A novel surgical method for total nail ablation: Use of triple flap technique

Directory of Open Access Journals (Sweden)

Berna Aksoy

2017-11-01

Full Text Available Total nail ablation for the treatment of onychodystrophies can be performed by using chemicals, surgical resection or laser ablation of nail matrix. A female patient with bilateral severe onychodystrophy as a result of inadvertent previous nail surgeries was treated surgically. Proximal complete nail matrix resection and distal 10 mm wide transverse strip partial nail bed resection were performed. A 5 mm wide transverse strip of nail bed was left intact proximally. Proximal nail matrix defect was closed by using the skin of proximal nail fold. The distal nail bed defect was reconstructed by using triple flap technique which was composed of a main central advancement flap containing ventral toe skin and two side flaps containing nail fold skin. The patient healed without any problem and her nail problem was treated successfully. The cosmetic appearance of her first toes was acceptable. Surgical nail ablation followed by volar skin coverage of dorsal surface of the distal phalanx bone by using triple flap technique is an effective surgical treatment method for the correction of advanced nail plate deformities requiring total nail ablation. 

26 CFR 1.61-3 - Gross income derived from business.

Science.gov (United States)

2010-04-01

... Section 1.61-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Definition of Gross Income, Adjusted Gross Income, and..., merchandising, or mining business, “gross income” means the total sales, less the cost of goods sold, plus any...

Validating the Rett Syndrome Gross Motor Scale.

Science.gov (United States)

Downs, Jenny; Stahlhut, Michelle; Wong, Kingsley; Syhler, Birgit; Bisgaard, Anne-Marie; Jacoby, Peter; Leonard, Helen

2016-01-01

Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98). The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.

Proximal Femoral Varus Derotation Osteotomy in Children with Cerebral Palsy: The Effect of Age, Gross Motor Function Classification System Level, and Surgeon Volume on Surgical Success.

Science.gov (United States)

Shore, Benjamin J; Zurakowski, David; Dufreny, Chantal; Powell, Dustin; Matheney, Travis H; Snyder, Brian D

2015-12-16

The purpose of this study was to evaluate mid-term results of proximal femoral varus derotation osteotomy (VDRO) in children with cerebral palsy and determine what effect age, Gross Motor Function Classification System (GMFCS) level, and surgeon volume had on surgical success. We analyzed a cohort of children with cerebral palsy who underwent VDRO for hip displacement at a tertiary-level pediatric hospital between 1994 and 2007. Age, sex, GMFCS level, preoperative radiographic parameters, previous botulinum toxin administration or soft-tissue release, adjunctive pelvic osteotomy, the performance of bilateral surgery at the index VDRO, and surgeon volume (the number of procedures performed) were recorded. Results were analyzed via univariate and multivariate analyses for association with the need for revision hip surgery. Kaplan-Meier survivorship curves were generated, determining the time from index surgery to failure (defined as the need for subsequent surgical procedures on the hip and/or pelvis, or a hip migration percentage of >50% at the time of final follow-up), and were further stratified according to osseous versus soft-tissue revision. A total of 567 VDROs were performed in 320 children (mean age [and standard deviation], 8.2 ± 3.8 years). The mean follow-up was 8.3 years (range, three to eighteen years). Of the initial 320 patients, 117 (37%) were considered to have had failure. Multivariate Cox regression analysis confirmed that younger age at surgery (p < 0.001), increased GMFCS level (p = 0.01), and lower annual surgical hip volume (p = 0.02) were significant independent predictors of any type of surgical revision. Furthermore, soft-tissue release at VDRO was protective against revision (p = 0.02). Five-year survivorship analysis revealed a 92% success rate for children classified as GMFCS levels I and II compared with a 76% success rate for those of GMFCS level V (p < 0.01). This study demonstrated a 37% failure rate after VDRO in children with

Emerging trends in the outsourcing of medical and surgical care.

Science.gov (United States)

Boyd, Jennifer B; McGrath, Mary H; Maa, John

2011-01-01

As total health care expenditures are expected to constitute an increasing portion of the US gross domestic product during the coming years, the US health care system is anticipating a historic spike in the need for care. Outsourcing medical and surgical care to other nations has expanded rapidly, and several ethical, legal, and financial considerations require careful evaluation. Ultimately, the balance between cost savings, quality, and patient satisfaction will be the key determinant in the future of medical outsourcing.

Hybrid procedure for total laryngectomy with a flexible robot-assisted surgical system.

Science.gov (United States)

Schuler, Patrick J; Hoffmann, Thomas K; Veit, Johannes A; Rotter, Nicole; Friedrich, Daniel T; Greve, Jens; Scheithauer, Marc O

2017-06-01

Total laryngectomy is a standard procedure in head-and-neck surgery for the treatment of cancer patients. Recent clinical experiences have indicated a clinical benefit for patients undergoing transoral robot-assisted total laryngectomy (TORS-TL) with commercially available systems. Here, a new hybrid procedure for total laryngectomy is presented. TORS-TL was performed in human cadavers (n = 3) using a transoral-transcervical hybrid procedure. The transoral approach was performed with a robotic flexible robot-assisted surgical system (Flex®) and compatible flexible instruments. Transoral access and visualization of anatomical landmarks were studied in detail. Total laryngectomy is feasible with a combined transoral-transcervical approach using the flexible robot-assisted surgical system. Transoral visualization of all anatomical structures is sufficient. The flexible design of the robot is advantageous for transoral surgery of the laryngeal structures. Transoral robot assisted surgery has the potential to reduce morbidity, hospital time and fistula rates in a selected group of patients. Initial clinical studies and further development of supplemental tools are in progress. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Validating the Rett Syndrome Gross Motor Scale.

Directory of Open Access Journals (Sweden)

Jenny Downs

Full Text Available Rett syndrome is a pervasive neurodevelopmental disorder associated with a pathogenic mutation on the MECP2 gene. Impaired movement is a fundamental component and the Rett Syndrome Gross Motor Scale was developed to measure gross motor abilities in this population. The current study investigated the validity and reliability of the Rett Syndrome Gross Motor Scale. Video data showing gross motor abilities supplemented with parent report data was collected for 255 girls and women registered with the Australian Rett Syndrome Database, and the factor structure and relationships between motor scores, age and genotype were investigated. Clinical assessment scores for 38 girls and women with Rett syndrome who attended the Danish Center for Rett Syndrome were used to assess consistency of measurement. Principal components analysis enabled the calculation of three factor scores: Sitting, Standing and Walking, and Challenge. Motor scores were poorer with increasing age and those with the p.Arg133Cys, p.Arg294* or p.Arg306Cys mutation achieved higher scores than those with a large deletion. The repeatability of clinical assessment was excellent (intraclass correlation coefficient for total score 0.99, 95% CI 0.93-0.98. The standard error of measurement for the total score was 2 points and we would be 95% confident that a change 4 points in the 45-point scale would be greater than within-subject measurement error. The Rett Syndrome Gross Motor Scale could be an appropriate measure of gross motor skills in clinical practice and clinical trials.

What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?

Science.gov (United States)

Harato, Kengo; Maeno, Shinichi; Tanikawa, Hidenori; Kaneda, Kazuya; Morishige, Yutaro; Nomoto, So; Niki, Yasuo

2016-08-01

It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study. A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively. Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts, P time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners. Therapeutic studies, Level IV.

The impact of old age on surgical outcomes of totally laparoscopic gastrectomy for gastric cancer.

Science.gov (United States)

Kim, Min Gyu; Kim, Hee Sung; Kim, Byung Sik; Kwon, Sung Joon

2013-11-01

Old age is regarded as the risk factor of major abdominal surgery due to the lack of functional reserve and the increased presence of comorbidities. This study aimed to evaluate the impact of old age on the surgical outcomes of totally laparoscopic gastrectomy for gastric cancer. This study enrolled 389 gastric cancer patients who underwent totally laparoscopic gastrectomy at Hanyang University Guri Hospital and ASAN Medical Center. The patients were classified into two groups according to age as those older than 70 years and those younger than 70 years. Early surgical outcomes such as operation time, postoperative complications, time to first flatus, days until soft diet began, and hospital stay were evaluated. No patient was converted to open surgery. The two groups differed significantly in terms of overall postoperative complication rate, time to first flatus, days until soft diet began, and hospital stay. The patients who underwent Roux-en-Y gastrojejunostomy differed in incidence of postoperative ileus but not in severe postoperative complication rate. The results of this study demonstrated that old age can have an effect on the surgical outcomes of totally laparoscopic gastrectomy. This study especially showed that elderly patients are affected by the return of bowel movement after totally laparoscopic gastrectomy. On the other hand, however, it is presumed that old age has not had a serious impact on surgical outcomes in totally laparoscopic gastrectomy because no difference in the severe postoperative complication rate was observed.

Increased Total Anesthetic Time Leads to Higher Rates of Surgical Site Infections in Spinal Fusions.

Science.gov (United States)

Puffer, Ross C; Murphy, Meghan; Maloney, Patrick; Kor, Daryl; Nassr, Ahmad; Freedman, Brett; Fogelson, Jeremy; Bydon, Mohamad

2017-06-01

A retrospective review of a consecutive series of spinal fusions comparing patient and procedural characteristics of patients who developed surgical site infections (SSIs) after spinal fusion. It is known that increased surgical time (incision to closure) is associated with a higher rate of postoperative SSIs. We sought to determine whether increased total anesthetic time (intubation to extubation) is a factor in the development of SSIs as well. In spine surgery for deformity and degenerative disease, SSI has been associated with operative time, revealing a nearly 10-fold increase in SSI rates in prolonged surgery. Surgical time is associated with infections in other surgical disciplines as well. No studies have reported whether total anesthetic time (intubation to extubation) has an association with SSIs. Surgical records were searched in a retrospective fashion to identify all spine fusion procedures performed between January 2010 and July 2012. All SSIs during that timeframe were recorded and compared with the list of cases performed between 2010 and 2012 in a case-control design. There were 20 (1.7%) SSIs in this fusion cohort. On univariate analyses of operative factors, there was a significant association between total anesthetic time (Infection 7.6 ± 0.5 hrs vs. no infection -6.0 ± 0.1 hrs, P operative time (infection 5.5 ± 0.4 hrs vs. no infection - 4.4 ± 0.06 hrs, P infections, whereas level of pathology and emergent surgery were not significant. On multivariate logistic analysis, BMI and total anesthetic time remained independent predictors of SSI whereas ASA status and operative time did not. Increasing BMI and total anesthetic time were independent predictors of SSIs in this cohort of over 1000 consecutive spinal fusions. 3.

Surgical treatment of cavernous malformations involving medulla oblongata.

Science.gov (United States)

Zhang, Si; Lin, Sen; Hui, Xuhui; Li, Hao; You, Chao

2017-03-01

Surgical treatment of cavernous malformations (CMs) involving medulla oblongata is more difficult than the CMs in other sites because of the surrounding vital structures. However, the distinctive features and treatment strategies have not been well illustrated. Therefore, we enrolled a total of 19 patients underwent surgical treatment of CMs involving medulla oblongata in our hospital from August 2008 to August 2014. The clinical features, surgical management and clinical outcome of these patients were retrospectively analyzed, while our institutional surgical indications, approaches and microsurgical techniques were discussed. In our study, gross total resection was achieved in 17 patients and subtotal resection in 2. Two patients underwent emergency surgeries due to severe and progressive neurological deficits. The postoperative new-onset or worsened neurological deficits occurred in 6 patients. After a mean follow-up of 45.8±22.2months, the neurological status was improved in 10 patients and remained stable in 7. The mean modified Rankin Scale (mRS) was 2.58±1.26 preoperatively, 3.11±0.99 postoperatively and 1.84±1.42 at the recent follow-up, respectively. During the follow-up period, no rehemorrhage and recurrence occurred, and the residual lesions remained stable. We recommended surgical resection of symptomatic CMs involving medulla oblongata via optimal approaches, feasible entry zones and meticulous microsurgical techniques in attempting to achieve safe resection and favorable outcome. The clinical features, surgical indications, timing and microsurgical techniques of this special entity should be distinctive from the brainstem cavernous malformations in other sites. Copyright © 2016 Elsevier Ltd. All rights reserved.

Surgical practices in total knee arthroplasty in Turkey.

Science.gov (United States)

Erduran, Mehmet; Akseki, Devrim; Araç, Sükrü

2012-01-01

The aim of this study was to determine the current practices in the total knee arthroplasty (TKA) and the differences of practice among the orthopedic surgeons in Turkey. Data in this cross-sectional and descriptive study was collected through a questionnaire from 76 orthopaedic surgeons performing TKA. The questionnaire form contained 57 questions under four main headings, covering the professional properties of the surgeon, pre-surgery approach, surgical technique applied for TKA and the surgical details peculiar to the technique with solutions applied for complication scenarios, and finally the postoperative approach. It was determined that 39.7% of the TKA applications were performed in operating theatres without laminar airflow or HEPA filters. Nearly 1/5 of the surgeons used more than one antibiotic for prophylaxis, and more than 85% continued prophylaxis use over 3 days. Low-molecular-weight heparin was the most commonly used method for thromboprophylaxis. 94.67% of the surgeons used only the cemented technique in primary TKA. 44% indicated that they performed simultaneous bilateral arthroplasty, 89% did not use any scoring system and 72.37% preferred fixed-bearing and posterior-cruciate-retaining type prosthesis. Results showed no standardization in TKA surgery among surgeons in Turkey, and important educational deficiencies were noted.

The relationship of hospital charges and volume to surgical site infection after total hip replacement.

Science.gov (United States)

Boas, Rebecca; Ensor, Kelsey; Qian, Edward; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-05-01

The purpose of this study was to analyze the effect of hospital volume and charges on the rate of surgical site infections for total hip replacements (THRs) in New York State (NYS). In NYS, higher volume hospitals have higher charges after THR. The study team analyzed 93,620 hip replacements performed in NYS between 2008 and 2011. Hospital charges increased significantly from $43,713 in 2008 to $50,652 in 2011 (P<.01). Compared with lower volume hospitals, patients who underwent THR at the highest volume hospitals had significantly lower surgical site infection rates (P=.003) and higher total hospital charges (P<.0001). The study team found that in the highest volume hospitals, preventing one surgical site infection was associated with $1.6 million dollars in increased charges. © 2014 by the American College of Medical Quality.

Intrahepatic cholangiocarcinoma : gross appearance and corresponding pathologic and radiologic features

International Nuclear Information System (INIS)

Yoon, Kwon Ha; Kim, Chang Guhn; Lee, Moon Gyu; Ha, Hyun Kwon; Auh, Yong Ho; Lim, Jae Hoon

1999-01-01

To assess the clinical and pathologic features of each type of intrahepatic cholangiocarcinoma, which is divided into three types according to gross appearance, and to determine the efficacy of CT in detecting this tumor. The pathologic and CT features of 53 surgically proven cases of intrahepatic cholangio-carcinoma were reviewed. On the basis of their gross appearance, the tumors were divided into three types, as follows : mass forming (n=33), periductal infiltrating (n=6), and intraductal growth type (n=14). CT scans were analyzed for sensitivity of detection and correlation between a tumors appearance and its histopathology. The most common histopathologic feature of mass forming and periductal infiltrating type was tubular adenocarcinoma, while in the intraductal growth type, papillary adenocarcinoma (100%) was common. With regard to pattern of tumor spread, intrahepatic and lymph node metastasis were more common in the mass forming and periductal infiltrating type than in the intraductal growth type. CT findings including intrahepatic mass, ductal wall thickening or intraductal mass associated with segmental dilatation of intrahepataic bile ducts, corresponded with these morphologic types. This classification according to gross appearance is of considerable value when interpreting the pathologic features of intrahepatic cholangiocarcinoma. CT seems to be a useful modality for the detection of tumors and may be consistent with their gross morphologic findings

The determination of the national background radioactivity of gross alpha and gross beta in water samples at the PUSPATI site and its neutrons

International Nuclear Information System (INIS)

Rahman, M.T.A.

1983-01-01

The determination of the natural background radioactivity in water samples has been made at the PUSPATI site and its environs. The study was performed in January 1981 until June 1981. Samples of river, rain and tap water are periodically collected and analyzed in order to determine gross alpha and gross beta activity. In general, the total radioactivity of water is considerably low. The mean concentration of gross alpha in river water and tap water samples are 1.2 +- 0.1 and 0.2 +- 0.1 pCi/ respectively. The level of gross alpha in rain water is however, below the background rate of the detector. The mean concentration of gross beta in river water, tap water and rain water samples are 4.2 +- 0.6, 1.6 +- 0.3, and 1.9 +- 0.3 pCi/ respectively. (author)

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery

Science.gov (United States)

Siletz, Anaar E.; Singer, Emily S.; Faltermeier, Claire; Hu, Q. Lina; Ko, Clifford Y.; Golladay, Gregory J.; Kates, Stephen L.; Wick, Elizabeth C.; Maggard-Gibbons, Melinda

2018-01-01

Background: Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery—a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). Study Design: This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Results: Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. Conclusion: This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving

Surgical Technical Evidence Review for Elective Total Joint Replacement Conducted for the AHRQ Safety Program for Improving Surgical Care and Recovery.

Science.gov (United States)

Childers, Christopher P; Siletz, Anaar E; Singer, Emily S; Faltermeier, Claire; Hu, Q Lina; Ko, Clifford Y; Golladay, Gregory J; Kates, Stephen L; Wick, Elizabeth C; Maggard-Gibbons, Melinda

2018-01-01

Use of enhanced recovery pathways (ERPs) can improve patient outcomes, yet national implementation of these pathways remains low. The Agency for Healthcare Research and Quality (AHRQ; funder), the American College of Surgeons, and the Johns Hopkins Medicine Armstrong Institute for Patent Safety and Quality have developed the Safety Program for Improving Surgical Care and Recovery-a national effort to catalyze implementation of practices to improve perioperative care and enhance recovery of surgical patients. This review synthesizes evidence that can be used to develop a protocol for elective total knee arthroplasty (TKA) and total hip arthroplasty (THA). This review focuses on potential components of the protocol relevant to surgeons; anesthesia components are reported separately. Components were identified through review of existing pathways and from consultation with technical experts. For each, a structured review of MEDLINE identified systematic reviews, randomized trials, and observational studies that reported on these components in patients undergoing elective TKA/THA. This primary evidence review was combined with existing clinical guidelines in a narrative format. Sixteen components were reviewed. Of the 10 preoperative components, most were focused on risk factor assessment including anemia, diabetes mellitus, tobacco use, obesity, nutrition, immune-modulating therapy, and opiates. Preoperative education, venous thromboembolism (VTE) prophylaxis, and bathing/ Staphylococcus aureus decolonization were also included. The routine use of drains was the only intraoperative component evaluated. The 5 postoperative components included early mobilization, continuous passive motion, extended duration VTE prophylaxis, early oral alimentation, and discharge planning. This review synthesizes the evidence supporting potential surgical components of an ERP for elective TKA/THA. The AHRQ Safety Program for Improving Surgical Care and Recovery aims to guide hospitals and

Innovation in pediatric surgical education.

Science.gov (United States)

Clifton, Matthew S; Wulkan, Mark L

2015-06-01

Pediatric surgical training in the United States remained basically unchanged from the model developed by Ladd and Gross in the 1930s until recently. Standardized curriculum and novel evaluation methods are now being implemented. Pediatric Surgical education is currently undergoing a transition to competency-based evaluation and promotion. Unfortunately, there is little data on the efficacy of these changes. This presents an opportunity for further study of how we conduct training, and how we evaluate and promote our trainees. Copyright © 2015 Elsevier Inc. All rights reserved.

Gross Motor Skills and Cardiometabolic Risk in Children: A Mediation Analysis.

Science.gov (United States)

Burns, Ryan D; Brusseau, Timothy A; Fu, You; Hannon, James C

2017-04-01

The purpose of this study was to examine the linear relationship between gross motor skills and cardiometabolic risk, with aerobic fitness as a mediator variable, in low-income children from the United States. Participants were a convenience sample of 224 children (mean ± SD age = 9.1 ± 1.1 yr; 129 girls and 95 boys) recruited from five low-income elementary schools from the Mountain West Region of the United States. Gross motor skills were assessed using the Test for Gross Motor Development, 3rd Edition. Gross motor skills were analyzed using a locomotor skill, a ball skill, and a total gross motor skill score. Aerobic fitness was assessed using the Progressive Aerobic Cardiovascular Endurance Run that was administered during physical education class. A continuous and age- and sex-adjusted metabolic syndrome score (MetS) was calculated from health and blood marker measurements collected in a fasted state before school hours. Total effects, average direct effects, and indirect effects (average causal mediation effect) were calculated using a bootstrap mediation analysis method via a linear regression algorithm. The average causal mediation effect of gross locomotor skills on MetS scores, using aerobic fitness as the mediator variable, was statistically significant (β = -0.055, 95% confidence interval = -0.097 to -0.021, P = 0.003). The model explained approximately 17.5% of the total variance in MetS with approximately 43.7% of the relationship between locomotor skills and MetS mediated through aerobic fitness. Ball skills did not significantly relate with cardiometabolic risk. There is a significant relationship between gross locomotor skills and cardiometabolic risk that is partially mediated through aerobic fitness in a sample of low-income children from the United States.

Determination of gross alpha and gross beta in soil around repository facility at Bukit Kledang, Perak, Malaysia

Science.gov (United States)

Adziz, Mohd Izwan Abdul; Siong, Khoo Kok

2018-04-01

Recently, the Long Term Storage Facility (LTSF) in Bukit Kledang, Perak, Malaysia, has been upgraded to repository facility upon the completion of decontamination and decommissioning (D&D) process. Thorium waste and contaminated material that may contain some minor amounts of thorium hydroxide were disposed in this facility. This study is conducted to determine the concentrations of gross alpha and gross beta radioactivities in soil samples collected around the repository facility. A total of 12 soil samples were collected consisting 10 samples from around the facility and 2 samples from selected residential area near the facility. In addition, the respective dose rates were measured 5 cm and 1 m above the ground by using survey meter with Geiger Muller (GM) detector and Sodium Iodide (NaI) detector. Soil samples were collected using hand auger and then were taken back to the laboratory for further analysis. Samples were cleaned, dried, pulverized and sieved prior to analysis. Gross alpha and gross beta activity measurements were carried out using gas flow proportional counter, Canberra Series 5 XLB - Automatic Low Background Alpha and Beta Counting System. The obtained results show that, the gross alpha and gross beta activity concentration ranged from 1.55 to 5.34 Bq/g with a mean value of 3.47 ± 0.09 Bq/g and 1.64 to 5.78 Bq/g with a mean value of 3.49 ± 0.09 Bq/g, respectively. These results can be used as an additional data to represent terrestrial radioactivity baseline data for Malaysia environment. This estimation will also serve as baseline for detection of any future related activities of contamination especially around the repository facility area.

Is lumbosacral plexus blockade effective and safe for surgical anesthesia in total hip replacement?

DEFF Research Database (Denmark)

Nielsen, Niels Dalsgaard; Larsen, Jens Rolighed; Børglum, Jens

Background and Aims Patients scheduled for total hip replacement often presents cardiovascular comorbidity, which increases perioperative risk of complications. This pilot study aimed to compare lumbosacral plexus blockade with continuous and single-dose spinal anesthesia for surgical anesthesia...... had lumbosacral plexus blockade (lumbar plexus block, sacral plexus block and fascia transversalis plane block) with ropivacaine. Group 2 had continuous spinal anesthesia with repeated bupivacaine-doses. Group 3 had single-dose spinal anesthesia with bupivacaine. Hemodynamic data were recorded during...... vascular resistance, and arterial and central venous pressures. (table 1) No patients in group 1 achieved complete surgical anesthesia due to lack of anesthesia of the cranial part of the surgical incision. Conclusions Neither lumbosacral plexus block nor continuous spinal anesthesia affected any...

MR imaging of soft tissue alterations after total hip arthroplasty: comparison of classic surgical approaches

Energy Technology Data Exchange (ETDEWEB)

Agten, Christoph A.; Sutter, Reto; Pfirrmann, Christian W.A. [Balgrist University Hospital, Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland); Dora, Claudio [Balgrist University Hospital, Orthopedic Surgery, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

2017-03-15

To compare soft-tissue changes after total hip arthroplasty with posterior, direct-lateral, anterolateral, or anterior surgical approaches. MRI of 120 patients after primary total hip arthroplasty (30 per approach) were included. Each MRI was assessed by two readers regarding identification of surgical access, fatty muscle atrophy (Goutallier classification), tendon quality (0 = normal, 1 = tendinopathy, 2 = partial tear, 3 = avulsion), and fluid collections. Readers were blinded to the surgical approach. Surgical access was correctly identified in all cases. The direct lateral approach showed highest Goutallier grades and tendon damage for gluteus minimus muscle (2.07-2.67 and 2.00-2.77; p = 0.017 and p = 0.001 for readers 1 and 2, respectively) and tendon (2.30/1.67; p < 0.0005 for reader 1/2), and the lateral portion of the gluteus medius tendon (2.77/2.20; p < 0.0005 for reader 1/2). The posterior approach showed highest Goutallier grades and tendon damage for external rotator muscles (1.97-2.67 and 1.57-2.40; p < 0.0005-0.006 for reader 1/2) and tendons (1.41-2.45 and 1.93-2.76; p < 0.0005 for reader 1/2). The anterolateral and anterior approach showed less soft tissue damage. Fluid collections showed no differences between the approaches. MRI is well suited to identify surgical approaches after THA. The anterior and anterolateral approach showed less soft tissue damage compared to the posterior and direct lateral approach. (orig.)

MR imaging of soft tissue alterations after total hip arthroplasty: comparison of classic surgical approaches

International Nuclear Information System (INIS)

Agten, Christoph A.; Sutter, Reto; Pfirrmann, Christian W.A.; Dora, Claudio

2017-01-01

To compare soft-tissue changes after total hip arthroplasty with posterior, direct-lateral, anterolateral, or anterior surgical approaches. MRI of 120 patients after primary total hip arthroplasty (30 per approach) were included. Each MRI was assessed by two readers regarding identification of surgical access, fatty muscle atrophy (Goutallier classification), tendon quality (0 = normal, 1 = tendinopathy, 2 = partial tear, 3 = avulsion), and fluid collections. Readers were blinded to the surgical approach. Surgical access was correctly identified in all cases. The direct lateral approach showed highest Goutallier grades and tendon damage for gluteus minimus muscle (2.07-2.67 and 2.00-2.77; p = 0.017 and p = 0.001 for readers 1 and 2, respectively) and tendon (2.30/1.67; p < 0.0005 for reader 1/2), and the lateral portion of the gluteus medius tendon (2.77/2.20; p < 0.0005 for reader 1/2). The posterior approach showed highest Goutallier grades and tendon damage for external rotator muscles (1.97-2.67 and 1.57-2.40; p < 0.0005-0.006 for reader 1/2) and tendons (1.41-2.45 and 1.93-2.76; p < 0.0005 for reader 1/2). The anterolateral and anterior approach showed less soft tissue damage. Fluid collections showed no differences between the approaches. MRI is well suited to identify surgical approaches after THA. The anterior and anterolateral approach showed less soft tissue damage compared to the posterior and direct lateral approach. (orig.)

Gross National Happiness

DEFF Research Database (Denmark)

Giri, Krishna Prasad; Kjær-Rasmussen, Lone Krogh

This paper investigates practices related to the ideology of infusing Gross National Happiness (GNH) into school curriculum, the effectiveness of the meditation and mind training and the implication of GNH for school environment. It also explores how GNH ambience has been managed and practiced...... of Gross National Happiness and Educating for Gross National happiness....

A Method Validation for Determination of Gross Alpha and Gross Beta in Water Sample Using Low Background Gross Alpha/ Beta Counting System

International Nuclear Information System (INIS)

Zal Uyun Wan Mahmood; Norfaizal Mohamed; Nita Salina Abu Bakar

2016-01-01

Method validation (MV) for the measurement of gross alpha and gross beta activity in water (drinking, mineral and environmental) samples using Low Background Gross Alpha/ Beta Counting System was performed to characterize precision, accuracy and reliable results. The main objective of this assignment is to ensure that both the instrument and method always good performed and resulting accuracy and reliable results. Generally, almost the results of estimated RSD, z-score and U_s_c_o_r_e were reliable which are recorded as ≤30 %, less than 2 and less than 1.5, respectively. Minimum Detected Activity (MDA) was estimated based on the counting time of 100 minutes and present background counting value of gross alpha (0.01 - 0.35 cpm) and gross beta (0.50 - 2.18 cpm). Estimated Detection Limit (DL) was 0.1 Bq/ L for gross alpha and 0.2 Bq/ L for gross beta and expended uncertainty was relatively small of 9.77 % for gross alpha and 10.57 % for gross beta. Align with that, background counting for gross alpha and gross beta was ranged of 0.01 - 0.35 cpm and 0.50 - 2.18 cpm, respectively. While, sample volume was set at minimum of 500 mL and maximum of 2000 mL. These proven the accuracy and precision result that are generated from developed method/ technique is satisfactory and method is recommended to be used. Therefore, it can be concluded that the MV found no doubtful on the ability of the developed method. The test result showed the method is suitable for all types of water samples which are contained several radionuclides and elements as well as any impurities that interfere the measurement analysis of gross alpha and gross beta. (author)

Associations between gross motor skills and physical activity in Australian toddlers.

Science.gov (United States)

Veldman, Sanne L C; Jones, Rachel A; Santos, Rute; Sousa-Sá, Eduarda; Pereira, João R; Zhang, Zhiguang; Okely, Anthony D

2018-08-01

Physical activity can be promoted by high levels of gross motor skills. A systematic review found a positive relationship in children (3-18 years) but only few studies examined this in younger children. The aim of this study was to examine the association between gross motor skills and physical activity in children aged 11-29 months. Cross-sectional study. This study involved 284 children from 30 childcare services in NSW, Australia (Mean age=19.77±4.18months, 53.2% boys). Physical activity was measured using accelerometers (Actigraph GT3X+). Gross motor skills were assessed using the Peabody Developmental Motor Scales Second Edition (PDMS-2). Multilevel linear regression analyses were computed to assess associations between gross motor skills and physical activity, adjusting for sex, age and BMI. Children spent 53.08% of their time in physical activity and 10.39% in moderate to vigorous physical activity (MVPA). Boys had higher total physical activity (pskills score was 96.16. Boys scored higher than girls in object manipulation (pskills and total physical activity or MVPA. Although gross motor skills were not associated with physical activity in this sample, stronger associations are apparent in older children. This study therefore highlights a potential important age to promote gross motor skills. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

A comparative study on the volume and localization of the internal gross target volume defined using the seroma and surgical clips based on 4DCT scan for external-beam partial breast irradiation after breast conserving surgery

International Nuclear Information System (INIS)

Ding, Yun; Li, Jianbin; Wang, Wei; Wang, Suzhen; Wang, Jinzhi; Ma, Zhifang; Shao, Qian; Xu, Min

2014-01-01

To explore the volume and localization of the internal gross target volume defined using the seroma and/or surgical clips based on the four-dimensional computed tomography (4DCT) during free-breathing. Fifteen breast cancer patients after breast-conserving surgery (BCS) were recruited for EB-PBI. On the ten sets CT images, the gross target volume formed by the clips, the seroma, both the clips and seroma delineated by one radiation oncologist and defined as GTVc, GTVs and GTVc + s, respectively. The ten GTVc, GTVs and GTVc + s on the ten sets CT images produced the IGTVc, IGTVs, IGTVc + s, respectively. The IGTV volume and the distance between the center of IGTVc, IGTVs, IGTVc + s were all recorded. Conformity index (CI), degree of inclusion (DI) were calculated for IGTV/IGTV, respectively. The volume of IGTVc + s were significantly larger than the IGTVc and IGTVs (p < 0.05). There was significant difference between the DIs of IGTVc vs IGTVc + s, the DIs of IGTVs vs IGTVc + s. There was significant difference among the CIs of IGTV/IGTV. The DIs and CIs of IGTV/IGTV were negatively correlated with their centroid distance (r < 0, p < 0.05). There were volume difference and spatial mismatch between the IGTVs delineated based on the surgical clips and seroma. The IGTV defined as the seroma and surgical clips provided the best overall representation of the ‘true’ moving GTV

Closed Incision Negative Pressure Therapy Versus Standard of Care Surgical Dressing in Revision Total Knee Arthroplasty

Science.gov (United States)

2018-06-07

Surgical Wound; Revision Total Knee Arthroplasty; Wounds and Injuries; Joint Disease; Musculoskeletal Disease; Prosthesis-Related Infections; Infection; Postoperative Complications; Pathologic Processes

Surgical approach in patients with hyperparathyroidism in multiple endocrine neoplasia type 1: total versus partial parathyroidectomy

Directory of Open Access Journals (Sweden)

Francesco Tonelli

2012-01-01

Full Text Available Usually, primary hyperparathyroidism is the first endocrinopathy to be diagnosed in patients with multiple endocrine neoplasia type 1, and is also the most common one. The timing of the surgery and strategy in multiple endocrine neoplasia type 1/hyperparathyroidism are still under debate. The aims of surgery are to: 1 correct hypercalcemia, thus preventing persistent or recurrent hyperparathyroidism; 2 avoid persistent hypoparathyroidism; and 3 facilitate the surgical treatment of possible recurrences. Currently, two types of surgical approach are indicated: 1 subtotal parathyroidectomy with removal of at least 3-3 K glands; and 2 total parathyroidectomy with grafting of autologous parathyroid tissue. Transcervical thymectomy must be performed with both of these procedures. Unsuccessful surgical treatment of hyperparathyroidism is more frequently observed in multiple endocrine neoplasia type 1 than in sporadic hyperparathyroidism. The recurrence rate is strongly influenced by: 1 the lack of a pre-operative multiple endocrine neoplasia type 1 diagnosis; 2 the surgeon's experience; 3 the timing of surgery; 4 the possibility of performing intra-operative confirmation (histologic examination, rapid parathyroid hormone assay of the curative potential of the surgical procedure; and, 5 the surgical strategy. Persistent hyperparathyroidism seems to be more frequent after subtotal parathyroidectomy than after total parathyroidectomy with autologous graft of parathyroid tissue. Conversely, recurrent hyperparathyroidism has a similar frequency in the two surgical strategies. To plan further operations, it is very helpful to know all the available data about previous surgery and to undertake accurate identification of the site of recurrence.

Clinical anatomy of the subserous layer: An amalgamation of gross and clinical anatomy.

Science.gov (United States)

Yabuki, Yoshihiko

2016-05-01

The 1998 edition of Terminologia Anatomica introduced some currently used clinical anatomical terms for the pelvic connective tissue or subserous layer. These innovations persuaded the present author to consider a format in which the clinical anatomical terms could be reconciled with those of gross anatomy and incorporated into a single anatomical glossary without contradiction or ambiguity. Specific studies on the subserous layer were undertaken on 79 Japanese women who had undergone surgery for uterine cervical cancer, and on 26 female cadavers that were dissected, 17 being formalin-fixed and 9 fresh. The results were as follows: (a) the subserous layer could be segmentalized by surgical dissection in the perpendicular, horizontal and sagittal planes; (b) the segmentalized subserous layer corresponded to 12 cubes, or ligaments, of minimal dimension that enabled the pelvic organs to be extirpated; (c) each ligament had a three-dimensional (3D) structure comprising craniocaudal, mediolateral, and dorsoventral directions vis-á-vis the pelvic axis; (d) these 3D-structured ligaments were encoded morphologically in order of decreasing length; and (e) using these codes, all the surgical procedures for 19th century to present-day radical hysterectomy could be expressed symbolically. The establishment of clinical anatomical terms, represented symbolically through coding as demonstrated in this article, could provide common ground for amalgamating clinical anatomy with gross anatomy. Consequently, terms in clinical anatomy and gross anatomy could be reconciled and compiled into a single anatomical glossary. © 2015 Wiley Periodicals, Inc.

Measurement of gross alpha and gross beta activity concentrations in human tooth

International Nuclear Information System (INIS)

Soeguet, Omer; Aydin, Mehmet Fatih; Kuecuekoender, Erdal; Zorer, Ozlem Selcuk; Dogru, Mahmut

2010-01-01

The gross alpha and gross beta activity concentrations were measured in human tooth taken from 3 to 6 age-groups to 40 and over ones. Accumulated teeth samples are investigated in two groups as under and above 18 years. The gross alpha and beta radioactivity of human tooth samples was measured by using a gas-flow proportional counter (PIC-MPC 9604-α/β counter). In tooth samples, for female age-groups, the obtained results show that the mean gross alpha and gross beta activity concentrations varied between 0.534-0.203 and 0.010-0.453 Bq g -1 and the same concentrations for male age-groups varied between 0.009-1.168 and 0.071-0.204 Bq g -1 , respectively.

Pathology Gross Photography: The Beginning of Digital Pathology.

Science.gov (United States)

Rampy, B Alan; Glassy, Eric F

2015-06-01

The underutilized practice of photographing anatomic pathology specimens from surgical pathology and autopsies is an invaluable benefit to patients, clinicians, pathologists, and students. Photographic documentation of clinical specimens is essential for the effective practice of pathology. When considering what specimens to photograph, all grossly evident pathology, absent yet expected pathologic features, and gross-only specimens should be thoroughly documented. Specimen preparation prior to photography includes proper lighting and background, wiping surfaces of blood, removing material such as tubes or bandages, orienting the specimen in a logical fashion, framing the specimen to fill the screen, positioning of probes, and using the right-sized scale. Copyright © 2015 Elsevier Inc. All rights reserved.

Surgical time and complications of total transvaginal (total-NOTES, single-port laparoscopic-assisted and conventional ovariohysterectomy in bitches

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M.A.M. Silva

2015-06-01

Full Text Available The recently developed minimally invasive techniques of ovariohysterectomy (OVH have been studied in dogs in order to optimize their benefits and decrease risks to the patients. The purpose of this study was to compare surgical time, complications and technical difficulties of transvaginal total-NOTES, single-port laparoscopic-assisted and conventional OVH in bitches. Twelve bitches were submitted to total-NOTES (NOTES group, while 13 underwent single-port laparoscopic-assisted (SPLA group and 15 were submitted to conventional OVH (OPEN group. Intra-operative period was divided into 7 stages: (1 access to abdominal cavity; (2 pneumoperitoneum; approach to the right (3 and left (4 ovarian pedicle and uterine body (5; (6 abdominal or vaginal synthesis, performed in 6 out of 12 patients of NOTES; (7 inoperative time. Overall and stages operative times, intra and postoperative complications and technical difficulties were compared among groups. Mean overall surgical time in NOTES (25.7±6.8 minutes and SPLA (23.1±4.0 minutes groups were shorter than in the OPEN group (34.0±6.4 minutes (P<0.05. The intraoperative stage that required the longest time was the approach to the uterine body in the NOTES group and abdominal and cutaneous sutures in the OPEN group. There was no difference regarding the rates of complications. Major complications included postoperative bleeding requiring reoperation in a bitch in the OPEN group, while minor complications included mild vaginal discharge in four patients in the NOTES group and seroma in three bitches in the SPLA group. In conclusion, total-NOTES and SPLA OVH were less time-consuming then conventional OVH in bitches. All techniques presented complications, which were properly managed.

Comparing survival outcomes of gross total resection and subtotal resection with radiotherapy for craniopharyngioma: a meta-analysis.

Science.gov (United States)

Wang, Guoqing; Zhang, Xiaoyang; Feng, Mengzhao; Guo, Fuyou

2018-06-01

Recent studies suggest that subtotal resection (STR) followed by radiation therapy (RT) is an appealing alternative to gross total resection (GTR) for craniopharyngioma, but it remains controversial. We conducted a meta-analysis to determine whether GTR is superior to STR with RT for craniopharyngioma. A systematic search was performed for articles published until October 2017 in the PubMed, Embase, and Cochrane Central databases. The endpoints of interest are overall survival and progression-free survival. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) were calculated using a fixed or random-effects model. The data were analyzed using Review Manager 5.3 software. A total of 744 patients (seven cohort studies) were enrolled for analyses. There were no significant differences between the GTR and STR with RT groups when the authors compared the pooled HRs at the end of the follow-up period. Overall survival (pooled HR = 0.76, 95% CI: 0.46-1.25, P = 0.28) and progression-free survival (pooled HR = 1.52, 95% CI: 0.42-5.44, P = 0.52) were similar between the two groups. The current meta-analysis suggests that GTR and STR with RT have the similar survival outcomes for craniopharyngioma. Copyright © 2018 Elsevier Inc. All rights reserved.

[Congenital cyst of the common bile duct. Surgical treatment with total excision of the cyst].

Science.gov (United States)

Orozco-Sánchez, J; Carreón-Carranza, J J; Benitez-Sánchez, J A; Rosas-Salas, G; Casian-Castellanos, G; Llanes-González, E; Turcio-Cortazar, E

1989-02-01

Congenital choledochal cyst (CChC) has a very low frequency in our population; it is more frequent among females and its pattern of inheritance is multifactorial. The frequency of CChC in our population was 1 per 20,000 to 1 per 30,000 hospitalized patients in the pediatrics department of the Hospital Juarez and Hospital Infantil de Tacubaya, respectively. Four new cases of CChC are reported, two school children and two teenagers. Pre-operative diagnosis was accomplished clinically, which is the most precise non-invasive method. The most effective actual diagnostic methods include ultrasonography, CAT scan, and basic laboratory data, which can corroborate the clinical diagnosis of CChC with 100% certainty. The surgical treatment of CChC is controversial, but the surgical procedures of choice are choledochocystojejunostomy with total cyst removal, Roux's Y, and cholecystectomy. One case was treated with latero-terminal choledochocystojejunostomy and 3 cases with total removal of the cyst. The results were excellent.

Macroeconomic costs of the unmet burden of surgical disease in Sierra Leone: a retrospective economic analysis.

Science.gov (United States)

Grimes, Caris E; Quaife, Matthew; Kamara, Thaim B; Lavy, Christopher B D; Leather, Andy J M; Bolkan, Håkon A

2018-03-14

The Lancet Commission on Global Surgery estimated that low/middle-income countries will lose an estimated cumulative loss of US$12.3 trillion from gross domestic product (GDP) due to the unmet burden of surgical disease. However, no country-specific data currently exist. We aimed to estimate the costs to the Sierra Leone economy from death and disability which may have been averted by surgical care. We used estimates of total, met and unmet need from two main sources-a cluster randomised, cross-sectional, countrywide survey and a retrospective, nationwide study on surgery in Sierra Leone. We calculated estimated disability-adjusted life years from morbidity and mortality for the estimated unmet burden and modelled the likely economic impact using three different methods-gross national income per capita, lifetime earnings foregone and value of a statistical life. In 2012, estimated, discounted lifetime losses to the Sierra Leone economy from the unmet burden of surgical disease was between US$1.1 and US$3.8 billion, depending on the economic method used. These lifetime losses equate to between 23% and 100% of the annual GDP for Sierra Leone. 80% of economic losses were due to mortality. The incremental losses averted by scale up of surgical provision to the Lancet Commission target of 80% were calculated to be between US$360 million and US$2.9 billion. There is a large economic loss from the unmet need for surgical care in Sierra Leone. There is an immediate need for massive investment to counteract ongoing economic losses. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

ASSETS ADMITTED TO COVER GROSS TECHNICAL RESERVES CASE STUDY: INSURANCE – REINSURANCE COMPANY ASTRA SA

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IRINELA – CONSTANTINA BADEA

2015-12-01

Full Text Available The aim of this paper is to analyze the asset structure and the coverage of gross technical reserves of the Insurance – Reinsurance Company Astra SA, for the period 2003 – 2014. Insurance companies are required to constitute technical reserves, in order to cope with the payment obligations to policyholders. These reserves may only be covered on account of certain assets, admitted by law. In Romania, Orders No. 8 and 9/2011, issued by the Insurance Supervisory Commission, contain Rules regarding the assets admitted to cover gross technical reserves, the dispersion of assets admitted to cover gross technical reserves and the liquidity coefficient. Order No. 9/2011, relating to general insurance, has been amended by Rule No. 22/2014. In this paper, we have analyzed the main elements of Astra’s assets, their share in total assets and we have calculated the coverage of gross technical reserves by total assets and liquid assets. In 2013 and 2014, the value of total assets was below the value of gross tehnical reserves, which demonstrated Astra’s financial instability, through negative capital and the inability to meet the obligations to policyholders. Failure to comply with the prudential indicators has been one of the main causes of Astra`s bankruptcy.

Evaluation of gross radioactivity in foodstuffs

International Nuclear Information System (INIS)

Zorer, Oezlem Selcuk; Oeter, Cigdem

2015-01-01

The paper presents the results of radiological investigations of food products sampled in the summer and fall of 2011 and 2012 in different parts of Van, Turkey. Gross radioactivity measurements in food products were evaluated. Food items were divided into eight groups: (1) water, (2) fish, (3) cheese products, (4) fruits, (5) vegetables, (6) herbs, (7) walnut and (8) rock salt. The levels of the gross alpha and gross beta radioactivity in all food samples varied widely ranging from 0.070 to 10.885 Bq/g and from 0.132 to 48.285 Bq/g on dry mass basis, respectively. In one sample, gross alpha and gross beta activity concentrations were found to be relatively high according to the other samples and in all samples, the gross alpha radioactivity was measured lower than the gross beta radioactivity. The gross α and gross β activities were measured by using α/β counter of the multi-detector low background system (PIC MPC-9604).

Evaluation of gross radioactivity in foodstuffs

Energy Technology Data Exchange (ETDEWEB)

Zorer, Oezlem Selcuk; Oeter, Cigdem [Yuzuncu Yil Univ., Van (Turkey). Dept. of Chemistry

2015-05-15

The paper presents the results of radiological investigations of food products sampled in the summer and fall of 2011 and 2012 in different parts of Van, Turkey. Gross radioactivity measurements in food products were evaluated. Food items were divided into eight groups: (1) water, (2) fish, (3) cheese products, (4) fruits, (5) vegetables, (6) herbs, (7) walnut and (8) rock salt. The levels of the gross alpha and gross beta radioactivity in all food samples varied widely ranging from 0.070 to 10.885 Bq/g and from 0.132 to 48.285 Bq/g on dry mass basis, respectively. In one sample, gross alpha and gross beta activity concentrations were found to be relatively high according to the other samples and in all samples, the gross alpha radioactivity was measured lower than the gross beta radioactivity. The gross α and gross β activities were measured by using α/β counter of the multi-detector low background system (PIC MPC-9604).

Total joint Perioperative Surgical Home: an observational financial review.

Science.gov (United States)

Raphael, Darren R; Cannesson, Maxime; Schwarzkopf, Ran; Garson, Leslie M; Vakharia, Shermeen B; Gupta, Ranjan; Kain, Zeev N

2014-01-01

The numbers of people requiring total arthroplasty is expected to increase substantially over the next two decades. However, increasing costs and new payment models in the USA have created a sustainability gap. Ad hoc interventions have reported marginal cost reduction, but it has become clear that sustainability lies only in complete restructuring of care delivery. The Perioperative Surgical Home (PSH) model, a patient-centered and physician-led multidisciplinary system of coordinated care, was implemented at UC Irvine Health in 2012 for patients undergoing primary elective total knee arthroplasty (TKA) or total hip arthroplasty (THA). This observational study examines the costs associated with this initiative. The direct cost of materials and services (excluding professional fees and implants) for a random index sample following the Total Joint-PSH pathway was used to calculate per diem cost. Cost of orthopedic implants was calculated based on audit-verified direct cost data. Operating room and post-anesthesia care unit time-based costs were calculated for each case and analyzed for variation. Benchmark cost data were obtained from literature search. Data are presented as mean ± SD (coefficient of variation) where possible. Total per diem cost was $10,042 ± 1,305 (13%) for TKA and $9,952 ± 1,294 (13%) for THA. Literature-reported benchmark per diem cost was $17,588 for TKA and $16,267 for THA. Implant cost was $7,482 ± 4,050 (54%) for TKA and $9869 ± 1,549 (16%) for THA. Total hospital cost was $17,894 ± 4,270 (24%) for TKA and $20,281 ± 2,057 (10%) for THA. In-room to incision time cost was $1,263 ± 100 (8%) for TKA and $1,341 ± 145 (11%) for THA. Surgery time cost was $1,558 ± 290 (19%) for TKA and $1,930 ± 374 (19%) for THA. Post-anesthesia care unit time cost was $507 ± 187 (36%) for TKA and $557 ± 302 (54%) for THA. Direct hospital costs were driven substantially below USA benchmark levels using the Total Joint-PSH pathway. The incremental

Parathyroid gland autotransplantation after total thyroidectomy in surgical management of hypopharyngeal and laryngeal carcinomas: A case series

Directory of Open Access Journals (Sweden)

Abd Elmaksoud M. Abd Elmaksoud

2015-06-01

Conclusions: Parathyroid gland autotranplantation is a simple safe technique with high success rate in preventing persistent hypoparathyroidism after total thyroidectomy in surgical management of advanced hypopharyngeal and laryngeal carcinomas.

Requirement of radiochemical recovery determination for gross alpha and gross beta estimation in drinking water

International Nuclear Information System (INIS)

Raveendran, Nanda; Rao, D.D.; Hegde, A.G.

2010-01-01

Presence of radionuclides in drinking water which emits Alpha and Beta particles are the potential sources of internal exposure in drinking water. Gross alpha and gross beta determination in drinking water and packaged drinking water (PDW) as per BIS (Bureau of Indian standards) standards is discussed here. The methods have been tested to account for losses in the radiochemical procedures using radionuclides such as 137 Cs, 90 Sr, 226 Ra, 239 Pu, 243 Am, 232 U. The methods have also been validated in an IAEA proficiency test conducted during 2009. Monitoring of gross alpha and gross beta activity observed in drinking water/packaged drinking water from various states of India were within the limits set by BIS. Average radiochemical recoveries of 84% and 63% were obtained for gross α and gross β respectively. (author)

Peritendinous calcinosis of calcaneus tendon associated with dermatomyositis: correlation between conventional radiograph, ultrasound, magnetic resonance imaging and gross surgical pathology; Calcinose peritendinea do tendao calcaneo associada a dermatomiosite: correlacao entre radiografia convencional, ultra-sonografia, ressonancia magnetica e macroscopia cirurgica

Energy Technology Data Exchange (ETDEWEB)

Rosa, Ana Claudia Ferreira; Gomide, Lidyane Marques de Paula; Lemes, Marcella Stival [Universidade Federal de Goias (UFG), Goiana, GO (Brazil). Faculdade de Medicina. Hospital das Clinicas; Costa, Edegmar Nunes; Rocha, Valney Luiz da [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Ortopedia; Machado, Marcio Martins; Santos Junior, Rubens Carneiro dos; Barros, Nestor de; Cerri, Giovanni Guido [Universidade Federal de Goias (UFG), Goiania, GO (Brazil). Faculdade de Medicina. Dept. de Radiologia; Sernik, Renato Antonio [Sao Paulo Univ., SP (Brazil). Hospital das Clinicas. Inst. de Radiologia; Nunes, Rodrigo Alvarenga [Universidade do Vale do Sapucai (UNIVAS), Pouso Alegre, MG (Brazil). Faculdade de Ciencias Medicas; Albieri, Alexandre Daher [Hospital de Acidentados de Goiania, GO (Brazil)

2006-01-15

Interstitial calcinosis is an uncommon condition in which there is either localized or widely disseminated deposition of calcium in the skin, subcutaneous tissues, muscles, and tendons. Calcinosis is often associated with collagen diseases, scleroderma and dermatomyositis. The authors report a case of interstitial calcinosis associated with dermatomyositis studied with conventional radiograph, ultrasound and magnetic resonance imaging, and correlate the imaging findings with the results of surgical pathology gross examination. (author)

Surgical outcomes of the endoscopic endonasal transsphenoidal approach for large and giant pituitary adenomas: institutional experience with special attention to approach-related complications

Directory of Open Access Journals (Sweden)

Edson Rocha Constantino

2016-05-01

Full Text Available ABSTRACT Objective In this study, we investigate our institutional experience of patients who underwent endoscopic endonasal transsphenoidal approach for treatment of large and giant pituitary adenomas emphasizing the surgical results and approach-related complications. Method The authors reviewed 28 consecutive patients who underwent surgery between March, 2010 and March, 2014. Results The mean preoperative tumor diameter was 4.6 cm. Gross-total resection was achieved in 14.3%, near-total in 10.7%, subtotal in 39.3%, and partial in 35.7%. Nine patients experienced improvement in visual acuity, while one patient worsened. The most common complications were transient diabetes insipidus (53%, new pituitary deficit (35.7%, endonasal adhesions (21.4%, and cerebrospinal fluid leak (17.8%. Surgical mortality was 7.1%. Conclusions Endoscopic endonasal transsphenoidal surgery is a valuable treatment option for large or giant pituitary adenomas, which results in high rates of surgical decompression of cerebrovascular structures.

Is Lumbosacral Plexus Block an Effective and Safe Alternative as Surgical Anesthesia for Total Hip Replacement?

DEFF Research Database (Denmark)

Nielsen, Niels Dalsgaard; Larsen, Jens Rolighed; Børglum, Jens

BACKGROUND An increasing number of patients for total hip replacement presents with cardiovascular comorbidities, that render them fragile to traditional methods of anesthesia. The aim of this intended study is to compare lumbosacral plexus blockade with continuous spinal anesthesia for surgical ...

A global assessment of gross and net land change dynamics for current conditions and future scenarios

Science.gov (United States)

Fuchs, Richard; Prestele, Reinhard; Verburg, Peter H.

