hz) was significantly lower than that during the exercise with 30% Vo2peak for 12 min (0.00781 ± 0.00338 Hz). There were significant differences in blood pH and blood lactate between the exercise with 70% Vo(2)peak and the exercise with 30% Vo(2)peak. It is concluded that TOI in nonexercising muscle oscillates during low-intensity exercise as well as during high-intensity exercise and that the difference in Fmax between the two exercises is associated with the difference in increase in blood lactate derived from the exercise.

  12. Changes in blood glucose among trained normoglycemic adults during a mini-trampoline exercise session.

    Science.gov (United States)

    Martins Cunha, Raphael; Raiana Bentes, Mariana; Araújo, Victor H; DA Costa Souza, Mayara C; Vasconcelos Noleto, Marcelo; Azevedo Soares, Ademar; Machado Lehnen, Alexandre

    2016-12-01

    Blood glucose changes response during and after exercise are modulated by the postabsorptive state, intensity and duration of exercise, and the level of physical fitness as well. This study focused on the idea that high-intensity interval exercise, as mini-trampoline class, can reduce blood glucose. Thus, we examined acute changes in blood glucose among trained normoglycemic adults during a mini-trampoline exercise session. Twenty-four normoglycemic adult subjects were enrolled in the study. After physical assessment they were randomly assigned to either the experimental (N.=12) or the control group (N.=12). The experimental group performed a 50-minute session of moderate-to-high intensity (70 to 85% HRmax) exercise on a mini-trampoline commonly used in fitness classes. The control group did not perform any exercise, and all procedures were otherwise similar to the experimental group. Capillary blood glucose was measured before and every 15 minutes during the exercise session. The effects of exercise on blood glucose levels (group; time; and group interaction) were estimated using a generalized estimating equation (GEE) followed by Bonferroni's post-hoc Test (Ptrampoline can be used for reducing blood glucose levels and thus can potentially control blood glucose.

  13. A guide to safe field operations

    Science.gov (United States)

    Yobbi, D.K.; Yorke, T.H.; Mycyk, R.T.

    1996-01-01

    Most functions of the U.S. Geological Survey (USGS), Water Resources Division (WRD) require employees to participate in numerous field activities ranging from routine meetings with cooperators, other federal and public officials, and private citizens to potentially hazardous assignments, such as making flood measurements and scuba diving to service underwater instruments. It is paramount that each employee be aware of safety procedures and operational policies of the WRD to ensure that (1) their activities avoid or minimize personal injury to the employee, coworkers, or anyone in the vicinity of the field activity, and (2) their conduct does not infringe on the personal or property rights of any individual or organization. The purpose of the guide is to familiarize employees with the operational and safety procedures expected to be followed by each employee as a representative of the WRD. It is also intended as a training tool for all new employees and a document to be reviewed by each employee before undertaking a field assignment. It includes general procedures that are standard and applicable to all field operations, such as communication, vehicle operation, and adequate preparation for anticipated weather conditions. It also includes a discussion of specific procedures and safety considerations for most of the routine field assignments undertaken by hydrologists and hydrologic technicians of the WRD. The guide is not intended to be a technical handbook outlining step-by-step procedures for performing specific tasks or a comprehensive discussion of every possible activity that may be undertaken by a USGS employee. Employees are referred to the Techniques for Water-Resources Investigations (TWRI) series for specific technical procedures and to the U.S. Geological Survey Safety and Environmental Health Handbook 445-1-H (USGS, August 1989), USGS Occupational Hazards and Safety Procedures Handbook 445-2-H (December 1993), the WRD notebook on Safety Policy and

  14. Acute chest pain after bench press exercise in a healthy young adult.

    Science.gov (United States)

    Smereck, Janet A; Papafilippaki, Argyro; Sudarshan, Sawali

    2016-01-01

    Bench press exercise, which involves repetitive lifting of weights to full arm extension while lying supine on a narrow bench, has been associated with complications ranging in acuity from simple pectoral muscle strain, to aortic and coronary artery dissection. A 39-year-old man, physically fit and previously asymptomatic, presented with acute chest pain following bench press exercise. Diagnostic evaluation led to the discovery of critical multivessel coronary occlusive disease, and subsequently, highly elevated levels of lipoprotein (a). Judicious use of ancillary testing may identify the presence of "high-risk" conditions in a seemingly "low-risk" patient. Emergency department evaluation of the young adult with acute chest pain must take into consideration an extended spectrum of potential etiologies, so as to best guide appropriate management.

  15. Measuring fuel moisture content in Alaska: standard methods and procedures.

    Science.gov (United States)

    Rodney A. Norum; Melanie. Miller

    1984-01-01

    Methods and procedures are given for collecting and processing living and dead plant materials for the purpose of determining their water content. Wild-land fuels in Alaska are emphasized, but the methodology is applicable elsewhere. Guides are given for determining the number of samples needed to attain a chosen precision. Detailed procedures are presented for...

  16. An Exercise for Illustrating the Logic of Hypothesis Testing

    Science.gov (United States)

    Lawton, Leigh

    2009-01-01

    Hypothesis testing is one of the more difficult concepts for students to master in a basic, undergraduate statistics course. Students often are puzzled as to why statisticians simply don't calculate the probability that a hypothesis is true. This article presents an exercise that forces students to lay out on their own a procedure for testing a…

  17. Advanced Resistive Exercise Device (ARED) Flight Software (FSW): A Unique Approach to Exercise in Long Duration Habitats

    Science.gov (United States)

    Mangieri, Mark

    2005-01-01

    ARED flight instrumentation software is associated with an overall custom designed resistive exercise system that will be deployed on the International Space Station (ISS). This innovative software application fuses together many diverse and new technologies into a robust and usable package. The software takes advantage of touchscreen user interface technology by providing a graphical user interface on a Windows based tablet PC, meeting a design constraint of keyboard-less interaction with flight crewmembers. The software interacts with modified commercial data acquisition (DAQ) hardware to acquire multiple channels of sensor measurment from the ARED device. This information is recorded on the tablet PC and made available, via International Space Station (ISS) Wireless LAN (WLAN) and telemetry subsystems, to ground based mission medics and trainers for analysis. The software includes a feature to accept electronically encoded prescriptions of exercises that guide crewmembers through a customized regimen of resistive weight training, based on personal analysis. These electronically encoded prescriptions are provided to the crew via ISS WLAN and telemetry subsystems. All personal data is securely associated with an individual crew member, based on a PIN ID mechanism.

  18. 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...

  19. Standard guide for laboratory simulation of corrosion under insulation

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2007-01-01

    1.1 This guide covers the simulation of corrosion under insulation (CUI), including both general and localized attack, on insulated specimens cut from pipe sections exposed to a corrosive environment usually at elevated temperature. It describes a CUI exposure apparatus (hereinafter referred to as a CUI-Cell), preparation of specimens, simulation procedures for isothermal or cyclic temperature, or both, and wet/dry conditions, which are parameters that need to be monitored during the simulation and the classification of simulation type. 1.2 The application of this guide is broad and can incorporate a range of materials, environments and conditions that are beyond the scope of a single test method. The apparatus and procedures contained herein are principally directed at establishing acceptable procedures for CUI simulation for the purposes of evaluating the corrosivity of CUI environments on carbon and low alloy pipe steels, and may possibly be applicable to other materials as well. However, the same or simi...

  20. 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