WorldWideScience

Sample records for fast track clinical

  1. Organizing and implementing a multidisciplinary fast track oncology clinic.

    Science.gov (United States)

    Basta, Y L; Tytgat, K M A J; Greuter, H H; Klinkenbijl, J H G; Fockens, P; Strikwerda, J

    2017-11-01

    Patients with gastrointestinal malignancies often need multiple appointments with different medical specialists, causing waiting times to accrue. In our hospital, care is organized in a sequential manner, causing long waiting times. To reduce this, a fast track outpatient clinic (FTC) was implemented. The FTC was organized within the hospital's existing structure. Patient centered care was achieved by ensuring that the medical specialists visit the patient, implementing nurse coordinators and considering patient wishes and co-morbidities when formulating a treatment plan. A mandate from the board (Top-down), ensured cooperation between different medical departments and a change in resource allocation (i.e. medical staff); a horizontal clinic across a vertical departmental structure. Brainstorm sessions between the departments led by two physicians who were going to work at the FTC (Bottom-up), assured a swift implementation of the FTC. Since implementation in 2009, patient influx has tripled. Waiting time for an appointment and start of treatment was reduced from 2-4 weeks to 6 working days and from 12-14 weeks to 17 working days, respectively. This was achieved by re-allocating recourses, but without increasing existing resources. The combination of a top-down and bottom-up strategy ensured participation from all involved departments, a strong foundation and a shared vision on patient centered care. The FTC facilitates sharing information between different medical specialists through both proximity and a shared electronic patient record. The implementation of the FTC comprises a change in organization, but not a change in structure. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. Fast track-hoftealloplastik

    DEFF Research Database (Denmark)

    Hansen, Torben Bæk; Gromov, Kirill; Kristensen, Billy B

    2017-01-01

    Fast-track surgery implies a coordinated perioperative approach aimed at reducing surgical stress and facilitating post-operative recovery. The fast-track programme has reduced post-operative length of stay and has led to shorter convalescence with more rapid functional recovery and decreased...... morbidity and mortality in total hip arthroplasty. It should now be a standard total hip arthroplasty patient pathway, but fine tuning of the multiple factors in the fast-track pathway is still needed in patients with special needs or high comorbidity burden....

  3. Fast-track rehabilitation in elective colorectal surgery patients: a prospective clinical and immunological single-centre study.

    Science.gov (United States)

    Wichmann, Matthias W; Eben, Ricarda; Angele, Martin K; Brandenburg, Franzis; Goetz, Alwin E; Jauch, Karl-Walter

    2007-07-01

    Recent clinical data indicate that fast-track surgery (multimodal rehabilitation) leads to shorter postoperative length of hospital stay, faster recovery of gastrointestinal function as well as reduced morbidity and mortality rates. To date, no study has focused on the effects of fast-track surgery on postoperative immune function. This study was initiated to determine whether fast-track rehabilitation results in improved clinical and immunological outcome of patients undergoing colorectal surgery. Forty patients underwent either conventional or fast-track rehabilitation after colorectal surgery. In addition to clinical parameters (return of gastrointestinal function, food intake, pain score, complication rates and postoperative length of stay), we determined parameters of perioperative immunity by flow cytometry (lymphocyte subgroups) and enzyme-linked immunosorbent assay (interleukin-6). Our findings indicate a better-preserved cell-mediated immune function (T cells, T-helper cells, natural killer cells) after fast-track rehabilitation, whereas the pro-inflammatory response (C-reactive protein, interleukin-6) was unchanged in both study groups. Furthermore, we detected a significantly faster return of gastrointestinal function (first bowel movement P<0.001, food intake P<0.05), significantly reduced pain scores in the postoperative course (P < 0.05) and a significantly shorter length of postoperative stay (P<0.001) in patients undergoing fast-track rehabilitation. Fast-track rehabilitation after colorectal surgery results in better-preserved cell-mediated immunity when compared with conventional postoperative care. Furthermore, patients undergoing fast-track rehabilitation suffer from less pain and have a faster return of gastrointestinal function in the postoperative course. In addition, postoperative length of hospital stay was significantly shorter in fast-track patients.

  4. Fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik

    2012-01-01

    Fast-track hip and knee arthroplasty aims at giving the patients the best available treatment at all times, being a dynamic entity. Fast-track combines evidence-based, clinical features with organizational optimization including a revision of traditions resulting in a streamlined pathway from...... on clinical and organizational aspects of fast-track hip and knee arthroplasty (I–IX). A detailed description of the fast-track set-up and its components is provided. Major results include identification of patient characteristics to predict length of stay and satisfaction with different aspects...... of the hospital stay (I); how to optimize analgesia by using a compression bandage in total knee arthroplasty (II); the clinical and organizational set-up facilitating or acting as barriers for early discharge (III); safety aspects following fast-track in the form of few readmissions in general (IV) and few...

  5. Fast Compressive Tracking.

    Science.gov (United States)

    Zhang, Kaihua; Zhang, Lei; Yang, Ming-Hsuan

    2014-10-01

    It is a challenging task to develop effective and efficient appearance models for robust object tracking due to factors such as pose variation, illumination change, occlusion, and motion blur. Existing online tracking algorithms often update models with samples from observations in recent frames. Despite much success has been demonstrated, numerous issues remain to be addressed. First, while these adaptive appearance models are data-dependent, there does not exist sufficient amount of data for online algorithms to learn at the outset. Second, online tracking algorithms often encounter the drift problems. As a result of self-taught learning, misaligned samples are likely to be added and degrade the appearance models. In this paper, we propose a simple yet effective and efficient tracking algorithm with an appearance model based on features extracted from a multiscale image feature space with data-independent basis. The proposed appearance model employs non-adaptive random projections that preserve the structure of the image feature space of objects. A very sparse measurement matrix is constructed to efficiently extract the features for the appearance model. We compress sample images of the foreground target and the background using the same sparse measurement matrix. The tracking task is formulated as a binary classification via a naive Bayes classifier with online update in the compressed domain. A coarse-to-fine search strategy is adopted to further reduce the computational complexity in the detection procedure. The proposed compressive tracking algorithm runs in real-time and performs favorably against state-of-the-art methods on challenging sequences in terms of efficiency, accuracy and robustness.

  6. Fast-Track Teacher Recruitment.

    Science.gov (United States)

    Grant, Franklin Dean

    2001-01-01

    Schools need a Renaissance human-resources director to implement strategic staffing and fast-track teacher-recruitment plans. The HR director must attend to customer satisfaction, candidate supply, web-based recruitment possibilities, stabilization of newly hired staff, retention of veteran staff, utilization of retired employees, and latest…

  7. ATLAS FTK Fast Track Trigger

    CERN Document Server

    Iizawa, T; The ATLAS collaboration

    2014-01-01

    The Fast TracKer (FTK) will perform global track reconstruction after each Level-1 trigger accept signal to enable the software-based higher level trigger to have early access to tracking information. FTK is a dedicated processor based on a mixture of advanced technologies. Modern, powerful Field Programmable Gate Arrays (FPGAs) form an important part of the system architecture, and the large level of computing power required for pattern recognition is provided by incorporating standard-cell ASICs named Associative Memory (AM). Motivation and the architecture of the FTK system will be presented, and the status of hardware and simulation will be following.

  8. Clinical evidence of traditional vs fast track recovery methodologies after total arthroplasty for osteoarthritic knee treatment. A retrospective observational study

    Science.gov (United States)

    Castorina, Sergio; Guglielmino, Claudia; Castrogiovanni, Paola; Szychlinska, Marta Anna; Ioppolo, Francesco; Massimino, Paolo; Leonardi, Pietro; Maci, Christian; Iannuzzi, Maurizio; Di Giunta, Angelo; Musumeci, Giuseppe

    2017-01-01

    Summary Background During the last years, programs to enhance postoperative recovery and decrease morbidity after total knee arthroplasty, have been developed across a variety of surgical procedures and referred to as “Fast-Track Surgery”. In this study we aimed to find some answers in the management of osteoarthritic patients subjected to total knee arthroplasty, by using the Fast-Track methodology. To this purpose we evaluated parameters such as early mobilization of patients, better pain management, bleeding, possible complications, reduced hospitalization time, an overall improved recovery and patient satisfaction. Methods 132 patients were selected, of which, 95 treated with “Fast Track” method and 37 treated with traditional method (control group). All the patients were hospitalized and underwent the same rehabilitation program for the first three days after surgery. Results In both groups, the parameters of pain and deformity demonstrated the most rapid improvement, while those of function and movement were normalized as gradual and progressive improvement over the next 2 months. The different functional test used (Barthel, MRC, VAS) showed that the mean values were significantly greater in Fast Track group when compared to the control. Conclusion The results of the study confirm that the application of the Fast Track protocol in orthopaedics after total knee replacement results in rapid post-surgery recovery. Level of evidence IV. Case series, low-quality cohort or case-control studies. PMID:29387645

  9. Percentage of Fast-Track Receipts

    Data.gov (United States)

    Social Security Administration — The dataset provides the percentage of fast-track receipts by state during the reporting fiscal year. Fast-tracked cases consist of those cases identified as Quick...

  10. ATLAS FTK: Fast Track Trigger

    CERN Document Server

    Volpi, Guido; The ATLAS collaboration

    2015-01-01

    An overview of the ATLAS Fast Tracker processor is presented, reporting the design of the system, its expected performance, and the integration status. The next LHC runs, with a significant increase in instantaneous luminosity, will provide a big challenge to the trigger and data acquisition systems of all the experiments. An intensive use of the tracking information at the trigger level will be important to keep high efficiency in interesting events, despite the increase in multiple p-p collisions per bunch crossing (pile-up). In order to increase the use of tracks within the High Level Trigger (HLT), the ATLAS experiment planned the installation of an hardware processor dedicated to tracking: the Fast TracKer (FTK) processor. The FTK is designed to perform full scan track reconstruction at every Level-1 accept. To achieve this goal, the FTK uses a fully parallel architecture, with algorithms designed to exploit the computing power of custom VLSI chips, the Associative Memory, as well as modern FPGAs. The FT...

  11. PUC fast track nips returns

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    In the first of what it says will be annual cost-of-capital proceedings to set returns on equity and rates of return on rate base for electric utilities, the California Public Utilities Commission (PUC) lowered from 1989 levels the 1990 returns on common equity (ROE) and rates of return (ROR) for the state's four major investor-owned electric utilities. Under this fast-track procedure, by May 8 of every year, utilities will have to file an application for rate adjustments that reflect their projected costs of capital for the following year

  12. Fast-track totalknæalloplastik

    DEFF Research Database (Denmark)

    Gromov, Kirill; Kristensen, Billy B; Jørgensen, Christoffer Calov

    2017-01-01

    patients are eligible for fast-track TKA, and hence the fast-track concept should be standard at all joint replacement facilities. Future challenges of fast-track TKA include safe introduction of outpatient protocols, acute and chronic pain after surgery and optimal utilization of post......Fast-track total knee arthroplasty (TKA) is a well-established concept including optimized logistics and evidence-based treatment, focusing on minimizing surgical stress and improved post-operative recovery, thus leading to lower mortality and morbidity as well as high patient satisfaction. All...

  13. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery...

  14. Delirium in fast-track colonic surgery

    DEFF Research Database (Denmark)

    Kurbegovic, Sorel; Andersen, Jens; Krenk, Lene

    2015-01-01

    BACKGROUND: Postoperative delirium (PD) is a common but serious problem after major surgery with a multifactorial pathogenesis including age, pain, opioid use, sleep disturbances and the surgical stress response. These factors have been minimised by the "fast-track methodology" previously...... demonstrated to enhance recovery and reduce morbidity. METHODS: Clinical symptoms of PD were routinely collected three times daily from preoperatively until discharge in a well-defined enhanced recovery program after colonic surgery in 247 consecutive patients. RESULTS: Total median length of hospital stay...... postoperative recovery program may decrease the risk and duration of PD after colonic surgery....

  15. The Danish Head and Neck Cancer fast-track program

    DEFF Research Database (Denmark)

    Roennegaard, Anders B.; Rosenberg, Tine; Bjørndal, Kristine

    2018-01-01

    -track clinical pathway solutions. Objectives: The objectives of this study were 1) to present the setup of the head and neck cancer (HNC) fast-track program at Odense University Hospital (OUH) as an example of the Danish model and 2) to present patient characteristics, diagnostic outcome, cancer detection rate...

  16. Fast-track revision knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2011-01-01

    Abstract Background and purpose Fast-track surgery has reduced the length of hospital stay (LOS), morbidity, and convalescence in primary hip and knee arthroplasty (TKA). We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery....... Methods 29 patients were operated with 30 revision arthroplasties. Median age was 67 (34-84) years. All patients followed a standardized fast-track set-up designed for primary TKA. We determined the outcome regarding LOS, morbidity, mortality, and satisfaction. Results Median LOS was 2 (1-4) days...

  17. A blueprint for multidisciplinary fast track gastrointestinal oncology care

    NARCIS (Netherlands)

    Basta, Y.L.

    2017-01-01

    In this thesis, we have evaluated the implementation of two key concepts of the Gastro Intestinal oncology Center Amsterdam (GIOCA): multidisciplinary teams (MDT) and the fast delivery of care in fast track clinics (FTC). The first part of this thesis investigates the value of multidisciplinary

  18. Fast-track surgery for breast cancer is possible

    DEFF Research Database (Denmark)

    Mertz, Birgitte G; Kroman, Niels; Williams, Helene

    2013-01-01

    INTRODUCTION: Breast cancer is common among Danish women with more than 4,100 new cases annually. In 2008 the concept of fast-track surgery was introduced at the Department of Breast Surgery at Rigshospitalet, Copenhagen. The aim of this study is to describe the new clinical pathway for breast...... to provide immediate advice and support. CONCLUSION: The results confirm that a short stay can be successfully carried out for breast cancer patients. Implementing the fast-track programme involved the introduction of a clear clinical pathway for the patients and more effective daily routines. Patients felt...... cancer patients after implementation of a fast-track surgery programme. MATERIAL AND METHODS: A clinical pathway of all involved disciplines was developed including anaesthetic, analgesics, nausea and vomiting, drain and wound management, discharge assessment and psychosocial support. RESULTS...

  19. Laparoscopy in combination with fast track multimodal management is the best perioperative strategy in patients undergoing colonic surgery: a randomized clinical trial (LAFA-study)

    NARCIS (Netherlands)

    Vlug, Malaika S.; Wind, Jan; Hollmann, Markus W.; Ubbink, Dirk T.; Cense, Huib A.; Engel, Alexander F.; Gerhards, Michael F.; van Wagensveld, Bart A.; van der Zaag, Edwin S.; van Geloven, Anna A. W.; Sprangers, Mirjam A. G.; Cuesta, Miguel A.; Bemelman, Willem A.; Preckel, Benedikt; Bossuyt, Patrick; Gouma, Dirk; van Berge Henegouwen, Mark; Fuhring, Jan; van Lenthe, Ineke Picard; Bakker, Chris; King-Kalimanis, Bellinda; Hofland, Jan; Dejong, Cornelis; van Dam, Ronald; van der Peet, Donald; van Zalingen, Edith; Noordhuis, Astrid; de Jong, Dick; Goei, T. Hauwy; de Stoppelaar, Erica; van den Dongen, Marjon; van Tets, Willem; van den Elsen, Maarten; Swart, Annemiek; deWit, Laurens; Siepel, Muriel; Molly, Glaresa; Juttmann, Jan; Clevers, Wilfred; Bieleman, Andrea; Coenen, Ludo; Bonekamp, Elly; van Abeelen, Jacobus; van Iterson-de Jong, Diana; Krombeen, Margriet

    2011-01-01

    To investigate which perioperative treatment, ie, laparoscopic or open surgery combined with fast track (FT) or standard care, is the optimal approach for patients undergoing segmental resection for colon cancer. Important developments in elective colorectal surgery are the introduction of

  20. Fast algorithm of track detection

    International Nuclear Information System (INIS)

    Nehrguj, B.

    1980-01-01

    A fast algorithm of variable-slope histograms is proposed, which allows a considerable reduction of computer memory size and is quite simple to carry out. Corresponding FORTRAN subprograms given a triple speed gain have been included in spiral reader data handling software

  1. An artificial retina for fast track finding

    International Nuclear Information System (INIS)

    Ristori, Luciano

    2000-01-01

    A new approach is proposed for fast track finding in position-sensitive detectors. The basic working principle is modeled on what is widely believed to be the low-level mechanism used by the eye to recognize straight edges. A number of receptors are tuned such that each one responds to a different range of track orientations, each track actually fires several receptors and an estimate of the orientation is obtained through interpolation. The feasibility of a practical device based on this principle and its possible implementation using currently available digital logic is discussed

  2. Accelerated Leadership Development: Fast Tracking School Leaders

    Science.gov (United States)

    Earley, Peter; Jones, Jeff

    2010-01-01

    "Accelerated Leadership Development" captures and communicates the lessons learned from successful fast-track leadership programmes in the private and public sector, and provides a model which schools can follow and customize as they plan their own leadership development strategies. As large numbers of headteachers and other senior staff…

  3. FTK: a Fast Track Trigger for ATLAS

    International Nuclear Information System (INIS)

    Anderson, J; Auerbach, B; Blair, R; Andreani, A; Andreazza, A; Citterio, M; Annovi, A; Beretta, M; Castegnaro, A; Atkinson, M; Cavaliere, V; Chang, P; Bevacqua, V; Crescioli, F; Blazey, G; Bogdan, M; Boveia, A; Canelli, F; Cheng, Y; Cervigni, F

    2012-01-01

    We describe the design and expected performance of a the Fast Tracker Trigger (FTK) system for the ATLAS detector at the Large Hadron Collider. The FTK is a highly parallel hardware system designed to operate at the Level 1 trigger output rate. It is designed to provide global tracks reconstructed in the inner detector with resolution comparable to the full offline reconstruction as input of the Level 2 trigger processing. The hardware system is based on associative memories for pattern recognition and fast FPGAs for track reconstruction. The FTK is expected to dramatically improve the performance of track based isolation and b-tagging with little to no dependencies of pile-up interactions.

  4. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Niels Kristian Stahl; Kristensen, Billy B

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been...

  5. Fast tracking in paediatric cardiac anaesthesia : an update.

    Directory of Open Access Journals (Sweden)

    Lake Carol

    2002-01-01

    Full Text Available A care plan in which cardiac surgical patients progress quickly through the perioperative course to hospital discharge is often referred to as a Fast Track. Such care plans have been used extensively in adult cardiac patients but are also applicable to paediatric patients. Although no randomised controlled trials are available to document a reduction in hospital costs and avoidance of iatrogenic complications with paediatric fast tracks, many healthcare administrators encourage their use. Fast Track clinical guidelines usually include same day surgery, use of short- acting anaesthetic drugs, early extubation, effective pain management, and reduced intensive care unit stays. These protocols are certainly appropriate for simple procedures such as repair of atrial or ventricular septal defects or ligation of a patent ductus arteriosus. However, many paediatric cardiac anaesthesiologists consider that all paediatric patients without significant pulmonary or residual cardiac pathology can be managed using expedited postoperative protocols. Essential components in a "fast track" protocol include use of minimally invasive surgical techniques, modified ultrafiltration during cardiopulmonary bypass, transoesophageal echocardiography to evaluate the cardiac repair, and postoperative pain control. Using such techniques, 80-90% of paediatric patients can be extubated in the operating room or within 2-4 hours postoperatively. Despite the opinions of recognised experts, an appropriately sized and powered multicentre, controlled, randomised, prospective study is still needed to conclusively document the efficiency and effectiveness of the Fast Track in paediatric cardiac patients.

  6. FAST-TRACK HIP AND KNEE ARTHROPLASTY (LITERATURE REVIEW

    Directory of Open Access Journals (Sweden)

    A. M. Ageenko

    2017-01-01

    Full Text Available In the present paper the authors discuss the history of fast-track formation, its development and current status. Fast-track advantages in comparison to other rehabilitation options are analyzed. The focus is placed on methods of accelerated rehabilitation after total hip and knee arthroplasty in the leading European and American clinics. Fast-track protocols of surgical centers of Denmark and Hospital for special surgery in the US are described, factors that determine time of hospital stay after total hip and knee arthroplasty are considered, predictors of hospital stay and patients satisfaction after the surgery are examined. The paper reflects the results of the comparison of frequency of thromboembolic and other complications as well as readmission rate after traditional rehabilitation and after fast-track. The paper considers fast-track in bilateral total knee replacement. The authors conclude that further research on acceleration of rehabilitation and reduction of hospital stay after total hip and knee arthroplasty needs to be focused on the optimization of pain relief, especially after discharge, blood preservation techniques, supplementation of fluids loss and strengthening of muscles. Literature analysis demonstrated that the implementation of the Protocol for accelerated recovery after joint arthroplasty in Russia is at an insufficient level. Data of foreign multicenter studies during recent years indicate a high efficacy and safety of this technique in different groups of patients.

  7. Fast track pathway for perforated appendicitis.

    Science.gov (United States)

    Frazee, Richard; Abernathy, Stephen; Davis, Matthew; Isbell, Travis; Regner, Justin; Smith, Randall

    2017-04-01

    Perforated appendicitis is associated with an increased morbidity and length of stay. "Fast track" protocols have demonstrated success in shortening hospitalization without increasing morbidity for a variety of surgical processes. This study evaluates a fast track pathway for perforated appendicitis. In 2013, a treatment pathway for perforated appendicitis was adopted by the Acute Care Surgery Service for patients having surgical management of perforated appendicitis. Interval appendectomy was excluded. Patients were treated initially with intravenous antibiotics and transitioned to oral antibiotics and dismissed when medically stable and tolerating oral intake. A retrospective review of patients managed on the fast track pathway was undertaken to analyze length of stay, morbidity, and readmissions. Thirty-four males and twenty-one females with an average age of 46.8 years underwent laparoscopic appendectomy for perforated appendicitis between January 2013 and December 2014. Pre-existing comorbidities included hypertension 42%, diabetes mellitus 11%, COPD 5% and heart disease 2%. No patient had conversion to open appendectomy. Average length of stay was 2.67 days and ranged from 1 to 12 days (median 2 days). Postoperative morbidity was 20% and included abscess (6 patients), prolonged ileus (3 patients), pneumonia (1 patient), and congestive heart failure (1 patient). Five patients were readmitted for abscess (3 patients), congestive heart failure (1 patient), and pneumonia (1 patient). A fast track pathway for perforated appendicitis produced shorter length of stay and acceptable postoperative morbidity and readmission. This offers the potential for significant cost savings over current national practice patterns. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Care principles at four fast-track arthroplasty departments in Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Solgaard, Søren; Hansen, Torben B

    2010-01-01

    The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery.......The goal of this study was to describe the logistic and clinical set-up at four Danish arthroplasty departments offering fast-track surgery....

  9. A fast-track anaemia clinic in the Emergency Department: cost-analysis of intravenous iron administration for treating iron-deficiency anaemia.

    Science.gov (United States)

    Quintana-Díaz, Manuel; Muñoz-Romo, Raúl; Gómez-Ramírez, Susana; Pavía, José; Borobia, Alberto M; García-Erce, José A; Muñoz, Manuel

    2017-09-01

    A fast-track anaemia clinic (FTAC) for the management of moderate-to-severe iron-deficiency anaemia (IDA) was established in our Emergency Department in 2010. In this FTAC, the replacement of packed red cell transfusion by ferric carboxymaltose administration was proven to be safe and effective. The aim of this study was a cost-analysis of IDA management in the FTAC, comparing this management with the previous standard care pathway consisting of packed red cell transfusion, if needed, and referral to outpatient specialised care. A cost study was performed for patients with IDA who were at risk of requiring transfusion (haemoglobin costs in the FTAC were compared to those theoretically incurred if these patients had been managed using the standard care pathway. In addition, a sensitivity analysis considering variations of up to ±30% in ferric carboxymaltose and packed red cell acquisition costs was performed (49 possible scenarios). Between 2012 and 2015, 238 IDA patients were treated in the FTAC. The average treatment cost was € 594±337/patient in the FTAC group and € 672±301/patient in the standard care pathway group, with a saving of € 78±28/patient (95% CI, 22-133; pcosts in the FTAC (€ 480-722/patient), compared with those of the standard care pathway (€ 550-794/patient), resulted in significant cost-savings for all studied scenarios (€ 51-104/patient; pcost-saving compared with the standard care pathway.

  10. Readmissions after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Otte, Kristian Stahl; Kristensen, Billy B

    2010-01-01

    With the implementation of fast-track surgery with optimization of both logistical and clinical features, the postoperative convalescence has been reduced as functional milestones have been achieved earlier and consequently length of stay (LOS) in hospital has been reduced. However, it has been s...... speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA)....

  11. Fast and Practical Head Tracking in Brain Imaging with Time-of-Flight Camera

    DEFF Research Database (Denmark)

    Wilm, Jakob; Olesen, Oline Vinter; Jensen, Rasmus Ramsbøl

    2013-01-01

    scanners. Particularly in MRI and PET, the newest generation of TOF cameras could become a method of tracking small and large scale patient movement in a fast and user friendly way required in clinical environments. We present a novel methodology for fast tracking from TOF point clouds without the need...

  12. Evidence Basis for Regional Anesthesia in Multidisciplinary Fast-Track Surgical Care Pathways

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele

    2011-01-01

    Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type...... of surgeries. The aim of this article was to identify and discuss potential advantages offerred by regional anesthesia and analgesia techniques to fast-track programs. In the first section, the impact of regional anesthesia on the main elements of fast-track surgery is addressed. In the second section......, procedure-specific fast-track programs for colorectal, hernia, esophageal, cardiac, vascular, and orthopedic surgeries are presented. For each, regional anesthesia and analgesia techniques more frequently used are discussed. Furthermore, clinical studies, which included regional techniques as elements...

  13. Standardising fast-track surgical nursing care in Denmark

    DEFF Research Database (Denmark)

    Hjort Jakobsen, Dorthe; Rud, Kirsten; Kehlet, Henrik

    2014-01-01

    guidelines based on the principles of fast-track surgery-i.e. patient information, surgical stress reduction, effective analgesia, early mobilisation and rapid return to normal eating. Fast-track surgery was introduced systematically in Denmark by the establishment of the Unit of Perioperative Nursing (UPN...

  14. Fast-track knee arthroplasty – status and future challenges

    DEFF Research Database (Denmark)

    Kehlet, Henrik; Thienpont, Emmanuel

    2013-01-01

    Fast-track programs have been developed for different surgical procedures leading to higher patient satisfaction and lower morbidity. This concept has been extended to knee arthroplasty in recent years. The purpose of this narrative review was to discuss the different aspects of fast-track knee...... arthroplasty....

  15. Delirium after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Krenk, Lene; Rasmussen, L S; Hansen, T B

    2012-01-01

    hospital stay and medical morbidity. No data on PD are available in fast-track surgery. The aim of this study was to evaluate the incidence of PD after fast-track hip (THA) and knee arthroplasty (TKA) with anticipated length of stay (LOS) of In a prospective multicentre study to evaluate postoperative...

  16. Bilateral simultaneous total hip arthroplasty in a fast track setting

    DEFF Research Database (Denmark)

    Otte, Kristian S; Husted, Henrik; Ørsnes, Thue

    2011-01-01

    and low complication rates when performed in a fast-track setting. We believed it would be useful to assess hip arthroplasty in this context, and we report 50 consecutive fast-track simultaneous bilateral hip arthroplasty procedures. The median length of stay was 4 days. Mortality within 90 days was 4......% and 8% required a further operative procedure. The overall complication rate was 22%. 55% of the complications were considered to be caused by failures in surgical technique and 45% by other factors. Bilateral simultaneous hip arthroplasty may have a high complication rate in a fast-track setting...

  17. [Fast-track treatment--second revolution of colorectal surgery].

    Science.gov (United States)

    Kellokumpu, Ilmo

    2012-01-01

    The fast-track treatment model can be regarded as the second revolution of colorectal surgery after the introduction of laparoscopic surgery. In the gastro-surgical unit of the Central Hospital of Central Finland, results equivalent to international studies in colorectal surgery have been achieved by using fast-track model. In a study setting, this treatment model has resulted in significant decrease of total treatment costs and speeded up discharge of the patients from the hospital. The fast-track treatment model requires both a motivated, trained medical team and a motivated patient.

  18. Evidence Basis for Regional Anesthesia in Multidisciplinary Fast-Track Surgical Care Pathways

    DEFF Research Database (Denmark)

    Carli, Francesco; Kehlet, Henrik; Baldini, Gabriele

    2011-01-01

    Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type of surge......Fast-track programs have been developed with the aim to reduce perioperative surgical stress and facilitate patient's recovery after surgery. Potentially, regional anesthesia and analgesia techniques may offer physiological advantages to support fast-track methodologies in different type...... of surgeries. The aim of this article was to identify and discuss potential advantages offerred by regional anesthesia and analgesia techniques to fast-track programs. In the first section, the impact of regional anesthesia on the main elements of fast-track surgery is addressed. In the second section......, procedure-specific fast-track programs for colorectal, hernia, esophageal, cardiac, vascular, and orthopedic surgeries are presented. For each, regional anesthesia and analgesia techniques more frequently used are discussed. Furthermore, clinical studies, which included regional techniques as elements...

  19. Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track

    DEFF Research Database (Denmark)

    Burgdorf, Stefan K; Rosenberg, Jacob

    2012-01-01

    Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks...... care, that is, without implementing fast track principles, on length of stay after colorectal resection for cancer. Methods. Records of all patients operated for colorectal cancer from November 2004 to December 2008 in our department were reviewed. No specific patients were selected for laparoscopic...... in our department resulted in shorter hospital stay without using fast track principles for peri- and postoperative care in patients not receiving a stoma during the operation. Consequently, we aimed to reduce hospitalisation without increasing cost in nursing staff per hospital bed. Length of stay...

  20. Orchestrating care through the fast-track perspective: A qualitative content analysis of the provision of individualised nursing care in orthopaedic fast-track programmes.

    Science.gov (United States)

    Berthelsen, Connie Bøttcher; Frederiksen, Kirsten

    2017-02-01

    The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying individualised care-related actions in the fast-track programme. The study concluded that, even though the nurses struggled to comply with the programme, they still found themselves compromising their nursing care and ethics to follow the standardised regime. There is a need to establish more specific inclusion criteria to maintain the effective elements in the programme and to facilitate nurses' opportunities to offer individual care, thereby ensuring that fragile patients have access to other possibilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Fast particle tracking with wake fields

    Energy Technology Data Exchange (ETDEWEB)

    Dohlus, M.; Floettmann, K.; Henning, C.

    2012-01-15

    Tracking calculations of charged particles in electromagnetic fields require in principle the simultaneous solution of the equation of motion and of Maxwell's equations. In many tracking codes a simpler and more efficient approach is used: external fields like that of the accelerating structures are provided as field maps, generated in separate computations and for the calculation of self fields the model of a particle bunch in uniform motion is used. We describe how an externally computed wake function can be approximated by a table of Taylor coefficients and how the wake field kick can be calculated for the particle distribution in a tracking calculation. The integrated kick, representing the effect of a distributed structure, is applied at a discrete time. As an example, we use our approach to calculate the emittance growth of a bunch in an undulator beam pipe due to resistive wall wake field effects. (orig.)

  2. Sufentanil Vs Fentanyl for Fast-Track Cardiac Anaesthesia

    Directory of Open Access Journals (Sweden)

    C M Deshpande

    2009-01-01

    Full Text Available A perioperative anaesthetic management that aims to facilitate tracheal extubation of patients within 1-6 hrs after cardiac surgery is called "fast-track′. Main advantage of ′fast-track" method is better usage of medical resources and lowering hospital costs without increasing morbidity and mortality of the patients. Standard fast-track protocols contain short acting anaesthetic agents, smaller incisions and decreased pump times without hypothermia. In this study we compared two short acting opioid drugs, fentanyl versus Sufentanil when used as a part of the balanced anaesthesia technique for fast track in cardiac surgery patients& evaluated the time taken for extubation, haemodynamic stability, analgesia requirements& incidence of awareness. The results from the study show thatboth agents provide good haemodynamic stability and postoperative analgesia. Although Sufentanil provides earlier extuba-tion, both agents reduce the ICU stay equally. In conclusion both agents can be used effectively for fasttrack cardiac anaesthesia.

  3. Fast-Track Management of Patients Undergoing Proximal Pancreatic Resection

    Science.gov (United States)

    French, JJ; Mansfield, SD; Jaques, K; Jaques, BC; Manas, DM; Charnley, RM

    2009-01-01

    INTRODUCTION To avoid the risk of complications of biliary drainage, a feasibility study was carried out to determine whether it might be possible to fast-track surgical treatment, with resection before biliary drainage, in jaundiced patients with proximal pancreatic/peri-ampullary malignancy. PATIENTS AND METHODS Over an 18-month period, based on their presenting bilirubin levels and other logistical factors, all jaundiced patients who might be suitable for fast-track management were identified. Data on complications and hospital stay were compared with those patients in whom a conventional pathway (with biliary drainage) was used during the same time period. Data were also compared with a group of patients from the preceding 6 months. RESULTS Nine patients were fast-tracked and 49 patients treated in the conventional pathway. Fast-track patients mean (SD) serum bilirubin level was 265 μmol/l (81.6) at the time of the operation compared to 43 μmol/l (51.3; P ≥ 0.0001) in conventional patients. Mean (SD) of time from referral to operation, 14 days (9) versus 59 days (36.9), was significantly shorter in fast-track patients than conventional patients (P ≤ 0.0001). Length of hospital stay mean (SD) at 17 (6) days versus 22 days (19.6; P = 0.2114), surgical complications and mortality in fast-track patients were similar to conventional patients. Prior to surgery, the 49 conventional patients underwent a total of 73 biliary drainage procedures resulting in seven major complications. Comparison with the group of patients from the previous 6 months indicated that the conventional group were not disadvantaged. CONCLUSIONS Fast-track management by resection without biliary drainage of selected patients with distal biliary strictures is safe and has the potential to reduce the waiting time to surgery, overall numbers of biliary drainage procedures and the complications thereof. PMID:19220943

  4. TRACKING TESTS FOR THE SNS FAST INJECTION BUMP POWER SUPPLY

    International Nuclear Information System (INIS)

    ENG, W.; CUTLER, R.; DEWAN, S.

    2004-01-01

    The tracking requirement of the SNS Fast Injection Bump power supplies is described. In addition to the usual tracking between the load current and the input reference of a power supply, these power supplies must also track between pairs of units under slightly different loads. This paper describes the use of a current-null test to measure tracking performances. For the actual tests, a single dummy magnet load was used to measure the tracking between the first two production units at the manufacturer's facility. Using the Yokogawa WE7000 waveform. PC-based measurement instrument, input and output waveforms are digitized and stored in data files. A program written for this application is then used to extract data from these files to construct, analyze the waveforms and characterize the power supply performance. Results of the measurements of two SNS Fast Injection Bump power supplies will be presented in this paper

  5. FATRAS - the ATLAS Fast Track Simulation project

    NARCIS (Netherlands)

    Mechnich, J.

    2011-01-01

    The Monte Carlo simulation of the detector response is an integral component of any analysis performed with data from the LHC experiments. As these simulated data sets must be both large and precise, their production is a CPU-intensive task. ATLAS has developed full and fast detector simulation

  6. Second Generation of a Fast-track Liver Resection Programme

    DEFF Research Database (Denmark)

    Schultz, Nicolai A; Larsen, Peter N; Klarskov, B

    2018-01-01

    was given to all patients before surgery, catheters and drains were systematically removed early, and patients were mobilized and started eating and drinking from the day of surgery. An opioid-sparing multimodal pain treatment was given for the first week. The discharge criteria were (1) pain sufficiently....... The readmission rate was 6% and the 30-day mortality zero. The LOS decreased compared to our first-generation fast-track programme with LOS 5 days. CONCLUSIONS: Fast-track principles for perioperative care and early discharge are safe even after major liver resection. The introduction of high-dose steroids...

  7. Fast-track video-assisted thoracoscopic surgery

    DEFF Research Database (Denmark)

    Holbek, Bo Laksafoss; Petersen, René Horsleben; Kehlet, Henrik

    2016-01-01

    Objectives To provide a short overview of fast-track video-assisted thoracoscopic surgery (VATS) and to identify areas requiring further research. Design A literature search was made using key words including: fast-track, enhanced recovery, video-assisted thoracoscopic surgery, robot......-assisted thoracoscopic surgery (RATS), robotic, thoracotomy, single-incision, uniportal, natural orifice transluminal endoscopic surgery (NOTES), chest tube, air-leak, digital drainage, pain management, analgesia, perioperative management, anaesthesia and non-intubated. References from articles were screened for further...

  8. Safety of fast track surgery in pancreaticoduodenectomy: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    LI Weinan

    2017-01-01

    Full Text Available ObjectiveTo investigate the safety and clinical effect of fast track surgery in pancreaticoduodenectomy, one of the most complex surgeries in general surgery. MethodsThe Chinese and foreign databases were searched for articles on the application of fast tract surgery in pancreaticoduodenectomy published from January 1994 to April 2016. Two researchers evaluated the quality of the articles which met the inclusion criteria and extracted related data. Stata 12.0 software was used to analyze the overall incidence rate of complications and the incidence rates of pancreatic leakage and gastrointestinal emptying disorder, and the Begg rank correlation test and Egger linear regression method were used to investigate publication bias. ResultsThe fast track surgery group had a significantly lower overall incidence rate of complications than the conventional group (RR=0.748, 95%CI: 0.680-0.824, P<0.001. There was no significant difference in the incidence rate of pancreatic leakage between the two groups (RR=0.894, 95%CI:0.734-1.089, P=0.266. The fast track surgery group had a significantly lower incidence rate of gastrointestinal emptying disorder than the conventional group (RR=0.520, 95%CI:0.400-0.670, P<0.001. ConclusionFast track surgery is safe and effective in pancreaticoduodenectomy, but the application of some measures in fast track surgery still needs more medical evidence.

  9. A fast neutron detector with IP by track measurement

    International Nuclear Information System (INIS)

    Miao Zhengqiang; Yang Jun; Zhang Qiang; Zhao Xiangfeng; Wang Daohua

    2004-01-01

    Imaging Plate(IP) is very sensitive to electric particles, especially to heavy ions. As we know, the recoiling protons are produced while fast neutrons scattered in light material containing hydrogen. When the recoiling proton enters in the sensitive layer of IP, a track will be recorded by IP. In this paper, a fast neutron detector based on IP and (n, p) reaction is described in detail, the detector's efficiency is studied also. (authors)

  10. Fast track trigger processor for the OPAL detector at LEP

    Energy Technology Data Exchange (ETDEWEB)

    Carter, A A; Carter, J R; Ward, D R; Heuer, R D; Jaroslawski, S; Wagner, A

    1986-09-20

    A fast hardware track trigger processor being built for the OPAL experiment is described. The processor will analyse data from the central drift chambers of OPAL to determine whether any tracks come from the interaction region, and thereby eliminate background events. The processor will find tracks over a large angular range, vertical strokecos thetavertical stroke < or approx. 0.95. The design of the processor is described, together with a brief account of its hardware implementation for OPAL. The results of feasibility studies are also presented.

  11. ATLAS Fast Tracker Status and Tracking at High luminosity LHC

    CERN Document Server

    Ilic, Nikolina; The ATLAS collaboration

    2018-01-01

    The LHC’s increase in centre of mass energy and luminosity in 2015 makes controlling trigger rates with high efficiency challenging. The ATLAS Fast TracKer (FTK) is a hardware processor built to reconstruct tracks at a rate of up to 100 kHz and provide them to the high level trigger. The FTK reconstructs tracks by matching incoming detector hits with pre-defined track patterns stored in associative memory on custom ASICs. Inner detector hits are fit to these track patterns using modern FPGAs. This talk describes the electronics system used for the FTK’s massive parallelization. The installation, commissioning and running of the system is happening in 2016, and is detailed in this talk. Tracking at High luminosity LHC is also presented.

  12. Towards Fast Tracking of the Keyhole Geometry

    Science.gov (United States)

    Brock, C.; Hohenstein, R.; Schmidt, M.

    We describe a sensor principle permitting the fast online measurement of the position of the optical process emissions in deep penetration laser welding. Experiments show a strong correlation between the position of the vapour plume and the keyhole geometry, demonstrated here by varying the penetration depth of the weld. In order to achieve an absolute position measurement, the sensor was calibrated using a light source with well defined characteristics. The setup for the calibration measurements and the corresponding data evaluation methods are discussed. The precision of the calibration with a green LED is 6 μm in lateral and 55 μm in axial direction, for a working distance of 200 mm.

  13. Faster recovery of gastrointestinal transit after laparoscopy and fast-track care in patients undergoing colonic surgery

    NARCIS (Netherlands)

    van Bree, Sjoerd; Vlug, Malaika; Bemelman, Willem; Hollmann, Markus; Ubbink, Dirk; Zwinderman, Koos; de Jonge, Wouter; Snoek, Susanne; Bolhuis, Karen; van der Zanden, Esmerij; The, Frans; Bennink, Roel; Boeckxstaens, Guy

    2011-01-01

    Postoperative ileus is characterized by delayed gastrointestinal (GI) transit and is a major determinant of recovery after colorectal surgery. Both laparoscopic surgery and fast-track multimodal perioperative care have been reported to improve clinical recovery. However, objective measures

  14. Fast-track Orthognathic Surgery: An Evidence-based Review

    Science.gov (United States)

    Otero, Joel Joshi; Detriche, Olivier; Mommaerts, Maurice Yves

    2017-01-01

    The aim of this study was to establish a fast-track protocol for bimaxillary orthognathic surgery (OGS). Fast-track surgery (FTS) is a multidisciplinary approach where the pre-, intra-, and postoperative management is focusing maximally on a quick patient recovery and early discharge. To enable this, the patients’ presurgical stress and postsurgical discomfort should be maximally reduced. Both referral patterns and expenses within the health-care system are positively influenced by FTS. University hospital-literature review through Medline, Embase, and the Cochrane Library (January 2000–July 2016) using the following words – “fast track, enhanced recovery, multimodal, and perioperative care” – to define a protocol evidence based for OGS, as well as evidenced-based medicine search of every term added to the protocol during the same period. The process has resulted in an OGS protocol that may improve the outcome of the patient through several nonoperative and operative measures such as preoperative patient education and intra/postoperative measures that should improve overall patient satisfaction, decrease morbidity such as postoperative nausea, headache, dizziness, pain, and intubation discomfort, and shorten hospital stay. A literature review allowed us to fine-tune a fast-track protocol for uncomplicated OGS that can be prospectively studied against currently applied ones. PMID:29264281

  15. Low manipulation prevalence following fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Jørgensen, Christoffer C.; Gromov, Kirill

    2015-01-01

    BACKGROUND AND PURPOSE: Postoperative joint stiffness following total knee arthroplasty (TKA) may compromise the outcome and necessitate manipulation. Previous studies have not been in a fast-track setting with optimized pain treatment, early mobilization, and short length of stay (LOS), which ma...

  16. Fast-Track Cleanup at Closing DoD Installations

    Science.gov (United States)

    The Fast-Track Cleanup program strives to make parcels available for reuse as quickly as possible by the transfer of uncontaminated or remediated parcels, the lease of contaminated parcels where cleanup is underway, or the 'early transfer' of contaminated property undergoing cleanup.

  17. Patient-reported outcome after fast-track knee arthroplasty

    DEFF Research Database (Denmark)

    Larsen, Kristian; Hansen, Torben B; Søballe, Kjeld

    2012-01-01

    PURPOSE: The purpose of this study was to describe patient-related functional outcomes after fast-track total knee arthroplasty and unicompartmental knee arthroplasty. Furthermore, we wanted to assess physical areas where an additional need for rehabilitation could be identified, and finally, we...

  18. Fast emulation of track reconstruction in the CMS simulation

    CERN Document Server

    Komm, Matthias

    2017-01-01

    Simulated samples of various physics processes are a key ingredient within analyses to unlock the physics behind LHC collision data. Samples with more and more statistics are required to keep up with the increasing amounts of recorded data. During sample generation, significant computing time is spent on the reconstruction of charged particle tracks from energy deposits which additionally scales with the pileup conditions. In CMS, the FastSimulation package is developed for providing a fast alternative to the standard simulation and reconstruction workflow. It employs various techniques to emulate track reconstruction effects in particle collision events. Several analysis groups in CMS are utilizing the package, in particular those requiring many samples to scan the parameter space of physics models (e.g. SUSY) or for the purpose of estimating systematic uncertainties. The strategies for and recent developments in this emulation are presented, including a novel, flexible implementation of tracking emulation w...

  19. Nursing care in fast-track surgery strategy

    Directory of Open Access Journals (Sweden)

    Dorota Kozieł

    2015-10-01

    Full Text Available In recent years, many study results have been published confirming an improvement in the outcomes of treatment related with management of patients within the fast-track surgery programme. Early postoperative rehabilitation is possible provided there is engagement of a multi-disciplinary team, including well-educated nurses. Today, a diversion can be observed from traditional nursing on behalf of a coordinated, holistic approach, while more attention is paid to the, thus far marginalised, psychosocial aspects of care. The objective of the study is to discuss the basic assumptions of fast track surgery with respect to nursing care, with particular emphasis placed on the educational function. Modern nursing within the short-track surgery programme should focus on the provision of patients with care consisting of preliminary information concerning the perioperative period, social and psychological support, counselling in the area of home convalescence, and procedures in the case of complications.

  20. Why still in hospital after fast-track hip and knee arthroplasty?

    DEFF Research Database (Denmark)

    Husted, Henrik; Lunn, Troels H; Troelsen, Anders

    2011-01-01

    Background and purpose Length of stay (LOS) following total hip and knee arthroplasty (THA and TKA) has been reduced to about 3 days in fast-track setups with functional discharge criteria. Earlier studies have identified patient characteristics predicting LOS, but little is known about specific...... reasons for being hospitalized following fast-track THA and TKA. Patients and methods To determine clinical and logistical factors that keep patients in hospital for the first postoperative 24-72 hours, we performed a cohort study of consecutive, unselected patients undergoing unilateral primary THA (n...

  1. Fast-track surgery: Toward comprehensive peri-operative care.

    Science.gov (United States)

    Nanavati, Aditya J; Prabhakar, S

    2014-01-01

    Fast-track surgery is a multimodal approach to patient care using a combination of several evidence-based peri-operative interventions to expedite recovery after surgery. It is an extension of the critical pathway that integrates modalities in surgery, anesthesia, and nutrition, enforces early mobilization and feeding, and emphasizes reduction of the surgical stress response. It entails a great partnership between a surgeon and an anesthesiologist with several other specialists to form a multi-disciplinary team, which may then engage in patient care. The practice of fast-track surgery has yielded excellent results and there has been a significant reduction in hospital stay without a rise in complications or re-admissions. The effective implementation begins with the formulation of a protocol, carrying out each intervention and gathering outcome data. The care of a patient is divided into three phases: Before, during, and after surgery. Each stage needs active participation of few or all the members of the multi-disciplinary team. Other than surgical technique, anesthetic drugs, and techniques form the cornerstone in the ability of the surgeon to carry out a fast-track surgery safely. It is also the role of this team to keep abreast with the latest development in fast-track methodology and make appropriate changes to policy. In the Indian healthcare system, there is a huge benefit that may be achieved by the successful implementation of a fast-track surgery program at an institutional level. The lack of awareness regarding this concept, fear and apprehension regarding its implementation are the main barriers that need to be overcome.

  2. Scholarly productivity for nursing clinical track faculty.

    Science.gov (United States)

    Tschannen, Dana; Anderson, Christine; Strobbe, Stephen; Bay, Esther; Bigelow, April; Dahlem, Chin Hwa Gina Y; Gosselin, Ann K; Pollard, Jennifer; Seng, Julia S

    2014-01-01

    Recent years have yielded substantial advancement by clinical track faculty in cohort expansion and collective contributions to the discipline of nursing. As a result, standards for progression and promotion for clinical faculty need to be more fully developed, articulated, and disseminated. Our school formed a task force to examine benchmarks for the progression and promotion of clinical faculty across schools of nursing, with the goal of guiding faculty, reviewers, and decision makers about what constitutes excellence in scholarly productivity. Results from analyses of curriculum vitae of clinical professors or associate professors at six universities with high research activity revealed a variety of productivity among clinical track members, which included notable diversity in the types of scholarly products. Findings from this project help quantify types of scholarship for clinical faculty at the time of promotion. This work provides a springboard for greater understanding of the contributions of clinical track faculty to nursing practice. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Fast Track Open Partial Nephrectomy: Reduced Postoperative Length of Stay with a Goal-Directed Pathway Does Not Compromise Outcome

    Directory of Open Access Journals (Sweden)

    Bilal Chughtai

    2008-01-01

    Full Text Available Introduction. The aim of this study is to examine the feasibility of reducing postoperative hospital stay following open partial nephrectomy through the implementation of a goal directed clinical management pathway. Materials and Methods. A fast track clinical pathway for open partial nephrectomy was introduced in July 2006 at our institution. The pathway has daily goals and targets discharge for all patients on the 3rd postoperative day (POD. Defined goals are (1 ambulation and liquid diet on the evening of the operative day; (2 out of bed (OOB at least 4 times on POD 1; (3 removal of Foley catheter on the morning of POD 2; (4 removal of Jackson Pratt drain on the afternoon of POD 2; (4 discharge to home on POD 3. Patients and family are instructed in the fast track protocol preoperatively. Demographic data, tumor size, length of stay, and complications were captured in a prospective database, and compared to a control group managed consecutively immediately preceding the institution of the fast track clinical pathway. Results. Data on 33 consecutive patients managed on the fast track clinical pathway was compared to that of 25 control patients. Twenty two (61% out of 36 fast track patients and 4 (16% out of 25 control patients achieved discharge on POD 3. Overall, fast track patients had a shorter hospital stay than controls (median, 3 versus 4 days; P = .012. Age (median, 55 versus 57 years, tumor size (median, 2.5 versus 2.5 cm, readmission within 30 days (5.5% versus 5.1%, and complications (10.2% versus 13.8% were similar in the fast track patients and control, respectively. Conclusions. In the present series, a fast track clinical pathway after open partial nephrectomy reduced the postoperative length of hospital stay and did not appear to increase the postoperative complication rate.

  4. Fast simulation of the forward tracking detector of HPLUS

    International Nuclear Information System (INIS)

    Zhang Yapeng; Fan Ruirui; Fu Fen; Yue Ke; Yuan Xiaohua; Xu Huagen; Chinese Academy of Sciences, Beijing; Yao Nan; Xu Hushan; Jin Genming; Liang Jinjie; Chen Ruofu; Sun Zhiyu; Duan Limin; Xiao Zhigang; Tsinghua Univ., Beijing

    2008-01-01

    The necessity of installing a forward tracking detector stack is discussed for the Hadron Physics Lanzhou Spectrometer(HPLUS). A local tracker is developed to solve the multi-track finding problem. The track candidates are searched iteratively via Hough Transform. The fake tracks are removed by a least square fitting process. With this tracker we have studied the feasibility of pp→pp+φ(→K + K - ), a typical physical channel proposed on HPLUS. The single track momentum resolution due to the uncertainty of the positioning in FTD is 1.3%. The multiple scattering effect contributes about 20% to the momentum resolution in the FTD coverage. The width and the signal-to-background ratio of the reconstructed φ are 1.51 MeV and 4.36, respectively, taking into account the direct Kaon channel pp→pp+K + K - as background. The geometry coverage of FTD for qb events is about 85.4%. Based on the current fast simulation and estimation, the geometrical configuration of FTD meets the physical requirement of HPLUS under the current luminosity and multiplicity conditions. The tracker is applicable in the full simulation coming next and is extendable to other tracking component of HPLUS. (authors)

  5. Successful integration of fast track projects into turnarounds

    Energy Technology Data Exchange (ETDEWEB)

    Williams, J. Patrick; Loureiro, Ramon C. [KBC Advanced Technologies, Surrey (United Kingdom)

    2012-07-01

    Fast track projects can provide quick wins and competitive advantage. However, in most cases the implementation of these projects requires a shutdown for installing the necessary tie-ins or integration into an upcoming turnaround (TA). Depending on the nature of the project and complexity of the TA, the integration can be seamless or result in cost or duration overruns and safety incidents. The risk of such overruns and safety incidents increases with the amount of project work to be integrated into the operations, maintenance and inspection schedules to be executed during the TA. The risk further increases with TA size and other factors. If not planned and scheduled properly and in a timely fashion, capital projects, in particular fast track projects trying to take advantage of an upcoming TA, can severely impact both TA performance, and the safety and reliability of the facility until the next opportunity for eliminating the defects introduced during the TA. Successful TAs are those delivered in a safe, on time, on budget manner, and with the quality standards needed for a leak-free start-up and a safe and reliable operation over the next run cycle. This paper discusses the key elements that are required to minimize the TA risks derived from the inclusion of fast track projects and how to establish the cut off criteria to either cancel or defer the project, or delay the TA in order to balance TA scope freeze and the case for compelling economics.(author)

  6. Delirium in the fast-track surgery setting

    DEFF Research Database (Denmark)

    Krenk, Lene; Rasmussen, Lars S; Kehlet, Henrik

    2012-01-01

    Postoperative delirium (PD) and postoperative cognitive dysfunction (POCD) are two separate syndromes of cognitive decline after major surgery, especially in the elderly. Pathogenesis is multifactorial with some common risk factors, and to reduce the risk, a multimodal approach is necessary. The ....... In conclusion, the fast-track methodology may reduce the incidence of postoperative cognitive decline after surgery........ The fast-track methodology is becoming a well-established perioperative care regime with possible preventive effects for postoperative cognitive decline, including reduced pain and use of opioids, and early mobilisation with early discharge (≤3 days) to preoperative environment after total hip....../knee arthroplasty (THA/TKA). The fast-track set-up seems to be associated with a lower frequency of PD and early POCD after THA/TKA. Thus, in a series of 225 patients ≥60 years, no cases of PD were seen and the incidence of POCD was reduced by more than 50% at 1 week postoperatively compared to previous studies...

  7. Orchestrating care through the fast-track perspective: Orthopaedic nurses’ perceptions and experiences of providing individualised nursing care in older patients’ standardised fast-track programmes after total hip or knee replacement

    DEFF Research Database (Denmark)

    Bøttcher Berthelsen, Connie; Frederiksen, Kirsten

    2017-01-01

    The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised...... fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim...... and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying...

  8. The ATLAS Fast Tracker Processing Units - track finding and fitting

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00384270; The ATLAS collaboration; Alison, John; Ancu, Lucian Stefan; Andreani, Alessandro; Annovi, Alberto; Beccherle, Roberto; Beretta, Matteo; Biesuz, Nicolo Vladi; Bogdan, Mircea Arghir; Bryant, Patrick; Calabro, Domenico; Citraro, Saverio; Crescioli, Francesco; Dell'Orso, Mauro; Donati, Simone; Gentsos, Christos; Giannetti, Paola; Gkaitatzis, Stamatios; Gramling, Johanna; Greco, Virginia; Horyn, Lesya Anna; Iovene, Alessandro; Kalaitzidis, Panagiotis; Kim, Young-Kee; Kimura, Naoki; Kordas, Kostantinos; Kubota, Takashi; Lanza, Agostino; Liberali, Valentino; Luciano, Pierluigi; Magnin, Betty; Sakellariou, Andreas; Sampsonidis, Dimitrios; Saxon, James; Shojaii, Seyed Ruhollah; Sotiropoulou, Calliope Louisa; Stabile, Alberto; Swiatlowski, Maximilian; Volpi, Guido; Zou, Rui; Shochet, Mel

    2016-01-01

    The Fast Tracker is a hardware upgrade to the ATLAS trigger and data-acquisition system, with the goal of providing global track reconstruction by the start of the High Level Trigger starts. The Fast Tracker can process incoming data from the whole inner detector at full first level trigger rate, up to 100 kHz, using custom electronic boards. At the core of the system is a Processing Unit installed in a VMEbus crate, formed by two sets of boards: the Associative Memory Board and a powerful rear transition module called the Auxiliary card, while the second set is the Second Stage board. The associative memories perform the pattern matching looking for correlations within the incoming data, compatible with track candidates at coarse resolution. The pattern matching task is performed using custom application specific integrated circuits, called associative memory chips. The auxiliary card prepares the input and reject bad track candidates obtained from from the Associative Memory Board using the full precision a...

  9. A Midsize Tokamak As Fast Track To Burning Plasmas

    International Nuclear Information System (INIS)

    Mazzucato, E.

    2010-01-01

    This paper presents a midsize tokamak as a fast track to the investigation of burning plasmas. It is shown that it could reach large values of energy gain ((ge) 10) with only a modest improvement in confinement over the scaling that was used for designing the International Thermonuclear Experimental Reactor (ITER). This could be achieved by operating in a low plasma recycling regime that experiments indicate can lead to improved plasma confinement. The possibility of reaching the necessary conditions of low recycling using a more efficient magnetic divertor than those of present tokamaks is discussed.

  10. Short Hospital Stay after Laparoscopic Colorectal Surgery without Fast Track

    Directory of Open Access Journals (Sweden)

    Stefan K. Burgdorf

    2012-01-01

    Full Text Available Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks during the shorter hospital stay. Specific data on nursing requirements after laparoscopic surgery are lacking. The purpose of the study was to evaluate the effect of operative technique (open versus laparoscopic operation, but without changing nurse staffing or principles for peri- or postoperative care, that is, without implementing fast track principles, on length of stay after colorectal resection for cancer. Methods. Records of all patients operated for colorectal cancer from November 2004 to December 2008 in our department were reviewed. No specific patients were selected for laparoscopic repair, which was solely dependent on the presence of two specific surgeons at the same time. Thus, the patients were not selected for laparoscopic repair based on patient-related factors, but only on the simultaneous presence of two specific surgeons on the day of the operation. Results. Of a total of 540 included patients, 213 (39% were operated by a laparoscopic approach. The median hospital stay for patients with a primary anastomosis was significantly shorter after laparoscopic than after conventional open surgery (5 versus 8 days, while there was no difference in patients receiving a stoma (10 versus 10 days, ns, with no changes in the perioperative care regimens. Furthermore there were significant lower blood loss (50 versus 200 mL, and lower complication rate (21% versus 32%, in the laparoscopic group. Conclusion. Implementing laparoscopic colorectal surgery in our department resulted in shorter hospital stay without using fast track principles for peri- and postoperative care in patients not receiving a stoma during the operation. Consequently, we

  11. Environmental Impact Assessment of Kathmandu Terai Fast-Track

    Directory of Open Access Journals (Sweden)

    Padam Kanta Dahal

    2014-12-01

    Full Text Available  Road transport is dominant necessity for the overall economic development of any nation. In case of Nepal, an easy access between the Capital City and Terai, the store-house of the country and is very necessary. To facilitate this promotion of an improved core road network, Government of Nepal has launched the Kathmandu Terai Fast Track Project. Many concerned personalities and sectors had considered this project to be number one in the list of seventeen projects of national pride declared by the government. The main objective of this study was to identify the impacts of proposed project implementation on physical, biological, socio-economic and cultural environment of the project area and propose mitigation measures to avoid or mitigate such impacts. Primary information collection and secondary data review was the source of data with cross sectional descriptive study design. Data was taken purposively in the project affected area. Length of 72.6 km fast track from Kathmandu – Lalitpur – Makawanpur and up to Nijgadh in Bara district to link with the East West Highway will be of four lanes with 50 m on each side. The project was proposed to have 96 bridges big or small; 1.6 km long tunnel will be built in Thingan of Makawanpur on public-private partnership. It had projected costs of more than NRs 250 million. The impacts on land use will be on about 30km of agricultural land, 43km of forests and about 3km of other land uses, bridges etc. in the main alignment. The impacts on human life will mainly be in villages near the alignment. There are 38 villages within about 50m of the main alignment. The project can be continued with minimum of environmental degradation by applying the mitigation measures. Nation has been investing a lot of resources. Upon the completion of the fast track, the distance and time to reach the capital city from Terai will come down to only 1.5 hours and will transform the capital, eastern Terai and the country as a

  12. A midsize tokamak as a fast track to burning plasmas

    Directory of Open Access Journals (Sweden)

    E. Mazzucato

    2011-03-01

    Full Text Available This paper describes the conceptual design of a midsize tokamak as a fast track to the investigation of burning plasmas. It is shown that it could reach large values of energy gain (≥ 10 with only a modest improvement in confinement over the scaling that was used for designing the International Thermonuclear Experimental Reactor (ITER. This can be achieved by operating in a low plasma recycling regime that experiments indicate can lead to improved plasma confinement. The possibility of reaching the necessary conditions of low recycling using a different magnetic divertor from those currently employed in present experiments is discussed.

  13. FAST TRACK SURGERY IN TOTAL KNEE ARTHROPLASTY - A REVIEW.

    Directory of Open Access Journals (Sweden)

    Pencho Kosev

    2015-08-01

    Full Text Available The number of orthopedic surgeons who are convinced in the need for significant changes in planned total knee arthroplasty (TKA is increasing slowly and steadily. A new approach to pain control has been developed over the past 10-15 years, and the introduction of techniques to reduce perioperative stress, and the use of minimally invasive surgical techniques can help limit postoperative complications and shorten recovery time. This type of optimization is regarded as Fast-track Care program, where improved healing process is particularly useful to comorbid patients.

  14. Cognitive dysfunction after fast-track hip and knee replacement

    DEFF Research Database (Denmark)

    Krenk, Lene; Kehlet, Henrik; Bæk Hansen, Torben

    2014-01-01

    to 2 weeks and 3 months postoperatively. LOS, pain, opioid use, inflammatory response, and sleep quality were recorded. The practice effect of repeated cognitive testing was gauged using data from a healthy community-dwelling control group (n = 161). RESULTS: Median LOS was 2 days (interquartile range...... this (23.6% of patients with early POCD had late onset vs 6.7% in non-POCD group; risk difference 16.9 (95% CI, -2.1% to 41.1%; P = 0.089). CONCLUSIONS: The incidence of POCD early after total hip and knee replacement seems to be lower after a fast-track approach than rates previously reported...

  15. Tracking clinical competencies on the web.

    Science.gov (United States)

    Hobbs, Dan L

    2005-01-01

    The American Registry of Radiologic Technologists (ARRT) has defined several core examinations that student radiographers must perform to demonstrate competency. Furthermore, the ARRT has left the method of tracking competency exams to educators. This article describes a Web-based system that can be used to track clinical competencies. The pedagogy employed in designing a meaningful and successful Web site to track competencies can be overwhelming. Considerations include selecting software, the design and implementation process, and providing security to protect confidential information. The Web-based system described in this article is innovative, sensible and relatively easy to adopt. This tracking method provides faculty members with instantaneous access and a quick review of the student's competency examinations. Students' competency information for the entire program is contained in 1 electronic file. With minor modification, the system can be used in a variety of educational and administrative settings.

  16. Anesthetic and adjunctive drugs for fast-track surgery.

    Science.gov (United States)

    Baldini, G; Carli, F

    2009-08-01

    With the changes in health care dictated by economic pressure, there has been a realization that hospital stay could be shortened without compromising quality of care. Advances in surgical technology and anesthetic drugs have made an impact in the way perioperative care is delivered with some emphasis on multidisciplinary approach. From the expansion of ambulatory care, lessons were learnt how to apply same concepts to major surgery with the understanding that interventions to attenuate the surgical stress would facilitate the return to "baseline". Beside minimal invasive approach to surgery, anesthesia interventions are arranged with the intent to decrease the negative effects of surgical stress and pain, to minimize the side effects of drugs and at the same time to facilitate the recuperation which follows after surgery. Fast-track or accelerated care encompasses many aspects of anesthesia care, not only preoperative preparation and prehabilitation, but intraoperative attenuation of surgical stress and postoperative rehabilitation. The anesthesiologist is part of this team with the specific mission to use medications and techniques which have the least side effects on organ functions, provide analgesia which in turn facilitates the intake of food and mobilization out of bed. This chapter has been conceived with the intention to direct the clinician towards procedure-specific protocols where the choice of medications and techniques is based on published evidence. The success of implementing fast-track depends more on dynamic harmony amongst the various participants (surgeons, anesthesiologists, nurses, nutrtionists, physiotherapists) than on reaching an optimum level of excellence at each separate organization level.

  17. Fast regional readout CMOS Image Sensor for dynamic MLC tracking

    Science.gov (United States)

    Zin, H.; Harris, E.; Osmond, J.; Evans, P.

    2014-03-01

    Advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT) require verification of the complex beam delivery including tracking of multileaf collimators (MLC) and monitoring the dose rate. This work explores the feasibility of a prototype Complementary metal-oxide semiconductor Image Sensor (CIS) for tracking these complex treatments by utilising fast, region of interest (ROI) read out functionality. An automatic edge tracking algorithm was used to locate the MLC leaves edges moving at various speeds (from a moving triangle field shape) and imaged with various sensor frame rates. The CIS demonstrates successful edge detection of the dynamic MLC motion within accuracy of 1.0 mm. This demonstrates the feasibility of the sensor to verify treatment delivery involving dynamic MLC up to ~400 frames per second (equivalent to the linac pulse rate), which is superior to any current techniques such as using electronic portal imaging devices (EPID). CIS provides the basis to an essential real-time verification tool, useful in accessing accurate delivery of complex high energy radiation to the tumour and ultimately to achieve better cure rates for cancer patients.

  18. Fast regional readout CMOS image sensor for dynamic MLC tracking

    International Nuclear Information System (INIS)

    Zin, H; Harris, E; Osmond, J; Evans, P

    2014-01-01

    Advanced radiotherapy techniques such as volumetric modulated arc therapy (VMAT) require verification of the complex beam delivery including tracking of multileaf collimators (MLC) and monitoring the dose rate. This work explores the feasibility of a prototype Complementary metal-oxide semiconductor Image Sensor (CIS) for tracking these complex treatments by utilising fast, region of interest (ROI) read out functionality. An automatic edge tracking algorithm was used to locate the MLC leaves edges moving at various speeds (from a moving triangle field shape) and imaged with various sensor frame rates. The CIS demonstrates successful edge detection of the dynamic MLC motion within accuracy of 1.0 mm. This demonstrates the feasibility of the sensor to verify treatment delivery involving dynamic MLC up to ∼400 frames per second (equivalent to the linac pulse rate), which is superior to any current techniques such as using electronic portal imaging devices (EPID). CIS provides the basis to an essential real-time verification tool, useful in accessing accurate delivery of complex high energy radiation to the tumour and ultimately to achieve better cure rates for cancer patients.

  19. Fast track diagnosis as a means of reducing diagnostic delay in cancer

    DEFF Research Database (Denmark)

    Larsen, Mette Bach; Vedsted, Peter; Olesen, Frede

    of cancer and expanded services to the general practitioners. Objective: To investigate the diagnostic delay of cancer, patient and provider satisfaction and health economic aspects in two Danish regions with special emphasis on the possible benefits of fast track diagnosis. Methods: The study......Background: Denmark has the highest morbidity and mortality from cancer in Western Europe, and studies suggest that Danish cancer patients are diagnosed at a later stage than patients in the other Nordic countries. To address this issue a Danish hospital has introduced fast track diagnosis...... will be designed as a cross-sectional study with the construction of a clinical database of all incident cancers in two Danish regions within a year (12,000 patients). Data will be collected from general practitioners, patients and national registers. In the first part of the analysis the general variation...