2018-05-01

The consideration of gross land changes, meaning all area gains and losses within a pixel or administrative unit (e.g. country), plays an essential role in the estimation of total land changes. Gross land changes affect the magnitude of total land changes, which feeds back to the attribution of biogeochemical and biophysical processes related to climate change in Earth system models. Global empirical studies on gross land changes are currently lacking. Whilst the relevance of gross changes for global change has been indicated in the literature, it is not accounted for in future land change scenarios. In this study, we extract gross and net land change dynamics from large-scale and high-resolution (30-100 m) remote sensing products to create a new global gross and net change dataset. Subsequently, we developed an approach to integrate our empirically derived gross and net changes with the results of future simulation models by accounting for the gross and net change addressed by the land use model and the gross and net change that is below the resolution of modelling. Based on our empirical data, we found that gross land change within 0.5° grid cells was substantially larger than net changes in all parts of the world. As 0.5° grid cells are a standard resolution of Earth system models, this leads to an underestimation of the amount of change. This finding contradicts earlier studies, which assumed gross land changes to appear in shifting cultivation areas only. Applied in a future scenario, the consideration of gross land changes led to approximately 50 % more land changes globally compared to a net land change representation. Gross land changes were most important in heterogeneous land systems with multiple land uses (e.g. shifting cultivation, smallholder farming, and agro-forestry systems). Moreover, the importance of gross changes decreased over time due to further polarization and intensification of land use. Our results serve as an empirical database for

Total pancreatectomy and islet autotransplantation in children for chronic pancreatitis: indication, surgical techniques, postoperative management, and long-term outcomes.

Science.gov (United States)

Chinnakotla, Srinath; Bellin, Melena D; Schwarzenberg, Sarah J; Radosevich, David M; Cook, Marie; Dunn, Ty B; Beilman, Gregory J; Freeman, Martin L; Balamurugan, A N; Wilhelm, Josh; Bland, Barbara; Jimenez-Vega, Jose M; Hering, Bernhard J; Vickers, Selwyn M; Pruett, Timothy L; Sutherland, David E R

2014-07-01

Describe the surgical technique, complications, and long-term outcomes of total pancreatectomy and islet autotransplantation (TP-IAT) in a large series of pediatric patients. Surgical management of childhood pancreatitis is not clear; partial resection or drainage procedures often provide transient pain relief, but long-term recurrence is common due to the diffuse involvement of the pancreas. Total pancreatectomy (TP) removes the source of the pain, whereas islet autotransplantation (IAT) potentially can prevent or minimize TP-related diabetes. Retrospective review of 75 children undergoing TP-IAT for chronic pancreatitis who had failed medical, endoscopic, or surgical treatment between 1989 and 2012. Pancreatitis pain and the severity of pain statistically improved in 90% of patients after TP-IAT (P Puestow procedure (P = 0.018), lower body surface area (P = 0.048), higher islet equivalents (IEQ) per kilogram body weight (P = 0.001), and total IEQ (100,000) (P = 0.004) were associated with insulin independence. By multivariate analysis, 3 factors were associated with insulin independence after TP-IAT: (1) male sex, (2) lower body surface area, and (3) higher total IEQ per kilogram body weight. Total IEQ (100,000) was the single factor most strongly associated with insulin independence (odds ratio = 2.62; P < 0.001). Total pancreatectomy and islet autotransplantation provides sustained pain relief and improved quality of life. The β-cell function is dependent on islet yield. Total pancreatectomy and islet autotransplantation is an effective therapy for children with painful pancreatitis that failed medical and/or endoscopic management.

Monitoring of gross alpha, gross beta and tritium activities in portuguese drinking waters

International Nuclear Information System (INIS)

Lopes, I.; Madruga, M.J.; Ferrador, G.O.; Sequeira, M.M.; Oliveira, E.J.; Gomes, A.R.; Rodrigues, F.D.; Carvalho, F.P.

2006-01-01

The gross beta and tritium activities in the forty Portuguese drinking waters analyzed using the ISO standard methods (Portuguese Guidelines) are below the guidance levels proposed in the Portuguese Drinking Water Quality Guidelines. In what concerns the gross alpha activity only 18% exceeded the recommended level. In general, it can be concluded that the ingestion of these drinking waters does not create a radiological hazard to the human consumption, however, more detailed analyses will be necessary mainly the determinations of the individual alpha emitters radionuclide concentrations. The minimum gross alpha and gross beta detectable activities by L.S.C. methodology are higher than for the proportional counting technique (ISO method). Higher concentration factors will be needed to reach lower required detection limits. (authors)

[Surgical research in Germany--an international comparison].

Science.gov (United States)

Fendrich, V; Rothmund, M

2010-04-01

Surgical research in Germany occupies a lower position in international ranking than expected. According to the size of the population, the economic impact, the gross domestic product and the research funding capacity, the impact of German surgical research should be much higher. Reasons are a more intensive commitment to patient care, structural differences and a changing lifestyle in younger doctors in comparison to many leading countries. If the situation is to be improved all factors have to be evaluated and, if possible, changed. Overall, German surgeons are underrepresented as readers and authors in the scientific market, which is mostly in the English language.

Protocol for concomitant temporomandibular joint custom-fitted total joint reconstruction and orthognathic surgery utilizing computer-assisted surgical simulation.

Science.gov (United States)

Movahed, Reza; Teschke, Marcus; Wolford, Larry M

2013-12-01

Clinicians who address temporomandibular joint (TMJ) pathology and dentofacial deformities surgically can perform the surgery in 1 stage or 2 separate stages. The 2-stage approach requires the patient to undergo 2 separate operations and anesthesia, significantly prolonging the overall treatment. However, performing concomitant TMJ and orthognathic surgery (CTOS) in these cases requires careful treatment planning and surgical proficiency in the 2 surgical areas. This article presents a new treatment protocol for the application of computer-assisted surgical simulation in CTOS cases requiring reconstruction with patient-fitted total joint prostheses. The traditional and new CTOS protocols are described and compared. The new CTOS protocol helps decrease the preoperative workup time and increase the accuracy of model surgery. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

NM Gross Receipts Baseline

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

The Current State of Screening and Decolonization for the Prevention of Staphylococcus aureus Surgical Site Infection After Total Hip and Knee Arthroplasty.

Science.gov (United States)

Weiser, Mitchell C; Moucha, Calin S

2015-09-02

The most common pathogens in surgical site infections after total hip and knee arthroplasty are methicillin-sensitive Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), and coagulase-negative staphylococci. Patients colonized with MSSA or MRSA have an increased risk for a staphylococcal infection at the site of a total hip or knee arthroplasty. Most colonized individuals who develop a staphylococcal infection at the site of a total hip or total knee arthroplasty have molecularly identical S. aureus isolates in their nares and wounds. Screening and nasal decolonization of S. aureus can potentially reduce the rates of staphylococcal surgical site infection after total hip and total knee arthroplasty. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

Combined enteral feeding and total parenteral nutritional support improves outcome in surgical intensive care unit patients.

Science.gov (United States)

Hsu, Min-Hui; Yu, Ying E; Tsai, Yueh-Miao; Lee, Hui-Chen; Huang, Ying-Che; Hsu, Han-Shui

2012-09-01

For intensive care unit (ICU) patients with gastrointestinal dysfunction and in need of total parenteral nutrition (TPN) support, the benefit of additional enteral feeding is not clear. This study aimed to investigate whether combined TPN with enteral feeding is associated with better outcomes in surgical intensive care unit (SICU) patients. Clinical data of 88 patients in SICU were retrospectively collected. Variables used for analysis included route and percentage of nutritional support, total caloric intake, age, gender, body weight, body mass index, admission diagnosis, surgical procedure, Acute Physiology and Chronic Health Evaluation (APACHE) II score, comorbidities, length of hospital stay, postoperative complications, blood glucose values and hospital mortality. Wound dehiscence and central catheter infection were observed more frequently in the group of patients receiving TPN calories less than 90% of total calorie intake (p = 0.004 and 0.043, respectively). APACHE II scores were higher in nonsurvivors than in survivors (p = 0.001). More nonsurvivors received TPN calories exceeding 90% of total calorie intake and were in need of dialysis during ICU admission (p = 0.005 and 0.013, respectively). Multivariate analysis revealed that the percentage of TPN calories over total calories and APACHE II scores were independent predictors of ICU mortality in patients receiving supplementary TPN after surgery. In SICU patients receiving TPN, patients who could be fed enterally more than 10% of total calories had better clinical outcomes than patients receiving less than 10% of total calorie intake from enteral feeding. Enteral feeding should be given whenever possible in severely ill patients. 2012 Published by Elsevier B.V

Validation of an imageable surgical resection animal model of Glioblastoma (GBM).

Science.gov (United States)

Sweeney, Kieron J; Jarzabek, Monika A; Dicker, Patrick; O'Brien, Donncha F; Callanan, John J; Byrne, Annette T; Prehn, Jochen H M

2014-08-15

Glioblastoma (GBM) is the most common and malignant primary brain tumour having a median survival of just 12-18 months following standard therapy protocols. Local recurrence, post-resection and adjuvant therapy occurs in most cases. U87MG-luc2-bearing GBM xenografts underwent 4.5mm craniectomy and tumour resection using microsurgical techniques. The cranial defect was repaired using a novel modified cranial window technique consisting of a circular microscope coverslip held in place with glue. Immediate post-operative bioluminescence imaging (BLI) revealed a gross total resection rate of 75%. At censor point 4 weeks post-resection, Kaplan-Meier survival analysis revealed 100% survival in the surgical group compared to 0% in the non-surgical cohort (p=0.01). No neurological defects or infections in the surgical group were observed. GBM recurrence was reliably imaged using facile non-invasive optical bioluminescence (BLI) imaging with recurrence observed at week 4. For the first time, we have used a novel cranial defect repair method to extend and improve intracranial surgical resection methods for application in translational GBM rodent disease models. Combining BLI and the cranial window technique described herein facilitates non-invasive serial imaging follow-up. Within the current context we have developed a robust methodology for establishing a clinically relevant imageable GBM surgical resection model that appropriately mimics GBM recurrence post resection in patients. Copyright © 2014 Elsevier B.V. All rights reserved.

AQUACEL® Ag Surgical Dressing Reduces Surgical Site Infection and Improves Patient Satisfaction in Minimally Invasive Total Knee Arthroplasty: A Prospective, Randomized, Controlled Study

Directory of Open Access Journals (Sweden)

Feng-Chih Kuo

2017-01-01

Full Text Available The use of modern surgical dressings to prevent wound complications and surgical site infection (SSI after minimally invasive total knee arthroplasty (MIS-TKA is lacking. In a prospective, randomized, controlled study, 240 patients were randomized to receive either AQUACEL Ag Surgical dressing (study group or a standard dressing (control group after MIS-TKA. The primary outcome was wound complication (SSI and blister. The secondary outcomes were wear time and number of dressing changes in the hospital and patient satisfaction (pain, comfort, and ease of use. In the intention-to-treat analysis, there was a significant reduction in the incidence of superficial SSI (0.8%, 95% CI∶ 0.00–2.48 in the study group compared to 8.3% (95% CI∶ 3.32–13.3 in the control group (p=0.01. There were no differences in blister and deep/organ-space SSIs between the two groups. Multivariate analysis revealed that AQUACEL Ag Surgical dressing was an independent risk factor for reduction of SSI (odds ratio: 0.07, 95% CI: 0.01–0.58, p=0.01. The study group had longer wear time (5.2±0.7 versus 1.7±0.4 days, p<0.0001 and lower number of dressing changes (1.0±0.2 versus 3.6±1.3 times, p<0.0001. Increased patient satisfaction (p<0.0001 was also noted in the study group. AQUACEL Ag Surgical dressing is an ideal dressing to provide wound care efficacy, patient satisfaction, reduction of SSI, and cost-effectiveness following MIS-TKA.

Surgical and radiological effects upon the development of speech after total laryngectomy

International Nuclear Information System (INIS)

Richardson, J.L.

1981-01-01

The data presented examine the relationship between postlaryngectomy communication method, and the extent of total laryngectomy and the use of radiation therapy. The expectations of speech therapy providers were also examined. The author interviewed 60 laryngectomy patients who were six months to 3 1/2 years postsurgery. Surgeries were grouped into four categories and correlated with communication method. The relationship was statistically significant with the most apparent deterrent effect exhibited only for the most extreme surgical excisions. There was no relationship with the use of radiation therapy. In many cases speech therapy providers' expectations were not supported by the data

Determination of gross gamma and gross beta activities in liquid effluent samples. Phase I

International Nuclear Information System (INIS)

Curtis, K.E.; Sood, S.P.

1985-08-01

Several inadequacies in the presently used procedures for gross gamma and gross beta measurements in aqueous wastes have been identified. Both the presence of suspended particulate activity and the use of cesium-137 as a calibration standard can cause gross gamma measurements to overestimate the actual activity in the sample. At the same time, sample preparation for the determination of gross beta activities causes large losses of radioiodine before the measurement step and the presence of solid material can cause a serious decrease in the beta counting efficiency. A combination of these errors could result in large discrepancies between the results obtained by the two measurement methods. Improved procedures are required to overcome these problems

A global assessment of gross and net land change dynamics for current conditions and future scenarios

Directory of Open Access Journals (Sweden)

R. Fuchs

2018-05-01

Full Text Available The consideration of gross land changes, meaning all area gains and losses within a pixel or administrative unit (e.g. country, plays an essential role in the estimation of total land changes. Gross land changes affect the magnitude of total land changes, which feeds back to the attribution of biogeochemical and biophysical processes related to climate change in Earth system models. Global empirical studies on gross land changes are currently lacking. Whilst the relevance of gross changes for global change has been indicated in the literature, it is not accounted for in future land change scenarios. In this study, we extract gross and net land change dynamics from large-scale and high-resolution (30–100 m remote sensing products to create a new global gross and net change dataset. Subsequently, we developed an approach to integrate our empirically derived gross and net changes with the results of future simulation models by accounting for the gross and net change addressed by the land use model and the gross and net change that is below the resolution of modelling. Based on our empirical data, we found that gross land change within 0.5° grid cells was substantially larger than net changes in all parts of the world. As 0.5° grid cells are a standard resolution of Earth system models, this leads to an underestimation of the amount of change. This finding contradicts earlier studies, which assumed gross land changes to appear in shifting cultivation areas only. Applied in a future scenario, the consideration of gross land changes led to approximately 50 % more land changes globally compared to a net land change representation. Gross land changes were most important in heterogeneous land systems with multiple land uses (e.g. shifting cultivation, smallholder farming, and agro-forestry systems. Moreover, the importance of gross changes decreased over time due to further polarization and intensification of land use. Our results serve as

Gross alpha and gross beta determination in surface and groundwater water by liquid scintillation counting (LSC)

International Nuclear Information System (INIS)

Faria, Ligia S.; Moreira, Rubens M.

2013-01-01

The present study has used 40 samples of groundwater and surface water collected at four different sites along the period of one year in Brumadinho and Nova Lima, two municipalities in the State of Minas Gerais, Brazil, as part of a more extensive study aiming at determination of the natural radioactivity in the water used for domestic use. These two sites are inside an Environmental Protection Area is located in a region of very intensive iron ore exploration. In addition of mineral resources, the region has a geological characteristic that includes quartzitic conglomerates associated with uranium. Radioactivity levels were determined via liquid scintillation counting (LSC), a fast and high counting efficiency method that can be advantageously employed to determine gross alpha and gross beta activity in liquid samples. Previously to gross alpha and gross beta counting the samples were acidified with concentrated HNO 3 in the field. The technique involved a pre-concentration of the sample to obtain a low detection limit. Specific details of the employed methodology are commented. The results showed that concentrations of gross alpha natural activity and gross beta values ranged from less than the detection limit of the equipment (0.03 Bq.L -1 ) to 0.275 ± 0.05 Bq.L -1 for gross alpha. As regards gross beta, all samples were below the limit of detection. (author)

Gross motor skill development of 5-year-old Kindergarten children in Myanmar.

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Aye, Thanda; Oo, Khin Saw; Khin, Myo Thuzar; Kuramoto-Ahuja, Tsugumi; Maruyama, Hitoshi

2017-10-01

[Purpose] The purpose of this study was to examine the gross motor skill development of 5-year-old Kindergarten children in Myanmar. [Subjects and Methods] Total 472 healthy Kindergarten children (237 males, 235 females) of 2016-2017 academic year from four schools in urban area and four schools in rural area of Myanmar were recruited. The gross motor skill development of all subjects was assessed with the test of gross motor development second edition (TGMD-2). All subjects performed two trials for each gross motor skill and the performance was video recorded and scored. The assessment procedures were done according to the standardized guidelines of TGMD-2. [Results] The majority of subjects had average level of gross motor skill rank. The significant differences were found on the run and gallop of locomotor skills and the most of object control skills except the catch between males and females. The significant differences were also found between subjects from urban and rural areas. [Conclusion] Gross motor skill development of 5-year-old Kindergarten children in Myanmar had gender-based and region-based differences on both locomotor and object control skills. This study added a valuable information to the establishment of a normative reference of Kindergarten aged children for future studies.

Surgical pathology report in the era of desktop publishing.

Science.gov (United States)

Pillarisetti, S G

1993-01-01

Since it is believed that "a picture is worth a thousand words," incorporation of computer-generated line art was used as a adjunct to gross description in surgical pathology reporting in selected cases. The lack of an integrated software program was overcome by using commercially available graphic and word processing software. A library of drawings was developed over the last few years. Most time-consuming is the development of templates and the graphic library. With some effort it is possible to integrate graphics of high quality into surgical pathology reports.

GROSS ANATOMY AND SURGICAL APPROACH TO THE HUMERAL SHAFT IN GIANT ANTEATER (MYRMECOPHAGA TRIDACTYLA).

Science.gov (United States)

Sesoko, Natália Ferreira; Rahal, Sheila Canevese; Bortolini, Zara; Merlini, Natalie Bertelis; Teixeira, Carlos Roberto

2016-09-01

Anteater forelimbs are distinguished morphologically from domestic animals, especially due to their unique movement and their natural habits. A knowledge of the pectoral limb anatomy and the proper surgical approach are fundamental to success in osteosynthesis and other surgeries. This study aimed to describe the muscles and neurovascular structures of the pectoral limb and the surgical approach to the humeral shaft of the giant anteater ( Myrmecophaga tridactyla ). Dissections of the forelimbs of seven cadavers were performed to identify the major muscles and neurovascular structures. Three of these animals' contralateral forearms were used to simulate the surgical approach to the humeral shaft. Some specific characteristics of the muscle morphology were biceps muscle had two heads, triceps muscle had three heads, and there was an olecranon-epicondylar muscle. To expose the shaft of the humerus, it was necessary to incise the superficial pectoral muscle and separate the heads of the biceps muscle. Due to the anatomical characteristics of the humerus, the craniomedial approach was the most appropriate because it accommodated the anatomical peculiarities of the giant anteater.

Gross alpha/beta analyses in water by liquid scintillation counting

International Nuclear Information System (INIS)

Wong, C.T.; Lawrence Livermore National Laboratory, CA; Soliman, V.M.; Perera, S.K.

2005-01-01

The standard procedure for analyzing gross alpha and gross beta in water is evaporation of the sample and radioactivity determination of the resultant solids by proportional counting. This technique lacks precision, and lacks sensitivity for samples with high total dissolved solids. Additionally, the analytical results are dependent on the choice of radionuclide calibration standard and the sample matrix. Direct analysis by liquid scintillation counting has the advantages of high counting efficiencies and minimal sample preparation time. However, due to the small sample aliquants used for analysis, long count times are necessary to reach required detection limits. The procedure proposed consists of evaporating a sample aliquant to dryness, dissolving the resultant solids in a small volume of dilute acid, followed by liquid scintillation counting to determine radioactivity. This procedure can handle sample aliquants containing up to 500 mg of dissolved solids. Various acids, scintillation cocktail mixtures, instrument discriminator settings, and regions of interest (ROI) were evaluated to determine optimum counting conditions. Precision is improved and matrix effects are reduced as compared to proportional counting. Tests indicate that this is a viable alternative to proportional counting for gross alpha and gross beta analyses of water samples. (author)

Promoting gross motor skills and physical activity in childcare: A translational randomized controlled trial.

Science.gov (United States)

Jones, Rachel A; Okely, Anthony D; Hinkley, Trina; Batterham, Marijka; Burke, Claire

2016-09-01

Educator-led programs for physical activity and motor skill development show potential but few have been implemented and evaluated using a randomized controlled design. Furthermore, few educator-led programs have evaluated both gross motor skills and physical activity. Therefore, the aim of this study was to evaluate a gross motor skill and physical activity program for preschool children which was facilitated solely by childcare educators. A six-month 2-arm randomized controlled trial was implemented between April and September 2012 in four early childhood centers in Tasmania, Australia. Educators participated in ongoing professional development sessions and children participated in structured physical activity lessons and unstructured physical activity sessions. In total, 150 children were recruited from four centers which were randomized to intervention or wait-list control group. Six early childhood educators from the intervention centers were trained to deliver the intervention. Gross motor skills were assessed using the Test of Gross Motor Development (2nd edition) and physical activity was measured objectively using GT3X+ Actigraph accelerometers. No statistically significant differences were identified. However, small to medium effect sizes, in favor of the intervention group, were evident for four of the five gross motor skills and the total gross motor skill score and small to medium effect sizes were reported for all physical activity outcomes. This study highlights the potential of educator-led physical activity interventions and supports the need for further translational trials within the early childhood sector. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Effect of temperate climate tree species on gross ammonification, gross nitrification and N2O formation

Science.gov (United States)

Brüggemann, N.; Rosenkranz, P.; Papen, H.; Butterbach-Bahl, K.

2003-04-01

Microbial nitrogen turnover processes in the soil, like ammonification, nitrification and denitrification, play an important role in the formation of nitrous oxide (N2O): (i) ammonification, because it releases nitrogen from organic material in the form of ammonium (NH4+), which in turn can serve as substrate for nitrification; (ii) nitrification itself (i.e. the turnover of NH4+ to nitrate, NO3-), during which nitric oxide (NO) and N2O can be released as by-products at varying ratios; (iii) denitrification, in which NO3- serves as electron acceptor and is converted to molecular nitrogen (N2) via NO and N2O as intermediates, that can also be partially lost to the atmosphere. Temperate forest soils are a substantial source of atmospheric N2O contributing up to 10% to the total atmospheric N2O budget. However, this figure is afflicted with a huge uncertainty due to a number of factors governing the soil N2O formation, consumption, release and uptake, which are not fully understood at present. To one of these factors belongs the influence of the tree species on nitrogen turnover processes in the soil and the formation of N trace gases related with them. The aim of the present work was to analyse this tree species effect for the temperate climate region. For this purpose the effect of five different temperate tree species, having the same age and growing on the same soil in direct vicinity to each other, on gross ammonification and gross nitrification as well as on N2O formation was investigated. The trees (common beech, Fagus sylvatica; pedunculate oak, Quercus robur; Norway spruce, Picea abies; Japanese larch, Larix leptolepis; mountain pine, Pinus mugo) were part of a species trial in Western Jutland, Denmark, established in 1965 on a former sandy heathland. Samples from the soil under these five tree species were taken in spring and in summer 2002, respectively, differentiating between organic layer and mineral soil. The gross rates of ammonification as well of

Teaching surgical exposures to undergraduate medical students: an integration concept for anatomical and surgical education.

Science.gov (United States)

Hammer, Niels; Hepp, Pierre; Löffler, Sabine; Schleifenbaum, Stefan; Steinke, Hanno; Klima, Stefan

2015-06-01

Decreasing numbers of students are interested in starting a surgical career, posing substantial challenges to patient care in the next years. The anatomy course is one of the key subjects in medical training, especially in surgical disciplines. Innovative teaching concepts that integrate surgically relevant anatomy and manual dexterity might help boost student interest in surgery. A preclinical workshop entitled "Surgical exposures" was developed. A team of anatomists and surgeons introduced the surgical exposures, demonstrating the procedures on Thiel-fixed body donors. Following this introduction, students practiced the exposures in an operating room-like manner. A six-point Likert scale was used to evaluate the workshop and to compare it to the first-year dissection course. The overall evaluation result for the surgical exposures was excellent, proving to be a significantly better result when compared to the first-year dissection course. The students were more satisfied with the teaching time invested by the peers and regarded the workshop as clinically highly relevant. Furthermore, they felt that questions were addressed better and that the overall atmosphere was better than in the gross anatomy course. Subject to criticism was the course size and practicing time in both cases. The surgical exposures workshop provides preclinical students with clinically relevant anatomy and manual dexterity. It may positively influence the decision to follow a surgical career. This course, however, requires extensive teaching resources. The given concept may help implement practical medical skills in the preclinical curriculum, strengthening the professional identity of surgeons and anatomists.

26 CFR 1.61-1 - Gross income.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 2 2010-04-01 2010-04-01 false Gross income. 1.61-1 Section 1.61-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES (CONTINUED) Definition of Gross Income, Adjusted Gross Income, and Taxable Income § 1.61-1 Gross...

Dual pathology causing severe pulmonary hypertension following surgical repair of total anomalous pulmonary venous connection: Successful outcome following serial transcatheter interventions.

Science.gov (United States)

Jain, Shreepal; Bachani, Neeta S; Pinto, Robin J; Dalvi, Bharat V

2018-01-01

Surgical repair of total anomalous pulmonary venous connection (TAPVC) can be complicated by the development of pulmonary venous stenosis later on. In addition, the vertical vein, if left unligated, can remain patent and lead to hemodynamically significant left to right shunting. We report an infant who required transcatheter correction of both these problems after surgical repair of TAPVC.

Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure.

Science.gov (United States)

Pagenstert, Geert; Hintermann, Beat

2011-10-13

Simultaneous osteoarthritis (OA) of the ankle joint complicates primary total knee arthroplasty (TKA). In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA) during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week) and hospital stay (12 days) of this special patient was markedly reduced compared to the usual course of separate TJA. Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

Simultaneous bilateral total knee and ankle arthroplasty as a single surgical procedure

Directory of Open Access Journals (Sweden)

Hintermann Beat

2011-10-01

Full Text Available Abstract Background Simultaneous osteoarthritis (OA of the ankle joint complicates primary total knee arthroplasty (TKA. In such cases, rehabilitation of TKA is limited by debilitating ankle pain, but varus or valgus ankle arthritis may even compromise placement of knee prosthetic components. Case presentation We present a patient with simultaneous bilateral valgus and patellofemoral OA of the knees and bilateral varus OA of the ankle joints that equally contributed to overall disability. This 63 years old, motivated and otherwise healthy patient was treated by simultaneous bilateral total knee and ankle arthroplasty (quadruple total joint arthroplasty, TJA during the same anesthesia. Two years outcome showed excellent alignment and function of all four replaced joints. Postoperative time for rehabilitation, back to work (6th week and hospital stay (12 days of this special patient was markedly reduced compared to the usual course of separate TJA. Conclusions Simultaneous quadruple TJA in equally disabling OA of bilateral deformed knees and ankles resulted in a better functional outcome and faster recovery compared to the average reported results after TKA and TAA in literature. However, careful preoperative planning, extensive patient education, and two complete surgical teams were considered essential for successful performance. To the best of our knowledge this is the first case report in literature about quadruple major total joint arthroplasty implanted during the same anesthesia in the same patient.

Gross and microscopic lesions in corals from Micronesia

Science.gov (United States)

Work, Thierry M.; Aeby, Greta S.; Hughen, Konrad A.

2015-01-01

The authors documented gross and microscopic morphology of lesions in corals on 7 islands spanning western, southern, and eastern Micronesia, sampling 76 colonies comprising 30 species of corals among 18 genera, with Acropora, Porites, and Montipora dominating. Tissue loss comprised the majority of gross lesions sampled (41%), followed by discoloration (30%) and growth anomaly (29%). Of 31 cases of tissue loss, most lesions were subacute (48%), followed by acute and chronic (26% each). Of 23 samples with discoloration, most were dark discoloration (40%), with bleaching and other discoloration each constituting 30%. Of 22 growth anomalies, umbonate growth anomalies composed half, with exophytic, nodular, and rugose growth anomalies composing the remainder. On histopathology, for 9 cases of dark discoloration, fungal infections predominated (77%); for 7 bleached corals, depletion of zooxanthellae from the gastrodermis made up a majority of microscopic diagnoses (57%); and for growth anomalies other than umbonate, hyperplasia of the basal body wall was the most common microscopic finding (63%). For the remainder of the gross lesions, no single microscopic finding constituted >50% of the total. Host response varied with the agent present on histology. Fragmentation of tissues was most often associated with algae (60%), whereas necrosis dominated (53%) for fungi. Two newly documented potentially symbiotic tissue-associated metazoans were seen in Porites and Montipora. Findings of multiple potential etiologies for a given gross lesion highlight the importance of incorporating histopathology in coral disease surveys. This study also expands the range of corals infected with cell-associated microbial aggregates.

Gross total resection of pituitary adenomas after endoscopic vs. microscopic transsphenoidal surgery: a meta-analysis.

Science.gov (United States)

Almutairi, Reem D; Muskens, Ivo S; Cote, David J; Dijkman, Mark D; Kavouridis, Vasileios K; Crocker, Erin; Ghazawi, Kholoud; Broekman, Marike L D; Smith, Timothy R; Mekary, Rania A; Zaidi, Hasan A

2018-05-01

Microscopic transsphenoidal surgery (mTSS) is a well-established method to address adenomas of the pituitary gland. Endoscopic transsphenoidal surgery (eTSS) has become a viable alternative, however. Advocates suggest that the greater illumination, panoramic visualization, and angled endoscopic views afforded by eTSS may allow for higher rates of gross total tumor resection (GTR). The aim of this meta-analysis was to determine the rate of GTR using mTSS and eTSS. A meta-analysis of the literature was conducted using PubMed, EMBASE, and Cochrane databases through July 2017 in accordance with PRISMA guidelines. Seventy case series that reported GTR rate in 8257 pituitary adenoma patients were identified. For all pituitary adenomas, eTSS (GTR=74.0%; I 2  = 92.1%) was associated with higher GTR as compared to mTSS (GTR=66.4%; I 2  = 84.0%) in a fixed-effect model (P-interaction  0.05). No significant publication bias was identified for any of the outcomes. Among patients who were not randomly allocated to either approach, eTSS resulted in a higher rate of GTR as compared to mTSS for all patients and for NFPA patients alone, but only in a fixed-effect model. For FPA, however, eTSS did not seem to offer a significantly higher rate of GTR. These conclusions should be interpreted with caution because of the nature of the included non-comparative studies.

Dual pathology causing severe pulmonary hypertension following surgical repair of total anomalous pulmonary venous connection: Successful outcome following serial transcatheter interventions

Directory of Open Access Journals (Sweden)

Shreepal Jain

2018-01-01

Full Text Available Surgical repair of total anomalous pulmonary venous connection (TAPVC can be complicated by the development of pulmonary venous stenosis later on. In addition, the vertical vein, if left unligated, can remain patent and lead to hemodynamically significant left to right shunting. We report an infant who required transcatheter correction of both these problems after surgical repair of TAPVC.

Is it All About the Money? Not All Surgical Subspecialization Leads to Higher Lifetime Revenue when Compared to General Surgery.

Science.gov (United States)

Baimas-George, Maria; Fleischer, Brian; Slakey, Douglas; Kandil, Emad; Korndorffer, James R; DuCoin, Christopher

It is believed that spending additional years gaining expertise in surgical subspecialization leads to higher lifetime revenue. Literature shows that more surgeons are pursuing fellowship training and dedicated research years; however, there are no data looking at the aggregate economic impact when training time is accounted for. It is hypothesized that there will be a discrepancy in lifetime income when delay to practice is considered. Data were collected from the Medical Group Management Association's 2015 report of average annual salaries. Fixed time of practice was set at 30 years, and total adjusted revenue was calculated based on variable years spent in research and fellowship. All total revenue outcomes were compared to general surgery and calculated in US dollars. The financial data on general surgeons and 9 surgical specialties (vascular, pediatric, plastic, breast, surgical oncology, cardiothoracic, thoracic primary, transplant, and trauma) were examined. With fellowship and no research, breast and surgical oncology made significantly less than general surgery (-$1,561,441, -$1,704,958), with a difference in opportunity cost equivalent to approximately 4 years of work. Pediatric and cardiothoracic surgeons made significantly more than general surgeons, with an increase of opportunity cost equivalent to $5,301,985 and $3,718,632, respectively. With 1 research year, trauma surgeons ended up netting less than a general surgeon by $325,665. With 2 research years, plastic and transplant surgeons had total lifetime revenues approximately equivalent to that of a general surgeon. Significant disparities exist in lifetime total revenue between surgical subspecialties and in comparison, to general surgery. Although most specialists do gross more than general surgeons, breast and surgical oncologists end up netting significantly less over their lifetime as well as trauma surgeons if they do 1 year of research. Thus, the economic advantage of completing additional

Complete surgical resection improves outcome in INRG high-risk patients with localized neuroblastoma older than 18 months.

Science.gov (United States)

Fischer, Janina; Pohl, Alexandra; Volland, Ruth; Hero, Barbara; Dübbers, Martin; Cernaianu, Grigore; Berthold, Frank; von Schweinitz, Dietrich; Simon, Thorsten

2017-08-04

Although several studies have been conducted on the role of surgery in localized neuroblastoma, the impact of surgical timing and extent of primary tumor resection on outcome in high-risk patients remains controversial. Patients from the German neuroblastoma trial NB97 with localized neuroblastoma INSS stage 1-3 age > 18 months were included for retrospective analysis. Imaging reports were reviewed by two independent physicians for Image Defined Risk Factors (IDRF). Operation notes and corresponding imaging reports were analyzed for surgical radicality. The extent of tumor resection was classified as complete resection (95-100%), gross total resection (90-95%), incomplete resection (50-90%), and biopsy (Neuroblastoma Risk Group (INRG) staging system. Survival curves were estimated according to the method of Kaplan and Meier and compared by the log-rank test. A total of 179 patients were included in this study. 77 patients underwent more than one primary tumor operation. After best surgery, 68.7% of patients achieved complete resection of the primary tumor, 16.8% gross total resection, 14.0% incomplete surgery, and 0.5% biopsy only. The cumulative complication rate was 20.3% and the surgery associated mortality rate was 1.1%. Image defined risk factors (IDRF) predicted the extent of resection. Patients with complete resection had a better local-progression-free survival (LPFS), event-free survival (EFS) and OS (overall survival) than the other groups. Subgroup analyses showed better EFS, LPFS and OS for patients with complete resection in INRG high-risk patients. Multivariable analyses revealed resection (complete vs. other), and MYCN (non-amplified vs. amplified) as independent prognostic factors for EFS, LPFS and OS. In patients with localized neuroblastoma age 18 months or older, especially in INRG high-risk patients harboring MYCN amplification, extended surgery of the primary tumor site improved local control rate and survival with an acceptable risk of

The San Andreas fault experiment. [gross tectonic plates relative velocity

Science.gov (United States)

Smith, D. E.; Vonbun, F. O.

1973-01-01

A plan was developed during 1971 to determine gross tectonic plate motions along the San Andreas Fault System in California. Knowledge of the gross motion along the total fault system is an essential component in the construction of realistic deformation models of fault regions. Such mathematical models will be used in the future for studies which will eventually lead to prediction of major earthquakes. The main purpose of the experiment described is the determination of the relative velocity of the North American and the Pacific Plates. This motion being so extremely small, cannot be measured directly but can be deduced from distance measurements between points on opposite sites of the plate boundary taken over a number of years.

COST OF PRODUCTION, GROSS RETURN AND NET PROFIT IN COMMERCIAL EGG PRODUCTION

Directory of Open Access Journals (Sweden)

M. Farooq, Zahoor-ul-Haq1, M.A. Mian, F.R. Durrani and M. Syed

2003-01-01

Full Text Available The present study was carried out in Chakwal, Pakistan by collecting data from randomly selected 109 flocks to investigate cost of production, gross return and net profit per layer. Majority of the buildings in the study area were rented therefore, rent per layer was added to the total cost of production instead of depreciation on building and equipments. Overall total cost of production, gross return and net profit per layer was Rs. 393.88 ± 5.36, 432.14 ± 8.01 and 38.26 ± 6.66, respectively. Rate of return over the invested capital was 27%. Mean feed cost per layer was Rs. 302.23 ± 5.01, including Rs. 10.27 ± 0.24, 29.19 ± 0.42 and 262.77 ± 5.08 for starter, grower and layer ration, respectively. Feed cost was the major component contributing 76.73% to the total cost of production. Average cost of labor, day-old chick, building rent, vaccination, therapy, miscellaneous item, electricity, bedding material and transportation was Rs. 19.90 ± 0.45, 19.75 ± 0.05, 16.25 ± 0.26, 12.80 ± 0.10, 10.90 ± 2.32, 4.35 ± 0.09, 3.15 ± 0.07, 2.65 ± 0.09 and 1.90 ± 0.08, respectively, contributing 5.05, 5.01, 4.13, 3.25, 2.77, 1.10, 0.80, 0.67 and 0.48 % to the total cost of production. Gross return from the sale of marketable eggs, culled eggs, spent/culled bird, empty bags and manure was Rs. 388.84 ± 7.91, 3.85 ± 0.01, 35.80 ± 0.23, 2.20 ± 0.04 and 1.45 ± 0.01, respectively, contributing 89.98, 0.89, 8.28, 0.51 and 0.34% to the total return. Determining the effect of different parameters on the cost of production and net profit, large flocks, Hisex strain, brood-grow and lay system of rearing, good hygienic conditions of the farm, normal stocking rate and cage system of housing wee found to give maximum gross return as well as net profit.

Clinical, radiological, surgical, and pathological determinants of olfactory groove schwannoma

Directory of Open Access Journals (Sweden)

Andi Sadayandi Ramesh

2014-01-01

Full Text Available Background: Olfactory groove schwannomas (OGS are rare anterior cranial fossa base tumors with only 41 cases reported in literature. Olfactory ensheathing cell schwannoma (OECS has similar clinico-radiological features as OGS, but a different cell of origin. In recent years, there is growing interest in OECS as more cases are being reported. Aims: The objective was to study the clinico-radiological features of OGS and define the histological differentiation from OECS. Materials and Methods: We retrospectively analyzed clinical, radiological, surgical and histopathological picture of all cases of OGS managed in our institute. Immuno histochemical studies were performed in these tumors for differentiating from OECS. A comprehensive review of articles published until date describing the operative treatment was done. Results: All three cases had presented with seizures, two had anosmia and papilledema. Gross-total resection was achieved in all our patients. One patient expired in the postoperative period due to septicemia. Positive expression to newer immuno histochemical biomarker CD57 (Leu7, with negative staining to smooth muscle α-actin (SMA was helpful in confirming the diagnosis of OGS and differentiating it from OECS in all our cases. Conclusions: OECS, though rare has to be differentiated from OGS using immuno histochemistry. Gross-total resection of OGS with preservation of olfactory function is often possible and curative. Although these tumors are commonly treated with microsurgical skull base approaches, an endoscopic endonasal approach can be considered in some cases, with repair using mucoperiosteal pedicled flap to prevent cerebrospinal fluid leak.

Intramedullary spinal immature teratoma: resolution of quadriplegia following resection in a 4-week-old infant.

Science.gov (United States)

Nickols, Hilary Highfield; Chambless, Lola B; Carson, Robert P; Coffin, Cheryl M; Pearson, Matthew M; Abel, Ty W

2010-12-01

Intramedullary spinal cord teratomas are rare entities in infants. Management of these lesions is primarily surgical, with outcome dependent on rapid surgical decompression and complete gross-total tumor resection. The lesions are typically of the mature type, with immature teratomas displaying unique pathological features. The authors report a case of an extensive intramedullary immature teratoma in an infant with resolution of quadriplegia following gross-total radical resection. At the 1-year follow-up, there was radiographic evidence of tumor, and surgical reexploration yielded portions of immature teratoma and extensive gliosis.

Innovative procedure for the determination of gross-alpha/gross-beta activities in drinking water

International Nuclear Information System (INIS)

Wisser, S.; Frenzel, E.; Dittmer, M.

2006-01-01

An alternative sample preparation method for the determination of gross-alpha/beta activity concentrations in drinking water is introduced in this paper. After the freeze-drying of tap water samples, determination by liquid scintillation counting can be applied utilizing alpha/beta separation. It has been shown that there is no adsorption or loss of solid radionuclides during the freeze-drying procedure. However, the samples have to be measured quickly after the preparation since the ingrowth of daughter isotopes negatively effects the measurement. The limits of detection for gross-alpha and gross-beta activity are in the range 25-210 mBq/l, respectively, for a measurement time of only 8-9 h

In search of the rainbow: Colored inks in surgical pathology

Directory of Open Access Journals (Sweden)

Chandralekha Tampi

2012-01-01

Full Text Available Introduction: Although surgical pathologists are aware of the multiple advantages that coloured inks contribute to surgical pathology practice, these coloured inks are not available in India and importing them is not a viable proposition. A systematic search for locally available coloring agents was done, and resulted in identifying specific shades within a popular set of children′s hobby colors of a particular brand. They retain their bright distinct colors on paraffin blocks and sections. These paints are available all over India, and are cheap, safe, and easy to use. Coloring gross specimen excision margins with different colors, adds precision to margin examination. It allows three-dimensional microscopic reconstruction of the tumor vis-a-vis its various neighboring anatomic structures. It allows postoperative comparison of tissue planes predicted by preoperative imaging. It maintains orientation of grossed and dissected specimens, enabling the pathologist to re-visit the grossed specimen, if required, and confidently allows further sampling if necessary. Aim: A systematic search for indigenous coloring agents was carried out, which included the dyes used in the histopathology laboratory, gelatin, commercially available paints, including acrylic paints and inks. Results: The study identified specific shades within a brand of acrylic colors that are easily available and simple to use, with good results on microscopic examination. Conclusion: Colored inks lend precision to margin examination. A set of easily procurable colors are available in our country, which are easy to use, with distinct bright colors, safe, and reliable.

Total Pancreatectomy and Islet Auto-Transplantation in Children for Chronic Pancreatitis. Indication, Surgical Techniques, Post Operative Management and Long-Term Outcomes

Science.gov (United States)

Chinnakotla, Srinath; Bellin, Melena D.; Schwarzenberg, Sarah J.; Radosevich, David M.; Cook, Marie; Dunn, Ty B.; Beilman, Gregory J.; Freeman, Martin L.; Balamurugan, A.N.; Wilhelm, Josh; Bland, Barbara; Jimenez-Vega, Jose M; Hering, Bernhard J.; Vickers, Selwyn M.; Pruett, Timothy L.; Sutherland, David E.R.

2014-01-01

Objective Describe the surgical technique, complications and long term outcomes of total pancreatectomy and islet auto transplantation (TP-IAT) in a large series of pediatric patients. Summary Background Data Surgical management of childhood pancreatitis is not clear; partial resection or drainage procedures often provide transient pain relief, but long term recurrence is common due to the diffuse involvement of the pancreas. Total pancreatectomy (TP) removes the source of the pain, while islet auto transplantation (IAT) potentially can prevent or minimize TP-related diabetes. Methods Retrospective review of 75 children undergoing TP-IAT for chronic pancreatitis who had failed medical, endoscopic or surgical treatment between 1989–2012. Results Pancreatitis pain and the severity of pain statistically improved in 90% of patients after TP-IAT (p =Puestow (p=0.018), lower body surface area (p=0.048), IEQ per Kg Body Weight (p=0.001) and total IEQ (100,000) (0.004) were associated with insulin independence. By multivariate analysis, 3 factors were associated with insulin independence after TP-IAT:(1) male gender, (2) lower body surface area and the (3) higher total IEQ per kilogram body weight. Total IEQ (100,000) was the single factor most strongly associated with insulin independence (OR = 2.62; p value < 0.001). Conclusions TP-IAT provides sustained pain relief and improved quality of life. The β cell function is dependent on islet yield. TP-IAT is an effective therapy for children with painful pancreatitis that fail medical and or endoscopic management PMID:24509206

The efficacy of 12 weeks non-surgical treatment for patients not eligible for total knee replacement

DEFF Research Database (Denmark)

Skou, Søren Thorgaard; Rasmussen, Sten; Laursen, Mogens Berg

2015-01-01

OBJECTIVE: To compare the efficacy of a 12-week non-surgical treatment program with usual care in patients with knee osteoarthritis (OA) not eligible for total knee replacement (TKR). METHOD: This two-arm parallel group assessor-blinded randomized controlled trial (RCT) included 100 adults from...... secondary care with knee OA, confirmed by radiography (Kellgren-Lawrence grade ≥1), but not eligible for a TKR. The 12-week non-surgical treatment program consisted of individualized progressed neuromuscular exercise, patient education, insoles, dietary advice and prescription of pain medication...... if indicated, while usual care comprised two leaflets with information and advice on knee OA and recommended treatments. The primary outcome was the change from baseline to 12 months in the Knee injury and Osteoarthritis Outcome Score (KOOS)4 defined as the average score for the KOOS subscales of pain...

Gross Motor Skills in Children With Idiopathic Clubfoot and the Association Between Gross Motor Skills, Foot Involvement, Gait, and Foot Motion.

Science.gov (United States)

Lööf, Elin; Andriesse, Hanneke; André, Marie; Böhm, Stephanie; Iversen, Maura D; Broström, Eva W

2017-02-24

Little is known regarding gross motor skills (GMS) in children with idiopathic clubfoot (IC). This study describes GMS, specifically foot involvement and asymmetries, and analyses the association between GMS, gait, and foot status in children with IC. Gross motor tasks and gait were analyzed in children with IC and typically developed (TD) children. GMS were assessed using videotapes and the Clubfoot Assessment Protocol (CAP). The Gait Deviation Index (GDI) and GDI-Kinetic were calculated from gait analyses. Children were divided into bilateral, unilateral clubfoot, or TD groups. To analyze asymmetries, feet within each group were further classified into superior or inferior foot, depending on their CAP scores. Correlations identified associations between CAP and GDI, GDI-Kinetic, passive foot motion, and Dimeglio Classification Scores at birth in the clubfeet. In total, 75 children (mean age, 5 years) were enrolled (bilateral n=22, unilateral clubfoot n=25, TD=28). Children with clubfeet demonstrated significantly lower GMS, gait, and foot motion compared with TD children. One leg standing and hopping deviated in 84% and 91%, respectively, in at least one foot in children with clubfoot. Gross motor asymmetries were evident in both children with bilateral and unilateral involvement. In children with unilateral clubfoot, contralateral feet showed few deviations in GMS compared with TD; however, differences existed in gait and foot motion. The association between GMS and gait, foot motion, and initial foot status varied between poor and moderate. Gross motor deficits and asymmetries are present in children with both bilateral and unilateral IC. Development of GMS of the contralateral foot mirrors that of TD children, but modifies to the clubfoot in gait and foot motion. The weak association with gait, foot motion, and initial clubfoot severity indicates that gross motor measurements represent a different outcome entity in clubfoot treatment. We therefore, recommend

Repair of Total Tractional Retinal Detachment in Norrie Disease: Report of Technique and Successful Surgical Outcome.

Science.gov (United States)

Todorich, Bozho; Thanos, Aristomenis; Yonekawa, Yoshihiro; Capone, Antonio

2017-03-01

Norrie disease is a rare, but devastating cause of pediatric retinal detachment, universally portending a poor visual prognosis. This paper describes successful surgical management of an infant with total retinal detachment associated with Norrie disease mutation. The infant was a full-term white male who presented with bilateral total funnel retinal detachments (RDs). He underwent genetic testing, which demonstrated single-point mutation 133 G>A transition in exon 2 of the NDP gene. The retinal detachment was managed with translimbal iridectomy, lensectomy, capsulectomy, and vitrectomy. Careful dissection of the retrolental membranes resulted in opening of the funnel. Single-stage surgery in this child's eye achieved re-attachment of the posterior pole with progressive reabsorption of subretinal fluid and cholesterol without the need for external drainage. Fluorescein angiography, performed at 2 months postoperatively, demonstrated perfusion of major vascular arcades, but with significant abnormalities and aneurysmal changes of higher-order vessels, suggestive of retinal and vascular dysplasia. The child has maintained brisk light perception vision. Early surgical intervention with careful dissection of tractional tissues can potentially result in good anatomic outcomes in some patients with Norrie disease-associated retinal detachment. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:260-262.]. Copyright 2017, SLACK Incorporated.

NM Gross Receipts January - June 2012

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Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

NM Gross Receipts July - December 2013

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Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

NM Gross Receipts January - June 2014

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Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

NM Gross Receipts July - December 2012

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

NM Gross Receipts January - June 2013

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

NM Gross Receipts January - June 2011

Data.gov (United States)

Earth Data Analysis Center, University of New Mexico — This layer represents boundaries for New Mexico's gross receipts tax districts as identified on the "Gross Receipts Tax Rate Schedule" published by the Taxation and...

Effects of land use change on soil gross nitrogen transformation rates in subtropical acid soils of Southwest China.

Science.gov (United States)

Xu, Yongbo; Xu, Zhihong

2015-07-01

Land use change affects soil gross nitrogen (N) transformations, but such information is particularly lacking under subtropical conditions. A study was carried out to investigate the potential gross N transformation rates in forest and agricultural (converted from the forest) soils in subtropical China. The simultaneously occurring gross N transformations in soil were quantified by a (15)N tracing study under aerobic conditions. The results showed that change of land use types substantially altered most gross N transformation rates. The gross ammonification and nitrification rates were significantly higher in the agricultural soils than in the forest soils, while the reverse was true for the gross N immobilization rates. The higher total carbon (C) concentrations and C / N ratio in the forest soils relative to the agricultural soils were related to the greater gross N immobilization rates in the forest soils. The lower gross ammonification combined with negligible gross nitrification rates, but much higher gross N immobilization rates in the forest soils than in the agricultural soils suggest that this may be a mechanism to effectively conserve available mineral N in the forest soils through increasing microbial biomass N, the relatively labile organic N. The greater gross nitrification rates and lower gross N immobilization rates in the agricultural soils suggest that conversion of forests to agricultural soils may exert more negative effects on the environment by N loss through NO3 (-) leaching or denitrification (when conditions for denitrification exist).

Middle infratemporal fossa less invasive approach for radical resection of parapharyngeal tumors: surgical microanatomy and clinical application.

Science.gov (United States)

Nonaka, Yoichi; Fukushima, Takanori; Watanabe, Kentaro; Sakai, Jun; Friedman, Allan H; Zomorodi, Ali R

2016-01-01

Surgery of the infratemporal fossa (ITF) and parapharyngeal area presents a formidable challenge to the surgeon due to its anatomical complexity and limited access. Conventional surgical approaches to these regions were often too invasive and necessitate sacrifice of normal function and anatomy. To describe a less invasive transcranial extradural approach to ITF parapharyngeal lesions and to determine its advantages, 17 patients with ITF parapharyngeal neoplasms who underwent tumor resection via this approach were enrolled in the study. All lesions located in the ITF precarotid parapharyngeal space were resected through a small operative corridor between the trigeminal nerve third branch (V3) and the temporomandibular joint (TMJ). Surgical outcomes and postoperative complications were evaluated. Pathological diagnosis included schwannoma in eight cases, paraganglioma in two cases, gangliocytoma in two cases, carcinosarcoma in one case, giant cell tumor in one case, pleomorphic adenoma in one case, chondroblastoma in one case, and juvenile angiofibroma in one case. Gross total resection was achieved in 12 cases, near-total and subtotal resection were in 3 and 2 cases, respectively. The most common postoperative complication was dysphagia. Surgical exposure can be customized from minimal (drilling of retrotrigeminal area) to maximal (full skeletonization of V3, removal of all structures lying lateral to the petrous segment of internal carotid artery) according to tumor size and location. Since the space between the V3 and TMJ is the main corridor of this approach, the key maneuver is the anterior translocation of V3 to obtain an acceptable surgical field.

Goats reinfected with Toxoplasma gondii: loss of viable prolificacy and gross revenue

Directory of Open Access Journals (Sweden)

H. M. Silva

2015-10-01

Full Text Available ABSTRACTWe determined the reproductive parameters and clinical disorders in pregnant goats infected and reinfected with Toxoplasma gondii, and posteriorly the loss of gross revenue due to congenital toxoplasmosis was estimated. Of the 25 non-pregnant females negative for T. gondii, 20 were orally inoculated (ME 49 strain and of these, 15 pregnant females chronically infected were orally reinoculated (VEG strain with T. gondii oocysts. Five groups were formed (n=5: GI, GII and GIII (reinoculations at 40, 80 and 120 days of gestation, respectively, GIV (inoculation and GV (no inoculation. Clinical and serological exams were performed on days 0 (prior to inoculation, 3, 6 9, 15 and 21 and every 7 days post-inoculation. Exams were also performed on day 3 and every 7 days post-reinoculation. Reproductive management was performed on all females and initiated when the females infected displayed IgG titers IFAT<1,024. From the average prolificacy indexes of each experimental group were estimated: total production of kilograms of live weight (total kg LW of goats for slaughter, gross revenue and loss of gross revenue in U.S. dollars (US$, designed for a herd of 1,000 matrices. The unviable prolificacy indexes were 0.8 (GI, 1.2 (GII and 0.2 (GIII. Clinical disorders affected 57.1% (GI, 75.0% (GII and 16.7% (GIII of the offspring of goats reinfected with T. gondii. Congenital toxoplasmosis in goats reinfected resulted in the loss of 26.5% of gross revenues, being GI (US$ 10,577.60 or 57.1% and GII (US$ 12,693.12 or 60% holders of the highest values and percentages of economic losses. It was found that congenital toxoplasmosis reinfection cause clinical disorders in goats chronically infected with T. gondii and their offspring with birth of unviable animals and loss of gross revenue, at different stages of pregnancy (40, 80 and 120 days of gestation, being in the initial and intermediate stages of pregnancy the largest estimates of these losses.

