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Sample records for fludarabine-based reduced intensity

  1. Fludarabine Melphalan reduced-intensity conditioning allotransplanation provides similar disease control in lymphoid and myeloid malignancies: analysis of 344 patients.

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    Bryant, A; Nivison-Smith, I; Pillai, E S; Kennedy, G; Kalff, A; Ritchie, D; George, B; Hertzberg, M; Patil, S; Spencer, A; Fay, K; Cannell, P; Berkahn, L; Doocey, R; Spearing, R; Moore, J

    2014-01-01

    This was an Australasian Bone Marrow Transplant Recipient Registry (ABMTRR)-based retrospective study assessing the outcome of Fludarabine Melphalan (FluMel) reduced-intensity conditioning between 1998 and 2008. Median follow-up was 3.4 years. There were 344 patients with a median age of 54 years (18-68). In all, 234 patients had myeloid malignancies, with AML (n=166) being the commonest indication. There were 110 lymphoid patients with non-hodgkins lymphoma (NHL) (n=64) the main indication. TRM at day 100 was 14% with no significant difference between the groups. OS and disease-free survival (DFS) were similar between myeloid and lymphoid patients (57 and 50% at 3 years, respectively). There was no difference in cumulative incidence of relapse or GVHD between groups. Multivariate analysis revealed four significant adverse risk factors for DFS: donor other than HLA-identical sibling donor, not in remission at transplant, previous autologous transplant and recipient CMV positive. Chronic GVHD was associated with improved DFS in multivariate analysis predominantly due to a marked reduction in relapse (HR:0.44, P=0.003). This study confirms that FluMel provides durable and equivalent remissions in both myeloid and lymphoid malignancies. Disease stage and chronic GVHD remain important determinants of outcome for FluMel allografting.

  2. Fludarabine-mediated circumvention of cytarabine resistance is associated with fludarabine triphosphate accumulation in cytarabine-resistant leukemic cells.

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    Yamamoto, Shuji; Yamauchi, Takahiro; Kawai, Yasukazu; Takemura, Haruyuki; Kishi, Shinji; Yoshida, Akira; Urasaki, Yoshimasa; Iwasaki, Hiromichi; Ueda, Takanori

    2007-02-01

    The combination of cytarabine (ara-C) with fludarabine is a common approach to treating resistant acute myeloid leukemia. Success depends on a fludarabine triphosphate (F-ara-ATP)-mediated increase in the active intracellular metabolite of ara-C, ara-C 5'-triphosphate (ara-CTP). Therapy-resistant leukemia may exhibit ara-C resistance, the mechanisms of which might induce cross-resistance to fludarabine with reduced F-ara-ATP formation. The present study evaluated the effect of combining ara-C and fludarabine on ara-C-resistant leukemic cells in vitro. Two variant cell lines (R1 and R2) were 8-fold and 10-fold more ara-C resistant, respectively, than the parental HL-60 cells. Reduced deoxycytidine kinase activity was demonstrated in R1 and R2 cells, and R2 cells also showed an increase in cytosolic 5'-nucleotidase II activity. Compared with HL-60 cells, R1 and R2 cells produced smaller amounts of ara-CTP. Both variants accumulated less F-ara-ATP than HL-60 cells and showed cross-resistance to fludarabine nucleoside (F-ara-A). R2 cells, however, accumulated much smaller amounts of F-ara-ATP and were more F-ara-A resistant than R1 cells. In HL-60 and R1 cells, F-ara-A pretreatment followed by ara-C incubation produced F-ara-ATP concentrations sufficient for augmenting ara-CTP production, thereby enhancing ara-C cytotoxicity. No potentiation was observed in R2 cells. Nucleotidase might preferentially degrade F-ara-A monophosphate over ara-C monophosphate, leading to reduced F-ara-ATP production and thereby compromising the F-ara-A-mediated potentiation of ara-C cytotoxicity in R2 cells. Thus, F-ara-A-mediated enhancement of ara-C cytotoxicity depended on F-ara-ATP accumulation in ara-C-resistant leukemic cells but ultimately was associated with the mechanism of ara-C resistance.

  3. Stable long-term pulmonary function after fludarabine, antithymocyte globulin and i.v. BU for reduced-intensity conditioning allogeneic SCT.

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    Dirou, S; Malard, F; Chambellan, A; Chevallier, P; Germaud, P; Guillaume, T; Delaunay, J; Moreau, P; Delasalle, B; Lemarchand, P; Mohty, M

    2014-05-01

    Lung function decline is a well-recognized complication following allogeneic SCT (allo-SCT). Reduced-intensity conditioning (RIC) and in vivo T-cell depletion by administration of antithymocyte globulin (ATG) may have a protective role in the occurrence of late pulmonary complications. This retrospective study reported the evolution of lung function parameters within the first 2 years after allo-SCT in a population receiving the same RIC regimen that included fludarabine and i.v. BU in combination with low-dose ATG. The median follow-up was 35.2 months. With a median age of 59 years at the time of transplant, at 2 years, the cumulative incidences of non-relapse mortality was as low as 9.7%. The cumulative incidence of relapse was 33%. At 2 years, the cumulative incidences of extensive chronic GVHD (cGVHD) and of pulmonary cGVHD were 23.1% and 1.9%, respectively. The cumulative incidences of airflow obstruction and restrictive pattern were 3.8% and 9.6%, respectively. Moreover, forced expiratory volume (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio remained stable from baseline up to 2 years post transplantation (P=0.26, P=0.27 and P=0.07, respectively). These results correspond favorably with the results obtained with other RIC regimens not incorporating ATG, and suggest that ATG may have a protective pulmonary role after allo-SCT.

  4. Effect of intra-peritoneal fludarabine on rat spinal cord tolerance to fractionated irradiation

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    Gregoire, V; Ruifrok, A C.C.; Price, R E; Brock, W A; Hittelman, W N; Plunkett, W K; Ang, K K

    1995-07-01

    The effect of fludarabine (9-{beta}-d-arabinosyl-2-fluoroadenine-5'-monophosphate), an adenine nucleoside analogue, on the tolerance of the spinal cord to fractionated irradiation was studied in a rat model. Anesthesized female Fisher 344 rats received irradiation to 2 cm of the cervical spine with a telecobalt unit (dose rate 1.14 Gy/min). Radiation was administered in two, four or eight fractions spread over a 48-h period with or without fludarabine. Animals assigned to combined therapy received two daily intraperitoneal injections of fludarabine (150 mg/kg) given 3 h prior to the first daily radiation fraction. It was found that fludarabine reduced the iso-effect dose required to induce leg paresis at 9 months after irradiation for all fractionation schedules. Dose modification factors of 1.23, 1.29 and greater than 1.27 were obtained for two, four and eight fractions, respectively. Fitting the data with the direct analysis method of Thames et al. with an incomplete repair model [18] showed that the potentiating effect of fludarabine may be mediated through reduction in the number of 'tissue-rescuing units' (lnK). Alpha and {beta} values were slightly but not significantly decreased, whereas the ({alpha}({beta})) ratio was unchanged. These features suggest that fludarabine did not significantly inhibit cellular repair processes but rather reduced the spinal cord tolerance by a fixed additive toxic effect on the same target cells. In rodent models, the combination of fludarabine and fractionated radiation has previously been found to yield a therapeutic gain, i.e., the drug enhanced tumor response to a greater extent than it reduced normal tissue tolerance. However, given our results, caution should be exercised in extrapolating these findings to the clinic. Normal tissue reactions will have to be monitored rigorously in phase I clinical studies.

  5. Reduced intensity haplo plus single cord transplant compared to double cord transplant: improved engraftment and graft-versus-host disease-free, relapse-free survival

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    van Besien, Koen; Hari, Parameswaran; Zhang, Mei-Jie; Liu, Hong-Tao; Stock, Wendy; Godley, Lucy; Odenike, Olatoyosi; Larson, Richard; Bishop, Michael; Wickrema, Amittha; Gergis, Usama; Mayer, Sebastian; Shore, Tsiporah; Tsai, Stephanie; Rhodes, Joanna; Cushing, Melissa M.; Korman, Sandra; Artz, Andrew

    2016-01-01

    Umbilical cord blood stem cell transplants are commonly used in adults lacking HLA-identical donors. Delays in hematopoietic recovery contribute to mortality and morbidity. To hasten recovery, we used co-infusion of progenitor cells from a partially matched related donor and from an umbilical cord blood graft (haplo-cord transplant). Here we compared the outcomes of haplo-cord and double-cord transplants. A total of 97 adults underwent reduced intensity conditioning followed by haplo-cord transplant and 193 patients received reduced intensity conditioning followed by double umbilical cord blood transplantation. Patients in the haplo-cord group were more often from minority groups and had more advanced malignancy. Haplo-cord recipients received fludarabine-melphalan-anti-thymocyte globulin. Double umbilical cord blood recipients received fludarabine-cyclophosphamide and low-dose total body irradiation. In a multivariate analysis, haplo-cord had faster neutrophil (HR=1.42, P=0.007) and platelet (HR=2.54, Pdisease (HR=0.26, Pdisease (HR=0.06, Pdisease-free, relapse-free survival was superior with haplo-cord (HR 0.63, P=0.002) but not overall survival (HR=0.97, P=0.85). Haplo-cord transplantation using fludarabine-melphalan-thymoglobulin conditioning hastens hematopoietic recovery with a lower risk of relapse relative to double umbilical cord blood transplantation using the commonly used fludarabine-cyclophosphamide-low-dose total body irradiation conditioning. Graft-versus-host disease-free and relapse-free survival is significantly improved. Haplo-cord is a readily available graft source that improves outcomes and access to transplant for those lacking HLA-matched donors. Trials registered at clinicaltrials.gov identifiers 00943800 and 01810588. PMID:26869630

  6. Synergistic apoptotic response between valproic acid and fludarabine in chronic lymphocytic leukaemia (CLL) cells involves the lysosomal protease cathepsin B

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    Yoon, J-Y; Szwajcer, D; Ishdorj, G; Benjaminson, P; Xiao, W; Kumar, R; Johnston, J B; Gibson, S B

    2013-01-01

    Fludarabine, a nucleoside analogue, is commonly used in combination with other agents for the treatment of chronic lymphocytic leukaemia (CLL). In previous studies, valproic acid (VPA), an inhibitor of histone deacetylases, combined with fludarabine to synergistically increase apoptotic cell death in CLL cells. In the present study, we found that the combination of fludarabine and VPA decreases the level of the anti-apoptotic proteins Mcl-1 and XIAP in primary CLL cells. Treatment with fludarabine alone, or in combination with VPA, led to the loss of lysosome integrity, and chemical inhibition of the lysosomal protease cathepsin B, using CA074-Me, was sufficient to reduce apoptosis. VPA treatment increased cathepsin B levels and activities in primary CLL cells, thereby priming CLL cells for lysosome-mediated cell death. Six previously treated patients with relapsed CLL were treated with VPA, followed by VPA/fludarabine combination. The combined therapy resulted in reduced lymphocyte count in five out of six and reduced lymph node sizes in four out of six patients. In vivo VPA treatment increased histone-3 acetylation and cathepsin B expression levels. Thus, the synergistic apoptotic response with VPA and fludarabine in CLL is mediated by cathepsin B activation leading to a decrease in the anti-apoptotic proteins

  7. Fludarabine-based versus CHOP-like regimens with or without rituximab in patients with previously untreated indolent lymphoma: a retrospective analysis of safety and efficacy

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    Xu XX

    2013-10-01

    Full Text Available Xiao-xiao Xu,1 Bei Yan,2 Zhen-xing Wang,3 Yong Yu,1 Xiao-xiong Wu,2 Yi-zhuo Zhang11Department of Hematology, Tianjin Medical University Cancer Institute and Hospital, Tianjin Key Laboratory of Cancer Prevention and Therapy, Tianjin, 2Department of Hematology, First Affiliated Hospital of Chinese People's Liberation Army General Hospital, Beijing, 3Department of Stomach Oncology, TianJin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin, People's Republic of ChinaAbstract: Fludarabine-based regimens and CHOP (doxorubicin, cyclophosphamide, vincristine, prednisone-like regimens with or without rituximab are the most common treatment modalities for indolent lymphoma. However, there is no clear evidence to date about which chemotherapy regimen should be the proper initial treatment of indolent lymphoma. More recently, the use of fludarabine has raised concerns due to its high number of toxicities, especially hematological toxicity and infectious complications. The present study aimed to retrospectively evaluate both the efficacy and the potential toxicities of the two main regimens (fludarabine-based and CHOP-like regimens in patients with previously untreated indolent lymphoma. Among a total of 107 patients assessed, 54 patients received fludarabine-based regimens (FLU arm and 53 received CHOP or CHOPE (doxorubicin, cyclophosphamide, vincristine, prednisone, or plus etoposide regimens (CHOP arm. The results demonstrated that fludarabine-based regimens could induce significantly improved progression-free survival (PFS compared with CHOP-like regimens. However, the FLU arm showed overall survival, complete response, and overall response rates similar to those of the CHOP arm. Grade 3–4 neutropenia occurred in 42.6% of the FLU arm and 7.5% of the CHOP arm (P 60 years and presentation of grade 3–4 myelosuppression were the independent factors to infection, and the FLU arm had significantly

  8. Evidence for a GVL effect following reduced-intensity allo-SCT in ALL: a British Society of Blood and Marrow Transplantation study.

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    Medd, P G; Peniket, A J; Littlewood, T J; Pearce, R; Perry, J; Kirkland, K E; Shaw, B E; Potter, M N; Craddock, C F; Milligan, D W; Fielding, A K; Marks, D I; Cook, G

    2013-07-01

    Myeloablative allo-SCT decreases relapse incidence (RI) in ALL. Reduced intensity conditioning (RIC) may extend allo-SCT to older and less fit patients. Sixty-nine ALL patients reported to the BSBMT underwent fludarabine-based RIC allo-SCT, 38 from unrelated donors (UD). Forty-four patients received alemtuzumab. ALL was in CR in 64 patients (93%). This was a second or third SCT in 23 patients. Two-year OS and PFS were 36% and 32%, respectively. In multivariate analysis male recipients demonstrated better OS and PFS (hazard ratio (HR) = 0.42, P = 0.008 and HR = 0.45, P = 0.012, respectively). Two-year TRM was 29%: higher with younger age (HR = 0.97/year, P = 0.041), female recipient (HR = 2.55, P = 0.049) and increasing grade of acute GVHD (HR = 1.87, P = 0.001). Two-year RI was 38% and was lower in patients with acute and chronic GVHD (HR = 0.62 per increasing grade, P = 0.035 and HR = 0.52, P = 0.025, respectively). Long-term ALL-free survival is achievable following fludarabine-based RIC allo-SCT. The association between GVHD and decreased RI suggests the presence of a GVL effect.

  9. Mobilization of peripheral blood stem cells in CLL patients after front-line fludarabine treatment.

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    Lysak, D; Koza, V; Steinerova, K; Jindra, P; Vozobulova, V; Schutzova, M

    2005-07-01

    Autologous peripheral blood stem cell transplantation is performed in an increasing number of chronic lymphocytic leukaemia (CLL) patients who are in the first remission following fludarabine treatment. There are contradictory data about the adverse impact of fludarabine on stem cell harvest. We analysed retrospectively mobilization results in 56 poor-risk CLL patients (median age: 56 years) who underwent first-line treatment with fludarabine and cyclophosphamide. The mobilization, consisting of cyclophosphamide 3 g/m(2) and granulocyte colony-stimulating factor (G-CSF) 10 microg/kg per day, was performed with a median of 77 days following the last fludarabine course. The target yield was >or=2.0x10(6) CD34+ cells/kg. The procedure was successful in 23 (41%) patients. A median of 3.3x10(6) CD34+ cells/kg was collected per patient. The successful mobilization was associated with a longer interval from the last chemotherapy (>2 months). The mobilization result was not influenced by the number of fludarabine cycles. No correlation was found in other parameters such as disease stage at diagnosis, disease status at stimulation or age. The poorly mobilized patients had significantly lower prestimulation blood counts (platelets, WBC and haemoglobin). Our data show that fludarabine does not generally prevent the stem cell mobilization; nevertheless, mechanisms related to the impact of fludarabine on stem cell harvest must be further investigated.

  10. The combined effect of fludarabine monophosphate and radiation on lymphatic cell lines in vitro

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    Nitsche, M.; Rave-Fraenk, M.; Wolter, C.; Hess, C.F. [Gottingen Univ. Georg-August, Dept. of Radiation Oncology (Germany); Pradier, O. [Centre Hospitalier Universitaire, Dept. de Cancerologie, 29 - Brest (France)

    2006-11-15

    We could demonstrate a fludarabine-induced radiosensitization in two of four cell lines tested. We conclude, that fludarabine may play a role as radiosensitizer. The combined effect of low dose fludarabine and low dose radiation emphasizes the idea of possible multiple reapplication of radio chemotherapy in progressive lymphoma. Further investigations are warranted to identify the potential of this drug as a radiosensitizer in vivo and to elucidate the mechanism of interaction of the drug and radiation. (N.C.)

  11. Detailed Functional and Proteomic Characterization of Fludarabine Resistance in Mantle Cell Lymphoma Cells.

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    Lucie Lorkova

    Full Text Available Mantle cell lymphoma (MCL is a chronically relapsing aggressive type of B-cell non-Hodgkin lymphoma considered incurable by currently used treatment approaches. Fludarabine is a purine analog clinically still widely used in the therapy of relapsed MCL. Molecular mechanisms of fludarabine resistance have not, however, been studied in the setting of MCL so far. We therefore derived fludarabine-resistant MCL cells (Mino/FR and performed their detailed functional and proteomic characterization compared to the original fludarabine sensitive cells (Mino. We demonstrated that Mino/FR were highly cross-resistant to other antinucleosides (cytarabine, cladribine, gemcitabine and to an inhibitor of Bruton tyrosine kinase (BTK ibrutinib. Sensitivity to other types of anti-lymphoma agents was altered only mildly (methotrexate, doxorubicin, bortezomib or remained unaffacted (cisplatin, bendamustine. The detailed proteomic analysis of Mino/FR compared to Mino cells unveiled over 300 differentially expressed proteins. Mino/FR were characterized by the marked downregulation of deoxycytidine kinase (dCK and BTK (thus explaining the observed crossresistance to antinucleosides and ibrutinib, but also by the upregulation of several enzymes of de novo nucleotide synthesis, as well as the up-regulation of the numerous proteins of DNA repair and replication. The significant upregulation of the key antiapoptotic protein Bcl-2 in Mino/FR cells was associated with the markedly increased sensitivity of the fludarabine-resistant MCL cells to Bcl-2-specific inhibitor ABT199 compared to fludarabine-sensitive cells. Our data thus demonstrate that a detailed molecular analysis of drug-resistant tumor cells can indeed open a way to personalized therapy of resistant malignancies.

  12. Anti-CD3 Antibody Ameliorates Transfusion-Associated Graft-Versus-Host Disease in a Chemotherapy-Based Mouse Model With Busulfan and Fludarabine

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    Xiaofan Li

    2017-05-01

    Full Text Available ABSTRACT To establish a transfusion-associated graft-versus-host disease (TA-GVHD mouse model with busulfan and fludarabine for effective treatment evaluation. BALB/c (H-2d mice were injected with busulfan (15 mg/kg and fludarabine (30 mg/kg twice a day for 4 days. The mice were transfused with 106 T cell-depleted bone marrow (TCD-BM and cells in different groups 3 days after chemotherapy: syngeneic BALB/c, MHC minor mismatch DBA/2 (H-2d, or MHC major mismatch C57BL/6(H2-b. Recipient BALB/c mice were injected with either blood only or blood+splenocyte. TA-GVHD was monitored in terms of body weight loss, clinical scores, and survival. Dexamethasone (50 mg/kg, cyclophosphamide (50 mg/kg, cyclosporine A (30 mg/kg, and anti-CD3 (1 mg/kg were injected to each group to examine the treatments. Blood transfusion alone is insufficient to induce TA-GVHD in a chemotherapy-based mouse model. A MHC-mismatched TA-GVHD model can be induced by splenocyte and blood transfusion. This MHC-mismatched TA-GVHD model was resistant to dexamethasone treatment. Treatment based on anti-CD3 monoclonal antibody slightly ameliorated TA-GVHD. Treatment effectiveness was associated with T-cell depletion following activation by anti-CD3. Busulfan and fludarabine chemotherapy regimen can be used to establish a TA-GVHD mouse model. Anti-CD3 monoclonal antibody is a potential alternative to treat TA-GVHD.

  13. Targeted Delivery of Deoxycytidine Kinase to Her2-Positive Cells Enhances the Efficacy of the Nucleoside Analog Fludarabine.

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    Sujatha P Koduvayur

    Full Text Available Cytotoxic drugs, such as nucleoside analogs and toxins, commonly suffer from off-target effects. One approach to mitigate this problem is to deliver the cytotoxic drug selectively to the intended site. While for toxins this can be achieved by conjugating the cell-killing moiety to a targeting moiety, it is not an option for nucleoside analogs, which rely on intracellular enzymes to convert them to their active triphosphorylated form. To overcome this limitation, and achieve site-targeted activation of nucleoside analogs, we fused the coding region of a prodrug-activating enzyme, deoxycytidine kinase (dCK, to affinity reagents that bind to the Her2 cell surface protein. We evaluated dCK fusions to an anti-Her2 affibody and Designed Ankyrin Repeat Protein (DARPin for their ability to kill cancer cells by promoting the activation of the nucleoside analog fludarabine. Cell staining and flow cytometry experiments with three Her2 positive cancer cell lines (BT-474-JB, JIMT-1 and SK-OV-3 indicate dCK fusions binding and cellular internalization. In contrast, these reagents bind only weakly to the Her2 negative cell line, MCF-7. Cell proliferation assays indicate that SK-OV-3 and BT-474-JB cell lines exhibit significantly reduced proliferation rates when treated with targeting-module fused dCK and fludarabine, compared to fludarabine alone. These findings demonstrate that we have succeeded in delivering active dCK into the Her2-positive cells, thereby increasing the activation of fludarabine, which ultimately reduces the dose of nucleoside analog needed for cell killing. This strategy may help establish the therapeutic index required to differentiate between healthy tissues and cancer cells.

  14. Efficient Fludarabine-Activating PNP From Archaea as a Guidance for Redesign the Active Site of E. Coli PNP.

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    Cacciapuoti, Giovanna; Bagarolo, Maria Libera; Martino, Elisa; Scafuri, Bernardina; Marabotti, Anna; Porcelli, Marina

    2016-05-01

    The combination of the gene of purine nucleoside phosphorylase (PNP) from Escherichia coli and fludarabine represents one of the most promising systems in the gene therapy of solid tumors. The use of fludarabine in gene therapy is limited by the lack of an enzyme that is able to efficiently activate this prodrug which, consequently, has to be administered in high doses that cause serious side effects. In an attempt to identify enzymes with a better catalytic efficiency than E. coli PNP towards fludarabine to be used as a guidance on how to improve the activity of the bacterial enzyme, we have selected 5'-deoxy-5'-methylthioadenosine phosphorylase (SsMTAP) and 5'-deoxy-5'-methylthioadenosine phosphorylase II (SsMTAPII), two PNPs isolated from the hyperthermophilic archaeon Sulfolobus solfataricus. Substrate specificity and catalytic efficiency of SsMTAP and SsMTAPII for fludarabine were analyzed by kinetic studies and compared with E. coli PNP. SsMTAP and SsMTAPII share with E. coli PNP a comparable low affinity for the arabinonucleoside but are better catalysts of fludarabine cleavage with k(cat)/K(m) values that are 12.8-fold and 6-fold higher, respectively, than those reported for the bacterial enzyme. A computational analysis of the interactions of fludarabine in the active sites of E. coli PNP, SsMTAP, and SsMTAPII allowed to identify the crucial residues involved in the binding with this substrate, and provided structural information to improve the catalytic efficiency of E. coli PNP by enzyme redesign. © 2015 Wiley Periodicals, Inc.

  15. Conditioning with Treosulfan and Fludarabine Followed by Allogeneic Hematopoietic Cell Transplantation for High-Risk Hematologic Malignancies

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    Nemecek, Eneida R.; Guthrie, Katherine A.; Sorror, Mohamed L.; Wood, Brent L.; Doney, Kristine C.; Hilger, Ralf A.; Scott, Bart L.; Kovacsovics, Tibor J.; Maziarz, Richard T.; Woolfrey, Ann E.; Bedalov, Antonio; Sanders, Jean E.; Pagel, John M.; Sickle, Eileen J.; Witherspoon, Robert; Flowers, Mary E.; Appelbaum, Frederick R.; Deeg, H. Joachim

    2010-01-01

    In this prospective study 60 patients of median age 46 (range 5–60) years, with acute myeloid leukemia (AML; n=44), acute lymphoblastic leukemia (ALL; n=3), or myelodysplastic syndrome (MDS; n=13) were conditioned for allogeneic hematopoietic cell transplantation with a treosulfan/fludarabine combination. Most patients were considered at high risk for relapse or non-relapse mortality (NRM). Patients received intravenous treosulfan, 12 g/m2/day (n=5) or 14 g/m2/day (n=55) on days -6 to -4, and fludarabine (30 mg/m2/day) on days -6 to -2, followed by infusion of marrow (n=7) or peripheral blood stem cells (n=53) from HLA-identical siblings (n=30) or unrelated donors (n=30). All patients engrafted. NRM was 5% at day 100, and 8% at 2 years. With a median follow-up of 22 months, the 2-year relapse-free survival for all patients was 58% and 88% for patients without high risk cytogenetics. The 2-year cumulative incidence of relapse was 33% (15% for patients with MDS, 34% for AML in first remission, 50% for AML or ALL beyond first remission and 63% for AML in refractory relapse). Thus, a treosulfan/fludarabine regimen was well tolerated and yielded encouraging survival and disease control with minimal NRM. Further trials are warranted to compare treosulfan/fludarabine to other widely used regimens, and to study the impact of using this regimen in more narrowly defined groups of patients. PMID:20685259

  16. Magnetic resonance imaging may simulate progressive multifocal leucoencephalopathy in a patient with chronic lymphocytic leukemia after fludarabine therapy

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    Kalita J

    2008-01-01

    Full Text Available A 60-year-old male with chronic lymphatic leukemia (CLL after 6 months of fludarabine therapy was admitted with status epilepticus and developed left hemiplegia. His magnetic resonance imaging revealed multiple T2 hyperintense lesions in the right frontal and left parieto-occipital lesion, simulating progressive multifocal leucoencephalopathy (PML. Cerebrospinal fluid Polymerase Chain Reaction (PCR for JC virus was negative. We suggest the possible role of fludarabine in producing PML-like lesions in patients with Chronic Lymphocytic Leukemia (CLL.

  17. Cyclophosphamide/fludarabine nonmyeloablative allotransplant for acute myeloid leukemia.

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    Khawaja, Muhammad Rizwan; Perkins, Susan M; Schwartz, Jennifer E; Robertson, Michael J; Kiel, Patrick J; Sayar, Hamid; Cox, Elizabeth A; Vance, Gail H; Farag, Sherif S; Cripe, Larry D; Nelson, Robert P

    2015-02-01

    We compared survival outcomes following myeloablative allotransplant (MAT) or cyclophosphamide/fludarabine (Cy/Flu) nonmyeloablative allotransplant (NMAT) for 165 patients with acute myelogenous leukemia (AML) in remission or without frank relapse. Patients who received NMAT were more likely to be older and have secondary AML and lower performance status. At a median follow-up of 61 months, median event-free survival and overall survival survival were not different between NMAT and MAT in univariate as well as multivariate analyses. Cy/Flu NMAT may provide similar disease control and survival when compared with MAT in patients with AML in remission or without frank relapse. © 2014 Wiley Periodicals, Inc.

  18. Reduced dose cyclophosphamide, fludarabine and antithymocyte globulin for sibling and unrelated transplant of children with severe and very severe aplastic anemia.

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    Chung, Nack-Gyun; Lee, Jae Wook; Jang, Pil-Sang; Jeong, Dae-Chul; Cho, Bin; Kim, Hack-Ki

    2013-06-01

    We evaluated the results of a novel conditioning regimen of reduced dose cyclophosphamide (Cy, 25 mg/kg for four days), fludarabine (Flu, 30 mg/m(2) for four days), and rabbit ATG (2.5 mg/kg for three days) for allogeneic transplant of children with SAA, implemented since January 2009. Overall, 23 patients were treated with this regimen (16 male, seven female), including 10 diagnosed with VSAA. Donors included eight-MSD and 15 UD (five-matched UD, and 10 mismatched UD). All patients showed neutrophil and platelet engraftment. Cumulative incidence of acute (grade 2 or above) and chronic GVHD was 26.1% and 8.7%, respectively. Estimated two-yr FFS and OS for the entire cohort was 90.3 ± 6.5%. Rates of TRM and graft failure were 5.3% and 4.3%, respectively. No difference in OS was found according to disease severity (SAA vs. VSAA, p = 0.184), or according to donor type (MSD vs. UD, p = 0.699). Excellent outcomes of patients with VSAA underscore the efficacy of allogeneic transplant as a means of expediting hematopoietic recovery. Improved survival of UD transplant reaffirms its role as a valid therapeutic alternative in the absence of MSD. © 2013 John Wiley & Sons A/S.

  19. Fludarabine inhibits STAT1-mediated up-regulation of caspase-3 expression in dexamethasone-induced osteoblasts apoptosis and slows the progression of steroid-induced avascular necrosis of the femoral head in rats.

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    Feng, Zhenhua; Zheng, Wenhao; Tang, Qian; Cheng, Liang; Li, Hang; Ni, Wenfei; Pan, Xiaoyun

    2017-08-01

    Steroid-induced avascular necrosis of the femoral head (SANFH) is a major limitation of long-term or excessive clinical administration of glucocorticoids. Fludarabine, which is a compound used to treat various hematological malignancies, such as chronic lymphocytic leukemia, acts by down-regulating signal transducer and activator of transcription 1 (STAT1) by inhibiting STAT1 phosphorylation in both normal and cancer cells. This study assessed the effects of fludarabine in vitro (primary murine osteoblasts) and in vivo (rat SANFH model). In vitro, pretreatment with fludarabine significantly inhibited Dexamethasone (Dex)-induced apoptosis in osteoblasts, which was examined by TUNEL staining. Treatment with Dex caused a remarkable decrease in the expression of Bcl-2; an increase in cytochrome c release; activation of BAX, caspase-9, and caspase-3; and an obvious enhancement in STAT1 phosphorylation. However, treatment resulted in the up-regulation of caspase-3 expression. Enhanced P-STAT1 activity and up-regulation of caspase-3 expression were also observed in osteoblasts. In vivo, the subchondral trabeculae in fludarabine-treated rats exhibited less bone loss and a lower ratio of empty lacunae. Taken together, our results suggest that STAT1-mediated up-regulation of caspase-3 is involved in osteoblast apoptosis induced by Dex and indicates that fludarabine may serve as a potential agent for the treatment of SANFH.

  20. Fludarabine plus alemtuzumab (FA) front-line treatment in young patients with chronic lymphocytic leukemia (CLL) and an adverse biologic profile.

    Science.gov (United States)

    Mauro, Francesca R; Molica, Stefano; Laurenti, Luca; Cortelezzi, Agostino; Carella, Angelo M; Zaja, Francesco; Chiarenza, Annalisa; Angrilli, Francesco; Nobile, Francesco; Marasca, Roberto; Musolino, Caterina; Brugiatelli, Maura; Piciocchi, Alfonso; Vignetti, Marco; Fazi, Paola; Gentile, Giuseppe; De Propris, Maria S; Della Starza, Irene; Marinelli, Marilisa; Chiaretti, Sabina; Del Giudice, Ilaria; Nanni, Mauro; Albano, Francesco; Cuneo, Antonio; Guarini, Anna; Foà, Robin

    2014-02-01

    In 45, ≤ 60 years old patients with CLL and an adverse biologic profile, a front-line treatment with Fludarabine and Campath (Alemtuzumab(®)) was given. The overall response rate was 75.5%, the complete response rate (CR) 24.4% with the lowest CR rates, 16.7% and 8.3%, in 11q and 17p deleted cases. The 3-year progression-free survival (PFS) and overall survival were 42.5% and 79.9%, respectively. PFS was significantly influenced by CLL duration, beta2-microglobulin, and improved by post-remissional stem cell transplantation. Front-line fludarabine and alemtuzumab showed a manageable safety profile and evidence of a benefit in a small series of CLL patients with adverse biologic features. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Intensive agriculture reduces soil biodiversity across Europe.

    Science.gov (United States)

    Tsiafouli, Maria A; Thébault, Elisa; Sgardelis, Stefanos P; de Ruiter, Peter C; van der Putten, Wim H; Birkhofer, Klaus; Hemerik, Lia; de Vries, Franciska T; Bardgett, Richard D; Brady, Mark Vincent; Bjornlund, Lisa; Jørgensen, Helene Bracht; Christensen, Sören; Hertefeldt, Tina D'; Hotes, Stefan; Gera Hol, W H; Frouz, Jan; Liiri, Mira; Mortimer, Simon R; Setälä, Heikki; Tzanopoulos, Joseph; Uteseny, Karoline; Pižl, Václav; Stary, Josef; Wolters, Volkmar; Hedlund, Katarina

    2015-02-01

    Soil biodiversity plays a key role in regulating the processes that underpin the delivery of ecosystem goods and services in terrestrial ecosystems. Agricultural intensification is known to change the diversity of individual groups of soil biota, but less is known about how intensification affects biodiversity of the soil food web as a whole, and whether or not these effects may be generalized across regions. We examined biodiversity in soil food webs from grasslands, extensive, and intensive rotations in four agricultural regions across Europe: in Sweden, the UK, the Czech Republic and Greece. Effects of land-use intensity were quantified based on structure and diversity among functional groups in the soil food web, as well as on community-weighted mean body mass of soil fauna. We also elucidate land-use intensity effects on diversity of taxonomic units within taxonomic groups of soil fauna. We found that between regions soil food web diversity measures were variable, but that increasing land-use intensity caused highly consistent responses. In particular, land-use intensification reduced the complexity in the soil food webs, as well as the community-weighted mean body mass of soil fauna. In all regions across Europe, species richness of earthworms, Collembolans, and oribatid mites was negatively affected by increased land-use intensity. The taxonomic distinctness, which is a measure of taxonomic relatedness of species in a community that is independent of species richness, was also reduced by land-use intensification. We conclude that intensive agriculture reduces soil biodiversity, making soil food webs less diverse and composed of smaller bodied organisms. Land-use intensification results in fewer functional groups of soil biota with fewer and taxonomically more closely related species. We discuss how these changes in soil biodiversity due to land-use intensification may threaten the functioning of soil in agricultural production systems. © 2014 John Wiley

  2. Reduced-intensity conditioning and HLA-matched haemopoietic stem-cell transplantation in patients with chronic granulomatous disease: a prospective multicentre study.

    Science.gov (United States)

    Güngör, Tayfun; Teira, Pierre; Slatter, Mary; Stussi, Georg; Stepensky, Polina; Moshous, Despina; Vermont, Clementien; Ahmad, Imran; Shaw, Peter J; Telles da Cunha, José Marcos; Schlegel, Paul G; Hough, Rachel; Fasth, Anders; Kentouche, Karim; Gruhn, Bernd; Fernandes, Juliana F; Lachance, Silvy; Bredius, Robbert; Resnick, Igor B; Belohradsky, Bernd H; Gennery, Andrew; Fischer, Alain; Gaspar, H Bobby; Schanz, Urs; Seger, Reinhard; Rentsch, Katharina; Veys, Paul; Haddad, Elie; Albert, Michael H; Hassan, Moustapha

    2014-02-01

    In chronic granulomatous disease allogeneic haemopoietic stem-cell transplantation (HSCT) in adolescents and young adults and patients with high-risk disease is complicated by graft-failure, graft-versus-host disease (GVHD), and transplant-related mortality. We examined the effect of a reduced-intensity conditioning regimen designed to enhance myeloid engraftment and reduce organ toxicity in these patients. This prospective study was done at 16 centres in ten countries worldwide. Patients aged 0-40 years with chronic granulomatous disease were assessed and enrolled at the discretion of individual centres. Reduced-intensity conditioning consisted of high-dose fludarabine (30 mg/m(2) [infants HLA-matched related-donors or HLA-9/10 or HLA-10/10 matched unrelated-donors were infused. The primary endpoints were overall survival and event-free survival (EFS), probabilities of overall survival and EFS at 2 years, incidence of acute and chronic GVHD, achievement of at least 90% myeloid donor chimerism, and incidence of graft failure after at least 6 months of follow-up. 56 patients (median age 12·7 years; IQR 6·8-17·3) with chronic granulomatous disease were enrolled from June 15, 2003, to Dec 15, 2012. 42 patients (75%) had high-risk features (ie, intractable infections and autoinflammation), 25 (45%) were adolescents and young adults (age 14-39 years). 21 HLA-matched related-donor and 35 HLA-matched unrelated-donor transplants were done. Median time to engraftment was 19 days (IQR 16-22) for neutrophils and 21 days (IQR 16-25) for platelets. At median follow-up of 21 months (IQR 13-35) overall survival was 93% (52 of 56) and EFS was 89% (50 of 56). The 2-year probability of overall survival was 96% (95% CI 86·46-99·09) and of EFS was 91% (79·78-96·17). Graft-failure occurred in 5% (three of 56) of patients. The cumulative incidence of acute GVHD of grade III-IV was 4% (two of 56) and of chronic graft-versus-host disease was 7% (four of 56). Stable (≥90%) myeloid

  3. Reduced intensity conditioning, combined transplantation of haploidentical hematopoietic stem cells and mesenchymal stem cells in patients with severe aplastic anemia.

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Li

    Full Text Available We examined if transplantation of combined haploidentical hematopoietic stem cells (HSC and mesenchymal stem cells (MSC affected graft failure and graft-versus-host disease (GVHD in patients with severe aplastic anemia (SAA. Patients with SAA-I (N = 17 received haploidentical HSCT plus MSC infusion. Stem cell grafts used a combination of granulocyte colony-stimulating factor (G-CSF-primed bone marrow and G-CSF-mobilized peripheral blood stem cells of haploidentical donors and the culture-expanded third-party donor-derived umbilical cord MSCs (UC-MSCs, respectively. Reduced intensity conditioning consisted of fludarabine (30 mg/m2·d+cyclosphamide (500 mg/m2·d+anti-human thymocyte IgG. Transplant recipients also received cyclosporin A, mycophenolatemofetil, and CD25 monoclonal antibody. A total of 16 patients achieved hematopoietic reconstitution. The median mononuclear cell and CD34 count was 9.3×10(8/kg and 4.5×10(6/kg. Median time to ANC was >0.5×10(9/L and PLT count >20×10(9/L were 12 and 14 days, respectively. Grade III-IV acute GVHD was seen in 23.5% of the cases, while moderate and severe chronic GVHD were seen in 14.2% of the cases. The 3-month and 6-month survival rates for all patients were 88.2% and 76.5%, respectively; mean survival time was 56.5 months. Combined transplantation of haploidentical HSCs and MSCs on SAA without an HLA-identical sibling donor was safe, effectively reduced the incidence of severe GVHD, and improved patient survival.

  4. Reducing nosocomial infections in neonatal intensive care.

    Science.gov (United States)

    Rogers, Eileen; Alderdice, Fiona; McCall, Emma; Jenkins, John; Craig, Stanley

    2010-09-01

    Nosocomial infection is a common problem in neonatal intensive care. A pilot quality improvement initiative focussing on hand hygiene and aimed at reducing nosocomial infection in very low birth weight (VLBW) infants was introduced in five Neonatal Intensive Care Units. Line associated laboratory confirmed bloodstream infection (LCBSI) and ventilator associated pneumonia (VAP) were chosen as main outcome measures. In VLBW infants, the rate of line associated LCBSI per 1000 central venous catheter days fell by 24%. The rate of VAP per 1000 ventilator days in VLBW infants fell by 38%. Pre- and post-intervention questionnaires showed a statistically significant increase in use of alcohol-based gels and increased knowledge of hand hygiene.

  5. Matrix metalloproteinase-9 is involved in chronic lymphocytic leukemia cell response to fludarabine and arsenic trioxide.

    Directory of Open Access Journals (Sweden)

    Irene Amigo-Jiménez

    Full Text Available Matrix metalloproteinase-9 (MMP-9 contributes to chronic lymphocytic leukemia (CLL pathology by regulating cell migration and preventing spontaneous apoptosis. It is not known if MMP-9 is involved in CLL cell response to chemotherapy and we address this in the present study, using arsenic trioxide (ATO and fludarabine as examples of cytotoxic drugs.We used primary cells from the peripheral blood of CLL patients and MEC-1 cells stably transfected with an empty vector or a vector containing MMP-9. The effect of ATO and fludarabine was determined by flow cytometry and by the MTT assay. Expression of mRNA was measured by RT-PCR and qPCR. Secreted and cell-bound MMP-9 was analyzed by gelatin zymography and flow cytometry, respectively. Protein expression was analyzed by Western blotting and immunoprecipitation. Statistical analyses were performed using the two-tailed Student's t-test.In response to ATO or fludarabine, CLL cells transcriptionally upregulated MMP-9, preceding the onset of apoptosis. Upregulated MMP-9 primarily localized to the membrane of early apoptotic cells and blocking apoptosis with Z-VAD prevented MMP-9 upregulation, thus linking MMP-9 to the apoptotic process. Culturing CLL cells on MMP-9 or stromal cells induced drug resistance, which was overcome by anti-MMP-9 antibodies. Accordingly, MMP-9-MEC-1 transfectants showed higher viability upon drug treatment than Mock-MEC-1 cells, and this effect was blocked by silencing MMP-9 with specific siRNAs. Following drug exposure, expression of anti-apoptotic proteins (Mcl-1, Bcl-xL, Bcl-2 and the Mcl-1/Bim, Mcl-1/Noxa, Bcl-2/Bax ratios were higher in MMP-9-cells than in Mock-cells. Similar results were obtained upon culturing primary CLL cells on MMP-9.Our study describes for the first time that MMP-9 induces drug resistance by modulating proteins of the Bcl-2 family and upregulating the corresponding anti-apoptotic/pro-apoptotic ratios. This is a novel role for MMP-9 contributing to CLL

  6. Umbilical cord blood as an alternative source of reduced-intensity hematopoietic stem cell transplantation for chronic Epstein-Barr virus-associated T or natural killer cell lymphoproliferative diseases.

    Science.gov (United States)

    Sawada, Akihisa; Inoue, Masami; Koyama-Sato, Maho; Kondo, Osamu; Yamada, Kayo; Shimizu, Mariko; Isaka, Kanako; Kimoto, Tomiko; Kikuchi, Hiroaki; Tokimasa, Sadao; Yasui, Masahiro; Kawa, Keisei

    2014-02-01

    Chronic Epstein-Barr virus-associated T/natural killer cell lymphoproliferative diseases represented by chronic active Epstein-Barr virus infection are lethal but are curable with several courses of chemotherapy and allogeneic hematopoietic stem cell transplantation (HSCT). Recently, we reported that reduced-intensity conditioning (RIC) provided better outcomes than myeloablative conditioning because RIC was less toxic. However, it was unclear whether cord blood transplantation (CBT) works in the context of RIC. We retrospectively analyzed 17 patients who underwent RIC followed by bone marrow transplantation (RIC-BMT) and 15 patients who underwent RIC followed by CBT (RIC-CBT). The representative regimen was fludarabine and melphalan based. The overall survival rates with RIC-BMT and RIC-CBT were 92.9% ± 6.9% and 93.3% ± 6.4%, respectively (P = .87). One patient died of lung graft-versus-host disease after RIC-BMT, and 1 patient died of multiple viral infections after RIC-CBT. Although cytotoxic chemotherapy was also immunosuppressive and might contribute to better donor cell engraftment after RIC-HSCT, the rate of engraftment failure after RIC-CBT was still higher than that after RIC-BMT (not significant); however, patients who had experienced graft failure were successfully rescued with a second HSCT. Unrelated cord blood can be an alternative source for RIC-HSCT if a patient has no family donor. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  7. Adding Fludarabine to Cyclophophamide-dexamethason induction therapy impair stem cell harvest in MM

    DEFF Research Database (Denmark)

    Johnsen, Hans Erik; Meldgaard Knudsen, Lene; Mylin, Anne Kærsgaard

    BACKGROUND AND OBJECTIVES Recent data have indicated that the myeloma cell hierarchy includes resistant Recent data have indicated that the myeloma cell hierarchy includes resistant circulating clonal memory B cells, which differ considerably from the classical end stage plasma cells infiltrating......, placebo controlled, single blinded, phase II study evaluating This was a randomized, placebo controlled, single blinded, phase II study evaluating toxicity and safety of Fludarabine added to Cyclophosphamide and Dexamethasone (CyDex) as induction therapy in younger patients with untreated and treatment...

  8. Relevance of the immunoglobulin VH somatic mutation status in patients with chronic lymphocytic leukemia treated with fludarabine, cyclophosphamide, and rituximab (FCR) or related chemoimmunotherapy regimens.

    Science.gov (United States)

    Lin, Katherine I; Tam, Constantine S; Keating, Michael J; Wierda, William G; O'Brien, Susan; Lerner, Susan; Coombes, Kevin R; Schlette, Ellen; Ferrajoli, Alessandra; Barron, Lynn L; Kipps, Thomas J; Rassenti, Laura; Faderl, Stefan; Kantarjian, Hagop; Abruzzo, Lynne V

    2009-04-02

    Although immunoglobulin V(H) mutation status (IgV(H) MS) is prognostic in patients with chronic lymphocytic leukemia (CLL) who are treated with alkylating agents or single-agent fludarabine, its significance in the era of chemoimmunotherapy is not known. We determined the IgV(H) somatic mutation status (MS) in 177 patients enrolled in a phase 2 study of fludarabine, cyclophosphamide, and rituximab (FCR) and in 127 patients treated with subsequent chemoimmunotherapy protocols. IgV(H) MS did not impact significantly on the complete remission (CR) rate of patients receiving FCR or related regimens. However, CR duration was significantly shorter in patients with CLL that used unmutated IgV(H) than those whose CLL used mutated IgV(H) (TTP 47% vs 82% at 6 years, P IgV(H) MS emerged as the only determinant of remission duration (hazard ratio 3.8, P IgV(H) status.

  9. Gonadal function and fertility after stem cell transplantation in childhood: comparison of a reduced intensity conditioning regimen containing melphalan with a myeloablative regimen containing busulfan.

    Science.gov (United States)

    Panasiuk, Anna; Nussey, Stephen; Veys, Paul; Amrolia, Persis; Rao, Kanchan; Krawczuk-Rybak, Maryna; Leiper, Alison

    2015-09-01

    The occurrence of late sequelae after myeloablative conditioning regimens for stem-cell transplantation (SCT) has prompted the introduction of reduced-intensity chemotherapy (RIC) regimens in an attempt to reduce toxicity and spare fertility. We retrospectively evaluated gonadal function in survivors of SCT in childhood by comparing patients conditioned with a myeloablative regimen containing busulfan and cyclophosphamide (BuCy, N = 51, 28 boys) and a RIC regimen containing fludarabine and melphalan (FluMel, N = 40, 19 boys). Spontaneous puberty occurred in 56% of girls and 89% of boys after BuCy, whereas 90% of females and all males in the FluMel group entered puberty spontaneously (P = 0·012). Significantly more females (61%) conditioned with BuCy required hormone replacement compared with the FluMel group (10·5%, P = 0·012). Females in the FluMel group took significantly longer to develop elevation of serum follicle-stimulating hormone (FSH) concentrations (>10 iu/l) from the onset of puberty than females in the BuCy group (median 5·2 years vs. 2·7 years respectively, P = 0·0135). In males no difference was noted between the two conditioning groups in time to FSH elevation (median 4 years in FluMel versus 6 years in BuCy). Whilst the two regimens have similar effects on the testis, ovarian function seems to be better preserved in females undergoing SCT with RIC. © 2015 John Wiley & Sons Ltd.

  10. A reduced-form intensity-based model under fuzzy environments

    Science.gov (United States)

    Wu, Liang; Zhuang, Yaming

    2015-05-01

    The external shocks and internal contagion are the important sources of default events. However, the external shocks and internal contagion effect on the company is not observed, we cannot get the accurate size of the shocks. The information of investors relative to the default process exhibits a certain fuzziness. Therefore, using randomness and fuzziness to study such problems as derivative pricing or default probability has practical needs. But the idea of fuzzifying credit risk models is little exploited, especially in a reduced-form model. This paper proposes a new default intensity model with fuzziness and presents a fuzzy default probability and default loss rate, and puts them into default debt and credit derivative pricing. Finally, the simulation analysis verifies the rationality of the model. Using fuzzy numbers and random analysis one can consider more uncertain sources in the default process of default and investors' subjective judgment on the financial markets in a variety of fuzzy reliability so as to broaden the scope of possible credit spreads.

  11. How I treat elderly or comorbid patients with chronic lymphocytic leukemia.

    Science.gov (United States)

    Smolej, Lukás

    2010-01-01

    Treatment of chronic lymphocytic leukemia (CLL) has recently undergone several major changes. Most importantly, large randomized trials (CLL-8 in first line and REACH in relapse) clearly demonstrated superiority of chemoimmunotherapy consisting of fludarabine, cyclophosphamide and rituximab (FCR) over fludarabine and cyclophosphamide (FC) alone, thus establishing FCR regimen as the new gold standard in younger and physically fit patients. However, management of elderly and/or comorbid patients is still a challenging task because they cannot be treated with agressive approaches due to high risk of unacceptable toxicity. To date, no randomized trials in this patient population have improved therapeutic results over chlorambucil; therefore, this agent remains the backbone of treatment against which the new protocols should be tested. When deciding about the intensity of treatment, performance status, biological age and number as well as severity of comorbidities should be taken into account. Emerging treatment concepts for elderly/comorbid patients include combination of chlorambucil with monoclonal antibodies (rituximab, ofatumumab, GA-101), fludarabine-based regimens in reduced doses or protocols based on bendamustine and lenalidomide. Combination of high-dose steroids with rituximab represent a promising option in relapsed/refractory CLL; however, infectious toxicity remains a serious issue. Finally, ofatumumab monotherapy appears to be a safe and effective therapy for heavily pretreated patients with CLL. This article reviews the current and future possibilities in the treatment of elderly and comorbid patients with CLL.

  12. Effects of two doses of anti-T lymphocyte globulin-Fresenius given after full-match sibling stem cell transplantation in acute myeloblastic leukemia patients who underwent myeloablative fludarabine/busulfan conditioning.

    Science.gov (United States)

    Boga, Can; Yeral, Mahmut; Gereklioglu, Ciğdem; Asma, Suheyl; Maytalman, Erkan; Aytan, Pelin; Kozanoglu, Ilknur; Sariturk, Cagla; Ozdogu, Hakan

    2018-02-20

    Anti-T lymphocyte globulin Fresenius (rATG-F; ATG-Fresenius) and antithymocyte globulin (thymoglobulin), which are included in transplant protocols, are used to reduce the risk of chronic graft-versus-host disease (cGVHD) or suppress allograft rejection. Available clinical studies have been conducted in heterogenous patient populations and with different administration protocols including stem cell sources. Additionally, the pharmacokinetics of ATG is variable, and the clinically effective dose of rATG-F, in particular, is not exactly known. The aim of the study was to investigate the clinical outcomes of acute myeloid leukemia (AML) patients who underwent hemopoietic peripheral stem cell transplantation from full-matched sibling donors and given two different doses of r-ATG-F. This was a single-center, retrospective chart review conducted between July 2005 and July 2016. Sixty-nine consecutive AML patients who underwent transplant with fludarabine- and busulfan-based conditioning were included in the study. Patients in Group 1 received 15 mg/kg body weight rATG-F to 2013 (n = 46), and Group 2 received 30 mg/kg of rATG-F dose begining in 2013 to reduce to cGVHD (n = 23). Cyclosporine and methotrexate were used to treat acute GVHD (aGVHD) prophylaxis. Outcome parameters were compared between the groups. Although the recommended dose r-ATG-F had led to a decrease in the cumulative incidence of cGVHD (27 [58.7%] vs. 8 [34.8%]; p = .03), it also increased the infection rate at 1 year (3 [6.5%] vs. 4 [17.4%]; p = .02). The two groups were similar in terms of engraftment time, aGVHD, relapse, nonrelapse mortality, and rATG-F-related toxicity. A Cox regression model revealed that aGVHD III-IV was associated with increased nonrelapse mortality at 1 year (hazard ratio = 18.2; 95% confidence interval, 1.667-199.255; p = <.02). No patients developed rATG-F-related severe adverse events (Common Terminology Criteria grade 4 or 5). Dose difference of

  13. Emotional intensity reduces later generalized anxiety disorder symptoms when fear of anxiety and negative problem-solving appraisal are low.

    Science.gov (United States)

    Sugiura, Yoshinori; Sugiura, Tomoko

    2015-08-01

    While research based on the emotion dysregulation model indicates a positive relationship between intense emotions and generalized anxiety disorder (GAD) symptoms, emotion-focused intervention involves the use of techniques to enhance emotional experiences, based on the notion that GAD patients are engaging in avoidance strategies. To reveal the conditions under which intense emotions lead to reduced GAD symptoms, we designed a longitudinal study to monitor changes in GAD symptoms among students (N = 129) over 3 months. Our focus was on possible moderators of the effect of emotional intensity. Results indicated that when fear of emotions and negative appraisals about problem solving were low, negative emotional intensity reduced later GAD symptoms. Moreover, under the condition of high responsibility to continue thinking, emotional intensity tended to reduce later GAD symptoms. Results suggest that reduced fear of emotions and reduced negative appraisals about problem solving may enhance the use of emotional processing techniques (e.g., emotional exposure). The interaction between responsibility to continue thinking and emotional intensity requires further examination. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. How I Treat Elderly or Comorbid Patients with Chronic Lymphocytic Leukemia

    Directory of Open Access Journals (Sweden)

    Lukáš Smolej

    2010-01-01

    Full Text Available Treatment of chronic lymphocytic leukemia (CLL has recently undergone several major changes. Most importantly, large randomized trials (CLL-8 in first line and REACH in relapse clearly demonstrated superiority of chemoimmunotherapy consisting of fludarabine, cyclophosphamide and rituximab (FCR over fludarabine and cyclophosphamide (FC alone, thus establishing FCR regimen as the new gold standard in younger and physically fit patients. However, management of elderly and/or comorbid patients is still a challenging task because they cannot be treated with agressive approaches due to high risk of unacceptable toxicity. To date, no randomized trials in this patient population have improved therapeutic results over chlorambucil; therefore, this agent remains the backbone of treatment against which the new protocols should be tested. When deciding about the intensity of treatment, performance status, biological age and number as well as severity of comorbidities should be taken into account. Emerging treatment concepts for elderly/comorbid patients include combination of chlorambucil with monoclonal antibodies (rituximab, ofatumumab, GA-101, fludarabine-based regimens in reduced doses or protocols based on bendamustine and lenalidomide. Combination of highdose steroids with rituximab represent a promising option in relapsed/refractory CLL; however, infectious toxicity remains a serious issue. Finally, ofatumumab monotherapy appears to be a safe and effective therapy for heavily pretreated patients with CLL. This article reviews the current and future possibilities in the treatment of elderly and comorbid patients with CLL.

  15. First-line chemoimmunotherapy with bendamustine and rituximab versus fludarabine, cyclophosphamide, and rituximab in patients with advanced chronic lymphocytic leukaemia (CLL10)

    DEFF Research Database (Denmark)

    Eichhorst, Barbara; Fink, Anna-Maria; Bahlo, Jasmin

    2016-01-01

    BACKGROUND: Chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab is the standard therapy for physically fit patients with advanced chronic lymphocytic leukaemia. This international phase 3 study compared the efficacy and tolerance of the standard therapy with a potentially less....... The final analysis was done by intention to treat. The study is registered with ClinicalTrials.gov, number NCT%2000769522. FINDINGS: 688 patients were recruited between Oct 2, 2008, and July 11, 2011, of which 564 patients who met inclusion criteria were randomly assigned. 561 patients were included...

  16. Cost-Effectiveness Model for Chemoimmunotherapy Options in Patients with Previously Untreated Chronic Lymphocytic Leukemia Unsuitable for Full-Dose Fludarabine-Based Therapy.

    Science.gov (United States)

    Becker, Ursula; Briggs, Andrew H; Moreno, Santiago G; Ray, Joshua A; Ngo, Phuong; Samanta, Kunal

    2016-06-01

    To evaluate the cost-effectiveness of treatment with anti-CD20 monoclonal antibody obinutuzumab plus chlorambucil (GClb) in untreated patients with chronic lymphocytic leukemia unsuitable for full-dose fludarabine-based therapy. A Markov model was used to assess the cost-effectiveness of GClb versus other chemoimmunotherapy options. The model comprised three mutually exclusive health states: "progression-free survival (with/without therapy)", "progression (refractory/relapsed lines)", and "death". Each state was assigned a health utility value representing patients' quality of life and a specific cost value. Comparisons between GClb and rituximab plus chlorambucil or only chlorambucil were performed using patient-level clinical trial data; other comparisons were performed via a network meta-analysis using information gathered in a systematic literature review. To support the model, a utility elicitation study was conducted from the perspective of the UK National Health Service. There was good agreement between the model-predicted progression-free and overall survival and that from the CLL11 trial. On incorporating data from the indirect treatment comparisons, it was found that GClb was cost-effective with a range of incremental cost-effectiveness ratios below a threshold of £30,000 per quality-adjusted life-year gained, and remained so during deterministic and probabilistic sensitivity analyses under various scenarios. GClb was estimated to increase both quality-adjusted life expectancy and treatment costs compared with several commonly used therapies, with incremental cost-effectiveness ratios below commonly referenced UK thresholds. This article offers a real example of how to combine direct and indirect evidence in a cost-effectiveness analysis of oncology drugs. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Muscle injury after low-intensity downhill running reduces running economy.

    Science.gov (United States)

    Baumann, Cory W; Green, Michael S; Doyle, J Andrew; Rupp, Jeffrey C; Ingalls, Christopher P; Corona, Benjamin T

    2014-05-01

    Contraction-induced muscle injury may reduce running economy (RE) by altering motor unit recruitment, lowering contraction economy, and disturbing running mechanics, any of which may have a deleterious effect on endurance performance. The purpose of this study was to determine if RE is reduced 2 days after performing injurious, low-intensity exercise in 11 healthy active men (27.5 ± 5.7 years; 50.05 ± 1.67 VO2peak). Running economy was determined at treadmill speeds eliciting 65 and 75% of the individual's peak rate of oxygen uptake (VO2peak) 1 day before and 2 days after injury induction. Lower extremity muscle injury was induced with a 30-minute downhill treadmill run (6 × 5 minutes runs, 2 minutes rest, -12% grade, and 12.9 km·h(-1)) that elicited 55% VO2peak. Maximal quadriceps isometric torque was reduced immediately and 2 days after the downhill run by 18 and 10%, and a moderate degree of muscle soreness was present. Two days after the injury, steady-state VO2 and metabolic work (VO2 L·km(-1)) were significantly greater (4-6%) during the 65% VO2peak run. Additionally, postinjury VCO2, VE and rating of perceived exertion were greater at 65% but not at 75% VO2peak, whereas whole blood-lactate concentrations did not change pre-injury to postinjury at either intensity. In conclusion, low-intensity downhill running reduces RE at 65% but not 75% VO2peak. The results of this study and other studies indicate the magnitude to which RE is altered after downhill running is dependent on the severity of the injury and intensity of the RE test.

  18. MRPack: Multi-Algorithm Execution Using Compute-Intensive Approach in MapReduce

    Science.gov (United States)

    2015-01-01

    Large quantities of data have been generated from multiple sources at exponential rates in the last few years. These data are generated at high velocity as real time and streaming data in variety of formats. These characteristics give rise to challenges in its modeling, computation, and processing. Hadoop MapReduce (MR) is a well known data-intensive distributed processing framework using the distributed file system (DFS) for Big Data. Current implementations of MR only support execution of a single algorithm in the entire Hadoop cluster. In this paper, we propose MapReducePack (MRPack), a variation of MR that supports execution of a set of related algorithms in a single MR job. We exploit the computational capability of a cluster by increasing the compute-intensiveness of MapReduce while maintaining its data-intensive approach. It uses the available computing resources by dynamically managing the task assignment and intermediate data. Intermediate data from multiple algorithms are managed using multi-key and skew mitigation strategies. The performance study of the proposed system shows that it is time, I/O, and memory efficient compared to the default MapReduce. The proposed approach reduces the execution time by 200% with an approximate 50% decrease in I/O cost. Complexity and qualitative results analysis shows significant performance improvement. PMID:26305223

  19. Cladribine and Fludarabine Nucleotides Induce Distinct Hexamers Defining a Common Mode of Reversible RNR Inhibition.

    Science.gov (United States)

    Wisitpitthaya, Somsinee; Zhao, Yi; Long, Marcus J C; Li, Minxing; Fletcher, Elaine A; Blessing, William A; Weiss, Robert S; Aye, Yimon

    2016-07-15

    The enzyme ribonucleotide reductase (RNR) is a major target of anticancer drugs. Until recently, suicide inactivation in which synthetic substrate analogs (nucleoside diphosphates) irreversibly inactivate the RNR-α2β2 heterodimeric complex was the only clinically proven inhibition pathway. For instance, this mechanism is deployed by the multifactorial anticancer agent gemcitabine diphosphate. Recently reversible targeting of RNR-α-alone coupled with ligand-induced RNR-α-persistent hexamerization has emerged to be of clinical significance. To date, clofarabine nucleotides are the only known example of this mechanism. Herein, chemoenzymatic syntheses of the active forms of two other drugs, phosphorylated cladribine (ClA) and fludarabine (FlU), allow us to establish that reversible inhibition is common to numerous drugs in clinical use. Enzyme inhibition and fluorescence anisotropy assays show that the di- and triphosphates of the two nucleosides function as reversible (i.e., nonmechanism-based) inhibitors of RNR and interact with the catalytic (C site) and the allosteric activity (A site) sites of RNR-α, respectively. Gel filtration, protease digestion, and FRET assays demonstrate that inhibition is coupled with formation of conformationally diverse hexamers. Studies in 293T cells capable of selectively inducing either wild-type or oligomerization-defective mutant RNR-α overexpression delineate the central role of RNR-α oligomerization in drug activity, and highlight a potential resistance mechanism to these drugs. These data set the stage for new interventions targeting RNR oligomeric regulation.

  20. Cost savings from reduced catheter-related bloodstream infection after simulation-based education for residents in a medical intensive care unit.

    Science.gov (United States)

    Cohen, Elaine R; Feinglass, Joe; Barsuk, Jeffrey H; Barnard, Cynthia; O'Donnell, Anna; McGaghie, William C; Wayne, Diane B

    2010-04-01

    Interventions to reduce preventable complications such as catheter-related bloodstream infections (CRBSI) can also decrease hospital costs. However, little is known about the cost-effectiveness of simulation-based education. The aim of this study was to estimate hospital cost savings related to a reduction in CRBSI after simulation training for residents. This was an intervention evaluation study estimating cost savings related to a simulation-based intervention in central venous catheter (CVC) insertion in the Medical Intensive Care Unit (MICU) at an urban teaching hospital. After residents completed a simulation-based mastery learning program in CVC insertion, CRBSI rates declined sharply. Case-control and regression analysis methods were used to estimate savings by comparing CRBSI rates in the year before and after the intervention. Annual savings from reduced CRBSIs were compared with the annual cost of simulation training. Approximately 9.95 CRBSIs were prevented among MICU patients with CVCs in the year after the intervention. Incremental costs attributed to each CRBSI were approximately $82,000 in 2008 dollars and 14 additional hospital days (including 12 MICU days). The annual cost of the simulation-based education was approximately $112,000. Net annual savings were thus greater than $700,000, a 7 to 1 rate of return on the simulation training intervention. A simulation-based educational intervention in CVC insertion was highly cost-effective. These results suggest that investment in simulation training can produce significant medical care cost savings.

  1. Automated drug dispensing system reduces medication errors in an intensive care setting.

    Science.gov (United States)

    Chapuis, Claire; Roustit, Matthieu; Bal, Gaëlle; Schwebel, Carole; Pansu, Pascal; David-Tchouda, Sandra; Foroni, Luc; Calop, Jean; Timsit, Jean-François; Allenet, Benoît; Bosson, Jean-Luc; Bedouch, Pierrick

    2010-12-01

    We aimed to assess the impact of an automated dispensing system on the incidence of medication errors related to picking, preparation, and administration of drugs in a medical intensive care unit. We also evaluated the clinical significance of such errors and user satisfaction. Preintervention and postintervention study involving a control and an intervention medical intensive care unit. Two medical intensive care units in the same department of a 2,000-bed university hospital. Adult medical intensive care patients. After a 2-month observation period, we implemented an automated dispensing system in one of the units (study unit) chosen randomly, with the other unit being the control. The overall error rate was expressed as a percentage of total opportunities for error. The severity of errors was classified according to National Coordinating Council for Medication Error Reporting and Prevention categories by an expert committee. User satisfaction was assessed through self-administered questionnaires completed by nurses. A total of 1,476 medications for 115 patients were observed. After automated dispensing system implementation, we observed a reduced percentage of total opportunities for error in the study compared to the control unit (13.5% and 18.6%, respectively; perror (20.4% and 13.5%; perror showed a significant impact of the automated dispensing system in reducing preparation errors (perrors caused no harm (National Coordinating Council for Medication Error Reporting and Prevention category C). The automated dispensing system did not reduce errors causing harm. Finally, the mean for working conditions improved from 1.0±0.8 to 2.5±0.8 on the four-point Likert scale. The implementation of an automated dispensing system reduced overall medication errors related to picking, preparation, and administration of drugs in the intensive care unit. Furthermore, most nurses favored the new drug dispensation organization.

  2. Power requirements reducing of FBG based all-optical switching

    Science.gov (United States)

    Scholtz, Ľubomír.; Solanská, Michaela; Ladányi, Libor; Müllerová, Jarmila

    2017-12-01

    Although Fiber Bragg gratings (FBGs) are well known devices, their using as all-optical switching elements has been still examined. Current research is focused on optimization of their properties for their using in future all-optical networks. The main problem are high switching intensities needed for achieving the changes of the transmission state. Over several years switching intensities have been reduced from hundreds of GW/cm2 to tens of MW/cm2 by selecting appropriate gratings and signal parameters or using suitable materials. Two principal nonlinear effects with similar power requirements can result in the bistable transmission/reflection of an input optical pulse. In the self-phase modulation (SPM) regime switching is achieved by the intense probe pulse itself. Using cross-phase modulation (XPM) a strong pump alters the FBG refractive index experienced by a weak probe pulse. As a result of this the detuning of the probe pulse from the center of the photonic band gap occurs. Using of XPM the effect of modulation instability is reduced. Modulation instability which is the main SPM degradation mechanism. We focused on nonlinear FBGs based on chalcogenide glasses which are very often used in various applications. Thanks to high nonlinear parameters chalcogenide glasses are suitable candidates for reducing switching intensities of nonlinear FBGs.

  3. Long-term safety and outcome of fludarabine, cyclophosphamide and mitoxantrone (FCM) regimen in previously untreated patients with advanced follicular lymphoma: 12 years follow-up of a phase 2 trial.

    Science.gov (United States)

    Magnano, Laura; Montoto, Silvia; González-Barca, Eva; Briones, Javier; Sancho, Juan Manuel; Muntañola, Ana; Salar, Antonio; Besalduch, Joan; Escoda, Lourdes; Moreno, Carol; Domingo-Domenech, Eva; Estany, Cristina; Oriol, Albert; Altés, Albert; Pedro, Carmen; Gardella, Santiago; Asensio, Antoni; Vivancos, Pilar; Fernández de Sevilla, Alberto; Ribera, Josep María; Colomer, Dolors; Campo, Elias; López-Guillermo, Armando

    2017-04-01

    Fludarabine combinations are very affective in follicular lymphoma (FL) with high rates of complete response and prolonged survival. However, late toxicities could be a concern. The aim of the present study was to analyze the long-term impact on survival, relapse and late toxicities of a trial of treatment with fludarabine, mitoxantrone and cyclophosphamide (FCM regimen) for untreated patients with advanced stage FL. One hundred and twenty patients enrolled in a phase 2 trial of treatment with FCM regimen between 2000 and 2003 were evaluated. After a median follow-up of 12 years, 52 patients eventually relapsed/progressed with 10 year progression-free survival (PFS) of 46 %. Ten patients showed histological transformation to aggressive lymphoma with a risk of transformation of 2 and 9 % at 5 and 10 years, respectively. Three patients developed therapy-related myelodysplastic syndrome/acute myeloid leukaemia (MDS/AML) and seven solid neoplasms with an overall risk of 3 and 8 % at 5 and 10 years, respectively. Twenty-six patients eventually died during the follow-up. Overall survival at 10 years was 83 %. In conclusion, FCM regimen allows excellent long-lasting response in previously untreated patients with FL. The incidence of late events including histological transformation and secondary neoplasia is low but not negligible.

  4. Sound-Intensity Feedback During Running Reduces Loading Rates and Impact Peak.

    Science.gov (United States)

    Tate, Jeremiah J; Milner, Clare E

    2017-08-01

    Study Design Controlled laboratory study, within-session design. Background Gait retraining has been proposed as an effective intervention to reduce impact loading in runners at risk of stress fractures. Interventions that can be easily implemented in the clinic are needed. Objective To assess the immediate effects of sound-intensity feedback related to impact during running on vertical impact peak, peak vertical instantaneous loading rate, and vertical average loading rate. Methods Fourteen healthy, college-aged runners who ran at least 9.7 km/wk participated (4 male, 10 female; mean ± SD age, 23.7 ± 2.0 years; height, 1.67 ± 0.08 m; mass, 60.9 ± 8.7 kg). A decibel meter provided real-time sound-intensity feedback of treadmill running via an iPad application. Participants were asked to reduce the sound intensity of running while receiving continuous feedback for 15 minutes, while running at their self-selected preferred speed. Baseline and follow-up ground reaction force data were collected during overground running at participants' self-selected preferred running speed. Results Dependent t tests indicated a statistically significant reduction in vertical impact peak (1.56 BW to 1.13 BW, P≤.001), vertical instantaneous loading rate (95.48 BW/s to 62.79 BW/s, P = .001), and vertical average loading rate (69.09 BW/s to 43.91 BW/s, P≤.001) after gait retraining, compared to baseline. Conclusion The results of the current study support the use of sound-intensity feedback during treadmill running to immediately reduce loading rate and impact force. The transfer of within-session reductions in impact peak and loading rates to overground running was demonstrated. Decreases in loading were of comparable magnitude to those observed in other gait retraining methods. J Orthop Sports Phys Ther 2017;47(8):565-569. Epub 6 Jul 2017. doi:10.2519/jospt.2017.7275.

  5. China's numerical management system for reducing national energy intensity

    International Nuclear Information System (INIS)

    Li, Huimin; Zhao, Xiaofan; Yu, Yuqing; Wu, Tong; Qi, Ye

    2016-01-01

    In China, the national target for energy intensity reduction, when integrated with target disaggregation and information feedback systems, constitutes a numerical management system, which is a hallmark of modern governance. This paper points out the technical weaknesses of China's current numerical management system. In the process of target disaggregation, the national target cannot be fully disaggregated to local governments, sectors and enterprises without omissions. At the same time, governments at lower levels face pressure for reducing energy intensity that exceeds their respective jurisdictions. In the process of information feedback, information failure is inevitable due to statistical inaccuracy. Furthermore, the monitoring system is unable to correct all errors, and data verification plays a limited role in the examination system. To address these problems, we recommend that the government: use total energy consumption as the primary indicator of energy management; reform the accounting and reporting of energy statistics toward greater consistency, timeliness and transparency; clearly define the responsibility of the higher levels of government. - Highlights: •We assess drawbacks of China's numerical management system for energy intensity. •The national energy intensity target cannot be fully disaggregated without omissions. •Data distortion is due to failures in statistics, monitoring and examination system. •Lower-level governments’ ability to meet energy target is weaker than their pressure. •We provide three policy recommendations for China's policy-makers.