  20. Cognitive dysfunction after fast-track hip and knee replacement.

    Science.gov (United States)

    Krenk, Lene; Kehlet, Henrik; Bæk Hansen, Torben; Solgaard, Søren; Soballe, Kjeld; Rasmussen, Lars Simon

    2014-05-01

    Postoperative cognitive dysfunction (POCD) is reported to occur after major surgery in as many as 20% of patients, elderly patients may especially experience problems in the weeks and months after surgery. Recent studies vary greatly in methods of evaluation and diagnosis of POCD, and the pathogenic mechanisms are still unclear. We evaluated a large uniform cohort of elderly patients in a standardized approach, after major joint replacement surgery (total hip and knee replacement). Patients were in an optimized perioperative approach (fast track) with multimodal opioid-sparing analgesia, early mobilization, and short length of stay (LOS ≤3 days) and discharged to home. In a prospective multicenter study, we included 225 patients aged ≥60 years undergoing well-defined fast-track total hip or total knee replacement. Patients had neuropsychological testing preoperatively and 1 to 2 weeks and 3 months postoperatively. LOS, pain, opioid use, inflammatory response, and sleep quality were recorded. The practice effect of repeated cognitive testing was gauged using data from a healthy community-dwelling control group (n = 161). Median LOS was 2 days (interquartile range 2-3). The incidence of POCD at 1 to 2 weeks was 9.1% (95% confidence interval [CI], 5.4%-13.1%) and 8.0% (95% CI, 4.5%-12.0%) at 3 months. There was no statistically significant difference between patients with and without early POCD, regarding pain, opioid use, sleep quality, or C-reactive protein response, although the CIs were wide. Patients with early POCD had a higher Mini Mental State Examination score preoperatively (difference in medians 0.5 [95% CI, -1.0% to 0.0%]; P = 0.034). If there was an association between early POCD and late POCD, the sample size was unfortunately too small to verify this (23.6% of patients with early POCD had late onset vs 6.7% in non-POCD group; risk difference 16.9 (95% CI, -2.1% to 41.1%; P = 0.089). The incidence of POCD early after total hip and knee replacement

  1. LiTrack A Fast longitudinal phase space tracking code with graphical user interface

    CERN Document Server

    Emma, Paul

    2005-01-01

    Many linear accelerators, such as linac-based light sources and linear colliders, apply longitudinal phase space manipulations in their design, including electron bunch compression and wakefield-induced energy spread control. Several computer codes handle such issues, but most require detailed information on the transverse focusing lattice. In fact, in most linear accelerators, the transverse distributions do not significantly affect the longitudinal, and can be ignored initially. This allows the use of a fast 2D code to study longitudinal aspects without time-consuming considerations of the transverse focusing. LiTrack is based on a 15-year old code (same name) originally written by one of us (KB), which is now a MATLAB-based code with additional features, such as a graphical user interface and output plotting. The single-bunch tracking includes RF acceleration, bunch compression to 3rd order, geometric and resistive wakefields, aperture limits, synchrotron radiation, and flexible output plotting. The code w...

  2. Fast neutron detection using solid state nuclear track detectors

    International Nuclear Information System (INIS)

    Vilela, E.C.

    1990-01-01

    CR-39 and Makrofol-E solid state nuclear track detectors were studied aiming their application to fast neutron detection. Optimum etching conditions of those two kinds of materials were determined the followings - the Makrofol-E detector is electrochemically etched in a PEW solution (15% KOH, 40% ethilic alcohol and 45% water) for 2 h., with an applied electric field strength of 30 kV/cm (r/m/s/) and frequency of 2 kHz, at room temperature; - the CR-39 detector is chemically pre-etched during 1 h in a 20% (w/v) NaOH solution at 70 sup(0)C, followed by 13 h electrochemical etch using the same solution at room temperature and an electric field strength of 30 kV/cm (r.m.s.) and frequency of 2 kHz.(E.G.)

  3. A Fast Track towards the `Higgs' Spin and Parity

    CERN Document Server

    Ellis, John; Sanz, Veronica; You, Tevong

    2012-01-01

    The LHC experiments ATLAS and CMS have discovered a new boson that resembles the long-sought Higgs boson: it cannot have spin one, and has couplings to other particles that increase with their masses, but the spin and parity remain to be determined. We show here that the `Higgs' + gauge boson invariant-mass distribution in `Higgs'-strahlung events at the Tevatron or the LHC would be very different under the J^P = 0+, 0- and 2+ hypotheses, and could provide a fast-track indicator of the `Higgs' spin and parity. Our analysis is based on simulations of the experimental event selections and cuts using PYTHIA and Delphes, and incorporates statistical samples of `toy' experiments.

  4. Nursing in fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Specht, Kirsten; Kjaersgaard-Andersen, Per; Kehlet, Henrik

    2015-01-01

    must still focus on the individual patient. Nurses need to have enough education to manage the complex tasks and increased responsibility. To prevent undesirable outcomes in the future, there is a need to pay attention to the nursing quality in balance with the nursing budget. It may, therefore......AIM: To describe the increased activity in total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2002 to 2012 in a single orthopaedic department, the organisation of fast-track and its consequences for nursing care. METHODS: Retrospective, descriptive design. Data collection; from...... gained tasks from surgeons and physiotherapists and thus gained more responsibility, for example, for pain management and mobilisation. Staffing levels in the ward in 2002 and 2012 were almost unchanged; 16.0 and 15.8 respectively. Nurses were undertaking more complicated tasks. CONCLUSION: Nursing care...

  5. Sleep disturbances after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Krenk, L; Jennum, P; Kehlet, H

    2012-01-01

    BACKGROUND: /st>Major surgery is followed by pronounced sleep disturbances after traditional perioperative care potentially leading to prolonged recovery. The aim was to evaluate the rapid eye movement (REM) sleep duration and sleep architecture before and after fast-track hip and knee replacement......, and on the fourth postoperative night at home. Sleep staging was performed according to the American Academy of Sleep Medicine manual. Opioid use, pain, and inflammatory response (C-reactive protein) were also evaluated. RESULTS: /st>The mean LOS was 1.5 (1-2) days. The mean REM sleep time decreased from a mean...... on the fourth postoperative night. There was no association between opioid use, pain scores, and inflammatory response with a disturbed sleep pattern. CONCLUSIONS: /st>Despite ultra-short LOS and provision of spinal anaesthesia with multimodal opioid-sparing analgesia, REM sleep was almost eliminated...

  6. Fast-Acquisition/Weak-Signal-Tracking GPS Receiver for HEO

    Science.gov (United States)

    Wintemitz, Luke; Boegner, Greg; Sirotzky, Steve

    2004-01-01

    A report discusses the technical background and design of the Navigator Global Positioning System (GPS) receiver -- . a radiation-hardened receiver intended for use aboard spacecraft. Navigator is capable of weak signal acquisition and tracking as well as much faster acquisition of strong or weak signals with no a priori knowledge or external aiding. Weak-signal acquisition and tracking enables GPS use in high Earth orbits (HEO), and fast acquisition allows for the receiver to remain without power until needed in any orbit. Signal acquisition and signal tracking are, respectively, the processes of finding and demodulating a signal. Acquisition is the more computationally difficult process. Previous GPS receivers employ the method of sequentially searching the two-dimensional signal parameter space (code phase and Doppler). Navigator exploits properties of the Fourier transform in a massively parallel search for the GPS signal. This method results in far faster acquisition times [in the lab, 12 GPS satellites have been acquired with no a priori knowledge in a Low-Earth-Orbit (LEO) scenario in less than one second]. Modeling has shown that Navigator will be capable of acquiring signals down to 25 dB-Hz, appropriate for HEO missions. Navigator is built using the radiation-hardened ColdFire microprocessor and housing the most computationally intense functions in dedicated field-programmable gate arrays. The high performance of the algorithm and of the receiver as a whole are made possible by optimizing computational efficiency and carefully weighing tradeoffs among the sampling rate, data format, and data-path bit width.

  7. Preoperative fasting: a clinical audit.

    Science.gov (United States)

    Roberts, Stuart

    2013-01-01

    This clinical audit examines the adherence to guidelines suggested by the Royal College of Nursing (2005); the results uphold previous studies of a preoperative starving period for patients undergoing elective surgical procedures. Patients excessively starved of food or fluids report problems relating to their health. These include hunger, distress and complaints of nausea.

  8. Clinical application of fast neutrons

    International Nuclear Information System (INIS)

    Battermann, J.J.

    1981-01-01

    The results of treatments and clinical experiments with neutrons (from a medical d+T neutron generator with an output of 10 12 neutrons per second) are reported and discussed. Data on RBE values are presented after single doses and multiple fractions of neutrons and 60 Co-gamma rays on pulmonary metastases. The results of pilot studies on head and neck tumours, brain tumours and pelvic tumours are discussed. The accuracy of the calculated dose is tested with some in-vivo experiments during neutron irradiation of the pelvis. Estimations of RBE values for tumour control, skin damage and intestinal damage after fractionated neutron therapy are dealt with and the results obtained in treatment of sarcomas are discussed. The preliminary results are given of some clinical trials in Amsterdam. Also some data from other centres are reviewed. From these data some remarks about the future of neutron therapy are made. (Auth.)

  9. Cardiac surgery fast-track treatment in a postanesthetic care unit: six-month results of the Leipzig fast-track concept.

    Science.gov (United States)

    Ender, Joerg; Borger, Michael Andrew; Scholz, Markus; Funkat, Anne-Kathrin; Anwar, Nadeem; Sommer, Marcus; Mohr, Friedrich Wilhelm; Fassl, Jens

    2008-07-01

    The authors compared the safety and efficacy of a newly developed fast-track concept at their center, including implementation of a direct admission postanesthetic care unit, to standard perioperative management. All fast-track patients treated within the first 6 months of implementation of our direct admission postanesthetic care unit were matched via propensity scores and compared with a historical control group of patients who underwent cardiac surgery prior to fast-track implementation. A total of 421 fast-track patients were matched successfully to 421 control patients. The two groups of patients had a similar age (64 +/- 13 vs. 64 +/- 12 yr for fast-track vs. control, P = 0.45) and European System for Cardiac Operative Risk Evaluation-predicted risk of mortality (4.8 +/- 6.1% vs. 4.6 +/- 5.1%, P = 0.97). Fast-track patients had significantly shorter times to extubation (75 min [45-110] vs. 900 min [600-1140]), as well as shorter lengths of stay in the postanesthetic or intensive care unit (4 h [3.0-5] vs. 20 h [16-25]), intermediate care unit (21 h [17-39] vs. 26 h [19-49]), and hospital (10 days [8-12] vs. 11 days [9-14]) (expressed as median and interquartile range, all P operations.

  10. "Fast Track" and "Traditional Path" Coaches: Affordances, Agency and Social Capital

    Science.gov (United States)

    Rynne, Steven

    2014-01-01

    A recent development in large-scale coach accreditation (certification) structures has been the "fast tracking" of former elite athletes. Former elite athletes are often exempted from entry-level qualifications and are generally granted access to fast track courses that are shortened versions of the accreditation courses undertaken by…

  11. Which fast track elements predict early recovery after colon cancer surgery?

    NARCIS (Netherlands)

    Vlug, M. S.; Bartels, S. A. L.; Wind, J.; Ubbink, D. T.; Hollmann, M. W.; Bemelman, W. A.; Sprangers, Mirjam; Preckel, Benedikt; Bossuyt, Patrick; Gouma, Dirk; van Berge Henegouwen, Mark; Fuhring, Jan; Lenthe, Ineke Picard-van; Bakker, Chris; King-Kalimanis, Bellinda; Hofland, Jan; Dejong, Cornelis; van Dam, Ronald; Cuesta, Miguel; van der Peet, Donald; van Zalingen, Edith; Noordhuis, Astrid; de Jong, Dick; Engel, Alexander; Goei, T. Hauwy; de Stoppelaar, Erica; van den Dongen, Marjon; van Wagensveld, Bart; van Tets, Willem; van den Elsen, Maarten; Swart, Annemiek; Gerhards, Michael; de Wit, Laurens; Siepel, Muriel; Molly, Glaresa; Gasthuis, Onze Lieve Vrouwe; van Geloven, Anna; Juttmann, Jan; Clevers, Wilfred; Bieleman, Andrea; van der Zaag, Edwin; Coenen, Ludo; Bonekamp, Elly; Cense, Huib; van Abeelen, Jacobus; van Iterson-de Jong, Diana; Krombeen, Margriet

    2012-01-01

    Aim It is questioned whether all separate fast track elements are essential for enhanced postoperative recovery. We aimed to determine which baseline characteristics and which fast track elements are independent predictors of faster postoperative recovery in patients undergoing resection for colon

  12. Implementation of the scientific evidence into daily practice - example from fast-track colonic cancer surgery

    DEFF Research Database (Denmark)

    Hammer, J.; Harling, H.; Wille-Jorgensen, P.

    2008-01-01

    Objective To report the implementation and results of fast-track surgery for colonic cancer in the daily routine. Method A total of 131 consecutive patients scheduled for elective colonic cancer resections entered a fast-track perioperative course after thorough information. The regimen contained...

  13. The role of pain for early rehabilitation in fast track total knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Myhrmann, Lis

    2010-01-01

    To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA).......To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA)....

  14. Laparoscopic surgery contributes more to nutritional and immunologic recovery than fast-track care in colorectal cancer.

    Science.gov (United States)

    Xu, Dong; Li, Jun; Song, Yongmao; Zhou, Jiaojiao; Sun, Fangfang; Wang, Jianwei; Duan, Yin; Hu, Yeting; Liu, Yue; Wang, Xiaochen; Sun, Lifeng; Wu, Linshan; Ding, Kefeng

    2015-02-04

    Many clinical trials had repeatedly shown that fast-track perioperative care and laparoscopic surgery are both preferred in the treatment of colorectal cancer. But few studies were designed to explore the diverse biochemical impacts of the two counterparts on human immunologic and nutritional status. Ninety-two cases of colorectal cancer patients meeting the inclusion criteria were randomized to four groups: laparoscopy with fast-track treatment (LAFT); open surgery with fast-track treatment (OSFT); laparoscopy with conventional treatment (LAC); open surgery with conventional treatment (OSC). Peripheral blood tests including nutritional factors (albumin, prealbumin, and transferrin), humoral immunologic factors (IgG, IgM, and IgA), and cellular immunologic factors (T and NK cells) were evaluated. Blood samples were collected preoperatively (baseline) and 12 and 96 h after surgery (indicated as POH12 and POH96, respectively). Albumin, transferrin, prealbumin, and IgG levels were the highest in the LAFT group for both POH12 and POH96 time intervals. Repeated measures (two-way ANOVA) indicated that the difference of albumin, transferrin, and IgG level were attributed to surgery type (P  0.05). Only in the laparoscopy-included groups, the relative albumin and IgG levels of POH96 were obviously higher than that of POH12. Laparoscopic surgery accelerated postoperative nutrition and immune levels rising again while fast-track treatment retarded the drop of postoperative nutrition and immune levels. Laparoscopic surgery might play a more important role than fast-track treatment in the earlier postoperative recovery of nutritional and immunologic status. Combined laparoscopic surgery with fast-track treatment provided best postoperative recovery of nutrition and immune status. These results should be further compared with the clinical outcomes of our FTMDT trial (clinicaltrials.gov: NCT01080547).

  15. Fast-track aquifer characterization and bioremediation of groundwater

    International Nuclear Information System (INIS)

    Owen, S.B.; Erskine, J.A.; Adkisson, C.

    1995-01-01

    A short duration step-drawdown pumping test has been used to characterize a highly permeable aquifer contaminated with petroleum hydrocarbons in support of an in situ, closed loop extraction and reinjection bioremediation system for groundwater. The short-term pumping test produces a manageable quantity of contaminated groundwater while yielding a range of values for transmissivity and specific yield parameters. This range of aquifer coefficients is used in an analytical model to estimate a range of groundwater extraction rates that provide a suitable radius of influence for the extraction and reinjection system. A multi-enzyme complex catalyzed bioremediation process has been used to aerobically degrade petroleum hydrocarbons. Enzymes, amino acids, and biosurfactants are supplied to the extracted groundwater to significantly speed up the degradation by naturally occurring bacteria. During the process, amino acids promote the rapid growth of the microbial population while enzymes and bacteria attach to hydrocarbons forming a transformation state complex that degrades to fatty acids, carbon dioxide, and water. This paper presents a case study of a fast-track bioremediation using pumping test data, analytical modeling, and an enzyme technology

  16. LiTrack: A Fast Longitudinal Phase Space Tracking Code with Graphical User Interface

    International Nuclear Information System (INIS)

    Bane, K.L.F.

    2005-01-01

    Linac-based light sources and linear colliders typically apply longitudinal phase space manipulations in their design, including electron bunch compression and wakefield-induced energy spread control. Several computer codes handle such issues, but most also require detailed information on the transverse focusing lattice. In fact, in most linear accelerators, the transverse distributions do not significantly affect the longitudinal, and can be ignored initially. This allows the use of a fast 2D code to study longitudinal aspects without time-consuming considerations of the transverse focusing. LiTrack is based on a 15-year old code (same name) originally written by one of us (KB), which is now a Matlab [1] code with additional features, such as graphical user interface, prompt output plotting, and functional call within a script. This single-bunch tracking code includes RF acceleration, bunch compression to 3rd order, geometric and resistive short-range wakefields, aperture limits, synchrotron radiation, and flexible output plotting. The code was used to design both the LCLS [2] and the SPPS [3] projects at SLAC and typically runs 10 5 particles in < 1 minute. We describe the features, show some examples, and provide free access to the code

  17. [Laparoscopic "fast-track" sigmoidectomy for diverticulitis disease in Germany. Results of a prospective quality assurance program].

    Science.gov (United States)

    Tsilimparis, N; Haase, O; Wendling, P; Kipfmüller, K; Schmid, M; Engemann, R; Schwenk, W

    2010-09-01

    The natural course of sigmoid colon diverticulitis during conservative therapy and the assessment of the perioperative morbidity after sigmoid colon resection are differently evaluated by surgeons and gastroenterologists. The "fast-track" rehabilitation accelerates the reconvalescence and reduces the rate of postoperative general complications after colorectal surgery. The results of the laparoscopic "Fast-track" sigmoidectomy should be examined within a quality assurance program to better evaluate the perioperative risks following surgical management of diverticulitis. A prospective data collection within the voluntary quality assurance program "fast-track" Kolon II was performed. All participating clinics agreed on a multimodal, evidence-based standard perioperative treatment in terms of a "fast-track" rehabilitation for elective operations for sigmoid diverticulitis. Data from 846 patients undergoing laparoscopic "fast-track" sigmoid colon resection in 23 surgical departments in Germany were collected and evaluated. The mean age of the patients was 63 years (range 23 - 91). 203 patients (24 %) had severe co-morbidities (ASA classification III - IV). A conversion to conventional open surgery was necessary in 51 cases (6 %). Complications occurred in 93 patients (11 %). 76 patients suffered a surgical complication (8.9 %) and 32 patients (3.8 %) a general complication. Two patients died postoperatively due to multi-organ failure following anastomotic leaks. The patients took solid food in median on day 1 after surgery (range, 0 - 5) and passed stool on day 2 (range, 0 - 22). Predefined discharge criteria (free of pain on oral medication, normal oral feeding, stool) were met on day 4 (range, 1 - 58) and the patients were discharged on day 7 (range, 3 - 72). The 30-day re-admission rate was 3.9 %. Patients undergoing laparoscopic "fast-track" sigmoidectomy had a low rate of general complications and had a rapid reconvalescence with a short postoperative in

  18. [Shortened hospital stay for elective cesarean section after initiation of a fast-track program and midwifery home-care].

    Science.gov (United States)

    Gunnarsdottir, Johanna; Bjornsdottir, Thorbjörg Edda; Halldorsson, Thorhallur Ingi; Halldorsdottir, Gudrun; Geirsson, Reynir Tomas

    2011-07-01

    To audit whether hospital stay shortened without increasing readmissions after implementation of fast-track methodology for elective cesarean section and characterize what influences length of stay. A fast-track program was initiated in November 2008, with a one year clinical audit and satisfaction survey. Discharge criteria were predefined and midwife home visits included if discharge was within 48 hours. Hospital stay by parity for women with elective section for singleton pregnancy between 1.11. 2008 - 31.10. 2009 (n=213, fast-track 182) was compared to 2003 (n=199) and 2007 (n=183). Readmissions and outpatient visits 2007 and 2008-9 were counted. Reasons for longer stay were recorded in fast-track, and body mass index. Median hospital stay decreased significantly from 81 to 52 hours between 2007 and 2008-9. Readmissions were four in each period and outpatient visit rates similar. In 2008-9, 66% of all women were discharged within 48 hours. Women in the fast-track program were satisfied with early discharge. Hospital stay for parous women was shorter in 2007 compared to 2003, but unchanged for nulliparas. Parity had a minimal influence on length of stay in 2008-9, although nulliparous women ≤ 25 years were more likely to stay >48 hours. Body mass index did not correlate with length of stay. Pain was rarely the reason for a longer stay in the fast-track program and 90% were satisfied with pain-medication after discharge. Most healthy women can be discharged early after singleton birth by elective cesarean, without increasing readmissions.

  19. PREDICTING A FAST-TRACK MARITIME CAREER: CHARACTERISTICS OF SUCCESSFUL OFFICERS DURING TEENAGE YEARS

    Directory of Open Access Journals (Sweden)

    Manuel Joaquín Fernández González

    2017-12-01

    Full Text Available Fast-track maritime career is a topical question worldwide due to the shortage of seafarers in maritime industry. Assuming that the fast-track career officers’ relevant common characteristics in adolescence could predict future maritime career speed, the research questions of this research are: What were the common characteristics of fast-track career officers when they were 16-18? Were there any statistically significant differences between the fast-track career groups and the officers with a slower career at that age? A questionnaire survey involving 175 maritime officers was conducted in Latvia in January – October 2016, regarding officers’ family context, school achievement, involvement in sports, and personality traits when they were 16-18. Fast-track career officers perceived themselves as more conscientious, calm and more leadership oriented than the whole group in adolescence. Statistically significant differences among career-speed groups were found regarding family socioeconomic status, family atmosphere and family career support at that age. Based on those communalities among maritime officers with a fast-track carrier when they were 16-18, maritime education and training institutions could better find and give appropriate career guidance to prospective maritime officers. Even if maritime career speed is a very individualized phenomenon, family characteristics could be studied further as a potential good predictor of fast-track maritime career.

  20. [Effects of a nutritional intervention in a fast-track program for a colorectal cancer surgery: systematic review].

    Science.gov (United States)

    Wanden-Berghe, Carmina; Sanz-Valero, Javier; Arroyo-Sebastián, Antonio; Cheikh-Moussa, Kamila; Moya-Forcen, Pedro

    2016-07-19

    Introducción: Preoperative nutritional status (NS) has consequences on postoperative (POSTOP) recovery. Our aim was to systematically review the nutritional interventions (NI) in Fast-Track protocols for colorectal cancer surgery and assess morbidity-mortality and patient´s recovery. Systematic review of scientific literature after consulting bibliographic databases: Medline, The Cochrane Library, Scopus, Embase, Web of Science, Institute for Scientific Information, Latin American and Caribbean Health Sciences Literature, The Cumulative Index to Nursing and Allied Health Literature. MeSH Descriptors: "Colorectal Surgery", "Fast-Track", "Perioperative Care", "Nutrition Therapy" and "Enhanced recovery programme". Filters: "Humans", Adult (19+ years) and "Clinical Trial". Variables POSTOP outcomes: bowel recovery (BR), hospital stay (HS), complications and death. Selected studies, 27, had good or excellent methodological quality. From 25 to 597 patients were included. Aged between 16-94 years, men were predominant in 66.6%. NS was evaluated in 13 studies; 7 by Body Mass Index while one by Subjective Global Assessment. One presented POSTOP data. Fast-Track groups had solids, liquids or supplements (SS) in prior 2-8 hours. SS were high in carbohydrates, immune-nutrients and non-residue. Free liquids, solids and SS intake was allowed in POSTOP. Half traditional groups fasted between 3-12 hours and resumed POSTOP food intake progressively. Fast-Track groups had early BR (p Nutritional status must be assessed for a higher acknowledgement of NI impact.

  1. Research on Fast Track Surgery Application in Lung Cancer Surgery

    Directory of Open Access Journals (Sweden)

    Kaiyun YANG

    2010-02-01

    Full Text Available Background and objective Fast track surgery (FTS is a systematical method to accelerate the recovery of surgical patients by reducing the physical and mental trauma stress of them. The research is to investigate the feasibility of FTS application in lung cancer surgery. Methods A total of 80 cases of lung cancer patients with single leaf lobotomy resection were randomized into two groups. While the experimental group was treated with the conception of FTS, and the control group was treated with the traditional methods. The incident rate of post-operation pain degrees, telecasts, pleural effusion, the post-operation time stay in hospital time and the total cost during hospitalization in two groups were compared respectively. Results In FTS group: the VAS score of post-operation pain at 1 h, 6 h, 12 h, 24 h and 48 h all significantly decreased compared to the traditional therapy group. The incidence rate of telecast was 10.53%. The incidence rate of pleural effusion was 26.31%. The length of stay after operation was (4±1 d and the total cost was RMB 15 600±7 600. In the control group, the above values were 77.78%, 33.33%, 22.22%, (9±1 d, RMB 23 600±5 400, respectively. The post operation pain (VAS method of FTS group was remarkablely below the control group. There has significant difference of the incident rate of telecasts, stay time in hospital and the total cast in two groups (P < 0.05. No significant difference was observed in the incident rate of pleural effusion. Conclusion The new methods of FTS can apparently accelerates recovery after lung cancer resection, reduces complications, shorten timestay in hospital and cut down the total cost.

  2. Variation in 'fast-track' referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites.

    Science.gov (United States)

    Zhou, Y; Mendonca, S C; Abel, G A; Hamilton, W; Walter, F M; Johnson, S; Shelton, J; Elliss-Brookes, L; McPhail, S; Lyratzopoulos, G

    2018-01-01

    In England, 'fast-track' (also known as 'two-week wait') general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. We examined data from 669 220 patients with 35 cancers diagnosed in 2006-2010 following either fast-track or 'routine' primary-to-secondary care referrals using 'Routes to Diagnosis' data. We estimated the proportion of fast-track referrals by sociodemographic characteristic and cancer site and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. There were large variations in the odds of fast-track referral by cancer (P<0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35, respectively, using rectal cancer as reference); whereas patients with brain cancer and leukaemias least likely (adjusted odds ratios 0.05 and 0.09, respectively, for brain cancer and acute myeloid leukaemia). There were sex, age and deprivation differences in the odds of fast-track referral (P<0.013) that varied in their size and direction for patients with different cancers (P<0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Fast-track referrals are less likely for cancers characterised by nonspecific presenting symptoms and patients belonging to low cancer incidence demographic groups. Interventions beyond clinical guidelines for 'alarm' symptoms are needed to improve diagnostic timeliness.

  3. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs......BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...

  4. Fast-track surgery-an update on physiological care principles to enhance recovery

    DEFF Research Database (Denmark)

    Kehlet, Henrik

    2011-01-01

    INTRODUCTION: The concept of fast-track surgery (enhanced recovery programs) has been evolved and been documented to be successful by decreasing length of stay, morbidity and convalescence across procedures. FUTURE STRATEGIES: However, there are several possibilities for further improvement of mo...... of the components of fast-track surgery, where surgical stress, fluid and pain management are key factors. There is an urgent need for better design of studies, especially in minimal invasive surgery to achieve maximal outcome effects when integrated into the fast-track methodology....

  5. Improving the quality of pretreatment staging in patients with esophageal carcinoma - a fast track study

    Energy Technology Data Exchange (ETDEWEB)

    Didden, Paul; Spaander, Manon C. W.; Kuipers, Ernst J.; Bruno, Marco J. (Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam (Netherlands)), E-mail: v.spaander@erasmusmc.nl; Wijnhoven, Bas P. L. (Department of Surgery, Erasmus University Medical Center, Rotterdam (Netherlands))

    2012-03-15

    Background: Current guidelines for esophageal cancer recommend series of diagnostic investigations to determine pretreatment TNM stage. When investigations are done sequentially, diagnostic work-up time may be prolonged considerably. Aim of the study was to determine the feasibility and efficacy of a fast track staging strategy within five days after the first consultation. Material and methods: Between 2007 and 2010 all patients presenting with esophageal cancer at the Department of Gastroenterology in a tertiary referral center were prospectively analyzed. At Day 1 all patients underwent computed tomography (CT), endoscopic ultrasound (EUS) and ultrasonography of the neck (United States). Results and treatment implications were discussed within a multidisciplinary meeting. This fast track strategy was considered completed successfully if pre-treatment TNM classification was achieved and therapy was proposed to the patient at the outpatient clinic at Day five. In those cases where staging period time was prolonged, the number and type of additional tests were documented including the ensuing time delay. Results: In 111 patients CT, EUS and US were performed in 100%, 88.3% and 97.3% respectively. A final TNM stage and treatment proposal was reached at Day 5 in 60% of the patients. Additional tests were diverse and mainly used to prove local irresectability or presence of distant metastasis. Multivariate analysis identified presence of lymphadenopathy (HR 0.25 p 0.03) and metastasis (HR 0.27 p = 0.03) as significant predictors of not completing the staging period within five days. In 18% of patients overuse of at least one test occurred, most commonly because CT already revealed distant metastasis. Conclusion: Employment of a fast track five day staging strategy in patients with esophageal carcinoma is feasible. Definite TNM stage and treatment proposal can be achieved in 60% of cases, but comes at the expense of test overuse in about one fifth of patients

  6. The risk of manipulation under anesthesia due to unsatisfactory knee flexion after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Wied, Christian; Thomsen, Morten G; Kallemose, Thomas

    2015-01-01

    BACKGROUND: Fast-track TKA has significantly shortened the time available for physiotherapists to optimize knee ROM before discharge. Safety aspects concerning knee stiffness and the need for manipulation in a fast-track setting need to be illuminated. The study aims were to analyze if fast-track...

  7. Clinical track faculty: merits and issues.

    Science.gov (United States)

    Lee, Won-Hee; Kim, Cho Ja; Roh, Young Sook; Shin, Hyunsook; Kim, Mi Ja

    2007-01-01

    Clinical track faculty (CTF) has been in operation for more than two decades in the United States, and 12 of the top 20 schools of nursing with the highest National Institutes of Health funding in the United States have CTF in place. Yet, only limited articles have been published regarding the merits and issues related to its operation. This article examines the advantages/merits of establishing CTF in schools of nursing, discusses the qualification criteria and types of appointment for CTF, and analyzes issues related to operating CTF in Korea. A questionnaire survey and two workshops were conducted involving faculty from a college of nursing and clinical nurse managers from university-affiliated medical centers and community agencies. Most of the respondents indicated that establishing CTF was advantageous. Merits included the following: increasing reality-based clinical education and training; decreasing the reality shock of students; increasing student satisfaction; and linking education, practice, and research more effectively. Major issues were as follows: getting the approval of medical centers/universities; developing an agreement on CTF operation between the college of nursing and clinical agencies; clarifying types and criteria of appointment and promotion; and developing a statement on role and compensation policies. Most issues are similar to what U.S. schools of nursing have faced, except for the first one. In conclusion, establishing CTF in Korea appears to be highly desirable. Merits outweigh issues/concerns, and Korean nursing schools may look for an opportune time for obtaining the approval of medical centers/universities. Nursing schools in other countries that face a similar challenge of providing clinical teaching with high research performance may consider instituting CTF.

  8. When is it optimal to delegate: the theory of fast-track authority

    Czech Academy of Sciences Publication Activity Database

    Celik, Levent; Karabay, B.; McLaren, J.

    2015-01-01

    Roč. 7, č. 3 (2015), s. 347-389 ISSN 1945-7669 Institutional support: RVO:67985998 Keywords : fast-track authority * free trade * protectionist rents Subject RIV: AH - Economics Impact factor: 1.359, year: 2015

  9. L0 Confirmation with fast, Tsa based tracking in the T-stations

    CERN Document Server

    Albrecht, J; Terrier, H

    2007-01-01

    A fast tracking algorithm to confirm the high $p_T$ L0 trigger objects with tracks from the T-stations is presented. The L0 trigger candidate is used to define a search window to a potential track. Using this, a seeded track search is performed. The track finding algorithm is based on the \\textit{TsaSeeding} algorithm~\\cite{bib:Tsa}. The efficiency to confirm a true L0 trigger signal is around 96\\%, the momentum can be measured up to $\\Delta p/p$=3\\%.

  10. The use of a break-even analysis: financial analysis of a fast-track program.

    Science.gov (United States)

    Saywell, R M; Cordell, W H; Nyhuis, A W; Giles, B K; Culler, S D; Woods, J R; Chu, D K; McKinzie, J P; Rodman, G H

    1995-08-01

    To calculate the financial break-even point and illustrate how changes in third-party reimbursement and eligibility could affect a program's fiscal standing. Demographic, clinical, and financial data were collected retrospectively for 446 patients treated in a fast-track program during June 1993. The fast-track program is located within the confines of the emergency medicine and trauma center at a 1,050-bed tertiary care Midwestern teaching hospital and provides urgent treatment to minimally ill patients. A financial break-even analysis was performed to determine the point where the program generated enough revenue to cover its total variable and fixed costs, both direct and indirect. Given the relatively low average collection rate (62%) and high percentage of uninsured patients (31%), the analysis showed that the program's revenues covered its direct costs but not all of the indirect costs. Examining collection rates or payer class mix without examining both costs and revenues may lead to an erroneous conclusion about a program's fiscal viability. Sensitivity analysis also shows that relatively small changes in third-party coverage or eligibility (income) requirements can have a large impact on the program's financial solvency and break-even volumes.

  11. Comparison of fast neutron-induced tracks in plastics using the electrochemical etching method

    International Nuclear Information System (INIS)

    Cotter, S.J.; Gammage, R.B.; Thorngate, J.H.; Ziemer, P.L.

    1979-01-01

    Four plastics were examined by the electrochemical etching method for their suitability in registering fast neutron-induced recoil particle tracks. The plastics were cellulose acetate, cellulose triacetate, cellulose acetobutyrate and polycarbonate. Cellulose acetate and triacetate displayed high levels of water absorptivity during etching while the acetobutyrate foils cracked due to electromechanical stresses at high frequencies (>500 Hz). The clarity of the etched track was superior in the polycarbonate foils, suggesting the latter as the generally preferred dosimeter for fast neutrons. (author)

  12. After colonic surgery: The lived experience of participating in a fast-track programme

    DEFF Research Database (Denmark)

    Norlyk, Annelise; Harder, Ingegerd

    2009-01-01

    Postoperative recovery can be accelerated and hospitalization reduced through fast-track programmes. However, documented knowledge is limited and primarily focusing on a medical perspective whereas the patients' perspective lacks documentation. This study describes the lived experience of partici......Postoperative recovery can be accelerated and hospitalization reduced through fast-track programmes. However, documented knowledge is limited and primarily focusing on a medical perspective whereas the patients' perspective lacks documentation. This study describes the lived experience...

  13. Restoring integrity--A grounded theory of coping with a fast track surgery programme.

    Science.gov (United States)

    Jørgensen, Lene Bastrup; Fridlund, Bengt

    2016-01-01

    The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. The study design used classical grounded theory. The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients' main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme.

  14. Fast algorithm of track reconstruction for the Delphy TPC

    International Nuclear Information System (INIS)

    Maillard, J.

    1984-01-01

    We describe a simple geometrical method (polar inversion) to reconstruct tracks. When the magnetic field is constant in magnitude and direction. This method uses geometrical properties of the trajectories. In the case of the DELPHI apparatus, the track reconstruction is done using TPC informations. After explaining the algorithm, we give results on ''GEANT'' simulated events using the ''Lund'' generator. Today we get a computer time of the order of 1.2 milliseconds on a CDC 7600 and an efficiency of 98% [fr

  15. Implementing large scale fast track diagnostics in a comprehensive cancer center, pre- and post-measurement data.

    Science.gov (United States)

    van Harten, W H; Goedbloed, N; Boekhout, A H; Heintzbergen, S

    2018-02-07

    In general, patients with a cancer suspicion visit the hospital multiple times before diagnosis is completed. Using various "operations management" techniques a few fast track diagnostic services were implemented in the Netherlands Cancer Institute (NKI) in 2006. Growing patient numbers and increasing process complexity, led to diminished service levels. To decrease the amount of patient visits and to extend these services beyond the (obvious) breast cancer services, fast track diagnostics is now implemented for all 18 cancer types that present with a frequency of minimally one per week. The throughput time (first visit to diagnosis conversation) was measured before, and after implementation of fast track diagnostics. The process was redesigned closely involving the multidisciplinary teams. In an eclectic approach elements from lean management, theory of constraints and mathematical analysis were used to organize slots per tumor type for MRI, CT, PET and echography. A post measurement was performed after 3 and 6 months. In pre measurement access time was calculated to be 10 to 15 workdays, mean throughput time was 6.0 workdays. It proved possible to design the process of 18 tumors as a fast track, of which 7 as "one stop shop" (diagnosis completed in one visit). Involvement of clinical- and board leadership, massive communication efforts and commitment of physicians to reschedule their work proved decisive. After 3 and 6 months of implementation, the mean access time was 8.2 and 8.7 workdays respectively and mean throughput time was 3.4 and 3.3 workdays respectively. Throughput- and access time were considerably shortened after implementation of fast track diagnostics for 18 cancer types. The involvement of physicians in reorganizing their work and rapid responding to their needs during the implementation phase were a crucial success factor.

  16. Time-driven Activity-based Cost of Fast-Track Total Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Andreasen, Signe E; Holm, Henriette B; Jørgensen, Mira

    2017-01-01

    this between 2 departments with different logistical set-ups. METHODS: Prospective data collection was analyzed using the time-driven activity-based costing method (TDABC) on time consumed by different staff members involved in patient treatment in the perioperative period of fast-track THA and TKA in 2 Danish...... orthopedic departments with standardized fast-track settings, but different logistical set-ups. RESULTS: Length of stay was median 2 days in both departments. TDABC revealed minor differences in the perioperative settings between departments, but the total cost excluding the prosthesis was similar at USD......-track methodology, the result could be a more cost-effective pathway altogether. As THA and TKA are potentially costly procedures and the numbers are increasing in an economical limited environment, the aim of this study is to present baseline detailed economical calculations of fast-track THA and TKA and compare...

  17. Fast symplectic map tracking for the CERN Large Hadron Collider

    Directory of Open Access Journals (Sweden)

    Dan T. Abell

    2003-06-01

    Full Text Available Tracking simulations remain the essential tool for evaluating how multipolar imperfections in ring magnets restrict the domain of stable phase-space motion. In the Large Hadron Collider (LHC at CERN, particles circulate at the injection energy, when multipole errors are most significant, for more than 10^{7} turns, but systematic tracking studies are limited to a small fraction of this total time—even on modern computers. A considerable speedup is expected by replacing element-by-element tracking with the use of a symplectified one-turn map. We have applied this method to the realistic LHC lattice, version 6, and report here our results for various map orders, with special emphasis on precision and speed.

  18. The Fleet Application for Scheduling and Tracking (FAST) Management Website

    Science.gov (United States)

    Marrero-Perez, Radames J.

    2014-01-01

    The FAST application was designed to replace the paper and pen method of checking out and checking in GSA Vehicles at KSC. By innovating from a paper and pen based checkout system to a fully digital one, not only the resources wasted by printing the checkout forms have been reduced, but it also reduces significantly the time that users and fleet managers need to interact with the system as well as improving the record accuracy for each vehicle. The vehicle information is pulled from a centralized database server in the SPSDL. In an attempt to add a new feature to the FAST application, the author of this report (alongside the FAST developers) has been designing and developing the FAST Management Website. The GSA fleet managers had to rely on the FAST developers in order to add new vehicles, edit vehicles and previous transactions, or for generating vehicles reports. By providing an easy-to-use FAST Management Website portal, the GSA fleet managers are now able to easily move vehicles, edit records, and print reports.

  19. Study of hardware implementations of fast tracking algorithms

    International Nuclear Information System (INIS)

    Song, Z.; Huang, G.; Wang, D.; Lentdecker, G. De; Dong, J.; Léonard, A.; Robert, F.; Yang, Y.

    2017-01-01

    Real-time track reconstruction at high event rates is a major challenge for future experiments in high energy physics. To perform pattern-recognition and track fitting, artificial retina or Hough transformation methods have been introduced in the field which have to be implemented in FPGA firmware. In this note we report on a case study of a possible FPGA hardware implementation approach of the retina algorithm based on a Floating-Point core. Detailed measurements with this algorithm are investigated. Retina performance and capabilities of the FPGA are discussed along with perspectives for further optimization and applications.

  20. Fast neural-net based fake track rejection in the LHCb reconstruction

    CERN Document Server

    De Cian, Michel; Seyfert, Paul; Stahl, Sascha

    2017-01-01

    A neural-network based algorithm to identify fake tracks in the LHCb pattern recognition is presented. This algorithm, called ghost probability, retains more than 99 % of well reconstructed tracks while reducing the number of fake tracks by 60 %. It is fast enough to fit into the CPU time budget of the software trigger farm and thus reduces the combinatorics of the decay reconstructions, as well as the number of tracks that need to be processed by the particle identification algorithms. As a result, it strongly contributes to the achievement of having the same reconstruction online and offline in the LHCb experiment in Run II of the LHC.

  1. Fast track multi-discipline treatment (FTMDT trial versus conventional treatment in colorectal cancer--the design of a prospective randomized controlled study

    Directory of Open Access Journals (Sweden)

    Zhou Jiao-Jiao

    2011-11-01

    Full Text Available Abstract Background Laparoscopy-assisted surgery, fast-track perioperative treatment are both increasingly used in colorectal cancer treatment, for their short-time benefits of enhanced recovery and short hospital stays. However, the benefits of the integration of the Laparoscopy-assisted surgery, fast-track perioperative treatment, and even with the Xelox chemotherapy, are still unknown. In this study, the three treatments integration is defined as "Fast Track Multi-Discipline Treatment Model" for colorectal cancer and this model extends the benefits to the whole treatment process of colorectal cancer. The main purpose of the study is to explore the feasibility of "Fast Track Multi-Discipline Treatment" model in treatment of colorectal cancer. Methods The trial is a prospective randomized controlled study with 2 × 2 balanced factorial design. Patients eligible for the study will be randomized to 4 groups: (I Laparoscopic surgery with fast track perioperative treatment and Xelox chemotherapy; (II Open surgery with fast track perioperative treatment and Xelox chemotherapy; (III Laparoscopic surgery with conventional perioperative treatment and mFolfox6 chemotherapy; (IV Open surgery with conventional perioperative treatment and mFolfox6 chemotherapy. The primary endpoint of this study is the hospital stays. The secondary endpoints are the quality of life, chemotherapy related adverse events, surgical complications and hospitalization costs. Totally, 340 patients will be enrolled with 85 patients in each group. Conclusions The study initiates a new treatment model "Fast Track Multi-Discipline Treatment" for colorectal cancer, and will provide feasibility evidence on the new model "Fast Track Multi-Discipline Treatment" for patients with colorectal cancer. Trial registration ClinicalTrials.gov: NCT01080547

  2. An Improved Fast Compressive Tracking Algorithm Based on Online Random Forest Classifier

    Directory of Open Access Journals (Sweden)

    Xiong Jintao

    2016-01-01

    Full Text Available The fast compressive tracking (FCT algorithm is a simple and efficient algorithm, which is proposed in recent years. But, it is difficult to deal with the factors such as occlusion, appearance changes, pose variation, etc in processing. The reasons are that, Firstly, even if the naive Bayes classifier is fast in training, it is not robust concerning the noise. Secondly, the parameters are required to vary with the unique environment for accurate tracking. In this paper, we propose an improved fast compressive tracking algorithm based on online random forest (FCT-ORF for robust visual tracking. Firstly, we combine ideas with the adaptive compressive sensing theory regarding the weighted random projection to exploit both local and discriminative information of the object. The second reason is the online random forest classifier for online tracking which is demonstrated with more robust to the noise adaptively and high computational efficiency. The experimental results show that the algorithm we have proposed has a better performance in the field of occlusion, appearance changes, and pose variation than the fast compressive tracking algorithm’s contribution.

  3. Auger processes in tracks of fast multicharged ions

    International Nuclear Information System (INIS)

    Katin, V.V.; Martynenko, Yu.V.; Yavlinskij, Yu.N.

    1992-01-01

    The fast multicharged ion spends about 40% of energy losses on vacancy creation in the inner electron shells. This energy is transferred to the kinetic energy of electrons due to the cascade of Auger processes during ∼ 10 -14 s whereas the primary excited electrons receive the energy in ∼10 -16 s. (author)

  4. 4D tracking with ultra-fast silicon detectors

    Science.gov (United States)

    F-W Sadrozinski, Hartmut; Seiden, Abraham; Cartiglia, Nicolò

    2018-02-01

    The evolution of particle detectors has always pushed the technological limit in order to provide enabling technologies to researchers in all fields of science. One archetypal example is the evolution of silicon detectors, from a system with a few channels 30 years ago, to the tens of millions of independent pixels currently used to track charged particles in all major particle physics experiments. Nowadays, silicon detectors are ubiquitous not only in research laboratories but in almost every high-tech apparatus, from portable phones to hospitals. In this contribution, we present a new direction in the evolution of silicon detectors for charge particle tracking, namely the inclusion of very accurate timing information. This enhancement of the present silicon detector paradigm is enabled by the inclusion of controlled low gain in the detector response, therefore increasing the detector output signal sufficiently to make timing measurement possible. After providing a short overview of the advantage of this new technology, we present the necessary conditions that need to be met for both sensor and readout electronics in order to achieve 4D tracking. In the last section, we present the experimental results, demonstrating the validity of our research path.

  5. Note: Fast neutron efficiency in CR-39 nuclear track detectors

    Energy Technology Data Exchange (ETDEWEB)

    Cavallaro, S. [Dipartimento di Fisica ed Astronomia,Università di Catania, Via S. Sofia 44, 95123 Catania, Italy and INFN-LNS, Via S. Sofia 42, 95123 Catania (Italy)

    2015-03-15

    CR-39 samples are commonly employed for fast neutron detection in fusion reactors and in inertial confinement fusion experiments. The literature reported efficiencies are strongly depending on experimental conditions and, in some cases, highly dispersed. The present note analyses the dependence of efficiency as a function of various parameters and experimental conditions in both the radiator-assisted and the stand-alone CR-39 configurations. Comparisons of literature experimental data with Monte Carlo calculations and optimized efficiency values are shown and discussed.

  6. Fast pattern recognition with the ATLAS L1 track trigger for the HL-LHC

    CERN Document Server

    Martensson, Mikael; The ATLAS collaboration

    2016-01-01

    A fast hardware based track trigger for high luminosity upgrade of the Large Hadron Collider (HL- LHC) is being developed in ATLAS. The goal is to achieve trigger levels in high pileup collisions that are similar or even better than those achieved at low pile-up running of LHC by adding tracking information to the ATLAS hardware trigger which is currently based on information from calorimeters and muon trigger chambers only. Two methods for fast pattern recognition are investigated. The first is based on matching tracker hits to pattern banks of simulated high momentum tracks which are stored in a custom made Associative Memory (AM) ASIC. The second is based on the Hough transform where detector hits are transformed into 2D Hough space with one variable related to track pt and one to track direction. Hits found by pattern recognition will be sent to a track fitting step which calculates the track parameters . The speed and precision of the track fitting depends on the quality of the hits selected by the patte...

  7. Evidence-based surgical care and the evolution of fast-track surgery

    DEFF Research Database (Denmark)

    Kehlet, H.; Wilmore, D.W.

    2008-01-01

    , randomized studies, and meta-analyses, the concept of the "fast-track methodology" has uniformly provided a major enhancement in recovery leading to decreased hospital stay and with an apparent reduction in medical morbidity but unaltered "surgery-specific" morbidity in a variety of procedures. However......BACKGROUND: Optimization of postoperative outcome requires the application of evidence-based principles of care carefully integrated into a multimodal rehabilitation program. OBJECTIVE: To assess, synthesize, and discuss implementation of "fast-track" recovery programs. DATA SOURCES: Medline MBASE...... (January 1966-May 2007) and the Cochrane library (January 1966-May 2007) were searched using the following keywords: fast-track, enhanced recovery, accelerated rehabilitation, and multimodal and perioperative care. In addition, the synthesis on the many specific interventions and organizational...

  8. Postoperative morbidity after fast-track laparoscopic resection of rectal cancer

    DEFF Research Database (Denmark)

    Stottmeier, S; Harling, H; Wille-Jørgensen, Peer Anders

    2012-01-01

    Aim: Analysis was carried out of the nature and chronological order of early complications after fast-track laparoscopic rectal surgery with a view to optimize the short-time outcome of rectal cancer surgery. Method: 102 consecutive patients who underwent elective fast-track laparoscopic rectal......: Postoperative morbidity remains a significant problem even in the fast-track era, even in experienced surgical hands. Our results suggest that besides improvement of surgical technique further improvement of outcome lies in early recognition and proper treatment of complications and the perioperative...... cancer surgery were analysed prospectively from the Danish Colorectal Cancer Database supplemented by data from the medical records. We studied in detail the nature and chronological order of postoperative morbidity and reason for prolonged stay (>5 days). Results: Twenty-five patients (25 per cent) had...

  9. Trevino Project: a fast-track approach for a small construction project

    International Nuclear Information System (INIS)

    Schick, C.J.; Lynn, N.S.

    1982-01-01

    The approach to a construction project can vary according to the size, location, and degree of difficulty associated with the project. This paper deals with one approach that can be taken to a small construction project, the fast-track approach. A small construction project can be defined as a project having less than $20 million capital cost or a project with a low degree of difficulty. This approach is very applicable to in-situ leaching uranium projects, small precious metal operations, etc. The approach to the small project is that of fast-tracking the project in order to minimize the time over which capital expenditure occurs and also to reduce the indirect costs of field expense, construction supplies, construction equipment, etc. In order to fast-track a project it is necessary to do a very precise job on the preliminary phases of the project such as preliminary engineering, plant site location, environmental permits, etc. 2 figures, 2 tables

  10. Comparison of remifentanil and low-dose fentanyl for fast-track cardiac anesthesia

    DEFF Research Database (Denmark)

    Khanykin, Boris; Siddiqi, Rizwan; Jensen, Per F

    2013-01-01

    BACKGROUND: Different anesthetic techniques have been used for fast tracking in cardiac anesthesia. Remifentanil, with its unique pharmacokinetic profile, could be an ideal drug for fast tracking. Possible limitations of remifentanil are rapid onset of postoperative pain after discontinuation...... of the drug infusion, which may increase the risk of an ischemic event. We conducted this randomized study to compare the efficacy of remifentanil versus low doses of fentanyl in fast-track cardiac anesthesia. It has been hypothesized that remifentanil would provide a safe anesthesia with no impact...... anesthesia. The study was designed as a prospective randomized study. The primary outcomes were changes in the cardiac index and creatine kinase MB fraction (CKMB), extubation times, mobilization times, and lengths of stay in the intensive care unit (ICU) and the hospital. Frequency of myocardial infarction...

  11. Design of a Hardware Track Finder (Fast Tracker) for the ATLAS Trigger

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00010976; Albicocco, P.; Alison, J.; Ancu, L.S.; Anderson, J.; Andari, N.; Andreani, A.; Andreazza, A.; Annovi, A.; Antonelli, M.; Asbah, N.; Atkinson, M.; Baines, J.; Barberio, E.; Beccherle, R.; Beretta, M.; Bertolucci, F.; Biesuz, N.V.; Blair, R.; Bogdan, M.; Boveia, A.; Britzger, D.; Bryant, P.; Burghgrave, B.; Calderini, G.; Camplani, A.; Cavasinni, V.; Chakraborty, D.; Chang, P.; Cheng, Y.; Citraro, S.; Citterio, M.; Crescioli, F.; Dawe, N.; Dell'Orso, M.; Donati, S.; Dondero, P.; Drake, G.; Gadomski, S.; Gatta, M.; Gentsos, C.; Giannetti, P.; Gkaitatzis, S.; Gramling, J.; Howarth, J.W.; Iizawa, T.; Ilic, N.; Jiang, Z.; Kaji, T.; Kasten, M.; Kawaguchi, Y.; Kim, Y.K.; Kimura, N.; Klimkovich, T.; Kolb, M.; Kordas, K.; Krizka, K.; Kubota, T.; Lanza, A.; Li, H.L.; Liberali, V.; Lisovyi, M.; Liu, L.; Love, J.; Luciano, P.; Luongo, C.; Magalotti, D.; Maznas, I.; Meroni, C.; Mitani, T.; Nasimi, H.; Negri, A.; Neroutsos, P.; Neubauer, M.; Nikolaidis, S.; Okumura, Y.; Pandini, C.; Petridou, C.; Piendibene, M.; Proudfoot, J.; Rados, P.; Roda, C.; Rossi, E.; Sakurai, Y.; Sampsonidis, D.; Saxon, J.; Schmitt, S.; Schoening, A.; Shochet, M.; Shojaii, S.; Soltveit, H.; Sotiropoulou, C.L.; Stabile, A.; Swiatlowski, M.; Tang, F.; Taylor, P.T.; Testa, M.; Tompkins, L.; Vercesi, V.; Volpi, G.; Wang, R.; Watari, R.; Webster, J.; Wu, X.; Yorita, K.; Yurkewicz, A.; Zeng, J.C.; Zhang, J.; Zou, R.

    2016-01-01

    The use of tracking information at the trigger level in the LHC Run II period is crucial for the trigger an data acquisition (TDAQ) system and will be even more so as contemporary collisions that occur at every bunch crossing will increase in Run III. The Fast TracKer (FTK) is part of the ATLAS trigger upgrade project; it is a hardware processor that will provide every Level-1 accepted event (100 kHz) and within 100$\\mu$s, full tracking information for tracks with momentum as low as 1 GeV. Providing fast, extensive access to tracking information, with resolution comparable to the offline reconstruction, FTK will help in precise detection of the primary and secondary vertices to ensure robust selections and improve the trigger performance.

  12. Restoring integrity—A grounded theory of coping with a fast track surgery programme

    Directory of Open Access Journals (Sweden)

    Lene Bastrup Jørgensen

    2016-01-01

    Full Text Available Aims and objectives: The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Background: Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. Design: The study design used classical grounded theory. Methods: The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Results: Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients’ main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. Conclusion: In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme.

  13. Restoring integrity—A grounded theory of coping with a fast track surgery programme

    Science.gov (United States)

    Jørgensen, Lene Bastrup; Fridlund, Bengt

    2016-01-01

    Aims and objectives The aim of this study was to generate a theory conceptualizing and explaining behavioural processes involved in coping in order to identify the predominant coping types and coping type-specific features. Background Patients undergoing fast track procedures do not experience a higher risk of complications, readmission, or mortality. However, such programmes presuppose an increasing degree of patient involvement, placing high educational, physical, and mental demands on the patients. There is a lack of knowledge about how patients understand and cope with fast track programmes. Design The study design used classical grounded theory. Methods The study used a multimodal approach with qualitative and quantitative data sets from 14 patients. Results Four predominant types of coping, with distinct physiological, cognitive, affective, and psychosocial features, existed among patients going through a fast track total hip replacement programme. These patients’ main concern was to restore their physical and psychosocial integrity, which had been compromised by reduced function and mobility in daily life. To restore integrity they economized their mental resources, while striving to fulfil the expectations of the fast track programme. This goal was achieved by being mentally proactive and physically active. Three out of the four predominant types of coping matched the expectations expressed in the fast track programme. The non-matching behaviour was seen among the most nervous patients, who claimed the right to diverge from the programme. Conclusion In theory, four predominant types of coping with distinct physiological, cognitive, affective, and psychosocial features occur among patients going through a fast track total hip arthroplasty programme. PMID:26751199

  14. Multiphase Interface Tracking with Fast Semi-Lagrangian Contouring.

    Science.gov (United States)

    Li, Xiaosheng; He, Xiaowei; Liu, Xuehui; Zhang, Jian J; Liu, Baoquan; Wu, Enhua

    2016-08-01

    We propose a semi-Lagrangian method for multiphase interface tracking. In contrast to previous methods, our method maintains an explicit polygonal mesh, which is reconstructed from an unsigned distance function and an indicator function, to track the interface of arbitrary number of phases. The surface mesh is reconstructed at each step using an efficient multiphase polygonization procedure with precomputed stencils while the distance and indicator function are updated with an accurate semi-Lagrangian path tracing from the meshes of the last step. Furthermore, we provide an adaptive data structure, multiphase distance tree, to accelerate the updating of both the distance function and the indicator function. In addition, the adaptive structure also enables us to contour the distance tree accurately with simple bisection techniques. The major advantage of our method is that it can easily handle topological changes without ambiguities and preserve both the sharp features and the volume well. We will evaluate its efficiency, accuracy and robustness in the results part with several examples.

  15. Interactive and automated systems for nuclear track measurements with applications to fast neutron dosimetry

    International Nuclear Information System (INIS)

    Roberts, J.H.; Gold, R.; McNeece, J.P.; Preston, C.C.; Ruddy, F.H.

    1983-12-01

    Interactive and automatic track measuring systems have been developed primarily for fast neutron dosimetry in and around reactors. The interactive system is used for proton recoil measurements in nuclear research emulsions and the automatic systems for counting fission fragment tracks in Muscovite mica. The status of these systems, along with illustrative applications, are presented, particularly with regard to their relationship to neutron personnel dosimetry. 16 references, 12 figures

  16. Effect of an Emergency Department Fast Track on Press-Ganey Patient Satisfaction Scores

    Directory of Open Access Journals (Sweden)

    Hwang, Calvin E.

    2014-12-01

    Full Text Available Introduction: Mandated patient surveys have become an integral part of Medicare remuneration, putting hundreds of millions of dollars in funding at risk. The Centers for Medicare & Medicaid Services (CMS recently announced a patient experience survey for the emergency department (ED. Development of an ED Fast Track, where lower acuity patients are rapidly seen, has been shown to improve many of the metrics that CMS examines. This is the first study examining if ED Fast Track implementation affects Press-Ganey scores of patient satisfaction. Methods: We analyzed returned Press-Ganey questionnaires from all ESI 4 and 5 patients seen 11AM - 11PM, August-December 2011 (pre-fast track, and during the identical hours of fast track, August-December 2012. Raw ordinal scores were converted to continuous scores for paired student t-test analysis. We calculated an odds ratio with 100% satisfaction considered a positive response. Results: An academic ED with 52,000 annual visits had 140 pre-fast track and 85 fast track respondents. Implementation of a fast track significantly increased patient satisfaction with the following: wait times (68% satisfaction to 88%, OR 4.13, 95% CI [2.32-7.33], doctor courtesy (90% to 95%, OR 1.97, 95% CI [1.04-3.73], nurse courtesy (87% to 95%, OR 2.75, 95% CI [1.46-5.15], pain control (79% to 87%, OR 2.13, 95% CI [1.16-3.92], likelihood to recommend (81% to 90%, OR 2.62, 95% CI [1.42-4.83], staff caring (82% to 91%, OR 2.82, 95% CI [1.54-5.19], and staying informed about delays (66% to 83%, OR 3.00, 95% CI [1.65-5.44]. Conclusion: Implementation of an ED Fast Track more than doubled the odds of significant improvements in Press-Ganey patient satisfaction metrics and may play an important role in improving ED performance on CMS benchmarks. [West J Emerg Med. 2015;16(1:34–38.

  17. Pathogenesis of morbidity after fast-track laparoscopic colonic cancer surgery

    DEFF Research Database (Denmark)

    Stottmeier, S; Harling, H; Wille-Jørgensen, P

    2011-01-01

    AIM: Analysis of the nature and time course of early complications after laparoscopic colonic surgery is required to allow rational strategies for their prevention and management. METHOD: One hundred and four consecutive patients who underwent elective fast-track laparoscopic colonic cancer surgery...... occurred in 14 patients, of which four were preceded by medical complications. Three patients had only medical complications. Median length of stay was 3 days (range 1-44). CONCLUSION: Further improvement of outcomes after fast-track laparoscopic colonic surgery might be obtained by improved surgical...

  18. Convalescence after colonic resection with fast-track versus conventional care

    DEFF Research Database (Denmark)

    Hjort Jakobsen, D; Sonne, E; Basse, L

    2004-01-01

    BACKGROUND: Multi-modal rehabilitation programmes may improve early postoperative body composition, pulmonary function, exercise capacity, and reduce hospital stay. So far, no data are available on convalescence after discharge. AIM: The objectives were to compare convalescence data (fatigue, sleep...... vs. 8 days in the fast-track vs. conventional care group, respectively (p sleep were increased in the conventional care group when compared with the fast-track group (p ... results in earlier resumption of normal activities with reduced fatigue and need for sleep postoperatively compared to conventional care, and without increased need for nursing care or visits to general practitioners. However, readmissions may occur more frequently....

  19. A fast fiducial marker tracking model for fully automatic alignment in electron tomography

    KAUST Repository

    Han, Renmin; Zhang, Fa; Gao, Xin

    2017-01-01

    Automatic alignment, especially fiducial marker-based alignment, has become increasingly important due to the high demand of subtomogram averaging and the rapid development of large-field electron microscopy. Among the alignment steps, fiducial marker tracking is a crucial one that determines the quality of the final alignment. Yet, it is still a challenging problem to track the fiducial markers accurately and effectively in a fully automatic manner.In this paper, we propose a robust and efficient scheme for fiducial marker tracking. Firstly, we theoretically prove the upper bound of the transformation deviation of aligning the positions of fiducial markers on two micrographs by affine transformation. Secondly, we design an automatic algorithm based on the Gaussian mixture model to accelerate the procedure of fiducial marker tracking. Thirdly, we propose a divide-and-conquer strategy against lens distortions to ensure the reliability of our scheme. To our knowledge, this is the first attempt that theoretically relates the projection model with the tracking model. The real-world experimental results further support our theoretical bound and demonstrate the effectiveness of our algorithm. This work facilitates the fully automatic tracking for datasets with a massive number of fiducial markers.The C/C ++ source code that implements the fast fiducial marker tracking is available at https://github.com/icthrm/gmm-marker-tracking. Markerauto 1.6 version or later (also integrated in the AuTom platform at http://ear.ict.ac.cn/) offers a complete implementation for fast alignment, in which fast fiducial marker tracking is available by the

  20. A fast fiducial marker tracking model for fully automatic alignment in electron tomography

    KAUST Repository

    Han, Renmin

    2017-10-20

    Automatic alignment, especially fiducial marker-based alignment, has become increasingly important due to the high demand of subtomogram averaging and the rapid development of large-field electron microscopy. Among the alignment steps, fiducial marker tracking is a crucial one that determines the quality of the final alignment. Yet, it is still a challenging problem to track the fiducial markers accurately and effectively in a fully automatic manner.In this paper, we propose a robust and efficient scheme for fiducial marker tracking. Firstly, we theoretically prove the upper bound of the transformation deviation of aligning the positions of fiducial markers on two micrographs by affine transformation. Secondly, we design an automatic algorithm based on the Gaussian mixture model to accelerate the procedure of fiducial marker tracking. Thirdly, we propose a divide-and-conquer strategy against lens distortions to ensure the reliability of our scheme. To our knowledge, this is the first attempt that theoretically relates the projection model with the tracking model. The real-world experimental results further support our theoretical bound and demonstrate the effectiveness of our algorithm. This work facilitates the fully automatic tracking for datasets with a massive number of fiducial markers.The C/C ++ source code that implements the fast fiducial marker tracking is available at https://github.com/icthrm/gmm-marker-tracking. Markerauto 1.6 version or later (also integrated in the AuTom platform at http://ear.ict.ac.cn/) offers a complete implementation for fast alignment, in which fast fiducial marker tracking is available by the

  1. A fast track trigger processor for the OPAL detector at LEP

    International Nuclear Information System (INIS)

    Carter, A.A.; Jaroslawski, S.; Wagner, A.

    1986-01-01

    A fast hardware track trigger processor being built for the OPAL experiment is described. The processor will analyse data from the central drift chambers of OPAL to determine whether any tracks come from the interaction region, and thereby eliminate background events. The processor will find tracks over a large angular range, vertical strokecos thetavertical stroke < or approx. 0.95. The design of the processor is described, together with a brief account of its hardware implementation for OPAL. The results of feasibility studies are also presented. (orig.)

  2. L1Track: A fast Level 1 track trigger for the ATLAS high luminosity upgrade

    International Nuclear Information System (INIS)

    Cerri, Alessandro

    2016-01-01

    With the planned high-luminosity upgrade of the LHC (HL-LHC), the ATLAS detector will see its collision rate increase by approximately a factor of 5 with respect to the current LHC operation. The earliest hardware-based ATLAS trigger stage (“Level 1”) will have to provide a higher rejection factor in a more difficult environment: a new improved Level 1 trigger architecture is under study, which includes the possibility of extracting with low latency and high accuracy tracking information in time for the decision taking process. In this context, the feasibility of potential approaches aimed at providing low-latency high-quality tracking at Level 1 is discussed. - Highlights: • HL-LH requires highly performing event selection. • ATLAS is studying the implementation of tracking at the very first trigger level. • Low latency and high-quality seem to be achievable with dedicated hardware and adequate detector readout architecture.

  3. Fast motion-including dose error reconstruction for VMAT with and without MLC tracking

    DEFF Research Database (Denmark)

    Ravkilde, Thomas; Keall, Paul J.; Grau, Cai

    2014-01-01

    of the algorithm for reconstruction of dose and motion-induced dose errors throughout the tracking and non-tracking beam deliveries was quantified. Doses were reconstructed with a mean dose difference relative to the measurements of -0.5% (5.5% standard deviation) for cumulative dose. More importantly, the root...... validate a simple model for fast motion-including dose error reconstruction applicable to intrafractional QA of MLC tracking treatments of moving targets. MLC tracking experiments were performed on a standard linear accelerator with prototype MLC tracking software guided by an electromagnetic transponder......-mean-square deviation between reconstructed and measured motion-induced 3%/3 mm γ failure rates (dose error) was 2.6%. The mean computation time for each calculation of dose and dose error was 295 ms. The motion-including dose reconstruction allows accurate temporal and spatial pinpointing of errors in absorbed dose...

  4. The ATLAS Fast Tracker and Tracking at the High-Luminosity LHC

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00236423; The ATLAS collaboration

    2016-01-01

    The LHC’s increase in centre of mass energy and luminosity in 2015 makes controlling trigger rates with high efficiency challenging. The ATLAS Fast TracKer (FTK) is a hardware processor built to reconstruct tracks at a rate of up to 100 kHz and provide them to the high level trigger. The FTK reconstructs tracks by matching incoming detector hits with pre-defined track patterns stored in associative memory on custom ASICs. Inner detector hits are fit to these track patterns using modern FPGAs. These procedings describe the electronics system used for the FTK’s massive parallelization. An overview of the installation, commissioning and running of the system is given. The ATLAS upgrades planned to enable tracking at the High Luminosity LHC are also discussed.

  5. Fast Flux Test Facility Asbestos Location Tracking Program

    International Nuclear Information System (INIS)

    REYNOLDS, J.A.

    1999-01-01

    Procedure Number HNF-PRO-408, revision 0, paragraph 1.0, ''Purpose,'' and paragraph 2.0, ''Requirements for Facility Management of Asbestos,'' relate building inspection and requirements for documentation of existing asbestos-containing building material (ACBM) per each building assessment. This documentation shall be available to all personnel (including contractor personnel) entering the facility at their request. Corrective action was required by 400 Area Integrated Annual Appraisal/Audit for Fiscal Year 1992 (IAA-92-0007) to provide this notification documentation. No formal method had been developed to communicate the location and nature of ACBM to maintenance personnel in the Fast Flux Test Facility (FFTF) 400 Area. The scope of this Data Package Document is to locate and evaluate any ACBM found at FFTF which constitutes a baseline. This includes all buildings within the protected area. These findings are compiled from earlier reports, numerous work packages and engineering evaluations of employee findings

  6. Fast Neutron Dosimetry Using CR-39 Nuclear Track Detector

    International Nuclear Information System (INIS)

    ZAKI, M.; ABDEL-NABY, A.; MORSY, A.

    2010-01-01

    Measurement of the neutron dose in and around the neutron sources is important for the purpose of personnel and environmental neutron dosimetry. In the present study, a method for the measurement of neutron dose using the UV-Vis spectra of CR-39 plastic track detector was investigated. A set of CR-39 plastic detectors was exposed to 252 Cf neutron source, which had the yield of 0.68x10 8 /s, and neutron dose equivalent rate 1m apart from the source is equal to 3.8 mrem/h. The samples were etched for 10 h in 6.25 N NaOH at 70 o C. The absorbance of the etched samples was measured using UV-visible spectrophotometer as a function of neutron dose. It was observed that there was a linear relationship between the optical absorption of these detectors and neutron dose. This means that the exposure dose of neutron can be determined by knowing the optical absorption of the sample. These results were compared with previous study. It was found that there was a matching and good agreement with their investigations.

  7. New Medical-School Programs Put Students on a Fast Track to the White Coat

    Science.gov (United States)

    Mangan, Katherine

    2009-01-01

    California's lieutenant governor has proposed a fast-track medical school that would shave three years off the training needed to become a physician. It is not the first time such an idea has been offered. The proposal, for a hoped-for medical school at the University of California at Merced, struck some medical educators as both unrealistic and…

  8. Fast track surgery at the University Teaching Hospital of Kigali: a ...

    African Journals Online (AJOL)

    Background: Fast Track Surgery is synonymous with Enhanced Recovery after Surgery. It was started in the 1990's initially for colorectal surgery, but later became applicable to other aspects of surgery. Its core elements include epidural or regional anaesthesia, perioperative fluid management, minimally invasive surgical ...

  9. A process model for design team communication within fast-track building projects using project websites

    NARCIS (Netherlands)

    Otter, den A.F.H.J.; Reymen, I.M.M.J.