Effects of hippotherapy on gross motor function and functional performance of children with cerebral palsy.

Science.gov (United States)

Park, Eun Sook; Rha, Dong Wook; Shin, Jung Soon; Kim, Soohyeon; Jung, Soojin

2014-11-01

The purpose of our study was to investigate the effects of hippotherapy on gross motor function and functional performance in children with spastic cerebral palsy (CP). We recruited 34 children (M:F=15:19, age: 3-12 years) with spastic CP who underwent hippotherapy for 45 minutes twice a week for 8 weeks. Twenty-one children with spastic CP were recruited for control group. The distribution of gross motor function classification system level and mean age were not significantly different between the two groups. Outcome measures, including the Gross Motor Function Measure (GMFM)-66, GMFM-88 and the Pediatric Evaluation of Disability Inventory: Functional Skills Scale (PEDI-FSS), were assessed before therapy and after the 8-weeks intervention as outcome measures. There were no significant differences between intervention and control groups in mean baseline total scores of GMFM-66, GMFM-88 or PEDI-FSS. After the 8-weeks intervention, mean GMFM-66 and GMFM-88 scores were significantly improved in both groups. However, the hippotherapy group had significantly greater improvement in dimension E and GMFM-66 total score than the control group. The total PEDI-FSS score and the sub-scores of its 3 domains were significantly improved in the hippotherapy group, but not in the control group. The results of our study demonstrate the beneficial effects of hippotherapy on gross motor function and functional performance in children with CP compared to control group. The significant improvement in PEDI-FSS scores suggests that hippotherapy may be useful to maximize the functional performance of children with CP.

Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center.

Science.gov (United States)

Mehr, Chelsea R; Obstfeld, Amrom E; Barrett, Amanda C; Montone, Kathleen T; Schwartz, Lauren E

2017-01-01

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center

Directory of Open Access Journals (Sweden)

Chelsea R. Mehr MD

2017-11-01

Full Text Available Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

Effect of age and surgical approach on perioperative wound complication following ovariohysterectomy in shelter-housed cats in Australia

Directory of Open Access Journals (Sweden)

Madeleine L Roberts

2015-10-01

Full Text Available Objectives The aim of the study was to investigate the effects of age and/or surgical approach on perioperative wound complication following ovariohysterectomy (OHE. Methods A retrospective search of perioperative monitoring records from a shelter desexing program was conducted to identify cats that underwent OHE between 1 June 2010 and 31 December 2012 inclusive. A wound complication was defined as gross observation of inflammation or wound dehiscence at the surgical site in the 5 day postoperative period. Cases were grouped according to age (≤12 weeks or >12 weeks and surgical approach (flank or midline. Stratified analyses were conducted to evaluate the association between surgical approach and wound complications, after adjusting for age. Mantel–Haenszel adjusted risk ratio, Cochran–Mantel–Haenszel test statistic and their 95% confidence intervals were presented. Results A total of 312 cases met the study criteria. The overall wound complication risk was low (6.09% and was not related to age. A midline approach was associated with a 4.59-times increased risk of wound complication, compared with a flank approach in cats up to 12 weeks of age ( P = 0.015 but not in older cats. Conclusions and relevance These findings support the practice of prepubertal desexing for cats.

Global Landslide Total Economic Loss Risk Deciles

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National Aeronautics and Space Administration — Global Landslide Total Economic Loss Risk Deciles is a 2.5 minute grid of global landslide total economic loss risks. A process of spatially allocating Gross...

Global Drought Total Economic Loss Risk Deciles

Data.gov (United States)

National Aeronautics and Space Administration — Global Drought Total Economic Loss Risk Deciles is a 2.5 minute grid of global drought total economic loss risks. A process of spatially allocating Gross Domestic...

Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

Science.gov (United States)

Hedgecock, James B; Dannemiller, Lisa A; Shui, Amy M; Rapport, Mary Jane; Katz, Terry

2018-04-01

Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. This study used a cross-sectional, retrospective analysis. Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (β = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: β = 1.79 SE = 0.17; for subscale score: β = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (β = - 0.39 SE = 0.01; β = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (β = - 0.026 SE = 0.005]; β = - 0.019 SE = 0.007). The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross

Measurement of gross alpha, gross beta, radon and radium activity concentrations in aqueous samples using liquid scintillation technique

International Nuclear Information System (INIS)

Zaini Hamzah; Ahmad Saat; Masitah Alias; Siti Afiqah Abdul Rahman; Mohamed Kasim; Abdul Kadir Ishak

2011-01-01

Recently, Malaysia has taken a positive step toward providing a better water quality by introducing more water quality parameters into its Water Quality Standard. With regard to the natural radionuclides that may present in the water, 3 parameters were introduced that is gross alpha, gross beta and radium which need to be measured and cannot exceed 0.1, 1.0 and 1.0 Bq/ L respectively. This study was conducted to develop a more practical method in measuring these parameters in aqueous environmental samples. Besides having a lot of former tin mining areas, some part of Malaysia is located on the granitic rock which also contributes to a certain extent the amount of natural radionuclides such as uranium and thorium. For all we know these two radionuclides are the origin of other radionuclides being produced from their decay series. The State of Kelantan was chosen as the study area, where the water samples were collected from various part of the Kelantan River. 25 liters of samples were collected, acidify to pH 2 and filtered before the analysis. Measurement of these parameters was done using liquid scintillation counter (LSC). The LSC was set up to the optimum discriminator level and counting was done using alpha-beta mode. The results show that gross alpha and beta can be measured using scintillation cocktail and radium and radon using extraction method. The results for gross alpha, gross beta, 222 Ra and 226 Ra are 0.39-6.42, 0.66-16.18, 0.40-4.65 and 0.05-0.56 Bq/ L. MDA for gross alpha, gross beta and radium is 0.03, 0.08 and 0.00035 Bq/ L respectively. (Author)

Global economic consequences of selected surgical diseases: a modelling study.

Science.gov (United States)

Alkire, Blake C; Shrime, Mark G; Dare, Anna J; Vincent, Jeffrey R; Meara, John G

2015-04-27

The surgical burden of disease is substantial, but little is known about the associated economic consequences. We estimate the global macroeconomic impact of the surgical burden of disease due to injury, neoplasm, digestive diseases, and maternal and neonatal disorders from two distinct economic perspectives. We obtained mortality rate estimates for each disease for the years 2000 and 2010 from the Institute of Health Metrics and Evaluation Global Burden of Disease 2010 study, and estimates of the proportion of the burden of the selected diseases that is surgical from a paper by Shrime and colleagues. We first used the value of lost output (VLO) approach, based on the WHO's Projecting the Economic Cost of Ill-Health (EPIC) model, to project annual market economy losses due to these surgical diseases during 2015-30. EPIC attempts to model how disease affects a country's projected labour force and capital stock, which in turn are related to losses in economic output, or gross domestic product (GDP). We then used the value of lost welfare (VLW) approach, which is conceptually based on the value of a statistical life and is inclusive of non-market losses, to estimate the present value of long-run welfare losses resulting from mortality and short-run welfare losses resulting from morbidity incurred during 2010. Sensitivity analyses were performed for both approaches. During 2015-30, the VLO approach projected that surgical conditions would result in losses of 1·25% of potential GDP, or $20·7 trillion (2010 US$, purchasing power parity) in the 128 countries with data available. When expressed as a proportion of potential GDP, annual GDP losses were greatest in low-income and middle-income countries, with up to a 2·5% loss in output by 2030. When total welfare losses are assessed (VLW), the present value of economic losses is estimated to be equivalent to 17% of 2010 GDP, or $14·5 trillion in the 175 countries assessed with this approach. Neoplasm and injury account

A time series analysis of transportation energy use per dollar of gross domestic product

Science.gov (United States)

2009-06-01

Transportation energy use relative to gross domestic product (GDP) has been declining within the past decade. However, the total transportation energy consumed (see figure 1) shows only a more recent decline. To see clearly the long-term decline, the...

The relationship between body mass index and gross motor development in children aged 3 to 5 years.

Science.gov (United States)

Nervik, Deborah; Martin, Kathy; Rundquist, Peter; Cleland, Joshua

2011-01-01

To investigate the relationship between obesity and gross motor development in children who are developing typically and determine whether body mass index (BMI) predicts difficulty in gross motor skills. BMIs were calculated and gross motor skills examined in 50 children who were healthy aged 3 to 5 years using the Peabody Developmental Motor Scales, 2nd edition (PDMS-2). Pearson chi-square statistic and stepwise linear hierarchical regression were used for analysis. A total of 24% of the children were overweight/obese, whereas 76% were found not to be overweight/obese. Fifty-eight percent of the overweight/obese group scored below average on the PDMS-2 compared to 15% of the nonoverweight group. Association between BMI and gross motor quotients was identified with significance of less than 0.002. Regression results were nonsignificant with all 50 subjects, yet showed significance (P = 0.018) when an outlier was excluded. Children aged 3 to 5 years with high BMIs may have difficulty with their gross motor skills. Further research is needed.

Estimation of delayed neutron emission probability by using the gross theory of nuclear β-decay

International Nuclear Information System (INIS)

Tachibana, Takahiro

1999-01-01

The delayed neutron emission probabilities (P n -values) of fission products are necessary in the study of reactor physics; e.g. in the calculation of total delayed neutron yields and in the summation calculation of decay heat. In this report, the P n -values estimated by the gross theory for some fission products are compared with experiment, and it is found that, on the average, the semi-gross theory somewhat underestimates the experimental P n -values. A modification of the β-decay strength function is briefly discussed to get more reasonable P n -values. (author)

Quantum Gross-Pitaevskii Equation

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Jutho Haegeman, Damian Draxler, Vid Stojevic, J. Ignacio Cirac, Tobias J. Osborne, Frank Verstraete

2017-07-01

Full Text Available We introduce a non-commutative generalization of the Gross-Pitaevskii equation for one-dimensional quantum gasses and quantum liquids. This generalization is obtained by applying the time-dependent variational principle to the variational manifold of continuous matrix product states. This allows for a full quantum description of many body system ---including entanglement and correlations--- and thus extends significantly beyond the usual mean-field description of the Gross-Pitaevskii equation, which is known to fail for (quasi one-dimensional systems. By linearizing around a stationary solution, we furthermore derive an associated generalization of the Bogoliubov -- de Gennes equations. This framework is applied to compute the steady state response amplitude to a periodic perturbation of the potential.

Bariatric Surgery Prior to Total Joint Arthroplasty May Not Provide Dramatic Improvements In Post Arthroplasty Surgical Outcomes

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Paxton, Elizabeth W.; Fisher, David; Li, Robert A.; Barber, Thomas C.; Singh, Jasvinder A.

2014-01-01

This study compared the total joint arthroplasty (TJA) surgical outcomes of patients who had bariatric surgery prior to TJA to TJA patients who were candidates but did not have bariatric surgery. Patients were retrospectively grouped into: Group 1 (n=69), those with bariatric surgery >2 years prior to TJA, Group 2 (n=102), those with surgery within 2 years of TJA, and Group 3 (n=11,032), those without bariatric surgery. In Group 1, 2.9% (95%CI 0.0–6.9%) had complications within 1 year compared to 5.9% (95%CI 1.3–10.4%) in Group 2, and 4.1% (95%CI 3.8–4.5%) in Group 3. 90-day readmission (7.2%, 95%CI 1.1–13.4%) and revision density (3.4/100 years of observation) was highest in Group 1. Bariatric surgery prior to TJA may not provide dramatic improvements in post-operative TJA surgical outcomes. PMID:24674730

Gross domestic product and health expenditure associated with incidence, 30-day fatality, and age at stroke onset: a systematic review.

Science.gov (United States)

Sposato, Luciano A; Saposnik, Gustavo

2012-01-01

Differences in definitions of socioeconomic status and between study designs hinder their comparability across countries. We aimed to analyze the correlation between 3 widely used macrosocioeconomic status indicators and clinical outcomes. We selected population-based studies reporting incident stroke risk and/or 30-day case-fatality according to prespecified criteria. We used 3 macrosocioeconomic status indicators that are consistently defined by international agencies: per capita gross domestic product adjusted for purchasing power parity, total health expenditures per capita at purchasing power parity, and unemployment rate. We examined the correlation of each macrosocioeconomic status indicator with incident risk of stroke, 30-day case-fatality, proportion of hemorrhagic strokes, and age at stroke onset. Twenty-three articles comprising 30 population-based studies fulfilled the eligibility criteria. Age-adjusted incident risk of stroke using the standardized World Health Organization World population was associated to lower per capita gross domestic product adjusted for purchasing power parity (ρ=-0.661, P=0.027, R(2)=0.32) and total health expenditures per capita at purchasing power parity (ρ=-0.623, P=0.040, R(2)=0.26). Thirty-day case-fatality rates and proportion of hemorrhagic strokes were also related to lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. Moreover, stroke occurred at a younger age in populations with low per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. There was no correlation between unemployment rates and outcome measures. Lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity were associated with higher incident risk of stroke, higher case-fatality, a greater

Gross motor skill development of kindergarten children in Japan.

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Aye, Thanda; Kuramoto-Ahuja, Tsugumi; Sato, Tamae; Sadakiyo, Kaori; Watanabe, Miyoko; Maruyama, Hitoshi

2018-05-01

[Purpose] The purposes of this study were to assess and explore the gender-based differences in gross motor skill development of 5-year-old Japanese children. [Subjects and Methods] This cross-sectional study recruited 60 healthy 5-year-old (third-year kindergarten, i.e., nencho ) children (34 boys, 26 girls) from one local private kindergarten school in Otawara city, Tochigi Prefecture, Japan. Gross motor skills, including six locomotor and six object control skills, were assessed using the test of gross motor development, second edition (TGMD-2). All subjects performed two trials of each gross motor skill, and the performances were video-recorded and scored. Assessment procedures were performed according to the standardized guidelines of the TGMD-2. [Results] The majority of subjects had an average level of overall gross motor skills. Girls had significantly better locomotor skills. Boys had significantly better object control skills. [Conclusion] The gross motor skill development of 5-year-old Japanese children involves gender-based differences in locomotor and object control skills. This study provided valuable information that can be used to establish normative references for the gross motor skills of 5-year-old Japanese children.

The Gross-Llewellyn Smith sum rule

International Nuclear Information System (INIS)

Scott, W.G.

1981-01-01

We present the most recent data on the Gross-Llewellyn Smith sum rule obtained from the combined BEBC Narrow Band Neon and GGM-PS Freon neutrino/antineutrino experiments. The data for the Gross-Llewellyn Smith sum rule as a function of q 2 suggest a smaller value for the QCD coupling constant parameter Λ than is obtained from the analysis of the higher moments. (author)

75 FR 78897 - Definition of Omission From Gross Income

Science.gov (United States)

2010-12-17

... Definition of Omission From Gross Income AGENCY: Internal Revenue Service (IRS), Treasury. ACTION: Final regulations. SUMMARY: This document contains final regulations defining an omission from gross income for... overstatement of basis in a sold asset results in an omission from gross income. The regulations will affect any...

The relationships between gross motor coordination and sport-specific skills in adolescent non-athletes

Directory of Open Access Journals (Sweden)

Chagas Daniel V

2017-12-01

Full Text Available Purpose. While the usefulness of gross motor coordination score as predictor of sports performance in young athletes has been demonstrated, practical applications in the settings where the focus is not on elite performance is limited. Further, little is known about the extent to which gross motor coordination score is associated with sport-specific skills among adolescent nonathletes. The aim of this study was to analyse the relationship between the degree of gross motor coordination and execution in specific volleyball tests among adolescent non-athletes. Methods. The total of 34 students (27 females and 7 males aged 13-14 years who regularly participated in volleyball during physical education classes were randomly recruited. Gross motor coordination was assessed with the Körperkoordinationstest für Kinder. Motor performance on volley-specific skills was indicated by two product-oriented tasks: volleyball under service and service reception. Correlation and linear regression analyses were applied to examine the associations between motor coordination scores and motor performance in volley-specific skills. Results. Motor coordination score was positively correlated with motor performance on specific skills (r = 0.503, p = 0.02. Linear regression analysis revealed that motor coordination score accounted for 23% of the variance in the motor performance on volleyball skills (R2 = 0.253, R2 adjusted = 0.230, F = 10.836, p = 0.02. Conclusions. The degree of gross motor coordination seems to play a significant role in the execution of specific volleyball tasks.

Alternative Measure of Wellbeing: Bhutan's Gross National ...

International Development Research Centre (IDRC) Digital Library (Canada)

There is growing demand for innovative yet rigorous measures of national wellbeing beyond gross domestic product. In 2008, the Centre for Bhutan Studies - Bhutan's main policy research centre - posted data from a preliminary survey of the country's Gross National Happiness (GNH). The Centre for Bhutan Studies ...

MODIFIED TECHNIQUE OF TOTAL LARYNGECTOMY

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Predrag Spirić

2010-12-01

Full Text Available Surgical technique of total laryngectomy is well presented in many surgical textbooks. Essentially, it has remained the same since Gluck an Soerensen in 1922 described all its details. Generally, it stresses the U shape skin incision with releasing laryngeal structures and removing larynx from up to down. Further, pharyngeal reconstruction is performed with different kinds of sutures in two or more layers and is finished with skin suture and suction drainage. One of worst complications following this surgery is pharyngocutaneous fistula (PF. Modifications proposed in this this article suggests vertical skin incision with larynx removal from below upwards. In pharyngeal reconstruction we used the running locked suture in submucosal plan with „tobacco sac“ at the end on the tongue base instead of traditional T shaped suture. Suction drains were not used.The aim of study was to present the modified surgical technique of total laryingectomy and its impact on hospital stay duration and pharyngocutanous fistula formation. In this randomized study we analyzed 49 patients operated with modified surgical technique compared to 49 patient operated with traditional surgical technique of total laryngectomy. The modified technique of total laryngectomy was presented. Using modified technique we managed to decrease the PF percentage from previous 20,41% to acceptable 8,16% (p=0,0334. Also, the average hospital stay was shortened from 14,96 to 10,63 days (t =-2.9850; p=0.0358.The modified technique of total laryngectomy is safe, short and efficient surgical intervention which decreases the number of pharyngocutaneos fistulas and shortens the hospital stay.

7 CFR 1424.7 - Gross payable units.

Science.gov (United States)

2010-01-01

... payments (APP), and base production payments (BPP). Repayment rates shall be based on previous payment... 50 gallons of net production increase. (2) For BPP, which will be made on production not eligible for... biodiesel production gross payable units. (3) Adding the APP and BPP to determine biodiesel gross payable...

Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital.

Science.gov (United States)

Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Huang, Susan S

2013-11-01

Public reporting of surgical site infections (SSIs) by hospitals is largely limited to infections detected during surgical hospitalizations or readmissions to the same facility. SSI rates may be underestimated if patients with SSIs are readmitted to other hospitals. We assessed the impact of readmissions to other facilities on hospitals' SSI rates following primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). This was a retrospective cohort study of all patients who underwent primary THA or TKA at California hospitals between 1 January 2006 and 31 December 2009. SSIs were identified using ICD-9-CM diagnosis codes predictive of SSI assigned at any California hospital within 365 days of surgery using a statewide repository of hospital data that allowed tracking of patients between facilities. We used statewide data to estimate the fraction of each hospital's THA and TKA SSIs identified at the operative hospital versus other hospitals. A total of 91 121 THA and 121 640 TKA procedures were identified. Based on diagnosis codes, SSIs developed following 2214 (2.3%) THAs and 2465 (2.0%) TKAs. Seventeen percent of SSIs would have been missed by operative hospital surveillance alone. The proportion of hospitals' SSIs detected at nonoperative hospitals ranged from 0% to 100%. Including SSIs detected at nonoperative hospitals resulted in better relative ranking for 61% of THA hospitals and 61% of TKA hospitals. Limiting SSI surveillance to the operative hospital caused varying degrees of SSI underestimation and substantially impacted hospitals' relative rankings, suggesting that alternative methods for comprehensive postdischarge surveillance are needed for accurate benchmarking.

Evaluation of surgical staging prior to combined modality therapy for esophageal cancer

International Nuclear Information System (INIS)

Suntharalingam, M.; Vines, E.; Echo, D. van; Greenwald, B.; Krasna, M.

1996-01-01

microscopic celiac node involvement while 2 had mediastinal disease. In total, 10 pts. (40%) had their clinical stage confirmed by surgical findings. Fifteen pts. (60%) had variation between these two staging methods. Among the 28 pts. taken to surgical resection, operative mortality was 15%. Additionally four patients did not undergo surgical resection (2 pts. unresectable, 1 pt. arrested during anesthesia, 1 unsuspected 5 mm metastatic liver lesion). Twenty-four pts. are available for analysis of response. Pathologic CR rate of 46% was observed using strict criteria including gross and microscopic evaluation and immunohistochemical staining. Seventeen percent had only microscopic disease remaining and 37% had a partial response with evidence of gross residual. To date only two pts. have shown evidence of local failure. Nine pts. (45%) have presented back with systemic spread. Ten pts. are alive NED, 3 AWD, 2 DNED, 5 DOD. Patients with positive celiac LN at laparoscopy did significantly worse than pts. whose celiac nodes were negative, with a 24-month actuarial disease free survival (DFS) of 0% vs 58% respectively (p=0.01). Patients surgically staged as T 2 had a significantly better outcome than T 3 patients (DFS 100% vs 43% at 18 months, p=0.04). CONCLUSIONS: In our experience surgical staging has proven to be a more accurate method of defining disease extent as compared to current noninvasive techniques. Pretreatment surgical staging should improve our ability to select patients for this aggressive treatment approach. A preliminary analysis of the information gathered at the time of staging has confirmed the predictive value of the current T stage system. This data also suggests that microscopic celiac lymph node involvement may represent the most significant predictor of a poor outcome

Gross Sales Tax Collections

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City of Jackson, Mississippi — This data is captured directly from the MS Department of Revenue and specific to the City of Jackson. It is compiled from Gross Sales Tax reported by taxpayers each...

Loovkirjutamist õpetab Philip Gross

Index Scriptorium Estoniae

2011-01-01

T.S. Elioti luulepreemia laureaat Philip Gross on Tallinna Ülikooli talvekooli rahvusvahelise kursuse "Poetry: A Conversation between Words and Silence" läbiviija. Oma seminarides keskendub ta lisaks loovkirjutamisele ka loova lugemise vajadusele

Pattern of Gross Congenital Malformations in a Tertiary Referral Hospital in Northeast India.

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Baruah, Jenita; Kusre, Giriraj; Bora, Reeta

2015-10-01

To explore the prevalence of structural congenital malformations among newborns and study some of the fetal and maternal characteristics of the malformed babies in North east India where such systematic study on congenital malformation has not been undertaken before. A cross sectional study was undertaken from May 2010 through Feb 2013 for estimation of gross congenital malformations among live birth and stillbirth children born in Assam Medical College. All live births were clinically examined for detection of gross congenital malformations and autopsy was carried out on still births and neonates dying within 24 h of birth to detect gross congenital malformations in the internal organs. All malformations were classified as per ICD 10 classification. The mothers of the newborns with congenital malformations were interviewed in a predesigned, pretested proforma. The variables included maternal age, antenatal registration, antenatal history of drug intake, consanguinity and previous history of malformations. Statistical analysis was done using chi square test. A total 18,192 births including live births and still births were examined and 206 cases of structural malformations were observed. Prevalence of congenital malformations was 1.2 % of the total live births. Distribution of malformation was predominant among males than in females (60.67 vs. 37.37 %; p malformation of the cardiovascular system was found to be very low. Malformations among stillbirths and newborns born to unregistered mothers were significantly more. Percentage of malformations in babies born to mothers of more than 30 y of age was higher than other age groups (2.2 %). Occurrence of malformations in low birth weight babies were significantly more (p malformations was 1.2 % of the total live births. Musculoskeletal system was the most common system involved. Congenital malformations were significantly associated with sex of the new born, registration of the mother and birth weight of the

Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

Energy Technology Data Exchange (ETDEWEB)

Liang, GangZhu; Zhang, FuXian, E-mail: gangzhuliang@126.com; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi [Capital Medical University, Department of Vascular Surgery, Beijing Shijitan Hospital (China)

2016-12-15

PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

International Nuclear Information System (INIS)

Liang, GangZhu; Zhang, FuXian; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi

2016-01-01

PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

26 CFR 1.832-1 - Gross income.

Science.gov (United States)

2010-04-01

..., except that in the case of a mutual fire insurance company described in § 1.831-1 the amount of single... TAXES Other Insurance Companies § 1.832-1 Gross income. (a) Gross income as defined in section 832(b)(1... approved by the National Convention of Insurance Commissioners, as well as the gain derived from the sale...

Influence of crosstalk phenomenon on the measurement of gross alpha and gross beta radioactivity in drinking water

International Nuclear Information System (INIS)

Gerilemandahu; Haribala; Xu Xiao; Shen Na; Sai Wenga; Bai Guilin; Wang Chengguo

2014-01-01

Objective: To study the influence of crosstalk phenomenon on the measurement of gross radioactivity in drinking water. Methods: The gross activity in different standard materials with different thickness and area was measured using national standard method. Results: There was no obvious change in crosstalk factor with the increase of "2"4"1Am powder amount in the measurement, whereas the larger amount of uranium used might lead to larger crosstalk factor. The different measurement channels resulted in different crosstalk factors. The influence of beta radioactivity on alpha radioactivity measurement was significant. On the contrary, the alpha-to-beta crosstalk factor was negligible. The area of sample plate imposed no significant influence on crosstalk factor. Conclusions: The gross beta activity can be corrected to decrease the influence of alpha radioactivity using powder standard samples, when simultaneous alpha and beta counting mode is applied in measurement grass radioactivity in drinking water. (authors)

Uranium, thorium, gross alpha and gross beta assessment in fountain waters in towns of the Iron Quadrangle, Brazil

International Nuclear Information System (INIS)

Ferreira, Claudia A.; Palmieri, Helena E.L.; Menezes, Maria Angela de B.C.; Chaves, Renata D.A.; Dalmazio, Ilza

2013-01-01

The Iron Quadrangle region is known worldwide for its diversity, both ores and rock types, which record a long and important period of Earth's history. For thousands of years erosive processes have exposed ancient rocks, Archean and Proterozoic, in this region. The concentration of uranium, thorium, gross alpha and gross beta activities has been assessed in 34 fountains water samples collected from different towns in the Iron Quadrangle. The results obtained were compared to values established by CONAMA nº 396/2008 and Decree nº 2914/2011 by the Ministry of Health. For Th in water consumption there is no value established in the Brazilian legislation and the concentrations in all samples were lower than 0.01 μg L -1 . For uranium, the values ranged from less than 0.002 to 0.61 μg L -1 , and all results were lower than the value allowed of 15 μg L -1 and 30 μg L -1 established by the legislations above, respectively. The results for the radiation levels of gross alpha and gross beta activity in some fountains waters were slightly above the limits (0.5 Bq L -1 and 1.0 Bq L -1 ) established by CONAMA nº 396/2008 and Decreet nº 2914/2011, respectively. (author)

Small cell carcinoma of the urinary bladder without gross hematuria: a case report.

Science.gov (United States)

Huang, Wanqiu; Luan, Yang; Jin, Lu; Wang, Tao; Chen, Ruibao; Liu, Zheng; Chen, Zhiqiang; Lan, Ruzhu

2015-09-01

Small cell carcinoma of the urinary bladder (SCCB) is a rare and aggressive form of bladder cancer with poor prognosis. Hematuria is the main symptom of this malignancy, and most patients have a history of smoking. The disease incidence of malignant bladder tumors in China is approximately 0.74%. Early and accurate diagnosis of SCCB can ensure timely and appropriate treatment of this malignant disease. Oncologic surgery is the standard treatment; however, it may not be a curative approach. Chemotherapy and/or radiotherapy should be performed following surgical removal. This case report describes a patient with a single neoplasm diagnosed as SCCB that arose because of recurrence of bladder cancer after bladder tumor resection. In contrast to previously reported cases, this patient had no gross hematuria and no history of smoking.

Determination of radon daughter activities of different aerosol fractions by gross-α and gross-β measurements

International Nuclear Information System (INIS)

Katona, T.; Kanyar, B.; Jobbagy, V.; Kavasi, N.; Molnar, A.; Imre, K.

2004-01-01

The aim was to determine the radioactivities of the radon progenies ( 218 Po, 214 Pb, 214 Bi and 214 Po) attached to the carrier aerosol particles with respect to the size distribution in order to improve the assessment of the inhalation dose. We derived the radionuclide-specific activity concentrations from gross alpha and gross beta measurements provided during 2 hours after sampling and model calculations including parameter estimation. For the aerosol sampling we used an electrical low pressure impactor, which is able to collect aerosol particles in 12 different diameter ranges. In our test investigations the aerosol particles were collected from a closed chamber in a common laboratory building. The chamber contained a relatively high radon concentration (60-90 kBq/m 3 ) in equilibrium with the short lived daughters generated previously without any additional aerosol sources. For the nuclear measurements of the aerosol samples ZnS/plastic sandwich detectors have been used. The time series data of gross alpha and gross beta activities were fitted simultaneously and the initial activities of the daughters were estimated. According to the results from two different fractions (0.06 and 0.7 μm) just followed the end of sampling they contain a higher 218 Po activity than the 214 Pb and 214 Bi ones. The preliminary assessments for the special air conditions show that the 214 Pb-to- 218 Po activity ratios are higher for the small aerosol particles than for the larger ones. The estimated errors of the initial activities were near to 50% in a large part of cases. (author)

Gross Domestic Savings and Gross Capital: what Matters to Their Formation in an Era of Economic Recession in Nigeria?

Directory of Open Access Journals (Sweden)

Success Abusomwan

2017-09-01

Full Text Available The objective of this study is to empirically investigate the long run and short run dynamic impact of interest rate and output on gross domestic savings and gross capital formation in Nigeria. Literatures, both theoretical and empirical, suggest that the rate of interest and output are the key factors influencing savings and investments. A review of factors influencing interest rates and output in Nigeria is necessitated by the recent economic downturns in Nigeria that has resulted in tight monetary policy which some commentators regard as inimical to growth. Employing Ordinary Least Squares, Co-integration, Error Correction Mechanism and Granger Causality econometric techniques on a data spanning 1981 to 2014 of the Nigerian economy sourced from the World Development Index, it was found that changes in output explains the long run and short run dynamic behaviour of gross domestic savings and gross capital formation which were used as proxies for savings and investment respectively. Whereas, a bi-causality was established between output and investment, causality flowed from output to savings in Nigeria. The research also found that interest rate is not a significant determinant of savings and investment in Nigeria in both long run and short run. It is therefore recommended that to enhance investment in a period of economic downturn in Nigeria, aggregate demand should be boosted to enhance output through vigorous pursuit of fiscal policy while implementing contractionary monetary policy to address inflationary pressures created by the increase in demand. Domestic savings will improve and gross capital formation will be sustained.

Estimation of inhalation doses from airborne releases using gross monitors

International Nuclear Information System (INIS)

Goldstein, N.P.

1978-01-01

Monitoring programs at most nuclear facilities involve continuous gross measurements supplemented by periodic isotopic analyses of release samples. The isotopic measurements are required to accurately assess the potential dose from the various effluent streams, but in between these measurements, one depends on the gross monitors to provide approximate indications of the dose. The effluent streams release a variety of nuclides, each with its own dose factor. This means that the relationship between the counting rate in a gross monitor and the potential dose of the effluent being monitored will depend on the isotopic composition of this release. If this composition changes, then the dose indicated by the gross monitor (calibrated for the original group of isotopes) may be significantly in error. The problem of indicating inhalation doses from gross monitoring of airborne releases is considered. In order for this type of monitor to accurately indicate dose, regardless of the isotopic makeup of a release, the analysis shows that its response to each isotope should be proportional to the dose factor of that isotope. These ideas are applied to the monitoring of air particulates using gross beta and gross gamma monitors. The study shows that the former more closely satisfies this condition and as a result, satisfactorily indicates the actual dose from reactor effluents, as determined from detailed isotopic data published in the literature. On the other hand, the gross gamma monitor, with its poorer fit to the condition, provided less than satisfactory accuracy in its dose estimates. In addition, a variety of other mathematical response functions were considered but their dose estimation capabilities were not much better than the straight beta response. The study shows that reasonably accurate dose estimates can be made using properly selected gross monitors, but that significant errors can result with improper ones. (author)

Psychiatric Symptoms in Children with Gross Motor Problems

Science.gov (United States)

Emck, Claudia; Bosscher, Ruud J.; van Wieringen, Piet C. W.; Doreleijers, Theo; Beek, Peter J.

2012-01-01

Children with psychiatric disorders often demonstrate gross motor problems. This study investigates if the reverse also holds true by assessing psychiatric symptoms present in children with gross motor problems. Emotional, behavioral, and autism spectrum disorders (ASD), as well as psychosocial problems, were assessed in a sample of 40 children…

The Gross Motor Skills of Children with Mild Learning Disabilities

Science.gov (United States)

Nonis, Karen P.; Jernice, Tan Sing Yee

2014-01-01

Many international studies have examined the gross motor skills of children studying in special schools while local studies of such nature are limited. This study investigated the gross motor skills of children with Mild Learning Disabilities (MLD; n = 14, M age = 8.93 years, SD = 0.33) with the Test of Gross Motor Development-2 (TGMD-2, Ulrich,…

Sources of variability in the determination by evaporation method of gross alpha activity in water samples

Energy Technology Data Exchange (ETDEWEB)

Baeza, A.; Corbacho, J.A. [LARUEX, Caceres (Spain). Environmental Radioactivity Lab.

2013-07-01

Determining the gross alpha activity concentration of water samples is one way to screen for waters whose radionuclide content is so high that its consumption could imply surpassing the Total Indicative Dose as defined in European Directive 98/83/EC. One of the most commonly used methods to prepare the sources to measure gross alpha activity in water samples is desiccation. Its main advantages are the simplicity of the procedure, the low cost of source preparation, and the possibility of simultaneously determining the gross beta activity. The preparation of the source, the construction of the calibration curves, and the measurement procedure itself involve, however, various factors that may introduce sufficient variability into the results to significantly affect the screening process. We here identify the main sources of this variability, and propose specific procedures to follow in the desiccation process that will reduce the uncertainties, and ensure that the result is indeed representative of the sum of the activities of the alpha emitters present in the sample. (orig.)

Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers

International Nuclear Information System (INIS)

Gemignani, Mary L.; Alektiar, Kaled M.; Leitao, Mario; Mychalczak, Boris; Chi, Dennis; Venkatraman, Ennapadam; Barakat, Richard R.; Curtin, John P.

2001-01-01

Objective: To determine the outcome for patients with recurrent gynecologic tumors treated with radical resection and combined high-dose intraoperative radiation therapy (HDR-IORT). Methods and Materials: Between November 1993 and June 1998, 17 patients with recurrent gynecologic malignancies underwent radical surgical resection and high-dose-rate brachytherapy. The mean age of the study group was 49 years (range 28-72 years). The site of the primary tumor was the cervix in 9 (53%) patients, the uterus in 7 (41%) patients, and the vagina in 1 (6%) patient. The treatment for the primary disease was surgery with or without adjuvant radiation in 14 (82%) patients and definitive radiation in 3 (18%) patients. The current surgery consisted of exenterative surgery in 10 (59%) patients and tumor resection in 7 (41%) patients. Complete gross resection was achieved in 13 (76%) patients. The mean HDR-IORT dose was 14 Gy (range 12-15). Additional radiation in the form of permanent Iodine-125 implant was given to 3 of 4 patients with gross residual disease. The median peripheral dose was 140 Gy. Results: With a median follow-up of 20 months (range 3-65 months), the 3-year actuarial local control (LC) rate was 67%. In patients with complete gross resection, the 3-year LC rate was 83%, compared to 25% in patients with gross residual disease, p<0.01. The 3-year distant metastasis disease-free and overall survival rates were 54% and 54%, respectively. The complications were as follows: gastrointestinal obstruction, 4 (24%); wound complications, 4 (24%); abscesses, 3 (18%); peripheral neuropathy, 3 (18%); rectovaginal fistula, 2 (12%); and ureteral obstruction, 2 (12%). Conclusion: Radical surgical resection and combined IORT for patients with recurrent gynecologic tumors seems to provide a reasonable local-control rate in patients who have failed prior surgery and/or definitive radiation. Patient selection is very important, however, as only those patients with complete gross

Technique of total thyroidectomy

International Nuclear Information System (INIS)

Rao, R.S.

1999-01-01

It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

Uranium, thorium, gross alpha and gross beta assessment in fountain waters in towns of the Iron Quadrangle, Brazil

Energy Technology Data Exchange (ETDEWEB)

Ferreira, Claudia A.; Palmieri, Helena E.L.; Menezes, Maria Angela de B.C.; Chaves, Renata D.A.; Dalmazio, Ilza, E-mail: cferreiraquimica@yahoo.com.br, E-mail: help@cdtn.br, E-mail: menezes@cdtn.br, E-mail: rda@cdtn.br, E-mail: id@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2013-07-01

The Iron Quadrangle region is known worldwide for its diversity, both ores and rock types, which record a long and important period of Earth's history. For thousands of years erosive processes have exposed ancient rocks, Archean and Proterozoic, in this region. The concentration of uranium, thorium, gross alpha and gross beta activities has been assessed in 34 fountains water samples collected from different towns in the Iron Quadrangle. The results obtained were compared to values established by CONAMA nº 396/2008 and Decree nº 2914/2011 by the Ministry of Health. For Th in water consumption there is no value established in the Brazilian legislation and the concentrations in all samples were lower than 0.01 μg L{sup -1}. For uranium, the values ranged from less than 0.002 to 0.61 μg L{sup -1}, and all results were lower than the value allowed of 15 μg L{sup -1} and 30 μg L{sup -1} established by the legislations above, respectively. The results for the radiation levels of gross alpha and gross beta activity in some fountains waters were slightly above the limits (0.5 Bq L{sup -1} and 1.0 Bq L{sup -1}) established by CONAMA nº 396/2008 and Decreet nº 2914/2011, respectively. (author)

The relationship between gross motor skills and visual perception of preschoolers

OpenAIRE

TEPELI, Kezban

2014-01-01

Answers were searched for these questions; “Is there a relationship between visual perceptions and gross motor skills of preschool children?”, “Are preschool children's visual perceptions predictors of their gross motor skills?”, “Is there any difference between visual perceptions of the children having low, average and high level of gross motor skills?” within this study where the relationship between preschool children's visual perceptions and their gross motor skills were compara...

Port positioning and docking for single-stage totally robotic dissection for rectal cancer surgery with the Si and Xi Da Vinci Surgical System.

Science.gov (United States)

Toh, James Wei Tatt; Kim, Seon-Hahn

2017-11-04

We have previously reported our technique of single-docking totally robotic dissection for rectal cancer surgery using the Da Vinci ® Si Surgical System in 2009. However, we have since optimised our port placement for the Si system and have developed a novel configuration of port placement and docking for the Da Vinci ® Xi Surgical System. We have performed over 700 cases using this technique with the Si system and have used our Xi technique since 2016 for totally robotic dissection for rectal cancer. We have kept the configuration of port placements for both the Xi and Si system as similar as possible, with the priorities to avoid arm collisions as well as to provide a workable port configuration of two left-handed instruments and one right-handed instrument. To date, there have had no major complications or arm collisions related to this technique of docking, port positioning and instrument placement.

Participation in asynchronous online discussion forums does improve student learning of gross anatomy.

Science.gov (United States)

Green, Rodney A; Farchione, Davide; Hughes, Diane L; Chan, Siew-Pang

2014-01-01

Asynchronous online discussion forums are common in blended learning models and are popular with students. A previous report has suggested that participation in these forums may assist student learning in a gross anatomy subject but it was unclear as to whether more academically able students post more often or whether participation led to improved learning outcomes. This study used a path model to analyze the contribution of forum participation, previous academic ability, and student campus of enrolment to final marks in a multicampus gross anatomy course for physiotherapy students. The course has a substantial online learning management system (LMS) that incorporates asynchronous forums as a learning tool, particularly to answer learning objectives. Students were encouraged to post new threads and answer queries in threads started by others. The forums were moderated weekly by staff. Discussion forums were the most used feature of the LMS site with 31,920 hits. Forty-eight percent of the students posted at least once with 186 threads initiated by students and a total of 608 posts. The total number of posts made a significant direct contribution to final mark (P = 0.008) as did previous academic ability (P = 0.002). Although campus did not contribute to final mark, there was a trend for students at the campus where the course coordinator was situated to post more often than those at the other campus (P = 0.073). These results indicate that asynchronous online discussion forums can be an effective tool for improving student learning outcomes as evidenced by final marks in gross anatomy teaching. Copyright © 2013 American Association of Anatomists.

Changes in gross grasp strength and fine motor skills in adolescents with pediatric multiple sclerosis.

Science.gov (United States)

Squillace, Mary; Ray, Sharon; Milazzo, Maria

2015-01-01

This study examined the gross grasp strength and fine motor dexterity of adolescents, who are diagnosed with multiple sclerosis (MS). A total sample size of 72 participants between the ages of 13 to 17 was studied. Thirty six with a diagnosis of pediatric relapse remitting MS and 36 matched control participants were selected from various local youth groups. Data on hand strength and dexterity was collected using a dynamometer, nine hole peg board and Purdue pegboard on both groups. Utilizing ANCOVA to describe the differences across the two groups by diagnosis, controlling for age and gender, it was found that the MS group demonstrated significantly decreased dexterity when compared to age and gender matched controls. There was no significant difference in gross grasp strength by diagnostic group. This preliminary study showed that children with a diagnosis of pediatric MS may have differences in fine motor dexterity, but not gross grasp strength from their peers who do not have the diagnosis. Further study is indicated to examine this phenomenon.

Gross anatomy education for South African undergraduate physiotherapy students.

Science.gov (United States)

Shead, Dorothy A; Roos, Ronel; Olivier, Benita; Ihunwo, Amadi O

2018-01-16

Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

The relation between household income and surgical outcome in the Dutch setting of equal access to and provision of healthcare.

Science.gov (United States)

Ultee, Klaas H J; Tjeertes, Elke K M; Bastos Gonçalves, Frederico; Rouwet, Ellen V; Hoofwijk, Anton G M; Stolker, Robert Jan; Verhagen, Hence J M; Hoeks, Sanne E

2018-01-01

The impact of socioeconomic disparities on surgical outcome in the absence of healthcare inequality remains unclear. Therefore, we set out to determine the association between socioeconomic status (SES), reflected by household income, and overall survival after surgery in the Dutch setting of equal access and provision of care. Additionally, we aim to assess whether SES is associated with cause-specific survival and major 30-day complications. Patients undergoing surgery between March 2005 and December 2006 in a general teaching hospital in the Netherlands were prospectively included. Adjusted logistic and cox regression analyses were used to assess the independent association of SES-quantified by gross household income-with major 30-day complications and long-term postoperative survival. A total of 3929 patients were included, with a median follow-up of 6.3 years. Low household income was associated with worse survival in continuous analysis (HR: 1.05 per 10.000 euro decrease in income, 95% CI: 1.01-1.10) and in income quartile analysis (HR: 1.58, 95% CI: 1.08-2.31, first [i.e. lowest] quartile relative to the fourth quartile). Similarly, low income patients were at higher risk of cardiovascular death (HR: 1.26 per 10.000 decrease in income, 95% CI: 1.07-1.48, first income quartile: HR: 3.10, 95% CI: 1.04-9.22). Household income was not independently associated with cancer-related mortality and major 30-day complications. Low SES, quantified by gross household income, is associated with increased overall and cardiovascular mortality risks among surgical patients. Considering the equality of care provided by this study setting, the associated survival hazards can be attributed to patient and provider factors, rather than disparities in healthcare. Increased physician awareness of SES as a risk factor in preoperative decision-making and focus on improving established SES-related risk factors may improve surgical outcome of low SES patients.

[The physical therapy undergraduate students' responses to the gross human anatomy subjects].

Science.gov (United States)

Anahara, Reiko; Kawashiro, Yukiko; Matsuno, Yoshiharu; Mori, Chisato; Kohno, Toshihiko

2008-09-01

Instruction in gross human anatomy is one of the important items in the subject for co-medical students of the physical therapist course. The physical therapy undergraduate students are required to have a solid understanding of the structure and formation of the human body. Therefore, their good-understanding of the course on the gross human anatomy and their experience of the gross human anatomy laboratory (observation practice) are acquired to improve their knowledge of the human body. To clarify the student responses to the gross human anatomy course including the gross human anatomy laboratory, several questionnaires were administered to the freshman physical therapy undergraduate student for two years. We found that more than 80% of the students, who felt a negative attitude for gross human anatomy before the course started, had a positive attitude about the gross human anatomy after going through the course. The experience of the gross human anatomy laboratory increased the students' activity of learning and they thought more about the dignity of being human after the course than before viewing. In addition, the results suggested that the multiple experiences of the gross human anatomy course are useful for the physical therapy undergraduate students to improve the quality of their understanding of the human body.

Surgical management of thalamic gliomas: case selection, technical considerations, and review of literature.

Science.gov (United States)

Sai Kiran, Narayanam Anantha; Thakar, Sumit; Dadlani, Ravi; Mohan, Dilip; Furtado, Sunil Valentine; Ghosal, Nandita; Aryan, Saritha; Hegde, Alangar S

2013-07-01

This study aimed to identify (1) the thalamic gliomas suitable for surgical resection and (2) the appropriate surgical approach based on their location and the displacement of the posterior limb of the internal capsule (PLIC). A retrospective study over a 5-year period (from 2006 to 2010) was performed in 41 patients with thalamic gliomas. The mean age of these patients was 20.4 years (range, 2-65 years). Twenty (49 %) tumors were thalamic, 19 (46 %) were thalamopeduncular, and 2 (5 %) were bilateral. The PLIC, based on T2-weighted magnetic resonance axial sections, was displaced anterolaterally in 23 (56 %) cases and laterally in 6 (14 %) cases. It was involved by lesion in eight (20 %) cases and could not be identified in four (10 %) cases. Resection, favored in patients with well-defined, contrast-enhancing lesions, was performed in 34 (83 %) cases, while a biopsy was resorted to in 7 (17 %) cases. A gross total resection or near total resection (>90 %) could be achieved in 26 (63 %) cases. The middle temporal gyrus approach, used when the PLIC was displaced anterolaterally, was the commonly used approach (63.5 %). Common pathologies were pilocytic astrocytoma (58 %) in children and grade III/IV astrocytomas (86 %) in adults. Preoperative motor deficits improved in 64 % of the patients with pilocytic lesions as compared to 0 % in patients with grade III/IV lesions (P value, 0.001). Postoperatively, two patients (5 %) had marginal worsening of motor power, two patients developed visual field defects, and one patient developed a third nerve paresis. Radical resection of thalamic gliomas is a useful treatment modality in a select subset of patients and is the treatment of choice for pilocytic astrocytomas. Tailoring the surgical approach, depending on the relative position of the PLIC, has an important bearing on outcome.

Surgical treatment of gastroesophageal reflux disease: total or partial fundoplication? Systematic review and meta-analysis

Directory of Open Access Journals (Sweden)

Rodrigo F Ramos

2011-12-01

Full Text Available CONTEXT: Although the high incidence of gastroesophageal reflux disease (GERD in the population, there is much controversy in this topic, especially in the surgical treatment. The decision to use of a total or partial fundoplication in the treatment of GERD is still a challenge to many surgeons because the few evidence found in the literature. OBJECTIVE: To bring more clear evidence in the comparison between total and partial fundoplication. DATA SOURCES: A systematic review of the literature and metaanalysis with randomized controlled trials accessed from MEDLINE, LILACS, Cochrane Controlled Trials Database was done. The outcomes remarked were: dysphagia, inability to belch, bloating, recurrence of acid reflux, heartburn and esophagitis. For data analysis the odds ratio was used with corresponding 95% confidence interval. Statistical heterogeneity in the results of the metaanalysis was assessed by calculating a test of heterogeneity. The software Review Manager 5 (Cochrane Collaboration was utilized for the data gathered and the statistical analysis. Sensitive analysis was applied using only trials that included follow-up over 2 years. RESULTS: Ten trials were included with 1003 patients: 502 to total fundoplication group and 501 to partial fundoplication group. The outcomes dysphagia and inability to belch had statistical significant difference (P = 0.00001 in favor of partial fundoplication. There was not statistical difference in outcomes related with treatment failure. There were no heterogeneity in the outcomes dysphagia and recurrence of the acid reflux. CONCLUSION: The partial fundoplication has lower incidence of obstructive side effects.

Handling Uncertain Gross Margin and Water Demand in Agricultural Water Resources Management using Robust Optimization

Science.gov (United States)

Chaerani, D.; Lesmana, E.; Tressiana, N.

2018-03-01

In this paper, an application of Robust Optimization in agricultural water resource management problem under gross margin and water demand uncertainty is presented. Water resource management is a series of activities that includes planning, developing, distributing and managing the use of water resource optimally. Water resource management for agriculture can be one of the efforts to optimize the benefits of agricultural output. The objective function of agricultural water resource management problem is to maximizing total benefits by water allocation to agricultural areas covered by the irrigation network in planning horizon. Due to gross margin and water demand uncertainty, we assume that the uncertain data lies within ellipsoidal uncertainty set. We employ robust counterpart methodology to get the robust optimal solution.

Pricing, renegotiation and gross inequities

Energy Technology Data Exchange (ETDEWEB)

Kirkham, J.S. (Van Cott, Bagley, Cornwall McCarthy, Salt Lake City, UT (USA))

1990-01-01

Reviews pricing, renegotiation and gross inequity provisions of coal supply agreements in order to provide practical assistance to an attorney called upon to draft in written form the intent of buyer and seller. 26 refs.

26 CFR 1.872-1 - Gross income of nonresident alien individuals.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 9 2010-04-01 2010-04-01 false Gross income of nonresident alien individuals. 1...) INCOME TAX (CONTINUED) INCOME TAXES Nonresident Aliens and Foreign Corporations § 1.872-1 Gross income of nonresident alien individuals. (a) In general—(1) Inclusions. The gross income of a nonresident alien...

Low-grade astrocytoma: surgical outcomes in eloquent versus non-eloquent brain areas

Directory of Open Access Journals (Sweden)

André de Macedo Bianco

2013-01-01

Full Text Available A retrospective study of 81 patients with low-grade astrocytoma (LGA comparing the efficacy of aggressive versus less aggressive surgery in eloquent and non-eloquent brain areas was conducted. Extent of surgical resection was analyzed to assess overall survival (OS and progression- free survival (PFS. Degree of tumor resection was classified as gross total resection (GTR, subtotal resection (STR or biopsy. GTR, STR and biopsy in patients with tumors in non-eloquent areas were performed in 31, 48 and 21% subjects, whereas in patients with tumors in eloquent areas resections were 22.5, 35 and 42.5%. Overall survival was 4.7 and 1.9 years in patients with tumors in non-eloquent brain areas submitted to GTR/STR and biopsy (p=0.013, whereas overall survival among patients with tumors in eloquent area was 4.5 and 2.1 years (p=0.33. Improved outcome for adult patients with LGA is predicted by more aggressive surgery in both eloquent and non-eloquent brain areas.

Cost-Effectiveness Analysis of Total Hip Arthroplasty Performed by a Canadian Short-Stay Surgical Team in Ecuador.

Science.gov (United States)

Schlegelmilch, Michael; Rashiq, Saifee; Moreau, Barbara; Jarrín, Patricia; Tran, Bach; Chuck, Anderson

2017-01-01

Few charitable overseas surgical missions produce cost-effectiveness analyses of their work. We compared the pre- and postoperative health status for 157 total hip arthroplasty (THA) patients operated on from 2007 to 2011 attended by an annual Canadian orthopedic mission to Ecuador to determine the quality-adjusted life years (QALYs) gained. The costs of each mission are known. The cost per surgery was divided by the average lifetime QALYs gained to estimate an incremental cost-effectiveness ratio (ICER) in Canadian dollars per QALY. The average lifetime QALYs (95% CI) gained were 1.46 (1.4-1.5), 2.5 (2.4-2.6), and 2.9 (2.7-3.1) for unilateral, bilateral, and staged (two THAs in different years) operations, respectively. The ICERs were $4,442 for unilateral, $2,939 for bilateral, and $4392 for staged procedures. Seventy percent of the mission budget was spent on the transport and accommodation of volunteers. THA by a Canadian short-stay surgical team was highly cost-effective, according to criteria from the National Institute for Health and Care Excellence and the World Health Organization. We encourage other international missions to provide similar cost-effectiveness data to enable better comparison between mission types and between mission and nonmission care.

Determinants of gross motor skill performance in children with visual impairments.