  6. Propagation based phase retrieval of simulated intensity measurements using artificial neural networks

    Science.gov (United States)

    Kemp, Z. D. C.

    2018-04-01

    Determining the phase of a wave from intensity measurements has many applications in fields such as electron microscopy, visible light optics, and medical imaging. Propagation based phase retrieval, where the phase is obtained from defocused images, has shown significant promise. There are, however, limitations in the accuracy of the retrieved phase arising from such methods. Sources of error include shot noise, image misalignment, and diffraction artifacts. We explore the use of artificial neural networks (ANNs) to improve the accuracy of propagation based phase retrieval algorithms applied to simulated intensity measurements. We employ a phase retrieval algorithm based on the transport-of-intensity equation to obtain the phase from simulated micrographs of procedurally generated specimens. We then train an ANN with pairs of retrieved and exact phases, and use the trained ANN to process a test set of retrieved phase maps. The total error in the phase is significantly reduced using this method. We also discuss a variety of potential extensions to this work.

  7. A new smoothing procedure to reduce delivery segments for static MLC-based IMRT planning

    International Nuclear Information System (INIS)

    Sun Xuepeng; Xia Ping

    2004-01-01

    In the application of pixel-based intensity-modulated radiation therapy (IMRT) using the step-and-shoot delivery method, one major difficulty is the prolonged delivery time. In this study, we present an integrated IMRT planning system that involves a simple smoothing method to reduce the complexity of the beam profiles. The system consists of three main steps: (a) an inverse planning process based on a least-square dose-based cost function; (b) smoothing of the intensity maps; (c) reoptimization of the segment weights. Step (a) obtains the best plan with the lowest cost value using a simulated annealing optimization algorithm with discrete intensity levels. Step (b) takes the intensity maps obtained from (a) and reduces the complexity of the maps by smoothing the adjacent beamlet intensities. During this process each beamlet is assigned a structure index based on anatomical information. A smoothing update is applied to average adjacent beamlets with the same index. To control the quality of the plan, a predefined clinical protocol is used as an acceptance criterion. The smoothing updates that violate the criterion are rejected. After the smoothing process, the segment weights are reoptimized in step (c) to further improve the plan quality. Three clinical cases were studied using this system: a medulloblastoma, a prostate cancer, and an oropharyngeal carcinoma. While the final plans demonstrate a degradation of the original plan quality, they still meet the plan acceptance criterion. On the other hand, the segment numbers or delivery times are reduced by 40%, 20%, and 20% for the three cases, respectively

  8. REDUCING THE INTENSITY OF TAKEAWAY PULVERIZED COAL BY USING SPECIAL SOLUTION

    Directory of Open Access Journals (Sweden)

    M. M. Biliaiev

    2017-04-01

    Full Text Available Purpose. The article is aimed: 1 to develop the coal coating solution in open railway cars or to cover coal piles to minimize the coal dust losses; 2 creating a mathematical model of the process of the solution feeding to the surface of coal. Methodology. To solve this problem, it was developed a special solution containing cheap industrial wastes and semiproducts of chemical industries. It was conducted a physical experiment to assess the intensity of coal dust loss when using the developed solution. A mathematical model based on the use of the motion equations of the ideal fluid and mass transfer was developed. The developed numerical models are the basis of the application program package created for assessing the quality of processing the coal surface by special solution. Findings. The results of the conducted physical experiment to assess the magnitude of the coal dust loss on the model of the coal pile in the processing of its surface with a special solution and without processing are presented in the article. It is shown that the application of the proposed solution for surface processing of coal can significantly reduce the coal dust loss. This makes it possible to reduce the amount of economic losses and reduce the level of air dust pollution in work areas. The results of computational experiments carried out on the basis of the constructed numerical models are presented in the article. Originality. Authors proposed a new solution for the coal surface processing in order to minimize the removal of pulverized coal from the coal pile, which substantially reduces the coal losses. There were created numerical models to take into account the relevant factors influencing the solution dispersion process in the atmosphere from coal processing in gondola cars. Practical value. Solution, proposed in the article has a low price, because it can be created on the basis of industrial production wastes. Application of this solution can significantly

  9. Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units.

    Science.gov (United States)

    Lee, Wen-Sen; Hsieh, Tai-Chin; Shiau, Justine C; Ou, Tsong-Yih; Chen, Fu-Lun; Liu, Yu-Hsin; Yen, Muh-Yong; Hsueh, Po-Ren

    2017-10-01

    This prospective before-after study was intended to investigate the effect of Bio-Kil on reducing environmental bacterial burden and healthcare-associated infections (HAIs) in intensive care units (ICUs) at the Municipal Wan-Fang Hospital, Taipei, Taiwan in 2014. Four rooms in the medical and surgical ICUs were investigated and designated as study rooms (n = 2) or control rooms (n = 2). Routine disinfection was performed during the pre-intervention period in both room types. Bio-Kil was applied to the fomites and surroundings of the study rooms during the intervention period. Total bacterial burden and proportion of colonization of fomites and surroundings by multidrug-resistance organisms (MDROs) were determined before and after the intervention. The demographic characteristics, underlying conditions, and clinical outcomes of patients were analyzed. After application of Bio-Kil, the bacterial burden declined in both groups, although the reduction was greater in the study rooms as compared with the control rooms (p = 0.001). During the pre-intervention period, 16 patients were admitted to control rooms and 18 patients to study rooms. After the intervention, 22 patients were admitted to control rooms and 21 patients to study rooms. The number of cases of new-onset sepsis declined in the intervention group (from 33% to 23.8%), but increased in the control group (from 25% to 40.9%); however, there was no significant difference in incidence of new-onset sepsis between the study and control rooms after intervention. Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs. Copyright © 2016. Published by Elsevier B.V.

  10. A "Neurological Emergency Trolley" reduces turnaround time for high-risk medications in a general intensive care unit.

    Science.gov (United States)

    Ajzenberg, Henry; Newman, Paula; Harris, Gail-Anne; Cranston, Marnie; Boyd, J Gordon

    2018-02-01

    To reduce medication turnaround times during neurological emergencies, a multidisciplinary team developed a neurological emergency crash trolley in our intensive care unit. This trolley includes phenytoin, hypertonic saline and mannitol, as well as other equipment. The aim of this study was to assess whether the cart reduced turnaround times for these medications. In this retrospective cohort study, medication delivery times for two year epochs before and after its implementation were compared. Eligible patients were identified from our intensive care unit screening log. Adults who required emergent use of phenytoin, hypertonic saline or mannitol while in the intensive care unit were included. Groups were compared with nonparametric analyses. 33-bed general medical-surgical intensive care unit in an academic teaching hospital. Time to medication administration. In the pre-intervention group, there were 43 patients with 66 events. In the post-intervention group, there were 45 patients with 80 events. The median medication turnaround time was significantly reduced after implementation of the neurological emergency trolley (25 vs. 10minutes, p=0.003). There was no statistically significant difference in intensive care or 30-day survival between the two cohorts. The implementation of a novel neurological emergency crash trolley in our intensive care unit reduced medication turnaround times. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Intensive Communicative Therapy Reduces Symptoms of Depression in Chronic Nonfluent Aphasia

    Science.gov (United States)

    Mohr, Bettina; Stahl, Benjamin; Berthier, Marcelo L.; Pulvermüller, Friedemann

    2017-01-01

    Background. Patients with brain lesions and resultant chronic aphasia frequently suffer from depression. However, no effective interventions are available to target neuropsychiatric symptoms in patients with aphasia who have severe language and communication deficits. Objective. The present study aimed to investigate the efficacy of 2 different methods of speech and language therapy in reducing symptoms of depression in aphasia on the Beck Depression Inventory (BDI) using secondary analysis (BILAT-1 trial). Methods. In a crossover randomized controlled trial, 18 participants with chronic nonfluent aphasia following left-hemispheric brain lesions were assigned to 2 consecutive treatments: (1) intensive language-action therapy (ILAT), emphasizing communicative language use in social interaction, and (2) intensive naming therapy (INT), an utterance-centered standard method. Patients were randomly assigned to 2 groups, receiving both treatments in counterbalanced order. Both interventions were applied for 3.5 hours daily over a period of 6 consecutive working days. Outcome measures included depression scores on the BDI and a clinical language test (Aachen Aphasia Test). Results. Patients showed a significant decrease in symptoms of depression after ILAT but not after INT, which paralleled changes on clinical language tests. Treatment-induced decreases in depression scores persisted when controlling for individual changes in language performance. Conclusions. Intensive training of behaviorally relevant verbal communication in social interaction might help reduce symptoms of depression in patients with chronic nonfluent aphasia. PMID:29192534

  12. Photobiomodulation Leads to Reduced Oxidative Stress in Rats Submitted to High-Intensity Resistive Exercise

    Directory of Open Access Journals (Sweden)

    Helenita Antonia de Oliveira

    2018-01-01

    Full Text Available The aim of this study was to determine whether oxidative stress markers are influenced by low-intensity laser therapy (LLLT in rats subjected to a high-intensity resistive exercise session (RE. Female Wistar rats divided into three experimental groups (Ctr: control, 4J: LLLT, and RE and subdivided based on the sampling times (instantly or 24 h postexercise underwent irradiation with LLLT using three-point transcutaneous method on the hind legs, which was applied to the gastrocnemius muscle at the distal, medial, and proximal points. Laser (4J or placebo (device off were carried out 60 sec prior to RE that consisted of four climbs bearing the maximum load with a 2 min time interval between each climb. Lipoperoxidation levels and antioxidant capacity were obtained in muscle. Lipoperoxidation levels were increased (4-HNE and CL markers instantly post-RE. LLLT prior to RE avoided the increase of the lipid peroxidation levels. Similar results were also notified for oxidation protein assays. The GPx and FRAP activities did not reduce instantly or 24 h after RE. SOD increased 24 h after RE, while CAT activity did not change with RE or LLLT. In conclusion, LLLT prior to RE reduced the oxidative stress markers, as well as, avoided reduction, and still increased the antioxidant capacity.

  13. Steganography based on pixel intensity value decomposition

    Science.gov (United States)

    Abdulla, Alan Anwar; Sellahewa, Harin; Jassim, Sabah A.

    2014-05-01

    This paper focuses on steganography based on pixel intensity value decomposition. A number of existing schemes such as binary, Fibonacci, Prime, Natural, Lucas, and Catalan-Fibonacci (CF) are evaluated in terms of payload capacity and stego quality. A new technique based on a specific representation is proposed to decompose pixel intensity values into 16 (virtual) bit-planes suitable for embedding purposes. The proposed decomposition has a desirable property whereby the sum of all bit-planes does not exceed the maximum pixel intensity value, i.e. 255. Experimental results demonstrate that the proposed technique offers an effective compromise between payload capacity and stego quality of existing embedding techniques based on pixel intensity value decomposition. Its capacity is equal to that of binary and Lucas, while it offers a higher capacity than Fibonacci, Prime, Natural, and CF when the secret bits are embedded in 1st Least Significant Bit (LSB). When the secret bits are embedded in higher bit-planes, i.e., 2nd LSB to 8th Most Significant Bit (MSB), the proposed scheme has more capacity than Natural numbers based embedding. However, from the 6th bit-plane onwards, the proposed scheme offers better stego quality. In general, the proposed decomposition scheme has less effect in terms of quality on pixel value when compared to most existing pixel intensity value decomposition techniques when embedding messages in higher bit-planes.

  14. A hybrid biomechanical intensity based deformable image registration of lung 4DCT

    International Nuclear Information System (INIS)

    Samavati, Navid; Velec, Michael; Brock, Kristy

    2015-01-01

    Deformable image registration (DIR) has been extensively studied over the past two decades due to its essential role in many image-guided interventions (IGI). IGI demands a highly accurate registration that maintains its accuracy across the entire region of interest. This work evaluates the improvement in accuracy and consistency by refining the results of Morfeus, a biomechanical model-based DIR algorithm.A hybrid DIR algorithm is proposed based on, a biomechanical model–based DIR algorithm and a refinement step based on a B-spline intensity-based algorithm. Inhale and exhale reconstructions of four-dimensional computed tomography (4DCT) lung images from 31 patients were initially registered using the biomechanical DIR by modeling contact surface between the lungs and the chest cavity. The resulting deformations were then refined using the intensity-based algorithm to reduce any residual uncertainties. Important parameters in the intensity-based algorithm, including grid spacing, number of pyramids, and regularization coefficient, were optimized on 10 randomly-chosen patients (out of 31). Target registration error (TRE) was calculated by measuring the Euclidean distance of common anatomical points on both images after registration. For each patient a minimum of 30 points/lung were used.Grid spacing of 8 mm, 5 levels of grid pyramids, and regularization coefficient of 3.0 were found to provide optimal results on 10 randomly chosen patients. Overall the entire patient population (n = 31), the hybrid method resulted in mean ± SD (90th%) TRE of 1.5 ± 1.4 (2.9) mm compared to 3.1 ± 1.9 (5.6) using biomechanical DIR and 2.6 ± 2.5 (6.1) using intensity-based DIR alone.The proposed hybrid biomechanical modeling intensity based algorithm is a promising DIR technique which could be used in various IGI procedures. The current investigation shows the efficacy of this approach for the registration of 4DCT images of the lungs with average accuracy of 1.5

  15. Eight weeks of a combination of high intensity interval training and conventional training reduce visceral adiposity and improve physical fitness: a group-based intervention.

    Science.gov (United States)

    Giannaki, Christoforos D; Aphamis, George; Sakkis, Panikos; Hadjicharalambous, Marios

    2016-04-01

    High intensity interval training (HIIT) has been recently promoted as an effective, low volume and time-efficient training method for improving fitness and health related parameters. The aim of the current study was to examine the effect of a combination of a group-based HIIT and conventional gym training on physical fitness and body composition parameters in healthy adults. Thirty nine healthy adults volunteered to participate in this eight-week intervention study. Twenty three participants performed regular gym training 4 days a week (C group), whereas the remaining 16 participants engaged twice a week in HIIT and twice in regular gym training (HIIT-C group) as the other group. Total body fat and visceral adiposity levels were calculated using bioelectrical impedance analysis. Physical fitness parameters such as cardiorespiratory fitness, speed, lower limb explosiveness, flexibility and isometric arm strength were assessed through a battery of field tests. Both exercise programs were effective in reducing total body fat and visceral adiposity (Ptraining improved cardiorespiratory fitness levels (Ptraining (Ptraining improve various physical fitness parameters and reduce both total and visceral fat levels. This type of training was also found to be superior compared with conventional exercise training alone in terms of reducing more visceral adiposity levels. Group-based HIIT may consider as a good methods for individuals who exercise in gyms and craving to acquire significant fitness benefits in relatively short period of time.

  16. Is reducing variability of blood glucose the real but hidden target of intensive insulin therapy?

    Science.gov (United States)

    Egi, Moritoki; Bellomo, Rinaldo; Reade, Michael C

    2009-01-01

    Since the first report that intensive insulin therapy reduced mortality in selected surgical critically ill patients, lowering of blood glucose levels has been recommended as a means of improving patient outcomes. In this initial Leuven trial, blood glucose control by protocol using insulin was applied to 98.7% of patients in the intensive group but to only 39.2% (P dimension of glucose management, a possible mechanism by which an intensive insulin protocol exerts its putative beneficial effects, and an important goal of glucose management in the intensive care unit. Clinicians need to be aware of this controversy when considering the application of intensive insulin therapy and interpreting future trials.

  17. Analisi di minimizzazione dei costi del trattamento della leucemia cronica con fludarabina fosfato (Fludara® e.v. e p.o.: metodologia e risultati di un’indagine empirica

    Directory of Open Access Journals (Sweden)

    Carlo Lazzaro

    2004-12-01

    Full Text Available The aim of the paper is to compare healthcare-related costs of a 5-day course with fludarabine phosphate i.v. vs a 5-day course with oral fludarabine phosphate in Italian patients with chronic leukemia. A cost-minimization analysis was performed from both Italian National Healthcare Service (INHS and hospital perspectives. Healthcare-related costs were collected from 2 out of a sample of 28 Ematology wards and included those of drug acquisition, drug preparation, drug administration, reception and discharge of patient before and after drug administration; hospital overheads were calculated as a percentage of the total healthcare-related costs. The reimbursement schemes for acquisition and administration of fludarabine phosphate i.v. were gathered from the whole sample of 28 Ematology wards taken into account. Costs were expressed in euros 2004. When compared to fludarabine phosphate i.v., oral fludarabine phosphate allowed savings ranging from 223,47 euros (hospital perspective to 477,05 euros (INHS perspective per patient. As far as hospital perspective was concerned, savings associated with oral fludarabine phosphate were due to hospital overheads (115.1%, drug preparation (19.6%, drug administration (17.3%, reception and discharge of patient before and after drug administration (2.9%, whereas costs for drug acquisition was higher for oral formulation (-54.8%. When INHS perspective was taken into account, 3 out of 28 Ematology wards (11% were reimbursed on a drug-plus-outpatient-drug-administration-basis, whereas 25 out of 28 Ematology wards (89% were reimbursed on a day-hospital-stay-basis. Savings associated with oral fludarabine phosphate were due to day-hospital stay (253.4%, outpatient drug administration (1.1%, whereas cost for drug acquisition were higher for oral formulation (-154.5%. Sensitivity analysis confirmed the robustness of basecase results. Savings associated with oral fludarabine phosphate may be of relevant interest for

  18. Bio-Kil, a nano-based disinfectant, reduces environmental bacterial burden and multidrug-resistant organisms in intensive care units

    Directory of Open Access Journals (Sweden)

    Wen-Sen Lee

    2017-10-01

    Conclusion: Application of Bio-Kil reduced the environmental bacterial burden and MDROs in ICUs. Further studies are needed to evaluate the efficacy of this nanotechnology-based disinfectant in reducing HAIs.

  19. The Importance of Vigorous-Intensity Leisure-Time Physical Activity in Reducing Cardiovascular Disease Mortality Risk in the Obese.

    Science.gov (United States)

    O'Donovan, Gary; Stamatakis, Emmanuel; Stensel, David J; Hamer, Mark

    2018-03-02

    To investigate the role of vigorous-intensity leisure-time physical activity in reducing cardiovascular disease (CVD) mortality risk in the obese. Trained interviewers assessed physical activity and body mass index (BMI; calculated as the weight in kilograms divided by the height in meters squared) in 59,005 adult participants (mean ± SD age, 57±12 years; 46.5% male) in 2 household-based surveillance studies: Health Survey for England and Scottish Health Survey. Mortality was ascertained from death certificates. Data were collected from January 1, 1994, through March 31, 2011. Cox proportional hazards models were adjusted for age, sex, smoking habit, total physical activity, long-standing illness, prevalent CVD, and occupation. There were 2302 CVD deaths during 532,251 person-years of follow-up (mean ± SD, 9±4 years). A total of 15,002 (25%) participants were categorized as obese (BMI ≥30). Leisure-time physical activity was inversely associated and BMI was positively associated with CVD mortality. Compared with those who reported meeting physical activity guidelines including some vigorous-intensity physical activity and who had a normal BMI (18.5-24.9) (reference group), the CVD mortality hazard ratio was not significantly different in the obese who also reported meeting physical activity guidelines including some vigorous-intensity physical activities (1.25; 95% CI, 0.50-3.12). Compared with the reference group, the CVD mortality hazard ratio was more than 2-fold in the obese who reported meeting physical activity guidelines, including only moderate-intensity physical activities (2.52; 95% CI, 1.15-2.53). This large, statistically powerful study suggests that vigorous-intensity leisure-time physical activity is important in reducing CVD mortality risk in the obese. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  20. Antioxidant capacity reduced in scallions grown under elevated CO 2 independent of assayed light intensity

    Science.gov (United States)

    Levine, Lanfang H.; Paré, Paul W.

    2009-10-01

    Long-duration manned space missions mandate the development of a sustainable life support system and effective countermeasures against damaging space radiation. To mitigate the risk of inevitable exposure to space radiation, cultivation of fresh fruits and vegetables rich in antioxidants is an attractive alternative to pharmacological agents. However it has yet to be established whether antioxidant properties of crops can be preserved or enhanced in a space environment where environmental conditions differ from that which plants have acclimated to on earth. Scallion ( Allium fistulosum) rich in antioxidant vitamins C and A, and flavonoids was used as a model plant to study the impact of a range of CO 2 concentrations and light intensities that are likely encountered in a space habitat on food quality traits. Scallions were hydroponically grown in controlled environmental chambers under a combination of 3 CO 2 concentrations of 400, 1200 and 4000 μmol mol -1 and 3 light intensity levels of 150, 300, 450 μmol m -2 s -1. Total antioxidant activity (TAA) of scallion extracts was determined using a radical cation scavenging assay. Both elevated CO 2 and increasing light intensity enhanced biomass accumulation, but effects on TAA (based on dry weight) differed. TAA was reduced for plants grown under elevated CO 2, but remained unchanged with increases in light intensity. Elevated CO 2 stimulated greater biomass production than antioxidants, while an increase in photosynthetic photo flux promoted the synthesis of antioxidant compounds at a rate similar to that of biomass. Consequently light is a more effective stimulus than CO 2 for antioxidant production.

  1. Development and Testing of a Decision Making Based Method to Adjust Automatically the Harrowing Intensity

    Directory of Open Access Journals (Sweden)

    Roland Gerhards

    2013-05-01

    Full Text Available Harrowing is often used to reduce weed competition, generally using a constant intensity across a whole field. The efficacy of weed harrowing in wheat and barley can be optimized, if site-specific conditions of soil, weed infestation and crop growth stage are taken into account. This study aimed to develop and test an algorithm to automatically adjust the harrowing intensity by varying the tine angle and number of passes. The field variability of crop leaf cover, weed density and soil density was acquired with geo-referenced sensors to investigate the harrowing selectivity and crop recovery. Crop leaf cover and weed density were assessed using bispectral cameras through differential images analysis. The draught force of the soil opposite to the direction of travel was measured with electronic load cell sensor connected to a rigid tine mounted in front of the harrow. Optimal harrowing intensity levels were derived in previously implemented experiments, based on the weed control efficacy and yield gain. The assessments of crop leaf cover, weed density and soil density were combined via rules with the aforementioned optimal intensities, in a linguistic fuzzy inference system (LFIS. The system was evaluated in two field experiments that compared constant intensities with variable intensities inferred by the system. A higher weed density reduction could be achieved when the harrowing intensity was not kept constant along the cultivated plot. Varying the intensity tended to reduce the crop leaf cover, though slightly improving crop yield. A real-time intensity adjustment with this system is achievable, if the cameras are attached in the front and at the rear or sides of the harrow.

  2. Development and Testing of a Decision Making Based Method to Adjust Automatically the Harrowing Intensity

    Science.gov (United States)

    Rueda-Ayala, Victor; Weis, Martin; Keller, Martina; Andújar, Dionisio; Gerhards, Roland

    2013-01-01

    Harrowing is often used to reduce weed competition, generally using a constant intensity across a whole field. The efficacy of weed harrowing in wheat and barley can be optimized, if site-specific conditions of soil, weed infestation and crop growth stage are taken into account. This study aimed to develop and test an algorithm to automatically adjust the harrowing intensity by varying the tine angle and number of passes. The field variability of crop leaf cover, weed density and soil density was acquired with geo-referenced sensors to investigate the harrowing selectivity and crop recovery. Crop leaf cover and weed density were assessed using bispectral cameras through differential images analysis. The draught force of the soil opposite to the direction of travel was measured with electronic load cell sensor connected to a rigid tine mounted in front of the harrow. Optimal harrowing intensity levels were derived in previously implemented experiments, based on the weed control efficacy and yield gain. The assessments of crop leaf cover, weed density and soil density were combined via rules with the aforementioned optimal intensities, in a linguistic fuzzy inference system (LFIS). The system was evaluated in two field experiments that compared constant intensities with variable intensities inferred by the system. A higher weed density reduction could be achieved when the harrowing intensity was not kept constant along the cultivated plot. Varying the intensity tended to reduce the crop leaf cover, though slightly improving crop yield. A real-time intensity adjustment with this system is achievable, if the cameras are attached in the front and at the rear or sides of the harrow. PMID:23669712

  3. MapReduce Based Parallel Neural Networks in Enabling Large Scale Machine Learning.

    Science.gov (United States)

    Liu, Yang; Yang, Jie; Huang, Yuan; Xu, Lixiong; Li, Siguang; Qi, Man

    2015-01-01

    Artificial neural networks (ANNs) have been widely used in pattern recognition and classification applications. However, ANNs are notably slow in computation especially when the size of data is large. Nowadays, big data has received a momentum from both industry and academia. To fulfill the potentials of ANNs for big data applications, the computation process must be speeded up. For this purpose, this paper parallelizes neural networks based on MapReduce, which has become a major computing model to facilitate data intensive applications. Three data intensive scenarios are considered in the parallelization process in terms of the volume of classification data, the size of the training data, and the number of neurons in the neural network. The performance of the parallelized neural networks is evaluated in an experimental MapReduce computer cluster from the aspects of accuracy in classification and efficiency in computation.

  4. Reducing false asystole alarms in intensive care.

    Science.gov (United States)

    Dekimpe, Remi; Heldt, Thomas

    2017-07-01

    High rates of false monitoring alarms in intensive care can desensitize staff and therefore pose a significant risk to patient safety. Like other critical arrhythmia alarms, asystole alarms require immediate attention by the care providers as a true asystole event can be acutely life threatening. Here, it is illustrated that most false asystole alarms can be attributed to poor signal quality, and we propose and evaluate an algorithm to identify data windows of poor signal quality and thereby help suppress false asystole alarms. The algorithm combines intuitive signal-quality features (degree of signal saturation and baseline wander) and information from other physiological signals that might be available. Algorithm training and testing was performed on the MIMIC II and 2015 PhysioNet/Computing in Cardiology Challenge databases, respectively. The algorithm achieved an alarm specificity of 81.0% and sensitivity of 95.4%, missing only one out of 22 true asystole alarms. On a separate neonatal data set, the algorithm was able to reject 89.7% (890 out of 992) of false asystole alarms while keeping all 22 true events. The results show that the false asystole alarm rate can be significantly reduced through basic signal quality evaluation.

  5. High intensity and reduced volume training attenuates stress and recovery levels in elite swimmers

    DEFF Research Database (Denmark)

    Elbe, Anne-Marie; Rasmussen, Camilla P; Nielsen, Glen

    2016-01-01

    This study investigated the effect of increased high-intensity interval training (HIT) at the expense of total training volume on the stress and recovery levels of elite swimmers. Forty-one elite swimmers participated in the study and were randomly assigned to either a HIT or a control group (CON....... The Recovery Stress Questionnaire - Sport was used to measure the swimmers' stress and recovery levels. After the 12 week intervention, the general stress level was 16.6% (2.6-30.7%; mean and 95% CI) lower and the general recovery level was 6.5% (0.7-12.4%) higher in HIT compared to the CON, after adjusting...... for baseline values. No significant effects could be observed in sports-specific stress or sports-specific recovery. The results indicate that increasing training intensity and reducing training volume for 12 weeks can reduce general stress and increase general recovery levels in competitive swimmers....

  6. Fuel treatment effectiveness in reducing fire intensity and spread rate - An experimental overview

    Science.gov (United States)

    Eric Mueller; Nicholas Skowronski; Albert Simeoni; Kenneth Clark; Robert Kremens; William Mell; Michael Gallagher; Jan Thomas; Alexander Filkov; Mohamad El Houssami; John Hom; Bret Butler

    2014-01-01

    Fuel treatments represent a significant component of the wildfire mitigation strategy in the United States. However, the lack of research aimed at quantifying the explicit effectiveness of fuel treatments in reducing wildfire intensity and spread rate limits our ability to make educated decisions about the type and placement of these treatments. As part of a larger...

  7. MapReduce Based Parallel Neural Networks in Enabling Large Scale Machine Learning

    Directory of Open Access Journals (Sweden)

    Yang Liu

    2015-01-01

    Full Text Available Artificial neural networks (ANNs have been widely used in pattern recognition and classification applications. However, ANNs are notably slow in computation especially when the size of data is large. Nowadays, big data has received a momentum from both industry and academia. To fulfill the potentials of ANNs for big data applications, the computation process must be speeded up. For this purpose, this paper parallelizes neural networks based on MapReduce, which has become a major computing model to facilitate data intensive applications. Three data intensive scenarios are considered in the parallelization process in terms of the volume of classification data, the size of the training data, and the number of neurons in the neural network. The performance of the parallelized neural networks is evaluated in an experimental MapReduce computer cluster from the aspects of accuracy in classification and efficiency in computation.

  8. Nonmyeloablative and reduced-intensity conditioning for allogeneic hematopoietic stem cell transplantation: a clinical review.

    Science.gov (United States)

    Pollack, Seth M; O'Connor, Thomas P; Hashash, Jana; Tabbara, Imad A

    2009-12-01

    Allogeneic hematopoietic stem cell transplantation provides many patients, with hematological and malignant diseases, hope of remission and in some cases cure. Because the toxicities of this approach are severe, its use has been limited to younger healthier patients. Nonmyeloablative and reduced intensity conditioning regimens depend more on donor cellular immune effects and less on the cytotoxic effects of the conditioning regimen to eradicate the underlying disease. This approach is based on the induction of host tolerance to donor cells followed by the administration of scheduled donor T-lymphocytes infusions. Accumulated clinical data have been encouraging, and prospective studies are underway to compare this approach to conventional myeloablative allogeneic stem cell transplantation with regard to outcome, durability of responses, effects on the immune system, and the consequences of late complications such as chronic graft-versus-host disease.

  9. Lean Six Sigma to Reduce Intensive Care Unit Length of Stay and Costs in Prolonged Mechanical Ventilation.

    Science.gov (United States)

    Trzeciak, Stephen; Mercincavage, Michael; Angelini, Cory; Cogliano, William; Damuth, Emily; Roberts, Brian W; Zanotti, Sergio; Mazzarelli, Anthony J

    Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. Before-and-after cohort study. Multidisciplinary intensive care unit (ICU) in an academic medical center. Adult patients admitted to the ICU and treated with PMV, as defined by diagnosis-related group (DRG). We implemented a clinical redesign intervention based on LSS principles. We identified eight distinct processes in preparing patients with PMV for post-acute care. Our clinical redesign included reengineering daily patient care rounds ("Lean ICU rounds") to reduce variation and waste in these processes. We compared hospital LOS and direct cost per case in patients with PMV before (2013) and after (2014) our LSS intervention. Among 259 patients with PMV (131 preintervention; 128 postintervention), median hospital LOS decreased by 24% during the intervention period (29 vs. 22 days, p < .001). Accordingly, median hospital direct cost per case decreased by 27% ($66,335 vs. $48,370, p < .001). We found that a LSS-based clinical redesign reduced hospital LOS and the costs of care for patients with PMV.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  11. Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

    International Nuclear Information System (INIS)

    Broderick, Maria; Leech, Michelle; Coffey, Mary

    2009-01-01

    Intensity Modulated Radiation Therapy (IMRT) is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC) shapes in the sequencing step. One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU) required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality. The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one. Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct Aperture optimization

  12. Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

    Directory of Open Access Journals (Sweden)

    Coffey Mary

    2009-02-01

    Full Text Available Abstract Intensity Modulated Radiation Therapy (IMRT is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC shapes in the sequencing step. One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality. The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one. Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct

  13. Direct aperture optimization as a means of reducing the complexity of intensity modulated radiation therapy plans

    Energy Technology Data Exchange (ETDEWEB)

    Broderick, Maria; Leech, Michelle; Coffey, Mary [Division of Radiation Therapy, School of Medicine, Trinity College Dublin, Dublin, Ireland (United Kingdom)

    2009-02-16

    Intensity Modulated Radiation Therapy (IMRT) is a means of delivering radiation therapy where the intensity of the beam is varied within the treatment field. This is done by dividing a large beam into many small beamlets. Dose constraints are assigned to both the target and sensitive structures and computerised inverse optimization is performed to find the individual weights of this large number of beamlets. The computer adjusts the intensities of these beamlets according to the required planning dose objectives. The optimized intensity patterns are then decomposed into a series of deliverable multi leaf collimator (MLC) shapes in the sequencing step. One of the main problems of IMRT, which becomes even more apparent as the complexity of the IMRT plan increases, is the dramatic increase in the number of Monitor Units (MU) required to deliver a fractionated treatment. The difficulty with this increase in MU is its association with increased treatment times and a greater leakage of radiation from the MLCs increasing the total body dose and the risk of secondary cancers in patients. Therefore one attempts to find ways of reducing these MU without compromising plan quality. The design of inverse planning systems where the beam is divided into small beamlets to produce the required intensity map automatically introduces complexity into IMRT treatment planning. Plan complexity is associated with many negative factors such as dosimetric uncertainty and delivery issues A large search space is required necessitating much computing power. However, the limitations of the delivery technology are not taken into consideration when designing the ideal intensity map therefore a further step termed the sequencing step is required to convert the ideal intensity map into a deliverable one. Many approaches have been taken to reduce the complexity. These include setting intensity limits, putting penalties on the cost function and using smoothing filters Direct Aperture optimization

  14. OHBM 2017: Practical intensity based meta-analysis

    OpenAIRE

    Maumet, Camille

    2017-01-01

    "Practical intensity-based meta-analysis" slides from my talk in the OHBM 2017 educational talk on Neuroimaging meta-analysis.http://www.humanbrainmapping.org/files/2017/ED Courses/Neuroimaging Meta-Analysis.pdf

  15. Disease Control After Reduced Volume Conformal and Intensity Modulated Radiation Therapy for Childhood Craniopharyngioma

    Energy Technology Data Exchange (ETDEWEB)

    Merchant, Thomas E., E-mail: thomas.merchant@stjude.org [St Jude Children' s Research Hospital, Radiological Sciences, Memphis, Tennessee (United States); Kun, Larry E.; Hua, Chia-Ho [St Jude Children' s Research Hospital, Radiological Sciences, Memphis, Tennessee (United States); Wu, Shengjie; Xiong, Xiaoping [St Jude Children' s Research Hospital, Biostatistics, Memphis, Tennessee (United States); Sanford, Robert A.; Boop, Frederick A. [Semmes Murphey Neurologic and Spine Institute, Neurosurgery, Memphis, Tennessee (United States)

    2013-03-15

    Purpose: To estimate the rate of disease control after conformal radiation therapy using reduced clinical target volume (CTV) margins and to determine factors that predict for tumor progression. Methods and Materials: Eighty-eight children (median age, 8.5 years; range, 3.2-17.6 years) received conformal or intensity modulated radiation therapy between 1998 and 2009. The study group included those prospectively treated from 1998 to 2003, using a 10-mm CTV, defined as the margin surrounding the solid and cystic tumor targeted to receive the prescription dose of 54 Gy. The CTV margin was subsequently reduced after 2003, yielding 2 groups of patients: those treated with a CTV margin greater than 5 mm (n=26) and those treated with a CTV margin less than or equal to 5 mm (n=62). Disease progression was estimated on the basis of additional variables including sex, race, extent of resection, tumor interventions, target volume margins, and frequency of weekly surveillance magnetic resonance (MR) imaging during radiation therapy. Median follow-up was 5 years. Results: There was no difference between progression-free survival rates based on CTV margins (>5 mm vs ≤5 mm) at 5 years (88.1% ± 6.3% vs 96.2% ± 4.4% [P=.6386]). There were no differences based on planning target volume (PTV) margins (or combined CTV plus PTV margins). The PTV was systematically reduced from 5 to 3 mm during the time period of the study. Factors predictive of superior progression-free survival included Caucasian race (P=.0175), no requirement for cerebrospinal fluid shunting (P=.0066), and number of surveillance imaging studies during treatment (P=.0216). Patients whose treatment protocol included a higher number of weekly surveillance MR imaging evaluations had a lower rate of tumor progression. Conclusions: These results suggest that targeted volume reductions for radiation therapy using smaller margins are feasible and safe but require careful monitoring. We are currently investigating

  16. Intensity-based bayesian framework for image reconstruction from sparse projection data

    International Nuclear Information System (INIS)

    Rashed, E.A.; Kudo, Hiroyuki

    2009-01-01

    This paper presents a Bayesian framework for iterative image reconstruction from projection data measured over a limited number of views. The classical Nyquist sampling rule yields the minimum number of projection views required for accurate reconstruction. However, challenges exist in many medical and industrial imaging applications in which the projection data is undersampled. Classical analytical reconstruction methods such as filtered backprojection (FBP) are not a good choice for use in such cases because the data undersampling in the angular range introduces aliasing and streak artifacts that degrade lesion detectability. In this paper, we propose a Bayesian framework for maximum likelihood-expectation maximization (ML-EM)-based iterative reconstruction methods that incorporates a priori knowledge obtained from expected intensity information. The proposed framework is based on the fact that, in tomographic imaging, it is often possible to expect a set of intensity values of the reconstructed object with relatively high accuracy. The image reconstruction cost function is modified to include the l 1 norm distance to the a priori known information. The proposed method has the potential to regularize the solution to reduce artifacts without missing lesions that cannot be expected from the a priori information. Numerical studies showed a significant improvement in image quality and lesion detectability under the condition of highly undersampled projection data. (author)

  17. Two-year outcome of team-based intensive case management for patients with schizophrenia.

    Science.gov (United States)

    Aberg-Wistedt, A; Cressell, T; Lidberg, Y; Liljenberg, B; Osby, U

    1995-12-01

    Two-year outcomes of patients with schizophrenic disorders who were assigned to an intensive, team-based case management program and patients who received standard psychiatric services were assessed. The case management model featured increased staff contact time with patients, rehabilitation plans based on patients' expressed needs, and patients' attendance at team meetings where their rehabilitation plan was discussed. Forty patients were randomly assigned to either the case management group or the control group that received standard services. Patients' use of emergency and inpatient services, their quality of life, the size of their social networks, and their relatives' burden of care were assessed at assignment to the study groups and at two-year follow-up. Patients in the case management group had significantly fewer emergency visits compared with the two years before the study, and their relatives reported significantly reduced burden of care associated with relationships with psychiatric services over the two-year period. The size of patients' social networks increased for the case management group and decreased for the control group. A team-based intensive case management model is an effective intervention in the rehabilitation of patients with chronic schizophrenia.

  18. Intensity-Stabilized Fast-Scanned Direct Absorption Spectroscopy Instrumentation Based on a Distributed Feedback Laser with Detection Sensitivity down to 4 × 10−6

    Directory of Open Access Journals (Sweden)

    Gang Zhao

    2016-09-01

    Full Text Available A novel, intensity-stabilized, fast-scanned, direct absorption spectroscopy (IS-FS-DAS instrumentation, based on a distributed feedback (DFB diode laser, is developed. A fiber-coupled polarization rotator and a fiber-coupled polarizer are used to stabilize the intensity of the laser, which significantly reduces its relative intensity noise (RIN. The influence of white noise is reduced by fast scanning over the spectral feature (at 1 kHz, followed by averaging. By combining these two noise-reducing techniques, it is demonstrated that direct absorption spectroscopy (DAS can be swiftly performed down to a limit of detection (LOD (1σ of 4 × 10−6, which opens up a number of new applications.

  19. Impact of cyclophosphamide dose of conditioning on the outcome of allogeneic hematopoietic stem cell transplantation for aplastic anemia from human leukocyte antigen-identical sibling.

    Science.gov (United States)

    Mori, Takehiko; Koh, Hideo; Onishi, Yasushi; Kako, Shinichi; Onizuka, Makoto; Kanamori, Heiwa; Ozawa, Yukiyasu; Kato, Chiaki; Iida, Hiroatsu; Suzuki, Ritsuro; Ichinohe, Tatsuo; Kanda, Yoshinobu; Maeda, Tetsuo; Nakao, Shinji; Yamazaki, Hirohito

    2016-04-01

    The standard conditioning regimen in allogeneic hematopoietic stem cell transplantation (HSCT) for aplastic anemia from a human leukocyte antigen (HLA)-identical sibling has been high-dose cyclophosphamide (CY 200 mg/kg). In the present study, results for 203 patients with aplastic anemia aged 16 years or older who underwent allogeneic HSCT from HLA-identical siblings were retrospectively analyzed using the registry database of Japan Society for Hematopoietic Cell Transplantation. Conditioning regimens were defined as a (1) high-dose CY (200 mg/kg or greater)-based (n = 117); (2) reduced-dose CY (100 mg/kg or greater, but less than 200 mg/kg)-based (n = 38); and (3) low-dose CY (less than 100 mg/kg)-based (n = 48) regimen. Patient age and the proportion of patients receiving fludarabine were significantly higher in the reduced- and low-dose CY groups than the high-dose CY group. Engraftment was comparable among the groups. Five-year overall survival (OS) tended to be higher in the low-dose CY group [93.0 % (95 % CI 85.1-100.0 %)] than the high-dose CY [84.2 % (95 % CI 77.1-91.3 %)] or reduced-dose CY groups [83.8 % (95 % CI 71.8-95.8 %); P = 0.214]. Age-adjusted OS was higher in the low-dose CY group than the high- and reduced-dose CY groups with borderline significance (P = 0.067). These results suggest that CY dose can safely be reduced without increasing graft rejection by adding fludarabine in allogeneic HSCT for aplastic anemia from an HLA-identical sibling.

  20. Influence of Signal Intensity Non-Uniformity on Brain Volumetry Using an Atlas-Based Method

    International Nuclear Information System (INIS)

    Takao, Hidemasa; Kunimatsu, Akira; Mori, Harushi

    2012-01-01

    Many studies have reported pre-processing effects for brain volumetry; however, no study has investigated whether non-parametric non-uniform intensity normalization (N3) correction processing results in reduced system dependency when using an atlas-based method. To address this shortcoming, the present study assessed whether N3 correction processing provides reduced system dependency in atlas-based volumetry. Contiguous sagittal T1-weighted images of the brain were obtained from 21 healthy participants, by using five magnetic resonance protocols. After image preprocessing using the Statistical Parametric Mapping 5 software, we measured the structural volume of the segmented images with the WFU-PickAtlas software. We applied six different bias-correction levels (Regularization 10, Regularization 0.0001, Regularization 0, Regularization 10 with N3, Regularization 0.0001 with N3, and Regularization 0 with N3) to each set of images. The structural volume change ratio (%) was defined as the change ratio (%) = (100 X[measured volume - mean volume of five magnetic resonance protocols] / mean volume of five magnetic resonance protocols) for each bias-correction level. A low change ratio was synonymous with lower system dependency. The results showed that the images with the N3 correction had a lower change ratio compared with those without the N3 correction. The present study is the first atlas-based volumetry study to show that the precision of atlas-based volumetry improves when using N3-corrected images. Therefore, correction for signal intensity non-uniformity is strongly advised for multi-scanner or multi-site imaging trials.

  1. Influence of signal intensity non-uniformity on brain volumetry using an atlas-based method.

    Science.gov (United States)

    Goto, Masami; Abe, Osamu; Miyati, Tosiaki; Kabasawa, Hiroyuki; Takao, Hidemasa; Hayashi, Naoto; Kurosu, Tomomi; Iwatsubo, Takeshi; Yamashita, Fumio; Matsuda, Hiroshi; Mori, Harushi; Kunimatsu, Akira; Aoki, Shigeki; Ino, Kenji; Yano, Keiichi; Ohtomo, Kuni

    2012-01-01

    Many studies have reported pre-processing effects for brain volumetry; however, no study has investigated whether non-parametric non-uniform intensity normalization (N3) correction processing results in reduced system dependency when using an atlas-based method. To address this shortcoming, the present study assessed whether N3 correction processing provides reduced system dependency in atlas-based volumetry. Contiguous sagittal T1-weighted images of the brain were obtained from 21 healthy participants, by using five magnetic resonance protocols. After image preprocessing using the Statistical Parametric Mapping 5 software, we measured the structural volume of the segmented images with the WFU-PickAtlas software. We applied six different bias-correction levels (Regularization 10, Regularization 0.0001, Regularization 0, Regularization 10 with N3, Regularization 0.0001 with N3, and Regularization 0 with N3) to each set of images. The structural volume change ratio (%) was defined as the change ratio (%) = (100 × [measured volume - mean volume of five magnetic resonance protocols] / mean volume of five magnetic resonance protocols) for each bias-correction level. A low change ratio was synonymous with lower system dependency. The results showed that the images with the N3 correction had a lower change ratio compared with those without the N3 correction. The present study is the first atlas-based volumetry study to show that the precision of atlas-based volumetry improves when using N3-corrected images. Therefore, correction for signal intensity non-uniformity is strongly advised for multi-scanner or multi-site imaging trials.

  2. Influence of Signal Intensity Non-Uniformity on Brain Volumetry Using an Atlas-Based Method

    Energy Technology Data Exchange (ETDEWEB)

    Takao, Hidemasa; Kunimatsu, Akira; Mori, Harushi [University of Tokyo Hospital, Tokyo (Japan); and others

    2012-07-15

    Many studies have reported pre-processing effects for brain volumetry; however, no study has investigated whether non-parametric non-uniform intensity normalization (N3) correction processing results in reduced system dependency when using an atlas-based method. To address this shortcoming, the present study assessed whether N3 correction processing provides reduced system dependency in atlas-based volumetry. Contiguous sagittal T1-weighted images of the brain were obtained from 21 healthy participants, by using five magnetic resonance protocols. After image preprocessing using the Statistical Parametric Mapping 5 software, we measured the structural volume of the segmented images with the WFU-PickAtlas software. We applied six different bias-correction levels (Regularization 10, Regularization 0.0001, Regularization 0, Regularization 10 with N3, Regularization 0.0001 with N3, and Regularization 0 with N3) to each set of images. The structural volume change ratio (%) was defined as the change ratio (%) = (100 X[measured volume - mean volume of five magnetic resonance protocols] / mean volume of five magnetic resonance protocols) for each bias-correction level. A low change ratio was synonymous with lower system dependency. The results showed that the images with the N3 correction had a lower change ratio compared with those without the N3 correction. The present study is the first atlas-based volumetry study to show that the precision of atlas-based volumetry improves when using N3-corrected images. Therefore, correction for signal intensity non-uniformity is strongly advised for multi-scanner or multi-site imaging trials.

  3. Intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care: a descriptive qualitative study.

    Science.gov (United States)

    Ballangrud, Randi; Hall-Lord, Marie Louise; Persenius, Mona; Hedelin, Birgitta

    2014-08-01

    To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. The study uses a qualitative descriptive design. Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  4. Isochoric heating of reduced mass targets by ultra-intense laser produced relativistic electrons

    Energy Technology Data Exchange (ETDEWEB)

    Neumayer, P; Lee, H J; Offerman, D; Shipton, E; Kemp, A; Kritcher, A L; Doppner, T; Back, C A; Glenzer, S H

    2009-02-04

    We present measurements of the chlorine K-alpha emission from reduced mass targets, irradiated with ultra-high intensity laser pulses. Chlorinated plastic targets with diameters down to 50 micrometers and mass of a few 10{sup -8} g were irradiated with up to 7 J of laser energy focused to intensities of several 10{sup 19} W/cm{sup 2}. The conversion of laser energy to K-alpha radiation is measured, as well as high resolution spectra that allow observation of line shifts, indicating isochoric heating of the target up to 18 eV. A zero-dimensional 2-temperature equilibration model, combined with electron impact K-shell ionization and post processed spectra from collisional radiative calculations reproduces the observed K-alpha yields and line shifts, and shows the importance of target expansion due to the hot electron pressure.

  5. Intense charge transfer surface based on graphene and thymine-Hg(II)-thymine base pairs for detection of Hg(2.).

    Science.gov (United States)

    Li, Jiao; Lu, Liping; Kang, Tianfang; Cheng, Shuiyuan

    2016-03-15

    In this article, we developed an electrochemiluminescence (ECL) sensor with a high-intensity charge transfer interface for Hg(2+) detection based on Hg(II)-induced DNA hybridization. The sensor was fabricated by the following simple method. First, graphene oxide (GO) was electrochemically reduced onto a glassy carbon electrode through cyclic voltammetry. Then, amino-labeled double-stranded (ds)DNA was assembled on the electrode surface using 1-pyrenebutyric acid N-hydroxysuccinimide as a linker between GO and DNA. The other terminal of dsDNA, which was labeled with biotin, was linked to CdSe quantum dots via biotin-avidin interactions. Reduced graphene oxide has excellent electrical conductivity. dsDNA with T-Hg(II)-T base pairs exhibited more facile charge transfer. They both accelerate the electron transfer performance and sensitivity of the sensor. The increased ECL signals were logarithmically linear with the concentration of Hg(II) when Hg(2+) was present in the detection solution. The linear range of the sensor was 10(-11) to 10(-8)mol/L (R=0.9819) with a detection limit of 10(-11)mol/L. This biosensor exhibited satisfactory results when it was used to detect Hg(II) in real water samples. The biosensor with high-intense charge transfer performance is a prospect avenue to pursue more and more sensitive detection method. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. A comparison of the health benefits of reduced-exertion high-intensity interval training (REHIT) and moderate-intensity walking in type 2 diabetes patients.

    Science.gov (United States)

    Ruffino, José S; Songsorn, Preeyaphorn; Haggett, Malindi; Edmonds, Daniel; Robinson, Anthony M; Thompson, Dylan; Vollaard, Niels B J

    2017-02-01

    Reduced-exertion high-intensity interval training (REHIT) is a genuinely time-efficient intervention that can improve aerobic capacity and insulin sensitivity in sedentary individuals. The present study compared the effects of REHIT and moderate-intensity walking on health markers in patients with type 2 diabetes (T2D) in a counter-balanced crossover study. Sixteen men with T2D (mean ± SD age: 55 ± 5 years, body mass index: 30.6 ± 2.8 kg·m -2 , maximal aerobic capacity: 27 ± 4 mL·kg -1 ·min -1 ) completed 8 weeks of REHIT (three 10-min low-intensity cycling sessions/week with two "all-out" 10-20-s sprints) and 8 weeks of moderate-intensity walking (five 30-min sessions/week at an intensity corresponding to 40%-55% of heart-rate reserve), with a 2-month wash-out period between interventions. Before and after each intervention, participants underwent an incremental fitness test, an oral glucose tolerance test (OGTT), a whole-body dual-energy X-ray absorptiometry scan, and continuous glucose monitoring. REHIT was associated with a significantly larger increase in maximal aerobic capacity compared with walking (7% vs. 1%; time × intervention interaction effect: p body composition. We conclude that REHIT is superior to a 5-fold larger volume of moderate-intensity walking in improving aerobic fitness, but similar to walking REHIT is not an effective intervention for improving insulin sensitivity or glycaemic control in T2D patients in the short term.

  7. Measures of Competitive Intensity – Analysis Based on Literature Review

    Directory of Open Access Journals (Sweden)

    Dariusz Kwieciński

    2017-03-01

    Full Text Available Purpose: To systematize the existing approaches and tools used for measuring competitive intensity. Methodology: Systematic literature review along with critical literature review. Findings: Identifcation of two main approaches to measuring competition intensity: the frst pertains to research based on experts’ opinions and involves the use of questionnaires (primary sources, while the second is based on structural variables used with a variety of indexes (secondary sources. In addition, variables applied for the purpose of measuring the intensity of competition are divided into structural and behavioural. Research implications: Research implications are two-fold. Firstly, a distinction is made between various types of existing approaches to measuring competitive intensity. Secondly, research is carried out, inter alia, with regard to the actual object of certain measures, as opposed to their object stemming from commonly accepted defnitions. Practical implications: The issue of measuring competition intensity occupies a prominent place in the discussion on the effectiveness of inter-organizational relationships. The fndings outlined in this paper may help managers to develop/adopt the right approach supporting their strategic decisions. Originality: The paper provides a complex review of the existing methods and measures of competitive intensity. It systematizes recent knowledge about competitive intensity measurements.

  8. A retrospective study of long-term treatment outcomes for reduced vocal intensity in hypokinetic dysarthria

    Directory of Open Access Journals (Sweden)

    Christopher R. Watts

    2016-02-01

    Full Text Available Abstract Background Reduced vocal intensity is a core impairment of hypokinetic dysarthria in Parkinson’s disease (PD. Speech treatments have been developed to rehabilitate the vocal subsystems underlying this impairment. Intensive treatment programs requiring high-intensity voice and speech exercises with clinician-guided prompting and feedback have been established as effective for improving vocal function. Less is known, however, regarding long-term outcomes of clinical benefit in speakers with PD who receive these treatments. Methods A retrospective cohort design was utilized. Data from 78 patient files across a three year period were analyzed. All patients received a structured, intensive program of voice therapy focusing on speaking intent and loudness. The dependent variable for all analyses was vocal intensity in decibels (dBSPL. Vocal intensity during sustained vowel production, reading, and novel conversational speech was compared at pre-treatment, post-treatment, six month follow-up, and twelve month follow-up periods. Results Statistically significant increases in vocal intensity were found at post-treatment, 6 months, and 12 month follow-up periods with intensity gains ranging from 5 to 17 dB depending on speaking condition and measurement period. Significant treatment effects were found in all three speaking conditions. Effect sizes for all outcome measures were large, suggesting a strong degree of practical significance. Conclusions Significant increases in vocal intensity measured at 6 and 12 moth follow-up periods suggested that the sample of patients maintained treatment benefit for up to a year. These findings are supported by outcome studies reporting treatment outcomes within a few months post-treatment, in addition to prior studies that have reported long-term outcome results. The positive treatment outcomes experienced by the PD cohort in this study are consistent with treatment responses subsequent to other treatment

  9. Acid-base regulation in intensively farmed air-breathing fish

    DEFF Research Database (Denmark)

    Bayley, Mark; Damsgaard, Christian; Thomsen, Mikkel

    Hypercapnia in slow moving organically loaded tropical waters is a natural occurrence with several records of pCO2 at 60 mm Hg. Despite this, studies on South American air-breathing fish have revealed a low capacity for extracellular pH (pHe) regulation. The two underlying reasons proposed are; 1......) an osmorespiratory compromise with reduced branchial surface area and reduced branchial ventilation 2) low ion concentrations in the very soft amazon waters limiting the capacity for branchial pH regulation. The Mekong delta region houses extremely intensive aquaculture of a large number of air-breathing species...

  10. A tesselation-based model for intensity estimation and laser plasma interactions calculations in three dimensions

    Science.gov (United States)

    Colaïtis, A.; Chapman, T.; Strozzi, D.; Divol, L.; Michel, P.

    2018-03-01

    A three-dimensional laser propagation model for computation of laser-plasma interactions is presented. It is focused on indirect drive geometries in inertial confinement fusion and formulated for use at large temporal and spatial scales. A modified tesselation-based estimator and a relaxation scheme are used to estimate the intensity distribution in plasma from geometrical optics rays. Comparisons with reference solutions show that this approach is well-suited to reproduce realistic 3D intensity field distributions of beams smoothed by phase plates. It is shown that the method requires a reduced number of rays compared to traditional rigid-scale intensity estimation. Using this field estimator, we have implemented laser refraction, inverse-bremsstrahlung absorption, and steady-state crossed-beam energy transfer with a linear kinetic model in the numerical code Vampire. Probe beam amplification and laser spot shapes are compared with experimental results and pf3d paraxial simulations. These results are promising for the efficient and accurate computation of laser intensity distributions in holhraums, which is of importance for determining the capsule implosion shape and risks of laser-plasma instabilities such as hot electron generation and backscatter in multi-beam configurations.

  11. Reduced intensity versus full myeloablative stem cell transplant for advanced CLL.

    Science.gov (United States)

    Peres, E; Braun, T; Krijanovski, O; Khaled, Y; Levine, J E; Yanik, G; Kato, K; Mineishi, S

    2009-11-01

    CLL remains incurable with the standard therapy. Allogeneic hematopoietic stem cell transplant may be curative. We examined 50 patients with advanced CLL who underwent allogeneic HCT at the University of Michigan between 1996 and 2006. Twenty-one patients received reduced-intensity conditioning (RIC) and twenty-nine patients received full-intensity conditioning (FIC) consisting of CY, etoposide and BCNU (n=20) or BU and CY (n=9). RIC recipients were older than FIC recipients (median age 54 vs 51, P=0.009). There were no statistically significant differences between groups in terms of the number of earlier therapies or patients with adverse cytogenetics. There were more unrelated donors in the RIC group 62% than in the FIC group 31% (P=0.030). Despite their older age and greater use of URD, the 5-year overall survival (OS) rate was 63% in the RIC group as compared with 18% in the FIC group (P=0.006). The primary cause of inferior survival in the FIC recipients was TRM, which was twice as high at day 100 for the FIC group 27% compared with the RIC group 14% (P=0.005). The relapse rate was 15% regardless with the majority of relapses occurring after day 100. These results suggest a favorable outcome for advanced CLL who undergo a RIC regimen compared with FIC.

  12. Intensity-based readout of resonant-waveguide grating biosensors: Systems and nanostructures

    Science.gov (United States)

    Paulsen, Moritz; Jahns, Sabrina; Gerken, Martina

    2017-09-01

    Resonant waveguide gratings (RWG) - also called photonic crystal slabs (PCS) - have been established as reliable optical transducers for label-free biochemical assays as well as for cell-based assays. Current readout systems are based on mechanical scanning and spectrometric measurements with system sizes suitable for laboratory equipment. Here, we review recent progress in compact intensity-based readout systems for point-of-care (POC) applications. We briefly introduce PCSs as sensitive optical transducers and introduce different approaches for intensity-based readout systems. Photometric measurements have been realized with a simple combination of a light source and a photodetector. Recently a 96-channel, intensity-based readout system for both biochemical interaction analyses as well as cellular assays was presented employing the intensity change of a near cut-off mode. As an alternative for multiparametric detection, a camera system for imaging detection has been implemented. A portable, camera-based system of size 13 cm × 4.9 cm × 3.5 cm with six detection areas on an RWG surface area of 11 mm × 7 mm has been demonstrated for the parallel detection of six protein binding kinetics. The signal-to-noise ratio of this system corresponds to a limit of detection of 168 M (24 ng/ml). To further improve the signal-to-noise ratio advanced nanostructure designs are investigated for RWGs. Here, results on multiperiodic and deterministic aperiodic nanostructures are presented. These advanced nanostructures allow for the design of the number and wavelengths of the RWG resonances. In the context of intensity-based readout systems they are particularly interesting for the realization of multi-LED systems. These recent trends suggest that compact point-of-care systems employing disposable test chips with RWG functional areas may reach market in the near future.

  13. Randomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-Life Care.

    Science.gov (United States)

    Curtis, J Randall; Treece, Patsy D; Nielsen, Elizabeth L; Gold, Julia; Ciechanowski, Paul S; Shannon, Sarah E; Khandelwal, Nita; Young, Jessica P; Engelberg, Ruth A

    2016-01-15

    Communication with family of critically ill patients is often poor and associated with family distress. To determine if an intensive care unit (ICU) communication facilitator reduces family distress and intensity of end-of-life care. We conducted a randomized trial at two hospitals. Eligible patients had a predicted mortality greater than or equal to 30% and a surrogate decision maker. Facilitators supported communication between clinicians and families, adapted communication to family needs, and mediated conflict. Outcomes included depression, anxiety, and post-traumatic stress disorder (PTSD) among family 3 and 6 months after ICU and resource use. We identified 488 eligible patients and randomized 168. Of 352 eligible family members, 268 participated (76%). Family follow-up at 3 and 6 months ranged from 42 to 47%. The intervention was associated with decreased depressive symptoms at 6 months (P = 0.017), but there were no significant differences in psychological symptoms at 3 months or anxiety or PTSD at 6 months. The intervention was not associated with ICU mortality (25% control vs. 21% intervention; P = 0.615) but decreased ICU costs among all patients (per patient: $75,850 control, $51,060 intervention; P = 0.042) and particularly among decedents ($98,220 control, $22,690 intervention; P = 0.028). Among decedents, the intervention reduced ICU and hospital length of stay (28.5 vs. 7.7 d and 31.8 vs. 8.0 d, respectively; P Communication facilitators may be associated with decreased family depressive symptoms at 6 months, but we found no significant difference at 3 months or in anxiety or PTSD. The intervention reduced costs and length of stay, especially among decedents. This is the first study to find a reduction in intensity of end-of-life care with similar or improved family distress. Clinical trial registered with www.clinicaltrials.gov (NCT 00720200).

  14. Distributions of emissions intensity for individual beef cattle reared on pasture-based production systems.

    Science.gov (United States)

    McAuliffe, G A; Takahashi, T; Orr, R J; Harris, P; Lee, M R F

    2018-01-10

    Life Cycle Assessment (LCA) of livestock production systems is often based on inventory data for farms typical of a study region. As information on individual animals is often unavailable, livestock data may already be aggregated at the time of inventory analysis, both across individual animals and across seasons. Even though various computational tools exist to consider the effect of genetic and seasonal variabilities in livestock-originated emissions intensity, the degree to which these methods can address the bias suffered by representative animal approaches is not well-understood. Using detailed on-farm data collected on the North Wyke Farm Platform (NWFP) in Devon, UK, this paper proposes a novel approach of life cycle impact assessment that complements the existing LCA methodology. Field data, such as forage quality and animal performance, were measured at high spatial and temporal resolutions and directly transferred into LCA processes. This approach has enabled derivation of emissions intensity for each individual animal and, by extension, its intra-farm distribution, providing a step towards reducing uncertainty related to agricultural production inherent in LCA studies for food. Depending on pasture management strategies, the total emissions intensity estimated by the proposed method was higher than the equivalent value recalculated using a representative animal approach by 0.9-1.7 kg CO 2 -eq/kg liveweight gain, or up to 10% of system-wide emissions. This finding suggests that emissions intensity values derived by the latter technique may be underestimated due to insufficient consideration given to poorly performing animals, whose emissions becomes exponentially greater as average daily gain decreases. Strategies to mitigate life-cycle environmental impacts of pasture-based beef productions systems are also discussed.

  15. Reduced dietary intake of simple sugars alters perceived sweet taste intensity but not perceived pleasantness.

    Science.gov (United States)

    Wise, Paul M; Nattress, Laura; Flammer, Linda J; Beauchamp, Gary K

    2016-01-01

    Individuals who adhere to reduced-sodium diets come to prefer less salt over time, but it is unclear whether sweet taste perception is modulated by reduced sugar intake. The objective was to determine how a substantial reduction in dietary intake of simple sugars affects sweetness intensity and pleasantness of sweet foods and beverages. Healthy men and women aged 21-54 y participated for 5 mo. After the baseline month, 2 subject groups were matched for demographic characteristics, body mass index, and intake of simple sugars. One group (n = 16; 13 of whom completed key experimental manipulations) was randomly assigned to receive a low-sugar diet during the subsequent 3 mo, with instructions to replace 40% of calories from simple sugars with fats, proteins, and complex carbohydrates. The other (control) group (n = 17; 16 of whom completed the study) did not change their sugar intake. During the final month, both groups chose any diet they wished. Each month subjects rated the sweetness intensity and pleasantness of vanilla puddings and raspberry beverages that varied in sucrose concentration. ANOVA showed no systematic differences between groups in rated sweetness during the baseline or first diet month. During the second diet month, the low-sugar group rated low-sucrose pudding samples as more intense than did the control group (significant group-by-concentration interaction, P = 0.002). During the third diet month, the low-sugar subjects rated both low and high concentrations in puddings as ∼40% sweeter than did the control group (significant effect of group, P = 0.01). A weaker effect on rated sweetness was obtained for the beverages. Rated pleasantness was not affected for either of the stimuli. This experiment provides empirical evidence that changes in consumption of simple sugars influence perceived sweet taste intensity. More work is needed to determine whether sugar intake ultimately shifts preferences for sweet foods and beverages. This trial was

  16. No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients

    OpenAIRE

    Thiel, U.; Wawer, A.; Wolf, P.; Badoglio, M.; Santucci, A.; Klingebiel, T.; Basu, O.; Borkhardt, A.; Laws, H.-J; Kodera, Y.; Yoshimi, A.; Peters, C.; Ladenstein, R.; Pession, A.; Prete, A.

    2017-01-01

    Background: Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts. Patients and methods: We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia ...

  17. Moderate-intensity exercise reduces fatigue and improves mobility in cancer survivors: a systematic review and meta-regression

    Directory of Open Access Journals (Sweden)

    Amy M Dennett

    2016-04-01

    Full Text Available Question: Is there a dose-response effect of exercise on inflammation, fatigue and activity in cancer survivors? Design: Systematic review with meta-regression analysis of randomised trials. Participants: Adults diagnosed with cancer, regardless of specific diagnosis or treatment. Intervention: Exercise interventions including aerobic and/or resistance as a key component. Outcome measures: The primary outcome measures were markers of inflammation (including C-reactive protein and interleukins and various measures of fatigue. The secondary outcomes were: measures of activity, as defined by the World Health Organization's International Classification of Functioning, Disability and Health, including activities of daily living and measures of functional mobility (eg, 6-minute walk test, timed sit-to-stand and stair-climb tests. Risk of bias was evaluated using the PEDro scale, and overall quality of evidence was assessed using the Grades of Research, Assessment, Development and Evaluation (GRADE approach. Results: Forty-two trials involving 3816 participants were included. There was very low-quality to moderate-quality evidence that exercise results in significant reductions in fatigue (SMD 0.32, 95% CI 0.13 to 0.52 and increased walking endurance (SMD 0.77, 95% CI 0.26 to 1.28. A significant negative association was found between aerobic exercise intensity and fatigue reduction. A peak effect was found for moderate-intensity aerobic exercise for improving walking endurance. No dose-response relationship was found between exercise and markers of inflammation or exercise duration and outcomes. Rates of adherence were typically high and few adverse events were reported. Conclusions: Exercise is safe, reduces fatigue and increases endurance in cancer survivors. The results support the recommendation of prescribing moderate-intensity aerobic exercise to reduce fatigue and improve activity in people with cancer. Review registration: PROSPERO CRD

  18. Evidence based exercise - clinical benefits of high intensity interval training.

    Science.gov (United States)

    Shiraev, Tim; Barclay, Gabriella

    2012-12-01

    Aerobic exercise has a marked impact on cardiovascular disease risk. Benefits include improved serum lipid profiles, blood pressure and inflammatory markers as well as reduced risk of stroke, acute coronary syndrome and overall cardiovascular mortality. Most exercise programs prescribed for fat reduction involve continuous, moderate aerobic exercise, as per Australian Heart Foundation clinical guidelines. This article describes the benefits of exercise for patients with cardiovascular and metabolic disease and details the numerous benefits of high intensity interval training (HIIT) in particular. Aerobic exercise has numerous benefits for high-risk populations and such benefits, especially weight loss, are amplified with HIIT. High intensity interval training involves repeatedly exercising at a high intensity for 30 seconds to several minutes, separated by 1-5 minutes of recovery (either no or low intensity exercise). HIT is associated with increased patient compliance and improved cardiovascular and metabolic outcomes and is suitable for implementation in both healthy and 'at risk' populations. Importantly, as some types of exercise are contraindicated in certain patient populations and HIIT is a complex concept for those unfamiliar to exercise, some patients may require specific assessment or instruction before commencing a HIIT program.

  19. Accurate thermometry based on the red and green fluorescence intensity ratio in NaYF4: Yb, Er nanocrystals for bioapplication.

    Science.gov (United States)

    Liu, Lixin; Qin, Feng; Lv, Tianquan; Zhang, Zhiguo; Cao, Wenwu

    2016-10-15

    A biological temperature measurement method based on the fluorescence intensity ratio (FIR) was developed to reduce uncertainty. The upconversion luminescence of NaYF4:Yb, Er nanocrystals was studied as a function of temperature around the physiologically relevant range of 300-330 K. We found that the green-green FIR Fe and red-green FIR (I660/I540) varied linearly as temperature increased. The thermometric uncertainties using the two FIRs were discussed and were determined to be almost constant at 0.6 and 0.09 K for green-green and red-green, respectively. The lower thermometric uncertainty comes from the intense signal-to-noise ratio of the measured FIRs owing to their comparable fluorescence intensities.

  20. High-Intensity Exercise Reduces Cardiac Fibrosis and Hypertrophy but Does Not Restore the Nitroso-Redox Imbalance in Diabetic Cardiomyopathy

    Directory of Open Access Journals (Sweden)

    Ulises Novoa

    2017-01-01

    Full Text Available Diabetic cardiomyopathy refers to the manifestations in the heart as a result of altered glucose homeostasis, reflected as fibrosis, cellular hypertrophy, increased oxidative stress, and apoptosis, leading to ventricular dysfunction. Since physical exercise has been indicated as cardioprotective, we tested the hypothesis that high-intensity exercise training could reverse the cardiac maladaptations produced by diabetes. For this, diabetes was induced in rats by a single dose of alloxan. Diabetic rats were randomly assigned to a sedentary group or submitted to a program of exercise on a treadmill for 4 weeks at 80% of maximal performance. Another group of normoglycemic rats was used as control. Diabetic rat hearts presented cardiomyocyte hypertrophy and interstitial fibrosis. Chronic exercise reduced both parameters but increased apoptosis. Diabetes increased the myocardial levels of the mRNA and proteins of NADPH oxidases NOX2 and NOX4. These altered levels were not reduced by exercise. Diabetes also increased the level of uncoupled endothelial nitric oxide synthase (eNOS that was not reversed by exercise. Finally, diabetic rats showed a lower degree of phosphorylated phospholamban and reduced levels of SERCA2 that were not restored by high-intensity exercise. These results suggest that high-intensity chronic exercise was able to reverse remodeling in the diabetic heart but was unable to restore the nitroso-redox imbalance imposed by diabetes.

  1. Measuring energy efficiency: Is energy intensity a good evidence base?

    International Nuclear Information System (INIS)

    Proskuryakova, L.; Kovalev, A.