    2008-01-01

    The factor time within building projects is on high pressure because of the increasing need for faster delivery of buildings. Within fast track, complex building projects the design process is an important key. Through case analyses offart-hack design processes it became obvious that process and

  10. SMEs in Energy: Are they the parallel fast track for electrification of Africa?

    Energy Technology Data Exchange (ETDEWEB)

    Abdel-Rahman, Mohamed

    2010-09-15

    The African continent is suffering from a chronic energy shortage that hiders its development. The conventional wisdom is to put the Mega projects under focus. However, a parallel fast track for the energy as an SME business may bring faster results to the continent. To that end, this paper presents proposed steps to promote the concept within the continent.

  11. The Effects of the Fast Track Preventive Intervention on the Development of Conduct Disorder across Childhood

    Science.gov (United States)

    Child Development, 2011

    2011-01-01

    The impact of the Fast Track intervention on externalizing disorders across childhood was examined. Eight hundred-ninety-one early-starting children (69% male; 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention addressed parent behavior-management, child social…

  12. Design of a 300-Watt Isolated Power Supply for Ultra-Fast Tracking Converters

    DEFF Research Database (Denmark)

    Nguyen-Duy, Khiem; Ouyang, Ziwei; Petersen, Lars Press

    2015-01-01

    This paper presents the design of a medium-powerrating isolated power supply for ultra-fast tracking converters and MOS-gate driver circuits in medium and high voltage applications. The key feature of the design is its very low circuit input-to-output parasitic capacitance, which maximizes its...

  13. Hardware realization of a fast neural network algorithm for real-time tracking in HEP experiments

    International Nuclear Information System (INIS)

    Leimgruber, F.R.; Pavlopoulos, P.; Steinacher, M.; Tauscher, L.; Vlachos, S.; Wendler, H.

    1995-01-01

    A fast pattern recognition system for HEP experiments, based on artificial neural network algorithms (ANN), has been realized with standard electronics. The multiplicity and location of tracks in an event are determined in less than 75 ns. Hardware modules of this first level trigger were extensively tested for performance and reliability with data from the CPLEAR experiment. (orig.)

  14. Families' Divided: The place of the Family in Zimbabwe's Fast Track ...

    African Journals Online (AJOL)

    The political history and the political economy continue to mould the quality of life for most families in significant ways. Human beings have always lived in families from the beginning of time. The family is a pillar of society as it influences the way society is structured, organized and functions, yet the Fast Track Land Reform ...

  15. "Joined up" Thinking? Unsupported "Fast-Track" Transitions in the Context of Parental Substance Use

    Science.gov (United States)

    Wilson, Sarah; Cunningham-Burley, Sarah; Bancroft, Angus; Backett-Milburn, Kathryn

    2008-01-01

    Recent policy responses to the risks entailed in "fast-track" school-work transitions have targeted careleavers and young people identified as "not in education, employment or training" (NEET). However, this approach has been criticised as diverting attention away from the fragile circumstances of others who may receive little…

  16. Subacute pain and function after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Andersen, Lasse Østergaard; Gaarn-Larsen, L; Kristensen, B B

    2009-01-01

    In a well-defined fast-track setup for total hip and knee arthroplasty, with a multimodal analgesic regimen consisting of intra-operative local anaesthetic infiltration and oral celecoxib, gabapentin and paracetamol for 6 days postoperatively, we conducted a prospective, consecutive, observationa...

  17. Role of patient characteristics for fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C.; Jacobsen, M; Søballe, Kjeld

    2013-01-01

    BACKGROUND: /st>Patient age and comorbidity have been found to increase the length of hospital stay (LOS), readmissions, and mortality after surgery, including in elective primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Whether the same applies in fast-track THA and TKA...

  18. When is it optimal to delegate: the theory of fast-track authority

    Czech Academy of Sciences Publication Activity Database

    Celik, Levent; Karabay, Bilgehan; McLaren, J.

    2015-01-01

    Roč. 7, č. 3 (2015), s. 347-389 ISSN 1945-7669 R&D Projects: GA ČR(CZ) GAP402/12/0666 Institutional support: PRVOUK-P23 Keywords : fast-track authority * free trade * protectionist rents Subject RIV: AH - Economics Impact factor: 1.359, year: 2015

  19. Evaluation of a fast-track programme for patients undergoing liver resection

    DEFF Research Database (Denmark)

    Schultz, Nicolai A.; Larsen, Peter Nørgaard; Klarskov, Birthe Michaelsen

    2013-01-01

    BACKGROUND: Recent developments in perioperative pathophysiology and care have documented evidence-based, multimodal rehabilitation (fast-track) to hasten recovery and to decrease morbidity and hospital stay for several major surgical procedures. The aim of this study was to investigate the effect...

  20. Time course and reasons for 90-day mortality in fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C C; Kehlet, H

    2017-01-01

    : Prospective observational study in 13,775 consecutive THA/TKAs with similar fast-track protocols and a median length of stay of 2 days. Complete 90-days follow-up through national registries, followed by review of medical records and death certificates. Relation between mortality and surgically induced organ...

  1. Fasting: Molecular Mechanisms and Clinical Applications

    OpenAIRE

    Longo, Valter D.; Mattson, Mark P.

    2014-01-01

    Fasting has been practiced for millennia, but only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps...

  2. Fasting: molecular mechanisms and clinical applications.

    Science.gov (United States)

    Longo, Valter D; Mattson, Mark P

    2014-02-04

    Fasting has been practiced for millennia, but, only recently, studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism, and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity, in part, by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease, and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma, and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Fasting: Molecular Mechanisms and Clinical Applications

    Science.gov (United States)

    Longo, Valter D.; Mattson, Mark P.

    2014-01-01

    Fasting has been practiced for millennia, but only recently studies have shed light on its role in adaptive cellular responses that reduce oxidative damage and inflammation, optimize energy metabolism and bolster cellular protection. In lower eukaryotes, chronic fasting extends longevity in part by reprogramming metabolic and stress resistance pathways. In rodents intermittent or periodic fasting protects against diabetes, cancers, heart disease and neurodegeneration, while in humans it helps reduce obesity, hypertension, asthma and rheumatoid arthritis. Thus, fasting has the potential to delay aging and help prevent and treat diseases while minimizing the side effects caused by chronic dietary interventions. PMID:24440038

  4. Fast-track protocols in devascularization for cirrhotic portal hypertension

    Directory of Open Access Journals (Sweden)

    Yang Fei

    2015-06-01

    Full Text Available Summary Introduction/objective: fast-tract surgery (FTS has been rapidly embraced by surgeons as a mechanism for improving patient care and driving down complications and costs. The aim of this study was to determine if any improvement in outcomes occurred after FTS protocol for selective double portazygous disconnection with preserving vagus (SDPDPV compared with non-FTS postoperative care. Methods: patients eligible for SDPDPV in the period January 2012-April 2014 were randomly selected for the FTS group or non-FTS group. A designed protocol was used in the FTS group with emphasis on an interdisciplinary approach. The non-FTS group was treated using previously established standard procedures. The number of postoperative complications, time of functional recovery and duration of hospital stay were recorded. Results: patients in the FTS group (n=59 and non-FTS group (n=57 did not differ in terms of preoperative data and operative details (p>0.05. The FTS procedure led to significantly better control and faster restoration of gastrointestinal functions, food tolerance, rehabilitation and hospital discharge (p<0.05. Postoperative complications, including nausea/vomiting, severe ascites, wound infection, urinary tract infection and pulmonary infection were all significantly lower in the FTS group (p<0.05. According to the postoperative morbidity classification used by Clavien, overall complications and grade I complications were both significantly lower in the FTS group compared with the non-FTS group (p<0.05. Conclusion: adopting the FTS protocol helped to recover gastrointestinal functions, to reduce frequency of postoperative complications and to reduce hospital stay. The FTS strategy is safe and effective in improving postoperative outcomes.

  5. Fast pattern recognition with the ATLAS L1Track trigger for HL-LHC

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00530554; The ATLAS collaboration

    2017-01-01

    A fast hardware based track trigger is being developed in ATLAS for the High Luminosity upgrade of the Large Hadron Collider. The goal is to achieve trigger levels in the high pile-up conditions of the High Luminosity Large Hadron Collider that are similar or better than those achieved at low pile-up conditions by adding tracking information to the ATLAS hardware trigger. A method for fast pattern recognition using the Hough transform is investigated. In this method, detector hits are mapped onto a 2D parameter space with one parameter related to the transverse momentum and one to the initial track direction. The performance of the Hough transform is studied at different pile-up values. It is also compared, using full event simulation of events with average pile-up of 200, with a method based on matching detector hits to pattern banks of simulated tracks stored in a custom made Associative Memory ASICs. The pattern recognition is followed by a track fitting step which calculates the track parameters. The spee...

  6. Hardware-based Tracking at Trigger Level for ATLAS: The Fast TracKer (FTK) Project

    CERN Document Server

    Gramling, Johanna; The ATLAS collaboration

    2015-01-01

    Physics collisions at 13 TeV are expected at the LHC with an average of 40-50 proton-proton collisions per bunch crossing. Tracking at trigger level is an essential tool to control the rate in high-pileup conditions while maintaining a good efficiency for relevant physics processes. The Fast TracKer (FTK) is an integral part of the trigger upgrade for the ATLAS detector. For every event passing the Level 1 trigger (at a maximum rate of 100 kHz) the FTK receives data from the 80 million channels of the silicon detectors, providing tracking information to the High Level Trigger in order to ensure a selection robust against pile-up. The FTK performs a hardware- based track reconstruction, using associative memory (AM) that is based on the use of a custom chip, designed to perform pattern matching at very high speed. It finds track candidates at low resolution (roads) that seed a full-resolution track fitting done by FPGAs. Narrow roads permit a fast track fitting but need many patterns stored in the AM to ensure...

  7. Hardware-based tracking at trigger level for ATLAS: The Fast Tracker (FTK) Project

    CERN Document Server

    Gramling, Johanna; The ATLAS collaboration

    2015-01-01

    Physics collisions at 13 TeV are expected at the LHC with an average of 40-50 proton-proton collisions per bunch crossing. Tracking at trigger level is an essential tool to control the rate in high-pileup conditions while maintaining a good efficiency for relevant physics processes. The Fast TracKer (FTK) is an integral part of the trigger upgrade for the ATLAS detector. For every event passing the Level 1 trigger (at a maximum rate of 100 kHz) the FTK receives data from the 80 million channels of the silicon detectors, providing tracking information to the High Level Trigger in order to ensure a selection robust against pile-up. The FTK performs a hardware-based track reconstruction, using associative memory (AM) that is based on the use of a custom chip, designed to perform pattern matching at very high speed. It finds track candidates at low resolution (roads) that seed a full-resolution track fitting done by FPGAs. Narrow roads permit a fast track fitting but need many patterns stored in the AM to ensure ...

  8. A modified fast-track program for pancreatic surgery: a prospective single-center experience.

    Science.gov (United States)

    di Sebastiano, Pierluigi; Festa, Leonardina; De Bonis, Antonio; Ciuffreda, Andrea; Valvano, Maria Rosa; Andriulli, Angelo; di Mola, F Francesco

    2011-03-01

    The objective of this study is to evaluate the impact of a fast-track protocol in a high-volume center for patients with pancreatic disorders. The concept of fast-track surgery allowing accelerated postoperative recovery is accepted in colorectal surgery, but efficacy data are only preliminary for patients undergoing major pancreatic surgery. We aimed to evaluate the impact of a modified fast-track protocol in a high-volume center for patients with pancreatic disorders. Between February 2005 and January 2010, 145 subjects had resective pancreatic surgery and were enrolled in the program. Essential features of the program were no preanaesthetic medication, upper and lower air-warming device, avoidance of excessive i.v. fluids perioperatively, effective control of pain, early reinstitution of oral feeding, and immediate mobilization and restoration of bowel function following surgery. Outcome measures were postoperative complications such as pancreatic fistula, delayed gastric emptying, biliary leak, intra-abdominal abscess, post-pancreatectomy hemorrhage, acute pancreatitis, wound infection, 30-day mortality, postoperative hospital stay, and readmission rates. On average, patients were discharged on postoperative day 10 (range 6-69), with a 30-day readmission rate of 6.2%. Percentage of patients with at least one complication was 38.6%. Pancreatic anastomotic leakage occurred in seven of 101 pancreatico-jejunostomies, and biliary leak in three of 109 biliary jejunostomies. Postoperative hemorrhage occurred in ten (6.9%) patients and wound infection in nine (6.2%) cases. In-hospital mortality was 2.7%. Fast-track parameters, such as normal food and first stool, correlated significantly with early discharge (jaundice, and resumption of normal diet by the 5th postoperative day were independent factors of early discharge. Fast-track programs are feasible, easy, and also applicable for patients undergoing a major surgery such as pancreatic resection.

  9. Fast Track Extubation In Adult Patients On Pump Open Heart Surgery At A Tertiary Care Hospital.

    Science.gov (United States)

    Akhtar, Mohammad Irfan; Sharif, Hasanat; Hamid, Mohammad; Samad, Khalid; Khan, Fazal Hameed

    2016-01-01

    Fast-track cardiac surgery programs have been established as the standard of cardiac surgical care. Studies have shown that early extubation in elective cardiac surgery patients, including coronary and non-coronary open-heart surgery patients does not increase perioperative morbidity and mortality. The objective of this observational study was to determine the success and failure profile of fast track extubation (FTE) practice in adult open-heart surgical patients. The study was conducted at cardiac operating room and Cardiac Intensive Care Unit (CICU) of a tertiary care hospital for a period of nine months, i.e., from Oct 2014 to June-2015. All on pump elective adult cardiac surgery patients including isolated CABG, isolated Valve replacements, combined procedures and aortic root replacements were enrolled in the study. Standardized anesthetic technique was adopted. Surgical and bypass techniques were tailored according to the procedure. Success of Fast track extubation was defined as extubation within 6 hours of arrival in CICU. A total of 290 patients were recruited. The average age of the patients was 56.3±10.5 years. There were 77.6% male and 22.4% female patients. Overall success rate was 51.9% and failure rate was 48.1%. The peri-operative renal insufficiency, cross clamp time and CICU stay (hours) were significantly lower in success group. Re-intubation rate was 0.74%. The perioperative parameters were significantly better in success group and the safety was also demonstrated in the patients who were fast tracked successfully. To implement the practice in its full capacity and benefit, a fast track protocol needs to be devised to standardize the current practices and to disseminate the strategy among junior anaesthesiologists, perfusionists and nursing staff.

  10. The yield of colorectal cancer among fast track patients with normocytic and microcytic anaemia.

    Science.gov (United States)

    Panagiotopoulou, I G; Fitzrol, D; Parker, R A; Kuzhively, J; Luscombe, N; Wells, A D; Menon, M; Bajwa, F M; Watson, M A

    2014-05-01

    We receive fast track referrals on the basis of iron deficiency anaemia (IDA) for patients with normocytic anaemia or for patients with no iron studies. This study examined the yield of colorectal cancer (CRC) among fast track patients to ascertain whether awaiting confirmation of IDA is necessary prior to performing bowel investigations. A review was undertaken of 321 and 930 consecutive fast track referrals from Centre A and Centre B respectively. Contingency tables were analysed using Fisher's exact test. Logistic regression analyses were performed to investigate significant predictors of CRC. Overall, 229 patients were included from Centre A and 689 from Centre B. The odds ratio for microcytic anaemia versus normocytic anaemia in the outcome of CRC was 1.3 (95% confidence interval [CI]: 0.5-3.9) for Centre A and 1.6 (95% CI: 0.8-3.3) for Centre B. In a logistic regression analysis (Centre B only), no significant difference in CRC rates was seen between microcytic and normocytic anaemia (adjusted odds ratio: 1.9, 95% CI: 0.9-3.9). There was no statistically significant difference in the yield of CRC between microcytic and normocytic anaemia (p=0.515, Fisher's exact test) in patients with anaemia only and no colorectal symptoms. Finally, CRC cases were seen in both microcytic and normocytic groups with or without low ferritin. There is no significant difference in the yield of CRC between fast track patients with microcytic and normocytic anaemia. This study provides insufficient evidence to support awaiting confirmation of IDA in fast track patients with normocytic anaemia prior to requesting bowel investigations.

  11. Fast tracking in adult cardiac surgery at Pakistan Institute of Medical Sciences

    International Nuclear Information System (INIS)

    Ahmed, N.; Khan, F.; Zahoor, M.; Rafique, M.; Faisal, M.

    2010-01-01

    Background: Early extubation after cardiac operation is an important aspect of fast-track cardiac anaesthesia. The length of stay in ICU limits utilisation of operation theatre in cardiac surgery. Increasing cost, limited resources, and newer surgical strategies have stimulated effectiveness of all routines in cardiac surgery, anaesthesia, and intensive care. Aim of this study was to determine the feasibility of fast-tracking in adult cardiac surgery and its effects on post operative recovery in our setup. Methods: This descriptive study was conducted over 14 months between Jul 16, 2007 to Sep 16, 2008. All the open heart cases were included unless absolute contraindications were there. We applied the rapid recovery protocol adopted from Oslo Hospital Norway in an attempt to achieve fast-tracking in our setup. Results: Two-hundred-seventy-four consecutive cases out of 400 operated cases were included in this study. Mean age was 47.69 +- 15.11 years, 27.7% were females, 5.8% were emergency cases, 5.1% were COPD, 11.1% were atrial fibrillation, and 6.9% were NYHA class-III cases. CABG was done in 66.1% cases and mean CPB-time was 75.92 +- 16.20 min. Mean Ventilation-time was 4.47+-4.48 hrs., 86% patients were fast-tracked to be extubated within 6 hours, and 85.4% patients remained free of post-op complications. Six (2.2%) re-intubatIions, 2.6% arrhythmias, 6.6% pleural effusions and 2.2% consolidation were observed post-operatively. Mean ICU stay was 2.49 +- 0.95 days and in-hospital mortality was 2.2%. Conclusion: Fast-tracking with extubation within 6 hours is feasible approach which minimises the post-operative complications significantly in adult cardiac surgical patients. (author)

  12. MODERN POSSIBILITIES OF SPECKLE TRACKING ECHOCARDIOGRAPHY IN CLINICAL PRACTICE

    Directory of Open Access Journals (Sweden)

    V. S. Nikiforov

    2017-01-01

    Full Text Available Speckle-tracking echocardiography is promising modern technique for evaluation of structural and functional changes in the myocardium. It evaluates the indicator of global longitudinal myocardial deformation, which is more sensitive than ejection fraction to early changes of left ventricular contractility. The diagnostic capabilities of speckle tracking echocardiography are reflected in clinical recommendations and consensus statements of European Society of Cardiology (ESC, European Association of Cardiovascular Imaging (EACVI and American Society of Echocardiography (ASE. The aim of this paper is describe basic principles of speckle tracking echocardiography and clinical applications of this new technology. Attention is paid to the use of speckle tracking echocardiography in such heart pathologies as heart failure, coronary heart disease and myocardial infarction, left ventricular hypertrophy in arterial hypertension, hypertrophic cardiomyopathy and amyloidosis of the heart, valvular heart disease, constrictive pericarditis and cancer therapy-induced cardiotoxicity.

  13. Radiology film tracking in a distributed clinical network

    International Nuclear Information System (INIS)

    Marquette, D.D.; Arrildt, W.

    1985-01-01

    This paper describes a system for tracking radiology films designed and installed at the Johns Hopkins Hospital. The installation of database and network capabilities in a large hospital environment provide the opportunity to extend to all nursing units and clinics access to the hospital's film tracking system. Ethernet communication technology allows communication to remote libraries. The integration of film tracking with scheduling and order entry systems in radiology make it possible to attain a high level of automated database interface and film jacket label production

  14. Application of fast track surgery in elderly patients during perioperative period of laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    ZHANG Yong

    2014-12-01

    Full Text Available ObjectiveTo investigate the safety and superiority of fast track surgery (FTS in elderly patients during the perioperative period of laparoscopic cholecystectomy (LC. MethodsThe clinical data of 124 elderly patients who underwent LC at the Department of General Surgery in our institution between January 2010 and March 2014 were assessed, with 62 cases assigned to FTS group and 62 cases to conventional method group. Anal exhaust time, feeding time, off-bed activity time, and length of hospital stay were compared between the two groups, and postoperative results and adverse reactions were recorded. Continuous data were analyzed using the independent-samples t test, and categorical data were compared using the chi-square test. Results Compared with the control method group, patients in the FTS group showed earlier postoperative anal exhaust, feeding, and off-bed activity, a shorter length of hospital stay, and a lower incidence of postoperative cardiovascular and cerebrovascular complications (P<0.05. ConclusionFTS is an effective approach to accelerate rehabilitation in elderly patients after LC.

  15. Fast-track program vs traditional care in surgery for gastric cancer.

    Science.gov (United States)

    Chen, Zhi-Xing; Liu, Ae-Huey Jennifer; Cen, Ying

    2014-01-14

    To systematically review the evidence for the effectiveness of fast-track program vs traditional care in laparoscopic or open surgery for gastric cancer. PubMed, Embase and the Cochrane library databases were electronically searched for published studies between January 1995 and April 2013, and only randomized trials were included. The references of relevant studies were manually searched for further studies that may have been missed. Search terms included "gastric cancer", "fast track" and "enhanced recovery". Five outcome variables were considered most suitable for analysis: postoperative hospital stay, medical cost, duration to first flatus, C-reactive protein (CRP) level and complications. Postoperative hospital stay was calculated from the date of operation to the date of discharge. Fixed effects model was used for meta-analysis. Compared with traditional care, fast-track program could significantly decrease the postoperative hospital stay [weighted mean difference (WMD) = -1.19, 95%CI: -1.79--0.60, P = 0.0001, fixed model], duration to first flatus (WMD = -6.82, 95%CI: -11.51--2.13, P = 0.004), medical costs (WMD = -2590, 95%CI: -4054--1126, P = 0.001), and the level of CRP (WMD = -17.78, 95%CI: -32.22--3.35, P = 0.0001) in laparoscopic surgery for gastric cancer. In open surgery for gastric cancer, fast-track program could also significantly decrease the postoperative hospital stay (WMD = -1.99, 95%CI: -2.09--1.89, P = 0.0001), duration to first flatus (WMD = -12.0, 95%CI: -18.89--5.11, P = 0.001), medical cost (WMD = -3674, 95%CI: -5025--2323, P = 0.0001), and the level of CRP (WMD = -27.34, 95%CI: -35.42--19.26, P = 0.0001). Furthermore, fast-track program did not significantly increase the incidence of complication (RR = 1.39, 95%CI: 0.77-2.51, P = 0.27, for laparoscopic surgery; and RR = 1.52, 95%CI: 0.90-2.56, P = 0.12, for open surgery). Our overall results suggested that compared with traditional care, fast-track program could result in shorter

  16. Error tracking in a clinical biochemistry laboratory

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Ødum, Lars

    2009-01-01

    BACKGROUND: We report our results for the systematic recording of all errors in a standard clinical laboratory over a 1-year period. METHODS: Recording was performed using a commercial database program. All individuals in the laboratory were allowed to report errors. The testing processes were cl...

  17. Implementation and Performance of FPGA based track fitting for the Atlas Fast TracKer

    CERN Document Server

    Zou, Rui; The ATLAS collaboration

    2018-01-01

    The Fast TracKer (FTK) within the ATLAS trigger system provides global track reconstruction for all events passing the ATLAS Level 1 trigger by dividing the detector into parallel processing pipelines that implement pattern matching in custom integrated circuits and data routing, reduction, and parameter extraction in FPGAs. In this presentation we will describe the implementation of a critical component of the system which does partial track fitting using a method based on a principal component analysis at a rate of greater than 1 fit per 10 ps, system-wide, to reduce the output of the pattern matching. Firmware design, timing performance and preliminary results will be discussed.

  18. Cost-effectiveness of an integrated 'fast track' rehabilitation service for multi-trauma patients involving dedicated early rehabilitation intervention programs: design of a prospective, multi-centre, non-randomised clinical trial.

    NARCIS (Netherlands)

    Kosar, S.; Seelen, H.A.M.; Hemmen, B.; Evers, S.M.; Brink, P.R.

    2009-01-01

    ABSTRACT: BACKGROUND: In conventional multi-trauma care service (CTCS), patients are admitted to hospital via the accident & emergency room. After surgery they are transferred to the IC-unit followed by the general surgery ward. Ensuing treatment takes place in a hospital's outpatient clinic, a

  19. Fast neutron dosimetry by means of different solid state nuclear track detectors

    International Nuclear Information System (INIS)

    Spurny, F.; Turek, K.

    1977-01-01

    The comparative study of three different types of fast neutron dosimeters based on solid state nuclear track detectors is presented; the dosimeters studied were: - microscopic soda glass in contact with 232 Th; - polycarbonate Makrofol E; and - cellulose nitrate Kodak LR 115. All detectors were evaluated by visual counting in a microscope. The authors have studied such properties as the background, angular as well as energetical dependences of detectors. The results obtained show that all studied detectors are suitable for fast neutron dosimetry; their application depends however on the concrete experimental conditions (neutron spectrum, fluence etc.). Both advantages and disadvantages of each of them are presented. (Auth.)

  20. TUW @ TREC Clinical Decision Support Track

    Science.gov (United States)

    2014-11-01

    and the ShARe/CLEF eHealth Evaluation Lab [8,3] running in 2013 and 2014. Here we briefly describe the goals of the first TREC Clinical Decision...Wendy W. Chapman, David Mart́ınez, Guido Zuccon, and João R. M. Palotti. Overview of the share/clef ehealth evalu- ation lab 2014. In Information Access...Zuccon. Overview of the share/clef ehealth evaluation lab 2013. In Information Access Evaluation. Multilinguality, Multimodality, and Visualization

  1. Most patients regain prefracture basic mobility after hip fracture surgery in a fast-track programme

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Kehlet, Henrik

    2012-01-01

    Treatment of patients with hip fracture has improved over the past decade. Still, some patients do not regain independent mobility within their primary hospital stay even if they follow a multimodal fast-track surgical programme. The aim of the present article was to examine the validity of the p......Treatment of patients with hip fracture has improved over the past decade. Still, some patients do not regain independent mobility within their primary hospital stay even if they follow a multimodal fast-track surgical programme. The aim of the present article was to examine the validity...... of the preliminary prefracture New Mobility Score (NMS), age and fracture type as independent predictors of in-hospital outcome after hip fracture surgery....

  2. Orthostatic intolerance during early mobilization after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, O; Bundgaard-Nielsen, M; Solgaard, S

    2012-01-01

    has not been established after THA. This study evaluated the cardiovascular response and tissue oxygenation to mobilization before and after surgery in relation to OI in fast-track THA patients. METHODS: /st>OI and the cardiovascular response to standing were evaluated with a standardized mobilization......BACKGROUND: /st>Early postoperative mobilization is a cornerstone in fast-track total hip arthroplasty (THA), but postoperative orthostatic intolerance (OI) may delay early recovery or lead to fainting, falls, and prosthesis dislocation or fracture. However, the prevalence and pathophysiology of OI...... protocol, before, 6, and 24 h after surgery in 26 patients undergoing THA with spinal anaesthesia and an opioid-sparing analgesic regime. Haemoglobin, fluid balance, and opioid use were recorded. Systolic (SAP) and diastolic (DAP) arterial pressure, heart rate (HR), stroke volume (SV), cardiac output (CO...

  3. Research on Precision Tracking on Fast Steering Mirror and Control Strategy

    Science.gov (United States)

    Di, Lin; Yi-ming, Wu; Fan, Zhu

    2018-01-01

    Fast steering mirror is a device used for controlling the beam direction precisely. Due to the short travel of the push-pull FSM, a compound fast steering mirror system driven by both limited-angle voice coil motor and push-pull FSM together is proposed. In the compound FSM system, limited-angle voice coil motor quickly swings at wide angle, while the push-pull FSM do high frequency movement in a small range, which provides the system with the high bandwidth and long travel. In the control strategy, the method of combining feed-forward control in Kalman filtering with auto-disturbance rejection control is used to improve trajectory tracking accuracy. The simulation result shows that tracking accuracy measured by the compound method can be improved by more than 5 times than that of the conventional PID.

  4. How Does the Fast Track Intervention Prevent Adverse Outcomes in Young Adulthood?

    Science.gov (United States)

    Sorensen, Lucy C; Dodge, Kenneth A

    2016-01-01

    Numerous studies have shown that childhood interventions can foster improved outcomes in adulthood. Less well understood is precisely how-that is, through which developmental pathways-these interventions work. This study assesses mechanisms by which the Fast Track project (n = 891), a randomized intervention in the early 1990s for high-risk children in four communities (Durham, NC; Nashville, TN; rural PA; and Seattle, WA), reduced delinquency, arrests, and general and mental health service utilization in adolescence through young adulthood (ages 12-20). A decomposition of treatment effects indicates that about a third of Fast Track's impact on later crime outcomes can be accounted for by improvements in social and self-regulation skills during childhood (ages 6-11), such as prosocial behavior, emotion regulation, and problem solving. These skills proved less valuable for the prevention of general and mental health problems. © 2015 The Authors. Child Development © 2015 Society for Research in Child Development, Inc.

  5. High patient satisfaction in 445 patients who underwent fast-track hip or knee replacement

    DEFF Research Database (Denmark)

    Specht, Kirsten; Kjaersgaard-Andersen, Per; Kehlet, Henrik

    2015-01-01

    BACKGROUND AND PURPOSE: Patient satisfaction is important in fast-track total hip and knee replacement (THR, TKR). We assessed: (1) how satisfied patients were with the treatment; (2) factors related to overall satisfaction; and (3) whether there was a difference between THR and TKR regarding...... length of stay (LOS) and patient satisfaction. PATIENTS AND METHODS: In this follow-up study, a consecutive series of 445 patients undergoing THR and TKR completed a questionnaire 2 weeks after discharge. LOS and short-term patient satisfaction with the fast-track management were measured. Patient...... satisfaction was measured using a numerical rating scale (NRS; 0-10). RESULTS: For THR, the median satisfaction score was 9-10 and for TKR it was 8.5-10 in all parameters. Older THR patients had higher overall satisfaction. No association was found between overall satisfaction following THR or TKR and sex...

  6. A fast track path improves access to palliative care for people with learning disabilities.

    Science.gov (United States)

    Whitington, Jane; Ma, Peng

    People with learning disabilities often experience inequalities in accessing general health services. This group, their families and carers need access to effective palliative care when facing a life limiting illness. This article describes the development and implementation of a fast track referral pathway for people with learning disabilities at St Francis Hospice in Essex. Our aim is to share this pathway so others can replicate the collaborative working to improve access to palliative care services for this group.

  7. Patient-reported outcome after fast-track hip arthroplasty: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Hansen Torben B

    2010-11-01

    Full Text Available Abstract Background A fast-track intervention with a short preoperative optimization period and short postoperative hospitalization has a potential for reduced convalescence and thereby a reduced need for postoperative rehabilitation. The purpose of this study was to describe patient-related outcomes, the need for additional rehabilitation after a fast-track total hip arthroplasty (THA, and the association between generic and disease specific outcomes. Methods The study consisted of 196 consecutive patients of which none received additional rehabilitation beyond an instructional exercise plan at discharge, which was adjusted at one in-patient visit. The patients filled in 3 questionnaires to measure health-related quality-of-life (HRQOL and hip specific function (EQ-5 D, SF36, and Harris Hip Score (HHS at 2 time points pre- and 2 time points postoperatively. The observed results were compared to normative population data for EQ-5 D, SF36, and HHS. Results 3-months postoperatively patients had reached a HRQOL level of 0.84 (SD, 0.14, which was similar to the population norm (P = 0.33, whereas they exceeded the population norm at 12 months postoperatively (P P P = 0.35. For HHS, patients never reached the population norm within 12 months postoperatively. Generic and disease specific outcomes were strongly associated. Conclusions If HRQOL is considered the primary outcome after THA, the need for additional postoperative rehabilitation for all THA patients following a fast-track intervention is questionable. However, a pre- or early postoperative physical intervention seems relevant if the PF of the population norm should be reached at 3 months. If disease specific outcome is considered the primary outcome after fast-track THA, clear goals for the rehabilitation must be established before patient selection, intervention type and timing of intervention can be made.

  8. The Effects of the Fast Track Preventive Intervention on the Development of Conduct Disorder Across Childhood

    OpenAIRE

    2011-01-01

    The impact of the Fast Track intervention on externalizing disorders across childhood was examined. Eight hundred-ninety-one early-starting children (69% male; 51% African American) were randomly assigned by matched sets of schools to intervention or control conditions. The 10-year intervention addressed parent behavior-management, child social cognitive skills, reading, home visiting, mentoring, and classroom curricula. Outcomes included psychiatric diagnoses after grades 3, 6, 9, and 12 for...

  9. Preoperative prediction of potentially preventable morbidity after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer C; Petersen, Morten Aa; Kehlet, Henrik

    2016-01-01

    . DESIGN: Prospective observational study. SETTING: Elective primary unilateral total hip and knee arthroplasty with prospectively collected preoperative patient characteristics; similar standardised fast-track protocols; evaluation of complications through discharge and medical records; and complete 90...... days follow-up through nationwide databases. PARTICIPANTS: 8373 consecutive unselected total hip arthroplasty (THA) and knee arthroplasty from January 2010 to November 2012. RESULTS: There were 557 procedures (6.4%) followed by potentially preventable complications resulting in hospitalisation >4 days...

  10. Maintaining Unity - relatives in older patients' fast-track treatment programmes. A grounded theory study.

    Science.gov (United States)

    Berthelsen, Connie Bøttcher; Lindhardt, Tove; Frederiksen, Kirsten

    2014-12-01

    To generate a substantive grounded theory of relatives' pattern of behaviour in older patients' fast-track treatment programmes during total hip or knee replacement. Fast-track treatment programmes are designed to make total hip and knee replacements more efficient through recovery improvements. The support of relatives during older patients' trajectory is important. However, knowledge is needed on the relatives' pattern of behaviour to strengthen their involvement in fast-track treatment programmes. We used a Glaserian grounded theory approach based on a systematic generation of theory from data to explain the latent pattern of behaviour of relatives. Data were collected from 2010-2011 in orthopaedic wards at two Danish university hospitals and consisted of 14 non-participant observations, 14 postobservational interviews and five interviews. Seven relatives of patients over 70 years of age participated. The constant comparative method was the guiding principle for simultaneous data collection, data analysis and coding, while theoretically sampling and writing memos. Maintaining Unity emerged as the relatives' pattern of behaviour through which they resolved their main concern: preventing the patients from feeling alone. The relatives resolved their main concern through three interchangeable behavioural modes: Protecting Mode, by providing loving and respectful support; Substituting Mode, with practical and cognitive support; and an Adapting Mode, by trying to fit in with the patients' and health professionals' requirements. The substantive theory of Maintaining Unity offers knowledge of relatives' strong desire to provide compassionate and loving support for the older patients during fast-track treatment programmes. © 2014 John Wiley & Sons Ltd.

  11. FAST: A fully asynchronous and status-tracking pattern for geoprocessing services orchestration

    Science.gov (United States)

    Wu, Huayi; You, Lan; Gui, Zhipeng; Gao, Shuang; Li, Zhenqiang; Yu, Jingmin

    2014-09-01

    Geoprocessing service orchestration (GSO) provides a unified and flexible way to implement cross-application, long-lived, and multi-step geoprocessing service workflows by coordinating geoprocessing services collaboratively. Usually, geoprocessing services and geoprocessing service workflows are data and/or computing intensive. The intensity feature may make the execution process of a workflow time-consuming. Since it initials an execution request without blocking other interactions on the client side, an asynchronous mechanism is especially appropriate for GSO workflows. Many critical problems remain to be solved in existing asynchronous patterns for GSO including difficulties in improving performance, status tracking, and clarifying the workflow structure. These problems are a challenge when orchestrating performance efficiency, making statuses instantly available, and constructing clearly structured GSO workflows. A Fully Asynchronous and Status-Tracking (FAST) pattern that adopts asynchronous interactions throughout the whole communication tier of a workflow is proposed for GSO. The proposed FAST pattern includes a mechanism that actively pushes the latest status to clients instantly and economically. An independent proxy was designed to isolate the status tracking logic from the geoprocessing business logic, which assists the formation of a clear GSO workflow structure. A workflow was implemented in the FAST pattern to simulate the flooding process in the Poyang Lake region. Experimental results show that the proposed FAST pattern can efficiently tackle data/computing intensive geoprocessing tasks. The performance of all collaborative partners was improved due to the asynchronous mechanism throughout communication tier. A status-tracking mechanism helps users retrieve the latest running status of a GSO workflow in an efficient and instant way. The clear structure of the GSO workflow lowers the barriers for geospatial domain experts and model designers to

  12. Controlling type I error rate for fast track drug development programmes.

    Science.gov (United States)

    Shih, Weichung J; Ouyang, Peter; Quan, Hui; Lin, Yong; Michiels, Bart; Bijnens, Luc

    2003-03-15

    The U.S. Food and Drug Administration (FDA) Modernization Act of 1997 has a Section (No. 112) entitled 'Expediting Study and Approval of Fast Track Drugs' (the Act). In 1998, the FDA issued a 'Guidance for Industry: the Fast Track Drug Development Programs' (the FTDD programmes) to meet the requirement of the Act. The purpose of FTDD programmes is to 'facilitate the development and expedite the review of new drugs that are intended to treat serious or life-threatening conditions and that demonstrate the potential to address unmet medical needs'. Since then many health products have reached patients who suffered from AIDS, cancer, osteoporosis, and many other diseases, sooner by utilizing the Fast Track Act and the FTDD programmes. In the meantime several scientific issues have also surfaced when following the FTDD programmes. In this paper we will discuss the concept of two kinds of type I errors, namely, the 'conditional approval' and the 'final approval' type I errors, and propose statistical methods for controlling them in a new drug submission process. Copyright 2003 John Wiley & Sons, Ltd.

  13. Electrochemical etching amplification of low-let recoil particle tracks in polymers for fast neutron dosimetry

    International Nuclear Information System (INIS)

    Sohrabi, M.; Morgan, K.Z.

    1975-11-01

    An electrochemical etching method for the amplification of fast-neutron-induced recoil particle tracks in polymers was investigated. The technique gave superior results over those obtained by conventional etching methods especially when polycarbonate foils were used for recoil particle track amplification. Electrochemical etching systems capable of multi-foil processing were designed and constructed to demonstrate the feasibility of the techniques for large-scale neutron dosimetry. Electrochemical etching parameters were studied including the nature or type of the polymer foil used, foil thickness and its effect on etching time, the applied voltage and its frequency, the chemical composition, concentration, and temperature of the etchant, distance and angle between the electrodes, and the type of particles such as recoil particles including protons. Recoil particle track density, mean track diameter, and optical density as functions of the mentioned parameters were determined. Each parameter was found to have a distinct effect on the etching results in terms of the measured responses. Several new characteristics of this fast neutron dosimetry method were studied especially for personnel dosimetry using various radiation sources such as nuclear reactors, medical cyclotrons, and isotopic neutron sources. The dose range, neutron energy dependence, directional response, fading characteristics, neutron threshold energy, etc. were investigated

  14. Fast Track Finding in the ILC's Silicon Detector, SiD01

    International Nuclear Information System (INIS)

    Baker, David E.

    2007-01-01

    A fast track finder is presented which, unlike its more efficient, more computationally costly O(n3) time counterparts, tracks particles in O(n) time (for n being the number of hits). Developed as a tool for processing data from the ILC's proposed SiD detector, development of this fast track finder began with that proposed by Pablo Yepes in 1996 and adjusted to accommodate the changes in geometry of the SiD detector. First, space within the detector is voxellated, with hits assigned to voxels according to their r, φ, and η coordinates. A hit on the outermost layer is selected, and a 'sample space' is built from the hits in the selected hit's surrounding voxels. The hit in the sample space with the smallest distance to the first is then selected, and the sample space recalculated for this hit. This process continues until the list of hits becomes large enough, at which point the helical circle in the x, y plane is conformally mapped to a line in the x', y' plane, and hits are chosen from the sample spaces of the previous fit by selecting the hits which fit a line to the previously selected points with the smallest χ 2 . Track finding terminates when the innermost layer has been reached or no hit in the sample space fits those previously selected to an acceptable χ 2 . Again, a hit on the outermost layer is selected and the process repeats until no assignable hits remain. The algorithm proved to be very efficient on artificial diagnostic events, such as one hundred muons scattered at momenta of 1 GeV/c to 10 GeV/c. Unfortunately, when tracking simulated events corresponding to actual physics, the track finder's efficiency decreased drastically (mostly due to signal noise), though future data cleaning programs could noticeably increase its efficiency on these events

  15. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs......BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...

  16. International collaborative project to compare and track the nutritional composition of fast foods

    Directory of Open Access Journals (Sweden)

    2012-07-01

    Full Text Available Abstract Background Chronic diseases are the leading cause of premature death and disability in the world with over-nutrition a primary cause of diet-related ill health. Excess quantities of energy, saturated fat, sugar and salt derived from fast foods contribute importantly to this disease burden. Our objective is to collate and compare nutrient composition data for fast foods as a means of supporting improvements in product formulation. Methods/design Surveys of fast foods will be done in each participating country each year. Information on the nutrient composition for each product will be sought either through direct chemical analysis, from fast food companies, in-store materials or from company websites. Foods will be categorized into major groups for the primary analyses which will compare mean levels of saturated fat, sugar, sodium, energy and serving size at baseline and over time. Countries currently involved include Australia, New Zealand, France, UK, USA, India, Spain, China and Canada, with more anticipated to follow. Discussion This collaborative approach to the collation and sharing of data will enable low-cost tracking of fast food composition around the world. This project represents a significant step forward in the objective and transparent monitoring of industry and government commitments to improve the quality of fast foods.

  17. International collaborative project to compare and track the nutritional composition of fast foods.

    Science.gov (United States)

    2012-07-27

    Chronic diseases are the leading cause of premature death and disability in the world with over-nutrition a primary cause of diet-related ill health. Excess quantities of energy, saturated fat, sugar and salt derived from fast foods contribute importantly to this disease burden. Our objective is to collate and compare nutrient composition data for fast foods as a means of supporting improvements in product formulation. Surveys of fast foods will be done in each participating country each year. Information on the nutrient composition for each product will be sought either through direct chemical analysis, from fast food companies, in-store materials or from company websites. Foods will be categorized into major groups for the primary analyses which will compare mean levels of saturated fat, sugar, sodium, energy and serving size at baseline and over time. Countries currently involved include Australia, New Zealand, France, UK, USA, India, Spain, China and Canada, with more anticipated to follow. This collaborative approach to the collation and sharing of data will enable low-cost tracking of fast food composition around the world. This project represents a significant step forward in the objective and transparent monitoring of industry and government commitments to improve the quality of fast foods.

  18. Fast parallel tracking algorithm for the muon detector of the CBM experiment at FAIR

    International Nuclear Information System (INIS)

    Lebedev, A.; Hoehne, C.; Kisel', I.; Ososkov, G.

    2010-01-01

    Particle trajectory recognition is an important and challenging task in the Compressed Baryonic Matter (CBM) experiment at the future FAIR accelerator at Darmstadt. The tracking algorithms have to process terabytes of input data produced in particle collisions. Therefore, the speed of the tracking software is extremely important for data analysis. In this contribution, a fast parallel track reconstruction algorithm, which uses available features of modern processors is presented. These features comprise a SIMD instruction set (SSE) and multithreading. The first allows one to pack several data items into one register and to operate on all of them in parallel thus achieving more operations per cycle. The second feature enables the routines to exploit all available CPU cores and hardware threads. This parallel version of the tracking algorithm has been compared to the initial serial scalar version which uses a similar approach for tracking. A speed-upfactor of 487 was achieved (from 730 to 1.5 ms/event) for a computer with 2 x Intel Core 17 processors at 2.66 GHz

  19. Hardware-based Tracking at Trigger Level for ATLAS the Fast TracKer (FTK) Project

    CERN Document Server

    INSPIRE-00245767

    2015-01-01

    Physics collisions at 13 TeV are expected at the LHC with an average of 40-50 proton-proton collisions per bunch crossing under nominal conditions. Tracking at trigger level is an essential tool to control the rate in high-pileup conditions while maintaining a good efficiency for relevant physics processes. The Fast TracKer is an integral part of the trigger upgrade for the ATLAS detector. For every event passing the Level-1 trigger (at a maximum rate of 100 kHz) the FTK receives data from all the channels of the silicon detectors, providing tracking information to the High Level Trigger in order to ensure a selection robust against pile-up. The FTK performs a hardware-based track reconstruction, using associative memory that is based on the use of a custom chip, designed to perform pattern matching at very high speed. It finds track candidates at low resolution (roads) that seed a full-resolution track fitting done by FPGAs. An overview of the FTK system with focus on the pattern matching procedure will be p...

  20. A fast track approach to commercializing the sodium cooled fast reactor

    International Nuclear Information System (INIS)

    Boardman, C.E.; Hui, Marvin; Carroll, Douglas

    1999-01-01

    As a result of more than 50 years of Liquid Metal Reactor design and development work the basic technology is well understood. However, commercialization of the Fast Breeder Reactor (FBR) has been delayed while various approaches to achieving competitive plant and fuel cycle costs are explored, developed, and demonstrated in prototype systems. Most designers have elected to take advantage of the economy of scale but are burdened by the cost and risk associated with the need for incremental scale up through the design, construction, and operation of multiple demonstration plants. An alternative commercialization path developed by GE would utilize a modular plant design to reduce the plant construction, R and D, and economic risk associated with the need to build multiple demonstration plants to reach a competitive size'. The key question is can a modular FBR compete with alternative electrical generation systems? Recently completed studies indicate that the answer to this question is yes if the modular plant designers keep the design simple by incorporating passive safety features and optimizing the manner in which supporting service systems are shared. (author)

  1. Fast and Accurate Rat Head Motion Tracking With Point Sources for Awake Brain PET.

    Science.gov (United States)

    Miranda, Alan; Staelens, Steven; Stroobants, Sigrid; Verhaeghe, Jeroen

    2017-07-01

    To avoid the confounding effects of anesthesia and immobilization stress in rat brain positron emission tomography (PET), motion tracking-based unrestrained awake rat brain imaging is being developed. In this paper, we propose a fast and accurate rat headmotion tracking method based on small PET point sources. PET point sources (3-4) attached to the rat's head are tracked in image space using 15-32-ms time frames. Our point source tracking (PST) method was validated using a manually moved microDerenzo phantom that was simultaneously tracked with an optical tracker (OT) for comparison. The PST method was further validated in three awake [ 18 F]FDG rat brain scans. Compared with the OT, the PST-based correction at the same frame rate (31.2 Hz) reduced the reconstructed FWHM by 0.39-0.66 mm for the different tested rod sizes of the microDerenzo phantom. The FWHM could be further reduced by another 0.07-0.13 mm when increasing the PST frame rate (66.7 Hz). Regional brain [ 18 F]FDG uptake in the motion corrected scan was strongly correlated ( ) with that of the anesthetized reference scan for all three cases ( ). The proposed PST method allowed excellent and reproducible motion correction in awake in vivo experiments. In addition, there is no need of specialized tracking equipment or additional calibrations to be performed, the point sources are practically imperceptible to the rat, and PST is ideally suitable for small bore scanners, where optical tracking might be challenging.

  2. Concept of fast-track surgery and its application in perioperative period of hepatectomy for liver cancer

    Directory of Open Access Journals (Sweden)

    HAN Wei

    2016-10-01

    Full Text Available Fast-track surgery (FTS is widely used in the field of hepatopancreatobiliary surgery and has achieved a great success in the perioperative period of liver cancer. It has been recognized by clinical doctors and patients. This article introduces the concept of FTS, reviews its development, summarizes the detailed measures of FTS in the perioperative period of liver cancer and long-term application experience of FTS, and analyzes the current status of its clinical application. It is pointed out that when applied in the perioperative period of hepatectomy for liver cancer, FTS can reduce stress, lower the incidence of postoperative complications, shorten the length of hospital stay, and bring true benefits to patients.

  3. An innovative strategy to increase a professional workforce: the fast track initiative for health visitors in England.

    Science.gov (United States)

    Sayer, Lynn; Barriball, K Louise; Bliss, Julie; Bakhshi, Savita; While, Alison E

    2016-04-01

    Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analyse the quantitative data. The qualitative data were analysed thematically. Motivations for health visiting as a career choice were similar for fast track and standard entry students, with career progression and interest in health promotion being key motivators. There was consensus that personal qualities and characteristics were more important than experience or qualifications. However, fast track students were significantly less confident about their public health competencies in leadership and management (p communication (p  0.5). Fast tracking offers a useful recruitment strategy in order to expand the health visitor workforce, but longitudinal research is needed to confirm benefits such as retention and career trajectories. © The Author(s) 2015.

  4. Fast neutron dosimetry using CR-39 track detectors with polyethylene as radiator

    International Nuclear Information System (INIS)

    Castillo, F.; Espinosa, G.; Golzarri, J.I.; Osorio, D.; Rangel, J.; Reyes, P.G.; Herrera, J.J.E.

    2013-01-01

    The chemical etching parameters (etching time, temperature, normality of etchant, etc.) for the use of CR-39 (allyl diglycol carbonate – Lantrack ® ) as a fast neutron dosimeter have been optimized. The CR-39 chips, placed under a 1.5 mm polyethylene radiator, were exposed for calibration to an 241 Am-Be source at different time intervals for a given neutron fluence. After several chemical etching processes of the detectors with different conditions, the optimum characteristics for the chemical etching were found at 6N KOH solution, 60 ± 1 °C, for 12 h. An accurate relationship between the dose and fluence calculations was obtained as a function of the track density. - Highlights: ► Optimum etching time for fast neutron irradiated CR-39 track detectors is found. ► Relationship between dose and fluence obtained as a function of the track density. ► Results are consistent with those reported elsewhere, and extend the dose range

  5. Physiotherapy Exercise After Fast-Track Total Hip and Knee Arthroplasty: Time for Reconsideration?

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Kehlet, Henrik

    2012-01-01

    Bandholm T, Kehlet H. Physiotherapy exercise after fast-track total hip and knee arthroplasty: time for reconsideration? Major surgery, including total hip arthroplasty (THA) and total knee arthroplasty (TKA), is followed by a convalescence period, during which the loss of muscle strength......-track methodology or enhanced recovery programs. It is the nature of this methodology to systematically and scientifically optimize all perioperative care components, with the overall goal of enhancing recovery. This is also the case for the care component "physiotherapy exercise" after THA and TKA. The 2 latest...... meta-analyses on the effectiveness of physiotherapy exercise after THA and TKA generally conclude that physiotherapy exercise after THA and TKA either does not work or is not very effective. The reason for this may be that the "pill" of physiotherapy exercise typically offered after THA and TKA does...

  6. Fast neutron detection by means of an organic solid state track detector

    International Nuclear Information System (INIS)

    Doerschel, B.; Streubel, G.

    1980-01-01

    Solid state track detectors consisting of cellulose triacetate foils are appropriate for measuring the fast neutron fluence without applying external radiators. Detector sensitivity has been determined as a function of neutron energy by performing irradiations with various neutron sources and monoenergetic neutrons of different energies. A comparison with theoretical results given in the literature for a simple model of track recording has shown sufficient agreement. The measuring errors and the influence of spectral changes in the neutron field on detector response are discussed for the studied method of fluence measurement. By means of these errors the measuring range has been determined for well defined irradiation conditions, taking into account spectral changes in the neutron field. (author)

  7. Fast Tracker: A Hardware Real Time Track Finder for the ATLAS Trigger System

    CERN Document Server

    Kimura, N; The ATLAS collaboration

    2014-01-01

    The Fast Tracker (FTK) is an integral part of the trigger upgrade program for the ATLAS detector at the Large Hadron Collider (LHC). As the LHC luminosity approaches its design level of 10^34cm^−2s^−1, the combinatorial problem posed by charged particle tracking becomes increasingly difficult due to the swelling of multiple interactions per bunch crossing (pile-up). The FTK is a highly-parallel hardware system intended to provide high-quality tracks with transverse momentum above 1 GeV/c in real time for online trigger system. The FTK system’s design, based on a mixture of advanced technologies, and expected physics performance will be presented.

  8. Perioperative strategy in colonic surgery; LAparoscopy and/or FAst track multimodal management versus standard care (LAFA trial).

    NARCIS (Netherlands)

    Wind, J.; Hofland, J.; Preckel, B.; Hollman, M.W.; Bossuyt, P.M.M.; Gouma, D.J.; Berge Henegouwen, M.I.; Fuhring, J.W.; Dejong, C.H.C.; Dam, R.M. van; Cuesta, M.A.; Noordhuis, A.; Jong, D. de; Zalingen, E. van; Engel, A.F.; Goei, T.H.; Stoppelaar, I.E. de; Tets, W.F. van; Wagensveld, B.A. van; Swart, A.; Elsen, M.J.L.J. van den; Gerhards, M.F.; Wit, L.Th. De; Siepel, M.A.M.; Geloven, A.A.W. van; Juttmann, J.-W.; Clevers, J.C.; Bemelman, W.A.

    2006-01-01

    BACKGROUND: Recent developments in large bowel surgery are the introduction of laparoscopic surgery and the implementation of multimodal fast track recovery programs. Both focus on a faster recovery and shorter hospital stay.The randomized controlled multicenter LAFA-trial (LAparoscopy and/or FAst

  9. Perioperative strategy in colonic surgery; LAparoscopy and/or FAst track multimodal management versus standard care (LAFA trial)

    NARCIS (Netherlands)

    Wind, Jan; Hofland, Jan; Preckel, Benedikt; Hollmann, Markus W.; Bossuyt, Patrick M. M.; Gouma, Dirk J.; van Berge Henegouwen, Mark I.; Fuhring, Jan Willem; Dejong, Cornelis H. C.; van Dam, Ronald M.; Cuesta, Miguel A.; Noordhuis, Astrid; de Jong, Dick; van Zalingen, Edith; Engel, Alexander F.; Goei, T. Hauwy; de Stoppelaar, I. Erica; van Tets, Willem F.; van Wagensveld, Bart A.; Swart, Annemiek; van den Elsen, Maarten J. L. J.; Gerhards, Michael F.; de Wit, Laurens Th; Siepel, Muriel A. M.; van Geloven, Anna A. W.; Juttmann, Jan-Willem; Clevers, Wilfred; Bemelman, Willem A.

    2006-01-01

    BACKGROUND: Recent developments in large bowel surgery are the introduction of laparoscopic surgery and the implementation of multimodal fast track recovery programs. Both focus on a faster recovery and shorter hospital stay.The randomized controlled multicenter LAFA-trial (LAparoscopy and/or FAst

  10. Early Progressive Strength Training to Enhance Recovery After Fast-Track Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Jakobsen, Thomas Linding; Kehlet, Henrik; Husted, Henrik

    2014-01-01

    different interventions: 7 weeks of supervised physical rehabilitation with PST (PST group) and without PST (CON group) commenced early after fast-track TKA. The primary outcome was the maximal distance walked in 6 minutes (6-minute walk test). Secondary outcomes were lower extremity strength and power......, knee joint effusion and range of motion, knee pain, and self-reported disability and quality of life. All outcome measures were assessed before TKA (baseline) and 4, 8, and 26 weeks after TKA. RESULTS: There was no statistically significant difference between the PST and CON groups in the change score...

  11. Fast-track surgery: A new concept of perioperative management of surgical patients

    Directory of Open Access Journals (Sweden)

    Gabriel Rodrigues

    2013-01-01

    Full Text Available In the past few decades, surgery has advanced greatly because of an improved understanding of perioperative pathophysiology, development of minimally invasive operative techniques and advanced anaesthetic techniques. Fewer operations are requiring extended periods of hospital stay and a growing number of procedures are performed on an ambulatory basis. The pressure on medical systems is continuously growing as a result of economic constraints, increasing numbers of patients undergoing surgical procedures and greater patient autonomy. Patient awareness is steadily increasing along with their participation in their own care, leading to expectations of a higher standard of care. This has led to the development of a new concept of fast-track surgery.

  12. Fast Track to the Cloud: Design Patterns for 12-Factor Earth Sciences Applications

    Science.gov (United States)

    Pawloski, Andrew; McLaughlin, Brett; Lynnes, Christopher

    2016-01-01

    As expanding service offerings and decreasing prices make the cloud increasingly attractive to Earth Science applications, there are nontrivial practical considerations which can hinder its meaningful use. In this talk, we will discuss architectural recommendations and lessons learned while working on EOSDIS' cloud efforts, particularly the NASA-compliant General Application Platform (NGAP) and its associated applications. Prominent in our findings is the importance of 12-factor design patterns and the powerful "wins" they enable in the cloud. We will share our strategies for "fast-tracking" applications to the cloud --whether they be legacy, planned for the future, or somewhere in between.

  13. Improving the ATLAS physics potential with the Fast Track Trigger System

    CERN Document Server

    Cavaliere, Viviana; The ATLAS collaboration

    2015-01-01

    The ATLAS Fast TracKer (FTK) is a custom electronics system that will operate at the full Level-1 accept rate, 100 kHz, to provide high quality tracks as input to the High-Level Trigger. The event reconstruction is performed in hardware, thanks to the massive parallelism of associative memories (AM) and FPGAs. We present the advantages for the physics goals of the ATLAS experiment and the recent results on the design, technological advancements and testing of some of the core components used in the processor.

  14. Incidence of and risk factors for postoperative urinary retention in fast-track total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars; Bogø, Stina; Raaschou, Sofie

    2015-01-01

    BACKGROUND AND PURPOSE: Postoperative urinary retention (POUR) is a clinical challenge, but there is no scientific evidence for treatment principles. We describe the incidence of and predictive factors for POUR in fast-track total hip (THA) and knee arthroplasty (TKA). PATIENTS AND METHODS......, and preoperative international prostate symptom score (IPSS) were compared between catheterized and non-catheterized patients. RESULTS: The incidence of POUR was 40% (range between departments: 30-55%). Median bladder volume evacuated by catheterization was 0.6 (0.1-1.9) L. Spinal anesthesia increased the risk...... was 40%, with spinal anesthesia and increased IPSS in males as predictive factors. The large variation in perioperative bladder management and in bladder volumes evacuated by catheterization calls for randomized studies to define evidence-based principles for treatment of POUR in the future....

  15. Perioperative strategy in colonic surgery; LAparoscopy and/or FAst track multimodal management versus standard care (LAFA trial

    Directory of Open Access Journals (Sweden)

    Swart Annemiek

    2006-11-01

    Full Text Available Abstract Background Recent developments in large bowel surgery are the introduction of laparoscopic surgery and the implementation of multimodal fast track recovery programs. Both focus on a faster recovery and shorter hospital stay. The randomized controlled multicenter LAFA-trial (LAparoscopy and/or FAst track multimodal management versus standard care was conceived to determine whether laparoscopic surgery, fast track perioperative care or a combination of both is to be preferred over open surgery with standard care in patients having segmental colectomy for malignant disease. Methods/design The LAFA-trial is a double blinded, multicenter trial with a 2 × 2 balanced factorial design. Patients eligible for segmental colectomy for malignant colorectal disease i.e. right and left colectomy and anterior resection will be randomized to either open or laparoscopic colectomy, and to either standard care or the fast track program. This factorial design produces four treatment groups; open colectomy with standard care (a, open colectomy with fast track program (b, laparoscopic colectomy with standard care (c, and laparoscopic surgery with fast track program (d. Primary outcome parameter is postoperative hospital length of stay including readmission within 30 days. Secondary outcome parameters are quality of life two and four weeks after surgery, overall hospital costs, morbidity, patient satisfaction and readmission rate. Based on a mean postoperative hospital stay of 9 +/- 2.5 days a group size of 400 patients (100 each arm can reliably detect a minimum difference of 1 day between the four arms (alfa = 0.95, beta = 0.8. With 100 patients in each arm a difference of 10% in subscales of the Short Form 36 (SF-36 questionnaire and social functioning can be detected. Discussion The LAFA-trial is a randomized controlled multicenter trial that will provide evidence on the merits of fast track perioperative care and laparoscopic colorectal surgery in

  16. Does BMI influence hospital stay and morbidity after fast-track hip and knee arthroplasty?

    DEFF Research Database (Denmark)

    Husted, Henrik; Jørgensen, Christoffer C; Gromov, Kirill

    2016-01-01

    Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality in such pat......Background and purpose - Body mass index (BMI) outside the normal range possibly affects the perioperative morbidity and mortality following total hip arthroplasty (THA) and total knee arthroplasty (TKA) in traditional care programs. We determined perioperative morbidity and mortality...... in such patients who were operated with the fast-track methodology and compared the levels with those in patients with normal BMI. Patients and methods - This was a prospective observational study involving 13,730 procedures (7,194 THA and 6,536 TKA operations) performed in a standardized fast-track setting....... Complete 90-day follow-up was achieved using national registries and review of medical records. Patients were grouped according to BMI as being underweight, of normal weight, overweight, obese, very obese, and morbidly obese. Results - Median length of stay (LOS) was 2 (IQR: 2-3) days in all BMI groups. 30...

  17. A Fast Track approach to deal with the temporal dimension of crop water footprint

    Science.gov (United States)

    Tuninetti, Marta; Tamea, Stefania; Laio, Francesco; Ridolfi, Luca

    2017-07-01

    Population growth, socio-economic development and climate changes are placing increasing pressure on water resources. Crop water footprint is a key indicator in the quantification of such pressure. It is determined by crop evapotranspiration and crop yield, which can be highly variable in space and time. While the spatial variability of crop water footprint has been the objective of several investigations, the temporal variability remains poorly studied. In particular, some studies approached this issue by associating the time variability of crop water footprint only to yield changes, while considering evapotranspiration patterns as marginal. Validation of this Fast Track approach has yet to be provided. In this Letter we demonstrate its feasibility through a comprehensive validation, an assessment of its uncertainty, and an example of application. Our results show that the water footprint changes are mainly driven by yield trends, while evapotranspiration plays a minor role. The error due to considering constant evapotranspiration is three times smaller than the uncertainty of the model used to compute the crop water footprint. These results confirm the suitability of the Fast Track approach and enable a simple, yet appropriate, evaluation of time-varying crop water footprint.

  18. Fast-track program in laparoscopic liver surgery: Theory or fact?

    Science.gov (United States)

    Sánchez-Pérez, Belinda; Aranda-Narváez, José Manuel; Suárez-Muñoz, Miguel Angel; Eladel-Delfresno, Moises; Fernández-Aguilar, José Luis; Pérez-Daga, Jose Antonio; Pulido-Roa, Ysabel; Santoyo-Santoyo, Julio

    2012-11-27

    To analyze our results after the introduction of a fast-track (FT) program after laparoscopic liver surgery in our Hepatobiliarypancreatic Unit. All patients (43) undergoing laparoscopic liver surgery between March 2004 and March 2010 were included and divided into two consecutive groups: Control group (CG) from March 2004 until December 2006 with traditional perioperative cares (17 patients) and fast-track group (FTG) from January 2007 until March 2010 with FT program cares (26 patients). Primary endpoint was the influence of the program on the postoperative stay, the amount of re-admissions, morbidity and mortality. Secondarily we considered duration of surgery, use of drains, conversion to open surgery, intensive cares needs and transfusion. Both groups were homogeneous in age and sex. No differences in technique, time of surgery or conversion to open surgery were found, but more malignant diseases were operated in the FTG, and then transfusions were higher in FTG. Readmissions and morbidity were similar in both groups, without mortality. Postoperative stay was similar, with a median of 3 for CG vs 2.5 for FTG. However, the 80.8% of patients from FTG left the hospital within the first 3 d after surgery (58.8% for CG). The introduction of a FT program after laparoscopic liver surgery improves the recovery of patients without increasing complications or re-admissions, which leads to a reduction of the stay and costs.

  19. Japanese experience with clinical trails of fast neutrons

    International Nuclear Information System (INIS)

    Tsunemoto, H.; Arai, T.; Morita, S.; Ishikawa, T.; Aoki, Y.; Takada, N.; Kamata, S.

    1982-01-01

    Between November, 1975 and November, 1981, 825 patients were treated with 30 MeV (d-Be) neutrons at the National Institute of Radiological Sciences, Chiba. At the Institute of Medical Science, Tokyo, 302 patients were referred to the Radiation Therapy department and were treated with 16 MeV (d-Be) neutrons. The emphasis of these clinical trials with fast neutrons was placed on the estimation of the effect of fast neutrons for locally advanced cancers or radioresistant cancers, and on evaluation of the rate of complication of normal tissues following irradiaton with fast neutrons. Results were evaluated for patients with previously untreated cancer; local control of the tumor was observed in 59.1%. Complications requiring medical care developed in only 32 patients. Patients who had received pre- or postoperative irradiation were excluded from this evaluation. Late reaction of soft tissue seemed to be more severe than that observed with photon beams. The results also suggest that for carcinoma of the larynx, esophagus, uterine cervix, Pancoasts's tumor of the lung and osteosarcoma, fast neutrons were considered to be effectively applied in this randomized clinical trial. For carcinoma of the larynx, a fast nuetron boost was effectively delivered, although an interstitial implant was necessarily combined with fast neutrons for carcinoma of the tongue. The cumulative survival rate of the patients with carcinoma of the esophagus treated with fast neutrons was 26% compared to the survival rate of 10.5% obtained using photons. This was supported by evidence from the pathological studies that showed that the tumor cells which had deeply invaded into the esophagus were effectively destroyed when fast neutrons were applied

  20. Japanese experience with clinical trials of fast neutrons

    International Nuclear Information System (INIS)

    Tsunemoto, H.; Arai, T.; Morita, S.; Ishikawa, T.; Aoki, Y.; Takada, N.; Kamata, S.

    1982-01-01

    Between November, 1975 and November, 1981, 825 patients were treated with 30 MeV (d-Be) neutrons at the National Institute of Radiological Sciences, Chiba. At the Institute of Medical Science, Tokyo, 302 patients were referred to the Radiation Therapy department and were treated with 16 MeV (d-Be) neutrons. The emphasis of these clinical trials with fast neutrons was placed on the estimation of the effect of fast neutrons for locally advanced cancers or radioresistant cancers, and on evaluation of the rate of complication of normal tissues following irradiation with fast neutrons. Results were evaluated for patients with previously untreated cancer; local control of the tumor was observed in 59.1%. Complications requiring medical care developed in only 32 patients. Late reaction of soft tissue seemed to be more severe than that observed with photon beams. The results also suggest that for carcinoma of the larynx, esophagus, uterine cervix, Pancoast's tumor of the lung and osteosarcoma, fast neutrons were considered to be effectively applied in this randomized clinical trial. For carcinoma of the larynx, a fast neutron boost was effectively delivered, although an interstitial implant was necessarily combined with fast neutrons for carcinoma of the tongue. The cumulative survival rate of the patients with carcinoma of the esophagus treated with fast neutrons of 26% compared to the survival rate of 10.5% obtained using photons. The results also indicate that local control and relief of the symptom related to Pancoast's tumor of the lung seemed to be better with neutrons than with photons. For patients suffering from osteosarcoma, the surgical procedures preserving the function of the leg and arm were studied according to the better local control rate of the tumor following fast neutron beam therapy

  1. Application of fast track surgery strategy in perioperative period of primary suture of laparoscopic choledocholithotomy

    Directory of Open Access Journals (Sweden)

    LIU Jinheng

    2016-11-01

    Full Text Available ObjectiveTo investigate the clinical application value of fast track surgery strategy (EARS in the perioperative period of primary suture of laparoscopy in the treatment of common bile duct stones. MethodsA total of 64 patients with gallstones complicated by common bile duct stones who were hospitalized in Department of Hepatobiliary Surgery in The Second People′s Hospital of Chengdu from October 2015 to February 2016 were enrolled, and according to the treatment in the perioperative period, the patients were divided into EARS group (32 patients and control group (32 patients. Clinical indices and complications were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the control group, the ERAS group had significantly shortened time of extraction of drainage tube (1.6±0.9 d vs 2.7±1.0 d, t=-5.675, P<0.01 and length of hospital stay (5.1±1.0 d vs 6.8±1.1 d, t=-5.910, P<0.01, significantly shorter time to first ambulation (1.0±0.3 d vs 1.6±0.7 d, t=-4.313, P<0.01 and time to intestinal functional recovery (1.1±0.4 d vs 1.8±0.6 d, t=-4.842, P<0.01, a significantly shortened time to stopping infusion after surgery (3.8±1.0 d vs 4.9±1.2 d, t=-3.923, P<0.01, significantly reduced total hospital costs (17 433.5±1411.3 ten thousand yuan vs 26 651.6±2945.8 ten thousand yuan, t=-15.942, P<0.001, a significantly lower proportion of patients who experienced pain after surgery [4 (12.5% vs 13 (40.6%, χ2=6.490, P=0.011], and significantly lower levels of alanine aminotransferase (105.25±35.34 U/L vs 179.00±48.64 U/L, t=-5.973, P<0.05 and total bilirubin (50.78±12.60 μmol/L vs 79.70±18.56 μmol/L, t=-7.090, P<0.05 after surgery. ConclusionEARS is highly practical in the perioperative period of laparoscopic surgery and can promote patients′ rapid recovery. Therefore

  2. Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery

    DEFF Research Database (Denmark)

    Andersen, Jens; Hjort-Jakobsen, Dorthe; Christiansen, P. S.