Science.gov (United States)

Haibach, Pamela S; Wagner, Matthias O; Lieberman, Lauren J

2014-10-01

Children with visual impairments (CWVI) generally perform poorer in gross motor skills when compared with their sighted peers. This study examined the influence of age, sex, and severity of visual impairment upon locomotor and object control skills in CWVI. Participants included 100 CWVI from across the United States who completed the Test of Gross Motor Development II (TGMD-II). The TGMD-II consists of 12 gross motor skills including 6 object control skills (catching, kicking, striking, dribbling, throwing, and rolling) and 6 locomotor skills (running, sliding, galloping, leaping, jumping, and hopping). The full range of visual impairments according to United States Association for Blind Athletes (USABA; B3=20/200-20/599, legally blind; B2=20/600 and up, travel vision; B1=totally blind) were assessed. The B1 group performed significantly worse than the B2 (0.000 ≤ p ≤ 0.049) or B3 groups (0.000 ≤ p ≤ 0.005); however, there were no significant differences between B2 and B3 except for the run (p=0.006), catch (p=0.000), and throw (p=0.012). Age and sex did not play an important role in most of the skills, with the exception of boys outperforming girls striking (p=0.009), dribbling (p=0.013), and throwing (p=0.000), and older children outperforming younger children in dribbling (p=0.002). The significant impact of the severity of visual impairment is likely due to decreased experiences and opportunities for children with more severe visual impairments. In addition, it is likely that these reduced experiences explain the lack of age-related differences in the CWVI. The large disparities in performance between children who are blind and their partially sighted peers give direction for instruction and future research. In addition, there is a critical need for intentional and specific instruction on motor skills at a younger age to enable CWVI to develop their gross motor skills. Copyright © 2014 Elsevier Ltd. All rights reserved.

Disposable surgical face masks for preventing surgical wound infection in clean surgery

Directory of Open Access Journals (Sweden)

Allyson Lipp

Full Text Available BACKGROUND: Surgical face masks were originally developed to contain and filter droplets containing microorganisms expelled from the mouth and nasopharynx of healthcare workers during surgery, thereby providing protection for the patient. However, there are several ways in which surgical face masks could potentially contribute to contamination of the surgical wound, e.g. by incorrect wear or by leaking air from the side of the mask due to poor string tension. OBJECTIVES: To determine whether disposable surgical face masks worn by the surgical team during clean surgery prevent postoperative surgical wound infection. SEARCH METHODS: We searched The Cochrane Wounds Group Specialised Register (searched 14 September 2011; The Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library 2011, Issue 3; Ovid MEDLINE (2008 to August Week 5 2011; Ovid MEDLINE (In-Process &Other Non-Indexed Citations September 13, 2011; Ovid EMBASE (2008 to 2011 Week 35; and EBSCO CINAHL (2008 to 9 September 2011. SELECTION CRITERIA: Randomized controlled trials (RCTs and quasi-randomized controlled trials comparing the use of disposable surgical masks with the use of no mask. DATA COLLECTION AND ANALYSIS: Two review authors extracted data independently. MAIN RESULTS: Three trials were included, involving a total of 2113 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. AUTHORS' CONCLUSIONS: From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.

26 CFR 1.61-14 - Miscellaneous items of gross income.

Science.gov (United States)

2010-04-01

... as treble damages under the antitrust laws and exemplary damages for fraud are gross income. Another... by law. Illegal gains constitute gross income. Treasure trove, to the extent of its value in United...

26 CFR 1.993-6 - Definition of gross receipts.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 10 2010-04-01 2010-04-01 false Definition of gross receipts. 1.993-6 Section 1.993-6 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Domestic International Sales Corporations § 1.993-6 Definition of gross receipts. (a...

Guidelines for Standard Photography in Gross and Clinical Anatomy

Science.gov (United States)

Barut, Cagatay; Ertilav, Hakan

2011-01-01

Photography has a widespread usage in medicine and anatomy. In this review, authors focused on the usage of photography in gross and clinical anatomy. Photography in gross and clinical anatomy is not only essential for accurate documentation of morphological findings but also important in sharing knowledge and experience. Photographs of cadavers…

Systematic review and meta-analysis of the effect of equine assisted activities and therapies on gross motor outcome in children with cerebral palsy.

Science.gov (United States)

Tseng, Sung-Hui; Chen, Hung-Chou; Tam, Ka-Wai

2013-01-01

To evaluate the literature on the efficacy of equine assisted activities and therapies (EAAT) on gross motor outcomes representing the ICF component of body functions and activity in children with cerebral palsy (CP). We conducted a systematic review and meta-analysis of randomized controlled trials and observational studies of hippotherapy (HPOT) and therapeutic horseback riding (TR) for children with spastic CP. Gross motor outcomes, assessed via muscle activity and muscle tone, gait, posture and Gross Motor Function Measures (GMFM) were evaluated. Five TR studies and nine HPOT studies were included. Our meta-analysis indicated that short-term HPOT (total riding time 8-10 min) significantly reduced asymmetrical activity of the hip adductor muscles. HPOT could improve postural control in children with spastic CP, GMFCS level < 5. However, the evidence did not show a statistically significant effect on GMFM after long-term HPOT or TR (total riding time, 8-22 h) in children with spastic CP. This systematic review found insufficient evidence to support the claim that long-term TR or HPOT provide a significant benefit to children with spastic CP. We found no statistically significant evidence of either therapeutic effect or maintenance effects on the gross motor activity status in CP children.

Relationship Between Broiler Body Weights, Eimeria maxima Gross Lesion Scores, and Microscores in Three Anticoccidial Sensitivity Tests.

Science.gov (United States)

Barrios, Miguel A; Da Costa, Manuel; Kimminau, Emily; Fuller, Lorraine; Clark, Steven; Pesti, Gene; Beckstead, Robert

2017-06-01

Anticoccidial sensitivity tests (ASTs) serve to determine the efficacy of anticoccidial drugs against Eimeria field isolates in a controlled laboratory setting. The most commonly measured parameters are body weight gain, feed conversion ratio, gross intestinal lesion scores, and mortality. Due to the difficulty in reliably scoring gross lesion scores of Eimeria maxima , microscopic analysis of intestinal scrapings (microscores) can be used in the field to indicate the presence of this particular Eimeria. The goal of this study was to determine the relationship between E. maxima microscores and broiler body weights and gross E. maxima lesion scores in three ASTs. Day-old broiler chicks were raised for 12 days on a standard corn-soy diet. On Day 12, chicks were placed in Petersime batteries and treatment diets were provided. There were six birds per pen, four pens per treatment, and 12 treatments, for a total of 288 chicks per AST. The treatments were as follows: 1) nonmedicated, noninfected; 2) nonmedicated, infected; 3) lasalocid, infected; 4) salinomycin, infected; 5) diclazuril, infected; 6) monensin, infected; 7) decoquinate, infected; 8) narasin + nicarbazin, infected; 9) narasin, infected; 10) nicarbazin, infected; 11) robenidine, infected; and 12) zoalene, infected. On Day 14, chicks were challenged with an Eimeria field isolate by oral gavage. On Day 20, broilers were weighed, and gross lesion scores and microscores were classified from 0 to 4 depending on the severity of the gross lesion scores and E. maxima microscores. Data from three trials using different field isolates were statistically analyzed using a logarithmic regression model. There was no relationship (P = 0.1224) between microscores and body weight gain. There was a positive relationship between microscores and gross lesion scores (P = 0.004). However, there was also an interaction between isolate and treatment (P Eimeria or the amount of E. maxima in the inoculum.

PROMOTING GROSS MOTOR SKILLS IN TODDLERS: THE ACTIVE BEGINNINGS PILOT CLUSTER RANDOMIZED TRIAL.

Science.gov (United States)

Veldman, Sanne L C; Okely, Anthony D; Jones, Rachel A

2015-12-01

This study examined the feasibility, acceptability, and potential efficacy of a gross motor skill program for toddlers. An 8-wk. skills program in which children practiced three skills was implemented for 10 min. daily in two randomly designated childcare centers. Two other centers served as the control group. Recruitment and retention rates were collected for feasibility. Data on professional development, children's participation, program duration, and appropriateness of the lessons were collected for acceptability, and the Test of Gross Motor Development-2 and Get Skilled, Get Active (total of 28 points) were used to look at the potential efficacy. The participants were 60 toddlers (M age=2.5 yr., SD=0.4; n=29 boys), and the retention rate was 95%. Overall participation was 76%, and educators rated 98% of the lessons as appropriate. Compared with the control group, the intervention group showed significantly greater improvements in motor skills (pmotor skills among toddlers.

Incident radiation and the allocation of nitrogen within Arctic plant canopies: implications for predicting gross primary productivity

NARCIS (Netherlands)

Street, L.E.; Shaver, G.R.; Rastetter, E.B.; Wijk, van M.T.; Kaye, B.A.; Williams, M.

2012-01-01

Arctic vegetation is characterized by high spatial variability in plant functional type (PFT) composition and gross primary productivity (P). Despite this variability, the two main drivers of P in sub-Arctic tundra are leaf area index (LT) and total foliar nitrogen (NT). LT and NT have been shown to

Integration of digital gross pathology images for enterprise-wide access

Directory of Open Access Journals (Sweden)

Milon Amin

2012-01-01

Full Text Available Background: Sharing digital pathology images for enterprise- wide use into a picture archiving and communication system (PACS is not yet widely adopted. We share our solution and 3-year experience of transmitting such images to an enterprise image server (EIS. Methods: Gross pathology images acquired by prosectors were integrated with clinical cases into the laboratory information system′s image management module, and stored in JPEG2000 format on a networked image server. Automated daily searches for cases with gross images were used to compile an ASCII text file that was forwarded to a separate institutional Enterprise Digital Imaging and Communications in Medicine (DICOM Wrapper (EDW server. Concurrently, an HL7-based image order for these cases was generated, containing the locations of images and patient data, and forwarded to the EDW, which combined data in these locations to generate images with patient data, as required by DICOM standards. The image and data were then "wrapped" according to DICOM standards, transferred to the PACS servers, and made accessible on an institution-wide basis. Results: In total, 26,966 gross images from 9,733 cases were transmitted over the 3-year period from the laboratory information system to the EIS. The average process time for cases with successful automatic uploads (n=9,688 to the EIS was 98 seconds. Only 45 cases (0.5% failed requiring manual intervention. Uploaded images were immediately available to institution- wide PACS users. Since inception, user feedback has been positive. Conclusions: Enterprise- wide PACS- based sharing of pathology images is feasible, provides useful services to clinical staff, and utilizes existing information system and telecommunications infrastructure. PACS-shared pathology images, however, require a "DICOM wrapper" for multisystem compatibility.

Perioperative Allogeneic Red Blood-Cell Transfusion Associated with Surgical Site Infection After Total Hip and Knee Arthroplasty.

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Everhart, Joshua S; Sojka, John H; Mayerson, Joel L; Glassman, Andrew H; Scharschmidt, Thomas J

2018-02-21

Perioperative allogeneic red blood-cell transfusion is a suspected risk factor for surgical site infection (SSI) after total joint arthroplasty (TJA), but the interrelationships among SSI risk, transfusion dose, preoperative anemia, and the presence of coagulopathies have not been well described. Data on SSI within 1 year after surgery as well as on transfusion with blood products within 30 days after surgery were obtained for 6,788 patients who had undergone primary or revision total hip or knee arthroplasty from 2000 to 2011 in a single hospital system. Multivariate logistic regression modeling was used to determine the independent association between allogeneic red blood-cell transfusion and SSI. There was a dose-dependent association between allogeneic red blood-cell transfusion and SSI, with the infection rate increasing as the transfusion dose increased from 1 unit (odds ratio [OR] = 1.97; 95% confidence interval [CI] = 1.38, 2.79; p 3 units (OR = 7.40; CI = 4.91, 11.03; p conservation strategies. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Effects of preoperative walking ability and patient's surgical education on quality of life and functional outcomes after total knee arthroplasty

Directory of Open Access Journals (Sweden)

Sunil K. Dash

Full Text Available ABSTRACT OBJECTIVE: Prospectively analyze the effect of preoperative walking status and the patient's surgical education on functional outcomes and the three dimensions of quality of life (QoL (pain, physical function, and mental health after elective total knee arthroplasty (TKA. METHODS: A comparative analysis on the QoL and functional outcomes in patients who underwent total knee arthroplasty between January 2014 and June 2015. To compare effects of the patient's walking status and knowledge of the surgical procedure on QoL and functional outcomes following TKA by means of SF-36 questionnaire, CES D10, VAS, KSS, KSFS, WOMAC, as well as Friedmann and Wyman scores, 10MWT, and 30-second timed chair test, assessed before the operation and one, three, and six months after the operation. RESULTS: There were 168 knees in 154 patients: 46.75% men and 53.24% women. 52.38% of knees had grade-III OA and 40.47% of knees had grade-IV OA. Preoperatively, SF-36 PCS was 33.2 and MCS was 35.4. Mean KSS and KSFS in females was 37.3 (16.2 and 31.5 (13.8; in males it was 49.2 (18.4 and 42.5 (15.7, respectively. Mean WOMAC scores were 64.2 in females and 56.5 in males. Mean VAS and CES D10 scores were 8.8 and 8.2 in females, and 6.9 and 6.4 in males, respectively. Post operatively at the first, third, and sixth month, significant improvements in QoL and mean SF-36, CES D10, VAS, KSS, KSFS, WOMAC, and Friedmann and Wyman scores were observed, as well as in the 10MWT and 30 s timed chair test scores. Patients with better preoperative functional activity and satisfactory understanding of TKA presented a better functional performance and achieved a good quality life (p< 0.01. DISCUSSION: Surgeons educate TKA candidates regarding the surgical procedure, the nature of implants, and how the procedure would affect their lifestyle and what their expectations from TKA should be. These crucial considerations should boost their confidence, enhancing their involvement and

Oropharyngeal dysphagia and gross motor skills in children with cerebral palsy.

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Benfer, Katherine A; Weir, Kelly A; Bell, Kristie L; Ware, Robert S; Davies, Peter S W; Boyd, Roslyn N

2013-05-01

To determine the prevalence of oropharyngeal dysphagia (OPD) and its subtypes (oral phase, pharyngeal phase, saliva control), and their relationship to gross motor functional skills in preschool children with cerebral palsy (CP). It was hypothesized that OPD would be present across all gross motor severity levels, and children with more severe gross motor function would have increased prevalence and severity of OPD. Children with a confirmed diagnosis of CP, 18 to 36 months corrected age, born in Queensland between 2006 and 2009, participated. Children with neurodegenerative conditions were excluded. This was a cross-sectional population-based study. Children were assessed by using 2 direct OPD measures (Schedule for Oral Motor Assessment; Dysphagia Disorders Survey), and observations of signs suggestive of pharyngeal phase impairment and impaired saliva control. Gross motor skills were described by using the Gross Motor Function Measure, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System, and motor type/ distribution. OPD was prevalent in 85% of children with CP, and there was a stepwise relationship between OPD and GMFCS level. There was a significant increase in odds of having OPD, or a subtype, for children who were nonambulant (GMFCS V) compared with those who were ambulant (GMFCS I) (odds ratio = 17.9, P = .036). OPD was present across all levels of gross motor severity using direct assessments. This highlights the need for proactive screening of all young children with CP, even those with mild impairments, to improve growth and nutritional outcomes and respiratory health.

Middle Temporal Gyrus Versus Inferior Temporal Gyrus Transcortical Approaches to High-Grade Astrocytomas in the Mediobasal Temporal Lobe: A Comparison of Outcomes, Functional Restoration, and Surgical Considerations.

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Quinones-Hinojosa, Alfredo; Raza, Shaan M; Ahmed, Ishrat; Rincon-Torroella, Jordina; Chaichana, Kaisorn; Olivi, Alessandro

2017-01-01

High-grade astrocytomas of the mesial temporal lobe may pose surgical challenges. Several approaches (trans-sylvian, subtemporal, and transcortical) have been designed to circumnavigate the critical neurovascular structures and white fiber tracts that surround this area. Considering the paucity of literature on the transcortical approach for these lesions, we describe our institutional experience with transcortical approaches to Grade III/IV astrocytomas in the mesial temporal lobe. Between 1999 and 2009, 23 patients underwent surgery at the Johns Hopkins Medical Institutions for Grade III/IV astrocytomas involving the mesial temporal lobe (without involvement of the temporal neocortex). Clinical notes, operative records, and imaging were reviewed. Thirteen patients had tumors in the dominant hemisphere. All patients underwent surgery via a transcortical approach (14 via the inferior temporal gyrus and 9 via the middle temporal gyrus). Gross total resection was obtained in 92 % of the cohort. Neurological outcomes were: clinically significant stroke (2 patients), new visual deficits (2 patients), new speech deficit (1 patient); seizure control (53 %). In comparison to reported results in the literature for the transylvian and subtemporal approaches, the transcortical approach may provide the access necessary for a gross total resection with minimal neurological consequences. In our series of patients, there was no statistically significant difference in outcomes between the middle temporal gyrus versus the inferior temporal gyrus trajectories.

Determination of self absorption correction factor (SAF) for gross alpha measurement in water samples by BIS method

International Nuclear Information System (INIS)

Raveendran, Nanda; Baburajan, A.; Ravi, P.M.

2018-01-01

The laboratories accredited by AERB undertake the measurement of gross alpha and gross beta in packaged drinking water from manufactures across the country and analyze as per the procedure of Bureau of Indian standards. The accurate measurements of gross alpha in the drinking water sample is a challenge due to the self absorption of alpha particle from varying precipitate (Fe(OH) 3 +BaSO 4 ) thickness and total dissolved solids (TDS). This paper deals with a study on tracer recovery generation and self absorption correction factor (SAF). ESL, Tarapur has participated in an inter-laboratory comparison exercise conducted by IDS, RSSD, BARC as per the recommendation of AERB for the accredited laboratories. The thickness of the precipitate is an important aspect which affected the counting process. The activity was reported after conducting multiple experiments with uranium tracer recovery and precipitate thickness. Later on to make our efforts simplified, an average tracer recovery and Self Absorption correction Factor (SAF) was derived by the present experiment and the same was used for the re-calculation of activity from the count rate reported earlier

Surgical Site Infection Following Fixation of Acetabular Fractures.

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Iqbal, Faizan; Younus, Sajid; Asmatullah; Zia, Osama Bin; Khan, Naveed

2017-09-01

Acetabular fractures are mainly caused by high energy trauma. Surgical fixation of these fractures requires extensive surgical exposure which increases the length of operation and blood loss as well. This may increase the risk of surgical site infection. Our aim is to evaluate the prevalence of surgical site infections and the risk factors associated with it so as to minimize its chances. A total of 261 patients who underwent acetabular fracture surgery were retrospectively reviewed. Patients were divided into 2 groups, with or without surgical site infection. Factors examined include patients' gender, age, body mass index (BMI), time between injury and surgery, operative time, estimated blood loss, number of packed red blood cell transfused, length of total intensive care unit (ICU) stay, fracture type, surgical approach, smoking status, patients' comorbids and associated injuries. Fourteen patients (5.4%) developed surgical site infection. Out of 14 infections, 4 were superficial and 10 were deep. The factors that were found to be associated with surgical site infection following acetabular fracture fixation were prolonged operation time, increased BMI, prolonged ICU stay, larger amount of packed red blood cell transfused and associated genitourinary and abdominal trauma. In our study, we conclude that measures should be undertaken to attenuate the chances of surgical site infection in this major surgery by considering the risk factors significantly associated with it.

Evaluation of gross tumor size using CT, 18F-FDG PET, integrated 18F-FDG PET/CT and pathological analysis in non-small cell lung cancer

International Nuclear Information System (INIS)

Yu Huiming; Liu Yunfang; Hou Ming; Liu Jie; Li Xiaonan; Yu Jinming

2009-01-01

Purpose: The correlation of gross tumor sizes between combined 18 F-FDG PET/CT images and macroscopic surgical samples has not yet been studied in detail. In the present study, we compared CT, 18 F-FDG PET and combined 18 F-FDG PET/CT for the delineation of gross tumor volume (GTV) and validated the results through examination of the macroscopic surgical specimen. Methods: Fifty-two operable non-small cell lung cancer (NSCLC) patients had integrated 18 F-FDG PET/CT scans preoperatively and pathological examination post-operation. Four separate maximal tumor sizes at X (lateral direction), Y (ventro-dorsal direction) and Z (cranio-caudal direction) axis were measured on 18 F-FDG PET, CT, combined 18 F-FDG PET/CT and surgical specimen, respectively. Linear regression was calculated for each of the three imaging measurements versus pathological measurement. Results: No significant differences were observed among the tumor sizes measured by three images and pathological method. Compared with pathological measurement, CT size at X, Y, Z axis was larger, whereas combined 18 F-FDG PET/CT and 18 F-FDG PET size were smaller. Combined 18 F-FDG PET/CT size was more similar to the pathological size than that of 18 F-FDG PET or CT. Results of linear regressions showed that integrated 18 F-FDG PET/CT was the most accurate modality in measuring the size of cancer. Conclusions: 18 F-FDG PET/CT correlates more faithfully with pathological findings than 18 F-FDG PET or CT. Integrated 18 F-FDG PET/CT is an effective tool to define the target of GTV in radiotherapy.

Provision of general paediatric surgical services in a regional hospital.

LENUS (Irish Health Repository)

Zgraj, O

2012-01-31

BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

Evaluation of free i-applications for tertiary level gross anatomy education

Directory of Open Access Journals (Sweden)

Matthew F. Pollard

2012-04-01

Full Text Available BackgroundThe use of electronic resources in education, including i-applications used on portable handheld devices, is increasing. Apple® handheld devices are popular, with free applications the most prevalent download form. Many gross anatomy i-applications are available, however no information on the quality of free anatomy products is available. Rating such products could therefore guide product recommendations.AimTo evaluate the quality and range of free iPod® applications that are applicable for tertiary level gross anatomy education.MethodsA search of the iTunes® Application Store with keywords anatomy, free, medical, functional, clinical, gross, and human was performed, with inclusion based on free applications containing human gross anatomy usable for tertiary education purposes. Application specification was noted; each was trialled independently and rated for usability, specification, academic level, and quality (image and programme.ResultsSixty-three applications were identified and eleven met inclusion criteria. Two provided gross anatomy of the entire body, nine examined specific regions or systems. Five were judged introductory in academic level, five intermediate, and one advanced. One application was rated low quality, and four excellent. None were considered difficult to use (six easy, five medium. Application size ranged between 1.2MB and 229MB (mean 27MB.ConclusionsThere are few free i-applications for learning gross anatomy and most concentrate on individual body systems, with the academic level and usability of all products well rated. Results suggest some free I-applications could be suitable adjuncts for gross anatomy education at both an undergraduate and graduate level.

Gross alpha and beta activities in drinking water from Goias State, Brazil

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Mingote, Raquel M. [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN), Belo Horizonte, MG (Brazil); Nogueira, Regina A.; Costa, Heliana F. da, E-mail: raquel.mingote@cdtn.br, E-mail: rnogueira@cnen.gov.br, E-mail: heliana@cnen.gov.br [Centro Regional de Ciencias Nucleares do Centro-Oeste (CRCN-CO/CNEN), Abadia de Goias, GO (Brazil). Parque Estadual Telma Ortegal

2017-07-01

Detection of gross alpha and beta radioactivity is important for a quick surveying of both natural and anthropogenic radioactivity in water. Furthermore, gross alpha and gross beta parameters are included in Brazilian legislation on quality of drinking water. In this work, a low background liquid scintillation spectrometer was used to simultaneously determine gross alpha and gross beta in samples of the public water supplies in the state of Goias, Brazil, during 2010-2015. Sample preparation involved evaporation to concentrate the sample ten-fold. The results indicate that the water meets the radioactivity standards required by the regulations MS 2914/2011 of the Brazilian Department of Health. Concerning the high level of censored observations, a statistical treatment of data was conducted by using analysis methods of censored data to provide a reference value of the gross alpha and beta radioactivity in drinking water from the state of Goias. The estimated typical activities are very low, 0.030 Bq•L{sup -1} and 0.058 Bq•L{sup -1}, respectively. (author)

Use of Quantile Regression to Determine the Impact on Total Health Care Costs of Surgical Site Infections Following Common Ambulatory Procedures.

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Olsen, Margaret A; Tian, Fang; Wallace, Anna E; Nickel, Katelin B; Warren, David K; Fraser, Victoria J; Selvam, Nandini; Hamilton, Barton H

2017-02-01

To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data. SSIs within 90 days post-procedure were identified; infections during a hospitalization or requiring surgery were considered serious. We used quantile regression, controlling for patient, operative, and postoperative factors to examine the impact of SSIs on 180-day health care costs throughout the cost distribution. The incidence of serious and nonserious SSIs was 0.8% and 0.2%, respectively, after 21,062 anterior cruciate ligament reconstruction, 0.5% and 0.3% after 57,750 cholecystectomy, 0.6% and 0.5% after 60,681 hernia, and 0.8% and 0.8% after 42,489 breast-conserving surgery procedures. Serious SSIs were associated with significantly higher costs than nonserious SSIs for all 4 procedures throughout the cost distribution. The attributable cost of serious SSIs increased for both cholecystectomy and hernia repair as the quantile of total costs increased ($38,410 for cholecystectomy with serious SSI vs no SSI at the 70th percentile of costs, up to $89,371 at the 90th percentile). SSIs, particularly serious infections resulting in hospitalization or surgical treatment, were associated with significantly increased health care costs after 4 common surgical procedures. Quantile regression illustrated the differential effect of serious SSIs on health care costs at the upper end of the cost distribution.

Successful surgical treatment of intractable hemifacial spasm: A case report and review of cerebellar hamartomas of the floor of the fourth ventricle

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Joseph H. Miller

2016-12-01

Full Text Available Introduction: Hamartomas involving the floor of the fourth ventricle and cerebellum are rare, but can be associated with medically recalcitrant hemifacial spasm. These lesions present early in the neonatal or infantile period and respond well to surgical excision. Case Report: A 3-month-old white male presented with recurrent left hemifacial spasm, left eye deviation, and absent movement of the extremities. The patient was found to have a left eccentric lesion in the floor of the fourth ventricle and cerebellum. The patient showed no improvement with medical therapy by 6 months of age. He was taken to the operating room for suboccipital craniotomy and removal of the posterior arch of C1 followed by intralesional recording of epileptogenic activity and gross total resection of the lesion. After histologic analysis, the lesion was determined to be ectopic cerebral tissue consistent with a hamartoma. Postoperative MRI showed complete removal of the lesion, and the patient exhibited complete remission of his hemifacial spasm and associated symptoms. Conclusions: Hamartomas involving the floor of the fourth ventricle can present with hemifacial spasm and respond well to surgical excision. Keywords: Cerebellar, Seizure, Epilepsy, Hamartoma

Acetabular Dysplasia and Surgical Approaches Other Than Direct Anterior Increases Risk for Malpositioning of the Acetabular Component in Total Hip Arthroplasty

DEFF Research Database (Denmark)

Gromov, Kirill; Greene, Meridith E; Huddleston, James I

2016-01-01

BACKGROUND: Persistent acetabular dysplasia (AD) after periacetabular osteotomy has been hypothesized to increase the risk for malpositioning of the acetabular component. In this study, we investigate whether AD is an independent risk factor for cup malpositioning during primary total hip...... arthroplasty (THA). METHODS: Patient demographics, surgical approach, presence of AD assessed using the lateral center-edge angle, and acetabular cup positioning determined using Martell Hip Analysis Suite were investigated in 836 primary THA patients enrolled in a prospective multicenter study. RESULTS: We...

Advantages of combined touch screen technology and text hyperlink for the pathology grossing manual: a simple approach to access instructive information in biohazardous environments.

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Qu, Zhenhong; Ghorbani, Rhonda P; Li, Hongyan; Hunter, Robert L; Hannah, Christina D

2007-03-01

Gross examination, encompassing description, dissection, and sampling, is a complex task and an essential component of surgical pathology. Because of the complexity of the task, standardized protocols to guide the gross examination often become a bulky manual that is difficult to use. This problem is further compounded by the high specimen volume and biohazardous nature of the task. As a result, such a manual is often underused, leading to errors that are potentially harmful and time consuming to correct-a common chronic problem affecting many pathology laboratories. To combat this problem, we have developed a simple method that incorporates complex text and graphic information of a typical procedure manual and yet allows easy access to any intended instructive information in the manual. The method uses the Object-Linking-and-Embedding function of Microsoft Word (Microsoft, Redmond, WA) to establish hyperlinks among different contents, and then it uses the touch screen technology to facilitate navigation through the manual on a computer screen installed at the cutting bench with no need for a physical keyboard or a mouse. It takes less than 4 seconds to reach any intended information in the manual by 3 to 4 touches on the screen. A 3-year follow-up study shows that this method has increased use of the manual and has improved the quality of gross examination. The method is simple and can be easily tailored to different formats of instructive information, allowing flexible organization, easy access, and quick navigation. Increased compliance to instructive information reduces errors at the grossing bench and improves work efficiency.

On-call emergency workload of a general surgical team.

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Jawaid, Masood; Raza, Syed Muhammad; Alam, Shams Nadeem; Manzar, S

2009-01-01

To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients. Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

Effect of a 12-Week Physical Activity Program on Gross Motor Skills in Children.

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Burns, Ryan D; Fu, You; Fang, Yi; Hannon, James C; Brusseau, Timothy A

2017-12-01

This study examined the effects of a 12-week Comprehensive School Physical Activity Program (CSPAP) on gross motor skill development in children from low-income families. Participants were 1,460 school-aged children (mean age = 8.4 ± 1.8 years; 730 girls, 730 boys) recruited from three schools receiving U.S. governmental financial assistance. Students were recruited from grades K-6. CSPAP was implemented over one semester during the 2014-2015 school year. Select gross motor skill items were assessed during each student's physical education class at baseline and at a 12-week follow-up using the Test for Gross Motor Development-2nd Edition (TGMD-2). Each student's TGMD-2 score was converted to a percentage of the total possible score. A 7 × 2 × 2 analysis of variance test with repeated measures was employed to examine the effects of age, sex, and time on TGMD-2 percent scores, adjusting for clustering within the data structure. There were greater TGMD-2 percent scores at follow-up compared with baseline (82.4% vs. 72.6%, mean difference = 9.8%, p < .001, Cohen's d = 0.67), and greater improvements were seen in younger children compared with older children (mean difference of change = 4.0%-7.5%, p < .01, Cohen's d = 0.30-0.55).

Effect of water content nitrogen gross mineralization and immobilization

International Nuclear Information System (INIS)

Videla C, Ximena; Parada, Ana Maria; Nario M, Adriana; Pino N, Ines; Hood, Rebeca

2005-01-01

The decomposition of organic matter in soil, and the accompanying mineralization and immobilization of inorganic N, are key processes in the soil plant cycle. It is hypothesized that moisture regime may also play an important role on these processes. Two laboratory studies were carried out to investigate the effect of moisture regime on gross mineralization and immobilization of N, in and Ultisol soil, which was incubated at 25 o C, under two moisture regimes, field capacity (CC) (40% w/w) and 85% of field capacity (34% w/w): Using mirror image 15 N isotope dilution techniques, it was possible to determine gross nitrification and mineralization rates. The rates of gross mineralization and nitrification rate in this soil was extremely rapid and efficient, specially with 85% CC. The N transformations varied with moisture regime (author)

The Value of Large Sections in Surgical Pathology

Directory of Open Access Journals (Sweden)

Maria P. Foschini

2012-01-01

Full Text Available Large format sections (LS first have been introduced in breast pathology more than a century ago. Since then, they constituted for longtime a research tool to better understand breast microanatomy and the relationship between radiological images and pathological features. Similarly LS have been used to study neoplastic, inflammatory, and degenerative diseases affecting various organs, as brain, lung, gastrointentinal tract, bone, urinary tract, prostate, and placenta. Currently LS are mostly applied to diagnostic routine to better stage tumours such as prostate and breast carcinomas or to correlate radiologic imaging to gross specimens. The purpose of the present paper is to review the historical background and the basis of the applications of LS in surgical pathology, with special emphasis on breast tumours.

The one-dimensional Gross-Pitaevskii equation and its some excitation states

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Prayitno, T. B., E-mail: trunk-002@yahoo.com [Physics Department, Faculty of Mathematics and Natural Science, Universitas Negeri Jakarta, Jl. Pemuda Rawamangun no. 10, Jakarta, 13220 (Indonesia)

2015-04-16

We have derived some excitation states of the one-dimensional Gross-Pitaevskii equation coupled by the gravitational potential. The methods that we have used here are taken by pursuing the recent work of Kivshar et. al. by considering the equation as a macroscopic quantum oscillator. To obtain the states, we have made the appropriate transformation to reduce the three-dimensional Gross-Pitaevskii equation into the one-dimensional Gross-Pitaevskii equation and applying the time-independent perturbation theory in the general solution of the one-dimensional Gross-Pitaevskii equation as a linear superposition of the normalized eigenfunctions of the Schrödinger equation for the harmonic oscillator potential. Moreover, we also impose the condition by assuming that some terms in the equation should be so small in order to preserve the use of the perturbation method.

Vitamin D levels are associated with gross motor function in amyotrophic lateral sclerosis.

Science.gov (United States)

Paganoni, Sabrina; Macklin, Eric A; Karam, Chafic; Yu, Hong; Gonterman, Fernando; Fetterman, K Ashley; Cudkowicz, Merit; Berry, James; Wills, Anne-Marie

2017-10-01

The objective of this study was to determine whether serum vitamin D [25(OH)D] levels are associated with disease progression in amyotrophic lateral sclerosis (ALS). 25(OH)D was measured in subjects enrolled in a multicenter study for validation of ALS biomarkers. Baseline 25(OH)D levels were correlated with baseline ALSFRS-R scores. Average 25(OH)D levels from baseline and month 6 visits (seasonally asynchronous) were used to predict subsequent rate of change in ALSFRS-R from month 6 to month 18. Most subjects had either insufficient or deficient 25(OH)D levels. Lower 25(OH)D was associated with lower ALSFRS-R gross motor scores, but not lower ALSFRS-R total scores at baseline. Levels of 25(OH)D were not predictive of disease progression over the next 12 months. 25(OH)D was associated with baseline gross motor ALSFRS-R scores but did not predict the rate of disease progression. Vitamin D levels may reflect poor mobility in patients with ALS. Muscle Nerve, 2017 Muscle Nerve 56: 726-731, 2017. © 2017 Wiley Periodicals, Inc.

Surgical difficulties for Total Knee Replacement in Stickler syndrome: A case report

Science.gov (United States)

Verma, Gopalkrishna G; Zarough, Adel; Suraliwala, KH

2008-01-01

Stickler syndrome is believed to be the most common connective tissue disorder in Europe and the USA. Severe osteoarthritis sets in at very early age in 3rd to 4th decade of life necessitating joint arthroplasty. This case report highlights the intraoperative surgical difficulties faced by the surgeon and the planning needed for the operation. PMID:18816376

Surgical management for upper urinary tract transitional cell carcinoma.

Science.gov (United States)

Rai, Bhavan Prasad; Shelley, Mike; Coles, Bernadette; Biyani, Chandra S; El-Mokadem, Ismail; Nabi, Ghulam

2011-04-13

Upper tract transitional cell carcinomas (TCC) are uncommon and aggressive tumours. There are a number of surgical approaches to manage this condition including open radical nephroureterectomy and laparoscopic procedures. To determine the best surgical management option for upper tract transitional cell carcinoma. A sensitive search strategy was developed to identify relevant studies for inclusion in this review. The following databases were searched for randomised trials evaluating surgical approaches to the management of upper tract TCC: Medline EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, British Nursing Index, AMED, LILACS, Web of Science®, Scopus, Biosis, TRIP, Biomed Central, Dissertation Abstracts, and ISI Proceedings. The following criteria that were considered for this review.Types of studies - All randomised or quasi-randomised controlled trials comparing the various surgical methods and approaches for the management of localised upper tract transitional cell carcinoma. Types of participants - All adult patients with localised transitional cell carcinoma. Localised disease was defined as limited to the kidney or ureter with no gross regional lymph nodal enlargement on imaging. Types of interventions - Any surgical method or approach for managing localised upper tract transitional cell carcinoma. Types of outcome measures - Overall and cancer-specific survival were primary outcomes. Surgery-related morbidity. Quality of life and health economics outcomes were secondary outcomes. Two review authors examined the search results independently to identify trials for inclusion. We identified one randomised controlled trial that met our inclusion criteria. The trial showed that the laparoscopic approach had superior peri-operative outcomes compared to open approach. Laparoscopic was superior and statistically significant for blood loss (104 mL (millilitres) versus 430 mL, P management of upper tract transitional cell carcinoma

Vast Portfolio Selection with Gross-exposure Constraints().

Science.gov (United States)

Fan, Jianqing; Zhang, Jingjin; Yu, Ke

2012-01-01

We introduce the large portfolio selection using gross-exposure constraints. We show that with gross-exposure constraint the empirically selected optimal portfolios based on estimated covariance matrices have similar performance to the theoretical optimal ones and there is no error accumulation effect from estimation of vast covariance matrices. This gives theoretical justification to the empirical results in Jagannathan and Ma (2003). We also show that the no-short-sale portfolio can be improved by allowing some short positions. The applications to portfolio selection, tracking, and improvements are also addressed. The utility of our new approach is illustrated by simulation and empirical studies on the 100 Fama-French industrial portfolios and the 600 stocks randomly selected from Russell 3000.

Soil gross nitrogen transformations in responses to land use conversion in a subtropical karst region.

Science.gov (United States)

Li, Dejun; Liu, Jing; Chen, Hao; Zheng, Liang; Wang, Kelin

2018-04-15

Gross nitrogen (N) transformations can provide important information for assessing indigenous soil N supply capacity and soil nitrate leaching potential. The current study aimed to assess the variation of gross N transformations in response to conversion of maize-soybean fields to sugarcane, mulberry, and forage grass fields in a subtropical karst region of southwest China. Mature forests were included for comparison. Gross rates of N mineralization (GNM) were highest in the forests, intermediate in the maize-soybean and forage grass fields, and lowest in the sugarcane and mulberry fields, suggesting capacity of indigenous soil N supply derived from organic N mineralization was lowered after conversion to sugarcane and mulberry fields. The relative high indigenous soil N supply capacity in the maize-soybean fields was obtained at the cost of soil organic N depletion. Gross nitrification (GN) rates were highest in the forests, intermediate in the forage grass fields and lowest in the other three agricultural land use types. The nitrate retention capacity (24.1 ± 2.0% on average) was similar among the five land use types, implying that nitrate leaching potential was not changed after land use conversion. Microbial biomass N exerted significant direct effects on the rates of N mineralization, nitrification, ammonium immobilization and nitrate immobilization. Soil organic carbon, total N and exchangeable magnesium had significant indirect effects on these N transformation rates. Our findings suggest that forage grass cultivation instead of other agricultural land uses should be recommended from the perspective of increasing indigenous soil N supply while not depleting soil organic N pool. Copyright © 2018 Elsevier Ltd. All rights reserved.

On-call emergency workload of a general surgical team

Directory of Open Access Journals (Sweden)

Jawaid Masood

2009-01-01

Full Text Available Background: To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. Patients and Methods: During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Results: Total 456 patients (326 males and 130 females were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9% were received from 8 am to 5 pm. 224 (49.1% calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0% patients. Total 73 (16.0% calls were received for trauma. Total 131 (28.7% patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5% patients were discharged from A and E. 92 (20.1% patients were referred to other units with medical referral accounts for 45 (9.8% patients. Total 104 (22.8% emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7% patients. Conclusion: Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

Gross Motor Profile and Its Association with Socialization Skills in Children with Autism Spectrum Disorders.

Science.gov (United States)

Pusponegoro, Hardiono D; Efar, Pustika; Soedjatmiko; Soebadi, Amanda; Firmansyah, Agus; Chen, Hui-Ju; Hung, Kun-Long

2016-12-01

While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and socialization skills in children with ASD. This was a cross-sectional study including 40 ASD children aged from 18 months to 6 years and 40 age-matched typically developing controls. Gross motor and socialization skills were scored using the Vineland Adaptive Behavior Scales, 2 nd edition (Vineland-II). Below average gross motor function was found in eight of 40 (20%) ASD children. The mean gross motor v-scale score in the ASD group was 15.1 [standard deviation (SD) 3.12], significantly lower than in the control group [18.7, SD 2.09, p = 0.0001; 95% confidence intervals (CI) from -4.725 to -2.525]. The differences were most prominent in ball throwing and catching, using stairs, jumping, and bicycling. The ASD children with gross motor impairments had a mean socialization domain score of 66.6 (SD 6.50) compared to 85.7 (SD 10.90) in those without gross motor impairments (p = 0.0001, 95% CI from -25.327 to -12.736). Children with ASD had lower gross motor skills compared to typically developing children. Gross motor impairments were found in 20% of the ASD children, and these children also had lower socialization skills than those without gross motor impairments. Copyright © 2016. Published by Elsevier B.V.

Measurement of Gross Alpha and Gross Beta Radioactivity of River Yobe, North Eastern Nigeria

International Nuclear Information System (INIS)

Abba, H. T.; Sadiq, U.; Adeyemo, D. J.

2013-01-01

Measurement of the gross alpha and gross beta radioactivity of River Yobe has been carried out. Fifteen samples of the river water were collected from the farming, fishing, domestic/livestock and control areas along the river and were analyzed using desktop alpha/beta (MPC 2000- DP) counting system. The count results show the average alpha activities in farming, fishing, domestic/livestock and control areas are 0.207±0.082, 0.257±0.13, 0.437±0.315 and 0.237±0.10 Bq L -1 , respectively. The average beta activities in the four areas are 0.813±0.122, 0.308±0.0145, 0.563±0.230 and 0.225±0.0096 Bq L -1 , respectively. The overall results show that the alpha and beta activities in the four areas are far below the practical screening level of radioactivity in drinking water of 0.5 Bq L -1 for alpha and 1 Bq L -1 for beta recommended by CEC-FAO and WHO and therefore may not pose any serious detrimental health side-effects to the public users of the river.

Integrability of the Gross-Pitaevskii equation with Feshbach resonance management

International Nuclear Information System (INIS)

Zhao Dun; Luo Honggang; Chai Huayue

2008-01-01

In this Letter we study the integrability of a class of Gross-Pitaevskii equations managed by Feshbach resonance in an expulsive parabolic external potential. By using WTC test, we find a condition under which the Gross-Pitaevskii equation is completely integrable. Under the present model, this integrability condition is completely consistent with that proposed by Serkin, Hasegawa, and Belyaeva [V.N. Serkin, A. Hasegawa, T.L. Belyaeva, Phys. Rev. Lett. 98 (2007) 074102]. Furthermore, this integrability can also be explicitly shown by a transformation, which can convert the Gross-Pitaevskii equation into the well-known standard nonlinear Schroedinger equation. By this transformation, each exact solution of the standard nonlinear Schroedinger equation can be converted into that of the Gross-Pitaevskii equation, which builds a systematical connection between the canonical solitons and the so-called nonautonomous ones. The finding of this transformation has a significant contribution to understanding the essential properties of the nonautonomous solitons and the dynamics of the Bose-Einstein condensates by using the Feshbach resonance technique

School Physical Activity Programming and Gross Motor Skills in Children.

Science.gov (United States)

Burns, Ryan D; Fu, You; Hannon, James C; Brusseau, Timothy A

2017-09-01

We examined the effect of a comprehensive school physical activity program (CSPAP) on gross motor skills in children. Participants were 959 children (1st-6th grade; Mean age = 9.1 ± 1.5 years; 406 girls, 553 boys) recruited from 5 low-income schools receiving a year-long CSPAP intervention. Data were collected at the beginning of the school year and at a 36-week follow-up. Gross motor skills were assessed using the Test for Gross Motor Development (3rd ed.) (TGMD-3) instrument. Multi-level mixed effects models were employed to examine the effect of CSPAP on TGMD-3 scores, testing age and sex as effect modifiers and adjusting for clustering of observations within the data structure. There were statistically significant coefficients for time (β = 8.1, 95% CI [3.9, 12.3], p skills and ball skills sub-test scores. Children showed improved gross motor skill scores at the end of the 36-week CSPAP that were modified by age, as younger children displayed greater improvements in TGMD-3 scores compared to older children.

Improved compliance with the World Health Organization Surgical Safety Checklist is associated with reduced surgical specimen labelling errors.

Science.gov (United States)

Martis, Walston R; Hannam, Jacqueline A; Lee, Tracey; Merry, Alan F; Mitchell, Simon J

2016-09-09

A new approach to administering the surgical safety checklist (SSC) at our institution using wall-mounted charts for each SSC domain coupled with migrated leadership among operating room (OR) sub-teams, led to improved compliance with the Sign Out domain. Since surgical specimens are reviewed at Sign Out, we aimed to quantify any related change in surgical specimen labelling errors. Prospectively maintained error logs for surgical specimens sent to pathology were examined for the six months before and after introduction of the new SSC administration paradigm. We recorded errors made in the labelling or completion of the specimen pot and on the specimen laboratory request form. Total error rates were calculated from the number of errors divided by total number of specimens. Rates from the two periods were compared using a chi square test. There were 19 errors in 4,760 specimens (rate 3.99/1,000) and eight errors in 5,065 specimens (rate 1.58/1,000) before and after the change in SSC administration paradigm (P=0.0225). Improved compliance with administering the Sign Out domain of the SSC can reduce surgical specimen errors. This finding provides further evidence that OR teams should optimise compliance with the SSC.

Does simulation-based training facilitate the integration of human anatomy with surgery? A report of a novel Surgical Anatomy Course.

Science.gov (United States)

Torres, K; Denisow-Pietrzyk, M; Pietrzyk, Ł; Maciejewski, R; Torres, A

2018-01-01

Knowledge of gross anatomy, as a basic core subject, is fundamental for medical students and essential to medical practitioners, particularly for those intending a surgical career. However, both medical students and clinical teachers have found a significant gap in teaching basic sciences and the transition into clinical skills. The authors present a Surgical Anatomy Course developed to teach the anatomical basis of surgical procedures with particular emphasis on laparo-scopic skills while incorporating medical simulation. An evaluation of the students' satisfaction of the Surgical Anatomy Course was completed using a mix of multiple choice and open-ended questions, and a six-point Likert Scale. Questions were asked about the students' perceived improvement in surgical and laparoscopic skills. Manual skills were assessed using a laparoscopic simulator. Both evaluation of the course structure and the general impression of the course were positive. Most students believed the course should be an integral part of a modern curriculum. The course supported the traditional surgical classes and improved anatomical knowledge and strengthened students' confidentiality and facilitated understanding and taking surgical rotations. A medical course combining the practical learning of anatomy and surgical-based approaches will bring out the best from the students. Medical students positively evaluated the Surgical Anatomy Course as useful and benefi-cial regarding understanding anatomical structure and relationship necessary for further surgical education. (Folia Morphol 2018; 77, 2: 279-285).

Duration of orthognathic-surgical treatment.

Science.gov (United States)

Paunonen, Jaakko; Helminen, Mika; Peltomäki, Timo

2017-07-01

The objective of this study was to determine the duration of orthognathic-surgical treatment conducted with conventional pre- and post-surgical orthodontic treatment phases. The study material was comprised of the files of 185 consecutive patients treated in Oral and Maxillofacial Unit, Tampere University Hospital, Finland, in 2007-2014. The files were reviewed and the following data was obtained: gender and age of patients, ICD-10 diagnosis, type of malocclusion, duration of pre- and post-surgical orthodontic treatment and type of operation. Total treatment duration (median) from placement of separating rings for banding until fixed orthodontic appliances were removed and retention period started was 31.1 months, of which pre-surgical orthodontics took 24.4 months and postsurgical 6.4 months. Treatment duration (median) was in BSSO was 32.1, LeFort 1 30.1 and bimaxillary osteotomy 29.7 months. Orthodontic extractions were performed in 35 patients (19%). If the orthodontic treatment included tooth extraction, the duration of pre-surgical treatment was on average 10 months longer, which is a statistically highly significant difference (p pre-surgical orthodontic treatment prolong treatment time by an average of 8-9 months.

46 CFR 167.01-8 - Inspection of school ships using gross tonnage criterion.

Science.gov (United States)

2010-10-01

... 46 Shipping 7 2010-10-01 2010-10-01 false Inspection of school ships using gross tonnage criterion... SCHOOLS PUBLIC NAUTICAL SCHOOL SHIPS General Provisions § 167.01-8 Inspection of school ships using gross... school ships by relative sizes in gross tonnages. When it is determined in accordance with § 70.05-20 of...

Prognostic value of medulloblastoma extent of resection after accounting for molecular subgroup: a retrospective integrated clinical and molecular analysis.

Science.gov (United States)

Thompson, Eric M; Hielscher, Thomas; Bouffet, Eric; Remke, Marc; Luu, Betty; Gururangan, Sridharan; McLendon, Roger E; Bigner, Darell D; Lipp, Eric S; Perreault, Sebastien; Cho, Yoon-Jae; Grant, Gerald; Kim, Seung-Ki; Lee, Ji Yeoun; Rao, Amulya A Nageswara; Giannini, Caterina; Li, Kay Ka Wai; Ng, Ho-Keung; Yao, Yu; Kumabe, Toshihiro; Tominaga, Teiji; Grajkowska, Wieslawa A; Perek-Polnik, Marta; Low, David C Y; Seow, Wan Tew; Chang, Kenneth T E; Mora, Jaume; Pollack, Ian F; Hamilton, Ronald L; Leary, Sarah; Moore, Andrew S; Ingram, Wendy J; Hallahan, Andrew R; Jouvet, Anne; Fèvre-Montange, Michelle; Vasiljevic, Alexandre; Faure-Conter, Cecile; Shofuda, Tomoko; Kagawa, Naoki; Hashimoto, Naoya; Jabado, Nada; Weil, Alexander G; Gayden, Tenzin; Wataya, Takafumi; Shalaby, Tarek; Grotzer, Michael; Zitterbart, Karel; Sterba, Jaroslav; Kren, Leos; Hortobágyi, Tibor; Klekner, Almos; László, Bognár; Pócza, Tímea; Hauser, Peter; Schüller, Ulrich; Jung, Shin; Jang, Woo-Youl; French, Pim J; Kros, Johan M; van Veelen, Marie-Lise C; Massimi, Luca; Leonard, Jeffrey R; Rubin, Joshua B; Vibhakar, Rajeev; Chambless, Lola B; Cooper, Michael K; Thompson, Reid C; Faria, Claudia C; Carvalho, Alice; Nunes, Sofia; Pimentel, José; Fan, Xing; Muraszko, Karin M; López-Aguilar, Enrique; Lyden, David; Garzia, Livia; Shih, David J H; Kijima, Noriyuki; Schneider, Christian; Adamski, Jennifer; Northcott, Paul A; Kool, Marcel; Jones, David T W; Chan, Jennifer A; Nikolic, Ana; Garre, Maria Luisa; Van Meir, Erwin G; Osuka, Satoru; Olson, Jeffrey J; Jahangiri, Arman; Castro, Brandyn A; Gupta, Nalin; Weiss, William A; Moxon-Emre, Iska; Mabbott, Donald J; Lassaletta, Alvaro; Hawkins, Cynthia E; Tabori, Uri; Drake, James; Kulkarni, Abhaya; Dirks, Peter; Rutka, James T; Korshunov, Andrey; Pfister, Stefan M; Packer, Roger J; Ramaswamy, Vijay; Taylor, Michael D

2016-04-01

Patients with incomplete surgical resection of medulloblastoma are controversially regarded as having a marker of high-risk disease, which leads to patients undergoing aggressive surgical resections, so-called second-look surgeries, and intensified chemoradiotherapy. All previous studies assessing the clinical importance of extent of resection have not accounted for molecular subgroup. We analysed the prognostic value of extent of resection in a subgroup-specific manner. We retrospectively identified patients who had a histological diagnosis of medulloblastoma and complete data about extent of resection and survival from centres participating in the Medulloblastoma Advanced Genomics International Consortium. We collected from resections done between April, 1997, and February, 2013, at 35 international institutions. We established medulloblastoma subgroup affiliation by gene expression profiling on frozen or formalin-fixed paraffin-embedded tissues. We classified extent of resection on the basis of postoperative imaging as gross total resection (no residual tumour), near-total resection (30 Gy vs no craniospinal irradiation). The primary analysis outcome was the effect of extent of resection by molecular subgroup and the effects of other clinical variables on overall and progression-free survival. We included 787 patients with medulloblastoma (86 with WNT tumours, 242 with SHH tumours, 163 with group 3 tumours, and 296 with group 4 tumours) in our multivariable Cox models of progression-free and overall survival. We found that the prognostic benefit of increased extent of resection for patients with medulloblastoma is attenuated after molecular subgroup affiliation is taken into account. We identified a progression-free survival benefit for gross total resection over sub-total resection (hazard ratio [HR] 1·45, 95% CI 1·07-1·96, p=0·16) but no overall survival benefit (HR 1·23, 0·87-1·72, p=0·24). We saw no progression-free survival or overall survival

Gross Motor Profile and Its Association with Socialization Skills in Children with Autism Spectrum Disorders

OpenAIRE

Hardiono D. Pusponegoro; Pustika Efar; Soedjatmiko; Amanda Soebadi; Agus Firmansyah; Hui-Ju Chen; Kun-Long Hung

2016-01-01

While social impairment is considered to be the core deficit in children with autism spectrum disorder (ASD), a large proportion of these children have poor gross motor ability, and gross motor deficits may influence socialization skills in children with ASD. The objectives of this study were to compare gross motor skills in children with ASD to typically developing children, to describe gross motor problems in children with ASD, and to investigate associations between gross motor and sociali...

The impact of pre-operative weight loss on incidence of surgical site infection and readmission rates after total joint arthroplasty.