    2015-01-01

    Highlights: • Energy intensity measure reflects consumption, not energy efficiency. • Thermodynamic indicators should describe energy efficiency at all levels. • These indicators should have no reference to economic or financial parameters. • A set of energy efficiency indicators should satisfy several basic principles. • There are trade-offs between energy efficiency, power and costs. - Abstract: There is a widespread assumption in energy statistics and econometrics that energy intensity and energy efficiency are equivalent measures of energy performance of economies. The paper points to the discrepancy between the engineering concept of energy efficiency and the energy intensity as it is understood in macroeconomic statistics. This double discrepancy concerns definitions (while engineering concept of energy efficiency is based on the thermodynamic definition, energy intensity includes economic measures) and use. With regard to the latter, the authors conclude that energy intensity can only provide indirect and delayed evidence of technological and engineering energy efficiency of energy conversion processes, which entails shortcomings for management and policymaking. Therefore, we suggest to stop considering subsectoral, sectoral and other levels of energy intensities as aggregates of lower-level energy efficiency. It is suggested that the insufficiency of energy intensity indicators can be compensated with the introduction of thermodynamic indicators describing energy efficiency at the physical, technological, enterprise, sub-sector, sectoral and national levels without references to any economic or financial parameters. Structured statistical data on thermodynamic efficiency is offered as a better option for identifying break-through technologies and technological bottle-necks that constrain efficiency advancements. It is also suggested that macro-level thermodynamic indicators should be based on the thermodynamic first law efficiency and the energy

  2. The primipara respons based on individual personality type to the intensity of delivery pain

    Directory of Open Access Journals (Sweden)

    Gita N Sari

    2016-01-01

    Full Text Available Delivery period is one of periods that can cause stress to the mother and the fetus. This period is the natural common phenomenon that for some women subjectively can be considered as pain process that can cause simultaneous anxiety and pain. Psychology research has shown that pain is not only connected to physical respond, the culture that teaches and nurtures us also play important role in coping the pain. These two factors shape different personality for each individual. The objective of this study is to find out the primipara respons based on individual personality type to the intensity of delivery pain. The method of this study was analytical method with survey cross sectional approach. The data was collected prospectively from interview and questionnaire in the same time to find out the correlation between individual personality type and the intensity of delivery pain based on inclusive and exclusive period February 1st 2009 to April 30th 2009. The result with chi-square test and spearman rank test showed significant correlation between individual personality type and the intensity of delivery pain (X2= 8,571 ; p = 0,014. There is the negative correlation between extrovert individual personality and intensity of delivery pain (rs= -0,730; p <0,001, and there is the positive correlation between introvert individual personality type and intensity of delivery pain (rs = 0,726; p <0,001. Based on mann whitney, showed significant difference between extrovert personality type and introverts personality type to intensity of delivery pain (Z M-W: 3,050, p: 0,002. Based on chi-square test showed significant correlation between knowledge based on individual personality type to the intensity of delivery pain (X2= 4,418; p = 0,036 The conclusion of these study are the more extrovert individual personality type the less intense the delivery pain would be, the more introvert individual personality type then the more intense delivery pain would be. The

  3. Chinas carbon-intensity target: climate actors and policy developments

    Energy Technology Data Exchange (ETDEWEB)

    Stensdal, Iselin

    2012-11-01

    China has become the largest GHG emitting country, and announced in 2009 its first policy objective measured in carbon emissions. The carbon-intensity target is to reduce the carbon intensity by 40-45 % by 2020 compared to 200 levels. Since then there has been further policy developments in order to attain the reduction carbon intensity and steer China towards a low-carbon development. The 12th 5-year plan (2011-2015) is strong on incentives for reducing China's carbon intensity such as energy conservation measures and the establishment of new market-based mechanisms. While the central government forms the policies, the implementation is dependent on a range of actors. In addition to the climate change bureaucracy, the positive forces and actors on GHG mitigation is presented. All in all, there are promising developments in China for the years to come.(auth)

  4. Successful Reduced Intensity Allogeneic Transplant With Full Donor Chimerism and Good Quality of Life in Adolescent Patient With Wiskott-Aldrich Syndrome.

    Science.gov (United States)

    Ali, Salah; Gacsadi, Anna; McDougall, Elizabeth; Armstrong, Christine; Krueger, Joerg; Schechter, Tal; Ali, Muhammad

    2017-07-01

    Wiskott-Aldrich syndrome (WAS) is an X-linked disease characterized by microthrombocytopenia, eczema, immune deficiency, and autoimmune phenomena. Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment. Myeloablative conditioning is the most common regimen used for HSCT in patients with WAS to avoid the risk of mixed donor chimerism and autoimmunity post-HSCT. There is limited data on the use of reduced intensity conditioning for HSCT in patients with WAS. Here, we report a case with severe phenotype of WAS transplanted successfully with reduced intensity conditioning, which is an acceptable conditioning regimen and can be considered in patients with WAS with significantly impaired organ functions.

  5. USGS "Did You Feel It?" internet-based macroseismic intensity maps

    Science.gov (United States)

    Wald, D.J.; Quitoriano, V.; Worden, B.; Hopper, M.; Dewey, J.W.

    2011-01-01

    The U.S. Geological Survey (USGS) "Did You Feel It?" (DYFI) system is an automated approach for rapidly collecting macroseismic intensity data from Internet users' shaking and damage reports and generating intensity maps immediately following earthquakes; it has been operating for over a decade (1999-2011). DYFI-based intensity maps made rapidly available through the DYFI system fundamentally depart from more traditional maps made available in the past. The maps are made more quickly, provide more complete coverage and higher resolution, provide for citizen input and interaction, and allow data collection at rates and quantities never before considered. These aspects of Internet data collection, in turn, allow for data analyses, graphics, and ways to communicate with the public, opportunities not possible with traditional data-collection approaches. Yet web-based contributions also pose considerable challenges, as discussed herein. After a decade of operational experience with the DYFI system and users, we document refinements to the processing and algorithmic procedures since DYFI was first conceived. We also describe a number of automatic post-processing tools, operations, applications, and research directions, all of which utilize the extensive DYFI intensity datasets now gathered in near-real time. DYFI can be found online at the website http://earthquake.usgs.gov/dyfi/. ?? 2011 by the Istituto Nazionale di Geofisica e Vulcanologia.

  6. Intense heavy ion beam-induced temperature effects in carbon-based stripper foils

    International Nuclear Information System (INIS)

    Kupka, K.; Tomut, M.; Simon, P.; Hubert, C.; Romanenko, A.; Lommel, B.; Trautmann, C.

    2015-01-01

    At the future FAIR facility, reliably working solid carbon stripper foils are desired for providing intermediate charge states to SIS18. With the expected high beam intensities, the foils experience enhanced degradation and limited lifetime due to severe radiation damage, stress waves, and thermal effects. This work presents systematic measurements of the temperature of different carbon-based stripper foils (amorphous, diamond-like, and carbon-nanotube based) exposed to 4.8 MeV/u U, Bi, and Au beams of different pulse intensities. Thermal and spectroscopic analyses were performed by means of infrared thermography and Fourier transform infrared spectroscopy. The resulting temperature depends on the foil thickness and strongly increases with increasing pulse intensity and repetition rate. (author)

  7. Implementing a Mobility Program to Minimize Post-Intensive Care Syndrome.

    Science.gov (United States)

    Hopkins, Ramona O; Mitchell, Lorie; Thomsen, George E; Schafer, Michele; Link, Maggie; Brown, Samuel M

    2016-01-01

    Immobility in the intensive care unit (ICU) is associated with neuromuscular weakness, post-intensive care syndrome, functional limitations, and high costs. Early mobility-based rehabilitation in the ICU is feasible and safe. Mobility-based rehabilitation varied widely across 5 ICUs in 1 health care system, suggesting a need for continuous training and evaluation to maintain a strong mobility-based rehabilitation program. Early mobility-based rehabilitation shortens ICU and hospital stays, reduces delirium, and increases muscle strength and the ability to ambulate. Long-term effects include increased ability for self-care, faster return to independent functioning, improved physical function, and reduced hospital readmission and death. Factors that influence early mobility-based rehabilitation include having an interdisciplinary team; strong unit leadership; access to physical, occupational, and respiratory therapists; a culture focused on patient safety and quality improvement; a champion of early mobility; and a focus on measuring performance and outcomes.

  8. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E.; Bourne, Jessica E.; Voth, Elizabeth

    2015-01-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P HIIT and MICT (P HIIT and MICT (P HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose. PMID:26139217

  9. The response of sward-dwelling arthropod communities to reduced grassland management intensity in pastures

    Directory of Open Access Journals (Sweden)

    Helden Alvin J.

    2015-12-01

    Full Text Available We compared arthropod taxon richness, diversity and community structure of two replicated grassland husbandry experiments to investigate effects of reduced management intensity, as measured by nutrient input levels (390, 224 and 0 kg/ha per year N in one experiment, and 225 and 88 kg/ha per year N in another. Suction sampling was used to collect Araneae, Coleoptera, Hemiptera and Hymenoptera, with Araneae and Coleoptera also sampled with pitfall trapping. Univariate analyses found no significant differences in abundance and species density between treatments. However, with multivariate analysis, there were significant differences in arthropod community structure between treatments in both experiments.

  10. A new Monte Carlo-based treatment plan optimization approach for intensity modulated radiation therapy.

    Science.gov (United States)

    Li, Yongbao; Tian, Zhen; Shi, Feng; Song, Ting; Wu, Zhaoxia; Liu, Yaqiang; Jiang, Steve; Jia, Xun

    2015-04-07

    Intensity-modulated radiation treatment (IMRT) plan optimization needs beamlet dose distributions. Pencil-beam or superposition/convolution type algorithms are typically used because of their high computational speed. However, inaccurate beamlet dose distributions may mislead the optimization process and hinder the resulting plan quality. To solve this problem, the Monte Carlo (MC) simulation method has been used to compute all beamlet doses prior to the optimization step. The conventional approach samples the same number of particles from each beamlet. Yet this is not the optimal use of MC in this problem. In fact, there are beamlets that have very small intensities after solving the plan optimization problem. For those beamlets, it may be possible to use fewer particles in dose calculations to increase efficiency. Based on this idea, we have developed a new MC-based IMRT plan optimization framework that iteratively performs MC dose calculation and plan optimization. At each dose calculation step, the particle numbers for beamlets were adjusted based on the beamlet intensities obtained through solving the plan optimization problem in the last iteration step. We modified a GPU-based MC dose engine to allow simultaneous computations of a large number of beamlet doses. To test the accuracy of our modified dose engine, we compared the dose from a broad beam and the summed beamlet doses in this beam in an inhomogeneous phantom. Agreement within 1% for the maximum difference and 0.55% for the average difference was observed. We then validated the proposed MC-based optimization schemes in one lung IMRT case. It was found that the conventional scheme required 10(6) particles from each beamlet to achieve an optimization result that was 3% difference in fluence map and 1% difference in dose from the ground truth. In contrast, the proposed scheme achieved the same level of accuracy with on average 1.2 × 10(5) particles per beamlet. Correspondingly, the computation

  11. Preemptive antibiotic treatment based on gram staining reduced the incidence of ARDS in mechanically ventilated patients.

    Science.gov (United States)

    Matsushima, Asako; Tasaki, Osamu; Shimizu, Kentaro; Tomono, Kazunori; Ogura, Hiroshi; Shimazu, Takeshi; Sugimoto, Hisashi

    2008-08-01

    Ventilator-associated pneumonia (VAP) is one of the major complications in the intensive care unit. VAP sometimes results in acute respiratory distress syndrome (ARDS), and the associated mortality is high. We hypothesized that preemptive antibiotic therapy based on results of bedside gram staining would reduce the incidence of VAP. Patients who were endotracheally intubated in our intensive care unit for more than 72 hours were included. Patients younger than 16 years of age or patients died because of brain death were excluded. The study was divided into two periods. During the first period, we used antibiotics according to the American Thoracic Society guidelines. During the second period, antibiotics were given according to the results of bedside gram staining even before radiographic infiltrate appeared. One hundred twenty-eight patients and 133 patients were included in the first and second periods, respectively. The incidence of VAP was significantly decreased in the second period (first period, 22%; second period, 9%, p gram staining significantly reduced the incidences of VAP and ARDS without an increase in the use of antibiotics.

  12. Moderate, but not vigorous, intensity exercise training reduces C-reactive protein.

    Science.gov (United States)

    Fedewa, Michael V; Hathaway, Elizabeth D; Higgins, Simon; Forehand, Ronald L; Schmidt, Michael D; Evans, Ellen M

    2018-06-01

    Sprint interval cycle training is a contemporary popular mode of training but its relative efficacy, under conditions of matched energy expenditure, to reduce risk factors for cardiometabolic disease is incompletely characterised, especially in young women. The purpose of this investigation was to determine the relative efficacy of six weeks of moderate-intensity cycling (MOD-C) and vigorous sprint-interval cycling (VIG-SIC) on lipid profile, insulin (INS) and insulin resistance using the homeostatic model assessment (HOMA-IR) and C-reactive protein (CRP) in inactive, overweight/obese (OW/OB) young women. Participants (BMI ≥25 kg/m 2 , waist circumference ≥88 cm) were randomly assigned to MOD-C (20-30 min at 60-70% of heart rate reserve(HRR)) or VIG-SIC (5-7 repeated bouts 30-second maximal effort sprints, followed by four minutes of active recovery) supervised training three days/week for six weeks, with each group matched on energy expenditure. Adiposity (%Fat) was measured using dual x-ray absorptiometry. Forty-four participants (20.4 ± 1.6 years, 65.9% Caucasian, 29.8 ± 4.1 kg/m 2 ) were included in the analysis. The improvement in CRP observed in the MOD-C group was larger than the VIG-C group (p = .034). Overall, high-density lipoprotein (HDL-C) and low-density lipoprotein (LDL-C) levels improved following training (p  .05). These results indicate MOD-C training may be more effective in reducing CRP than VIG-SIC.

  13. In silico simulations of STAT1 and STAT3 inhibitors predict SH2 domain cross-binding specificity.

    Science.gov (United States)

    Szelag, Malgorzata; Sikorski, Krzysztof; Czerwoniec, Anna; Szatkowska, Katarzyna; Wesoly, Joanna; Bluyssen, Hans A R

    2013-11-15

    Signal transducers and activators of transcription (STATs) comprise a family of transcription factors that are structurally related and which participate in signaling pathways activated by cytokines, growth factors and pathogens. Activation of STAT proteins is mediated by the highly conserved Src homology 2 (SH2) domain, which interacts with phosphotyrosine motifs for specific contacts between STATs and receptors and for STAT dimerization. By generating new models for human (h)STAT1, hSTAT2 and hSTAT3 we applied comparative in silico docking to determine SH2-binding specificity of the STAT3 inhibitor stattic, and of fludarabine (STAT1 inhibitor). Thus, we provide evidence that by primarily targeting the highly conserved phosphotyrosine (pY+0) SH2 binding pocket stattic is not a specific hSTAT3 inhibitor, but is equally effective towards hSTAT1 and hSTAT2. This was confirmed in Human Micro-vascular Endothelial Cells (HMECs) in vitro, in which stattic inhibited interferon-α-induced phosphorylation of all three STATs. Likewise, fludarabine inhibits both hSTAT1 and hSTAT3 phosphorylation, but not hSTAT2, by competing with the highly conserved pY+0 and pY-X binding sites, which are less well-preserved in hSTAT2. Moreover we observed that in HMECs in vitro fludarabine inhibits cytokine and lipopolysaccharide-induced phosphorylation of hSTAT1 and hSTAT3 but does not affect hSTAT2. Finally, multiple sequence alignment of STAT-SH2 domain sequences confirmed high conservation between hSTAT1 and hSTAT3, but not hSTAT2, with respect to stattic and fludarabine binding sites. Together our data offer a molecular basis that explains STAT cross-binding specificity of stattic and fludarabine, thereby questioning the present selection strategies of SH2 domain-based competitive small inhibitors. © 2013 Elsevier B.V. All rights reserved.

  14. Half-Fan-Based Intensity-Weighted Region-of-Interest Imaging for Low-Dose Cone-Beam CT in Image-Guided Radiation Therapy.

    Science.gov (United States)

    Yoo, Boyeol; Son, Kihong; Pua, Rizza; Kim, Jinsung; Solodov, Alexander; Cho, Seungryong

    2016-10-01

    With the increased use of computed tomography (CT) in clinics, dose reduction is the most important feature people seek when considering new CT techniques or applications. We developed an intensity-weighted region-of-interest (IWROI) imaging method in an exact half-fan geometry to reduce the imaging radiation dose to patients in cone-beam CT (CBCT) for image-guided radiation therapy (IGRT). While dose reduction is highly desirable, preserving the high-quality images of the ROI is also important for target localization in IGRT. An intensity-weighting (IW) filter made of copper was mounted in place of a bowtie filter on the X-ray tube unit of an on-board imager (OBI) system such that the filter can substantially reduce radiation exposure to the outer ROI. In addition to mounting the IW filter, the lead-blade collimation of the OBI was adjusted to produce an exact half-fan scanning geometry for a further reduction of the radiation dose. The chord-based rebinned backprojection-filtration (BPF) algorithm in circular CBCT was implemented for image reconstruction, and a humanoid pelvis phantom was used for the IWROI imaging experiment. The IWROI image of the phantom was successfully reconstructed after beam-quality correction, and it was registered to the reference image within an acceptable level of tolerance. Dosimetric measurements revealed that the dose is reduced by approximately 61% in the inner ROI and by 73% in the outer ROI compared to the conventional bowtie filter-based half-fan scan. The IWROI method substantially reduces the imaging radiation dose and provides reconstructed images with an acceptable level of quality for patient setup and target localization. The proposed half-fan-based IWROI imaging technique can add a valuable option to CBCT in IGRT applications.

  15. Reduced-intensity conditioning lowers treatment-related mortality of allogeneic stem cell transplantation for chronic lymphocytic leukemia : a population-matched analysis

    NARCIS (Netherlands)

    Dreger, P; Brand, R; Milligan, D; Corradini, P; Finke, J; Deliliers, GL; Martino, R; Russell, N; van Biezen, A; Michallet, M; Niederwieser, D

    To elucidate whether reduced-intensity conditioning (RIC) decreases treatment-related mortality (TRM) after allogeneic stem cell transplantation (allo-SCT) for chronic lymphocytic leukemia (CLL), we retrospectively compared 73 RIC cases from a recent EBMT survey with 82 patients from the EBMT

  16. Intravenous artesunate reduces parasite clearance time, duration of intensive care, and hospital treatment in patients with severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2015-01-01

    Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive...

  17. TLS FIELD DATA BASED INTENSITY CORRECTION FOR FOREST ENVIRONMENTS

    Directory of Open Access Journals (Sweden)

    J. Heinzel

    2016-06-01

    Full Text Available Terrestrial laser scanning (TLS is increasingly used for forestry applications. Besides the three dimensional point coordinates, the 'intensity' of the reflected signal plays an important role in forestry and vegetation studies. The benefit of the signal intensity is caused by the wavelength of the laser that is within the near infrared (NIR for most scanners. The NIR is highly indicative for various vegetation characteristics. However, the intensity as recorded by most terrestrial scanners is distorted by both external and scanner specific factors. Since details about system internal alteration of the signal are often unknown to the user, model driven approaches are impractical. On the other hand, existing data driven calibration procedures require laborious acquisition of separate reference datasets or areas of homogenous reflection characteristics from the field data. In order to fill this gap, the present study introduces an approach to correct unwanted intensity variations directly from the point cloud of the field data. The focus is on the variation over range and sensor specific distortions. Instead of an absolute calibration of the values, a relative correction within the dataset is sufficient for most forestry applications. Finally, a method similar to time series detrending is presented with the only pre-condition of a relative equal distribution of forest objects and materials over range. Our test data covers 50 terrestrial scans captured with a FARO Focus 3D S120 scanner using a laser wavelength of 905 nm. Practical tests demonstrate that our correction method removes range and scanner based alterations of the intensity.

  18. An Efficient Estimation Method for Reducing the Axial Intensity Drop in Circular Cone-Beam CT

    Directory of Open Access Journals (Sweden)

    Lei Zhu

    2008-01-01

    Full Text Available Reconstruction algorithms for circular cone-beam (CB scans have been extensively studied in the literature. Since insufficient data are measured, an exact reconstruction is impossible for such a geometry. If the reconstruction algorithm assumes zeros for the missing data, such as the standard FDK algorithm, a major type of resulting CB artifacts is the intensity drop along the axial direction. Many algorithms have been proposed to improve image quality when faced with this problem of data missing; however, development of an effective and computationally efficient algorithm remains a major challenge. In this work, we propose a novel method for estimating the unmeasured data and reducing the intensity drop artifacts. Each CB projection is analyzed in the Radon space via Grangeat's first derivative. Assuming the CB projection is taken from a parallel beam geometry, we extract those data that reside in the unmeasured region of the Radon space. These data are then used as in a parallel beam geometry to calculate a correction term, which is added together with Hu’s correction term to the FDK result to form a final reconstruction. More approximations are then made on the calculation of the additional term, and the final formula is implemented very efficiently. The algorithm performance is evaluated using computer simulations on analytical phantoms. The reconstruction comparison with results using other existing algorithms shows that the proposed algorithm achieves a superior performance on the reduction of axial intensity drop artifacts with a high computation efficiency.

  19. Reconstruction of structural damage based on reflection intensity spectra of fiber Bragg gratings

    International Nuclear Information System (INIS)

    Huang, Guojun; Wei, Changben; Chen, Shiyuan; Yang, Guowei

    2014-01-01

    We present an approach for structural damage reconstruction based on the reflection intensity spectra of fiber Bragg gratings (FBGs). Our approach incorporates the finite element method, transfer matrix (T-matrix), and genetic algorithm to solve the inverse photo-elastic problem of damage reconstruction, i.e. to identify the location, size, and shape of a defect. By introducing a parameterized characterization of the damage information, the inverse photo-elastic problem is reduced to an optimization problem, and a relevant computational scheme was developed. The scheme iteratively searches for the solution to the corresponding direct photo-elastic problem until the simulated and measured (or target) reflection intensity spectra of the FBGs near the defect coincide within a prescribed error. Proof-of-concept validations of our approach were performed numerically and experimentally using both holed and cracked plate samples as typical cases of plane-stress problems. The damage identifiability was simulated by changing the deployment of the FBG sensors, including the total number of sensors and their distance to the defect. Both the numerical and experimental results demonstrate that our approach is effective and promising. It provides us with a photo-elastic method for developing a remote, automatic damage-imaging technique that substantially improves damage identification for structural health monitoring. (paper)

  20. Erythropoietin does not reduce plasma lactate, H+, and K+ during intense exercise

    DEFF Research Database (Denmark)

    Nordsborg, Nikolai Baastrup; Robach, P; Boushel, R

    2015-01-01

    It is investigated if recombinant human erythropoietin (rHuEPO) treatment for 15 weeks (n = 8) reduces extracellular accumulation of metabolic stress markers such as lactate, H(+) , and K(+) during incremental exhaustive exercise. After rHuEPO treatment, normalization of blood volume...... and composition by hemodilution preceded an additional incremental test. Group averages were calculated for an exercise intensity ∼80% of pre-rHuEPO peak power output. After rHuEPO treatment, leg lactate release to the plasma compartment was similar to before (4.3 ± 1.6 vs 3.9 ± 2.5 mmol/min) and remained similar...... after hemodilution. Venous lactate concentration was higher (P release to the plasma compartment after rHuEPO was similar to before (19.6 ± 5.4 vs 17.6 ± 6.0 mmol/min) and remained similar after hemodilution. Nevertheless, venous p...

  1. ELF whistler events with a reduced intensity observed by the DEMETER spacecraft

    Science.gov (United States)

    Zahlava, J.; Nemec, F.; Santolik, O.; Kolmasova, I.; Parrot, M.

    2017-12-01

    A survey of VLF frequency-time spectrograms obtained by the DEMETER spacecraft (2004-2010, altitude about 700 km) revealed that the intensity of fractional hop whistlers is sometimes significantly reduced at specific frequencies. These frequencies are typically above about 3.4 kHz (second cutoff frequency of the Earth-ionosphere waveguide), and they vary smoothly in time. The events were explained by the wave propagation in the Earth-ionosphere waveguide, and a resulting interference of the first few waveguide modes. We analyze the events whose frequency-time structure is rather similar, but at frequencies below 1 kHz. Altogether, 284 events are identified during the periods with active Burst mode, when high resolution data are measured by DEMETER. The vast majority of events (93%) occurs during the nighttime. All six electromagnetic field components are available, which allows us to perform a detailed wave analysis. An overview of the properties of these events is presented, and their possible origin is discussed.

  2. Characteristic Analysis Light Intensity Sensor Based On Plastic Optical Fiber At Various Configuration

    Science.gov (United States)

    Arifin, A.; Lusiana; Yunus, Muhammad; Dewang, Syamsir

    2018-03-01

    This research discusses the light intensity sensor based on plastic optical fiber. This light intensity sensor is made of plastic optical fiber consisting of two types, namely which is cladding and without cladding. Plastic optical fiber used multi-mode step-index type made of polymethyl metacrylate (PMMA). The infrared LED emits light into the optical fiber of the plastic and is subsequently received by the phototransistor to be converted to an electric voltage. The sensor configuration is made with three models: straight configuration, U configuration and gamma configuration with cladding and without cladding. The measured light source uses a 30 Watt high power LED with a light intensity of 0 to 10 Klux. The measured light intensity will affect the propagation of light inside the optical fiber sensor. The greater the intensity of the measured light, the greater the output voltage that is read on the computer. The results showed that the best optical fiber sensor characteristics were obtained in U configuration. Sensors with U-configuration without cladding had the best sensitivity and resolution values of 0.0307 volts/Klux and 0.0326 Klux. The advantages of this measuring light intensity based on the plastic optical fiber instrument are simple, easy-to-make operational systems, low cost, high sensitivity and resolution.

  3. Evidence-based review: Quality of life following head and neck intensity-modulated radiotherapy

    International Nuclear Information System (INIS)

    Scott-Brown, Martin; Miah, Aisha; Harrington, Kevin; Nutting, Chris

    2010-01-01

    Inverse planned Intensity modulated radiotherapy (IMRT) can minimize the dose to normal structures and therefore can reduce long-term radiotherapy-related morbidity and may improve patients' long-term quality of life. Despite overwhelming evidence that IMRT can reduce late functional deficits in patients with head and neck cancer, treated with radiotherapy, a review of the published literature produced conflicting results with regard to quality of life outcomes. Following a critical appraisal of the literature, reasons for the discrepant outcomes are proposed.

  4. Polyphenolic composition and antioxidant capacity of legume based swards are affected by light intensity in a Mediterranean agroforestry system.

    Science.gov (United States)

    Re, Giovanni Antonio; Piluzza, Giovanna; Sanna, Federico; Molinu, Maria Giovanna; Sulas, Leonardo

    2018-06-01

    In Mediterranean grazed woodlands, microclimate changes induced by trees influence the growth and development of the understory, but very little is known about its polyphenolic composition in relation to light intensity. We investigated the bioactive compounds and antioxidant capacity of different legume-based swards and variations due to full sunlight and partial shade. The research was carried out in a cork oak agrosilvopastoral system in Sardinia. The highest values of DPPH reached 7 mmol TEAC 100 g -1 DW, total phenolics 67.1 g GAE kg -1 DW and total flavonoids 7.5 g CE kg -1 DW. Compared to full sunlight, partial shade reduced DPPH values by 29 and 42%, and the total phenolic content by 23 and 53% in 100% legume mixture and semi natural pasture. Twelve phenolic compounds were detected: chlorogenic acid in 80% legume mixture (partial shade) and verbascoside in pure sward of bladder clover (full sunlight) were the most abundant. Light intensity significantly affected antioxidant capacity, composition and levels of phenolic compounds. Our results provide new insights into the effects of light intensity on plant secondary metabolites from legume based swards, underlining the important functions provided by agroforestry systems. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  5. Intensity-modulated radiotherapy significantly reduces xerostomia compared with conventional radiotherapy

    International Nuclear Information System (INIS)

    Braam, Petra M.; Terhaard, Chris H.J. M.D.; Roesink, Judith M.; Raaijmakers, Cornelis P.J.

    2006-01-01

    Purpose: Xerostomia is a severe complication after radiotherapy for oropharyngeal cancer, as the salivary glands are in close proximity with the primary tumor. Intensity-modulated radiotherapy (IMRT) offers theoretical advantages for normal tissue sparing. A Phase II study was conducted to determine the value of IMRT for salivary output preservation compared with conventional radiotherapy (CRT). Methods and Materials: A total of 56 patients with oropharyngeal cancer were prospectively evaluated. Of these, 30 patients were treated with IMRT and 26 with CRT. Stimulated parotid salivary flow was measured before, 6 weeks, and 6 months after treatment. A complication was defined as a stimulated parotid flow rate <25% of the preradiotherapy flow rate. Results: The mean dose to the parotid glands was 48.1 Gy (SD 14 Gy) for CRT and 33.7 Gy (SD 10 Gy) for IMRT (p < 0.005). The mean parotid flow ratio 6 weeks and 6 months after treatment was respectively 41% and 64% for IMRT and respectively 11% and 18% for CRT. As a result, 6 weeks after treatment, the number of parotid flow complications was significantly lower after IMRT (55%) than after CRT (87%) (p = 0.002). The number of complications 6 months after treatment was 56% for IMRT and 81% for CRT (p = 0.04). Conclusions: IMRT significantly reduces the number of parotid flow complications for patients with oropharyngeal cancer

  6. High-Intensity Interval Training in Patients with Heart Failure with Reduced Ejection Fraction

    DEFF Research Database (Denmark)

    Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane

    2017-01-01

    Background: Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial...... compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Methods: Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate...... ventricular end-diastolic diameter from baseline to 12 weeks. Results: Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT (P=0.45); left...

  7. Potential for reducing GHG emissions and energy consumption from implementing the aluminum intensive vehicle fleet in China

    International Nuclear Information System (INIS)

    Du, J.D.; Han, W.J.; Peng, Y.H.; Gu, C.C.

    2010-01-01

    The automobile industry in China has rapidly developed in recent years which resulted in an increase in gasoline usage and greenhouse gas (GHG) emissions. Focus on climate change has also accelerated to grow pressure on reducing vehicle weight and improving fuel efficiency. Aluminum (Al) as a light metal has demonstrated a great potential for weight savings in applications such as engine blocks, cylinder heads, wheels, hoods, tailgates etc. However, primary Al production requires intensive energy and the cost of Al is more than traditional steel, which may affect the total benefits realized from using Al in automobiles. Therefore, it is very essential to conduct a study to quantify the life cycle GHG emissions and energy consumption if the plan is to achieve fleet-wide Al intensive vehicles. This paper describes a life cycle assessment (LCA) methodology and the general modeling assumptions used to evaluate the impact of Al intensive vehicle on GHG emissions and energy consumption. The results indicated that the reductions in life cycle GHG emissions and energy consumption were not significant when the maximum Al content in an automobile is 145 kg, which is the average level of Al usage in automobiles in North America. A neural network methodology was used to forecast the vehicle stock in China from 2010 to 2020 and a vehicle fleet model was established to track GHG emissions and energy consumption of the vehicle fleet. A material availability factor was also introduced into the LCA methodology to further assist decision makers in providing rational proposals for a widespread implementation of Al in automobiles. A sensitivity analysis was also conducted to study the impact of the Al content in a vehicle on the final outcomes. The GHG emissions and energy consumption could be further reduced when the Al content in an automobile increases.

  8. Rituximab-containing reduced-intensity conditioning improves progression-free survival following allogeneic transplantation in B cell non-Hodgkin lymphoma

    Directory of Open Access Journals (Sweden)

    Narendranath Epperla

    2017-06-01

    Full Text Available Abstract Background In B cell non-Hodgkin lymphoma (B-NHL, rituximab-containing reduced-intensity conditioning regimens (R-RIC have been shown to provide favorable outcomes in single-arm studies; however, large multicenter studies comparing R-RIC and non-rituximab-containing reduced-intensity conditioning regimens (nonR-RIC have not been performed. Using the CIBMTR database, we report the outcomes of R-RIC versus nonR-RIC regimens in B-NHL. Methods We evaluated 1401 adult B-NHL patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT who received nonR-RIC (n = 1022 or R-RIC (n = 379 regimens. Graft-versus-host disease (GVHD prophylaxis was limited to calcineurin inhibitor-based approaches. Results Median follow-up of survivors in the R-RIC and nonR-RIC groups was 47 and 37 months, respectively. On multivariate analysis, no difference was seen between the R-RIC and nonR-RIC cohorts in terms of acute GVHD grade II–IV (RR = 1.14, 95%CI = 0.83–1.56, p = 0.43 or grade III–IV (RR = 1.16, 95%CI = 0.72–1.89, p = 0.54, chronic GVHD (RR = 1.15, 95%CI = 0.92–1.46, p = 0.22, non-relapse mortality (RR = 0.90; 95%CI = 0.67–1.22; p = 0.51, relapse/progression (RR = 0.79; 95%CI = 0.63–1.01; p = 0.055, and mortality (RR = 0.84, 95%CI = 0.69–1.02, p = 0.08 risk. However, R-RIC was associated with a significantly improved progression-free survival (RR = 0.76; 95%CI 0.62–0.92; p = 0.006. On subgroup analysis, mortality benefit was noted in the R-RIC group patients not receiving busulfan-based RIC (RR = 0.76; 95%CI = 0.60–0.96; p = 0.02 and with the use of a higher cumulative rituximab dose (RR = 0.43; 95%CI = 0.21–0.90; p = 0.02. Conclusion Our analysis shows that inclusion of rituximab in RIC regimens improves progression-free survival in patients with B cell NHL. These data supports the use of R-RIC in B

  9. The effects of a distracting N-back task on recognition memory are reduced by negative emotional intensity.

    Directory of Open Access Journals (Sweden)

    Luciano G Buratto

    Full Text Available Memory performance is usually impaired when participants have to encode information while performing a concurrent task. Recent studies using recall tasks have found that emotional items are more resistant to such cognitive depletion effects than non-emotional items. However, when recognition tasks are used, the same effect is more elusive as recent recognition studies have obtained contradictory results. In two experiments, we provide evidence that negative emotional content can reliably reduce the effects of cognitive depletion on recognition memory only if stimuli with high levels of emotional intensity are used. In particular, we found that recognition performance for realistic pictures was impaired by a secondary 3-back working memory task during encoding if stimuli were emotionally neutral or had moderate levels of negative emotionality. In contrast, when negative pictures with high levels of emotional intensity were used, the detrimental effects of the secondary task were significantly attenuated.

  10. The Effects of a Distracting N-Back Task on Recognition Memory Are Reduced by Negative Emotional Intensity

    Science.gov (United States)

    Buratto, Luciano G.; Pottage, Claire L.; Brown, Charity; Morrison, Catriona M.; Schaefer, Alexandre

    2014-01-01

    Memory performance is usually impaired when participants have to encode information while performing a concurrent task. Recent studies using recall tasks have found that emotional items are more resistant to such cognitive depletion effects than non-emotional items. However, when recognition tasks are used, the same effect is more elusive as recent recognition studies have obtained contradictory results. In two experiments, we provide evidence that negative emotional content can reliably reduce the effects of cognitive depletion on recognition memory only if stimuli with high levels of emotional intensity are used. In particular, we found that recognition performance for realistic pictures was impaired by a secondary 3-back working memory task during encoding if stimuli were emotionally neutral or had moderate levels of negative emotionality. In contrast, when negative pictures with high levels of emotional intensity were used, the detrimental effects of the secondary task were significantly attenuated. PMID:25330251

  11. Nitrification inhibitors mitigated reactive gaseous nitrogen intensity in intensive vegetable soils from China.

    Science.gov (United States)

    Fan, Changhua; Li, Bo; Xiong, Zhengqin

    2018-01-15

    Nitrification inhibitors, a promising tool for reducing nitrous oxide (N 2 O) losses and promoting nitrogen use efficiency by slowing nitrification, have gained extensive attention worldwide. However, there have been few attempts to explore the broad responses of multiple reactive gaseous nitrogen emissions of N 2 O, nitric oxide (NO) and ammonia (NH 3 ) and vegetable yield to nitrification inhibitor applications across intensive vegetable soils in China. A greenhouse pot experiment with five consecutive vegetable crops was performed to assess the efficacies of two nitrification inhibitors, namely, nitrapyrin and dicyandiamide on reactive gaseous nitrogen emissions, vegetable yield and reactive gaseous nitrogen intensity in four typical vegetable soils representing the intensive vegetable cropping systems across mainland China: an Acrisol from Hunan Province, an Anthrosol from Shanxi Province, a Cambisol from Shandong Province and a Phaeozem from Heilongjiang Province. The results showed soil type had significant influences on reactive gaseous nitrogen intensity, with reactive gaseous nitrogen emissions and yield mainly driven by soil factors: pH, nitrate, C:N ratio, cation exchange capacity and microbial biomass carbon. The highest reactive gaseous nitrogen emissions and reactive gaseous nitrogen intensity were in Acrisol while the highest vegetable yield occurred in Phaeozem. Nitrification inhibitor applications decreased N 2 O and NO emissions by 1.8-61.0% and 0.8-79.5%, respectively, but promoted NH 3 volatilization by 3.2-44.6% across all soils. Furthermore, significant positive correlations were observed between inhibited N 2 O+NO and stimulated NH 3 emissions with nitrification inhibitor additions across all soils, indicating that reduced nitrification posed the threat of NH 3 losses. Additionally, reactive gaseous nitrogen intensity was significantly reduced in the Anthrosol and Cambisol due to the reduced reactive gaseous nitrogen emissions and increased

  12. First experiences with model based iterative reconstructions influence on quantitative plaque volume and intensity measurements in coronary computed tomography angiography

    International Nuclear Information System (INIS)

    Precht, H.; Kitslaar, P.H.; Broersen, A.; Gerke, O.; Dijkstra, J.; Thygesen, J.; Egstrup, K.; Lambrechtsen, J.

    2017-01-01

    Purpose: Investigate the influence of adaptive statistical iterative reconstruction (ASIR) and the model-based IR (Veo) reconstruction algorithm in coronary computed tomography angiography (CCTA) images on quantitative measurements in coronary arteries for plaque volumes and intensities. Methods: Three patients had three independent dose reduced CCTA performed and reconstructed with 30% ASIR (CTDI vol at 6.7 mGy), 60% ASIR (CTDI vol 4.3 mGy) and Veo (CTDI vol at 1.9 mGy). Coronary plaque analysis was performed for each measured CCTA volumes, plaque burden and intensities. Results: Plaque volume and plaque burden show a decreasing tendency from ASIR to Veo as median volume for ASIR is 314 mm 3 and 337 mm 3 –252 mm 3 for Veo and plaque burden is 42% and 44% for ASIR to 39% for Veo. The lumen and vessel volume decrease slightly from 30% ASIR to 60% ASIR with 498 mm 3 –391 mm 3 for lumen volume and vessel volume from 939 mm 3 to 830 mm 3 . The intensities did not change overall between the different reconstructions for either lumen or plaque. Conclusion: We found a tendency of decreasing plaque volumes and plaque burden but no change in intensities with the use of low dose Veo CCTA (1.9 mGy) compared to dose reduced ASIR CCTA (6.7 mGy & 4.3 mGy), although more studies are warranted. - Highlights: • Veo decrease plaque volumes and plaque burden using low-dose CCTA. • Moving from ASIR 30%, ASIR 60% to Veo did not appear to influence the plaque intensities. • Studies including larger sample size are needed to investigate the effect on plaque.

  13. Realization of spin-dependent splitting with arbitrary intensity patterns based on all-dielectric metasurfaces

    Energy Technology Data Exchange (ETDEWEB)

    Ke, Yougang; Liu, Yachao; He, Yongli; Zhou, Junxiao; Luo, Hailu, E-mail: hailuluo@hnu.edu.cn; Wen, Shuangchun [Laboratory for Spin Photonics, School of Physics and Electronics, Hunan University, Changsha 410082 (China)

    2015-07-27

    We report the realization of spin-dependent splitting with arbitrary intensity patterns based on all-dielectric metasurfaces. Compared with the plasmonic metasurfaces, the all-dielectric metasurface exhibits more high transmission efficiency and conversion efficiency, which makes it possible to achieve the spin-dependent splitting with arbitrary intensity patterns. Our findings suggest a way for generation and manipulation of spin photons, and thereby offer the possibility of developing spin-based nanophotonic applications.

  14. O papel da Fludarabina no tratamento dos linfomas não Hodgkin de baixo grau de malignidade The role of Fludarabine in the treatment of low-grade non-Hodgkin's lymphomas

    Directory of Open Access Journals (Sweden)

    Gino Santini

    2001-09-01

    Full Text Available Dentro das perspectivas futuras do tratamento dos linfomas não Hodgkin (LMH está aquela de melhorar os resultados com os denominados linfomas de baixo grau de malignidade. Dentro do estado-da-arte atual, este grupo de linfomas pode ser considerado incurável. Desde o observar-e-esperar até o transplante alogênico de medula óssea, muitas dúvidas existem e devem ser esclarecidas. O objetivo desta revisão é de apresentar e discutir a utilização da Fludarabina , isolada ou associada à antraciclínicos e alquilantes no tratamento dos linfomas não Hodgkin de baixo grau de malignidade (LBG.Concerning to the perspective of low-grade non-Hodgkin's lymphoma remains the challenge to find the best treatment improving the objective responses and the possibility of cure . Low-grade lymphoma may be currently considered a group of incurable diseases. From watch-and-wait until allogeneic bone marrow transplantation, many doubts exist and should be clarify. The aim of this article is to present and to discuss the role of Fludarabine, alone or in combination with anthracyclines and/or cyclophosphamide, in the treatment of low-grade lymphomas.

  15. A study of an intensive home-based treatment program and its ...

    African Journals Online (AJOL)

    Adele

    Key words: Intensive home based program, health services, admission, outpatient, inpatient, aged care. Received: ... vate agencies were sometimes also used and funded by APS or more .... result of other structural changes in the system.

  16. Electronic Health Record for Intensive Care based on Usual Windows Based Software.

    Science.gov (United States)

    Reper, Arnaud; Reper, Pascal

    2015-08-01

    In Intensive Care Units, the amount of data to be processed for patients care, the turn over of the patients, the necessity for reliability and for review processes indicate the use of Patient Data Management Systems (PDMS) and electronic health records (EHR). To respond to the needs of an Intensive Care Unit and not to be locked with proprietary software, we developed an EHR based on usual software and components. The software was designed as a client-server architecture running on the Windows operating system and powered by the access data base system. The client software was developed using Visual Basic interface library. The application offers to the users the following functions: medical notes captures, observations and treatments, nursing charts with administration of medications, scoring systems for classification, and possibilities to encode medical activities for billing processes. Since his deployment in September 2004, the EHR was used to care more than five thousands patients with the expected software reliability and facilitated data management and review processes. Communications with other medical software were not developed from the start, and are realized by the use of basic functionalities communication engine. Further upgrade of the system will include multi-platform support, use of typed language with static analysis, and configurable interface. The developed system based on usual software components was able to respond to the medical needs of the local ICU environment. The use of Windows for development allowed us to customize the software to the preexisting organization and contributed to the acceptability of the whole system.

  17. Rituximab and new regimens for indolent lymphoma: a brief update from 2012 ASCO Annual Meeting

    Directory of Open Access Journals (Sweden)

    Zhao Jiangning

    2012-08-01

    Full Text Available Abstract Indolent lymphoma (IL, the second most common lymphoma, remains incurable with chemotherapy alone. While R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone remains the standard frontline regimen for diffuse Large B –cell lymphoma, the optimal chemotherapy regimen for frontline therapy of advanced IL remains uncertain. FCR (fludarabine, cyclophosphamide, rituximab has been shown to be better than fludarabine alone and fludarabine plus cyclophosphamide for IL. In FOLL05 trial, R-CHOP was compared with R-CVP (cyclophosphamide, vincristine, prednisone and R-FM (fludarabine, mitoxantrone. The study showed that R-CHOP appears to have the best risk-benefit ratio for IL. The StiL NHL1 trial showed that BR (bendamustine, rituximab has longer progression free survival and is better tolerated than R-CHOP. Long-term complications with secondary malignancies between the two regimens appear to be comparable. In this review, new combination regimens reported at 2012 ASCO annual meeting were evaluated for frontline and salvage therapy of indolent lymphoma.

  18. Upcoversion performance improvement of NaYF4:Yb, Er by Sn codoping: Enhanced emission intensity and reduced decay time

    International Nuclear Information System (INIS)

    Yu, Han; Cao, Wenbing; Huang, Qingming; Ma, En; Zhang, Xinqi; Yu, Jianchang

    2013-01-01

    In this manuscript we report a phenomenon that upconversion emission intensity of Er 3+ was enhanced while decay time constant was decreased obviously by Sn codoping with Yb/Er into hexagonal NaYF 4 synchronously. X-ray powder diffiraction, field emission scanning electron microscope, transmission electron microscopy, X-ray photoelectron spectroscopy, electron spin-resonance spectroscopy and upconversion emission spectra were employed to explore the relation of crystal structure and properties. From these characterizations we found that symmetry of the rare earth ion local crystal field could be tuned by different Sn codoping concentration. For the variable valence property of Sn the local crystal field asymmetry and emission intensity of NaYF 4 :Yb, Er arrived to the maximum when 3 mol% Sn was codoped, while decay time was reduced. The study of this changing tends of upconversion emission intensity and decay time constant may be helpful for design and fabrication of high performance upconversion materials. - Graphical abstract: Variable-valenced Sn is introduced with Yb/Er into NaFY 4 to tune structure and local crystal field. Upconversion emission intensity of Er 3+ was enhanced while decay time constant was decreased. Display Omitted - Highlights: • NaYF 4 : Yb, Er was codoped with different concentration Sn. • Upconversion emission intensity was enhanced while decay time constant was decreased. • Introduction of variable-valenced Sn is effective to tune structure and crystal field of NaFY 4

  19. Motivational intensity modulates attentional scope: evidence from behavioral and ERP studies.

    Science.gov (United States)

    Liu, Lei; Zhang, Guangnan; Zhou, Renlai; Wang, Zuowei

    2014-10-01

    Previous studies have found that affective states with high motivational intensity narrow attentional scope, whereas affective states with low motivational intensity broaden attentional scope. This conclusion, however, is based on fragmented evidence based on several separate studies. The present study tests this conclusion within a single study using both behavioral (Experiment 1) and neurophysiological (Experiment 2) measures. Experiment 1 showed that individuals had the global precedence effect in the neutral affective state. However, the global precedence effect was reduced for affective states with high motivational intensity, whereas the global precedence effect was not significantly enhanced for those with low motivational intensity. Experiment 2 replicated these results with event-related potential (ERP) recording. ERP results showed that affective states with high motivational intensity induced smaller N2 and greater late positive potential (LPP) amplitudes than low motivational intensity and neutral affective states. However, no differences were found between the low motivational intensity and neutral affective states. Furthermore, smaller LPP predicted the tendency a global attentional focus in the frontal and central areas and larger LPP predicted a narrowed focus in the frontal area. The findings suggested that high motivational intensity of affective states can affect attentional scope.

  20. ETLMR: A Highly Scalable Dimensional ETL Framework based on MapReduce

    DEFF Research Database (Denmark)

    Xiufeng, Liu; Thomsen, Christian; Pedersen, Torben Bach

    2011-01-01

    Extract-Transform-Load (ETL) flows periodically populate data warehouses (DWs) with data from different source systems. An increasing challenge for ETL fl ows is processing huge volumes of data quickly. MapReduce is establishing itself as the de-facto standard for large-scale data-intensive process......Extract-Transform-Load (ETL) flows periodically populate data warehouses (DWs) with data from different source systems. An increasing challenge for ETL fl ows is processing huge volumes of data quickly. MapReduce is establishing itself as the de-facto standard for large-scale data...

  1. Evaluación económica de rituximab en combinación con fludarabina y ciclofosfamida en comparación con fludarabina y ciclofosfamida en el tratamiento de la leucemia linfática crónica Economic evaluation of rituximab added to fludarabine plus cyclophosphamide versus fludarabine plus cyclophosphamide for the treatment of chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Luis Felipe Casado

    2011-08-01

    Full Text Available Objetivos: Evaluar el coste-efectividad del esquema de rituximab, fludarabina y ciclofosfamida (R-FC en comparación con el de fludarabina y ciclofosfamida (FC en dos tipos de pacientes con leucemia linfática crónica (LLC: no tratados previamente o bien en recidiva/resistentes al tratamiento previo. Métodos: Dos modelos de Markov, utilizando los resultados publicados de superviviencia libre de progresión (SLP de pacientes con LLC tratados con R-FC o FC en primera o segunda línea, las tasas de progresión de la enfermedad y las tasas de mortalidad en España. A los estados de SLP y progresión se les asignaron utilidades obtenidas en un estudio sobre LLC. Los costes de los medicamentos y de los tratamientos de soporte, así como los años de vida ajustados por calidad (AVAC, se estimaron para un periodo de 10 años. Se efectuaron análisis de sensibilidad univariados y probabilísticos (Monte Carlo. Resultados: La adición de rituximab a la quimioterapia con FC aumentó los años de vida ganados (AVG y los AVAC tanto en primera como en segunda línea de tratamiento. La razón de coste-eficacia incremental fue de 20.703 € por AVG y de 19.343 € por AVAC con la primera línea de tratamiento, y de 23.183 € por AVG y 24.781 € por AVAC con la segunda línea de tratamiento. Conclusiones: En los pacientes con LLC no tratados previamente y en aquellos en recaída o resistentes al tratamiento previo, la adición de rituximab al esquema FC aumentó la esperanza de vida y los AVAC, y en ambos casos resultó ser un tratamiento coste-efectivo.Objectives: We evaluated the cost-effectiveness of rituximab added to the chemotherapy regimen of fludarabine plus cyclophosphamide (R-FC versus fludarabine plus cyclophosphamide (FC for the treatment of patients with previously untreated or relapsed/refractory chronic lymphocytic leukemia (CLL. Methods: Two Markov models were built, using published results on progression-free survival (PFS in patients

  2. The effectiveness of environmental strategies on noise reduction in a pediatric intensive care unit: creation of single-patient bedrooms and reducing noise sources.

    Science.gov (United States)

    Kol, Emine; Aydın, Perihan; Dursun, Oguz

    2015-07-01

    Noise is a substantial problem for both patients and healthcare workers in hospitals. This study aimed to determine the effectiveness of environmental strategies (creating single-patient rooms and reducing noise sources) in noise reduction in a pediatric intensive care unit. Noise measurement in the unit was conducted in two phases. In the first phase, measurements aimed at determining the unit's present level of noise were performed over 4 weeks in December 2013. During the month following the first measurement phase, the intensive care unit (ICU) was moved to a new location and noise-reducing strategies were implemented. The second phase, in May 2014, measured noise levels in the newly constructed environment. The noise levels before and after environmental changes were statistically significant at 72.6 dB-A and 56 dB-A, respectively (p noise-reducing strategies can be effective in controlling environmental noise in the ICU. © 2015, Wiley Periodicals, Inc.

  3. Alternative donor hematopoietic stem cell transplantation for mature lymphoid malignancies after reduced-intensity conditioning regimen

    DEFF Research Database (Denmark)

    Rodrigues, Celso Arrais; Rocha, Vanderson; Dreger, Peter

    2014-01-01

    We have reported encouraging results of unrelated cord blood transplantation for patients with lymphoid malignancies. Whether those outcomes are comparable to matched unrelated donor transplants remains to be defined. We studied 645 adult patients with mature lymphoid malignancies who received...... an allogeneic unrelated donor transplant using umbilical cord blood (n=104) or mobilized peripheral blood stem cells (n=541) after a reduced-intensity conditioning regimen. Unrelated cord blood recipients had more refractory disease. Median follow-up time was 30 months. Neutrophil engraftment (81% vs. 97......%, respectively; Pblood than after matched unrelated donor, whereas no differences were observed in grade II-IV acute graft-versus-host disease (29% vs. 32%), non-relapse mortality (29% vs. 28...

  4. Inhibition of nucleotide excision repair by fludarabine in normal lymphocytes in vitro, measured by the alkaline single cell gel electrophoresis (comet) assay

    Energy Technology Data Exchange (ETDEWEB)

    Yamauchi, Takahiro; Kawai, Yasukazu; Ueda, Takanori [Fukui Medical Univ., Matsuoka (Japan)

    2002-05-01

    Alkylating agents or platinum analogues initiate several excision repair mechanisms, which involve incision of the DNA strand, excision of the damaged nucleotide, gap filling by DNA resynthesis, and rejoining by ligation. The previous study described that nucleotide excision repair permitted incorporation of fludarabine nucleoside (F-area-A) into the repair patch, thereby inhibiting the DNA resynthesis. In the present study, to clarify the repair kinetics in view of the inhibition by F-ara-A, normal lymphocytes were stimulated to undergo nucleotide excision repair by ultraviolet C (UV) irradiation in the presence or absence of F-ara-A. The repair kinetics were determined as DNA single strand breaks resulting from the incision and the rejoining using the alkaline single cell gel electrophoresis (comet) assay. DNA resynthesis was evaluated in terms of the uptake of tritiated thymidine into DNA. The lymphocytes initiated the incision step maximally at 1 h, and completed the rejoining process within 4 h after UV exposure. UV also initiated thymidine uptake, which increased time-dependently and reached a plateau at 4 h. A 2-h pre-incubation with F-ara-A inhibited the repair in a concentration-dependent manner, with the maximal inhibition by 5 {mu}M. This inhibitory effect was demonstrated by the reduction of the thymidine uptake and by the inhibition of the rejoining. A DNA polymerase inhibitor, aphidicolin, and a ribonucleotide reductase inhibitor, hydroxyurea, were not so inhibitory to the repair process as F-ara-A at equimolar concentrations. The present findings suggest that inhibition of nucleotide excision repair may represent a novel therapeutic strategy against cancer, especially in the context of resistant cells with an increased repair capacity. (author)

  5. System dynamics analysis of strategies to reduce energy use in aluminum-intensive sectors

    Energy Technology Data Exchange (ETDEWEB)

    Hanes, Rebecca J.; Nicholson, Scott; 25-29 June 2017, Carpenter, Alberta

    2017-07-13

    Aluminum is one of the most widely used materials in industry, with applications in buildings, vehicles, aircraft, and consumer products. Its ubiquity is also on the rise: aluminum is beginning to supplant steel in lightweight vehicles and aircraft, and is used in many green or LEED-certified buildings. Although aluminum tends to be highly recycled, particularly by manufacturers of aluminum products, the sector as a whole is still far from a closed system. As a result, the increase in aluminum consumption also means an increase in primary aluminum production-an energy-intensive process-and an increase in consumption of the raw material bauxite, which in the U.S. is almost entirely imported. Our objectives for this study are to identify and analyze aluminum sector technologies and practices that reduce the energy required to manufacture aluminum products and reduce U.S. dependence on imported aluminum and bauxite. To accomplish these objectives, we will develop a system dynamics (SD) model of aluminum production, use and recycling in key application areas, including aerospace, ground vehicles and consumer products. The model will cover the entire aluminum supply chain as it exists in the U.S., from bauxite importing and refining, to the manufacture of products, to the product use phase and end-of-life processing steps. Aluminum flows throughout the model will be determined by the annual domestic demand for each application area as well as demand projections that extend to 2030. Energy consumption will be tracked based on the flows of aluminum through each step of the supply chain. Using the SD model, we will evaluate several technologies and practices that have the potential to reduce energy consumption and reliance on imported bauxite. These include implementation of advanced primary aluminum production technologies, increased recycling within and between application areas, increased material efficiency and increased product lifetimes. Each of these strategies

  6. Reducing Production Basis Risk through Rainfall Intensity Frequency (RIF) Indexes: Global Sensitivity Analysis' Implication on Policy Design

    Science.gov (United States)

    Muneepeerakul, Chitsomanus; Huffaker, Ray; Munoz-Carpena, Rafael

    2016-04-01

    The weather index insurance promises financial resilience to farmers struck by harsh weather conditions with swift compensation at affordable premium thanks to its minimal adverse selection and moral hazard. Despite these advantages, the very nature of indexing causes the presence of "production basis risk" that the selected weather indexes and their thresholds do not correspond to actual damages. To reduce basis risk without additional data collection cost, we propose the use of rain intensity and frequency as indexes as it could offer better protection at the lower premium by avoiding basis risk-strike trade-off inherent in the total rainfall index. We present empirical evidences and modeling results that even under the similar cumulative rainfall and temperature environment, yield can significantly differ especially for drought sensitive crops. We further show that deriving the trigger level and payoff function from regression between historical yield and total rainfall data may pose significant basis risk owing to their non-unique relationship in the insured range of rainfall. Lastly, we discuss the design of index insurance in terms of contract specifications based on the results from global sensitivity analysis.

  7. Reduced clot debris size using standing waves formed via high intensity focused ultrasound

    Science.gov (United States)

    Guo, Shifang; Du, Xuan; Wang, Xin; Lu, Shukuan; Shi, Aiwei; Xu, Shanshan; Bouakaz, Ayache; Wan, Mingxi

    2017-09-01

    The feasibility of utilizing high intensity focused ultrasound (HIFU) to induce thrombolysis has been demonstrated previously. However, clinical concerns still remain related to the clot debris produced via fragmentation of the original clot potentially being too large and hence occluding downstream vessels, causing hazardous emboli. This study investigates the use of standing wave fields formed via HIFU to disintegrate the thrombus while achieving a reduced clot debris size in vitro. The results showed that the average diameter of the clot debris calculated by volume percentage was smaller in the standing wave mode than in the travelling wave mode at identical ultrasound thrombolysis settings. Furthermore, the inertial cavitation dose was shown to be lower in the standing wave mode, while the estimated cavitation bubble size distribution was similar in both modes. These results show that a reduction of the clot debris size with standing waves may be attributed to the particle trapping of the acoustic potential well which contributed to particle fragmentation.

  8. Acceptance- and imagery-based strategies can reduce chocolate cravings: A test of the elaborated-intrusion theory of desire.

    Science.gov (United States)

    Schumacher, Sophie; Kemps, Eva; Tiggemann, Marika

    2017-06-01

    The elaborated-intrusion theory of desire proposes that craving is a two-stage process whereby initial intrusions about a desired target are subsequently elaborated with mental imagery. The present study tested whether the craving reduction strategies of cognitive defusion and guided imagery could differentially target the intrusion and elaboration stages, respectively, and thus differentially impact the craving process. Participants were randomly assigned to a cognitive defusion, a guided imagery or a mind-wandering control condition. Pre- and post-intervention chocolate-related thoughts, intrusiveness of thoughts, vividness of imagery, craving intensity, and chocolate consumption were compared. Experiment 1 recruited a general sample of young women (n = 94), whereas Experiment 2 recruited a sample of chocolate cravers who wanted to reduce their chocolate consumption (n = 97). Across both experiments, cognitive defusion lowered intrusiveness of thoughts, vividness of imagery and craving intensity. Guided imagery reduced chocolate-related thoughts, intrusiveness, vividness and craving intensity for chocolate cravers (Experiment 2), but not for the general sample (Experiment 1). There were no group differences in chocolate consumption in either experiment. Results add to existing evidence supporting the elaborated-intrusion theory of desire in the food domain, and suggest that acceptance- and imagery-based techniques have potential for use in combatting problematic cravings. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The Association between Cigarette Smoking and Acne Intensity

    Directory of Open Access Journals (Sweden)

    Taheri Ramin

    2009-06-01

    Full Text Available Background: Acne vulgaris is a common chronic inflammatory disease of pilosebaceous unit. Different factors have been suggested to influence acne including diet, menstruation and occupation. The role of some of these factors on acne intensity is confirmed. The affect of Cigarette smoking on acne intensity has been suggested. In this research, we evaluated the association between cigarette smoking and the acne intensity.Materials and Methods: This cross-sectional study was performed on 278 smoker and 277non smoker males referred to dermatology clinics of Semnan during 2006-2007. The dermatologists interviewing the patients completed questionnaires based on clinical diagnosis and intensity of acne. Data analysis was performed using t-test, Mann-Whitney, Chi-square and Spearman coefficient tests. P-value less than 0.05 were considered significant. Results: Severe acne was observed in 16.6% of non-smokers and 22.7% of smokers. Distribution of acne intensity in both groups was significant (P=0.023. Association between duration of cigarette smoking and acne intensity was significant too (P<0.001. The association between dosage of cigarette smoking and acne intensity was also significant (P<0.001.Conclusion: Significant association between cigarette smoking and acne intensity showed that smoking withdrawal is helpful for reducing the acne intensity

  10. Comparing the costs and benefits of floating rice-based and intensive rice-based farming systems in the Mekong delta

    OpenAIRE

    Van Kien Nguyen; Oc Van Vo; Duc Ngoc Huynh

    2015-01-01

    This paper compares financial costs and benefits of floating rice-based and intensive rice farming systems using data from focus group discussions and household survey in four locations in the Mekong Delta. We argue that the net financial benefit per 1000m2 of integrated floating rice-based farming systems is greater than the net financial benefit of intensive rice farming system. The total net benefit of floating rice-leeks shows the highest net benefit (VND 24.8 mil./1000 m2), followed by f...

  11. Relapsed Diffuse Large B-Cell Lymphoma Treated by Reduced-Intensity Allogeneic Stem Cell Transplantation with Donor Lymphocyte Infusion

    International Nuclear Information System (INIS)

    Chudhry, Q.N.; Ahmed, P.; Ullah, K.; Satti, T.M.; Raza, S.; Mehmood, S.K.; Akram, M.; Ahmed, S.

    2010-01-01

    A 42 years old male with relapsed diffuse large B-cell lymphoma was given second-line chemotherapy followed by reduced intensity allogeneic stem cell transplantation from HLA matched brother. Twelve weeks post transplant, his disease relapsed evidenced by the appearance of lymphoma cells in the peripheral blood and declining donor chimerism. Donor lymphocyte infusion was given that induced complete lymphoma remission. The patient is well 3 years post transplant with his disease in complete remission. (author)

  12. Differential standard deviation of log-scale intensity based optical coherence tomography angiography.

    Science.gov (United States)

    Shi, Weisong; Gao, Wanrong; Chen, Chaoliang; Yang, Victor X D

    2017-12-01

    In this paper, a differential standard deviation of log-scale intensity (DSDLI) based optical coherence tomography angiography (OCTA) is presented for calculating microvascular images of human skin. The DSDLI algorithm calculates the variance in difference images of two consecutive log-scale intensity based structural images from the same position along depth direction to contrast blood flow. The en face microvascular images were then generated by calculating the standard deviation of the differential log-scale intensities within the specific depth range, resulting in an improvement in spatial resolution and SNR in microvascular images compared to speckle variance OCT and power intensity differential method. The performance of DSDLI was testified by both phantom and in vivo experiments. In in vivo experiments, a self-adaptive sub-pixel image registration algorithm was performed to remove the bulk motion noise, where 2D Fourier transform was utilized to generate new images with spatial interval equal to half of the distance between two pixels in both fast-scanning and depth directions. The SNRs of signals of flowing particles are improved by 7.3 dB and 6.8 dB on average in phantom and in vivo experiments, respectively, while the average spatial resolution of images of in vivo blood vessels is increased by 21%. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  13. CUTANEUS STIMULATION: SLOW-STROKE BACK MASSAGE REDUCES THE INTENSITY OF OSTEOARTRITIS PAIN OF ELDERLY

    Directory of Open Access Journals (Sweden)

    Mira Triharini

    2017-04-01

    Full Text Available Introduction: Osteoarthritis disease is the result of both mechanical and biological process which lead come to unstable degradation and synthesis of condrozyte cartilage and extracellular matrix. The risk factor of this instability is aging process. The aging process stimulates osteophytes formation and degradation of cartilage, and emerged pain as primary clinical symptom. One of the non pharmacological ways to cope this pain is by applying cutaneus stimulation through slow-stroke back massage method. The objective of this study was to analyze the effect of applying cutaneus stimulation with slow-stroke back massage method to osteoarthritis’s pain intensity. Method: Pre experimental design with one group pre test-post test approach was used in this study. The subject of this study were elderly above 50 years old living in Panti Werdha Hargo Dedali Surabaya, 15 participants were involved using purpose sampling technique. This study started on January 29th until February 6th, 2010. Data were collected by interview and observation and analyzed by WIlcoxcon Signed Rank Test α = 0.05, p value <α. Result: The Result showed that the message intervention was significantly affect the elder’s level of osteoarthritis pain in Panti Werdha Hargo Dedali Surabaya (p = 0.003. Discussion: It can be concluded that gives stimulation cutaneus: slow-stroke back massage reduce osteoathritis pain intensity. Slow-stroke back massage increase level of endorphin, so that pain reduction and individual pain perception will decrease.

  14. Energy intensity and its determinants in China's regional economies

    International Nuclear Information System (INIS)

    Wu Yanrui

    2012-01-01

    This paper contributes to the existing literature as well as policy debates by examining energy intensity and its determinants in China's regional economies. The analysis is based on a comprehensive database of China's regional energy balance constructed for this project. Through its focus on regional China, this study extends the existing literature, which mainly covers nationwide studies. It is found in this paper that energy intensity declined substantially in China. The main contributing factor is the improvement in energy efficiency. Changes in the economic structure have so far affected energy intensity modestly. Thus there is considerable scope to reduce energy intensity through the structural transformation of the Chinese economy in the future. - Highlights: ► First study examining energy intensity and its determinants using sectoral data in Chinese regions. ► Major findings. ► Decline in energy intensity is due to the rise in energy efficiency. ► Economic structural change has played little role. ► Growth in capital intensity alone would not lead to the decline in energy consumption.

  15. A scintillating fibre-based profiler for low intensity ion beams

    Energy Technology Data Exchange (ETDEWEB)

    Finocchiaro, P. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Amato, A. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Ciavola, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Cuttone, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Gu, M. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Raia, G. [Istituto Nazionale di Fisica Nucleare, Catania (Italy); Rovelli, A. [Istituto Nazionale di Fisica Nucleare, Catania (Italy)

    1997-01-11

    In the framework of the EXCYT radioactive ion beam facility, now under development at LNS Catania, we have developed a new beam profile monitor based on a scintillating fibre and a photodetector. Its sensitivity allows the detection of single beam particles in pulse mode, thus representing a useful tool for diagnostics of low and very low intensity beams. (orig.).

  16. A scintillating fibre-based profiler for low intensity ion beams

    International Nuclear Information System (INIS)

    Finocchiaro, P.; Amato, A.; Ciavola, G.; Cuttone, G.; Gu, M.; Raia, G.; Rovelli, A.

    1997-01-01

    In the framework of the EXCYT radioactive ion beam facility, now under development at LNS Catania, we have developed a new beam profile monitor based on a scintillating fibre and a photodetector. Its sensitivity allows the detection of single beam particles in pulse mode, thus representing a useful tool for diagnostics of low and very low intensity beams. (orig.)

  17. Respiration rate detection based on intensity modulation using plastic optical fiber

    Science.gov (United States)

    Anwar, Zawawi Mohd; Ziran Nurul Sufia, Nor; Hadi, Manap

    2017-11-01

    This paper presents the implementation of respiration rate measurement via a simple intensity-based optical fiber sensor using optical fiber technology. The breathing rate is measured based on the light intensity variation due to the longitudinal gap changes between two separated fibers. In order to monitor the breathing rate continuously, the output from the photodetector conditioning circuit is connected to a low-cost Arduino kit. At the sensing point, two optical fiber cables are positioned in series with a small gap and fitted inside a transparent plastic tube. To ensure smooth movement of the fiber during inhale and exhale processes as well as to maintain the gap of the fiber during idle condition, the fiber is attached firmly to a stretchable bandage. This study shows that this simple fiber arrangement can be applied to detect respiration activity which might be critical for patient monitoring.

  18. Respiration rate detection based on intensity modulation using plastic optical fiber

    Directory of Open Access Journals (Sweden)

    Mohd Anwar Zawawi

    2017-01-01

    Full Text Available This paper presents the implementation of respiration rate measurement via a simple intensity-based optical fiber sensor using optical fiber technology. The breathing rate is measured based on the light intensity variation due to the longitudinal gap changes between two separated fibers. In order to monitor the breathing rate continuously, the output from the photodetector conditioning circuit is connected to a low-cost Arduino kit. At the sensing point, two optical fiber cables are positioned in series with a small gap and fitted inside a transparent plastic tube. To ensure smooth movement of the fiber during inhale and exhale processes as well as to maintain the gap of the fiber during idle condition, the fiber is attached firmly to a stretchable bandage. This study shows that this simple fiber arrangement can be applied to detect respiration activity which might be critical for patient monitoring.

  19. TU-EF-304-07: Monte Carlo-Based Inverse Treatment Plan Optimization for Intensity Modulated Proton Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Li, Y [Tsinghua University, Beijing, Beijing (China); UT Southwestern Medical Center, Dallas, TX (United States); Tian, Z; Jiang, S; Jia, X [UT Southwestern Medical Center, Dallas, TX (United States); Song, T [Southern Medical University, Guangzhou, Guangdong (China); UT Southwestern Medical Center, Dallas, TX (United States); Wu, Z; Liu, Y [Tsinghua University, Beijing, Beijing (China)

    2015-06-15

    Purpose: Intensity-modulated proton therapy (IMPT) is increasingly used in proton therapy. For IMPT optimization, Monte Carlo (MC) is desired for spots dose calculations because of its high accuracy, especially in cases with a high level of heterogeneity. It is also preferred in biological optimization problems due to the capability of computing quantities related to biological effects. However, MC simulation is typically too slow to be used for this purpose. Although GPU-based MC engines have become available, the achieved efficiency is still not ideal. The purpose of this work is to develop a new optimization scheme to include GPU-based MC into IMPT. Methods: A conventional approach using MC in IMPT simply calls the MC dose engine repeatedly for each spot dose calculations. However, this is not the optimal approach, because of the unnecessary computations on some spots that turned out to have very small weights after solving the optimization problem. GPU-memory writing conflict occurring at a small beam size also reduces computational efficiency. To solve these problems, we developed a new framework that iteratively performs MC dose calculations and plan optimizations. At each dose calculation step, the particles were sampled from different spots altogether with Metropolis algorithm, such that the particle number is proportional to the latest optimized spot intensity. Simultaneously transporting particles from multiple spots also mitigated the memory writing conflict problem. Results: We have validated the proposed MC-based optimization schemes in one prostate case. The total computation time of our method was ∼5–6 min on one NVIDIA GPU card, including both spot dose calculation and plan optimization, whereas a conventional method naively using the same GPU-based MC engine were ∼3 times slower. Conclusion: A fast GPU-based MC dose calculation method along with a novel optimization workflow is developed. The high efficiency makes it attractive for clinical

  20. TU-EF-304-07: Monte Carlo-Based Inverse Treatment Plan Optimization for Intensity Modulated Proton Therapy

    International Nuclear Information System (INIS)

    Li, Y; Tian, Z; Jiang, S; Jia, X; Song, T; Wu, Z; Liu, Y

    2015-01-01

    Purpose: Intensity-modulated proton therapy (IMPT) is increasingly used in proton therapy. For IMPT optimization, Monte Carlo (MC) is desired for spots dose calculations because of its high accuracy, especially in cases with a high level of heterogeneity. It is also preferred in biological optimization problems due to the capability of computing quantities related to biological effects. However, MC simulation is typically too slow to be used for this purpose. Although GPU-based MC engines have become available, the achieved efficiency is still not ideal. The purpose of this work is to develop a new optimization scheme to include GPU-based MC into IMPT. Methods: A conventional approach using MC in IMPT simply calls the MC dose engine repeatedly for each spot dose calculations. However, this is not the optimal approach, because of the unnecessary computations on some spots that turned out to have very small weights after solving the optimization problem. GPU-memory writing conflict occurring at a small beam size also reduces computational efficiency. To solve these problems, we developed a new framework that iteratively performs MC dose calculations and plan optimizations. At each dose calculation step, the particles were sampled from different spots altogether with Metropolis algorithm, such that the particle number is proportional to the latest optimized spot intensity. Simultaneously transporting particles from multiple spots also mitigated the memory writing conflict problem. Results: We have validated the proposed MC-based optimization schemes in one prostate case. The total computation time of our method was ∼5–6 min on one NVIDIA GPU card, including both spot dose calculation and plan optimization, whereas a conventional method naively using the same GPU-based MC engine were ∼3 times slower. Conclusion: A fast GPU-based MC dose calculation method along with a novel optimization workflow is developed. The high efficiency makes it attractive for clinical

  1. Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study.

    Science.gov (United States)

    Trimmer, Chris; Tyo, Richard; Pikard, Jennifer; McKenna, Claire; Naeem, Farooq

    2018-03-01

    Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.