    2007-01-01

    BACKGROUND: Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme....... There was no difference in type and incidence of morbidity between the two periods. CONCLUSION: Readmission after fast-track open colonic resection was reduced by planning discharge 3 instead of 2 days after surgery, with the same discharge criteria. Copyright (c) 2007 British Journal of Surgery Society Ltd. Published...... from August 2004. All patients were examined 8 and 30 days after surgery. RESULTS: Readmission rates fell from 20.1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11.3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P

  3. Fast-track, ambulatory ultrasound-guided Tru-Cut liver biopsy is feasible and cost-efficient

    DEFF Research Database (Denmark)

    Huang, Chenxi; Lorentzen, Torben; Skjoldbye, Bjørn

    2015-01-01

    INTRODUCTION: Most institutions perform percutaneous liver biopsy with a post-biopsy patient observation period lasting up to eight hours, which is resource-demanding. This study aimed to evaluate the safety of liver biopsy performed in a fast-track set-up with an only one-hour post......-biopsy observation time. METHODS: Patients referred to our institution underwent fast-track ultrasound-guided 18-gauge Tru-Cut liver biopsy procedures. Each single biopsy procedure was followed by a post-procedure observational period of one hour and an additional focused assessment with sonography for trauma before...... safely discharged from our institution. No fatality or long-term complications were found during this study. CONCLUSION: The fast-track approach reported herein is a feasible option when adequate patient information is given. Besides the obvious, positive effect on patient logistics and departmental...

  4. Fast cine-magnetic resonance imaging point tracking for prostate cancer radiation therapy planning

    International Nuclear Information System (INIS)

    Dowling, J; Chandra, S; Dang, K; Fox, Chris D; Gill, Suki; Kron, T; Pham, D; Foroudi, F

    2014-01-01

    The analysis of intra-fraction organ motion is important for improving the precision of radiation therapy treatment delivery. One method to quantify this motion is for one or more observers to manually identify anatomic points of interest (POIs) on each slice of a cine-MRI sequence. However this is labour intensive and inter- and intra- observer variation can introduce uncertainty. In this paper a fast method for non-rigid registration based point tracking in cine-MRI sagittal and coronal series is described which identifies POIs in 0.98 seconds per sagittal slice and 1.35 seconds per coronal slice. The manual and automatic points were highly correlated (r>0.99, p<0.001) for all organs and the difference generally less than 1mm. For prostate planning peristalsis and rectal gas can result in unpredictable out of plane motion, suggesting the results may require manual verification.

  5. Post-discharge symptoms following fast-track colonic cancer surgery: a phenomenological hermeneutic study

    DEFF Research Database (Denmark)

    Krogsgaard, Marianne; Dreyer, Pia; Egerod, Ingrid

    2014-01-01

    OBJECTIVE: To obtain knowledge of patients' experiences of postoperative symptoms during the initial two weeks following fast-track colonic cancer surgery. METHOD: Semi-structured in-depth interviews with seven colonic cancer patients two weeks post hospital discharge. Analysis was performed using...... a phenomenological hermeneutical approach. RESULTS: During the first two weeks after discharge the patients experienced unfamiliar symptoms that affected their everyday lives. Despite distressing symptoms, they applied a "wait-and-see" strategy, and only reacted when symptoms became intolerable. The patients failed...... to shorter hospitalisation and improved physical performance, post-colonic surgery patients experience various symptoms after discharge. Healthcare professionals need to address symptoms that might have immediate and long-term consequences on patients' everyday life. Follow-up studies are encouraged...

  6. Health preemption behind closed doors: trade agreements and fast-track authority.

    Science.gov (United States)

    Crosbie, Eric; Gonzalez, Mariaelena; Glantz, Stanton A

    2014-09-01

    Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies' influence is weak and transfers it to jurisdictions where they have an advantage. International trade agreements relocate decisions about tobacco control policy to venues where there is little opportunity for public scrutiny, participation, and debate. Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same. "Fast-track authority," in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests.

  7. Health Preemption Behind Closed Doors: Trade Agreements and Fast-Track Authority

    Science.gov (United States)

    Crosbie, Eric; Gonzalez, Mariaelena

    2014-01-01

    Noncommunicable diseases result from consuming unhealthy products, including tobacco, which are promoted by transnational corporations. The tobacco industry uses preemption to block or reverse tobacco control policies. Preemption removes authority from jurisdictions where tobacco companies’ influence is weak and transfers it to jurisdictions where they have an advantage. International trade agreements relocate decisions about tobacco control policy to venues where there is little opportunity for public scrutiny, participation, and debate. Tobacco companies are using these agreements to preempt domestic authority over tobacco policy. Other transnational corporations that profit by promoting unhealthy foods could do the same. “Fast-track authority,” in which Congress cedes ongoing oversight authority to the President, further distances the public from the debate. With international agreements binding governments to prioritize trade over health, transparency and public oversight of the trade negotiation process is necessary to safeguard public health interests. PMID:25033124

  8. Postoperative anemia and early functional outcomes after fast-track hip arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Bandholm, Thomas; Kurbegovic, Sorel

    2016-01-01

    BACKGROUND: Postoperative anemia is prevalent in fast-track hip arthroplasty (THA) where patients are mobilized and discharged early, but whether anemia impairs functional recovery after discharge has not been adequately evaluated previously. This study aimed to evaluate whether postoperative...... anemia influenced recovery of mobility and quality of life (Qol) during the first 2 weeks after discharge from THA. STUDY DESIGN AND METHODS: This was a prospective observational study in 122 THA patients more than 65 years of age. Mobility and Qol were assessed pre- and postoperatively by the 6-minute...... walk test (6MWT; primary outcome), the timed up-and-go test, and the FACT-anemia subscale. Twenty-four-hour mobility at home was assessed by activity monitoring on Days 1 to 6 after discharge. Hemoglobin (Hb) at discharge (HbD) and the Hb decrease from preoperatively (ΔHb) were compared to mobility...

  9. Postoperative Urinary Catheterization Thresholds of 500 versus 800 ml after Fast-track Total Hip and Knee Arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars Stryhn; Hornum, Ulla Marianne; Troldborg, C.

    2016-01-01

    arthroplasty (THA) and total knee arthroplasty (TKA). METHODS: This was a randomized, controlled, open-label trial that included patients greater than or equal to 18 yr who underwent THA or TKA in three Danish, fast-track, orthopedic departments. Consenting patients were eligible if they were cooperative......BACKGROUND: No evidence-based threshold exists for postoperative urinary bladder catheterization. The authors hypothesized that a catheterization threshold of 800 ml was superior to 500 ml in reducing postoperative urinary catheterization and urological complications after fast-track total hip...

  10. Development of Ultra-Fast Silicon Detectors for 4D tracking

    Science.gov (United States)

    Staiano, A.; Arcidiacono, R.; Boscardin, M.; Dalla Betta, G. F.; Cartiglia, N.; Cenna, F.; Ferrero, M.; Ficorella, F.; Mandurrino, M.; Obertino, M.; Pancheri, L.; Paternoster, G.; Sola, V.

    2017-12-01

    In this contribution we review the progress towards the development of a novel type of silicon detectors suited for tracking with a picosecond timing resolution, the so called Ultra-Fast Silicon Detectors. The goal is to create a new family of particle detectors merging excellent position and timing resolution with GHz counting capabilities, very low material budget, radiation resistance, fine granularity, low power, insensitivity to magnetic field, and affordability. We aim to achieve concurrent precisions of ~ 10 ps and ~ 10 μm with a 50 μm thick sensor. Ultra-Fast Silicon Detectors are based on the concept of Low-Gain Avalanche Detectors, which are silicon detectors with an internal multiplication mechanism so that they generate a signal which is factor ~10 larger than standard silicon detectors. The basic design of UFSD consists of a thin silicon sensor with moderate internal gain and pixelated electrodes coupled to full custom VLSI chip. An overview of test beam data on time resolution and the impact on this measurement of radiation doses at the level of those expected at HL-LHC is presented. First I-V and C-V measurements on a new FBK sensor production of UFSD, 50 μm thick, with B and Ga, activated at two diffusion temperatures, with and without C co-implantation (in Low and High concentrations), and with different effective doping concentrations in the Gain layer, are shown. Perspectives on current use of UFSD in HEP experiments (UFSD detectors have been installed in the CMS-TOTEM Precision Protons Spectrometer for the forward physics tracking, and are currently taking data) and proposed applications for a MIP timing layer in the HL-LHC upgrade are briefly discussed.

  11. Fast-track remediation case study: Southern California refined fuel distributor

    International Nuclear Information System (INIS)

    Bubier, T.W.; Felix, P.R.

    1993-01-01

    Successful environmental remediation projects have three requirements in common: (1) an adequate data base that defines the extent and severity of the problem; (2) a detailed understanding of the actual performance of the remediation technologies being considered; and (3) good communication with the regulatory agencies to assure them that the health and safety of the community and workers will not be jeopardized. In a fast-track remediation project, these requirements are key issues in the critical path. The case study involves soil and groundwater remediation of a 16-acre bulk fuel storage and distribution facility. The facility was in operation for approximately 75 years and contained 20 large aboveground tanks with a total capacity in excess of 20 million gallons. Activities at the facility included receipt, storage, and distribution of refined fuel products, such as kerosene, gasoline, diesel, and bunker fuel. A harbor-widening project was undertaken to increase the level of safety for larger ships when passing through the port. Because of the critical need for harbor-widening, the environmental cleanup needed to be completed as quickly as possible. The following steps were taken during the fast-track remediation case study to meet the above-listed requirements: (1) New Data Quality Objectives (DQOs) were identified for the project; (2) Potentially applicable remedial technologies were evaluated and tested; and (3) An agency task force was developed to enhance communication with the regulatory agencies. This paper discusses these steps and presents examples of how each step was implemented during the remediation case study

  12. Measured and calculated absorptance of tracks of fast heavy ions in Ilford G5 nuclear emulsion

    International Nuclear Information System (INIS)

    Jensen, M.; Mathiesen, O.

    1975-04-01

    A modified form of the delta-ray theory of track formation developed by Katz and coworkers has been used to calculate the absorptance of tracks of fast heavy ions in Ilford G5 nuclear emulsion. The theoretical data have been compared with results of different photometrical investigations reported in the literature. In most cases the theoretical predictions are found to be in good agreement with experiments. This suggests that the theory can be used in the planning and execution of future experiments, i.e. to optimize the geometry of the photometer and to obtain an absolute charge calibration of the detector. It is shown that the basic photometrical properties of an emulsion stack can be described by a single quantity which can be determined from measurements. Knowing this quantity it is possible to predict the response of the emulsion stack for different types of photometers. The practical limits of the use of the modified theory at high and low levels of energy dose are discussed. (Auth.)

  13. Measured and calculated absorptance of tracks of fast heavy ions in Ilford G5 nuclear emulsion

    International Nuclear Information System (INIS)

    Jensen, M.; Mathiesen, O.

    1976-01-01

    A modified form of the delta-ray theory of track formation developed by Katz and coworkers has been used to calculate the absorptance of tracks of fast heavy ions in Ilford G5 nuclear emulsion. The theoretical data have been compared with results of different photometrical investigations reported in the literature. In most cases the theoretical predictions are found to be in good agreement with experiments. This suggests that the theory can be used in the planning and execution of future experiments, i.e. to optimize the geometry of the photometer and to obtain an absolute charge calibration of the detector. It is shown that the basic photometrical properties of an emulsion stack can be described by a single quantity which can be determined from measurements. Knowing this quantity it is possible to predict the response of the detector system, for different types of photometers. The practical limits of the use of the modified theory at high and low levels of energy dose are discussed. (Auth.)

  14. Measurements of fast deuterons from plasma accelerator by means of PM-355 track detectors

    Energy Technology Data Exchange (ETDEWEB)

    Skladnik-Sadowska, E. [Andrzej Soltan Institute for Nuclear Studies (IPJ), 05-400 Otwock-Swierk (Poland); Malinowski, K., E-mail: k.malinowski@ipj.gov.p [Andrzej Soltan Institute for Nuclear Studies (IPJ), 05-400 Otwock-Swierk (Poland); Sadowski, M.J.; Czaus, K. [Andrzej Soltan Institute for Nuclear Studies (IPJ), 05-400 Otwock-Swierk (Poland)

    2009-10-15

    This paper reports on studies of fast ions (mostly deuterons) emitted from an RPI (Rod-Plasma-Injector) plasma accelerator. The first aim was the verification of applicability of PM-355 track detectors for dosimetry of lower-energy (<200 KeV) deuterons. The second aim was information about energy spectra of deuterons from RPI-IBIS device in different operational modes. Mass- and energy spectra of ions were investigated with a Thomson-analyzer and PM-355 detectors. On the recorded deuteron-parabolas we chose points, and from numbers of tracks we determined the deuteron energy distribution. In the slow-mode the energy distribution peak was observed at about 40 keV, while the maximum energy amounted to about 150 keV. Those measurements confirmed an influence of the initial gas-conditions on energy distributions of the deuteron streams. The results are of importance for plasma-physics and applications. Another result was the confirmation that PM-355 detectors might be used for accurate measurements of low-energy (<200 keV) deuterons.

  15. Fast Tracker : A Hardware Real Time Track Finder for the ATLAS Trigger System

    CERN Document Server

    Kimura, N; The ATLAS collaboration

    2013-01-01

    The Large Hadron Collider (LHC) after the 2013-­‐2014 shutdown period is expected to improve the yet impressive performance obtained up to this year: collisions’ energy will increase to 14 TeV and instantaneous luminosity will reach and then overcome 10^34 cm‐2s‐1, with a bunch crossing period of 25 ns. The LHC experiments will need to adapt to the more crowded events, maintaining the physics output and the quality of the final results. The pileup higher than the LHC run 1, with peaks expected to reach 50 or more, will make more difficult to have efficient online selection of rare events based mostly on calorimeters and muon detectors as it is done now. A more extensive use of the information collected by the tracking detector will allow building more robust selections, limiting the degradation effects due to the high pileup. We report on the development of the Fast Tracker (FTK) processor for the ATLAS experiment, devoted to reconstruct tracks with transverse momentum above 1 GeV in the whole detect...

  16. Detection of a faint fast-moving near-Earth asteroid using the synthetic tracking technique

    Energy Technology Data Exchange (ETDEWEB)

    Zhai, Chengxing; Shao, Michael; Nemati, Bijan; Werne, Thomas; Zhou, Hanying; Turyshev, Slava G.; Sandhu, Jagmit [Jet Propulsion Laboratory, California Institute of Technology, 4800 Oak Grove Drive, Pasadena, CA 91109 (United States); Hallinan, Gregg; Harding, Leon K., E-mail: chengxing.zhai@jpl.nasa.gov [Department of Astronomy, California Institute of Technology, 1200 East California Boulevard, Pasadena, CA 91125 (United States)

    2014-09-01

    We report a detection of a faint near-Earth asteroid (NEA) using our synthetic tracking technique and the CHIMERA instrument on the Palomar 200 inch telescope. With an apparent magnitude of 23 (H = 29, assuming detection at 20 lunar distances), the asteroid was moving at 6.°32 day{sup –1} and was detected at a signal-to-noise ratio (S/N) of 15 using 30 s of data taken at a 16.7 Hz frame rate. The detection was confirmed by a second observation 77 minutes later at the same S/N. Because of its high proper motion, the NEA moved 7 arcsec over the 30 s of observation. Synthetic tracking avoided image degradation due to trailing loss that affects conventional techniques relying on 30 s exposures; the trailing loss would have degraded the surface brightness of the NEA image on the CCD down to an approximate magnitude of 25 making the object undetectable. This detection was a result of our 12 hr blind search conducted on the Palomar 200 inch telescope over two nights, scanning twice over six (5.°3 × 0.°046) fields. Detecting only one asteroid is consistent with Harris's estimates for the distribution of the asteroid population, which was used to predict a detection of 1.2 NEAs in the H-magnitude range 28-31 for the two nights. The experimental design, data analysis methods, and algorithms are presented. We also demonstrate milliarcsecond-level astrometry using observations of two known bright asteroids on the same system with synthetic tracking. We conclude by discussing strategies for scheduling observations to detect and characterize small and fast-moving NEAs using the new technique.

  17. Outcomes in smokers and alcohol users after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C C; Kehlet, Henrik; Hansen, Torben Bæk

    2013-01-01

    and knee arthroplasty. RESULTS: In 3041 consecutive patients, 458 reported smoking and 216 drinking > 2 drinks a day, of which 66 did both. Smokers/alcohol users were younger than non-users (mean age: 64.3 vs. 68.0 years, P  4 days and smoking (odds ratio [95% confidence interval], P) (1.34 [0.92-1.95], 0......BACKGROUND: Smoking and alcohol use impair post-operative outcomes. However, no studies include fast-track surgery, which is a multimodal-enhanced recovery programme demonstrated to improve outcome. We hypothesised that outcome is similar in smokers and alcohol users as in non-users after fast.......127) or alcohol use (0.59 [0.30-1.16], 0.127). Thirty- and ninety-day readmission rate was 6.6% (n = 201) and 9.4% (n = 285). Multiple logistic regression analysis showed an increased risk of readmissions in smokers at 30 (1.60 [1.05-2.44], 0.028) but not 90-day follow-up (1.17 [0.80-1.73], 0.419). No increased...

  18. Fast Tracker (FTK): A Hardware Track Finder for the ATLAS Trigger

    CERN Document Server

    Mitani, Takashi; The ATLAS collaboration

    2015-01-01

    During the 2010-2012 run of Large Hadron Collider experiment, the ATLAS trigger system was successfully operated and it contributed to several important results such as observation of Higgs boson with a mass of about 125 GeV. From 2015, collision energy will increase to 13-14 TeV and its instantaneous luminosity will reach $1$-$2\\times10^{34}$cm$^{-2}$s$^{-1}$ with a 25 ns bunch crossing period. Due to the energy increase, the cross sections for SM processes are expected to get much larger. Additionally, the number of overlapping proton-proton interactions per bunch crossing, which is refereed to as pile-up, is expected to increase significantly up to about 80. Therefore it will be challenging to control trigger rates while keeping good efficiency for interesting physics events. This document summarizes the development of Fast Tracker and its tracking performance for the ATLAS experiment. The Fast Tracker is a custom electronics system that will operate at the full Level 1 accepted rate of 100 kHz and provide...

  19. Application Effect of Fast Track Surgery for Patients with Lung Cancer: 
A Meta-analysis

    Directory of Open Access Journals (Sweden)

    Yan XIA

    2016-12-01

    Full Text Available Background and objective Fast track surgery (FTS can accelerate rehabilitation and reduce postoperative hospital stay. It has been effectively applied to several surgical diseases. However, the safety and effectiveness of FTS for patients with lung cancer in China is unclear. This meta-analysis aimed to evaluate the effect of FTS undergoing lung cancer surgery in China. Methods Using home and abroad databases to search all documents required. The deadline of retrieval was January 31, 2016. Then the studies were screened according to the inclusion and exclusion criteria. Data were analyzed by RevMan 5.3 software. Results 8 randomized controlled trials (RCTs and 5 clinical controlled trials (CCTs with 1,241 patients were eligible for analysis. Compared with control group, FTS group can significantly shorten postoperative hospital time (MD=-3.61, 95%CI: -5.05--2.16, P<0.000,01 and chest tube duration (MD=-2.62, 95%CI: -3.07-2.17, P<0.000,01, reduce incidence of postoperative complications (OR=0.30, 95%CI: 0.19-0.47, P<0.000,01 and hospitalization costs (MD=-0.92, 95%CI: -1.19--0.65, P<0.000,01. Conclusion FTS can safely and effectively accelerate the recovery of patients with lung cancer in China, it exhibits important clinical values.

  20. Role of preoperative pain, muscle function, and activity level in discharge readiness after fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Bandholm, Thomas; Lunn, Troels Haxholdt

    2014-01-01

    therefore investigated the role of preoperative pain and functional characteristics in discharge readiness and actual LOS in fast-track THA and TKA. METHODS: Before surgery, hip pain (THA) or knee pain (TKA), lower-extremity muscle power, functional performance, and physical activity were assessed...

  1. Fast-track, ambulatory ultrasound-guided Tru-Cut liver biopsy is feasible and cost-efficient

    DEFF Research Database (Denmark)

    Huang, Chenxi; Lorentzen, Torben; Skjoldbye, Bjørn

    2015-01-01

    safely discharged from our institution. No fatality or long-term complications were found during this study. CONCLUSION: The fast-track approach reported herein is a feasible option when adequate patient information is given. Besides the obvious, positive effect on patient logistics and departmental...

  2. Ultra-Fast Tracking Power Supply with 4th order Output Filter and Fixed-Frequency Hysteretic Control

    DEFF Research Database (Denmark)

    Høyerby, Mikkel Christian Wendelboe; Andersen, Michael Andreas E.

    2008-01-01

    A practical solution is presented for the design of a non-isolated DC/DC power converter with very low output ripple voltage and very fast output voltage step response. The converter is intended for use as an envelope tracking power supply for an RFPA (Radio Frequency Power Amplifier) in a Tetra2...

  3. Fast track land reform, tenure security and investments in soil conservation: Micro-evidence from Mazowe district in Zimbabwe

    NARCIS (Netherlands)

    Zikhali, P.

    2010-01-01

    The government of Zimbabwe launched the Fast Track Land Reform Programme (FTLRP) in 2000 as part of its ongoing land reform and resettlement programme which aims to address a racially skewed land distribution. Its goal has been to accelerate both land acquisition and redistribution, targeting at

  4. Fall-related admissions after fast-track total hip and knee arthroplasty - cause of concern or consequence of success?

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer Calov; Kehlet, Henrik; Hip, Lundbeck Foundation Centre for Fast-track

    2013-01-01

    Total hip (THA) and knee arthroplasty (TKA) are common procedures in elderly persons, who are at potential increased risk of postoperative fall due to loss of muscle strength and impaired balance. Fast-track surgery with early mobilization and opioid-sparing analgesia have improved outcomes after...

  5. Fast Poisson Solvers for Self-Consistent Beam-Beam and Space-Charge Field Computation in Multiparticle Tracking Simulations

    CERN Document Server

    Florio, Adrien; Pieloni, Tatiana; CERN. Geneva. ATS Department

    2015-01-01

    We present two different approaches to solve the 2-dimensional electrostatic problem with open boundary conditions to be used in fast tracking codes for beam-beam and space charge simulations in high energy accelerators. We compare a fast multipoles method with a hybrid Poisson solver based on the fast Fourier transform and finite differences in polar coordinates. We show that the latter outperforms the first in terms of execution time and precision, allowing for a reduction of the noise in the tracking simulation. Furthermore the new algorithm is shown to scale linearly on parallel architectures with shared memory. We conclude by effectively replacing the HFMM by the new Poisson solver in the COMBI code.

  6. Surgical Stress Response and Postoperative Immune Function After Laparoscopy or Open Surgery With Fast Track or Standard Perioperative Care A Randomized Trial

    NARCIS (Netherlands)

    Veenhof, A. A. F. A.; Vlug, M. S.; van der Pas, M. H. G. M.; Sietses, C.; van der Peet, D. L.; de Lange-de Klerk, E. S. M.; Bonjer, H. J.; Bemelman, W. A.; Cuesta, M. A.

    2012-01-01

    Objective: To evaluate the effect of laparoscopic or open colectomy with fast track or standard perioperative care on patient's immune status and stress response after surgery. Methods: Patients with nonmetastasized colon cancer were randomized to laparoscopic or open colectomy with fast track or

  7. Experience with "Fast track" postoperative care after deep brain stimulation surgery.

    Science.gov (United States)

    Martín, Nuria; Valero, Ricard; Hurtado, Paola; Gracia, Isabel; Fernández, Carla; Rumià, Jordi; Valldeoriola, Francesc; Carrero, Enrique J; Tercero, Francisco Javier; de Riva, Nicolás; Fàbregas, Neus

    A 24-h-stay in the post-anesthesia care unit (PACU) is a common postoperative procedure after deep brain stimulation surgery (DBS). We evaluated the impact of a fast-track (FT) postoperative care protocol. An analysis was performed on all patients who underwent DBS in 2 periods: 2006, overnight monitored care (OMC group), and 2007-2013, FT care (FT group). The study included 19 patients in OMC and 95 patients in FT. Intraoperative complications occurred in 26.3% patients in OMC vs. 35.8% in FT. Post-operatively, one patient in OMC developed hemiparesis, and agitation in 2 patients. In FT, two patients with intraoperative hemiparesis were transferred to the ICU. While on the ward, 3 patients from the FT developed hemiparesis, two of them 48h after the procedure. Thirty eight percent of FT had an MRI scan, while the remaining 62% and all patients of OMC had a CT-scan performed on their transfer to the ward. One patient in OMC had a subthalamic hematoma. Two patients in FT had a pallidal hematoma, and 3 a bleeding along the electrode. A FT discharge protocol is a safe postoperative care after DBS. There are a small percentage of complications after DBS, which mainly occur within the first 6h. Copyright © 2016 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.

  8. Prototypdetektoren für das geplante Upgradeprojekt 'Muon Track Fast Tag' am CMS-Experiment

    CERN Document Server

    Weingarten, Simon; Stahl, Achim

    Upgrading the muon system will be one of the major challenges for the CMS experiment atthe projected high luminosity LHC (HL-LHC) with an expected instantaneous luminosityof L = 1035 /(cm2 · s). Most importantly, the muon trigger rate has to be reduced inorder to keep the level 1 trigger rate inside the reserved bandwidth. Another concernthat has to be dealt with is the rising number of ambiguities in the muon chambers dueto simultaneously traversing muons, so-called ghost hits. With the Muon Track fast Tag(MTT), a new detector subsystem between the CMS solenoid and the first muon stationis proposed to solve these problems. An implementation of the MTT system based on fastplastic scintillators read out by silicon photomultipliers (SiPM) is under development atthe Physics Institute III of RWTH Aachen University.In this thesis, results of prototype detectors with 100 × 100 × 5 mm3 scintillator-tilesand dual SiPM-readout are presented. All studies have been done with cosmic muons andfocus on parameter optimi...

  9. Fertility and the fast-track: Continued childbearing among professionals in Sweden, 1991-2009

    Directory of Open Access Journals (Sweden)

    Maria Stanfors

    2014-08-01

    Full Text Available Background: During recent decades women have made considerable advances in education and the labor market, even in fast-track professions such as law, medicine, and academia. While women have entered high-status professions, the career paths of some jobs have changed little and are still inflexible, which implies that professional gains may be offset by familial losses. Objective: We investigate continued childbearing, focusing on the relationship between occupation and second and third births, among highly educated men and women in three high-status professions. Methods: We analyze the determinants of having a second or a third birth using longitudinal data from population registers in Sweden, 1991-2009. We use descriptive statistics and logistic models. Results: Net of demographic and socioeconomic controls, medical doctors are more likely to continue childbearing than lawyers and academics, irrespective of parity and gender. The patterns that emerge are independent of income. Public sector work is conducive to continued childbearing, especially for women. Conclusions: Although there are more opportunities to combine career and family in Sweden than in many other countries, this does not hold equally for all. The results indicate that working conditions and career structures contribute to making it easier for some groups than others to combine a professional career and children. Patterns that emerge reflect that women and men are not equally sensitive to career structures that imply a tradeoff between career and children at an early stage of the career. This puts policies promoting work and family for all into perspective.

  10. Possibilities of fast track surgery principles in the treatment of congenital urological anomalies

    Directory of Open Access Journals (Sweden)

    Bižić Marta R.

    2012-01-01

    Full Text Available Introduction. Urogenital congenital anomalies are among the most common congenital anomalies and very frequent pathology in paediatric urology. Health care systems strive to shorten the duration and reduce the costs of hospitalization, while maintaining treatment effectiveness. Objective. To evaluate the duration of hospital stay of surgically treated patients with congenital urogenital anomalies and estimate the possibility of using fast track surgery principles in paediatric urology in the local settings of a developing country. Methods. Retrospective non-randomized study included 552 patients who had been surgically treated at the Urology Department of the University Children’s Hospital, during 2010. In line with their congenital anomalies, all patients were classified in one of four groups: I - upper urinary tract anomalies (252 patients; II - genital anomalies (164 patients; III - testicular anomalies (76 patients and IV - associated anomalies (60 patients. We analyzed the total duration of stay as well as preand post-operative stay in the hospital. Results. The average duration of hospitalization was 4.7±4.0 days. Patients with testicular anomalies stayed for the shortest period (2.3±1.9 days (p<0.01 and patients with associated anomalies stayed in the hospital the longest (6.5±4.7 days (p<0.01. Conclusion. Modern methods of surgical treatment allow reduction of hospitalization, financial savings to the healthcare system and greater comfort for patients. Our results showed that this is also possible to apply in our environment.

  11. The Fast Tracker Real Time Processor: high quality real-time tracking at ATLAS

    CERN Document Server

    Stabile, A; The ATLAS collaboration

    2011-01-01

    As the LHC luminosity is ramped up to the design level of 1x1034 cm−2 s−1 and beyond, the high rates, multiplicities, and energies of particles seen by the detectors will pose a unique challenge. Only a tiny fraction of the produced collisions can be stored on tape and immense real-time data reduction is needed. An effective trigger system must maintain high trigger efficiencies for the most important physics and at the same time suppress the enormous QCD backgrounds. This requires massive computing power to minimize the online execution time of complex algorithms. A multi-level trigger is an effective solution for an otherwise impossible problem. The Fast Tracker (FTK)[1], [2] is a proposed upgrade to the current ATLAS trigger system that will operate at full Level-1 output rates and provide high quality tracks reconstructed over the entire detector by the start of processing in Level-2. FTK is a dedicated Super Computer based on a mixture of advanced technologies. The architecture broadly employs powerf...

  12. Mass tracking and material accounting in the integral fast reactor (IFR)

    International Nuclear Information System (INIS)

    Orechwa, Y.; Adams, C.H.; White, A.M.

    1991-01-01

    This paper reports on the Integral Fast Reactor (IFR) which is a generic advanced liquid metal cooled reactor concept being developed at Argonne National Laboratory. There are a number of technical features of the IFR which contribute to its potential as a next-generation reactor. These are associated with large safety margins with regard to off-normal events involving the heat transport system, and the use of metallic fuel which makes possible the utilization of innovative fuel cycle processes. The latter feature permits fuel cycle closure with compact, low-cost reprocessing facilities, collocated with the reactor plant. These primary features are being demonstrated in the facilities at ANL-West, utilizing Experimental Breeder Reactor II and the associated Fuel Cycle Facility (FCF) as an IFR prototype. The demonstration of this IFR prototype includes the design and implementation of the Mass-tracking System (MTG). In this system, data from the operations of the FCF, including weights and batch-process parameters, are collected and maintained by the MTG running on distributed workstations

  13. The Mass Tracking System for the Integral Fast Reactor fuel cycle

    International Nuclear Information System (INIS)

    Adams, C.H.; Beitel, J.C.; Birgersson, G.; Bucher, R.G.; Carrico, C.B.; Daly, T.A.; Keyes, R.W.

    1994-01-01

    As part of the Fuel Cycle Facility (FCF) of Argonne National Laboratory's Integral Fast Reactor (IFR) demonstration, a computer-based Mass-Tracking (MTG) System has been developed. The MTG System collects, stores, retrieves and processes data on all operations which directly affect the flow of process material through FCF and supports such activities as process modeling, compliance with operating limits (e.g., criticality safety), material control and accountability and operational information services. Its architecture is client/server, with input and output connections to operator's equipment-control stations on the floor of FCF as well as to terminal sessions. Its heterogeneous database includes a relational-database manager as well as both binary and ASCII data files. The design of the database, and the software that supports it, is based on a model of discrete accountable items distributed in space and time and constitutes a complete historical record of the material processed in FCF. Although still under development, much of the MTG System has been qualified and is in production use

  14. Anesthesia and fast-track in video-assisted thoracic surgery (VATS): from evidence to practice.

    Science.gov (United States)

    Umari, Marzia; Falini, Stefano; Segat, Matteo; Zuliani, Michele; Crisman, Marco; Comuzzi, Lucia; Pagos, Francesco; Lovadina, Stefano; Lucangelo, Umberto

    2018-03-01

    In thoracic surgery, the introduction of video-assisted thoracoscopic techniques has allowed the development of fast-track protocols, with shorter hospital lengths of stay and improved outcomes. The perioperative management needs to be optimized accordingly, with the goal of reducing postoperative complications and speeding recovery times. Premedication performed in the operative room should be wisely administered because often linked to late discharge from the post-anesthesia care unit (PACU). Inhalatory anesthesia, when possible, should be preferred based on protective effects on postoperative lung inflammation. Deep neuromuscular blockade should be pursued and carefully monitored, and an appropriate reversal administered before extubation. Management of one-lung ventilation (OLV) needs to be optimized to prevent not only intraoperative hypoxemia but also postoperative acute lung injury (ALI): protective ventilation strategies are therefore to be implemented. Locoregional techniques should be favored over intravenous analgesia: the thoracic epidural, the paravertebral block (PVB), the intercostal nerve block (ICNB), and the serratus anterior plane block (SAPB) are thoroughly reviewed and the most common dosages are reported. Fluid therapy needs to be administered critically, to avoid both overload and cardiovascular compromisation. All these practices are analyzed singularly with the aid of the most recent evidences aimed at the best patient care. Finally, a few notes on some of the latest trends in research are presented, such as non-intubated video-assisted thoracoscopic surgery (VATS) and intravenous lidocaine.

  15. Mass tracking and material accounting in the Integral Fast Reactor (IFR)

    International Nuclear Information System (INIS)

    Orechwa, Y.; Adams, C.H.; White, A.M.

    1991-01-01

    The Integral Fast Reactor (IFR) is a generic advanced liquid metal cooled reactor concept being developed at Argonne National Laboratory (ANL). There are a number of technical features of the IFR which contribute to its potential as a next-generation reactor. These are associated with large safety margins with regard to off-normal events involving the heat transport system, and the use of metallic fuel which makes possible the utilization of innovative fuel cycle processes. The latter feature permits fuel cycle closure the compact, low-cost reprocessing facilities, collocated with the reactor plant. These primary features are being demonstrated in the facilities at ANL-West, utilizing Experimental Breeder Reactor 2 and the associated Fuel Cycle Facility (FCF) as an IFR prototype. The demonstration of this IFR prototype includes the design and implementation of the Mass-Tracking System (MTG). In this system, data from the operations of the FCF, including weights and batch-process parameters, are collected and maintained by the MTG running on distributed workstations. The components of the MTG System include: (1) an Oracle database manager with a Fortran interface, (2) a set of MTG ''Tasks'' which collect, manipulate and report data, (3) a set of MTG ''Terminal Sessions'' which provide some interactive control of the Tasks, and (4) a set of servers which manage the Tasks and which provide the communications link between the MTG System and Operator Control Stations, which control process equipment and monitoring devices within the FCF

  16. Analysis of etchants behavior on the electrochemical etching amplification of fast-neutron-induced recoil particle tracks in polycarbonate

    International Nuclear Information System (INIS)

    Masnadi Shirazi Nezhad, K.

    1979-08-01

    The composition, concentration, and temperature of etchant are important parameters controlling electrochemical etching (ECE) amplification of charged particle tracks in polymers. These parameters were further studied for sohralir polycarbonate neutron dosimeter (Sohrabi 1974), using potassium hydroxide (KOH) and sodium hydroxide (NaOH) solutions, and a mixture of potassium hydroxide, ethanol, and water (PEW solution), at different concentrations applying a field strength of 32KV/cm at 2KHz frequency using 250 μ thick polycarbonate exposed to fast neutrons. The recoal track density per rad of neutrons, in general, was found to increase by increasing the etchant concentration reaching a semi-platean after which it increases again. This increase is up to a concentration at which a track removing process occurs and no tracks have been amplified anymore. This track removing process occurred at about 11 normality in both KOH (50% by weight) and NaOH (30% by weight) solution at 25degC. The mean track diameter, in general, passed through a cyclic variation having a maximun and a minimum. For NaOH solution, the track removing process occurred at the minimum point. In the three regions of the track diameter curve the tracks appear in different shapes especially in KOH solution. The PEW solution at its optimum conditions was more effective in terms of both sensitivity, track diameter and a shorter period of etching. The chemical mechanism of etching process may be explained to be a ''saponification'' process. These studies further support the adequacy of Sohrabi dosimeter for routing health physics and radiation research applications. The above parameters are further discussed and the results as well as the advantages and disadvantages of the above etchants are given. (author)

  17. A Comparative Study of Analog Voltage-mode Control Methods for Ultra-Fast Tracking Power Supplies

    DEFF Research Database (Denmark)

    Høyerby, Mikkel Christian Wendelboe; Andersen, Michael Andreas E.

    2007-01-01

    This paper presents a theoretical and experimental comparison of the standard PWM/PID voltage-mode control method for single-phase buck converters with two highperformance self-oscillating (a.k.a. sliding mode) control methods. The application considered is ultra-fast tracking power supplies...... (UFTPSs) for RF power amplifiers, where the switching converter needs to track a varying reference voltage precisely and quickly while maintaining low output impedance. The small-signal analyses performed on the different controllers show that the hysteretic-type controller can achieve the highest loop...

  18. Opportune acquisition and tracking time for the fast-moving targets in a ground-based telescope

    Science.gov (United States)

    Chen, Juan; Wang, Jianli; Chen, Tao

    2004-10-01

    Acquisition is defined as identification for a fixed target in the related field of sight (FOS), while tracking means the sway of the telescope's axis of sight (AOS). The automatic acquisition and tracking is a process in which the operating way of the telescope should be switched from guiding to automatic tracking. There are some kinds of method to improve the acquisition and tracking ability for fast moving targets: to extend the acquisition and tracking FOS with memory and storage information of the sensor system; the multimode control to improve the dynamic property of the servo system; to choose an opportune time for acquisition and tracking; to select the control regulator parameter in every working states. If the processor of the CCD sensor can temporarily remember and save the information of the target before it moves out of the FOS, correspondingly, the FOS may be extended. The data forecast technology is used to store the target information. The automatic interception experiments are carried out to verify the control strategy.

  19. A "package solution" fast track program can reduce the diagnostic waiting time in head and neck cancer

    DEFF Research Database (Denmark)

    Sørensen, Jesper Roed; Johansen, Jørgen; Gano, Lars

    2014-01-01

    and Neck Surgery during three comparable time intervals 2006-2007, 2007-2008, and 2011-2012 (groups 1-3) were investigated. We recorded the time from patient referral, to first consultation and final diagnosis. The first interval was before initiation of the "package solution", the second just after......In 2007, a fast track program for patients with suspicion of head and neck cancer (HNC) was introduced in Denmark to reduce unnecessary waiting time. The program was based on so called "package solutions" including pre-booked slots for outpatient evaluation, imaging, and diagnostic surgical...... procedures. The purpose of this study is to present a model for fast track handling of patients suspicious of cancer in the head and neck region and to evaluate the effect of implementation on the diagnostic work up time. Patients with suspicion of HNC referred to the same university department of ENT Head...

  20. Relatives in older patients' fast-track treatment programme during total hip or knee replacement. A grounded theory study

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher

    and considerate support in concern for the patients; Substituting mode, with practical and cognitive support; and Adapting mode, by trying to fit in with the patients’ and health professionals’ requirements. Study II: 16 patients aged 70 to 94 were included and data was collected through 15 non......The aim of this Ph.D.-dissertation was to generate grounded theories of relatives, patients, and health professionals’ pattern of behaviour, respectively, in relation to the relatives of older patients’ fast-track treatment programmes during total hip or knee replacement. The dissertation includes...... to the older patients’ self-determination of being autonomous and how they adapt and are perceived in the health professionals’ environment. This may be useful to the health professionals in orthopaedic fast-track treatment programmes and their future collaboration with older patients and their relatives....

  1. Role of preoperative anemia for risk of transfusion and postoperative morbidity in fast-track hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jans, Øivind; Jørgensen, Christoffer; Kehlet, Henrik

    2014-01-01

    BACKGROUND: Preoperative anemia has been associated with increased risk of allogeneic blood transfusion and postoperative morbidity and mortality. The prevalence of preoperative anemia and its association with postoperative outcomes has not previously been reported in relation to fast......-track elective total hip arthroplasty (THA) and total knee arthroplasty (TKA). We aimed to evaluate the prevalence of preoperative anemia in elective fast-track THA and TKA and its association with risk of perioperative transfusion, prolonged length of hospital stay (LOS), and postoperative readmission. STUDY...... national databases and patient charts. Adjusted risk estimates for transfusion, prolonged LOS, and all-cause readmission according to preoperative anemia status were obtained by multivariate logistic regression. RESULTS: A total of 5.165 THA or TKA procedures were included with a mean patient age of 67...

  2. Comparison of two modes of ventilation after fast-track cardiac surgery: Adaptive support ventilation versus synchronized intermittent mandatory ventilation

    International Nuclear Information System (INIS)

    Aghadavoudi, O.

    2012-01-01

    Objective: There is substantial debate regarding the appropriate protocol for ventilatory management in fast-track cardiac anesthesia (FTCA). This study was carried out to assess and compare the risks and benefits of respiratory weaning based on adaptive support ventilation (ASV) and synchronized intermittent mandatory ventilation (SIMV) after uncomplicated cardiac surgery. Methodology: In a randomized clinical trial, after receiving approval of the Department Research Committee and informed consent from study subjects, 100 patients undergoing elective coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) were enrolled during a 4-month period at a university-based hospital. After surgery and admission to the intensive care unit (ICU), patients were randomized to ASV and SIMV groups. Arterial blood gas (ABG) and hemodynamic variables, respiratory and ventilator characteristics including lung compliance, rapid shallow breathing index (RSBI), tidal volume (TV), respiratory rate (RR), peak inspiratory pressure (P peak), mean airway pressure (p mean), Pao2/FIo2, duration of mechanical ventilation and tracheal intubation, and length of ICU stay were recorded and compared between the two groups. The data were analyzed in 82 patients after considering the exclusion criteria. Results: There were no differences between ASV and SIMV groups in demographics and preoperative characteristics. The duration of tracheal intubation and the length of ICU stay were similar in both groups. There were no statistically and clinically relevant differences between the two groups in ABG, hemodynamic changes, and respiratory and ventilator characteristics during ICU stay. Conclusion: Although ASV may facilitate postoperative respiratory management in FTCA, both ASV and SIMV provide similarly safe and practicable respiratory weaning in the cardiac ICU. The evaluation of potential advantages in patient outcomes and resource utilization of respiratory weaning based on ASV

  3. Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Zhang, Shaoyun; Xu, Bin; Huang, Qiang; Yao, Huan; Xie, Jinwei; Pei, Fuxing

    2017-07-01

    There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups. Patients in group A (31 patients) indwelled wound drainage tube for 6 hours after surgery while group B (34 patients) for 12 hours and group C (36 patients) for 18 hours. The knee circumference, resting and moving visual analogue score (VAS), hemoglobin (Hb), hematocrit, white blood count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), the volume of blood loss and drainage, and postoperative length of stay (LOS) among three groups were recorded and compared. There was no statistically significant difference in the volume of total and hidden blood loss among three groups ( p  > 0.05), but as the time of drainage prolonged, total volume of drainage and dominant blood loss increased gradually ( p   0.05), the decrease of Hb in the perioperative period and postoperative LOS as well. Early removal of wound drainage tube could drain the hematocele and reduce the risk of infection, and it doesn't increase the sense of pain, inflammatory reaction, limb swelling, and total blood loss. It's safe and feasible to remove the drainage tube within 6 to 12 hours after FT primary TKA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Getting on the fast track, or how to get an MLIS through distance education, with a specialization in medical librarianship.

    Science.gov (United States)

    Detlefsen, Ellen G

    2004-01-01

    The article describes an innovation in MLIS education for medical librarianship, with an introduction to the FastTrack, the distance education program at the University of Pittsburgh's library and information science school, together with an overview of a model program linking the biomedical library at Vanderbilt University with the School of Information Sciences in Pittsburgh. Admissions requirements and specific curriculum for the distance education master's degree are detailed in an FAQ format.

  5. Real-time tracking and fast retrieval of persons in multiple surveillance cameras of a shopping mall

    Science.gov (United States)

    Bouma, Henri; Baan, Jan; Landsmeer, Sander; Kruszynski, Chris; van Antwerpen, Gert; Dijk, Judith

    2013-05-01

    The capability to track individuals in CCTV cameras is important for e.g. surveillance applications at large areas such as train stations, airports and shopping centers. However, it is laborious to track and trace people over multiple cameras. In this paper, we present a system for real-time tracking and fast interactive retrieval of persons in video streams from multiple static surveillance cameras. This system is demonstrated in a shopping mall, where the cameras are positioned without overlapping fields-of-view and have different lighting conditions. The results show that the system allows an operator to find the origin or destination of a person more efficiently. The misses are reduced with 37%, which is a significant improvement.

  6. Thigh and knee circumference, knee-extension strength, and functional performance after fast-track total hip arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Kristensen, Morten Tange; Husted, Henrik

    2011-01-01

    OBJECTIVE: To (1) quantify changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA) and (2) investigate whether these changes correlate to changes in thigh and knee circumference (ie, swelling) or pain. DESIGN: A prospective, descrip......OBJECTIVE: To (1) quantify changes in knee-extension strength and functional-performance at discharge after fast-track total hip arthroplasty (THA) and (2) investigate whether these changes correlate to changes in thigh and knee circumference (ie, swelling) or pain. DESIGN: A prospective......, descriptive, hypothesis-generating study. SETTING: A special unit for fast-track hip and knee arthroplasty operations at a university hospital. PARTICIPANTS: Twenty-four patients (20 women and 4 men; ages 69 ± 6.1 years) scheduled for primary unilateral THA. METHODS: All patients were evaluated before surgery......, except for hip pain. The average loss in knee-extension strength after surgery (32%, P = .01) did not correlate with increased thigh circumference (6%, P

  7. Influencing Factor of Postoperation Fast-track Recovery and in Hospital Cost after Lobctomy for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Jianhua SU

    2014-07-01

    Full Text Available Background and objective It is unknown that the postoperation fast-track recovery and in hospital cost of the lobectomy in lung cancer, we explored the influencing factor of postoperative fast-track recovery and in hospital cost after undergoing lobectomy for lung cancer. Methods We retrospectively reviewed the medical records of all patients (n=176 who underwent lobectomy for lung cancer between January 2010 and November 2011 by a thoracic surgeon. Results The hospital costs of video-assisted thoracic surgery (VATS lobectomy (47,308.21 ¥ is significantly higher than open lobectomy (45,664.31 ¥(P=0.007. The hospital costs of body mass index (BMI ≥ 24 kg/m2 (51,186.99 ¥ is significantly higher than BMI < 24 kg/m2 (41,701.64 ¥(P=0.032. The hospital stay of VATS lobectomy (5.70 d is significantly less than open lobectomy (7.10 d(P<0.001. Conclusion These findings indicate that preoperative pulmonary rehabilitation and VATS lobectomy is contributed to fast-track recovery for patients who undergo lobectomy, but increase the hospital costs.

  8. Detecting fast, online reasoning processes in clinical decision making.

    Science.gov (United States)

    Flores, Amanda; Cobos, Pedro L; López, Francisco J; Godoy, Antonio

    2014-06-01

    In an experiment that used the inconsistency paradigm, experienced clinical psychologists and psychology students performed a reading task using clinical reports and a diagnostic judgment task. The clinical reports provided information about the symptoms of hypothetical clients who had been previously diagnosed with a specific mental disorder. Reading times of inconsistent target sentences were slower than those of control sentences, demonstrating an inconsistency effect. The results also showed that experienced clinicians gave different weights to different symptoms according to their relevance when fluently reading the clinical reports provided, despite the fact that all the symptoms were of equal diagnostic value according to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000). The diagnostic judgment task yielded a similar pattern of results. In contrast to previous findings, the results of the reading task may be taken as direct evidence of the intervention of reasoning processes that occur very early, rapidly, and online. We suggest that these processes are based on the representation of mental disorders and that these representations are particularly suited to fast retrieval from memory and to making inferences. They may also be related to the clinicians' causal reasoning. The implications of these results for clinician training are also discussed.

  9. Safeguarding Self-Governance: A Grounded Theory of Older Patients’ Pattern of Behavior in Relation to their Relatives in Fast-track Programs

    DEFF Research Database (Denmark)

    Berthelsen, Connie B.; Frederiksen, Kirsten; Lindhardt Damsgaard, Tove

    2014-01-01

    Abstract The aim of this study was to generate a grounded theory of older patients’ pattern of behavior in relation to their relatives’ involvement in fast-track programs during total joint replacement. Sixteen patients were recruited in orthopedic wards. Data collection included 11 interviews......, shielding, distancing, and masking. Keywords: Fast-track program, grounded theory, older patients, relatives, total joint replacement.......-governance emerged in the analysis as the core category of our theory and pattern of behavior of the older patients in relation to their relatives. The older patients’ main concern was to complete the fast-track program while maintaining autonomy, which they resolved through four strategies of actions: embracing...

  10. Assessment of fast and thermal neutron ambient dose equivalents around the KFUPM neutron source storage area using nuclear track detectors

    Energy Technology Data Exchange (ETDEWEB)

    Fazal-ur-Rehman [Physics Department, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia)]. E-mail: fazalr@kfupm.edu.sa; Al-Jarallah, M.I. [Physics Department, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia); Abu-Jarad, F. [Radiation Protection Unit, Environmental Protection Department, Saudi Aramco, P. O. Box 13027, Dhahran 31311 (Saudi Arabia); Qureshi, M.A. [Center for Applied Physical Sciences, King Fahd University of Petroleum and Minerals, Dhahran 31261 (Saudi Arabia)

    2005-11-15

    A set of five {sup 241}Am-Be neutron sources are utilized in research and teaching at King Fahd University of Petroleum and Minerals (KFUPM). Three of these sources have an activity of 16Ci each and the other two are of 5Ci each. A well-shielded storage area was designed for these sources. The aim of the study is to check the effectiveness of shielding of the KFUPM neutron source storage area. Poly allyl diglycol carbonate (PADC) Nuclear track detectors (NTDs) based fast and thermal neutron area passive dosimeters have been utilized side by side for 33 days to assess accumulated low ambient dose equivalents of fast and thermal neutrons at 30 different locations around the source storage area and adjacent rooms. Fast neutron measurements have been carried out using bare NTDs, which register fast neutrons through recoils of protons, in the detector material. NTDs were mounted with lithium tetra borate (Li{sub 2}B{sub 4}O{sub 7}) converters on their surfaces for thermal neutron detection via B10(n,{alpha})Li6 and Li6(n,{alpha})H3 nuclear reactions. The calibration factors of NTD both for fast and thermal neutron area passive dosimeters were determined using thermoluminescent dosimeters (TLD) with and without a polyethylene moderator. The calibration factors for fast and thermal neutron area passive dosimeters were found to be 1.33 proton tracks cm{sup -2}{mu}Sv{sup -1} and 31.5 alpha tracks cm{sup -2}{mu}Sv{sup -1}, respectively. The results show variations of accumulated dose with the locations around the storage area. The fast neutron dose equivalents rates varied from as low as 182nSvh{sup -1} up to 10.4{mu}Svh{sup -1} whereas those for thermal neutron ranged from as low as 7nSvh{sup -1} up to 9.3{mu}Svh{sup -1}. The study indicates that the area passive neutron dosimeter was able to detect dose rates as low as 7 and 182nSvh{sup -1} from accumulated dose for thermal and fast neutrons, respectively, which were not possible to detect with the available active neutron

  11. Fasting conditions: Influence of water intake on clinical chemistry analytes.

    Science.gov (United States)

    Benozzi, Silvia F; Unger, Gisela; Campion, Amparo; Pennacchiotti, Graciela L

    2018-02-15

    Currently available recommendations regarding fasting requirements before phlebotomy do not specify any maximum water intake volume permitted during the fasting period. The aim was to study the effects of 300 mL water intake 1 h before phlebotomy on specific analytes. Blood was collected from 20 women (median age (min-max): 24 (22 - 50) years) in basal state (T 0 ) and 1 h after 300 mL water intake (T 1 ). Glucose, total proteins (TP), urea, creatinine, cystatin C, total bilirubin (BT), total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides (Tg), uric acid (UA), high-sensitivity C-reactive protein, gamma-glutamyl transferase (GGT), aspartate-aminotransferase (AST), alanine-aminotransferase and lactate-dehydrogenase (LD) were studied. Results were analyzed using Wilcoxon test. Mean difference (%) was calculated for each analyte and was further compared with reference change value (RCV). Only mean differences (%) higher than RCV were considered clinically significant. Significant differences (median T 0 vs median T 1 , P) were observed for TP (73 vs 74 g/L, 0.001); urea (4.08 vs 4.16 mmol/L, 0.010); BT (12 vs 13 µmol/L, 0.021); total cholesterol (4.9 vs 4.9 mmol/L, 0.042); Tg (1.05 vs 1.06 mmol/L, 0.002); UA (260 vs 270 µmol/L, 0.006); GGT (12 vs 12 U/L, 0.046); AST (22 vs 24 U/L, 0.001); and LD (364 vs 386 U/L, 0.001). Although the differences observed were statistically significant, they were not indicative of clinically significant changes. A water intake of 300 mL 1 h prior to phlebotomy does not interfere with the analytes studied in the present work.

  12. Fast tracking detector with fiber scintillators and a position sensitive photomultiplier

    International Nuclear Information System (INIS)

    Salomon, M.; Li, V.; Smith, G.; Wu, Y.S.

    1988-11-01

    We have studied the properties of a tracking detector composed of 32 fiber scintillators coupled to a multianode photomultiplier placed in a pion beam at TRIUMF. We measured the efficiency of the detector, as well as its tracking capabilities and double hit resolution

  13. A Fast-Track Path to DEMO Enabled by ITER and FNSF-AT

    Energy Technology Data Exchange (ETDEWEB)

    Garofalo, A. M.; Choi, M.; Humphreys, D. A.; Kinsey, J. E.; Lao, L. L.; Snyder, P. B.; John, H. E.St.; Turnbull, A. D.; Taylor, T.S., E-mail: garofalo@fusion.gat.com [General Atomics, San Diego (United States); Chan, V. S.; Canik, J. M. [Oak Ridge National Laboratory, Oak Ridge (United States); Sawan, M. E. [University of Wisconsin, Madison (United States); Stangeby, P. C. [University of Toronto Institute for Aerospace Studies, Toronto (Canada)

    2012-09-15

    Full text: A Fusion Nuclear Science Facility based on the Advanced Tokamak concept (FNSF-AT) [1] is a key element of a fast track plan to a commercially attractive fusion DEMO. The next step forward on the path towards fusion commercialization must be a device that complements ITER in addressing the community identified science and technology gaps to DEMO, and that enables a DEMO construction decision triggered by the achievement of Q = 10 in ITER, presently scheduled for the year 2030. This paper elucidates the logic flow leading to the FNSF-AT approach for such a next step forward, and presents the results of recent analysis resolving key physics and engineering issues. A FNSF-AT will show fusion can make its own fuel, provide a materials irradiation facility, show fusion can produce high-grade process heat and electricity. In order to accomplish these goals, the FNSF has to operate steady-state with significant duty cycle and significant neutron fluence. In FNSF-AT, advanced tokamak physics enables steady-state burning plasmas with the high fluence required for FNSF's nuclear science development objective, in the compact size required to demonstrate Tritium fuel self-sufficiency using only a moderate quantity of the limited supply of Tritium. Physics based integrated modeling has found a steady-state baseline equilibrium with good stability and controllability properties. 2-D analysis assuming ITER heat and particle diffusion coefficients in the SOL predicts peak heat flux < 10 MW/m{sup 2} at the outer divertor targets. High fidelity and high-resolution 3D neutronics calculations have also been carried out, showing acceptable cumulative end-of-life organic insulator dose levels in all the device coils, and TBR > 1 for two blanket concepts considered. This FNSF-AT baseline plasma scenario has significant margin to meet the FNSF nuclear science mission. Moreover, the facility allows the development of more advanced scenarios to close the physics gaps to DEMO

  14. Contrast agent bolus tracking with a fixed threshold or a manual fast start for coronary CT angiography

    Energy Technology Data Exchange (ETDEWEB)

    Stenzel, Fabian; Rief, Matthias; Zimmermann, Elke; Greupner, Johannes; Richter, Felicitas; Dewey, Marc [Charite - Universitaetsmedizin Berlin, Department of Radiology, Berlin (Germany)

    2014-06-15

    Comparison of bolus tracking with a fixed threshold versus a manual fast start for coronary CT angiography. We retrospectively analysed 320-row coronary CT angiography of 50 patients with suspected or known coronary artery disease. Twenty-five examinations were initiated by a bolus tracking method (group 1), 25 examinations with a manual fast surestart (group 2). Mean attenuation values in the ascending aorta were 519 ± 111 Hounsfield units (HU) in group 1 and 476 ± 65 HU in group 2 (p = 0.10). Assessable vessel lengths were 171 ± 44 mm vs 172 ± 29 mm for the right coronary artery (p = 0.91), 11 ± 4 mm vs 12 ± 4 mm for the left main (p = 0.9), 163 ± 28 mm vs 151 ± 26 mm for the left anterior descending coronary artery (p = 0.11) and 125 ± 41 mm vs 110 ± 37 mm for the left circumflex coronary artery (p = 0.18). Image quality for all coronary arteries was not significantly different between the groups (p > 0.41). The attenuation ratio between the left and right ventricle was 2.8 ± 0.7 vs 3.6 ± 1.0 (p = 0.003). Significantly less contrast agent was used in group 2 (64 ± 6 ml vs 80 ± 0 ml; p < 0.001). Bolus tracking with a fixed threshold and with a manual fast start are both suitable methods; the fast start allowed a reduction of contrast agent volumes. (orig.)

  15. Radiation-hardened fast acquisition/weak signal tracking system and method

    Science.gov (United States)

    Winternitz, Luke (Inventor); Boegner, Gregory J. (Inventor); Sirotzky, Steve (Inventor)

    2009-01-01

    A global positioning system (GPS) receiver and method of acquiring and tracking GPS signals comprises an antenna adapted to receive GPS signals; an analog radio frequency device operatively connected to the antenna and adapted to convert the GPS signals from an analog format to a digital format; a plurality of GPS signal tracking correlators operatively connected to the analog RF device; a GPS signal acquisition component operatively connected to the analog RF device and the plurality of GPS signal tracking correlators, wherein the GPS signal acquisition component is adapted to calculate a maximum vector on a databit correlation grid; and a microprocessor operatively connected to the plurality of GPS signal tracking correlators and the GPS signal acquisition component, wherein the microprocessor is adapted to compare the maximum vector with a predetermined correlation threshold to allow the GPS signal to be fully acquired and tracked.

  16. First results of the silicon telescope using an 'artificial retina' for fast track finding

    Energy Technology Data Exchange (ETDEWEB)

    Neri, N. [Istituto Nazionale di Fisica Nucleare - INFN, Sezione di Milano, Milano (Italy); Abba, A.; Caponio, F.; Geraci, A.; Grizzuti, M.; Lusardi, N. [INFN Milano and Politecnico di Milano, Milano (Italy); Citterio, M.; Coelli, S.; Fu, J.; Monti, M.; Petruzzo, M. [INFN Milano, Milano (Italy); Bedeschi, F.; Ninci, D.; Piucci, A.; Spinella, F.; Walsh, J. [INFN Pisa, Pisa (Italy); Cenci, R.; Marino, P.; Morello, M. J.; Stracka, S. [INFN Pisa and Scuola Normale Superiore di Pisa, Pisa (Italy); Punzi, G. [INFN Pisa and Universita di Pisa, Pisa (Italy); Tonelli, D. [CERN, Geneva (Switzerland); Ristori, L. [INFN Pisa, Pisa (Italy); Fermilab, Batavia, Illinois (United States)

    2015-07-01

    We present the first results of the prototype of a silicon tracker with trigger capabilities based on a novel approach for fast track finding. The working principle of the 'artificial retina' is inspired by the processing of visual images by the brain and it is based on extensive parallelization of data distribution and pattern recognition. The algorithm has been implemented in commercial FPGAs in three main logic modules: a switch for the routing of the detector hits, a pool of engines for the digital processing of the hits, and a block for the calculation of the track parameters. The architecture is fully pipelined and allows the reconstruction of real-time tracks with a latency less then 100 clock cycles, corresponding to 0.25 microsecond at 400 MHz clock. The silicon telescope consists of 8 layers of single-sided silicon strip detectors with 512 strips each. The detector size is about 10 cm x 10 cm and the strip pitch is 183 μm. The detectors are read out by the Beetle chip, a custom ASICs developed for LHCb, which provides the measurement of the hit position and pulse height of 128 channels. The 'artificial retina' algorithm has been implemented on custom data acquisition boards based on FPGAs Xilinx Kintex 7 lx160. The parameters of the tracks detected are finally transferred to host PC via USB 3.0. The boards manage the read-out ASICs and the sampling of the analog channels. The read-out is performed at 40 MHz on 4 channels for each ASIC that corresponds to a decoding of the telescope information at 1.1 MHz. We report on the first results of the fast tracking device and compare with simulations. (authors)

  17. Surgery-induced changes and early recovery of hip-muscle strength, leg-press power, and functional performance after fast-track total hip arthroplasty

    DEFF Research Database (Denmark)

    Holm, Bente; Thorborg, Kristian; Husted, Henrik

    2013-01-01

    By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA), post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits.......By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA), post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits....

  18. Fast track in total hip and knee arthroplasty--experiences from Hvidovre University Hospital, Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte

    2006-01-01

    This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the track...... and a planned LOS of maximum 5 days. 22 patient characteristics and 11 satisfaction parameters were registered as well as readmissions within 3 months. 95% of patients had a LOS of maximum 5 days with a mean of 3.9 days. Median and mean values of satisfaction for the entire track were 10 and 9.4 out of 10...

  19. Particle tracking at 4K: The Fast Annihilation Cryogenic Tracking (FACT) detector for the AEgIS antimatter gravity experiment

    CERN Document Server

    Storey, J; Ahlén, O; Amsler, C; Ariga, A; Ariga, T; Belov, A.S; Bonomi, G; Bräunig, P; Bremer, J; Brusa, R.S; Burghart, G; Cabaret, L; Canali, C; Carante, M; Caravita, R; Castelli, F; Cerchiari, G; Cialdi, S; Comparat, D; Consolati, G; Dassa, L; Di Domizio, S; Di Noto, L; Doser, M; Dudarev, A; Ereditato, A; Ferragut, R; Fontana, A; Genova, P; Giammarchi, M; Gligorova, A; Gninenko, S.N; Haider, S; Hogan, S.D; Huse, T; Jordan, E; Jørgensen, L.V; Kaltenbacher, T; Kawada, J; Kellerbauer, A; Kimura, M; Knecht, A; Krasnický, D; Lagomarsino, V; Magnani, A; Mariazzi, S; Matveev, V.A; Merkt, F; Moia, F; Nebbia, G; Nédélec, P; Oberthaler, M.K; Pacifico, N; Petrácek, V; Pistillo, C; Prelz, F; Prevedelli, M; Regenfus, C; Riccardi, C; Røhne, O; Rotondi, A; Sandaker, H; Scampoli, P; Spacek, M; Subieta Vasquez, M.A; Testera, G; Trezzi, D; Vaccarone, R; Zavatarelli, S

    2013-01-01

    The AEgIS experiment is an international collaboration with the main goal of performing the fi rst direct measurement of the Earth ' s gravitational acceleration on antimatter. Critical to the success of AEgIS is the production of cold antihydrogen ( H) atoms. The FACT detector is used to measure the production and temperature of the H atoms and for establishing the formation of a H beam. The operating requirements for this detector are very challenging: it must be able to identify each of the thousand or so annihilations in the 1 ms period of pulsed H production, operate at 4 K inside a 1 T solenoidal fi eld and not produce more than 10 W of heat. The FACT detector consists of two concentric cylindrical layers of 400 scintillator fi bres with a 1 mm diameter and a 0.6 mm pitch. The scintillating fi bres are coupled to clear fi bres which transport the scintillation light to 800 silicon photomultipliers. Each silicon photomultiplier signal is connected to a linear ampli fi er and a fast discriminator, the out...

  20. Simple and fast system for analysis of charged particle tracks in multiplane hodoscopes

    Energy Technology Data Exchange (ETDEWEB)

    Reuter, J P [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire

    1977-01-15

    A digital-analog system is described, which performs in less than 400 ns the recognition of a linear relation between three 10-bit-coded digital coordinates, giving a 10/sup -3/ precision on track location.

  1. A method for the measurement of fission rates in fast neutron fields using solid state track detectors

    International Nuclear Information System (INIS)

    Hansen, W.; Vogel, W.

    1984-04-01

    Solid state track detectors (SSTDs) are increasingly used for the registration of radiation in different fields of nuclear physics. Because of their small sizes and masses and the absence of any electronics during exposure SSTDs do not cause distortions in the system to be investigated and are useful for measurements at such places being difficult of access. The elaboration of a method is described for fission rate measurements in fast neutron fields applying SSTDs and different fissionable isotopes which were electrodeposited on stainless steel backings. Experiences of the electrodeposition and results of quality checks are presented. The evaluation of the etched tracks is performed with spark counter technique. The dependence of the counting result on essential influence parameters is discussed. (author)

  2. The design and simulated performance of a fast Level 1 track trigger for the ATLAS High Luminosity Upgrade

    CERN Document Server

    Martensson, Mikael; The ATLAS collaboration

    2017-01-01

    The ATLAS experiment at the High Luminosity LHC will face a fivefold increase in the number of interactions per bunch crossing relative to the ongoing Run 2. This will require a proportional improvement in rejection power at the earliest levels of the detector trigger system, while preserving good signal efficiency. One critical aspect of this improvement will be the implementation of precise track reconstruction, through which sharper trigger turn-on curves can be achieved, and b-tagging and tau-tagging techniques can in principle be implemented. The challenge of such a project comes in the development of a fast, custom electronic device integrated in the hardware based first trigger level of the experiment. This article will discuss the requirements, architecture and projected performance of the system in terms of tracking, timing and physics, based on detailed simulations. Studies are carried out using data from the strip subsystem only or both strip and pixel subsystems.

  3. Particle tracking at 4 K: The Fast Annihilation Cryogenic Tracking (FACT) detector for the AEgIS antimatter gravity experiment

    Energy Technology Data Exchange (ETDEWEB)

    Storey, J., E-mail: james.storey@cern.ch [Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics, University of Bern, 3012 Bern (Switzerland); Canali, C. [University of Zurich, Physics Institute, Winterthurerstrasse 190, 8057 Zurich (Switzerland); Aghion, S. [Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano (Italy); Istituto Nazionale di Fisica Nucleare, Sez. di Milano, Via Celoria 16, 20133 Milano (Italy); Ahlén, O. [European Organisation for Nuclear Research, Physics Department, 1211 Geneva 23 (Switzerland); Amsler, C.; Ariga, A.; Ariga, T. [Albert Einstein Center for Fundamental Physics, Laboratory for High Energy Physics, University of Bern, 3012 Bern (Switzerland); Belov, A.S. [Institute for Nuclear Research of the Russian Academy of Sciences, Moscow 117312 (Russian Federation); Bonomi, G. [University of Brescia, Department of Mechanical and Industrial Engineering, Via Branze 38, 25133 Brescia (Italy); Istituto Nazionale di Fisica Nucleare, Sez. di Pavia, Via Agostino Bassi 6, 27100 Pavia (Italy); Bräunig, P. [University of Heidelberg, Kirchhoff Institute for Physics, Im Neuenheimer Feld 227, 69120 Heidelberg (Germany); Bremer, J. [European Organisation for Nuclear Research, Physics Department, 1211 Geneva 23 (Switzerland); Brusa, R.S. [Dipartimento di Fisica, Università di Trento and INFN, Gruppo Collegato di Trento, Via Sommarive 14, 38050 Povo, Trento (Italy); Burghart, G. [European Organisation for Nuclear Research, Physics Department, 1211 Geneva 23 (Switzerland); Cabaret, L. [Laboratoire Aimé Cotton, CNRS, Université Paris Sud, ENS Cachan, Bâtiment 505, Campus d' Orsay, 91405 Orsay Cedex (France); Carante, M. [Istituto Nazionale di Fisica Nucleare, Sez. di Pavia, Via Agostino Bassi 6, 27100 Pavia (Italy); Caravita, R. [University of Milano, Department of Physics, Via Celoria 16, 20133 Milano (Italy); and others

    2013-12-21

    The AEgIS experiment is an international collaboration with the main goal of performing the first direct measurement of the Earth's gravitational acceleration on antimatter. Critical to the success of AEgIS is the production of cold antihydrogen (H{sup ¯}) atoms. The FACT detector is used to measure the production and temperature of the H{sup ¯} atoms and for establishing the formation of a H{sup ¯} beam. The operating requirements for this detector are very challenging: it must be able to identify each of the thousand or so annihilations in the 1 ms period of pulsed H{sup ¯} production, operate at 4 K inside a 1 T solenoidal field and not produce more than 10 W of heat. The FACT detector consists of two concentric cylindrical layers of 400 scintillator fibres with a 1 mm diameter and a 0.6 mm pitch. The scintillating fibres are coupled to clear fibres which transport the scintillation light to 800 silicon photomultipliers. Each silicon photomultiplier signal is connected to a linear amplifier and a fast discriminator, the outputs of which are sampled continuously by Field Programmable Gate Arrays (FPGAs). In the course of the developments for the FACT detector we have established the performance of scintillating fibres at 4 K by means of a cosmic-ray tracker operating in a liquid helium cryostat. The FACT detector was installed in the AEgIS apparatus in December 2012 and will be used to study the H{sup ¯} formation when the low energy antiproton physics programs resume at CERN in the Summer of 2014. This paper presents the design requirements and construction methods of the FACT detector and provides the first results of the detector commissioning.