Science.gov (United States)

Inacio, Maria C S; Kritz-Silverstein, Donna; Raman, Rema; Macera, Caroline A; Nichols, Jeanne F; Shaffer, Richard A; Fithian, Donald C

2014-03-01

This study characterized a cohort of obese total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients (1/1/2008-12/31/2010) and evaluated whether a clinically significant amount of pre-operative weight loss (5% decrease in body weight) is associated with a decreased risk of surgical site infections (SSI) and readmissions post-surgery. 10,718 TKAs and 4066 THAs were identified. During the one year pre-TKA 7.6% of patients gained weight, 12.4% lost weight, and 79.9% remained the same. In the one year pre-THA, 6.3% of patients gained weight, 18.0% lost weight, and 75.7% remained the same. In TKAs and THAs, after adjusting for covariates, the risk of SSI and readmission was not significantly different in the patients who gained or lost weight pre-operatively compared to those who remained the same. © 2013.

Vast Portfolio Selection with Gross-exposure Constraints*

Science.gov (United States)

Fan, Jianqing; Zhang, Jingjin; Yu, Ke

2012-01-01

We introduce the large portfolio selection using gross-exposure constraints. We show that with gross-exposure constraint the empirically selected optimal portfolios based on estimated covariance matrices have similar performance to the theoretical optimal ones and there is no error accumulation effect from estimation of vast covariance matrices. This gives theoretical justification to the empirical results in Jagannathan and Ma (2003). We also show that the no-short-sale portfolio can be improved by allowing some short positions. The applications to portfolio selection, tracking, and improvements are also addressed. The utility of our new approach is illustrated by simulation and empirical studies on the 100 Fama-French industrial portfolios and the 600 stocks randomly selected from Russell 3000. PMID:23293404

Design of a Quality Control Program for the Measurement of Gross Alpha and Gross Beta Activities (LMPR-CIEMAT); Diseno del Control de Calidad de las Medidas de Actividad Alfa-Beta Total (LMPR-CIEMAT)

Energy Technology Data Exchange (ETDEWEB)

Alvarez, A.; Yague, L.; Gasco, C.; Navarro, N.; Higueras, E.; Noguerales, C.

2010-10-21

In accordance with international standards, general requirements for testing laboratories have to include a quality system for planning, implementing, and assessing the work performed by the organization and for carrying out required quality assurance and quality control. The purpose of internal laboratory quality control is to monitor performance, identify problems, and initiate corrective actions. This report describes the internal quality control to monitor the gross alpha and beta activities determination. Identification of specific performance indicators, the principles that govern their use and statistical means of evaluation are explained. Finally, calculation of alpha and beta specific activities, uncertainties and detection limits are performed. (Author) 10 refs.

Improving Surveillance and Prevention of Surgical Site Infection in Pediatric Cardiac Surgery.

Science.gov (United States)

Cannon, Melissa; Hersey, Diane; Harrison, Sheilah; Joy, Brian; Naguib, Aymen; Galantowicz, Mark; Simsic, Janet

2016-03-01

Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs. To improve surgical wound surveillance and reduce the incidence of surgical site infections. An institutional review of surgical site infections led to implementation of 8 surveillance and process measures: appropriate preparation the night before surgery and the day of surgery, use of appropriate preparation solution in the operating room, appropriate timing of preoperative antibiotic administration, placement of a photograph of the surgical site in the patient's chart at discharge, sending a photograph of the surgical site to the patient's primary care physician, 30-day follow-up of the surgical site by an advanced nurse practitioner, and placing a photograph of the surgical site obtained on postoperative day 30 in the patient's chart. Mean overall compliance with the 8 measures from March 2013 through February 2014 was 88%. Infections occurred in 10 of 417 total operative cases (2%) in 2012, in 8 of 437 total operative cases (2%) in 2013, and in 7 of 452 total operative cases (1.5%) in 2014. Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients' family members and referring physicians. ©2016 American Association of Critical-Care Nurses.

Surgical versus non-surgical management of abdominal injury.

Science.gov (United States)

Oyo-Ita, Angela; Chinnock, Paul; Ikpeme, Ikpeme A

2015-11-13

Injury to the abdomen can be blunt or penetrating. Abdominal injury can damage internal organs such as the liver, spleen, kidneys, intestine, and large blood vessels. There are controversies about the best approach to manage abdominal injuries. To assess the effects of surgical and non-surgical interventions in the management of abdominal trauma in a haemodynamically stable and non-peritonitic abdomen. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic+EMBASE (Ovid), ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), CINAHL Plus (EBSCO), and clinical trials registers, and screened reference lists. We ran the most recent search on 17 September 2015. Randomised controlled trials of surgical interventions and non-surgical interventions involving people with abdominal injury who were haemodynamically stable with no signs of peritonitis. The abdominal injury could be blunt or penetrating. Two review authors independently applied the selection criteria. Data were extracted by two authors using a standard data extraction form, and are reported narratively. Two studies are included, which involved a total of 114 people with penetrating abdominal injuries. Both studies are at moderate risk of bias because the randomisation methods are not fully described, and the original study protocols are no longer available. The studies were undertaken in Finland between 1992 and 2002, by the same two researchers.In one study, 51 people were randomised to surgery or an observation protocol. None of the participants in the study died. Seven people had complications: 5 (18.5%) in the surgical group and 2 (8.3%) in the observation group; the difference was not statistically significant (P = 0.42; Fischer's exact). Among the 27 people who had surgery, 6 (22.2%) surgeries were negative laparotomies, and 15 (55.6%) were non

Artifacts in conventional computed tomography (CT) and free breathing four-dimensional CT induce uncertainty in gross tumor volume determination

DEFF Research Database (Denmark)

Persson, Gitte Fredberg; Nygaard, Ditte Eklund; Af Rosenschöld, Per Munck

2011-01-01

was to compare delineated gross tumor volume (GTV) sizes in 3DCT, 4DCT, and BHCT scans of patients with lung tumors. METHODS AND MATERIALS: A total of 36 patients with 46 tumors referred for stereotactic radiotherapy of lung tumors were included. All patients underwent positron emission tomography (PET)/CT, 4DCT...

The Convergent Evolution of Romania’s Gross Domestic Product in Relation to the Average Macro-Economic Result of the European Union Countries

Directory of Open Access Journals (Sweden)

Raluca Necula

2016-08-01

Full Text Available Romania's economic growth is a target that can be achieved only within the accordance of all the economic sectors with the Europe 2020 Strategy. As provided in the Convergence Programme 2014-2020, this objective entails a series of steps that Romania must rigorously follow in order to be able to ensure a real converge process at the level of developed European Union (EU countries form the Euro Area. This paper aims an overview presentation of the economy synthetized in its major result, respectively in the dynamics of the total Gross Domestic Product (GDP /capita and agricultural Gross Domestic Product (GDP /capita, and it also compares with the level of the EU 28 average and the level of the Euro Area average. There are calculated, using linear and quadratic functions, the Gross Domestic Product GDP trends, and, with the convergence equation, there are calculated the years that separate Romania from the level of other countries, through the application of annual growth rates. The calculations result shows a strong economic boost of Romania, the annual growth rates being high, both for Gross Domestic Product (GDP / capita (US$ and for agricultural Gross Domestic Product (GDP/ capita (US$, but also a pretty big gap between its development level and the EU 28 and the Euro Area average level.

Surgical reconstruction of pressure ulcer defects: a single- or two-stage procedure?

LENUS (Irish Health Repository)

Laing, Tereze A

2012-02-01

BACKGROUND: The surgical management of pressure ulcers traditionally involved staged procedures, with initial debridement of necrotic or infected material followed by reconstruction at a later date when the wound was deemed viable and free of gross infection. However, over the past decade, it has been suggested that a single-stage procedure, combining initial debridement and definitive reconstruction, may provide advantages over staged surgery. We present our experience with the staged approach and review the current evidence for both methods. SUBJECTS AND SETTINGS: : We reviewed medical records of all patients referred to our service for pressure ulcer management between October 2001 and October 2007. The National Rehabilitation Hospital is the national center in Ireland for primary rehabilitation of adults and children suffering from spinal and brain injury, serving patients locally and from around the country. METHODS: All subjects who were managed surgically underwent a 2-stage procedure, with initial debridement and subsequent reconstruction. The main outcome measures were length of hospital stay, postoperative morbidity and mortality, and time to complete ulcer healing. RESULTS: Forty-one of 108 patients with 58 pressure ulcers were managed surgically. All patients underwent initial surgical debridement and 20 patients underwent subsequent pressure ulcer reconstruction. Postreconstructive complications occurred in 5 patients (20%). The mean time to complete ulcer healing was 17.4 weeks. Partial flap necrosis occurred in 3 patients, but there were no episodes of flap failure. CONCLUSIONS: We achieved favorable results with a 2-stage reconstruction technique and suggest that the paucity of evidence related to single-stage procedures does not support a change in surgical management.

The relationship between gross motor skills and academic achievement in children with learning disabilities

NARCIS (Netherlands)

Westendorp, Marieke; Hartman, Esther; Houwen, Suzanne; Smith, Joanne; Visscher, Chris

2011-01-01

The present study compared the gross motor skills of 7- to 12-year-old children with learning disabilities (n = 104) with those of age-matched typically developing children (n = 104) using the Test of Gross Motor Development-2. Additionally, the specific relationships between subsets of gross motor

Isolation and characterization of human articular chondrocytes from surgical waste after total knee arthroplasty (TKA

Directory of Open Access Journals (Sweden)

Jakob Naranda

2017-03-01

Full Text Available Background Cartilage tissue engineering is a fast-evolving field of biomedical engineering, in which the chondrocytes represent the most commonly used cell type. Since research in tissue engineering always consumes a lot of cells, simple and cheap isolation methods could form a powerful basis to boost such studies and enable their faster progress to the clinics. Isolated chondrocytes can be used for autologous chondrocyte implantation in cartilage repair, and are the base for valuable models to investigate cartilage phenotype preservation, as well as enable studies of molecular features, nature and scales of cellular responses to alterations in the cartilage tissue. Methods Isolation and consequent cultivation of primary human adult articular chondrocytes from the surgical waste obtained during total knee arthroplasty (TKA was performed. To evaluate the chondrogenic potential of the isolated cells, gene expression of collagen type 2 (COL2, collagen 1 (COL1 and aggrecan (ACAN was evaluated. Immunocytochemical staining of all mentioned proteins was performed to evaluate chondrocyte specific production. Results Cartilage specific gene expression of COL2 and ACAN has been shown that the proposed protocol leads to isolation of cells with a high chondrogenic potential, possibly even specific phenotype preservation up to the second passage. COL1 expression has confirmed the tendency of the isolated cells dedifferentiation into a fibroblast-like phenotype already in the second passage, which confirms previous findings that higher passages should be used with care in cartilage tissue engineering. To evaluate the effectiveness of our approach, immunocytochemical staining of the evaluated chondrocyte specific products was performed as well. Discussion In this study, we developed a protocol for isolation and consequent cultivation of primary human adult articular chondrocytes with the desired phenotype from the surgical waste obtained during TKA. TKA is a

[Surgical treatment of Marfan syndrome; analysis of the patients required multiple surgical interventions].

Science.gov (United States)

Yamazaki, F; Shimamoto, M; Fujita, S; Nakai, M; Aoyama, A; Chen, F; Nakata, T; Yamada, T

2002-07-01

Without treatment, the life expectancy of patients with Marfan syndrome is reduced by the associated cardiovascular abnormalities. In this study, we reviewed our experience of the patients with Marfan syndrome who required multiple surgical interventions to identify the optimal treatment for these patients. Between January 1986 and December 2000, 44 patients with Marfan syndrome were operated on at Shizuoka City Hospital (SCH). Among them, 10 patients (22.7%) underwent multiple surgical interventions. There were 5 male and 5 female patients with a mean age of 40.6 +/- 16.1 years at the initial surgery. Only one patient was operated on at another hospital for his first, second, and third operations. His fourth operation was carried out at SCH. The remaining 9 patients underwent a total of 14 additional surgical procedures at SCH. Computed tomography (CT) scans were taken every 6 months postoperatively, and aortic diameter greater than 60 mm was considered as the indication for the additional surgery. There were no early death and one late death. The causes of additional surgery were enlargement of true aneurysm in 6, enlargement of residual dissection in 4, new dissection in 4, false aneurysm at the coronary anastomosis of Bentall procedure in 1. In 9 patients, both ascending and descending aorta were replaced. Among these 9 patients, only 3 patients underwent total arch replacement, and remaining 6 patients had their arch left in place with or without dissection. Our current strategy of the treatment of Marfan patients with acute type A dissection is total arch replacement with an elephant trunk at the initial emergent surgery.

Totally laparoscopic pylorus-preserving gastrectomy for early gastric cancer in the middle stomach: technical report and surgical outcomes.

Science.gov (United States)

Kumagai, Koshi; Hiki, Naoki; Nunobe, Souya; Sekikawa, Sayuri; Chiba, Takehiro; Kiyokawa, Takashi; Jiang, Xiaohua; Tanimura, Shinya; Sano, Takeshi; Yamaguchi, Toshiharu

2015-01-01

The feasibility, safety, and improved quality of postoperative life following laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) with a hand-sewn anastomosis via a mini-laparotomy for early gastric cancer (EGC) have been previously established. Here we describe the surgical procedure of totally laparoscopic pylorus-preserving gastrectomy (TLPPG) using an intracorporeal delta-shaped anastomosis technique, and the short-term surgical outcomes of 60 patients with EGC in the middle stomach are reported. After lymphadenectomy and mobilization of the stomach, intraoperative gastroscopy was performed in order to verify the location of the tumor, and then the distal and proximal transecting lines were established, 5 cm from the pyloric ring and just proximal to Demel's line, respectively. Following transection of the stomach, a delta-shaped intracorporeal gastrogastrostomy was made with linear staplers. There were no intraoperative complications or conversions to open surgery. Mean operation time and blood loss were 259 min and 28 mL, respectively. Twelve patients (20.0%) experienced postoperative complications classified as grade II using the Clavien-Dindo classification, with the most frequent complication being gastric stasis (6 cases, 10.0 %). The incidence of severe complications classified as grade III or above was 1.7%; only one patient required reoperation and intensive care due to postoperative intraabdominal bleeding and subsequent multiple organ failure. TLPPG with an intracorporeal delta-shaped anastomosis was found to be a safe procedure, although it tended to require a longer operating time than the well-established LAPPG with a hand-sewn gastrogastrostomy.

Can Economic Performance Predict Pediatric Surgical Capacity in Sub-Saharan Africa?

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Okoye, Mekam T; Nguyen, Evelyn T; Kushner, Adam L; Ameh, Emmanuel A; Nwomeh, Benedict C

2016-06-01

The relationship between economic status and pediatric surgical capacity in low- and middle-income countries (LMICs) is poorly understood. In sub-Saharan Africa (SSA), Nigeria accounts for 20 % of the population and has the highest Gross Domestic Product (GDP), but whether this economic advantage translates to increased pediatric surgical capacity is unknown. This study compares the pediatric surgical capacity between Nigeria and other countries within the region. The Pediatric Personnel, Infrastructure, Procedures, Equipment and Supplies (PediPIPES) survey, a recent tool that is useful in assessing and comparing the capacity of health facilities to deliver essential and emergency surgical care (EESC) to children in LMICs, was used for this evaluation. Data from hospitals in Nigeria (n = 24) and hospitals in 17 other sub-Saharan African countries (n = 25) were compared. The GDP of Nigeria was approximately twenty-five times the average GDP of the 17 other countries represented in our survey. Running water was unavailable in 58 % of the hospitals in Nigeria compared to 20 % of the hospitals in the other countries. Most hospitals in Nigeria and in the other countries did not have a CT scan (67 and 60 %, respectively). Endoscopes were unavailable in 58 % of the hospitals in Nigeria and 44 % of the hospitals in the other countries. Despite better economic indicators in Nigeria, there were no distinct advantages over the other countries in the ability to deliver EESC to children. Our findings highlighted the urgent need for specific allocation of more resources to pediatric surgical capacity building efforts across the entire region.

Newton-Gauss Algorithm of Robust Weighted Total Least Squares Model

Directory of Open Access Journals (Sweden)

WANG Bin

2015-06-01

Full Text Available Based on the Newton-Gauss iterative algorithm of weighted total least squares (WTLS, a robust WTLS (RWTLS model is presented. The model utilizes the standardized residuals to construct the weight factor function and the square root of the variance component estimator with robustness is obtained by introducing the median method. Therefore, the robustness in both the observation and structure spaces can be simultaneously achieved. To obtain standardized residuals, the linearly approximate cofactor propagation law is employed to derive the expression of the cofactor matrix of WTLS residuals. The iterative calculation steps for RWTLS are also described. The experiment indicates that the model proposed in this paper exhibits satisfactory robustness for gross errors handling problem of WTLS, the obtained parameters have no significant difference with the results of WTLS without gross errors. Therefore, it is superior to the robust weighted total least squares model directly constructed with residuals.

Criteria for requesting specific radionuclide analysis through gross α and gross β concentration measurements in environmental samples

International Nuclear Information System (INIS)

Ferreira, E.G.

1988-01-01

This paper suggests some criteria for the decision to proceed with the analysis of specific radionuclides based on results of the determination of gross α and β concentrations in environmental samples of aerosols, water, dairy and agricultural products, soil and sediments. The samples considered are provenient from the environmental surveillance of uranium mining and milling facilities as well as the mining and processing plants of monazite sands. The radionuclides to be analysed are those considered to be the most critical to human health, that is: U-nat; Th-nat; Th-230; Ra-228; Ra-226; Po-210; Pb-210. The measured gross α and β concentrations will be compared with the Maximum Allowable Concentrations for some defined radionuclides. Radiochemical analysis of specific radionuclides may then become necessary, depending upon the results of this comparison. The main goal of the proposed guide is to simplify and to discipline the execution of environmental surveillance programs in a safe and economical way, avoiding unnecessary analysis. (author) [pt

Impact of Vitamin D Supplementation on Gross Motor Development of Healthy Term Infants: A Randomized Dose-Response Trial.

Science.gov (United States)

Wicklow, Brandy; Gallo, Sina; Majnemer, Annette; Vanstone, Catherine; Comeau, Kathryn; Jones, Glenville; L'Abbe, Mary; Khamessan, Ali; Sharma, Atul; Weiler, Hope; Rodd, Celia

2016-08-01

In addition to benefits for bone health, vitamin D is implicated in muscle function in children and adults. To determine if vitamin D dosage positively correlated with gross motor development at 3 and 6 months of age. We hypothesized that higher doses would be associated with higher scores for gross motor skills. A consecutive sample of 55 healthy, term, and breastfed infants from Montreal, Canada were recruited from a randomized trial of vitamin D supplementation between 2009 and 2012. Infants were randomized to 400 International Units (IU) (n = 19), 800 IU (n = 18) or 1,200 IU (n = 18) vitamin D3/day. Motor performance at 3 and 6 months was quantified by the Alberta Infant Motor Scale (AIMS). Plasma vitamin D3 metabolites were measured by tandem mass spectrometry. AIMS scores did not differ at 3 months. However, total AIMS scores and sitting subscores were significantly higher at 6 months in infants receiving 400 IU/day compared to 800 IU/day and 1,200 IU/day groups (p gross motor achievements were significantly higher in infants receiving 400 IU/day vitamin D. Our findings also support longer infants being slightly delayed.

Gross xenon stability

International Nuclear Information System (INIS)

Lewins, J.D.; Wilson, P.P.H.

1997-01-01

The effect of xenon in thermal reactors on steady operation is generally destabilizing. Illustrating this involves the study of appropriate transfer functions, which may be conveniently displayed in three ways: as Bode, Nyquist, and root-locus diagrams. The three forms allow different aspects to be highlighted. These are illustrated for the effect of xenon with allowance not only for the stabilizing effect of the direct yield in fission but also to show the consequences of neglecting the time dependence due to the thermal capacity of the reactor. With careful interpretation, all these forms give an interpretation of stability that is consistent with direct evaluation and promote the understanding of the onset of gross oscillations in power

Gross and fine motor function in fibromyalgia and chronic fatigue syndrome.

Science.gov (United States)

Rasouli, Omid; Fors, Egil A; Borchgrevink, Petter Chr; Öhberg, Fredrik; Stensdotter, Ann-Katrin

2017-01-01

This paper aimed to investigate motor proficiency in fine and gross motor function, with a focus on reaction time (RT) and movement skill, in patients with fibromyalgia (FM) and chronic fatigue syndrome (CFS) compared to healthy controls (HC). A total of 60 individuals (20 CFS, 20 FM, and 20 HC), age 19-49 years, participated in this study. Gross motor function in the lower extremity was assessed using a RT task during gait initiation in response to an auditory trigger. Fine motor function in the upper extremity was measured during a precision task (the Purdue Pegboard test) where the number of pins inserted within 30 s was counted. No significant differences were found between FM and CFS in any parameters. FM and CFS groups had significantly longer RT than HC in the gait initiation ( p =0.001, and p =0.004 respectively). In the Purdue Pegboard test, 20% in the FM group, 15% in the CFS groups, and 0% of HC group, scored below the threshold of the accepted performance. However, there were no significant differences between FM, CFS, and HC in this task ( p =0.12). Compared to controls, both CFS and FM groups displayed significantly longer RT in the gait initiation task. Generally, FM patients showed the worst results in both tests, although no group differences were found in fine motor control, according to the Purdue Pegboard test.

Surgical versus non-surgical management for pleural empyema.

Science.gov (United States)

Redden, Mark D; Chin, Tze Yang; van Driel, Mieke L

2017-03-17

Empyema refers to pus in the pleural space, commonly due to adjacent pneumonia, chest wall injury, or a complication of thoracic surgery. A range of therapeutic options are available for its management, ranging from percutaneous aspiration and intercostal drainage to video-assisted thoracoscopic surgery (VATS) or thoracotomy drainage. Intrapleural fibrinolytics may also be administered following intercostal drain insertion to facilitate pleural drainage. There is currently a lack of consensus regarding optimal treatment. To assess the effectiveness and safety of surgical versus non-surgical treatments for complicated parapneumonic effusion or pleural empyema. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (2016, Issue 9), MEDLINE (Ebscohost) (1946 to July week 3 2013, July 2015 to October 2016) and MEDLINE (Ovid) (1 May 2013 to July week 1 2015), Embase (2010 to October 2016), CINAHL (1981 to October 2016) and LILACS (1982 to October 2016) on 20 October 2016. We searched ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for ongoing studies (December 2016). Randomised controlled trials that compared a surgical with a non-surgical method of management for all age groups with pleural empyema. Two review authors independently assessed trials for inclusion and risk of bias, extracted data, and checked the data for accuracy. We contacted trial authors for additional information. We assessed the quality of the evidence using the GRADE approach. We included eight randomised controlled trials with a total of 391 participants. Six trials focused on children and two on adults. Trials compared tube thoracostomy drainage (non-surgical), with or without intrapleural fibrinolytics, to either VATS or thoracotomy (surgical) for the management of pleural empyema. Assessment of risk of bias for the included studies was generally unclear for selection and blinding but low for attrition and reporting bias. Data analyses compared

26 CFR 41.4482(b)-1 - Definition of taxable gross weight.

Science.gov (United States)

2010-04-01

... Motor Vehicles § 41.4482(b)-1 Definition of taxable gross weight. (a) Actual unloaded weight—(1) In... general. The taxable gross weight of a highway motor vehicle is the sum of the actual unloaded weight of the vehicle fully equipped for service, the actual unloaded weight of any semitrailers or trailers...

The effect of a Lean quality improvement implementation program on surgical pathology specimen accessioning and gross preparation error frequency.

Science.gov (United States)

Smith, Maxwell L; Wilkerson, Trent; Grzybicki, Dana M; Raab, Stephen S

2012-09-01

Few reports have documented the effectiveness of Lean quality improvement in changing anatomic pathology patient safety. We used Lean methods of education; hoshin kanri goal setting and culture change; kaizen events; observation of work activities, hand-offs, and pathways; A3-problem solving, metric development, and measurement; and frontline work redesign in the accessioning and gross examination areas of an anatomic pathology laboratory. We compared the pre- and post-Lean implementation proportion of near-miss events and changes made in specific work processes. In the implementation phase, we documented 29 individual A3-root cause analyses. The pre- and postimplementation proportions of process- and operator-dependent near-miss events were 5.5 and 1.8 (P < .002) and 0.6 and 0.6, respectively. We conclude that through culture change and implementation of specific work process changes, Lean implementation may improve pathology patient safety.

Gross greenhouse gas fluxes from hydro-power reservoir compared to thermo-power plants

International Nuclear Information System (INIS)

Santos, Marco Aurelio dos; Pinguelli Rosa, Luiz; Sikar, Bohdan; Sikar, Elizabeth; Santos, Ednaldo Oliveira dos

2006-01-01

This paper presents the findings of gross carbon dioxide and methane emissions measurements in several Brazilian hydro-reservoirs, compared to thermo power generation. The term 'gross emissions' means gas flux measurements from the reservoir surface without natural pre-impoundment emissions by natural bodies such as the river channel, seasonal flooding and terrestrial ecosystems. The net emissions result from deducting pre-existing emissions by the reservoir. A power dam emits biogenic gases such as CO 2 and CH 4 . However, studies comparing gas emissions (gross emissions) from the reservoir surface with emissions by thermo-power generation technologies show that the hydro-based option presents better results in most cases analyzed. In this study, measurements were carried in the Miranda, Barra Bonita, Segredo, Tres Marias, Xingo, and Samuel and Tucurui reservoirs, located in two different climatological regimes. Additional data were used here from measurements taken at the Itaipu and Serra da Mesa reservoirs. Comparisons were also made between emissions from hydro-power plants and their thermo-based equivalents. Bearing in mind that the estimated values for hydro-power plants include emissions that are not totally anthropogenic, the hydro-power plants studied generally posted lower emissions than their equivalent thermo-based counterparts. Hydro-power complexes with greater power densities (capacity/area flooded-W/m 2 ), such as Itaipu, Xingo, Segredo and Miranda, have the best performance, well above thermo-power plants using state-of-the-art technology: combined cycle fueled by natural gas, with 50% efficiency. On the other hand, some hydro-power complexes with low-power density perform only slightly better or even worse than their thermo-power counterparts

The Relationship between Gross Motor Skills and Academic Achievement in Children with Learning Disabilities

Science.gov (United States)

Westendorp, Marieke; Hartman, Esther; Houwen, Suzanne; Smith, Joanne; Visscher, Chris

2011-01-01

The present study compared the gross motor skills of 7- to 12-year-old children with learning disabilities (n = 104) with those of age-matched typically developing children (n = 104) using the Test of Gross Motor Development-2. Additionally, the specific relationships between subsets of gross motor skills and academic performance in reading,…

Measurement of gross beta radioactivity in high-level liquid waste

International Nuclear Information System (INIS)

Lu Feng; Lin Cansheng; Zhang Xianzi; Chen Guoan; Zhang Chonghai

1992-01-01

Using beta plastic scintillation counter of low level background, gross beta radioactivity of twelve samples for high-level liquid waste is determined directly. Beta efficiency curves of plastic scintillation counter for four mass thickness are calibrated in advance. Determining gross beta radioactivity, gross efficiency of the scintillation counter for various energy beta ray is calculated via weighted mean method with the ratio of radioactivity for each nuclide. The ratio of radioactivity for nuclides which have gamma disintegration is determined in terms of the radioactivity measured by gamma spectrometer. The ratio of the radioactivity for 90 Sr which has purity beta disintegration is calculated in terms of half life time approximation. The ratio of the radioactivity for 147 Pm which also has purity disintegration is calculated by means of apparent cooling-time approximation. The uncertainty of results for the present work is about +-15%

[Surgical therapy of gynecomastia].

Science.gov (United States)

Heckmann, A; Leclère, F M; Vogt, P M; Steiert, A

2011-09-01

Nowadays surgical intervention is an essential part of the treatment of idiopathic gynecomastia. Choosing the right method is crucial and is based on the current status in the clinical and histological evaluation. Before finalizing the process of choosing a specific method a prior interdisciplinary evaluation of the patient is necessary to ascertain clear indications for a surgical intervention. Liposuction is one of the methods which have become popular in recent years. The advantages are the possible combination with traditional techniques, such as subcutaneous mastectomy or periareolar mastopexy. The main indication is for gynecomastia stage IIa/b and is justifiable due to the reduction in surgical complications and scarring. Furthermore this technique provides an excellent aesthetical outcome for the patient. A total of 162 patients suffering from gynecomastia stages I-III (according to Simon) were surgically treated between 2000 and 2010 and these cases were retrospectively evaluated. The results showed a decline in the use of a T-shaped incision in combination with subcutaneous mastectomy with periareolar tightening compared to an increase in the use of subcutaneous mastectomy in combination with liposuction. The excised tissue should always be sent for histological examination to make sure no malignant cells were present.

The implications of particle energy and acidic media on gross alpha and gross beta determination using liquid scintillation

Energy Technology Data Exchange (ETDEWEB)

Zapata-Garcia, D. [Laboratori de Radiologia Ambiental (LRA), Departament de Quimica Analitica, Universitat de Barcelona, Marti i Franques, 1-11 Planta 3, E-08028 Barcelona (Spain); Llaurado, M., E-mail: montse.llaurado@ub.edu [Laboratori de Radiologia Ambiental (LRA), Departament de Quimica Analitica, Universitat de Barcelona, Marti i Franques, 1-11 Planta 3, E-08028 Barcelona (Spain); Rauret, G. [Laboratori de Radiologia Ambiental (LRA), Departament de Quimica Analitica, Universitat de Barcelona, Marti i Franques, 1-11 Planta 3, E-08028 Barcelona (Spain)

2012-04-15

The interaction of humans with radioactivity present in the environment from natural and artificial sources necessitates an evaluation of its risk on human health. Gross alpha and gross beta activities can provide a rapid evaluation of the radioactive content of a sample and can be simultaneously determined by using liquid scintillation counters. However, calibration of the liquid scintillation counter is required and is affected by many factors, such as particle energy and the acidity of the media. This study investigates what effect the particle energy used for calibration has on misclassification and how to account for this misclassification in routine measurements. The variability in measurement produced by the final pH, as well as any acids used in sample treatment, was also studied. These results showed that the most commonly used acid for these types of analyses, HNO{sub 3}, produced a high amount of misclassifications at very low pH. The results improved when HCl was used to adjust the sample to low pH. - Highlights: Black-Right-Pointing-Pointer We study the effect of alpha and beta energies on PSA optimisation. Black-Right-Pointing-Pointer The optimum PSA shifts to higher values as the alpha energy increases. Beta energies do not affect it. Black-Right-Pointing-Pointer We study the effect of pH on the simultaneous determination of gross alpha/beta activities. Black-Right-Pointing-Pointer HNO{sub 3} produces a high amount of misclassification at very low pH. Black-Right-Pointing-Pointer The results improve when HCl is used to adjust the sample to low pH.

The implications of particle energy and acidic media on gross alpha and gross beta determination using liquid scintillation

International Nuclear Information System (INIS)

Zapata-García, D.; Llauradó, M.; Rauret, G.

2012-01-01

The interaction of humans with radioactivity present in the environment from natural and artificial sources necessitates an evaluation of its risk on human health. Gross alpha and gross beta activities can provide a rapid evaluation of the radioactive content of a sample and can be simultaneously determined by using liquid scintillation counters. However, calibration of the liquid scintillation counter is required and is affected by many factors, such as particle energy and the acidity of the media. This study investigates what effect the particle energy used for calibration has on misclassification and how to account for this misclassification in routine measurements. The variability in measurement produced by the final pH, as well as any acids used in sample treatment, was also studied. These results showed that the most commonly used acid for these types of analyses, HNO 3 , produced a high amount of misclassifications at very low pH. The results improved when HCl was used to adjust the sample to low pH. - Highlights: ► We study the effect of alpha and beta energies on PSA optimisation. ► The optimum PSA shifts to higher values as the alpha energy increases. Beta energies do not affect it. ► We study the effect of pH on the simultaneous determination of gross alpha/beta activities. ► HNO 3 produces a high amount of misclassification at very low pH. ► The results improve when HCl is used to adjust the sample to low pH.

Control of the dynamics of coupled atomic-molecular Bose-Einstein condensates: Modified Gross-Pitaevskii approach

International Nuclear Information System (INIS)

Gupta, Moumita; Dastidar, Krishna Rai

2009-01-01

We study the dynamics of the atomic and molecular Bose-Einstein condensates (BECs) of 87 Rb in a spherically symmetric trap coupled by stimulated Raman photoassociation process. Considering the higher order nonlinearity in the atom-atom interaction we analyze the dynamics of the system using coupled modified Gross-Pitaevskii (MGP) equations and compare it with mean-field coupled Gross-Pitaevskii (GP) dynamics. Considerable differences in the dynamics are obtained in these two approaches at large scattering length, i.e., for large values of peak-gas parameter x pk ≥10 -3 . We show how the dynamics of the coupled system is affected when the atom-molecule and molecule-molecule interactions are considered together with the atom-atom interaction and also when the strengths of these three interactions are increased. The effect of detuning on the efficiency of conversion of atomic fractions into molecules is demonstrated and the feasibility of maximum molecular BEC formation by varying the Raman detuning parameter at different values of time is explored. Thus by varying the Raman detuning and the scattering length for atom-atom interaction one can control the dynamics of the coupled atomic-molecular BEC system. We have also solved coupled Gross-Pitaevskii equations for atomic to molecular condensate formation through magnetic Feshbach resonance in a BEC of 85 Rb. We found similar features for oscillations between atomic and molecular condensates noted in previous theoretical study and obtained fairly good agreement with the evolution of total atomic condensate observed experimentally.

17 CFR 270.5b-1 - Definition of “total assets.”

Science.gov (United States)

2010-04-01

... (CONTINUED) RULES AND REGULATIONS, INVESTMENT COMPANY ACT OF 1940 § 270.5b-1 Definition of “total assets... 17 Commodity and Securities Exchanges 3 2010-04-01 2010-04-01 false Definition of âtotal assets.â..., shall mean the gross assets of the company with respect to which the computation is made, taken as of...

Gross-Pitaevski map as a chaotic dynamical system.

Science.gov (United States)

Guarneri, Italo

2017-03-01

The Gross-Pitaevski map is a discrete time, split-operator version of the Gross-Pitaevski dynamics in the circle, for which exponential instability has been recently reported. Here it is studied as a classical dynamical system in its own right. A systematic analysis of Lyapunov exponents exposes strongly chaotic behavior. Exponential growth of energy is then shown to be a direct consequence of rotational invariance and for stationary solutions the full spectrum of Lyapunov exponents is analytically computed. The present analysis includes the "resonant" case, when the free rotation period is commensurate to 2π, and the map has countably many constants of the motion. Except for lowest-order resonances, this case exhibits an integrable-chaotic transition.

GLOBALIZATION AND GROSS DOMESTIC PRODUCT CONSTRUCTION IN ASEAN

Directory of Open Access Journals (Sweden)

Muhammad Sri Wahyudi Suliswanto

2011-09-01

Full Text Available There is no more doubt about the importance of economic growth, which can be calculated fromGross Domestic Product (GDP. This research analyzes the role of globalization on GDP inASEAN-5 by estimating panel data. It uses a fixed effect approach to accommodate various characteristicsin the countries. To accommodate such variation, it assumes that the intercepts variesacross these countries, while the slopes remain similar. Based on the estimation result, it suggeststhat net export and foreign direct investment represent the globalization process. Both have positiveand significant influences on GDP in the corresponding countries.Keywords: Globalization, international trade, foreign direct investment, gross domestic productJEL classification numbers: E01, F51, F43

Development of a Computerized Adaptive Test of Children's Gross Motor Skills.

Science.gov (United States)

Huang, Chien-Yu; Tung, Li-Chen; Chou, Yeh-Tai; Wu, Hing-Man; Chen, Kuan-Lin; Hsieh, Ching-Lin

2018-03-01

To (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT. Retrospective study. A developmental center of a medical center. Children with and without developmental delay (N=1738). Not applicable. The CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination. The item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group. The results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Surgical team turnover and operative time: An evaluation of operating room efficiency during pulmonary resection.

Science.gov (United States)

Azzi, Alain Joe; Shah, Karan; Seely, Andrew; Villeneuve, James Patrick; Sundaresan, Sudhir R; Shamji, Farid M; Maziak, Donna E; Gilbert, Sebastien

2016-05-01

Health care resources are costly and should be used judiciously and efficiently. Predicting the duration of surgical procedures is key to optimizing operating room resources. Our objective was to identify factors influencing operative time, particularly surgical team turnover. We performed a single-institution, retrospective review of lobectomy operations. Univariate and multivariate analyses were performed to evaluate the impact of different factors on surgical time (skin-to-skin) and total procedure time. Staff turnover within the nursing component of the surgical team was defined as the number of instances any nurse had to leave the operating room over the total number of nurses involved in the operation. A total of 235 lobectomies were performed by 5 surgeons, most commonly for lung cancer (95%). On multivariate analysis, percent forced expiratory volume in 1 second, surgical approach, and lesion size had a significant effect on surgical time. Nursing turnover was associated with a significant increase in surgical time (53.7 minutes; 95% confidence interval, 6.4-101; P = .026) and total procedure time (83.2 minutes; 95% confidence interval, 30.1-136.2; P = .002). Active management of surgical team turnover may be an opportunity to improve operating room efficiency when the surgical team is engaged in a major pulmonary resection. Copyright © 2016 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Improvement of gross theory of beta-decay for application to nuclear data

Science.gov (United States)

Koura, Hiroyuki; Yoshida, Tadashi; Tachibana, Takahiro; Chiba, Satoshi

2017-09-01

A theoretical study of β decay and delayed neutron has been carried out with a global β-decay model, the gross theory. The gross theory is based on a consideration of the sum rule of the β-strength function, and gives reasonable results of β-decay rates and delayed neutron in the entire nuclear mass region. In a fissioning nucleus, neutrons are produced by β decay of neutron-rich fission fragments from actinides known as delayed neutrons. The average number of delayed neutrons is estimated based on the sum of the β-delayed neutron-emission probabilities multiplied by the cumulative fission yield for each nucleus. Such a behavior is important to manipulate nuclear reactors, and when we adopt some new high-burn-up reactors, properties of minor actinides will play an important roll in the system, but these data have not been sufficient. We re-analyze and improve the gross theory. For example, we considered the parity of neutrons and protons at the Fermi surface, and treat a suppression for the allowed transitions in the framework of the gross theory. By using the improved gross theory, underestimated half-lives in the neutron-rich indium isotopes and neighboring region increase, and consequently follow experimental trend. The ability of reproduction (and also prediction) of the β-decay rates, delayed-neutron emission probabilities is discussed. With this work, we have described the development of a programming code of the gross theory of β-decay including the improved parts. After preparation finished, this code can be released for the nuclear data community.

[Application of Da Vinci surgical robot in the dissection of splenic hilar lymph nodes for gastric cancer patients with total gastrectomy].

Science.gov (United States)

Yang, Kun; Chen, Xinzu; Zhang, Weihan; Chen, Xiaolong; Hu, Jiankun

2016-08-25

To investigate the feasibility and safety of Da Vinci surgical robot in the dissection of splenic hilar lymph nodes for gastric cancer patients with total gastrectomy. Clinical data of two cases who underwent total gastrectomy for cardia cancer at our department in January 2016 were analyzed retrospectively. Two male patients were 62 and 55 years old respectively, with preoperative diagnosis as cT2-3N0M0 and cT1-2N0M0 gastric cancer by gastroscope and biopsy, and both received robotic total gastrectomy spleen-preserving splenic hilar lymph node dissection successfully. The operative time for splenic hilar lymph node dissection was 30 min and 25 min respectively. The intraoperative estimated blood loss was both 100 ml, while the number of total harvested lymph node was 38 and 33 respectively. One dissected splenic hilar lymph node and fatty tissues in two patients were proven by pathological examinations. There were no anastomotic leakage, pancreatic fistula, splenic infarction, intraluminal bleeding, digestive tract bleeding, aneurysm of splenic artery, and other operation-associated complications. Both patients suffered from postoperative pneumonia, and were cured by conservative therapy. The robotic spleen-preserving splenic hilar lymph node dissection is feasible and safe, but its superiority needs further evaluation.

Surgical ergonomics. Analysis of technical skills, simulation models and assessment methods.

Science.gov (United States)

Papaspyros, Sotiris C; Kar, Ashok; O'Regan, David

2015-06-01

Over the past two centuries the surgical profession has undergone a profound evolution in terms of efficiency and outcomes. Societal concerns in relation to quality assurance, patient safety and cost reduction have highlighted the issue of training expert surgeons. The core elements of a training model build on the basic foundations of gross and fine motor skills. In this paper we provide an analysis of the ergonomic principles involved and propose relevant training techniques. We have endeavored to provide both the trainer and trainee perspectives. This paper is structured into four sections: 1) Pre-operative preparation issues, 2) technical skills and instrument handling, 3) low fidelity simulation models and 4) discussion of current concepts in crew resource management, deliberate practice and assessment. Rehearsal, warm-up and motivation-enhancing techniques aid concentration and focus. Appropriate posture, comprehension of ergonomic principles in relation to surgical instruments and utilisation of the non-dominant hand are essential skills to master. Low fidelity models can be used to achieve significant progress through the early stages of the learning curve. Deliberate practice and innate ability are complementary to each other and may be considered useful adjuncts to surgical skills development. Safe medical care requires that complex patient interventions be performed by highly skilled operators supported by reliable teams. Surgical ergonomics lie at the heart of any training model that aims to produce professionals able to function as leaders of a patient safety oriented culture. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

Long-term outcomes of adjuvant radiotherapy after surgical resection of central neurocytoma

International Nuclear Information System (INIS)

Chen, Yi-Dong; Li, Wen-Bin; Feng, Jin; Qiu, Xiao-Guang

2014-01-01

The role of adjuvant radiotherapy for central neurocytomas (CNs) is not clear. Therefore, we aimed to examine the clinical outcomes of treating histologically confirmed CNs with adjuvant RT after surgical resection. Sixty-three CN patients were retrospectively evaluated: 24 patients underwent gross total resection (GTR); 28, subtotal resection (STR); 9, partial resection (PR), and 2, biopsy (Bx). They underwent adjuvant RT after surgery (median dose, 54 Gy). The median follow-up was 69 months (15–129 months). The 5-year overall survival (OS) and 5-year progression-free survival (PFS) were 94.4% and 95% after GTR + RT, 96.4% and 100% after STR + RT, and 100% and 90.9% after PR + RT. Only three patients had tumor recurrence: at the primary site at 30 and 24 months in two GTR + PR patients, and dissemination to the spinal cord at 75 months in one STR + RT patient. Thirty-eight (63.3%) patients experienced late neurotoxicity (28, grade 1; 7, grade 2; 3, grade 3). Short-term memory impairment was the most common toxicity. RT after incomplete resection (IR) led to OS and PFS comparable to those for GTR. Considering the excellent outcomes and limited late toxicity, adjuvant RT maybe a good option for CN patients who undergo IR

Are gross motor skills and sports participation related in children with intellectual disabilities?

Science.gov (United States)

Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Visscher, Chris

2011-01-01

This study compared the specific gross motor skills of 156 children with intellectual disabilities (ID) (50 ≤ IQ ≥ 79) with that of 255 typically developing children, aged 7-12 years. Additionally, the relationship between the specific gross motor skills and organized sports participation was examined in both groups. The Test of Gross Motor Development-2 and a self-report measure were used to assess children's gross motor skills and sports participation, respectively. The children with ID scored significantly lower on almost all specific motor skill items than the typically developing children. Children with mild ID scored lower on the locomotor skills than children with borderline ID. Furthermore, we found in all groups that children with higher object-control scores participated more in organized sports than children with lower object-control scores. Our results support the importance of attention for well-developed gross motor skills in children with borderline and mild ID, especially to object-control skills, which might contribute positively to their sports participation. Copyright © 2011 Elsevier Ltd. All rights reserved.

Duodenum-preserving total pancreatic head resection for benign cystic neoplastic lesions.

Science.gov (United States)

Beger, Hans G; Schwarz, Michael; Poch, Bertram

2012-11-01

Cystic neoplasms of the pancreas are diagnosed frequently due to early use of abdominal imaging techniques. Intraductal papillary mucinous neoplasm, mucinous cystic neoplasm, and serous pseudopapillary neoplasia are considered pre-cancerous lesions because of frequent transformation to cancer. Complete surgical resection of the benign lesion is a pancreatic cancer preventive treatment. The application for a limited surgical resection for the benign lesions is increasingly used to reduce the surgical trauma with a short- and long-term benefit compared to major surgical procedures. Duodenum-preserving total pancreatic head resection introduced for inflammatory tumors in the pancreatic head transfers to the patient with a benign cystic lesion located in the pancreatic head, the advantages of a minimalized surgical treatment. Based on the experience of 17 patients treated for cystic neoplastic lesions with duodenum-preserving total pancreatic head resection, the surgical technique of total pancreatic head resection for adenoma, borderline tumors, and carcinoma in situ of cystic neoplasm is presented. A segmental resection of the peripapillary duodenum is recommended in case of suspected tissue ischemia of the peripapillary duodenum. In 305 patients, collected from the literature by PubMed search, in about 40% of the patients a segmental resection of the duodenum and 60% a duodenum and common bile duct-preserving total pancreatic head resection has been performed. Hospital mortality of the 17 patients was 0%. In 305 patients collected, the hospital mortality was 0.65%, 13.2% experienced a delay of gastric emptying and a pancreatic fistula in 18.2%. Recurrence of the disease was 1.5%. Thirty-two of 175 patients had carcinoma in situ. Duodenum-preserving total pancreatic head resection for benign cystic neoplastic lesions is a safe surgical procedure with low post-operative morbidity and mortality.

Impact of surgical complications on length of stay after hip fracture surgery

DEFF Research Database (Denmark)

Foss, Nicolai Bang; Palm, Henrik; Krasheninnikoff, Michael

2006-01-01

BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact...... of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall...... showed that 64 complications (55%) were due to suboptimal surgery, 18 (16%) to infection, 6 (5%) to falls and 28 (24%) to no obvious cause. CONCLUSION: Surgical complications secondary to primary hip fracture surgery account for 27.1% of total hospital bed consumption within 6 months. Approximately, 50...

ϵ-expansion in the Gross-Neveu

Energy Technology Data Exchange (ETDEWEB)

Raju, Avinash [Center for High Energy Physics, Indian Institute of Science,Bangalore 560012 (India)

2016-10-18

We use the recently developed CFT techniques of Rychkov and Tan to compute anomalous dimensions in the O(N) Gross-Neveu model in d=2+ϵ dimensions. To do this, we extend the “cowpie contraction' algorithm of http://arxiv.org/abs/1506.06616 to theories with fermions. Our results match perfectly with Feynman diagram computations.

A comparative analysis of radiological and surgical placement of central venous catheters

International Nuclear Information System (INIS)

McBride, Kieran D.; Fisher, Ross; Warnock, Neil; Winfield, David A.; Reed, Malcolm W.; Gaines, Peter A.

1997-01-01

Purpose. To compare the differences in practice and outcome of all radiologically and surgically placed central venous catheters retrospectively over a 2-year period simultaneously, at a single institution. Methods.A total of 253 Hickman catheters were inserted in 209 patients; 120 were placed radiologically in 102 patients and 133 were placed surgically in 107 patients. The indication was chemotherapy in 76% of radiological and in 47% of surgical cases; the remainder were for total parenteral nutrition and venous access. Results. There were 6 (4.5%) primary surgical failures and a further 17 (13%) surgical cases requiring multiple placement attempts. Pneumothorax occurred once (0.8%) surgically and four times (3.3%) radiologically. There were no radiological primary misplacements but there were five (3.7%) surgical ones. Catheter or central vein thrombosis occurred in four (3.3%) radiological and five (3.7%) surgical cases. The rate of infection per 1000 catheter-days was 1.9 in radiologically placed catheters and 4.0 in surgically placed ones (p<0.001). Average catheter life-span was similar for the two placement methods (100±23 days). Conclusion. Radiological placement is consistently more reliable than surgical placement. There are fewer placement complications and fewer catheter infections overall

Summarized report of geothermal well Gross Buchholz Gt1; Kurzprofil der Geothermiebohrung Gross Buchholz Gt1

Energy Technology Data Exchange (ETDEWEB)

Schaefer, Frauke; Hesshaus, Annalena; Jatho, Reiner; Luppold, Friedrich-Wilhelm; Pletsch, Thomas; Tischner, Torsten [Bundesanstalt fuer Geowissenschaften und Rohstoffe (BGR), Hannover (Germany); Hunze, Sabine; Orilski, Judith; Wonik, Thomas [Leibniz-Institut fuer Angewandte Geophysik (LIAG), Hannover (Germany); Roehling, Heinz-Gerd [Landesamt fuer Bergbau, Energie und Geologie (LBEG), Hannover (Germany)

2012-01-15

The well Gross Buchholz Gt1 is a deep geothermal well intended to demonstrate the feasibility of deep geothermal energy mining from tight sedimentary rocks. It is the core part of the GeneSys (Generated Geothermal Energy Systems) project, aiming at developing single well concepts for direct use of geothermal energy. During the course of the project, three different single well concepts have been developed and tested at the research well Horstberg Z1 which is geologically comparable to the Gross Buchholzwell. The latter is intended to supply the heating energy for the premises of Geozentrum Hannover, an office and lab complex of some 35.000 m{sup 2} housing about 1000 employees. The geothermal target are the sandstones of the Lower Triassic Middle Buntsandstein Formation, which have a temperature of about 165 C at 3700 depth. The well has reached a final depth of 3901 m below ground level, penetrating a nearly complete succession from the Lower Cretaceous (Albian) to the Lower Triassic (Lower Buntsandstein), while Tertiary and Upper Cretaceous sediments are missing. This article summarizes technical and geographic data, stratigraphic classification, geophysical logging, cores, and sidewall cores of the well. (orig.)

Lower cranial nerves function after surgical treatment of Fisch Class C and D tympanojugular paragangliomas.

Science.gov (United States)

Bacciu, Andrea; Medina, Marimar; Ait Mimoune, Hassen; D'Orazio, Flavia; Pasanisi, Enrico; Peretti, Giorgio; Sanna, Mario

2015-02-01

The aim of this study was to report the postoperative lower cranial nerves (LCNs) function in patients undergoing surgery for tympanojugular paraganglioma (TJP) and to evaluate risk factors for postoperative LCN dysfunction. A retrospective case review of 122 patients having Fisch class C or D TJP, surgically treated from 1988 to 2012, was performed. The follow-up of the series ranged from 12 to 156 months (mean, 39.4 ± 32.6 months). The infratemporal type A approach was the most common surgical procedure. Gross total tumor removal was achieved in 86% of cases. Seventy-two percent of the 54 patients with preoperative LCN deficit had intracranial tumor extension. Intraoperatively, LCNs had to be sacrificed in 63 cases (51.6%) due to tumor infiltration. Sixty-six patients (54.09%) developed a new deficit of one or more of the LCNs. Of those patients who developed new LCN deficits, 23 of them had intradural extension. Postoperative follow-up of at least 1 year showed that the LCN most commonly affected was the CN IX (50%). Logistic regression analysis showed that intracranial transdural tumor extension was correlated with the higher risk of LCN sacrifice (p < 0.05). Despite the advances in skull base surgery, new postoperative LCN deficits still represent a challenge. The morbidity associated with resection of the LCNs is dependent on the tumor's size and intradural tumor extension. Though no recovery of LCN deficits may be expected, on long-term follow-up, patients usually compensate well for their LCNs loss.

The gross anatomy of the renal sympathetic nerves revisited.

Science.gov (United States)

Mompeo, Blanca; Maranillo, Eva; Garcia-Touchard, Arturo; Larkin, Theresa; Sanudo, Jose

2016-07-01

Catheter-based renal denervation techniques focus on reducing blood pressure in resistant hypertension. This procedure requires exact knowledge of the anatomical interrelation between the renal arteries and the targeted renal nervous plexus. The aim of this work was to build on classical anatomical studies and describe the gross anatomy and anatomical relationships of the renal arteries and nerve supply to the kidneys in a sample of human cadavers. Twelve human cadavers (six males and six females), age range 73 to 94 years, were dissected. The nervous fibers and renal arteries were dissected using a surgical microscope. The renal plexus along the hilar renal artery comprised a fiber-ganglionic ring surrounding the proximal third of the renal artery, a neural network along the middle and distal thirds, and smaller accessory ganglia along the course of the nerve fibers. The fibers of the neural network were mainly located on the superior (95.83%) and inferior (91.66%) surfaces of the renal artery and they were sparsely interconnected by diagonal fibers. Polar arteries were present in 33.33% of cases and the renal nerve pattern for these was similar to that of the hilar arteries. Effective renal denervation needs to target the superior and inferior surfaces of the hilar and polar arteries, where the fibers of the neural network are present. Clin. Anat. 29:660-664, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Gross Revenue risk in Swiss dairy farming

NARCIS (Netherlands)

Benni, El N.; Finger, R.

2013-01-01

This study investigated how agricultural policy reforms, including market liberalization and market deregulation, have influenced gross revenue risk of Swiss dairy producers using farm-level panel data between 1990 and 2009. Based on detrended data, variance decomposition was applied to assess how

An Audit of Surgical Antibiotic Prophylaxis at the Veterinary ...

African Journals Online (AJOL)

An audit of surgical antibiotic prophylaxis at the Veterinary Teaching Hospital, Ibadan between 2008 and 2011 was conducted to evaluate the level of compliance with standard practices. The study involved retrospective case note audit of surgical procedures performed during the period. A total number of 108 operations ...