  2. Tissue-Based MRI Intensity Standardization: Application to Multicentric Datasets

    Directory of Open Access Journals (Sweden)

    Nicolas Robitaille

    2012-01-01

    Full Text Available Intensity standardization in MRI aims at correcting scanner-dependent intensity variations. Existing simple and robust techniques aim at matching the input image histogram onto a standard, while we think that standardization should aim at matching spatially corresponding tissue intensities. In this study, we present a novel automatic technique, called STI for STandardization of Intensities, which not only shares the simplicity and robustness of histogram-matching techniques, but also incorporates tissue spatial intensity information. STI uses joint intensity histograms to determine intensity correspondence in each tissue between the input and standard images. We compared STI to an existing histogram-matching technique on two multicentric datasets, Pilot E-ADNI and ADNI, by measuring the intensity error with respect to the standard image after performing nonlinear registration. The Pilot E-ADNI dataset consisted in 3 subjects each scanned in 7 different sites. The ADNI dataset consisted in 795 subjects scanned in more than 50 different sites. STI was superior to the histogram-matching technique, showing significantly better intensity matching for the brain white matter with respect to the standard image.

  3. Shortening Delivery Times of Intensity Modulated Proton Therapy by Reducing Proton Energy Layers During Treatment Plan Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Water, Steven van de, E-mail: s.vandewater@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands); Kooy, Hanne M. [F. H. Burr Proton Therapy Center, Department of Radiation Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts (United States); Heijmen, Ben J.M.; Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam (Netherlands)

    2015-06-01

    Purpose: To shorten delivery times of intensity modulated proton therapy by reducing the number of energy layers in the treatment plan. Methods and Materials: We have developed an energy layer reduction method, which was implemented into our in-house-developed multicriteria treatment planning system “Erasmus-iCycle.” The method consisted of 2 components: (1) minimizing the logarithm of the total spot weight per energy layer; and (2) iteratively excluding low-weighted energy layers. The method was benchmarked by comparing a robust “time-efficient plan” (with energy layer reduction) with a robust “standard clinical plan” (without energy layer reduction) for 5 oropharyngeal cases and 5 prostate cases. Both plans of each patient had equal robust plan quality, because the worst-case dose parameters of the standard clinical plan were used as dose constraints for the time-efficient plan. Worst-case robust optimization was performed, accounting for setup errors of 3 mm and range errors of 3% + 1 mm. We evaluated the number of energy layers and the expected delivery time per fraction, assuming 30 seconds per beam direction, 10 ms per spot, and 400 Giga-protons per minute. The energy switching time was varied from 0.1 to 5 seconds. Results: The number of energy layers was on average reduced by 45% (range, 30%-56%) for the oropharyngeal cases and by 28% (range, 25%-32%) for the prostate cases. When assuming 1, 2, or 5 seconds energy switching time, the average delivery time was shortened from 3.9 to 3.0 minutes (25%), 6.0 to 4.2 minutes (32%), or 12.3 to 7.7 minutes (38%) for the oropharyngeal cases, and from 3.4 to 2.9 minutes (16%), 5.2 to 4.2 minutes (20%), or 10.6 to 8.0 minutes (24%) for the prostate cases. Conclusions: Delivery times of intensity modulated proton therapy can be reduced substantially without compromising robust plan quality. Shorter delivery times are likely to reduce treatment uncertainties and costs.

  4. Upcoversion performance improvement of NaYF{sub 4}:Yb, Er by Sn codoping: Enhanced emission intensity and reduced decay time

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Han, E-mail: fjfzyh@fzu.edu.cn [College of Materials Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108 (China); Cao, Wenbing [College of Materials Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108 (China); Huang, Qingming [Instrumentation Analysis and Research Center, Fuzhou University, Fuzhou, Fujian 350002 (China); Ma, En [Fujian Institute of Research on the Structure of Matter, Chinese Academy of Sciences, Fuzhou, Fujian 350002 (China); Zhang, Xinqi [Instrumentation Analysis and Research Center, Fuzhou University, Fuzhou, Fujian 350002 (China); Yu, Jianchang [College of Materials Science and Engineering, Fuzhou University, Fuzhou, Fujian 350108 (China)

    2013-11-15

    In this manuscript we report a phenomenon that upconversion emission intensity of Er{sup 3+} was enhanced while decay time constant was decreased obviously by Sn codoping with Yb/Er into hexagonal NaYF{sub 4} synchronously. X-ray powder diffiraction, field emission scanning electron microscope, transmission electron microscopy, X-ray photoelectron spectroscopy, electron spin-resonance spectroscopy and upconversion emission spectra were employed to explore the relation of crystal structure and properties. From these characterizations we found that symmetry of the rare earth ion local crystal field could be tuned by different Sn codoping concentration. For the variable valence property of Sn the local crystal field asymmetry and emission intensity of NaYF{sub 4}:Yb, Er arrived to the maximum when 3 mol% Sn was codoped, while decay time was reduced. The study of this changing tends of upconversion emission intensity and decay time constant may be helpful for design and fabrication of high performance upconversion materials. - Graphical abstract: Variable-valenced Sn is introduced with Yb/Er into NaFY{sub 4} to tune structure and local crystal field. Upconversion emission intensity of Er{sup 3+} was enhanced while decay time constant was decreased. Display Omitted - Highlights: • NaYF{sub 4}: Yb, Er was codoped with different concentration Sn. • Upconversion emission intensity was enhanced while decay time constant was decreased. • Introduction of variable-valenced Sn is effective to tune structure and crystal field of NaFY{sub 4}.

  5. Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy.

    Science.gov (United States)

    Gyorkos, Theresa W; Gilbert, Nicolas L; Larocque, Renée; Casapía, Martín; Montresor, Antonio

    2012-01-01

    The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (light); 1,000-9,999 epg (moderate), and ≥ 10,000 epg (heavy)) were developed in the 1980s, when there were little epidemiological data available on dose-response relationships. This study was undertaken to determine a threshold for T. trichiura-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions. In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg) had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg). They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62) and 1.73 (95% CI: 1.09, 2.74), respectively. This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly.

  6. Changes in energy intensity in the manufacturing sector 1985--1991

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-15

    In this report, energy intensity is defined as the ratio of energy consumption per unit of output. Output is measured as the constant dollar of value of shipments and receipts, and two measures of energy consumption are presented in British thermal units (Btu): Offsite-Produced Energy and Total Inputs of Energy. A decrease in energy intensity from one period to another suggests an increase in energy efficiency, and vice versa. Energy efficiency can be defined and measured in various ways. Certain concepts of energy efficiency, especially those limited to equipment efficiencies, cannot be measured over time using changes in energy-intensity ratios. While improved energy efficiency will tend to reduce energy intensity, it is also true that a change in energy intensity can be due to factors unrelated to energy efficiency. For this report, energy intensity is used as a surrogate measure for energy efficiency, based on industry knowledge and current methodological analyses.

  7. Signal intensity enhancement of laser ablated volume holograms

    Science.gov (United States)

    Versnel, J. M.; Williams, C.; Davidson, C. A. B.; Wilkinson, T. D.; Lowe, C. R.

    2017-11-01

    Conventional volume holographic gratings (VHGs) fabricated in photosensitive emulsions such as gelatin containing silver salts enable the facile visualization of the holographic image in ambient lighting. However, for the fabrication of holographic sensors, which require more defined and chemically-functionalised polymer matrices, laser ablation has been introduced to create the VHGs and thereby broaden their applications, although the replay signal can be challenging to detect in ambient lighting. When traditional photochemical bleaching solutions used to reduce light scattering and modulate refractive index within the VHG are applied to laser ablated volume holographic gratings, these procedures decrease the holographic peak intensity. This is postulated to occur because both light and dark fringes contain a proportion of metal particles, which upon solubilisation are converted immediately to silver iodide, yielding no net refractive index modulation. This research advances a hypothesis that the reduced intensity of holographic replay signals is linked to a gradient of different sized metal particles within the emulsion, which reduces the holographic signal and may explain why traditional bleaching processes result in a reduction in intensity. In this report, a novel experimental protocol is provided, along with simulations based on an effective medium periodic 1D stack, that offers a solution to increase peak signal intensity of holographic sensors by greater than 200%. Nitric acid is used to etch the silver nanoparticles within the polymer matrix and is thought to remove the smaller particles to generate more defined metal fringes containing a soluble metal salt. Once the grating efficiency has been increased, this salt can be converted to a silver halide, to modulate the refractive index and increase the intensity of the holographic signal. This new protocol has been tested in a range of polymer chemistries; those containing functional groups that help to

  8. Light-intensity and high-intensity interval training improve cardiometabolic health in rats.

    Science.gov (United States)

    Batacan, Romeo B; Duncan, Mitch J; Dalbo, Vincent J; Connolly, Kylie J; Fenning, Andrew S

    2016-09-01

    Physical activity has the potential to reduce cardiometabolic risk factors but evaluation of different intensities of physical activity and the mechanisms behind their health effects still need to be fully established. This study examined the effects of sedentary behaviour, light-intensity training, and high-intensity interval training on biometric indices, glucose and lipid metabolism, inflammatory and oxidative stress markers, and vascular and cardiac function in adult rats. Rats (12 weeks old) were randomly assigned to 1 of 4 groups: control (CTL; no exercise), sedentary (SED; no exercise and housed in small cages to reduce activity), light-intensity trained (LIT; four 30-min exercise bouts/day at 8 m/min separated by 2-h rest period, 5 days/week), and high-intensity interval trained (HIIT, four 2.5-min work bouts/day at 50 m/min separated by 3-min rest periods, 5 days/week). After 12 weeks of intervention, SED had greater visceral fat accumulation (p HIIT demonstrated beneficial changes in body weight, visceral and epididymal fat weight, glucose regulation, low-density lipoprotein cholesterol, total cholesterol, and mesenteric vessel contractile response compared with the CTL group (p HIIT had significant improvements in systolic blood pressure and endothelium-independent vasodilation to aorta and mesenteric artery compared with the CTL group (p HIIT induce health benefits by improving traditional cardiometabolic risk factors. LIT improves cardiac health while HIIT promotes improvements in vascular health.

  9. Comparing climate policies to reduce carbon emissions in China

    International Nuclear Information System (INIS)

    Li, Aijun; Lin, Boqiang

    2013-01-01

    Currently, China is the largest carbon emitter mainly due to growing consumption of fossil fuels. In 2009, the Chinese government committed itself to reducing domestic carbon emissions per unit of GDP by 40–45% by 2020 compared to 2005 levels. Therefore, it is a top priority for the Chinese government to adopt efficient policy instruments to reduce its carbon intensity. Against this background, this paper develops a general equilibrium model and seeks to provide empirical contributions by comparing the potential impacts of several different policy options to reduce China's carbon emissions. The main findings are as follows. Firstly, these climate policies would affect the structure of economy and contribute to carbon emissions reduction and carbon intensity reduction. Secondly, there would be significant differences in the economic and environmental effects among different climate policies and hence, the government would trade-off among different economic objectives to overcome any potential resistances. Thirdly, there would be considerable differences in the emissions effects of absolute and intensity-based carbon emissions controls, implying that the government might adopt different climate policies for absolute or intensity-based carbon emissions controls. Looking ahead, the government should trade-off among different objectives when designing climate reforms. - Highlights: • We develop a static general equilibrium model to simulate the impacts of climate policies. • We compare the potential impacts of various climate policies in China. • We discuss how to design these policies to make them more effective

  10. Tacrolimus and mycophenolate mofetil after nonmyeloablative matched-sibling donor allogeneic stem-cell transplantations conditioned with fludarabine and low-dose total body irradiation.

    Science.gov (United States)

    Nieto, Yago; Patton, Nigel; Hawkins, Timothy; Spearing, Ruth; Bearman, Scott I; Jones, Roy B; Shpall, Elizabeth J; Rabinovitch, Rachel; Zeng, Chan; Barón, Anna; McSweeney, Peter A

    2006-02-01

    We evaluated tacrolimus/mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis after a nonmyeloablative stem cell transplantation (NST) from a matched sibling donor (MSD). Thirty-two patients (median age, 57 years) with advanced hematologic malignancies, who were poor candidates for a conventional myeloablative transplantation, received fludarabine (30 mg/m(2), day -4 to day -2), total-body irradiation (TBI) (200 cGy, day 0), infusion of donor peripheral blood progenitor cells (day 0), oral tacrolimus 0.06 mg/kg twice daily (from day 3), and oral MMF at 15 mg/kg twice daily (days 0-+27). Tacrolimus was tapered from day +100 to day +180 in those patients with indolent malignancies (n = 25), and from day +35 to day +56 in those with aggressive tumors (n = 7). Regimen toxicities and myelosuppression were mild, allowing 75% of patients to have entirely outpatient transplantations. One patient (3%) experienced a nonfatal graft rejection. Rates of grades II-IV and III-IV acute GVHD were 15.6% and 3%, respectively. Acute GVHD was diagnosed at median day +78 (range, days +31-+84). Extensive chronic GVHD was observed in 10 of 24 evaluable patients (41.6%) at a median onset of day +198 (range, days +128-+277), either spontaneously (n = 5) or elicited after tumor progression (n = 5). Five patients experienced transplantation-related mortality (TRM) (15.6%) from either acute GVHD-related multiorgan failure (MOF) (n = 3) or infectious complications (n = 2). At median follow-up of 19 months (range, 2-41 months), the overall survival, progression-free survival, and disease-free survival rates are 62.5%, 50%, and 40%, respectively. In conclusion, the use of tacrolimus/MMF after MSD NST is associated with encouraging rates of GVHD control.

  11. DIaaS: Data-Intensive workflows as a service - Enabling easy composition and deployment of data-intensive workflows on Virtual Research Environments

    Science.gov (United States)

    Filgueira, R.; Ferreira da Silva, R.; Deelman, E.; Atkinson, M.

    2016-12-01

    We present the Data-Intensive workflows as a Service (DIaaS) model for enabling easy data-intensive workflow composition and deployment on clouds using containers. DIaaS model backbone is Asterism, an integrated solution for running data-intensive stream-based applications on heterogeneous systems, which combines the benefits of dispel4py with Pegasus workflow systems. The stream-based executions of an Asterism workflow are managed by dispel4py, while the data movement between different e-Infrastructures, and the coordination of the application execution are automatically managed by Pegasus. DIaaS combines Asterism framework with Docker containers to provide an integrated, complete, easy-to-use, portable approach to run data-intensive workflows on distributed platforms. Three containers integrate the DIaaS model: a Pegasus node, and an MPI and an Apache Storm clusters. Container images are described as Dockerfiles (available online at http://github.com/dispel4py/pegasus_dispel4py), linked to Docker Hub for providing continuous integration (automated image builds), and image storing and sharing. In this model, all required software (workflow systems and execution engines) for running scientific applications are packed into the containers, which significantly reduces the effort (and possible human errors) required by scientists or VRE administrators to build such systems. The most common use of DIaaS will be to act as a backend of VREs or Scientific Gateways to run data-intensive applications, deploying cloud resources upon request. We have demonstrated the feasibility of DIaaS using the data-intensive seismic ambient noise cross-correlation application (Figure 1). The application preprocesses (Phase1) and cross-correlates (Phase2) traces from several seismic stations. The application is submitted via Pegasus (Container1), and Phase1 and Phase2 are executed in the MPI (Container2) and Storm (Container3) clusters respectively. Although both phases could be executed

  12. [Combination of busulfan with increased-dose of fludarabine as conditioning regimen for MDS and MDS-AML patients with allo-HSCT].

    Science.gov (United States)

    Yuan, Jing; Ren, Hanyun; Qiu, Zhixiang; Li, Yuan; Wang, Mangju; Liu, Wei; Xu, Weilin; Sun, Yuhua; Wang, Lihong; Liang, Zeyin; Dong, Yujun; Ou, Jinping; Wang, Wensheng; Yin, Yue; Cen, Xinan; Wang, Qian

    2015-06-01

    To investigate the safety and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for myelodysplastic syndrome (MDS) and secondary acute myelogenous leukemia (MDS-AML) using conditioning regimen with busulfan (Bu) and increased-dose of fludarabine (ID-Flu). A total of 49 patients with MDS or MDS-AML were treated by allo-HSCT, the clinical data was analyzed retrospectively. All patients achieved hematopoietic reconstitution. Neutrophil engraftment was at 10 - 22 days (median 13 days), and platelet engraftment was at 8 - 66 days (median 16 days). The cumulative incidences of Ⅱ-Ⅳ degree acute graft-versus-host disease (GVHD), hemorrhagic cystitis (HC), and hepatic venous occlusive disease (VOD) were 28.6%, 14.3% and 2.0%, respectively. The transplant-related mortality (TRM) was only 4.1% at 100d and 8.2% at 1-92 months of followed-up (median 14 months) period. Overall survival (OS) and disease free survival (DFS) was 75.5%, 73.5%, respectively. Kaplan-Meier curve showed that 3-year OS and 3-year DFS was (71.1 ± 7.8)%, (66.7 ± 8.3)%, respectively, with a relapse incidence (RI) 16.3%. OS for MDS and MDS-AML was 81.5% and 68.2%, and RI in two settings was 3.7%, 31.8%, respectively. OS for MDS-AML at complete remission (CR) and non-CR subgroup was 83.3% and 50.0%, respectively, while cumulative RR was 16.7% and 50.0%, respectively. OS and RI except for non-CR subgroup were 82.1% and 7.7%. Univariate analysis showed that pre-HSCT disease status had correlation with OS (P=0.031), but age, decitabine in conditioning regimen, stem cell source, HLA matching, patient-donor gender, dose of mononuclear cells and GVHD had no correlation with OS. Bu/ID-Flu conditioning regimen for MDS and MDS-AML has high efficiency, fewer complications, lower toxicity and TRM. The OS and DFS were higher and RI was lower except for refractory MDS-AML patients. The regimen is valuable for clinical application.

  13. Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial.

    Science.gov (United States)

    da Costa Poubel, Luiz Augusto; de Gouvea, Cresus Vinicius Deppes; Calazans, Fernanda Signorelli; Dip, Etyene Castro; Alves, Wesley Veltri; Marins, Stella Soares; Barcelos, Roberta; Barceleiro, Marcos Oliveira

    2018-04-25

    This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching. A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48 h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48 h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey's test, respectively. In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar. It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity. The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity. NCT02956070.

  14. Reduced-intensity conditioning for alternative donor hematopoietic stem cell transplantation in patients with dyskeratosis congenita.

    Science.gov (United States)

    Nishio, Nobuhiro; Takahashi, Yoshiyuki; Ohashi, Haruhiko; Doisaki, Sayoko; Muramatsu, Hideki; Hama, Asahito; Shimada, Akira; Yagasaki, Hiroshi; Kojima, Seiji

    2011-03-01

    DC is an inherited bone marrow failure syndrome mainly characterized by nail dystrophy, abnormal skin pigmentation, and oral leukoplakia. Bone marrow failure is the most common cause of death in patients with DC. Because previous results of HSCT with a myeloablative regimen were disappointing, we used a reduced-intensity conditioning regimen for two patients with classic DC, and one patient with cryptic DC who harbored the TERT mutation. Graft sources included two mismatched-related bone marrow (BM) donors and one unrelated BM donor. Successful engraftment was achieved with few regimen-related toxicities in all patients. They were alive 10, 66, and 72 months after transplantation, respectively. Long-term follow-up is crucial to determine the late effects of our conditioning regimen. © 2010 John Wiley & Sons A/S.

  15. Ofatumumab for the treatment of chronic lymphocytic leukaemia in patients who are refractory to fludarabine and alemtuzumab: a critique of the submission from GSK.

    Science.gov (United States)

    Hoyle, M; Crathorne, L; Garside, R; Hyde, C

    2011-05-01

    This paper presents a summary of the evidence review group (ERG) report into the clinical effectiveness and cost-effectiveness of ofatumumab for the treatment of refractory chronic lymphocytic leukaemia (CLL), based upon the manufacturer's submission (MS) to the National Institute for Health and Clinical Excellence (NICE) as part of the single technology appraisal process. The submitted clinical evidence included one study: a non-randomised, single-arm study. Two other studies were identified but both were non-comparative and provided evidence for therapies other than ofatumumab. For this reason these studies were not discussed in full in the main body of the submission. In the Hx-CD20-406 study, the overall response rate was 58% (99% confidence interval 40% to 74%, p constitutional symptoms and improved performance status occurred in 57% of patients. Median progression-free survival (PFS) and overall survival (OS) times were 5.7 and 13.7 months, respectively. The most common adverse events during treatment were infusion reactions and infections, which were primarily grade 1 or 2 events. The MS concluded that ofatumumab provides a new, effective and well-tolerated therapy for patients with CLL who are refractory to both fludarabine and alemtuzumab [double refractory (DR)]. The ERG undertook a critical appraisal of the submission. The ERG had a number of concerns regarding the manufacturer's estimates of effectiveness based on evidence from a single-arm, non-randomised study. An 'area-under-the-curve' or 'partitioned-survival' model was used to project expected clinical and economic outcomes for patients with DR CLL who were assumed to receive ofatumumab or best supportive care (BSC). The model had a three-state structure: 'alive pre-progression', 'alive post progression' and 'dead'. Overall, the modelling approach is reasonable given the limited evidence available for the drug in the patient population under review. However, a number of uncertainties were

  16. Cost-effectiveness of adding rituximab to fludarabine and cyclophosphamide for treatment of chronic lymphocytic leukemia in Ukraine

    Directory of Open Access Journals (Sweden)

    Mandrik O

    2015-08-01

    Full Text Available Olena Mandrik,1 Isaac Corro Ramos,2 Saskia Knies,1,3 Maiwenn Al,1,2 Johan L Severens1,2 1Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands; 2Institute of Medical Technology Assessment (iMTA, Erasmus University Rotterdam, Rotterdam, the Netherlands; 3National Health Care Institute, Diemen, the Netherlands Abstract: The aim of this study was to assess the cost-effectiveness, from a health care perspective, of adding rituximab to fludarabine and cyclophosphamide scheme (FCR versus FC for treatment-naïve and refractory/relapsed Ukrainian patients with chronic lymphocytic leukemia. A decision-analytic Markov cohort model with three health states and 1-month cycle time was developed and run within a life time horizon. Data from two multinational, prospective, open-label Phase 3 studies were used to assess patients' survival. While utilities were generalized from UK data, local resource utilization and disease-associated treatment, hospitalization, and side effect costs were applied. The alternative scenario was performed to assess the impact of lower life expectancy of the general population in Ukraine on the incremental cost-effectiveness ratio (ICER for treatment-naïve patients. One-way, two-way, and probabilistic sensitivity analyses were conducted to assess the robustness of the results. The ICER (in US dollars of treating chronic lymphocytic leukemia patients with FCR versus FC is US$8,704 per quality-adjusted life year gained for treatment-naïve patients and US$11,056 for refractory/relapsed patients. When survival data were modified to the lower life expectancy of the general population in Ukraine, the ICER for treatment-naïve patients was higher than US$13,000. This value is higher than three times the current gross domestic product per capita in Ukraine. Sensitivity analyses have shown a high impact of rituximab costs and a moderate impact of differences in utilities on the ICER

  17. Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

    Energy Technology Data Exchange (ETDEWEB)

    Mikell, John L., E-mail: jmikell@emory.edu [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Waller, Edmund K. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Switchenko, Jeffrey M. [Department of Biostatistics and Bioinformatics, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Hall, William A. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Langston, Amelia A. [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Esiashvili, Natia [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khoury, H. Jean [Department of Hematology and Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Khan, Mohammad K. [Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)

    2014-06-01

    Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details of the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen between

  18. A novel vision-based mold monitoring system in an environment of intense vibration

    International Nuclear Information System (INIS)

    Hu, Fen; He, Zaixing; Zhao, Xinyue; Zhang, Shuyou

    2017-01-01

    Mold monitoring has been more and more widely used in the modern manufacturing industry, especially when based on machine vision, but these systems cannot meet the detection speed and accuracy requirements for mold monitoring because they must operate in environments that exhibit intense vibration during production. To ensure that the system runs accurately and efficiently, we propose a new descriptor that combines the geometric relationship-based global context feature and the local scale-invariant feature transform for the image registration step of the mold monitoring system. The experimental results of four types of molds showed that the detection accuracy of the mold monitoring system is improved in the environment with intense vibration. (paper)

  19. A novel vision-based mold monitoring system in an environment of intense vibration

    Science.gov (United States)

    Hu, Fen; He, Zaixing; Zhao, Xinyue; Zhang, Shuyou

    2017-10-01

    Mold monitoring has been more and more widely used in the modern manufacturing industry, especially when based on machine vision, but these systems cannot meet the detection speed and accuracy requirements for mold monitoring because they must operate in environments that exhibit intense vibration during production. To ensure that the system runs accurately and efficiently, we propose a new descriptor that combines the geometric relationship-based global context feature and the local scale-invariant feature transform for the image registration step of the mold monitoring system. The experimental results of four types of molds showed that the detection accuracy of the mold monitoring system is improved in the environment with intense vibration.

  20. Comparison of the Effect of Dry Cupping Therapy and Acupressure at BL23 Point on Intensity of Postpartum Perineal Pain Based on the Short Form of McGill Pain Questionnaire.

    Science.gov (United States)

    Akbarzade, Marzieh; Ghaemmaghami, Mehrnoush; Yazdanpanahi, Zahra; Zare, Najaf; Mohagheghzadeh, Abdolali; Azizi, Amir

    2016-01-01

    Perineal pain is a major morbidity in the first few days after delivery. This study aimed to investigate the effect of dry cupping therapy and acupressure at BL23 point on the intensity of postpartum perineal pain based on the short-form of McGill pain questionnaire (SMPQ). The present clinical trial was conducted on 150 subjects in 3 groups of 50 cases. After at least 4-8 hr of delivery, cupping therapy was performed for 15-20 min up to 3 times a week (once a day) and acupressure was performed for 15-20 min based on clockwise model. The short-form of McGill pain questionnaire was completed both before and after the intervention. The SPSS statistical software was used to analyze the data using repeated measures ANOVA. Besides, pcupping therapy group, mean of the perineal pain intensity reduced from 37.5±6.8 before the intervention to 11.1±6.1, 6.9±4.7, and 3.8±3.6 immediately, 24 hr, and 2 weeks after the intervention, respectively. The results of study showed that the differences between the intervention and control groups were statistically significant (pcupping therapy and acupressure reduced perineal pain. Therefore, they may be considered as effective treatments for reducing pain intensity of allowing delivery.

  1. Do services reduce gender inequality in labor markets? The service sector, knnowledge-intensive services and the gender pay gap

    OpenAIRE

    Dueñas, Diego; Iglesias, Carlos; Llorente, Raquel

    2014-01-01

    The expansion of services and the dissemination of information technologies and communication are identified as important factors that can improve employment opportunities for women, reducing labor by gender differences. The objective of the study is to determine the extent to which services and especially those most closely linked with the knowledge and ICTs such as Knowledge Intensive Services (KIS) are changing some of the basics of labor gender differences. To do it: a), we first measure ...

  2. Re-visiting Trichuris trichiura intensity thresholds based on anemia during pregnancy.

    Directory of Open Access Journals (Sweden)

    Theresa W Gyorkos

    Full Text Available The intensity categories, or thresholds, currently used for Trichuris trichiura (ie. epg intensities of 1-999 (light; 1,000-9,999 epg (moderate, and ≥ 10,000 epg (heavy were developed in the 1980s, when there were little epidemiological data available on dose-response relationships. This study was undertaken to determine a threshold for T. trichiura-associated anemia in pregnant women and to describe the implications of this threshold in terms of the need for primary prevention and chemotherapeutic interventions.In Iquitos, Peru, 935 pregnant women were tested for T. trichiura infection in their second trimester of pregnancy; were given daily iron supplements throughout their pregnancy; and had their blood hemoglobin levels measured in their third trimester of pregnancy. Women in the highest two T. trichiura intensity quintiles (601-1632 epg and ≥ 1633 epg had significantly lower mean hemoglobin concentrations than the lowest quintile (0-24 epg. They also had a statistically significantly higher risk of anemia, with adjusted odds ratios of 1.67 (95% CI: 1.02, 2.62 and 1.73 (95% CI: 1.09, 2.74, respectively.This analysis provides support for categorizing a T. trichiura infection ≥ 1,000 epg as 'moderate', as currently defined by the World Health Organization. Because this 'moderate' level of T. trichiura infection was found to be a significant risk factor for anemia in pregnant women, the intensity of Trichuris infection deemed to cause or aggravate anemia should no longer be restricted to the 'heavy' intensity category. It should now include both 'heavy' and 'moderate' intensities of Trichuris infection. Evidence-based deworming strategies targeting pregnant women or populations where anemia is of concern should be updated accordingly.

  3. A Novel Dose Constraint to Reduce Xerostomia in Head-and-Neck Cancer Patients Treated With Intensity-Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Strigari, Lidia; Benassi, Marcello; Arcangeli, Giorgio; Bruzzaniti, Vicente; Giovinazzo, Giuseppe; Marucci, Laura

    2010-01-01

    Purpose: To investigate the predictors of incidence and duration of xerostomia (XT) based on parotid glands (PG), submandibular glands (SMG), and both glands taken as a whole organ (TG) in head-and-neck cancer patients treated with intensity-modulated radiotherapy. Methods and Materials: A prospective study was initiated in May 2003. Sixty-three head-and-neck patients (44 with nasopharynx cancer) were included in the analysis. Using the dose-volume histogram the PG, SMG, and TG mean doses were calculated. Unstimulated and stimulated salivary flow were measured and XT-related questionnaires were compiled before and at 3, 6, 12, 18, and 24 months after radiotherapy. Salivary gland toxicity was evaluated using the Radiation Therapy Oncology Group scale, and Grade ≥3 toxicity was used as the endpoint. The XT incidence was investigated according to descriptive statistics and univariate and multivariate analysis. The Bonferroni method was used for multiple comparison adjustment. Results: After a reduced flow at 3 months after radiotherapy, recovery of salivary flow was observed over time. Primary site and salivary gland mean doses and volumes were identified in univariate analysis as prognostic factors. Multivariate analysis confirmed that TG mean dose (p = 0.00066) and pretreatment stimulated salivary flow (p = 0.00420) are independent factors for predicting XT. Conclusion: The TG mean dose correlates with XT as assessed by Radiation Therapy Oncology Group criteria, salivary output, and XT-related questionnaires. Our results suggest that TG mean dose is a candidate dose constraint for reducing XT, requiring considerably more validation in non-nasopharyngeal cancer patients.

  4. Impact of graft-versus-host disease after reduced-intensity conditioning allogeneic stem cell transplantation for acute myeloid leukemia

    DEFF Research Database (Denmark)

    Baron, F; Labopin, M; Niederwieser, D

    2012-01-01

    This report investigated the impact of graft-versus-host disease (GVHD) on transplantation outcomes in 1859 acute myeloid leukemia patients given allogeneic peripheral blood stem cells after reduced-intensity conditioning (RIC allo-SCT). Grade I acute GVHD was associated with a lower risk...... of relapse (hazards ratio (HR)=0.7, P=0.02) translating into a trend for better overall survival (OS; HR=1.3; P=0.07). Grade II acute GVHD had no net impact on OS, while grade III-IV acute GVHD was associated with a worse OS (HR=0.4, P...

  5. A New Displacement-based Approach to Calculate Stress Intensity Factors With the Boundary Element Method

    Directory of Open Access Journals (Sweden)

    Marco Gonzalez

    Full Text Available Abstract The analysis of cracked brittle mechanical components considering linear elastic fracture mechanics is usually reduced to the evaluation of stress intensity factors (SIFs. The SIF calculation can be carried out experimentally, theoretically or numerically. Each methodology has its own advantages but the use of numerical methods has become very popular. Several schemes for numerical SIF calculations have been developed, the J-integral method being one of the most widely used because of its energy-like formulation. Additionally, some variations of the J-integral method, such as displacement-based methods, are also becoming popular due to their simplicity. In this work, a simple displacement-based scheme is proposed to calculate SIFs, and its performance is compared with contour integrals. These schemes are all implemented with the Boundary Element Method (BEM in order to exploit its advantages in crack growth modelling. Some simple examples are solved with the BEM and the calculated SIF values are compared against available solutions, showing good agreement between the different schemes.

  6. Caffeine intake improves intense intermittent exercise performance and reduces muscle interstitial potassium accumulation

    DEFF Research Database (Denmark)

    Mohr, Magni; Nielsen, Jens Jung; Bangsbo, Jens

    2011-01-01

    The effect of oral caffeine ingestion on intense intermittent exercise performance and muscle interstitial ion concentrations was examined. The study consists of two studies (S1 and S2). In S1 twelve subjects completed the Yo-Yo intermittent recovery level 2 (Yo-Yo IR2) test with prior caffeine (6...... mg/kg b.w.; CAF) or placebo (PLA) intake. In S2 six subjects performed one low intense (20 W) and three intense (50 W) 3-min (separated by 5 min) one-legged knee-extension exercise bouts with (CAF) and without (CON) prior caffeine supplementation for determination of muscle interstitial K(+) and Na...

  7. PATHOS: a phase II/III trial of risk-stratified, reduced intensity adjuvant treatment in patients undergoing transoral surgery for Human papillomavirus (HPV) positive oropharyngeal cancer

    International Nuclear Information System (INIS)

    Owadally, Waheeda; Hurt, Chris; Timmins, Hayley; Parsons, Emma; Townsend, Sarah; Patterson, Joanne; Hutcheson, Katherine; Powell, Ned; Beasley, Matthew; Palaniappan, Nachi; Robinson, Max; Jones, Terence M.; Evans, Mererid

    2015-01-01

    Human papillomavirus-positive oropharyngeal squamous cell carcinoma is increasing in incidence worldwide. Current treatments are associated with high survival rates but often result in significant long-term toxicities. In particular, long-term dysphagia has a negative impact on patient quality of life and health. The aim of PATHOS is to determine whether reducing the intensity of adjuvant treatment after minimally invasive transoral surgery in this favourable prognosis disease will result in better long-term swallowing function whilst maintaining excellent disease-specific survival outcomes. The study is a multicentre phase II/III randomised controlled trial for patients with biopsy-proven Human papillomavirus-positive oropharyngeal squamous cell cancer staged T1-T3 N0-N2b with a primary tumour that is resectable via a transoral approach. Following transoral surgery and neck dissection, patients are allocated into three groups based on pathological risk factors for recurrence. Patients in the low-risk pathology group will receive no adjuvant treatment, as in standard practice. Patients in the intermediate-risk pathology group will be randomised to receive either standard dose post-operative radiotherapy (control) or reduced dose radiotherapy. Patients in the high-risk pathology group will be randomised to receive either post-operative chemoradiotherapy (control) or radiotherapy alone. The primary outcome of the phase II study is patient reported swallowing function measured using the MD Anderson Dysphagia Inventory score at 12 months post-treatment. If the phase II study is successful, PATHOS will proceed to a phase III non-inferiority trial with overall survival as the primary endpoint. PATHOS is a prospective, randomised trial for Human papillomavirus-positive oropharyngeal cancer, which represents a different disease entity compared with other head and neck cancers. The trial aims to demonstrate that long-term dysphagia can be lessened by reducing the intensity

  8. 7 CFR 1412.45 - Reducing or terminating base acreage.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 10 2010-01-01 2010-01-01 false Reducing or terminating base acreage. 1412.45 Section... and Peanuts 2008 through 2012 § 1412.45 Reducing or terminating base acreage. (a)(1) Subject to the limitation in paragraph (a)(2) of this section, a permanent reduction of all or a portion of a farm's base...

  9. Prediction of SEP Peak Proton Intensity Based on CME Speed, Direction and Observations of Associated Solar Phenomena

    Science.gov (United States)

    Richardson, I. G.; Mays, M. L.; Thompson, B. J.; Kwon, R.; Frechette, B. P.

    2017-12-01

    We assess whether a formula obtained by Richardson et al. (Solar Phys., 289, 3059, 2014; DOI 10.1007/s11207-014-0524-8) relating the intensity of 14-24 MeV protons in a solar energetic particle event at 1 AU to the solar event location and the speed of the associated coronal mass ejection (CME), may be used to "predict" the intensity of a solar energetic particle event. Starting with a subset of several hundred CMEs in the CCMC/SWRC DONKI real-time database (http://kauai.ccmc.gsfc.nasa.gov/DONKI/) selected without consideration of whether they were associated with SEP events, we first use the CME speed and direction to predict the proton intensity at Earth or the STEREO spacecraft using this formula. Since most of these CMEs were not in fact associated with SEP events, many "false alarms" result. We then examine whether considering other phenomena which may accompany the CMEs, such as the X-ray flare intensity and the properties of type II and type III radio emissions, may help to reduce the false alarm rate. We also use CME parameters calculated from an ellipsoidal shell fit to multi-spacecraft CME shock observations for a smaller number of events to predict the SEP intensity. We calculate skill scores for each case and assess whether the Richardson et al. (2014) formula, using additional observations to reduce the false alarm rate, has any potential as a SEP prediction tool, assuming that the required observations could be acquired sufficiently rapidly following the onset of the related solar event/CME.

  10. Dynamic model-based N management reduces surplus nitrogen and improves the environmental performance of corn production

    Science.gov (United States)

    Sela, S.; Woodbury, P. B.; van Es, H. M.

    2018-05-01

    The US Midwest is the largest and most intensive corn (Zea mays, L.) production region in the world. However, N losses from corn systems cause serious environmental impacts including dead zones in coastal waters, groundwater pollution, particulate air pollution, and global warming. New approaches to reducing N losses are urgently needed. N surplus is gaining attention as such an approach for multiple cropping systems. We combined experimental data from 127 on-farm field trials conducted in seven US states during the 2011–2016 growing seasons with biochemical simulations using the PNM model to quantify the benefits of a dynamic location-adapted management approach to reduce N surplus. We found that this approach allowed large reductions in N rate (32%) and N surplus (36%) compared to existing static approaches, without reducing yield and substantially reducing yield-scaled N losses (11%). Across all sites, yield-scaled N losses increased linearly with N surplus values above ~48 kg ha‑1. Using the dynamic model-based N management approach enabled growers to get much closer to this target than using existing static methods, while maintaining yield. Therefore, this approach can substantially reduce N surplus and N pollution potential compared to static N management.

  11. Fludarabine Injection

    Science.gov (United States)

    ... red or purple dots on the skin, nosebleeds, heavy menstrual bleeding, blood in the urine, coughing up ... changes. Do not drive a car or operate machinery until you know how this medication affects you. ...

  12. The Multi-state Latent Factor Intensity Model for Credit Rating Transitions

    NARCIS (Netherlands)

    Koopman, S.J.; Lucas, A.; Monteiro, A.

    2008-01-01

    A new empirical reduced-form model for credit rating transitions is introduced. It is a parametric intensity-based duration model with multiple states and driven by exogenous covariates and latent dynamic factors. The model has a generalized semi-Markov structure designed to accommodate many of the

  13. Lymphocyte Redox Imbalance and Reduced Proliferation after a Single Session of High Intensity Interval Exercise.

    Science.gov (United States)

    Tossige-Gomes, Rosalina; Costa, Karine Beatriz; Ottone, Vinícius de Oliveira; Magalhães, Flávio de Castro; Amorim, Fabiano Trigueiro; Rocha-Vieira, Etel

    2016-01-01

    This study investigated whether an acute session of high-intensity interval training (HIIT) is sufficient to alter lymphocyte function and redox status. Sixteen young healthy men underwent a HIIT session on a cycloergometer, consisting of eight bouts of 1 min at 90-100% of peak power, with 75 seconds of active recovery at 30 W between bouts. Venous blood was collected before, immediately after, and 30 minutes after the HIIT session. In response to Staphylococcus aureus superantigen B (SEB) stimulation, lymphocyte proliferation decreased and the IL-2 concentration increased after the HIIT session. However, the HIIT session had no effect on lymphocyte proliferation or IL-2 response to phytohemagglutinin stimulation. The HIIT session also induced lymphocyte redox imbalance, characterized by an increase in the concentration of thiobarbituric acid reactive substances and a decrease in the activity of the antioxidant enzyme catalase. Lymphocyte viability was not affected by the HIIT session. The frequencies of CD25+ and CD69+ T helper and B lymphocytes in response to superantigen stimulation were lower after exercise, suggesting that superantigen-induced lymphocyte activation was reduced by HIIT. However, HIIT also led to a reduction in the frequency of CD4+ and CD19+ cells, so the frequencies of CD25+ and CD69+ cells within the CD4 and CD19 cell populations were not affected by HIIT. These data indicate that the reduced lymphocyte proliferation observed after HIIT is not due to reduced early lymphocyte activation by superantigen. Our findings show that an acute HIIT session promotes lymphocyte redox imbalance and reduces lymphocyte proliferation in response to superantigenic, but not to mitogenic stimulation. This observation cannot be explained by alteration of the early lymphocyte activation response to superantigen. The manner in which lymphocyte function modulation by an acute HIIT session can affect individual immunity and susceptibility to infection is important

  14. Intensity-Modulated Radiotherapy Results in Significant Decrease in Clinical Toxicities Compared With Conventional Wedge-Based Breast Radiotherapy

    International Nuclear Information System (INIS)

    Harsolia, Asif; Kestin, Larry; Grills, Inga; Wallace, Michelle; Jolly, Shruti; Jones, Cortney; Lala, Moinaktar; Martinez, Alvaro; Schell, Scott; Vicini, Frank A.

    2007-01-01

    Purpose: We have previously demonstrated that intensity-modulated radiotherapy (IMRT) with a static multileaf collimator process results in a more homogenous dose distribution compared with conventional wedge-based whole breast irradiation (WBI). In the present analysis, we reviewed the acute and chronic toxicity of this IMRT approach compared with conventional wedge-based treatment. Methods and Materials: A total of 172 patients with Stage 0-IIB breast cancer were treated with lumpectomy followed by WBI. All patients underwent treatment planning computed tomography and received WBI (median dose, 45 Gy) followed by a boost to 61 Gy. Of the 172 patients, 93 (54%) were treated with IMRT, and the 79 patients (46%) treated with wedge-based RT in a consecutive fashion immediately before this cohort served as the control group. The median follow-up was 4.7 years. Results: A significant reduction in acute Grade 2 or worse dermatitis, edema, and hyperpigmentation was seen with IMRT compared with wedges. A trend was found toward reduced acute Grade 3 or greater dermatitis (6% vs. 1%, p = 0.09) in favor of IMRT. Chronic Grade 2 or worse breast edema was significantly reduced with IMRT compared with conventional wedges. No difference was found in cosmesis scores between the two groups. In patients with larger breasts (≥1,600 cm 3 , n = 64), IMRT resulted in reduced acute (Grade 2 or greater) breast edema (0% vs. 36%, p <0.001) and hyperpigmentation (3% vs. 41%, p 0.001) and chronic (Grade 2 or greater) long-term edema (3% vs. 30%, p 0.007). Conclusion: The use of IMRT in the treatment of the whole breast results in a significant decrease in acute dermatitis, edema, and hyperpigmentation and a reduction in the development of chronic breast edema compared with conventional wedge-based RT

  15. Reduced intensity conditioning is superior to nonmyeloablative conditioning for older chronic myelogenous leukemia patients undergoing hematopoietic cell transplant during the tyrosine kinase inhibitor era

    DEFF Research Database (Denmark)

    Warlick, Erica; Ahn, Kwang Woo; Pedersen, Tanya L

    2012-01-01

    Tyrosine kinase inhibitors (TKIs) and reduced intensity conditioning (RIC)/nonmyeloablative (NMA) conditioning hematopoietic cell transplants (HCTs) have changed the therapeutic strategy for chronic myelogenous leukemia (CML) patients. We analyzed post-HCT outcomes of 306 CML patients reported to...

  16. CO2 emissions and economic activity: Short- and long-run economic determinants of scale, energy intensity and carbon intensity

    International Nuclear Information System (INIS)

    Andersson, Fredrik N.G.; Karpestam, Peter

    2013-01-01

    We analyze the short-term and the long-term determinants of energy intensity, carbon intensity and scale effects for eight developed economies and two emerging economies from 1973 to 2007. Our results show that there is a difference between the short-term and the long-term results and that climate policy are more likely to affect emission over the long-term than over the short-term. Climate policies should therefore be aimed at a time horizon of at least 8 years and year-on-year changes in emissions contains little information about the trend path of emissions. In the long-run capital accumulation is the main driver of emissions. Productivity growth reduces the energy intensity while the real oil price reduces both the energy intensity and the carbon intensity. The real oil price effect suggests that a global carbon tax is an important policy tool to reduce emissions, but our results also suggest that a carbon tax is likely to be insufficient decouple emission from economic growth. Such a decoupling is likely to require a structural transformation of the economy. The key policy challenge is thus to build new economic structures where investments in green technologies are more profitable. - Highlights: • We model determinants of scale, energy intensity and carbon intensity. • Using band spectrum regressions, we separate between short and long run effects. • Different economic variables affect emission in the short and long run. • CO 2 reducing policies should have a long run horizon of (at least 8 years). • A low carbon society requires a structural transformation of the economy

  17. [Activity-based costing methodology to manage resources in intensive care units].

    Science.gov (United States)

    Alvear V, Sandra; Canteros G, Jorge; Jara M, Juan; Rodríguez C, Patricia

    2013-11-01

    An accurate estimation of resources use by individual patients is crucial in hospital management. To measure financial costs of health care actions in intensive care units of two public regional hospitals in Chile. Prospective follow up of 716 patients admitted to two intensive care units during 2011. The financial costs of health care activities was calculated using the Activity-Based Costing methodology. The main activities recorded were procedures and treatments, monitoring, response to patient needs, patient maintenance and coordination. Activity-Based Costs, including human resources and assorted indirect costs correspond to 81 to 88% of costs per disease in one hospital and 69 to 80% in the other. The costs associated to procedures and treatments are the most significant and are approximately $100,000 (Chilean pesos) per day of hospitalization. The second most significant cost corresponds to coordination activities, which fluctuates between $86,000 and 122,000 (Chilean pesos). There are significant differences in resources use between the two hospitals studied. Therefore cost estimation methodologies should be incorporated in the management of these clinical services.

  18. Public budgets for energy RD&D and the effects on energy intensity and pollution levels.

    Science.gov (United States)

    Balsalobre, Daniel; Álvarez, Agustín; Cantos, José María

    2015-04-01

    This study, based on the N-shaped cubic model of the environmental Kuznets curve, analyzes the evolution of per capita greenhouse gas emissions (GHGpc) using not just economic growth but also public budgets dedicated to energy-oriented research development and demonstration (RD&D) and energy intensity. The empirical evidence, obtained from an econometric model of fixed effects for 28 OECD countries during 1994-2010, suggests that energy innovations help reduce GHGpc levels and mitigate the negative impact of energy intensity on environmental quality. When countries develop active energy RD&D policies, they can reduce both the rates of energy intensity and the level of GHGpc emissions. This paper incorporates a moderating variable to the econometric model that emphasizes the effect that GDP has on energy intensity. It also adds a variable that reflects the difference between countries that have made a greater economic effort in energy RD&D, which in turn corrects the GHG emissions resulting from the energy intensity of each country.

  19. Risk mapping of NO/sub 3/-N contamination on groundwater under intensive rice-based cropping systems in the Philippines

    International Nuclear Information System (INIS)

    Pascual, C.M.; Baga, M.C.S.; Valencia, D.P.

    2005-01-01

    The groundwater resources in a 265 ha watershed of highly diversified and intensive rice-based environment was endangered to NO/sub 3/-N contamination with spatial degree of influence and temporal vulnerability risks as affected by intensive cropping systems with application of high N-fertilizer and judicious use of groundwater for irrigation. Such nitrate contamination levels are above the World Health Organization's maximum contamination level of 10 ppm for drinking water. Tree-joining, complete cluster analysis of monthly groundwater depths on observation wells revealed three distinct groups of wells differentiated by groundwater depths. Planting of nitrate catch crops such as legumes to reduce groundwater contamination and vigorous information dissemination on ill-effects of high NO/sub 3/-N, as well as groundwater recharging were considered to reduce contamination. However, the groundwater extraction for irrigation is still sustainable due to natural recharging of rainfall and hydraulic connections from surface water along rivers and creeks. The combined-use of GIS and GPS proved useful for spatial and temporal risk mapping assessment on groundwater NO/sub 3/-N vulnerability among other geo-referenced attributes of groundwater and other environmental considerations at the study site. Such systems analysis tools can be used by planners, researchers, extension workers, students and farmers for other sustainable development and environmental risk mapping, assessment, extrapolation analysis and strategic planning of sustainable development of the environment. (author)

  20. Micromachined diffraction based optical microphones and intensity probes with electrostatic force feedback

    Science.gov (United States)

    Bicen, Baris

    Measuring acoustic pressure gradients is critical in many applications such as directional microphones for hearing aids and sound intensity probes. This measurement is especially challenging with decreasing microphone size, which reduces the sensitivity due to small spacing between the pressure ports. Novel, micromachined biomimetic microphone diaphragms are shown to provide high sensitivity to pressure gradients on one side of the diaphragm with low thermal mechanical noise. These structures have a dominant mode shape with see-saw like motion in the audio band, responding to pressure gradients as well as spurious higher order modes sensitive to pressure. In this dissertation, integration of a diffraction based optical detection method with these novel diaphragm structures to implement a low noise optical pressure gradient microphone is described and experimental characterization results are presented, showing 36 dBA noise level with 1mm port spacing, nearly an order of magnitude better than the current gradient microphones. The optical detection scheme also provides electrostatic actuation capability from both sides of the diaphragm separately which can be used for active force feedback. A 4-port electromechanical equivalent circuit model of this microphone with optical readout is developed to predict the overall response of the device to different acoustic and electrostatic excitations. The model includes the damping due to complex motion of air around the microphone diaphragm, and it calculates the detected optical signal on each side of the diaphragm as a combination of two separate dominant vibration modes. This equivalent circuit model is verified by experiments and used to predict the microphone response with different force feedback schemes. Single sided force feedback is used for active damping to improve the linearity and the frequency response of the microphone. Furthermore, it is shown that using two sided force feedback one can significantly suppress

  1. Parent-based interventions for preventing or reducing adolescent substance use - A systematic literature review.

    Science.gov (United States)

    Kuntsche, Sandra; Kuntsche, Emmanuel

    2016-04-01

    Despite the increasing relevance of peers, parents remain important socializing agents for their adolescent children and are therefore promising agents for inclusion in prevention or intervention programs. This systematic review provides an overview of the effectiveness of parent-based programs in preventing, curbing or reducing substance use (i.e. alcohol, tobacco and cannabis) among 10 to 18-year-olds. The databases PubMed, PsychInfo, Eric and Google Scholar were used to identify randomized trials published within the past 12years evaluating effects on adolescent substance use. Of the 653 identified in the first screening, 39 publications dealing with 13 programs were included. Results reveal desirable effects of parenting measures such as rule-setting, monitoring and parent-child communication. There was also some evidence in terms of preventing, curbing or reducing adolescent substance use. However, this appears to depend particularly on the age group of the adolescents in question, the kind of parents included and the intensity of the program. To conclude, the results of this systematic review underline the importance of including parents in programs aiming to impede initiation of substance use or curb or reduce already existing substance use in adolescence. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Rationale for reduced tornado design bases

    International Nuclear Information System (INIS)

    Rutherford, P.D.; Ho, H.W.; Hartung, J.A.; Kastenberg, W.E.

    1985-01-01

    This paper provides a rationale for relaxing the present NRC tornado design requirements, which are based on a design basis tornado (DBT) whose frequency of exceedance is 10 -7 per year. It is proposed that a reduced DBT frequency of 10 -5 to 10 -6 per year is acceptable. This change in the tornado design bases for LMFBRs (and possibly all types of nuclear plants) is justified based on (1) existing NRC regulations and guidelines, (2) probabilistic arguments, (3) consistency with NRC trial safety goals, and (4) cost-benefit analysis

  3. High-intensity focused ultrasound sonothrombolysis: the use of perfluorocarbon droplets to achieve clot lysis at reduced acoustic power.

    Science.gov (United States)

    Pajek, Daniel; Burgess, Alison; Huang, Yuexi; Hynynen, Kullervo

    2014-09-01

    The purpose of this study was to evaluate use of intravascular perfluorocarbon droplets to reduce the sonication power required to achieve clot lysis with high-intensity focused ultrasound. High-intensity focused ultrasound with droplets was initially applied to blood clots in an in vitro flow apparatus, and inertial cavitation thresholds were determined. An embolic model for ischemic stroke was used to illustrate the feasibility of this technique in vivo. Recanalization with intravascular droplets was achieved in vivo at 24 ± 5% of the sonication power without droplets. Recanalization occurred in 71% of rabbits that received 1-ms pulsed sonications during continuous intravascular droplet infusion (p = 0.041 vs controls). Preliminary experiments indicated that damage was confined to the ultrasonic focus, suggesting that tolerable treatments would be possible with a more tightly focused hemispheric array that allows the whole focus to be placed inside of the main arteries in the human brain. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  4. Changes in CO2 emission intensities in the Mexican industry

    International Nuclear Information System (INIS)

    González, Domingo; Martínez, Manuel

    2012-01-01

    A CO 2 emission intensity analysis in the Mexican industry from 1965 to 2010 is carried out by taking into consideration four stages: 1965–1982, 1982–1994, 1994–2003, and 2004–2010. Based on the LMDI decomposition methodology, three influencing factors are analyzed: energy intensity, CO 2 coefficient, and structure in terms of their contributions of each individual attributes to the overall percent change of them as it was proposed in Choi and Ang (2011). The energy intensity effect was the driving factor behind the main decreases of CO 2 intensity, the CO 2 coefficient effect contributed to less extent to mitigate it, and the structure effect tended to increased it. It is observed that CO 2 intensity declined by 26.2% from 1965 to 2003, but it increased by 10.1% from 2004 to 2010. In addition, the move of Mexico from an economic model based on import-substitution to an export-oriented economy brought more importance to the Mexican industry intended to export, thus maintaining high levels of activity of industries such as cement, iron and steel, chemical, and petrochemical, while industries such as automotive, and ‘other’ industries grown significantly not only as far their energy consumptions and related CO 2 emissions but they also increased their contributions to the national economy. - Highlights: ► Industrial CO 2 emission intensity was reduced by 26.2% from 1965 to 2003. ► Industrial CO 2 emission intensity was increased by 10.1% from 2003 to 2010. ► 1965–2003: Intensity effect took down CO 2 emission intensity. ► 2003–2010: Export-oriented industries raised CO 2 emission intensity.

  5. Are labour-intensive efforts to prevent pressure ulcers cost-effective?

    Science.gov (United States)

    Mathiesen, Anne Sofie Mølbak; Nørgaard, Kamilla; Andersen, Marie Frederikke Bruun; Møller, Klaus Meyer; Ehlers, Lars Holger

    2013-10-01

    Pressure ulcers are a major problem in Danish healthcare with a prevalence of 13-43% among hospitalized patients. The associated costs to the Danish Health Care Sector are estimated to be €174.5 million annually. In 2010, The Danish Society for Patient Safety introduced the Pressure Ulcer Bundle (PUB) in order to reduce hospital-acquired pressure ulcers by a minimum of 50% in five hospitals. The PUB consists of evidence-based preventive initiatives implemented by ward staff using the Model for Improvement. To investigate the cost-effectiveness of labour-intensive efforts to reduce pressure ulcers in the Danish Health Care Sector, comparing the PUB with standard care. A decision analytic model was constructed to assess the costs and consequences of hospital-acquired pressure ulcers during an average hospital admission in Denmark. The model inputs were based on a systematic review of clinical efficacy data combined with local cost and effectiveness data from the Thy-Mors Hospital, Denmark. A probabilistic sensitivity analysis (PSA) was conducted to assess the uncertainty. Prevention of hospital-acquired pressure ulcers by implementing labour-intensive effects according to the PUB was cost-saving and resulted in an improved effect compared to standard care. The incremental cost of the PUB was -€38.62. The incremental effects were a reduction of 9.3% prevented pressure ulcers and 0.47% prevented deaths. The PSAs confirmed the incremental cost-effectiveness ratio (ICER)'s dominance for both prevented pressure ulcers and saved lives with the PUB. This study shows that labour-intensive efforts to reduce pressure ulcers on hospital wards can be cost-effective and lead to savings in total costs of hospital and social care. The data included in the study regarding costs and effects of the PUB in Denmark were based on preliminary findings from a pilot study at Thy-Mors Hospital and literature.

  6. Evaluation of finite difference and FFT-based solutions of the transport of intensity equation.

    Science.gov (United States)

    Zhang, Hongbo; Zhou, Wen-Jing; Liu, Ying; Leber, Donald; Banerjee, Partha; Basunia, Mahmudunnabi; Poon, Ting-Chung

    2018-01-01

    A finite difference method is proposed for solving the transport of intensity equation. Simulation results show that although slower than fast Fourier transform (FFT)-based methods, finite difference methods are able to reconstruct the phase with better accuracy due to relaxed assumptions for solving the transport of intensity equation relative to FFT methods. Finite difference methods are also more flexible than FFT methods in dealing with different boundary conditions.

  7. Colonic polyp detection method from 3D abdominal CT images based on local intensity analysis

    International Nuclear Information System (INIS)

    Oda, M.; Nakada, Y.; Kitasaka, T.; Mori, K.; Suenaga, Y.; Takayama, T.; Takabatake, H.; Mori, M.; Natori, H.; Nawano, S.

    2007-01-01

    This paper presents a detection method of colonic polyps from 3D abdominal CT images based on local intensity analysis. Recently, virtual colonoscopy (VC) has widely received attention as a new colon diagnostic method. VC is considered as a less-invasive inspection method which reduces patient load. However, since the colon has many haustra and its shape is long and convoluted, a physician has to change the viewpoint and the viewing direction of the virtual camera of VC many times while diagnosis. Additionally, there is a risk to overlook lesions existing in blinded areas caused by haustra. This paper proposes an automated colonic polyp detection method from 3D abdominal CT images. Colonic polyps are located on the colonic wall. Their CT values are higher than those of colonic lumen regions and lower than those of fecal materials tagged by an X-ray opaque contrast agent. CT values inside polyps which exist outside the tagged fecal materials tend to gradually increase from outward to inward (blob-like structure). CT values inside polyps that exist inside the tagged fecal materials tend to gradually decrease from outward to inward (inv-blob-like structure). We employ the blob and the inv-blob structure enhancement filters based on the eigenvalues of the Hessian matrix to detect polyps using intensity characteristic of polyps. Connected components with low output values of the enhancement filter are eliminated in false positive reduction process. Small connected components are also eliminated. We applied the proposed method to 44 cases of abdominal CT images. Sensitivity for polyps of 6 mm or larger was 80% with 4.7 false positives per case. (orig.)

  8. A CMOS Luminescence Intensity and Lifetime Dual Sensor Based on Multicycle Charge Modulation.

    Science.gov (United States)

    Fu, Guoqing; Sonkusale, Sameer R

    2018-06-01

    Luminescence plays an important role in many scientific and industrial applications. This paper proposes a novel complementary metal-oxide-semiconductor (CMOS) sensor chip that can realize both luminescence intensity and lifetime sensing. To enable high sensitivity, we propose parasitic insensitive multicycle charge modulation scheme for low-light lifetime extraction benefiting from simplicity, accuracy, and compatibility with deeply scaled CMOS process. The designed in-pixel capacitive transimpedance amplifier (CTIA) based structure is able to capture the weak luminescence-induced voltage signal by accumulating photon-generated charges in 25 discrete gated 10-ms time windows and 10-μs pulsewidth. A pinned photodiode on chip with 1.04 pA dark current is utilized for luminescence detection. The proposed CTIA-based circuitry can achieve 2.1-mV/(nW/cm 2 ) responsivity and 4.38-nW/cm 2 resolution at 630 nm wavelength for intensity measurement and 45-ns resolution for lifetime measurement. The sensor chip is employed for measuring time constants and luminescence lifetimes of an InGaN-based white light-emitting diode at different wavelengths. In addition, we demonstrate accurate measurement of the lifetime of an oxygen sensitive chromophore with sensitivity to oxygen concentration of 7.5%/ppm and 6%/ppm in both intensity and lifetime domain. This CMOS-enabled oxygen sensor was then employed to test water quality from different sources (tap water, lakes, and rivers).

  9. Influence of model based iterative reconstruction algorithm on image quality of multiplanar reformations in reduced dose chest CT

    International Nuclear Information System (INIS)

    Barras, Heloise; Dunet, Vincent; Hachulla, Anne-Lise; Grimm, Jochen; Beigelman-Aubry, Catherine

    2016-01-01

    Model-based iterative reconstruction (MBIR) reduces image noise and improves image quality (IQ) but its influence on post-processing tools including maximal intensity projection (MIP) and minimal intensity projection (mIP) remains unknown. To evaluate the influence on IQ of MBIR on native, mIP, MIP axial and coronal reformats of reduced dose computed tomography (RD-CT) chest acquisition. Raw data of 50 patients, who underwent a standard dose CT (SD-CT) and a follow-up RD-CT with a CT dose index (CTDI) of 2–3 mGy, were reconstructed by MBIR and FBP. Native slices, 4-mm-thick MIP, and 3-mm-thick mIP axial and coronal reformats were generated. The relative IQ, subjective IQ, image noise, and number of artifacts were determined in order to compare different reconstructions of RD-CT with reference SD-CT. The lowest noise was observed with MBIR. RD-CT reconstructed by MBIR exhibited the best relative and subjective IQ on coronal view regardless of the post-processing tool. MBIR generated the lowest rate of artefacts on coronal mIP/MIP reformats and the highest one on axial reformats, mainly represented by distortions and stairsteps artifacts. The MBIR algorithm reduces image noise but generates more artifacts than FBP on axial mIP and MIP reformats of RD-CT. Conversely, it significantly improves IQ on coronal views, without increasing artifacts, regardless of the post-processing technique

  10. Life-cycle analysis on energy consumption and GHG emission intensities of alternative vehicle fuels in China

    International Nuclear Information System (INIS)

    Ou, Xunmin; Yan, Xiaoyu; Zhang, Xiliang; Liu, Zhen

    2012-01-01

    Highlights: ► We analyzed the life cycle energy intensity and GHG emissions of about 40 pathways of alternative vehicle fuels in China. ► Coal-based liquid fuel has higher life cycle energy intensities and first generation technology bio-fuel has relatively lower intensity. ► By 2020 electricity will have significantly lower GHG intensity and second generation technology bio-fuel will have near zero intensities. -- Abstract: Fossil energy consumption (FEC) and greenhouse gas (GHG) emission intensities of major alternative vehicle fuels (AVFs) in China are calculated and compared with conventional fuels by means of full life-cycle analysis. Currently most of the AVFs have not relatively obvious GHG emission reduction when compared to the gasoline pathway: (1) coal-based AVF has higher intensities in terms of both the FEC and GHG emissions; (2) electricity from the average Chinese grid has the GHG emission intensity similar to that of gasoline pathway although relatively lower FEC intensity; and (3) first generation technology bio-fuel has relatively lower GHG emission intensity and substantially lower FEC intensity. It is forecasted that by 2020 when still comparing to the gasoline pathway: (1) coal-based AVF will still have FEC and GHG emission intensities that are 1.5–1.8 and 1.8–2.5 time those of gasoline pathway, and the application of carbon capture and storage technology can reduce the GHG emission intensity of coal-based AVF; (2) electricity will have significantly lower GHG intensity; and (3) second generation technology bio-fuel will have near zero FEC and GHG intensities.

  11. A usability evaluation of a SNOMED CT based compositional interface terminology for intensive care

    NARCIS (Netherlands)

    Bakhshi-Raiez, F.; de Keizer, N. F.; Cornet, R.; Dorrepaal, M.; Dongelmans, D.; Jaspers, M. W. M.

    2012-01-01

    Objective: To evaluate the usability of a large compositional interface terminology based on SNOMED CT and the terminology application for registration of the reasons for intensive care admission in a Patient Data Management System. Design: Observational study with user-based usability evaluations

  12. Intensity-Modulated Radiotherapy of Head and Neck Cancer Aiming to Reduce Dysphagia: Early Dose-Effect Relationships for the Swallowing Structures

    International Nuclear Information System (INIS)

    Feng, Felix Y.; Kim, Hyungjin M.; Lyden, Teresa H.; Haxer, Marc J.; Feng, Mary; Worden, Frank P.; Chepeha, Douglas B.; Eisbruch, Avraham

    2007-01-01

    Purpose: To present initial results of a clinical trial of intensity-modulated radiotherapy (IMRT) aiming to spare the swallowing structures whose dysfunction after chemoradiation is a likely cause of dysphagia and aspiration, without compromising target doses. Methods and Materials: This was a prospective, longitudinal study of 36 patients with Stage III-IV oropharyngeal (31) or nasopharyngeal (5) cancer. Definitive chemo-IMRT spared salivary glands and swallowing structures: pharyngeal constrictors (PC), glottic and supraglottic larynx (GSL), and esophagus. Lateral but not medial retropharyngeal nodes were considered at risk. Dysphagia endpoints included objective swallowing dysfunction (videofluoroscopy), and both patient-reported and observer-rated scores. Correlations between doses and changes in these endpoints from pre-therapy to 3 months after therapy were assessed. Results: Significant correlations were observed between videofluoroscopy-based aspirations and the mean doses to the PC and GSL, as well as the partial volumes of these structures receiving 50-65 Gy; the highest correlations were associated with doses to the superior PC (p = 0.005). All patients with aspirations received mean PC doses >60 Gy or PC V 65 >50%, and GSL V 50 >50%. Reduced laryngeal elevation and epiglottic inversion were correlated with mean PC and GSL doses (p 70 >50%. Worsening patient-reported liquid swallowing was correlated with mean PC (p = 0.05) and esophageal (p 0.02) doses. Only mean PC doses were correlated with worsening patient-reported solid swallowing (p = 0.04) and observer-rated swallowing scores (p = 0.04). Conclusions: These dose-volume-effect relationships provide initial IMRT optimization goals and motivate further efforts to reduce swallowing structures doses to reduce dysphagia and aspiration

  13. Non-homologous end joining is the responsible pathway for the repair of fludarabine-induced DNA double strand breaks in mammalian cells

    International Nuclear Information System (INIS)

    Campos-Nebel, Marcelo de; Larripa, Irene; Gonzalez-Cid, Marcela

    2008-01-01

    Fludarabine (FLU), an analogue of adenosine, interferes with DNA synthesis and inhibits the chain elongation leading to replication arrest and DNA double strand break (DSB) formation. Mammalian cells use two main pathways of DSB repair to maintain genomic stability: homologous recombination (HR) and non-homologous end joining (NHEJ). The aim of the present work was to evaluate the repair pathways employed in the restoration of DSB formed following replication arrest induced by FLU in mammalian cells. Replication inhibition was induced in human lymphocytes and fibroblasts by FLU. DSB occurred in a dose-dependent manner on early/middle S-phase cells, as detected by γH2AX foci formation. To test whether conservative HR participates in FLU-induced DSB repair, we measured the kinetics of Rad51 nuclear foci formation in human fibroblasts. There was no significant induction of Rad51 foci after FLU treatment. To further confirm these results, we analyzed the frequency of sister chromatid exchanges (SCE) in both human cells. We did not find increased frequencies of SCE after FLU treatment. To assess the participation of NHEJ pathway in the repair of FLU-induced damage, we used two chemical inhibitors of the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs), vanillin and wortmannin. Human fibroblasts pretreated with DNA-PKcs inhibitors showed increased levels of chromosome breakages and became more sensitive to cell death. An active role of NHEJ pathway was also suggested from the analysis of Chinese hamster cell lines. XR-C1 (DNA-PKcs-deficient) and XR-V15B (Ku80-deficient) cells showed hypersensitivity to FLU as evidenced by the increased frequency of chromosome aberrations, decreased mitotic index and impaired survival rates. In contrast, CL-V4B (Rad51C-deficient) and V-C8 (Brca2-deficient) cell lines displayed a FLU-resistant phenotype. Together, our results suggest a major role for NHEJ repair in the preservation of genome integrity against FLU-induced DSB

  14. Non-homologous end joining is the responsible pathway for the repair of fludarabine-induced DNA double strand breaks in mammalian cells

    Energy Technology Data Exchange (ETDEWEB)

    Campos-Nebel, Marcelo de [Departamento de Genetica, Instituto de Investigaciones Hematologicas Mariano R. Castex, Academia Nacional de Medicina, Buenos Aires (Argentina)], E-mail: mnebel@hematologia.anm.edu.ar; Larripa, Irene; Gonzalez-Cid, Marcela [Departamento de Genetica, Instituto de Investigaciones Hematologicas Mariano R. Castex, Academia Nacional de Medicina, Buenos Aires (Argentina)

    2008-11-10

    Fludarabine (FLU), an analogue of adenosine, interferes with DNA synthesis and inhibits the chain elongation leading to replication arrest and DNA double strand break (DSB) formation. Mammalian cells use two main pathways of DSB repair to maintain genomic stability: homologous recombination (HR) and non-homologous end joining (NHEJ). The aim of the present work was to evaluate the repair pathways employed in the restoration of DSB formed following replication arrest induced by FLU in mammalian cells. Replication inhibition was induced in human lymphocytes and fibroblasts by FLU. DSB occurred in a dose-dependent manner on early/middle S-phase cells, as detected by {gamma}H2AX foci formation. To test whether conservative HR participates in FLU-induced DSB repair, we measured the kinetics of Rad51 nuclear foci formation in human fibroblasts. There was no significant induction of Rad51 foci after FLU treatment. To further confirm these results, we analyzed the frequency of sister chromatid exchanges (SCE) in both human cells. We did not find increased frequencies of SCE after FLU treatment. To assess the participation of NHEJ pathway in the repair of FLU-induced damage, we used two chemical inhibitors of the catalytic subunit of DNA-dependent protein kinase (DNA-PKcs), vanillin and wortmannin. Human fibroblasts pretreated with DNA-PKcs inhibitors showed increased levels of chromosome breakages and became more sensitive to cell death. An active role of NHEJ pathway was also suggested from the analysis of Chinese hamster cell lines. XR-C1 (DNA-PKcs-deficient) and XR-V15B (Ku80-deficient) cells showed hypersensitivity to FLU as evidenced by the increased frequency of chromosome aberrations, decreased mitotic index and impaired survival rates. In contrast, CL-V4B (Rad51C-deficient) and V-C8 (Brca2-deficient) cell lines displayed a FLU-resistant phenotype. Together, our results suggest a major role for NHEJ repair in the preservation of genome integrity against FLU

  15. RECORD-SETTING COSMIC-RAY INTENSITIES IN 2009 AND 2010

    International Nuclear Information System (INIS)

    Mewaldt, R. A.; Davis, A. J.; Leske, R. A.; Stone, E. C.; Cummings, A. C.; Labrador, A. W.; Lave, K. A.; Binns, W. R.; Israel, M. H.; Wiedenbeck, M. E.; Christian, E. R.; De Nolfo, G. A.; Von Rosenvinge, T. T.

    2010-01-01

    We report measurements of record-setting intensities of cosmic-ray nuclei from C to Fe, made with the Cosmic Ray Isotope Spectrometer carried on the Advanced Composition Explorer in orbit about the inner Sun-Earth Lagrangian point. In the energy interval from ∼70 to ∼450 MeV nucleon -1 , near the peak in the near-Earth cosmic-ray spectrum, the measured intensities of major species from C to Fe were each 20%-26% greater in late 2009 than in the 1997-1998 minimum and previous solar minima of the space age (1957-1997). The elevated intensities reported here and also at neutron monitor energies were undoubtedly due to several unusual aspects of the solar cycle 23/24 minimum, including record-low interplanetary magnetic field (IMF) intensities, an extended period of reduced IMF turbulence, reduced solar-wind dynamic pressure, and extremely low solar activity during an extended solar minimum. The estimated parallel diffusion coefficient for cosmic-ray transport based on measured solar-wind properties was 44% greater in 2009 than in the 1997-1998 solar-minimum period. In addition, the weaker IMF should result in higher cosmic-ray drift velocities. Cosmic-ray intensity variations at 1 AU are found to lag IMF variations by 2-3 solar rotations, indicating that significant solar modulation occurs inside ∼20 AU, consistent with earlier galactic cosmic-ray radial-gradient measurements. In 2010, the intensities suddenly decreased to 1997 levels following increases in solar activity and in the inclination of the heliospheric current sheet. We describe the conditions that gave cosmic rays greater access to the inner solar system and discuss some of their implications.