  4. Particle tracking at 4 K: The Fast Annihilation Cryogenic Tracking (FACT) detector for the AEgIS antimatter gravity experiment

    International Nuclear Information System (INIS)

    Storey, J.; Canali, C.; Aghion, S.; Ahlén, O.; Amsler, C.; Ariga, A.; Ariga, T.; Belov, A.S.; Bonomi, G.; Bräunig, P.; Bremer, J.; Brusa, R.S.; Burghart, G.; Cabaret, L.; Carante, M.; Caravita, R.

    2013-01-01

    The AEgIS experiment is an international collaboration with the main goal of performing the first direct measurement of the Earth's gravitational acceleration on antimatter. Critical to the success of AEgIS is the production of cold antihydrogen (H ¯ ) atoms. The FACT detector is used to measure the production and temperature of the H ¯ atoms and for establishing the formation of a H ¯ beam. The operating requirements for this detector are very challenging: it must be able to identify each of the thousand or so annihilations in the 1 ms period of pulsed H ¯ production, operate at 4 K inside a 1 T solenoidal field and not produce more than 10 W of heat. The FACT detector consists of two concentric cylindrical layers of 400 scintillator fibres with a 1 mm diameter and a 0.6 mm pitch. The scintillating fibres are coupled to clear fibres which transport the scintillation light to 800 silicon photomultipliers. Each silicon photomultiplier signal is connected to a linear amplifier and a fast discriminator, the outputs of which are sampled continuously by Field Programmable Gate Arrays (FPGAs). In the course of the developments for the FACT detector we have established the performance of scintillating fibres at 4 K by means of a cosmic-ray tracker operating in a liquid helium cryostat. The FACT detector was installed in the AEgIS apparatus in December 2012 and will be used to study the H ¯ formation when the low energy antiproton physics programs resume at CERN in the Summer of 2014. This paper presents the design requirements and construction methods of the FACT detector and provides the first results of the detector commissioning

  5. MANAJEMEN RISIKO PADA PROYEK KONSTRUKSI DENGAN METODE FAST TRACK STUDI KASUS PROYEK QUNCI VILLAS DAN PUTRI NAGA KOMODO

    Directory of Open Access Journals (Sweden)

    I Gusti Ketut Wirawan

    2015-07-01

    Full Text Available The rapid economic development such as now day, it need a construction method that may provide a facility faster and less cost. Therefore, fast track method has been widely applied in project management as happened in Qunci Villas Project at Lombok and Putri Naga Komodo Project at Loh Liang of Komodo Island. Fast track construction method has potential risks that can interfere the success of the project. This study aims to identify the risks, especially the mayor risk, to formulate the mitigation action, and to determine the risk ownership. This study was conducted using qualitative descriptive method by identifying the risks arising during the implementation of the fast track method on Qunci Villas and Putri Naga Komodo Projects through the study of literature, brainstorming, interview using questionnaires to those who knew or were involved in the project. So the frequency and magnitude of the consequences of each risk can be known. Then the risk assessment can be conducted to determine the mayor risk and the minor risk. Then determining mitigation action for the mayor risk to reduce the negative impact that may arise. Then allocating the risk ownership in other to the mitigation action can be handled properly. The risk identified totaled 25 risks consisting of : 1 risk (4% which was medium risk rating,  6 risks (24% which were high risk rating, and 18 risks (72% which were extreme risk rating. The mayor risk amounted to 24 risks (96%. The mayor risk which were high risk rating consisting of : 1 planning risk, 3 technical risks, 1 project risk and 1 criminal risk. While mayor risk which were extreme risk rating consisting of : 5 technical risks, 10 project risks, 2 financial risks, and 1 human risk. Mitigation action were handled by reducing likelihood and consequence. The most risks ownership were allocated to the contractor.

  6. Impact of fast-track concept elements in the classical pancreatic head resection (Kausch-Whipple procedure).

    Science.gov (United States)

    Gastinger, Ingo; Meyer, Frank; Lembcke, Thomas; Schmidt, Uwe; Ptok, Henry; Lippert, Hans

    2012-08-01

    The aim of the study was to determine statistically significant factors with an impact on the early postoperative surgical outcome. The influence of applied fast-track components on surgical results and early postoperative outcome in 143 consecutive Kausch-Whipple procedure patients was evaluated in a single-center retrospective analysis of a prospective collection of patient-associated pre-, peri- and postoperative data from 1997-2006. The in-hospital mortality rate was 2.8% (n=4). Fast-track measures were shown to have no effect on the morbidity rate in the multi-variate analysis. Over the study period, a decrease of intraoperative infusion volume from 14.2 mL/kg body weight/h in the first year to 10.7 mL/kg body weight/h in the last year was accompanied by an increase in patients requiring intraoperative catecholamines, up from 17% to 95%. The administration of ropivacain/sufentanil via thoracic peri-dural catheter injection initiated in 2000 and now considered the leading analgesic method, was used in 95% of the cases in 2006. Early extubation rate rose from 16.6% to 57.9%. Fast-track aspects in the perioperative management have become more important in several surgical procedure even in those with a greater invasiveness such as Kausch-Whipple. However, such techniques used in peri-operative management of Kausch-Whipple pancreatic-head resections had no impact on the morbidity rate. In addition, the low in-hospital mortality rate was particularly attributed to surgical competence.

  7. Effect of fast track surgery on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    LU Xia

    2017-02-01

    Full Text Available ObjectiveTo investigate the effect of fast track surgery (FTS on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy. MethodsThe patients who were hospitalized in Department of General Surgery, The Second People′s Hospital of Lanzhou, from March 2015 to July 2016 and underwent laparoscopic cholecystectomy were enrolled and randomly divided into FTS group and conventional treatment group, with 200 patients in each group. The patients in the FTS group were given FTS in the perioperative period, and those in the conventional treatment group were given conventional treatment. The C-reactive protein (CRP level, white blood cell count (WBC, and interleukin-6 (IL-6 level were measured on admission, at 1 hour before surgery, and at 24 and 48 hours after surgery, as well as the anxiety index in Hamilton anxiety scale (HAMA. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in anxiety index between the FTS group and the conventional treatment group on admission (P>0.05; at 1 hour before surgery and at 24 and 48 hours after surgery, there were significant differences in anxiety index between the two groups (χ2=12.73, 13.17, and 14.12, all P<0.05. On admission and at 1 hour before surgery, there were no significant differences in the CRP level, WBC, and IL-6 level between the FTS group and the conventional treatment group (all P>0.05; at 24 and 48 hours after surgery, there were significant differences in the CRP level, WBC, and IL-6 level between the two groups [CRP24h: 8.47±0.78 mg/L vs 17.56±1.31 mg/L, t=17.63, P<0.05; WBC24h: (8.3±3.4×109/L vs (10.2±3.8×109/L, t=21.62, P<0.05; IL-624h: 127.43±37.46 ng/L vs 146.25±42.56 ng/L, t=2632, P<0.05; CRP48h:(6.57±1.27 mg/L vs (10.76±1.25 mg/L,t=19.25,P<0.05;WBC48h:(7.1±2.3×109/L vs (9.3±2.4×109/L

  8. Fast TPC Online Tracking on GPUs and Asynchronous Data Processing in the ALICE HLT to facilitate Online Calibration

    International Nuclear Information System (INIS)

    Rohr, David; Gorbunov, Sergey; Krzewicki, Mikolaj; Breitner, Timo; Kretz, Matthias; Lindenstruth, Volker

    2015-01-01

    ALICE (A Large Heavy Ion Experiment) is one of the four major experiments at the Large Hadron Collider (LHC) at CERN, which is today the most powerful particle accelerator worldwide. The High Level Trigger (HLT) is an online compute farm of about 200 nodes, which reconstructs events measured by the ALICE detector in real-time. The HLT uses a custom online data-transport framework to distribute data and workload among the compute nodes.ALICE employs several calibration-sensitive subdetectors, e.g. the TPC (Time Projection Chamber). For a precise reconstruction, the HLT has to perform the calibration online. Online- calibration can make certain Offline calibration steps obsolete and can thus speed up Offline analysis. Looking forward to ALICE Run III starting in 2020, online calibration becomes a necessity.The main detector used for track reconstruction is the TPC. Reconstructing the trajectories in the TPC is the most compute-intense step during event reconstruction. Therefore, a fast tracking implementation is of great importance. Reconstructed TPC tracks build the basis for the calibration making a fast online-tracking mandatory.We present several components developed for the ALICE High Level Trigger to perform fast event reconstruction and to provide features required for online calibration.As first topic, we present our TPC tracker, which employs GPUs to speed up the processing, and which bases on a Cellular Automaton and on the Kalman filter. Our TPC tracking algorithm has been successfully used in 2011 and 2012 in the lead-lead and the proton-lead runs. We have improved it to leverage features of newer GPUs and we have ported it to support OpenCL, CUDA, and CPUs with a single common source code. This makes us vendor independent.As second topic, we present framework extensions required for online calibration. The extensions, however, are generic and can be used for other purposes as well. We have extended the framework to support asynchronous compute chains

  9. Cyclo-oxygenase 2 inhibitors and the risk of anastomotic leakage after fast-track colonic surgery

    DEFF Research Database (Denmark)

    Holte, K; Andersen, Jens; Jakobsen, D Hjort

    2009-01-01

    -oxygenase inhibitor for postoperative analgesia. METHODS: Patients with anastomotic leakage following a standard fast-track procotol between April 1997 and May 2006 were identified from a prospective, consecutive database. During this period there were two changes in perioperative management: cessation......BACKGROUND: Anastomotic leakage occurs after 3-6 per cent of colonic resections. The influence of analgesic agents is largely unknown. This study determined the rate of anastomotic leakage in a series of patients who had colonic surgery over a 9-year period with or without use of a cyclo...

  10. Avoiding ICU Admission by Using a Fast-Track Protocol Is Safe in Selected Adult-to-Adult Live Donor Liver Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Juan Echeverri, MD

    2017-10-01

    Full Text Available Background. We evaluated patient characteristics of live donor liver transplant (LDLT recipients undergoing a fast-track protocol without intensive care unit (ICU admission versus LDLT patients receiving posttransplant ICU care. Methods. Of the 153 LDLT recipients, 46 patients were included in our fast-track protocol without ICU admission. Both, fast-tracked patients and ICU-admitted patients were compared regarding donor and patient characteristics, perioperative characteristics, and postoperative outcomes and complications. In a subgroup analysis, we compared fast-tracked patients with patients who were admitted in the ICU for less than 24 hours. Results. Fast-tracked versus ICU patients had a lower model for end-stage liver disease score (13 ± 4 vs 18 ± 7; P < 0.0001, lower preoperative bilirubin levels (51 ± 50 μmol/L vs 119.4 ± 137.3 μmol/L; P < 0.001, required fewer units of packed red blood cells (1.7 ± 1.78 vs 4.4 ± 4; P < 0.0001, and less fresh-frozen plasma (2.7 ± 2 vs 5.8 ± 5; P < 0.0001 during transplantation. Regarding postoperative outcomes, fast-tracked patients presented fewer bacterial infections within 30 days (6.5% [3] vs 29% [28]; P = 0.002, no episodes of pneumonia (0% vs 11.3% [11]; P = 0.02, and less biliary complications within the first year (6% [3] vs 26% [25]; P = 0.001. Also, fast-tracked patients had a shorter posttransplant hospital stay (10.8 ± 5 vs 21.3 ± 29; P = 0.002. In the subgroup analysis, fast-tracked vs ICU patients admitted for less than 24 hours had lower requirements of packed red blood cells (1.7 ± 1.78 vs 3.9 ± 4; P = 0.001 and fresh-frozen plasma (2.7 ± 2 vs 5.8 ± 4.5; P = 0.0001. Conclusions. Fast-track of selected patients after LDLT is safe and feasible. An objective score to perioperatively select LDLT recipients amenable to fast track is yet to be determined.

  11. Nanostructured Material for Accurate and Fast Tracking of Cryogenic Temperatures, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The use of cryogenic propellants in next-generation launch vehicles and rockets relies to a great extent on the availability of rugged, high accuracy (0.2%), fast...

  12. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc, E-mail: Luc.Beaulieu@phy.ulaval.ca [Département de physique, de génie physique et d’optique et Centre de recherche sur le cancer de l’Université Laval, Université Laval, Québec, Québec G1V 0A6, Canada and Département de radio-oncologie et Axe Oncologie du Centre de recherche du CHU de Québec, CHU de Québec, 11 Côte du Palais, Québec, Québec G1R 2J6 (Canada); Binnekamp, Dirk [Integrated Clinical Solutions and Marketing, Philips Healthcare, Veenpluis 4-6, Best 5680 DA (Netherlands)

    2015-03-15

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora{sup ®} Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators.

  13. Fast, automatic, and accurate catheter reconstruction in HDR brachytherapy using an electromagnetic 3D tracking system

    International Nuclear Information System (INIS)

    Poulin, Eric; Racine, Emmanuel; Beaulieu, Luc; Binnekamp, Dirk

    2015-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), current catheter reconstruction protocols are relatively slow and error prone. The purpose of this technical note is to evaluate the accuracy and the robustness of an electromagnetic (EM) tracking system for automated and real-time catheter reconstruction. Methods: For this preclinical study, a total of ten catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a 18G biopsy needle, used as an EM stylet and equipped with a miniaturized sensor, and the second generation Aurora ® Planar Field Generator from Northern Digital Inc. The Aurora EM system provides position and orientation value with precisions of 0.7 mm and 0.2°, respectively. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical computed tomography (CT) system with a spatial resolution of 89 μm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, five catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 s, leading to a total reconstruction time inferior to 3 min for a typical 17-catheter implant. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.66 ± 0.33 mm and 1.08 ± 0.72 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be more accurate. A maximum difference of less than 0.6 mm was found between successive EM reconstructions. Conclusions: The EM reconstruction was found to be more accurate and precise than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators

  14. Imaging of fast-neutron sources using solid-state track-recorder pinhole radiography

    International Nuclear Information System (INIS)

    Ruddy, F.H.; Gold, R.; Roberts, J.H.; Kaiser, B.J.; Preston, C.C.

    1983-08-01

    Pinhole imaging methods are being developed and tested for potential future use in imaging the intense neutron source of the Fusion Materials Irradiation Test (FMIT) Facility. Previously reported, extensive calibration measurements of the proton, neutron, and alpha particle response characteristics of CR-39 polymer solid state track recorders (SSTRs) are being used to interpret the results of imaging experiments using both charged particle and neutron pinhole collimators. High resolution, neutron pinhole images of a 252 Cf source have been obtained in the form of neutron induced proton recoil tracks in CR-39 polymer SSTR. These imaging experiments are described as well as their potential future applications to FMIT

  15. Fast region-based object detection and tracking using correlation of features

    CSIR Research Space (South Africa)

    Senekal, F

    2010-11-01

    Full Text Available and track a target object (or objects) over a series of digital images. Visual target tracking can be accomplished by feature-based or region-based approaches. In feature-based approaches, interest points are calculated in a digital image, and a local...-time performance based on the computational power that is available on a specific platform. To further reduce the computational requirements, process- ing is restricted to the region of interest (ROI). The region of interest is provided as an input parameter...

  16. Mathematical framework for fast and rigorous track fit for the ZEUS detector

    Energy Technology Data Exchange (ETDEWEB)

    Spiridonov, Alexander

    2008-12-15

    In this note we present a mathematical framework for a rigorous approach to a common track fit for trackers located in the inner region of the ZEUS detector. The approach makes use of the Kalman filter and offers a rigorous treatment of magnetic field inhomogeneity, multiple scattering and energy loss. We describe mathematical details of the implementation of the Kalman filter technique with a reduced amount of computations for a cylindrical drift chamber, barrel and forward silicon strip detectors and a forward straw drift chamber. Options with homogeneous and inhomogeneous field are discussed. The fitting of tracks in one ZEUS event takes about of 20ms on standard PC. (orig.)

  17. Technical experiences of implementing a wireless tracking and facial biometric verification system for a clinical environment

    Science.gov (United States)

    Liu, Brent; Lee, Jasper; Documet, Jorge; Guo, Bing; King, Nelson; Huang, H. K.

    2006-03-01

    By implementing a tracking and verification system, clinical facilities can effectively monitor workflow and heighten information security in today's growing demand towards digital imaging informatics. This paper presents the technical design and implementation experiences encountered during the development of a Location Tracking and Verification System (LTVS) for a clinical environment. LTVS integrates facial biometrics with wireless tracking so that administrators can manage and monitor patient and staff through a web-based application. Implementation challenges fall into three main areas: 1) Development and Integration, 2) Calibration and Optimization of Wi-Fi Tracking System, and 3) Clinical Implementation. An initial prototype LTVS has been implemented within USC's Healthcare Consultation Center II Outpatient Facility, which currently has a fully digital imaging department environment with integrated HIS/RIS/PACS/VR (Voice Recognition).

  18. Readmission rates after a planned hospital stay of 2 versus 3 days in fast-track colonic surgery

    DEFF Research Database (Denmark)

    Andersen, Jens; Hjort-Jakobsen, Dorthe; Christiansen, P. S.

    2007-01-01

    BACKGROUND: Initial programmes of fast-track open colonic surgery with a planned 2-day postoperative hospital stay have had a high readmission rate (about 20 per cent). The aim of this large, consecutive series was to compare readmission rates after a fast-track open colonic surgery programme...... from August 2004. All patients were examined 8 and 30 days after surgery. RESULTS: Readmission rates fell from 20.1 per cent in 408 patients with a planned 2-day hospital stay (period 1) to 11.3 per cent in 133 patients with a planned 3-day hospital stay (period 2) (P ... hospital stay was 2 and 3 days, median stay after readmission was 5 and 5.5 days, and median (mean) total stay was 3 (5.6) and 3 (5.7) days in periods 1 and 2 respectively. The readmission rate in period 2 was lower because there were fewer readmissions for short-term observation or social reasons...

  19. Evaluation of the influence of pulmonary hypertension in ultra-fast-track anesthesia technique in adult patients undergoing cardiac surgery

    Directory of Open Access Journals (Sweden)

    Paulo Sérgio da Silva

    2015-08-01

    Full Text Available Abstract Objective: To evaluate the influence of pulmonary hypertension in the ultra-fast-track anesthesia technique in adult cardiac surgery. Methods: A retrospective study. They were included 40 patients divided into two groups: GI (without pulmonary hypertension and GII (with pulmonary hypertension. Based on data obtained by transthoracic echocardiography. We considered as the absence of pulmonary hypertension: a pulmonary artery systolic pressure (sPAP 40 mmHg associated with additional echocardiographic signs of PH. It was established as influence of pulmonary hypertension: the impossibility of extubation in the operating room, the increase in the time interval for extubation and reintubation the first 24 hours postoperatively. Univariate and multivariate analyzes were performed when necessary. Considered significant a P value <0.05. Results: The GI was composed of 21 patients and GII for 19. All patients (100% were extubated in the operating room in a medium time interval of 17.58±8.06 min with a median of 18 min in GII and 17 min in GI. PH did not increase the time interval for extubation (P=0.397. It required reintubation of 2 patients in GII (5% of the total, without statistically significant as compared to GI (P=0.488. Conclusion: In this study, pulmonary hypertension did not influence on ultra-fast-track anesthesia in adult cardiac surgery.

  20. 'Fast-track' colonic surgery in Austria and Germany--results from the survey on patterns in current perioperative practice.

    Science.gov (United States)

    Hasenberg, T; Keese, M; Längle, F; Reibenwein, B; Schindler, K; Herold, A; Beck, G; Post, S; Jauch, K W; Spies, C; Schwenk, W; Shang, E

    2009-02-01

    'Fast-track' rehabilitation has been shown to accelerate recovery, reduce general morbidity and decrease hospital stay after elective colonic surgery. Despite this evidence, there is no information on the acceptance and utilization of these concepts among the entirety of Austrian and German surgeons. In 2006, a questionnaire concerning perioperative routines in elective, open colonic resection was sent to the chief surgeons of 1270 German and 120 Austrian surgical centres. The response rate was 63% in Austria (76 centres) and 30% in Germany (385 centres). Mechanical bowel preparation is used by the majority (Austria, 91%; Germany, 94%); the vertical incision is the standard method of approach to the abdomen in Austria (79%) and Germany (83%), nasogastric decompression tubes are rarely used, one-third of the questioned surgeons in both countries use intra-abdominal drains. Half of the surgical centres allow the intake of clear fluids on the day of surgery and one-fifth offer solid food on that day. Epidural analgesia is used in three-fourths of the institutions. Although there is an evident benefit of fast-track management, the survey shows that they are not yet widely used as a routine in Austria and Germany.

  1. Fast track in total hip and knee arthroplasty--experiences from Hvidovre University Hospital, Denmark

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte

    2006-01-01

    This study investigated whether unselected patients operated on with total hip arthroplasty (THA) or total knee arthroplasty (TKA) could accomplish a self-developed accelerated track, ANORAK-HH, with a planned length of stay (LOS) of maximum 5 days and patient satisfaction at all parts of the tra...

  2. Energy loss and online directional track visualization of fast electrons with the pixel detector Timepix

    Czech Academy of Sciences Publication Activity Database

    Granja, C.; Krist, Pavel; Chvátil, David; Šolc, J.; Pospíšil, S.; Jakubek, J.; Opalka, L.

    2013-01-01

    Roč. 59, DEC (2013), s. 245-261 ISSN 1350-4487 Institutional support: RVO:61389005 Keywords : interaction of radiation with matter * dE/dx detectors * particle tracking detectors * hybrid pixel detectors * active nuclear emulsion * energy loss Subject RIV: BG - Nuclear, Atomic and Molecular Physics, Colliders Impact factor: 1.140, year: 2013

  3. Comparison of granisetron, metoclopramide and gastric decompression for prevention of postoperative nausea and vomiting after fast track cardiac anesthesia

    Directory of Open Access Journals (Sweden)

    Omid Aghadavoudi

    2008-08-01

    Full Text Available

    • BACKGROUND: Different methods have been suggested to prevent postoperative nausea and vomiting (PONV, but the efficacy of these methods has not been fully studied in fast track cardiac anesthesia (FTCA.
    • METHODS: In a randomized double blind clinical trial study, 120 patients aged 18-70 years with ASA II or III, undergoing elective cardiac surgery, were selected. They were divided randomly into four groups. In group M, group G and group P, intravenous (IV metoclopramide (0.1 mg/kg, granisetron (0.01 mg/kg, and normal saline were administered, respectively, about thirty minutes before extubation in the intensive care unit (ICU. In group N, a nasogastric (NG tube was inserted after tracheal intubation in the operating room and removed about thirty minutes before extubation in the ICU. The incidence and severity of nausea and the episodes of vomiting were recorded by a blinded investigator at the time of extubation and performed regularly for a maximum of 24 hours. Assessment of severity of nausea was scored using a visual analogue scale (VAS device. Data were analyzed by using ANOVA, chi-squared and Kruskal- Wallis and repeated measures tests.
    • RESULTS: Overall the 24-h incidence of PONV was significantly lower in the G and M groups than in the P and N groups (10% and 16.7% vs. 33.3% and 40%, respectively; P < 0.02. Postoperative rescue medication was significantly less required in the G and M groups compared to the other two groups (P < 0.01. Less satisfaction, according to PONV status, was observed in the P and N groups (P < 0.01.
    • CONCLUSIONS: According to this study, metoclopramide and granisetron, but not gastric decompression, are effective regimens for preventing PONV after FTCA. Given the economics and a considerable background incidence in patients exhibiting PONV, we suggest metoclopramide as a routine prophylactic antiemetic in FTCA

    • Effect of fast-track cardiac anesthesia on myocardial oxidative damage, inflammation and nerve related peptides of patients undergoing cardiac operation

      Directory of Open Access Journals (Sweden)

      Xing-Tao Cai

      2016-01-01

      Full Text Available Objective: To study the effect of fast-track cardiac anesthesia on myocardial oxidative damage, inflammation and nerve related peptides of patients undergoing cardiac operation. Methods: Sixty patients with rheumatic heart disease undergoing heart valve surgery were randomly divided into the fast track group (n=30 and conventional group (n=30. Then myocardial injury indicators, mitochondrial oxidative stress indicators, inflammation indicators and nerverelated peptides of both groups were analyzed. Results: cTnI contents at T2-T4 points in time of both groups showed an increasing trend and the increasing trend of fast track group was weaker than that of conventional group; SOD contents as well as mitochondrial tristate respiratory function, respiratory control ratios and phosphorus oxygen ratios in myocardial tissue of fast track group were higher than those of conventional group, and MDA contents was lower than those of conventional group; plasma TNF-α, IL-6, IL-8, NSE, S100β and Aβ contents of fast track group were lower than those of conventional group. Conclusions: Fasttrack cardiac anesthesia can protect myocardial cells, reduce mitochondrial oxidative stress, relieve inflammation and improve nerve function; it is an ideal anesthesia method for cardiac operation.

    • A new approach for the screening of carotid lesions: a 'fast-track' method with the use of new generation hand-held ultrasound devices.

      Science.gov (United States)

      Aboyans, V; Lacroix, P; Jeannicot, A; Guilloux, J; Bertin, F; Laskar, M

      2004-09-01

      We assessed the usefulness of fast-track neck sonography with a new-generation hand-held ultrasound scanner in the detection of > or =60% carotid stenosis. Patients with a past history of atherosclerotic disease or presence of risk factors were enrolled. All had fast-track carotid screening with a hand-held ultrasound scanner. Initial assessment was performed with our quick imaging protocol. A second examiner performed a conventional complete carotid duplex as gold-standard. We enrolled 197 consecutive patients with a mean age of 67 years (range 35-94). A carotid stenosis >60% was detected in 13 cases (6%). The sensitivity, specificity, positive and negative predictive value of fast-track sonography was 100%, 64%, 17% and 100%, respectively. Concomitant power Doppler imaging during the fast-track method did not improve accuracy. The use of a fast-track method with a hand-held ultrasound device can reduce the number of unnecessary carotid Duplex and enhance the screening efficiency without missing significant carotid stenoses.

    • AUTOMATIC FAST VIDEO OBJECT DETECTION AND TRACKING ON VIDEO SURVEILLANCE SYSTEM

      Directory of Open Access Journals (Sweden)

      V. Arunachalam

      2012-08-01

      Full Text Available This paper describes the advance techniques for object detection and tracking in video. Most visual surveillance systems start with motion detection. Motion detection methods attempt to locate connected regions of pixels that represent the moving objects within the scene; different approaches include frame-to-frame difference, background subtraction and motion analysis. The motion detection can be achieved by Principle Component Analysis (PCA and then separate an objects from background using background subtraction. The detected object can be segmented. Segmentation consists of two schemes: one for spatial segmentation and the other for temporal segmentation. Tracking approach can be done in each frame of detected Object. Pixel label problem can be alleviated by the MAP (Maximum a Posteriori technique.

    • Fast neutron irradiation effects on CR-39 nuclear track detector for dosimetric applications

      International Nuclear Information System (INIS)

      Kader, M.H.

      2005-01-01

      The effect of neutron irradiation on the dosimetric properties of CR-39 solid-state nuclear track detector have been investigated. CR-39 samples were irradiated with neutrons of energies follow a Maxwellian distribution centered about 2 MeV. These samples were irradiated with different doses in the range 0.1-1 Sv. The background and track density were measured as a function of etching time. In addition, the dependence of sensitivity of CR-39 detector on the neutrons dose has been investigated. The results show that the Sensitivity started to increase at 0.4 Sv neutrons dose, so this sample were chosen to be a subject for further study to investigate the effect of gamma dose on its properties. The sample irradiated with 0.4 Sv were exposed to different doses of gamma rays at levels between 10 and 80 kGy. The effect of gamma doses on the bulk etching rate VB, the track diameter and the sensitivity of the CR-39 samples was investigated. The results show that the dosimetric properties of CR-39 SSNTD are greatly affected by both neutron and gamma irradiation

    • Fast leaf-fitting with generalized underdose/overdose constraints for real-time MLC tracking

      International Nuclear Information System (INIS)

      Moore, Douglas; Sawant, Amit; Ruan, Dan

      2016-01-01

      Purpose: Real-time multileaf collimator (MLC) tracking is a promising approach to the management of intrafractional tumor motion during thoracic and abdominal radiotherapy. MLC tracking is typically performed in two steps: transforming a planned MLC aperture in response to patient motion and refitting the leaves to the newly generated aperture. One of the challenges of this approach is the inability to faithfully reproduce the desired motion-adapted aperture. This work presents an optimization-based framework with which to solve this leaf-fitting problem in real-time. Methods: This optimization framework is designed to facilitate the determination of leaf positions in real-time while accounting for the trade-off between coverage of the PTV and avoidance of organs at risk (OARs). Derived within this framework, an algorithm is presented that can account for general linear transformations of the planned MLC aperture, particularly 3D translations and in-plane rotations. This algorithm, together with algorithms presented in Sawant et al. [“Management of three-dimensional intrafraction motion through real-time DMLC tracking,” Med. Phys. 35, 2050–2061 (2008)] and Ruan and Keall [Presented at the 2011 IEEE Power Engineering and Automation Conference (PEAM) (2011) (unpublished)], was applied to apertures derived from eight lung intensity modulated radiotherapy plans subjected to six-degree-of-freedom motion traces acquired from lung cancer patients using the kilovoltage intrafraction monitoring system developed at the University of Sydney. A quality-of-fit metric was defined, and each algorithm was evaluated in terms of quality-of-fit and computation time. Results: This algorithm is shown to perform leaf-fittings of apertures, each with 80 leaf pairs, in 0.226 ms on average as compared to 0.082 and 64.2 ms for the algorithms of Sawant et al., Ruan, and Keall, respectively. The algorithm shows approximately 12% improvement in quality-of-fit over the Sawant et al

    • Fast track-finding trigger processor for the SLAC/LBL Mark II Detector

      International Nuclear Information System (INIS)

      Brafman, H.; Breidenbach, M.; Hettel, R.; Himel, T.; Horelick, D.

      1977-10-01

      The SLAC/LBL Mark II Magnetic Detector consists of various particle detectors arranged in cylindrical symmetry located in and around an axial magnetic field. A versatile, programmable secondary trigger processor was designed and built to find curved tracks in the detector. The system operates at a 10 MHz clock rate with a total processing time of 34 μsec and is used to ''trigger'' the data processing computer, thereby rejecting background and greatly improving the data acquisition aspects of the detector-computer combination

    • Fast leaf-fitting with generalized underdose/overdose constraints for real-time MLC tracking

      Energy Technology Data Exchange (ETDEWEB)

      Moore, Douglas, E-mail: douglas.moore@utsouthwestern.edu; Sawant, Amit [Department of Radiation Oncology, UT Southwestern Medical Center, Dallas, Texas 75390 (United States); Ruan, Dan [Department of Radiation Oncology, University of California, Los Angeles, California 90095 (United States)

      2016-01-15

      Purpose: Real-time multileaf collimator (MLC) tracking is a promising approach to the management of intrafractional tumor motion during thoracic and abdominal radiotherapy. MLC tracking is typically performed in two steps: transforming a planned MLC aperture in response to patient motion and refitting the leaves to the newly generated aperture. One of the challenges of this approach is the inability to faithfully reproduce the desired motion-adapted aperture. This work presents an optimization-based framework with which to solve this leaf-fitting problem in real-time. Methods: This optimization framework is designed to facilitate the determination of leaf positions in real-time while accounting for the trade-off between coverage of the PTV and avoidance of organs at risk (OARs). Derived within this framework, an algorithm is presented that can account for general linear transformations of the planned MLC aperture, particularly 3D translations and in-plane rotations. This algorithm, together with algorithms presented in Sawant et al. [“Management of three-dimensional intrafraction motion through real-time DMLC tracking,” Med. Phys. 35, 2050–2061 (2008)] and Ruan and Keall [Presented at the 2011 IEEE Power Engineering and Automation Conference (PEAM) (2011) (unpublished)], was applied to apertures derived from eight lung intensity modulated radiotherapy plans subjected to six-degree-of-freedom motion traces acquired from lung cancer patients using the kilovoltage intrafraction monitoring system developed at the University of Sydney. A quality-of-fit metric was defined, and each algorithm was evaluated in terms of quality-of-fit and computation time. Results: This algorithm is shown to perform leaf-fittings of apertures, each with 80 leaf pairs, in 0.226 ms on average as compared to 0.082 and 64.2 ms for the algorithms of Sawant et al., Ruan, and Keall, respectively. The algorithm shows approximately 12% improvement in quality-of-fit over the Sawant et al

    • Indirect Effects of the Fast Track Intervention on Conduct Disorder Symptoms and Callous-Unemotional Traits: Distinct Pathways Involving Discipline and Warmth.

      Science.gov (United States)

      Pasalich, Dave S; Witkiewitz, Katie; McMahon, Robert J; Pinderhughes, Ellen E

      2016-04-01

      Little is known about intervening processes that explain how prevention programs improve particular youth antisocial outcomes. We examined whether parental harsh discipline and warmth in childhood differentially account for Fast Track intervention effects on conduct disorder (CD) symptoms and callous-unemotional (CU) traits in early adolescence. Participants included 891 high-risk kindergarteners (69% male; 51% African American) from urban and rural United States communities who were randomized into either the Fast Track intervention (n = 445) or non-intervention control (n = 446) groups. The 10-year intervention included parent management training and other services (e.g., social skills training, universal classroom curriculum) targeting various risk factors for the development of conduct problems. Harsh discipline (Grades 1 to 3) and warmth (Grades 1 and 2) were measured using parent responses to vignettes and direct observations of parent-child interaction, respectively. Parents reported on children's CD symptoms in Grade 6 and CU traits in Grade 7. Results demonstrated indirect effects of the Fast Track intervention on reducing risk for youth antisocial outcomes. That is, Fast Track was associated with lower scores on harsh discipline, which in turn predicted decreased levels of CD symptoms. In addition, Fast Track was associated with higher scores on warmth, which in turn predicted reduced levels of CU traits. Our findings inform developmental and intervention models of youth antisocial behavior by providing evidence for the differential role of harsh discipline and warmth in accounting for indirect effects of Fast Track on CD symptoms versus CU traits, respectively.

    • A reengineering success story: process improvement in emergency department x-ray cycle time, leading to breakthrough performance in the ED ambulatory care (Fast Track) process.

      Science.gov (United States)

      Espinosa, J A; Treiber, P M; Kosnik, L

      1997-01-01

      This article describes the journey of a multidisciplinary reengineering team, which worked to reduce a critical, high-leverage process in an emergency department setting. The process selected was emergency department radiology services. This process was selected on a rational basis. The team knew tht 60 percent of our emergency department patients were truly ambulatory, and that most could be seen in a "fast track" process as part of our emergency department's core mission. However, we knew from customer satisfaction data, that patients would like to be "in and out" of emergency department Fast Track in less than an hour. Over half of our Fast Track patients require x-rays. For most, this was their sole reason for seeking emergency care. Our state, at the start of the project, included an average x-ray cycle time of over 60 minutes. The associated Fast-Track cycle time was over 90 minutes median. It was clear to the emergency department leadership, as well as to members of the Fast-Track management team, that a cycle time of 30 minutes or less for x-ray service was needed as a necessary condition to an hour or less Fast Track cycle time. It was also felt that a more rapid x-ray cycle time would allow for more rapid turn over of ED rooms, leading to a virtual greater capacity to the ED. It was hoped that this would lead to a reduction in the time from arrival to treatment by the emergency physician for all patients.

    • IODA - a fast, automated and flexible system for ion track analysis on film detectors

      International Nuclear Information System (INIS)

      Guth, H.; Hellmann, A.

      1995-02-01

      The IODA System (Ion Density Analysis) is used to analyse detector films, resulting from experiments at the pulse power generator KALIF (Karlsruhe Light Ion Facility). The system consists of evaluation software and a microcomputer, which controls a microscope, a video interface, and a multiprocessor subsystem. The segmentation of ion tracks is done automatically by means of digital image processing and pattern recognition. After defining an evaluation range and selecting a suitable analysis method, the film is scanned by the microscope for counting the impacts of the underlying image. According to the appearance of the ion tracks on the film, different methods can be selected. The evaluation results representing the ion density are stored in a matrix. The time needed for an evaluation at a high resolution can be shortened by shipping time consuming pattern recognition calculations to the multiprocessor subsystem. The bottlenecks of the system are the data transfer and the speed of the microscope stage. Simple handling of the system even on alphanumeric terminals had been an important design issue. This was implemented by a logically structured menue system including online help features. This report can be used a s a manual to support the user with system operation. (orig.) [de

    • Fast front-end electronics for semiconductor tracking detectors: Trends and perspectives

      Energy Technology Data Exchange (ETDEWEB)

      Rivetti, Angelo

      2014-11-21

      In the past few years, extensive research efforts pursued by both the industry and the academia have lead to major improvements in the performance of Analog to Digital Converters (ADCs) and Time to Digital Converters (TDCs). ADCs achieving 8–10 bit resolution, 50–100 MHz conversion frequency and less than 1 mW power consumption are the today's standard, while TDCs have reached sub-picosecond time resolution. These results have been made possible by architectural upgrades combined with the use of ultra deep submicron CMOS technologies with minimum feature size of 130 nm or smaller. Front-end ASICs in which a prompt digitization is followed by signal conditioning in the digital domain can now be envisaged also within the tight power budget typically available in high density tracking systems. Furthermore, tracking detectors embedding high resolution timing capabilities are gaining interest. In the paper, ADC's and TDC's developments which are of particular relevance for the design front-end electronics for semiconductor trackers are discussed along with the benefits and challenges of exploiting such high performance building blocks in implementing the next generation of ASICs for high granularity particle detectors.

    • Fast track segment finding in the Monitored Drift Tubes of the ATLAS Muon Spectrometer using a Legendre transform algorithm

      CERN Document Server

      Ntekas, Konstantinos; The ATLAS collaboration

      2018-01-01

      The upgrade of the ATLAS first-level muon trigger for High- Luminosity LHC foresees incorporating the precise tracking of the Monitored Drift Tubes in the current system based on Resistive Plate Chambers and Thin Gap Chambers to improve the accuracy in the transverse momentum measurement and control the single muon trigger rate by suppressing low quality fake triggers. The core of the MDT trigger algorithm is the segment identification and reconstruction which is performed per MDT chamber. The reconstructed segment positions and directions are then combined to extract the muon candidate’s transverse momentum. A fast pattern recognition segment finding algorithm, called the Legendre transform, is proposed to be used for the MDT trigger, implemented in a FPGA housed on a ATCA blade.

    • Nopea toipuminen lihavuusleikkauksen jälkeen : Fast track- toimintamallin mukainen potilasohjausvihko lihavuusleikkauspotilaalle Oulun yliopistollisen sairaalan osastolle yhdeksän

      OpenAIRE

      Niskala, Jenni; Nevala, Elisa

      2013-01-01

      Oulun yliopistollisen sairaalan osastolla yhdeksän oli tarve saada Fast track -toimintamallin mukainen potilasohjausvihko lihavuusleikkauspotilaille. Opinnäytetyön tekijät valitsivat opinnäytetyön aiheen perioperatiivisen suuntautumisvaihtoehdon mukaan. Tämä opinnäytetyö toteutettiin projektityönä. Opinnäytetyön tarkoituksena oli tehdä Fast track- toimintamallin mukainen potilasohjausvihko Oulun Yliopistollisen sairaalan osasto yhdeksän käyttöön. Opinnäytetyön tavoitteena oli edesauttaa ...

    • The impact of a fast track area on quality and effectiveness outcomes: a Middle Eastern emergency department perspective.

      LENUS (Irish Health Repository)

      Devkaran, Subashnie

      2009-01-01

      BACKGROUND: Emergency department (ED) overcrowding is a ubiquitous problem with serious public health implications. The fast track area is a novel method which aims to reduce waiting time, patient dissatisfaction and morbidity. |The study objective was to determine the impact of a fast track area (FTA) on both effectiveness measures (i.e. waiting times [WT] and length of stay [LOS]) and quality measures (i.e. LWBS rates and mortality rates) in non-urgent patients. The secondary objective was to assess if a FTA negatively impacted on urgent patients entering the ED. METHODS: The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706). RESULTS: Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, P < 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, P < 0.001) post FTA. The mean WTs of urgent patients (CTAS 2\\/3) were also significantly reduced after the FTA was opened (P < 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; P < 0.001). Opening a FTA had no significant impact on mortality rates (P = 0.88). CONCLUSION: The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.

    • Fast-track surgery protocol in elderly patients undergoing laparoscopic radical gastrectomy for gastric cancer: a randomized controlled trial

      Directory of Open Access Journals (Sweden)

      Liu G

      2016-06-01

      Full Text Available Guozheng Liu,1 Fengguo Jian,2 Xiuqin Wang,2 Lin Chen1 1Department of General Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China; 2Second Department of General Surgery, Changyi People’s Hospital, Shandong, People’s Republic of China Aim: To study the efficacy of the fast-track surgery (FTS program combined with laparoscopic radical gastrectomy for elderly gastric cancer (GC patients.Methods: Eighty-four elderly patients diagnosed with GC between September 2014 and August 2015 were recruited to participate in this study and were divided into four groups randomly based on the random number table as follows: FTS + laparoscopic group (Group A, n=21, FTS + laparotomy group (Group B, n=21, conventional perioperative care (CC + laparoscopic group (Group C, n=21, and CC + laparotomy group (Group D, n=21. Observation indicators include intrasurgery indicators, postoperative recovery indicators, nutritional status indicators, and systemic stress response indicators.Results: Preoperative and intraoperative baseline characteristics showed no significant differences between patients in each group (P>0.05. There were no significant differences between each group in nausea and vomiting, intestinal obstruction, urinary retention, incision infection, pulmonary infection, and urinary tract infection after operation (P>0.05. Time of first flatus and postoperative hospital stay time of FTS Group A were the shortest, and total medical cost of this group was the lowest. For all groups, serum albumin, prealbumin, and transferrin significantly decreased, while CRP and interleukin 6 were significantly increased postoperative day 1. From postoperative day 4–7, all indicators of the four groups gradually recovered, but compared with other three groups, those of Group A recovered fastest.Conclusion: FTS combined with laparoscopic surgery can promote faster postoperative recovery, improve early postoperative nutritional status, and more

    • Can eye-tracking technology improve situational awareness in paramedic clinical education?

      Science.gov (United States)

      Williams, Brett; Quested, Andrew; Cooper, Simon

      2013-01-01

      Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing medical error: eye-tracking technology can be used to provide an objective and qualitative measure of the initial perception component of SA. Feedback from eye-tracking technology can be used to improve the understanding and teaching of SA in clinical contexts, and consequently, has potential for reducing clinician error and the concomitant adverse events.

    • The design and simulated performance of a fast Level 1 track trigger for the ATLAS High Luminosity Upgrade

      CERN Document Server

      Martensson, Mikael; The ATLAS collaboration

      2017-01-01

      The ATLAS experiment at the high-luminosity LHC will face a five-fold increase in the number of interactions per collision relative to the ongoing Run 2. This will require a proportional improvement in rejection power at the earliest levels of the detector trigger system, while preserving good signal efficiency. One critical aspect of this improvement will be the implementation of precise track reconstruction, through which sharper trigger turn-on curves can be achieved, and b-tagging and tau-tagging techniques can in principle be implemented. The challenge of such a project comes in the development of a fast, custom electronic device integrated in the hardware-based first trigger level of the experiment, with repercussions propagating as far as the detector read-out philosophy. This talk will discuss the requirements, architecture and projected performance of the system in terms of tracking, timing and physics, based on detailed simulations. Studies are carried out comparing two detector geometries and using...

  1. Beam dynamics analysis of dielectric laser acceleration using a fast 6D tracking scheme

    Directory of Open Access Journals (Sweden)

    Uwe Niedermayer

    2017-11-01

    Full Text Available A six-dimensional symplectic tracking approach exploiting the periodicity properties of dielectric laser acceleration (DLA gratings is presented. The longitudinal kick is obtained from the spatial Fourier harmonics of the laser field within the structure, and the transverse kicks are obtained using the Panofsky-Wenzel theorem. Additionally to the usual, strictly longitudinally periodic gratings, our approach is also applicable to periodicity chirped (subrelativistic and tilted (deflection gratings. In the limit of small kicks and short periods we obtain the 6D Hamiltonian, which allows, for example, to obtain matched beam distributions in DLAs. The scheme is applied to beam and grating parameters similar to recently performed experiments. The paper concludes with an outlook to laser based focusing schemes, which are promising to overcome fundamental interaction length limitations, in order to build an entire microchip-sized laser driven accelerator.

  2. An energy and direction independent fast neutron dosemeter based on electrochemically etched CR-39 nuclear track detectors

    International Nuclear Information System (INIS)

    James, K.; Matiullah; Durrani, S.A.

    1987-01-01

    A computer-based model is presented, which simulates the dose equivalent response of electrochemically etched CR-39 to fast neutrons of various energies and angles of incidence. Most previous calculations of the response of CR-39 have neglected the production of recoiling oxygen and carbon nuclei as well as α particles in the CR-39. We calculate that these 'heavy recoils' and α particles are the major source of electrochemically etchable tracks in bare CR-39 at neutron energies above approx. 2 MeV under typical etching conditions. Our calculations have been extended to predict the response of CR-39 used in conjunction with various combinations of polymeric front radiators and we have determined the radiator stack configuration with produces the most energy independent response. Again, the heavy recoils and α particles cannot be neglected and, for energies above approx. 2 MeV, these produce typically about 20% of the total response of our optimum stack. This type of fast neutron dosemeter is, however, strongly direction dependent. We have integrated the response over all appropriate angles to predict the dose equivalent response for two representative neutron fields, and we suggest a method for minimising the angular dependence. (author)

  3. Transforming clinical practice guidelines and clinical pathways into fast-and-frugal decision trees to improve clinical care strategies.

    Science.gov (United States)

    Djulbegovic, Benjamin; Hozo, Iztok; Dale, William

    2018-02-27

    Contemporary delivery of health care is inappropriate in many ways, largely due to suboptimal Q5 decision-making. A typical approach to improve practitioners' decision-making is to develop evidence-based clinical practice guidelines (CPG) by guidelines panels, who are instructed to use their judgments to derive practice recommendations. However, mechanisms for the formulation of guideline judgments remains a "black-box" operation-a process with defined inputs and outputs but without sufficient knowledge of its internal workings. Increased explicitness and transparency in the process can be achieved by implementing CPG as clinical pathways (CPs) (also known as clinical algorithms or flow-charts). However, clinical recommendations thus derived are typically ad hoc and developed by experts in a theory-free environment. As any recommendation can be right (true positive or negative), or wrong (false positive or negative), the lack of theoretical structure precludes the quantitative assessment of the management strategies recommended by CPGs/CPs. To realize the full potential of CPGs/CPs, they need to be placed on more solid theoretical grounds. We believe this potential can be best realized by converting CPGs/CPs within the heuristic theory of decision-making, often implemented as fast-and-frugal (FFT) decision trees. This is possible because FFT heuristic strategy of decision-making can be linked to signal detection theory, evidence accumulation theory, and a threshold model of decision-making, which, in turn, allows quantitative analysis of the accuracy of clinical management strategies. Fast-and-frugal provides a simple and transparent, yet solid and robust, methodological framework connecting decision science to clinical care, a sorely needed missing link between CPGs/CPs and patient outcomes. We therefore advocate that all guidelines panels express their recommendations as CPs, which in turn should be converted into FFTs to guide clinical care. © 2018 John Wiley

  4. Dexmedetomidine; an adjuvant drug for fast track technique in pediatric cardiac surgery

    Directory of Open Access Journals (Sweden)

    Gamal Z. El-Morsy

    2014-10-01

    Conclusion: Dexmedetomidine is a short-acting alpha2-adrenoceptor agonist with many desirable clinical benefits that encourage its use in the perioperative period. Dexmedetomidine has anesthesia-sparing effects, it decreases MAP, HR and with reasonable analgesic effect.

  5. Study Protocol: Phase III single-blinded fast-track pragmatic randomised controlled trial of a complex intervention for breathlessness in advanced disease

    Directory of Open Access Journals (Sweden)

    Brafman-Kennedy Barbara

    2011-05-01

    Full Text Available Abstract Background Breathlessness in advanced disease causes significant distress to patients and carers and presents management challenges to health care professionals. The Breathlessness Intervention Service (BIS seeks to improve the care of breathless patients with advanced disease (regardless of cause through the use of evidence-based practice and working with other healthcare providers. BIS delivers a complex intervention (of non-pharmacological and pharmacological treatments via a multi-professional team. BIS is being continuously developed and its impact evaluated using the MRC's framework for complex interventions (PreClinical, Phase I and Phase II completed. This paper presents the protocol for Phase III. Methods/Design Phase III comprises a pragmatic, fast-track, single-blind randomised controlled trial of BIS versus standard care. Due to differing disease trajectories, the service uses two broad service models: one for patients with malignant disease (intervention delivered over two weeks and one for patients with non-malignant disease (intervention delivered over four weeks. The Phase III trial therefore consists of two sub-protocols: one for patients with malignant conditions (four week protocol and one for patients with non-malignant conditions (eight week protocol. Mixed method interviews are conducted with patients and their lay carers at three to five measurement points depending on randomisation and sub-protocol. Qualitative interviews are conducted with referring and non-referring health care professionals (malignant disease protocol only. The primary outcome measure is 'patient distress due to breathlessness' measured on a numerical rating scale (0-10. The trial includes economic evaluation. Analysis will be on an intention to treat basis. Discussion This is the first evaluation of a breathlessness intervention for advanced disease to have followed the MRC framework and one of the first palliative care trials to use fast

  6. Open LED Illuminator: A Simple and Inexpensive LED Illuminator for Fast Multicolor Particle Tracking in Neurons

    Science.gov (United States)

    Bosse, Jens B.; Tanneti, Nikhila S.; Hogue, Ian B.; Enquist, Lynn W.

    2015-01-01

    Dual-color live cell fluorescence microscopy of fast intracellular trafficking processes, such as axonal transport, requires rapid switching of illumination channels. Typical broad-spectrum sources necessitate the use of mechanical filter switching, which introduces delays between acquisition of different fluorescence channels, impeding the interpretation and quantification of highly dynamic processes. Light Emitting Diodes (LEDs), however, allow modulation of excitation light in microseconds. Here we provide a step-by-step protocol to enable any scientist to build a research-grade LED illuminator for live cell microscopy, even without prior experience with electronics or optics. We quantify and compare components, discuss our design considerations, and demonstrate the performance of our LED illuminator by imaging axonal transport of herpes virus particles with high temporal resolution. PMID:26600461

  7. Open LED Illuminator: A Simple and Inexpensive LED Illuminator for Fast Multicolor Particle Tracking in Neurons.

    Directory of Open Access Journals (Sweden)

    Jens B Bosse

    Full Text Available Dual-color live cell fluorescence microscopy of fast intracellular trafficking processes, such as axonal transport, requires rapid switching of illumination channels. Typical broad-spectrum sources necessitate the use of mechanical filter switching, which introduces delays between acquisition of different fluorescence channels, impeding the interpretation and quantification of highly dynamic processes. Light Emitting Diodes (LEDs, however, allow modulation of excitation light in microseconds. Here we provide a step-by-step protocol to enable any scientist to build a research-grade LED illuminator for live cell microscopy, even without prior experience with electronics or optics. We quantify and compare components, discuss our design considerations, and demonstrate the performance of our LED illuminator by imaging axonal transport of herpes virus particles with high temporal resolution.

  8. Clinical applications of the imatron fast CT scanner

    International Nuclear Information System (INIS)

    Stanford, W.

    1986-01-01

    Utilizing three imaging modes, Cine CT has proven satisfactory in the assessment of left ventricular mass and function including ejection fractions and abnormalities of wall motion. It is helpful in documenting pericardial constrictions, as well as in assessing intracavitary tumors and thrombi. In the lungs, it is used to document AV fistulae and to evaluate the vascularity of mediastinal masses and to exclude invasion or major thoracic vessels. It can be used, as in the conventional scanner, for needle directed lung and chest well biopsies. It is frequently used in a airway studies to differentiate fixed from physiologic constrictions and to assess tracheomalacia and bronchopulmonary dysplasias. It can be used to plan radiation ports in the treatment of breast carcinoma. In the abdomen, successful applications include its use in the assessment of renal blood flow and the evaluation of cavernous hemangiomas of the liver as well as in screening of possible aortic aneurysms. In orthopedics, Cine CT is used to evaluate patellofermoral tracking in subluxations of the patella and used to evaluate subluxations and dislocations of the radio-ulnar joint. Cine CT by virtue of its speed and satisfactory spatial resolution is a significant imaging modality for evaluating the beating heart. Other applications include the evaluation of aortic aneurysms and dissections, para-aortic mass lesions, airway obstructions and patellar tracking and forearm subluxations

  9. Design and DSP implementation of star image acquisition and star point fast acquiring and tracking

    Science.gov (United States)

    Zhou, Guohui; Wang, Xiaodong; Hao, Zhihang

    2006-02-01

    Star sensor is a special high accuracy photoelectric sensor. Attitude acquisition time is an important function index of star sensor. In this paper, the design target is to acquire 10 samples per second dynamic performance. On the basis of analyzing CCD signals timing and star image processing, a new design and a special parallel architecture for improving star image processing are presented in this paper. In the design, the operation moving the data in expanded windows including the star to the on-chip memory of DSP is arranged in the invalid period of CCD frame signal. During the CCD saving the star image to memory, DSP processes the data in the on-chip memory. This parallelism greatly improves the efficiency of processing. The scheme proposed here results in enormous savings of memory normally required. In the scheme, DSP HOLD mode and CPLD technology are used to make a shared memory between CCD and DSP. The efficiency of processing is discussed in numerical tests. Only in 3.5ms is acquired the five lightest stars in the star acquisition stage. In 43us, the data in five expanded windows including stars are moved into the internal memory of DSP, and in 1.6ms, five star coordinates are achieved in the star tracking stage.

  10. The design of a fast Level-1 track trigger for the high luminosity upgrade of ATLAS.

    CERN Document Server

    AUTHOR|(INSPIRE)INSPIRE-00413032; The ATLAS collaboration

    2016-01-01

    The high/luminosity upgrade of the LHC will increase the rate of the proton-proton collisions by approximately a factor of 5 with respect to the initial LHC-design. The ATLAS experiment will upgrade consequently, increasing its robustness and selectivity in the expected high radiation environment. In particular, the earliest, hardware based, ATLAS trigger stage ("Level 1") will require higher rejection power, still maintaining efficient selection on many various physics signatures. The key ingredient is the possibility of extracting tracking information from the brand new full-silicon detector and use it for the process. While fascinating, this solution poses a big challenge in the choice of the architecture, due to the reduced latency available at this trigger level (few tens of micro-seconds) and the high expected working rates (order of MHz). In this paper, we review the design possibilities of such a system in a potential new trigger and readout architecture, and present the performance resulting from a d...

  11.  MULTIMODAL ANALGESIA IN FAST TRACK HIP AND KNEE ARTHROPLASTY

    DEFF Research Database (Denmark)

    Holm, Bente; Bak, Mikkel; Kristensen, Billy Bjarne

    underwent the "Timed Up & Go" test, a test for functional mobility. Patients were discharged according to criteria mentioned above and were asked to evaluate the quality of the hospital stay. EVALUATION: LOS was decreased for the THA patients from an already accelerated track of 3.8 days to 3.1 days...... to 2.5 for THA, and for TKA from 5.0 to 3.6. Gait VAS mean score for THA was 2.8 at day one, reduced to 1.9 at discharge, and for TKA from 5.2 to 2.4. The TUG test for THA showed a mean value of 27.4 sec. at day two, reduced at discharge to 21.0 sec. For TKA from 31.3 to 22.0 sec. At discharge patients......-up after rehabilitation are needed. IMPLICATIONS: Due to the short LOS goals and guidelines for outpatients physiotherapy treatment including functional tests and outcome measurements are needed....

  12. FAST

    DEFF Research Database (Denmark)

    Zuidmeer-Jongejan, Laurian; Fernandez-Rivas, Montserrat; Poulsen, Lars K.

    2012-01-01

    ABSTRACT: The FAST project (Food Allergy Specific Immunotherapy) aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT), using subcutaneous injections with aqu...

  13. Spouses’ involvement in older patients’ fast-track programmes during total hip replacement using case management intervention. A study protocol of the SICAM-trial

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Kristensson, Jimmie

    2015-01-01

    Aim To present the protocol of a two-group quasi-experimental study of spouses’ involvement through case management (The SICAM-trial) in older patients’ fast-track programmes during total hip replacement. Background Patients in fast-track programmes are required to take an active part in their tr......Aim To present the protocol of a two-group quasi-experimental study of spouses’ involvement through case management (The SICAM-trial) in older patients’ fast-track programmes during total hip replacement. Background Patients in fast-track programmes are required to take an active part...... in their treatment and rehabilitation. Spouses of older patients can often provide valued practical and emotional support, reducing stress, pain and length of stay – yet they are seldom invited to participate in a supporting role. Design A two-group quasi-experimental design with pre-test and repeated post...... and subsequently include the intervention group to avoid contamination of the control group. A case manager will be recruited to perform the case management intervention. Data will be collected from both groups at baseline, 2 weeks and 3 months after surgery. Outcome measures for patients include: functional...

  14. 171. Funcionamiento y resultados del programa de fast-track en el tratamiento de la tetralogía de fallot

    Directory of Open Access Journals (Sweden)

    J. Orrit Palacios

    2010-01-01

    Conclusiones: La corrección completa de la tetralogía de Fallot con el programa de fast-track de anestesia disminuye la ventilación mecánica, la estancia en cuidados intensivos y el tiempo de hospitalización. Asimismo se reducen los costes económicos del tratamiento.

  15. Using location tracking data to assess efficiency in established clinical workflows.

    Science.gov (United States)

    Meyer, Mark; Fairbrother, Pamela; Egan, Marie; Chueh, Henry; Sandberg, Warren S

    2006-01-01

    Location tracking systems are becoming more prevalent in clinical settings yet applications still are not common. We have designed a system to aid in the assessment of clinical workflow efficiency. Location data is captured from active RFID tags and processed into usable data. These data are stored and presented visually with trending capability over time. The system allows quick assessments of the impact of process changes on workflow, and isolates areas for improvement.

  16. Improvements in fast-response flood modeling: desktop parallel computing and domain tracking

    Energy Technology Data Exchange (ETDEWEB)

    Judi, David R [Los Alamos National Laboratory; Mcpherson, Timothy N [Los Alamos National Laboratory; Burian, Steven J [UNIV. OF UTAH

    2009-01-01

    It is becoming increasingly important to have the ability to accurately forecast flooding, as flooding accounts for the most losses due to natural disasters in the world and the United States. Flood inundation modeling has been dominated by one-dimensional approaches. These models are computationally efficient and are considered by many engineers to produce reasonably accurate water surface profiles. However, because the profiles estimated in these models must be superimposed on digital elevation data to create a two-dimensional map, the result may be sensitive to the ability of the elevation data to capture relevant features (e.g. dikes/levees, roads, walls, etc...). Moreover, one-dimensional models do not explicitly represent the complex flow processes present in floodplains and urban environments and because two-dimensional models based on the shallow water equations have significantly greater ability to determine flow velocity and direction, the National Research Council (NRC) has recommended that two-dimensional models be used over one-dimensional models for flood inundation studies. This paper has shown that two-dimensional flood modeling computational time can be greatly reduced through the use of Java multithreading on multi-core computers which effectively provides a means for parallel computing on a desktop computer. In addition, this paper has shown that when desktop parallel computing is coupled with a domain tracking algorithm, significant computation time can be eliminated when computations are completed only on inundated cells. The drastic reduction in computational time shown here enhances the ability of two-dimensional flood inundation models to be used as a near-real time flood forecasting tool, engineering, design tool, or planning tool. Perhaps even of greater significance, the reduction in computation time makes the incorporation of risk and uncertainty/ensemble forecasting more feasible for flood inundation modeling (NRC 2000; Sayers et al

  17. High rate particle tracking and ultra-fast timing with a thin hybrid silicon pixel detector

    Science.gov (United States)

    Fiorini, M.; Aglieri Rinella, G.; Carassiti, V.; Ceccucci, A.; Cortina Gil, E.; Cotta Ramusino, A.; Dellacasa, G.; Garbolino, S.; Jarron, P.; Kaplon, J.; Kluge, A.; Marchetto, F.; Mapelli, A.; Martin, E.; Mazza, G.; Morel, M.; Noy, M.; Nuessle, G.; Perktold, L.; Petagna, P.; Petrucci, F.; Poltorak, K.; Riedler, P.; Rivetti, A.; Statera, M.; Velghe, B.

    2013-08-01

    The Gigatracker (GTK) is a hybrid silicon pixel detector designed for the NA62 experiment at CERN. The beam spectrometer, made of three GTK stations, has to sustain high and non-uniform particle rate (∼ 1 GHz in total) and measure momentum and angles of each beam track with a combined time resolution of 150 ps. In order to reduce multiple scattering and hadronic interactions of beam particles, the material budget of a single GTK station has been fixed to 0.5% X0. The expected fluence for 100 days of running is 2 ×1014 1 MeV neq /cm2, comparable to the one foreseen in the inner trackers of LHC detectors during 10 years of operation. To comply with these requirements, an efficient and very low-mass (< 0.15 %X0) cooling system is being constructed, using a novel microchannel cooling silicon plate. Two complementary read-out architectures have been produced as small-scale prototypes: one is based on a Time-over-Threshold circuit followed by a TDC shared by a group of pixels, while the other makes use of a constant-fraction discriminator followed by an on-pixel TDC. The read-out ASICs are produced in 130 nm IBM CMOS technology and will be thinned down to 100 μm or less. An overview of the Gigatracker detector system will be presented. Experimental results from laboratory and beam tests of prototype bump-bonded assemblies will be described as well. These results show a time resolution of about 170 ps for single hits from minimum ionizing particles, using 200 μm thick silicon sensors.

  18. Effects of intermittent fasting on body composition and clinical health markers in humans.

    Science.gov (United States)

    Tinsley, Grant M; La Bounty, Paul M

    2015-10-01

    Intermittent fasting is a broad term that encompasses a variety of programs that manipulate the timing of eating occasions by utilizing short-term fasts in order to improve body composition and overall health. This review examines studies conducted on intermittent fasting programs to determine if they are effective at improving body composition and clinical health markers associated with disease. Intermittent fasting protocols can be grouped into alternate-day fasting, whole-day fasting, and time-restricted feeding. Alternate-day fasting trials of 3 to 12 weeks in duration appear to be effective at reducing body weight (≈3%-7%), body fat (≈3-5.5 kg), total cholesterol (≈10%-21%), and triglycerides (≈14%-42%) in normal-weight, overweight, and obese humans. Whole-day fasting trials lasting 12 to 24 weeks also reduce body weight (≈3%-9%) and body fat, and favorably improve blood lipids (≈5%-20% reduction in total cholesterol and ≈17%-50% reduction in triglycerides). Research on time-restricted feeding is limited, and clear conclusions cannot be made at present. Future studies should examine long-term effects of intermittent fasting and the potential synergistic effects of combining intermittent fasting with exercise. © The Author(s) 2015. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Fasting Ramadan in chronic kidney disease patients: Clinical and biochemical effects

    Directory of Open Access Journals (Sweden)

    Bernieh Bassam

    2010-01-01

    Full Text Available Fasting of the month of Ramadan is a pillar of Islam. Muslim patients with chronic kidney disease (CKD usually fast this month. To determine the effects of fasting on renal function in CKD patients, we prospectively studied 31 (19 males and mean age 54 ±14.2 years CKD patients during the month of Ramadan 1426 Hijra (4 th October - 4 th November 2005; 14 patients were in stage III CKD, 12 had stage IV and 5 had stage V. The mean estimated glomerular filtration rate (e-GFR was 29 ± 16.3 mL/min. Diabetes was the main cause of CKD (19 (61% patients, and hypertension was present in 22 (71% patients. Clinical assessment and renal function tests were performed one month prior to fasting then during and a month later. Medications were taken in two divided doses at sunset (time of breaking the fast and pre dawn (before starting the fast. All patients fasted the whole month of Ramadan with a good tolerance, tendency to weight reduction, and lower systolic and diastolic blood pressure. eGFR showed a significant improvement during the fast and the month after. The blood sugar was high during fasting with an increment in the Hb A1c. There was better lipid profile, reduction of the pro-teinuria and urinary sodium. We conclude that this study demonstrates a good tolerance and safety of fasting Ramadan in CKD patients.

  20. Fast spin echo MRI techniques. Contrast characteristics and clinical potential

    International Nuclear Information System (INIS)

    Melki, P.; Mulkern, R.V.; Dacher, J.N.; Helenon, O.; Higuchi, N.; Oshio, K.; Jolesz, F.; Pourcelot, L.; Einstein, S.

    1993-01-01

    Based on partial RF echo planar principles, Fast Spin Echo techniques (FSE) were implemented on high field systems. These methods produce image quality and contrast which resemble to conventional spin echo (SE) techniques. By reducing acquisition times by factors between 1.4 and 16 over SE methods, FSE allows for several imaging options usually prohibitive with conventional spin echo (SE) sequences. These include fast scans (especially breathold acquisitions); improved T2 contrast with longer TR intervals; increased spatial resolution with the use of larger image matrices and/or smaller fields of view; and 3D volume imaging with a 3D multislab FSE technique. Contrast features of FSE techniques are directly comparable to those of multiple echo SE sequences using the same echo spacing than FSE methods. However, essential contrast differences existing between the FSE sequences and their routine asymmetric dual SE counterpart can be identified. Decreased magnetic susceptibility effects and increased fat signal present within T2 weighted images compared to conventional dual SE images are due to the use of shorter echo spacings employed in FSE sequences. Off-resonance irradiation inherent to the use of a large number of radio frequency pulses in shown to results in dramatic magnetization contrast transfer effects in FSE images acquired in multislice mode

  1. Knee Pain during Strength Training Shortly following Fast-Track Total Knee Arthroplasty

    DEFF Research Database (Denmark)

    Bandholm, Thomas; Thorborg, Kristian; Lunn, Troels Haxholdt

    2014-01-01

    BACKGROUND: Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA). It is unkn......BACKGROUND: Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA......). It is unknown how these exercise variables influence knee pain after TKA. OBJECTIVE: To investigate the effect of loading and contraction failure on knee pain during strength training, shortly following TKA. DESIGN: Cross-sectional study. SETTING: Consecutive sample of patients from the Copenhagen area, Denmark...... TKA. However, only the increase in pain during repetitions to contraction failure exceeded that defined as clinically relevant, and was very short-lived. TRIAL REGISTRATION: ClinicalTrials.gov NCT01729520....

  2. Measuring the radial density distribution of light emission around the track of fast ions in nitrogen

    International Nuclear Information System (INIS)

    Ibach, T.