Surgical treatment of gynecomastia: complications and outcomes.

Science.gov (United States)

Li, Chun-Chang; Fu, Ju-Peng; Chang, Shun-Cheng; Chen, Tim-Mo; Chen, Shyi-Gen

2012-11-01

Gynecomastia is defined as the benign enlargement of the male breast. Multiple surgical options have been used to improve outcomes. The aim of this study was to analyze the surgical approaches to the treatment of gynecomastia and their outcomes over a 10-year period. All patients undergoing surgical correction of gynecomastia in our department between 2000 and 2010 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and revision rate. The surgical result was evaluated with self-assessment questionnaires. A total of 41 patients with 75 operations were included. Techniques included subcutaneous mastectomy alone or with additional ultrasound-assisted liposuction (UAL) and isolated UAL. The surgical revision rate for all patients was 4.8%. The skin-sparing procedure gave good surgical results in grade IIb and grade III gynecomastia with low revision and complication rates. The self-assessment report revealed a good level of overall satisfaction and improvement in self-confidence (average scores 9.4 and 9.2, respectively, on a 10-point scale). The treatment of gynecomastia requires an individualized approach. Subcutaneous mastectomy combined with UAL could be used as the first choice for surgical treatment of grade II and III gynecomastia.

A variational approach to the Gross-Neveu model

International Nuclear Information System (INIS)

Mishra, H.; Misra, P.; Mishra, A.

1988-01-01

The authors solve the instability of perturbative vacuum of Gross-Neveu model. They use a variational method. The analysis is nonperturbative as it uses only equal time commmutator/anticommutator algebra

A reformed surgical treatment modality for children with giant cystic craniopharyngioma.

Science.gov (United States)

Zhu, Wanchun; Li, Xiang; He, Jintao; Sun, Tao; Li, Chunde; Gong, Jian

2017-09-01

Surgical removal plays an important role in treating children's craniopharyngioma. For a safe and minimally invasive craniotomy, a reformed surgical modality was proposed in this paper by combining the insertion of an Ommaya reservoir system (ORS) by stereotactic puncture, aspiration of cystic fluid in 2-day interval for consecutive 7-10 days, and the delayed tumor resection. Eleven patients (aged from 5 to 9 years old) with giant cystic craniopharyngiomas who had undergone the reformed surgical modality during November 2014 and December 2015 were collected as group A. In contrast, seven patients (aged from 5 to 11 years old) who had undergone the traditional directed operation without any prior management from January 2014 to October 2014 were collected into group B. A retrospective analysis was performed for both groups at one institution. The preoperative and postoperative clinical presentations, neuroimaging, early postoperative outcome, and the surgery-related complications of both groups were reviewed. For group A, the mean value of the maximum tumor diameters shank from 52.36 to 23.82 mm after implementing aspiration of the cystic fluid in 1-day interval for consecutive 8.23 days. Eight patients (72.73%) in group A underwent a gross total resection (GTR), while two (28.57%) patients underwent GTR in group B. The postoperative electrolyte disturbance rate and endocrine disorder rate of group B were significantly higher than those of group A (42.86 vs 36.36%; 71.43 vs 45.45%). Postoperative long-term diabetes insipidus only occurred in one patient of group B, and postoperative visual deterioration occurred in two patients of group B. Besides, one patient of group B died of severe postoperative hypothalamus dysfunction. Patients with residual tumors were applied with additional adjuvant radiotherapy, and no recurrence was observed in follow-up examinations. A favorable outcome can be achieved by combining the insertion of an ORS by stereotactic puncture

GLOBALIZATION OF ECONOMY AND GREATER CYCLES OF THE TOTAL REGIONAL PRODUCT, INFLATION AND UNEMPLOYMENT

Directory of Open Access Journals (Sweden)

V.A. Belkin

2009-06-01

Full Text Available The process of synchronization of greater and small waves of real gross national product of the USA and a total regional product of the Chelyabinsk area is shown on the materials of economic statistics. The conclusion about defining influence of dynamics of real gross national product of the USA on the basic macroeconomic parameters of the Chelyabinsk area owing to high dependence of its economy on export of metal products is done from here. It is evidently shown, that the modern world economic crisis quite keeps within the theory of greater cycles of an economic conjuncture of N.D. Kondratyev. To greater cycles of a total regional product of the Chelyabinsk area there correspond return greater cycles of inflation and unemployment.

Frontal burr hole approach for neuroendoscopic resection of craniopharyngioma with the NICO Myriad device: report of two cases.

Science.gov (United States)

Moore, Reilin J; Scherer, Andrea; Fulkerson, Daniel H

2017-04-01

Craniopharyngiomas are challenging tumors to resect due to their deep location and proximity to vital structures. The perceived benefit of gross total resection may be tempered by the possibility of permanent disability. Minimally invasive techniques may reduce surgical morbidity while still allowing effective resection. The authors describe their initial experience with a neuroendoscopic transcortical, transventricular approach to two craniopharyngiomas. The surgeries were performed through a right frontal burr hole using the NICO Myriad, a side-cutting, aspiration device that fits through the working channel of a standard neuroendoscope. The imaging and medical records of two children (a 5-year-old male and a 9-year-old female) undergoing endoscopic resection of a craniopharyngioma with this technique were reviewed. Outcomes, results, and complications were noted. A gross total resection was achieved in both patients. The operative time was 180 and 143 min, respectively. The estimated blood loss was 20 and 50 cm 3 , respectively. Both patients required a cerebrospinal fluid shunt. There were no surgical complications. The NICO Myriad is an effective tool that allows a safe minimally invasive endoscopic resection of craniopharyngiomas in patients with amenable anatomy. Surgeons with experience in neuroendoscopy may be able to achieve a gross total resection of these challenging tumors through a minimally invasive burr hole approach.

Short-term efficacy of surgical treatment of secondary hyperparathyroidism.

Science.gov (United States)

Liang, Y; Sun, Y; Ren, L; Qi, X-W; Li, Y; Zhang, F

2015-10-01

We wished to explore short-term efficacy of surgical treatment of secondary hyperparathyroidism in patients with the end-stage renal disease. The treatment methods were subtotal or total parathyroidectomy, or total parathyroidectomy and autotransplantation. 63 patients with secondary hyperparathyroidism were randomly divided into three groups which were respectively treated with subtotal parathyroidectomy (SPTX group), total parathyroidectomy (TPTX group), or total parathyroidectomy and autotransplantation (TPTX+AT group). The surgical outcomes included operating time, transoperative bleeding volume, length of stay, and cost of hospitalization. In addition, complication (e.g., postoperative wound infection, hematoma, hypocalcemia in perioperative period) rates were compared among groups. Blood levels of calcium and parathyroid hormone were assessed before the surgery, and 1 day, 1 months, 3 months and 6 months after the surgery. The follow-up period comprised 6 months. Surgical outcomes were the lowest in SPTX group and the highest in in TPTX+AT group. There were no significant differences among groups in treatment efficacy. Complication rates were also comparable among the three groups. The occurrence of hypocalcemia was the lowest in SPTX group (p < 0.05 vs. other groups). However, postoperative relapse rate was the highest in this group (p < 0.05 vs. other groups). There were no correlations between the levels of blood calcium and PTH preoperatively and postoperatively. Appropriate surgical treatment is selected in accordance with the patient's condition and willingness, with the attention paid to the prevention of hypocalcemia.

Removal of uranium and gross radioactivity from coal bottom ash by CaCl{sub 2} roasting followed by HNO{sub 3} leaching

Energy Technology Data Exchange (ETDEWEB)

Lei, Xuefei; Qi, Guangxia; Sun, Yinglong; Xu, Hui; Wang, Yi, E-mail: yi_wang@tsinghua.edu.cn

2014-07-15

Highlight: • Roasting the ash with CaCl{sub 2} enhanced the removal of uranium and gross radioactivity. • 87.3% of the total uranium was removed via the optimized roast-leach process. • Nearly 90% of gross α and β radioactivity was removed via the roast-leach process. • Molten CaCl{sub 2} promoted the incorporation of Ca and Al into Si-O matrices in ash. • Radionuclides were removed by the acid decomposition of newly formed silicates. - Abstract: A roast-leach method using CaCl{sub 2} and HNO{sub 3} to remove uranium and gross radioactivity in coal bottom ash was investigated. Heat treatment of the ash with 100% CaCl{sub 2} (900 °C, 2 h) significantly enhanced uranium leachability (>95%) compared with direct acid-leaching (22.6–25.5%). The removal efficiency of uranium and gross radioactivity increased steeply with increasing CaCl{sub 2} content, from 10% to 50%, and a HNO{sub 3} leaching time from 5 min to 1 h, but remained nearly constant or decreased slightly with increasing CaCl{sub 2} dosage >50% or acid-leaching time >1 h. The majority of the uranium (87.3%), gross α (92.9%) and gross β (84.9%) were removed under the optimized roast-leach conditions (50% CaCl{sub 2}, 1 M HNO{sub 3} leaching for 1 h). The mineralogical characteristics of roasted clinker indicated that molten CaCl{sub 2} promoted the incorporation of Ca into silica and silicates and resulted in its progressive susceptibility to acid attack. Uranium and other radionuclides, most likely present in the form of silicates or in association with miscellaneous silicates in the highest density fraction (>2.5 g mL{sup −1}), were probably leached out as the result of the acid decomposition of newly formed “gelatinizing silicates”.

Dengue endemic and its impact on the gross national product of BRAZILIAN'S economy.

Science.gov (United States)

Montibeler, Everlam Elias; Oliveira, Daniel Ribeiro de

2018-02-01

In history disease has caused social and economic damage. Dengue is an illness typically found in the tropics that has affected more and more people. In Brazil, according to the Brazilian Institute of Geography and Statistics (IBGE), in 2013 at least 12.9% of the population (25.8 million) reported already having had dengue in their life. So, how wide are the economic impacts that dengue's contagion has on the gross national product? Using Leontief's method, it became possible to estimate the direct and indirect impact on the workforce and output by one country. Workforce absenteeism reduced the national productiveness and welfare state where we found maximum inoperability of 0.027% and a minimum of 0.002%. This paper develops a methodology for estimation of the impact dengue has incurred in each sector of an economy; designing a ranking with sectors that have been more affected and forecasting the propagation of the endemic throughout a region. This research measures the impact of dengue on economy, the result was that the total loss of the Brazilian economy in 2013 was around BRL 1,023,174,876.83; the importance of 0.02% of the Gross Domestic Product. Copyright © 2017 Elsevier B.V. All rights reserved.

Managing infection in the revision total hip replacement patient.

Science.gov (United States)

Halley, D K

1993-01-01

Deep infection is one of the most devastating complications in total hip replacement. This dreaded complication is presented in considerable detail with special emphasis on prevention, diagnosis, and various methods of surgical and antibiotic treatment. Basic fundamentals of antibiotic therapy are reviewed. In addition, guidelines are given for the indications of surgical intervention, the type and staging of operative procedures, with detailed techniques of the various operative procedures used to treat the infected total hip implant patient.

26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

Science.gov (United States)

2010-04-01

... trading gross receipts. 1.924(a)-1T Section 1.924(a)-1T Internal Revenue INTERNAL REVENUE SERVICE... United States § 1.924(a)-1T Temporary regulations; definition of foreign trading gross receipts. (a) In general. The term “foreign trading gross receipts” means any of the five amounts described in paragraphs...

Gross-Motor Skill Acquisition by Preschool Dance Students under Self-Instruction Procedures

Science.gov (United States)

Vintere, Parsla; Hemmes, Nancy S.; Brown, Bruce L.; Poulson, Claire L.

2004-01-01

The effects of two training procedures -- (a) modeling and praise and (b) self-instruction, modeling, and praise -- on complex gross-motor chain acquisition for preschool dance class students were evaluated. Six girls participated in the study. A multiple baseline design across six gross-motor chains with a secondary group comparison for treatment…

Surgical treatment of chronic pancreatitis in young patients.

Science.gov (United States)

Zhou, Feng; Gou, Shan-Miao; Xiong, Jiong-Xin; Wu, He-Shui; Wang, Chun-You; Liu, Tao

2014-10-01

The main treatment strategies for chronic pancreatitis in young patients include therapeutic endoscopic retrograde cholangio-pancreatography (ERCP) intervention and surgical intervention. Therapeutic ERCP intervention is performed much more extensively for its minimally invasive nature, but a part of patients are referred to surgery at last. Historical and follow-up data of 21 young patients with chronic pancreatitis undergoing duodenum-preserving total pancreatic head resection were analyzed to evaluate the outcomes of therapeutic ERCP intervention and surgical intervention in this study. The surgical complications of repeated therapeutic ERCP intervention and surgical intervention were 38% and 19% respectively. During the first therapeutic ERCP intervention to surgical intervention, 2 patients developed diabetes, 5 patients developed steatorrhea, and 5 patients developed pancreatic type B pain. During the follow-up of surgical intervention, 1 new case of diabetes occurred, 1 case of steatorrhea recovered, and 4 cases of pancreatic type B pain were completely relieved. In a part of young patients with chronic pancreatitis, surgical intervention was more effective than therapeutic ERCP intervention on delaying the progression of the disease and relieving the symptoms.

Measurement of gross alpha and beta in air filter samples by using liquid scintillation counter

International Nuclear Information System (INIS)

Sudheendran, V.; Baburajan, A.; Gaikwad, R.H.; Ravi, P.M.; Tripathi, R.M.

2015-01-01

The determination of gross alpha and gross beta in particulate air filter samples was carried out by alpha, beta discrimination method using Liquid Scintillation Analyzer by setting the PSA value at 55 for 5 ml 0.1 HCl plus 15 ml of Ultima Gold AB cocktail by using 241 Am and 90 Sr/ 90 Y sources. The standardized method was compared with the gross alpha and gross beta activity determined by conventional method of direct counting with end window G.M. counter and ZnS (Ag). The minimum detectable activity of LSA method was found to be 9.3 mBq and 17.7 mBq for gross alpha and gross beta respectively for 6000 sec compared to the conventional method of 9.8 mBq and 189 mBq respectively at the same counting time. The result of analysis by both method indicate that the alpha, beta discrimination set up of LSA method is highly effective in the determination of low level alpha, beta activity in air filter samples. (author)

Procurement of Human Tissues for Research Banking in the Surgical Pathology Laboratory: Prioritization Practices at Washington University Medical Center

Science.gov (United States)

Chernock, Rebecca D.; Leach, Tracey A.; Kahn, Ajaz A.; Yip, James H.; Rossi, Joan; Pfeifer, John D.

2011-01-01

Academic hospitals and medical schools with research tissue repositories often derive many of their internal human specimen acquisitions from their site's surgical pathology service. Typically, such acquisitions come from appropriately consented tissue discards sampled from surgical resections. Because the practice of surgical pathology has patient care as its primary mission, competing needs for tissue inevitably arise, with the requirement to preserve adequate tissue for clinical diagnosis being paramount. A set of best-practice gross pathology guidelines are summarized here, focused on the decision for tissue banking at the time specimens are macroscopically evaluated. These reflect our collective experience at Washington University School of Medicine, and are written from the point of view of our site biorepository. The involvement of trained pathology personnel in such procurements is very important. These guidelines reflect both good surgical pathology practice (including the pathologic features characteristic of various anatomic sites) and the typical objectives of research biorepositories. The guidelines should be helpful to tissue bank directors, and others charged with the procurement of tissues for general research purposes. We believe that appreciation of these principles will facilitate the partnership between surgical pathologists and biorepository directors, and promote both good patient care and strategic, value-added banking procurements. PMID:23386925

Analysis of historical gross gamma logging data from BX tank farm

International Nuclear Information System (INIS)

MYERS, D.A.

1999-01-01

Gross gamma ray logs, recorded from January 1975 through mid-year 1994 as part of the Single-Shell Tank Farm Dry Well Surveillance Program, have been reanalyzed for the BX tank farm to locate the presence of mobile radionuclides in the subsurface. This report presents the BX tank farm gross gamma ray data in such a way as to assist others in their study of vadose zone mechanism

Correlates of Gross Motor Competence in Children and Adolescents: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Barnett, Lisa M; Lai, Samuel K; Veldman, Sanne L C; Hardy, Louise L; Cliff, Dylan P; Morgan, Philip J; Zask, Avigdor; Lubans, David R; Shultz, Sarah P; Ridgers, Nicola D; Rush, Elaine; Brown, Helen L; Okely, Anthony D

2016-11-01

Gross motor competence confers health benefits, but levels in children and adolescents are low. While interventions can improve gross motor competence, it remains unclear which correlates should be targeted to ensure interventions are most effective, and for whom targeted and tailored interventions should be developed. The aim of this systematic review was to identify the potential correlates of gross motor competence in typically developing children and adolescents (aged 3-18 years) using an ecological approach. Motor competence was defined as gross motor skill competency, encompassing fundamental movement skills and motor coordination, but excluding motor fitness. Studies needed to assess a summary score of at least one aspect of motor competence (i.e., object control, locomotor, stability, or motor coordination). A structured electronic literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Six electronic databases (CINAHL Complete, ERIC, MEDLINE Complete, PsycINFO ® , Scopus and SPORTDiscus with Full Text) were searched from 1994 to 5 August 2014. Meta-analyses were conducted to determine the relationship between potential correlates and motor competency if at least three individual studies investigated the same correlate and also reported standardized regression coefficients. A total of 59 studies were identified from 22 different countries, published between 1995 and 2014. Studies reflected the full range of age groups. The most examined correlates were biological and demographic factors. Age (increasing) was a correlate of children's motor competence. Weight status (healthy), sex (male) and socioeconomic background (higher) were consistent correlates for certain aspects of motor competence only. Physical activity and sport participation constituted the majority of investigations in the behavioral attributes and skills category. Whilst we found physical activity to be a positive

Trained, generalized, and collateral behavior changes of preschool children receiving gross-motor skills training.

OpenAIRE

Kirby, K C; Holborn, S W

1986-01-01

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Ten target behaviors were measured in the training setting to assess direct effects of the program. Generalization probes for two gross-motor behaviors, one fine-motor skill, and two social behaviors were conducted in other settings. Results indicated that the training program improved the gross-motor skills trained and that improvements sometimes generalized to other settings. Contrary...

Modeling of the Gross Regional Product on the Basis of Production Functions

Science.gov (United States)

Sadovin, Nikolay S.; Kokotkina, Tatiana N.; Barkalova, Tatiana G.; Tsaregorodsev, Evgeny I.

2016-01-01

The article is devoted to elaboration and construction of a static model of macroeconomics in which economics is considered as an unstructured holistic unit, the input of which receives the resources, and the output is the result of the functioning of economics in the form of gross domestic product or gross regional product. Resources are…

Controls on gross fluxes of nitrous oxide and methane from an active agricultural ecosystem

Science.gov (United States)

Yang, W. H.; Silver, W. L.

2013-12-01

Agricultural soils can be a significant source of greenhouse gas emissions. Most research on the dynamics of these gases measure net fluxes across the soil-atmosphere interface. This approach limits our ability to determine driving variables because production and consumption processes occur simultaneously, and may be controlled by different factors. We used the trace gas stable isotope pool dilution technique to simultaneously measure field rates of gross production and consumption of N2O and CH4 during the growing season in a corn field located in the Sacramento-San Joaquin Delta, California. We also measured net nitrogen (N) mineralization and nitrification rates, soil temperature, soil moisture, and soil carbon dioxide (CO2) emissions to explore their role as drivers of greenhouse gas fluxes. Across five sampling dates spanning from seeding to senescence, net N2O fluxes ranged from 0 - 4.5 mg N m-2 d-1 and averaged 1.6 × 0.2 mg N m-2 d-1 (n = 112). Gross N2O production ranged from 0.09 - 6.6 mg N m-2 d-1 and gross N2O reduction rates ranged from 0.00 - 0.95 mg N m-2 d-1. The N2O yield averaged 0.68 × 0.02 (n = 40). At peak growth (days after seeding 59 and 94), 89 % of the variability in gross N2O production rates was predicted by the combination of soil moisture, soil temperature, net N mineralization, and CO2 emissions (n = 15, p seeding 11, 24, and 171), gross N2O production was most strongly correlated with soil temperature (R2 = 0.20, n = 24, p = 0.03), and gross N2O reduction rates were best predicted by CO2 emissions (R2 = 0.80, n =24, p production in 36 out of 37 measurements. Gross CH4 production reached as high as 5.4 mg C m-2 d-1 with rates trending higher throughout the growing season. Gross CH4 production rates were marginally significantly higher in rows than in inter-rows (p = 0.10). Gross CH4 oxidation did not differ significantly among sampling dates (Figure 2b), averaging 1.1 × 0.2 mg C m-2 d-1 across all measurements (n = 37). However

Data Reconciliation and Gross Error Detection for Troubleshooting of Ammonia Reactor

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Adhi Tri Partono

2018-01-01

Full Text Available Data reconciliation (DR and gross error detection are two common tools used in industry to provide accurate and reliable data, which is useful to analyse plant performance and basis for troubleshooting. DR techniques improve the accuracy of measurements by using redundancies in material and energy balances. This provides reliable information that could help decision making regarding plant operation, which potentially leads to financial benefit. This paper presents the utilization of plant data to perform troubleshooting of ammonia reactor, in particular the profile of catalyst activity. Bad plant data are collected and then analysed using DR to produces reconciled data, which could be used to detect and identify the gross error measurements. The input data for DR and gross error detection were gathered from Aspen HYSYS V8.8 simulations by modelling the single-bed ammonia reactor. The result presents that bad plant data could define actual system condition such as gross error measurements in normal condition or catalyst activity problem. Both conditions are modelled by DR to indicate actual system condition using statistical analysis and to perform troubleshooting. Appropriate troubleshooting could save time and provide financial benefits by avoiding wrong accusation of system problem, specifically in ammonia reactor evaluated in this paper.

Intramedullary spinal melanocytoma

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Meic H. Schmidt

2010-06-01

Full Text Available Meningeal melanocytoma is a benign lesion arising from leptomeningeal melanocytes that at times can mimic its malignant counterpart, melanoma. Lesions of the spine usually occur in extramedullary locations and present with spinal cord compression symptoms. Because most reported spinal cases occur in the thoracic region, these symptoms usually include lower extremity weakness or numbness. The authors present a case of primary intrame­dullary spinal meningeal melanocytoma presenting with bilateral lower extremity symptoms in which the patient had no known supratentorial primary lesions. Gross total surgical resection allowed for full recovery, but early recurrence of tumor was detected on close follow-up monitoring, allowing for elective local radiation without loss of neurological function. Case reports of such tumors discuss different treatment strategies, but just as important is the close follow-up monitoring in these patients even after gross total surgical resection, since these tumors can recur.

Factors Associated with Enhanced Gross Motor Progress in Children with Cerebral Palsy: A Register-Based Study.

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Størvold, Gunfrid V; Jahnsen, Reidun B; Evensen, Kari Anne I; Romild, Ulla K; Bratberg, Grete H

2018-05-01

To examine associations between interventions and child characteristics; and enhanced gross motor progress in children with cerebral palsy (CP). Prospective cohort study based on 2048 assessments of 442 children (256 boys, 186 girls) aged 2-12 years registered in the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Gross motor progress estimates were based on repeated measures of reference percentiles for the Gross Motor Function Measure (GMFM-66) in a linear mixed model. Mean follow-up time: 2.9 years. Intensive training was the only intervention factor associated with enhanced gross motor progress (mean 3.3 percentiles, 95% CI: 1.0, 5.5 per period of ≥3 sessions per week and/or participation in an intensive program). Gross motor function was on average 24.2 percentiles (95% CI: 15.2, 33.2) lower in children with intellectual disability compared with others. Except for eating problems (-10.5 percentiles 95% CI: -18.5, -2.4) and ankle contractures by age (-1.9 percentiles 95% CI: -3.6, -0.2) no other factors examined were associated with long-term gross motor progress. Intensive training was associated with enhanced gross motor progress over an average of 2.9 years in children with CP. Intellectual disability was a strong negative prognostic factor. Preventing ankle contractures appears important for gross motor progress.

Divergence of fine and gross motor skills in prelingually deaf children: implications for cochlear implantation.

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Horn, David L; Pisoni, David B; Miyamoto, Richard T

2006-08-01

The objective of this study was to assess relations between fine and gross motor development and spoken language processing skills in pediatric cochlear implant users. The authors conducted a retrospective analysis of longitudinal data. Prelingually deaf children who received a cochlear implant before age 5 and had no known developmental delay or cognitive impairment were included in the study. Fine and gross motor development were assessed before implantation using the Vineland Adaptive Behavioral Scales, a standardized parental report of adaptive behavior. Fine and gross motor scores reflected a given child's motor functioning with respect to a normative sample of typically developing, normal-hearing children. Relations between these preimplant scores and postimplant spoken language outcomes were assessed. In general, gross motor scores were found to be positively related to chronologic age, whereas the opposite trend was observed for fine motor scores. Fine motor scores were more strongly correlated with postimplant expressive and receptive language scores than gross motor scores. Our findings suggest a disassociation between fine and gross motor development in prelingually deaf children: fine motor skills, in contrast to gross motor skills, tend to be delayed as the prelingually deaf children get older. These findings provide new knowledge about the links between motor and spoken language development and suggest that auditory deprivation may lead to atypical development of certain motor and language skills that share common cortical processing resources.

The Schroedinger functional for Gross-Neveu models

International Nuclear Information System (INIS)

Leder, B.

2007-01-01

Gross-Neveu type models with a finite number of fermion flavours are studied on a two-dimensional Euclidean space-time lattice. The models are asymptotically free and are invariant under a chiral symmetry. These similarities to QCD make them perfect benchmark systems for fermion actions used in large scale lattice QCD computations. The Schroedinger functional for the Gross-Neveu models is defined for both, Wilson and Ginsparg-Wilson fermions, and shown to be renormalisable in 1-loop lattice perturbation theory. In two dimensions four fermion interactions of the Gross-Neveu models have dimensionless coupling constants. The symmetry properties of the four fermion interaction terms and the relations among them are discussed. For Wilson fermions chiral symmetry is explicitly broken and additional terms must be included in the action. Chiral symmetry is restored up to cut-off effects by tuning the bare mass and one of the couplings. The critical mass and the symmetry restoring coupling are computed to second order in lattice perturbation theory. This result is used in the 1-loop computation of the renormalised couplings and the associated beta-functions. The renormalised couplings are defined in terms of suitable boundary-to-boundary correlation functions. In the computation the known first order coefficients of the beta-functions are reproduced. One of the couplings is found to have a vanishing betafunction. The calculation is repeated for the recently proposed Schroedinger functional with exact chiral symmetry, i.e. Ginsparg-Wilson fermions. The renormalisation pattern is found to be the same as in the Wilson case. Using the regularisation dependent finite part of the renormalised couplings, the ratio of the Lambda-parameters is computed. (orig.)

Surgical repair of a rupture of the pectoralis major muscle

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Pochini, Alberto De Castro; Andreoli, Carlos Vicente; Ejnisman, Benno; Maffulli, Nicola

2015-01-01

Muscle rupture is rarely treated surgically. Few reports of good outcomes after muscular suture have been published. Usually, muscular lesions or partial ruptures heal with few side effects or result in total recovery. We report a case of an athlete who was treated surgically to repair a total muscular rupture in the pectoralis major muscle. After 6 months, the athlete returned to competitive practice. After a 2-year follow-up, the athlete still competes in skateboard championships. PMID:25716033

Comparison of a gross anatomy laboratory to online anatomy software for teaching anatomy.

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Mathiowetz, Virgil; Yu, Chih-Huang; Quake-Rapp, Cindee

2016-01-01

This study was designed to assess the grades, self-perceived learning, and satisfaction between occupational therapy students who used a gross anatomy laboratory versus online anatomy software (AnatomyTV) as tools to learn anatomy at a large public university and a satellite campus in the mid-western United States. The goal was to determine if equivalent learning outcomes could be achieved regardless of learning tool used. In addition, it was important to determine why students chose the gross anatomy laboratory over online AnatomyTV. A two group, post-test only design was used with data gathered at the end of the course. Primary outcomes were students' grades, self-perceived learning, and satisfaction. In addition, a survey was used to collect descriptive data. One cadaver prosection was available for every four students in the gross anatomy laboratory. AnatomyTV was available online through the university library. At the conclusion of the course, the gross anatomy laboratory group had significantly higher grade percentage, self-perceived learning, and satisfaction than the AnatomyTV group. However, the practical significance of the difference is debatable. The significantly greater time spent in gross anatomy laboratory during the laboratory portion of the course may have affected the study outcomes. In addition, some students may find the difference in (B+) versus (A-) grade as not practically significant. Further research needs to be conducted to identify what specific anatomy teaching resources are most effective beyond prosection for students without access to a gross anatomy laboratory. © 2015 American Association of Anatomists.

Acute radiotherapy toxicity in 57 dogs with gross and microscopic mast cell tumours.

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Blackwood, L; Tanis, J B; Harper, A; Amores-Fuster, I; Killick, D R; Finotello, R

2018-05-15

Mast cell tumours (MCTs) are commonly treated with radiation therapy, most often in a microscopic disease setting. Poorer outcomes are expected in patients with gross disease, and irradiation of gross disease may be associated with greater toxicity. The aim of this study was to compare acute radiation adverse events (AE) in dogs with gross and microscopic MCTs receiving radiotherapy. Fifty-seven dogs were included, 28 with gross disease and 29 with microscopic. In order to assess mucosal and skin toxicity, patients were assigned to 2 groups: head (29 patients, 14 patients with gross and 15 microscopic) and other sites (28 patients, 14 each). All were treated with external beam radiotherapy, and toxicity assessed at the end of treatment and 10 to 14 days later (first recheck). All patients developed some acute radiation toxicity by the end of the course. However, there was no difference in the severity of toxicity between gross and microscopic disease in either site group at either time point. The only variable associated with an increased frequency of grade 2 or 3 toxicity at the first recheck was the use of prednisolone prior to radiotherapy (P = .05). No other factors were identified which were associated with increased toxicity. For the head group, the site of highest grade toxicity was mucosa or, if included in the field, nasal planum, which was often more severely affected than the mucosa. No significant late toxicity was identified. Two dogs developed acute haematemesis during the radiotherapy course, but both completed the course without further events. © 2018 John Wiley & Sons Ltd.

Fine and gross motor skills: The effects on skill-focused dual-tasks.

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Raisbeck, Louisa D; Diekfuss, Jed A

2015-10-01

Dual-task methodology often directs participants' attention towards a gross motor skill involved in the execution of a skill, but researchers have not investigated the comparative effects of attention on fine motor skill tasks. Furthermore, there is limited information about participants' subjective perception of workload with respect to task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. The task required participants to stand 15 feet from a projector screen which depicted virtual targets and fire a modified Glock 17 handgun equipped with an infrared laser. Participants performed the primary shooting task alone (control), or were also instructed to focus their attention on a gross motor skill relevant to task execution (gross skill-focused) and a fine motor skill relevant to task execution (fine skill-focused). Results revealed that workload was significantly greater during the fine skill-focused task for both skill levels, but performance was only affected for the lesser-skilled participants. Shooting performance for the lesser-skilled participants was greater during the gross skill-focused condition compared to the fine skill-focused condition. Correlational analyses also demonstrated a significant negative relationship between shooting performance and workload during the gross skill-focused task for the higher-skilled participants. A discussion of the relationship between skill type, workload, skill level, and performance in dual-task paradigms is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparative study of total shoulder arthroplasty versus total shoulder surface replacement for glenohumeral osteoarthritis with minimum 2-year follow-up

NARCIS (Netherlands)

Kooistra, B.W.; Willems, W.J.H.; Lemmens, E.; Hartel, B.P.; Bekerom, M.P. van den; Deurzen, D.F.P. van

2017-01-01

BACKGROUND: Compared with total shoulder arthroplasty (TSA), total shoulder surface replacement (TSSR) may offer the advantage of preservation of bone stock and shorter surgical time, possibly at the expense of glenoid component positioning and increasing lateral glenohumeral offset. We hypothesized

Are gross motor skills and sports participation related in children with intellectual disabilities?

NARCIS (Netherlands)

Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Visscher, Chris

2011-01-01

This study compared the specific gross motor skills of 156 children with intellectual disabilities (ID) (50 79) with that of 255 typically developing children, aged 7-12 years. Additionally, the relationship between the specific gross motor skills and organized sports participation was examined

Solitons in Gross-Pitaevskii equation

International Nuclear Information System (INIS)

Lopes, E.

1985-01-01

It is observed that, when the potential is integrable and repulsive, the Gross-Pitaevskii Equation, with non-vanishing boundary conditions, describes a family of planar solitons. A method is presented which provides an exact soliton field to the Dirac Delta potential and an approximation solution to any other kind of potential. As an example the method is then applied to the case of a repulsive Yukawa potential. A brief discuss the relation between these solitons and Anderson's superfluidity mechanism, is also presented. (author) [pt

The new energy management policy: Indonesian PSC-gross-split applied on steam flooding project

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Irham, S.; Julyus, P.

2018-01-01

“SIPY” oil field has been producing oil using steam flooding technology since 1992 under the PSC-Cost-Recovery policy. In 2021, the contract will be finished, and a new agreement must be submitted to the Indonesian government. There are two applied fiscal policies on oil and gas management: PSC-Cost-Recovery and PSC-Gross-Split (introduced in 2017 as the new energy management plan). The contractor must choose between PSC-Cost-Recovery and PSC-Gross-split which makes more profit. The aim of this research is to determine the best oil and gas contract policy for the contractor. The methods are calculating contractor cash flow and comparing the Profitability Indexes. The results of this study are (1) Net Present Values for the PSC-Cost-Recovery and the PSC-Gross-Split are 15 MMUS and 61 MMUS, respectively; and (2) Internal Rate of Return values for the PSC-Cost-Recovery and PSC-Gross-Split are 10% and 11%, respectively. The conclusion is that the Net Present Value and Internal Rate of Return of PSC-Gross-Split are greater than those of PSC-Cost-Recovery, but in Pay Out Time of PSC-Gross-split is longer than Pay Out Time in PSC-Cost-Recovery. Thus, the new energy management policy will be more attractive than PSC-Cost-Recovery.

The new management policy: Indonesian PSC-Gross split applied on CO2 flooding project

Science.gov (United States)

Irham, S.; Sibuea, S. N.; Danu, A.

2018-01-01

“SIAD” oil field will be developed by CO2 flooding. CO2, a famous pollutant gas, is injected into the oil reservoir to optimize the oil recovery. This technique should be conducted economically according to the energy management policy in Indonesia. In general, Indonesia has two policy contracts on oil and gas: the old one is PSC-Cost-Recovery, and the new one is PSC-Gross-Split (introduced in 2017 as the new energy management plan). The contractor must choose between PSC-Cost-Recovery and PSC-Gross-Split which makes more profit. The aim of this paper is to show the best oil and gas contract policy for the contractor. The methods are calculating and comparing the economic indicators. The result of this study are (1) NPV for the PSC-Cost-Recovery is -46 MUS, while for the PSC-Gross-Split is 73 MUS, and (2) IRR for the PSC-Cost-Recovery is 9%, whereas for the PSC-Gross-Split is 11%. The conclusion is that the NPV and IRR for PSC-Gross-Split are greater than the NPV and IRR of PSC-Cost-Recovery, but POT in PSC-Gross-split is longer than POT in PSC-Cost-Recovery. Thus, in this case, the new energy policy contract can be applied for CO2 flooding technology since it yields higher economic indicators than its antecendent.

Gross efficiency and energy expenditure in kayak ergometer exercise.

Science.gov (United States)

Gomes, B B; Mourão, L; Massart, A; Figueiredo, P; Vilas-Boas, J P; Santos, A M C; Fernandes, R J

2012-08-01

We purposed to study energy expenditure, power output and gross efficiency during kayak ergometer exercise in 12 elite sprint kayakers. 6 males (age 24.2±4.8 years, height 180.4±4.8 cm, body mass 79.7±8.5 kg) and 6 females (age 24.3±4.5 years, height 164.5±3.9 cm, body mass 65.4±3.5 kg), performed an incremental intermittent protocol on kayak ergometer with VO2 and blood lactate concentration assessment, a non-linear increase between power output and energy expenditure being observed. Paddling power output, energy expenditure and gross efficiency corresponding to VO2max averaged 199.92±50.41 W, 75.27±6.30 ml.kg - 1.min - 1, and 10.10±1.08%. Male kayakers presented higher VO2max, power output and gross efficiency at the VO2max, and lower heart rate and maximal lactate concentration than females, but no differences were found between genders regarding energy expenditure at VO2max. Aerobic and anaerobic components of energy expenditure evidenced a significant contribution of anaerobic energy sources in sprint kayak performance. Results also suggested the dependence of the gross efficiency on the changes in the amount of the aerobic and anaerobic contributions, at heavy and severe intensities. The inter-individual variance of the relationship between energy expenditure and the corresponding paddling power output revealed a relevant tracking for females (FDγ=0.73±0.06), conversely to the male group (FDγ=0.27±0.08), supporting that some male kayakers are more skilled in some paddling intensities than others. © Georg Thieme Verlag KG Stuttgart · New York.

Brain abscess: surgical experiences of 162 cases

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Forhad Hossain Chowdhury

2015-01-01

Full Text Available Aim: Brain abscess still poses a public health challenge in spite of the advent of modern neurosurgical techniques and antibiotics. Here, we present our surgical experiences and ultimate outcome in the management of brain abscess. Methods: Totally, 162 patients with proved brain abscess who underwent surgical treatment were included in this study. The prospectively recorded data of surgical management of brain abscess and the ultimate outcome (by Glasgow outcome scale were studied retrospectively. Results: Total number of cases was 162, of which 113 were acute pyogenic abscess while 49 were chronic abscess. Among the chronic abscess, 29 were chronic pyogenic abscess, 14 were tubercular, 3 aspergillus, and 3 abscesses were in malignant brain metastases. In acute cases, common clinical features were headache, fever, vomiting, focal deficit and seizure. In chronic abscesses, common clinical features were mild to moderate headache and progressive focal deficit. Seventy-three (45.06% patients had adjacent localized sinus, middle ear or cranial infection. The common predisposing factors included postneurosurgery, postpenetrating injury to brain, chronic suppurative otitis media, and congenital heart disease, infective endocarditis, sinusitis and sub optimum immuno-status. Frontal lobe involved in 30.2% cases, temporal lobe is next to involved. Single time burr hole aspiration in 111 (68.5% cases, two or more times burr hole aspiration were done in 34 (21% cases. Pus culture was negative in 129 (79.62% cases. Total number of death was 22 (13.58% cases. Complete resolution of abscess with complete recovery of preoperative neuro-deficit was seen in 80.86% cases and recovery with major neuro-deficit was observed in 5.55% cases. There is a significant association between Glasgow coma scale (GCS on admission and mortality in brain abscess. Conclusion: In most of the cases, pus culture did not yield growth of any causative organism. Mortality was not

The Determination of Gross Alpha And Beta Activity of Drinking Water in Turkey

International Nuclear Information System (INIS)

Dilaver, A.T.; Cifter, C.; Altay, T.

2002-01-01

Man and his environment must be protected from the adverse effects of pesticides, radiation, noise and other forms of pollutions. Radioactive materials occur naturally in the environment (for example uranium, thorium and potassium). Same radioactive compounds arise from human activities (for example from medical or industrial uses of radioactivity). Drinking water should be safe to use and aesthetically pleasing. World Health Organisation (WHO) and Turkish Standards (TSE) have established maximum contaminant levels for gross alpha and gross beta. The purpose of these study is to determine the level of gross alpha and gross beta activities of samples collected from the different Regional Directories of The State Hydraulic Works (DSI)). After that compare the results versus permissible values of World Health Organisation and Turkish Standards. Collected samples from 14 Regional Directories of The State Hydraulic Works (DSI), have completed. All the analyses results suitable for WHO and TSE. We will give all the research our final report after completed the other Regional Directories' s analyses

[Parametric monitoring of the quality of total mesorectal excision and surgical treatment of rectal carcinoma results of a multicenter study].

Science.gov (United States)

Hoch, J; Ferko, A; Bláha, M; Ryška, A; Čapov, I; Dušek, L; Feit, J; Grega, M; Hermanová, M; Hovorková, E; Chmelová, R; Kala, Z; Klos, D; Kodet, R; Langer, D; Hadži-Nikolov, D; Örhalmi, J; Páral, J; Tichý, M; Tučková, I; Vjaclovský, M; Vlček, P

Tumour size and the quality of its complete surgical removal are the main prognostic factors in rectal cancer treatment. The number of postoperative local recurrences depends on whether the mesorectum has been completely removed - total mesorectal excision (TME) - and whether tumour-free resection margins have been achieved. The surgery itself and its quality depend on the accuracy of preoperative diagnosis and detection of risk areas in the rectum and mesorectum, on the surgeons skills, and finally on pathological assessment evaluating whether complete tumour excision has been accomplished including circumferential margins of the tumour, and whether mesorectal excision is complete. The aim of our study was to implement and standardize a new method of evaluation of the quality of the surgical procedure - TME - in rectal cancer treatment using an assessment of its circumferential margins (CRO) and completeness of the excision. The study consisted of two parts. The first, multi-centre retrospective phase with 288 patients analysed individual partial parameters of the diagnosis, operations and histological examinations of the rectal cancer. Critical points were identified and a unified follow-up protocol was prepared. In the second, prospective part of this study 600 patients were monitored parametrically focusing on the quality of the TME and its effect on the oncological treatment results. The proportion of patients with restaging following neoadjuvant therapy increased from 60.0% to 81.7% based on preoperative diagnosis. The number of specimens missing an assessment of the mesorectal excision quality decreased from 52.9% in the retrospective part of to the study to 22.8% in the prospective part. The proportion of actually complete TMEs rose from 22.6% to 26.0%, and that of nearly complete TMEs from 10.1% to 24.0%. The introduction of parametric monitoring into routine clinical practice improved the quality of pre-treatment and preoperative diagnosis, examination of

Surgical and nonsurgical treatment of total rupture of the pectoralis major muscle in athletes: update and critical appraisal

Directory of Open Access Journals (Sweden)

Jörn Kircher

2010-10-01

Full Text Available Jörn Kircher, Christoph Ziskoven, Thilo Patzer, Daniela Zaps, Bernd Bittersohl, Rüdiger KrauspeUniversity Hospital, Orthopaedic Department, Heinrich-Heine University Düsseldorf, Düsseldorf, GermanyAbstract: The complete rupture of the pectoralis major tendon is an uncommon injury but has become increasingly common among athletes in recent years. This may be due to a higher number of individuals taking part in high-impact sports and weightlifting as well as the use of anabolic substances, which can make muscles and tendons vulnerable to injury. In recent literature, there are only few recommendations to rely on conservative treatment alone, but there are a number of reports and case series recommending early surgical intervention. Comparing the results of the two treatment regimens, there is clear evidence for a superior outcome after surgical repair with better cosmesis, better functional results, regaining of muscle power, and return to sports compared with the conservative treatment. In summary, anatomic surgical repair is the treatment of choice for complete acute ruptures of the pectoralis major tendon or muscle in athletes.Keywords: pectoralis major, rupture, athlete, conservative treatment, surgical treatment, steroid, tendon, sports injury

Jatropha curcas – Analysis of Gross Calorific Value

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Juraj Ružbarský

2014-01-01

Full Text Available In recent years biofuels have obtained a considerable interest, due to the implementation of ruling and gradual replacement of fossil fuels. One of production steps at gaining the oil is a pressing process. Wastes come into being from this process. These wastes are used as feed, fertilizer prospectively as fuel. A contemporary scientific literature pays attention namely to one of prospective produces which is a produce of the tropical and subtropical zones Jatropa curcas. Tests were performed at Jatropha Curcas seeds of a brown colour (that means gnaw. The aim of a research is an analysis of Jatropa curcas seed from the utilization point of view of the gross calorific value. The basic instrument to evaluate the gross calorific value of each variant of the experiment was a calorimeter PARR 6200 and digital scales for accurate laboratory weighing.

The Performance of Fundamental Gross Motor Skills by Children Enrolled in Head Start.

Science.gov (United States)

Woodard, Rebecca J.; Yun, Joonkoo

2001-01-01

This study sought to descriptively evaluate the performance of fundamental gross motor skills among Head Start children. Levels of performance were compared and contrasted with performance profiles of the Test of Gross Motor Development. Findings suggest that Head Start curriculum should focus on the importance of developing fundamental gross…

Total pleurectomy as the surgical treatment for recurrent secondary spontaneous pneumothorax in a child with severe pulmonary Langerhans cells histiocytosis.

Science.gov (United States)

Abdul Aziz, Dayang Anita; Abdul Rahman, Nur Afdzillah; Tang, Swee Fong; Abdul Latif, Hasniah; Zaki, Faizah Mohd; Annuar, Zulfiqar Mohd; Alias, Hamidah; Abdul Latiff, Zarina

2011-12-01

Pulmonary Langerhans cell histiocytosis (LCH) in children is more extensive and is a rare cause of spontaneous secondary pneumothorax (SSP) which tends to be recurrent and refractory to conventional treatment. Its occurrence in paediatric patients posed great challenge to the choice of surgical management. Surgery in the form of pleurodesis is only considered if SSP does not improve after chemotherapy and after considering all relevant risk and benefits of surgery to patients. Chemical pleurodesis will not give the expected effect to eradicate SSP in this patient. Therefore mechanical pleurodesis is the treatment of choice. There are various techniques to perform mechanical pleurodesis; from pleural abrasion to pleurectomy. In the authors' experience, bilateral total pleurectomy provided the best outcome for this 9-year-old patient with persistent respiratory distress from SSP due to extensive pulmonary LCH.

Surgical treatment of radiation proctitis

Energy Technology Data Exchange (ETDEWEB)

Maruyama, Izumi; Sato, Gohei; Okaue, Toyotake; Isobe, Yoshinari; Ohtsu, Akira; Sugimoto, Yuzo (Kansai Electric Power Co., Inc., Osaka (Japan))

1982-08-01

Severe radiation proctitis was surgically treated in 8 cases. Colostomy was performed in 2 cases, total resection of the rectum in 2 and proctectomy with colostomy in 4. Perineal abscess developed in the 2 cases with total resection of the rectum. Rather than completely resection of the lesion, a procedure leaving no dead space i.e. proctectomy with colostomy, is desirable for radiation proctitis. Complete preoperative examination of the condition of the underlying disease and possible urinary tract complications is important.

Surgical treatment of radiation proctitis

International Nuclear Information System (INIS)

Maruyama, Izumi; Sato, Gohei; Okaue, Toyotake; Isobe, Yoshinari; Ohtsu, Akira; Sugimoto, Yuzo

1982-01-01

Severe radiation proctitis was surgically treated in 8 cases. Colostomy was performed in 2 cases, total resection of the rectum in 2 and proctectomy with colostomy in 4. Perineal abscess developed in the 2 cases with total resection of the rectum. Rather than completely resection of the lesion, a procedure leaving no dead space i.e. proctectomy with colostomy, is desirable for radiation proctitis. Complete preoperative examination of the condition of the underlying disease and possible urinary tract complications is important. (Chiba, N.)

Landscape History of Grosses Moos, NW Swiss Alpine Foreland.

Science.gov (United States)

Joanna Heer, Aleksandra; Adamiec, Grzegorz; Veit, Heinz; May, Jan-Hendrik; Novenko, Elena; Hajdas, Irka

2017-04-01

The western Swiss Plateau with Lake Neuchâtel is part of the alpine foreland and among the key areas for the reconstruction of environmental changes since the last postglacial. This study was carried out in a landscape located NE of the lake and called Grosses Moos (The Large Fen) - currently designated the Swiss largest, continuous farming area, after the fen was drained in course of landscape engineering projects performed in Switzerland at the end of the 19th century. The study contributes new results from nine excavations of littoral ridges identified in Grosses Moos, and integrates sedimentology, paleo-environmental analysis and three independent chronological methods. Radiocarbon dating, pollen analysis and optically stimulated luminescence (OSL) were applied to the sediments. While pollen and radiocarbon follow the standard procedures, the evaluation of the luminescence age estimates demanded adjustment according to the physical and microdosimetric properties of the alpine quartz, and consideration of the peculiarities of the changing littoral environments of Grosses Moos. The Grosses Moos landscape developed on the temporary surface of the post-Last Glacial sedimentary infill of the over-deepened glacial Aare valley. In this study the landscape history has been fitted into the existing supraregional time scales of NGRIP, the Swiss bio-zones system and the human history based on archaeological and historic records and covers a time span of up to 15'000 yr b2k. The wide-ranging suite of geomorphic features and sedimentary sequences, including littoral lake sediments, beach ridges, dunes, palaeo-channels, peat and colluvial deposits, enable the extensive reconstruction of spatially and temporally variable natural shaping processes. In addition, our results indicate remobilization of soil, colluvium, and sediment due to human settlement activities since the Neolithic - with an important increase in sediment load and spatial variability since the Bronze Age

Cooperative Study of the Spanish Pancreas Transplant Group (GETP): Surgical Complications.

Science.gov (United States)

Moya-Herraiz, Angel; Muñoz-Bellvis, Luis; Ferrer-Fábrega, Joana; Manrique Municio, Alejandro; Pérez-Daga, José Antonio; Muñoz-Casares, Cristóbal; Alarcó-Hernández, Antonio; Gómez-Gutiérrez, Manuel; Casanova-Rituerto, Daniel; Sanchez-Bueno, Francisco; Jimenez-Romero, Carlos; Fernández-Cruz Pérez, Laureano

2015-05-01

Technical failure in pancreas transplant has been the main cause of the loss of grafts. In the last few years, the number of complications has reduced, and therefore the proportion of this problem. The Spanish Pancreas Transplant Group wanted to analyze the current situation with regard to surgical complications and their severity. A retrospective and multicenter study was performed. 10 centers participated, with a total of 410 pancreas transplant recipients between January and December 2013. A total of 316 transplants were simultaneous with kidney, 66 after kidney, pancreas-only 10, 7 multivisceral and 11 retrasplants. Surgical complication rates were 39% (n=161). A total of 7% vascular thrombosis, 13% bleeding, 6% the graft pancreatitis, 12% surgical infections and others to a lesser extent. Relaparotomy rate was 25%. The severity of complications were of type IIIb (13%), type II (12%) and type IVa (8.5%). Graft loss was 8%. Early mortality was 0.5%. The percentage of operations for late complications was 17%. The number of surgical complications after transplantation is not negligible, affecting one in 3 patients. They are severe in one out of 5 and, in one of every 10 patients graft loss occurs. Therefore, there is still a significant percentage of surgical complications in this type of activity, as shown in our country. Copyright © 2014 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Surgical Residents are Excluded From Robot-assisted Surgery

DEFF Research Database (Denmark)

Broholm, Malene; Rosenberg, Jacob

2015-01-01

PURPOSE: Implementation of a robotic system may influence surgical training. The aim was to report the charge of the operating surgeon and the bedside assistant at robot-assisted procedures in urology, gynecology, and colorectal surgery. MATERIALS AND METHODS: A review of hospital charts from...... performed. In 10 (1.3%) of these procedures, a resident attended as bedside assistant and never as operating surgeon in the console. CONCLUSIONS: Our results demonstrate a severe problem with surgical education. Robot-assisted surgery is increasingly used; however, robotic surgical training during residency...... surgical procedures during a 1-year period from October 2013 to October 2014. All robot-assisted urologic, gynecologic, and colorectal procedures were identified. Charge of both operating surgeon in the console and bedside assistant were registered. RESULTS: A total of 774 robot-assisted procedures were...

Open surgical management of pediatric urolithiasis: A developing country perspective.

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Rizvi, Syed A; Sultan, Sajid; Ijaz, Hussain; Mirza, Zafar N; Ahmed, Bashir; Saulat, Sherjeel; Umar, Sadaf Aba; Naqvi, Syed A

2010-10-01

To describe decision factors and outcome of open surgical procedures in the management of children with stone. Between January 2004 and December 2008, 3969 surgical procedures were performed in 3053 children with stone disease. Procedures employed included minimally invasive techniques shockwave lithotripsy (SWL), percutaneous nephrolithotomy (PCNL), ureterorenoscopy (URS), perurethral cystolithotripsy (PUCL), percutaneous cystolithotripsy (PCCL), and open surgery. From sociomedical records demographics, clinical history, operative procedures, complications, and outcome were recorded for all patients. Of 3969 surgeries, 2794 (70%) were minimally invasive surgery (MIS) techniques to include SWL 19%, PCNL 16%, URS 18.9%, and PUCL+PCCL 16% and 1175 (30%) were open surgeries. The main factors necessitating open surgery were large stone burden 37%, anatomical abnormalities 16%, stones with renal failure 34%, gross hydronephrosis with thin cortex 58%, urinary tract infection (UTI) 25%, and failed MIS 18%. Nearly 50% of the surgeries were necessitated by economic constraints and long distance from center where one-time treatment was preferred by the patient. Stone-free rates by open surgeries were pyelolithotomy 91%, ureterolithotomy 100%, and cystolithotomy 100% with complication rate of upto 3%. In developing countries, large stone burden, neglected stones with renal failure, paucity of urological facilities, residence of poor patients away from tertiary centers necessitate open surgical procedures as the therapy of choice in about 1/3rd of the patients. Open surgery provides comparable success rates to MIS although the burden and nature of disease is more complex. The scope of open surgery will remain much wide for a large population for considered time in developing countries.

Interventions to improve gross motor performance in children with neurodevelopmental disorders: a meta-analysis.