  16. Outcomes in a Community-Based Intensive Cardiac Rehabilitation Program: Comparison with Hospital-Based and Academic Programs.

    Science.gov (United States)

    Katzenberg, Charles; Silva, Edna; Young, M Jean; Gilles, Greg

    2018-04-13

    The purpose of this study was to test the hypothesis that a community-based intensive cardiac rehabilitation program could produce positive changes in risk factor profile and outcomes in an at-risk population. Participants seeking either primary or secondary coronary artery disease prevention voluntarily enrolled in the 12-week intensive cardiac rehabilitation program. Data were obtained at baseline and 6-12 months after completion of the program. A total of 142 individuals, mean age 69 years, completed the Heart Series between 2012 and 2016. Follow-up data were available in 105 participants (74%). Participants showed statistically significant improvements in mean weight (165 to 162 lbs, P = .0005), body mass index (26 to 25 kg/m 2 , P = .001), systolic blood pressure (126 to 122 mm Hg, P = .01), diastolic blood pressure (73 to 70 mm Hg, P = .0005), total cholesterol (175 to 168 mg/dL, P = .03), low-density lipoprotein cholesterol (LDL-C) (100 to 93 mg/dL, P = .005), LDL-C/high-density lipoprotein cholesterol (HDL-C) ratio (1.8 to 1.6, P = .005), and cholesterol/HDL-C ratio (3.2 to 3.0, P = .003). Changes in HDL-C, triglycerides, and fasting blood glucose did not reach statistical significance, but all trended in favorable directions. Adverse cardiovascular disease outcomes were rare (one stent placement, no deaths). A total of 105 participants completed our 12-week community-based intensive cardiac rehabilitation program and showed significant positive changes in several measures of cardiac risk, with only 1 adverse event. These results compare favorably with those of hospital-based and academic institutional programs. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. National Institutes of Health classification for chronic graft-versus-host disease predicts outcome of allo-hematopoietic stem cell transplant after fludarabine-busulfan-antithymocyte globulin conditioning regimen.

    Science.gov (United States)

    Saillard, Colombe; Crocchiolo, Roberto; Furst, Sabine; El-Cheikh, Jean; Castagna, Luca; Signori, Alessio; Oudin, Claire; Faucher, Catherine; Lemarie, Claude; Chabannon, Christian; Granata, Angela; Blaise, Didier

    2014-05-01

    Abstract In 2005, the National Institutes of Health (NIH) proposed standard criteria for diagnosis, organ scoring and global assessment of chronic graft-versus-host disease (cGvHD) severity. We retrospectively reclassified cGvHD with NIH criteria in a monocentric cohort of 130 consecutive adult patients with hematological malignancies presenting cGvHD after receiving allo-hematopoietic stem cell transplant (HSCT) with a fludarabine-busulfan-antithymocyte globulin (ATG) conditioning regimen, among 313 consecutive HSCT recipients. We compared NIH and Seattle classifications to correlate severity and outcome. The follow up range was effectively 2-120 months. Forty-four percent developed Seattle-defined cGvHD (22% limited, 78% extensive forms). Using NIH criteria, there were 23%, 40% and 37% mild, moderate and severe forms, respectively, and 58%, 32% and 8% classic cGvHD, late acute GvHD and overlap syndrome. Five-year overall survival was 55% (49-61), and cumulative incidences of non-relapse mortality (NRM) and relapse/progression at 2 years were 19% (14-23) and 19% (14-24). NIH mild and moderate forms were associated with better survival compared to severe cGvHD (hazard ratio [HR] = 3.28, 95% confidence interval [CI]: 1.38-7.82, p = 0.007), due to higher NRM among patients with severe cGvHD (HR = 3.04, 95% CI: 1.05-8.78, p = 0.04) but comparable relapse risk (p = NS). In conclusion, the NIH classification appears to be more accurate in predicting outcome mostly by the reclassification of old-defined extensive forms into NIH-defined moderate or severe.

  18. Effects of an intensive data-based decision making intervention on teacher efficacy

    NARCIS (Netherlands)

    van der Scheer, Emmelien; Visscher, Arend J.

    2016-01-01

    Research into the effects of interventions on teacher efficacy is scarce. In this study, the long-term effects of an intensive data-based decision making intervention on teacher efficacy of mainly grade 4 teachers were investigated by means of a delayed treatment control group design (62 teachers).

  19. Intensity liquid level sensor based on multimode interference and fiber Bragg grating

    International Nuclear Information System (INIS)

    Oliveira, Ricardo; Aristilde, Stenio; Osório, Jonas H; Cordeiro, Cristiano M B; Franco, Marcos A R; Bilro, Lúcia; Nogueira, Rogério N

    2016-01-01

    In this paper an intensity liquid level sensor based on a single-mode—no-core—single-mode (SMS) fiber structure together with a Bragg grating inscribed in the later single mode fiber is proposed. As the no-core fiber is sensitive to the external refractive index, the SMS spectral response will be shifted related to the length of no-core fiber that is immersed in a liquid. By positioning the FBG central wavelength at the spectral region of the SMS edge filter, it is possible to measure the liquid level using the reflected FBG peak power through an intensity-based approach. The sensor is also self-referenced using the peak power of another FBG that is placed before and far from the sensing part. The temperature error analysis was also studied revealing that the sensor can operate in environments where the temperature changes are minimal. The possibility to use a second setup that makes the whole device temperature insensitive is also discussed. (paper)

  20. Reduced-intensity conditioning allogeneic SCT as salvage treatment for relapsed multiple myeloma.

    Science.gov (United States)

    de Lavallade, H; El-Cheikh, J; Faucher, C; Fürst, S; Stoppa, A-M; Coso, D; Bouabdallah, R; Chabannon, C; Gastaut, J-A; Blaise, D; Mohty, M

    2008-06-01

    The aim of this retrospective analysis was to assess the benefit of reduced-intensity conditioning allo SCT (RIC allo-SCT) in a cohort of 32 relapsed multiple myeloma (MM) patients. A total of 19 patients had an HLA-identical sibling donor ('donor' group), while 13 patients had no donor ('no-donor' group). There were no significant differences between these two groups as for prognosis risk factors. Eighteen patients from the 'donor' group could actually proceed to RIC allo-SCT. With a median follow-up of 36 (range, 21-60) months, six patients died from transplant-related toxicity (cumulative incidence, 33% (95% CI, 11-55%)). Only 4 patients from the 18 transplanted patients (22%; 95% CI, 7-48%) progressed after RIC allo-SCT, as compared to 12 (86%; 95% CI, 56-98%; P=0.0003) among the nontransplanted patients. In an 'intention-to-treat' analysis, the Kaplan-Meier estimate of PFS was significantly higher in the 'donor' group as compared to the 'no-donor' group (P=0.01; 46 versus 8% at 3 years). There was no difference in terms of overall survival. However, in multivariate analysis, actual performance of RIC allo-SCT was associated with better PFS (relative risk, 0.35; 95% CI, 0.15-0.82; P=0.01). These data suggest a potential benefit for RIC allo-SCT in the management of relapsed MM warranting further prospective investigations.

  1. Testing Probation Outcomes in an Evidence-Based Practice Setting: Reduced Caseload Size and Intensive Supervision Effectiveness

    Science.gov (United States)

    Jalbert, Sarah Kuck; Rhodes, William; Flygare, Christopher; Kane, Michael

    2010-01-01

    Probation and parole professionals argue that supervision outcomes would improve if caseloads were reduced below commonly achieved standards. Criminal justice researchers are skeptical because random assignment and strong observation studies have failed to show that criminal recidivism falls with reductions in caseload sizes. One explanation is…

  2. Intensive Intervention Practice Guide: School-Based Functional Analysis

    Science.gov (United States)

    Pennington, Brittany; Pokorski, Elizabeth A.; Kumm, Skip; Sterrett, Brittany I.

    2017-01-01

    The National Center for Leadership in Intensive Intervention (NCLII), a consortium funded by the Office of Special Education Programs (OSEP), prepares special education leaders to become experts in research on intensive intervention for students with disabilities who have persistent and severe academic (e.g., reading and math) and behavioral…

  3. Innovation Intensity and Adoption at the Base of the Pyramid Market: A Study of Household Appliances

    Directory of Open Access Journals (Sweden)

    Vitor Koki da Costa Nogami

    2015-08-01

    Full Text Available The paper analyzes the innovation intensity and adoption characteristics at the base of the pyramid market. The innovation intensity is configured as radical and incremental, while the innovation adoption is configured as early and tardy. As an empirical approach it was conducted a study type survey. Data analysis is based on non-parametric statistics. The results indicate that the base of the pyramid consumers is characterized by adopting incremental innovations tardily, as pointed out by the literature. Furthermore, it was also observed that women have greater decision-making power in the families of this segment.

  4. A PCT algorithm for discontinuation of antibiotic therapy is a cost-effective way to reduce antibiotic exposure in adult intensive care patients with sepsis

    NARCIS (Netherlands)

    Kip, Michelle Maria Aleida; Kusters, Ron; IJzerman, Maarten Joost; Steuten, Lotte Maria Gertruda

    2015-01-01

    Objective: Procalcitonin (PCT) is a specific marker for differentiating bacterial from non-infective causes of inflammation. It can be used to guide initiation and duration of antibiotic therapy in intensive care unit (ICU) patients with suspected sepsis, and might reduce the duration of hospital

  5. Vortex network community based reduced-order force model

    Science.gov (United States)

    Gopalakrishnan Meena, Muralikrishnan; Nair, Aditya; Taira, Kunihiko

    2017-11-01

    We characterize the vortical wake interactions by utilizing network theory and cluster-based approaches, and develop a data-inspired unsteady force model. In the present work, the vortical interaction network is defined by nodes representing vortical elements and the edges quantified by induced velocity measures amongst the vortices. The full vorticity field is reduced to a finite number of vortical clusters based on network community detection algorithm, which serves as a basis for a skeleton network that captures the essence of the wake dynamics. We use this reduced representation of the wake to develop a data-inspired reduced-order force model that can predict unsteady fluid forces on the body. The overall formulation is demonstrated for laminar flows around canonical bluff body wake and stalled flow over an airfoil. We also show the robustness of the present network-based model against noisy data, which motivates applications towards turbulent flows and experimental measurements. Supported by the National Science Foundation (Grant 1632003).

  6. Fluorescence intensity and lifetime-based cyanide sensitive probes for physiological safeguard

    International Nuclear Information System (INIS)

    Badugu, Ramachandram; Lakowicz, Joseph R.; Geddes, Chris D.

    2004-01-01

    We characterize six new fluorescent probes that show both intensity and lifetime changes in the presence of free uncomplexed aqueous cyanide, allowing for fluorescence based cyanide sensing up to physiological safeguard levels, i.e. 2 to the anionic R-B - (CN) 3 form, a new cyanide binding mechanism which we have recently reported. The presence of an electron deficient quaternary heterocyclic nitrogen nucleus, and the electron rich cyanide bound form, provides for the intensity changes observed. We have determined the disassociation constants of the probes to be in the range ∼15-84 μM 3 . In addition we have synthesized control compounds which do not contain the boronic acid moiety, allowing for a rationale of the cyanide responses between the probe isomers to be made. The lifetime of the cyanide bound probes are significantly shorter than the free R-B(OH) 2 probe forms, providing for the opportunity of lifetime based cyanide sensing up to physiologically lethal levels. Finally, while fluorescent probes containing the boronic acid moiety have earned a well-deserved reputation for monosaccharide sensing, we show that strong bases such as CN - and OH - preferentially bind as compared to glucose, enabling the potential use of these probes for cyanide safeguard and determination in physiological fluids, especially given that physiologies do not experience any notable changes in pH

  7. Maintaining reduced noise levels in a resource-constrained neonatal intensive care unit by operant conditioning.

    Science.gov (United States)

    Ramesh, A; Denzil, S B; Linda, R; Josephine, P K; Nagapoornima, M; Suman Rao, P N; Swarna Rekha, A

    2013-03-01

    To evaluate the efficacy of operant conditioning in sustaining reduced noise levels in the neonatal intensive care unit (NICU). Quasi-experimental study on quality of care. Level III NICU of a teaching hospital in south India. 26 staff employed in the NICU. (7 Doctors, 13 Nursing staff and 6 Nursing assistants). Operant conditioning of staff activity for 6 months. This method involves positive and negative reinforcement to condition the staff to modify noise generating activities. Comparing noise levels in decibel: A weighted [dB (A)] before conditioning with levels at 18 and 24 months after conditioning. Decibel: A weighted accounts for noise that is audible to human ears. Operant conditioning for 6 months sustains the reduced noise levels to within 62 dB in ventilator room 95% CI: 60.4 - 62.2 and isolation room (95% CI: 55.8 - 61.5). In the preterm room, noise can be maintained within 52 dB (95% CI: 50.8 - 52.6). This effect is statistically significant in all the rooms at 18 months (P = 0.001). At 24 months post conditioning there is a significant rebound of noise levels by 8.6, 6.7 and 9.9 dB in the ventilator, isolation and preterm room, respectively (P =0.001). Operant conditioning for 6 months was effective in sustaining reduced noise levels. At 18 months post conditioning, the noise levels were maintained within 62 dB (A), 60 dB (A) and 52 dB (A) in the ventilator, isolation and pre-term room, respectively. Conditioning needs to be repeated at 12 months in the ventilator room and at 18 months in the other rooms.

  8. Enabling big geoscience data analytics with a cloud-based, MapReduce-enabled and service-oriented workflow framework.

    Directory of Open Access Journals (Sweden)

    Zhenlong Li

    Full Text Available Geoscience observations and model simulations are generating vast amounts of multi-dimensional data. Effectively analyzing these data are essential for geoscience studies. However, the tasks are challenging for geoscientists because processing the massive amount of data is both computing and data intensive in that data analytics requires complex procedures and multiple tools. To tackle these challenges, a scientific workflow framework is proposed for big geoscience data analytics. In this framework techniques are proposed by leveraging cloud computing, MapReduce, and Service Oriented Architecture (SOA. Specifically, HBase is adopted for storing and managing big geoscience data across distributed computers. MapReduce-based algorithm framework is developed to support parallel processing of geoscience data. And service-oriented workflow architecture is built for supporting on-demand complex data analytics in the cloud environment. A proof-of-concept prototype tests the performance of the framework. Results show that this innovative framework significantly improves the efficiency of big geoscience data analytics by reducing the data processing time as well as simplifying data analytical procedures for geoscientists.

  9. Enabling big geoscience data analytics with a cloud-based, MapReduce-enabled and service-oriented workflow framework.

    Science.gov (United States)

    Li, Zhenlong; Yang, Chaowei; Jin, Baoxuan; Yu, Manzhu; Liu, Kai; Sun, Min; Zhan, Matthew

    2015-01-01

    Geoscience observations and model simulations are generating vast amounts of multi-dimensional data. Effectively analyzing these data are essential for geoscience studies. However, the tasks are challenging for geoscientists because processing the massive amount of data is both computing and data intensive in that data analytics requires complex procedures and multiple tools. To tackle these challenges, a scientific workflow framework is proposed for big geoscience data analytics. In this framework techniques are proposed by leveraging cloud computing, MapReduce, and Service Oriented Architecture (SOA). Specifically, HBase is adopted for storing and managing big geoscience data across distributed computers. MapReduce-based algorithm framework is developed to support parallel processing of geoscience data. And service-oriented workflow architecture is built for supporting on-demand complex data analytics in the cloud environment. A proof-of-concept prototype tests the performance of the framework. Results show that this innovative framework significantly improves the efficiency of big geoscience data analytics by reducing the data processing time as well as simplifying data analytical procedures for geoscientists.

  10. Enabling Big Geoscience Data Analytics with a Cloud-Based, MapReduce-Enabled and Service-Oriented Workflow Framework

    Science.gov (United States)

    Li, Zhenlong; Yang, Chaowei; Jin, Baoxuan; Yu, Manzhu; Liu, Kai; Sun, Min; Zhan, Matthew

    2015-01-01

    Geoscience observations and model simulations are generating vast amounts of multi-dimensional data. Effectively analyzing these data are essential for geoscience studies. However, the tasks are challenging for geoscientists because processing the massive amount of data is both computing and data intensive in that data analytics requires complex procedures and multiple tools. To tackle these challenges, a scientific workflow framework is proposed for big geoscience data analytics. In this framework techniques are proposed by leveraging cloud computing, MapReduce, and Service Oriented Architecture (SOA). Specifically, HBase is adopted for storing and managing big geoscience data across distributed computers. MapReduce-based algorithm framework is developed to support parallel processing of geoscience data. And service-oriented workflow architecture is built for supporting on-demand complex data analytics in the cloud environment. A proof-of-concept prototype tests the performance of the framework. Results show that this innovative framework significantly improves the efficiency of big geoscience data analytics by reducing the data processing time as well as simplifying data analytical procedures for geoscientists. PMID:25742012

  11. Tablet-Based Education to Reduce Depression-Related Stigma

    Science.gov (United States)

    Lu, Catherine; Winkelman, Megan; Wong, Shane Shucheng

    2016-01-01

    Objectives: This study investigated the efficacy of a tablet-based multimedia education application, the Project Not Alone Depression Module, in improving depression literacy and reducing depression stigma among a community-based mental health clinic population. Methods: A total of 93 participants completed either a tablet-based multimedia…

  12. Impact of postremission consolidation chemotherapy on outcome after reduced-intensity conditioning allogeneic stem cell transplantation for patients with acute myeloid leukemia in first complete remission

    DEFF Research Database (Denmark)

    Yeshurun, Moshe; Labopin, Myriam; Blaise, Didier

    2014-01-01

    The objective of the current study was to investigate the role of postremission consolidation chemotherapy before reduced-intensity conditioning (RIC) allogeneic stem cell transplantation (alloSCT) for patients with acute myeloid leukemia (AML) in first complete remission (CR1)....

  13. Bacteria killing nanotechnology Bio-Kil effectively reduces bacterial burden in intensive care units.

    Science.gov (United States)

    Hsueh, P-R; Huang, H-C; Young, T-G; Su, C-Y; Liu, C-S; Yen, M-Y

    2014-04-01

    A contaminated hospital environment has been identified as an important reservoir of pathogens causing healthcare-associated infections. This study is to evaluate the efficacy of bacteria killing nanotechnology Bio-Kil on reducing bacterial counts in an intensive care unit (ICU). Two single-bed rooms (S-19 and S-20) in the ICU were selected from 7 April to 27 May 2011. Ten sets of new textiles (pillow cases, bed sheets, duvet cover, and patient clothing) used by patients in the two single-bed rooms were provided by the sponsors. In the room S-20, the 10 sets of new textiles were washed with Bio-Kil; the room walls, ceiling, and air-conditioning filters were treated with Bio-Kil; and the surfaces of instruments (respirator, telephone, and computer) were covered with Bio-Kil-embedded silicon pads. Room S-19 served as the control. We compared the bacterial count on textiles and environment surfaces as well as air samples between the two rooms. A total of 1,364 samples from 22 different sites in each room were collected. The mean bacterial count on textiles and environmental surfaces in room S-20 was significantly lower than that in room S-19 (10.4 vs 49.6 colony-forming units [CFU]/100 cm(2); P < 0.001). Room S-20 had lower bacterial counts in air samples than room S-19 (33.4-37.6 vs 21.6-25.7 CFU/hour/plate; P < 0.001). The density of microbial isolations was significantly greater among patients admitted to room S-19 than those to room S-20 (9.15 vs 5.88 isolates per 100 patient-days, P < 0.05). Bio-Kil can significantly reduce bacterial burden in the environment of the ICU.

  14. Reducing Risk in DoD Software-Intensive Systems Development

    Science.gov (United States)

    2016-03-01

    schedule overruns, impacting modernization timetables and reducing funding for other developmental priorities. This research is a continuation and...Postgraduate School and an undergraduate degree in economics from Weber State University. He is a graduate of the Command and General Staff College...overruns, impacting modernization timetables and reducing funding for other developmental priorities. This research is a continuation and

  15. What is the role of tobacco control advertising intensity and duration in reducing adolescent smoking prevalence? Findings from 16 years of tobacco control mass media advertising in Australia.

    Science.gov (United States)

    White, Victoria M; Durkin, Sarah J; Coomber, Kerri; Wakefield, Melanie A

    2015-03-01

    To examine how the intensity and duration of tobacco control advertising relate to adolescent smoking prevalence. Australian students (aged 12-17 years) participating in a national survey conducted triennially between 1993 and 2008 (sample size range 12 314-16 611). The outcome measure was students' smoking in the previous 4 weeks collected through anonymous, self-completed surveys. For each student, monthly targeted rating points (TRPs, a measure of television advertising exposure) for tobacco control advertising was calculated for the 3 and 12 months prior to surveying. For each time period, cumulative TRPs exposure and exposure to three intensity levels (≥100 TRPs/month; ≥400 TRPs/month; ≥800 TRPs/month) over increasing durations (eg, 1 month, 2 months, etc) were calculated. Logistic regression examined associations between TRPs and adolescent smoking after controlling for demographic and policy variables. Past 3-month cumulative TRPs were found to have an inverse relationship with smoking prevalence. Low TRPs exposure in the past 12 months was positively associated with adolescent smoking prevalence. However, smoking prevalence reduced with cumulative exposure levels above 5800 cumulative TRPs. Additionally, exposure to ≥400 TRPs/month and ≥800 TRPs/month were associated with reduced likelihood of smoking, although the duration needed for this effect differed for the two intensity levels. When intensity was ≥400 TRPs/month, the odds of smoking only reduced with continuous exposure. When intensity was ≥800 TRPs/month, exposure at levels less than monthly was associated with reductions in smoking prevalence. Both antismoking advertising intensity and duration are important for ensuring reductions in adolescent smoking prevalence. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Whole vertebral bone segmentation method with a statistical intensity-shape model based approach

    Science.gov (United States)

    Hanaoka, Shouhei; Fritscher, Karl; Schuler, Benedikt; Masutani, Yoshitaka; Hayashi, Naoto; Ohtomo, Kuni; Schubert, Rainer

    2011-03-01

    An automatic segmentation algorithm for the vertebrae in human body CT images is presented. Especially we focused on constructing and utilizing 4 different statistical intensity-shape combined models for the cervical, upper / lower thoracic and lumbar vertebrae, respectively. For this purpose, two previously reported methods were combined: a deformable model-based initial segmentation method and a statistical shape-intensity model-based precise segmentation method. The former is used as a pre-processing to detect the position and orientation of each vertebra, which determines the initial condition for the latter precise segmentation method. The precise segmentation method needs prior knowledge on both the intensities and the shapes of the objects. After PCA analysis of such shape-intensity expressions obtained from training image sets, vertebrae were parametrically modeled as a linear combination of the principal component vectors. The segmentation of each target vertebra was performed as fitting of this parametric model to the target image by maximum a posteriori estimation, combined with the geodesic active contour method. In the experimental result by using 10 cases, the initial segmentation was successful in 6 cases and only partially failed in 4 cases (2 in the cervical area and 2 in the lumbo-sacral). In the precise segmentation, the mean error distances were 2.078, 1.416, 0.777, 0.939 mm for cervical, upper and lower thoracic, lumbar spines, respectively. In conclusion, our automatic segmentation algorithm for the vertebrae in human body CT images showed a fair performance for cervical, thoracic and lumbar vertebrae.

  17. Extraction of a long-pulsed intense electron beam from a pulsed plasma based on hollow cathode discharge

    International Nuclear Information System (INIS)

    Uramoto, Johshin.

    1977-05-01

    An intense electron beam (up to 1.0 kV, 0.8 kA in 0.8 cm phi) is extracted along a uniform magnetic field with a long decay time (up to 2 msec) from a pulsed high density plasma source which is produced with a fast rise time (< 100 μsec) by a secondary discharge based on a dc hollow cathode discharge. Through a back stream of ionized ions from a beam-extracting anode region where a neutral gas is fed, a space charge limit of the electron beam is so reduced that the beam current is determined by an initially injected electron flux and concentrated in a central aperture of the extracting anode. Moreover, the beam pulse width is much extended by the neutral gas feed into the anode space. (auth.)

  18. Intensity Based Seismic Hazard Map of Republic of Macedonia

    Science.gov (United States)

    Dojcinovski, Dragi; Dimiskovska, Biserka; Stojmanovska, Marta

    2016-04-01

    The territory of the Republic of Macedonia and the border terrains are among the most seismically active parts of the Balkan Peninsula belonging to the Mediterranean-Trans-Asian seismic belt. The seismological data on the R. Macedonia from the past 16 centuries point to occurrence of very strong catastrophic earthquakes. The hypocenters of the occurred earthquakes are located above the Mohorovicic discontinuity, most frequently, at a depth of 10-20 km. Accurate short -term prognosis of earthquake occurrence, i.e., simultaneous prognosis of time, place and intensity of their occurrence is still not possible. The present methods of seismic zoning have advanced to such an extent that it is with a great probability that they enable efficient protection against earthquake effects. The seismic hazard maps of the Republic of Macedonia are the result of analysis and synthesis of data from seismological, seismotectonic and other corresponding investigations necessary for definition of the expected level of seismic hazard for certain time periods. These should be amended, from time to time, with new data and scientific knowledge. The elaboration of this map does not completely solve all issues related to earthquakes, but it provides basic empirical data necessary for updating the existing regulations for construction of engineering structures in seismically active areas regulated by legal regulations and technical norms whose constituent part is the seismic hazard map. The map has been elaborated based on complex seismological and geophysical investigations of the considered area and synthesis of the results from these investigations. There were two phases of elaboration of the map. In the first phase, the map of focal zones characterized by maximum magnitudes of possible earthquakes has been elaborated. In the second phase, the intensities of expected earthquakes have been computed according to the MCS scale. The map is prognostic, i.e., it provides assessment of the

  19. Determination of Geometrical REVs Based on Volumetric Fracture Intensity and Statistical Tests

    Directory of Open Access Journals (Sweden)

    Ying Liu

    2018-05-01

    Full Text Available This paper presents a method to estimate a representative element volume (REV of a fractured rock mass based on the volumetric fracture intensity P32 and statistical tests. A 150 m × 80 m × 50 m 3D fracture network model was generated based on field data collected at the Maji dam site by using the rectangular window sampling method. The volumetric fracture intensity P32 of each cube was calculated by varying the cube location in the generated 3D fracture network model and varying the cube side length from 1 to 20 m, and the distribution of the P32 values was described. The size effect and spatial effect of the fractured rock mass were studied; the P32 values from the same cube sizes and different locations were significantly different, and the fluctuation in P32 values clearly decreases as the cube side length increases. In this paper, a new method that comprehensively considers the anisotropy of rock masses, simplicity of calculation and differences between different methods was proposed to estimate the geometrical REV size. The geometrical REV size of the fractured rock mass was determined based on the volumetric fracture intensity P32 and two statistical test methods, namely, the likelihood ratio test and the Wald–Wolfowitz runs test. The results of the two statistical tests were substantially different; critical cube sizes of 13 m and 12 m were estimated by the Wald–Wolfowitz runs test and the likelihood ratio test, respectively. Because the different test methods emphasize different considerations and impact factors, considering a result that these two tests accept, the larger cube size, 13 m, was selected as the geometrical REV size of the fractured rock mass at the Maji dam site in China.

  20. Effects on referral patterns of reducing intensive informational campaigns about first-episode psychosis

    DEFF Research Database (Denmark)

    Joa, Inge; Johannessen, Jan Olav; Auestad, Bjørn

    2007-01-01

    The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study.......The primary aim of this study was to assess referral patterns and duration of untreated psychosis (DUP) following the partial dismantling of intensive, information campaigns (IC) to help detect first-episode, non-affective psychosis via early detection teams in the TIPS study....

  1. Including dynamic CO2 intensity with demand response

    International Nuclear Information System (INIS)

    Stoll, Pia; Brandt, Nils; Nordström, Lars

    2014-01-01

    Hourly demand response tariffs with the intention of reducing or shifting loads during peak demand hours are being intensively discussed among policy-makers, researchers and executives of future electricity systems. Demand response rates have still low customer acceptance, apparently because the consumption habits requires stronger incentive to change than any proposed financial incentive. An hourly CO 2 intensity signal could give customers an extra environmental motivation to shift or reduce loads during peak hours, as it would enable co-optimisation of electricity consumption costs and carbon emissions reductions. In this study, we calculated the hourly dynamic CO 2 signal and applied the calculation to hourly electricity market data in Great Britain, Ontario and Sweden. This provided a novel understanding of the relationships between hourly electricity generation mix composition, electricity price and electricity mix CO 2 intensity. Load shifts from high-price hours resulted in carbon emission reductions for electricity generation mixes where price and CO 2 intensity were positively correlated. The reduction can be further improved if the shift is optimised using both price and CO 2 intensity. The analysis also indicated that an hourly CO 2 intensity signal can help avoid carbon emissions increases for mixes with a negative correlation between electricity price and CO 2 intensity. - Highlights: • We present a formula for calculating hybrid dynamic CO 2 intensity of electricity generation mixes. • We apply the dynamic CO 2 Intensity on hourly electricity market prices and generation units for Great Britain, Ontario and Sweden. • We calculate the spearman correlation between hourly electricity market price and dynamic CO 2 intensity for Great Britain, Ontario and Sweden. • We calculate carbon footprint of shifting 1 kWh load daily from on-peak hours to off-peak hours using the dynamic CO 2 intensity. • We conclude that using dynamic CO 2 intensity for

  2. [Nursing interventions on the physical environment of Neonatal Intensive Care Units].

    Science.gov (United States)

    Miquel Capó Rn, I

    2016-01-01

    The objectives of this study are to analyse nursing interventions regarding noise and lighting that influence neurodevelopment of the preterm infant in the Neonatal Intensive Care Unit. A review of the literature was performed using the databases: Cuiden Plus, PubMed, IBECS and Cochrane Library Plus. The inclusion and exclusion criteria were established in accordance with the objectives and limits used in each database. Of the 35 articles used, most were descriptive quantitative studies based on the measurement of sound pressure levels and lighting in the Neonatal Intensive Care Units. The countries included in this study are Brazil and the United States, and the variables analysed were the recording the times of light and noise. Based on the high levels of light and noise recorded in the Neonatal Intensive Care Units, nursing interventions that should be carried out to reduce them are described. The evidence indicates that after the implementation of these interventions, the high levels of both environmental stimuli are reduced significantly. Despite the extensive literature published on this problem, the levels of light and noise continue to exceed the recommended limits. Therefore, nurses need to increase and enhance their efforts in this environment, in order to positively influence neurodevelopment of premature newborn. Copyright © 2016 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  3. Data-Intensive Text Processing with MapReduce

    CERN Document Server

    Lin, Jimmy

    2010-01-01

    Our world is being revolutionized by data-driven methods: access to large amounts of data has generated new insights and opened exciting new opportunities in commerce, science, and computing applications. Processing the enormous quantities of data necessary for these advances requires large clusters, making distributed computing paradigms more crucial than ever. MapReduce is a programming model for expressing distributed computations on massive datasets and an execution framework for large-scale data processing on clusters of commodity servers. The programming model provides an easy-to-underst

  4. Experimental and numerical analysis for high intensity swirl based ultra-low emission flameless combustor operating with liquid fuels

    KAUST Repository

    Vanteru, Mahendra Reddy; Katoch, Amit; Roberts, William L.; Kumar, Sudarshan

    2014-01-01

    Flameless combustion offers many advantages over conventional combustion, particularly uniform temperature distribution and lower emissions. In this paper, a new strategy is proposed and adopted to scale up a burner operating in flameless combustion mode from a heat release density of 5.4-21 MW/m(3) (thermal input 21.5-84.7 kW) with kerosene fuel. A swirl flow based configuration was adopted for air injection and pressure swirl type nozzle with an SMD 35-37 lm was used to inject the fuel. Initially, flameless combustion was stabilized for a thermal input of 21.5 kW ((Q) over dot '''= 5.37 MW/m(3)). Attempts were made to scale this combustor to higher intensities i.e. 10.2, 16.3 and 21.1 MW/m(3). However, an increase in fuel flow rate led to incomplete combustion and accumulation of unburned fuel in the combustor. Two major difficulties were identified as possible reasons for unsustainable flameless combustion at the higher intensities. (i) A constant spray cone angle and SMD increases the droplet number density. (ii) Reactants dilution ratio (R-dil) decreased with increased thermal input. To solve these issues, a modified combustor configuration, aided by numerical computations was adopted, providing a chamfer near the outlet to increase the R-dil. Detailed experimental investigations showed that flameless combustion mode was achieved at high intensities with an evenly distributed reaction zone and temperature in the combustor at all heat intensities. The emissions of CO, NOx and HC for all heat intensities (Phi = 1-0.6) varied between 11-41, 6-19 and 0-9 ppm, respectively. These emissions are well within the range of emissions from other flameless combustion systems reported in the literature. The acoustic emission levels were also observed to be reduced by 8-9 dB at all conditions. (C) 2014 The Combustion Institute. Published by Elsevier Inc. All rights reserved.

  5. Experimental and numerical analysis for high intensity swirl based ultra-low emission flameless combustor operating with liquid fuels

    KAUST Repository

    Vanteru, Mahendra Reddy

    2014-06-21

    Flameless combustion offers many advantages over conventional combustion, particularly uniform temperature distribution and lower emissions. In this paper, a new strategy is proposed and adopted to scale up a burner operating in flameless combustion mode from a heat release density of 5.4-21 MW/m(3) (thermal input 21.5-84.7 kW) with kerosene fuel. A swirl flow based configuration was adopted for air injection and pressure swirl type nozzle with an SMD 35-37 lm was used to inject the fuel. Initially, flameless combustion was stabilized for a thermal input of 21.5 kW ((Q) over dot \\'\\'\\'= 5.37 MW/m(3)). Attempts were made to scale this combustor to higher intensities i.e. 10.2, 16.3 and 21.1 MW/m(3). However, an increase in fuel flow rate led to incomplete combustion and accumulation of unburned fuel in the combustor. Two major difficulties were identified as possible reasons for unsustainable flameless combustion at the higher intensities. (i) A constant spray cone angle and SMD increases the droplet number density. (ii) Reactants dilution ratio (R-dil) decreased with increased thermal input. To solve these issues, a modified combustor configuration, aided by numerical computations was adopted, providing a chamfer near the outlet to increase the R-dil. Detailed experimental investigations showed that flameless combustion mode was achieved at high intensities with an evenly distributed reaction zone and temperature in the combustor at all heat intensities. The emissions of CO, NOx and HC for all heat intensities (Phi = 1-0.6) varied between 11-41, 6-19 and 0-9 ppm, respectively. These emissions are well within the range of emissions from other flameless combustion systems reported in the literature. The acoustic emission levels were also observed to be reduced by 8-9 dB at all conditions. (C) 2014 The Combustion Institute. Published by Elsevier Inc. All rights reserved.

  6. Damage Detection for Historical Architectures Based on Tls Intensity Data

    Science.gov (United States)

    Li, Q.; Cheng, X.

    2018-04-01

    TLS (Terrestrial Laser Scanner) has long been preferred in the cultural heritage field for 3D documentation of historical sites thanks to its ability to acquire the geometric information without any physical contact. Besides the geometric information, most TLS systems also record the intensity information, which is considered as an important measurement of the spectral property of the scanned surface. Recent studies have shown the potential of using intensity for damage detection. However, the original intensity is affected by scanning geometry such as range and incidence angle and other factors, thus making the results less accurate. Therefore, in this paper, we present a method to detect certain damage areas using the corrected intensity data. Firstly, two data-driven models have been developed to correct the range and incidence angle effect. Then the corrected intensity is used to generate 2D intensity images for classification. After the damage areas being detected, they are re-projected to the 3D point cloud for better visual representation and further investigation. The experiment results indicate the feasibility and validity of the corrected intensity for damage detection.

  7. Postoperative Irradiation of Gynecologic Malignancies: Improving Treatment Delivery Using Aperture-Based Intensity-Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Nadeau, Sylvain; Bouchard, Myriam; Germain, Isabelle; Raymond, Paul-Emile; Beaulieu, Frederic; Beaulieu, Luc; Roy, Rene; Gingras, Luc

    2007-01-01

    Purpose: To evaluate dosimetric and treatment delivery advantages of aperture-based intensity-modulated radiotherapy (AB-IMRT) for the treatment of patients receiving whole pelvic radiotherapy for gynecologic malignancies. Methods and Materials: Nineteen patients undergoing pelvic radiotherapy after resection of endometrial cancers were selected. A 45-Gy dose was prescribed to the target volume delineated on a planning CT scan. An in-house inverse planning system, Ballista, was used to develop a treatment plan using aperture-based multileaf collimator segments. This approach was compared with conventional four-field, enlarged four-field, and static beamlet-based IMRT (BB-IMRT) techniques in terms of target coverage, dose-volume histogram statistics for surrounding normal tissues, and numbers of segments and monitor units (MU). Results: Three quarters (76.4%) of the planning target volume received the prescription dose with conventional four-field plans. With adequate target coverage, the Ballista plans significantly reduced the volume of bowel and bladder irradiated at the prescribed dose (p < 0.001), whereas the two approaches provided equivalent results for the rectum (p 0.5). On the other hand, AB-IMRT and BB-IMRT plans showed only small differences in dose-volume histogram statistics of unknown clinical impact, whereas Ballista plan delivery required on average 73% and 59% fewer segments and MU, respectively. Conclusion: With respect to conventional techniques, AB-IMRT for the treatment of gynecologic malignancies provides dosimetric advantages similar to those with BB-IMRT but with clear treatment delivery improvements

  8. Allowance Allocation and CO2 intensity of the EU15 and Norwegian refineries

    International Nuclear Information System (INIS)

    Nilsson, Kristina; Zetterberg, Lars; Aahman, Markus

    2005-02-01

    On 1 January 2005, the European Union Emission Trading Scheme (EU ETS) was launched. The launch has been preceded by an allocation process in each of the Member States. The main objective of this study was to analyse the allocation in relation to CO 2 efficiency for the mineral oil refining sector. A CO 2 intensity index for mineral oil refineries has been defined and calculated for the refineries within the EU15 and Norway. The IVL CO 2 intensity index is based both on the Solomon Energy Intensity Index (EII), an assumed fuel mix, and process-specific emissions. Due to uncertainties in input data, the determined values for the individual refineries are quite uncertain. However, the regional values can be used to identify trends. It was concluded that there are substantial differences in the CO 2 intensity between refineries within different regions/countries in the EU and these differences have not been considered in the allocation process. Only a few countries have mentioned energy efficiency or reduction potential due to CO 2 intensity of fuels used. Only one country (Denmark) has explicitly given a benchmark that will be used for allocation to new mineral oil refineries. The allocation has generally been based on historic emissions, which will result in refineries with historically higher emissions being allocated larger amounts than refineries with historically lower emissions. This might be favourable for refineries that recently have performed emission-reducing measures but might be less favourable for refineries that during a long time period have implemented emission-reducing measures

  9. A Model-Based Approach for Joint Analysis of Pain Intensity and Opioid Consumption in Postoperative Pain

    DEFF Research Database (Denmark)

    Juul, Rasmus V; Knøsgaard, Katrine R; Olesen, Anne E

    2016-01-01

    Joint analysis of pain intensity and opioid consumption is encouraged in trials of postoperative pain. However, previous approaches have not appropriately addressed the complexity of their interrelation in time. In this study, we applied a non-linear mixed effects model to simultaneously study pain...... intensity and opioid consumption in a 4-h postoperative period for 44 patients undergoing percutaneous kidney stone surgery. Analysis was based on 748 Numerical Rating Scale (NRS) scores of pain intensity and 51 observed morphine and oxycodone dosing events. A joint model was developed to describe...... the recurrent pattern of four key phases determining the development of pain intensity and opioid consumption in time; (A) Distribution of pain intensity scores which followed a truncated Poisson distribution with time-dependent mean score ranging from 0.93 to 2.45; (B) Probability of transition to threshold...

  10. Linear accelerator-based intensity-modulated total marrow irradiation technique for treatment of hematologic malignancies: a dosimetric feasibility study.

    Science.gov (United States)

    Yeginer, Mete; Roeske, John C; Radosevich, James A; Aydogan, Bulent

    2011-03-15

    To investigate the dosimetric feasibility of linear accelerator-based intensity-modulated total marrow irradiation (IM-TMI) in patients with hematologic malignancies. Linear accelerator-based IM-TMI treatment planning was performed for 9 patients using the Eclipse treatment planning system. The planning target volume (PTV) consisted of all the bones in the body from the head to the mid-femur, except for the forearms and hands. Organs at risk (OAR) to be spared included the lungs, heart, liver, kidneys, brain, eyes, oral cavity, and bowel and were contoured by a physician on the axial computed tomography images. The three-isocenter technique previously developed by our group was used for treatment planning. We developed and used a common dose-volume objective method to reduce the planning time and planner subjectivity in the treatment planning process. A 95% PTV coverage with the 99% of the prescribed dose of 12 Gy was achieved for all nine patients. The average dose reduction in OAR ranged from 19% for the lungs to 68% for the lenses. The common dose-volume objective method decreased the planning time by an average of 35% and reduced the inter- and intra- planner subjectivity. The results from the present study suggest that the linear accelerator-based IM-TMI technique is clinically feasible. We have demonstrated that linear accelerator-based IM-TMI plans with good PTV coverage and improved OAR sparing can be obtained within a clinically reasonable time using the common dose-volume objective method proposed in the present study. Copyright © 2011. Published by Elsevier Inc.

  11. Accelerator-based intense neutron source for materials R ampersand D

    International Nuclear Information System (INIS)

    Jameson, R.A.

    1990-01-01

    Accelerator-based neutron sources for R ampersand D of materials in nuclear energy systems, including fusion reactors, can provide sufficient neutron flux, flux-volume, fluence and other attractive features for many aspects of materials research. The neutron spectrum produced from the D-Li reaction has been judged useful for many basic materials research problems, and to be a satisfactory approximation to that of the fusion process. The technology of high-intensity linear accelerators can readily be applied to provide the deuteron beam for the neutron source. Earlier applications included the Los Alamos Meson Physics Facility and the Fusion Materials Irradiation Test facility prototype. The key features of today's advanced accelerator technology are presented to illustrate the present state-of-the-art in terms of improved understanding of basic physical principles and engineering technique, and to show how these advances can be applied to present demands in a timely manner. These features include how to produce an intense beam current with the high quality required to minimize beam losses along the accelerator and transport system that could cause maintenance difficulties, by controlling the beam emittance through proper choice of the operating frequency, balancing of the forces acting on the beam, and realization in practical hardware. A most interesting aspect for materials researchers is the increased flexibility and opportunities for experimental configurations that a modern accelerator-based source could add to the set of available tools. 8 refs., 5 figs

  12. [Geriatric intensive care patients : Perspectives and limits of geriatric intensive care medicine].

    Science.gov (United States)

    Müller-Werdan, U; Heppner, H-J; Michels, G

    2018-04-18

    Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age. The main reasons for changes in therapeutic targets are the will of the patient and risk-benefit considerations. The guidelines of the ethics section of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI) provide assistance and suggestions for a structured decision-making process.

  13. Reduced Urban Heat Island intensity under warmer conditions

    Science.gov (United States)

    Scott, Anna A.; Waugh, Darryn W.; Zaitchik, Ben F.

    2018-06-01

    The Urban Heat Island (UHI), the tendency for urban areas to be hotter than rural regions, represents a significant health concern in summer as urban populations are exposed to elevated temperatures. A number of studies suggest that the UHI increases during warmer conditions, however there has been no investigation of this for a large ensemble of cities. Here we compare urban and rural temperatures in 54 US cities for 2000–2015 and show that the intensity of the Urban Heat Island, measured here as the differences in daily-minimum or daily-maximum temperatures between urban and rural stations or ΔT, in fact tends to decrease with increasing temperature in most cities (38/54). This holds when investigating daily variability, heat extremes, and variability across climate zones and is primarily driven by changes in rural areas. We relate this change to large-scale or synoptic weather conditions, and find that the lowest ΔT nights occur during moist weather conditions. We also find that warming cities have not experienced an increasing Urban Heat Island effect.

  14. Erythropoietin does not reduce plasma lactate, H⁺, and K⁺ during intense exercise.

    Science.gov (United States)

    Nordsborg, N B; Robach, P; Boushel, R; Calbet, J A L; Lundby, C

    2015-12-01

    It is investigated if recombinant human erythropoietin (rHuEPO) treatment for 15 weeks (n = 8) reduces extracellular accumulation of metabolic stress markers such as lactate, H(+) , and K(+) during incremental exhaustive exercise. After rHuEPO treatment, normalization of blood volume and composition by hemodilution preceded an additional incremental test. Group averages were calculated for an exercise intensity ∼80% of pre-rHuEPO peak power output. After rHuEPO treatment, leg lactate release to the plasma compartment was similar to before (4.3 ± 1.6 vs 3.9 ± 2.5 mmol/min) and remained similar after hemodilution. Venous lactate concentration was higher (P release to the plasma compartment after rHuEPO was similar to before (19.6 ± 5.4 vs 17.6 ± 6.0 mmol/min) and remained similar after hemodilution. Nevertheless, venous pH was lower (P release to the plasma compartment after rHuEPO treatment was similar to before (0.8 ± 0.5 vs 0.7 ± 0.7 mmol/min) and remained similar after hemodilution. Additionally, venous K(+) concentrations were similar after vs before rHuEPO (5.3 ± 0.3 vs 5.1 ± 0.4 mM). In conclusion, rHuEPO does not reduce plasma accumulation of lactate, H(+) , and K(+) at work rates corresponding to ∼80% of peak power output. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Temporal and subjective work demands in office-based patient care: an exploration of the dimensions of physician work intensity.

    Science.gov (United States)

    Jacobson, C Jeff; Bolon, Shannon; Elder, Nancy; Schroer, Brian; Matthews, Gerald; Szaflarski, Jerzy P; Raphaelson, Marc; Horner, Ronnie D

    2011-01-01

    Physician work intensity (WI) during office-based patient care affects quality of care and patient safety as well as physician job-satisfaction and reimbursement. Existing, brief work intensity measures have been used in physician studies, but their validity in clinical settings has not been established. Document and describe subjective and temporal WI dimensions for physicians in office-based clinical settings. Examine these in relation to the measurement procedures and dimensions of the SWAT and NASA-TLX intensity measures. A focused ethnographic study using interviews and direct observations. Five family physicians, 5 general internists, 5 neurologists, and 4 surgeons. Through interviews, each physician was asked to describe low and high intensity work responsibilities, patients, and events. To document time and task allotments, physicians were observed during a routine workday. Notes and transcripts were analyzed using the editing method in which categories are obtained from the data. WI factors identified by physicians matched dimensions assessed by standard, generic instruments of work intensity. Physicians also reported WI factors outside of the direct patient encounter. Across specialties, physician time spent in direct contact with patients averaged 61% for office-based services. Brief work intensity measures such as the SWAT and NASA-TLX can be used to assess WI in the office-based clinical setting. However, because these measures define the physician work "task" in terms of effort in the presence of the patient (ie, intraservice time), substantial physician effort dedicated to pre- and postservice activities is not captured.

  16. Evaluation of Intensive Construction Land Use in the Emerging City Based on PSR-Entropy model

    Science.gov (United States)

    Jia, Yuanyuan; Lei, Guangyu

    2018-01-01

    A comprehensive understanding of emerging city land utilization and the evaluation of intensive land use in the Emerging City will provide the comprehensive and reliable technical basis for the planning and management. It is an important node. According to the Han cheng from 2008 to 2016 years of land use, based on PSR-Entropy model of land use evaluation system, using entropy method to determine the index weight, the introduction of comprehensive index method to evaluate the degree of land use. The results show that the intensive land use comprehensive evaluation index of Han cheng increased from 2008 to 2015, but the land intensive use can not achieve the standards. The potential of further enhancing space is relatively large.

  17. Technological Options to Ameliorate Waste Treatment of Intensive Pig Production in China:An Analysis Based on Bio-Economic Model

    Institute of Scientific and Technical Information of China (English)

    LU Wen-cong; MA Yong-xi; Holger Bergmann

    2014-01-01

    Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment beneifts of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental beneifts of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efifciency, the waste treatment capacity and the economic beneifts could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.

  18. Feasibility of geometric-intensity-based semi-automated delineation of the tentorium cerebelli from MRI scans.

    Science.gov (United States)

    Penumetcha, Neeraja; Kabadi, Suraj; Jedynak, Bruno; Walcutt, Charles; Gado, Mokhtar H; Wang, Lei; Ratnanather, J Tilak

    2011-04-01

    This paper describes a feasibility study of a method for delineating the tentorium cerebelli in magnetic resonance imaging (MRI) brain scans. The tentorium cerebelli is a thin sheet of dura matter covering the cerebellum and separating it from the posterior part of the temporal lobe and the occipital lobe of the cerebral hemispheres. Cortical structures such as the parahippocampal gyrus can be indistinguishable from tentorium in magnetized prepared rapid gradient echo and T1-weighted MRI scans. Similar intensities in these neighboring regions make it difficult to perform accurate cortical analysis in neuroimaging studies of schizophrenia and Alzheimer's disease. A semi-automated, geometric, intensity-based procedure for delineating the tentorium from a whole-brain scan is described. Initial and final curves are traced within the tentorium. A cost function, based on intensity and Euclidean distance, is computed between the two curves using the Fast Marching method. The initial curve is then evolved to the final curve based on the gradient of the computed costs, generating a series of intermediate curves. These curves are then used to generate a triangulated surface of the tentorium. For 3 scans, surfaces were found to be within 2 voxels from hand segmentations. Copyright © 2009 by the American Society of Neuroimaging.

  19. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... for a breath. Absolute Intensity The amount of energy used by the body per minute of activity. ... or vigorous-intensity based upon the amount of energy used by the body while doing the activity. ...

  20. Measuring Physical Activity Intensity

    Medline Plus

    Full Text Available ... Share Compartir For more help with what counts as aerobic activity, watch this video: Windows Media Player, ... The table below lists examples of activities classified as moderate-intensity or vigorous-intensity based upon the ...

  1. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes.

    Science.gov (United States)

    Maillard, F; Rousset, S; Pereira, B; Traore, A; de Pradel Del Amaze, P; Boirie, Y; Duclos, M; Boisseau, N

    2016-12-01

    This study compared the effect of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) for 16 weeks on whole-body and abdominal fat mass (FM) in postmenopausal women with type 2 diabetes (T2D). Seventeen women (69±1 years; BMI: 31±1kg.m -2 ) were randomly assigned to either a HIIT [60×(8s at 77-85% HR max , 12s of active recovery)] or MICT (40min at 55-60% of their individual HRR) cycling program for 16 weeks, 2 days/week. Dual-energy X-ray absorptiometry was used to measure whole-body and regional FM content, including abdominal adiposity and visceral adipose tissue. Plasma cholesterol, HDL, LDL, triglycerides, glucose and HbA 1c levels were measured. Levels of nutritional intake and physical activity were evaluated by 7-day self-reports. Dietary energy (caloric) intake, physical activity level and total body mass did not vary in either group from the beginning to the end of the training intervention. Overall, total FM decreased and total fat-free mass significantly increased over time (by around 2-3%). Total FM reduction at the end of the intervention was not significantly different between groups. However, significant loss of total abdominal (-8.3±2.2%) and visceral (-24.2±7.7%) FM was observed only with HIIT. Time effects were noted for HbA 1c and total cholesterol/HDL ratio. With no concomitant caloric restriction, an HIIT program in postmenopausal women with T2D (twice a week for 16 weeks) appeared to be more effective for reducing central obesity than MICT, and could be proposed as an alternative exercise training program for this population. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Desensitizing Addiction: Using Eye Movements to Reduce the Intensity of Substance-Related Mental Imagery and Craving.

    Science.gov (United States)

    Littel, Marianne; van den Hout, Marcel A; Engelhard, Iris M

    2016-01-01

    Eye movement desensitization and reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder. During this treatment, patients recall traumatic memories while making horizontal eye movements (EM). Studies have shown that EM not only desensitize negative memories but also positive memories and imagined events. Substance use behavior and craving are maintained by maladaptive memory associations and visual imagery. Preliminary findings have indicated that these mental images can be desensitized by EMDR techniques. We conducted two proof-of-principle studies to investigate whether EM can reduce the sensory richness of substance-related mental representations and accompanying craving levels. We investigated the effects of EM on (1) vividness of food-related mental imagery and food craving in dieting and non-dieting students and (2) vividness of recent smoking-related memories and cigarette craving in daily smokers. In both experiments, participants recalled the images while making EM or keeping eyes stationary. Image vividness and emotionality, image-specific craving and general craving were measured before and after the intervention. As a behavioral outcome measure, participants in study 1 were offered a snack choice at the end of the experiment. Results of both experiments showed that image vividness and craving increased in the control condition but remained stable or decreased after the EM intervention. EM additionally reduced image emotionality (experiment 2) and affected behavior (experiment 1): participants in the EM condition were more inclined to choose healthy over unhealthy snack options. In conclusion, these data suggest that EM can be used to reduce intensity of substance-related imagery and craving. Although long-term effects are yet to be demonstrated, the current studies suggest that EM might be a useful technique in addiction treatment.

  3. The ETLMR MapReduce-Based ETL Framework

    DEFF Research Database (Denmark)

    Xiufeng, Liu; Thomsen, Christian; Pedersen, Torben Bach

    2011-01-01

    This paper presents ETLMR, a parallel Extract--Transform--Load (ETL) programming framework based on MapReduce. It has built-in support for high-level ETL-specific constructs including star schemas, snowflake schemas, and slowly changing dimensions (SCDs). ETLMR gives both high programming...

  4. Magnetic Resonance-Based Treatment Planning for Prostate Intensity-Modulated Radiotherapy: Creation of Digitally Reconstructed Radiographs

    International Nuclear Information System (INIS)

    Chen, Lili; Nguyen, Thai-Binh; Jones, Elan; Chen Zuoqun; Luo Wei; Wang Lu; Price, Robert A.; Pollack, Alan; Ma, C.-M. Charlie

    2007-01-01

    Purpose: To develop a technique to create magnetic resonance (MR)-based digitally reconstructed radiographs (DRR) for initial patient setup for routine clinical applications of MR-based treatment planning for prostate intensity-modulated radiotherapy. Methods and Materials: Twenty prostate cancer patients' computed tomography (CT) and MR images were used for the study. Computed tomography and MR images were fused. The pelvic bony structures, including femoral heads, pubic rami, ischium, and ischial tuberosity, that are relevant for routine clinical patient setup were manually contoured on axial MR images. The contoured bony structures were then assigned a bulk density of 2.0 g/cm 3 . The MR-based DRRs were generated. The accuracy of the MR-based DDRs was quantitatively evaluated by comparing MR-based DRRs with CT-based DRRs for these patients. For each patient, eight measuring points on both coronal and sagittal DRRs were used for quantitative evaluation. Results: The maximum difference in the mean values of these measurement points was 1.3 ± 1.6 mm, and the maximum difference in absolute positions was within 3 mm for the 20 patients investigated. Conclusions: Magnetic resonance-based DRRs are comparable to CT-based DRRs for prostate intensity-modulated radiotherapy and can be used for patient treatment setup when MR-based treatment planning is applied clinically

  5. A tunable, linac based, intense, broad-band THz source forpump-probe experiments

    Energy Technology Data Exchange (ETDEWEB)

    Schmerge, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Adolphsen, C. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Corbett, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Dolgashev, V. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Durr, H. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Fazio, M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Fisher, A. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Frisch, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Gaffney, K. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Guehr, M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hastings, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hettel, B. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hoffmann, M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Hogan, M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Holtkamp, N. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Huang, X. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Huang, Z. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Kirchmann, P. [SLAC National Accelerator Lab., Menlo Park, CA (United States); LaRue, J. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Limborg, C. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Lindenberg, A. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Loos, H. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Maxwell, T. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Nilsson, A. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Raubenheimer, T. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Reis, D. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Ross, M. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Shen, Z. -X. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Stupakov, G. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Tantawi, S. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Tian, K. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Wu, Z. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Xiang, D. [SLAC National Accelerator Lab., Menlo Park, CA (United States); Yakimenko, V. [SLAC National Accelerator Lab., Menlo Park, CA (United States)

    2015-02-02

    We propose an intense THz source with tunable frequency and bandwidth that can directly interact with the degrees of freedom that determine the properties of materials and thus provides a new tool for controlling and directing these ultrafast processes as well as aiding synthesis of new materials with new functional properties. This THz source will broadly impact our understanding of dynamical processes in matter at the atomic-scale and in real time. Established optical pumping schemes using femtosecond visible frequency laser pulses for excitation are extended into the THz frequency regime thereby enabling resonant excitation of bonds in correlated solid state materials (phonon pumping), to drive low energy electronic excitations, to trigger surface chemistry reactions, and to all-optically bias a material with ultrashort electric fields or magnetic fields. A linac-based THz source can supply stand-alone experiments with peak intensities two orders of magnitude stronger than existing laser-based sources, but when coupled with atomic-scale sensitive femtosecond x-ray probes it opens a new frontier in ultrafast science with broad applications to correlated materials, interfacial and liquid phase chemistry, and materials in extreme conditions.

  6. Taming of the monitors: reducing false alarms in intensive care units

    Czech Academy of Sciences Publication Activity Database

    Plešinger, Filip; Klimeš, Petr; Halámek, Josef; Jurák, Pavel

    2016-01-01

    Roč. 37, č. 8 (2016), s. 1313-1325 ISSN 0967-3334 R&D Projects: GA ČR GAP102/12/2034; GA MŠk(CZ) LO1212; GA MŠk ED0017/01/01 Institutional support: RVO:68081731 Keywords : ECG * critical care * arrhythmia * intensive care unit * ICU monitor * false alarm * beat detection Subject RIV: FS - Medical Facilities ; Equipment Impact factor: 2.058, year: 2016

  7. Stochastic conditional intensity processes

    DEFF Research Database (Denmark)

    Bauwens, Luc; Hautsch, Nikolaus

    2006-01-01

    model allows for a wide range of (cross-)autocorrelation structures in multivariate point processes. The model is estimated by simulated maximum likelihood (SML) using the efficient importance sampling (EIS) technique. By modeling price intensities based on NYSE trading, we provide significant evidence......In this article, we introduce the so-called stochastic conditional intensity (SCI) model by extending Russell’s (1999) autoregressive conditional intensity (ACI) model by a latent common dynamic factor that jointly drives the individual intensity components. We show by simulations that the proposed...... for a joint latent factor and show that its inclusion allows for an improved and more parsimonious specification of the multivariate intensity process...

  8. In-hospital fellow coverage reduces communication errors in the surgical intensive care unit.

    Science.gov (United States)

    Williams, Mallory; Alban, Rodrigo F; Hardy, James P; Oxman, David A; Garcia, Edward R; Hevelone, Nathanael; Frendl, Gyorgy; Rogers, Selwyn O

    2014-06-01

    Staff coverage strategies of intensive care units (ICUs) impact clinical outcomes. High-intensity staff coverage strategies are associated with lower morbidity and mortality. Accessible clinical expertise, team work, and effective communication have all been attributed to the success of this coverage strategy. We evaluate the impact of in-hospital fellow coverage (IHFC) on improving communication of cardiorespiratory events. A prospective observational study performed in an academic tertiary care center with high-intensity staff coverage. The main outcome measure was resident to fellow communication of cardiorespiratory events during IHFC vs home coverage (HC) periods. Three hundred twelve cardiorespiratory events were collected in 114 surgical ICU patients in 134 study days. Complete data were available for 306 events. One hundred three communication errors occurred. IHFC was associated with significantly better communication of events compared to HC (Pcommunicated 89% of events during IHFC vs 51% of events during HC (PCommunication patterns of junior and midlevel residents were similar. Midlevel residents communicated 68% of all on-call events (87% IHFC vs 50% HC, Pcommunicated 66% of events (94% IHFC vs 52% HC, PCommunication errors were lower in all ICUs during IHFC (Pcommunication errors. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Allowance Allocation and CO{sub 2} intensity of the EU15 and Norwegian refineries

    Energy Technology Data Exchange (ETDEWEB)

    Nilsson, Kristina; Zetterberg, Lars; Aahman, Markus

    2005-02-01

    On 1 January 2005, the European Union Emission Trading Scheme (EU ETS) was launched. The launch has been preceded by an allocation process in each of the Member States. The main objective of this study was to analyse the allocation in relation to CO{sub 2} efficiency for the mineral oil refining sector. A CO{sub 2} intensity index for mineral oil refineries has been defined and calculated for the refineries within the EU15 and Norway. The IVL CO{sub 2} intensity index is based both on the Solomon Energy Intensity Index (EII), an assumed fuel mix, and process-specific emissions. Due to uncertainties in input data, the determined values for the individual refineries are quite uncertain. However, the regional values can be used to identify trends. It was concluded that there are substantial differences in the CO{sub 2} intensity between refineries within different regions/countries in the EU and these differences have not been considered in the allocation process. Only a few countries have mentioned energy efficiency or reduction potential due to CO{sub 2} intensity of fuels used. Only one country (Denmark) has explicitly given a benchmark that will be used for allocation to new mineral oil refineries. The allocation has generally been based on historic emissions, which will result in refineries with historically higher emissions being allocated larger amounts than refineries with historically lower emissions. This might be favourable for refineries that recently have performed emission-reducing measures but might be less favourable for refineries that during a long time period have implemented emission-reducing measures.

  10. An intervention to reduce sitting and increase light-intensity physical activity at work: Design and rationale of the 'Stand & Move at Work' group randomized trial.

    Science.gov (United States)

    Buman, Matthew P; Mullane, Sarah L; Toledo, Meynard J; Rydell, Sarah A; Gaesser, Glenn A; Crespo, Noe C; Hannan, Peter; Feltes, Linda; Vuong, Brenna; Pereira, Mark A

    2017-02-01

    American workers spend 70-80% of their time at work being sedentary. Traditional approaches to increase moderate-vigorous physical activity (MVPA) may be perceived to be harmful to productivity. Approaches that target reductions in sedentary behavior and/or increases in standing or light-intensity physical activity [LPA] may not interfere with productivity and may be more feasible to achieve through small changes accumulated throughout the workday METHODS/DESIGN: This group randomized trial (i.e., cluster randomized trial) will test the relative efficacy of two sedentary behavior focused interventions in 24 worksites across two states (N=720 workers). The MOVE+ intervention is a multilevel individual, social, environmental, and organizational intervention targeting increases in light-intensity physical activity in the workplace. The STAND+ intervention is the MOVE+ intervention with the addition of the installation and use of sit-stand workstations to reduce sedentary behavior and enhance light-intensity physical activity opportunities. Our primary outcome will be objectively-measured changes in sedentary behavior and light-intensity physical activity over 12months, with additional process measures at 3months and longer-term sustainability outcomes at 24months. Our secondary outcomes will be a clustered cardiometabolic risk score (comprised of fasting glucose, insulin, triglycerides, HDL-cholesterol, and blood pressure), workplace productivity, and job satisfaction DISCUSSION: This study will determine the efficacy of a multi-level workplace intervention (including the use of a sit-stand workstation) to reduce sedentary behavior and increase LPA and concomitant impact on cardiometabolic health, workplace productivity, and satisfaction. ClinicalTrials.gov Identifier: NCT02566317 (date of registration: 10/1/2015). Copyright © 2016 Elsevier Inc. All rights reserved.

  11. The impact of center experience on results of reduced intensity:allogeneic hematopoietic SCT for AML. An analysis from the Acute Leukemia Working Party of the EBMT

    DEFF Research Database (Denmark)

    Giebel, S; Labopin, M; Mohty, M

    2013-01-01

    Allogeneic hematopoietic SCT with reduced-intensity conditioning (RIC-HSCT) is increasingly adopted for the treatment of older adults with AML. Our goal was to verify for the first time, if center experience influences outcome of RIC-HSCT. Results of 1413 transplantations from HLA-matched related...

  12. Macroseismic intensity attenuation in Iran

    Science.gov (United States)

    Yaghmaei-Sabegh, Saman

    2018-01-01

    Macroseismic intensity data plays an important role in the process of seismic hazard analysis as well in developing of reliable earthquake loss models. This paper presents a physical-based model to predict macroseismic intensity attenuation based on 560 intensity data obtained in Iran in the time period 1975-2013. The geometric spreading and energy absorption of seismic waves have been considered in the proposed model. The proposed easy to implement relation describes the intensity simply as a function of moment magnitude, source to site distance and focal depth. The prediction capability of the proposed model is assessed by means of residuals analysis. Prediction results have been compared with those of other intensity prediction models for Italy, Turkey, Iran and central Asia. The results indicate the higher attenuation rate for the study area in distances less than 70km.

  13. Ultrasound image based visual servoing for moving target ablation by high intensity focused ultrasound.

    Science.gov (United States)

    Seo, Joonho; Koizumi, Norihiro; Mitsuishi, Mamoru; Sugita, Naohiko

    2017-12-01

    Although high intensity focused ultrasound (HIFU) is a promising technology for tumor treatment, a moving abdominal target is still a challenge in current HIFU systems. In particular, respiratory-induced organ motion can reduce the treatment efficiency and negatively influence the treatment result. In this research, we present: (1) a methodology for integration of ultrasound (US) image based visual servoing in a HIFU system; and (2) the experimental results obtained using the developed system. In the visual servoing system, target motion is monitored by biplane US imaging and tracked in real time (40 Hz) by registration with a preoperative 3D model. The distance between the target and the current HIFU focal position is calculated in every US frame and a three-axis robot physically compensates for differences. Because simultaneous HIFU irradiation disturbs US target imaging, a sophisticated interlacing strategy was constructed. In the experiments, respiratory-induced organ motion was simulated in a water tank with a linear actuator and kidney-shaped phantom model. Motion compensation with HIFU irradiation was applied to the moving phantom model. Based on the experimental results, visual servoing exhibited a motion compensation accuracy of 1.7 mm (RMS) on average. Moreover, the integrated system could make a spherical HIFU-ablated lesion in the desired position of the respiratory-moving phantom model. We have demonstrated the feasibility of our US image based visual servoing technique in a HIFU system for moving target treatment. © 2016 The Authors The International Journal of Medical Robotics and Computer Assisted Surgery Published by John Wiley & Sons Ltd.

  14. Real time quantitative phase microscopy based on single-shot transport of intensity equation (ssTIE) method

    Science.gov (United States)

    Yu, Wei; Tian, Xiaolin; He, Xiaoliang; Song, Xiaojun; Xue, Liang; Liu, Cheng; Wang, Shouyu

    2016-08-01

    Microscopy based on transport of intensity equation provides quantitative phase distributions which opens another perspective for cellular observations. However, it requires multi-focal image capturing while mechanical and electrical scanning limits its real time capacity in sample detections. Here, in order to break through this restriction, real time quantitative phase microscopy based on single-shot transport of the intensity equation method is proposed. A programmed phase mask is designed to realize simultaneous multi-focal image recording without any scanning; thus, phase distributions can be quantitatively retrieved in real time. It is believed the proposed method can be potentially applied in various biological and medical applications, especially for live cell imaging.

  15. Multi-energy CT based on a prior rank, intensity and sparsity model (PRISM)

    International Nuclear Information System (INIS)

    Gao, Hao; Osher, Stanley; Yu, Hengyong; Wang, Ge

    2011-01-01

    We propose a compressive sensing approach for multi-energy computed tomography (CT), namely the prior rank, intensity and sparsity model (PRISM). To further compress the multi-energy image for allowing the reconstruction with fewer CT data and less radiation dose, the PRISM models a multi-energy image as the superposition of a low-rank matrix and a sparse matrix (with row dimension in space and column dimension in energy), where the low-rank matrix corresponds to the stationary background over energy that has a low matrix rank, and the sparse matrix represents the rest of distinct spectral features that are often sparse. Distinct from previous methods, the PRISM utilizes the generalized rank, e.g., the matrix rank of tight-frame transform of a multi-energy image, which offers a way to characterize the multi-level and multi-filtered image coherence across the energy spectrum. Besides, the energy-dependent intensity information can be incorporated into the PRISM in terms of the spectral curves for base materials, with which the restoration of the multi-energy image becomes the reconstruction of the energy-independent material composition matrix. In other words, the PRISM utilizes prior knowledge on the generalized rank and sparsity of a multi-energy image, and intensity/spectral characteristics of base materials. Furthermore, we develop an accurate and fast split Bregman method for the PRISM and demonstrate the superior performance of the PRISM relative to several competing methods in simulations. (papers)

  16. Time-course changes of oxidative stress response to high-intensity discontinuous training versus moderate-intensity continuous training in masters runners.

    Directory of Open Access Journals (Sweden)

    Alessandra Vezzoli

    Full Text Available Beneficial systemic effects of regular physical exercise have been demonstrated to reduce risks of a number of age-related disorders. Antioxidant capacity adaptations are amongst these fundamental changes in response to exercise training. However, it has been claimed that acute physical exercise performed at high intensity (>60% of maximal oxygen uptake may result in oxidative stress, due to reactive oxygen species being generated excessively by enhanced oxygen consumption. The aim of this study was to evaluate the effect of high-intensity discontinuous training (HIDT, characterized by repeated variations of intensity and changes of redox potential, on oxidative damage. Twenty long-distance masters runners (age 47.8 ± 7.8 yr on the basis of the individual values of gas exchange threshold were assigned to a different 8-weeks training program: continuous moderate-intensity training (MOD, n = 10 or HIDT (n = 10. In both groups before (PRE and after (POST training we examined the following oxidative damage markers: thiobarbituric acid reactive substances (TBARS as marker of lipid peroxidation; protein carbonyls (PC as marker of protein oxidation; 8-hydroxy-2-deoxy-guanosine (8-OH-dG as a biomarker of DNA base modifications; and total antioxidant capacity (TAC as indicator of the overall antioxidant system. Training induced a significant (p<0.05 decrease in resting plasma TBARS concentration in both MOD (7.53 ± 0.30 and 6.46 ± 0.27 µM, PRE and POST respectively and HIDT (7.21 ± 0.32 and 5.85 ± 0.46 µM, PRE and POST respectively. Resting urinary 8-OH-dG levels were significantly decreased in both MOD (5.50 ± 0.66 and 4.16 ± 0.40 ng mg(-1creatinine, PRE and POST respectively and HIDT (4.52 ± 0.50 and 3.18 ± 0.34 ng mg(-1creatinine, PRE and POST respectively. Training both in MOD and HIDT did not significantly modify plasma levels of PC. Resting plasma TAC was reduced in MOD while no significant changes were observed in HIDT. In conclusion

  17. LIGHT INTENSITY INFLUENCE ON STRONTIUM TITANATE BASED PHOTO- ELECTROCHEMICAL CELLS

    Directory of Open Access Journals (Sweden)

    D. Hertkorn

    2017-07-01

    Full Text Available The influence of light intensity on photo-electrochemical cells (PECs consisting of an n-type strontium titanate (SrTiO₃ photoanode and nickel cathode in potassium hydroxide electrolyte is studied. The band levels of an electrolyte-metal-semiconductor-electrolyte system are presented and the effect of different light intensities on the energy levels is investigated. Photocurrent density, quantum efficiency, and open circuit potential measurements are performed on the processed PECs under different light intensities (375 nm. It is demonstrated that a threshold value of the light intensity has to be reached in order to obtain positive photo activity and that beyond this value the performance remains nearly constant.