    1983-01-01

    For analysing the emission and stopping of ionization electrons (σ-electrons) emitted by fast ions passing through a gas, the radial density distribution of the light emission of the (0,0) transition of two optical bands in nitrogen have been measured. The systems selected for the epxeriments are the 2nd positive system (2.PS) at 337.1 nm primarily excited by low-energy electrons of about 20 eV, and the first negative system (1.NS) at 391.4 nm excited by faster electrons and simultaneous ionization. The equipment developed for the experiments records the light emission with a telescope-type optical arrangement including interference filters, allowing high local resolution and dynamics of the measured range. The measurements have been carried out at pressures between 0.133 and 13.3 mbar, using photons of energies ranging from 270 keV to 2.8 MeV, helium 3 beams of 270 keV/u and 500 keV/u, and neon beams of 270 keV/u. Abel's inversion applied to the distance functions allows calculation of the spatial light emission density which is normalized for a gas density of 1 g/cm 3 . The profiles of the two bands indicate that the σ-electron spectrum gets harder in outward direction. Next to the beam the impact density decreases faster with increasing ion energy than the stopping power (increasing interaction range of the σ-electrons). With photon beams, about half of the whole light emission in the 1. NS, and of the ionization, is induced by primary interactions of the ion beam. This proportion decreases at constant energy per nucleon with increasing atomic number of the ions as compared with the σ-electrons. The primary σ-emission gets harder with higher atomic numbers. (orig./HP) [de

  3. A Fusion Nuclear Science Facility for a fast-track path to DEMO

    Energy Technology Data Exchange (ETDEWEB)

    Garofalo, A.M., E-mail: garofalo@fusion.gat.com [General Atomics, San Diego, CA (United States); Abdou, M.A. [University of California, Los Angeles, Los Angeles, CA (United States); Canik, J.M. [Oak Ridge National Laboratory, Oak Ridge, TN (United States); Chan, V.S.; Hyatt, A.W. [General Atomics, San Diego, CA (United States); Hill, D.N. [Lawrence Livermore National Laboratory, Livermore, CA (United States); Morley, N.B. [University of California, Los Angeles, Los Angeles, CA (United States); Navratil, G.A. [Columbia University, New York, NY (United States); Sawan, M.E. [University of Wisconsin Madison, Madison, WI (United States); Taylor, T.S.; Wong, C.P.C.; Wu, W. [General Atomics, San Diego, CA (United States); Ying, A. [University of California, Los Angeles, Los Angeles, CA (United States)

    2014-10-15

    Highlights: • A FNSF is needed to reduce the knowledge gaps to a fusion DEMO and accelerate progress toward fusion energy. • FNSF will test and qualify first-wall/blanket components and materials in a DEMO-relevant fusion environment. • The Advanced Tokamak approach enables reduced size and risks, and is on a direct path to an attractive target power plant. • Near term research focus on specific tasks can enable starting FNSF construction within the next ten years. - Abstract: An accelerated fusion energy development program, a “fast-track” approach, requires proceeding with a nuclear and materials testing program in parallel with research on burning plasmas, ITER. A Fusion Nuclear Science Facility (FNSF) would address many of the key issues that need to be addressed prior to DEMO, including breeding tritium and completing the fuel cycle, qualifying nuclear materials for high fluence, developing suitable materials for the plasma-boundary interface, and demonstrating power extraction. The Advanced Tokamak (AT) is a strong candidate for an FNSF as a consequence of its mature physics base, capability to address the key issues, and the direct relevance to an attractive target power plant. The standard aspect ratio provides space for a solenoid, assuring robust plasma current initiation, and for an inboard blanket, assuring robust tritium breeding ratio (TBR) >1 for FNSF tritium self-sufficiency and building of inventory needed to start up DEMO. An example design point gives a moderate sized Cu-coil device with R/a = 2.7 m/0.77 m, κ = 2.3, B{sub T} = 5.4 T, I{sub P} = 6.6 MA, β{sub N} = 2.75, P{sub fus} = 127 MW. The modest bootstrap fraction of ƒ{sub BS} = 0.55 provides an opportunity to develop steady state with sufficient current drive for adequate control. Proceeding with a FNSF in parallel with ITER provides a strong basis to begin construction of DEMO upon the achievement of Q ∼ 10 in ITER.

  4. Registration of clinical volumes to beams-eye-view images for real-time tracking

    Energy Technology Data Exchange (ETDEWEB)

    Bryant, Jonathan H.; Rottmann, Joerg; Lewis, John H.; Mishra, Pankaj; Berbeco, Ross I., E-mail: rberbeco@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006 (Australia)

    2014-12-15

    Purpose: The authors combine the registration of 2D beam’s eye view (BEV) images and 3D planning computed tomography (CT) images, with relative, markerless tumor tracking to provide automatic absolute tracking of physician defined volumes such as the gross tumor volume (GTV). Methods: During treatment of lung SBRT cases, BEV images were continuously acquired with an electronic portal imaging device (EPID) operating in cine mode. For absolute registration of physician-defined volumes, an intensity based 2D/3D registration to the planning CT was performed using the end-of-exhale (EoE) phase of the four dimensional computed tomography (4DCT). The volume was converted from Hounsfield units into electron density by a calibration curve and digitally reconstructed radiographs (DRRs) were generated for each beam geometry. Using normalized cross correlation between the DRR and an EoE BEV image, the best in-plane rigid transformation was found. The transformation was applied to physician-defined contours in the planning CT, mapping them into the EPID image domain. A robust multiregion method of relative markerless lung tumor tracking quantified deviations from the EoE position. Results: The success of 2D/3D registration was demonstrated at the EoE breathing phase. By registering at this phase and then employing a separate technique for relative tracking, the authors are able to successfully track target volumes in the BEV images throughout the entire treatment delivery. Conclusions: Through the combination of EPID/4DCT registration and relative tracking, a necessary step toward the clinical implementation of BEV tracking has been completed. The knowledge of tumor volumes relative to the treatment field is important for future applications like real-time motion management, adaptive radiotherapy, and delivered dose calculations.

  5. Automatic detection of recoil-proton tracks and background rejection criteria in liquid scintillator-micro-capillary-array fast neutron spectrometer

    Science.gov (United States)

    Mor, Ilan; Vartsky, David; Dangendorf, Volker; Tittelmeier, Kai.; Weierganz, Mathias; Goldberg, Mark Benjamin; Bar, Doron; Brandis, Michal

    2018-06-01

    We describe an analysis procedure for automatic unambiguous detection of fast-neutron-induced recoil proton tracks in a micro-capillary array filled with organic liquid scintillator. The detector is viewed by an intensified CCD camera. This imaging neutron detector possesses the capability to perform high position-resolution (few tens of μm), energy-dispersive transmission-imaging using ns-pulsed beams. However, when operated with CW or DC beams, it also features medium-quality spectroscopic capabilities for incident neutrons in the energy range 2-20 MeV. In addition to the recoil proton events which display a continuous extended track structure, the raw images exhibit complex ion-tracks from nuclear interactions of fast-neutrons in the scintillator, capillaries quartz-matrix and CCD. Moreover, as expected, one also observes a multitude of isolated scintillation spots of varying intensity (henceforth denoted "blobs") that originate from several different sources, such as: fragmented proton tracks, gamma-rays, heavy-ion reactions as well as events and noise that occur in the image-intensifier and CCD. In order to identify the continuous-track recoil proton events and distinguish them from all these background events, a rapid, computerized and automatic track-recognition-procedure was developed. Based on an appropriately weighted analysis of track parameters such as: length, width, area and overall light intensity, the method is capable of distinguishing a single continuous-track recoil proton from typically surrounding several thousands of background events that are found in each CCD frame.

  6. Voluntary total fasting in political prisoners – clinical and ...

    African Journals Online (AJOL)

    Sound doctor-patient relationships were established by eDlphasis of the principle of full patient participation in clinical decision-making at every level, by rejection of police interference in patient care, and by refusal to discharge subjects back into detention. Depression and abdominal pains were the predominant symptoms.

  7. Fast tracking the design of theory-based KT interventions through a consensus process.

    Science.gov (United States)

    Bussières, André E; Al Zoubi, Fadi; Quon, Jeffrey A; Ahmed, Sara; Thomas, Aliki; Stuber, Kent; Sajko, Sandy; French, Simon

    2015-02-11

    Despite available evidence for optimal management of spinal pain, poor adherence to guidelines and wide variations in healthcare services persist. One of the objectives of the Canadian Chiropractic Guideline Initiative is to develop and evaluate targeted theory- and evidence-informed interventions to improve the management of non-specific neck pain by chiropractors. In order to systematically develop a knowledge translation (KT) intervention underpinned by the Theoretical Domains Framework (TDF), we explored the factors perceived to influence the use of multimodal care to manage non-specific neck pain, and mapped behaviour change techniques to key theoretical domains. Individual telephone interviews exploring beliefs about managing neck pain were conducted with a purposive sample of 13 chiropractors. The interview guide was based upon the TDF. Interviews were digitally recorded, transcribed verbatim and analysed by two independent assessors using thematic content analysis. A 15-member expert panel formally met to design a KT intervention. Nine TDF domains were identified as likely relevant. Key beliefs (and relevant domains of the TDF) included the following: influence of formal training, colleagues and patients on clinicians (Social Influences); availability of educational material (Environmental Context and Resources); and better clinical outcomes reinforcing the use of multimodal care (Reinforcement). Facilitating factors considered important included better communication (Skills); audits of patients' treatment-related outcomes (Behavioural Regulation); awareness and agreement with guidelines (Knowledge); and tailoring of multimodal care (Memory, Attention and Decision Processes). Clinicians conveyed conflicting beliefs about perceived threats to professional autonomy (Social/Professional Role and Identity) and speed of recovery from either applying or ignoring the practice recommendations (Beliefs about Consequences). The expert panel mapped behaviour change

  8. A fast-track preliminary thermo-mechanical design of oil export pipelines from P-56 platform

    Energy Technology Data Exchange (ETDEWEB)

    Solano, Rafael F.; Mendonca, Salete M. de [PETROBRAS S.A., Rio de Janeiro, RJ (Brazil); Franco, Luciano D.; Walker, Alastair; El-Gebaly, Sherif H. [INTECSEA, Rio de Janeiro, RJ (Brazil)

    2009-12-19

    The oil export pipelines of Marlim Sul field Module 3, Campus Basin, offshore Brazil, will operate in high pressure and temperature conditions, and will be laid on seabed crossing ten previously laid pipelines along the routes. In terms of thermo-mechanical design, these conditions turn out to be great challenges. In order to obtain initial results and recommendations for detail design, a preliminary thermo-mechanical design of pipelines was carried out as a fast-track design before the bid. This way, PETROBRAS can assess and emphasize the susceptibility of these lines to lateral buckling and pipeline walking behavior. Therefore, PETROBRAS can present a preliminary mitigation strategy for lateral buckling showing solutions based on displacement controlled criteria and by introducing buckle initiation along the pipeline using distribution buoyancy. Besides that, axial displacements and loads at the pipeline ends can be furnished also in order to provide a basis for the detailed design. The work reported in this paper follows the SAFEBUCK JIP methodology and recommendation, which were used to determine the allowable strain and maximum allowable VAS (Virtual Anchor Spacing) considered in the buckling mitigation strategy. The paper presents also the formation of uncontrolled buckles on the seabed and the propensity for pipeline walking in its sections between buckles. The buckling mitigation strategy established in this preliminary design confirms that the oil pipeline specifications are adequate to maintain integrity during design life. (author)

  9. Application of fast-track surgery concept in perioperative patients with biliary calculi and liver cirrhosis: a prospective study

    Directory of Open Access Journals (Sweden)

    WANG Hua

    2014-11-01

    Full Text Available ObjectiveTo investigate the advantage and safety of the concept of fast-track surgery (FTS applied in perioperative patients with biliary calculi and liver cirrhosis. MethodsFifty-two patients undergoing operation for biliary calculi and liver cirrhosis from January 2011 to September 2013 were included in this study. These patients were randomly divided into FTS group (n = 30 and control group (n = 22. Patients in the FTS group received perioperative care measures guided by FTS concept, while patients in the control group received traditional perioperative management measures. The intraoperative situation of patients, time to postoperative recovery of intestinal function, length of postoperative hospital stay, total medical expenses during hospitalization, and postoperative complications were compared between the two groups. Continuous data and categorical data were compared by t-test and χ2 test, respectively. ResultsAs compared with the control group, the FTS group had significantly time to postoperative recovery of intestinal function (t = 2.239, P = 0.045, a significantly shortened length of postoperative stay (t = 4.246, P = 0.038, and significantly reduced total medical expenses during hospitalization (t = 3.045, P = 0.033. No significant difference in postoperative complications was observed between the two groups (P>0.05. ConclusionThe concept of FTS can be safely and effectively applied in perioperative patients with biliary calculi and liver cirrhosis, which can accelerate rehabilitation without increasing the risk of surgery.

  10. Real-time three-dimensional speckle tracking echocardiography: technical aspects and clinical applications

    Directory of Open Access Journals (Sweden)

    Sorrentino R

    2016-11-01

    Full Text Available Regina Sorrentino, Roberta Esposito, Enrica Pezzullo, Maurizio Galderisi Department of Advanced Biomedical Sciences, Interdepartmental Laboratory of Cardiac Imaging, Federico II University Hospital, Naples, Italy Abstract: Three-dimensional speckle tracking echocardiography (3D STE is a novel technique for the quantification of cardiac deformation based on tracking of ultrasonic speckles in gray scale full-volume 3D images. Developments in ultrasound technologies have made 3D speckle tracking widely available. Two-dimensional echocardiography has intrinsic limitations regarding estimation of left ventricular (LV volumes, ejection fraction, and LV mechanics, due to its inherent foreshortening errors and dependency on geometric models. The development of 3D echocardiography has improved reproducibility and accuracy. Data regarding the feasibility, accuracy, and clinical applications of 3D STE are rapidly assembling. From the tracking results, 3D STE derives several parameters, including longitudinal, circumferential and radial strain, as well as a combined assessment of longitudinal and circumferential strain, termed area strain. 3D STE can also quantify LV rotational movements such as rotation, twist, and torsion. 3D STE provides a better insight on global and regional myocardial deformation. Main applications include detection of subclinical myocardial involvement in heart failure, arterial hypertension, dyssynchrony, and ischemic heart disease. Emerging areas of application include a large spectrum of heart-involving systemic conditions, such as prediction of rejection in heart transplant patients, early detection of cardiotoxicity in patients receiving chemotherapy for cancer, and deeper physiological understanding of LV contraction mechanics in different types of athletes. Aim of this review is to discuss background, technical acquisition and processing aspects as well as recognized and developing clinical applications of this emerging

  11. Fast-track rehabilitation following video-assisted pulmonary sublobar wedge resection: A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Christos Asteriou

    2016-01-01

    Full Text Available Background: Postoperative morbidity and inhospital length of stay are considered major determinants of total health care expenditure associated with thoracic operations. The aim of this study was to prospectively evaluate the role of video-assisted thoracic surgery (VATS compared to mini-muscle-sparing thoracotomy in facilitating early recovery and hospital discharge after pulmonary sublobar wedge resections. Patients and Methods: A total number of 120 patients undergoing elective pulmonary sublobar wedge resection were randomly assigned to VATS (n = 60 or mini-muscle-sparing thoracotomy (n = 60. The primary endpoint was time to hospital discharge. Postoperative complications, cardiopulmonary morbidity and 30-day mortality served as secondary endpoints. Results: Patients' baseline demographic and clinical data did not differ among study arms as well as the number of pulmonary segments resected and the morphology of the nodular lesions. Total hospital stay was significantly shorter in patients assigned to the thoracoscopic technique as opposed to those who were operated using the mini-muscle-sparing thoracotomy approach (4 ± 0.6 versus 4.4 ± 0.6 days respectively, P = 0.006. Multivariate analysis revealed that VATS approach was inversely associated with longer inhospital stay whereas the number of resected segments was positively associated with an increased duration of hospitalization. Patients in the VATS group were less likely to develop atelectasis (≥1 lobe compared to those who underwent thoracotomy (0% versus 6.7% respectively, P = 0.042. Kaplan-Meier analysis revealed similar 30-day mortality rates in both study arms (Log-rank P = 0.560. Conclusion: VATS was associated with shorter duration of hospitalization positively affecting the patients' quality of life and satisfaction. Significant suppression of the total cost of recovery after thoracoscopic pulmonary resections is expected.

  12. Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-07-01

    Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

  13. Pre-Hospital Fast Positive Cases Identified by DFB Ambulance Paramedics – Final Clinical Diagnosis

    LENUS (Irish Health Repository)

    Feeney, A

    2016-04-01

    Ischaemic stroke clinical outcomes are improved by earlier treatment with intravenous thrombolysis. An existing pathway at the Mater University Hospital for assessment of suspected acute stroke in the Emergency Department was updated, aiming to shorten ‘door to needle time’. This study examines the final clinical diagnosis of Dublin Fire Brigade Ambulance Paramedic identified Face Arm Speech Test (FAST) positive patients presenting to the Emergency Department over a 7 month period. A retrospective analysis was carried out of 177 consecutive FAST positive patients presenting between March and November 2014. The final clinical diagnosis was acute stroke in 57.1% (n=101) of patients. Of these, 76 were ischaemic strokes of whom 56.5% (n=43) were thrombolysed. In the pre-hospital setting Ambulance Paramedics can identify, with reasonable accuracy, acute stroke using the FAST test. Over half of the ischaemic stroke patients presenting via this pathway can be treated with intravenous thrombolysis

  14. Inhibiting Interference - a grounded theory of health professionals' pattern of behaviour related to the relatives of older patients in fast-track treatment programmes

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Lindhardt, Tove; Frederiksen, Kirsten

    2014-01-01

    AIM: To generate a grounded theory explaining health professionals' pattern of behaviour and experience related to the relatives of older patients in fast-track treatment programmes during total joint replacement. BACKGROUND: Health professionals uphold standardised care for patients, and effect...... on quality is seen when relatives support patients during total joint replacement. Since health professionals often have problematic relationships with relatives, knowledge is needed of the health professionals' pattern of behaviour in relation to relatives of older patients in fast-track treatment programme....... DESIGN: Grounded theory according to Glaser's methodology was used to generate substantive theory of health professionals' pattern of behaviour. METHODS: Data were collected from 2010 to 2011 by 44 health professionals in orthopaedic wards at two Danish hospitals. Data from nonparticipant observations...

  15. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte; Jacobsen, Steffen

    2008-01-01

    BACKGROUND AND PURPOSE: Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction...... aids, pre- and postoperative hemoglobin levels, the need for blood transfusion, ASA score, and time between surgery and mobilization, were all found to influence postoperative outcome in general, and LOS and patient satisfaction in particular. INTERPRETATION: We identified several patient...... characteristics that influence postoperative outcome, LOS, and patient satisfaction in our series of consecutive fast-track joint replacement patients, enabling further attention to be paid to certain aspects of surgery and rehabilitation....

  16. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study.

    Science.gov (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan

    2015-12-01

    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. Predictors of length of stay and patient satisfaction after hip and knee replacement surgery: fast-track experience in 712 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Holm, Gitte; Jacobsen, Steffen

    2008-01-01

    BACKGROUND AND PURPOSE: Very few studies have focused on patient characteristics that influence length of stay (LOS) in fast-track total hip (THR) and knee arthroplasty (TKR). The aim of this prospective study was to identify patient characteristics associated with LOS and patient satisfaction...... after total hip and knee replacement surgery. PATIENTS AND METHODS: Between September 2003 and December 2005, 712 consecutive, unselected patients (440 women) with a mean age of 69 (31-91) years were admitted for hip and knee replacement surgery at our specialized fast-track joint replacement unit....... Epidemiological, physical, and perioperative parameters were registered and correlated to LOS and patient satisfaction. RESULTS: 92% of the patients were discharged directly to their homes within 5 days, and 41% were discharged within 3 days. Age, sex, marital status, co-morbidity, preoperative use of walking...

  18. Relationship between self-reported pain sensitivity and pain after total knee arthroplasty: a prospective study of 71 patients 8 weeks after a standardized fast-track

    Directory of Open Access Journals (Sweden)

    Valeberg BT

    2016-09-01

    Full Text Available Berit T Valeberg,1 Lise H Høvik,2 Kari H Gjeilo3–6 1Faculty of Nursing, Oslo and Akershus University College of Applied Sciences, Oslo, 2Clinic of Anaesthesia and Intensive Care Medicine, St. Olavs Hospital, Trondheim University Hospital, 3Department of Cardiothoracic Surgery, 4Department of Cardiology, 5National Competence Centre for Complex Symptom Disorders, St. Olavs Hospital, Trondheim University Hospital, 6Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway Background and purpose: This was a prospective cohort study assessing data from 71 adult patients undergoing total knee arthroplasty (TKA following a standardized fast-track program between January and July 2013. The objective was to examine the relationship between self-rated pain sensitivity, as measured by the Pain Sensitivity Questionnaire (PSQ, and postoperative pain after TKA. Methods: The baseline questionnaires, PSQ and Brief Pain Inventory, were given to the patients for self-administration at the presurgical evaluation (1–2 weeks prior to surgery. The follow-up questionnaire, Brief Pain Inventory, was administered at the first follow-up, 8 weeks after surgery. Results: A statistically significant association was found between average preoperative pain and average pain 8 weeks after surgery (P=0.001. The PSQ-minor was statistically significantly associated with average pain only for patients younger than 70 years (P=0.03. Interpretation: This is the first study to examine the relationship between pain sensitivity measured by PSQ and postoperative pain in patients after TKA. We found that a lower score on the PSQ-minor was statistically significantly associated with patients’ pain 8 weeks after TKA surgery, but only for younger patients. Further research is needed to explore whether the PSQ could be a useful screening tool for patients’ pain sensitivity in clinical settings. Keywords

  19. Implementing a Comprehensive Program for the Prevention of Conduct Problems in Rural Communities: The Fast Track Experience1

    Science.gov (United States)

    Bierman, Karen L.

    2012-01-01

    Childhood conduct problems are predictive of a number of serious long-term difficulties (e.g., school failure, delinquent behavior, and mental health problems), making the design of effective prevention programs a priority. The Fast Track Program is a demonstration project currently underway in four demographically diverse areas of the United States, testing the feasibility and effectiveness of a comprehensive, multicomponent prevention program targeting children at risk for conduct disorders. This paper describes some lessons learned about the implementation of this program in a rural area. Although there are many areas of commonality in terms of program needs, program design, and implementation issues in rural and urban sites, rural areas differ from urban areas along the dimensions of geographical dispersion and regionalism, and community stability and insularity. Rural programs must cover a broad geographical area and must be sensitive to the multiple, small and regional communities that constitute their service area. Small schools, homogeneous populations, traditional values, limited recreational, educational and mental health services, and politically conservative climates are all more likely to emerge as characteristics of rural rather than urban sites (Sherman, 1992). These characteristics may both pose particular challenges to the implementation of prevention programs in rural areas, as well as offer particular benefits. Three aspects of program implementation are described in detail: (a) community entry and program initiation in rural areas, (b) the adaptation of program components and service delivery to meet the needs of rural families and schools, and (c) issues in administrative organization of a broadly dispersed tricounty rural prevention program. PMID:9338956

  20. Safety and efficacy of fast-track surgery in perioperative nursing for biliary calculi surgery: a meta-analysis

    Directory of Open Access Journals (Sweden)

    LI Qinan

    2015-10-01

    Full Text Available ObjectiveTo systematically review the efficacy and safety of fast-track surgery (FTS in perioperative nursing for biliary calculi surgery. MethodsOnline databases of PubMed, Cochrane Library, CBM, CNKI, VIP, and Wanfang Data were comprehensively searched for relevant randomized controlled trials (RCTs. Potential bias was evaluated by Cochrane tools and data were analyzed by RevMan 5.3. ResultsA total of 11 RCTs with 1455 patients were included (738 cases in FTS group and 717 cases in control group. The results of meta-analysis showed that FTS significantly reduced the length of postoperative hospital stay (MD=-4.10, 95% CI: -5.68 to -2.52, P<0.000 01 and hospital costs (MD=-0.47, 95%CI: -0.60 to -0.34, P<0.000 01; meanwhile, FTS shortened the time to gastrointestinal recovery (SMD=-2.05, 95%CI: -2.84 to -1.27, P<0.000 01, as well as the time to first defecation (SMD=-1.27, 95% CI: -2.08 to -0.46, P<0.000 01. As for safety, FTS significantly reduced the total complications of choledocholithiasis (RR=0.53, 95%CI: 0.43-0.65, P<0.000 01 and hepatolithiasis (RR=0.52, 95% CI: 0.35-0.77, P=0.001. ConclusionFTS is effective and safe in perioperative nursing for biliary calculi surgery. It can significantly reduce the length of postoperative hospital stay, enhance gastrointestinal recovery, shorten the time to first defecation, and reduce total complications.

  1. Beyond trend analysis: How a modified breakpoint analysis enhances knowledge of agricultural production after Zimbabwe's fast track land reform

    Science.gov (United States)

    Hentze, Konrad; Thonfeld, Frank; Menz, Gunter

    2017-10-01

    In the discourse on land reform assessments, a significant lack of spatial and time-series data has been identified, especially with respect to Zimbabwe's ;Fast-Track Land Reform Programme; (FTLRP). At the same time, interest persists among land use change scientists to evaluate causes of land use change and therefore to increase the explanatory power of remote sensing products. This study recognizes these demands and aims to provide input on both levels: Evaluating the potential of satellite remote sensing time-series to answer questions which evolved after intensive land redistribution efforts in Zimbabwe; and investigating how time-series analysis of Normalized Difference Vegetation Index (NDVI) can be enhanced to provide information on land reform induced land use change. To achieve this, two time-series methods are applied to MODIS NDVI data: Seasonal Trend Analysis (STA) and Breakpoint Analysis for Additive Season and Trend (BFAST). In our first analysis, a link of agricultural productivity trends to different land tenure regimes shows that regional clustering of trends is more dominant than a relationship between tenure and trend with a slightly negative slope for all regimes. We demonstrate that clusters of strong negative and positive productivity trends are results of changing irrigation patterns. To locate emerging and fallow irrigation schemes in semi-arid Zimbabwe, a new multi-method approach is developed which allows to map changes from bimodal seasonal phenological patterns to unimodal and vice versa. With an enhanced breakpoint analysis through the combination of STA and BFAST, we are able to provide a technique that can be applied on large scale to map status and development of highly productive cropping systems, which are key for food production, national export and local employment. We therefore conclude that the combination of existing and accessible time-series analysis methods: is able to achieve both: overcoming demonstrated limitations of

  2. Nurse Practitioners' attitude to nutritional challenges dealing with the patients' nutritional needs and ability to care for themselves in a fast track program

    DEFF Research Database (Denmark)

    Graarup, Jytte; Pedersen, Preben Ulrich; Bjerrum, Merete

    2014-01-01

    Background: Nutrition plays an important role to the success of fast track programs, but under nutrition are still reported. Nutritional care seems to be a low priority among nurses even though it is well-known that insufficient nutrition has severe consequences for the patients. The aim is to re......Background: Nutrition plays an important role to the success of fast track programs, but under nutrition are still reported. Nutritional care seems to be a low priority among nurses even though it is well-known that insufficient nutrition has severe consequences for the patients. The aim...... is to report to what extent a training program has made Nutritional Nurse Practitioners aware of the nutritional care for short-term hospitalized patients, and how they deal with patients’ nutritional needs and ability to provide self-care in the context of a fast track program. Methods: Deductive content...... analysis was used to analyse data from four focus group interviews. Sixteen Nutritional Nurse Practitioners from either medical or surgery wards participated. The Nutritional Nurse Practitioners were interviewed twice. The interviews were recorded and verbally transcribed. Results: In the Nutritional Nurse...

  3. Remote removal of an obstruction from FFTF [Fast Flux Test Facility] in-service inspection camera track

    International Nuclear Information System (INIS)

    Gibbons, P.W.

    1990-11-01

    Remote techniques and special equipment were used to clear the path of a closed-circuit television camera system that travels on a monorail track around the reactor vessel support arm structure. A tangle of wire-wrapped instrumentation tubing had been inadvertently inserted through a dislocated guide-tube expansion joint and into the camera track area. An externally driven auger device, mounted on the track ahead of the camera to view the procedure, was used to retrieve the tubing. 6 figs

  4. Creating an effort tracking tool to improve therapeutic cancer clinical trials workload management and budgeting.

    Science.gov (United States)

    James, Pam; Bebee, Patty; Beekman, Linda; Browning, David; Innes, Mathew; Kain, Jeannie; Royce-Westcott, Theresa; Waldinger, Marcy

    2011-11-01

    Quantifying data management and regulatory workload for clinical research is a difficult task that would benefit from a robust tool to assess and allocate effort. As in most clinical research environments, The University of Michigan Comprehensive Cancer Center (UMCCC) Clinical Trials Office (CTO) struggled to effectively allocate data management and regulatory time with frequently inaccurate estimates of how much time was required to complete the specific tasks performed by each role. In a dynamic clinical research environment in which volume and intensity of work ebbs and flows, determining requisite effort to meet study objectives was challenging. In addition, a data-driven understanding of how much staff time was required to complete a clinical trial was desired to ensure accurate trial budget development and effective cost recovery. Accordingly, the UMCCC CTO developed and implemented a Web-based effort-tracking application with the goal of determining the true costs of data management and regulatory staff effort in clinical trials. This tool was developed, implemented, and refined over a 3-year period. This article describes the process improvement and subsequent leveling of workload within data management and regulatory that enhanced the efficiency of UMCCC's clinical trials operation.

  5. Clinical utility of speckle-tracking echocardiography in cardiac resynchronisation therapy.

    Science.gov (United States)

    Khan, Sitara G; Klettas, Dimitris; Kapetanakis, Stam; Monaghan, Mark J

    2016-03-01

    Cardiac resynchronisation therapy (CRT) can profoundly improve outcome in selected patients with heart failure; however, response is difficult to predict and can be absent in up to one in three patients. There has been a substantial amount of interest in the echocardiographic assessment of left ventricular dyssynchrony, with the ultimate aim of reliably identifying patients who will respond to CRT. The measurement of myocardial deformation (strain) has conventionally been assessed using tissue Doppler imaging (TDI), which is limited by its angle dependence and ability to measure in a single plane. Two-dimensional speckle-tracking echocardiography is a technique that provides measurements of strain in three planes, by tracking patterns of ultrasound interference ('speckles') in the myocardial wall throughout the cardiac cycle. Since its initial use over 15 years ago, it has emerged as a tool that provides more robust, reproducible and sensitive markers of dyssynchrony than TDI. This article reviews the use of two-dimensional and three-dimensional speckle-tracking echocardiography in the assessment of dyssynchrony, including the identification of echocardiographic parameters that may hold predictive potential for the response to CRT. It also reviews the application of these techniques in guiding optimal LV lead placement pre-implant, with promising results in clinical improvement post-CRT. © 2016 The authors.

  6. Clinical utility of speckle-tracking echocardiography in cardiac resynchronisation therapy

    Directory of Open Access Journals (Sweden)

    Sitara G Khan

    2016-05-01

    Full Text Available Cardiac resynchronisation therapy (CRT can profoundly improve outcome in selected patients with heart failure; however, response is difficult to predict and can be absent in up to one in three patients. There has been a substantial amount of interest in the echocardiographic assessment of left ventricular dyssynchrony, with the ultimate aim of reliably identifying patients who will respond to CRT. The measurement of myocardial deformation (strain has conventionally been assessed using tissue Doppler imaging (TDI, which is limited by its angle dependence and ability to measure in a single plane. Two-dimensional speckle-tracking echocardiography is a technique that provides measurements of strain in three planes, by tracking patterns of ultrasound interference (‘speckles’ in the myocardial wall throughout the cardiac cycle. Since its initial use over 15 years ago, it has emerged as a tool that provides more robust, reproducible and sensitive markers of dyssynchrony than TDI. This article reviews the use of two-dimensional and three-dimensional speckle-tracking echocardiography in the assessment of dyssynchrony, including the identification of echocardiographic parameters that may hold predictive potential for the response to CRT. It also reviews the application of these techniques in guiding optimal LV lead placement pre-implant, with promising results in clinical improvement post-CRT.

  7. Real-time tracking and fast retrieval of persons in multiple surveillance cameras of a shopping mall

    NARCIS (Netherlands)

    Bouma, H.; Baan, J.; Landsmeer, S.; Kruszynski, K.J.; Antwerpen, G. van; Dijk, J.

    2013-01-01

    The capability to track individuals in CCTV cameras is important for e.g. surveillance applications at large areas such as train stations, airports and shopping centers. However, it is laborious to track and trace people over multiple cameras. In this paper, we present a system for real-time

  8. Real-time non-rigid target tracking for ultrasound-guided clinical interventions

    Science.gov (United States)

    Zachiu, C.; Ries, M.; Ramaekers, P.; Guey, J.-L.; Moonen, C. T. W.; de Senneville, B. Denis

    2017-10-01

    Biological motion is a problem for non- or mini-invasive interventions when conducted in mobile/deformable organs due to the targeted pathology moving/deforming with the organ. This may lead to high miss rates and/or incomplete treatment of the pathology. Therefore, real-time tracking of the target anatomy during the intervention would be beneficial for such applications. Since the aforementioned interventions are often conducted under B-mode ultrasound (US) guidance, target tracking can be achieved via image registration, by comparing the acquired US images to a separate image established as positional reference. However, such US images are intrinsically altered by speckle noise, introducing incoherent gray-level intensity variations. This may prove problematic for existing intensity-based registration methods. In the current study we address US-based target tracking by employing the recently proposed EVolution registration algorithm. The method is, by construction, robust to transient gray-level intensities. Instead of directly matching image intensities, EVolution aligns similar contrast patterns in the images. Moreover, the displacement is computed by evaluating a matching criterion for image sub-regions rather than on a point-by-point basis, which typically provides more robust motion estimates. However, unlike similar previously published approaches, which assume rigid displacements in the image sub-regions, the EVolution algorithm integrates the matching criterion in a global functional, allowing the estimation of an elastic dense deformation. The approach was validated for soft tissue tracking under free-breathing conditions on the abdomen of seven healthy volunteers. Contact echography was performed on all volunteers, while three of the volunteers also underwent standoff echography. Each of the two modalities is predominantly specific to a particular type of non- or mini-invasive clinical intervention. The method demonstrated on average an accuracy of

  9. Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-03-01

    Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

  10. A national clinical quality program for Veterans Affairs catheterization laboratories (from the Veterans Affairs clinical assessment, reporting, and tracking program).

    Science.gov (United States)

    Maddox, Thomas M; Plomondon, Mary E; Petrich, Megan; Tsai, Thomas T; Gethoffer, Hans; Noonan, Gregory; Gillespie, Brian; Box, Tamara; Fihn, Stephen D; Jesse, Robert L; Rumsfeld, John S

    2014-12-01

    A "learning health care system", as outlined in a recent Institute of Medicine report, harnesses real-time clinical data to continuously measure and improve clinical care. However, most current efforts to understand and improve the quality of care rely on retrospective chart abstractions complied long after the provision of clinical care. To align more closely with the goals of a learning health care system, we present the novel design and initial results of the Veterans Affairs (VA) Clinical Assessment, Reporting, and Tracking (CART) program-a national clinical quality program for VA cardiac catheterization laboratories that harnesses real-time clinical data to support clinical care and quality-monitoring efforts. Integrated within the VA electronic health record, the CART program uses a specialized software platform to collect real-time patient and procedural data for all VA patients undergoing coronary procedures in VA catheterization laboratories. The program began in 2005 and currently contains data on 434,967 catheterization laboratory procedures, including 272,097 coronary angiograms and 86,481 percutaneous coronary interventions, performed by 801 clinicians on 246,967 patients. We present the initial data from the CART program and describe 3 quality-monitoring programs that use its unique characteristics-procedural and complications feedback to individual labs, coronary device surveillance, and major adverse event peer review. The VA CART program is a novel approach to electronic health record design that supports clinical care, quality, and safety in VA catheterization laboratories. Its approach holds promise in achieving the goals of a learning health care system. Published by Elsevier Inc.

  11. Clinically viable magnetic poly(lactide-co-glycolide) (PLGA) particles for MRI-based cell tracking

    Science.gov (United States)

    Granot, Dorit; Nkansah, Michael K.; Bennewitz, Margaret F.; Tang, Kevin S.; Markakis, Eleni A.; Shapiro, Erik M.

    2013-01-01

    Purpose To design, fabricate, characterize and in vivo assay clinically viable magnetic particles for MRI-based cell tracking. Methods PLGA encapsulated magnetic nano- and microparticles were fabricated. Multiple biologically relevant experiments were performed to assess cell viability, cellular performance and stem cell differentiation. In vivo MRI experiments were performed to separately test cell transplantation and cell migration paradigms, as well as in vivo biodegradation. Results Highly magnetic nano- (~100 nm) and microparticles (~1–2 μm) were fabricated. Magnetic cell labeling in culture occurred rapidly achieving 3–50 pg Fe/cell at 3 hrs for different particles types, and >100 pg Fe/cell after 10 hours, without the requirement of a transfection agent, and with no effect on cell viability. The capability of magnetically labeled mesenchymal or neural stem cells to differentiate down multiple lineages, or for magnetically labeled immune cells to release cytokines following stimulation, was uncompromised. An in vivo biodegradation study revealed that NPs degraded ~80% over the course of 12 weeks. MRI detected as few as 10 magnetically labeled cells, transplanted into the brains of rats. Also, these particles enabled the in vivo monitoring of endogenous neural progenitor cell migration in rat brains over 2 weeks. Conclusion The robust MRI properties and benign safety profile of these particles make them promising candidates for clinical translation for MRI-based cell tracking. PMID:23568825

  12. SU-G-JeP1-05: Clinical Impact of MLC Tracking for Lung SABR

    Energy Technology Data Exchange (ETDEWEB)

    Caillet, V; Colvill, E [Faculty of Medecine, The University of Sydney, Sydney, NSW (Australia); Royal North Shore Hospital, Sydney, NSW (Australia); Szymura, K; Stevens, M; Booth, J [Royal North Shore Hospital, Sydney, NSW (Australia); Keall, P [Faculty of Medecine, The University of Sydney, Sydney, NSW (Australia)

    2016-06-15

    Purpose: The objective of this study was to investigate the dosimetric benefits of multi-leaf collimator (MLC) tracking for lung SABR treatments in end-to-end clinically realistic planning and delivery scenarios. Methods: The clinical benefits of MLC tracking were assessed using previously delivered treatment plans and physical experiments. The 10 most recent single lesion lung SABR patients were re-planned following a 4D-GTV-based real-time adaptive protocol (PTV defined as the end-of-exhalation GTV plus 5.0 mm margins). The plans were delivered on a Trilogy Varian linac. Electromagnetic transponders (Calypso, Varian Medical Systems, USA) were embedded into a programmable moving phantom (HexaMotion platform) tracked with the Varian Calypso system. For each physical experiment, the MLC positions were collected and used as input for dose reconstruction. For both planned and physical experiments, the OAR dose metrics from the conventional and real-time adaptive SABR plans (Mean Lung Dose (MLD), V20 for lung, and near-maximum dose (D2%) for spine and heart) were statistically compared. The Wilcoxon test was used to compare plan and physical experiment dose metrics. Results: While maintaining target coverage, percentage reductions in dose metrics to the OARs were observed for both planned and physical experiments. Comparing the two plans showed MLD percentage reduction (MLDr) of 25.4% (absolute differences of 1.41 Gy) and 28.9% (1.29%) for the V20r. D2% percentage reduction for spine and heart were respectively 27.9% (0.3 Gy) and 20.2% (0.3 Gy). For the physical experiments, MLDr was 23.9% (1.3 Gy), and V20r 37.4% (1.6%). D2% reduction for spine and heart were respectively 27.3% (0.3 Gy) and 19.6% (0.3 Gy). For both plans and physical experiments, significant OAR dose differences (p<0.05) were found between the conventional SABR and real-time adaptive plans. Conclusion: Application of MLC tracking for lung SABR patients has the potential to reduce the dose to OARs

  13. SU-E-T-183: Clinical Quality Assurance Workflow for Dynamic Tumor Tracking Radiation Dose Delivery

    International Nuclear Information System (INIS)

    Mamalui-Hunter, M; Su, Z; Li, Z

    2015-01-01

    Purpose: One of the most important aspects of implementation of new treatment modalities is an ‘end-to-end’ verification of the treatment process. Radiation treatment based on dynamic tracking of a tumor is highly patient-specific, therefore, special attention should be paid to quality assurance of the treatment delivery. Our goal was to design the clinical workflow that ensures accurate delivery of the planned dose using the Dynamic Target Tracking option of VeroTM (BrainLab,MHI) linac. Methods: A patient simulation is designed to include a pre-treatment session to verify whether the system can reliably track the motion of the implanted marker and build the 4D model of the target motion. The external surrogate and target motion patterns are recorded in the ExactracTM log files. In this work, a spectrum of custom marker and external surrogate motion trajectories closely resembling the patient specific motion patterns was used. 1mm thick/11mm long VisicoilTM marker was placed 15 and 20mm from the center of the spherical tissue equivalent target (centroid to centroid distance) in the 4D motion phantom (CIRSTM). 3D conformal (3 mm block margin) SBRT plans were delivered to 2 moving targets in the phantom: 1) 20mm diameter target that allows ion chamber dose measurement and 2) 25mm target that allows using film to measure CAX dose (GafchromicTM EBT3 used). The measured dose was compared to the iPlanTM TPS results using MonteCarlo algorithm (1% variance, Dose-to-water). Results: On average, film shows 98.9% pass using gamma criterion for 2% and 2mm DTA, 94.3% match for 2% and 1 mm DTA, 98% pass for 1% and 2 mm DTA however only 88% points passing for 1% and 1 mm DTA. Ion chamber measurements agreed with the calculation within 1.5%. Conclusion: The clinical QA workflow was designed for SBRT delivery using real-time tumor tracking on VeroTM linac

  14. Profiling Fast Healthcare Interoperability Resources (FHIR) of Family Health History based on the Clinical Element Models

    OpenAIRE

    Lee, Jaehoon; Hulse, Nathan C.; Wood, Grant M.; Oniki, Thomas A.; Huff, Stanley M.

    2017-01-01

    In this study we developed a Fast Healthcare Interoperability Resources (FHIR) profile to support exchanging a full pedigree based family health history (FHH) information across multiple systems and applications used by clinicians, patients, and researchers. We used previously developed clinical element models (CEMs) that are capable of representing the FHH information, and derived essential data elements including attributes, constraints, and value sets. We analyzed gaps between the FHH CEM ...

  15. What Is Required to End the AIDS Epidemic as a Public Health Threat by 2030? The Cost and Impact of the Fast-Track Approach.

    Directory of Open Access Journals (Sweden)

    John Stover

    Full Text Available In 2011 a new Investment Framework was proposed that described how the scale-up of key HIV interventions could dramatically reduce new HIV infections and AIDS-related deaths in low and middle income countries by 2015. This framework included ambitious coverage goals for prevention and treatment services for 2015, resulting in a reduction of new HIV infections by more than half, in line with the goals of the declaration of the UN High Level Meeting in June 2011. However, the approach suggested a leveling in the number of new infections at about 1 million annually-far from the UNAIDS goal of ending AIDS by 2030. In response, UNAIDS has developed the Fast-Track approach that is intended to provide a roadmap to the actions required to achieve this goal. The Fast-Track approach is predicated on a rapid scale-up of focused, effective prevention and treatment services over the next 5 years and then maintaining a high level of programme implementation until 2030. Fast-Track aims to reduce new infections and AIDS-related deaths by 90% from 2010 to 2030 and proposes a set of biomedical, behavioral and enabling intervention targets for 2020 and 2030 to achieve that goal, including the rapid scale-up initiative for antiretroviral treatment known as 90-90-90. Compared to a counterfactual scenario of constant coverage for all services at early-2015 levels, the Fast-Track approach would avert 18 million HIV infections and 11 million deaths from 2016 to 2030 globally. This paper describes the analysis that produced these targets and the estimated resources needed to achieve them in low- and middle-income countries. It indicates that it is possible to achieve these goals with a significant push to achieve rapid scale-up of key interventions between now and 2020. The annual resources required from all sources would rise to US$7.4Bn in low-income countries, US$8.2Bn in lower middle-income countries and US$10.5Bn in upper-middle-income-countries by 2020 before

  16. The glenoid track: a review of the clinical relevance, method of calculation and current evidence behind this method

    Energy Technology Data Exchange (ETDEWEB)

    Younan, Yara; Wong, Philip K.; Umpierrez, Monica; Gonzalez, Felix; Singer, Adam Daniel [Emory University Hospital, Department of Radiology and Imaging Sciences, Section of Musculoskeletal Imaging, Atlanta, GA (United States); Karas, Spero [Emory University Hospital, Department of Orthopedic Surgery, Atlanta, GA (United States); Jose, Jean [University of Miami, Department of Radiology, Miami, FL (United States)

    2017-12-15

    In the setting of bipolar bone injury, orthopedic surgeons are currently making use of the glenoid track method to guide surgical management. Using preoperative CT or MR imaging, this method allows the identification of patients who are more likely to fail a primary capsuloligamentous Bankart repair. As the glenoid track method becomes increasingly used in preoperative planning, it is important for the radiologist to become familiar with its concept and method of calculation. This review article aims to concisely summarize the current literature and the clinical implications of the glenoid track method. (orig.)

  17. The performance of the γ-ray tracking array GRETINA for γ-ray spectroscopy with fast beams of rare isotopes

    International Nuclear Information System (INIS)

    Weisshaar, D.; Bazin, D.; Bender, P.C.; Campbell, C.M.; Recchia, F.; Bader, V.; Baugher, T.; Belarge, J.; Carpenter, M.P.; Crawford, H.L.; Cromaz, M.; Elman, B.; Fallon, P.; Forney, A.; Gade, A.

    2017-01-01

    The γ-ray tracking array GRETINA was coupled to the S800 magnetic spectrometer for spectroscopy with fast beams of rare isotopes at the National Superconducting Cyclotron Laboratory on the campus of Michigan State University. We describe the technical details of this powerful setup and report on GRETINA's performance achieved with source and in-beam measurements. The γ-ray multiplicity encountered in experiments with fast beams is usually low, allowing for a simplified and efficient treatment of the data in the γ-ray analysis in terms of Doppler reconstruction and spectral quality. The results reported in this work were obtained from GRETINA consisting of 8 detector modules hosting four high-purity germanium crystals each. Currently, GRETINA consists of 10 detector modules.

  18. Diagnostic methods for fast-track identification of endometrial cancer in women with postmenopausal bleeding and endometrial thickness greater than 5 mm

    DEFF Research Database (Denmark)

    Dueholm, Margit; Marinowskij, Edvard; Hansen, Estrid Stæhr

    2015-01-01

    efficiency (area under the curve) for malignancy diagnosis (ES, 0.90; TVS, 0.88; GIS, 0.92; HYpattern, 0.91). When insufficient samples were incorporated, ES was less efficient than the other techniques. ES was not more efficient in the subgroup of women without localized lesions than in the subgroup...... of women with localized lesions. MRI and HYpattern added limited efficiency, whereas hysteroscopy with biopsy was most efficient. CONCLUSIONS: As a first-line technique, pattern recognition on TVS, GIS, and HYpattern correctly identifies 9 of 10 women with malignancy and is superior to pattern recognition...... on ES when insufficient samples are included. Endometrial pattern evaluated with TVS and GIS is a fast and efficient first-line diagnostic tool that outperforms ES in women with or without localized lesions. Malignant patterns on TVS/GIS should warrant fast-track evaluation, whereas women with benign...

  19. The performance of the γ-ray tracking array GRETINA for γ-ray spectroscopy with fast beams of rare isotopes

    Energy Technology Data Exchange (ETDEWEB)

    Weisshaar, D., E-mail: weisshaar@nscl.msu.edu [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Bazin, D. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); Bender, P.C. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Campbell, C.M. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Recchia, F. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Bader, V.; Baugher, T. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); Belarge, J. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Carpenter, M.P. [Argonne National Laboratory, Argonne, IL 60439 (United States); Crawford, H.L.; Cromaz, M. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Elman, B. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); Fallon, P. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Forney, A. [Department of Chemistry and Biochemistry, University of Maryland, College Park, MD 20742 (United States); Gade, A. [National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, MI 48824 (United States); Department of Physics and Astronomy, Michigan State University, East Lansing, MI 48824 (United States); and others

    2017-03-01

    The γ-ray tracking array GRETINA was coupled to the S800 magnetic spectrometer for spectroscopy with fast beams of rare isotopes at the National Superconducting Cyclotron Laboratory on the campus of Michigan State University. We describe the technical details of this powerful setup and report on GRETINA's performance achieved with source and in-beam measurements. The γ-ray multiplicity encountered in experiments with fast beams is usually low, allowing for a simplified and efficient treatment of the data in the γ-ray analysis in terms of Doppler reconstruction and spectral quality. The results reported in this work were obtained from GRETINA consisting of 8 detector modules hosting four high-purity germanium crystals each. Currently, GRETINA consists of 10 detector modules.

  20. Characterization of plastic nuclear track detectors on solid state, CR-39 and LR-115 and its possibilities application on thermal and fast neutron dosimetry

    International Nuclear Information System (INIS)

    Vallejo Delgado, L.R.

    1989-01-01

    This work is an study about the use feasibility of plastic nuclear track detectors, LR 115, II-B (of Eastmann Kodak Co) and CR-39 (of American Acrylics and Plastics), for thermal and fast neutron dosimetry, respectively. The LR-115 with converter (n, alpha) was exposed to thermal neutrons with energy of 0,046 e V, proceeding from nuclear reactor RECH-1 of Nuclear Energy Chilean Commission. The irradiated films were submited to a chemical etching with NaOH, plus a washing and brushing. The CR-39 with polyethylene irradiator, was exposed to fast neutrons proceeding of calibrated sources of Am-Se. The irradiated plates were submited to a chemical pre-etching with KOH and a electrochemical post-etching. (author)

  1. SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

    International Nuclear Information System (INIS)

    Kabat, C; Cline, K; Li, Y; Ha, C; Stathakis, S

    2016-01-01

    Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process while also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.

  2. SU-F-T-100: Development and Implementation of a Treatment Planning Tracking System Into the Radiation Oncology Clinic

    Energy Technology Data Exchange (ETDEWEB)

    Kabat, C; Cline, K; Li, Y; Ha, C; Stathakis, S [University of Texas HSC SA, San Antonio, TX (United States)

    2016-06-15

    Purpose: With increasing numbers of cancer patients being diagnosed and the complexity of radiotherapy treatments rising it’s paramount that patient plan development continues to stay fluid within the clinic. In order to maintain a high standard of care and clinical efficiency the establishment of a tracking system for patient plan development allows healthcare providers to view real time plan progression and drive clinical workflow. In addition, it provides statistical datasets which can further identify inefficiencies within the clinic. Methods: An application was developed utilizing Microsoft’s ODBC SQL database engine to track patient plan status throughout the treatment planning process while also managing key factors pertaining to the patient’s treatment. Pertinent information is accessible to staff in many locations, including tracking monitors within dosimetry, the clinic network for both computers and handheld devices, and through email notifications. Plans are initiated with a CT and continually tracked through planning stages until final approval by staff. Patient’s status is dynamically updated by the physicians, dosimetrists, and medical physicists based on the stage of the patient’s plan. Results: Our application has been running over a six month period with all patients being processed through the system. Modifications have been made to allow for new features to be implemented along with additional tracking parameters. Based on in-house feedback, the application has been supportive in streamlining patient plans through the treatment planning process and data has been accumulating to further improve procedures within the clinic. Conclusion: Over time the clinic will continue to track data with this application. As data accumulates the clinic will be able to highlight inefficiencies within the workflow and adapt accordingly. We will add in new features to help support the treatment planning process in the future.

  3. Tracking the workforce: the American Society of Clinical Oncology workforce information system.

    Science.gov (United States)

    Kirkwood, M Kelsey; Kosty, Michael P; Bajorin, Dean F; Bruinooge, Suanna S; Goldstein, Michael A

    2013-01-01

    In anticipation of oncologist workforce shortages projected as part of a 2007 study, the American Society of Clinical Oncology (ASCO) worked with a contractor to create a workforce information system (WIS) to assemble the latest available data on oncologist supply and cancer incidence and prevalence. ASCO plans to publish findings annually, reporting on new data and tracking trends over time. THE WIS REPORT IS COMPOSED OF THREE SECTIONS: supply, new entrants, and cancer incidence and prevalence. Tabulations of the number of oncologists in the United States are derived mainly from the American Medical Association Physician Masterfile. Information on fellows and residents in the oncology workforce pipeline come from published sources such as Journal of the American Medical Association. Incidence and prevalence estimates are published by the American Cancer Society and National Cancer Institute. The WIS reports a total of 13,084 oncologists working in the United States in 2011. Oncologists are defined as those physicians who designate hematology, hematology/oncology, or medical oncology as their specialty. The WIS compares the characteristics of these oncologists with those of all physicians and tracks emerging trends in the physician training pipeline. Observing characteristics of the oncologist workforce over time allows ASCO to identify, prioritize, and evaluate its workforce initiatives. Accessible figures and reports generated by the WIS can be used by ASCO and others in the oncology community to advocate for needed health care system and policy changes to help offset future workforce shortages.

  4. Tracking the Workforce: The American Society of Clinical Oncology Workforce Information System

    Science.gov (United States)

    Kirkwood, M. Kelsey; Kosty, Michael P.; Bajorin, Dean F.; Bruinooge, Suanna S.; Goldstein, Michael A.

    2013-01-01

    Purpose: In anticipation of oncologist workforce shortages projected as part of a 2007 study, the American Society of Clinical Oncology (ASCO) worked with a contractor to create a workforce information system (WIS) to assemble the latest available data on oncologist supply and cancer incidence and prevalence. ASCO plans to publish findings annually, reporting on new data and tracking trends over time. Methods: The WIS report is composed of three sections: supply, new entrants, and cancer incidence and prevalence. Tabulations of the number of oncologists in the United States are derived mainly from the American Medical Association Physician Masterfile. Information on fellows and residents in the oncology workforce pipeline come from published sources such as Journal of the American Medical Association. Incidence and prevalence estimates are published by the American Cancer Society and National Cancer Institute. Results: The WIS reports a total of 13,084 oncologists working in the United States in 2011. Oncologists are defined as those physicians who designate hematology, hematology/oncology, or medical oncology as their specialty. The WIS compares the characteristics of these oncologists with those of all physicians and tracks emerging trends in the physician training pipeline. Conclusion: Observing characteristics of the oncologist workforce over time allows ASCO to identify, prioritize, and evaluate its workforce initiatives. Accessible figures and reports generated by the WIS can be used by ASCO and others in the oncology community to advocate for needed health care system and policy changes to help offset future workforce shortages. PMID:23633965

  5. Review of clinical results of fast neutron therapy in the USA

    International Nuclear Information System (INIS)

    Peters, L.J.; Maor, M.H.; Laramore, G.E.; Griffin, T.W.; Hendrickson, F.R.

    1986-01-01

    Fast neutron radiotherapy in the United States is entering a new era in which dedicated hospital-based generators with isocentric beam capability are replacing treatment facilities based on fixed beams extracted from physics accelerators. All available clinical data, however, come from the older facilities. The majority of randomized trials conducted in the U.S. have used neutrons in a mixed schedule with photons, in which the aim was to deliver two-fifths of the total dose with neutrons; the neutron dose per fraction was set as the estimated equivalent of 2 Gy photons in terms of late normal tissue injury. Overall treatment time was held constant compared with the control photon therapy regimens (usually 6-8 weeks). Random studies of this type showed no evidence of a therapeutic gain in the treatment of advanced primary carcinomas of the head and neck, lung, uterine cervix, or pancreas. Based on a reassessment of all the available clinical and radiobiological data, and taking advantage of the greater technical flexibility offered by hospital-based facilities, the strategy of fast neutron therapy for future trials has been changed. In these trials neutrons are being used in a 12 fraction, 4 week regimen to treat gross disease, with elective therapy given wherever possible using low LET irradiation. Concomitantly, research is proceeding to define predictors of tumor response to high LET radiations in order to better select patients for fast neutron radiotherapy

  6. A prospective cohort study to investigate cost-minimisation, of Traditional open, open fAst track recovery and laParoscopic fASt track multimodal management, for surgical patients with colon carcinomas (TAPAS study).

    NARCIS (Netherlands)

    Reurings, J.C.; Spanjersberg, W.R.; Oostvogel, H.J.M.; Buskens, E.; Maring, J.; Kruijt, F.; Rosman, C.; Duivendijk, P. van; Dejong, C.H.; Laarhoven, C.J.H.M. van

    2010-01-01

    BACKGROUND: The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS) recovery program. The Tapas-study was conceived to determine which of the

  7. Initial assessment of tumor tracking with a gimbaled linac system in clinical circumstances: A patient simulation study

    International Nuclear Information System (INIS)

    Depuydt, Tom; Poels, Kenneth; Verellen, Dirk; Engels, Benedikt; Collen, Christine; Haverbeke, Chloe; Gevaert, Thierry; Buls, Nico; Van Gompel, Gert; Reynders, Truus; Duchateau, Michael; Tournel, Koen; Boussaer, Marlies; Steenbeke, Femke; Vandenbroucke, Frederik; De Ridder, Mark

    2013-01-01

    Purpose: To have an initial assessment of the Vero Dynamic Tracking workflow in clinical circumstances and quantify the performance of the tracking system, a simulation study was set up on 5 lung and liver patients. Methods and materials: The preparatory steps of a tumor tracking treatment, based on fiducial markers implanted in the tumor, were executed allowing pursuit of the tumor with the gimbaled linac and monitoring X-rays acquisition, however, without activating the 6 MV beam. Data were acquired on workflow time-efficiency, tracking accuracy and imaging exposure. Results: The average time between the patient entering the treatment room and the first treatment field was about 9 min. The time for building the correlation model was 3.2 min. Tracking errors of 0.55 and 0.95 mm (1σ) were observed in PAN/TILT direction and a 2D range of 3.08 mm. A skin dose was determined of 0.08 mGy/image, with a source-to-skin distance of 900 mm and kV exposure of 1 mAs. On average 1.8 mGy/min kV skin dose was observed for 1 Hz monitoring. Conclusion: The Vero tracking solution proved to be fully functional and showed performance comparable with other real-time tracking systems

  8. Development, effectiveness and cost-effectiveness of a new out-patient Breathlessness Support Service: study protocol of a phase III fast-track randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Bausewein Claudia

    2012-09-01

    Full Text Available Abstract Background Breathlessness is a common and distressing symptom affecting many patients with advanced disease both from malignant and non-malignant origin. A combination of pharmacological and non-pharmacological measures is necessary to treat this symptom successfully. Breathlessness services in various compositions aim to provide comprehensive care for patients and their carers by a multiprofessional team but their effectiveness and cost-effectiveness have not yet been proven. The Breathlessness Support Service (BSS is a newly created multiprofessional and interdisciplinary outpatient service at a large university hospital in South East London. The aim of this study is to develop and evaluate the effectiveness and cost effectiveness of this multidisciplinary out–patient BSS for the palliation of breathlessness, in advanced malignant and non-malignant disease. Methods The BSS was modelled based on the results of qualitative and quantitative studies, and systematic literature reviews. A randomised controlled fast track trial (RCT comprising two groups: 1 intervention (immediate access to BSS in addition to standard care; 2 control group (standard best practice and access to BSS after a waiting time of six weeks. Patients are included if suffering from breathlessness on exertion or at rest due to advanced disease such as cancer, chronic obstructive pulmonary disease (COPD, chronic heart failure (CHF, interstitial lung disease (ILD or motor neurone disease (MND that is refractory to maximal optimised medical management. Both quantitative and qualitative outcomes are assessed in face to-face interviews at baseline, after 6 and 12 weeks. The primary outcome is patients' improvement of mastery of breathlessness after six weeks assessed on the Chronic Respiratory Disease Questionnaire (CRQ. Secondary outcomes for patients include breathlessness severity, symptom burden, palliative care needs, service use, and respiratory measures (spirometry

  9. Development of fast neutron therapy worldwide. Radiobiological, clinical and technical aspects

    International Nuclear Information System (INIS)

    Wambersie, A.; Richard, F.; Breteau, N.

    1994-01-01

    Radiobiological data indicate that fast neutrons could bring a benefit in the treatment of some tumour types, and suggest mechanisms through which this benefit could be achieved. However, radiobiology also clearly indicates that there is a need for patient selection as well as for a high-physical selectivity. The main difficulty when interpreting the results of neutron therapy are the poor technical conditions in which the first treatments were applied. This explains why the value and the place of neutron therapy are not universally recognized, although more than 15000 patients have been treated so far worldwide. There are, however, clinical indications of fast neutrons bringing a benefit for the following tumour sites: salivary glands, paranasal sinuses, soft tissue sarcomas, prostatic adenocarcinomas, palliative treatment of melanoma and rectum. These tumours represent about 10-15% of all patients currently referred to the radiation therapy departments. (orig.)

  10. Present status of fast neutron therapy survey of the clinical data and of the clinical research programmes

    International Nuclear Information System (INIS)

    Wambersie, A.; Richard, F.

    1989-01-01

    The clinical results reported from the different neutron therapy centres, in USA, Europe and Asia, are reviewed. Fast neutrons were proven to be superior to photons for locally extended inoperable salivary gland tumours. The reported overall local control rates are 67% and 24% respectively. Paranasal sinuses and some tumours of the head and neck area, especially extended tumours with large fixed lymph nodes, are also indications for neutrons. By contrast, the results obtained for brain tumours were, in general, disappointing. Neutrons were shown to bring a benefit in the treatment of well differentiated slowly growing soft tissue sarcomas. The reported overall local control rates were 53% and 38% after neutron and photon irradiation respectively. Better results, after neutron irradiation, were also reported for bone- and chondrosarcomas. The reported local control rates are 54% for osteosarcomas and 49% for chondrosarcomas after neutron irradiation; the corresponding values are 21% and 33% respectively after photon irradiation. For locally extended prostatic adenocarcinoma, the superiority of mixed schedule (neutrons + photons) was demonstrated by a RTOG randomized trial (local control rates 77% for mixed schedule compared to 31% for photons). Neutrons were also shown to be useful for palliative treatment of melanomas. Further studies are needed in order to definitively evaluate the benefit of fast neutrons for other localisations such as uterine cervix, bladder, and rectum. It can be concluded that fast neutrons are superior to photons for at least 10% to 20% of the radiotherapy patients. As far as the technical point of view is concerned, it is recognized that the first patient series were treated in ''suboptimal'' conditions. However, recently, important improvements were made. In particular, several high-energy hospital-based cyclotrons are now fully dedicated to neutron therapy. It is likely that these improved technical conditions will further extend the

  11. Development and clinical evaluation of automatic fiducial detection for tumor tracking in cine megavoltage images during volumetric modulated arc therapy

    International Nuclear Information System (INIS)

    Azcona, Juan Diego; Li Ruijiang; Mok, Edward; Hancock, Steven; Xing Lei

    2013-01-01

    accuracy during treatment. Results: The algorithm was able to accurately localize the fiducial position on MV images with success rates of more than 90% per case. The percentage of images in which each fiducial was localized in the studied cases varied between 23% and 65%, with at least one fiducial having been localized between 40% and 95% of the images. This depended mainly on the modulation of the plan and fiducial blockage. The prostate movement in the presented cases varied between 0.8 and 3.5 mm (mean values). The maximum displacement detected among all patients was of 5.7 mm. Conclusions: An algorithm for automatic detection of fiducial markers in cine MV images has been developed and tested with five clinical cases. Despite the challenges posed by complex beam aperture shapes, fiducial localization close to the field edge, partial occlusion of fiducials, fast leaf and gantry movement, and inherently low MV image quality, good localization results were achieved in patient images. This work provides a technique for enabling real-time accurate fiducial detection and tumor tracking during VMAT treatments without the use of extra imaging dose.

  12. Present status of fast neutron personnel dosimetry system based on CR-39 solid state nuclear track detectors

    International Nuclear Information System (INIS)

    Pal, Rupali; Sathian, Deepa; Jayalakshmi, V.; Bakshi, A.K.; Chougaonkar, M.P.; Mayya, Y.S.; Kumar, Valli; Babu, Rajesh; Kar, S.; Joshi, V.M.

    2011-08-01

    Neutron sources are of different types depending upon the method of production such as nuclear reactors, particle accelerators and laboratory sources. Neutron sources depending upon their energy, flux, size etc. are used for variety of applications in basic and applied sciences, neutron scattering experiments and in industry such as oil well - digging, coal mining and processing, ore processing etc. Personnel working in nuclear installations such as reactors, accelerators, spent fuel processing plants, nuclear fuel cycle operations and those working in various industries such as oil refining, oil well-digging, coal mining and processing, ore processing, etc. need to be monitored for neutron exposures, if any. Neutron monitoring is especially necessary in view of the fact that the radiation weighting factor for neutron is much higher than gamma rays and also it varies with energy. Radiological Physics and Advisory Division is involved in monitoring of personnel working in neutron fields. Around 2100 workers from 70 institutions (DAE and Non-DAE) are monitored on a quarterly basis. Neutron personnel monitoring, carried out in the country is based on Solid State Nuclear Track Detection (SSNTD) technique. In this technique, neutrons interact with hydrogen in CR-39 polymer to produce recoil protons. These protons create damages in the polymer, which are enlarged and appear as tracks when subjected to electrochemical etching (ECE). These tracks are counted in an optical system to evaluate the neutron dose. The neutron dosimetry system based on SSNTD has undergone a significant development, since it was started in 1990. The development includes upgradation of image analysis system for counting tracks, introduction of chemical etching (CE) at elevated temperatures for evaluation of dose equivalents above 10 mSv and use of carbon laser for cutting of CR-39 detectors. The entire dose evaluation process has been standardized, which includes calibration and performance tests

  13. Wearable Internet of Things - from human activity tracking to clinical integration.

    Science.gov (United States)

    Kumari, Poonam; Lopez-Benitez, Miguel; Gyu Myoung Lee; Tae-Seong Kim; Minhas, Atul S

    2017-07-01

    Wearable devices for human activity tracking have been emerging rapidly. Most of them are capable of sending health statistics to smartphones, smartwatches or smart bands. However, they only provide the data for individual analysis and their data is not integrated into clinical practice. Leveraging on the Internet of Things (IoT), edge and cloud computing technologies, we propose an architecture which is capable of providing cloud based clinical services using human activity data. Such services could supplement the shortage of staff in primary healthcare centers thereby reducing the burden on healthcare service providers. The enormous amount of data created from such services could also be utilized for planning future therapies by studying recovery cycles of existing patients. We provide a prototype based on our architecture and discuss its salient features. We also provide use cases of our system in personalized and home based healthcare services. We propose an International Telecommunication Union based standardization (ITU-T) for our design and discuss future directions in wearable IoT.

  14. Fast and high-energy neutron detection with nuclear track detectors: Results of the European joint experiments 1992/93

    Energy Technology Data Exchange (ETDEWEB)

    Schraube, H. [GSF - Forschungszentrum fuer Umwelt und Gesundheit Neuherberg GmbH, Oberschleissheim (Germany); Alberts, W.G. [Physikalisch-Technische Bundesanstalt, Braunschweig (Germany); Weeks, A.R. [comps.] [Nuclear Electric plc, Berkeley (United Kingdom). Berkeley Technology Centre

    1997-12-31

    Under the auspices of EURADOS, the European radiation dosimetry group, seventeen recognised laboratories engaged in the field of individual neutron dosimetry with passive track detectors participated in an international comparative experiment. A number of twenty-seven detector systems, predominantly etched track detectors with the material PADC (poly allyl diglycol carbonate), were employed by the participating laboratories. Quasi-monoenergetic neutrons were provided for irradiations free-in-air and on front of a PMMA phantom by the GSF (Forschungszentrum fuer Umwelt und Gesundheit, Neuherberg, Germany) and by the PTB (Physikalisch-Technische Bundesanstalt, Braunschweig, Germany). High energy irradiations were conducted by the PSI (Paul-Scherrer Institut, Villigen, Switzerland). The results of the on-phantom irradiations were used to derive energy and angular responses of the track detectors, those of the free-in-air irradiations to obtain data for the linearity characteristics of the response with dose. The report contains a short description and the original data of the participating laboratories, displays the irradiation and reference conditions, and provides an over-all evaluation. Emphasis is placed on the quantitative evaluation of the background characteristics and of the non-linearity observed with most of the systems employed which limits their useful dose-range of application. (orig.)