Science.gov (United States)

Lucas, Barbara R; Elliott, Elizabeth J; Coggan, Sarah; Pinto, Rafael Z; Jirikowic, Tracy; McCoy, Sarah Westcott; Latimer, Jane

2016-11-29

Gross motor skills are fundamental to childhood development. The effectiveness of current physical therapy options for children with mild to moderate gross motor disorders is unknown. The aim of this study was to systematically review the literature to investigate the effectiveness of conservative interventions to improve gross motor performance in children with a range of neurodevelopmental disorders. A systematic review with meta-analysis was conducted. MEDLINE, EMBASE, AMED, CINAHL, PsycINFO, PEDro, Cochrane Collaboration, Google Scholar databases and clinical trial registries were searched. Published randomised controlled trials including children 3 to ≤18 years with (i) Developmental Coordination Disorder (DCD) or Cerebral Palsy (CP) (Gross Motor Function Classification System Level 1) or Developmental Delay or Minimal Acquired Brain Injury or Prematurity (gross motor outcomes obtained using a standardised assessment tool. Meta-analysis was performed to determine the pooled effect of intervention on gross motor function. Methodological quality and strength of meta-analysis recommendations were evaluated using PEDro and the GRADE approach respectively. Of 2513 papers, 9 met inclusion criteria including children with CP (n = 2) or DCD (n = 7) receiving 11 different interventions. Only two of 9 trials showed an effect for treatment. Using the least conservative trial outcomes a large beneficial effect of intervention was shown (SMD:-0.8; 95% CI:-1.1 to -0.5) with "very low quality" GRADE ratings. Using the most conservative trial outcomes there is no treatment effect (SMD:-0.1; 95% CI:-0.3 to 0.2) with "low quality" GRADE ratings. Study limitations included the small number and poor quality of the available trials. Although we found that some interventions with a task-orientated framework can improve gross motor outcomes in children with DCD or CP, these findings are limited by the very low quality of the available evidence. High quality intervention

Infected primary knee arthroplasty: Risk factors for surgical treatment failure

Directory of Open Access Journals (Sweden)

Joao Gabriel Duarte Paes Pradella

2013-09-01

Full Text Available OBJECTIVE: To present epidemiological data and risk factors associated with surgical out-comes favorable or unfavorable for the treatment of infection in infected total knee arthroplasty. METHODS: We reviewed medical records of 48 patients who underwent treatment of primary total knee arthroplasty for infection between January 1994 and December 2008, in the Orthopedics and Traumatology Department of the Santa Casa de Misericórdia de São Paulo. The variables associated with favorable outcome of surgical treatment (debridement and retention or exchange arthroplasty in two days or unfavorable (arthrodesis or death infection. RESULTS: A total of 39 cases of infection after primary total knee arthroplasty, 22 progressed to 17 for a favorable outcome and unfavorable outcome. Early infections (OR: 14.0, 95% CI 1.5-133.2, p = 0.016 and diabetes (OR: 11.3, 95% CI 1.4-89.3, p = 0.032 were associated with arthrodesis joint and death respectively. CONCLUSION: Patients with early infection had a higher risk of developing surgical procedure with unfavorable outcome (arthrodesis and diabetics had higher odds of death after infection of primary knee arthroplasties.

Surgical techniques for treatment of gastroesophageal reflux disease

Directory of Open Access Journals (Sweden)

Carlos Édder de Mello Cardoso Lima

2015-12-01

Full Text Available Gastroesophageal reflux is one of the most frequently gastrointestinal tract diseases currently found, having a great impact on the patient's quality of life. Purpose: to analyze the main surgical techniques used in the treatment of this pathology, their indications, advantages and disadvantages. Methods: this is a literature review. Thirteen articles published between 1998 and 2013 in the Lilacs, Bireme e Scielo databases, addressing different surgical techniques for the treatment of gastroesophageal reflux were selected. Results: Five hundred and thirty-eight total fundoplications and 466 partial fundoplications were performed. Conclusion: The findings of this review show that total fundoplication is the most commonly used technique in the treatment of gastroesophageal reflux disease.

Advance organizers in a gross anatomy dissection course and their effects on academic achievement.

Science.gov (United States)

Chung, Eun-Kyung; Nam, Kwang-Il; Oh, Sun-A; Han, Eui-Ryoung; Woo, Young-Jong; Hitchcock, Maurice A

2013-04-01

We presented two kinds of advance organizers (AOs), video clips and prosection, for a gross anatomy dissection course and compared their effects on academic achievement and student perception of the learning experience. In total, 141 students at Chonnam National University Medical School were randomly assigned to two groups: Group 1 (n = 70) was provided with video clips AO, whereas Group 2 (n = 71) was provided with prosection AO, the use of cadaveric specimens dissected by the course instructor. Student self-assessment scores regarding the learning objectives of upper limb anatomy improved significantly in both groups. Academic achievement scores in Group 2 were significantly higher than those in Group 1, although the self-assessment scores were not significantly different between the groups. Additionally, students in Group 2 responded significantly more positively to the statements about perception of the learning experience such as helping them understand the course content and concepts, decreasing anxiety about the dissection course, and participating actively in the dissection. It would seem that the application of prosection as an AO improved academic achievement and increased student engagement and satisfaction. This study will contribute to designing effective AOs and developing a teaching and learning strategy for a gross anatomy dissection course. Copyright © 2012 Wiley Periodicals, Inc.

Technical Basis for the Use of Alpha Absorption Corrections on RCF Gross Alpha Data

International Nuclear Information System (INIS)

Ceffalo, G.M.

1999-01-01

This document provides the supporting data and rationale for making absorption corrections to gross alpha data to correct alpha data for loss due to absorption in the sample matrix. For some time there has been concern that the gross alpha data produced by the Environmental Restoration Contractor Radiological Counting Facility, particularly gross alpha analysis on soils, has been biased toward low results, as no correction for self-absorption was applied to the counting data. The process was investigated, and a new methodology for alpha self-absorption has been developed

Transportation-Related Safety Behaviors in Top-Grossing Children's Movies from 2008 to 2013.

Science.gov (United States)

Boppana, Shilpa; Shen, Jiabin; Schwebel, David C

2016-05-01

Children regularly imitate behavior from movies. The authors assessed injury risk behaviors in top-grossing children's films. The 5 top-grossing G- or PG-rated movies annually from 2008 to 2013 were included, including animated movies and those set in the past/future. Researchers coded transportation scenes for risk taking in 3 domains: protection/equipment, unsafe behaviors, and distraction/attention. Safe and risky behaviors were recorded across the 3 domains. With regard to protection and equipment, 20% of motor vehicle scenes showed characters riding without seat belts and 27% of scenes with motorcycles showed characters riding without helmets. Eighty-nine percent of scenes with horses showed riders without helmets and 67% of boat operators failed to wear personal flotation devices. The most common unsafe behaviors were speeding and unsafe street-crossing. Twenty-one percent of scenes with motor vehicles showed drivers speeding and 90% of pedestrians in films failed to wait for signal changes. Distracted and inattentive behaviors were rare, with distracted driving of motor vehicles occurring in only approximately 2% of total driving scenes. Although many safe transportation behaviors were portrayed, the film industry continues to depict unsafe behaviors in movies designed for pediatric audiences. There is a need for the film industry to continue to balance entertainment and art with modeling of safe behavior for children.

Relation between hand function and gross motor function in full term infants aged 4 to 8 months

Directory of Open Access Journals (Sweden)

Solange F. Nogueira

2015-02-01

Full Text Available Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time of manipulation to an object were extracted from video synchronized with the Qualisys(r movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (p<0.001, the time of manipulation (p<0.001 and gross motor function (p<0.001 over time, as well as associations between reaching and gross motor function (R2=0.84; p<0.001 and manipulation and gross motor function (R2=0.13; p=0.02 from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development.

Gross α/β analysis of spiked qater for IAEA 2008 world-wide open proficiency test

International Nuclear Information System (INIS)

Zhang Yaoling; Zhao Feng; Wu Meigui; Du Jinzhou

2010-01-01

The gross α/β analysis of the IAEA 2008 world-wide open proficiency test on the determination of natural radionuclides in spiked water was conducted. The Sample 03, Sample 04 and Sample 05 were tested for the gross α/β radioactivity according to the requirement of IAEA. The feedback statistics showed that the values of gross α/β of all of the three samples fell in the acceptable range of IAEA. (authors)

26 CFR 1.804-3 - Gross investment income of a life insurance company.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 8 2010-04-01 2010-04-01 false Gross investment income of a life insurance company. 1.804-3 Section 1.804-3 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES Investment Income § 1.804-3 Gross investment income of a life...

26 CFR 1.1332-1 - Inclusion in gross income of war loss recoveries.

Science.gov (United States)

2010-04-01

... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Inclusion in gross income of war loss recoveries. 1.1332-1 Section 1.1332-1 Internal Revenue INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY (CONTINUED) INCOME TAX (CONTINUED) INCOME TAXES War Loss Recoveries § 1.1332-1 Inclusion in gross income of...

Gross Motor Development of Malaysian Hearing Impaired Male Pre- and Early School Children

Science.gov (United States)

Zawi, Khairi; Lian, Denise Koh Choon; Abdullah, Rozlina Tan

2014-01-01

Acquisition of gross motor skill is a natural developmental process for children. This aspect of human development increases with one's chronological age, irrespective of any developmental conditions. The purpose of this study was to assess the level of gross motor skill development among pre- and early school-aged children with motor disability.…

Re-irradiation after gross total resection of recurrent glioblastoma. Spatial pattern of recurrence and a review of the literature as a basis for target volume definition

Energy Technology Data Exchange (ETDEWEB)

Straube, Christoph; Elpula, Greeshma [Technische Universitaet Muenchen (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Gempt, Jens; Gerhardt, Julia; Meyer, Bernhard [Technische Universitaet Muenchen (TUM), Department of Neurosurgery, Klinikum rechts der Isar, Muenchen (Germany); Bette, Stefanie; Zimmer, Claus [Technische Universitaet Muenchen (TUM), Department of Neuroradiology, Klinikum rechts der Isar, Muenchen (Germany); Schmidt-Graf, Friederike [Technische Universitaet Muenchen (TUM), Department of Neurology, Klinikum rechts der Isar, Muenchen (Germany); Combs, Stephanie E. [Technische Universitaet Muenchen (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Muenchen (Germany); Helmholtz Zentrum Muenchen, Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Oberschleissheim (Germany)

2017-11-15

Currently, patients with gross total resection (GTR) of recurrent glioblastoma (rGBM) undergo adjuvant chemotherapy or are followed up until progression. Re-irradiation, as one of the most effective treatments in macroscopic rGBM, is withheld in this situation, as uncertainties about the pattern of re-recurrence, the target volume, and also the efficacy of early re-irradiation after GTR exist. Imaging and clinical data from 26 consecutive patients with GTR of rGBM were analyzed. The spatial pattern of recurrences was analyzed according to the RANO-HGG criteria (''response assessment in neuro-oncology criteria for high-grade gliomas''). Progression-free (PFS) and overall survival (OS) were analyzed by the Kaplan-Meier method. Furthermore, a systematic review was performed in PubMed. All but 4 patients underwent adjuvant chemotherapy after GTR. Progression was diagnosed in 20 of 26 patients and 70% of recurrent tumors occurred adjacent to the resection cavity. The median extension beyond the edge of the resection cavity was 20 mm. Median PFS was 6 months; OS was 12.8 months. We propose a target volume containing the resection cavity and every contrast enhancing lesion as the gross tumor volume (GTV), a spherical margin of 5-10 mm to generate the clinical target volume (CTV), and a margin of 1-3 mm to generate the planning target volume (PTV). Re-irradiation of this volume is deemed to be safe and likely to prolong PFS. Re-irradiation is worth considering also after GTR, as the volumes that need to be treated are limited and re-irradiation has already proven to be a safe treatment option in general. The strategy of early re-irradiation is currently being tested within the GlioCave/NOA 17/Aro 2016/03 trial. (orig.) [German] Patienten mit einem rezidivierten Glioblastom (rGBM) werden, wenn eine komplette Resektion (GTR) des makroskopischen Rezidivs durchgefuehrt wurde, aktuell meist systemisch adjuvant behandelt oder einer engmaschigen Nachsorge

Abortion - surgical

Science.gov (United States)

Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

Gross changes in forest area shape the future carbon balance of tropical forests

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Li, Wei; Ciais, Philippe; Yue, Chao; Gasser, Thomas; Peng, Shushi; Bastos, Ana

2018-01-01

Bookkeeping models are used to estimate land-use and land-cover change (LULCC) carbon fluxes (ELULCC). The uncertainty of bookkeeping models partly arises from data used to define response curves (usually from local data) and their representativeness for application to large regions. Here, we compare biomass recovery curves derived from a recent synthesis of secondary forest plots in Latin America by Poorter et al. (2016) with the curves used previously in bookkeeping models from Houghton (1999) and Hansis et al. (2015). We find that the two latter models overestimate the long-term (100 years) vegetation carbon density of secondary forest by about 25 %. We also use idealized LULCC scenarios combined with these three different response curves to demonstrate the importance of considering gross forest area changes instead of net forest area changes for estimating regional ELULCC. In the illustrative case of a net gain in forest area composed of a large gross loss and a large gross gain occurring during a single year, the initial gross loss has an important legacy effect on ELULCC so that the system can be a net source of CO2 to the atmosphere long after the initial forest area change. We show the existence of critical values of the ratio of gross area change over net area change (γAnetAgross), above which cumulative ELULCC is a net CO2 source rather than a sink for a given time horizon after the initial perturbation. These theoretical critical ratio values derived from simulations of a bookkeeping model are compared with observations from the 30 m resolution Landsat Thematic Mapper data of gross and net forest area change in the Amazon. This allows us to diagnose areas in which current forest gains with a large land turnover will still result in LULCC carbon emissions in 20, 50 and 100 years.

Are Gross Motor Skills and Sports Participation Related in Children with Intellectual Disabilities?

Science.gov (United States)

Westendorp, Marieke; Houwen, Suzanne; Hartman, Esther; Visscher, Chris

2011-01-01

This study compared the specific gross motor skills of 156 children with intellectual disabilities (ID) (50 less than or equal to IQ greater than or equal to 79) with that of 255 typically developing children, aged 7-12 years. Additionally, the relationship between the specific gross motor skills and organized sports participation was examined in…

Post surgical complications from students' large animal surgical ...

African Journals Online (AJOL)

A retrospective study of post surgical complications was conducted on records of students' Large Animal Surgical Laboratories in the Faculty of Veterinary Medicine (F.V.M.), Ahmadu Bello University (A.B.U), Zaria from 1989 to 1993. Three hundred and eleven surgical complications were recorded from five surgical ...

The effect of music on robot-assisted laparoscopic surgical performance.

Science.gov (United States)

Siu, Ka-Chun; Suh, Irene H; Mukherjee, Mukul; Oleynikov, Dmitry; Stergiou, Nick

2010-12-01

Music is often played in the operating room to increase the surgeon's concentration and to mask noise. It could have a beneficial effect on surgical performance. Ten participants with limited experience with the da Vinci robotic surgical system were recruited to perform two surgical tasks: suture tying and mesh alignment when classical, jazz, hip-hop, and Jamaican music were presented. Kinematics of the instrument tips of the surgical robot and surface electromyography of the subjects were recorded. Results revealed that a significant music effect was found for both tasks with decreased time to task completion (P = .005) and total travel distance (P = .021) as well as reduced muscle activations ( P = .016) and increased median muscle frequency (P = .034). Subjects improved their performance significantly when they listened to either hip-hop or Jamaican music. In conclusion, music with high rhythmicity has a beneficial effect on robotic surgical performance. Musical environment may benefit surgical training and make acquisition of surgical skills more efficient.

Radiation therapy for angiosarcoma of the scalp: treatment outcomes of total scalp irradiation with X-rays and electrons.

Science.gov (United States)

Hata, Masaharu; Wada, Hidefumi; Ogino, Ichiro; Omura, Motoko; Koike, Izumi; Tayama, Yoshibumi; Odagiri, Kazumasa; Kasuya, Takeo; Inoue, Tomio

2014-10-01

Wide surgical excision is the standard treatment for angiosarcoma of the scalp, but many patients are inoperable. Therefore, we investigated the outcome of radiation therapy for angiosarcoma of the scalp. Seventeen patients with angiosarcoma of the scalp underwent radiation therapy with total scalp irradiation. Four patients had cervical lymph node metastases, but none had distant metastases. A median initial dose of 50 Gy in 25 fractions was delivered to the entire scalp. Subsequently, local radiation boost to the tumor sites achieved a median total dose of 70 Gy in 35 fractions. Fourteen of the 17 patients developed recurrences during the median follow-up period of 14 months after radiation therapy; 7 had recurrences in the scalp, including primary tumor progression in 2 patients and new disease in 5, and 12 patients developed distant metastases. The primary progression-free, scalp relapse-free, and distant metastasis-free rates were 86, 67, and 38 % at 1 year and 86, 38, and 16 % at 3 years, respectively. Thirteen patients died; the overall and cause-specific survival rates were both 73 % at 1 year and 23 and 44 % at 3 years, respectively. The median survival time was 16 months. There were no therapy-related toxicities ≥ grade 3. Total scalp irradiation is safe and effective for local tumor control, but a dose of ≤ 50 Gy in conventional fractions may be insufficient to eradicate microscopic tumors. For gross tumors, a total dose of 70 Gy, and > 70 Gy for tumors with deep invasion, is recommended.

Surgical therapy in chronic pancreatitis.

Science.gov (United States)

Neal, C P; Dennison, A R; Garcea, G

2012-12-01

Chronic pancreatitis (CP) is an inflammatory disease of the pancreas which causes chronic pain, as well as exocrine and endocrine failure in the majority of patients, together producing social and domestic upheaval and a very poor quality of life. At least half of patients will require surgical intervention at some stage in their disease, primarily for the treatment of persistent pain. Available data have now confirmed that surgical intervention may produce superior results to conservative and endoscopic treatment. Comprehensive individual patient assessment is crucial to optimal surgical management, however, in order to determine which morphological disease variant (large duct disease, distal stricture with focal disease, expanded head or small duct/minimal change disease) is present in the individual patient, as a wide and differing range of surgical approaches are possible depending upon the specific abnormality within the gland. This review comprehensively assesses the evidence for these differing approaches to surgical intervention in chronic pancreatitis. Surgical drainage procedures should be limited to a small number of patients with a dilated duct and no pancreatic head mass. Similarly, a small population presenting with a focal stricture and tail only disease may be successfully treated by distal pancreatectomy. Long-term results of both of these procedure types are poor, however. More impressive results have been yielded for the surgical treatment of the expanded head, for which a range of surgical options now exist. Evidence from level I studies and a recent meta-analysis suggests that duodenum-preserving resections offer benefits compared to pancreaticoduodenectomy, though the results of the ongoing, multicentre ChroPac trial are awaited to confirm this. Further data are also needed to determine which of the duodenum-preserving procedures provides optimal results. In relation to small duct/minimal change disease total pancreatectomy represents the only

Anomaly detection in real-time gross payment data

NARCIS (Netherlands)

Triepels, Ron; Daniels, Hennie; Heijmans, R.; Camp, Olivier; Filipe, Joaquim

2017-01-01

We discuss how an autoencoder can detect system-level anomalies in a real-time gross settlement system by reconstructing a set of liquidity vectors. A liquidity vector is an aggregated representation of the underlying payment network of a settlement system for a particular time interval.

Potato production in Europe - a gross margin analysis

DEFF Research Database (Denmark)

Pedersen, Søren Marcus; Bizik, Jan; Costa, Luisa Dalla

The purpose of this paper is to examine different cropping practices, cost structures and gross margins for producing conventional table potatoes in 6 different regions within the European Union: Czech Republic, Denmark, Italy, Poland, Portugal and Slovakia. Findings from this study show that pot...

MRI detection of posterior urethral diverticulum following surgical repair of anorectal malformations

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Ishan Kumar

2017-09-01

Full Text Available Aim: To identify and to assess imaging and clinical features of Posterior urethral diverticula (PUD in a single-centre series and include a brief review of literature. Materials and method: Post operative MRI of 140 children from north India were retrospectively reviewed who underwent surgical repair for anorectal malformation (ARM along with the Hospital records. Results: Ten cases had MRI features of posterior urethral diverticulum. All of these patients had undergone primary abdominoperineal pull through (APPT procedure. The lesions ranged between 6 mm and 38 mm in size. Two of these lesions were missed in the post operative MRI report. Only one of these patients was symptomatic and presented with dribbling of urine and gross bilateral vesicoureteric reflux in which the diverticulum was excised surgically. Conclusion: PUD is an under-recognised entity and can be identified in preclinical stage on MRI. Careful assessment of urethra and periurethral structures should be a mandatory step in MRI evaluation of post repair ARM cases. An observational conservative approach in selected asymptomatic patients can be an effective management strategy. Keywords: Posterior urethral diverticulum, MRI, Anorectal malformation

Improvements of mass formula and β-decay gross theory

International Nuclear Information System (INIS)

Tachibana, Takahiro

1987-01-01

The nuclear mass greatly decreases when the number of protons Z and neutrons N is simultaneously equal to a magic number (mutual support of magicities). The mass also tends to decrease due to deformation as both N and Z are away from the magic numbers (mutual support of deformations). These two effects are introduced to a nuclear mass formula containing a constant-type shell term to derive a new formula. The mass excess is expressed by a sum of three parts, i.e. gross part, even-odd part and shell part. The gross part, which represents the general nature, consists of two rest mass terms and a coulomb term. The even-odd part is of a typical form with a correction term. The shell part consists of a proton shell term, neutron shell term, third term expressing the two mutual support effects, and fourth term representing a decrease in coulomb energy due to deformation of the nucleus. The improvements made in the β-decay gross theory are associated with the single particle intensity function D 0 GT (E,ε). They are intended for: (1) reproducing the peak that accounts for about a half of the Gamow-Teller intensity, which has recently been found in (p,n) reactions at energies above the isobaric analogue state and (2) explaining the other half by an exponential-type D 0 GT (E,ε). (Nogami, K.)

Comparison of surgical and non-surgical orthodontic treatment approaches on occlusal and cephalometric outcomes in patients with Class II Division I malocclusions

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Sheila Daniels

2017-07-01

Full Text Available Abstract Background This study aimed to examine end-of-treatment outcomes of severe Class II Division I malocclusion patients treated with surgical or non-surgical approaches. This study tests the hypotheses that occlusal outcomes (ABO-OGS and cephalometric outcomes differ between these groups. Methods A total of 60 patients were included: 20 of which underwent surgical correction and 40 of which did not. Cast grading of initial and final study models was performed and information was gathered from pre- to post-treatment cephalometric radiographs. The end-of-treatment ABO-OGS and cephalometric outcomes were compared to Mann-Whitney U tests and multivariable linear regression models. Results Following adjustment for multiple confounders (age, gender, complexity of case, and skeletal patterns, the final deband score (ABO-OGS was similar for both groups (23.8 for surgical group versus 22.5 for non-surgical group. Those treated surgically had a significantly larger reduction in ANB angle, 3.4° reduction versus 1.5° reduction in the non-surgical group (p = 0.002. The surgical group also showed increased maxillary incisor proclination (p = 0.001 compared to the non-surgical group. This might be attributed to retroclination of maxillary incisors during treatment selection in the non-surgical group—namely, extraction of premolars to mask the discrepancy. Conclusions Those treated surgically had a significantly larger reduction in ANB angle and increased maxillary incisor proclination compared to those treated non-surgically with no significant changes in occlusal outcomes.

Comparison of gross anatomy test scores using traditional specimens vs. QuickTime Virtual Reality animated specimens

Science.gov (United States)

Maza, Paul Sadiri

In recent years, technological advances such as computers have been employed in teaching gross anatomy at all levels of education, even in professional schools such as medical and veterinary medical colleges. Benefits of computer based instructional tools for gross anatomy include the convenience of not having to physically view or dissect a cadaver. Anatomy educators debate over the advantages versus the disadvantages of computer based resources for gross anatomy instruction. Many studies, case reports, and editorials argue for the increased use of computer based anatomy educational tools, while others discuss the necessity of dissection for various reasons important in learning anatomy, such as a three-dimensional physical view of the specimen, physical handling of tissues, interactions with fellow students during dissection, and differences between specific specimens. While many articles deal with gross anatomy education using computers, there seems to be a lack of studies investigating the use of computer based resources as an assessment tool for gross anatomy, specifically using the Apple application QuickTime Virtual Reality (QTVR). This study investigated the use of QTVR movie modules to assess if using computer based QTVR movie module assessments were equal in quality to actual physical specimen examinations. A gross anatomy course in the College of Veterinary Medicine at Cornell University was used as a source of anatomy students and gross anatomy examinations. Two groups were compared, one group taking gross anatomy examinations in a traditional manner, by viewing actual physical specimens and answering questions based on those specimens. The other group took the same examinations using the same specimens, but the specimens were viewed as simulated three-dimensional objects in a QTVR movie module. Sample group means for the assessments were compared. A survey was also administered asking students' perceptions of quality and user-friendliness of the QTVR

Fine and gross motor skills differ between healthy-weight and obese children.

Science.gov (United States)

Gentier, Ilse; D'Hondt, Eva; Shultz, Sarah; Deforche, Benedicte; Augustijn, Mireille; Hoorne, Sofie; Verlaecke, Katja; De Bourdeaudhuij, Ilse; Lenoir, Matthieu

2013-11-01

Within the obesity literature, focus is put on the link between weight status and gross motor skills. However, research on fine motor skills in the obese (OB) childhood population is limited. Therefore, the present study focused on possible weight related differences in gross as well as fine motor skill tasks. Thirty-four OB children (12 ♀ and 22 ♂, aged 7-13 years) were recruited prior to participating in a multidisciplinary treatment program at the Zeepreventorium (De Haan, Belgium). Additionally, a control group of 34 age and gender-matched healthy-weight (HW) children was included in the study. Anthropometric measures were recorded and gross and fine motor skills were assessed using the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2). Results were analyzed by independent samples t-tests, multivariate analysis of variance, and a chi-squared test. Being OB was detrimental for all subtests evaluating gross motor skill performance (i.e., upper-limb coordination, bilateral coordination, balance, running speed and agility, and strength). Furthermore, OB children performed worse in fine motor precision and a manual dexterity task, when compared to their HW peers. No group differences existed for the fine motor integration task. Our study provides evidence that lower motor competence in OB children is not limited to gross motor skills alone; OB children are also affected by fine motor skill problems. Further investigation is warranted to provide possible explanations for these differences. It is tentatively suggested that OB children experience difficulties with the integration and processing of sensory information. Future research is needed to explore whether this assumption is correct and what the underlying mechanism(s) could be. Copyright © 2013 Elsevier Ltd. All rights reserved.

25 CFR 215.21 - Payment of gross production tax on lead and zinc.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Payment of gross production tax on lead and zinc. 215.21... ZINC MINING OPERATIONS AND LEASES, QUAPAW AGENCY § 215.21 Payment of gross production tax on lead and zinc. The superintendent of the Quapaw Indian Agency is hereby authorized and directed to pay at the...

Gross and microscopic pathology of hard and soft corals in New Caledonia

Science.gov (United States)

Work, Thierry M.; Aeby, Greta S.; Lasne, Gregory; Tribollet, Aline

2014-01-01

We surveyed the reefs of Grande Terre, New Caledonia, for coral diseases in 2010 and 2013. Lesions encountered in hard and soft corals were systematically described at the gross and microscopic level. We sampled paired and normal tissues from 101 and 65 colonies in 2010 and 2013, respectively, comprising 51 species of corals from 27 genera. Tissue loss was the most common gross lesion sampled (40%) followed by discoloration (28%), growth anomalies (13%), bleaching (10%), and flatworm infestation (1%). When grouped by gross lesions, the diversity of microscopic lesions as measured by Shannon–Wiener index was highest for tissue loss, followed by discoloration, bleaching, and growth anomaly. Our findings document an extension of the range of certain diseases such as Porites trematodiasis and endolithic hypermycosis (dark spots) to the Western Pacific as well as the presence of a putative cnidarian endosymbiont. We also expand the range of species infected by cell-associated microbial aggregates, and confirm the trend that these aggregates predominate in dominant genera of corals in the Indo-Pacific. This study highlights the importance of including histopathology as an integral component of baseline coral disease surveys, because a given gross lesion might be associated with multiple potential causative agents.

26 CFR 1.61-4 - Gross income of farmers.

Science.gov (United States)

2010-04-01

... exchange is to be included in gross income. Proceeds of insurance, such as hail or fire insurance on... include crop insurance proceeds in income for taxable year following taxable year of destruction. For...

Surgical and nonsurgical treatment of total rupture of the pectoralis major muscle in athletes: update and critical appraisal.

Science.gov (United States)

Kircher, Jörn; Ziskoven, Christoph; Patzer, Thilo; Zaps, Daniela; Bittersohl, Bernd; Krauspe, Rüdiger

2010-10-11

The complete rupture of the pectoralis major tendon is an uncommon injury but has become increasingly common among athletes in recent years. This may be due to a higher number of individuals taking part in high-impact sports and weightlifting as well as the use of anabolic substances, which can make muscles and tendons vulnerable to injury. In recent literature, there are only few recommendations to rely on conservative treatment alone, but there are a number of reports and case series recommending early surgical intervention. Comparing the results of the two treatment regimens, there is clear evidence for a superior outcome after surgical repair with better cosmesis, better functional results, regaining of muscle power, and return to sports compared with the conservative treatment. In summary, anatomic surgical repair is the treatment of choice for complete acute ruptures of the pectoralis major tendon or muscle in athletes.

The relationship between spasticity and gross motor capability in nonambulatory children with spastic cerebral palsy.

Science.gov (United States)

Katusic, Ana; Alimovic, Sonja

2013-09-01

Spasticity has been considered as a major impairment in cerebral palsy (CP), but the relationship between this impairment and motor functions is still unclear, especially in the same group of patients with CP. The aim of this investigation is to determine the relationship between spasticity and gross motor capability in nonambulatory children with spastic CP. Seventy-one children (30 boys, 41 girls) with bilateral spastic cerebral palsy and with Gross Motor Function Classification System (GMFCS) levels IV (n=34) and V (n=37) were included in the study. The spasticity level in lower limbs was evaluated using the Modified Modified Ashworth Scale and the gross motor function with the Gross Motor Function Measure (GMFM-88). Spearman's correlation analysis was used to determine the nature and the strength of the relationship. The results showed a moderate correlation between spasticity and gross motor skills (ρ=0.52 for the GMFCS level; ρ=0.57 for the GMFM-88), accounting for less than 30% of the explained variance. It seems that spasticity is just one factor among many others that could interfere with gross motor skills, even in children with severe forms of spastic CP. Knowledge of the impact of spasticity on motor skills may be useful in the setting of adequate rehabilitation strategies for nonambulatory children with spastic CP.

Fixed Point of Generalized Eventual Cyclic Gross in Fuzzy Norm Spaces for Contractive Mappings

Directory of Open Access Journals (Sweden)

S. A. M. Mohsenialhosseini

2015-01-01

Full Text Available We define generalized eventual cyclic gross contractive mapping in fuzzy norm spaces, which is a generalization of the eventual cyclic gross contractions. Also we prove the existence of a fixed point for this type of contractive mapping on fuzzy norm spaces.

Combined climate factors alleviate changes in gross soil nitrogen dynamics in heathlands

DEFF Research Database (Denmark)

Bjorsne, Anna-Karin; Rutting, Tobias; Ambus, Per

2014-01-01

of exposure to three climate change factors, i.e. warming, elevated CO2 (eCO(2)) and summer drought, applied both in isolation and in combination. By conducting laboratory N-15 tracing experiments we show that warming increased both gross N mineralization and nitrification rates. In contrast, gross......The ongoing climate change affects biogeochemical cycling in terrestrial ecosystems, but the magnitude and direction of this impact is yet unclear. To shed further light on the climate change impact, we investigated alterations in the soil nitrogen (N) cycling in a Danish heathland after 5 years......CO(2). In the full treatment combination, simulating the predicted climate for the year 2075, gross N transformations were only moderately affected compared to control, suggesting a minor alteration of the N cycle due to climate change. Overall, our study confirms the importance of multifactorial field...

The effect of height, weight and head circumference on gross motor development in achondroplasia.

Science.gov (United States)

Ireland, Penelope Jane; Ware, Robert S; Donaghey, Samantha; McGill, James; Zankl, Andreas; Pacey, Verity; Ault, Jenny; Savarirayan, Ravi; Sillence, David; Thompson, Elizabeth; Townshend, Sharron; Johnston, Leanne M

2013-02-01

This study aimed to investigate whether height, weight, head circumference and/or relationships between these factors are associated with gross motor milestone acquisition in children with achondroplasia. Population-based data regarding timing of major gross motor milestones up to 5 years were correlated with height, weight and head circumference at birth and 12 months in 48 children with achondroplasia born in Australia and New Zealand between 2000 and 2009. Although as a group children with achondroplasia showed delayed gross motor skill acquisition, within group differences in height, weight or head circumference did not appear to influence timing of gross motor skills before 5 years. The exception was lie to sit transitioning, which appears likely to occur earlier if the child is taller and heavier at 12 months, and later if the child has significant head-to-body disproportion. This is the first study to investigate the relationship between common musculoskeletal impairments associated with achondroplasia and timing of gross motor achievement. Identification of the musculoskeletal factors that exacerbate delays in transitioning from lying to sitting will assist clinicians to provide more proactive assessment, advice and intervention regarding motor skill acquisition for this population. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Surgical Masculinization of the Breast: Clinical Classification and Surgical Procedures.

Science.gov (United States)

Cardenas-Camarena, Lazaro; Dorado, Carlos; Guerrero, Maria Teresa; Nava, Rosa

2017-06-01

Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients. From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin. A specific surgical treatment was assigned according to each group. The surgical treatments included thoracic liposuction, subcutaneous mastectomy, periareolar skin resection in one or two stages, and mastectomy with a nipple areola complex graft. The evaluation was performed 6 months after surgery to determine the degree of satisfaction and presence of complications. Surgery was performed on a total of 68 patients, 45 male and 22 female, with ages ranging from 18 to 49 years, and an average age of 33 years. Liposuction alone was performed on five patients; subcutaneous mastectomy was performed on eight patients; subcutaneous mastectomy combined with liposuction was performed on 27 patients; periareolar skin resection was performed on 11 patients; and mastectomy with NAC free grafts was performed on 16 patients. The surgical procedure satisfied 94% of the patients, with very few complications. All patients who wish to obtain a masculine breast shape should be treated with only one objective regardless patient's gender: to obtain a masculine thorax. We recommend a simple mammary gland classification for determining the best surgical treatment for these patients LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

casual relationship between gross domestic saving and economic

African Journals Online (AJOL)

TOSHIBA

private saving has both direct and indirect effects on economic growth. ... sector have a bigger impact on GDP than gross domestic savings. ... Development economists have been concerned for decades about the crucial role of ..... higher investment and higher economic growth is not supported by East African countries.

Integral equation for inhomogeneous condensed bosons generalizing the Gross-Pitaevskii differential equation

International Nuclear Information System (INIS)

Angilella, G.G.N.; Pucci, R.; March, N.H.

2004-01-01

We give here the derivation of a Gross-Pitaevskii-type equation for inhomogeneous condensed bosons. Instead of the original Gross-Pitaevskii differential equation, we obtain an integral equation that implies less restrictive assumptions than are made in the very recent study of Pieri and Strinati [Phys. Rev. Lett. 91, 030401 (2003)]. In particular, the Thomas-Fermi approximation and the restriction to small spatial variations of the order parameter invoked in their study are avoided

Higher-spin currents in the Gross-Neveu model at 1/n"2

International Nuclear Information System (INIS)

Manashov, A.N.

2016-10-01

We calculate the anomalous dimensions of higher-spin currents, both singlet and non-singlet, in the Gross - Neveu model at the 1/n"2 order. It was conjectured that in the critical regime this model is dual to a higher-spin gauge theory on AdS_4. The AdS/CFT correspondence predicts that the masses of higher-spin fields correspond to the scaling dimensions of the singlet currents in the Gross - Neveu model.

[Surgical assessment of complications after thyroid gland operations].

Science.gov (United States)

Dralle, H

2015-01-01

The extent, magnitude and technical equipment used for thyroid surgery has changed considerably in Germany during the last decade. The number of thyroidectomies due to benign goiter have decreased while the extent of thyroidectomy, nowadays preferentially total thyroidectomy, has increased. Due to an increased awareness of surgical complications the number of malpractice claims is increasing. In contrast to surgical databases the frequency of complications in malpractice claims reflects the individual impact of complications on the quality of life. In contrast to surgical databases unilateral and bilateral vocal fold palsy are therefore at the forefront of malpractice claims. As guidelines are often not applicable for the individual surgical expert review, the question arises which are the relevant criteria for the professional expert witness assessing the severity of the individual complication. While in surgical databases major complications after thyroidectomy, such as vocal fold palsy, hypoparathyroidism, hemorrhage and infections are equally frequent (1-3 %), in malpractice claims vocal fold palsy is significantly more frequent (50 %) compared to hypoparathyroidism (15 %), hemorrhage and infections (about 5 % each). To avoid bilateral nerve palsy intraoperative nerve monitoring has become of utmost importance for surgical strategy and malpractice suits alike. For surgical expert review documentation of individual risk-oriented indications, the surgical approach and postoperative management are highly important. Guidelines only define the treatment corridors of good clinical practice. Surgical expert reviews in malpractice suits concerning quality of care and causality between surgical management, complications and sequelae of complications are therefore highly dependent on the grounds and documentation of risk-oriented indications for thyroidectomy, intraoperative and postoperative surgical management.

Single-incision total laparoscopic hysterectomy

Directory of Open Access Journals (Sweden)

Sinha Rakesh

2011-01-01

Full Text Available Single-incision laparoscopic surgery is an alternative to conventional multiport laparoscopy. Single-access laparoscopy using a transumbilical port affords maximum cosmetic benefits because the surgical incision is hidden in the umbilicus. The advantages of single-access laparoscopic surgery may include less bleeding, infection, and hernia formation and better cosmetic outcome and less pain. The disadvantages and limitations include longer surgery time, difficulty in learning the technique, and the need for specialized instruments. Ongoing refinement of the surgical technique and instrumentation is likely to expand its role in gynecologic surgery in the future. We perform single-incision total laparoscopic hysterectomy using three ports in the single transumbilical incision.

Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis.

Science.gov (United States)

Miller, Larry E; Gondusky, Joseph S; Bhattacharyya, Samir; Kamath, Atul F; Boettner, Friedrich; Wright, John

2018-04-01

The choice between anterior approach (AA) and posterior approach (PA) in primary total hip arthroplasty (THA) is controversial. Previous reviews have predominantly relied on data from retrospective studies. This systematic review included prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA. Outcomes were pain severity, narcotic usage, hip function using Harris Hip Score, and complications. Random effects meta-analysis was performed for all outcomes. Efficacy data were reported as standardized mean difference (SMD) where values of 0.2, 0.5, 0.8, and 1.0 were defined as small, medium, large, and very large effect sizes, respectively. Complications were reported as the absolute risk difference (RD) where a positive value implied higher risk with AA and a lower value implied lower risk with AA. A total of 13 prospective comparative studies (7 randomized) with patients treated with AA (n = 524) or PA (n = 520) were included. The AA was associated with lower pain severity (SMD = -0.37, P SMD = -0.36, P = .002), and improved hip function (SMD = 0.31, P = .002) compared to PA. No differences between surgical approaches were observed for dislocation (RD = 0.2%, P = .87), fracture (RD = 0.2%, P = .87), hematoma (RD = 0%, P = .99), infection (RD = 0.2%, P = .85), thromboembolic event (RD = -0.9%, P = .42), or reoperation (RD = 1.3%, P = .26). Conclusions of this study were unchanged when subjected to sensitivity analyses. In this systematic review and meta-analysis of prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA, patients treated with AA reported less pain, consumed fewer narcotics, and reported better hip function. No statistical differences in complication rates were detected between AA and PA. Ultimately, the choice of surgical approach in primary THA should consider preference and experience of the surgeon as well as preference and anatomy of the patient

Surgical site infections in an abdominal surgical ward at Kosovo Teaching Hospital.

Science.gov (United States)

Raka, Lul; Krasniqi, Avdyl; Hoxha, Faton; Musa, Ruustem; Mulliqi, Gjyle; Krasniqi, Selvete; Kurti, Arsim; Dervishaj, Antigona; Nuhiu, Beqir; Kelmendi, Baton; Limani, Dalip; Tolaj, Ilir

2008-01-01

Abdominal surgical site infections (SSI) cause substantial morbidity and mortality for patients undergoing operative procedures. We determined the incidence of and risk factors for SSI after abdominal surgery in the Department of Abdominal Surgery at the University Clinical Centre of Kosovo (UCCK). Prospective surveillance of patients undergoing abdominal surgery was performed between December 2005 and June 2006. CDC definitions were followed to detect SSI and study forms were based on Europe Link for Infection Control through Surveillance (HELICS) protocol. A total of 253 surgical interventions in 225 patients were evaluated. The median age of patients was 42 years and 55.1% of them were male. The overall incidence rate of SSI was 12%. Follow-up was achieved for 84.1% of the procedures. For patients with an SSI, the median duration of hospitalization was 9 days compared with 4 days for those without an SSI (p 2, use of antibiotic prophylaxis and NNIS class of > 2 were all significant at p < .001. The SSI rates for the NNIS System risk classes 0, 1 and 2-3 were 4.2%, 46.7% and 100%, respectively. SSI caused considerable morbidity among surgical patients in UCCK. Appropriate active surveillance and infection control measures should be introduced during preoperative, intra-operative, and postoperative care to reduce infection rates.

a Gross Error Elimination Method for Point Cloud Data Based on Kd-Tree

Science.gov (United States)

Kang, Q.; Huang, G.; Yang, S.

2018-04-01

Point cloud data has been one type of widely used data sources in the field of remote sensing. Key steps of point cloud data's pro-processing focus on gross error elimination and quality control. Owing to the volume feature of point could data, existed gross error elimination methods need spend massive memory both in space and time. This paper employed a new method which based on Kd-tree algorithm to construct, k-nearest neighbor algorithm to search, settled appropriate threshold to determine with result turns out a judgement that whether target point is or not an outlier. Experimental results show that, our proposed algorithm will help to delete gross error in point cloud data and facilitate to decrease memory consumption, improve efficiency.

A GROSS ERROR ELIMINATION METHOD FOR POINT CLOUD DATA BASED ON KD-TREE

Directory of Open Access Journals (Sweden)

Q. Kang

2018-04-01

Full Text Available Point cloud data has been one type of widely used data sources in the field of remote sensing. Key steps of point cloud data’s pro-processing focus on gross error elimination and quality control. Owing to the volume feature of point could data, existed gross error elimination methods need spend massive memory both in space and time. This paper employed a new method which based on Kd-tree algorithm to construct, k-nearest neighbor algorithm to search, settled appropriate threshold to determine with result turns out a judgement that whether target point is or not an outlier. Experimental results show that, our proposed algorithm will help to delete gross error in point cloud data and facilitate to decrease memory consumption, improve efficiency.

Barn music at St Donat's castle / Philip Gross

Index Scriptorium Estoniae

Gross, Philip, 1952-

2011-01-01

Muusikafestivalist "Vale of Glamorgan", mis oli 2010. a. pühendatud Arvo Pärdile. Eesti kammermuusikaansambli Resonabilis kavas oli ka festivali tellimusel valminud uelsi helilooja Gareth Peredur Churchilli "Vocable", mille teksti kirjutas Philip Gross. Festivalikontsertide muljeid leiab Grossi luuletsüklis "Barn music" (avaldatud samas ajakirjanumbris, lk. 42-43)

Methodology for full comparative assessment of direct gross glycerin combustion in a flame tube furnace

Energy Technology Data Exchange (ETDEWEB)

Maturana, Aymer Yeferson; Pagliuso, Josmar D. [Dept. of Mechanical Engineering. Sao Carlos School of Engineering. University of Sao Paulo, Sao Carlos, SP (Brazil)], e-mails: aymermat@sc.usp.br, josmar@sc.usp.br

2010-07-01

This study is to develop a methodology to identify and evaluate the emissions and heat transfer associated to combustion of gross glycerin a by-product of the Brazilian biodiesel manufacture process as alternative energy source. It aims to increase the present knowledge on the matter and to contribute to the improvement of the economic and environmental perspective of biodiesel industry. This methodology was considered to be used for assessment of gross glycerin combustion from three different types of biodiesel (bovine tallow, palm and soy). The procedures for evaluation and quantification of emissions of sulphur and nitrogen oxides, total hydrocarbons, carbon monoxide, carbon dioxide, and acrolein were analyzed, described and standardized. Experimental techniques for mutagenic and toxic effects assessment of gases similarly were analyzed and standardized, as well as the calorific power, the associate heat transfer and fundamentals operational parameters. The methodology was developed, using a full-instrumented flame tube furnace, continuous gas analyzers, a chromatograph, automatic data acquisition systems and other auxiliary equipment. The mutagenic and toxic effects of the study was based on Tradescantia clone KU-20, using chambers of intoxication and biological analytical techniques previously developed and others were specially adapted. The benchmark for the initial set up was based on the performance evaluation of the previous equipment tested with diesel considering its behavior during direct combustion. Finally, the following factors were defined for the combustion of crude glycerin, configurations of equipment types, operational parameters such as air fuel ratio adiabatic temperature and other necessary aspect for successful application of the methodology. The developed and integrated methodology was made available to the concern industry, environmental authorities and researchers as procedures to access the viability of gross glycerin or similar fuels as

Surgical planning of total hip arthroplasty: accuracy of computer-assisted EndoMap software in predicting component size

International Nuclear Information System (INIS)

Davila, Jesse A.; Kransdorf, Mark J.; Duffy, Gavan P.

2006-01-01

The purpose of our study was to assess the accuracy of a computer-assisted templating in the surgical planning of patients undergoing total hip arthroplasty utilizing EndoMap software (Siemans AG, Medical Solutions, Erlangen, Germany). Endomap Software is an electronic program that uses DICOM images to analyze standard anteroposterior radiographs for determination of optimal prosthesis component size. We retrospectively reviewed the preoperative radiographs of 36 patients undergoing uncomplicated primary total hip arthroplasty, utilizing EndoMap software, Version VA20. DICOM anteroposterior radiographs were analyzed using standard manufacturer supplied electronic templates to determine acetabular and femoral component sizes. No additional clinical information was reviewed. Acetabular and femoral component sizes were assessed by an orthopedic surgeon and two radiologists. Mean and estimated component size was compared with component size as documented in operative reports. The mean estimated acetabular component size was 53 mm (range 48-60 mm), 1 mm larger than the mean implanted size of 52 mm (range 48-62 mm). Thirty-one of 36 acetabular component sizes (86%) were accurate within one size. The mean calculated femoral component size was 4 (range 2-7), 1 size smaller than the actual mean component size of 5 (range 2-9). Twenty-six of 36 femoral component sizes (72%) were accurate within one size, and accurate within two sizes in all but four cases (94%). EndoMap Software predicted femoral component size well, with 72% within one component size of that used, and 94% within two sizes. Acetabular component size was predicted slightly better with 86% within one component size and 94% within two component sizes. (orig.)

Surgical lighting

NARCIS (Netherlands)

Knulst, A.J.

2017-01-01

The surgical light is an important tool for surgeons to create and maintain good visibility on the surgical task. Chapter 1 gives background to the field of (surgical) lighting and related terminology. Although the surgical light has been developed strongly since its introduction a long time ago,

[da Vinci surgical system].

Science.gov (United States)

Watanabe, Gou; Ishikawa, Norihiro

2014-07-01

The da Vinci surgical system was developed by Intuitive Surgical Inc. in the United States as an endoscopic surgical device to assist remote control surgeries. In 1998, the Da Vinci system was first used for cardiothoracic procedures. Currently a combination of robot-assisted internal thoracic artery harvest together with coronary artery bypass grafting (CABG) through a mini-incision (ThoraCAB) or totally endoscopic procedures including anastomoses under robotic assistance (TECAB) are being conducted for the treatment of coronary artery diseases. With the recent advances in catheter interventions, hybrid procedures combining catheter intervention with ThoraCAB or TECAB are anticipated in the future.On the other hand, with the decrease in number of coronary artery bypass surgeries, the share of valvular surgeries is expected to increase in the future. Among them, mitral valvuloplasty for mitral regurgitation is anticipated to be conducted mainly by low-invasive procedures, represented by minimally invasive cardiac surgery( MICS) and robot-assisted surgery. Apart from the intrinsic good surgical view, robotic-assisted systems offer additional advantages of the availability of an amplified view and the easy to observe the mitral valve in the physiological position. Thus, robotic surgical surgeries that make complicated procedures easier are expected to accomplish further developments in the future. Furthermore, while the number of surgeries for atrial septal defects has decreased dramatically following the widespread use of Amplatzer septal occluder, robotic surgery may become a good indication for cases in which the Amplatzer device is not indicated. In Japan, clinical trial of the da Vinci robotic system for heart surgeries has been completed. Statutory approval of the da Vinci system for mitral regurgitation and atrial septal defects is anticipated in the next few years.

Surgical smoke.

Science.gov (United States)

Fan, Joe King-Man; Chan, Fion Siu-Yin; Chu, Kent-Man

2009-10-01

Surgical smoke is the gaseous by-product formed during surgical procedures. Most surgeons, operating theatre staff and administrators are unaware of its potential health risks. Surgical smoke is produced by various surgical instruments including those used in electrocautery, lasers, ultrasonic scalpels, high speed drills, burrs and saws. The potential risks include carbon monoxide toxicity to the patient undergoing a laparoscopic operation, pulmonary fibrosis induced by non-viable particles, and transmission of infectious diseases like human papilloma virus. Cytotoxicity and mutagenicity are other concerns. Minimisation of the production of surgical smoke and modification of any evacuation systems are possible solutions. In general, a surgical mask can provide more than 90% protection to exposure to surgical smoke; however, in most circumstances it cannot provide air-tight protection to the user. An at least N95 grade or equivalent respirator offers the best protection against surgical smoke, but whether such protection is necessary is currently unknown.

Assessing the effects of land-use changes on annual average gross erosion

Directory of Open Access Journals (Sweden)

Armando Brath

2002-01-01

Full Text Available The effects of land-use changes on potential annual gross erosion in the uplands of the Emilia-Romagna administrative region, a broad geographical area of some 22 000 km2 in northern-central Italy, have been analysed by application of the Universal Soil Loss Equation (USLE. The presence of an extended mountain chain, particularly subject to soil erosion, makes the estimation of annual gross erosion relevant in defining regional soil-conservation strategies. The USLE, derived empirically for plots, is usually applied at the basin scale. In the present study, the method is implemented in a distributed framework for the hilly and mountainous portion of Emilia-Romagna through a discretisation of the region into elementary square cells. The annual gross erosion is evaluated by combining morphological, pedological and climatic information. The stream network and the tributary area drained by each elementary cell, which are needed for the local application of the USLE, are derived automatically from a Digital Elevation Model (DEM of grid size 250 x 250 m. The rainfall erosivity factor is evaluated from local estimates of rainfall of six-hour storm duration and two-year return period. The soil erodibility and slope length-steepness factors are derived from digital maps of land use, pedology and geomorphology. Furthermore, historical land-use maps of the district of Bologna (a large portion — 3720 km2 — of the area under study, allow the effect of actual land use changes on the soil erosion process to be assessed. The analysis shows the influence of land-use changes on annual gross erosion as well as the increasing vulnerability of upland areas to soil erosion processes during recent decades. Keywords: USLE, gross erosion, distributed modelling, land use changes, northern-central Italy

Gender preference between traditional and PowerPoint methods of teaching gross anatomy.

Science.gov (United States)

Nuhu, Saleh; Adamu, Lawan Hassan; Buba, Mohammed Alhaji; Garba, Sani Hyedima; Dalori, Babagana Mohammed; Yusuf, Ashiru Hassan

2018-01-01

Teaching and learning process is increasingly metamorphosing from the traditional chalk and talk to the modern dynamism in the information and communication technology. Medical education is no exception to this dynamism more especially in the teaching of gross anatomy, which serves as one of the bases of understanding the human structure. This study was conducted to determine the gender preference of preclinical medical students on the use of traditional (chalk and talk) and PowerPoint presentation in the teaching of gross anatomy. This was cross-sectional and prospective study, which was conducted among preclinical medical students in the University of Maiduguri, Nigeria. Using simple random techniques, a questionnaire was circulated among 280 medical students, where 247 students filled the questionnaire appropriately. The data obtained was analyzed using SPSS version 20 (IBM Corporation, Armonk, NY, USA) to find the method preferred by the students among other things. Majority of the preclinical medical students in the University of Maiduguri preferred PowerPoint method in the teaching of gross anatomy over the conventional methods. The Cronbach alpha value of 0.76 was obtained which is an acceptable level of internal consistency. A statistically significant association was found between gender and preferred method of lecture delivery on the clarity of lecture content where females prefer the conventional method of lecture delivery whereas males prefer the PowerPoint method, On the reproducibility of text and diagram, females prefer PowerPoint method of teaching gross anatomy while males prefer the conventional method of teaching gross anatomy. There are gender preferences with regard to clarity of lecture contents and reproducibility of text and diagram. It was also revealed from this study that majority of the preclinical medical students in the University of Maiduguri prefer PowerPoint presentation over the traditional chalk and talk method in most of the

TERATOGENIC EFFECTS OF SILVER NANOPARTICLES: GROSS ANOMALIES

OpenAIRE

Jyoti Prakash; Rajniti; Deepika; Royana

2015-01-01

BACK GROUND: Prenatal exposure of AgNPs can induces devastative and detrimental effect in the organogenesis period of the developing embryos and foetuses. Organogenesis period is highly condemnatory and persuadable. Any injury to embryo during this period leads to dysmorphogenesis or even death AIM: The present study means to evaluate the gross anomalies on developing f o etus subsequent to silver nanoparticle ingestion during the gestational period. ...