  18. Simultaneous beam geometry and intensity map optimization in intensity-modulated radiation therapy

    International Nuclear Information System (INIS)

    Lee, Eva K.; Fox, Tim; Crocker, Ian

    2006-01-01

    Purpose: In current intensity-modulated radiation therapy (IMRT) plan optimization, the focus is on either finding optimal beam angles (or other beam delivery parameters such as field segments, couch angles, gantry angles) or optimal beam intensities. In this article we offer a mixed integer programming (MIP) approach for simultaneously determining an optimal intensity map and optimal beam angles for IMRT delivery. Using this approach, we pursue an experimental study designed to (a) gauge differences in plan quality metrics with respect to different tumor sites and different MIP treatment planning models, and (b) test the concept of critical-normal-tissue-ring-a tissue ring of 5 mm thickness drawn around the planning target volume (PTV)-and its use for designing conformal plans. Methods and Materials: Our treatment planning models use two classes of decision variables to capture the beam configuration and intensities simultaneously. Binary (0/1) variables are used to capture 'on' or 'off' or 'yes' or 'no' decisions for each field, and nonnegative continuous variables are used to represent intensities of beamlets. Binary and continuous variables are also used for each voxel to capture dose level and dose deviation from target bounds. Treatment planning models were designed to explicitly incorporate the following planning constraints: (a) upper/lower/mean dose-based constraints, (b) dose-volume and equivalent-uniform-dose (EUD) constraints for critical structures, (c) homogeneity constraints (underdose/overdose) for PTV, (d) coverage constraints for PTV, and (e) maximum number of beams allowed. Within this constrained solution space, five optimization strategies involving clinical objectives were analyzed: optimize total intensity to PTV, optimize total intensity and then optimize conformity, optimize total intensity and then optimize homogeneity, minimize total dose to critical structures, minimize total dose to critical structures and optimize conformity

  19. β2 -microglobulin normalization within 6 months of ibrutinib-based treatment is associated with superior progression-free survival in patients with chronic lymphocytic leukemia.

    Science.gov (United States)

    Thompson, Philip A; O'Brien, Susan M; Xiao, Lianchun; Wang, Xuemei; Burger, Jan A; Jain, Nitin; Ferrajoli, Alessandra; Estrov, Zeev; Keating, Michael J; Wierda, William G

    2016-02-15

    A high pretreatment β2 -microglobulin (B2M) level is associated with inferior survival outcomes in patients with chronic lymphocytic leukemia. However, to the authors' knowledge, the prognostic and predictive significance of changes in B2M during treatment have not been reported to date. The authors analyzed 83 patients treated with ibrutinib-based regimens (66 with recurrent/refractory disease) and 198 treatment-naive patients who were treated with combined fludarabine, cyclophosphamide, and rituximab (FCR) to characterize changes in B2M and their relationship with clinical outcomes. B2M rapidly decreased during treatment with ibrutinib; on multivariable analysis, patients who received FCR (odds ratio, 0.40; 95% confidence interval [95% CI], 0.18-0.90 [P = .027]) were less likely to have normalized B2M at 6 months than patients treated with ibrutinib. On univariable analysis, normalization of B2M was associated with superior progression-free survival (PFS) from the 6-month landmark in patients treated with ibrutinib-based regimens and FCR. On multivariable analysis, failure to achieve normalized B2M at 6 months of treatment was associated with inferior PFS (hazard ratio, 16.9; 95% CI, 1.3-220.0 [P = .031]) for patients treated with ibrutinib, after adjusting for the effects of baseline B2M, stage of disease, fludarabine-refractory disease, and del(17p). In contrast, in patients treated with FCR, negative minimal residual disease status in the bone marrow was the only variable found to be significantly associated with superior PFS (hazard ratio, 0.28; 95% CI, 0.12-0.67 [P = .004]). Normalization of B2M at 6 months in patients treated with ibrutinib was found to be a useful predictor of subsequent PFS and may assist in clinical decision-making. © 2015 American Cancer Society.

  20. Infection prevention practices in adult intensive care units in a large community hospital system after implementing strategies to reduce health care-associated, methicillin-resistant Staphylococcus aureus infections.

    Science.gov (United States)

    Moody, Julia; Septimus, Edward; Hickok, Jason; Huang, Susan S; Platt, Richard; Gombosev, Adrijana; Terpstra, Leah; Avery, Taliser; Lankiewicz, Julie; Perlin, Jonathan B

    2013-02-01

    A range of strategies and approaches have been developed for preventing health care-associated infections. Understanding the variation in practices among facilities is necessary to improve compliance with existing programs and aid the implementation of new interventions. In 2009, HCA Inc administered an electronic survey to measure compliance with evidence-based infection prevention practices as well as identify variation in products or methods, such as use of special approach technology for central vascular catheters and ventilator care. Responding adult intensive care units (ICUs) were those considering participation in a clinical trial to reduce health care-associated infections. Responses from 99 ICUs in 55 hospitals indicated that many evidenced-based practices were used consistently, including methicillin-resistant Staphylococcus aureus (MRSA) screening and use of contact precautions for MRSA-positive patients. Other practices exhibited wide variability including discontinuation of precautions and use of antimicrobial technology or chlorhexidine patches for central vascular catheters. MRSA decolonization was not a predominant practice in ICUs. In this large, community-based health care system, there was substantial variation in the products and methods to reduce health care-associated infections. Despite system-wide emphasis on basic practices as a precursor to adding special approach technologies, this survey showed that these technologies were commonplace, including in facilities where improvement in basic practices was needed. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  1. Decomposition analysis of the change of energy intensity of manufacturing industries in Thailand

    International Nuclear Information System (INIS)

    Chontanawat, Jaruwan; Wiboonchutikula, Paitoon; Buddhivanich, Atinat

    2014-01-01

    The study computes and analyses the sources of the change of energy intensity of the manufacturing industries in Thailand during the period (1991–2011) using the decomposition method. The Logarithmic Mean Divisia Index is computed and the results show that the energy intensity in the period (1991–2000) increased greatly from the increased energy intensity of each industry. In the more recent period (2000–2011) the energy intensity declined a little. However the decline was mainly from the structural change effect with negligible contribution from decreased energy intensity of each industry. The findings imply the need to balance industrial restructuring policies with efforts to reduce energy intensity for a sustainable economic development. Besides, there is much room for individual industries to improve their energy efficiency. Policies on restructuring energy prices and other non-price related measures should be devised to induce individual industries, particularly the highly energy intensive ones, to reduce their energy intensity. - Highlights: • Decomposing change of energy intensity of Thai manufacturing industries, 1991–2011. • 1991–2000 energy intensity rose due to increased energy intensity of each industry. • 2000–2011 energy intensity declined due mainly to the structural change effect. • Need to balance industrial restructuring policies to reduce energy intensity

  2. An Industrial Radipgraphy Exposure Device Based on Measurement of Transmitted Gamma-Ray Intensity

    International Nuclear Information System (INIS)

    Polee, C.; Chankow, N.; Srisatit, S.; Thong-Aram, D.

    2014-01-01

    In film radiography, underexposure and overexposure may happen particularly when lacking knowledge of specimen material and hollowness. This paper describes a method and a device for determining exposure in industrial gamma-ray radiography based on quick measurement of transmitted gamma-ray intensity with a D3372 Hamamatsu small GM tube. Application software is developed for Android mobile phone to remotely control the device and to display the counting data via Bluetooth. Prior to placing film, the device is placed behind the specimen to be radiographed to determine the exposure time from the transmitted intensity which is independent on source activity, source-to-film distance, specimen thickness and kind of material. The developed technique and device make radiographic process economic, convenient and more reliable.

  3. 3D web based learning of medical equipment employed in intensive care units.

    Science.gov (United States)

    Cetin, Aydın

    2012-02-01

    In this paper, both synchronous and asynchronous web based learning of 3D medical equipment models used in hospital intensive care unit have been described over the moodle course management system. 3D medical equipment models were designed with 3ds Max 2008, then converted to ASE format and added interactivity displayed with Viewpoint-Enliven. 3D models embedded in a web page in html format with dynamic interactivity-rotating, panning and zooming by dragging a mouse over images-and descriptive information is embedded to 3D model by using xml format. A pilot test course having 15 h was applied to technicians who is responsible for intensive care unit at Medical Devices Repairing and Maintenance Center (TABOM) of Turkish High Specialized Hospital.

  4. Allogeneic hematopoietic stem cell transplantation from an alternative stem cell source in Fanconi anemia patients: analysis of 47 patients from a single institution

    Directory of Open Access Journals (Sweden)

    C.R. de Medeiros

    2006-10-01

    Full Text Available We transplanted 47 patients with Fanconi anemia using an alternative source of hematopoietic cells. The patients were assigned to the following groups: group 1, unrelated bone marrow (N = 15; group 2, unrelated cord blood (N = 17, and group 3, related non-sibling bone marrow (N = 15. Twenty-four patients (51% had complete engraftment, which was not influenced by gender (P = 0.87, age (P = 0.45, dose of cyclophosphamide (P = 0.80, nucleated cell dose infused (P = 0.60, or use of anti-T serotherapy (P = 0.20. Favorable factors for superior engraftment were full HLA compatibility (independent of the source of cells; P = 0.007 and use of a fludarabine-based conditioning regimen (P = 0.046. Unfavorable factors were > or = 25 transfusions pre-transplant (P = 0.011 and degree of HLA disparity (P = 0.007. Intensity of mucositis (P = 0.50 and use of androgen prior to transplant had no influence on survival (P = 0.80. Acute graft-versus-host disease (GVHD grade II-IV and chronic GVHD were diagnosed in 47 and 23% of available patients, respectively, and infections prevailed as the main cause of death, associated or not with GVHD. Eighteen patients are alive, the Kaplan-Meyer overall survival is 38% at ~8 years, and the best results were obtained with related non-sibling bone marrow patients. Three recommendations emerged from the present study: fludarabine as part of conditioning, transplant in patients with <25 transfusions and avoidance of HLA disparity. In addition, an extended family search (even when consanguinity is not present seeking for a related non-sibling donor is highly recommended.

  5. Desensitizing addiction: using eye movements to reduce the intensity of substance-related mental imagery and craving

    Directory of Open Access Journals (Sweden)

    Marianne eLittel

    2016-02-01

    Full Text Available Eye movement desensitization and reprocessing (EMDR is an effective treatment for posttraumatic stress disorder. During this treatment, patients recall a traumatic memory while making horizontal eye movements (EM. Studies have shown that EM not only desensitize negative memories, but also positive memories and imagined events. Substance use behavior and craving are maintained by maladaptive memory associations and visual imagery. Preliminary findings have indicated that these mental images can be desensitized by EMDR techniques. We conducted two proof-of-principle studies to investigate whether EM can reduce the sensory richness of substance-related mental representations and accompanying craving levels. We investigated the effects of EM on 1 vividness of food-related mental imagery and food craving in dieting and non-dieting students, and 2 vividness of recent smoking-related memories and cigarette craving in daily smokers. In both experiments, participants recalled the images while making EM or keeping eyes stationary. Image vividness and emotionality, image-specific craving and general craving were measured before and after the intervention. As a behavioral outcome measure, participants in study 1 were offered a snack choice at the end of the experiment.Results of both experiments showed that image vividness and craving increased in the control condition, but remained stable or decreased after the EM intervention. EM additionally reduced image emotionality (exp 2, and affected behavior (exp 1: participants in the EM condition were more inclined to choose healthy over unhealthy snack options. In conclusion, the data suggest that EM can be used to reduce intensity of substance related imagery and craving. Although long-term effects are yet to be demonstrated, the current studies suggest that EM might be a useful technique in addiction treatment.

  6. The use of a standardized PCT-algorithm reduces costs in intensive care in septic patients - a DRG-based simulation model

    Directory of Open Access Journals (Sweden)

    Wilke MH

    2011-12-01

    Full Text Available Abstract Introduction The management of bloodstream infections especially sepsis is a difficult task. An optimal antibiotic therapy (ABX is paramount for success. Procalcitonin (PCT is a well investigated biomarker that allows close monitoring of the infection and management of ABX. It has proven to be a cost-efficient diagnostic tool. In Diagnoses Related Groups (DRG based reimbursement systems, hospitals get only a fixed amount of money for certain treatments. Thus it's very important to obtain an optimal balance of clinical treatment and resource consumption namely the length of stay in hospital and especially in the Intensive Care Unit (ICU. We investigated which economic effects an optimized PCT-based algorithm for antibiotic management could have. Materials and methods We collected inpatient episode data from 16 hospitals. These data contain administrative and clinical information such as length of stay, days in the ICU or diagnoses and procedures. From various RCTs and reviews there are different algorithms for the use of PCT to manage ABX published. Moreover RCTs and meta-analyses have proven possible savings in days of ABX (ABD and length of stay in ICU (ICUD. As the meta-analyses use studies on different patient populations (pneumonia, sepsis, other bacterial infections, we undertook a short meta-analyses of 6 relevant studies investigating in sepsis or ventilator associated pneumonia (VAP. From this analyses we obtained savings in ABD and ICUD by calculating the weighted mean differences. Then we designed a new PCT-based algorithm using results from two very recent reviews. The algorithm contains evidence from several studies. From the patient data we calculated cost estimates using German National standard costing information for the German G-DRG system. We developed a simulation model where the possible savings and the extra costs for (in average 8 PCT tests due to our algorithm were brought into equation. Results We calculated ABD

  7. 12 min/week of high-intensity interval training reduces aortic reservoir pressure in individuals with metabolic syndrome: a randomized trial.

    Science.gov (United States)

    Ramos, Joyce S; Dalleck, Lance C; Ramos, Maximiano V; Borrani, Fabio; Roberts, Llion; Gomersall, Sjaan; Beetham, Kassia S; Dias, Katrin A; Keating, Shelley E; Fassett, Robert G; Sharman, James E; Coombes, Jeff S

    2016-10-01

    Decreased aortic reservoir function leads to a rise in aortic reservoir pressure that is an independent predictor of cardiovascular events. Although there is evidence that high-intensity interval training (HIIT) would be useful to improve aortic reservoir pressure, the optimal dose of high-intensity exercise to improve aortic reservoir function has yet to be investigated. Therefore, this study compared the effect of different volumes of HIIT and moderate-intensity continuous training (MICT) on aortic reservoir pressure in participants with the metabolic syndrome (MetS). Fifty individuals with MetS were randomized into one of the following 16-week training programs: MICT [n = 17, 30 min at 60-70% peak heart rate (HRpeak), five times/week]; 4 × 4-min high-intensity interval training (4HIIT) (n = 15, 4 × 4 min bouts at 85-95% HRpeak, interspersed with 3 min of active recovery at 50-70% HRpeak, three times/week); and 1 × 4-min high-intensity interval training (1HIIT) (n = 18, 1 × 4 min bout at 85-95% HRpeak, three times/week). Aortic reservoir pressure was calculated from radial applanation tonometry. Although not statistically significant, there was a trend for a small-to-medium group × time interaction effect on aortic reservoir pressure, indicating a positive adaptation following 1HIIT compared with 4HIIT and MICT [F (2,46) = 2.9, P = 0.07, η = 0.06]. This is supported by our within-group analysis wherein only 1HIIT significantly decreased aortic reservoir pressure from pre to postintervention (pre-post: 1HIIT 33 ± 16 to 31 ± 13, P = 0.03; MICT 29 ± 9-28 ± 8, P = 0.78; 4HIIT 28 ± 10-30 ± 9 mmHg, P = 0.10). Three sessions of 4 min of high-intensity exercise per week (12 min/week) was sufficient to improve aortic reservoir pressure, and thus may be a time-efficient exercise modality for reducing cardiovascular risk in individuals with MetS.

  8. Suppression of Repeat-Intensive False Targets Based on Temporal Pulse Diversity

    Directory of Open Access Journals (Sweden)

    Gang Lu

    2013-01-01

    Full Text Available This paper considers the problem of suppressing the repeat-intensive false targets produced by a deception electronic attack (EA system equipped with a Digital Radio Frequency Memory (DRFM device. Different from a conventional repeat jammer, this type of jamming intensively retransmits the intercepted signal stored in a DRFM to the victim radar in a very short time-delay interval relative to a radar pulse wide. A multipeak matched-filtering output is then produced other than the merely expected true target. An electronic protection (EP algorithm based on the space time block code (STBC is proposed to suppress the adverse effects of this jammer. By transmitting a pulse sequence generated from the STBC in succession and the following cancellation process applied upon the received signal, this algorithm performs successfully in a single antenna system provided that the target models are nonfluctuating or slow fluctuating and the pulse repetition frequency (PRF is comparatively high. The performance in white and correlated Gaussian disturbance is evaluated by means of Monte Carlo simulations.

  9. Solidification of Al-Sn-Cu Based Immiscible Alloys under Intense Shearing

    Science.gov (United States)

    Kotadia, H. R.; Doernberg, E.; Patel, J. B.; Fan, Z.; Schmid-Fetzer, R.

    2009-09-01

    The growing importance of Al-Sn based alloys as materials for engineering applications necessitates the development of uniform microstructures with improved performance. Guided by the recently thermodynamically assessed Al-Sn-Cu system, two model immiscible alloys, Al-45Sn-10Cu and Al-20Sn-10Cu, were selected to investigate the effects of intensive melt shearing provided by the novel melt conditioning by advanced shear technology (MCAST) unit on the uniform dispersion of the soft Sn phase in a hard Al matrix. Our experimental results have confirmed that intensive melt shearing is an effective way to achieve fine and uniform dispersion of the soft phase without macro-demixing, and that such dispersed microstructure can be further refined in alloys with precipitation of the primary Al phase prior to the demixing reaction. In addition, it was found that melt shearing at 200 rpm and 60 seconds will be adequate to produce fine and uniform dispersion of the Sn phase, and that higher shearing speed and prolonged shearing time can only achieve minor further refinement.

  10. Intensity-modulated radiotherapy in patients with locally advanced rectal cancer reduces volume of bowel treated to high dose levels

    International Nuclear Information System (INIS)

    Urbano, M. Teresa Guerrero; Henrys, Anthony J.; Adams, Elisabeth J.; Norman, Andrew R.; Bedford, James L.; Harrington, Kevin J.; Nutting, Christopher M.; Dearnaley, David P.; Tait, Diana M.

    2006-01-01

    Purpose: To investigate the potential for intensity-modulated radiotherapy (IMRT) to spare the bowel in rectal tumors. Methods and Materials: The targets (pelvic nodal and rectal volumes), bowel, and bladder were outlined in 5 patients. All had conventional, three-dimensional conformal RT and forward-planned multisegment three-field IMRT plans compared with inverse-planned simultaneous integrated boost nine-field equally spaced IMRT plans. Equally spaced seven-field and five-field and five-field, customized, segmented IMRT plans were also evaluated. Results: Ninety-five percent of the prescribed dose covered at least 95% of both planning target volumes using all but the conventional plan (mean primary and pelvic planning target volume receiving 95% of the prescribed dose was 32.8 ± 13.7 Gy and 23.7 ± 4.87 Gy, respectively), reflecting a significant lack of coverage. The three-field forward planned IMRT plans reduced the volume of bowel irradiated to 45 Gy and 50 Gy by 26% ± 16% and 42% ± 27% compared with three-dimensional conformal RT. Additional reductions to 69 ± 51 cm 3 to 45 Gy and 20 ± 21 cm 3 to 50 Gy were obtained with the nine-field equally spaced IMRT plans-64% ± 11% and 64% ± 20% reductions compared with three-dimensional conformal RT. Reducing the number of beams and customizing the angles for the five-field equally spaced IMRT plan did not significantly reduce bowel sparing. Conclusion: The bowel volume irradiated to 45 Gy and 50 Gy was significantly reduced with IMRT, which could potentially lead to less bowel toxicity. Reducing the number of beams did not reduce bowel sparing and the five-field customized segmented IMRT plan is a reasonable technique to be tested in clinical trials

  11. Increasing intensity of TENS prevents analgesic tolerance in rats

    Science.gov (United States)

    Sato, Karina L.; Sanada, Luciana S.; Rakel, Barbara A.; Sluka, Kathleen A.

    2012-01-01

    Transcutaneous electrical nerve stimulation (TENS) reduces hyperalgesia and pain. Both low frequency (LF) and high frequency (HF) TENS, delivered at the same intensity (90% motor threshold (MT)) daily, result in analgesic tolerance with repeated use by the 5th day of treatment. Thecurrentstudytestedif 1) increasingintensityby 10% per daypreventsthedevelopmentoftolerance to repeated TENS, and 2) iflowerintensity TENS (50 % MT) produces an equivalentreduction in hyperalgesia when compared to 90% MT TENS. Sprague-Dawley rats with unilateral knee joint inflammation (3% carrageenan) were separated according to the intensity of TENS used: Sham, 50% LF, 50% HF, 90% LF, 90% HF, and increased intensity by 10% per day (LF and HF). The reduced mechanical withdrawal threshold following the induction of inflammation was reversed by application of TENS applied at 90% MT and increasing intensity for the first 4 days. On the 5th day, the groups that received 90% MT intensity showed tolerance. Nevertheless, the group that received an increased intensity on each day still showed a reversal of the mechanical withdrawal threshold with TENS. These results show that the development of tolerance can be delayed by increasing intensity of TENS. PMID:22858165

  12. Spatial electromagnetic field intensity modelling of global system for mobile communication base stations in the Istanbul Technical University Ayazaga campus area.

    Science.gov (United States)

    Boz, Kubra; Denli, Hayri Hakan

    2018-05-07

    The rapid development of the global system for mobile communication services and the consequent increased electromagnetic field (EMF) exposure to the human body have generated debate on the potential danger with respect to human health. The many research studies focused on this subject have, however, not provided any certain evidence about harmful consequences due to mobile communication systems. On the other hand, there are still views suggesting such exposure might affect the human body in different ways. To reduce such effects to a minimum, the International Commission on Non-Ionizing Radiation Protection (ICNIRP) has declared boundary values for the energy released by the base stations, which are the main source of the electromagnetic fields. These values are accepted by many countries in various parts of the world. The aim of this study was to create EMF intensity maps for the area covered by Istanbul Technical University (ITU) and find areas of potential risk with regard to health considering the current situation and future trends. In this study, the field intensities of electromagnetic signals issued at the frequencies of 900 and 1800 MHz were measured in V/m at 29 pre-specified survey points using a spectrum analyzer (Spectran HF-6065). Geographic information systems and spatial interpolation techniques were used to produce EMF intensity maps. Three different spatial interpolation methods, minimum mean square error, Radial Basis and Empirical Bayesian Kriging, were compared. The results were geographically analyzed and the measurements expressed as heat maps covering the study area. Using these maps, the values measured were compared with the EMF intensity standards issued by ICNIRP. The results showed that the exposure levels to the EMF intensities were all within the ICNIRP limits at the ITU study area. However, since the EMF intensity level with respect to human health is not known, it is not possible to confirm if these levels are safe or not.

  13. Spatial electromagnetic field intensity modelling of global system for mobile communication base stations in the Istanbul Technical University Ayazaga campus area

    Directory of Open Access Journals (Sweden)

    Kubra Boz

    2018-05-01

    Full Text Available The rapid development of the global system for mobile communication services and the consequent increased electromagnetic field (EMF exposure to the human body have generated debate on the potential danger with respect to human health. The many research studies focused on this subject have, however, not provided any certain evidence about harmful consequences due to mobile communication systems. On the other hand, there are still views suggesting such exposure might affect the human body in different ways. To reduce such effects to a minimum, the International Commission on Non-Ionizing Radiation Protection (ICNIRP has declared boundary values for the energy released by the base stations, which are the main source of the electromagnetic fields. These values are accepted by many countries in various parts of the world. The aim of this study was to create EMF intensity maps for the area covered by Istanbul Technical University (ITU and find areas of potential risk with regard to health considering the current situation and future trends. In this study, the field intensities of electromagnetic signals issued at the frequencies of 900 and 1800 MHz were measured in V/m at 29 pre-specified survey points using a spectrum analyzer (Spectran HF-6065. Geographic information systems and spatial interpolation techniques were used to produce EMF intensity maps. Three different spatial interpolation methods, minimum mean square error, Radial Basis and Empirical Bayesian Kriging, were compared. The results were geographically analyzed and the measurements expressed as heat maps covering the study area. Using these maps, the values measured were compared with the EMF intensity standards issued by ICNIRP. The results showed that the exposure levels to the EMF intensities were all within the ICNIRP limits at the ITU study area. However, since the EMF intensity level with respect to human health is not known, it is not possible to confirm if these levels are safe

  14. Experimental study of intense radiation in terahertz region based on cylindrical surface wave resonator

    International Nuclear Information System (INIS)

    Gong, Shaoyan; Ogura, Kazuo; Yambe, Kiyoyuki; Nomizu, Shintaro; Shirai, Akihiro; Yamazaki, Kosuke; Kawamura, Jun; Miura, Takuro; Takanashi, Sho; San, Min Thu

    2015-01-01

    Periodical corrugations structured on a cylindrical conductor have cylindrical surface waves (CSWs), which are reflected at the corrugation ends and form a CSW-resonator. In this paper, intense radiations in terahertz region based on the CSW-resonator are reported. The CSW-resonators with upper cut off frequencies in the modern IEEE G-band (110–300 GHz) are excited by a coaxially injected annular beam in a weakly relativistic region less than 100 kV. It is shown that there exists an oscillation starting energy for the CSW-resonator. Above the starting energy, very intense terahertz radiations on the order of kW are obtained. The operation frequencies in the range of 166–173 GHz and 182–200 GHz are obtained using two types of CSW-resonator with the different corrugation amplitude. Electromagnetic properties of the CSW-resonator can be controlled by the artificial structure and may play an important role in high-intensity terahertz generations and applications

  15. Firm-level determinants of energy and carbon intensity in China

    International Nuclear Information System (INIS)

    Cao, Jing; Karplus, Valerie J.

    2014-01-01

    In recent years, China's leaders have sought to coordinate official energy intensity reduction targets with new targets for carbon dioxide (CO 2 ) intensity reduction. The Eleventh Five-Year Plan (2006–2010) included for the first time a binding target for energy intensity, while a binding target for CO 2 intensity was included later in the Twelfth Five-Year Plan (2011–2015). Using panel data for a sample of industrial firms in China covering 2005 to 2009, we investigate the drivers of energy intensity reduction (measured in terms of direct primary energy use and electricity use) and associated CO 2 intensity reduction. Rising electricity prices were associated with decreases in electricity intensity and increases in primary energy intensity, consistent with a substitution effect. Overall, we find that energy intensity reduction by industrial firms during the Eleventh Five-Year Plan translated into more than proportional CO 2 intensity reduction because reducing coal use—in direct industrial use as well as in the power sector—was a dominant abatement strategy. If similar dynamics characterize the Twelfth Five-Year Plan (2011–2015), the national 17 percent CO 2 intensity reduction target may not be difficult to meet—and the 16 percent energy intensity reduction target may result in significantly greater CO 2 intensity reduction. - Highlights: • We describe China's Eleventh Five-Year Plan energy policies. • We examine the drivers of energy, electricity and carbon intensity reduction. • Higher electricity prices correlated with reductions in industrial electricity intensity. • Energy intensity reduction efforts were effective at reducing carbon intensity

  16. Mis-segmentation in voxel-based morphometry due to a signal intensity change in the putamen.

    Science.gov (United States)

    Goto, Masami; Abe, Osamu; Miyati, Tosiaki; Aoki, Shigeki; Gomi, Tsutomu; Takeda, Tohoru

    2017-12-01

    The aims of this study were to demonstrate an association between changes in the signal intensity of the putamen on three-dimensional T1-weighted magnetic resonance images (3D-T1WI) and mis-segmentation, using the voxel-based morphometry (VBM) 8 toolbox. The sagittal 3D-T1WIs of 22 healthy volunteers were obtained for VBM analysis using the 1.5-T MR scanner. We prepared five levels of 3D-T1WI signal intensity (baseline, same level, background level, low level, and high level) in regions of interest containing the putamen. Groups of smoothed, spatially normalized tissue images were compared to the baseline group using a paired t test. The baseline was compared to the other four levels. In all comparisons, significant volume changes were observed around and outside the area that included the signal intensity change. The present study demonstrated an association between a change in the signal intensity of the putamen on 3D-T1WI and changed volume in segmented tissue images.

  17. Physiotherapy in the intensive care unit: an evidence-based, expert driven, practical statement and rehabilitation recommendations

    Science.gov (United States)

    Sommers, Juultje; Engelbert, Raoul HH; Dettling-Ihnenfeldt, Daniela; Gosselink, Rik; Spronk, Peter E; Nollet, Frans; van der Schaaf, Marike

    2015-01-01

    Objective: To develop evidence-based recommendations for effective and safe diagnostic assessment and intervention strategies for the physiotherapy treatment of patients in intensive care units. Methods: We used the EBRO method, as recommended by the ‘Dutch Evidence Based Guideline Development Platform’ to develop an ‘evidence statement for physiotherapy in the intensive care unit’. This method consists of the identification of clinically relevant questions, followed by a systematic literature search, and summary of the evidence with final recommendations being moderated by feedback from experts. Results: Three relevant clinical domains were identified by experts: criteria to initiate treatment; measures to assess patients; evidence for effectiveness of treatments. In a systematic literature search, 129 relevant studies were identified and assessed for methodological quality and classified according to the level of evidence. The final evidence statement consisted of recommendations on eight absolute and four relative contra-indications to mobilization; a core set of nine specific instruments to assess impairments and activity restrictions; and six passive and four active effective interventions, with advice on (a) physiological measures to observe during treatment (with stopping criteria) and (b) what to record after the treatment. Conclusions: These recommendations form a protocol for treating people in an intensive care unit, based on best available evidence in mid-2014. PMID:25681407

  18. Optimisation of intense X-ray sources of Z-pinch type connected to the high intensity current generator SPHINX

    International Nuclear Information System (INIS)

    Calamy, H.; Lassalle, F.; Grunenwald, J.; Zucchini, F.

    2010-01-01

    A new source of intense X-rays in the spectral range of the keV has been designed in the CEA facilities at Gramat (France). This Z-pinch source is based on the implosion of a cylinder of matter that has been ionized by the Lorentz force generated by the injection in the cylinder of an intense current pulse delivered by a HPP (High Pulsed Powers) generator named SPHINX. The cylinder of matter is made up of a few hundreds of thin metal wires (tungsten or aluminium) whose diameter is less than a few tenths of μm. The SPHINX generator is based on the LTD (Linear Transformer Driver) technology. SPHINX stores an energy of 2.2 MJ and delivers a current of 8 MA over a time of 1 μs. SPHINX does not use any technology of time compression, it is a robust, compact machine with reduced maintenance but the price to pay for this simplification is to maintain a high axial homogeneity of the implosion during the initiation phase, it means the pulse time of 1μs. The preliminary experiments that have been performed give the following results: -) for a tungsten cylinder (X ray 1 keV): 28 kJ, 0.6 TW and 25 ns

  19. An industrial radiography exposure device based on measurement of transmitted gamma-ray intensity

    International Nuclear Information System (INIS)

    Polee, C; Chankow, N; Srisatit, S; Thong-Aram, D

    2015-01-01

    In film radiography, underexposure and overexposure may happen particularly when lacking information of specimen material and hollowness. This paper describes a method and a device for determining exposure in industrial gamma-ray radiography based on quick measurement of transmitted gamma-ray intensity with a small detector. Application software was developed for Android mobile phone to remotely control the device and to display counting data via Bluetooth communication. Prior to film exposure, the device is placed behind a specimen to measure transmitted intensity which is inversely proportional to the exposure. Unlike in using the conventional exposure curve, correction factors for source decay, source-to- film distance, specimen thickness and kind of material are not needed. The developed technique and device make radiographic process economic, convenient and more reliable. (paper)

  20. Radiation control in the intensive care unit for high intensity iridium-192 brain implants

    International Nuclear Information System (INIS)

    Sewchand, W.; Drzymala, R.E.; Amin, P.P.; Salcman, M.; Salazar, O.M.

    1987-01-01

    A bedside lead cubicle was designed to minimize the radiation exposure of intensive care unit staff during routine interstitial brain irradiation by removable, high intensity iridium-192. The cubicle shields the patient without restricting intensive care routines. The design specifications were confirmed by exposure measurements around the shield with an implanted anthropomorphic phantom simulating the patient situation. The cubicle reduces the exposure rate around an implant patient by as much as 90%, with the exposure level not exceeding 0.1 mR/hour/mg of radium-equivalent 192 Ir. Evaluation of data accumulated for the past 3 years has shown that the exposure levels of individual attending nurses are 0.12 to 0.36 mR/mg of radium-equivalent 192 Ir per 12-hour shift. The corresponding range for entire nursing teams varies between 0.18 and 0.26. A radiation control index (exposure per mg of radium-equivalent 192 Ir per nurse-hour) is thus defined for individual nurses and nursing teams; this index is a significant guide to the planning of nurse rotations for brain implant patients with various 192 Ir loads. The bedside shield reduces exposure from 192 Ir implants by a factor of about 20, as expected, and the exposure from the lower energy radioisotope iodine-125 is barely detectable

  1. The effect of increasing exports on industrial energy intensity in China

    International Nuclear Information System (INIS)

    Zheng Yingmei; Qi Jianhong; Chen Xiaoliang

    2011-01-01

    Given China's heavy reliance on fuel energy and the dominance of its industrial sector in the economy, improving energy efficiency remains one of the practical means for the country to decrease energy intensity and to fulfill its commitment made at the Copenhagen Climate Change Conference to achieve a 40-45 percent reduction in CO 2 emission intensity by 2020. This study investigates the impact of exports on industrial energy intensity to explore the possibility of reducing energy intensity through greater exports. A panel varying-coefficient regression model with a dataset of China's 20 industrial sub-sectors over 1999-2007 suggests that in general, greater exports aggravate energy intensity of the industrial sector and that great divergences exist in the impact of exports on energy intensity across sub-sectors. A panel threshold model further estimates the thresholds for the major determinants of energy intensity: exports, input in technological innovations, and Foreign Direct Investment (FDI) intensity. Given the great differences in specific sub-sector characteristics and the changing roles played by different factors across sub-sectors, there is no general export policy that would work for all sub-sectors in reducing sub-sector energy intensity. Instead, policies and measures aiming to encourage more efficient use of energy should take into full consideration the characteristics and situations of individual sub-sectors. - Research highlights: → We examine the impact of exports on industrial energy intensity in China. → Greater exports increase industrial energy intensity as a whole. → Divergences exist in the impact of exports on energy intensity across sub-sectors. → China should discard policies encouraging exports at the cost of energy efficiency. → Export policy to reduce energy intensity should cater to sub-sector characteristics.

  2. The effect of increasing exports on industrial energy intensity in China

    Energy Technology Data Exchange (ETDEWEB)

    Zheng Yingmei [School of Economics, Shandong University, 27 Shanda South Road, Jinan, Shandong Province 250100 (China); Qi Jianhong, E-mail: sducatherine@gmail.co [School of Economics, Shandong University, 27 Shanda South Road, Jinan, Shandong Province 250100 (China); Chen Xiaoliang [School of Economics, Shandong University, 27 Shanda South Road, Jinan, Shandong Province 250100 (China)

    2011-05-15

    Given China's heavy reliance on fuel energy and the dominance of its industrial sector in the economy, improving energy efficiency remains one of the practical means for the country to decrease energy intensity and to fulfill its commitment made at the Copenhagen Climate Change Conference to achieve a 40-45 percent reduction in CO{sub 2} emission intensity by 2020. This study investigates the impact of exports on industrial energy intensity to explore the possibility of reducing energy intensity through greater exports. A panel varying-coefficient regression model with a dataset of China's 20 industrial sub-sectors over 1999-2007 suggests that in general, greater exports aggravate energy intensity of the industrial sector and that great divergences exist in the impact of exports on energy intensity across sub-sectors. A panel threshold model further estimates the thresholds for the major determinants of energy intensity: exports, input in technological innovations, and Foreign Direct Investment (FDI) intensity. Given the great differences in specific sub-sector characteristics and the changing roles played by different factors across sub-sectors, there is no general export policy that would work for all sub-sectors in reducing sub-sector energy intensity. Instead, policies and measures aiming to encourage more efficient use of energy should take into full consideration the characteristics and situations of individual sub-sectors. - Research highlights: {yields} We examine the impact of exports on industrial energy intensity in China. {yields} Greater exports increase industrial energy intensity as a whole. {yields} Divergences exist in the impact of exports on energy intensity across sub-sectors. {yields} China should discard policies encouraging exports at the cost of energy efficiency. {yields} Export policy to reduce energy intensity should cater to sub-sector characteristics.

  3. The patient experience of intensive care

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Bergbom, Ingegerd; Lindahl, Berit

    2015-01-01

    : Nordic intensive care units. PARTICIPANTS: Patients in Nordic intensive care units. METHODS: We performed a literature search of qualitative studies of the patient experience of intensive care based on Nordic publications in 2000-2013. We searched the following databases: PubMed, CINAHL, Scopus, and Psyc...

  4. Perceptions of Personal Well-Being among Youth Accessing Residential or Intensive Home-Based Treatment

    Science.gov (United States)

    Preyde, Michele; Watkins, Hanna; Ashbourne, Graham; Lazure, Kelly; Carter, Jeff; Penney, Randy; White, Sara; Frensch, Karen; Cameron, Gary

    2013-01-01

    The outcomes of youth accessing residential treatment or intensive home-based treatment are varied. Understanding youth's perceptions of their well-being may inform service. The purpose of this report was to explore perceptions of youth's mental health, life satisfaction, and outlook for the future. Youth reported ongoing struggles with mental…

  5. Temperature-dependent of Nonlinear Optical Conductance of Graphene-based Systems in High-intensity Terahertz Field

    Institute of Scientific and Technical Information of China (English)

    Jing Lv; Rui-yang Yuan; Hui Yan

    2014-01-01

    For multi-photon processed with the linear dispersion in the high-intensity terahertz(THz) field,we have systematically investigated the temperature-dependent nonlinear optical response of graphene-based systems, including single layer graphene, graphene superlattice and gapped graphene. In the intrinsic single layer graphene system, it demonstrates that, at low temperature, nonlinear optical conductivities of the thirdand fifth-order are respectively five and ten orders of magnitude larger than the universal conductivity with high-intensity and low frequency THz wave.In the graphene superlattice and gapped graphene systems, the optical responses enhanced because of the anisotropic massless and massive Dirac fermions.

  6. Estratégias de tratamento da leucemia linfóide crônica recidivada ou resistente incluindo o transplante de célula progenitora hematopoiética Strategies of treatment for relapsed or resistant chronic lymphocytic leukemia including to hematopoietic progenitor cell transplantation

    Directory of Open Access Journals (Sweden)

    Cármino A. Souza

    2005-12-01

    pacientes com doador HLA idêntico, preferentemente mais jovens (Despite much progress in therapy, chronic lymphocytic leukemia, the most common leukemia in the Western world, remains incurable. The use of fludarabine alone or associated to cyclophosphamide and/or mitoxantrone or doxorubicin improved the objective response, including complete response (also molecular and the progression- and relapse-free-survival. Several authors have suggested the introduction of monoclonal antibodies in order to improve the results. Despite that, all treated patients will further relapse or progress and salvage treatment should be used. In the present state-of-the art, salvage treatment is similar to those used as front line therapy. Indeed the criteria to start treatment are the same as defined by NCI for the front line therapy. Fludarabine alone or associated should be the therapy of choice for relapsed patients also for those previously treated with fludarabine. The use of monoclonal antibodies particularly rituximab is a good option although this procedure has not been considered as the standard therapy until now. Alemtuzumab is a very efficient monoclonal antibody and promotes significant benefits in clinical and hematological responses also in heavily treated or fludarabine refractory patients. The HPCT has limited indication due to the risks of high dose therapy in elderly patients. Autologous HPCT may be used specifically in young patients, if possible in complete remission, in order to improve the progression- or disease-free-survival. Conventional or with reduced intensity allogeneic HPCT may be used in patients presenting with a sibling donor particularly those under 60 years old, in fludarabine refractory patients or in patients presenting with unfavorable cytogenetics (17p-, with a curative objective.

  7. Standardised simulation-based emergency and intensive care nursing curriculum to improve nursing students' performance during simulated resuscitation: A quasi-experimental study.

    Science.gov (United States)

    Chen, Jie; Yang, Jian; Hu, Fen; Yu, Si-Hong; Yang, Bing-Xiang; Liu, Qian; Zhu, Xiao-Ping

    2018-03-14

    Simulation-based curriculum has been demonstrated as crucial to nursing education in the development of students' critical thinking and complex clinical skills during a resuscitation simulation. Few studies have comprehensively examined the effectiveness of a standardised simulation-based emergency and intensive care nursing curriculum on the performance of students in a resuscitation simulation. To evaluate the impact of a standardised simulation-based emergency and intensive care nursing curriculum on nursing students' response time in a resuscitation simulation. Two-group, non-randomised quasi-experimental design. A simulation centre in a Chinese University School of Nursing. Third-year nursing students (N = 39) in the Emergency and Intensive Care course were divided into a control group (CG, n = 20) and an experimental group (EG, n = 19). The experimental group participated in a standardised high-technology, simulation-based emergency and intensive care nursing curriculum. The standardised simulation-based curriculum for third-year nursing students consists of three modules: disaster response, emergency care, and intensive care, which include clinical priorities (e.g. triage), basic resuscitation skills, airway/breathing management, circulation management and team work with eighteen lecture hours, six skill-practice hours and twelve simulation hours. The control group took part in the traditional curriculum. This course included the same three modules with thirty-four lecture hours and two skill-practice hours (trauma). Perceived benefits included decreased median (interquartile ranges, IQR) seconds to start compressions [CG 32 (25-75) vs. EG 20 (18-38); p  0.05] and defibrillation [CG 222 (194-254) vs. EG 221 (214-248); p > 0.05] at the beginning of the course. A simulation-based emergency and intensive care nursing curriculum was created and well received by third-year nursing students and associated with decreased response time in a

  8. AN EVOLUTIONARY ALGORITHM FOR FAST INTENSITY BASED IMAGE MATCHING BETWEEN OPTICAL AND SAR SATELLITE IMAGERY

    Directory of Open Access Journals (Sweden)

    P. Fischer

    2018-04-01

    Full Text Available This paper presents a hybrid evolutionary algorithm for fast intensity based matching between satellite imagery from SAR and very high-resolution (VHR optical sensor systems. The precise and accurate co-registration of image time series and images of different sensors is a key task in multi-sensor image processing scenarios. The necessary preprocessing step of image matching and tie-point detection is divided into a search problem and a similarity measurement. Within this paper we evaluate the use of an evolutionary search strategy for establishing the spatial correspondence between satellite imagery of optical and radar sensors. The aim of the proposed algorithm is to decrease the computational costs during the search process by formulating the search as an optimization problem. Based upon the canonical evolutionary algorithm, the proposed algorithm is adapted for SAR/optical imagery intensity based matching. Extensions are drawn using techniques like hybridization (e.g. local search and others to lower the number of objective function calls and refine the result. The algorithm significantely decreases the computational costs whilst finding the optimal solution in a reliable way.

  9. Targeting intensive glycaemic control versus targeting conventional glycaemic control for type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Hemmingsen, Bianca; Lund, Søren; Gluud, Christian

    2013-01-01

    Patients with type 2 diabetes mellitus (T2D) have an increased risk of cardiovascular disease and mortality compared to the background population. Observational studies report an association between reduced blood glucose and reduced risk of both micro- and macrovascular complications in patients...... with T2D. Our previous systematic review of intensive glycaemic control versus conventional glycaemic control was based on 20 randomised clinical trials that randomised 29 ,986 participants with T2D. We now report our updated review....

  10. Reduced intensity-conditioned allogeneic stem cell transplantation for multiple myeloma relapsing or progressing after autologous transplantation: a study by the European Group for Blood and Marrow Transplantation.

    NARCIS (Netherlands)

    Auner, H.W.; Szydlo, R.; Biezen, A. van; Iacobelli, S.; Gahrton, G.; Milpied, N.; Volin, L.; Janssen, J.; Nguyen Quoc, S.; Michallet, M.; Schoemans, H.; Cheikh, J. El; Petersen, E.; Guilhot, F.; Schonland, S.; Ahlberg, L.; Morris, C.; Garderet, L.; Witte, T.J. de; Kroger, N.

    2013-01-01

    Outcomes and prognostic factors of reduced intensity-conditioned allo-SCT (RIC allo-SCT) for multiple myeloma (MM) relapsing or progressing after prior autologous (auto)-SCT are not well defined. We performed an analysis of 413 MM patients who received a related or unrelated RIC allo-SCT for the

  11. Intense transient electric field sensor based on the electro-optic effect of LiNbO{sub 3}

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Qing, E-mail: yangqing@cqu.edu.cn; Sun, Shangpeng; Han, Rui; Sima, Wenxia; Liu, Tong [State Key Laboratory of Power Transmission Equipment & System Security and New Technology, Chongqing University, Shapingba District, Chongqing, 400044 (China)

    2015-10-15

    Intense transient electric field measurements are widely applied in various research areas. An optical intense E-field sensor for time-domain measurements, based on the electro-optic effect of lithium niobate, has been studied in detail. Principles and key issues in the design of the sensor are presented. The sensor is insulated, small in size (65 mm × 15 mm × 15 mm), and suitable for high-intensity (<801 kV/m) electric field measurements over a wide frequency band (10 Hz–10 MHz). The input/output characteristics of the sensor were obtained and the sensor calibrated. Finally, an application using this sensor in testing laboratory lightning impulses and in measuring transient electric fields during switch-on of a disconnector confirmed that the sensor is expected to find widespread use in transient intense electric field measurement applications.

  12. An Evidence-Based Assessment of Faith-Based Programs: Do Faith-Based Programs "Work" to Reduce Recidivism?

    Science.gov (United States)

    Dodson, Kimberly D.; Cabage, Leann N.; Klenowski, Paul M.

    2011-01-01

    Faith-based organizations administer many of the prison-based programs aimed at reducing recidivism. Many of these organizations also manage treatment programs for substance abusers, at-risk juveniles, and ex-offenders. Much of the research on religiosity and delinquency indicates that the two are inversely related. Therefore, it seems plausible…

  13. Review of Alternative Management Options of Vegetable Crop Residues to Reduce Nitrate Leaching in Intensive Vegetable Rotations

    Directory of Open Access Journals (Sweden)

    Laura Agneessens

    2014-12-01

    Full Text Available Vegetable crop residues take a particular position relative to arable crops due to often large amounts of biomass with a N content up to 200 kg N ha−1 left behind on the field. An important amount of vegetable crops are harvested during late autumn and despite decreasing soil temperatures during autumn, high rates of N mineralization and nitrification still occur. Vegetable crop residues may lead to considerable N losses through leaching during winter and pose a threat to meeting water quality objectives. However, at the same time vegetable crop residues are a vital link in closing the nutrient and organic matter cycle of soils. Appropriate and sustainable management is needed to harness the full potential of vegetable crop residues. Two fundamentally different crop residue management strategies to reduce N losses during winter in intensive vegetable rotations are reviewed, namely (i on-field management options and modifications to crop rotations and (ii removal of crop residues, followed by a useful and profitable application.

  14. Phenylboronic acid functionalized reduced graphene oxide based fluorescence nano sensor for glucose sensing

    Energy Technology Data Exchange (ETDEWEB)

    Basiruddin, SK; Swain, Sarat K., E-mail: swainsk2@yahoo.co.in

    2016-01-01

    Reduced graphene has emerged as promising tools for detection based application of biomolecules as it has high surface area with strong fluorescence quenching property. We have used the concept of fluorescent quenching property of reduced graphene oxide to the fluorescent probes which are close vicinity of its surface. In present work, we have synthesized fluorescent based nano-sensor consist of phenylboronic acid functionalized reduced graphene oxide (rGO–PBA) and di-ol modified fluorescent probe for detection of biologically important glucose molecules. This fluorescent graphene based nano-probe has been characterized by high resolution transmission electron microscope (HRTEM), Atomic force microscope (AFM), UV–visible, Photo-luminescence (PL) and Fourier transformed infrared (FT-IR) spectroscopy. Finally, using this PBA functionalized reduced GO based nano-sensor, we were able to detect glucose molecule in the range of 2 mg/mL to 75 mg/mL in aqueous solution of pH 7.4. - Highlights: • Easy and simple synthesis of PBA functionalized reduced GO based nano probe. • PBA functionalized reduced GO graphene based nano-probes are characterized. • PBA functionalized reduced GO nano probe is used to detect glucose molecules. • It is very cost-effective and enzyme-free detection of glucose in solution.

  15. Effectiveness of Indoor Plant to Reduce CO2 in Indoor Environment

    Directory of Open Access Journals (Sweden)

    Suhaimi Mohd Mahathir

    2017-01-01

    Full Text Available Modern country strongly emphasizes on indoor air quality (IAQ because it can effect on human health and productivity. Numerous efforts were performed to make sure that sustainability of IAQ is guaranteed. In the last 4th decade, researchers discover that indoor plants have abilities to reduce indoor air pollution. Generally, plants, carbon dioxide (CO2, light, and temperature involve in the photosynthesis process. This paper intends to study the effectiveness of seven indoor plants (Anthurium, Dumb Cane, Golden Pothos, Kadaka Fern, Prayer Plant, Spider Plant, and Syngonium to reduce CO2 with different light level. This study was conducted in one cubic meter of chamber, and each plant was put into the chamber individually with CO2 concentration in the chamber is set at 1000±50ppm, and light intensities is set at 300 and 700 lux, while temperature were fixed at 25±1°C. Based on the results, only the Spider Plant was not able to absorb CO2 during the test at 300 lux of light intensity. Meanwhile, Prayer Plant performed well when tested at 300 or 700 lux of light intensity compare to other investigates plants. This study can conclude that light intensity play an important role for the plant to absorb CO2 effectively. All the indoor plants absorbed more CO2, when the light intensity is increased.

  16. Using grey intensity adjustment strategy to enhance the measurement accuracy of digital image correlation considering the effect of intensity saturation

    Science.gov (United States)

    Li, Bang-Jian; Wang, Quan-Bao; Duan, Deng-Ping; Chen, Ji-An

    2018-05-01

    Intensity saturation can cause decorrelation phenomenon and decrease the measurement accuracy in digital image correlation (DIC). In the paper, the grey intensity adjustment strategy is proposed to improve the measurement accuracy of DIC considering the effect of intensity saturation. First, the grey intensity adjustment strategy is described in detail, which can recover the truncated grey intensities of the saturated pixels and reduce the decorrelation phenomenon. The simulated speckle patterns are then employed to demonstrate the efficacy of the proposed strategy, which indicates that the displacement accuracy can be improved by about 40% by the proposed strategy. Finally, the true experimental image is used to show the feasibility of the proposed strategy, which indicates that the displacement accuracy can be increased by about 10% by the proposed strategy.

  17. Reduced-graphene-oxide-and-strontium-titanate-based double

    Indian Academy of Sciences (India)

    Microwave-absorbing materials based on reduced graphene oxide (r-GO)/ strontium titanate were prepared by embedding in epoxy matrix. R-GO and strontium titanate were synthesized and characterized before composite fabrication. Microstructures of the constituent elements were studied by scanning electron ...

  18. Do urbanization and industrialization affect energy intensity in developing countries?

    International Nuclear Information System (INIS)

    Sadorsky, Perry

    2013-01-01

    Against a backdrop of concerns about climate change, peak oil, and energy security issues, reducing energy intensity is often advocated as a way to at least partially mitigate these impacts. This study uses recently developed heterogeneous panel regression techniques like mean group estimators and common correlated effects estimators to model the impact that income, urbanization and industrialization has on energy intensity for a panel of 76 developing countries. In the long-run, a 1% increase in income reduces energy intensity by − 0.45% to − 0.35%. Long-run industrialization elasticities are in the range 0.07 to 0.12. The impact of urbanization on energy intensity is mixed. In specifications where the estimated coefficient on urbanization is statistically significant, it is slightly larger than unity. The implications of these results for energy policy are discussed. - Highlights: ► The impact of urbanization and industrialization on energy intensity is modeled. ► Use recently developed heterogeneous panel regression techniques ► The model is tested on a panel of developing countries. ► Income has a negative impact on energy intensity. ► Industrialization has a positive impact on energy intensity

  19. Change detection for synthetic aperture radar images based on pattern and intensity distinctiveness analysis

    Science.gov (United States)

    Wang, Xiao; Gao, Feng; Dong, Junyu; Qi, Qiang

    2018-04-01

    Synthetic aperture radar (SAR) image is independent on atmospheric conditions, and it is the ideal image source for change detection. Existing methods directly analysis all the regions in the speckle noise contaminated difference image. The performance of these methods is easily affected by small noisy regions. In this paper, we proposed a novel change detection framework for saliency-guided change detection based on pattern and intensity distinctiveness analysis. The saliency analysis step can remove small noisy regions, and therefore makes the proposed method more robust to the speckle noise. In the proposed method, the log-ratio operator is first utilized to obtain a difference image (DI). Then, the saliency detection method based on pattern and intensity distinctiveness analysis is utilized to obtain the changed region candidates. Finally, principal component analysis and k-means clustering are employed to analysis pixels in the changed region candidates. Thus, the final change map can be obtained by classifying these pixels into changed or unchanged class. The experiment results on two real SAR images datasets have demonstrated the effectiveness of the proposed method.

  20. Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

    International Nuclear Information System (INIS)

    Nithya, L.; Arulraj, Kumar; Rathinamuthu, Sasikumar; Pandey, Manish Bhushan; Nambi Raj, N. Arunai

    2014-01-01

    The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC) intensity modulated radiation therapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV) for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI) and the conformity index (CI) of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV) cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU) required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases. (author)

  1. Comparative analysis of volumetric-modulated arc therapy and intensity-modulated radiotherapy for base of tongue cancer

    Directory of Open Access Journals (Sweden)

    L Nithya

    2014-01-01

    Full Text Available The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC intensity modulated radiation therapy (IMRT plans with volumetric modulated arc therapy (VMAT plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI and the conformity index (CI of the PTV 70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT. In normal tissue dose analyses VMAT was better than IMRT. The number of monitor units (MU required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT. VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases.

  2. Reducible oxide based catalysts

    Science.gov (United States)

    Thompson, Levi T.; Kim, Chang Hwan; Bej, Shyamal K.

    2010-04-06

    A catalyst is disclosed herein. The catalyst includes a reducible oxide support and at least one noble metal fixed on the reducible oxide support. The noble metal(s) is loaded on the support at a substantially constant temperature and pH.

  3. Intensive care unit audit: invasive procedure surveillance

    Directory of Open Access Journals (Sweden)

    Mariama Amaral Michels

    2013-01-01

    Full Text Available Rationale and objective: currently, Healthcare-associated Infections (HAIs constitute a serious public health problem. It is estimated that for every ten hospitalized patients, one will have infection after admission, generating high costs resulting from increased length of hospitalization, additional diagnostic and therapeutic interventions. The intensive care unit (ICU, due to its characteristics, is one of the most complex units of the hospital environment, a result of the equipment, the available technology, the severity of inpatients and the invasive procedures the latter are submitted to. The aim of the study was to evaluate the adherence to specifi c HAI prevention measures in invasive ICU procedures. Methods: This study had a quantitative, descriptive and exploratory approach. Among the risk factors for HAIs are the presence of central venous access, indwelling vesical catheter and mechanical ventilation, and, therefore, the indicators were calculated for patients undergoing these invasive procedures, through a questionnaire standardized by the Hospital Infection Control Commission (HICC. Results: For every 1,000 patients, 15 had catheter-related bloodstream infection, 6.85 had urinary tract infection associated with indwelling catheter in the fi rst half of 2010. Conclusion: most HAIs cannot be prevented, for reasons inherent to invasive procedures and the patients. However, their incidence can be reduced and controlled. The implementation of preventive measures based on scientifi c evidence can reduce HAIs signifi cantly and sustainably, resulting in safer health care services and reduced costs. The main means of prevention include the cleaning of hands, use of epidemiological block measures, when necessary, and specifi c care for each infection site. KEYWORDS Nosocomial infection. Intensive care units.

  4. Forecasting overhaul or replacement intervals based on estimated system failure intensity

    Science.gov (United States)

    Gannon, James M.

    1994-12-01

    System reliability can be expressed in terms of the pattern of failure events over time. Assuming a nonhomogeneous Poisson process and Weibull intensity function for complex repairable system failures, the degree of system deterioration can be approximated. Maximum likelihood estimators (MLE's) for the system Rate of Occurrence of Failure (ROCOF) function are presented. Evaluating the integral of the ROCOF over annual usage intervals yields the expected number of annual system failures. By associating a cost of failure with the expected number of failures, budget and program policy decisions can be made based on expected future maintenance costs. Monte Carlo simulation is used to estimate the range and the distribution of the net present value and internal rate of return of alternative cash flows based on the distributions of the cost inputs and confidence intervals of the MLE's.

  5. Impact of treatment intensity on suicidal behavior and depression in borderline personality disorder: a critical review.

    Science.gov (United States)

    Davidson, Kate M; Tran, Cathy F

    2014-04-01

    The effectiveness of less versus more intensive psychological therapies in reducing suicidal behavior and depression in suicidal patients with borderline personality disorder (BPD) was examined. Electronic databases were searched. Trials were separated into less versus more intensive therapies. Suicidal acts and depression outcome data were assessed. Six trials met search criteria (cognitive-behavioral therapy for personality disorder, mentalization-based therapy, dialectical behavior therapy). Seven measures of suicidal acts and two measures of depression were used in studies. Both less and more intensive therapies report significant decreases in suicidal behaviors. Apart from one small trial, both less and more intensive therapies report decreases in depression with no differences between therapies and control conditions. Two follow-up studies showed that reductions in suicidal behavior and depression are maintained over time. The authors conclude that both less and more intensive therapies are effective in treating depression and suicidal behaviors in patients with BPD. Clinicians should deliver the least intensive interventions that will provide these significant health gains.

  6. Study on low intensity aeration oxygenation model and optimization for shallow water

    Science.gov (United States)

    Chen, Xiao; Ding, Zhibin; Ding, Jian; Wang, Yi

    2018-02-01

    Aeration/oxygenation is an effective measure to improve self-purification capacity in shallow water treatment while high energy consumption, high noise and expensive management refrain the development and the application of this process. Based on two-film theory, the theoretical model of the three-dimensional partial differential equation of aeration in shallow water is established. In order to simplify the equation, the basic assumptions of gas-liquid mass transfer in vertical direction and concentration diffusion in horizontal direction are proposed based on engineering practice and are tested by the simulation results of gas holdup which are obtained by simulating the gas-liquid two-phase flow in aeration tank under low-intensity condition. Based on the basic assumptions and the theory of shallow permeability, the model of three-dimensional partial differential equations is simplified and the calculation model of low-intensity aeration oxygenation is obtained. The model is verified through comparing the aeration experiment. Conclusions as follows: (1)The calculation model of gas-liquid mass transfer in vertical direction and concentration diffusion in horizontal direction can reflect the process of aeration well; (2) Under low-intensity conditions, the long-term aeration and oxygenation is theoretically feasible to enhance the self-purification capacity of water bodies; (3) In the case of the same total aeration intensity, the effect of multipoint distributed aeration on the diffusion of oxygen concentration in the horizontal direction is obvious; (4) In the shallow water treatment, reducing the volume of aeration equipment with the methods of miniaturization, array, low-intensity, mobilization to overcome the high energy consumption, large size, noise and other problems can provide a good reference.

  7. Simulation of novel intensity modulated cascaded coated LPFG sensor based on PMTP

    Science.gov (United States)

    Feng, Wenbin; Gu, Zhengtian; Lin, Qiang; Sang, Jiangang

    2017-12-01

    This paper presents a novel intensity modulated cascaded long-period fiber grating (CLPFG) sensor which is cascaded by two same coated long-period fiber gratings (LPFGs) operating at the phase-matching turning point (PMTP). The sensor combines the high sensitivity of LPFG operating at PMTP and the narrow bandwidth of interference attenuation band of CLPFG, so a higher response to small change of the surrounding refractive index (SRI) can be obtained by intensity modulation. Based on the coupled-mode theory, the grating parameters of the PMTP of a middle odd order cladding mode of a single LPFG are calculated. Then this two same LPFGs are cascaded into a CLPFG, and the optical transmission spectrum of the CLPFG is calculated by transfer matrix method. A resonant wavelength of a special interference attenuation band whose intensity has the highest response to SRI, is selected form CLPFG’s spectrum, and setting the resonant wavelength as the operating wavelength of the sensor. Furthermore, the simulation results show that the resolution of SRI of this CLPFG is available to 1.97 × 10-9 by optimizing the film optical parameters, which is about three orders of magnitude higher than coated dual-peak LPFG and cascaded LPFG sensors. It is noteworthy that the sensor is also sensitive to the refractive index of coat, so that the sensor is expected to be applied to detections of gas, PH value, humidity and so on, in the future.

  8. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness

    DEFF Research Database (Denmark)

    Jones, Christina; Bäckman, Carl; Capuzzo, Maurizia

    2010-01-01

    Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness...

  9. Reduced volume but increased training intensity elevates muscle Na+-K+ pump alpha1-subunit and NHE1 expression as well as short-term work capacity in humans

    DEFF Research Database (Denmark)

    Iaia, F. Marcello; Thomassen, Martin; Kolding, Helle

    2008-01-01

    by 30-s sprint runs three to four times a week, whereas CON continued the endurance training ( approximately 45 km/wk). After the 4-wk sprint period, the expression of the muscle Na(+)-K(+) pump alpha(1)-subunit and Na(+)/H(+)-exchanger isoform 1 was 29 and 30% higher (P ... pulmonary maximum oxygen uptake and 10-k time were unchanged. No changes in CON were observed. The present data suggest a role of the Na(+)-K(+) pump in the control of K(+) homeostasis and in the development of fatigue during repeated high-intensity exercise. Furthermore, performance during intense exercise....... Furthermore, plasma K(+) concentration was reduced (P

  10. Design of a Thermoacoustic Sensor for Low Intensity Ultrasound Measurements Based on an Artificial Neural Network

    Directory of Open Access Journals (Sweden)

    Jida Xing

    2015-06-01

    Full Text Available In therapeutic ultrasound applications, accurate ultrasound output intensities are crucial because the physiological effects of therapeutic ultrasound are very sensitive to the intensity and duration of these applications. Although radiation force balance is a benchmark technique for measuring ultrasound intensity and power, it is costly, difficult to operate, and compromised by noise vibration. To overcome these limitations, the development of a low-cost, easy to operate, and vibration-resistant alternative device is necessary for rapid ultrasound intensity measurement. Therefore, we proposed and validated a novel two-layer thermoacoustic sensor using an artificial neural network technique to accurately measure low ultrasound intensities between 30 and 120 mW/cm2. The first layer of the sensor design is a cylindrical absorber made of plexiglass, followed by a second layer composed of polyurethane rubber with a high attenuation coefficient to absorb extra ultrasound energy. The sensor determined ultrasound intensities according to a temperature elevation induced by heat converted from incident acoustic energy. Compared with our previous one-layer sensor design, the new two-layer sensor enhanced the ultrasound absorption efficiency to provide more rapid and reliable measurements. Using a three-dimensional model in the K-wave toolbox, our simulation of the ultrasound propagation process demonstrated that the two-layer design is more efficient than the single layer design. We also integrated an artificial neural network algorithm to compensate for the large measurement offset. After obtaining multiple parameters of the sensor characteristics through calibration, the artificial neural network is built to correct temperature drifts and increase the reliability of our thermoacoustic measurements through iterative training about ten seconds. The performance of the artificial neural network method was validated through a series of experiments. Compared

  11. Design of a Thermoacoustic Sensor for Low Intensity Ultrasound Measurements Based on an Artificial Neural Network.

    Science.gov (United States)

    Xing, Jida; Chen, Jie

    2015-06-23

    In therapeutic ultrasound applications, accurate ultrasound output intensities are crucial because the physiological effects of therapeutic ultrasound are very sensitive to the intensity and duration of these applications. Although radiation force balance is a benchmark technique for measuring ultrasound intensity and power, it is costly, difficult to operate, and compromised by noise vibration. To overcome these limitations, the development of a low-cost, easy to operate, and vibration-resistant alternative device is necessary for rapid ultrasound intensity measurement. Therefore, we proposed and validated a novel two-layer thermoacoustic sensor using an artificial neural network technique to accurately measure low ultrasound intensities between 30 and 120 mW/cm2. The first layer of the sensor design is a cylindrical absorber made of plexiglass, followed by a second layer composed of polyurethane rubber with a high attenuation coefficient to absorb extra ultrasound energy. The sensor determined ultrasound intensities according to a temperature elevation induced by heat converted from incident acoustic energy. Compared with our previous one-layer sensor design, the new two-layer sensor enhanced the ultrasound absorption efficiency to provide more rapid and reliable measurements. Using a three-dimensional model in the K-wave toolbox, our simulation of the ultrasound propagation process demonstrated that the two-layer design is more efficient than the single layer design. We also integrated an artificial neural network algorithm to compensate for the large measurement offset. After obtaining multiple parameters of the sensor characteristics through calibration, the artificial neural network is built to correct temperature drifts and increase the reliability of our thermoacoustic measurements through iterative training about ten seconds. The performance of the artificial neural network method was validated through a series of experiments. Compared to our previous

  12. Simultaneous measurement of refractive index and temperature based on intensity demodulation using matching grating method.

    Science.gov (United States)

    Qi, Liang; Zhao, Chun-Liu; Kang, Juan; Jin, Yongxing; Wang, Jianfeng; Ye, Manping; Jin, Shangzhong

    2013-07-01

    A solution refractive index (SRI) and temperature simultaneous measurement sensor with intensity-demodulation system based on matching grating method were demonstrated. Long period grating written in a photonic crystal fiber (LPG-PCF), provides temperature stable and wavelength dependent optical intensity transmission. The reflective peaks of two fiber Bragg gratings (FBGs), one of which is etched then sensitive to both SRI and temperature, another (FBG2) is only sensitive to temperature, were located in the same linear range of the LPG-PCF's transmission spectrum. An identical FBG with FBG2 was chosen as a matching FBG. When environments (SRI and temperature) change, the wavelength shifts of the FBGs are translated effectively to the reflection intensity changes. By monitoring output lights of unmatching and matching paths, the SRI and temperature were deduced by a signal processing unit. Experimental results show that the simultaneous refractive index and temperature measurement system work well. The proposed sensor system is compact and suitable for in situ applications at lower cost.

  13. Colour based fire detection method with temporal intensity variation filtration

    International Nuclear Information System (INIS)

    Trambitckii, K; Musalimov, V; Anding, K; Linß, G

    2015-01-01

    Development of video, computing technologies and computer vision gives a possibility of automatic fire detection on video information. Under that project different algorithms was implemented to find more efficient way of fire detection. In that article colour based fire detection algorithm is described. But it is not enough to use only colour information to detect fire properly. The main reason of this is that in the shooting conditions may be a lot of things having colour similar to fire. A temporary intensity variation of pixels is used to separate them from the fire. These variations are averaged over the series of several frames. This algorithm shows robust work and was realised as a computer program by using of the OpenCV library

  14. Colour based fire detection method with temporal intensity variation filtration

    Science.gov (United States)

    Trambitckii, K.; Anding, K.; Musalimov, V.; Linß, G.

    2015-02-01

    Development of video, computing technologies and computer vision gives a possibility of automatic fire detection on video information. Under that project different algorithms was implemented to find more efficient way of fire detection. In that article colour based fire detection algorithm is described. But it is not enough to use only colour information to detect fire properly. The main reason of this is that in the shooting conditions may be a lot of things having colour similar to fire. A temporary intensity variation of pixels is used to separate them from the fire. These variations are averaged over the series of several frames. This algorithm shows robust work and was realised as a computer program by using of the OpenCV library.

  15. Deadline based scheduling for data-intensive applications in clouds

    Institute of Scientific and Technical Information of China (English)

    Fu Xiong; Cang Yeliang; Zhu Lipeng; Hu Bin; Deng Song; Wang Dong

    2016-01-01

    Cloud computing emerges as a new computing pattern that can provide elastic services for any users around the world.It provides good chances to solve large scale scientific problems with fewer efforts.Application deployment remains an important issue in clouds.Appropriate scheduling mechanisms can shorten the total completion time of an application and therefore improve the quality of service (QoS) for cloud users.Unlike current scheduling algorithms which mostly focus on single task allocation,we propose a deadline based scheduling approach for data-intensive applications in clouds.It does not simply consider the total completion time of an application as the sum of all its subtasks' completion time.Not only the computation capacity of virtual machine (VM) is considered,but also the communication delay and data access latencies are taken into account.Simulations show that our proposed approach has a decided advantage over the two other algorithms.

  16. Reduced connection between the East Asian Summer Monsoon and Southern Hemisphere Circulation on interannual timescales under intense global warming

    Science.gov (United States)

    Yu, Tianlei; Guo, Pinwen; Cheng, Jun; Hu, Aixue; Lin, Pengfei; Yu, Yongqiang

    2018-03-01

    Previous studies show a close relationship between the East Asian Summer Monsoon (EASM) and Southern Hemisphere (SH) circulation on interannual timescales. In this study, we investigate whether this close relationship will change under intensive greenhouse-gas effect by analyzing simulations under two different climate background states: preindustrial era and Representative Concentration Pathway (RCP) 8.5 stabilization from the Community Climate System Model Version 4 (CCSM4). Results show a significantly reduced relationship under stabilized RCP8.5 climate state, such a less correlated EASM with the sea level pressure in the southern Indian Ocean and the SH branch of local Hadley Cell. Further analysis suggests that the collapse of the Atlantic Meridional Overturning Circulation (AMOC) due to this warming leads to a less vigorous northward meridional heat transport, a decreased intertropical temperature contrast in boreal summer, which produces a weaker cross-equatorial Hadley Cell in the monsoonal region and a reduced Interhemispheric Mass Exchange (IME). Since the monsoonal IME acts as a bridge connecting EASM and SH circulation, the reduced IME weakens this connection. By performing freshwater hosing experiment using the Flexible Global Ocean—Atmosphere—Land System model, Grid-point Version 2 (FGOALS-g2), we show a weakened relationship between the EASM and SH circulation as in CCSM4 when AMOC collapses. Our results suggest that a substantially weakened AMOC is the main driver leading to the EASM, which is less affected by SH circulation in the future warmer climate.

  17. Human Capital Intensity in Technology-Based Firms Located in Portugal: Do Foreign Multinationals Make a Difference?

    OpenAIRE

    Ana Teresa Tavares; Aurora A. C. Teixeira

    2005-01-01

    This paper contributes to the scarce empirical literature on the impact of foreign ownership on human capital intensity. New evidence is provided, based on a comprehensive, large-scale survey of technology-based firms located in Portugal. Using two alternatives measures of human capital (one based on skills, another on education), the key findings are that: (1) foreign ownership directly (and significantly) impacts on firms general human capital (education); (2) foreign ownership indirectly (...

  18. Modelling and assessment of urban flood hazards based on rainfall intensity-duration-frequency curves reformation

    OpenAIRE

    Ghazavi, Reza; Moafi Rabori, Ali; Ahadnejad Reveshty, Mohsen

    2016-01-01

    Estimate design storm based on rainfall intensity–duration–frequency (IDF) curves is an important parameter for hydrologic planning of urban areas. The main aim of this study was to estimate rainfall intensities of Zanjan city watershed based on overall relationship of rainfall IDF curves and appropriate model of hourly rainfall estimation (Sherman method, Ghahreman and Abkhezr method). Hydrologic and hydraulic impacts of rainfall IDF curves change in flood properties was evaluated via Stormw...