  15. Applications of solid-state nuclear track detectors (SSNTDs) for fast ion and fusion reaction product measurements in TEXTOR experiments

    Energy Technology Data Exchange (ETDEWEB)

    Szydlowski, A.; Malinowski, K.; Malinowska, A. [Association EURTOM-IPPLM Warsaw, The Andrzej Soltan Institute for Nuclear Studies, 05-400 Otwock-Swierk (Poland); Wassenhove, G. Van [EURATOM-Belgium State Association, LPP, ERM/KMS, Trilateral Euregio Cluster, B-1000 Brussels (Belgium); Schweer, B. [Association EURATOM-FZJ, Institutte of Plasma Physicx, Juelich (Germany)

    2011-07-01

    Full text of publication follows: The paper reports on measurements of fusion reaction protons which were performed on TEXTOR facility in January 2009. The basic experimental scheme was similar to that applied in the previous measurements [1, 2]. The main experimental tool equipment was a small ion pinhole camera which was equipped with a PM-355 detector sample and was attached to a water cooled manipulator. The camera was placed below the plasma ring in the direction of ion drifts, at a distance of 4.4 cm from LCFS. However, in the described experiment it was aligned at an angle to the mayor TEXTOR radius (contrary to previous experiments), so that the input pinhole was oriented first at {gamma} = 45 degrees (shots 108799 - 108818) and then {gamma} = 600 (shots 108832 - 108847). The discharges were executed with one neutral beam of the total power 0.6 - 1.0 MW. In the first series (Nos 108799 - 108818) the plasma was additionally heated by ICRH of frequency 38 MHz. The irradiated detector samples were subjected to the same interrupted etching procedure as the samples used in the CR-39/PM-355 detector calibration measurements [1, 2]. After that, track density distributions and track diameter histograms were measured under an optical microscope. By the use of the calibration curves, it was possible to distinguish craters produced by protons from other craters and to convert the obtained histograms into proton energy spectra. The craters induced by lower energy ions appeared to be concentrated in narrower areas, whereas higher energy ions were registered in a more diffused detector fields. The paper shows again that the CR-39/PM-355 detector is an useful diagnostic tool for tokamak experiments, for measurement of charged ions. References: [1] A. Szydlowski, A. Malinowska, M. Jaskola, A. Korman, M.J. Sadowski, G. Van Wassenhove, B. Schweer and the TEXTOR team, A. Galkowski, 'Application of Solid State Nuclear Track Detectors in TEXTOR Experiment for Measurements

  16. The effect of direct referral for fast CT scan in early lung cancer detection in general practice. A clinical, cluster-randomised trial.

    Science.gov (United States)

    Guldbrandt, Louise Mahncke

    2015-03-01

    This PhD thesis is based on the project "The effect of direct referral for fast CT scan in early lung cancer detection in general practice. A clinical, cluster-randomised trial", performed in Denmark in 2010-2013. The thesis includes four papers and focuses on early lung cancer diagnostics in general practice. A total of 4200 new cases of lung cancer are diagnosed in Denmark annually. The stage of the disease is an important prognostic factor; thus, the opportunity for curative treatment declines with more advanced tumour stage. Lung cancer patients in Denmark (like in the UK) have a poorer prognosis than lung cancer patients in other European countries. One explanation could be delayed diagnosis. A fast-track pathway was therefore introduced in an attempt to expedite the diagnosis of cancer. However, it seems that not all patients can be diagnosed through this pathway. In order to ensure fast and early lung cancer diagnosis, it is crucial to examine the initial diagnostic process in general and the role general practice plays in lung cancer diagnostics in particular. The specific areas of investigation include the pathways to diagnosis, the characteristics of patients who are at special risk of delayed diagnosis and the level of prediagnostic activity in general practice. A chest radiograph is often the first choice in the investigation of lung cancer. Unfortunately, radiographs are less suitable for central and small tumours. Low-dose computer tomography (LDCT), however, has a high sensitivity for lung cancer which implies that it can be used to detect patients with localised, potentially curable disease. The aim of this thesis was to increase our knowledge of the initial stages of lung cancer diagnostics in general practice. The thesis also examined the effect of a direct referral from general practice to an additional diagnostic test, the LDCT. The aims of this thesis were: 1) To describe Danish patients' pathways to the diagnosis of lung cancer in general and

  17. Fast track segment finding in the Monitored Drift Tubes (MDT) of the ATLAS Muon Spectrometer using a Legendre transform algorithm

    CERN Document Server

    Ntekas, Konstantinos; The ATLAS collaboration

    2018-01-01

    Many of the physics goals of ATLAS in the High Luminosity LHC era, including precision studies of the Higgs boson, require an unprescaled single muon trigger with a 20 GeV threshold. The selectivity of the current ATLAS first-level muon trigger is limited by the moderate spatial resolution of the muon trigger chambers. By incorporating the precise tracking of the MDT, the muon transverse momentum can be measured with an accuracy close to that of the offline reconstruction at the trigger level, sharpening the trigger turn-on curves and reducing the single muon trigger rate. A novel algorithm is proposed which reconstructs segments from MDT hits in an FPGA and find tracks within the tight latency constraints of the ATLAS first-level muon trigger. The algorithm represents MDT drift circles as curves in the Legendre space and returns one or more segment lines tangent to the maximum possible number of drift circles.  This algorithm is implemented without the need of resource and time consuming hit position calcul...

  18. Thromboembolic and major bleeding events in relation to perioperative bridging of vitamin K antagonists in 649 fast-track total hip and knee arthroplasties

    DEFF Research Database (Denmark)

    Jørgensen, Christoffer C.; Kehlet, Henrik; Husted, Henrik

    2017-01-01

    Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies.  Patients and meth......Background - The benefit of preoperative bridging in surgical patients with continuous anticoagulant therapy is debatable, and drawing of meaningful conclusions may have been limited by mixed procedures with different thromboembolic and bleeding risks in most published studies.  Patients...... and methods - This was an observational cohort treatment study in consecutive primary unilateral total hip and knee arthroplasty patients between January 2010 and November 2013 in 8 Danish fast-track departments. Data were collected prospectively on preoperative comorbidity and anticoagulants in patients...

  19. A survey of head movement during clinical brain SPECT using an optical tracking system

    International Nuclear Information System (INIS)

    Pandos, G.; Barnden, L.; Lineage, H.; Smith, T.; Unger, S.

    2002-01-01

    Full text: The aim of this study was to survey patient motion during clinical brain SPECT using a commercial motion detection system called Polaris. Polaris is an optical tracker that remotely tracks head position and orientation via a small target attached to the patient. Its accuracy for position measurement is 1mm or 1 degree (deg), 33% moved > 2mm or 2deg and 10% moved > 4mm or 4deg. 65% of subjects moved 3 or more times. Motion in the D and P groups was equally likely to be small (<3mm or <3deg) or large and equally likely to occur early or late during acquisition. Motion in the N, F and C groups was less likely to be large and for N and F more likely to occur late in the acquisition suggesting fatigue was the main cause. The most common large movements were anterior-posterior translations and axial (Z) rotations. Significant head movement is common in brain SPECT, particularly in dementia and psychiatric subjects, and accurate motion correction is desirable to maintain image quality. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  20. The FastTrack Real Time Processor and Its Impact on Muon Isolation, Tau and b-Jet Online Selections at ATLAS

    CERN Document Server

    Crescioli, F; The ATLAS collaboration; Zhang, J; Boveia, A; Bevacqua, V; Cheng, Y; Canelli, F; Bogdan, M; Dell'Orso, M; Bossini, E; Citterio, M; Dunford, M; Drake, G; Beretta, M; Genat, JF; Annovi, A; Kim, YK; Kimura, N; Andreazza, A; Kapliy, A; Kasten, M; Piendibene, M; Negri, A; Meroni, C; Giannetti, P; Melachrinos, C; Hoff, J; Liberali, V; McCarn, A; Neubauer, M; Tang, F; Shochet, M; Stabile, A; Sartori, L; Sabatini, F; Proudfoot, J; Riva, M; Liu, T; Punzi, G; Vercesi, V; Tuggle, J; Todri, A; Tripiccione, R; Lanza, A; Wu, J; Yorita, K; Volpi, G; Vitullo, R.A; Sacco, I

    2010-01-01

    As the LHC luminosity is ramped up to 31034 cm−2 s−1 and beyond, the high rates, multiplicities, and energies of particles seen by the detectors will pose a unique challenge. Only a tiny fraction of the produced collisions can be stored on tape and immense real-time data reduction is needed. An effective trigger system must maintain high trigger efficiencies for the physics we are most interested in, and at the same time suppress the enormous QCD backgrounds. This requires massive computing power to minimize the online execution time of complex algorithms. A multi-level trigger is an effective solution for an otherwise impossible problem. The Fast Tracker (FTK) is a proposed upgrade to the current ATLAS trigger system that will operate at full Level-1 output rates and provide high quality tracks reconstructed over the entire detector by the start of processing in Level-2. FTK solves the combinatorial challenge inherent to tracking by exploiting massive parallelism of associative memories that can compa...

  1. Single-photon sensitive fast ebCMOS camera system for multiple-target tracking of single fluorophores: application to nano-biophotonics

    Science.gov (United States)

    Cajgfinger, Thomas; Chabanat, Eric; Dominjon, Agnes; Doan, Quang T.; Guerin, Cyrille; Houles, Julien; Barbier, Remi

    2011-03-01

    Nano-biophotonics applications will benefit from new fluorescent microscopy methods based essentially on super-resolution techniques (beyond the diffraction limit) on large biological structures (membranes) with fast frame rate (1000 Hz). This trend tends to push the photon detectors to the single-photon counting regime and the camera acquisition system to real time dynamic multiple-target tracing. The LUSIPHER prototype presented in this paper aims to give a different approach than those of Electron Multiplied CCD (EMCCD) technology and try to answer to the stringent demands of the new nano-biophotonics imaging techniques. The electron bombarded CMOS (ebCMOS) device has the potential to respond to this challenge, thanks to the linear gain of the accelerating high voltage of the photo-cathode, to the possible ultra fast frame rate of CMOS sensors and to the single-photon sensitivity. We produced a camera system based on a 640 kPixels ebCMOS with its acquisition system. The proof of concept for single-photon based tracking for multiple single-emitters is the main result of this paper.

  2. Fast neutron therapy at the end of 1988 - a survey of the clinical data

    International Nuclear Information System (INIS)

    Wambersie, A.

    1990-01-01

    The clinical results reported from the different neutron therapy centres, in USA, Europe and Asia, are reviewed. Fast neutrons were proven to be superior to photons for locally extended inoperable salivary gland tumours. The reported overall local control rates are 67% and 24% respectively. Paranasal sinuses and some tumours of the head and neck area, especially extended tumours with large fixed lymph nodes, are also indications for neutrons. By contrast, the results obtained for brain tumours were, in general, disappointing. Neutrons were shown to bring a benefit in the treatment of well differentiated slowly growing soft tissue sarcomas. The reported overall local control rates are 53% and 38% after neutron and photon irradiation respectively. Better results were also reported for bone- and chondrosarcomas. The reported local control rates are 54% for osteosarcomas and 49% for chondrosarcomas after neutron irradiation; the corresponding values are 21% and 33% respectively after photon irradiation. For locally extended prostatic adenocarcinoma, the superiority of mixed schedule (neutrons+photons) was demonstrated by a RTOG randomized trial (local control rates 77% for mixed schedule compared to 31% for photons). Neutrons were also shown to be useful for palliative treatment of melanomas. Further studies are needed in order to evaluate the benefit of fast neutrons for other localisations such as cervix, bladder, rectum. It can be concluded that fast neutrons are superior to photons for at least 10% of the radiotherapy patients. It is likely that the new high-energy hospital-based cyclotron will further extend the indications of neutron therapy. However, patient selection remains one of the main problems and there is a need for development of individual predictive tests. (orig.)

  3. Normalized knee-extension strength or leg-press power after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aalund, Peter K; Larsen, Kristian; Hansen, Torben Bæk

    2013-01-01

    OBJECTIVE: (s): To investigate which of the two muscle-impairment measures for the operated leg, normalized knee extension strength or leg press power, is more closely associated to performance-based and self-reported measures of function shortly following total knee arthroplasty (TKA). DESIGN...... and dynamic leg presses to determine their body-mass normalized knee extension strength and leg press power, respectively. The 10-m fast speed walking and 30-s chair stand tests were used to determine performance-based function, while the Western Ontario McMaster University Osteoarthritis Index (WOMAC......) and Oxford Knee scores were used to determine self-reported function. RESULTS: Normalized leg press power was more closely associated to both performance-based (r=.82, P...

  4. Delirium after fast-track hip and knee arthroplasty – a cohort study of 6331 elderly patients

    DEFF Research Database (Denmark)

    Petersen, P. B.; Jørgensen, C. C.; Kehlet, H.

    2017-01-01

    without PD (P delirium symptoms contributing to LOS > 4 days in fast......Background: Postoperative delirium (PD) is a well-known complication among elderly surgical patients and associated with increased morbidity, mortality and length of stay (LOS). In elective orthopedic surgery, including hip and knee arthroplasty (THA/TKA), most studies report incidences between 5...... to November 2013. Results: We identified 43 (0.7%) cases of PD symptoms mentioned as a reason for LOS > 4 days among the 789 patients with LOS > 4 days (12.5% of all THA and TKA). PD patients had a mean age of 80.7 [[95% CI] 79.3–82.1] years, being 4.0 [[95% CI] 2.5–5.5] years older compared to patients...

  5. Profiling Fast Healthcare Interoperability Resources (FHIR) of Family Health History based on the Clinical Element Models.

    Science.gov (United States)

    Lee, Jaehoon; Hulse, Nathan C; Wood, Grant M; Oniki, Thomas A; Huff, Stanley M

    2016-01-01

    In this study we developed a Fast Healthcare Interoperability Resources (FHIR) profile to support exchanging a full pedigree based family health history (FHH) information across multiple systems and applications used by clinicians, patients, and researchers. We used previously developed clinical element models (CEMs) that are capable of representing the FHH information, and derived essential data elements including attributes, constraints, and value sets. We analyzed gaps between the FHH CEM elements and existing FHIR resources. Based on the analysis, we developed a profile that consists of 1) FHIR resources for essential FHH data elements, 2) extensions for additional elements that were not covered by the resources, and 3) a structured definition to integrate patient and family member information in a FHIR message. We implemented the profile using an open-source based FHIR framework and validated it using patient-entered FHH data that was captured through a locally developed FHH tool.

  6. A prospective cohort study to investigate cost-minimisation, of Traditional open, open fAst track recovery and laParoscopic fASt track multimodal management, for surgical patients with colon carcinomas (TAPAS study

    Directory of Open Access Journals (Sweden)

    van Duivendijk Peter

    2010-06-01

    Full Text Available Abstract Background The present developments in colon surgery are characterized by two innovations: the introduction of the laparoscopic operation technique and fast recovery programs such as the Enhanced Recovery After Surgery (ERAS recovery program. The Tapas-study was conceived to determine which of the three treatment programs: open conventional surgery, open 'ERAS' surgery or laparoscopic 'ERAS' surgery for patients with colon carcinomas is most cost minimizing? Method/design The Tapas-study is a three-arm multicenter prospective cohort study. All patients with colon carcinoma, eligible for surgical treatment within the study period in four general teaching hospitals and one university hospital will be included. This design produces three cohorts: Conventional open surgery is the control exposure (cohort 1. Open surgery with ERAS recovery (cohort 2 and laparoscopic surgery with ERAS recovery (cohort 3 are the alternative exposures. Three separate time periods are used in order to prevent attrition bias. Primary outcome parameters are the two main cost factors: direct medical costs (real cost price calculation and the indirect non medical costs (friction method. Secondary outcome parameters are mortality, complications, surgical-oncological resection margins, hospital stay, readmission rates, time back to work/recovery, health status and quality of life. Based on an estimated difference in direct medical costs (highest cost factor of 38% between open and laparoscopic surgery (alfa = 0.01, beta = 0.05, a group size of 3×40 = 120 patients is calculated. Discussion The Tapas-study is three-arm multicenter cohort study that will provide a cost evaluation of three treatment programs for patients with colon carcinoma, which may serve as a guideline for choice of treatment and investment strategies in hospitals. Trial registration ISRCTN44649165.

  7. The ALICE TPC, a large 3-dimensional tracking device with fast readout for ultra-high multiplicity events

    CERN Document Server

    INSPIRE-00249819; Appelshauser, H.; Bablok, S.; Bialas, N.; Bolgen, R.; Bonnes, U.; Bramm, R.; Braun-Munzinger, P.; Campagnolo, R.; Christiansen, P.; Dobrin, A.; Engster, C.; Fehlker, D.; Foka, Y.; Frankenfeld, U.; Gaardhoje, J.J.; Garabatos, C.; Glassel, P.; Gonzalez Gutierrez, C.; Gros, P.; Gustafsson, H.A.; Helstrup, H.; Hoch, M.; Ivanov, M.; Janik, R.; Junique, A.; Kalweit, A.; Keidel, R.; Kniege, S.; Kowalski, M.; Larsen, D.T.; Lesenechal, Y.; Lenoir, P.; Lindegaard, N.; Lippmann, C.; Mager, M.; Mast, M.; Matyja, A.; Munkejord, M.; Musa, L.; Nielsen, B.S.; Nikolic, V.; Oeschler, H.; Olsen, E.K.; Oskarsson, A.; Osterman, L.; Pikna, M.; Rehman, A.; Renault, G.; Renfordt, R.; Rossegger, S.; Rohrich, D.; Roed, K.; Richter, M.; Rueshmann, G.; Rybicki, A.; Sann, H.; Schmidt, H.R.; Siska, M.; Sitar, B.; Soegaard, C.; Soltveit, H.K.; Soyk, D.; Stachel, J.; Stelzer, H.; Stenlund, E.; Stock, R.; Strmen, P.; Szarka, I.; Ullaland, K.; Vranic, D.; Veenhof, R.; Westergaard, J.; Wiechula, J.; Windelband, B.

    2010-01-01

    The design, construction, and commissioning of the ALICE Time-Projection Chamber (TPC) is described. It is the main device for pattern recognition, tracking, and identification of charged particles in the ALICE experiment at the CERN LHC. The TPC is cylindrical in shape with a volume close to 90 m^3 and is operated in a 0.5 T solenoidal magnetic field parallel to its axis. In this paper we describe in detail the design considerations for this detector for operation in the extreme multiplicity environment of central Pb--Pb collisions at LHC energy. The implementation of the resulting requirements into hardware (field cage, read-out chambers, electronics), infrastructure (gas and cooling system, laser-calibration system), and software led to many technical innovations which are described along with a presentation of all the major components of the detector, as currently realized. We also report on the performance achieved after completion of the first round of stand-alone calibration runs and demonstrate result...

  8. Fast and accurate global multiphase arrival tracking: the irregular shortest-path method in a 3-D spherical earth model

    Science.gov (United States)

    Huang, Guo-Jiao; Bai, Chao-Ying; Greenhalgh, Stewart

    2013-09-01

    The traditional grid/cell-based wavefront expansion algorithms, such as the shortest path algorithm, can only find the first arrivals or multiply reflected (or mode converted) waves transmitted from subsurface interfaces, but cannot calculate the other later reflections/conversions having a minimax time path. In order to overcome the above limitations, we introduce the concept of a stationary minimax time path of Fermat's Principle into the multistage irregular shortest path method. Here we extend it from Cartesian coordinates for a flat earth model to global ray tracing of multiple phases in a 3-D complex spherical earth model. The ray tracing results for 49 different kinds of crustal, mantle and core phases show that the maximum absolute traveltime error is less than 0.12 s and the average absolute traveltime error is within 0.09 s when compared with the AK135 theoretical traveltime tables for a 1-D reference model. Numerical tests in terms of computational accuracy and CPU time consumption indicate that the new scheme is an accurate, efficient and a practical way to perform 3-D multiphase arrival tracking in regional or global traveltime tomography.

  9. Randomized controlled clinical trial on the three-dimensional accuracy of fast-set impression materials.

    Science.gov (United States)

    Rudolph, Heike; Quaas, Sebastian; Haim, Manuela; Preißler, Jörg; Walter, Michael H; Koch, Rainer; Luthardt, Ralph G

    2013-06-01

    The use of fast-setting impression materials with different viscosities for the one-stage impression technique demands precise working times when mixing. We examined the effect of varying working time on impression precision in a randomized clinical trial. Focusing on tooth 46, three impressions were made from each of 96 volunteers, using either a polyether (PE: Impregum Penta H/L DuoSoft Quick, 3 M ESPE) or an addition-curing silicone (AS: Aquasil Ultra LV, Dentsply/DeTrey), one with the manufacturer's recommended working time (used as a reference) and two with altered working times. All stages of the impression-taking were subject to randomization. The three-dimensional precision of the non-standard working time impressions was digitally analyzed compared to the reference impression. Statistical analysis was performed using multivariate models. The mean difference in the position of the lower right first molar (vs. the reference impression) ranged from ±12 μm for PE to +19 and -14 μm for AS. Significantly higher mean values (+62 to -40 μm) were found for AS compared to PE (+21 to -26 μm) in the area of the distal adjacent tooth. Fast-set impression materials offer high precision when used for single tooth restorations as part of a one-stage impression technique, even when the working time (mixing plus application of the light- and heavy-body components) diverges significantly from the manufacturer's recommended protocol. Best accuracy was achieved with machine-mixed heavy-body/light-body polyether. Both materials examined met the clinical requirements regarding precision when the teeth were completely syringed with light material.

  10. Clinical Validation of the Glenoid Track Concept in Anterior Glenohumeral Instability.

    Science.gov (United States)

    Shaha, James S; Cook, Jay B; Rowles, Douglas J; Bottoni, Craig R; Shaha, Steven H; Tokish, John M

    2016-11-16

    Glenoid and humeral bone loss are well-described risk factors for failure of arthroscopic shoulder stabilization. Recently, consideration of the interactions of these types of bone loss (bipolar bone loss) has been used to determine if a lesion is "on-track" or "off-track." The purpose of this study was to study the relationship of the glenoid track to the outcomes of arthroscopic Bankart reconstructions. Over a 2-year period, 57 shoulders that were treated with an isolated, primary arthroscopic Bankart reconstruction performed at a single facility were included in this study. The mean patient age was 25.5 years (range, 20 to 42 years) at the time of the surgical procedure, and the mean follow-up was 48.3 months (range, 23 to 58 months). Preoperative magnetic resonance imaging was used to determine glenoid bone loss and Hill-Sachs lesion size and location and to measure the glenoid track to classify the shoulders as on-track or off-track. Outcomes were assessed according to shoulder stability on examination and subjective outcome. There were 10 recurrences (18%). Of the 49 on-track patients, 4 (8%) had treatment that failed compared with 6 (75%) of 8 off-track patients (p = 0.0001). Six (60%) of 10 patients with recurrence of instability were off-track compared with 2 (4%) of 47 patients in the stable group (p = 0.0001). The positive predictive value of an off-track measurement was 75% compared with 44% for the predictive value of glenoid bone loss of >20%. The application of the glenoid track concept to our cohort was superior to using glenoid bone loss alone with regard to predicting postoperative stability. This method of assessment is encouraged as a routine part of the preoperative evaluation of all patients under consideration for arthroscopic anterior stabilization. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

  11. Comparative Evaluation of Pain, Stress, Neuropeptide Y, ACTH, and Cortisol Levels Between a Conventional Postoperative Care Protocol and a Fast-Track Recovery Program in Patients Undergoing Major Abdominal Surgery.

    Science.gov (United States)

    Kapritsou, Maria; Papathanassoglou, Elizabeth D; Bozas, Evangelos; Korkolis, Dimitrios P; Konstantinou, Evangelos A; Kaklamanos, Ioannis; Giannakopoulou, Margarita

    2017-03-01

    Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT ( n = 29) or CON ( n = 34). Demographic and clinical data were collected, and pain (Visual Analog Scale [VAS] and Behavioral Pain Scale [BPS]) and stress responses (3 self-report questions) assessed. NPY, ACTH, and cortisol plasma levels were measured at T1 = day of admission, T2 = day of surgery, and T3 = prior to discharge. ACTH T1 and ACTH T2 levels were positively correlated with self-reported stress levels (ρ = .43 and ρ = .45, respectively, p .05). Neuropeptidic levels were higher in the FT group. Future research should evaluate this association further, as these biomarkers might serve as objective indicators of postoperative pain and stress.

  12. Tracking the Iron Kα line and the Ultra Fast Outflow in NGC 2992 at different accretion states

    Science.gov (United States)

    Marinucci, A.; Bianchi, S.; Braito, V.; Matt, G.; Nardini, E.; Reeves, J.

    2018-06-01

    The Seyfert 2 galaxy NGC 2992 has been monitored eight times by XMM-Newton in 2010 and then observed again in 2013, while in 2015 it was simultaneously targeted by Swift and NuSTAR. XMM-Newton always caught the source in a faint state (2-10 keV fluxes ranging from 0.3 to 1.6× 10-11 erg cm-2 s-1) but NuSTAR showed an increase in the 2-10 keV flux up to 6× 10-11 erg cm-2 s-1. We find possible evidence of an Ultra Fast Outflow with velocity v1 = 0.21 ± 0.01c (detected at about 99% confidence level) in such a flux state. The UFO in NGC 2992 is consistent with being ejected at a few tens of gravitational radii only at accretion rates greater than 2% of the Eddington luminosity. The analysis of the low flux 2010/2013 XMM data allowed us to determine that the Iron Kα emission line complex in this object is likely the sum of three distinct components: a constant, narrow one due to reflection from cold, distant material (likely the molecular torus); a narrow, but variable one which is more intense in brighter observations and a broad relativistic one emitted in the innermost regions of the accretion disk, which has been detected only in the 2003 XMM observation.

  13. Clinical Accuracy of the Respiratory Tumor Tracking System of the CyberKnife: Assessment by Analysis of Log Files

    International Nuclear Information System (INIS)

    Hoogeman, Mischa; Prevost, Jean-Briac; Nuyttens, Joost; Poell, Johan; Levendag, Peter; Heijmen, Ben

    2009-01-01

    Purpose: To quantify the clinical accuracy of the respiratory motion tracking system of the CyberKnife treatment device. Methods and Materials: Data in log files of 44 lung cancer patients treated with tumor tracking were analyzed. Errors in the correlation model, which relates the internal target motion with the external breathing motion, were quantified. The correlation model error was compared with the geometric error obtained when no respiratory tracking was used. Errors in the prediction method were calculated by subtracting the predicted position from the actual measured position after 192.5 ms (the time lag to prediction in our current system). The prediction error was also measured for a time lag of 115 ms and a new prediction method. Results: The mean correlation model errors were less than 0.3 mm. Standard deviations describing intrafraction variations around the whole-fraction mean error were 0.2 to 1.9 mm for cranio-caudal, 0.1 to 1.9 mm for left-right, and 0.2 to 2.5 mm for anterior-posterior directions. Without the use of respiratory tracking, these variations would have been 0.2 to 8.1 mm, 0.2 to 5.5 mm, and 0.2 to 4.4 mm. The overall mean prediction error was small (0.0 ± 0.0 mm) for all directions. The intrafraction standard deviation ranged from 0.0 to 2.9 mm for a time delay of 192.5 ms but was halved by using the new prediction method. Conclusions: Analyses of the log files of real clinical cases have shown that the geometric error caused by respiratory motion is substantially reduced by the application of respiratory motion tracking.

  14. Neuroprotective effect of bispectral index-guided fast-track anesthesia using sevoflurane combined with dexmedetomidine for intracranial aneurysm embolization

    Directory of Open Access Journals (Sweden)

    Chao-liang Tang

    2018-01-01

    Full Text Available Dexmedetomidine has sedative, anxiolytic, analgesic, anti-sympathetic, and anti-shivering effects. Dexmedetomidine might be effective in combination with sevoflurane for anesthesia, but prospective randomized controlled clinical trials with which to verify this hypothesis are lacking. In total, 120 patients who underwent embolization of an intracranial aneurysm were recruited from Anhui Provincial Hospital and Renmin Hospital of Wuhan University of China and randomly allocated to two groups. After intraoperative administration of 2% to 3% sevoflurane inhalation, one group of patients received pump-controlled intravenous injection of 1.0 μg/kg dexmedetomidine for 15 minutes followed by maintenance with 0.3 μg/kg/h until the end of surgery; the other group of patients only underwent pump-controlled infusion of saline. Bispectral index monitoring revealed that dexmedetomidine-assisted anesthesia can shorten the recovery time of spontaneous breathing, time to eye opening, and time to laryngeal mask removal. Before anesthetic induction and immediately after laryngeal mask airway removal, the glucose and lactate levels were low, the S100β and neuron-specific enolase levels were low, the perioperative blood pressure and heart rate were stable, and postoperative delirium was minimal. These findings indicate that dexmedetomidine can effectively assist sevoflurane for anesthesia during surgical embolization of intracranial aneurysms, shorten the time to consciousness and extubation, reduce the stress response and energy metabolism, stabilize hemodynamic parameters, and reduce adverse reactions, thereby reducing the damage to the central nervous system. This trial was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn/ (registration number: ChiCTR-IPR-16008113.

  15. Knee Pain during Strength Training Shortly following Fast-Track Total Knee Arthroplasty: A Cross-Sectional Study

    Science.gov (United States)

    Bandholm, Thomas; Thorborg, Kristian; Lunn, Troels Haxholdt; Kehlet, Henrik; Jakobsen, Thomas Linding

    2014-01-01

    Background Loading and contraction failure (muscular exhaustion) are strength training variables known to influence neural activation of the exercising muscle in healthy subjects, which may help reduce neural inhibition of the quadriceps muscle following total knee arthroplasty (TKA). It is unknown how these exercise variables influence knee pain after TKA. Objective To investigate the effect of loading and contraction failure on knee pain during strength training, shortly following TKA. Design Cross-sectional study. Setting Consecutive sample of patients from the Copenhagen area, Denmark, receiving a TKA, between November 2012 and April 2013. Participants Seventeen patients, no more than 3 weeks after their TKA. Main outcome measures: In a randomized order, the patients performed 1 set of 4 standardized knee extensions, using relative loads of 8, 14, and 20 repetition maximum (RM), and ended with 1 single set to contraction failure (14 RM load). The individual loadings (kilograms) were determined during a familiarization session >72 hours prior. The patients rated their knee pain during each repetition, using a numerical rating scale (0–10). Results Two patients were lost to follow up. Knee pain increased with increasing load (20 RM: 3.1±2.0 points, 14 RM: 3.5±1.8 points, 8 RM: 4.3±2.5 points, P = 0.006), and repetitions to contraction failure (10% failure: 3.2±1.9 points, 100% failure: 5.4±1.6 points, Pknee pain 60 seconds after the final repetition (2.7±2.4 points) was not different from that recorded before strength training (2.7±1.8 points, P = 0.88). Conclusion Both loading and repetitions performed to contraction failure during knee- extension strength-training, increased post-operative knee pain during strength training implemented shortly following TKA. However, only the increase in pain during repetitions to contraction failure exceeded that defined as clinically relevant, and was very short-lived. Trial Registration Clinical

  16. Real-time non-rigid target tracking for ultrasound-guided clinical interventions

    NARCIS (Netherlands)

    Zachiu, Cornel; Ries, Mario G; Ramaekers, Pascal; Guey, Jean-Luc; Moonen, Chrit T W; de Senneville, Baudouin Denis

    2017-01-01

    Biological motion is a problem for non- or mini-invasive interventions when conducted in mobile/deformable organs due to the targeted pathology moving/deforming with the organ. This may lead to high miss rates and/or incomplete treatment of the pathology. Therefore, real-time tracking of the target

  17. User Resistance and Trust in a Clinical RFID Employee Location Tracking Information System

    Science.gov (United States)

    Wong, Wilson

    2013-01-01

    User resistance has been identified as a factor in information systems implementation failures in the health care industry. RFID, radio frequency identification, is being incorporated into new health care information systems in order to effect cost reductions by tracking, identifying and monitoring individuals and medical items. This is the first…

  18. The use of an intraarticular catheter on fast-track primary knee arthroplasty, is it a step forward?

    Science.gov (United States)

    Cáceres-Sánchez, L; García-Benítez, J B; Coronado-Hijón, V; Montero-Pariente, M

    This study compares the efficacy in post-operative pain control of the intraarticular catheter compared to the epidural catheter after primary total knee arthroplasty. Randomised clinical trial consisting of two groups of patients. A control group with intradural anaesthesia and an intraoperative epidural catheter (ropivacaine) and an intervention group using the same anaesthetic technique and an intraarticular catheter with an elastomeric pump (ropivacaine+dexketoprofen). Data such as demographic, anaesthetic and surgical variables, pain intensity according to Verbal Rating Scale, opioid use and complications, joint balance, onset of walking and hospital stay were recorded. A lower incidence and severity on Verbal Rating Scale and a better control of postoperative pain (p.001). Finally, the hospital stay decreased significantly, with 33.3% of intervention group patients discharged within the first 48h compared to none of the control group. The use of the intraarticular catheter as postoperative analgesia is a useful and safe alternative. It reduces the possibility of side effects. It helps in early improvement of joint balance, onset of walking and control of pain. All of which increase patient satisfaction and result in a shorter period of hospitalisation. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. A Fast-Track Referral System for Skin Lesions Suspicious of Melanoma: Population-Based Cross-Sectional Study from a Plastic Surgery Center

    Directory of Open Access Journals (Sweden)

    Reem Dina Jarjis

    2016-01-01

    Full Text Available Introduction. To minimize delay between presentation, diagnosis, and treatment of cutaneous melanoma (CM, a national fast-track referral system (FTRS was implemented in Denmark. The aim of this study was to analyze the referral patterns to our department of skin lesions suspicious of melanoma in the FTRS. Methods. Patients referred to the Department of Plastic Surgery and Breast Surgery in Zealand University Hospital were registered prospectively over a 1-year period in 2014. A cross-sectional study was performed analyzing referral patterns, including patient and tumor characteristics. Results. A total of 556 patients were registered as referred to the center in the FTRS for skin lesions suspicious of melanoma. Among these, a total of 312 patients (56.1% were diagnosed with CM. Additionally, 41 (7.4% of the referred patients were diagnosed with in situ melanoma. Conclusion. In total, 353 (63.5% patients had a malignant or premalignant melanocytic skin lesion. When only considering patients who where referred without a biopsy, the diagnostic accuracy for GPs and dermatologists was 29% and 45%, respectively. We suggest that efforts of adequate training for the referring physicians in diagnosing melanocytic skin lesions will increase diagnostic accuracy, leading to larger capacity in secondary care for the required treatment of malignant skin lesions.

  20. China's challenging fast track. Far more energy will have to be produced - and conserved - to power the expanding economy and protect the environment

    International Nuclear Information System (INIS)

    Wei Zhihong

    2004-01-01

    China's economy is on a fast track, with growth projected to quadruple in the first two decades of this century. A mix of clean and affordable energy sources will be needed to fuel and sustain development. Since China opened to outside markets in the 1980s, the national economy has expanded steadily, with an average annual growth rate of 9.6% in gross domestic product (GDP) from 1980 to 2000. Development has stayed strong in this century, and GDP grew 9.1% in 2003, the highest rate in the past six years. For the first time, per capita GDP topped $1000, reaching $1090 last year. How to best manage and sustain growth is driving energy decisions. Analyses show that China has entered a stage of manufacturing, chemical, and heavy industrial development that is energy intensive. At the same time, demands for energy at home and in businesses are growing among China's population of 1.3 billion people. As consumption grows, so do concerns about air, water, and land pollution in the context of sustainable energy development

  1. A stochastic frontier analysis of technical efficiency in smallholder maize production in Zimbabwe: The post-fast-track land reform outlook

    Directory of Open Access Journals (Sweden)

    Nelson Mango

    2015-12-01

    Full Text Available This article analyses the technical efficiency of maize production in Zimbabwe’s smallholder farming communities following the fast-track land reform of the year 2000 with a view of highlighting key entry points for policy. Using a randomly selected sample of 522 smallholder maize producers, a stochastic frontier production model was applied, using a linearised Cobb–Douglas production function to determine the production elasticity coefficients of inputs, technical efficiency and the determinants of efficiency. The study finds that maize output responds positively to increases in inorganic fertilisers, seed quantity, the use of labour and the area planted. The technical efficiency analysis suggests that about 90% of farmers in the sample are between 60 and 75% efficient, with an average efficiency in the sample of 65%. The significant determinants of technical efficiency were the gender of the household head, household size, frequency of extension visits, farm size and the farming region. The results imply that the average efficiency of maize production could be improved by 35% through better use of existing resources and technology. The results highlight the need for government and private sector assistance in improving efficiency by promoting access to productive resources and ensuring better and more reliable agricultural extension services.

  2. STTARR: a radiation treatment and multi-modal imaging facility for fast tracking novel agent development in small animal models

    International Nuclear Information System (INIS)

    Yeung, Ivan; McKee, Trevor; Jaffray, David; Hill, Richard

    2014-01-01

    Small animal models play a pivotal role in the pipeline development of novel agents and strategies in personalized cancer therapy. The Spatio-Temporal Targeting and Amplification of Radiation Response Program (STTARR) consists of an animal imaging and precision radiation facility designed to provide innovative biologic imaging and targeted radiation treatment strategies in small animals. The design is to mirror the imaging and radiation treatment facility in a modern cancer center. The STTARR features imaging equipment of small animal scale including CT, MRI, PET, SPECT, Optical devices as well as image guided irradiators. The fleet of imaging and irradiation equipment provides a platform for identification of biological targets of the specific molecular pathways that influence both tumor progression and a patient's response to radiation therapy. Examples will be given in the utilization of the imaging facilities for development in novel approaches in cancer therapy including a PET-FAZA study for hypoxia measurement in a pancreatic adenocarcinoma xenograft model. In addition, the cone-beam image guided small animal irradiator developed at our institute will also be described. The animal platform (couch) provides motion in 3 dimensions to position the animal to the isocentre of the beam. A pair of rotational arms supporting the X-ray/detector pair enables acquisition of cone-beam images of the animal which give rise to image guided precision of 0.5 mm. The irradiation energy ranges from 50 to 225 kVp at a dose rate from 10-400 cGy/min. The gantry is able to direct X-ray beam of different directions to give conformal radiation treatment to the animal. A dedicated treatment planning system is able to perform treatment planning and provide commonly used clinical metrics in the animal treatment plan. Examples will be given to highlight the use of the image guided irradiator for research of drug/irradiation regimen in animal models. (author)

  3. Tracking the footsteps: a constructivist grounded theory of the clinical reasoning processes that registered nurses use to recognise delirium.

    Science.gov (United States)

    El Hussein, Mohamed; Hirst, Sandra

    2016-02-01

    To construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognise delirium while caring for older adults in acute care settings. Delirium is often under-recognised in acute care settings; this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' clinical reasoning processes in complex situations such as delirium recognition. Seventeen registered nurses working in acute care settings were interviewed. Concurrent data collection and analysis, constant comparative analysis and theoretical sampling were conducted in 2013-2014. A grounded theory approach was used to analyse interview data about the clinical reasoning processes of registered nurse in acute hospital settings. The core category that emerged from data was 'Tracking the footsteps'. This refers to the common clinical reasoning processes that registered nurses in this study used to recognise delirium in older adults in acute care settings. It depicted the process of continuously trying to catch the state of delirium in older adults. Understanding the clinical reasoning processes that contribute to delirium under-recognition provides a strategy by which this problem can be brought to the forefront of awareness and intervention by registered nurses. Registered nurses could draw from the various processes identified in this research to develop their clinical reasoning practice to enhance their effective assessment strategies. Delirium recognition by registered nurses will contribute to quality care to older adults. © 2016 John Wiley & Sons Ltd.

  4. Symptom severity prediction from neuropsychiatric clinical records: Overview of 2016 CEGS N-GRID shared tasks Track 2.

    Science.gov (United States)

    Filannino, Michele; Stubbs, Amber; Uzuner, Özlem

    2017-11-01

    The second track of the CEGS N-GRID 2016 natural language processing shared tasks focused on predicting symptom severity from neuropsychiatric clinical records. For the first time, initial psychiatric evaluation records have been collected, de-identified, annotated and shared with the scientific community. One-hundred-ten researchers organized in twenty-four teams participated in this track and submitted sixty-five system runs for evaluation. The top ten teams each achieved an inverse normalized macro-averaged mean absolute error score over 0.80. The top performing system employed an ensemble of six different machine learning-based classifiers to achieve a score 0.86. The task resulted to be generally easy with the exception of two specific classes of records: records with very few but crucial positive valence signals, and records describing patients predominantly affected by negative rather than positive valence. Those cases proved to be very challenging for most of the systems. Further research is required to consider the task solved. Overall, the results of this track demonstrate the effectiveness of data-driven approaches to the task of symptom severity classification. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. SU-E-J-59: Feasibility of Markerless Tumor Tracking by Sequential Dual-Energy Fluoroscopy On a Clinical Tumor Tracking System

    Energy Technology Data Exchange (ETDEWEB)

    Dhont, J; Poels, K; Verellen, D; Tournel, K; Gevaert, T; Steenbeke, F; Burghelea, M; De Ridder, M [Department of Radiotherapy, Universitair Ziekenhuis Brussel, Brussels (Belgium)

    2015-06-15

    Purpose: To evaluate the feasibility of markerless tumor tracking through the implementation of a novel dual-energy imaging approach into the clinical dynamic tracking (DT) workflow of the Vero SBRT system. Methods: Two sequential 20 s (11 Hz) fluoroscopy sequences were acquired at the start of one fraction for 7 patients treated for primary and metastatic lung cancer with DT on the Vero system. Sequences were acquired using 2 on-board kV imaging systems located at ±45° from the MV beam axis, at respectively 60 kVp (3.2 mAs) and 120 kVp (2.0 mAs). Offline, a normalized cross-correlation algorithm was applied to match the high (HE) and low energy (LE) images. Per breathing phase (inhale, exhale, maximum inhale and maximum exhale), the 5 best-matching HE and LE couples were extracted for DE subtraction. A contrast analysis according to gross tumor volume was conducted based on contrast-to-noise ratio (CNR). Improved tumor visibility was quantified using an improvement ratio. Results: Using the implanted fiducial as a benchmark, HE-LE sequence matching was effective for 13 out of 14 imaging angles. Overlying bony anatomy was removed on all DE images. With the exception of two imaging angles, the DE images showed no significantly improved tumor visibility compared to HE images, with an improvement ratio averaged over all patients of 1.46 ± 1.64. Qualitatively, it was observed that for those imaging angles that showed no significantly improved CNR, the tumor tissue could not be reliably visualized on neither HE nor DE images due to a total or partial overlap with other soft tissue. Conclusion: Dual-energy subtraction imaging by sequential orthogonal fluoroscopy was shown feasible by implementing an additional LE fluoroscopy sequence. However, for most imaging angles, DE images did not provide improved tumor visibility over single-energy images. Optimizing imaging angles is likely to improve tumor visibility and the efficacy of dual-energy imaging. This work was in

  6. Fast T Wave Detection Calibrated by Clinical Knowledge with Annotation of P and T Waves

    Directory of Open Access Journals (Sweden)

    Mohamed Elgendi

    2015-07-01

    Full Text Available Background: There are limited studies on the automatic detection of T waves in arrhythmic electrocardiogram (ECG signals. This is perhaps because there is no available arrhythmia dataset with annotated T waves. There is a growing need to develop numerically-efficient algorithms that can accommodate the new trend of battery-driven ECG devices. Moreover, there is also a need to analyze long-term recorded signals in a reliable and time-efficient manner, therefore improving the diagnostic ability of mobile devices and point-of-care technologies. Methods: Here, the T wave annotation of the well-known MIT-BIH arrhythmia database is discussed and provided. Moreover, a simple fast method for detecting T waves is introduced. A typical T wave detection method has been reduced to a basic approach consisting of two moving averages and dynamic thresholds. The dynamic thresholds were calibrated using four clinically known types of sinus node response to atrial premature depolarization (compensation, reset, interpolation, and reentry. Results: The determination of T wave peaks is performed and the proposed algorithm is evaluated on two well-known databases, the QT and MIT-BIH Arrhythmia databases. The detector obtained a sensitivity of 97.14% and a positive predictivity of 99.29% over the first lead of the validation databases (total of 221,186 beats. Conclusions: We present a simple yet very reliable T wave detection algorithm that can be potentially implemented on mobile battery-driven devices. In contrast to complex methods, it can be easily implemented in a digital filter design.

  7. Prehospital fast track care for patients with hip fracture: Impact on time to surgery, hospital stay, post-operative complications and mortality a randomised, controlled trial.

    Science.gov (United States)

    Larsson, Glenn; Strömberg, Rn Ulf; Rogmark, Cecilia; Nilsdotter, Anna

    2016-04-01

    Ambulance organisations in Sweden have introduced prehospital fast track care (PFTC) for patients with suspected hip fracture. This means that the ambulance nurse starts the pre-operative procedure otherwise implemented at the accident & emergency ward (A&E) and transports the patient directly to the radiology department instead of A&E. If the diagnosis is confirmed, the patient is transported directly to the orthopaedic ward. No previous randomised, controlled studies have analysed PFTC to describe its possible advantages. The aim of this study is to examine whether PFTC has any impact on outcomes such as time to surgery, length of stay, post-operative complications and mortality. The design of this study is a prehospital randomised, controlled study, powered to include 400 patients. The patients were randomised into PFTC or the traditional care pathway (A&E group). Time from arrival to start for X-ray was faster for PFTC (mean, 28 vs. 145 min; pstart of X-ray to start of surgery (mean 18.40 h in both groups). No significant differences between the groups were observed with regard to: time from arrival to start of surgery (p=0.07); proportion operated within 24h (79% PFTC, 75% A&E; p=0.34); length of stay (p=0.34); post-operative complications (p=0.75); and 4 month mortality (18% PFTC, 15% A&E p=0.58). PFTC improved time to X-ray and admission to a ward, as expected, but did not significantly affect time to start of surgery, length of stay, post-operative complications or mortality. These outcomes were probably affected by other factors at the hospital. Patients with either possible life-threatening conditions or life-threatening conditions prehospital were excluded. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Clinical decision-making tools for exam selection, reporting and dose tracking

    International Nuclear Information System (INIS)

    Brink, James A.

    2014-01-01

    Although many efforts have been made to reduce the radiation dose associated with individual medical imaging examinations to ''as low as reasonably achievable,'' efforts to ensure such examinations are performed only when medically indicated and appropriate are equally if not more important. Variations in the use of ionizing radiation for medical imaging are concerning, regardless of whether they occur on a local, regional or national basis. Such variations among practices can be reduced with the use of decision support tools at the time of order entry. These tools help reduce radiation exposure among practices through the appropriate use of medical imaging. Similarly, adoption of best practices among imaging facilities can be promoted through tracking the radiation exposure among imaging patients. Practices can benchmark their aggregate radiation exposures for medical imaging through the use of dose index registries. However several variables must be considered when contemplating individual patient dose tracking. The specific dose measures and the variation among them introduced by variations in body habitus must be understood. Moreover the uncertainties in risk estimation from dose metrics related to age, gender and life expectancy must also be taken into account. (orig.)

  9. Clinical decision-making tools for exam selection, reporting and dose tracking

    Energy Technology Data Exchange (ETDEWEB)

    Brink, James A. [Massachusetts General Hospital, Harvard Medical School, Department of Radiology, Boston, MA (United States)

    2014-10-15

    Although many efforts have been made to reduce the radiation dose associated with individual medical imaging examinations to ''as low as reasonably achievable,'' efforts to ensure such examinations are performed only when medically indicated and appropriate are equally if not more important. Variations in the use of ionizing radiation for medical imaging are concerning, regardless of whether they occur on a local, regional or national basis. Such variations among practices can be reduced with the use of decision support tools at the time of order entry. These tools help reduce radiation exposure among practices through the appropriate use of medical imaging. Similarly, adoption of best practices among imaging facilities can be promoted through tracking the radiation exposure among imaging patients. Practices can benchmark their aggregate radiation exposures for medical imaging through the use of dose index registries. However several variables must be considered when contemplating individual patient dose tracking. The specific dose measures and the variation among them introduced by variations in body habitus must be understood. Moreover the uncertainties in risk estimation from dose metrics related to age, gender and life expectancy must also be taken into account. (orig.)

  10. Approaches to veterinary education--tracking versus a final year broad clinical experience. Part one: effects on career outcome.

    Science.gov (United States)

    Klosterman, E S; Kass, P H; Walsh, D A

    2009-08-01

    This is the first of two papers that provide extensive data and analysis on the two major approaches to clinical veterinary education, which either provide students with experience of a broad range of species (often defined as omni/general clinical competence), or just a few species (sometimes just one), usually termed 'tracking'. Together the two papers provide a detailed analysis of these two approaches for the first time. The responsibilities of veterinary medicine and veterinary education are rapidly increasing throughoutthe globe. It is critical for all in veterinary education to reassess the approaches that have been used, and evaluate on a school-by-school basis which may best meet its expanding and ever-deepening responsibilities.

  11. Using the web for recruitment, screen, tracking, data management, and quality control in a dietary assessment clinical validation trial.

    Science.gov (United States)

    Arab, Lenore; Hahn, Harry; Henry, Judith; Chacko, Sara; Winter, Ashley; Cambou, Mary C

    2010-03-01

    Screening and tracking subjects and data management in clinical trials require significant investments in manpower that can be reduced through the use of web-based systems. To support a validation trial of various dietary assessment tools that required multiple clinic visits and eight repeats of online assessments, we developed an interactive web-based system to automate all levels of management of a biomarker-based clinical trial. The "Energetics System" was developed to support 1) the work of the study coordinator in recruiting, screening and tracking subject flow, 2) the need of the principal investigator to review study progress, and 3) continuous data analysis. The system was designed to automate web-based self-screening into the trial. It supported scheduling tasks and triggered tailored messaging for late and non-responders. For the investigators, it provided real-time status overviews on all subjects, created electronic case reports, supported data queries and prepared analytic data files. Encryption and multi-level password protection were used to insure data privacy. The system was programmed iteratively and required six months of a web programmer's time along with active team engagement. In this study the enhancement in speed and efficiency of recruitment and quality of data collection as a result of this system outweighed the initial investment. Web-based systems have the potential to streamline the process of recruitment and day-to-day management of clinical trials in addition to improving efficiency and quality. Because of their added value they should be considered for trials of moderate size or complexity. Copyright 2009 Elsevier Inc. All rights reserved.

  12. A comparison of commercial and custom-made electronic tracking systems to measure patient flow through an ambulatory clinic.

    Science.gov (United States)

    Vakili, Sharif; Pandit, Ravi; Singman, Eric L; Appelbaum, Jeffrey; Boland, Michael V

    2015-10-29

    Understanding how patients move through outpatient clinics is important for optimizing clinic processes. This study compares the costs, benefits, and challenges of two clinically important methods for measuring patient flow: (1) a commercial system using infrared (IR) technology that passively tracks patient movements and (2) a custom-built, low cost, networked radio frequency identification (RFID) system that requires active swiping by patients at proximity card readers. Readers for both the IR and RFID systems were installed in the General Eye Service of the Wilmer Eye Institute. Participants were given both IR and RFID tags to measure the time they spent in various clinic stations. Simultaneously, investigators recorded the times at which patients moved between rooms. These measurements were considered the standard against which the other methods were compared. One hundred twelve patients generated a total of 252 events over the course of 6 days. The proportion of events successfully recorded by the RFID system (83.7%) was significantly greater than that obtained with the IR system (75.4%, p RFID system). There was no statistical difference between the IR, RFID, and manual time measurements (p > 0.05 for all comparisons). Both RFID and IR methods are effective at providing patient flow information. The custom-made RFID system was as accurate as IR and was installed at about 10% the cost. Given its significantly lower costs, the RFID option may be an appealing option for smaller clinics with more limited budgets.

  13. Feasibility of using microbeads with holographic barcodes to track DNA specimens in the clinical molecular laboratory

    Directory of Open Access Journals (Sweden)

    Jason D. Merker

    2013-07-01

    Full Text Available We demonstrate the feasibility of using glass microbeads with a holographic barcode identifier to track DNA specimens in the molecular pathology laboratory. These beads can be added to peripheral blood specimens and are carried through automated DNA extraction protocols that use magnetic glass particles. We found that an adequate number of microbeads are consistently carried over during genomic DNA extraction to allow specimen identification, that the beads do not interfere with the performance of several different molecular assays, and that the beads and genomic DNA remain stable when stored together under regular storage conditions in the molecular pathology laboratory. The beads function as an internal, easily readable specimen barcode. This approach may be useful for identifying DNA specimens and reducing errors associated with molecular laboratory testing.

  14. Clinical relevance of non-fasting and postprandial hypertriglyceridemia and remnant cholesterol

    DEFF Research Database (Denmark)

    Nordestgaard, Børge G; Freiberg, Jacob J

    2011-01-01

    Non-fasting triglycerides are measured at any time within up to 8 h (14 h) after any normal meal, while postprandial triglycerides are measured at a fixed time point within up to 8 h (14 h) of a standardised fat tolerance test. The simplest possible way of evaluating remnant cholesterol is non......-fasting/postprandial total cholesterol minus low-density lipoprotein (LDL) cholesterol minus high-density lipoprotein (HDL) cholesterol. Elevated levels of non-fasting/postprandial triglycerides directly correlate with elevated remnant cholesterol. In the general population, 38% of men have non......-fasting/postprandial triglycerides > 2mmol/L (>176 mg/dL) while 45% of men have non-fasting/postprandial triglyceride levels of 1-2 mmol/L (89-176 mg/dL); corresponding fractions in women are 20% and 47%. Also, 31% of men have remnant cholesterol levels > 1mmol/L (>39 mg/dL) while 46% of men have remnant cholesterol levels of 0...

  15. Linking ClinicalTrials.gov and PubMed to track results of interventional human clinical trials.

    Directory of Open Access Journals (Sweden)

    Vojtech Huser

    Full Text Available OBJECTIVE: In an effort to understand how results of human clinical trials are made public, we analyze a large set of clinical trials registered at ClinicalTrials.gov, the world's largest clinical trial registry. MATERIALS AND METHODS: We considered two trial result artifacts: (1 existence of a trial result journal article that is formally linked to a registered trial or (2 the deposition of a trial's basic summary results within the registry. RESULTS: The study sample consisted of 8907 completed, interventional, phase 2-or-higher clinical trials that were completed in 2006-2009. The majority of trials (72.2% had no structured trial-article link present. A total of 2367 trials (26.6% deposited basic summary results within the registry. Of those, 969 trials (10.9% were classified as trials with extended results and 1398 trials (15.7% were classified as trials with only required basic results. The majority of the trials (54.8% had no evidence of results, based on either linked result articles or basic summary results (silent trials, while a minimal number (9.2% report results through both registry deposition and publication. DISCUSSION: Our study analyzes the body of linked knowledge around clinical trials (which we refer to as the "trialome". Our results show that most trials do not report results and, for those that do, there is minimal overlap in the types of reporting. We identify several mechanisms by which the linkages between trials and their published results can be increased. CONCLUSION: Our study shows that even when combining publications and registry results, and despite availability of several information channels, trial sponsors do not sufficiently meet the mandate to inform the public either via a linked result publication or basic results submission.

  16. Multi-month prescriptions, fast-track refills, and community ART groups: results from a process evaluation in Malawi on using differentiated models of care to achieve national HIV treatment goals.

    Science.gov (United States)

    Prust, Margaret L; Banda, Clement K; Nyirenda, Rose; Chimbwandira, Frank; Kalua, Thokozani; Jahn, Andreas; Eliya, Michael; Callahan, Katie; Ehrenkranz, Peter; Prescott, Marta R; McCarthy, Elizabeth A; Tagar, Elya; Gunda, Andrews

    2017-07-21

    In order to facilitate scale-up of antiretroviral therapy (ART) in Malawi, innovative and pragmatic models have been developed to optimize the efficiency of HIV service delivery. In particular, three models of differentiated care have emerged for stable patients: adjusted appointment spacing through multi-month scripting (MMS); fast-track drug refills (FTRs) on alternating visits; and community ART groups (CAGs) where group members rotate in collecting medications at the facility for all members. This study aimed to assess the extent to which ART patients in Malawi are differentiated based on clinical stability and describe the characteristics and costs associated with the models of differentiated care offered. A mixed methods process evaluation was conducted from 30 purposefully selected ART facilities. Cross-sectional data for this evaluation was collected between February and May 2016. The following forms of data collection are reported here: structured surveys with 136 health care workers; reviews of 75,364 patient clinical records; 714 observations of visit time and flow; and 30 questionnaires on facility characteristics. Among ART patients, 77.5% (95% confidence interval [CI] 74.1-80.6) were eligible for differentiated models of care based on criteria for clinical stability from national guidelines. Across all facilities, 69% of patients were receiving MMS. In facilities offering FTRs and CAGs, 67% and 6% of patients were enrolled in the models, respectively. However, eligibility criteria were used inconsistently: 72.9% (95% CI 66.3-78.6) of eligible patients and 42.3% (95% CI 33.1-52.0) ineligible patients received MMS. Results indicated that patient travel and time costs were reduced by 67%, and the unit costs of ART service delivery through the MMS, FTR and CAG models were similar, representing a reduction of approximately 10% in the annual unit cost of providing care to stable patients that receive no model. MMS is being implemented nationally and has

  17. Metabolic and clinical effects of Ramadan fasting in patients with type II diabetes

    International Nuclear Information System (INIS)

    Yarahmadi, S.; Larijani, B.; Bastanhagh, M.H.; Pajouhi, M.; Bardar, J. R.; Zahedi, F.; Zendehdel, K.; Akrami, S.M.

    2003-01-01

    Objective: To evaluate the effects of fasting on anthropometric indices and carbohydrate and lipid metabolism in patients with type II diabetes. Results: Daily cholesterol intake increased in all subjects (p 0.01). Blood pressure, fasting blood glucose and serum fructosamine did not change during the study. Plasma insulin (p < 0.05), C-peptide (p < 0.01) and insulin resistance (p < 0.01) decreased only in men. Total and LDL cholesterol increased significantly in all subjects during the study. Conclusion: Ramadan fasting does not alter carbohydrate metabolism or tissue insulin sensitivity in patients with type II diabetes given appropriate dietary education and rescheduling of oral hypoglycaemic medication. Lipid profile is unfavorably altered due to changes in both diet and biochemical response to starvation. (author)

  18. Stereotactic radiotherapy with real-time tumor tracking for non-small cell lung cancer: Clinical outcome

    International Nuclear Information System (INIS)

    Voort van Zyp, Noelle C. van der; Prevost, Jean-Briac; Hoogeman, Mischa S.; Praag, John; Holt, Bronno van der; Levendag, Peter C.; Klaveren, Robertus J. van; Pattynama, Peter; Nuyttens, Joost J.

    2009-01-01

    Purpose: To report the clinical outcome of treatment using real-time tumor tracking for 70 patients with inoperable stage I non-small cell lung cancer (NSCLC). Materials and methods: Seventy inoperable patients with peripherally located early-stage NSCLC were treated with 45 or 60 Gy in three fractions using CyberKnife. Pathology was available in 51% of patients. Thirty-nine patients had a T1-tumor and 31 had a T2-tumor. Markers were placed using the vascular, percutaneous intra-, or extra-pulmonary approach, depending on the risk of pneumothorax. Results: The actuarial 2-year local control rate for patients treated with 60 Gy was 96%, compared to 78% for patients treated with a total dose of 45 Gy (p = 0.197). All local recurrences (n = 4) occurred in patients with T2-tumors. Overall survival for the whole group at two years was 62% and the cause specific survival was 85%. The median follow-up was 15 months. Grade 3 toxicity occurred in two patients (3%) after marker placement. Treatment-related late grade 3 toxicity occurred in 7 patients (10%). No grade ≥4 toxicity occurred. Conclusion: Excellent local control of 96% at 1- and 2-years was achieved using 60 Gy in three fractions for NSCLC patients treated with the real-time tumor tracking. Toxicity was low.

  19. Fast track, dynein-dependent nuclear targeting of human immunodeficiency virus Vpr protein; impaired trafficking in a clinical isolate

    Energy Technology Data Exchange (ETDEWEB)

    Caly, Leon [Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800 (Australia); Kassouf, Vicki T. [Centre for Virus Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145 (Australia); Moseley, Gregory W. [Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800 (Australia); Diefenbach, Russell J.; Cunningham, Anthony L. [Centre for Virus Research, The Westmead Institute for Medical Research, The University of Sydney, Westmead, NSW 2145 (Australia); Jans, David A., E-mail: david.jans@monash.edu [Department of Biochemistry and Molecular Biology, Monash University, Clayton, Vic. 3800 (Australia)

    2016-02-12

    Nuclear import of the accessory protein Vpr is central to infection by human immunodeficiency virus (HIV). We previously identified the Vpr F72L mutation in a HIV-infected, long-term non-progressor, showing that it resulted in reduced Vpr nuclear accumulation and altered cytoplasmic localisation. Here we demonstrate for the first time that the effects of nuclear accumulation of the F72L mutation are due to impairment of microtubule-dependent-enhancement of Vpr nuclear import. We use high resolution imaging approaches including fluorescence recovery after photobleaching and other approaches to document interaction between Vpr and the dynein light chain protein, DYNLT1, and impaired interaction of the F72L mutant with DYNLT1. The results implicate MTs/DYNLT1 as drivers of Vpr nuclear import and HIV infection, with important therapeutic implications. - Highlights: • HIV-1 Vpr utilizes the microtubule network to traffic towards the nucleus. • Mechanism relies on interaction between Vpr and dynein light chain protein DYNLT1. • Long-term non-progressor derived mutation (F72L) impairs this interaction. • Key residues in the vicinity of F72 contribute to interaction with DYNLT1.

  20. Fast track, dynein-dependent nuclear targeting of human immunodeficiency virus Vpr protein; impaired trafficking in a clinical isolate

    International Nuclear Information System (INIS)

    Caly, Leon; Kassouf, Vicki T.; Moseley, Gregory W.; Diefenbach, Russell J.; Cunningham, Anthony L.; Jans, David A.

    2016-01-01

    Nuclear import of the accessory protein Vpr is central to infection by human immunodeficiency virus (HIV). We previously identified the Vpr F72L mutation in a HIV-infected, long-term non-progressor, showing that it resulted in reduced Vpr nuclear accumulation and altered cytoplasmic localisation. Here we demonstrate for the first time that the effects of nuclear accumulation of the F72L mutation are due to impairment of microtubule-dependent-enhancement of Vpr nuclear import. We use high resolution imaging approaches including fluorescence recovery after photobleaching and other approaches to document interaction between Vpr and the dynein light chain protein, DYNLT1, and impaired interaction of the F72L mutant with DYNLT1. The results implicate MTs/DYNLT1 as drivers of Vpr nuclear import and HIV infection, with important therapeutic implications. - Highlights: • HIV-1 Vpr utilizes the microtubule network to traffic towards the nucleus. • Mechanism relies on interaction between Vpr and dynein light chain protein DYNLT1. • Long-term non-progressor derived mutation (F72L) impairs this interaction. • Key residues in the vicinity of F72 contribute to interaction with DYNLT1.

  1. Assessment and clinical relevance of non-fasting and postprandial triglycerides

    DEFF Research Database (Denmark)

    Kolovou, Genovefa D; Mikhailidis, Dimitri P; Kovar, Jan

    2011-01-01

    An Expert Panel group of scientists and clinicians met to consider several aspects related to non-fasting and postprandial triglycerides (TGs) and their role as risk factors for cardiovascular disease (CVD). In this context, we review recent epidemiological studies relevant to elevated non...

  2. ORIGINAL ARTICLE FAST as a predictor of clinical outcome in blunt ...

    African Journals Online (AJOL)

    detection of free fluid to be 0.64 - 0.98 and 0.86 - 1.00, respectively, compared with abdominal computed tomography (CT).1 Some authors in fact argue that FAST is more sensitive than CT for free fluid.2 Randomised controlled trials now show that triage pathways incorporating ultrasonography result in increased efficiency, ...

  3. Implementation of fast macromolecular proton fraction mapping on 1.5 and 3 Tesla clinical MRI scanners: preliminary experience

    Science.gov (United States)

    Yarnykh, V.; Korostyshevskaya, A.

    2017-08-01

    Macromolecular proton fraction (MPF) is a biophysical parameter describing the amount of macromolecular protons involved into magnetization exchange with water protons in tissues. MPF represents a significant interest as a magnetic resonance imaging (MRI) biomarker of myelin for clinical applications. A recent fast MPF mapping method enabled clinical translation of MPF measurements due to time-efficient acquisition based on the single-point constrained fit algorithm. However, previous MPF mapping applications utilized only 3 Tesla MRI scanners and modified pulse sequences, which are not commonly available. This study aimed to test the feasibility of MPF mapping implementation on a 1.5 Tesla clinical scanner using standard manufacturer’s sequences and compare the performance of this method between 1.5 and 3 Tesla scanners. MPF mapping was implemented on 1.5 and 3 Tesla MRI units of one manufacturer with either optimized custom-written or standard product pulse sequences. Whole-brain three-dimensional MPF maps obtained from a single volunteer were compared between field strengths and implementation options. MPF maps demonstrated similar quality at both field strengths. MPF values in segmented brain tissues and specific anatomic regions appeared in close agreement. This experiment demonstrates the feasibility of fast MPF mapping using standard sequences on 1.5 T and 3 T clinical scanners.

  4. Interconnecting smartphone, image analysis server, and case report forms in clinical trials for automatic skin lesion tracking in clinical trials

    Science.gov (United States)

    Haak, Daniel; Doma, Aliaa; Gombert, Alexander; Deserno, Thomas M.

    2016-03-01

    Today, subject's medical data in controlled clinical trials is captured digitally in electronic case report forms (eCRFs). However, eCRFs only insufficiently support integration of subject's image data, although medical imaging is looming large in studies today. For bed-side image integration, we present a mobile application (App) that utilizes the smartphone-integrated camera. To ensure high image quality with this inexpensive consumer hardware, color reference cards are placed in the camera's field of view next to the lesion. The cards are used for automatic calibration of geometry, color, and contrast. In addition, a personalized code is read from the cards that allows subject identification. For data integration, the App is connected to an communication and image analysis server that also holds the code-study-subject relation. In a second system interconnection, web services are used to connect the smartphone with OpenClinica, an open-source, Food and Drug Administration (FDA)-approved electronic data capture (EDC) system in clinical trials. Once the photographs have been securely stored on the server, they are released automatically from the mobile device. The workflow of the system is demonstrated by an ongoing clinical trial, in which photographic documentation is frequently performed to measure the effect of wound incision management systems. All 205 images, which have been collected in the study so far, have been correctly identified and successfully integrated into the corresponding subject's eCRF. Using this system, manual steps for the study personnel are reduced, and, therefore, errors, latency and costs decreased. Our approach also increases data security and privacy.

  5. Can eye-tracking technology improve situational awareness in paramedic clinical education?

    OpenAIRE

    Williams, Brett; Cooper,Simon; Quested,Andrew

    2013-01-01

    Brett Williams,1 Andrew Quested,1 Simon Cooper21Department of Community Emergency Health and Paramedic Practice, 2School of Nursing and Midwifery, Berwick, Monash University, Frankston, VIC, AustraliaAbstract: Human factors play a significant part in clinical error. Situational awareness (SA) means being aware of one's surroundings, comprehending the present situation, and being able to predict outcomes. It is a key human skill that, when properly applied, is associated with reducing ...

  6. Study on the clinical application of pulsed DC magnetic technology for tracking of intraoperative head motion during frameless stereotaxy

    Directory of Open Access Journals (Sweden)

    Stendel Rüdiger

    2006-04-01

    Full Text Available Abstract Background Tracking of post-registration head motion is one of the major problems in frameless stereotaxy. Various attempts in detecting and compensating for this phenomenon rely on a fixed reference device rigidly attached to the patient's head. However, most of such reference tools are either based on an invasive fixation technique or have physical limitations which allow mobility of the head only in a restricted range of motion after completion of the registration procedure. Methods A new sensor-based reference tool, the so-called Dynamic Reference Frame (DRF which is designed to allow an unrestricted, 360° range of motion for the intraoperative use in pulsed DC magnetic navigation was tested in 40 patients. Different methods of non-invasive attachment dependent on the clinical need and type of procedure, as well as the resulting accuracies in the clinical application have been analyzed. Results Apart from conventional, completely rigid immobilization of the head (type A, four additional modes of head fixation and attachment of the DRF were distinguished on clinical grounds: type B1 = pin fixation plus oral DRF attachment; type B2 = pin fixation plus retroauricular DRF attachment; type C1 = free head positioning with oral DRF; and type C2 = free head positioning with retroauricular DRF. Mean fiducial registration errors (FRE were as follows: type A interventions = 1.51 mm, B1 = 1.56 mm, B2 = 1.54 mm, C1 = 1.73 mm, and C2 = 1.75 mm. The mean position errors determined at the end of the intervention as a measure of application accuracy were: 1.45 mm in type A interventions, 1.26 mm in type B1, 1.44 mm in type B2, 1.86 mm in type C1, and 1.68 mm in type C2. Conclusion Rigid head immobilization guarantees most reliable accuracy in various types of frameless stereotaxy. The use of an additional DRF, however, increases the application scope of frameless stereotaxy to include e.g. procedures in which rigid pin fixation of the cranium is

  7. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    Energy Technology Data Exchange (ETDEWEB)

    Poulin, E; Racine, E; Beaulieu, L [CHU de Quebec - Universite Laval, Quebec, Quebec (Canada); Binnekamp, D [Integrated Clinical Solutions and Marketing, Philips Healthcare, Best, DA (Netherlands)

    2014-06-15

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical.

  8. WE-A-17A-10: Fast, Automatic and Accurate Catheter Reconstruction in HDR Brachytherapy Using An Electromagnetic 3D Tracking System

    International Nuclear Information System (INIS)

    Poulin, E; Racine, E; Beaulieu, L; Binnekamp, D

    2014-01-01

    Purpose: In high dose rate brachytherapy (HDR-B), actual catheter reconstruction protocols are slow and errors prompt. The purpose of this study was to evaluate the accuracy and robustness of an electromagnetic (EM) tracking system for improved catheter reconstruction in HDR-B protocols. Methods: For this proof-of-principle, a total of 10 catheters were inserted in gelatin phantoms with different trajectories. Catheters were reconstructed using a Philips-design 18G biopsy needle (used as an EM stylet) and the second generation Aurora Planar Field Generator from Northern Digital Inc. The Aurora EM system exploits alternating current technology and generates 3D points at 40 Hz. Phantoms were also scanned using a μCT (GE Healthcare) and Philips Big Bore clinical CT system with a resolution of 0.089 mm and 2 mm, respectively. Reconstructions using the EM stylet were compared to μCT and CT. To assess the robustness of the EM reconstruction, 5 catheters were reconstructed twice and compared. Results: Reconstruction time for one catheter was 10 seconds or less. This would imply that for a typical clinical implant of 17 catheters, the total reconstruction time would be less than 3 minutes. When compared to the μCT, the mean EM tip identification error was 0.69 ± 0.29 mm while the CT error was 1.08 ± 0.67 mm. The mean 3D distance error was found to be 0.92 ± 0.37 mm and 1.74 ± 1.39 mm for the EM and CT, respectively. EM 3D catheter trajectories were found to be significantly more accurate (unpaired t-test, p < 0.05). A mean difference of less than 0.5 mm was found between successive EM reconstructions. Conclusion: The EM reconstruction was found to be faster, more accurate and more robust than the conventional methods used for catheter reconstruction in HDR-B. This approach can be applied to any type of catheters and applicators. We would like to disclose that the equipments, used in this study, is coming from a collaboration with Philips Medical

  9. Feature tracking CMR reveals abnormal strain in preclinical arrhythmogenic right ventricular dysplasia/ cardiomyopathy: a multisoftware feasibility and clinical implementation study.

    Science.gov (United States)

    Bourfiss, Mimount; Vigneault, Davis M; Aliyari Ghasebeh, Mounes; Murray, Brittney; James, Cynthia A; Tichnell, Crystal; Mohamed Hoesein, Firdaus A; Zimmerman, Stefan L; Kamel, Ihab R; Calkins, Hugh; Tandri, Harikrishna; Velthuis, Birgitta K; Bluemke, David A; Te Riele, Anneline S J M

    2017-09-01

    Regional right ventricular (RV) dysfunction is the hallmark of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy (ARVD/C), but is currently only qualitatively evaluated in the clinical setting. Feature Tracking Cardiovascular Magnetic Resonance (FT-CMR) is a novel quantitative method that uses cine CMR to calculate strain values. However, most prior FT-CMR studies in ARVD/C have focused on global RV strain using different software methods, complicating implementation of FT-CMR in clinical practice. We aimed to assess the clinical value of global and regional strain using FT-CMR in ARVD/C and to determine differences between commercially available FT-CMR software packages. We analyzed cine CMR images of 110 subjects (39 overt ARVD/C [mutation+/phenotype+], 40 preclinical ARVD/C [mutation+/phenotype-] and 31 control) for global and regional (subtricuspid, anterior, apical) RV strain in the horizontal longitudinal axis using four FT-CMR software methods (Multimodality Tissue Tracking, TomTec, Medis and Circle Cardiovascular Imaging). Intersoftware agreement was assessed using Bland Altman plots. For global strain, all methods showed reduced strain in overt ARVD/C patients compared to control subjects (p  0.275). For regional strain, overt ARVD/C patients showed reduced strain compared to control subjects in all segments which reached statistical significance in the subtricuspid region for all software methods (p < 0.037), in the anterior wall for two methods (p < 0.005) and in the apex for one method (p = 0.012). Preclinical subjects showed abnormal subtricuspid strain compared to control subjects using one of the software methods (p = 0.009). Agreement between software methods for absolute strain values was low (Intraclass Correlation Coefficient = 0.373). Despite large intersoftware variability of FT-CMR derived strain values, all four software methods distinguished overt ARVD/C patients from control subjects by both global and subtricuspid

  10. Clinical applications of fast liquid chromatography: a review on the analysis of cardiovascular drugs and their metabolites.

    Science.gov (United States)

    Baranowska, Irena; Magiera, Sylwia; Baranowski, Jacek

    2013-05-15

    One of the major challenges facing the medicine today is developing new therapies that enhance human health. To help address these challenges the utilization of analytical technologies and high-throughput automated platforms has been employed; in order to perform more experiments in a shorter time frame with increased data quality. In the last decade various analytical strategies have been established to enhance separation speed and efficiency in liquid chromatography applications. Liquid chromatography is an increasingly important tool for monitoring drugs and their metabolites. Furthermore, liquid chromatography has played an important role in pharmacokinetics and metabolism studies at these drug development stages since its introduction. This paper provides an overview of current trends in fast chromatography for the analysis of cardiovascular drugs and their metabolites in clinical applications. Current trends in fast liquid chromatographic separations involve monolith technologies, fused-core columns, high-temperature liquid chromatography (HTLC) and ultra-high performance liquid chromatography (UHPLC). The high specificity in combination with high sensitivity makes it an attractive complementary method to traditional methodology used for routine applications. The practical aspects of, recent developments in and the present status of fast chromatography for the analysis of biological fluids for therapeutic drug and metabolite monitoring, pharmacokinetic studies and bioequivalence studies are presented. Copyright © 2013 Elsevier B.V. All rights reserved.

  11. Fast nonclinical ventricular tachycardia inducible after ablation in patients with structural heart disease: Definition and clinical implications.

    Science.gov (United States)

    Watanabe, Masaya; de Riva, Marta; Piers, Sebastiaan R D; Dekkers, Olaf M; Ebert, Micaela; Venlet, Jeroen; Trines, Serge A; Schalij, Martin J; Pijnappels, Daniël A; Zeppenfeld, Katja

    2018-01-08

    Noninducibility of ventricular tachycardia (VT) with an equal or longer cycle length (CL) than that of the clinical VT is considered the minimum ablation endpoint in patients with structural heart disease. Because their clinical relevance remains unclear, fast nonclinical VTs are often not targeted. However, an accepted definition for fast VT is lacking. The shortest possible CL of a monomorphic reentrant VT is determined by the ventricular refractory period (VRP). The purpose of this study was to propose a patient-specific definition for fast VT based on the individual VRP (fVT VRP ) and assess the prognostic significance of persistent inducibility after ablation of fVT VRP for VT recurrence. Of 191 patients with previous myocardial infarction or with nonischemic cardiomyopathy undergoing VT ablation, 70 (age 63 ± 13 years; 64% ischemic) remained inducible for a nonclinical VT and composed the study population. FVT VRP was defined as any VT with CL ≤VRP 400 + 30 ms. Patients were followed for VT recurrence. After ablation, 30 patients (43%) remained inducible exclusively for fVT VRP and 40 (57%) for any slower VT. Patients with only fVT VRP had 3-year VT-free survival of 64% (95% confidence interval [CI] 46%-82%) compared to 27% (95% CI 14%-48%) for patients with any slower remaining VT (P = .013). Inducibility of only fVT VRP was independently associated with lower VT recurrence (hazard ratio 0.38; 95% CI 0.19-0.86; P = .019). Among 36 patients inducible for any fVT VRP , only 1 had recurrence with fVT VRP . In patients with structural heart disease, inducibility of exclusively fVT VRP after ablation is associated with low VT recurrence. Copyright © 2018 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

  12. 头部多角度人脸快速跟踪算法DSP实现%Fast face tracking algorithm of head multi-position based on DSP

    Institute of Scientific and Technical Information of China (English)

    姜俊金; 王增才; 朱淑亮

    2012-01-01

    针对传统驾驶员疲劳检测人脸跟踪算法复杂,DSP实现时实时性不强,不能有效地实现多角度人脸跟踪的问题,提出了一种快速人脸跟踪算法.该算法通过对YCbCr肤色模型进行图像预处理、肤色检测,提取人脸区域,通过对亮度信号Y进行统计运算,判断人脸边界,再进行相似度判断,从而实现人脸区域的跟踪.实验结果表明,该方法简单、鲁棒性强,能够快速地实现彩色图像人脸多角度跟踪.%In the field of real-time human face tracking for driver fatigue detection, the classic algorithms are so complex that the DSP system can not track the face in multi-angle state quickly and exactly, so a new face tracking algorithm is presented. In YCbCr human face color model, the image is preprocessed first, then the face region is extracted through the face color detec-tion. Through calculating the brightness signal Y, the face edge can be detected. Then a symmetry similarity measure is used to check the factuality of the face tracking. In this way, the face region can be tracked Experimental results indicate that this algo-rithm is so simple and can realize the tracking of face in multi-angle of color image.

  13. Automated Real-Time Needle-Guide Tracking for Fast 3-T MR-guided Transrectal Prostate Biopsy: A Feasibility Study

    NARCIS (Netherlands)

    Zamecnik, P.; Schouten, M.G.; Krafft, A.J.; Maier, F.; Schlemmer, H.-P.; Barentsz, J.O.; Bock, M. de; Futterer, J.J.

    2014-01-01

    Purpose To assess the feasibility of automatic needle-guide tracking by using a real-time phase-only cross correlation (POCC) algorithm-based sequence for transrectal 3-T in-bore magnetic resonance (MR)-guided prostate biopsies. Materials and Methods This study was approved by the ethics review

  14. Fast ℓ1-SPIRiT Compressed Sensing Parallel Imaging MRI: Scalable Parallel Implementation and Clinically Feasible Runtime

    Science.gov (United States)

    Murphy, Mark; Alley, Marcus; Demmel, James; Keutzer, Kurt; Vasanawala, Shreyas; Lustig, Michael

    2012-01-01

    We present ℓ1-SPIRiT, a simple algorithm for auto calibrating parallel imaging (acPI) and compressed sensing (CS) that permits an efficient implementation with clinically-feasible runtimes. We propose a CS objective function that minimizes cross-channel joint sparsity in the Wavelet domain. Our reconstruction minimizes this objective via iterative soft-thresholding, and integrates naturally with iterative Self-Consistent Parallel Imaging (SPIRiT). Like many iterative MRI reconstructions, ℓ1-SPIRiT’s image quality comes at a high computational cost. Excessively long runtimes are a barrier to the clinical use of any reconstruction approach, and thus we discuss our approach to efficiently parallelizing ℓ1-SPIRiT and to achieving clinically-feasible runtimes. We present parallelizations of ℓ1-SPIRiT for both multi-GPU systems and multi-core CPUs, and discuss the software optimization and parallelization decisions made in our implementation. The performance of these alternatives depends on the processor architecture, the size of the image matrix, and the number of parallel imaging channels. Fundamentally, achieving fast runtime requires the correct trade-off between cache usage and parallelization overheads. We demonstrate image quality via a case from our clinical experimentation, using a custom 3DFT Spoiled Gradient Echo (SPGR) sequence with up to 8× acceleration via poisson-disc undersampling in the two phase-encoded directions. PMID:22345529

  15. Clinical outcomes according to symptom presentation in patients with acute myocardial infarction: Results from the FAST-MI 2010 registry.

    Science.gov (United States)

    Puymirat, Etienne; Aissaoui, Nadia; Bonello, Laurent; Cayla, Guillaume; Labèque, Jean-Noel; Nallet, Olivier; Motreff, Pascal; Varenne, Olivier; Schiele, François; Ferrières, Jean; Simon, Tabassome; Danchin, Nicolas

    2017-12-01

    Atypical clinical presentation in acute myocardial infarction (AMI) patients is not uncommon; most studies suggest that it is associated with unfavorable prognosis. Long-term clinical impact differs according to predominant symptom presentation (typical chest pain, atypical chest pain, syncope, cardiac arrest, or dyspnea) in AMI patients. FAST-MI 2010, a nationwide French registry, included 4169 patients with AMI in 213 centers at the end of 2010 (76% of active centers). Demographics, medical history, hospital management, and outcomes were compared according to predominant symptom presentation. Typical chest pain with no other symptom was reported in 3020 patients (68% in STEMI patients, 76% in NSTEMI patients). Atypical chest pain, dyspnea, syncope, and cardiac arrest were reported in 11%, 11%, 5%, and 1%, respectively. Patients with atypical clinical presentation had a higher cardiovascular risk profile and received fewer medications and a less invasive strategy. Using Cox multivariate analysis, atypical chest pain was not associated with higher death rate at 3 years (HR: 0.96, 95% CI: 0.69-1.33, P = 0.78), whereas cardiac arrest (HR: 2.44, 95% CI: 1.00-5.97, P = 0.05), syncope (HR: 1.70, 95% CI: 1.18-2.46, P = 0.005), and dyspnea (HR: 1.66, 95% CI: 1.31-2.10, P clinical presentation is observed in about 20% of AMI patients. Cardiac arrest, dyspnea, and syncope represent independent predictors of long-term mortality in STEMI and NSTEMI populations. © 2017 Wiley Periodicals, Inc.

  16. Surgery-induced changes and early recovery of hip-muscle strength, leg-press power, and functional performance after fast-track total hip arthroplasty: a prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Bente Holm

    Full Text Available By measuring very early changes in muscle strength and functional performance after fast-track total hip arthroplasty (THA, post-operative rehabilitation, introduced soon after surgery, can be designed to specifically target identified deficits.Firstly, to quantify changes (compared to pre-operative values in hip muscle strength, leg-press power, and functional performance in the first week after THA, and secondly, to explore relationships between the muscle strength changes, and changes in hip pain, systemic inflammation, and thigh swelling.Prospective, cohort study.Convenience sample of patients receiving a THA at Copenhagen University Hospital, Hvidovre, Denmark, between March and December 2011.Thirty-five patients (65.9 ± 7.2 years undergoing THA.Hip muscle strength, leg-press power, performance-based function, and self-reported disability were determined prior to, and 2 and 8 days after, THA (Day 2 and 8, respectively. Hip pain, thigh swelling, and C-Reactive Protein were also determined.Five patients were lost to follow-up. Hip muscle strength and leg press power were substantially reduced at Day 2 (range of reductions: 41-58%, P<0.001, but less pronounced at Day 8 (range of reductions: 23-31%, P<0.017. Self-reported symptoms and function (HOOS: Pain, Symptoms, and ADL improved at Day 8 (P<0.014. Changes in hip pain, C-Reactive Protein, and thigh swelling were not related to the muscle strength and power losses.Hip muscle strength and leg-press power decreased substantially in the first week after THA - especially at Day 2 - with some recovery at Day 8. The muscle strength loss and power loss were not related to changes in hip pain, systemic inflammation, or thigh swelling. In contrast, self-reported symptoms and function improved. These data on surgery-induced changes in muscle strength may help design impairment-directed, post-operative rehabilitation to be introduced soon after surgery.ClinicalTrials.gov NCT01246674.

  17. Clinical evaluation of fat suppressed fast-SPGR sequence of the breast MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Mitsuyuki; Hasegawa, Makoto; Matsubara, Tadashi [Yokohama Sakae Kyosai Hospital (Japan)

    1998-05-01

    MR-mammography by fat suppressed Fast-SPGR was evaluated for diagnosis and determination of invasion of tumor. Dynamic MRIs were performed in 12 phases, such as, before infusion of contrast media, right after and one to ten minutes after infusion with interval of one minute. In 15 patients (breast cancer, fibroadenoma, lymphocytic lobulitits and cystic intraductal papilloma), underwent MRI, the images were compared with pathological findings. Ten cases were confirmed as malignancy among 11 cases of breast cancer (sensitivity 91%). Eleven cases were confirmed as breast cancer among 12 cases diagnosed as breast cancer by MRI (specificity 92%). In 12 of all 15 cases, benignity or malignancy was checked correctly (accuracy 80%). Invasion of breast cancer was defined as the deep color dyeing area which was neighbored with the tumor in early stage of cystography. Eight of 11 cases were diagnosed precisely with fat suppression image, and nine were by subtraction image. Diagnosis was possible only by subtraction image in a case of scirrhous carcinoma accompanied with intradutal invasion. The area of invasion was not defined correctly in the case accompanied by mastopathy. It is difficult to evaluate benignity or malignancy of mammary gland tumor only by dynamic MRI, it is necessary to diagnose the shape and deep color image of tumor generally. (K.H.)

  18. Track B Clinical Science

    OpenAIRE

    Kyrychenko, T.; Dubynska, G.; Koval, T.; Kaidashev, I.; Korshenko, V.; Rono, K.; Kibuuka, H.; Maganga, L.; Kosgei, J.; Sekiziyivu, A.; Sanga, E.; Ngetich, E.; Bolen Valenzuela, A.; Michael, N.; Robb, M.

    2012-01-01

    Background Toll-like receptors (TLRs) are transmembrane receptors that activate cells of the innate immune systems upon recognition of pathogen-associated molecular patterns. The TLR4 is an essential component of the innate immune response to various microorganisms. We investigated the impact of TLR4 polymorphism on development of opportunistic diseases in HIV-infected patients. Methods The presence of TLR4 Asp299Gly single nucleotide polymorphisms (SNPs) was determined in a cohort of 180 ant...

  19. Fast Neutron Radiotherapy for Locally Advanced Prostate Cancer: Final Report of a Radiation Therapy Oncology Group Randomized Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Laramore, G. E.; Krall, J. M.; Thomas, F. J.; Russell, K. J.; Maor, M. H.; Hendrickson, F. R.; Martz, K. L.; Griffin, T. W.; Davis, L. W.

    1993-01-01

    Between June 1977 and April 1983 the Radiation Therapy Oncology Group (RTOG) sponsored a Phase III randomized trial investigating the use of fast neutron radiotherapy for patients with locally advanced (Stages C and D1) adenocarcinoma of the prostate gland. Patients were randomized to receive either conventional photon radiation or fast neutron radiation used in a mixed-beam (neutron/photon) treatment schedule. A total of 91 analyzable patients were entered into the study, and the two patient groups were balanced with respect to the major prognostic variables. Actuarial curves are presented for local/regional control and "overall" survival. Ten-year results for clinically assessed local control are 70% for the mixed-beam group versus 58% for the photon group (p = 0.03) and for survival are 46% for the mixed-beam group versus 29% for the photon group (p = 0.04). This study suggests that a regional method of treatment can influence both local tumor control and survival in patients with locally advanced adenocarcinoma of the prostate gland.

  20. Think big, start small, move fast a blueprint for transformation from the Mayo Clinic Center for Innovation

    CERN Document Server

    LaRusso, Nicholas; Farrugia, Gianrico

    2015-01-01

    The Only Innovation Guide You Will Ever Need--from the Award-Winning Minds at Mayo Clinic. A lot of businesspeople talk about innovation, but few companies have achieved the level of truly transformative innovation as brilliantly--or as famously--as the legendary Mayo Clinic. Introducing Think Big, Start Small, Move Fast, the first innovation guide based on the proven, decade-long program that’s made Mayo Clinic one of the most respected and successful organizations in the world. This essential must-have guide shows you how to: Inspire and ignite trailblazing innovation in your workplace Design a new business model that’s creative, collaborative, and sustainable Apply the traditional scientific method to the latest innovations in "design thinking" Build a customized toolkit of the best practices, project portfolios, and strategies Increase your innovation capacity--and watch how quickly you succeed These field-tested techniques grew out of the health care industry but are designed ...

  1. Initial clinical experience with dedicated ultra fast solid state cardiac gamma camera

    International Nuclear Information System (INIS)

    Aland, Nusrat; Lele, V.

    2010-01-01

    Full text: To analyze the imaging and diagnostic performance of new dedicated ultra fast solid state detector gamma camera and compare it with standard dual detector gamma camera in myocardial perfusion imaging. Material and Methods: In total 900 patients underwent myocardial perfusion imaging between 1st February 2010 and 29th August 2010 either stress/rest or rest/stress protocol. There was no age or gender bias (there were 630 males and 270 females). 5 and 15 mCi of 99m Tc - Tetrofosmin/MIBI was injected for 1st and 2nd part of the study respectively. Waiting period after injection was 20 min for regular stress and 40 min for pharmacological stress and 40 min after rest injection. Acquisition was performed on solid state detector gamma camera for a duration of 5 min and 3 min for 1st and 2nd part respectively. Interpretation of myocardial perfusion was done and QGS/QPS protocol was used for EF analysis. Out of these, 20 random patients underwent back to back myocardial perfusion SPECT imaging on standard dual detector gamma camera on same day. There was no age or gender bias (there were 9 males, 11 females). Acquisition time was 20 min for each part of the study. Interpretation was done using Autocard and EF analyses with 4 DM SPECT. Images obtained were then compared with those of solid state detector gamma camera. Result: Good quality and high count myocardial perfusion images were obtained with lesser amount of tracer activity on solid state detector gamma camera. Obese patients also showed good quality images with less tracer activity. As compared to conventional dual detector gamma camera images were brighter and showed better contrast with solid state gamma camera. Right ventricular imaging was better seen. Analyses of diastolic dysfunction was possible with 16 frame gated studies with solid state gamma camera. Shorter acquisition time with comfortable position reduced possibility of patient motion. All cardiac views were obtained with no movement of the

  2. Experimental and clinical studies of fast three-dimensional MR imaging of the heart

    International Nuclear Information System (INIS)

    Sato, Shuhei

    1999-01-01

    MRI has been utilized since its inception to study the anatomy and physiology of the heart. However, the sensitivity of MRI to motion has always posed a major challenge in imaging this organ. The purpose of this study was to develop a 3D MP-RAGE technique for the heart, and to apply it clinically. In the experimental study, data acquisition timing was discussed by normal volunteers. Changes in magnetization recovery time affected imaging contrast very little in the phantom study. Fourteen adults and 21 children were examined. In the adults, MP-RAGE images were rated as high in quality in the visual estimation. In the quantitative estimation, the images provided almost the same anatomical information as those of cine MRI. In the children, MP-RAGE was useful for cases of partial anomalous pulmonary venous drainage, particularly in the evaluation of abnormal pulmonary veins. The 3D MP-RAGE technique was useful in imaging the heart because it was possible to obtain continuous views in the same cardiac cycle and to reconstruct views from any direction after the examination. (author)

  3. Experimental and clinical studies of fast three-dimensional MR imaging of the heart

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Shuhei [Okayama Univ. (Japan). School of Medicine

    1999-07-01

    MRI has been utilized since its inception to study the anatomy and physiology of the heart. However, the sensitivity of MRI to motion has always posed a major challenge in imaging this organ. The purpose of this study was to develop a 3D MP-RAGE technique for the heart, and to apply it clinically. In the experimental study, data acquisition timing was discussed by normal volunteers. Changes in magnetization recovery time affected imaging contrast very little in the phantom study. Fourteen adults and 21 children were examined. In the adults, MP-RAGE images were rated as high in quality in the visual estimation. In the quantitative estimation, the images provided almost the same anatomical information as those of cine MRI. In the children, MP-RAGE was useful for cases of partial anomalous pulmonary venous drainage, particularly in the evaluation of abnormal pulmonary veins. The 3D MP-RAGE technique was useful in imaging the heart because it was possible to obtain continuous views in the same cardiac cycle and to reconstruct views from any direction after the examination. (author)

  4. Automated systems for the de-identification of longitudinal clinical narratives: Overview of 2014 i2b2/UTHealth shared task Track 1.

    Science.gov (United States)

    Stubbs, Amber; Kotfila, Christopher; Uzuner, Özlem

    2015-12-01

    The 2014 i2b2/UTHealth Natural Language Processing (NLP) shared task featured four tracks. The first of these was the de-identification track focused on identifying protected health information (PHI) in longitudinal clinical narratives. The longitudinal nature of clinical narratives calls particular attention to details of information that, while benign on their own in separate records, can lead to identification of patients in combination in longitudinal records. Accordingly, the 2014 de-identification track addressed a broader set of entities and PHI than covered by the Health Insurance Portability and Accountability Act - the focus of the de-identification shared task that was organized in 2006. Ten teams tackled the 2014 de-identification task and submitted 22 system outputs for evaluation. Each team was evaluated on their best performing system output. Three of the 10 systems achieved F1 scores over .90, and seven of the top 10 scored over .75. The most successful systems combined conditional random fields and hand-written rules. Our findings indicate that automated systems can be very effective for this task, but that de-identification is not yet a solved problem. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Fast spin echo MRI techniques. Contrast characteristics and clinical potential. Techniques d'IRM en fast spin echo. Caracteristiques de contraste et potentiels cliniques

    Energy Technology Data Exchange (ETDEWEB)

    Melki, P.; Mulkern, R.V.; Dacher, J.N.; Helenon, O.; Higuchi, N. (Harvard Medical School, Boston, MA (United States)); Oshio, K.; Jolesz, F. (Keio Univ., Tokyo (Japan)); Pourcelot, L. (Hopital Bretonneau, 37 - Tours (France)); Einstein, S. (General Electric Medical System, Milwaukee, WI (United States))

    1993-03-01

    Based on partial RF echo planar principles, Fast Spin Echo techniques (FSE) were implemented on high field systems. These methods produce image quality and contrast which resemble to conventional spin echo (SE) techniques. By reducing acquisition times by factors between 1.4 and 16 over SE methods, FSE allows for several imaging options usually prohibitive with conventional spin echo (SE) sequences. These include fast scans (especially breathold acquisitions); improved T2 contrast with longer TR intervals; increased spatial resolution with the use of larger image matrices and/or smaller fields of view; and 3D volume imaging with a 3D multislab FSE technique. Contrast features of FSE techniques are directly comparable to those of multiple echo SE sequences using the same echo spacing than FSE methods. However, essential contrast differences existing between the FSE sequences and their routine asymmetric dual SE counterpart can be identified. Decreased magnetic susceptibility effects and increased fat signal present within T2 weighted images compared to conventional dual SE images are due to the use of shorter echo spacings employed in FSE sequences. Off-resonance irradiation inherent to the use of a large number of radio frequency pulses in shown to results in dramatic magnetization contrast transfer effects in FSE images acquired in multislice mode.

  6. Real-Time Electronic Tracking of Diarrheal Episodes and Laxative Therapy Enables Verification of Clostridium difficile Clinical Testing Criteria and Reduction of Clostridium difficile Infection Rates.

    Science.gov (United States)

    Truong, Cynthia Y; Gombar, Saurabh; Wilson, Richard; Sundararajan, Gopalakrishnan; Tekic, Natasa; Holubar, Marisa; Shepard, John; Madison, Alexandra; Tompkins, Lucy; Shah, Neil; Deresinski, Stan; Schroeder, Lee F; Banaei, Niaz

    2017-05-01

    Health care-onset health care facility-associated Clostridium difficile infection (HO-CDI) is overdiagnosed for several reasons, including the high prevalence of C. difficile colonization and the inability of hospitals to limit testing to patients with clinically significant diarrhea. We conducted a quasiexperimental study from 22 June 2015 to 30 June 2016 on consecutive inpatients with C. difficile test orders at an academic hospital. Real-time electronic patient data tracking was used by the laboratory to enforce testing criteria (defined as the presence of diarrhea [≥3 unformed stools in 24 h] and absence of laxative intake in the prior 48 h). Outcome measures included C. difficile test utilization, HO-CDI incidence, oral vancomycin utilization, and clinical complications. During the intervention, 7.1% (164) and 9.1% (211) of 2,321 C. difficile test orders were canceled due to absence of diarrhea and receipt of laxative therapy, respectively. C. difficile test utilization decreased upon implementation from an average of 208.8 tests to 143.0 tests per 10,000 patient-days ( P difficile results. Real-time electronic clinical data tracking is an effective tool for verification of C. difficile clinical testing criteria and safe reduction of inflated HO-CDI rates. Copyright © 2017 American Society for Microbiology.

  7. Variation in ‘fast-track’ referrals for suspected cancer by patient characteristic and cancer diagnosis: evidence from 670 000 patients with cancers of 35 different sites

    Science.gov (United States)

    Zhou, Y; Mendonca, S C; Abel, G A; Hamilton, W; Walter, F M; Johnson, S; Shelton, J; Elliss-Brookes, L; McPhail, S; Lyratzopoulos, G

    2018-01-01

    Background: In England, ‘fast-track’ (also known as ‘two-week wait’) general practitioner referrals for suspected cancer in symptomatic patients are used to shorten diagnostic intervals and are supported by clinical guidelines. However, the use of the fast-track pathway may vary for different patient groups. Methods: We examined data from 669 220 patients with 35 cancers diagnosed in 2006–2010 following either fast-track or ‘routine’ primary-to-secondary care referrals using ‘Routes to Diagnosis’ data. We estimated the proportion of fast-track referrals by sociodemographic characteristic and cancer site and used logistic regression to estimate respective crude and adjusted odds ratios. We additionally explored whether sociodemographic associations varied by cancer. Results: There were large variations in the odds of fast-track referral by cancer (P<0.001). Patients with testicular and breast cancer were most likely to have been diagnosed after a fast-track referral (adjusted odds ratios 2.73 and 2.35, respectively, using rectal cancer as reference); whereas patients with brain cancer and leukaemias least likely (adjusted odds ratios 0.05 and 0.09, respectively, for brain cancer and acute myeloid leukaemia). There were sex, age and deprivation differences in the odds of fast-track referral (P<0.013) that varied in their size and direction for patients with different cancers (P<0.001). For example, fast-track referrals were least likely in younger women with endometrial cancer and in older men with testicular cancer. Conclusions: Fast-track referrals are less likely for cancers characterised by nonspecific presenting symptoms and patients belonging to low cancer incidence demographic groups. Interventions beyond clinical guidelines for ‘alarm’ symptoms are needed to improve diagnostic timeliness. PMID:29182609

  8. Multileaf Collimator Tracking Improves Dose Delivery for Prostate Cancer Radiation Therapy: Results of the First Clinical Trial

    DEFF Research Database (Denmark)

    Colvill, Emma; Booth, Jeremy T; O'Brien, Ricky T

    2015-01-01

    was tested for each dose-volume value via analysis of variance using the F test. RESULTS: Of the 513 fractions delivered, 475 (93%) were suitable for analysis. The mean difference and standard deviation between the planned and treated MLC tracking doses and the planned and without-MLC tracking doses for all...... 475 fractions were, respectively, PTV D99% -0.8% ± 1.1% versus -2.1% ± 2.7%; CTV D99% -0.6% ± 0.8% versus -0.6% ± 1.1%; rectum V65% 1.6% ± 7.9% versus -1.2% ± 18%; and bladder V65% 0.5% ± 4.4% versus -0.0% ± 9.2% (P

  9. A nonrandomized controlled clinical pilot trial on 8 wk of intermittent fasting (24 h/wk).

    Science.gov (United States)

    Kessler, Christian S; Stange, Rainer; Schlenkermann, Maike; Jeitler, Michael; Michalsen, Andreas; Selle, Antonia; Raucci, Franca; Steckhan, Nico

    2018-02-01

    The aim of the study was to evaluate whether intermittent fasting (IF) is an effective preventive measure, and whether it is feasible for healthy volunteers under every day conditions. A nonrandomized controlled clinical trial on IF was performed with healthy volunteers over a period of 8 wk, and a subsequent 4-mo follow-up. Outcomes were assessed at baseline, after 8 wk, and after 6 mo. Volunteers who were not interested in fasting served as a control group. Participants in the fasting group were asked to continue their regular nutritional habits on the nonfasting days, whereas the control group maintained their habitual nutrition throughout the whole period. Outcomes included changes of metabolic parameters (insulin, glucose, insulin resistance, insulin-like growth factor-1, brain-derived neurotropic factor, lipids, liver enzymes, hemoglobin A1c) and coagulation markers; bioelectrical impedance analysis; body mass index; abdominal girth; blood pressure; general quality of life (five-item World Health Organization Well-Being Index [WHO-5] questionnaire), as well as mood and anxiety (Hospital Anxiety and Depression Scale [HADS], Profile of Mood States, Flourishing-Scale, visual analog scale, Likert scales). The intervention consisted of a fasting day, which was repeated every week for 8 wk, with abstinence from solid food between 00:00 and 23:59 at minimum and a maximum caloric intake of 300 kcal on each fasting day. A per-protocol analysis was performed. P < 0.05 was considered significant. Thirty-six volunteers were included; 22 allocated themselves to the fasting group, and 14 to the control group. Thirty-three data sets were included in the final analysis. Although significant in-group changes were observed in both groups for a number of outcomes after 8 wk and 6 mo, no significant between-group differences were observed for any outcome other than overall body fat mass after 8 wk as well as for the HADS total score and the WHO-5 total score after 6

  10. Fast-track services for all? The preferences of Chinese-, Korean-, and Thai-speaking women attending a sexual health service.

    Science.gov (United States)

    Martin, Lynne; Knight, Vickie; Read, Phillip J; McNulty, Anna

    2013-12-01

    Sydney Sexual Health Centre (SSHC) Xpress clinic has significantly reduced the length of stay and waiting time for clients at SSHC but is currently only available to clients who can read and understand a high level of English. This reduces access for culturally and linguistically diverse (CALD) clients. This study sought to determine the acceptability of 4 proposed components of an express clinic model among CALD clients: computer-assisted self-interview (CASI), self-collection of swabs/urine specimens, not having a physical examination, and consultation with a health promotion officer rather than with a clinician. Differences in acceptability based on language group, new or return client status, sex worker status, clinic visited status, and age were analyzed. A cross-sectional, anonymous questionnaire was offered to all female Chinese, Thai, and Korean clients attending SSHC between March and November 2012. Multivariate regression and Pearson χ statistical analyses were conducted using STATA 12 software. A total of 366 questionnaires were returned from 149 Thai, 145 Chinese, and 72 Korean participants. After multivariate analysis, the only predictor of willingness to use an express model of service provision was language group: overall, 67% Thai (odds ratio, 3.74: confidence interval [CI], 2.03-6.89; P Korean (odds ratio, 3.58; CI, 1.77-7.25, P Korean (8.5%) (P Korean (40.9%) were happier with self-swabbing than Chinese women (23.9%, P Korean (11.1%; P < 0.001). This research shows that the components of an express model used at SSHC are not favorable to our CALD client base. Despite a CALD express clinic having the potential to reduce waiting times, most clients did not favor reduced waiting time over being physically examined or using a CASI.

  11. Tracking by Machine Learning Methods

    CERN Document Server

    Jofrehei, Arash

    2015-01-01

    Current track reconstructing methods start with two points and then for each layer loop through all possible hits to find proper hits to add to that track. Another idea would be to use this large number of already reconstructed events and/or simulated data and train a machine on this data to find tracks given hit pixels. Training time could be long but real time tracking is really fast Simulation might not be as realistic as real data but tacking has been done for that with 100 percent efficiency while by using real data we would probably be limited to current efficiency.

  12. Mediterranean diet or extended fasting's influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study.

    Science.gov (United States)

    Michalsen, Andreas; Riegert, Markus; Lüdtke, Rainer; Bäcker, Marcus; Langhorst, Jost; Schwickert, Myriam; Dobos, Gustav J

    2005-12-22

    Alterations in the intestinal bacterial flora are believed to be contributing factors to many chronic inflammatory and degenerative diseases including rheumatic diseases. While microbiological fecal culture analysis is now increasingly used, little is known about the relationship of changes in intestinal flora, dietary patterns and clinical outcome in specific diseases. To clarify the role of microbiological culture analysis we aimed to evaluate whether in patients with rheumatoid arthritis (RA) or fibromyalgia (FM) a Mediterranean diet or an 8-day fasting period are associated with changes in fecal flora and whether changes in fecal flora are associated with clinical outcome. During a two-months-period 51 consecutive patients from an Integrative Medicine hospital department with an established diagnosis of RA (n = 16) or FM (n = 35) were included in the study. According to predefined clinical criteria and the subjects' choice the patients received a mostly vegetarian Mediterranean diet (n = 21; mean age 50.9 +/-13.3 y) or participated in an intermittent modified 8-day fasting therapy (n = 30; mean age 53.7 +/- 9.4 y). Quantitative aerob and anaerob bacterial flora, stool pH and concentrations of secretory immunoglobulin A (sIgA) were analysed from stool samples at the beginning, at the end of the 2-week hospital stay and at a 3-months follow-up. Clinical outcome was assessed with the DAS 28 for RA patients and with a disease severity rating scale in FM patients. We found no significant changes in the fecal bacterial counts following the two dietary interventions within and between groups, nor were significant differences found in the analysis of sIgA and stool ph. Clinical improvement at the end of the hospital stay tended to be greater in fasting vs. non-fasting patients with RA (p = 0.09). Clinical outcome was not related to alterations in the intestinal flora. Neither Mediterranean diet nor fasting treatments affect the microbiologically assessed intestinal

  13. Mediterranean diet or extended fasting's influence on changing the intestinal microflora, immunoglobulin A secretion and clinical outcome in patients with rheumatoid arthritis and fibromyalgia: an observational study

    Directory of Open Access Journals (Sweden)

    Schwickert Myriam

    2005-12-01

    Full Text Available Abstract Background Alterations in the intestinal bacterial flora are believed to be contributing factors to many chronic inflammatory and degenerative diseases including rheumatic diseases. While microbiological fecal culture analysis is now increasingly used, little is known about the relationship of changes in intestinal flora, dietary patterns and clinical outcome in specific diseases. To clarify the role of microbiological culture analysis we aimed to evaluate whether in patients with rheumatoid arthritis (RA or fibromyalgia (FM a Mediterranean diet or an 8-day fasting period are associated with changes in fecal flora and whether changes in fecal flora are associated with clinical outcome. Methods During a two-months-period 51 consecutive patients from an Integrative Medicine hospital department with an established diagnosis of RA (n = 16 or FM (n = 35 were included in the study. According to predefined clinical criteria and the subjects' choice the patients received a mostly vegetarian Mediterranean diet (n = 21; mean age 50.9 +/-13.3 y or participated in an intermittent modified 8-day fasting therapy (n = 30; mean age 53.7 +/- 9.4 y. Quantitative aerob and anaerob bacterial flora, stool pH and concentrations of secretory immunoglobulin A (sIgA were analysed from stool samples at the beginning, at the end of the 2-week hospital stay and at a 3-months follow-up. Clinical outcome was assessed with the DAS 28 for RA patients and with a disease severity rating scale in FM patients. Results We found no significant changes in the fecal bacterial counts following the two dietary interventions within and between groups, nor were significant differences found in the analysis of sIgA and stool ph. Clinical improvement at the end of the hospital stay tended to be greater in fasting vs. non-fasting patients with RA (p = 0.09. Clinical outcome was not related to alterations in the intestinal flora. Conclusion Neither Mediterranean diet nor fasting

  14. A fast and highly sensitive blood culture PCR method for clinical detection of Salmonella enterica serovar Typhi

    Directory of Open Access Journals (Sweden)

    Zhou Liqing

    2010-04-01

    Full Text Available Abstract Background Salmonella Typhi causes an estimated 21 million new cases of typhoid fever and 216,000 deaths every year. Blood culture is currently the gold standard for diagnosis of typhoid fever, but it is time-consuming and takes several days for isolation and identification of causative organisms. It is then too late to initiate proper antibiotic therapy. Serological tests have very low sensitivity and specificity, and no practical value in endemic areas. As early diagnosis of the disease and prompt treatment are essential for optimal management, especially in children, a rapid sensitive detection method for typhoid fever is urgently needed. Although PCR is sensitive and rapid, initial research indicated similar sensitivity to blood culture and lower specificity. We developed a fast and highly sensitive blood culture PCR method for detection of Salmonella Typhi, allowing same-day initiation of treatment after accurate diagnosis of typhoid. Methods An ox bile tryptone soy broth was optimized for blood culture, which allows the complete lysis of blood cells to release intracellular bacteria without inhibiting the growth of Salmonella Typhi. Using the optimised broth Salmonella Typhi bacteria in artificial blood samples were enriched in blood culture and then detected by a PCR targeting the fliC-d gene of Salmonella Typhi. Results Tests demonstrated that 2.4% ox bile in blood culture not only lyzes blood cells completely within 1.5 hours so that the intracellular bacteria could be released, but also has no inhibiting effect on the growth of Salmonella Typhi. Three hour enrichment of Salmonella Typhi in tryptone soya broth containing 2.4% ox bile could increase the bacterial number from 0.75 CFU per millilitre of blood which is similar to clinical typhoid samples to the level which regular PCR can detect. The whole blood culture PCR assay takes less than 8 hours to complete rather than several days for conventional blood culture

  15. Investigating the condition of medical counseling and some of clinical aspects for fasting in holy month of Ramadan from the perspective of diabetic and hypertensive patients

    Directory of Open Access Journals (Sweden)

    Ahmad Mahmoudian

    2015-06-01

    Full Text Available Introduction: Although fasting has many benefits for health, it can be dangerous for patients. So it is necessary that physicians have adequate information about clinical aspects of fasting and they should advice patients. Therefore in this study we analyses the condition of physicians counseling about fasting from the perspective of patients. Methods:In this descriptive analytical cross-sectional study, patients with diabetes and hypertension who were going to doctors in Isfahan in holy month of Ramadan of 2012 and 2013 completed the questionnaires. A valid self-regulation questionnaire including patient`s satisfaction from the quality of physicians counseling about fasting (In the area of education, evaluation of the patient condition, communication /relationship with patients, caring for diseases in holy Ramadan and the incidence of symptoms in fasting had been used with  = 0.76. The patients completed the questionnaire after visit. The data was analyzed by Independent t-test, chi-square, Regression, one-way ANOVA in the19 spss software. Results: 285 patients, 199(69.8% female and 86(30.2% male, were selected. The mean satisfaction score of counseling was 70.50 ±13.23. The highest score (75.36±14.16 was referred to counseling of physician, and the least score (66.09±18.84 to patient assessment by physician. Mean score of Patients' satisfaction of specialists was higher than of general practitioner (p-value

  16. Effect of Alternate-Day Fasting on Weight Loss, Weight Maintenance, and Cardioprotection Among Metabolically Healthy Obese Adults: A Randomized Clinical Trial.

    Science.gov (United States)

    Trepanowski, John F; Kroeger, Cynthia M; Barnosky, Adrienne; Klempel, Monica C; Bhutani, Surabhi; Hoddy, Kristin K; Gabel, Kelsey; Freels, Sally; Rigdon, Joseph; Rood, Jennifer; Ravussin, Eric; Varady, Krista A

    2017-07-01

    Alternate-day fasting has become increasingly popular, yet, to date, no long-term randomized clinical trials have evaluated its efficacy. To compare the effects of alternate-day fasting vs daily calorie restriction on weight loss, weight maintenance, and risk indicators for cardiovascular disease. A single-center randomized clinical trial of obese adults (18 to 64 years of age; mean body mass index, 34) was conducted between October 1, 2011, and January 15, 2015, at an academic institution in Chicago, Illinois. Participants were randomized to 1 of 3 groups for 1 year: alternate-day fasting (25% of energy needs on fast days; 125% of energy needs on alternating "feast days"), calorie restriction (75% of energy needs every day), or a no-intervention control. The trial involved a 6-month weight-loss phase followed by a 6-month weight-maintenance phase. The primary outcome was change in body weight. Secondary outcomes were adherence to the dietary intervention and risk indicators for cardiovascular disease. Among the 100 participants (86 women and 14 men; mean [SD] age, 44 [11] years), the dropout rate was highest in the alternate-day fasting group (13 of 34 [38%]), vs the daily calorie restriction group (10 of 35 [29%]) and control group (8 of 31 [26%]). Mean weight loss was similar for participants in the alternate-day fasting group and those in the daily calorie restriction group at month 6 (-6.8% [95% CI, -9.1% to -4.5%] vs -6.8% [95% CI, -9.1% to -4.6%]) and month 12 (-6.0% [95% CI, -8.5% to -3.6%] vs -5.3% [95% CI, -7.6% to -3.0%]) relative to those in the control group. Participants in the alternate-day fasting group ate more than prescribed on fast days, and less than prescribed on feast days, while those in the daily calorie restriction group generally met their prescribed energy goals. There were no significant differences between the intervention groups in blood pressure, heart rate, triglycerides, fasting glucose, fasting insulin, insulin resistance, C

  17. Radiology image perception and observer performance: How does expertise and clinical information alter interpretation? Stroke detection explored through eye-tracking

    Science.gov (United States)

    Cooper, Lindsey; Gale, Alastair; Darker, Iain; Toms, Andoni; Saada, Janak

    2009-02-01

    Historically, radiology research has been dominated by chest and breast screening. Few studies have examined complex interpretative tasks such as the reading of multidimensional brain CT or MRI scans. Additionally, no studies at the time of writing have explored the interpretation of stroke images; from novices through to experienced practitioners using eye movement analysis. Finally, there appears a lack of evidence on the clinical effects of radiology reports and their influence on image appraisal and clinical diagnosis. A computer-based, eye-tracking study was designed to assess diagnostic accuracy and interpretation in stroke CT and MR imagery. Eight predetermined clinical cases, five images per case, were presented to participants (novices, trainee, and radiologists; n=8). The presence or absence of abnormalities was rated on a five-point Likert scale and their locations reported. Half cases of the cases were accompanied by clinical information; half were not, to assess the impact of information on observer performance. Results highlight differences in visual search patterns amongst novice, trainee and expert observers; the most marked differences occurred between novice readers and experts. Experts spent more time in challenging areas of interest (AOI) than novices and trainee, and were more confident unless a lesion was large and obvious. The time to first AOI fixation differed by size, shape and clarity of lesion. 'Time to lesion' dropped significantly when recognition appeared to occur between slices. The influence of clinical information was minimal.

  18. Ultrastructural characterization of mesenchymal stromal cells labeled with ultrasmall superparamagnetic iron-oxide nanoparticles for clinical tracking studies

    DEFF Research Database (Denmark)

    Hansen, Louise; Hansen, Alastair B; Mathiasen, Anders B

    2014-01-01

    INTRODUCTION: To evaluate survival and engraftment of mesenchymal stromal cells (MSCs) in vivo, it is necessary to track implanted cells non-invasively with a method, which does not influence cellular ultrastructure and functional characteristics. Iron-oxide particles have been applied for cell...... sequence of trans-activator of transcription (TAT) (IODEX-TAT) and evaluate the effect of labeling on ultrastructure, viability, phenotype and proliferative capacity of the cells. MATERIALS AND METHODS: MSCs were labeled with 5 and 10 μg IODEX-TAT/10(5) cells for 2, 6 and 21 hours. IODEX-TAT uptake...... and cellular ultrastructure were determined by electron microscopy. Cell viability was determined by propidium iodide staining and cell proliferation capacity by 5-bromo-2-deoxyuridine (BrdU) incorporation. Maintenance of stem cell surface markers was determined by flow cytometry. Results. IODEX-TAT labeling...

  19. Leadership in Australian Rural Schools: Bush Track, Fast Track

    Science.gov (United States)

    Graham, Lorraine; Paterson, David; Miller, Judith

    2008-01-01

    Due to the difficulties inherent in staffing rural schools it is increasingly common for beginning teachers to fill school leadership roles early in their careers. The accelerated progression of some teachers impacts on the overall nature of leadership in rural schools and creates unique pathways, generally different from those available to…

  20. Clinical feasibility and validation of 3D principal strain analysis from cine MRI: comparison to 2D strain by MRI and 3D speckle tracking echocardiography.

    Science.gov (United States)

    Satriano, Alessandro; Heydari, Bobak; Narous, Mariam; Exner, Derek V; Mikami, Yoko; Attwood, Monica M; Tyberg, John V; Lydell, Carmen P; Howarth, Andrew G; Fine, Nowell M; White, James A

    2017-12-01

    Two-dimensional (2D) strain analysis is constrained by geometry-dependent reference directions of deformation (i.e. radial, circumferential, and longitudinal) following the assumption of cylindrical chamber architecture. Three-dimensional (3D) principal strain analysis may overcome such limitations by referencing intrinsic (i.e. principal) directions of deformation. This study aimed to demonstrate clinical feasibility of 3D principal strain analysis from routine 2D cine MRI with validation to strain from 2D tagged cine analysis and 3D speckle tracking echocardiography. Thirty-one patients undergoing cardiac MRI were studied. 3D strain was measured from routine, multi-planar 2D cine SSFP images using custom software designed to apply 4D deformation fields to 3D cardiac models to derive principal strain. Comparisons of strain estimates versus those by 2D tagged cine, 2D non-tagged cine (feature tracking), and 3D speckle tracking echocardiography (STE) were performed. Mean age was 51 ± 14 (36% female). Mean LV ejection fraction was 66 ± 10% (range 37-80%). 3D principal strain analysis was feasible in all subjects and showed high inter- and intra-observer reproducibility (ICC range 0.83-0.97 and 0.83-0.98, respectively-p analysis is feasible using routine, multi-planar 2D cine MRI and shows high reproducibility with strong correlations to 2D conventional strain analysis and 3D STE-based analysis. Given its independence from geometry-related directions of deformation this technique may offer unique benefit for the detection and prognostication of myocardial disease, and warrants expanded investigation.

  1. Fasting leptin and glucose in normal weight, over weight and obese men and women diabetes patients with and without clinical depression.

    Science.gov (United States)

    Haleem, Darakhshan Jabeen; Sheikh, Shehnaz; Fawad, Asher; Haleem, Muhammad A

    2017-06-01

    A large number of diabetes patients suffer from major depression and are at high risk of mortality. In view of a role of leptin in diabetes, depression and energy homeostasis, the present study concerns circulating levels of leptin in different BMI groups of un-depressed and depressed diabetes patients. Six hundred thirty male and female patients with a primary diagnosis of diabetes were grouped according to BMI and with or without clinical symptoms of depression. Age matched healthy, normal weight male and female volunteers without clinical symptoms of depression or diabetes were taken as controls. Blood samples were obtained after an overnight fast of 12 h. Serum was stored for the determination of leptin and glucose. We found that there were more female than male diabetes patients with comorbid depression. Fasting leptin was higher in normal weight non-diabetes women than men; but comparable in normal weight men and women diabetes patients. Fasting glucose levels were higher in diabetes than non diabetes groups; values were comparable in men and women. Depression was associated with a decrease and increase in leptin respectively in normal-overweight and obese men and women diabetes patients. Glucose levels were also higher in obese depressed than un-depressed diabetes patients. The results suggested that the female gender is at greater risk to comorbid diabetes with depression. Adipo-insular axis plays an important role in diabetes, associated depression and in the greater risk of the female gender to comorbid diabetes with depression.

  2. Double attention bias for positive and negative emotional faces in clinical depression: evidence from an eye-tracking study.

    Science.gov (United States)

    Duque, Almudena; Vázquez, Carmelo

    2015-03-01

    According to cognitive models, attentional biases in depression play key roles in the onset and subsequent maintenance of the disorder. The present study examines the processing of emotional facial expressions (happy, angry, and sad) in depressed and non-depressed adults. Sixteen unmedicated patients with Major Depressive Disorder (MDD) and 34 never-depressed controls (ND) completed an eye-tracking task to assess different components of visual attention (orienting attention and maintenance of attention) in the processing of emotional faces. Compared to ND, participants with MDD showed a negative attentional bias in attentional maintenance indices (i.e. first fixation duration and total fixation time) for sad faces. This attentional bias was positively associated with the severity of depressive symptoms. Furthermore, the MDD group spent a marginally less amount of time viewing happy faces compared with the ND group. No differences were found between the groups with respect to angry faces and orienting attention indices. The current study is limited by its cross-sectional design. These results support the notion that attentional biases in depression are specific to depression-related information and that they operate in later stages in the deployment of attention. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Improved efficiency in clinical workflow of reporting measured oncology lesions via PACS-integrated lesion tracking tool.

    Science.gov (United States)

    Sevenster, Merlijn; Travis, Adam R; Ganesh, Rajiv K; Liu, Peng; Kose, Ursula; Peters, Joost; Chang, Paul J

    2015-03-01

    OBJECTIVE. Imaging provides evidence for the response to oncology treatment by the serial measurement of reference lesions. Unfortunately, the identification, comparison, measurement, and documentation of several reference lesions can be an inefficient process. We tested the hypothesis that optimized workflow orchestration and tight integration of a lesion tracking tool into the PACS and speech recognition system can result in improvements in oncologic lesion measurement efficiency. SUBJECTS AND METHODS. A lesion management tool tightly integrated into the PACS workflow was developed. We evaluated the effect of the use of the tool on measurement reporting time by means of a prospective time-motion study on 86 body CT examinations with 241 measureable oncologic lesions with four radiologists. RESULTS. Aggregated measurement reporting time per lesion was 11.64 seconds in standard workflow, 16.67 seconds if readers had to register measurements de novo, and 6.36 seconds for each subsequent follow-up study. Differences were statistically significant (p workflow-integrated lesion management tool, especially for patients with multiple follow-up examinations, reversing the onetime efficiency penalty at baseline registration.

  4. Particle tracking

    International Nuclear Information System (INIS)

    Mais, H.; Ripken, G.; Wrulich, A.; Schmidt, F.

    1986-02-01

    After a brief description of typical applications of particle tracking in storage rings and after a short discussion of some limitations and problems related with tracking we summarize some concepts and methods developed in the qualitative theory of dynamical systems. We show how these concepts can be applied to the proton ring HERA. (orig.)

  5. Timber tracking

    DEFF Research Database (Denmark)

    Düdder, Boris; Ross, Omry

    2017-01-01

    Managing and verifying forest products in a value chain is often reliant on easily manipulated document or digital tracking methods - Chain of Custody Systems. We aim to create a new means of tracking timber by developing a tamper proof digital system based on Blockchain technology. Blockchain...

  6. FAST TRACK COMMUNICATION: Graphene based quantum dots

    Science.gov (United States)

    Zhang, H. G.; Hu, H.; Pan, Y.; Mao, J. H.; Gao, M.; Guo, H. M.; Du, S. X.; Greber, T.; Gao, H.-J.

    2010-08-01

    Laterally localized electronic states are identified on a single layer of graphene on ruthenium by low temperature scanning tunneling spectroscopy (STS). The individual states are separated by 3 nm and comprise regions of about 90 carbon atoms. This constitutes a highly regular quantum dot-array with molecular precision. It is evidenced by quantum well resonances (QWRs) with energies that relate to the corrugation of the graphene layer. The dI/dV conductance spectra are modeled by a layer height dependent potential-well with a delta-function potential that describes the barrier for electron penetration into graphene. The resulting QWRs are strongest and lowest in energy on the isolated 'hill' regions with a diameter of 2 nm, where the graphene is decoupled from the surface.

  7. Grid - a fast threshold tracking procedure

    DEFF Research Database (Denmark)

    Fereczkowski, Michal; Dau, Torsten; MacDonald, Ewen

    2016-01-01

    A new procedure, called “grid”, is evaluated that allows rapid acquisition of threshold curves for psychophysics and, in particular, psychoacoustic, experiments. In this method, the parameterresponse space is sampled in two dimensions within a single run. This allows the procedure to focus more e...

  8. What is the fast track to future energy systems with lower CO2 emissions? Main findings and recommendations from Workshop on Future Energy Systems, Technical University of Denmark, 19 - 20 November 2008

    Energy Technology Data Exchange (ETDEWEB)

    Soenderberg Petersen, L.; Larsen, Hans (eds.)

    2009-04-15

    As part of the DTU Climate Change Technologies programme, DTU arranges a series of workshops and conferences on climate change technology focusing on assessment of and adaptation to climate changes as well as on mitigation of green house gasses (GHG). Each workshop target a specific problem area. This workshop focuses on the challenges for the future energy system from a Danish perspective as well as world wide with regard to both technology needs and policy measures with particular focus on identifying a fast track to energy systems with lower CO{sub 2} emissions. In the coming years, energy systems will be changed to consist of a combination of central units and smaller decentralized units - to a large extent based on renewable energy. At the same time there will be close links between the supply of energy and the individual end user of energy. These links will be based on extensive use of information and communication technology. This will allow end users to respond adequately to price signals and use the electricity for loading electric cars, laundry etc. while the electricity prices are low due to for example surplus of wind generated electricity. The workshop assessed the perspectives for a rapid development of energy systems with more renewable energy in order to reduce CO{sub 2} emissions. Furthermore, the workshop gives recommendations for the implementation of such energy systems. The recommendations are targeted at the research community, industry and public authorities. The recommendations include opportunities for synergy between the research community, the government and the energy industry as well as public authorities. This report presents summary and recommendations from the workshop. (au)

  9. Noninvasive in vivo tracking of mesenchymal stem cells and evaluation of cell therapeutic effects in a murine model using a clinical 3.0 T MRI.

    Science.gov (United States)

    Drey, Florian; Choi, Yeong-Hoon; Neef, Klaus; Ewert, Birgit; Tenbrock, Arne; Treskes, Philipp; Bovenschulte, Henning; Liakopoulos, Oliver J; Brenkmann, Meike; Stamm, Christof; Wittwer, Thorsten; Wahlers, Thorsten

    2013-01-01

    Cardiac cell therapy with mesenchymal stem cells (MSCs) represents a promising treatment approach for end-stage heart failure. However, little is known about the underlying mechanisms and the fate of the transplanted cells. The objective of the presented work is to determine the feasibility of magnetic resonance imaging (MRI) and in vivo monitoring after transplantation into infarcted mouse hearts using a clinical 3.0 T MRI device. The labeling procedure of bone marrow-derived MSCs with micron-sized paramagnetic iron oxide particles (MPIOs) did not affect the viability of the cells and their cell type-defining properties when compared to unlabeled cells. Using a clinical 3.0 T MRI scanner equipped with a dedicated small animal solenoid coil, 10(5) labeled MSCs could be detected and localized in the mouse hearts for up to 4 weeks after intramyocardial transplantation. Weekly ECG-gated scans using T1-weighted sequences were performed, and left ventricular function was assessed. Histological analysis of hearts confirmed the survival of labeled MSCs in the target area up to 4 weeks after transplantation. In conclusion, in vivo tracking of labeled MSCs using a clinical 3.0 T MRI scanner is feasible. In combination with assessment of heart function, this technology allows the monitoring of the therapeutic efficacy of regenerative therapies in a small animal model.

  10. KISTI at TREC 2014 Clinical Decision Support Track: Concept-based Document Re-ranking to Biomedical Information Retrieval

    Science.gov (United States)

    2014-11-01

    sematic type. Injury or Poisoning inpo T037 Anatomical Abnormality anab T190 Given a document D, a concept vector = {1, 2, … , ...integrating biomedical terminology . Nucleic acids research 32, Database issue (2004), 267–270. 5. Chapman, W.W., Hillert, D., Velupillai, S., et...Conference (TREC), (2011). 9. Koopman, B. and Zuccon, G. Understanding negation and family history to improve clinical information retrieval. Proceedings

  11. Making tracks

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    1986-10-15

    In many modern tracking chambers, the sense wires, rather than being lined up uniformly, are grouped into clusters to facilitate the pattern recognition process. However, with higher energy machines providing collisions richer in secondary particles, event reconstruction becomes more complicated. A Caltech / Illinois / SLAC / Washington group developed an ingenious track finding and fitting approach for the Mark III detector used at the SPEAR electron-positron ring at SLAC (Stanford). This capitalizes on the detector's triggering, which uses programmable logic circuits operating in parallel, each 'knowing' the cell patterns for all tracks passing through a specific portion of the tracker (drift chamber)

  12. The effect of nano-curcumin on HbA1c, fasting blood glucose, and lipid profile in diabetic subjects: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Hamid Reza Rahimi

    2016-08-01

    Full Text Available Objective: Diabetes mellitus is defined as a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both or insulin resistance. Curcumin inhibits NF-κB signaling pathway. The aim of this study is evaluation of the effect of Nano-curcumin on HbA1C, fast blood glucose and lipid profile in diabetic patients. Materials and Methods: Seventy type-2 diabetic patients (fasting blood glucose (FBG ≥ 126 mg/dL or 2-hr postprandial blood glucose ≥200 mg/dl randomly receivedeither Curcumin (as nano-micelle 80 mg/day or placebo for 3 months in a double blind randomized clinical trial. Fasting blood glucose, HbA1C, and lipids profile were checked before and after the intervention. Data analyses, including parametric and nonparametric tests were done using the SPSS 11.5 software. A p value < 0.05 was regarded as statistically significant. (RCT registration code: IRCT2013081114330N1 Results: Mean age, BMI, FBG, total cholesterol (TC, triglyceride (TG, LDL, HDL, HbA1c , and  sex and had no significant difference at the baseline between the groups. In Nano-curcumin group, a significant decrease was found in HbA1C, FBG, TG, and BMI comparing results of each subject before and after the treatment (p

  13. The CDF II eXtremely fast tracker upgrade

    Energy Technology Data Exchange (ETDEWEB)

    Abulencia, A.; Azzurri, P.; Cochran, E.; Dittmann, J.; Donati, S.; Efron, J.; Erbacher, R.; Errede, D.; Fedorko, I.; Flanagan, G.; Forrest, R.; /Illinois U., Urbana

    2006-09-01

    The CDF II Extremely Fast Tracker is the trigger track processor which reconstructs charged particle tracks in the transverse plane of the CDF II central outer tracking chamber. The system is now being upgraded to perform a three dimensional track reconstruction. A review of the upgrade is presented here.

  14. Why tracks

    International Nuclear Information System (INIS)

    Burchart, J.; Kral, J.

    1979-01-01

    A comparison is made of two methods of determining the age of rocks, ie., the krypton-argon method and the fission tracks method. The former method is more accurate but is dependent on the temperature and on the grain size of the investigated rocks (apatites, biotites, muscovites). As for the method of fission tracks, the determination is not dependent on grain size. This method allows dating and the determination of uranium concentration and distribution in rocks. (H.S.)

  15. A clinical measure of suicidal ideation, suicidal behavior, and associated symptoms in bipolar disorder: Psychometric properties of the Concise Health Risk Tracking Self-Report (CHRT-SR).

    Science.gov (United States)

    Ostacher, Michael J; Nierenberg, Andrew A; Rabideau, Dustin; Reilly-Harrington, Noreen A; Sylvia, Louisa G; Gold, Alexandra K; Shesler, Leah W; Ketter, Terence A; Bowden, Charles L; Calabrese, Joseph R; Friedman, Edward S; Iosifescu, Dan V; Thase, Michael E; Leon, Andrew C; Trivedi, Madhukar H

    2015-12-01

    People with bipolar disorder are at high risk of suicide, but no clinically useful scale has been validated in this population. The aim of this study was to evaluate the psychometric properties in bipolar disorder of the 7- and 12-item versions of the Concise Health Risk Tracking Self-Report (CHRT-SR), a scale measuring suicidal ideation, suicidal behavior, and associated symptoms. The CHRT was administered to 283 symptomatic outpatients with bipolar I or II disorder who were randomized to receive lithium plus optimized personalized treatment (OPT), or OPT without lithium in a six month longitudinal comparative effectiveness trial. Participants were assessed using structured diagnostic interviews, clinician-rated assessments, and self-report questionnaires. The internal consistency (Cronbach α) was 0.80 for the 7-item CHRT-SR and 0.90 for the 12-item CHRT-SR with a consistent factor structure, and three independent factors (current suicidal thoughts and plans, hopelessness, and perceived lack of social support) for the 7-item version. CHRT-SR scores are correlated with measures of depression, functioning, and quality of life, but not with mania scores. The 7- and 12-item CHRT-SR both had excellent psychometric properties in a sample of symptomatic subjects with bipolar disorder. The scale is highly correlated with depression, functioning, and quality of life, but not with mania. Future research is needed to determine whether the CHRT-SR will be able to predict suicide attempts in clinical practice. Published by Elsevier Ltd.

  16. Multiple feature fusion via covariance matrix for visual tracking

    Science.gov (United States)

    Jin, Zefenfen; Hou, Zhiqiang; Yu, Wangsheng; Wang, Xin; Sun, Hui

    2018-04-01

    Aiming at the problem of complicated dynamic scenes in visual target tracking, a multi-feature fusion tracking algorithm based on covariance matrix is proposed to improve the robustness of the tracking algorithm. In the frame-work of quantum genetic algorithm, this paper uses the region covariance descriptor to fuse the color, edge and texture features. It also uses a fast covariance intersection algorithm to update the model. The low dimension of region covariance descriptor, the fast convergence speed and strong global optimization ability of quantum genetic algorithm, and the fast computation of fast covariance intersection algorithm are used to improve the computational efficiency of fusion, matching, and updating process, so that the algorithm achieves a fast and effective multi-feature fusion tracking. The experiments prove that the proposed algorithm can not only achieve fast and robust tracking but also effectively handle interference of occlusion, rotation, deformation, motion blur and so on.

  17. Deformable Models for Eye Tracking

    DEFF Research Database (Denmark)

    Vester-Christensen, Martin; Leimberg, Denis; Ersbøll, Bjarne Kjær

    2005-01-01

    A deformable template method for eye tracking on full face images is presented. The strengths of the method are that it is fast and retains accuracy independently of the resolution. We compare the me\\$\\backslash\\$-thod with a state of the art active contour approach, showing that the heuristic...

  18. [The root of the deep and fast ongoing evolution of both structure and methodology of clinical research].

    Science.gov (United States)

    Tavazzi, Luigi

    2016-03-01

    The growing scientific knowledge and technology development are leading to radical changes in biological and medical research. The prevalent lines of development deal with a pragmatic evolution of controlled clinical trials, a massive diffusion of observational research, which is progressively incorporated in clinical practice, new models and designs of clinical research, the systematic use of information technology to build up vast networks of medical centers producing huge amounts of shared data to be managed through the big data methodology, personalized as well as precision medicine, a reshaped physician-patient relationship based on a co-working principle. All this is leading to profound changes in public health governance, a renewal of clinical epidemiology and prevention, a modified structure of several specific sectors of medical care, hopefully guided by scientific evidences. A few aspects of such an evolving picture are discussed in this article.

  19. ATLAS FTK: The Fast Tracker

    CERN Document Server

    T, Iizawa; The ATLAS collaboration

    2014-01-01

    The Fast TracKer (FTK) will perform global track reconstruction after each Level-1 trigger accept to enable the software-based High Level Trigger to have early access to tracking information. FTK is a dedicated processor based on a mixture of advanced technologies. Modern, powerful Field Programmable Gate Arrays (FPGAs) form an important part of the system architecture, and the large level of computing power required for pattern recognition is provided by incorporating standard-cell ASICs named Associative Memory (AM). FTK provides global track reconstruction in the full inner silicon detector in approximately 100 microseconds with resolution comparable to the offline algorithms. It allows a fast and precise detection of the primary and secondary vertex information. The track and vertex information is then used by the High Level Trigger algorithms, allowing highly improved trigger performance for the important signatures such as b-jets. In this paper, the architecture and the hardware development status of FT...

  20. Combined treatment with immunoadsorption and rituximab leads to fast and prolonged clinical remission in difficult-to-treat pemphigus vulgaris.

    Science.gov (United States)

    Behzad, M; Möbs, C; Kneisel, A; Möller, M; Hoyer, J; Hertl, M; Eming, R

    2012-04-01

    Pemphigus vulgaris (PV) is a potentially life-threatening autoimmune bullous disorder which is characterized by blisters and erosions of the skin and mucous membranes. A frequently applied first-line therapy for PV consists of systemic corticosteroids (CS) combined with immunosuppressive agents. In refractory cases, novel therapeutic strategies such as immunoadsorption (IA) and the anti-CD20 antibody rituximab (Rtx) aim at directly interfering with pathogenic autoantibodies (auto-Abs). To investigate the long-term efficacy of IA in combination with Rtx in patients with difficult-to-treat PV, we assessed the clinical response to treatment by monitoring the Autoimmune Bullous Skin Disorder Intensity Score, IgG auto-Abs against desmoglein 1 and 3 (Dsg1 and Dsg3) and the dose of systemic CS. We retrospectively analysed clinical and serological parameters of 10 patients with difficult-to-treat PV who received IA at 4-week intervals, followed by Rtx either twice at 1000 mg or four times at 375mg m(-2) . During a 12-month follow-up period, CS were tapered according to the individual clinical status. Six months after the first IA treatment eight of 10 patients were in complete remission on therapy while one patient showed a partial response and one patient was unresponsive to the treatment. At 12 months, six of eight patients were in complete remission on therapy, one patient showed stable disease and one patient had relapsed. Overall, anti-Dsg3 IgG and anti-Dsg1 IgG auto-Abs correlated well with the clinical activity and systemic CS were tapered gradually. The present findings show that the combination of IA and Rtx induces rapid clinical remission and long-term control in difficult-to-treat pemphigus. © 2011 The Authors. BJD © 2011 British Association of Dermatologists.