  19. The Influence of Aerosol Hygroscopicity on Precipitation Intensity During a Mesoscale Convective Event

    Science.gov (United States)

    Kawecki, Stacey; Steiner, Allison L.

    2018-01-01

    We examine how aerosol composition affects precipitation intensity using the Weather and Research Forecasting Model with Chemistry (version 3.6). By changing the prescribed default hygroscopicity values to updated values from laboratory studies, we test model assumptions about individual component hygroscopicity values of ammonium, sulfate, nitrate, and organic species. We compare a baseline simulation (BASE, using default hygroscopicity values) with four sensitivity simulations (SULF, increasing the sulfate hygroscopicity; ORG, decreasing organic hygroscopicity; SWITCH, using a concentration-dependent hygroscopicity value for ammonium; and ALL, including all three changes) to understand the role of aerosol composition on precipitation during a mesoscale convective system (MCS). Overall, the hygroscopicity changes influence the spatial patterns of precipitation and the intensity. Focusing on the maximum precipitation in the model domain downwind of an urban area, we find that changing the individual component hygroscopicities leads to bulk hygroscopicity changes, especially in the ORG simulation. Reducing bulk hygroscopicity (e.g., ORG simulation) initially causes fewer activated drops, weakened updrafts in the midtroposphere, and increased precipitation from larger hydrometeors. Increasing bulk hygroscopicity (e.g., SULF simulation) simulates more numerous and smaller cloud drops and increases precipitation. In the ALL simulation, a stronger cold pool and downdrafts lead to precipitation suppression later in the MCS evolution. In this downwind region, the combined changes in hygroscopicity (ALL) reduces the overprediction of intense events (>70 mm d-1) and better captures the range of moderate intensity (30-60 mm d-1) events. The results of this single MCS analysis suggest that aerosol composition can play an important role in simulating high-intensity precipitation events.

  20. Intensive postoperative glucose control reduces the surgical site infection rates in gynecologic oncology patients.

    Science.gov (United States)

    Al-Niaimi, Ahmed N; Ahmed, Mostafa; Burish, Nikki; Chackmakchy, Saygin A; Seo, Songwon; Rose, Stephen; Hartenbach, Ellen; Kushner, David M; Safdar, Nasia; Rice, Laurel; Connor, Joseph

    2015-01-01

    SSI rates after gynecologic oncology surgery vary from 5% to 35%, but are up to 45% in patients with diabetes mellitus (DM). Strict postoperative glucose control by insulin infusion has been shown to lower morbidity, but not specifically SSI rates. Our project studied continuous postoperative insulin infusion for 24h for gynecologic oncology patients with DM and hyperglycemia with a target blood glucose of controlled with intermittent subcutaneous insulin injections. Group 2 was composed of patients with DM and postoperative hyperglycemia whose blood glucose was controlled by insulin infusion. Group 3 was composed of patients with neither DM nor hyperglycemia. We controlled for all relevant factors associated with SSI. We studied a total of 372 patients. Patients in Group 2 had an SSI rate of 26/135 (19%), similar to patients in Group 3 whose rate was 19/89 (21%). Both were significantly lower than the SSI rate (43/148, 29%) of patients in Group 1. This reduction of 35% is significant (p = 0.02). Multivariate analysis showed an odd ratio = 0.5 (0.28-0.91) in reducing SSI rates after instituting this protocol. Initiating intensive glycemic control for 24h after gynecologic oncology surgery in patients with DM and postoperative hyperglycemia lowers the SSI rate by 35% (OR = 0.5) compared to patients receiving intermittent sliding scale insulin and to a rate equivalent to non-diabetics. Copyright © 2014. Published by Elsevier Inc.

  1. Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia.

    Science.gov (United States)

    Eslamian, Laleh; Jalili, Zorvan; Jamal, Ashraf; Marsoosi, Vajiheh; Movafegh, Ali

    2012-06-01

    It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision. Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain. The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0-150) vs. 250 mg (0-400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0-300) vs. 30 min (10-180) in group C, P = 0.0001]. Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.

  2. Mediterranean intense desert dust outbreaks and their vertical structure based on remote sensing data

    Directory of Open Access Journals (Sweden)

    A. Gkikas

    2016-07-01

    Full Text Available The main aim of the present study is to describe the vertical structure of the intense Mediterranean dust outbreaks, based on the use of satellite and surface-based retrievals/measurements. Strong and extreme desert dust (DD episodes are identified at 1°  ×  1° spatial resolution, over the period March 2000–February 2013, through the implementation of an updated objective and dynamic algorithm. According to the algorithm, strong DD episodes occurring at a specific place correspond to cases in which the daily aerosol optical depth at 550 nm (AOD550 nm exceeds or equals the long-term mean AOD550 nm (Mean plus two standard deviations (SD, which is also smaller than Mean+4 × SD. Extreme DD episodes correspond to cases in which the daily AOD550 nm value equals or exceeds Mean+4 × SD. For the identification of DD episodes, additional optical properties (Ångström exponent, fine fraction, effective radius and aerosol index derived by the MODIS-Terra & Aqua (also AOD retrievals, OMI-Aura and EP-TOMS databases are used as inputs. According to the algorithm using MODIS-Terra data, over the period March 2000–February 2013, strong DD episodes occur more frequently (up to 9.9 episodes year−1 over the western Mediterranean, while the corresponding frequencies for the extreme ones are smaller (up to 3.3 episodes year−1, central Mediterranean Sea. In contrast to their frequency, dust episodes are more intense (AODs up to 4.1, over the central and eastern Mediterranean Sea, off the northern African coasts. Slightly lower frequencies and higher intensities are found when the satellite algorithm operates based on MODIS-Aqua retrievals, for the period 2003–2012. The consistency of the algorithm is successfully tested through the application of an alternative methodology for the determination of DD episodes, which produced similar features of the episodes' frequency and intensity, with just slightly higher

  3. Energy intensity, target level of energy intensity, and room for improvement in energy intensity: An application to the study of regions in the EU

    International Nuclear Information System (INIS)

    Chang, Ming-Chung

    2014-01-01

    While the previous literature shows that a decline in energy intensity represents an improvement in energy use efficiency, it does not provide a target level of energy intensity, nor what room for improvement in terms of energy intensity could entail. This study establishes an indicator of such room for improvement in terms of energy intensity by measuring the difference between the target level of energy intensity and the actual energy intensity and thereby monitors energy use efficiency. The traditional indicator of energy intensity, defined as energy use over GDP, mainly estimates energy use efficiency, but is a partial effect between the energy input and GDP output. However, our proposed indicator of the room for improvement in terms of energy intensity is the total-factor effects based on the multiple-inputs model. By taking the 27 EU members to investigate their energy use efficiency using the indicator of the room for improvement in terms of energy intensity, this study concludes that an improvement in energy intensity does not fully depend on a decline in energy intensity, and we instead need to confirm whether the room for improvement in terms of energy intensity decreases. This finding is particularly relevant for energy policy-makers. - Highlights: • This paper establishes an indicator for the room for improvement in terms of energy intensity. • This study takes the 27 EU members to investigate their energy use efficiency. • A different result appears by using our proposed indicator

  4. Use of Six Sigma strategies to pull the line on central line-associated bloodstream infections in a neurotrauma intensive care unit.

    Science.gov (United States)

    Loftus, Kelli; Tilley, Terry; Hoffman, Jason; Bradburn, Eric; Harvey, Ellen

    2015-01-01

    The creation of a consistent culture of safety and quality in an intensive care unit is challenging. We applied the Six Sigma Define-Measure-Analyze-Improve-Control (DMAIC) model for quality improvement (QI) to develop a long-term solution to improve outcomes in a high-risk neurotrauma intensive care unit. We sought to reduce central line utilization as a cornerstone in preventing central line-associated bloodstream infections (CLABSIs). This study describes the successful application of the DMAIC model in the creation and implementation of evidence-based quality improvement designed to reduce CLABSIs to below national benchmarks.

  5. The ability of winter grazing to reduce wildfire size, intensity ...

    Science.gov (United States)

    A recent study by Davies et al. sought to test whether winter grazing could reduce wildfire size, fire behavior metrics, and fire-induced plant mortality in shrub-grasslands. The authors concluded that ungrazed rangelands may experience more fire-induced mortality of native perennial bunchgrasses. The authors also presented several statements regarding the benefits of winter grazing on post-fire plant community responses. However, this commentary will show that the study by Davies et al. has underlying methodological flaws, lacks data necessary to support their conclusions, and does not provide an accurate discussion on the effect of grazing on rangeland ecosystems. Importantly, Davies et al. presented no data on the post-fire mortality of the perennial bunchgrasses or on the changes in plant community composition following their experimental fires. Rather, Davies et al. inferred these conclusions based off their observed fire behavior metrics of maximum temperature and a term described as the “heat load”. However, neither metric is appropriate for elucidating the heat flux impacts on plants. This lack of post-fire data, several methodological flaws, and the use of inadequate metrics describing heat cast doubts on the authors’ ability to support their stated conclusions. This article is a commentary highlights the scientific shortcomings in a forthcoming paper by Davies et al. in the International Journal of Wildland Fire. The study has methodological flaw

  6. Low-cost vibration sensor based on dual fiber Bragg gratings and light intensity measurement.

    Science.gov (United States)

    Gao, Xueqing; Wang, Yongjiao; Yuan, Bo; Yuan, Yinquan; Dai, Yawen; Xu, Gang

    2013-09-20

    A vibration monitoring system based on light intensity measurement has been constructed, and the designed accelerometer is based on steel cantilever frame and dual fiber Bragg gratings (FBGs). By using numerical simulations for the dual FBGs, the dependence relationship of the area of main lobes on the difference of initial central wavelengths is obtained and the most optimal choice for the initial value and the vibration amplitude of the difference of central wavelengths of two FBGs is suggested. The vibration monitoring experiments are finished, and the measured data are identical to the simulated results.

  7. GeneChip microarrays-signal intensities, RNA concentrations and probe sequences

    International Nuclear Information System (INIS)

    Binder, Hans; Preibisch, Stephan

    2006-01-01

    GeneChip microarrays consist of hundreds of thousands of oligonucleotide probes. The transformation of their signal intensities into RNA transcript concentrations requires the knowledge of the response function of the measuring device. We analysed the 'apparatus' function of perfect match (PM) and mismatched (MM) oligonucleotide probes of GeneChip microarrays after changes of the target concentration using the results of a spiked-in experiment. In agreement with previous studies we found that a competitive two-species Langmuir-adsorption model describes the probe intensities well. Each PM and MM probe is characterized by two hybridization constants which specify the propensity of the probe to bind specific and non-specific transcripts. The affinity for non-specific hybridization is on average equal for PM and MM. The purine-pyrimidine asymmetry of base pair interaction strengths, however, causes a characteristic PM-MM intensity difference, the sign of which depends on the middle base of the probe. The affinity for specific hybridization of the PM exceeds that of the MM on average by nearly one order of magnitude because the central mismatched base only weakly contributes to the stability of the probe/target duplexes. For the first time we differentiate between the free energy parameters related to the 64 possible middle-triples of DNA/RNA oligomer duplexes with a central Watson-Crick pairing and a central mismatched pairing. Both the PM and MM probes respond to the concentration of specific transcripts, which can be estimated from the PM and MM probe intensities using the Langmuir-model. The analysis of the PM-MM intensity difference provides at least no loss of accuracy and precision of the estimated concentration compared with the PM-only estimates which in turn outperform the MM-only estimates. The results show that the processing of the PM-MM intensity difference requires the consideration of a background term due to non-specific hybridization, which is

  8. Reducing microscopy-based malaria misdiagnosis in a low ...

    African Journals Online (AJOL)

    In this paper we report on the outcomes of a simple intervention that utilized a social entrepreneurship approach (SEA) to reduce misdiagnosis associated with hospital-based microscopy of malaria in a low-transmission area of rural Tanzania. A pre-post assessment was conducted on patients presenting to the hospital ...

  9. The promise and peril of intensive-site-based ecological research: insights from the Hubbard Brook ecosystem study

    Science.gov (United States)

    Timothy J. Fahey; Pamela H. Templer; Bruce T. Anderson; John J. Battles; John L. Campbell; Charles T. Driscoll; Anthony R. Fusco; Mark B. Green; Karim-Aly S. Kassam; Nicholas L. Rodenhouse; Lindsey Rustad; Paul G. Schaberg; Matthew A. Vadeboncoeur

    2015-01-01

    Ecological research is increasingly concentrated at particular locations or sites. This trend reflects a variety of advantages of intensive, site-based research, but also raises important questions about the nature of such spatially delimited research: how well does site based research represent broader areas, and does it constrain scientific discovery? We provide an...

  10. The influence of metal-support interactions on the whiteline intensity

    NARCIS (Netherlands)

    Vaarkamp, M.; Miller, J.T.; Modica, F.S.; Koningsberger, D.C.; Kuroda, H.; Ohta, T.

    1993-01-01

    The whiteline intensity of Pt/K-LTL catalysts reduced at 300, 450, and 600 Deg decreases with increasing redn. temp. This change in whiteline intensity was ascribed to the removal of hydrogen from the metal-support interface by redn. at higher temp.

  11. Optical fibres sensor based in the intensity switch of a linear laser with two Bragg gratings

    International Nuclear Information System (INIS)

    Basurto P, M.A.; Kuzin, E.A.; Archundia B, C.; Marroquin, E.; May A, M.; Cerecedo N, H.H.; Sanchez M, J.J.; Tentori S, D.; Marquez B, I.; Shliagin, M.; Miridonov, S.

    2000-01-01

    In this work we propose a new configuration for an optical fiber temperature sensor, based on a linear type Er-doped fiber laser. The laser cavity consists of an Er-doped fiber and two identical Bragg gratings at the fiber ends (working as reflectors). Temperature changes are detected by measuring, through one of the gratings, the intensity variations at the system's output. When the temperature of one of the Bragg gratings is modified, a wavelength shift of its spectral reflectivity is observed. Hence, the laser emission intensity of the system is modified. We present experimental results of the intensity switch observed when the temperature difference between the gratings detunes their spectral reflectance. Making use of this effect it is possible to develop limit comparators to bound the temperature range for the object under supervision. This limiting work can be performed with a high sensitivity using a very simple interrogation procedure. (Author)

  12. Reverse time migration by Krylov subspace reduced order modeling

    Science.gov (United States)

    Basir, Hadi Mahdavi; Javaherian, Abdolrahim; Shomali, Zaher Hossein; Firouz-Abadi, Roohollah Dehghani; Gholamy, Shaban Ali

    2018-04-01

    Imaging is a key step in seismic data processing. To date, a myriad of advanced pre-stack depth migration approaches have been developed; however, reverse time migration (RTM) is still considered as the high-end imaging algorithm. The main limitations associated with the performance cost of reverse time migration are the intensive computation of the forward and backward simulations, time consumption, and memory allocation related to imaging condition. Based on the reduced order modeling, we proposed an algorithm, which can be adapted to all the aforementioned factors. Our proposed method benefit from Krylov subspaces method to compute certain mode shapes of the velocity model computed by as an orthogonal base of reduced order modeling. Reverse time migration by reduced order modeling is helpful concerning the highly parallel computation and strongly reduces the memory requirement of reverse time migration. The synthetic model results showed that suggested method can decrease the computational costs of reverse time migration by several orders of magnitudes, compared with reverse time migration by finite element method.

  13. Using a Reduced Spot Size for Intensity-Modulated Proton Therapy Potentially Improves Salivary Gland-Sparing in Oropharyngeal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Water, Tara A. van de, E-mail: t.a.van.de.water@rt.umcg.nl [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Lomax, Antony J. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Bijl, Hendrik P.; Schilstra, Cornelis [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands); Hug, Eugen B. [Centre for Proton Therapy, Paul Scherrer Institute, Villigen-PSI (Switzerland); Langendijk, Johannes A. [Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, Groningen (Netherlands)

    2012-02-01

    Purpose: To investigate whether intensity-modulated proton therapy with a reduced spot size (rsIMPT) could further reduce the parotid and submandibular gland dose compared with previously calculated IMPT plans with a larger spot size. In addition, it was investigated whether the obtained dose reductions would theoretically translate into a reduction of normal tissue complication probabilities (NTCPs). Methods: Ten patients with N0 oropharyngeal cancer were included in a comparative treatment planning study. Both IMPT plans delivered simultaneously 70 Gy to the boost planning target volume (PTV) and 54 Gy to the elective nodal PTV. IMPT and rsIMPT used identical three-field beam arrangements. In the IMPT plans, the parotid and submandibular salivary glands were spared as much as possible. rsIMPT plans used identical dose-volume objectives for the parotid glands as those used by the IMPT plans, whereas the objectives for the submandibular glands were tightened further. NTCPs were calculated for salivary dysfunction and xerostomia. Results: Target coverage was similar for both IMPT techniques, whereas rsIMPT clearly improved target conformity. The mean doses in the parotid glands and submandibular glands were significantly lower for three-field rsIMPT (14.7 Gy and 46.9 Gy, respectively) than for three-field IMPT (16.8 Gy and 54.6 Gy, respectively). Hence, rsIMPT significantly reduced the NTCP of patient-rated xerostomia and parotid and contralateral submandibular salivary flow dysfunction (27%, 17%, and 43% respectively) compared with IMPT (39%, 20%, and 79%, respectively). In addition, mean dose values in the sublingual glands, the soft palate and oral cavity were also decreased. Obtained dose and NTCP reductions varied per patient. Conclusions: rsIMPT improved sparing of the salivary glands and reduced NTCP for xerostomia and parotid and submandibular salivary dysfunction, while maintaining similar target coverage results. It is expected that rsIMPT improves quality

  14. Web-Based Treatment Program Using Intensive Therapeutic Contact for Patients With Eating Disorders : Before-After Study

    NARCIS (Netherlands)

    ter Huurne, E.D.; Postel, Marloes Gerda; de Haan, H.A.; Drossaert, Constance H.C.; Jong, C.A.J.

    2013-01-01

    Background: Although eating disorders are common in the Netherlands, only a few patients are treated by mental health care professionals. To reach and treat more patients with eating disorders, Tactus Addiction Treatment developed a web-based treatment program with asynchronous and intensive

  15. The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada.

    Science.gov (United States)

    Evans, Jessica; Kobewka, Daniel; Thavorn, Kednapa; D'Egidio, Gianni; Rosenberg, Erin; Kyeremanteng, Kwadwo

    2018-02-23

    To use theoretical modelling exercises to determine the effect of reduced intensive care unit (ICU) length of stay (LOS) on total hospital costs at a Canadian centre. We conducted a retrospective cost analysis from the perspective of one tertiary teaching hospital in Canada. Cost, demographic, clinical, and LOS data were retrieved through case-costing, patient registry, and hospital abstract systems of The Ottawa Hospital Data Warehouse for all new in-patient ward (30,483) and ICU (2,239) encounters between April 2012 and March 2013. Aggregate mean daily variable direct (VD) costs for ICU vs ward encounters were summarized by admission day number, LOS, and cost centre. The mean daily VD cost per ICU patient was $2,472 (CAD), accounting for 67.0% of total daily ICU costs per patient and $717 for patients admitted to the ward. Variable direct cost is greatest on the first day of ICU admission ($3,708), and then decreases by 39.8% to plateau by the fifth day of admission. Reducing LOS among patients with ICU stays ≥ four days could potentially result in an annual hospital cost saving of $852,146 which represents 0.3% of total in-patient hospital costs and 1.2% of ICU costs. Reducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy.

  16. Emergy-based comparative analysis of energy intensity in different industrial systems.

    Science.gov (United States)

    Liu, Zhe; Geng, Yong; Wang, Hui; Sun, Lu; Ma, Zhixiao; Tian, Xu; Yu, Xiaoman

    2015-12-01

    With the rapid economic development, energy consumption of China has been the second place in the world next to the USA. Usually, measuring energy consumption intensity or efficiency applies heat unit which is joule per gross domestic production (GDP) or coal equivalent per GDP. However, this measuring approach is only oriented by the conversion coefficient of heat combustion which does not match the real value of the materials during their formation in the ecological system. This study applied emergy analysis to evaluate the energy consumption intensity to fill this gap. Emergy analysis is considered as a bridge between ecological system and economic system, which can evaluate the contribution of ecological products and services as well as the load placed on environmental systems. In this study, emergy indicator for performing energy consumption intensity of primary energy was proposed. Industrial production is assumed as the main contributor of energy consumption compared to primary and tertiary industries. Therefore, this study validated this method by investigating the two industrial case studies which were Dalian Economic Development Area (DEDA) and Fuzhou economic and technological area (FETA), to comparatively study on their energy consumption intensity between the different kinds of industrial systems and investigate the reasons behind the differences. The results show that primary energy consumption (PEC) of DEDA was much higher than that of FETA during 2006 to 2010 and its primary energy consumption ratio (PECR) to total emergy involvement had a dramatically decline from year 2006 to 2010. In the same time, nonrenewable energy of PEC in DEDA was also much higher than that in FETA. The reason was that industrial structure of DEDA was mainly formed by heavy industries like petro-chemistry industry, manufacturing industries, and high energy-intensive industries. However, FETA was formed by electronic business, food industry, and light industries. Although

  17. Electrophysiological Correlates of Changes in Reaction Time Based on Stimulus Intensity

    Science.gov (United States)

    Lakhani, Bimal; Vette, Albert H.; Mansfield, Avril; Miyasike-daSilva, Veronica; McIlroy, William E.

    2012-01-01

    Background Although reaction time is commonly used as an indicator of central nervous system integrity, little is currently understood about the mechanisms that determine processing time. In the current study, we are interested in determining the differences in electrophysiological events associated with significant changes in reaction time that could be elicited by changes in stimulus intensity. The primary objective is to assess the effect of increasing stimulus intensity on the latency and amplitude of afferent inputs to the somatosensory cortex, and their relation to reaction time. Methods Median nerve stimulation was applied to the non-dominant hand of 12 healthy young adults at two different stimulus intensities (HIGH & LOW). Participants were asked to either press a button as fast as possible with their dominant hand or remain quiet following the stimulus. Electroencephalography was used to measure somatosensory evoked potentials (SEPs) and event related potentials (ERPs). Electromyography from the flexor digitorum superficialis of the button-pressing hand was used to assess reaction time. Response time was the time of button press. Results Reaction time and response time were significantly shorter following the HIGH intensity stimulus compared to the LOW intensity stimulus. There were no differences in SEP (N20 & P24) peak latencies and peak-to-peak amplitude for the two stimulus intensities. ERPs, locked to response time, demonstrated a significantly larger pre-movement negativity to positivity following the HIGH intensity stimulus over the Cz electrode. Discussion This work demonstrates that rapid reaction times are not attributable to the latency of afferent processing from the stimulated site to the somatosensory cortex, and those latency reductions occur further along the sensorimotor transformation pathway. Evidence from ERPs indicates that frontal planning areas such as the supplementary motor area may play a role in transforming the elevated sensory

  18. Intelligent agents in data-intensive computing

    CERN Document Server

    Correia, Luís; Molina, José

    2016-01-01

    This book presents new approaches that advance research in all aspects of agent-based models, technologies, simulations and implementations for data intensive applications. The nine chapters contain a review of recent cross-disciplinary approaches in cloud environments and multi-agent systems, and important formulations of data intensive problems in distributed computational environments together with the presentation of new agent-based tools to handle those problems and Big Data in general. This volume can serve as a reference for students, researchers and industry practitioners working in or interested in joining interdisciplinary work in the areas of data intensive computing and Big Data systems using emergent large-scale distributed computing paradigms. It will also allow newcomers to grasp key concepts and potential solutions on advanced topics of theory, models, technologies, system architectures and implementation of applications in Multi-Agent systems and data intensive computing. .

  19. Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training

    OpenAIRE

    Ballangrud, Randi

    2013-01-01

    Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven I...

  20. [Intensive medicine in Spain].

    Science.gov (United States)

    2011-03-01

    Intensive care medicine is a medical specialty that was officially established in our country in 1978, with a 5-year training program including two years of common core training followed by three years of specific training in an intensive care unit accredited for training. During this 32-year period, intensive care medicine has carried out an intense and varied activity, which has allowed its positioning as an attractive and with future specialty in the hospital setting. This document summarizes the history of the specialty, its current situation, the key role played in the programs of organ donation and transplantation of the National Transplant Organization (after more than 20 years of mutual collaboration), its training activities with the development of the National Plan of Cardiopulmonary Resuscitation, with a trajectory of more than 25 years, its interest in providing care based on quality and safety programs for the severely ill patient. It also describes the development of reference registries due to the need for reliable data on the care process for the most prevalent diseases, such as ischemic heart disease or ICU-acquired infections, based on long-term experience (more than 15 years), which results in the availability of epidemiological information and characteristics of care that may affect the practical patient's care. Moreover, features of its scientific society (SEMICYUC) are reported, an organization that agglutinates the interests of more than 280 ICUs and more than 2700 intensivists, with reference to the journal Medicina Intensiva, the official journal of the society and the Panamerican and Iberian Federation of Critical Medicine and Intensive Care Societies. Medicina Intensiva is indexed in the Thompson Reuters products of Science Citation Index Expanded (Scisearch(®)) and Journal Citation Reports, Science Edition. The important contribution of the Spanish intensive care medicine to the scientific community is also analyzed, and in relation to

  1. Male crickets adjust ejaculate quality with both risk and intensity of sperm competition.

    Science.gov (United States)

    Simmons, Leigh W; Denholm, Amy; Jackson, Chantelle; Levy, Esther; Madon, Ewa

    2007-10-22

    Sperm competition theory predicts that males should increase their expenditure on the ejaculate with increasing risk of sperm competition, but decrease their expenditure with increasing intensity. There is accumulating evidence for sperm competition theory, based on examinations of testes size and/or the numbers of sperm ejaculated. However, recent studies suggest that ejaculate quality can also be subject to selection by sperm competition. We used experimental manipulations of the risk and intensity of sperm competition in the cricket, Teleogryllus oceanicus. We found that males produced ejaculates with a greater percentage of live sperm when they had encountered a rival male prior to mating. However, when mating with a female that presented a high intensity of sperm competition, males did not respond to risk, but produced ejaculates with a reduced percentage of live sperm. Our data suggest that males exhibit a fine-tuned hierarchy of responses to these cues of sperm competition.

  2. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study

    NARCIS (Netherlands)

    Klopotowska, J.E.; Kuiper, R.; van Kan, H.J.; de Pont, A.C.; Dijkgraaf, M.G.; Lie-A-Huen, L.; Vroom, M.B.; Smorenburg, S.M.

    2010-01-01

    Introduction: Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an

  3. Reduced Pain Sensation and Reduced BOLD Signal in Parietofrontal Networks during Religious Prayer

    DEFF Research Database (Denmark)

    Elmholdt, Else-Marie; Skewes, Joshua Charles; Dietz, Martin

    2017-01-01

    Previous studies suggest that religious prayer can alter the experience of pain via expectation mechanisms. While brain processes related to other types of top-down modulation of pain have been studied extensively, no research has been conducted on the potential effects of active religious coping....... Here, we aimed at investigating the neural mechanisms during pain modulation by prayer and their dependency on the opioidergic system. Twenty-eight devout Protestants performed religious prayer and a secular contrast prayer during painful electrical stimulation in two fMRI sessions. Naloxone or saline...... was administered prior to scanning. Results show that pain intensity was reduced by 11% and pain unpleasantness by 26% during religious prayer compared to secular prayer. Expectancy predicted large amounts (70–89%) of the variance in pain intensity. Neuroimaging results revealed reduced neural activity during...

  4. Model predictive control based on reduced order models applied to belt conveyor system.

    Science.gov (United States)

    Chen, Wei; Li, Xin

    2016-11-01

    In the paper, a model predictive controller based on reduced order model is proposed to control belt conveyor system, which is an electro-mechanics complex system with long visco-elastic body. Firstly, in order to design low-degree controller, the balanced truncation method is used for belt conveyor model reduction. Secondly, MPC algorithm based on reduced order model for belt conveyor system is presented. Because of the error bound between the full-order model and reduced order model, two Kalman state estimators are applied in the control scheme to achieve better system performance. Finally, the simulation experiments are shown that balanced truncation method can significantly reduce the model order with high-accuracy and model predictive control based on reduced-model performs well in controlling the belt conveyor system. Copyright © 2016 ISA. Published by Elsevier Ltd. All rights reserved.

  5. Improving Intensity-Based Lung CT Registration Accuracy Utilizing Vascular Information

    Directory of Open Access Journals (Sweden)

    Kunlin Cao

    2012-01-01

    Full Text Available Accurate pulmonary image registration is a challenging problem when the lungs have a deformation with large distance. In this work, we present a nonrigid volumetric registration algorithm to track lung motion between a pair of intrasubject CT images acquired at different inflation levels and introduce a new vesselness similarity cost that improves intensity-only registration. Volumetric CT datasets from six human subjects were used in this study. The performance of four intensity-only registration algorithms was compared with and without adding the vesselness similarity cost function. Matching accuracy was evaluated using landmarks, vessel tree, and fissure planes. The Jacobian determinant of the transformation was used to reveal the deformation pattern of local parenchymal tissue. The average matching error for intensity-only registration methods was on the order of 1 mm at landmarks and 1.5 mm on fissure planes. After adding the vesselness preserving cost function, the landmark and fissure positioning errors decreased approximately by 25% and 30%, respectively. The vesselness cost function effectively helped improve the registration accuracy in regions near thoracic cage and near the diaphragm for all the intensity-only registration algorithms tested and also helped produce more consistent and more reliable patterns of regional tissue deformation.

  6. Designing a Method for AN Automatic Earthquake Intensities Calculation System Based on Data Mining and On-Line Polls

    Science.gov (United States)

    Liendo Sanchez, A. K.; Rojas, R.

    2013-05-01

    Seismic intensities can be calculated using the Modified Mercalli Intensity (MMI) scale or the European Macroseismic Scale (EMS-98), among others, which are based on a serie of qualitative aspects related to a group of subjective factors that describe human perception, effects on nature or objects and structural damage due to the occurrence of an earthquake. On-line polls allow experts to get an overview of the consequences of an earthquake, without going to the locations affected. However, this could be a hard work if the polls are not properly automated. Taking into account that the answers given to these polls are subjective and there is a number of them that have already been classified for some past earthquakes, it is possible to use data mining techniques in order to automate this process and to obtain preliminary results based on the on-line polls. In order to achieve these goal, a predictive model has been used, using a classifier based on a supervised learning techniques such as decision tree algorithm and a group of polls based on the MMI and EMS-98 scales. It summarized the most important questions of the poll, and recursive divides the instance space corresponding to each question (nodes), while each node splits the space depending on the possible answers. Its implementation was done with Weka, a collection of machine learning algorithms for data mining tasks, using the J48 algorithm which is an implementation of the C4.5 algorithm for decision tree models. By doing this, it was possible to obtain a preliminary model able to identify up to 4 different seismic intensities with 73% correctly classified polls. The error obtained is rather high, therefore, we will update the on-line poll in order to improve the results, based on just one scale, for instance the MMI. Besides, the integration of automatic seismic intensities methodology with a low error probability and a basic georeferencing system, will allow to generate preliminary isoseismal maps

  7. Changes in carbon intensity in China's industrial sector: Decomposition and attribution analysis

    International Nuclear Information System (INIS)

    Liu, Nan; Ma, Zujun; Kang, Jidong

    2015-01-01

    The industrial sector accounts for 70% of the total energy-related CO_2 emissions in China. To gain a better understanding of the changes in carbon intensity in China's industrial sector, this study first utilized logarithmic mean Divisia index (LMDI) decomposition analysis to disentangle the carbon intensity into three influencing factors, including the emission coefficient effect, the energy intensity effect, and the structure effect. Then, the analysis was furthered to explore the contributions of individual industrial sub-sectors to each factor by using an extension of the decomposition method proposed in Choi and Ang (2012). The results indicate that from 1996 to 2012, the energy intensity effect was the dominant factor in reducing carbon intensity, of which chemicals, iron and steel, metal and machinery, and cement and ceramics were the most representative sub-sectors. The structure effect did not show a strong impact on carbon intensity. The emission coefficient effect gradually increased the carbon intensity, mainly due to the expansion of electricity consumption, particularly in the metal and machinery and chemicals sub-sectors. The findings suggest that differentiated policies and measures should be considered for various industrial sub-sectors to maximize the energy efficiency potential. Moreover, readjusting the industrial structure and promoting clean and renewable energy is also urgently required to further reduce carbon intensity in China's industrial sector. - Highlights: • The study analyzed the changes in carbon intensity in China's industrial sector. • An extension of the Divisia index decomposition methodology was utilized. • Energy efficiency improvement was the dominant factor reducing carbon intensity. • The sub-sector contributions to the energy efficiency improvement varied markedly. • Emission coefficient growth can be mainly due to the expansion of electricity.

  8. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study

    NARCIS (Netherlands)

    Klopotowska, Joanna E.; Kuiper, Rob; van Kan, Hendrikus J.; de Pont, Anne-Cornelie; Dijkgraaf, Marcel G.; Lie-A-Huen, Loraine; Vroom, Margreeth B.; Smorenburg, Susanne M.

    2010-01-01

    Patients admitted to an intensive care unit (ICU) are at high risk for prescribing errors and related adverse drug events (ADEs). An effective intervention to decrease this risk, based on studies conducted mainly in North America, is on-ward participation of a clinical pharmacist in an ICU team. As

  9. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P fasting plasma glucose (P fasting glucose. Copyright © 2015 the American Physiological Society.

  10. Climate constraints on the carbon intensity of economic growth

    International Nuclear Information System (INIS)

    Rozenberg, Julie; Narloch, Ulf; Hallegatte, Stephane; Davis, Steven J

    2015-01-01

    Development and climate goals together constrain the carbon intensity of production. Using a simple and transparent model that represents committed CO 2 emissions (future emissions expected to come from existing capital), we explore the carbon intensity of production related to new capital required for different temperature targets across several thousand scenarios. Future pathways consistent with the 2 °C target which allow for continued gross domestic product growth require early action to reduce carbon intensity of new production, and either (i) a short lifetime of energy and industry capital (e.g. early retrofit of coal power plants), or (ii) large negative emissions after 2050 (i.e. rapid development and dissemination of carbon capture and sequestration). To achieve the 2 °C target, half of the scenarios indicate a carbon intensity of new production between 33 and 73 g CO 2 /$—much lower than the global average today, at 360 g CO 2 /$. The average lifespan of energy capital (especially power plants), and industry capital, are critical because they commit emissions far into the future and reduce the budget for new capital emissions. Each year of lifetime added to existing, carbon intensive capital, decreases the carbon intensity of new production required to meet a 2 °C carbon budget by 1.0–1.5 g CO 2 /$, and each year of delaying the start of mitigation decreases the required CO 2 intensity of new production by 20–50 g CO 2 /$. Constraints on the carbon intensity of new production under a 3 °C target are considerably relaxed relative to the 2 °C target, but remain daunting in comparison to the carbon intensity of the global economy today. (letter)

  11. Refuse dumps from leaf-cutting ant nests reduce the intensity of above-ground competition among neighboring plants in a Patagonian steppe

    Science.gov (United States)

    Farji-Brener, Alejandro G.; Lescano, María Natalia

    2017-11-01

    In arid environments, the high availability of sunlight due to the scarcity of trees suggests that plant competition take place mainly belowground for water and nutrients. However, the occurrence of soil disturbances that increase nutrient availability and thereby promote plant growth may enhance shoot competition between neighboring plants. We conducted a greenhouse experiment to evaluate the influence of the enriched soil patches generated by the leaf-cutting ant, Acromyrmex lobicornis, on the performance of the alien forb Carduus thoermeri (Asteraceae) under different intraspecific competition scenarios. Our results showed that substrate type and competition scenario affected mainly aboveground plant growth. As expected, plants growing without neighbors and in nutrient-rich ant refuse dumps showed more aboveground biomass than plants growing with neighbors and in nutrient-poor steppe soils. However, aboveground competition was more intense in nutrient-poor substrates: plants under shoot and full competition growing in the nutrient-rich ant refuse dumps showed higher biomass than those growing on steppe soils. Belowground biomass was similar among focal plants growing under different substrate type. Our results support the traditional view that increments in resource availability reduce competition intensity. Moreover, the fact that seedlings in this sunny habitat mainly compete aboveground illustrates how limiting factors may be scale-dependent and change in importance as plants grow.

  12. The odd couple: The relationship between state economic performance and carbon emissions economic intensity

    International Nuclear Information System (INIS)

    Davidsdottir, B.; Fisher, M.

    2011-01-01

    Historical time trends indicate that both carbon and energy intensity have declined in the United States over the last several decades, while economic performance, as measured by per capita GSP, has improved. This observation indicates that it may be possible to reduce carbon intensity without a reduction in economic performance. This paper assesses using panel analysis, the empirical relationship between carbon emissions intensity and economic performance, and examines the direction of causality between the two variables. Data for the analysis covered 48 states, excluding Hawaii, Alaska, and Washington DC, from 1980 to 2000. The results indicate significant bi-directional relationship between carbon emissions intensity and state economic performance, both using an aggregate indicator for carbon emissions intensity, decomposed using Laspeyres indexes and disaggregated by sector. This implies that it should be possible to implement statewide and sector-specific policies to reduce energy and carbon intensity and at the same time improve economic performance. - Highlights: → The empirical relationship between carbon emissions intensity and economic performance is assessed → The direction of causality between the two variables is examined. → Results indicate significant relationship between carbon emissions intensity and state economic performance. → Relationship is bi-directional, and holds for both aggregate analysis and by sector. → It is possible to implement policies to reduce carbon intensity and improve economic performance.

  13. Phenylephrine decreases frontal lobe oxygenation at rest but not during moderately intense exercise

    DEFF Research Database (Denmark)

    Brassard, Patrice; Seifert, Thomas; Wissenberg, Mads

    2010-01-01

    high-intensity exercise (-3%, P=not significant), where PaCO2 decreased 7% (Padministration of phenylephrine reduced ScO2 but that the increased cerebral metabolism needed for moderately intense exercise eliminated that effect....... the administration of phenylephrine during low-intensity exercise (approximately 15%), but this was attenuated (approximately 10%) during high-intensity exercise (Padministration of phenylephrine was attenuated during low-intensity exercise (-5%, P

  14. Noise Source Identification of a Ring-Plate Cycloid Reducer Based on Coherence Analysis

    Directory of Open Access Journals (Sweden)

    Bing Yang

    2013-01-01

    Full Text Available A ring-plate-type cycloid speed reducer is one of the most important reducers owing to its low volume, compactness, smooth and high performance, and high reliability. The vibration and noise tests of the reducer prototype are completed using the HEAD acoustics multichannel noise test and analysis system. The characteristics of the vibration and noise are obtained based on coherence analysis and the noise sources are identified. The conclusions provide the bases for further noise research and control of the ring-plate-type cycloid reducer.

  15. Absolute intensities of supersonic beams

    International Nuclear Information System (INIS)

    Beijerinck, H.C.W.; Habets, A.H.M.; Verster, N.F.

    1977-01-01

    In a molecular beam experiment the center-line intensity I(0) (particles s -1 sterad -1 ) and the flow rate dN/dt (particles s -1 ) of a beam source are important features. To compare the performance of different types of beam sources the peaking factor, kappa, is defined as the ratio kappa=π(I(0)/dN/dt). The factor π is added to normalize to kappa=1 for an effusive source. The ideal peaking factor for the supersonic flow from a nozzle follows from continuum theory. Numerical values of kappa are available. Experimental values of kappa for an argon expansion are presented in this paper, confirming these calculations. The actual center-line intensity of a supersonic beam source with a skimmer is reduced in comparison to this ideal intensity if the skimmer shields part of the virtual source from the detector. Experimental data on the virtual source radius are given enabling one to predict this shielding quantitatively. (Auth.)

  16. Designing adaptive intensive interventions using methods from engineering.

    Science.gov (United States)

    Lagoa, Constantino M; Bekiroglu, Korkut; Lanza, Stephanie T; Murphy, Susan A

    2014-10-01

    Adaptive intensive interventions are introduced, and new methods from the field of control engineering for use in their design are illustrated. A detailed step-by-step explanation of how control engineering methods can be used with intensive longitudinal data to design an adaptive intensive intervention is provided. The methods are evaluated via simulation. Simulation results illustrate how the designed adaptive intensive intervention can result in improved outcomes with less treatment by providing treatment only when it is needed. Furthermore, the methods are robust to model misspecification as well as the influence of unobserved causes. These new methods can be used to design adaptive interventions that are effective yet reduce participant burden. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  17. Concurrent hyperthermia estimation schemes based on extended Kalman filtering and reduced-order modelling.

    Science.gov (United States)

    Potocki, J K; Tharp, H S

    1993-01-01

    The success of treating cancerous tissue with heat depends on the temperature elevation, the amount of tissue elevated to that temperature, and the length of time that the tissue temperature is elevated. In clinical situations the temperature of most of the treated tissue volume is unknown, because only a small number of temperature sensors can be inserted into the tissue. A state space model based on a finite difference approximation of the bioheat transfer equation (BHTE) is developed for identification purposes. A full-order extended Kalman filter (EKF) is designed to estimate both the unknown blood perfusion parameters and the temperature at unmeasured locations. Two reduced-order estimators are designed as computationally less intensive alternatives to the full-order EKF. Simulation results show that the success of the estimation scheme depends strongly on the number and location of the temperature sensors. Superior results occur when a temperature sensor exists in each unknown blood perfusion zone, and the number of sensors is at least as large as the number of unknown perfusion zones. Unacceptable results occur when there are more unknown perfusion parameters than temperature sensors, or when the sensors are placed in locations that do not sample the unknown perfusion information.

  18. Evidence-Based Exercise Recommendations to Reduce Hepatic Fat Content in Youth- a Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Medrano, María; Cadenas-Sanchez, Cristina; Álvarez-Bueno, Celia; Cavero-Redondo, Iván; Ruiz, Jonatan R; Ortega, Francisco B; Labayen, Idoia

    2018-02-13

    The main purposes of this study were to elucidate the effects of supervised-exercise training (ET) interventions on hepatic fat content and on non-alcoholic fatty liver disease (NAFLD) prevalence in children and adolescents and to provide information about the optimal ET prescription (type, intensity, volume, and frequency) needed to reduce hepatic fat content in youths. Supervised-ET interventions performed in children and adolescents (6-19 years) that provided results of exercise effects on hepatic fat content or NAFLD prevalence were included. Supervised-exercise significantly reduced hepatic fat content compared to the control groups. Lifestyle interventions that included supervised-ET significantly reduced the prevalence of NAFLD. This systematic review and meta-analysis shows that supervised-ET could be an effective strategy in the management and prevention of NAFLD in children and adolescents. Both aerobic and resistance ET, at vigorous or moderate-to-vigorous intensities, with a volume ≥60 min/session and a frequency ≥3 sessions/week, aiming to improve cardiorespiratory fitness and muscular strength, had benefits on hepatic fat content reduction in youth. These data concur with the international recommendations of physical activity for health promotion in youth and may be useful when designing ET programs to improve and prevent hepatic steatosis in the pediatric population. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Improved BER based on intensity noise alleviation using developed detection technique for incoherent SAC-OCDMA systems

    Science.gov (United States)

    Al-Khafaji, Hamza M. R.; Aljunid, S. A.; Fadhil, Hilal A.

    2012-06-01

    The major drawback of incoherent spectral-amplitude coding optical code-division multiple-access (SAC-OCDMA) systems is their inherent intensity noise originating due to the incoherency of the broadband light sources. In this paper, we propose a developed detection technique named the modified-AND subtraction detection for incoherent SAC-OCDMA systems. This detection technique is based upon decreasing the received signal strength during the decoding process by dividing the spectrum of the utilized code sequence. The proposed technique is capable of mitigating the intensity noise effect, as well as suppressing the multiple-access interference impact. Based on modified quadratic congruence (MQC) code, the analytical results reveal that the modified-AND detection offer best bit-error rate (BER) performance and enables MQC code to support higher transmission rate up to 1.25 Gb/s compared to conventional AND detection. Furthermore, we ascertained that the proposed technique enhances the system performance using a simulation experiment.

  20. Experimental knee pain reduces muscle strength

    DEFF Research Database (Denmark)

    Henriksen, Marius; Mortensen, Sara Rosager; Aaboe, Jens

    2011-01-01

    Pain is the principal symptom in knee pathologies and reduced muscle strength is a common observation among knee patients. However, the relationship between knee joint pain and muscle strength remains to be clarified. This study aimed at investigating the changes in knee muscle strength following...... experimental knee pain in healthy volunteers, and if these changes were associated with the pain intensities. In a crossover study, 18 healthy subjects were tested on 2 different days. Using an isokinetic dynamometer, maximal muscle strength in knee extension and flexion was measured at angular velocities 0....... Knee pain reduced the muscle strength by 5 to 15% compared to the control conditions (P knee extension and flexion at all angular velocities. The reduction in muscle strength was positively correlated to the pain intensity. Experimental knee pain significantly reduced knee extension...

  1. Heuristic Data Placement for Data-Intensive Applications in Heterogeneous Cloud

    Directory of Open Access Journals (Sweden)

    Qing Zhao

    2016-01-01

    Full Text Available Data placement is an important issue which aims at reducing the cost of internode data transfers in cloud especially for data-intensive applications, in order to improve the performance of the entire cloud system. This paper proposes an improved data placement algorithm for heterogeneous cloud environments. In the initialization phase, a data clustering algorithm based on data dependency clustering and recursive partitioning has been presented, and both the factor of data size and fixed position are incorporated. And then a heuristic tree-to-tree data placement strategy is advanced in order to make frequent data movements occur on high-bandwidth channels. Simulation results show that, compared with two classical strategies, this strategy can effectively reduce the amount of data transmission and its time consumption during execution.

  2. Vitis phylogenomics: hybridization intensities from a SNP array outperform genotype calls.

    Directory of Open Access Journals (Sweden)

    Allison J Miller

    Full Text Available Understanding relationships among species is a fundamental goal of evolutionary biology. Single nucleotide polymorphisms (SNPs identified through next generation sequencing and related technologies enable phylogeny reconstruction by providing unprecedented numbers of characters for analysis. One approach to SNP-based phylogeny reconstruction is to identify SNPs in a subset of individuals, and then to compile SNPs on an array that can be used to genotype additional samples at hundreds or thousands of sites simultaneously. Although powerful and efficient, this method is subject to ascertainment bias because applying variation discovered in a representative subset to a larger sample favors identification of SNPs with high minor allele frequencies and introduces bias against rare alleles. Here, we demonstrate that the use of hybridization intensity data, rather than genotype calls, reduces the effects of ascertainment bias. Whereas traditional SNP calls assess known variants based on diversity housed in the discovery panel, hybridization intensity data survey variation in the broader sample pool, regardless of whether those variants are present in the initial SNP discovery process. We apply SNP genotype and hybridization intensity data derived from the Vitis9kSNP array developed for grape to show the effects of ascertainment bias and to reconstruct evolutionary relationships among Vitis species. We demonstrate that phylogenies constructed using hybridization intensities suffer less from the distorting effects of ascertainment bias, and are thus more accurate than phylogenies based on genotype calls. Moreover, we reconstruct the phylogeny of the genus Vitis using hybridization data, show that North American subgenus Vitis species are monophyletic, and resolve several previously poorly known relationships among North American species. This study builds on earlier work that applied the Vitis9kSNP array to evolutionary questions within Vitis vinifera

  3. The Influence of Activity-Based Funding on Treatment Intensity and Length of Stay of Geriatric Rehabilitation Patients.

    Science.gov (United States)

    Bouwstra, Hylco; Wattel, Lizette M; de Groot, Aafke J; Smalbrugge, Martin; Hertogh, Cees M

    2017-06-01

    Little is known about the impact of activity-based funding (ABF) to increase treatment intensity and decrease length of stay (LOS) of inpatient geriatric patients. In January 2014, ABF was implemented in The Netherlands with the aim to increase treatment intensity and shorten LOS in geriatric rehabilitation (GR). To describe the influence of ABF on treatment intensity and LOS of inpatient GR patients before and after ABF was implemented. Population-based, retrospective cohort study. Thirty nursing homes providing inpatient GR across The Netherlands. Digital medical records of patients who had received inpatient GR in Dutch nursing homes across The Netherlands were studied between January 1, 2013 and March 14, 2016. We calculated the mean treatment intensity in hours per week and median LOS in days in 3 cohorts according to the year of admittance. In addition, a historical representative cohort of GR patients who were admitted in 2007 was studied that represented the situation before the ABF reform was announced (eg, funding with a fixed price per day). In 2013, the funding with a fixed price per day was still in use but with compulsory ABF registration. In 2014 and 2015, the ABF was fully implemented. Statistical differences in treatment intensity and LOS were calculated between patients admitted in 2007 and 2013, 2013 and 2014, and 2013 and 2015. Statistical significance was set at a P value of <.02 (Bonferroni correction P = .05/3). Discharge destinations of patients discharged from March 1, 2015 to January 1, 2016 could be obtained and compared with 2007. The treatment intensity and LOS of 16,823 GR patients could be obtained and compared with the historical cohort from 2007 (n = 2950). Patients who were admitted in the year 2013 received higher treatment intensities and had the same median LOS compared with 2007. After the implementation of ABF in January 2014, the mean treatment intensity increased significantly by 37% (3.8 hours/week in 2013, 4.7

  4. MapReduce Based Parallel Bayesian Network for Manufacturing Quality Control

    Science.gov (United States)

    Zheng, Mao-Kuan; Ming, Xin-Guo; Zhang, Xian-Yu; Li, Guo-Ming

    2017-09-01

    Increasing complexity of industrial products and manufacturing processes have challenged conventional statistics based quality management approaches in the circumstances of dynamic production. A Bayesian network and big data analytics integrated approach for manufacturing process quality analysis and control is proposed. Based on Hadoop distributed architecture and MapReduce parallel computing model, big volume and variety quality related data generated during the manufacturing process could be dealt with. Artificial intelligent algorithms, including Bayesian network learning, classification and reasoning, are embedded into the Reduce process. Relying on the ability of the Bayesian network in dealing with dynamic and uncertain problem and the parallel computing power of MapReduce, Bayesian network of impact factors on quality are built based on prior probability distribution and modified with posterior probability distribution. A case study on hull segment manufacturing precision management for ship and offshore platform building shows that computing speed accelerates almost directly proportionally to the increase of computing nodes. It is also proved that the proposed model is feasible for locating and reasoning of root causes, forecasting of manufacturing outcome, and intelligent decision for precision problem solving. The integration of bigdata analytics and BN method offers a whole new perspective in manufacturing quality control.

  5. Light-Intensity Physical Activity and All-Cause Mortality.

    Science.gov (United States)

    Loprinzi, Paul D

    2017-07-01

    Research demonstrates that moderate-to-vigorous physical activity (MVPA) is associated with a reduced risk of all-cause mortality. Few studies have examined the effects of light-intensity physical activity on mortality. Therefore, the purpose of this study was to examine the association between objectively measured light-intensity physical activity and all-cause mortality risk. Longitudinal. National Health and Nutrition Examination Survey 2003-2006 with follow-up through December 31, 2011. Five thousand five hundred seventy-five U.S. adults. Participants wore an accelerometer for at least 4 days and completed questionnaires to assess sociodemographics and chronic disease information, with blood samples taken to assess biological markers. Follow-up mortality status was assessed via death certificate data from the National Death Index. Cox proportional hazard model. After adjusting for accelerometer-determined MVPA, age, gender, race-ethnicity, cotinine, weight status, poverty level, C-reactive protein, and comorbid illness, for every 60-minute increase in accelerometer-determined light-intensity physical activity, participants had a 16% reduced hazard of all-cause mortality (hazard ratio = .84; 95% confidence interval: .78-.91; p physical activity was inversely associated with all-cause mortality risk, independent of age, MVPA, and other potential confounders. In addition to MVPA, promotion of light-intensity physical activity is warranted.

  6. Blood component therapy in anesthesia and intensive care: Adoption of evidence based approaches

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2014-01-01

    Full Text Available Transfusion of blood and its components has undergone technological advancement, and its use is increasing both perioperatively as well as in the Intensive Care Unit. The separation of blood into its various components has made it very economical as blood donated from a single donor can be utilized for many recipients at the same time. However, the transfusion of blood and its components do carry the inherent risk of various transfusion reactions as well as transmission of infections. The indications for transfusion should be strictly adhered to for preventing nonjudicious use. The health care persons involved in transfusion should be well aware of implications of the mismatched transfusion and should be able to provide treatment if such mishaps do occur. A health care professional should carefully weigh the benefits of blood transfusion against the risks involved before subjecting the patients to the transfusion. This manuscript aims to comprehensively review the current evidence based approaches in blood and component transfusion which are being followed in anesthesiology and intensive care practice.

  7. BASE COMPOSITION OF THE DEOXYRIBONUCLEIC ACID OF SULFATE-REDUCING BACTERIA.

    Science.gov (United States)

    SIGAL, N; SENEZ, J C; LEGALL, J; SEBALD, M

    1963-06-01

    Sigal, Nicole (Laboratoire de Chimie Bactérienne du CNRS, Marseille, France), Jacques C. Senez, Jean Le Gall, and Madeleine Sebald. Base composition of the deoxyribonucleic acid of sulfate-reducing bacteria. J. Bacteriol. 85:1315-1318. 1963-The deoxyribonucleic acid constitution of several strains of sulfate-reducing bacteria has been analytically determined. The results of these studies show that this group of microorganisms includes at least four subgroups characterized by significantly different values of the adenine plus thymine to guanine plus cytosine ratio. The nonsporulated forms with polar flagellation, containing both cytochrome c(3) and desulfoviridin, are divided into two subgroups. One includes the fresh-water, nonhalophilic strains with base ratio from 0.54 to 0.59, and the other includes the halophilic or halotolerant strains with base ratio from 0.74 to 0.77. The sporulated, peritrichous strains without cytochrome and desulfoviridin ("nigrificans" and "orientis") are distinct from the above two types and differ from each other, having base ratios of 1.20 and 1.43, respectively.

  8. Cost-effectiveness of Intensive Blood Pressure Management

    DEFF Research Database (Denmark)

    Richman, Ilana B; Fairley, Michael; Jørgensen, Mads Emil

    2016-01-01

    Importance: Among high-risk patients with hypertension, targeting a systolic blood pressure of 120 mm Hg reduces cardiovascular morbidity and mortality compared with a higher target. However, intensive blood pressure management incurs additional costs from treatment and from adverse events......-effectiveness of intensive blood pressure management among 68-year-old high-risk adults with hypertension but not diabetes. We used the Systolic Blood Pressure Intervention Trial (SPRINT) to estimate treatment effects and adverse event rates. We used Centers for Disease Control and Prevention Life Tables to project age...... and accrued $155 261 in lifetime costs, while intensive management yielded 10.5 QALYs and accrued $176 584 in costs. Intensive blood pressure management cost $23 777 per QALY gained. In a sensitivity analysis, serious adverse events would need to occur at 3 times the rate observed in SPRINT and be 3 times...

  9. Temp erature-dep endent of Nonlinear Optical Conductance of Graphene-based Systems in High-intensity Terahertz Field

    Institute of Scientific and Technical Information of China (English)

    Jing Lv; Rui-yang Yuan; Hui Yan

    2014-01-01

    For multi-photon processed with the linear dispersion in the high-intensity terahertz (THz) field, we have systematically investigated the temperature-dependent nonlinear optical response of graphene-based systems, including single layer graphene, graphene superlattice and gapped graphene. In the intrinsic single layer graphene system, it demonstrates that, at low temperature, nonlinear optical conductivities of the third-and fifth-order are respectively five and ten orders of magnitude larger than the universal conductivity with high-intensity and low frequency THz wave.In the graphene superlattice and gapped graphene systems, the optical responses enhanced because of the anisotropic massless and massive Dirac fermions.

  10. A comparative study on the influential factors of China's provincial energy intensity

    International Nuclear Information System (INIS)

    Yang, Guangfei; Li, Wenli; Wang, Jianliang; Zhang, Dongqing

    2016-01-01

    China has become the largest energy consumer worldwide, and it is important to study the energy intensity to realize the sustainable development goal of China. This paper focuses on investigating the influential factors of China's energy intensity using provincial-level panel data from 1985 to 2012. More specifically, we try to identify which factor is relatively more important to pay attention to. A novel approach based on evolutionary computation is proposed to intelligently mine the intrinsic relations between observed phenomena and to let the important factors automatically emerge from the discovered nonlinear models. However, due to China's vast territory and significant heterogeneities, this approach may fail to examine some detailed or hidden information when analyzing the country as a whole. Instead, we concentrate on the provincial level because the provinces play vital roles in reducing energy intensity in China. From our analytical results, the main findings are as follows: (1) the Total Population is the most important influential factor across China's provinces, while the Energy Price Index has the least impact; and (2) the provinces could be naturally classified into four categories based on the primary factors emerged from data, and such classification could reveal more about the true underlying features of each area. - Highlights: • Identify the important factors of China's energy intensity by symbolic regression. • Analyze China's energy intensity using provincial-level panel data from 1985 to 2012. • Intelligently investigate nonlinear models and the emergence of important factors. • The Total Population is discovered to be the most important influential factor. • Provinces are naturally classified into four categories by the influential factors.

  11. elastix: a toolbox for intensity-based medical image registration.

    Science.gov (United States)

    Klein, Stefan; Staring, Marius; Murphy, Keelin; Viergever, Max A; Pluim, Josien P W

    2010-01-01

    Medical image registration is an important task in medical image processing. It refers to the process of aligning data sets, possibly from different modalities (e.g., magnetic resonance and computed tomography), different time points (e.g., follow-up scans), and/or different subjects (in case of population studies). A large number of methods for image registration are described in the literature. Unfortunately, there is not one method that works for all applications. We have therefore developed elastix, a publicly available computer program for intensity-based medical image registration. The software consists of a collection of algorithms that are commonly used to solve medical image registration problems. The modular design of elastix allows the user to quickly configure, test, and compare different registration methods for a specific application. The command-line interface enables automated processing of large numbers of data sets, by means of scripting. The usage of elastix for comparing different registration methods is illustrated with three example experiments, in which individual components of the registration method are varied.

  12. Water-saving ground cover rice production system reduces net greenhouse gas fluxes in an annual rice-based cropping system

    Science.gov (United States)

    Yao, Z.; Du, Y.; Tao, Y.; Zheng, X.; Liu, C.; Lin, S.; Butterbach-Bahl, K.

    2014-11-01

    To safeguard food security and preserve precious water resources, the technology of water-saving ground cover rice production system (GCRPS) is being increasingly adopted for rice cultivation. However, changes in soil water status and temperature under GCRPS may affect soil biogeochemical processes that control the biosphere-atmosphere exchanges of methane (CH4), nitrous oxide (N2O) and carbon dioxide (CO2). The overall goal of this study is to better understand how net ecosystem greenhouse gas exchanges (NEGE) and grain yields are affected by GCRPS in an annual rice-based cropping system. Our evaluation was based on measurements of the CH4 and N2O fluxes and soil heterotrophic respiration (CO2 emissions) over a complete year, and the estimated soil carbon sequestration intensity for six different fertilizer treatments for conventional paddy and GCRPS. The fertilizer treatments included urea application and no N fertilization for both conventional paddy (CUN and CNN) and GCRPS (GUN and GNN), and solely chicken manure (GCM) and combined urea and chicken manure applications (GUM) for GCRPS. Averaging across all the fertilizer treatments, GCRPS increased annual N2O emission and grain yield by 40 and 9%, respectively, and decreased annual CH4 emission by 69%, while GCRPS did not affect soil CO2 emissions relative to the conventional paddy. The annual direct emission factors of N2O were 4.01, 0.09 and 0.50% for GUN, GCM and GUM, respectively, and 1.52% for the conventional paddy (CUN). The annual soil carbon sequestration intensity under GCRPS was estimated to be an average of -1.33 Mg C ha-1 yr-1, which is approximately 44% higher than the conventional paddy. The annual NEGE were 10.80-11.02 Mg CO2-eq ha-1 yr-1 for the conventional paddy and 3.05-9.37 Mg CO2-eq ha-1 yr-1 for the GCRPS, suggesting the potential feasibility of GCRPS in reducing net greenhouse effects from rice cultivation. Using organic fertilizers for GCRPS considerably reduced annual emissions of CH4

  13. Box-particle intensity filter

    OpenAIRE

    Schikora, Marek; Gning, Amadou; Mihaylova, Lyudmila; Cremers, Daniel; Koch, Wofgang; Streit, Roy

    2012-01-01

    This paper develops a novel approach for multi-target tracking, called box-particle intensity filter (box-iFilter). The approach is able to cope with unknown clutter, false alarms and estimates the unknown number of targets. Furthermore, it is capable of dealing with three sources of uncertainty: stochastic, set-theoretic and data association uncertainty. The box-iFilter reduces the number of particles significantly, which improves the runtime considerably. The low particle number enables thi...

  14. Noise Source Identification of a Ring-Plate Cycloid Reducer Based on Coherence Analysis

    OpenAIRE

    Yang, Bing; Liu, Yan

    2013-01-01

    A ring-plate-type cycloid speed reducer is one of the most important reducers owing to its low volume, compactness, smooth and high performance, and high reliability. The vibration and noise tests of the reducer prototype are completed using the HEAD acoustics multichannel noise test and analysis system. The characteristics of the vibration and noise are obtained based on coherence analysis and the noise sources are identified. The conclusions provide the bases for further noise research and ...

  15. Real-Time Earthquake Intensity Estimation Using Streaming Data Analysis of Social and Physical Sensors

    Science.gov (United States)

    Kropivnitskaya, Yelena; Tiampo, Kristy F.; Qin, Jinhui; Bauer, Michael A.

    2017-06-01

    Earthquake intensity is one of the key components of the decision-making process for disaster response and emergency services. Accurate and rapid intensity calculations can help to reduce total loss and the number of casualties after an earthquake. Modern intensity assessment procedures handle a variety of information sources, which can be divided into two main categories. The first type of data is that derived from physical sensors, such as seismographs and accelerometers, while the second type consists of data obtained from social sensors, such as witness observations of the consequences of the earthquake itself. Estimation approaches using additional data sources or that combine sources from both data types tend to increase intensity uncertainty due to human factors and inadequate procedures for temporal and spatial estimation, resulting in precision errors in both time and space. Here we present a processing approach for the real-time analysis of streams of data from both source types. The physical sensor data is acquired from the U.S. Geological Survey (USGS) seismic network in California and the social sensor data is based on Twitter user observations. First, empirical relationships between tweet rate and observed Modified Mercalli Intensity (MMI) are developed using data from the M6.0 South Napa, CAF earthquake that occurred on August 24, 2014. Second, the streams of both data types are analyzed together in simulated real-time to produce one intensity map. The second implementation is based on IBM InfoSphere Streams, a cloud platform for real-time analytics of big data. To handle large processing workloads for data from various sources, it is deployed and run on a cloud-based cluster of virtual machines. We compare the quality and evolution of intensity maps from different data sources over 10-min time intervals immediately following the earthquake. Results from the joint analysis shows that it provides more complete coverage, with better accuracy and higher

  16. Use of active noise cancellation devices in caregivers in the intensive care unit.

    Science.gov (United States)

    Akhtar, S; Weigle, C G; Cheng, E Y; Toohill, R; Berens, R J

    2000-04-01

    Recent development of noise cancellation devices may offer relief from noise in the intensive care unit environment. This study was conducted to evaluate the effect of noise cancellation devices on subjective hearing assessment by caregivers in the intensive care units. Randomized, double-blind. Adult medical intensive care unit and pediatric intensive care unit of a teaching hospital. Caregivers of patients, including nurses, parents, respiratory therapists, and nursing assistants from a medical intensive care unit and pediatric intensive care, were enrolled in the study. Each participant was asked to wear the headphones, functional or nonfunctional noise cancellation devices, for a minimum of 30 mins. Subjective ambient noise level was assessed on a 10-point visual analog scale (VAS) before and during headphone use by each participant. Headphone comfort and the preference of the caregiver to wear the headphone were also evaluated on a 10-point VAS. Simultaneously, objective measurement of noise was done with a sound level meter using the decibel-A scale and at each of nine octave bands at each bedspace. The functional headphones significantly reduced the subjective assessment of noise by 2 (out of 10) VAS points (p noise profiles, based on decibel-A and octave band assessments. Noise cancellation devices improve subjective assessment of noise in caretakers. The benefit of these devices on hearing loss needs further evaluation in caregivers and critically ill patients.

  17. [Successful treatment with reduced-intensity cord blood transplantation for acute myeloid leukemia with complete tetraploidy (92, XXXX)].

    Science.gov (United States)

    Iwasaki, Junko; Onozawa, Masahiro; Takahashi, Shojiro; Okada, Kohei; Takahata, Mutsumi; Shigematsu, Akio; Kahata, Kaoru; Kondo, Takeshi; Hashino, Satoshi; Imamura, Masahiro; Asaka, Masahiro

    2011-03-01

    A 56-year-old female was diagnosed with acute myeloid leukemia (FAB: AML-M1). G-banding karyotype of her bone marrow showed complete tetraploidy (92, XXXX [24/24]). Although she achieved complete remission (CR) after induction therapy and maintained CR during consolidation therapy, relapse occurred only 2 months after discharge. When the relapse occurred, bone marrow karyotypic analysis showed complete tetraploidy again. The patient received reduced-intensity cord blood transplantation (RI-CBT), which induced CR for the second time. The patient is currently alive 24 months after transplantation and there have not been any signs of recurrence to date. There have been a few reports of AML with near-tetraploidy, but cases of AML with complete tetraploidy are extremely rare. Tetraploid AML has been reported to have a poor prognosis and there have been very few cases maintaining CR over the long term after chemotherapy alone. This is the first case of complete tetraploid AML successfully treated by RI-CBT. The clinical course of this case suggests that hematopoietic stem cell transplantation during the first CR phase should be considered a treatment option for tetraploid AML.

  18. Stabilization of the Beam Intensity in the Linac at the CTF3 CLIC Test Facility

    CERN Document Server

    Dubrovskiy, A; Bathe, BN; Srivastava, S

    2013-01-01

    A new electron beam stabilization system has been introduced in CTF3 in order to open new possibilities for CLIC beam studies in ultra-stable conditions and to provide a sustainable tool to keep the beam intensity and energy at its reference values for long term operations. The stabilization system is based on a pulse-to-pulse feedback control of the electron gun to compensate intensity deviations measured at the end of the injector and at the beginning of the linac. Thereby it introduces negligible beam distortions at the end of the linac and it significantly reduces energy deviations. A self-calibration mechanism has been developed to automatically configure the feedback controller for the optimum performance. The residual intensity jitter of 0.045% of the stabilized beam was measured whereas the CLIC requirement is 0.075%.

  19. Energy intensities: Prospects and potential

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    In the previous chapter, the author described how rising activity levels and structural change are pushing toward higher energy use in many sectors and regions, especially in the developing countries. The extent to which more activity leads to greater energy use will depend on the energy intensity of end-use activities. In this chapter, the author presents an overview of the potential for intensity reductions in each sector over the next 10-20 years. It is not the author's intent to describe in detail the various technologies that could be employed to improve energy efficiency, which has been done by others (see, for example, Lovins ampersand Lovins, 1991; Goldembert et al., 1987). Rather, he discusses the key factors that will shape future energy intensities in different parts of the world, and gives a sense for the changes that could be attained if greater attention were given to accelerate efficiency improvement. The prospects for energy intensities, and the potential for reduction, vary among sectors and parts of the world. In the majority of cases, intensities are tending to decline as new equipment and facilities come into use and improvements are made on existing stocks. The effect of stock turnover will be especially strong in the developing countries, where stocks are growing at a rapid pace, and the Former East Bloc, where much of the existing industrial plant will eventually be retired and replaced with more modern facilities. While reductions in energy intensity are likely in most areas, there is a large divergence between the technical and economic potential for reducing energy intensities and the direction in which present trends are moving. In the next chapter, the author presents scenarios that illustrate where trends are pointing, and what could be achieved if improving energy efficiency were a focus of public policies. 53 refs., 4 figs., 2 tabs

  20. Growth performance, carcass yield and gait score of Marshal broiler chicken reared on intensive and semi intensive management systems

    Directory of Open Access Journals (Sweden)

    Oluwadiya, B. O.

    2017-06-01

    Full Text Available The rearing system used in highly productive farms is often subjected to harsh criticism, one of the reasons being its failure to provide adequate welfare. A number of attempts have been made to introduce new technologies in rearing poultry for meat production aiming at improving rearing conditions, protecting the environment and enhancing the quality of poultry products. Given the above, one hundred and sixty eight unsexed 14-day old Marshall broiler chicks were used in a completely randomized design study to compare the effect of management systems (intensive and semi intensive on the growth performance, carcass characteristics and gait score of broiler chickens. The experiment lasted for 42 d. Data were collected on weight gain, feed intake, feed conversion ratio, carcass yield and gait score. Result showed that birds on the intensive management system recorded higher weight gain (P 0.05; 66.94%, 11.44% than those in semi-intensive system (54.55%, 10.92%, respectively. For the gait score broiler birds on semi intensive management system recorded reduced number of cases of severe and slight leg problems (P < 0.05, 25.76% vs 49.3%. It was concluded that broiler birds should be reared on intensive management system for better growth performance and carcass yield. However, birds reared on semi intensive management system had fewer leg problems compared to birds reared on intensive management system. The fewer severe leg problems observed in birds on semi intensive management system will help improve their market value thereby making birds more profitable to rear on semi intensive management system.

  1. Key elements of successful intensive therapy in patients with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Banshi Saboo

    2015-01-01

    Full Text Available An intensified diabetes management approach (including increased education, monitoring, and contact with diabetes team should be used for adolescents and also for younger children if glycaemic control is not achieved by insulin therapy. Treatment options may include increased frequency of injections (e.g. the patients on 2 bolus may require 3 or 4 bolus injections, change in the type of basal and/or bolus insulin depending on multiple times monitoring for adolescents and for younger children, and change to continuous subcutaneous insulin infusion pump therapy. Results of epidemiology of diabetes interventions and complications (EDIC Research Group, where the Diabetes Control and Complications Trial patients were further followed up almost for a period of 7 years or more showed that intensive therapy significantly reduced and maintained glycated hemoglobin with relative risk reduction of microvascular complications in the intensive therapy group. In addition, intensive treatment reduced the risk of any cardiovascular disease (CVD event by 42% and the risk of nonfatal myocardial infarction, stroke, or death from CVD by 57%. The reduction of microvascular and macrovascular events in the intensively-treated group persisted due to the "legacy effect" or "metabolic memory" of early intensive glycemic control. The main advantage of intensive insulin therapy is that it reduces the rate of diabetes complications, in the long run. Furthermore, it offers flexibility as the doses can be adjusted according to the activity and food consumed. The main disadvantage of intensive insulin therapy is the risk of hypoglycemia especially in type 1 diabetes mellitus and weight gain.

  2. Effects of intense ultraviolet radiation on electrostatic energy analyzers

    International Nuclear Information System (INIS)

    Mathew, J.; Jennings, W.C.; Hickok, R.L.; Connor, K.A.; Schoch, P.M.; Hallock, G.A.

    1984-01-01

    Intense ultraviolet radiation from the plasma poses a significant problem for the implementation of heavy ion beam probe diagnostic systems on fusion-oriented confinement devices. The radiation enters the electrostatic energy analyzer used to detect secondary ions, resulting in both a distortion of the electric field inside the analyzer and noise generation in the detector channels. Data acquisition procedures and mechanical design techniques have been developed to significantly reduce these effects. We have also been successful in modelling the electric field distortion and have developed a data correction procedure based on this model. Methods for approaching the problems anticipated in future devices are also suggested

  3. Introducing the Comprehensive Unit-based Safety Program for mechanically ventilated patients in Saudi Arabian Intensive Care Units

    Directory of Open Access Journals (Sweden)

    Raymond M Khan

    2017-01-01

    Full Text Available Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs. Earlier initiatives used the concept of ventilator care bundles (sets of interventions, with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization. The approach of the Comprehensive Unit-based Safety Program (CUSP was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework. In August 2015, 17 Intensive Care Units (ICUs (a total of 271 beds in eight hospitals in the Kingdom of Saudi Arabia joined the CUSP for MVPs (CUSP 4 MVP that was conducted in 235 ICUs in 169 US hospitals and led by the Johns Hopkins Armstrong Institute for Patient Safety and Quality. The CUSP 4 MVP project will set the stage for cooperation between multiple hospitals and thus strives to create a countrywide plan for the management of all MVPs in Saudi Arabia.

  4. Effects of alcohols on fluorescence intensity and color of a discharged-obelin-based biomarker.

    Science.gov (United States)

    Alieva, Roza R; Belogurova, Nadezhda V; Petrova, Alena S; Kudryasheva, Nadezhda S

    2014-05-01

    Photoproteins are responsible for bioluminescence of marine coelenterates; bioluminescent and fluorescent biomarkers based on photoproteins are useful for monitoring of calcium-dependent processes in medical investigations. Here, we present the analysis of intensity and color of light-induced fluorescence of Ca(2+)-discharged photoprotein obelin in the presence of alcohols (ethanol and glycerol). Complex obelin spectra obtained at different concentrations of the alcohols at 350- and 280-nm excitation (corresponding to polypeptide-bound coelenteramide and tryptophan absorption regions) were deconvoluted into Gaussian components; fluorescent intensity and contributions of the components to experimental spectra were analyzed. Five Gaussian components were found in different spectral regions-ultraviolet (tryptophan emission), blue-green (coelenteramide emission), and red (hypothetical indole-coelenteramide exciplex emission). Inhibition coefficients and contributions of the components to experimental fluorescent spectra showed that presence of alcohols increased contributions of ultraviolet, violet, and red components, but decreased contributions of components in the blue-green region. The effects were related to (1) changes of proton transfer efficiency in fluorescent S*1 state of coelenteramide in the obelin active center and (2) formation of indole-coelenteramide exciplex at 280-nm photoexcitation. The data show that variation of fluorescence color and intensity in the presence of alcohols and dependence of emission spectra on excitation wavelength should be considered while applying the discharged obelin as a fluorescence biomarker.

  5. Efficiency of analytical and sampling-based uncertainty propagation in intensity-modulated proton therapy

    Science.gov (United States)

    Wahl, N.; Hennig, P.; Wieser, H. P.; Bangert, M.

    2017-07-01

    The sensitivity of intensity-modulated proton therapy (IMPT) treatment plans to uncertainties can be quantified and mitigated with robust/min-max and stochastic/probabilistic treatment analysis and optimization techniques. Those methods usually rely on sparse random, importance, or worst-case sampling. Inevitably, this imposes a trade-off between computational speed and accuracy of the uncertainty propagation. Here, we investigate analytical probabilistic modeling (APM) as an alternative for uncertainty propagation and minimization in IMPT that does not rely on scenario sampling. APM propagates probability distributions over range and setup uncertainties via a Gaussian pencil-beam approximation into moments of the probability distributions over the resulting dose in closed form. It supports arbitrary correlation models and allows for efficient incorporation of fractionation effects regarding random and systematic errors. We evaluate the trade-off between run-time and accuracy of APM uncertainty computations on three patient datasets. Results are compared against reference computations facilitating importance and random sampling. Two approximation techniques to accelerate uncertainty propagation and minimization based on probabilistic treatment plan optimization are presented. Runtimes are measured on CPU and GPU platforms, dosimetric accuracy is quantified in comparison to a sampling-based benchmark (5000 random samples). APM accurately propagates range and setup uncertainties into dose uncertainties at competitive run-times (GPU ≤slant {5} min). The resulting standard deviation (expectation value) of dose show average global γ{3% / {3}~mm} pass rates between 94.2% and 99.9% (98.4% and 100.0%). All investigated importance sampling strategies provided less accuracy at higher run-times considering only a single fraction. Considering fractionation, APM uncertainty propagation and treatment plan optimization was proven to be possible at constant time complexity

  6. Dosimetric comparison between intensity modulated brachytherapy versus external beam intensity modulated radiotherapy for cervix cancer: a treatment planning study

    International Nuclear Information System (INIS)

    Subramani, V.; Sharma, D.N.; Jothy Basu, K.S.; Rath, G.K.; Gopishankar, N.

    2008-01-01

    To evaluate the dosimetric superiority of intensity modulated brachytherapy (IMBT) based on inverse planning optimization technique with classical brachytherapy optimization and also with external beam intensity modulated radiotherapy planning technique in patients of cervical carcinoma

  7. Quercetin Inhibits Peripheral and Spinal Cord Nociceptive Mechanisms to Reduce Intense Acute Swimming-Induced Muscle Pain in Mice

    Science.gov (United States)

    Borghi, Sergio M.; Pinho-Ribeiro, Felipe A.; Fattori, Victor; Bussmann, Allan J. C.; Vignoli, Josiane A.; Camilios-Neto, Doumit; Casagrande, Rubia; Verri, Waldiceu A.

    2016-01-01

    The present study aimed to evaluate the effects of the flavonoid quercetin (3,3´,4´,5,7-pentahydroxyflavone) in a mice model of intense acute swimming-induced muscle pain, which resembles delayed onset muscle soreness. Quercetin intraperitoneal (i.p.) treatment dose-dependently reduced muscle mechanical hyperalgesia. Quercetin inhibited myeloperoxidase (MPO) and N-acetyl-β-D- glucosaminidase (NAG) activities, cytokine production, oxidative stress, cyclooxygenase-2 (COX-2) and gp91phox mRNA expression and muscle injury (creatinine kinase [CK] blood levels and myoblast determination protein [MyoD] mRNA expression) as well as inhibited NFκB activation and induced Nrf2 and HO-1 mRNA expression in the soleus muscle. Beyond inhibiting those peripheral effects, quercetin also inhibited spinal cord cytokine production, oxidative stress and glial cells activation (glial fibrillary acidic protein [GFAP] and ionized calcium-binding adapter molecule 1 [Iba-1] mRNA expression). Concluding, the present data demonstrate that quercetin is a potential molecule for the treatment of muscle pain conditions related to unaccustomed exercise. PMID:27583449

  8. SPES: A new cyclotron-based facility for research and applications with high-intensity beams

    Science.gov (United States)

    Maggiore, M.; Campo, D.; Antonini, P.; Lombardi, A.; Manzolaro, M.; Andrighetto, A.; Monetti, A.; Scarpa, D.; Esposito, J.; Silvestrin, L.

    2017-06-01

    In 2016, Laboratori Nazionali di Legnaro (Italy) started the commissioning of a new accelerator facility based on a high-power cyclotron able to deliver proton beams up to 70 MeV of energy and 700 μA current. Such a machine is the core of the Selective Production of Exotic Species (SPES) project whose main goal is to provide exotics beam for nuclear and astrophysics research and to deliver high-intensity proton beams for medical applications and neutrons generator.

  9. Expansion of donor-reactive host T cells in primary graft failure after allogeneic hematopoietic SCT following reduced-intensity conditioning.

    Science.gov (United States)

    Koyama, M; Hashimoto, D; Nagafuji, K; Eto, T; Ohno, Y; Aoyama, K; Iwasaki, H; Miyamoto, T; Hill, G R; Akashi, K; Teshima, T

    2014-01-01

    Graft rejection remains a major obstacle in allogeneic hematopoietic SCT following reduced-intensity conditioning (RIC-SCT), particularly after cord blood transplantation (CBT). In a murine MHC-mismatched model of RIC-SCT, primary graft rejection was associated with activation and expansion of donor-reactive host T cells in peripheral blood and BM early after SCT. Donor-derived dendritic cells are at least partly involved in host T-cell activation. We then evaluated if such an expansion of host T cells could be associated with graft rejection after RIC-CBT. Expansion of residual host lymphocytes was observed in 4/7 patients with graft rejection at 3 weeks after CBT, but in none of the 17 patients who achieved engraftment. These results suggest the crucial role of residual host T cells after RIC-SCT in graft rejection and expansion of host T cells could be a marker of graft rejection. Development of more efficient T cell-suppressive conditioning regimens may be necessary in the context of RIC-SCT.

  10. Intensity-based fibre-optic sensing system using contrast modulation of subcarrier interference pattern

    Science.gov (United States)

    Adamovsky, G.; Sherer, T. N.; Maitland, D. J.

    1989-01-01

    A novel technique to compensate for unwanted intensity losses in a fiber-optic sensing system is described. The technique involves a continuous sinusoidal modulation of the light source intensity at radio frequencies and an intensity sensor placed in an unbalanced interferometer. The system shows high sensitivity and stability.

  11. Quantification of Parkinson Tremor Intensity Based On EMG Signal Analysis Using Fast Orthogonal Search Algorithm

    Directory of Open Access Journals (Sweden)

    H. Rezghian Moghadam

    2018-06-01

    Full Text Available The tremor injury is one of the common symptoms of Parkinson's disease. The patients suffering from Parkinson's disease have difficulty in controlling their movements owing to tremor. The intensity of the disease can be determined through specifying the range of intensity values of involuntary tremor in Parkinson patients. The level of disease in patients is determined through an empirical range of 0-5. In the early stages of Parkinson, resting tremor can be very mild and intermittent. So, diagnosing the levels of disease is difficult but important since it has only medication therapy. The aim of this study is to quantify the intensity of tremor by the analysis of electromyogram signal. The solution proposed in this paper is to employ a polynomial function model to estimate the Unified Parkinson's Disease Rating Scale (UPDRS value. The algorithm of Fast Orthogonal Search (FOS, which is based on identification of orthogonal basic functions, was utilized for model identification. In fact, some linear and nonlinear features extracted from wrist surface electromyogram signal were considered as the input of the model identified by FOS, and the model output was the UPDRS value. In this research, the proposed model was designed based on two different structures which have been called the single structure and parallel structure. The efficiency of designed models with different structures was evaluated. The evaluation results using K-fold cross validation approach showed that the proposed model with a parallel structure could determine the tremor severity of the Parkinson's disease with accuracy of 99.25% ±0.41, sensitivity of 97.17% ±1.9 and specificity of 99.72% ±0.18.

  12. Therapeutic advancement of chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Lu Kang

    2012-09-01

    Full Text Available Abstract Despite the combinations of chemotherapy with monoclonal antibodies have further improved response rates, chronic lymphocytic leukemia (CLL remains an incurable disease with an extremely variable course. This article reviews the ongoing clinical advances in the treatment of CLL in both previously untreated and relapsed disease and focuses on the benefit of different therapeutic strategies, the most effective therapy combinations and the potential activity of novel agents. Novel agents and combination therapies have been investigated by several studies in both the upfront and relapsed setting, particularly for patients with 17p deletion, TP53 mutation and fludarabine-refractory CLL. While these agents and combination therapies have improved initial response rates, ongoing studies are continued to determine and improve the efficacy and safety. Despite advancements in the treatment of CLL have led to high response rates, allogeneic hematopoietic stem cell transplantation (allo-HSCT remains the only curative option and reduced-intensity conditioning (RIC allo-HSCT must be strongly considered whenever feasible. As such, ongoing studies of these agents and other novel approaches in clinical development are needed to expand and improve treatment options for CLL patients.

  13. Intense low energy positron beams

    International Nuclear Information System (INIS)

    Lynn, K.G.; Jacobsen, F.M.

    1993-01-01

    Intense positron beams are under development or being considered at several laboratories. Already today a few accelerator based high intensity, low brightness e + beams exist producing of the order of 10 8 - 10 9 e + /sec. Several laboratories are aiming at high intensity, high brightness e + beams with intensities greater than 10 9 e + /sec and current densities of the order of 10 13 - 10 14 e + sec - 1 cm -2 . Intense e + beams can be realized in two ways (or in a combination thereof) either through a development of more efficient B + moderators or by increasing the available activity of B + particles. In this review we shall mainly concentrate on the latter approach. In atomic physics the main trust for these developments is to be able to measure differential and high energy cross-sections in e + collisions with atoms and molecules. Within solid state physics high intensity, high brightness e + beams are in demand in areas such as the re-emission e + microscope, two dimensional angular correlation of annihilation radiation, low energy e + diffraction and other fields. Intense e + beams are also important for the development of positronium beams, as well as exotic experiments such as Bose condensation and Ps liquid studies

  14. Intensity modulated tangential beam irradiation of the intact breast

    International Nuclear Information System (INIS)

    Hong, L.; Hunt, M.; Chui, C.; Forster, K.; Lee, H.; Lutz, W.; Yahalom, J.; Kutcher, G.J.; McCormick, B.

    1997-01-01

    the left breast, the mean dose to the peripheral branches of the coronary artery decreased 50% with intensity modulation compared with the conventional plan (from 36 Gy to 18 Gy based on a 46 Gy prescription). Dose to the origin of the coronary artery decreased by 50% also (from 26 Gy to 13 Gy). The lung volume irradiated to doses of 20 Gy or greater decreased by 25%. In general, dose homogeneity within the target volume improved approximately 10% with intensity modulation. The improvement was observed primarily in the superior and inferior regions of the breast although some decrease in the medial and lateral hot spots were observed. Improved homogeneity compared to conventional tangential wedged fields can also be obtained using 'standard' intensity profiles chosen from a library. Conclusion: The use of intensity modulation with standard tangential breast fields can significantly reduce the dose received by normal lung, contralateral breast and coronary arteries during treatment of the intact breast. Improvements in dose homogeneity throughout the target volume can also be achieved, particularly in the superior and inferior regions of the breast. By continuing to use a standard tangential beam arrangement, the improvements in normal tissue doses and target uniformity gained through intensity modulation can be achieved without significantly increasing treatment complexity

  15. Numerical evaluation of droplet sizing based on the ratio of fluorescent and scattered light intensities (LIF/Mie technique)

    International Nuclear Information System (INIS)

    Charalampous, Georgios; Hardalupas, Yannis

    2011-01-01

    The dependence of fluorescent and scattered light intensities from spherical droplets on droplet diameter was evaluated using Mie theory. The emphasis is on the evaluation of droplet sizing, based on the ratio of laser-induced fluorescence and scattered light intensities (LIF/Mie technique). A parametric study is presented, which includes the effects of scattering angle, the real part of the refractive index and the dye concentration in the liquid (determining the imaginary part of the refractive index). The assumption that the fluorescent and scattered light intensities are proportional to the volume and surface area of the droplets for accurate sizing measurements is not generally valid. More accurate sizing measurements can be performed with minimal dye concentration in the liquid and by collecting light at a scattering angle of 60 deg. rather than the commonly used angle of 90 deg. Unfavorable to the sizing accuracy are oscillations of the scattered light intensity with droplet diameter that are profound at the sidescatter direction (90 deg.) and for droplets with refractive indices around 1.4.

  16. Reducing discards without reducing profit: Free gear choice in a Danish result-based management trial

    DEFF Research Database (Denmark)

    Mortensen, Lars O.; Ulrich, Clara; Qvist Eliasen, Søren

    2017-01-01

    The 2013 Common Fisheries Policy introduced a landing obligation on a range of species. This is changing the fundamental principles on which EU fisheries management is based, with more focus on the full accountability of all catches (a move towards catch quota management) and less accountability...... on the means used to obtain these catches (a move towards results-based management). To investigate the potentials and challenges that these paradigm shifts give rise to, a 6-months ‘unrestricted gear’ trial was performed in Denmark in 2015,. Twelve trawlers of different size, rigging, fishing area and target......, where unwanted catches could be reduced to some extent without negative effects on economic viability. Some practical implementation challenges were nevertheless encountered, which are discussed in the perspective of implementing results-based management at full scale....

  17. The reduced VAT rate for small business in Croatia

    Directory of Open Access Journals (Sweden)

    Mira Dimitrić

    2009-06-01

    Full Text Available This paper assesses the potential effects of introduction of the reduced VAT rate for small business, based on the EU VAT legislation development. The analysis includes effects on prices, sales, shadow economy and employment. It starts with the assumption of no substantial effect. Survey for Croatia is done by small business owners’ interviews and encompasses descriptive and inferential statistics based on parametric tests. The EU expected existence of a link between VAT reduction, price reduction, sales increase and positive effects on employment (as well as decline in the shadow economy is proved even in this research. However, the pass-through to prices is very moderate as well as other effects. The reduced VAT rate could have some positive results for the restaurants and bars only. There exists also some possibility for construction of housing and construction services related to housing as well as some other labour intensive services.

  18. Chemo-radiotherapy for localized pancreatic cancer: increased dose intensity and reduced acute toxicity with concomitant radiotherapy and protracted venous infusion 5-fluorouracil

    International Nuclear Information System (INIS)

    Poen, Joseph C.; Collins, Helen L.; Niederhuber, John E.; Oberhelman, Harry A.; Vierra, Mark A.; Bastidas, Augusto J.; Young, Harvey S.; Slosberg, Edward A.; Jeffrey, Brooke R.; Longacre, Teri A.; Goffinet, Don R.

    1996-01-01

    intensity was significantly greater for the PVI treatment group. Cumulative 5-FU dose (mean = 7.1 gm/m 2 vs. 2.5 gm/m 2 , p 2 /wk vs. 0.5 gm/m2/wk, p < 0.001) were significantly higher in patients receiving PVI 5-FU. Following pancreaticoduodenectomy, 93% of those receiving PVI 5-FU were able to maintain a radiotherapy dose intensity of ≥ 900 cGy/wk throughout treatment, compared with 63% of those receiving bolus 5-FU (p = 0.03). No difference was seen for patients with locally advanced disease (67% vs. 76%, p = ns). Hematologic toxicity was reduced for patients receiving PVI 5-FU. Grade II-III neutropenia was less common for patients treated with PVI (10% vs. 34%, p = 0.04) compared with patients receiving bolus 5-FU. Thrombocytopenia was limited to Grade I in both treatment groups. Gastrointestinal toxicity as assessed by percent body weight loss during treatment was similar in the two treatment groups and was independent of disease stage. Mean percent weight loss for PVI and bolus 5-FU regimens were 4.7% and 4.1%, respectively (p = ns). Weight loss ≥ 5% body weight (32% vs. 31%) and ≥ 10% (10% vs. 7.7%, p = ns) were also similar between treatment groups. RT treatment interruptions for hematologic, gastrointestinal or other acute toxicities were less common for patients receiving PVI 5-FU (5% vs. 20%, p = 0.11) compared with patients receiving bolus 5-FU. Conclusion: Concurrent radiotherapy and protracted venous infusion 5-FU was well tolerated treatment for patients with localized pancreatic cancer and allowed for a 2.6 fold increase in 5-FU dose intensity for all patients, significantly greater radiotherapy dose intensity for resected patients and equivalent or reduced acute hematologic and gastrointestinal toxicity. Longer follow-up will be needed to assess late effects and the impact on overall survival

  19. High-Intensity Interval Training in Patients With Heart Failure With Reduced Ejection Fraction.

    Science.gov (United States)

    Ellingsen, Øyvind; Halle, Martin; Conraads, Viviane; Støylen, Asbjørn; Dalen, Håvard; Delagardelle, Charles; Larsen, Alf-Inge; Hole, Torstein; Mezzani, Alessandro; Van Craenenbroeck, Emeline M; Videm, Vibeke; Beckers, Paul; Christle, Jeffrey W; Winzer, Ephraim; Mangner, Norman; Woitek, Felix; Höllriegel, Robert; Pressler, Axel; Monk-Hansen, Tea; Snoer, Martin; Feiereisen, Patrick; Valborgland, Torstein; Kjekshus, John; Hambrecht, Rainer; Gielen, Stephan; Karlsen, Trine; Prescott, Eva; Linke, Axel

    2017-02-28

    Small studies have suggested that high-intensity interval training (HIIT) is superior to moderate continuous training (MCT) in reversing cardiac remodeling and increasing aerobic capacity in patients with heart failure with reduced ejection fraction. The present multicenter trial compared 12 weeks of supervised interventions of HIIT, MCT, or a recommendation of regular exercise (RRE). Two hundred sixty-one patients with left ventricular ejection fraction ≤35% and New York Heart Association class II to III were randomly assigned to HIIT at 90% to 95% of maximal heart rate, MCT at 60% to 70% of maximal heart rate, or RRE. Thereafter, patients were encouraged to continue exercising on their own. Clinical assessments were performed at baseline, after the intervention, and at follow-up after 52 weeks. Primary end point was a between-group comparison of change in left ventricular end-diastolic diameter from baseline to 12 weeks. Groups did not differ in age (median, 60 years), sex (19% women), ischemic pathogenesis (59%), or medication. Change in left ventricular end-diastolic diameter from baseline to 12 weeks was not different between HIIT and MCT ( P =0.45); left ventricular end-diastolic diameter changes compared with RRE were -2.8 mm (-5.2 to -0.4 mm; P =0.02) in HIIT and -1.2 mm (-3.6 to 1.2 mm; P =0.34) in MCT. There was also no difference between HIIT and MCT in peak oxygen uptake ( P =0.70), but both were superior to RRE. However, none of these changes was maintained at follow-up after 52 weeks. Serious adverse events were not statistically different during supervised intervention or at follow-up at 52 weeks (HIIT, 39%; MCT, 25%; RRE, 34%; P =0.16). Training records showed that 51% of patients exercised below prescribed target during supervised HIIT and 80% above target in MCT. HIIT was not superior to MCT in changing left ventricular remodeling or aerobic capacity, and its feasibility remains unresolved in patients with heart failure. URL: http

  20. Reducing the Probability of Incidents Through Behavior-Based Safety -- An Anomaly or Not?

    International Nuclear Information System (INIS)

    Turek, John A

    2002-01-01

    Reducing the probability of incidents through Behavior-Based Safety--an anomaly or not? Can a Behavior-Based Safety (BBS) process reduce the probability of an employee sustaining a work-related injury or illness? This presentation describes the actions taken to implement a sustainable BBS process and evaluates its effectiveness. The BBS process at the Stanford Linear Accelerator Center used a pilot population of national laboratory employees to: Achieve employee and management support; Reduce the probability of employees' sustaining work-related injuries and illnesses; and Provide support for additional funding to expand within the laboratory

  1. Forecast-based Interventions Can Reduce the Health and Economic Burden of Wildfires

    Science.gov (United States)

    We simulated public health forecast-based interventions during a wildfire smoke episode in rural North Carolina to show the potential for use of modeled smoke forecasts toward reducing the health burden and showed a significant economic benefit of reducing exposures. Daily and co...

  2. Effects of high-intensity training on cardiovascular risk factors in pre- and postmenopausal women

    DEFF Research Database (Denmark)

    Mandrup Jensen, Camilla Maria; Egelund, Jon; Nyberg, Michael Permin

    2017-01-01

    and cardiovascular disease in late pre- and early postmenopausal women, matched by age and body composition, and investigate the effect of high-intensity training. METHODS: A 3-month high-intensity aerobic training intervention, involving healthy, non-obese, late pre- (n=40) and early postmenopausal (n=39) women....... A three month intervention of high-intensity aerobic training reduces risk factors for type 2 diabetes and cardiovascular disease to a similar extent in late pre- and early postmenopausal women....... the postmenopausal women had higher total cholesterol (ptraining intervention reduced body weight (p

  3. The decline of sectorial components of the world's energy intensity

    International Nuclear Information System (INIS)

    Goldemberg, José; Siqueira Prado, Luiz Tadeo

    2013-01-01

    The world's primary energy consumption in the last 40 years has been increasing at 2.2%/year while GDP growth has been 3.4%/years over the same period. The decline of the energy intensity (I=E/GDP) has been, therefore, of 1.2%/year. In order to reduce the world's consumption growth proposal have been made to reduce the world's energy intensity by 40% by 2030 which corresponds to a reduction of 2.5%/year, roughly the double of the historical decline. Our analysis shoes that such goal could only be achieved by an unprecedented reduction of the energy intensity of “services” (which represent less than half the world energy consumption) since energy intensity of industry has remained practically constant in the last 40 years. - Highlights: ► GDP and world's energy consumption are split in 2 main sectors: industry and “services”, etc. ► The evolution of the energy intensity for these sectors since 1971 is calculated. ► The energy intensity of the industry sector is practically constant since 1971. ► All the decline of the energy intensity since 1971 comes from the “services” sector

  4. EU-US differences in the size of R&D intensive firms : Do they explain the overall R&D intensity gap?

    NARCIS (Netherlands)

    Ortega Argiles, Raquel; Brandsma, Andries

    The average firm size of the top R&D investors among US-based companies is smaller than that of the EU-based firms. Does this help to explain why the US has a greater R&D intensity, or is the greater firm size in the EU, just as its lower R&D intensity, determined by the sectors in which the top R&D

  5. AGS intensity record

    International Nuclear Information System (INIS)

    Bleser, Ed

    1994-01-01

    As flashed in the September issue, this summer the Brookhaven Alternating Gradient Synchrotron (AGS) reached a proton beam intensity of 4.05 x 10 13 protons per puise, claimed as the highest intensity ever achieved in a proton synchrotron. It is, however, only two-thirds of the way to its final goal of 6 x 10 13 . The achievement is the resuit of many years of effort. The Report of the AGS II Task Force, issued in February 1984, laid out a comprehensive programme largely based on a careful analysis of the PS experience at CERN. The AGS plan had two essential components: the construction of a new booster, and major upgrades to the AGS itself.

  6. Atmospheric stabilization of CO2 emissions: Near-term reductions and absolute versus intensity-based targets

    International Nuclear Information System (INIS)

    Timilsina, Govinda R.

    2008-01-01

    This study analyzes CO 2 emissions reduction targets for various countries and geopolitical regions by the year 2030 to stabilize atmospheric concentrations of CO 2 at 450 ppm (550 ppm including non-CO 2 greenhouse gases) level. It also determines CO 2 intensity cuts that would be required in those countries and regions if the emission reductions were to be achieved through intensity-based targets without curtailing their expected economic growth. Considering that the stabilization of CO 2 concentrations at 450 ppm requires the global trend of CO 2 emissions to be reversed before 2030, this study develops two scenarios: reversing the global CO 2 trend in (i) 2020 and (ii) 2025. The study shows that global CO 2 emissions would be limited at 42 percent above 1990 level in 2030 if the increasing trend of global CO 2 emissions were to be reversed by 2020. If reversing the trend is delayed by 5 years, global CO 2 emissions in 2030 would be 52 percent higher than the 1990 level. The study also finds that to achieve these targets while maintaining expected economic growth, the global average CO 2 intensity would require a 68 percent drop from the 1990 level or a 60 percent drop from the 2004 level by 2030

  7. Allogeneic stem cell transplantation provides durable disease control in poor-risk chronic lymphocytic leukemia: long-term clinical and MRD results of the German CLL Study Group CLL3X trial.

    Science.gov (United States)

    Dreger, Peter; Döhner, Hartmut; Ritgen, Matthias; Böttcher, Sebastian; Busch, Raymonde; Dietrich, Sascha; Bunjes, Donald; Cohen, Sandra; Schubert, Jörg; Hegenbart, Ute; Beelen, Dietrich; Zeis, Matthias; Stadler, Michael; Hasenkamp, Justin; Uharek, Lutz; Scheid, Christof; Humpe, Andreas; Zenz, Thorsten; Winkler, Dirk; Hallek, Michael; Kneba, Michael; Schmitz, Norbert; Stilgenbauer, Stephan

    2010-10-07

    The purpose of this prospective multicenter phase 2 trial was to investigate the long-term outcome of reduced-intensity conditioning allogeneic stem cell transplantation (alloSCT) in patients with poor-risk chronic lymphocytic leukemia. Conditioning was fludarabine/ cyclophosphamide-based. Longitudinal quantitative monitoring of minimal residual disease (MRD) was performed centrally by MRD-flow or real-time quantitative polymerase chain reaction. One hundred eligible patients were enrolled, and 90 patients proceeded to alloSCT. With a median follow-up of 46 months (7-102 months), 4-year nonrelapse mortality, event-free survival (EFS) and overall survival (OS) were 23%, 42%, and 65%, respectively. Of 52 patients with MRD monitoring available, 27 (52%) were alive and MRD negative at 12 months after transplant. Four-year EFS of this subset was 89% with all event-free patients except for 2 being MRD negative at the most recent assessment. EFS was similar for all genetic subsets, including 17p deletion (17p-). In multivariate analyses, uncontrolled disease at alloSCT and in vivo T-cell depletion with alemtuzumab, but not 17p-, previous purine analogue refractoriness, or donor source (human leukocyte antigen-identical siblings or unrelated donors) had an adverse impact on EFS and OS. In conclusion, alloSCT for poor-risk chronic lymphocytic leukemia can result in long-term MRD-negative survival in up to one-half of the patients independent of the underlying genomic risk profile. This trial is registered at http://clinicaltrials.gov as NCT00281983.

  8. Admission, discharge and triage guidelines for paediatric intensive care units in Spain.

    Science.gov (United States)

    de la Oliva, Pedro; Cambra-Lasaosa, Francisco José; Quintana-Díaz, Manuel; Rey-Galán, Corsino; Sánchez-Díaz, Juan Ignacio; Martín-Delgado, María Cruz; de Carlos-Vicente, Juan Carlos; Hernández-Rastrollo, Ramón; Holanda-Peña, María Soledad; Pilar-Orive, Francisco Javier; Ocete-Hita, Esther; Rodríguez-Núñez, Antonio; Serrano-González, Ana; Blanch, Luis

    2018-05-01

    A paediatric intensive care unit (PICU) is a separate physical facility or unit specifically designed for the treatment of paediatric patients who, because of the severity of illness or other life-threatening conditions, require comprehensive and continuous inten-sive care by a medical team with special skills in paediatric intensive care medicine. Timely and personal intervention in intensive care reduces mortality, reduces length of stay, and decreases cost of care. With the aim of defending the right of the child to receive the highest attainable standard of health and the facilities for the treatment of illness and rehabilitation, as well as ensuring the quality of care and the safety of critically ill paediatric patients, the Spanish Association of Paediatrics (AEP), Spanish Society of Paediatric Intensive Care (SECIP) and Spanish Society of Critical Care (SEMICYUC) have approved the guidelines for the admission, discharge and triage for Spanish PICUs. By using these guidelines, the performance of Spanish paediatric intensive care units can be optimised and paediatric patients can receive the appropriate level of care for their clinical condition. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  9. A multivariate analysis of the energy intensity of sprawl versus compact living in the U.S. for 2003

    Energy Technology Data Exchange (ETDEWEB)

    Shammin, Md. R.; Herendeen, Robert A.; Hanson, Michelle J.; Wilson, Eric J.H.

    2010-10-15

    We explore the energy intensity of sprawl versus compact living by analyzing the total energy requirements of U.S. households for the year 2003. The methods used are based on previous studies on energy cost of living. Total energy requirement is calculated as a function of individual energy intensities of goods and services derived from economic input-output analysis and expenditures for those goods and services. We use multivariate regression analysis to estimate patterns in household energy intensities. We define sprawl in terms of location in rural areas or in areas with low population size. We find that even though sprawl-related factors account for about 83% of the average household energy consumption, sprawl is only 17-19% more energy intensive than compact living based on how people actually lived. We observe that some of the advantages of reduced direct energy use by people living in high density urban centers are offset by their consumption of other non-energy products. A more detailed analysis reveals that lifestyle choices (household type, number of vehicles, and family size) that could be independent of location play a significant role in determining household energy intensity. We develop two models that offer opportunities for further analysis. (author)

  10. A reduced graphene oxide based electrochemical biosensor for tyrosine detection

    Science.gov (United States)

    Wei, Junhua; Qiu, Jingjing; Li, Li; Ren, Liqiang; Zhang, Xianwen; Chaudhuri, Jharna; Wang, Shiren

    2012-08-01

    In this paper, a ‘green’ and safe hydrothermal method has been used to reduce graphene oxide and produce hemin modified graphene nanosheet (HGN) based electrochemical biosensors for the determination of l-tyrosine levels. The as-fabricated HGN biosensors were characterized by UV-visible absorption spectra, fluorescence spectra, Fourier transform infrared spectroscopy (FTIR) spectra and thermogravimetric analysis (TGA). The experimental results indicated that hemin was successfully immobilized on the reduced graphene oxide nanosheet (rGO) through π-π interaction. TEM images and EDX results further confirmed the attachment of hemin on the rGO nanosheet. Cyclic voltammetry tests were carried out for the bare glass carbon electrode (GCE), the rGO electrode (rGO/GCE), and the hemin-rGO electrode (HGN/GCE). The HGN/GCE based biosensor exhibits a tyrosine detection linear range from 5 × 10-7 M to 2 × 10-5 M with a detection limitation of 7.5 × 10-8 M at a signal-to-noise ratio of 3. The sensitivity of this biosensor is 133 times higher than that of the bare GCE. In comparison with other works, electroactive biosensors are easily fabricated, easily controlled and cost-effective. Moreover, the hemin-rGO based biosensors demonstrate higher stability, a broader detection linear range and better detection sensitivity. Study of the oxidation scheme reveals that the rGO enhances the electron transfer between the electrode and the hemin, and the existence of hemin groups effectively electrocatalyzes the oxidation of tyrosine. This study contributes to a widespread clinical application of nanomaterial based biosensor devices with a broader detection linear range, improved stability, enhanced sensitivity and reduced costs.

  11. Prototype fiber Bragg Grattings (FBG) sensor based on intensity modulation of the laser diode low frequency vibrations measurement

    Science.gov (United States)

    Setiono, Andi; Ula, Rini Khamimatul; Hanto, Dwi; Widiyatmoko, Bambang; Purnamaningsih, Retno Wigajatri

    2016-02-01

    In general, Fiber Bragg Grating (FBG) sensor works based on observation of spectral response characteristic to detect the desired parameter. In this research, we studied intensity response characteristic of FBG to detect the dynamic strain. Experiment result show that the reflected intensity had linier relationships with dynamic strain. Based on these characteristics, we developed the FBG sensor to detect low frequency vibration. This sensor is designed by attaching the FBG on the bronze cantilever with dimensions of 85×3×0.5 mm. Measurement results showed that the sensor was able to detect vibrations in the frequency range of 7-10 Hz at temperature range of 25-45 ˚C. The measured frequency range is still within the frequency range of digging activity, therefore this vibration sensor can be applied for oil pipelines vandalisation detection system.

  12. Quantitative phase microscopy for cellular dynamics based on transport of intensity equation.

    Science.gov (United States)

    Li, Ying; Di, Jianglei; Ma, Chaojie; Zhang, Jiwei; Zhong, Jinzhan; Wang, Kaiqiang; Xi, Teli; Zhao, Jianlin

    2018-01-08

    We demonstrate a simple method for quantitative phase imaging of tiny transparent objects such as living cells based on the transport of intensity equation. The experiments are performed using an inverted bright field microscope upgraded with a flipping imaging module, which enables to simultaneously create two laterally separated images with unequal defocus distances. This add-on module does not include any lenses or gratings and is cost-effective and easy-to-alignment. The validity of this method is confirmed by the measurement of microlens array and human osteoblastic cells in culture, indicating its potential in the applications of dynamically measuring living cells and other transparent specimens in a quantitative, non-invasive and label-free manner.

  13. Intensive Versus Standard Blood Pressure Control in SPRINT-Eligible Participants of ACCORD-BP.

    Science.gov (United States)

    Buckley, Leo F; Dixon, Dave L; Wohlford, George F; Wijesinghe, Dayanjan S; Baker, William L; Van Tassell, Benjamin W

    2017-12-01

    We sought to determine the effect of intensive blood pressure (BP) control on cardiovascular outcomes in participants with type 2 diabetes mellitus (T2DM) and additional risk factors for cardiovascular disease (CVD). This study was a post hoc, multivariate, subgroup analysis of ACCORD-BP (Action to Control Cardiovascular Risk in Diabetes Blood Pressure) participants. Participants were eligible for the analysis if they were in the standard glucose control arm of ACCORD-BP and also had the additional CVD risk factors required for SPRINT (Systolic Blood Pressure Intervention Trial) eligibility. We used a Cox proportional hazards regression model to compare the effect of intensive versus standard BP control on CVD outcomes. The "SPRINT-eligible" ACCORD-BP participants were pooled with SPRINT participants to determine whether the effects of intensive BP control interacted with T2DM. The mean baseline Framingham 10-year CVD risk scores were 14.5% and 14.8%, respectively, in the intensive and standard BP control groups. The mean achieved systolic BP values were 120 and 134 mmHg in the intensive and standard BP control groups ( P control reduced the composite of CVD death, nonfatal myocardial infarction (MI), nonfatal stroke, any revascularization, and heart failure (hazard ratio 0.79; 95% CI 0.65-0.96; P = 0.02). Intensive BP control also reduced CVD death, nonfatal MI, and nonfatal stroke (hazard ratio 0.69; 95% CI 0.51-0.93; P = 0.01). Treatment-related adverse events occurred more frequently in participants receiving intensive BP control (4.1% vs. 2.1%; P = 0.003). The effect of intensive BP control on CVD outcomes did not differ between patients with and without T2DM ( P > 0.62). Intensive BP control reduced CVD outcomes in a cohort of participants with T2DM and additional CVD risk factors. © 2017 by the American Diabetes Association.

  14. Acute Impact of Moderate-Intensity and Vigorous-Intensity Exercise Bouts on Daily Physical Activity Energy Expenditure in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Xuewen Wang

    2011-01-01

    Full Text Available This study determined whether performing a single moderate- or vigorous-intensity exercise bout impacts daily physical activity energy expenditure (PAEE, by accelerometer. Overweight/obese postmenopausal women underwent a 5-month caloric restriction and moderate- (n=18 or vigorous-intensity (n=18 center-based aerobic exercise intervention. During the last month of intervention, in women performing moderate-intensity exercise, PAEE on days with exercise (577.7±219.7 kcal⋅d−1 was higher (P=.011 than on days without exercise (450.7±140.5 kcal⋅d−1; however, the difference (127.0±188.1 kcal⋅d−1 was much lower than the energy expended during exercise. In women performing vigorous-intensity exercise, PAEE on days with exercise (450.6±153.6 kcal⋅d−1 was lower (P=.047 than on days without exercise (519.2±127.4 kcal⋅d−1. Thus, women expended more energy on physical activities outside of prescribed exercise on days they did NOT perform center-based exercise, especially if the prescribed exercise was of a higher intensity.

  15. Mobilized peripheral blood stem cells compared with bone marrow from HLA-identical siblings for reduced-intensity conditioning transplantation in acute myeloid leukemia in complete remission

    DEFF Research Database (Denmark)

    Nagler, Arnon; Labopin, Myriam; Shimoni, Avichai

    2012-01-01

    Reduced-intensity conditioning (RIC)-alloSCT is increasingly used for acute myelogenous leukemia. Limited data are available for the comparison of peripheral blood stem cells with bone marrow for RIC-alloSCT. We used the European Group for Blood and Marrow Transplantation (EBMT) ALWP data...... to compare the outcome of mobilized peripheral blood stem cells (PBSC) (n = 1430) vs. bone marrow (BM) (n = 107) for acute myelogenous leukemia (AML) patients with complete remission that underwent RIC-alloSCT from compatible sibling donors. The leukemia features, the disease status, and the time from...

  16. Low-intensity beam diagnostics with particle detectors

    Energy Technology Data Exchange (ETDEWEB)

    Rovelli, A.; Ciavola, G.; Cuttone, G.; Finocchiaro, P.; Raia, G. [INFN-LNS, Via S. Sofia 44/A Catania, 95125 (Italy); De Martinis, C.; Giove, D. [INFN-LASA, Via F.lli Cervi 201 Segrate (Midway Islands), 20090 (Italy)

    1997-01-01

    The measure of low intensity beams at low-medium energy is one of the major challenge in beam diagnostics. This subject is of great interest for the design of accelerator-based medical and radioactive beam facilities. In this paper we discuss new developments in image-based devices to measure low-intensity beams. All the investigated devices must guarantee measurement of the total beam current and its transverse distribution. {copyright} {ital 1997 American Institute of Physics.}

  17. Low-intensity beam diagnostics with particle detectors

    International Nuclear Information System (INIS)

    Rovelli, A.; Ciavola, G.; Cuttone, G.; Finocchiaro, P.; Raia, G.; De Martinis, C.; Giove, D.

    1997-01-01

    The measure of low intensity beams at low-medium energy is one of the major challenge in beam diagnostics. This subject is of great interest for the design of accelerator-based medical and radioactive beam facilities. In this paper we discuss new developments in image-based devices to measure low-intensity beams. All the investigated devices must guarantee measurement of the total beam current and its transverse distribution. copyright 1997 American Institute of Physics

  18. All-fiber intensity bend sensor based on photonic crystal fiber with asymmetric air-hole structure

    Science.gov (United States)

    Budnicki, Dawid; Szostkiewicz, Lukasz; Szymanski, Michal O.; Ostrowski, Lukasz; Holdynski, Zbigniew; Lipinski, Stanislaw; Murawski, Michal; Wojcik, Grzegorz; Makara, Mariusz; Poturaj, Krzysztof; Mergo, Pawel; Napierala, Marek; Nasilowski, Tomasz

    2017-10-01

    Monitoring the geometry of an moving element is a crucial task for example in robotics. The robots equipped with fiber bend sensor integrated in their arms can be a promising solution for medicine, physiotherapy and also for application in computer games. We report an all-fiber intensity bend sensor, which is based on microstructured multicore optical fiber. It allows to perform a measurement of the bending radius as well as the bending orientation. The reported solution has a special airhole structure which makes the sensor only bend-sensitive. Our solution is an intensity based sensor, which measures power transmitted along the fiber, influenced by bend. The sensor is based on a multicore fiber with the special air-hole structure that allows detection of bending orientation in range of 360°. Each core in the multicore fiber is sensitive to bend in specified direction. The principle behind sensor operation is to differentiate the confinement loss of fundamental mode propagating in each core. Thanks to received power differences one can distinguish not only bend direction but also its amplitude. Multicore fiber is designed to utilize most common light sources that operate at 1.55 μm thus ensuring high stability of operation. The sensitivity of the proposed solution is equal 29,4 dB/cm and the accuracy of bend direction for the fiber end point is up to 5 degrees for 15 cm fiber length. Such sensitivity allows to perform end point detection with millimeter precision.

  19. Reducing School Violence: School-Based Curricular Programs and School Climate

    Science.gov (United States)

    Greene, Michael B.

    2008-01-01

    This article examines two different, but interrelated approaches to reduce school violence: school-based curricular programs and efforts to change school climate. The state of the research for each is reviewed and the relationship between them is explored.

  20. Rethinking the intensive care environment: considering nature in nursing practice.

    Science.gov (United States)

    Minton, Claire; Batten, Lesley

    2016-01-01

    With consideration of an environmental concept, this paper explores evidence related to the negative impacts of the intensive care unit environment on patient outcomes and explores the potential counteracting benefits of 'nature-based' nursing interventions as a way to improve care outcomes. The impact of the environment in which a patient is nursed has long been recognised as one determinant in patient outcomes. Whilst the contemporary intensive care unit environment contains many features that support the provision of the intensive therapies the patient requires, it can also be detrimental, especially for long-stay patients. This narrative review considers theoretical and evidence-based literature that supports the adoption of nature-based nursing interventions in intensive care units. Research and theoretical literature from a diverse range of disciplines including nursing, medicine, psychology, architecture and environmental science were considered in relation to patient outcomes and intensive care nursing practice. There are many nature-based interventions that intensive care unit nurses can implement into their nursing practice to counteract environmental stressors. These interventions can also improve the environment for patients' families and nurses. Intensive care unit nurses must actively consider and manage the environment in which nursing occurs to facilitate the best patient outcomes. © 2015 John Wiley & Sons Ltd.

  1. Automatic Recognition of Seismic Intensity Based on RS and GIS: A Case Study in Wenchuan Ms8.0 Earthquake of China

    Directory of Open Access Journals (Sweden)

    Qiuwen Zhang

    2014-01-01

    Full Text Available In recent years, earthquakes have frequently occurred all over the world, which caused huge casualties and economic losses. It is very necessary and urgent to obtain the seismic intensity map timely so as to master the distribution of the disaster and provide supports for quick earthquake relief. Compared with traditional methods of drawing seismic intensity map, which require many investigations in the field of earthquake area or are too dependent on the empirical formulas, spatial information technologies such as Remote Sensing (RS and Geographical Information System (GIS can provide fast and economical way to automatically recognize the seismic intensity. With the integrated application of RS and GIS, this paper proposes a RS/GIS-based approach for automatic recognition of seismic intensity, in which RS is used to retrieve and extract the information on damages caused by earthquake, and GIS is applied to manage and display the data of seismic intensity. The case study in Wenchuan Ms8.0 earthquake in China shows that the information on seismic intensity can be automatically extracted from remotely sensed images as quickly as possible after earthquake occurrence, and the Digital Intensity Model (DIM can be used to visually query and display the distribution of seismic intensity.

  2. Automatic recognition of seismic intensity based on RS and GIS: a case study in Wenchuan Ms8.0 earthquake of China.

    Science.gov (United States)

    Zhang, Qiuwen; Zhang, Yan; Yang, Xiaohong; Su, Bin

    2014-01-01

    In recent years, earthquakes have frequently occurred all over the world, which caused huge casualties and economic losses. It is very necessary and urgent to obtain the seismic intensity map timely so as to master the distribution of the disaster and provide supports for quick earthquake relief. Compared with traditional methods of drawing seismic intensity map, which require many investigations in the field of earthquake area or are too dependent on the empirical formulas, spatial information technologies such as Remote Sensing (RS) and Geographical Information System (GIS) can provide fast and economical way to automatically recognize the seismic intensity. With the integrated application of RS and GIS, this paper proposes a RS/GIS-based approach for automatic recognition of seismic intensity, in which RS is used to retrieve and extract the information on damages caused by earthquake, and GIS is applied to manage and display the data of seismic intensity. The case study in Wenchuan Ms8.0 earthquake in China shows that the information on seismic intensity can be automatically extracted from remotely sensed images as quickly as possible after earthquake occurrence, and the Digital Intensity Model (DIM) can be used to visually query and display the distribution of seismic intensity.

  3. Intensive care unit nurses' evaluation of simulation used for team training.

    Science.gov (United States)

    Ballangrud, Randi; Hall-Lord, Marie Louise; Hedelin, Birgitta; Persenius, Mona

    2014-07-01

    To implement a simulation-based team training programme and to investigate intensive care nurses' evaluations of simulation used for team training. Simulation-based training is recommended to make health care professionals aware of and understand the importance of teamwork related to patient safety. The study was based on a questionnaire evaluation design. A total of 63 registered nurses were recruited: 53 from seven intensive care units in four hospitals in one hospital trust and 10 from an intensive care postgraduate education programme. After conducting a simulation-based team training programme with two scenarios related to emergency situations in the intensive care, the participants evaluated each simulation activity with regard to: (i) outcome of satisfaction and self-confidence in learning, (ii) implementation of educational practice and (iii) simulation design/development. Intensive care nurses were highly satisfied with their simulation-based learning, and they were mostly in agreement with the statements about self-confidence in learning. They were generally positive in their evaluation of the implementation of the educational practice and the simulation design/development. Significant differences were found with regard to scenario roles, prior simulation experience and area of intensive care practice. The study indicates a positive reception of a simulation-based programme with regard to team training in emergency situations in an intensive care unit. The findings may motivate and facilitate the use of simulation for team training to promote patient safety in intensive care and provide educators with support to develop and improve simulation-based training programmes. © 2013 British Association of Critical Care Nurses.

  4. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Sachin Logani

    2011-01-01

    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  5. Hippocampal-Sparing Whole-Brain Radiotherapy: A 'How-To' Technique Using Helical Tomotherapy and Linear Accelerator-Based Intensity-Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Gondi, Vinai; Tolakanahalli, Ranjini; Mehta, Minesh P.; Tewatia, Dinesh; Rowley, Howard; Kuo, John S.; Khuntia, Deepak; Tome, Wolfgang A.

    2010-01-01

    Purpose: Sparing the hippocampus during cranial irradiation poses important technical challenges with respect to contouring and treatment planning. Herein we report our preliminary experience with whole-brain radiotherapy using hippocampal sparing for patients with brain metastases. Methods and Materials: Five anonymous patients previously treated with whole-brain radiotherapy with hippocampal sparing were reviewed. The hippocampus was contoured, and hippocampal avoidance regions were created using a 5-mm volumetric expansion around the hippocampus. Helical tomotherapy and linear accelerator (LINAC)-based intensity-modulated radiotherapy (IMRT) treatment plans were generated for a prescription dose of 30 Gy in 10 fractions. Results: On average, the hippocampal avoidance volume was 3.3 cm 3 , occupying 2.1% of the whole-brain planned target volume. Helical tomotherapy spared the hippocampus, with a median dose of 5.5 Gy and maximum dose of 12.8 Gy. LINAC-based IMRT spared the hippocampus, with a median dose of 7.8 Gy and maximum dose of 15.3 Gy. On a per-fraction basis, mean dose to the hippocampus (normalized to 2-Gy fractions) was reduced by 87% to 0.49 Gy 2 using helical tomotherapy and by 81% to 0.73 Gy 2 using LINAC-based IMRT. Target coverage and homogeneity was acceptable with both IMRT modalities, with differences largely attributed to more rapid dose fall-off with helical tomotherapy. Conclusion: Modern IMRT techniques allow for sparing of the hippocampus with acceptable target coverage and homogeneity. Based on compelling preclinical evidence, a Phase II cooperative group trial has been developed to test the postulated neurocognitive benefit.

  6. rFRET: A comprehensive, Matlab-based program for analyzing intensity-based ratiometric microscopic FRET experiments.

    Science.gov (United States)

    Nagy, Peter; Szabó, Ágnes; Váradi, Tímea; Kovács, Tamás; Batta, Gyula; Szöllősi, János

    2016-04-01

    Fluorescence or Förster resonance energy transfer (FRET) remains one of the most widely used methods for assessing protein clustering and conformation. Although it is a method with solid physical foundations, many applications of FRET fall short of providing quantitative results due to inappropriate calibration and controls. This shortcoming is especially valid for microscopy where currently available tools have limited or no capability at all to display parameter distributions or to perform gating. Since users of multiparameter flow cytometry usually apply these tools, the absence of these features in applications developed for microscopic FRET analysis is a significant limitation. Therefore, we developed a graphical user interface-controlled Matlab application for the evaluation of ratiometric, intensity-based microscopic FRET measurements. The program can calculate all the necessary overspill and spectroscopic correction factors and the FRET efficiency and it displays the results on histograms and dot plots. Gating on plots and mask images can be used to limit the calculation to certain parts of the image. It is an important feature of the program that the calculated parameters can be determined by regression methods, maximum likelihood estimation (MLE) and from summed intensities in addition to pixel-by-pixel evaluation. The confidence interval of calculated parameters can be estimated using parameter simulations if the approximate average number of detected photons is known. The program is not only user-friendly, but it provides rich output, it gives the user freedom to choose from different calculation modes and it gives insight into the reliability and distribution of the calculated parameters. © 2016 International Society for Advancement of Cytometry. © 2016 International Society for Advancement of Cytometry.

  7. Tuning the nonlinear optical absorption of reduced graphene oxide by chemical reduction.

    Science.gov (United States)

    Shi, Hongfei; Wang, Can; Sun, Zhipei; Zhou, Yueliang; Jin, Kuijuan; Redfern, Simon A T; Yang, Guozhen

    2014-08-11

    Reduced graphene oxides with varying degrees of reduction have been produced by hydrazine reduction of graphene oxide. The linear and nonlinear optical properties of both graphene oxide as well as the reduced graphene oxides have been measured by single beam Z-scan measurement in the picosecond region. The results reveal both saturable absorption and two-photon absorption, strongly dependent on the intensity of the pump pulse: saturable absorption occurs at lower pump pulse intensity (~1.5 GW/cm2 saturation intensity) whereas two-photon absorption dominates at higher intensities (≥5.7 GW/cm2). Intriguingly, we find that the two-photon absorption coefficient (from 1.5 cm/GW to 4.5cm/GW) and the saturation intensity (from 1 GW/cm2 to 2 GW/cm2) vary with chemical reduction, which is ascribed to the varying concentrations of sp2 domains and sp2 clusters in the reduced graphene oxides. Our results not only provide an insight into the evolution of the nonlinear optical coefficient in reduced graphene oxide, but also suggest that chemical engineering techniques may usefully be applied to tune the nonlinear optical properties of various nano-materials, including atomically thick graphene sheets.

  8. Single-intensity-recording optical encryption technique based on phase retrieval algorithm and QR code

    Science.gov (United States)

    Wang, Zhi-peng; Zhang, Shuai; Liu, Hong-zhao; Qin, Yi

    2014-12-01

    Based on phase retrieval algorithm and QR code, a new optical encryption technology that only needs to record one intensity distribution is proposed. In this encryption process, firstly, the QR code is generated from the information to be encrypted; and then the generated QR code is placed in the input plane of 4-f system to have a double random phase encryption. For only one intensity distribution in the output plane is recorded as the ciphertext, the encryption process is greatly simplified. In the decryption process, the corresponding QR code is retrieved using phase retrieval algorithm. A priori information about QR code is used as support constraint in the input plane, which helps solve the stagnation problem. The original information can be recovered without distortion by scanning the QR code. The encryption process can be implemented either optically or digitally, and the decryption process uses digital method. In addition, the security of the proposed optical encryption technology is analyzed. Theoretical analysis and computer simulations show that this optical encryption system is invulnerable to various attacks, and suitable for harsh transmission conditions.

  9. Low-intensity electromagnetic irradiation of 70.6 and 73 GHz frequencies enhances the effects of disulfide bonds reducer on Escherichia coli growth and affects the bacterial surface oxidation-reduction state

    International Nuclear Information System (INIS)

    Torgomyan, Heghine; Trchounian, Armen

    2011-01-01

    Highlights: → Low intensity 70.6 and 73 GHz electromagnetic irradiation (EMI) strongly suppressed Escherichia coli growth at 73 GHz and pH 7.3. → Reducer DL-dithiothreitol had bactericidal effect and disturbed the SH-groups number. → EMI enhanced E. coli sensitivity toward dithiothreitol. → EMI decreased the SH-groups number of membrane disturbed by ATP and N,N'-dicyclohexycarbodiimide. → The changed membrane oxidation-reduction state could be the primary mechanisms in EMI effects. -- Abstract: Low-intensity electromagnetic irradiation (EMI) of 70.6 and 73 GHz frequencies (flux capacity - 0.06 mW cm -2 ) had bactericidal effects on Escherichia coli. This EMI (1 h) exposure suppressed the growth of E. coli K-12(λ). The pH value (6.0-8.0) did not significantly affect the growth. The lag-phase duration was prolonged, and the growth specific rate was inhibited, and these effects were more noticeable after 73 GHz irradiation. These effects were enhanced by the addition of DL-dithiothreitol (DTT), a strong reducer of disulfide bonds in surface membrane proteins, which in its turn also has bactericidal effect. Further, the number of accessible SH-groups in membrane vesicles was markedly decreased by EMI that was augmented by N,N'-dicyclohexycarbodiimide and DTT. These results indicate a change in the oxidation-reduction state of bacterial cell membrane proteins that could be the primary membranous mechanism in the bactericidal effects of low-intensity EMI of the 70.6 and 73 GHz frequencies.

  10. Intensity changes in future extreme precipitation: A statistical event-based approach.

    Science.gov (United States)

    Manola, Iris; van den Hurk, Bart; de Moel, Hans; Aerts, Jeroen

    2017-04-01

    Short-lived precipitation extremes are often responsible for hazards in urban and rural environments with economic and environmental consequences. The precipitation intensity is expected to increase about 7% per degree of warming, according to the Clausius-Clapeyron (CC) relation. However, the observations often show a much stronger increase in the sub-daily values. In particular, the behavior of the hourly summer precipitation from radar observations with the dew point temperature (the Pi-Td relation) for the Netherlands suggests that for moderate to warm days the intensification of the precipitation can be even higher than 21% per degree of warming, that is 3 times higher than the expected CC relation. The rate of change depends on the initial precipitation intensity, as low percentiles increase with a rate below CC, the medium percentiles with 2CC and the moderate-high and high percentiles with 3CC. This non-linear statistical Pi-Td relation is suggested to be used as a delta-transformation to project how a historic extreme precipitation event would intensify under future, warmer conditions. Here, the Pi-Td relation is applied over a selected historic extreme precipitation event to 'up-scale' its intensity to warmer conditions. Additionally, the selected historic event is simulated in the high-resolution, convective-permitting weather model Harmonie. The initial and boundary conditions are alternated to represent future conditions. The comparison between the statistical and the numerical method of projecting the historic event to future conditions showed comparable intensity changes, which depending on the initial percentile intensity, range from below CC to a 3CC rate of change per degree of warming. The model tends to overestimate the future intensities for the low- and the very high percentiles and the clouds are somewhat displaced, due to small wind and convection changes. The total spatial cloud coverage in the model remains, as also in the statistical

  11. [Quality management in intensive care medicine].

    Science.gov (United States)

    Martin, J; Braun, J-P

    2013-09-01

    Treatment of critical ill patients in the intensive care unit is tantamount to well-designed risk or quality management. Several tools of quality management and quality assurance have been developed in intensive care medicine. In addition to extern quality assurance by benchmarking with regard to the intensive care medicine, peer review procedures have been established for external quality assurance in recent years. In the process of peer review of an intensive care unit (ICU), external physicians and nurses visit the ICU, evaluate on-site proceedings, and discuss with the managing team of the ICU possibilities for optimization. Furthermore, internal quality management in the ICU is possible based on the 10 quality indicators of the German Interdisciplinary Society for Intensive Care Medicine (DIVI, "Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin"). Thereby every ICU has numerous possibilities to improve their quality management system.

  12. SU-E-J-112: Intensity-Based Pulmonary Image Registration: An Evaluation Study

    Energy Technology Data Exchange (ETDEWEB)

    Yang, F; Meyer, J; Sandison, G [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)

    2015-06-15

    Purpose: Accurate alignment of thoracic CT images is essential for dose tracking and to safely implement adaptive radiotherapy in lung cancers. At the same time it is challenging given the highly elastic nature of lung tissue deformations. The objective of this study was to assess the performances of three state-of-art intensity-based algorithms in terms of their ability to register thoracic CT images subject to affine, barrel, and sinusoid transformation. Methods: Intensity similarity measures of the evaluated algorithms contained sum-of-squared difference (SSD), local mutual information (LMI), and residual complexity (RC). Five thoracic CT scans obtained from the EMPIRE10 challenge database were included and served as reference images. Each CT dataset was distorted by realistic affine, barrel, and sinusoid transformations. Registration performances of the three algorithms were evaluated for each distortion type in terms of intensity root mean square error (IRMSE) between the reference and registered images in the lung regions. Results: For affine distortions, the three algorithms differed significantly in registration of thoracic images both visually and nominally in terms of IRMSE with a mean of 0.011 for SSD, 0.039 for RC, and 0.026 for LMI (p<0.01; Kruskal-Wallis test). For barrel distortion, the three algorithms showed nominally no significant difference in terms of IRMSE with a mean of 0.026 for SSD, 0.086 for RC, and 0.054 for LMI (p=0.16) . A significant difference was seen for sinusoid distorted thoracic CT data with mean lung IRMSE of 0.039 for SSD, 0.092 for RC, and 0.035 for LMI (p=0.02). Conclusion: Pulmonary deformations might vary to a large extent in nature in a daily clinical setting due to factors ranging from anatomy variations to respiratory motion to image quality. It can be appreciated from the results of the present study that the suitability of application of a particular algorithm for pulmonary image registration is deformation-dependent.

  13. Reoptimization of Intensity Modulated Proton Therapy Plans Based on Linear Energy Transfer

    Energy Technology Data Exchange (ETDEWEB)

    Unkelbach, Jan, E-mail: junkelbach@mgh.harvard.edu [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Botas, Pablo [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States); Faculty of Physics, Ruprecht-Karls-Universität Heidelberg, Heidelberg (Germany); Giantsoudi, Drosoula; Gorissen, Bram L.; Paganetti, Harald [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2016-12-01

    Purpose: We describe a treatment plan optimization method for intensity modulated proton therapy (IMPT) that avoids high values of linear energy transfer (LET) in critical structures located within or near the target volume while limiting degradation of the best possible physical dose distribution. Methods and Materials: To allow fast optimization based on dose and LET, a GPU-based Monte Carlo code was extended to provide dose-averaged LET in addition to dose for all pencil beams. After optimizing an initial IMPT plan based on physical dose, a prioritized optimization scheme is used to modify the LET distribution while constraining the physical dose objectives to values close to the initial plan. The LET optimization step is performed based on objective functions evaluated for the product of LET and physical dose (LET×D). To first approximation, LET×D represents a measure of the additional biological dose that is caused by high LET. Results: The method is effective for treatments where serial critical structures with maximum dose constraints are located within or near the target. We report on 5 patients with intracranial tumors (high-grade meningiomas, base-of-skull chordomas, ependymomas) in whom the target volume overlaps with the brainstem and optic structures. In all cases, high LET×D in critical structures could be avoided while minimally compromising physical dose planning objectives. Conclusion: LET-based reoptimization of IMPT plans represents a pragmatic approach to bridge the gap between purely physical dose-based and relative biological effectiveness (RBE)-based planning. The method makes IMPT treatments safer by mitigating a potentially increased risk of side effects resulting from elevated RBE of proton beams near the end of range.

  14. The Impact of Urbanization on Energy Intensity in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Mounir Belloumi

    2016-04-01

    Full Text Available This paper investigates the long-term and causal relationship between energy intensity, real GDP per capita, urbanization and industrialization in Saudi Arabia over the period 1971–2012 using the breakpoint unit root tests developed by Perron (1989 and the autoregressive distributed lag (ARDL model bounds testing to cointegration proposed by Pesaran et al. (2001 and employing a modified version of the Granger causality test proposed by Toda and Yamamoto (1995. Additionally, to test the robustness of the results, the fully modified ordinary least squares (OLS regression, the dynamic OLS regression, and the Hansen test are used. Our results show that the variables are cointegrated when energy intensity is the dependent variable. It is also found that urbanization positively affects energy intensity in both the short term and the long term. Causality tests indicate that urbanization causes economic output that causes energy intensity in the long term. Our results do not support the urban compaction hypothesis where urban cities benefit from basic public services and economies of scale for public infrastructure. Therefore, measures that slow down the rapid urbanization process should be taken to reduce energy intensity in Saudi Arabia. In addition, reducing energy inefficiency in energy consumption should be a strategy to attain sustainable development in the near future in Saudi Arabia.

  15. Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients

    Directory of Open Access Journals (Sweden)

    Jau-Hong Lin

    2004-01-01

    Full Text Available This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living (ADL and motor function in patients more than 1 year after stroke. Twenty patients were recruited from a community stroke register in Nan-Tou County, Taiwan, to a randomized, crossover trial comparing intervention by a physical therapist immediately after entry into the trial (Group I or after a delay of 10 weeks (Group II. The intervention consisted of home-based physical therapy once a week for 10 weeks. The Barthel Index (BI and Stroke Rehabilitation Assessment of Movement (STREAM were used as standard measures for ADL and motor function. At the first follow-up assessment at 11 weeks, Group I showed greater improvement in lower limb motor function than Group II. At the second follow-up assessment at 22 weeks, Group II showed improvement while Group I had declined. At 22 weeks, the motor function of upper limbs, mobility, and ADL performance in Group II had improved slightly more than in Group I, but the between-group differences were not significant. It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors. Further studies will be needed to confirm these findings.

  16. High intensity proton accelerator controls network upgrade

    International Nuclear Information System (INIS)

    Krempaska, R.; Bertrand, A.; Lendzian, F.; Lutz, H.

    2012-01-01

    The High Intensity Proton Accelerator (HIPA) control system network is spread through a vast area in PSI and it was grown historically in an unorganized way. The miscellaneous network hardware infrastructure and the lack of the documentation and components overview could no longer guarantee the reliability of the control system and the facility operation. Therefore, a new network, based on modern network topology, PSI standard hardware with monitoring and detailed documentation and overview was needed. The number of active components has been reduced from 25 to 9 Cisco Catalyst 24- or 48-port switches. They are the same type as other PSI switches, thus a replacement emergency stock is not an issue anymore. We would like to present how we successfully achieved this goal and the advantages of the clean and well documented network infrastructure. (authors)

  17. Effects of 12 weeks high-intensity & reduced-volume training in elite athletes

    DEFF Research Database (Denmark)

    Kilen, Anders; Larsson, Tanja Hultengren; Jørgensen, Majke

    2014-01-01

    It was investigated if high-intensity interval training (HIT) at the expense of total training volume improves performance, maximal oxygen uptake and swimming economy. 41 elite swimmers were randomly allocated to a control (CON) or HIT group. For 12 weeks both groups trained ∼12 h per week. HIT c...... (3.8±0.7 vs. 3.8±0.7 l O2×min-1; n = 11) group. Oxygen uptake determined at fixed submaximal speed was not significantly affected in either group by the intervention. Body fat % tended to increase (P = 0.09) in the HIT group (15.4±1.6% vs. 16.3±1.6%; P = 0.09; n = 16) and increased (P...

  18. DRAWING FOR TRAFFIC MARKING USING BIDIRECTIONAL GRADIENT-BASED DETECTION WITH MMS LIDAR INTENSITY

    Directory of Open Access Journals (Sweden)

    G. Takahashi

    2016-06-01

    Full Text Available Recently, the development of autonomous cars is accelerating on the integration of highly advanced artificial intelligence, which increases demand for a digital map with high accuracy. In particular, traffic markings are required to be precisely digitized since automatic driving utilizes them for position detection. To draw traffic markings, we benefit from Mobile Mapping Systems (MMS equipped with high-density Laser imaging Detection and Ranging (LiDAR scanners, which produces large amount of data efficiently with XYZ coordination along with reflectance intensity. Digitizing this data, on the other hand, conventionally has been dependent on human operation, which thus suffers from human errors, subjectivity errors, and low reproductivity. We have tackled this problem by means of automatic extraction of traffic marking, which partially accomplished to draw several traffic markings (G. Takahashi et al., 2014. The key idea of the method was extracting lines using the Hough transform strategically focused on changes in local reflection intensity along scan lines. However, it failed to extract traffic markings properly in a densely marked area, especially when local changing points are close each other. In this paper, we propose a bidirectional gradient-based detection method where local changing points are labelled with plus or minus group. Given that each label corresponds to the boundary between traffic markings and background, we can identify traffic markings explicitly, meaning traffic lines are differentiated correctly by the proposed method. As such, our automated method, a highly accurate and non-human-operator-dependent method using bidirectional gradient-based algorithm, can successfully extract traffic lines composed of complex shapes such as a cross walk, resulting in minimizing cost and obtaining highly accurate results.

  19. Drawing for Traffic Marking Using Bidirectional Gradient-Based Detection with MMS LIDAR Intensity

    Science.gov (United States)

    Takahashi, G.; Takeda, H.; Nakamura, K.

    2016-06-01

    Recently, the development of autonomous cars is accelerating on the integration of highly advanced artificial intelligence, which increases demand for a digital map with high accuracy. In particular, traffic markings are required to be precisely digitized since automatic driving utilizes them for position detection. To draw traffic markings, we benefit from Mobile Mapping Systems (MMS) equipped with high-density Laser imaging Detection and Ranging (LiDAR) scanners, which produces large amount of data efficiently with XYZ coordination along with reflectance intensity. Digitizing this data, on the other hand, conventionally has been dependent on human operation, which thus suffers from human errors, subjectivity errors, and low reproductivity. We have tackled this problem by means of automatic extraction of traffic marking, which partially accomplished to draw several traffic markings (G. Takahashi et al., 2014). The key idea of the method was extracting lines using the Hough transform strategically focused on changes in local reflection intensity along scan lines. However, it failed to extract traffic markings properly in a densely marked area, especially when local changing points are close each other. In this paper, we propose a bidirectional gradient-based detection method where local changing points are labelled with plus or minus group. Given that each label corresponds to the boundary between traffic markings and background, we can identify traffic markings explicitly, meaning traffic lines are differentiated correctly by the proposed method. As such, our automated method, a highly accurate and non-human-operator-dependent method using bidirectional gradient-based algorithm, can successfully extract traffic lines composed of complex shapes such as a cross walk, resulting in minimizing cost and obtaining highly accurate results.

  20. Repeated intravenous administration of gadobutrol does not lead to increased signal intensity on unenhanced T1-weighted images - a voxel-based whole brain analysis

    Energy Technology Data Exchange (ETDEWEB)

    Langner, Soenke; Kromrey, Marie-Luise [University Medicine Greifswald, Institute of Diagnostic Radiology and Neuroradiology, Greifswald (Germany); Kuehn, Jens-Peter [University Medicine Greifswald, Institute of Diagnostic Radiology and Neuroradiology, Greifswald (Germany); University Hospital, Carl Gustav Carus University Dresden, Institute for Radiology, Dresden (Germany); Grothe, Matthias [University Medicine Greifswald, Department of Neurology, Greifswald (Germany); Domin, Martin [University Medicine Greifswald, Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, Greifswald (Germany)

    2017-09-15

    To identify a possible association between repeated intravenous administration of gadobutrol and increased signal intensity in the grey and white matter using voxel-based whole-brain analysis. In this retrospective single-centre study, 217 patients with a clinically isolated syndrome underwent baseline brain magnetic resonance imaging and at least one annual follow-up examination with intravenous administration of 0.1 mmol/kg body weight of gadobutrol. Using the ''Diffeomorphic Anatomical Registration using Exponentiated Lie algebra'' (DARTEL) normalisation process, tissue templates for grey matter (GM), white matter (WM), and cerebrospinal fluid (CSF) were calculated, as were GM-CSF and WM-CSF ratios. Voxel-based whole-brain analysis was used to calculate the signal intensity for each voxel in each data set. Paired t-test was applied to test differences to baseline MRI for significance. Voxel-based whole-brain analysis demonstrated no significant changes in signal intensity of grey and white matter after up to five gadobutrol administrations. There was no significant change in GM-CSF and grey WM-CSF ratios. Voxel-based whole-brain analysis did not demonstrate increased signal intensity of GM and WM on unenhanced T1-weighted images after repeated gadobutrol administration. The molecular structure of gadolinium-based contrast agent preparations may be an essential factor causing SI increase on unenhanced T1-weighted images. (orig.)

  1. Delirium screening in intensive care: A life saving opportunity.

    Science.gov (United States)

    Lamond, E; Murray, S; Gibson, C E

    2018-02-01

    Delirium is described as 'acute brain failure' and constitutes a medical emergency which presents a hazard for people cared for in intensive care units. The Scottish intensive care society audit group recommend that all people cared for in intensive care units be screened for signs of delirium so that treatment and management of complications can be implemented at an early stage. There is inconsistent evidence about when and how the assessment of delirium is carried out by nursing staff in the intensive care setting. This narrative review explores the pathophysiology and current practices of delirium screening in intensive care. Consideration is given to the role of the nurse in detecting and