Trained, Generalized, and Collateral Behavior Changes of Preschool Children Receiving Gross-Motor Skills Training.

Science.gov (United States)

Kirby, Kimberly C.; Holborn, Stephen W.

1986-01-01

Three preschool children participated in a behavioral training program to improve their gross-motor skills. Results indicated that the program improved the 10 targeted gross-motor skills and that improvements sometimes generalized to other settings. The program did not produce changes in fine-motor skills or social behaviors. Implications are…

Surgical instruction for general practitioners: how, who and how often?

LENUS (Irish Health Repository)

Collins, Anne M

2010-07-01

Educational programmes, designed to meet the training needs of General Practitioners (GPs) performing minor surgical procedures, have previously been shown to increase their surgical workload. The change in the level of competence following these programmes has not been assessed. The aims of this study were two-fold: to evaluate the vertical mattress suture for construct validity and to assess the impact of plastic surgery training on the surgical skill of GPs. Thirty non-consultant hospital doctors and 27 self-selected GPs were included. Using a modified objective structured assessment of technical skills (OSATS) scoring system, construct validity of the vertical mattress suture was confirmed. The median total OSATS score was 16 points (26.7%) in the novice group (medical registrars), 38.5 points (64.2%) in the intermediate group (surgical SHOs) and 59 points (98.3%) in the expert group (surgical registrars, p<0.001, Kruskal-Wallis test). Objective assessment in the GP group immediately following practical instruction revealed a median overall improvement of 31.7% (19 points) in total OSATS scores (p<0.001, Friedman non-parametric test, F). At six months follow-up all course participants had improved compared to their baseline. A median overall improvement of 13 points (21.7%) was noted (p<0.001, F). However, the majority (80%, n=20) had deteriorated from the standard set immediately after the course with a median overall reduction in total OSATS scores of six points (10%, p=0.001, F). Plastic surgery training is immediately efficacious in improving the technical proficiency of GPs. Through objective assessment of a standardised suture task we demonstrated a low rate of educational decay of 10% over a six-month period.

Gross and Histomorphological Assessment of the Oropharynx and ...

African Journals Online (AJOL)

The study investigated the morphology of the oropharynx and tongue of the guinea fowl using gross anatomical and histological techniques. The results showed that the mouth and pharynx of the guinea fowl lacked a definite line of demarcation, and so formed a common oropharyngeal cavity. The roof of the oropharynx ...

A study of gross morphological and histological syringeal features of ...

African Journals Online (AJOL)

A study of gross morphological and histological syringeal features of true francolins (Galliformes: Francolinus, Scleroptila, Peliperdix and Dendroperdix spp.) and spurfowls ( Pternistis spp.) in a phylogenetic context.

GROSS- GAMMA RAY OBSERVATORY ATTITUDE DYNAMICS SIMULATOR

Science.gov (United States)

Garrick, J.

1994-01-01

The Gamma Ray Observatory (GRO) spacecraft will constitute a major advance in gamma ray astronomy by offering the first opportunity for comprehensive observations in the range of 0.1 to 30,000 megaelectronvolts (MeV). The Gamma Ray Observatory Attitude Dynamics Simulator, GROSS, is designed to simulate this mission. The GRO Dynamics Simulator consists of three separate programs: the Standalone Profile Program; the Simulator Program, which contains the Simulation Control Input/Output (SCIO) Subsystem, the Truth Model (TM) Subsystem, and the Onboard Computer (OBC) Subsystem; and the Postprocessor Program. The Standalone Profile Program models the environment of the spacecraft and generates a profile data set for use by the simulator. This data set contains items such as individual external torques; GRO spacecraft, Tracking and Data Relay Satellite (TDRS), and solar and lunar ephemerides; and star data. The Standalone Profile Program is run before a simulation. The SCIO subsystem is the executive driver for the simulator. It accepts user input, initializes parameters, controls simulation, and generates output data files and simulation status display. The TM subsystem models the spacecraft dynamics, sensors, and actuators. It accepts ephemerides, star data, and environmental torques from the Standalone Profile Program. With these and actuator commands from the OBC subsystem, the TM subsystem propagates the current state of the spacecraft and generates sensor data for use by the OBC and SCIO subsystems. The OBC subsystem uses sensor data from the TM subsystem, a Kalman filter (for attitude determination), and control laws to compute actuator commands to the TM subsystem. The OBC subsystem also provides output data to the SCIO subsystem for output to the analysts. The Postprocessor Program is run after simulation is completed. It generates printer and CRT plots and tabular reports of the simulated data at the direction of the user. GROSS is written in FORTRAN 77 and

A preliminary investigation of the relationship between language and gross motor skills in preschool children.

Science.gov (United States)

Merriman, W J; Barnett, B E

1995-12-01

This study was undertaken to explore the relationship between language skills and gross-motor skills of 28 preschool children from two private preschools in New York City. Pearson product-moment correlation coefficients were calculated for language (revised Preschool Language Scale) and gross motor (Test of Gross Motor Development) scores. Locomotor skills were significantly related to both auditory comprehension and verbal ability while object control scores did not correlate significantly with either language score. These results were discussed in terms of previous research and with reference to dynamical systems theory. Suggestions for research were made.

Gross decontamination experiment report

International Nuclear Information System (INIS)

Mason, R.; Kinney, K.; Dettorre, J.; Gilbert, V.

1983-07-01

A Gross Decontamination Experiment was conducted on various levels and surfaces of the TMI - Unit 2 reactor building in March 1982. The polar crane, D-rings, missile shields, refueling canals, refueling bridges, equipment, and elevations 305' and 347'-6'' were flushed with low pressure water. Additionally, floor surfaces on elevation 305' and floor surfaces and major pieces of equipment on elevation 347'-6'' were sprayed with high pressure water. Selective surfaces were decontaminated with a mechanical scrubber and chemicals. Strippable coating was tested and evaluated on equipment and floor surfaces. The effectiveness, efficiency, and safety of several decontamination techniques were established for the large, complex decontamination effort. Various decontamination equipment was evaluated and its effectiveness was documented. Decontamination training and procedures were documented and evaluated, as were the support system and organization for the experiment

Gross decontamination experiment report

Energy Technology Data Exchange (ETDEWEB)

Mason, R.; Kinney, K.; Dettorre, J.; Gilbert, V.

1983-07-01

A Gross Decontamination Experiment was conducted on various levels and surfaces of the TMI - Unit 2 reactor building in March 1982. The polar crane, D-rings, missile shields, refueling canals, refueling bridges, equipment, and elevations 305' and 347'-6'' were flushed with low pressure water. Additionally, floor surfaces on elevation 305' and floor surfaces and major pieces of equipment on elevation 347'-6'' were sprayed with high pressure water. Selective surfaces were decontaminated with a mechanical scrubber and chemicals. Strippable coating was tested and evaluated on equipment and floor surfaces. The effectiveness, efficiency, and safety of several decontamination techniques were established for the large, complex decontamination effort. Various decontamination equipment was evaluated and its effectiveness was documented. Decontamination training and procedures were documented and evaluated, as were the support system and organization for the experiment.

Open surgical management of pediatric urolithiasis: A developing country perspective

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Syed A Rizvi

2010-01-01

Full Text Available Objectives : To describe decision factors and outcome of open surgical procedures in the management of children with stone. Materials and Methods : Between January 2004 and December 2008, 3969 surgical procedures were performed in 3053 children with stone disease. Procedures employed included minimally invasive techniques shockwave lithotripsy (SWL, percutaneous nephrolithotomy (PCNL, ureterorenoscopy (URS, perurethral cystolithotripsy (PUCL, percutaneous cystolithotripsy (PCCL, and open surgery. From sociomedical records demographics, clinical history, operative procedures, complications, and outcome were recorded for all patients. Results : Of 3969 surgeries, 2794 (70% were minimally invasive surgery (MIS techniques to include SWL 19%, PCNL 16%, URS 18.9%, and PUCL+PCCL 16% and 1175 (30% were open surgeries. The main factors necessitating open surgery were large stone burden 37%, anatomical abnormalities 16%, stones with renal failure 34%, gross hydronephrosis with thin cortex 58%, urinary tract infection (UTI 25%, and failed MIS 18%. Nearly 50% of the surgeries were necessitated by economic constraints and long distance from center where one-time treatment was preferred by the patient. Stone-free rates by open surgeries were pyelolithotomy 91%, ureterolithotomy 100%, and cystolithotomy 100% with complication rate of upto 3%. Conclusions : In developing countries, large stone burden, neglected stones with renal failure, paucity of urological facilities, residence of poor patients away from tertiary centers necessitate open surgical procedures as the therapy of choice in about 1/3rd of the patients. Open surgery provides comparable success rates to MIS although the burden and nature of disease is more complex. The scope of open surgery will remain much wide for a large population for considered time in developing countries.

Gross Motor Development in Children Aged 3-5 Years, United States 2012.

Science.gov (United States)

Kit, Brian K; Akinbami, Lara J; Isfahani, Neda Sarafrazi; Ulrich, Dale A

2017-07-01

Objective Gross motor development in early childhood is important in fostering greater interaction with the environment. The purpose of this study is to describe gross motor skills among US children aged 3-5 years using the Test of Gross Motor Development (TGMD-2). Methods We used 2012 NHANES National Youth Fitness Survey (NNYFS) data, which included TGMD-2 scores obtained according to an established protocol. Outcome measures included locomotor and object control raw and age-standardized scores. Means and standard errors were calculated for demographic and weight status with SUDAAN using sample weights to calculate nationally representative estimates, and survey design variables to account for the complex sampling methods. Results The sample included 339 children aged 3-5 years. As expected, locomotor and object control raw scores increased with age. Overall mean standardized scores for locomotor and object control were similar to the mean value previously determined using a normative sample. Girls had a higher mean locomotor, but not mean object control, standardized score than boys (p  0.05). Conclusions In a nationally representative sample of US children aged 3-5 years, TGMD-2 mean locomotor and object control standardized scores were similar to the established mean. These results suggest that standardized gross motor development among young children generally did not differ by demographic or weight status.

Total Thyroidectomy

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Lopez Moris E

2016-06-01

Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

Current management of surgical oncologic emergencies.

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Marianne R F Bosscher

Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

Current management of surgical oncologic emergencies.

Science.gov (United States)

Bosscher, Marianne R F; van Leeuwen, Barbara L; Hoekstra, Harald J

2015-01-01

For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC). In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed. A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days. In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%. In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

Preoperative management of surgical patients by "shortened fasting time": a study on the amount of total body water by multi-frequency impedance method.

Science.gov (United States)

Taniguchi, Hideki; Sasaki, Toshio; Fujita, Hisae

2012-01-01

Preoperative fasting is an established procedure to be practiced for patients before surgery, but optimal preoperative fasting time still remains controversial. The aim of this study was to investigate the effect of "shortened preoperative fasting time" on the change in the amount of total body water (TBW) in elective surgical patients. TBW was measured by multi-frequency impedance method. The patients, who were scheduled to undergo surgery for stomach cancer, were divided into two groups of 15 patients each. Before surgery, patients in the control group were managed with conventional preoperative fasting time, while patients in the "enhanced recovery after surgery (ERAS)" group were managed with "shortened preoperative fasting time" and "reduced laxative medication." TBW was measured on the day before surgery and the day of surgery before entering the operating room. Defecation times and anesthesia-related vomiting and aspiration were monitored. TBW values on the day of surgery showed changes in both groups as compared with those on the day before surgery, but the rate of change was smaller in the ERAS group than in the control group (2.4±6.8% [12 patients] vs. -10.6±4.6% [14 patients], pfasting time" and "reduced administration of laxatives" is effective in the maintenance of TBW in elective surgical patients.

The Share of Renewable Sources in Gross Final Energy Consumption in Croatia in 2014

International Nuclear Information System (INIS)

Kalea, M.

2016-01-01

Eurostat, the statistical agency of the European Union follows the share of renewable energy in gross final energy consumption for many years. The EU Directive 2009/28/EC on renewable energy sources takes as a key indicator of developments in the use of renewable sources of individual member states precisely this indicator. This directive has set the goals of testimony percentage value of the shares that each member state must be achieved by 2020. These are the objectives for each country-member generally different, depending on the starting achieved share (2005), about the possibilities of individual forms of renewable energy and the wealth of individual member states. The goals are set so that in the European Union as a whole in 2020 it reached the share of renewables by 20 percent. Incidentally, Croatia is the default target is also 20 percent, a marginal tasks are 10 percent (for Malta) and 49 percent (for Sweden). At the same time, the Directive sets all member states equal to the target share of energy from renewable sources in the total energy demand for the needs of road transport by 10 percent by 2020. This short work of explanation is very strictly defined way of determining the share of renewable sources in gross final energy consumption, including the data for Croatia in 2014.(author).

Gross changes in forest area shape the future carbon balance of tropical forests

Directory of Open Access Journals (Sweden)

W. Li

2018-01-01

Full Text Available Bookkeeping models are used to estimate land-use and land-cover change (LULCC carbon fluxes (ELULCC. The uncertainty of bookkeeping models partly arises from data used to define response curves (usually from local data and their representativeness for application to large regions. Here, we compare biomass recovery curves derived from a recent synthesis of secondary forest plots in Latin America by Poorter et al. (2016 with the curves used previously in bookkeeping models from Houghton (1999 and Hansis et al. (2015. We find that the two latter models overestimate the long-term (100 years vegetation carbon density of secondary forest by about 25 %. We also use idealized LULCC scenarios combined with these three different response curves to demonstrate the importance of considering gross forest area changes instead of net forest area changes for estimating regional ELULCC. In the illustrative case of a net gain in forest area composed of a large gross loss and a large gross gain occurring during a single year, the initial gross loss has an important legacy effect on ELULCC so that the system can be a net source of CO2 to the atmosphere long after the initial forest area change. We show the existence of critical values of the ratio of gross area change over net area change (γAnetAgross, above which cumulative ELULCC is a net CO2 source rather than a sink for a given time horizon after the initial perturbation. These theoretical critical ratio values derived from simulations of a bookkeeping model are compared with observations from the 30 m resolution Landsat Thematic Mapper data of gross and net forest area change in the Amazon. This allows us to diagnose areas in which current forest gains with a large land turnover will still result in LULCC carbon emissions in 20, 50 and 100 years.

Gross alpha and beta activities in Tunisian mineral water

International Nuclear Information System (INIS)

Hamrouni Benbelgacem, Samar

2011-01-01

The quality of natural mineral water is a universal health problem seeing its vital importance. This problem is related to the presence of the radionuclides since this water is coming from underground, during their circulation it dissolves and conveys the radionuclides which are present in the earth's crust. This problem which leads to the contamination of the mineral water urged the World Health Organization to set standards and to recommend the respect of the median values of the activities alpha and beta within the framework of the man protection against this internal exhibition. Concerning the radiological quality of Tunisian mineral water studied in this project, we showed, by using the gross alpha and beta activities counting, that this water is specific to human consumption since their gross alpha and beta activities do not forward any risk on health.

Gross Nitrogen Mineralization in Surface Sediments of the Yangtze Estuary

Science.gov (United States)

Liu, Min; Li, Xiaofei; Yin, Guoyu; Zheng, Yanling; Deng, Fengyu

2016-01-01

Nitrogen mineralization is a key biogeochemical process transforming organic nitrogen to inorganic nitrogen in estuarine and coastal sediments. Although sedimentary nitrogen mineralization is an important internal driver for aquatic eutrophication, few studies have investigated sedimentary nitrogen mineralization in these environments. Sediment-slurry incubation experiments combined with 15N isotope dilution technique were conducted to quantify the potential rates of nitrogen mineralization in surface sediments of the Yangtze Estuary. The gross nitrogen mineralization (GNM) rates ranged from 0.02 to 5.13 mg N kg-1 d-1 in surface sediments of the study area. The GNM rates were generally higher in summer than in winter, and the relative high rates were detected mainly at sites near the north branch and frontal edge of this estuary. The spatial and temporal distributions of GNM rates were observed to depend largely on temperature, salinity, sedimentary organic carbon and nitrogen contents, and extracellular enzyme (urease and L-glutaminase) activities. The total mineralized nitrogen in the sediments of the Yangtze Estuary was estimated to be about 6.17 × 105 t N yr-1, and approximately 37% of it was retained in the estuary. Assuming the retained mineralized nitrogen is totally released from the sediments into the water column, which contributed 12–15% of total dissolved inorganic nitrogen (DIN) sources in this study area. This result indicated that the mineralization process is a significant internal nitrogen source for the overlying water of the Yangtze Estuary, and thus may contribute to the estuarine and coastal eutrophication. PMID:26991904

Dislocation of total hip replacement in patients with fractures of the femoral neck.

Science.gov (United States)

Enocson, Anders; Hedbeck, Carl-Johan; Tidermark, Jan; Pettersson, Hans; Ponzer, Sari; Lapidus, Lasse J

2009-04-01

Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors influencing the stability of the total hip replacement, paying special attention to the surgical approach. We included 713 consecutive hips in a series of 698 patients (573 females) who had undergone a primary total hip replacement (n = 311) for a non-pathological, displaced femoral neck fracture (Garden III or IV) or a secondary total hip replacement (n = 402) due to a fracture-healing complication after a femoral neck fracture. We used Cox regression to evaluate factors associated with prosthetic dislocation after the operation. Age, sex, indication for surgery, the surgeon's experience, femoral head size, and surgical approach were tested as independent factors in the model. The overall dislocation rate was 6%. The anterolateral surgical approach was associated with a lower risk of dislocation than the posterolateral approach with or without posterior repair (2%, 12%, and 14%, respectively (p replacement in patients with femoral neck fractures.

Surgical treatment of buried penis.

Science.gov (United States)

Lipszyc, E; Pfister, C; Liard, A; Mitrofanoff, P

1997-10-01

The buried penis is a rare congenital entity, whose treatment is surgical. There are few publications concerning this matter. The authors report on their experience in 10 cases (1990-1995). In this abnormality, the tip of the glans does not project from the pubic or scrotal skin. It is due to: 1) an excessive development of the penile fascia which retracts the penis; 2) insufficient attachment of the penile skin at the base of the penis; 3) often excessive prepubic fat worsens the appearance of the abnormality but does not by itself totally explain it; 4) a tight phimosis is often present. Surgical treatment is necessary because this aspect tends to persist even after puberty. One cannot indeed count on the development at the age of puberty, neither on the diminution of the fat, nor on the simple cure of the phimosis. One must above all ban circumcision which causes the risk of eliminating the skin necessary for reconstruction. The surgical procedure will comprise: 1) a longitudinal dorsal incision extended circumferentially; 2) resection of the thickened fascia penis; 3) anchoring of the deep face of the dermis to the proximal part of the fascia penis at the base of the penis. This surgical procedure has always brought a significant improvement to the appearance of the penis.

Surgical Assisting

Science.gov (United States)

... instruction, including: Microbiology Pathophysiology Pharmacology Anatomy and physiology Medical terminology Curriculum . Course content includes: Advanced surgical anatomy Surgical microbiology Surgical pharmacology Anesthesia methods and agents Bioscience Ethical ...

Paediatric Abdominal Surgical Emergencies in a General Surgical ...

African Journals Online (AJOL)

... organized for general surgeons undertaking paediatric surgical emergencies. More paediatric surgeons should be trained and more paediatric surgical units should established in the country. Key Words: Paediatric Abdominal Surgical Emergencies; Paediatric Surgeons, General Surgeons. Journal of College of Medicine ...

Determination of gross-β and γ-ray activity concentrations of human tooth

Energy Technology Data Exchange (ETDEWEB)

Jeong, Hayun Ja [Dept. of Dental Hygene, Daegu Health College, Daegu (Korea, Republic of); Kang, Hyun Kyung [Dept. of Dental Hygene, Silla University, Daegu (Korea, Republic of); Kim, Sung Hwan [Dept. of Radiological Science, Cheongju University, Cheongju (Korea, Republic of)

2014-12-15

The γ-ray concentration and gross-β activity by age group were measured in the teeth of males and females of the domestic residents. They were divided into 7 age groups from 10s to the age of 70s. The gross-β activity concentration was measured by using the Tennelec XLB measuring instrument filled with P10 gas (argon 90%, methane 10%). The γ-ray was measured through the γ-ray spectroscopic analytical method by using the high purity germanium (HPGe) radiation detector. The range of gross-β activity concentration was measured 0.089 to 0.32 Bq/kg in females and 0.13 to 0.26 Bq/kg in males. From the γ-ray spectroscopic analysis of the teeth, the natural radioactive isotopes of '4{sup 0}K, {sup 208}Tl, {sup 228}Ac and {sup 234}Th were detected and their measured γ-ray activity concentrations were found to be 20.7, 21.9, 3.88 and 5.24 Bq/kg, respectively.

Fine and Gross Motor Ability in Males with ADHD

Directory of Open Access Journals (Sweden)

J Gordon Millichap

2003-09-01

Full Text Available Both fine and gross motor abilities were evaluated in 10-year-old males with attention deficit hyperactivity disorder (ADHD and compared to a group of control children at the School of Psychology, Curtin University of Technology, Perth, Australia.

Total urogenital sinus mobilization for ambiguous genitalia.

Science.gov (United States)

Jesus, Vinicius Menezes; Buriti, Francisco; Lessa, Rodrigo; Toralles, Maria Betânia; Oliveira, Luciana Barros; Barroso, Ubirajara

2018-04-01

Genital ambiguity is a very common phenomenon in disorders of sex development (DSD). According to the Chicago Consensus 2006, feminizing genitoplasty, when indicated, should be performed in the most virilized cases (Prader III to V). Advances in the knowledge of genital anatomy in DSD have enabled the development and improvement of various surgical techniques. Mobilization of the urogenital sinus (MUS), first described by Peña, has become incorporated by most surgeons. However, the proximity of the urethral sphincter prompts concern over urinary incontinence, especially for full mobilization of the urogenital sinus. To retrospectively evaluate the short-term surgical results of feminizing genitoplasty with total mobilization of the urogenital sinus in patients with DSD. Review of medical records of all patients undergoing feminizing genitoplasty with mobilization of the urogenital sinus. We evaluated the rates of complications from surgery and of urinary incontinence, as well as cosmetic results, according to the opinion of the surgeon and the family. A total of 8 patients were included in the study. The mean age at surgery was 51months. Congenital adrenal hyperplasia (CAH) was diagnosed in six patients, and gonadal dysgenesis in the other two. The vagina was separated from the urethra, with suitable distance in all cases. No patient had urinary incontinence after surgery. The mean follow-up of patients was. 20months (3-56months). In all cases, surgeons recorded being satisfied with the aesthetic result of post-surgical genitalia. The family was recorded as satisfied with the aesthetic result of the genitalia after surgery. In every case, there was no need for a second surgical procedure. The total mobilization of the urogenital sinus is a feasible and safe technique. The technique permits good cosmetic results, and urinary incontinence is absent. Therapeutic study. Level III. Copyright © 2017 Elsevier Inc. All rights reserved.

Surgical interventions for meniscal tears: a closer look at the evidence.

Science.gov (United States)

Mutsaerts, Eduard L A R; van Eck, Carola F; van de Graaf, Victor A; Doornberg, Job N; van den Bekerom, Michel P J

2016-03-01

The aim of the present study was to compare the outcomes of various surgical treatments for meniscal injuries including (1) total and partial meniscectomy; (2) meniscectomy and meniscal repair; (3) meniscectomy and meniscal transplantation; (4) open and arthroscopic meniscectomy and (5) various different repair techniques. The Bone, Joint and Muscle Trauma Group Register, Cochrane Database, MEDLINE, EMBASE and CINAHL were searched for all (quasi) randomized controlled clinical trials comparing various surgical techniques for meniscal injuries. Primary outcomes of interest included patient-reported outcomes scores, return to pre-injury activity level, level of sports participation and persistence of pain using the visual analogue score. Where possible, data were pooled and a meta-analysis was performed. A total of nine studies were included, involving a combined 904 subjects, 330 patients underwent a meniscal repair, 402 meniscectomy and 160 a collagen meniscal implant. The only surgical treatments that were compared in homogeneous fashion across more than one study were the arrow and inside-out technique, which showed no difference for re-tear or complication rate. Strong evidence-based recommendations regarding the other surgical treatments that were compared could not be made. This meta-analysis illustrates the lack of level I evidence to guide the surgical management of meniscal tears. Level I meta-analysis.

Surgical Safety Training of World Health Organization Initiatives.

Science.gov (United States)

Davis, Christopher R; Bates, Anthony S; Toll, Edward C; Cole, Matthew; Smith, Frank C T; Stark, Michael

2014-01-01

Undergraduate training in surgical safety is essential to maximize patient safety. This national review quantified undergraduate surgical safety training. Training of 2 international safety initiatives was quantified: (1) World Health Organization (WHO) "Guidelines for Safe Surgery" and (2) Department of Health (DoH) "Principles of the Productive Operating Theatre." Also, 13 additional safety skills were quantified. Data were analyzed using Mann-Whitney U tests. In all, 23 universities entered the study (71.9% response). Safety skills from WHO and DoH documents were formally taught in 4 UK medical schools (17.4%). Individual components of the documents were taught more frequently (47.6%). Half (50.9%) of the additional safety skills identified were taught. Surgical societies supplemented safety training, although the total amount of training provided was less than that in university curricula (P < .0001). Surgical safety training is inadequate in UK medical schools. To protect patients and maximize safety, a national undergraduate safety curriculum is recommended. © 2013 by the American College of Medical Quality.

Assessing Gross Motor Skills of Kosovar Preschool Children

Science.gov (United States)

Shala, Merita

2009-01-01

In the light of the new developments in preschool education in Kosovo, this study attempts to carry out an assessment of the development of gross motor skills of preschool children attending institutional education. The emphasis is on creating a set of tests to measure the motor attainments of these children by conducting assessments of the…

De Gross Motor Function Measure (GMFM): een onderzoek naar de betrouwbaarheid van de Nederlandse vertaling.

NARCIS (Netherlands)

Veenhof, C.; Ketelaar, M.; Petegem-van Beek, E. van

2003-01-01

This article is about the psychometric characteristics of the Dutch translation of the Gross Motor Function Measure (GMFM). It describes the reliability of the instrument. The article "Gross Motor Function Measure" (GMFM): a validity study of the Dutch translation focusses on the responsiveness of

De Gross Motor Function Measure (GMFM): een onderzoek naar de responsiviteit van de Nederlandse vertaling.

NARCIS (Netherlands)

Veenhof, C.; Ketelaar, M.; Petegem-van Beek, E. van; Vermeer, A.

2003-01-01

This article is about the psychometric characteristics of the Dutch translation of the Gross Motor Function Measure (GMFM). It describes the responsiveness to change. The article "Gross Motor Function Measure (GMFM): a reliability study of the Dutch translation" focuses on the reliability of the

The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia.

Science.gov (United States)

Dydykin, Sergey; Kapitonova, Marina

2015-01-01

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia. © 2015 American Association of Anatomists.

Surgical treatment of secondary hyperparathyroidism in elderly patients: an institutional experience.

Science.gov (United States)

Polistena, Andrea; Sanguinetti, Alessandro; Lucchini, Roberta; Galasse, Segio; Avenia, Stefano; Monacelli, Massimo; Johnson, Louis Banka; Jeppsson, Bengt; Avenia, Nicola

2017-02-01

Secondary hyperparathyroidism in elderly fragile patients presents clinical difficulties due to severity of symptoms and related comorbidity. The optimal surgical approach for this group of patients is still debated. The aim of the study was to define the optimal technique of parathyroidectomy in elderly patients with secondary hyperparathyroidism. Retrospective analysis in a series of 253 patients including 35 elderly individuals at a single institution was carried out. Postoperative parathyroid hormone decrease, surgical complications and symptoms control were analyzed for all patients in relation to the types of parathyroidectomy performed. In elderly patients, total parathyroidectomy was the most used approach. Subtotal parathyroidectomy was mostly reserved for younger patients suitable for kidney transplantation. No elderly patients treated with total parathyroidectomy were autotransplanted. No significant difference in surgical complications was observed between younger and elderly patients and considering the different procedures. Adequate symptom control after surgery was achieved in almost 90% of patients. A limited rate of recurrence requiring repeat surgery was observed only after subtotal parathyroidectomy. Considering the features of all types of parathyroidectomy, very low recurrence rate, contained postoperative hypocalcemia and limited complications following total parathyroidectomy, might represent specific advantages for elderly patients. Total parathyroidectomy without parathyroid transplantation is safe for elderly patients with secondary hyperparathyroidism and a good alternative to the well-established total parathyroidectomy with autografting.

Cadaver-specific CT scans visualized at the dissection table combined with virtual dissection tables improve learning performance in general gross anatomy.

Science.gov (United States)

Paech, Daniel; Giesel, Frederik L; Unterhinninghofen, Roland; Schlemmer, Heinz-Peter; Kuner, Thomas; Doll, Sara

2017-05-01

The purpose of this study was to quantify the benefit of the incorporation of radiologic anatomy (RA), in terms of student training in RA seminars, cadaver CT scans and life-size virtual dissection tables on the learning success in general anatomy. Three groups of a total of 238 students were compared in a multiple choice general anatomy exam during first-year gross anatomy: (1) a group (year 2015, n 1  = 50) that received training in radiologic image interpretation (RA seminar) and additional access to cadaver CT scans (CT + seminar group); (2) a group (2011, n 2  = 90) that was trained in the RA seminar only (RA seminar group); (3) a group (2011, n 3  = 98) without any radiologic image interpretation training (conventional anatomy group). Furthermore, the students' perception of the new curriculum was assessed qualitatively through a survey. The average test score of the CT + seminar group (21.8 ± 5.0) was significantly higher when compared to both the RA seminar group (18.3 ± 5.0) and the conventional anatomy group (17.1 ± 4.7) (p cadaver CT scans and life-size virtual dissection tables significantly improved the performance of medical students in general gross anatomy. Medical imaging and virtual dissection should therefore be considered to be part of the standard curriculum of gross anatomy. • Students provided with cadaver CT scans achieved 27 % higher scores in anatomy. • Radiological education integrated into gross anatomy is highly appreciated by medical students. • Simultaneous physical and virtual dissection provide unique conditions to study anatomy.

Gross motor function in children with spastic Cerebral Palsy and Cerebral Visual Impairment : A comparison between outcomes of the original and the Cerebral Visual Impairment adapted Gross Motor Function Measure-88 (GMFM-88-CVI)

NARCIS (Netherlands)

Salavati, M.; Rameckers, E. A. A.; Waninge, A.; Krijnen, W. P.; Steenbergen, B.; van der Schans, C. P.

Purpose: To investigate whether the adapted version of the Gross Motor Function Measure 88 (GMFM-88) for children with Cerebral Palsy (CP) and Cerebral Visual Impairment (CVI) results in higher scores. This is most likely to be a reflection of their gross motor function, however it may be the result

Tomato juices and tomato juice concentrates : a study of factors contributing to their gross viscosity

NARCIS (Netherlands)

Heutink, R.

1986-01-01

The gross viscosity of tomato juice and tomato juice concentrates was found to be determined primarily by the water insoluble solids (WIS) content. The serum viscosity did not contribute to gross viscosity. The WIS consisted of whole tomato cells, vascular bundles and skin fragments. In general the

Source of gross-alpha radioactivity anomalies in recharge wells, central Florida phosphate district. Final report

International Nuclear Information System (INIS)

Oural, C.R.; Brooker, H.R.; Upchurch, S.B.

1986-01-01

The central Florida phosphate industry utilizes recharge wells to mitigate withdrawals of water from the Florida aquifer and to dewater the surficial aquifer prior to mining. From a water-management point of view, these wells are efficient and serve a vital function. Recent monitoring of the radiation environment in these wells, however, casts doubts on the safety of the wells. While most of the wells conform to state and federal standards for radium, gross-alpha radiation frequently exceeds standards. The purpose of the study was to determine the radionuclide(s) responsible for the high gross-alpha radiation and to identify a method for sampling of the recharge wells that would standardize data across the phosphate district. It was found that excess gross alpha is primarily due to polonium-210. Since gross alpha and polonium-210 measurements are quite sensitive to methods of sample collections, preservation and analyses, standard procedures for sample processing are presented in the report

MODELING AND FORECASTING THE GROSS ENROLLMENT RATIO IN ROMANIAN PRIMARY SCHOOL

Directory of Open Access Journals (Sweden)

MARINOIU CRISTIAN

2014-06-01

Full Text Available The gross enrollment ratio in primary school is one of the basic indicators used in order to evaluate the proposed objectives of the educational system. Knowing its evolution allows a more rigorous substantiation of the strategies and of the human resources politics not only from the educational field but also from the economic one. In this paper we propose an econometric model in order to describe the gross enrollment ratio in Romanian primary school and we achieve its prediction for the next years, having as a guide the Box-Jenkins’s methodology. The obtained results indicate the continuous decrease of this rate for the next years.

Verbal priming and taste sensitivity make moral transgressions gross.

Science.gov (United States)

Herz, Rachel S

2014-02-01

The aims of the present study were to assess whether: (a) visceral and moral disgust share a common oral origin (taste); (b) moral transgressions that are also viscerally involving are evaluated accordingly as a function of individual differences in taste sensitivity; (c) verbal priming interacts with taste sensitivity to alter how disgust is experienced in moral transgressions; and (d) whether gender moderates these effects. Standard tests of disgust sensitivity, a questionnaire developed for this research assessing different types of moral transgressions (nonvisceral, implied-visceral, visceral) with the terms "angry" and "grossed-out," and a taste sensitivity test of 6-n-propylthiouracil (PROP) were administered to 102 participants. Results confirmed past findings that the more sensitive to PROP a participant was the more disgusted they were by visceral, but not moral, disgust elicitors. Importantly, the findings newly revealed that taste sensitivity had no bearing on evaluations of moral transgressions, regardless of their visceral nature, when "angry" was the emotion primed. However, when "grossed-out" was primed for evaluating moral violations, the more intense PROP tasted to a participant the more "grossed-out" they were by all transgressions. Women were generally more disgust sensitive and morally condemning than men, but disgust test, transgression type, and priming scale modulated these effects. The present findings support the proposition that moral and visceral disgust do not share a common oral origin, but show that linguistic priming can transform a moral transgression into a viscerally repulsive event and that susceptibility to this priming varies as a function of an individual's sensitivity to the origins of visceral disgust-bitter taste.

Pregnancy and Motherhood During Surgical Training.

Science.gov (United States)

Rangel, Erika L; Smink, Douglas S; Castillo-Angeles, Manuel; Kwakye, Gifty; Changala, Marguerite; Haider, Adil H; Doherty, Gerard M

2018-03-21

Although family priorities influence specialty selection and resident attrition, few studies describe resident perspectives on pregnancy during surgical training. To directly assess the resident experience of childbearing during training. A self-administered 74-question survey was electronically distributed in January 2017 to members of the Association of Women Surgeons, to members of the Association of Program Directors in Surgery listserv, and through targeted social media platforms. Surgeons who had 1 or more pregnancies during an Accreditation Council for Graduate Medical Education-accredited US general surgery residency program and completed training in 2007 or later were included. Important themes were identified using focus groups of surgeons who had undergone pregnancy during training in the past 7 years. Additional topics were identified through MEDLINE searches performed from January 2000 to July 2016 combining the keywords pregnancy, resident, attrition, and parenting in any specialty. Descriptive data on perceptions of work schedule during pregnancy, maternity leave policies, lactation and childcare support, and career satisfaction after childbirth. This study included 347 female surgeons (mean [SD] age, 30.5 [2.7] years) with 452 pregnancies. A total of 297 women (85.6%) worked an unmodified schedule until birth, and 220 (63.6%) were concerned that their work schedule adversely affected their health or the health of their unborn child. Residency program maternity leave policies were reported by 121 participants (34.9%). A total of 251 women (78.4%) received maternity leave of 6 weeks or less, and 250 (72.0%) perceived the duration of leave to be inadequate. The American Board of Surgery leave policy was cited as a major barrier to the desired length of leave by 268 of 326 respondents (82.2%). Breastfeeding was important to 329 (95.6%), but 200 (58.1%) stopped earlier than they wished because of poor access to lactation facilities and challenges leaving

Surgical management of gynecomastia--a 10-year analysis.

Science.gov (United States)

Handschin, A E; Bietry, D; Hüsler, R; Banic, A; Constantinescu, M

2008-01-01

Gynecomastia is defined as the benign enlargement of the male breast. Most studies on surgical treatment of gynecomastia show only small series and lack histopathology results. The aim of this study was to analyze the surgical approach in the treatment of gynecomastia and the related outcome over a 10-year period. All patients undergoing surgical gynecomastia corrections in our department between 1996 and 2006 were included for retrospective evaluation. The data were analyzed for etiology, stage of gynecomastia, surgical technique, complications, risk factors, and histological results. A total of 100 patients with 160 operations were included. Techniques included subcutaneous mastectomy alone or with additional hand-assisted liposuction, isolated liposuction, and formal breast reduction. Atypical histological findings were found in 3% of the patients (spindle-cell hemangioendothelioma, papilloma). The surgical revision rate among all patients was 7%. Body mass index and a weight of the resected specimen higher than 40 g were identified as significant risk factors for complications (p gynecomastia requires an individualized approach. Caution must be taken in performing large resections, which are associated with increased complication rates. Histological tissue analysis should be routinely performed in all true gynecomastia corrections, because histological results may reveal atypical cellular pathology.

Variational solution of the Gross-Neveu model; 2, finite-N and renormalization

CERN Document Server

Arvanitis, C; Iacomi, M; Kneur, J L; Neveu, A

1995-01-01

We show how to perform systematically improvable variational calculations in the O(2N) Gross-Neveu model for generic N, in such a way that all infinities usually plaguing such calculations are accounted for in a way compatible with the renormalization group. The final point is a general framework for the calculation of non-perturbative quantities like condensates, masses, etc..., in an asymptotically free field theory. For the Gross-Neveu model, the numerical results obtained from a "two-loop" variational calculation are in very good agreement with exact quantities down to low values of N.

Interlimb Coordination: An Important Facet of Gross-Motor Ability

Science.gov (United States)

Bobbio, Tatiana; Gabbard, Carl; Cacola, Priscila

2009-01-01

Motor development attains landmark significance during early childhood. Although early childhood educators may be familiar with the gross-motor skill category, the subcategory of interlimb coordination needs greater attention than it typically receives from teachers of young children. Interlimb coordination primarily involves movements requiring…

Intracorporeal esophagojejunostomy after totally laparoscopic total gastrectomy: A single-center 7-year experience

Science.gov (United States)

Chen, Ke; Pan, Yu; Cai, Jia-Qin; Xu, Xiao-Wu; Wu, Di; Yan, Jia-Fei; Chen, Rong-Gao; He, Yang; Mou, Yi-Ping

2016-01-01

AIM: To assess the efficacy and safety of intracorporeal esophagojejunostomy in patients undergoing laparoscopic total gastrectomy (LTG) for gastric cancer. METHODS: A retrospective review of 81 consecutive patients who underwent LTG with the same surgical team between November 2007 and July 2014 was performed. Four types of intracorporeal esophagojejunostomy using staplers or hand-sewn suturing were performed after LTG. Data on clinicopatholgoical characteristics, occurrence of complications, postoperative recovery, anastomotic time, and operation time among the surgical groups were obtained through medical records. RESULTS: The average operation time was 288.7 min, the average anastomotic time was 54.3 min, and the average estimated blood loss was 82.7 mL. There were no cases of conversion to open surgery. The first flatus was observed around 3.7 d, while the liquid diet was started, on average, from 4.9 d. The average postoperative hospital stay was 10.1 d. Postoperative complications occurred in 14 patients, nearly 17.3%. However, there were no cases of postoperative death. CONCLUSION: LTG performed with intracorporeal esophagojejunostomy using laparoscopic staplers or hand-sewn suturing is feasible and safe. The surgical results were acceptable from the perspective of minimal invasiveness. PMID:27022225

Gross anatomy of network security

Science.gov (United States)

Siu, Thomas J.

2002-01-01

Information security involves many branches of effort, including information assurance, host level security, physical security, and network security. Computer network security methods and implementations are given a top-down description to permit a medically focused audience to anchor this information to their daily practice. The depth of detail of network functionality and security measures, like that of the study of human anatomy, can be highly involved. Presented at the level of major gross anatomical systems, this paper will focus on network backbone implementation and perimeter defenses, then diagnostic tools, and finally the user practices (the human element). Physical security measures, though significant, have been defined as beyond the scope of this presentation.

Fortran programs for the time-dependent Gross-Pitaevskii equation in a fully anisotropic trap

Science.gov (United States)

Muruganandam, P.; Adhikari, S. K.

2009-10-01

Here we develop simple numerical algorithms for both stationary and non-stationary solutions of the time-dependent Gross-Pitaevskii (GP) equation describing the properties of Bose-Einstein condensates at ultra low temperatures. In particular, we consider algorithms involving real- and imaginary-time propagation based on a split-step Crank-Nicolson method. In a one-space-variable form of the GP equation we consider the one-dimensional, two-dimensional circularly-symmetric, and the three-dimensional spherically-symmetric harmonic-oscillator traps. In the two-space-variable form we consider the GP equation in two-dimensional anisotropic and three-dimensional axially-symmetric traps. The fully-anisotropic three-dimensional GP equation is also considered. Numerical results for the chemical potential and root-mean-square size of stationary states are reported using imaginary-time propagation programs for all the cases and compared with previously obtained results. Also presented are numerical results of non-stationary oscillation for different trap symmetries using real-time propagation programs. A set of convenient working codes developed in Fortran 77 are also provided for all these cases (twelve programs in all). In the case of two or three space variables, Fortran 90/95 versions provide some simplification over the Fortran 77 programs, and these programs are also included (six programs in all). Program summaryProgram title: (i) imagetime1d, (ii) imagetime2d, (iii) imagetime3d, (iv) imagetimecir, (v) imagetimesph, (vi) imagetimeaxial, (vii) realtime1d, (viii) realtime2d, (ix) realtime3d, (x) realtimecir, (xi) realtimesph, (xii) realtimeaxial Catalogue identifier: AEDU_v1_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/AEDU_v1_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data

Gross motor skill performance in children with and without visual impairments--research to practice.

Science.gov (United States)

Wagner, Matthias O; Haibach, Pamela S; Lieberman, Lauren J

2013-10-01

The aim of this study was to provide an empirical basis for teaching gross motor skills in children with visual impairments. For this purpose, gross motor skill performance of 23, 6-12 year old, boys and girls who are blind (ICD-10 H54.0) and 28 sighted controls with comparable age and gender characteristics was compared on six locomotor and six object control tasks using the Test of Gross Motor Development-Second Edition. Results indicate that children who are blind perform significantly (pskills, whereby running, leaping, kicking and catching are the most affected skills, and corresponding differences are related to most running, leaping, kicking and catching component. Practical implications are provided. Copyright © 2013 Elsevier Ltd. All rights reserved.

Approaching time is important for assessment of endoscopic surgical skills.

Science.gov (United States)

Tokunaga, Masakazu; Egi, Hiroyuki; Hattori, Minoru; Yoshimitsu, Masanori; Sumitani, Daisuke; Kawahara, Tomohiro; Okajima, Masazumi; Ohdan, Hideki

2012-05-01

This study aimed to verify whether the approaching time (the time taken to reach the target point from another point, a short distance apart, during point-to-point movement in endoscopic surgery), assessed using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), could distinguish the skill level of surgeons. Expert surgeons (who had performed more than 50 endoscopic surgeries) and novice surgeons (who had no experience in performing endoscopic surgery) were tested using the HUESAD. The approaching time, total time, and intermediate time (total time--approaching time) were measured and analyzed using the trajectory of the tip of the instrument. The approaching time and total time were significantly shorter in the expert group than in the novice group (p time did not significantly differ between the groups (p > 0.05). The approaching time, which is a component of the total time, is very mportant in the measurement of the total time to assess endoscopic surgical skills. Further, the approaching time was useful for skill assessment by the HUESAD for evaluating the skill of surgeons performing endoscopic surgery.

Gynecomastia Classification for Surgical Management: A Systematic Review and Novel Classification System.

Science.gov (United States)

Waltho, Daniel; Hatchell, Alexandra; Thoma, Achilleas

2017-03-01

Gynecomastia is a common deformity of the male breast, where certain cases warrant surgical management. There are several surgical options, which vary depending on the breast characteristics. To guide surgical management, several classification systems for gynecomastia have been proposed. A systematic review was performed to (1) identify all classification systems for the surgical management of gynecomastia, and (2) determine the adequacy of these classification systems to appropriately categorize the condition for surgical decision-making. The search yielded 1012 articles, and 11 articles were included in the review. Eleven classification systems in total were ascertained, and a total of 10 unique features were identified: (1) breast size, (2) skin redundancy, (3) breast ptosis, (4) tissue predominance, (5) upper abdominal laxity, (6) breast tuberosity, (7) nipple malposition, (8) chest shape, (9) absence of sternal notch, and (10) breast skin elasticity. On average, classification systems included two or three of these features. Breast size and ptosis were the most commonly included features. Based on their review of the current classification systems, the authors believe the ideal classification system should be universal and cater to all causes of gynecomastia; be surgically useful and easy to use; and should include a comprehensive set of clinically appropriate patient-related features, such as breast size, breast ptosis, tissue predominance, and skin redundancy. None of the current classification systems appears to fulfill these criteria.

[Pre- and post-surgical orthodontic treatment for skeletal open bite].

Science.gov (United States)

Zhou, Y; Hu, W; Sun, Y

2001-05-01

To Study the principles and rules of pre- and post-surgical orthodontic treatment for skeletal open bite patients. Thirty-two surgically treated open bite cases were analyzed, of which 9 were males, and 23 were females, aged from 16 to 38. Open bite was from 1 to 8.5 mm, average was 4 mm. 31 patients were Class III malocclusion, while 1 patient was Class II malocclusion. 1. Totally 21 patients were treated with orthodontics before and after orthognathic surgery, while 8 patients had pre-surgical orthodontics only, and other 3 had post-surgical orthodontics only. The duration for pre-surgical orthodontics was from 4 to 33 months, average was 12 months. The duration for post-surgical orthodontics was from 3 to 17 months, average was 8.5 months. 2. Presurgical orthodontic treatment included: Alignment of arches, decompensation of incisors, avoiding extrusion of incisors, and slight expansion of arches for coordination of arches. 3. Post-surgical orthodontic treatment included: Closure of residual spaces in the arches, realignment of arches, vertical elastics and Class II or III intermaxillary elastics. Skeletal open bites require combined orthodontic-orthognathic surgery for optimal and esthetical pleasing results.

Danish survey of acetabular component positioning practice during primary total hip arthroplasty

DEFF Research Database (Denmark)

Cotong, Dana; Troelsen, Anders; Husted, Henrik

2017-01-01

questions on optimal component positioning, surgical practice patterns in primary THA, indications and surgical techniques used in revision THA. RESULTS: A total of 42 questionnaires were collected, two were excluded, leaving 40 for analyses. 97% of the surgeons reported an optimum cup anteversion within...

Quantifying surgical access in eyebrow craniotomy with and without orbital bar removal: cadaver and surgical phantom studies.

Science.gov (United States)

Zador, Zsolt; Coope, David J; Gnanalingham, Kanna; Lawton, Michael T

2014-04-01

Eyebrow craniotomy is a recently described minimally invasive approach for tackling primarily pathology of the anterior skull base. The removal of the orbital bar may further expand the surgical corridor of this exposure, but the extent of benefit is poorly quantified. We assessed the effect of orbital bar removal with regards to surgical access in the eyebrow craniotomy using classic morphometric measurements in cadaver heads. Using surgical phantoms and neuronavigation, we also measured the 'working volume', a new parameter for characterising the volume of surgical access in these approaches. Silicon injected cadaver heads (n = 5) were used for morphometric analysis of the eyebrow craniotomy with and without orbital bar removal. Working depths and 'working areas' of surgical access were measured as defined by key anatomical landmarks. The eyebrow craniotomy with or without orbital bar removal was also simulated using surgical phantoms (n = 3, 90-120 points per trial), calibrated against a frameless neuronavigation system. Working volume was derived from reference coordinates recorded along the anatomical borders of the eyebrow craniotomy using the "α-shape algorithm" in R statistics. In cadaver heads, eyebrow craniotomy with removal of the orbital bar reduced the working depth to the ipsilateral anterior clinoid process (42 ± 2 versus 33 ± 3 mm; p < 0.05), but the working areas as defined by deep neurovascular and bony landmarks was statistically unchanged (total working areas of 418 ± 80 cm(2) versus 334 ± 48 cm(2); p = 0.4). In surgical phantom studies, however, working-volume for the simulated eyebrow craniotomies was increased with orbital bar removal (16 ± 1 cm(3) versus 21 ± 1 cm(3); p < 0.01). In laboratory studies, orbital bar removal in eyebrow craniotomy provides a modest reduction in working depth and increase in the working volume. But this must be weighed up against the added morbidity of the

Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

Science.gov (United States)

Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

2015-08-01

Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per

The tropical diabetic hand syndrome: a surgical perspective.

Science.gov (United States)

Nthumba, Peter; Cavadas, Pedro C; Landin, Luis

2013-01-01

Tropical diabetic hand syndrome (TDHS) is an aggressive type of hand sepsis that results in significant morbidity and mortality among patients with diabetes in the tropics. This study set out to establish a protocol for the holistic management of TDHS to improve digit/hand salvage and function at AIC Kijabe Hospital. This prospective study examined the following demographics of patients presenting to the authors institution between October 2009 and September 2010 with TDHS: their sex, age, comorbidities, length of in-hospital stay, surgical and medical treatment, total cost of treatment, and immediate postdischarge outcomes. A total of 10 patients (3 men and 7 women) were presented with TDHS during the study period. Surgical procedures included a thorough debridement of the hand at initial presentation, followed by procedures aimed at preserving length and hand function, with digit or hand amputation when there was no possibility of salvage. Three hands were salvaged, without the need for an amputation; 2 of these, however, developed severe stiffness with resultant poor function. Fifty percent of the patients developed considerable disability; 3 of these patients had disabilities of the arm, shoulder, and hand, (DASH) scores of >90 at 6 months after treatment. TDHS appears to be more aggressive in some patients than in others; a multidisciplinary approach, with early involvement of the surgical team, and a radical surgical debridement are essential to improved outcomes. Although the goal of medical treatment (ie, glycemic control) is simple and easily achieved, surgical goals (salvage of limb or life, preservation of hand function) are more complex, costly, and difficult to achieve. Educating health care workers, diabetic patients, and their relatives on hand care is an important preventive measure. Diligence in taking antidiabetic medicine, early presentation, and appropriate care of TDHS are required for meaningful improvement in outcomes of patients with

The central role of trunk control in the gross motor function of children with cerebral palsy

DEFF Research Database (Denmark)

Curtis, Derek John; Butler, Penny; Saavedra, Sandy

2015-01-01

. The participants were tested using the Gross Motor Function Measure (GMFM), the Pediatric Evaluation of Disability Inventory (PEDI), and the Segmental Assessment of Trunk Control (SATCo). Results Linear regression analysis showed a positive relationship between the segmental level of trunk control and age......, with both gross motor function and mobility. Segmental trunk control measured using the SATCo could explain between 38% and 40% of variation in GMFM and between 32% and 37% of variation in PEDI. Interpretation This study suggests a strong association between segmental trunk postural control and gross motor...

A Closer Look at Revealed Comparative Advantage: Gross-versus Value Added Trade Flows

OpenAIRE

Brakman, Steven; van Marrewijk, Charles

2015-01-01

With the availability of international value added trade data it has become evident that gross export data and value added data do not provide the same information. Although gross exports crosses national borders and is the target of trade policy, value added data tell us what fragment in the production chain is internationally competitive in a particular country. With respect to comparative advantage the differences between the two types of data are often illustrated by means of examples usi...

Higher-spin currents in the Gross-Neveu model at 1/n{sup 2}

Energy Technology Data Exchange (ETDEWEB)

Manashov, A.N. [Institut für Theoretische Physik, Universität Hamburg,Hamburg, D-22761 (Germany); Institut für Theoretische Physik, Universität Regensburg,Regensburg, D-93040 (Germany); Skvortsov, E.D. [Arnold Sommerfeld Center for Theoretical Physics, Ludwig-Maximilians University Munich, Theresienstr. 37, Munich, D-80333 (Germany); Lebedev Institute of Physics,Leninsky ave. 53, Moscow, 119991 (Russian Federation)

2017-01-30

We calculate the anomalous dimensions of higher-spin currents, both singlet and non-singlet, in the Gross-Neveu model at the 1/n{sup 2} order. It was conjectured that in the critical regime this model is dual to a higher-spin gauge theory on AdS{sub 4}. The AdS/CFT correspondence predicts that the masses of higher-spin fields correspond to the scaling dimensions of the singlet currents in the Gross-Neveu model.

Gross morphometric study on the reproductive system of Japanese ...

African Journals Online (AJOL)

Quail farming is emerging in commercial poultry farming to provide alternatives to domestic chicken production and also strengthen the poultry production demands for animal protein. This study was conducted to determine the gross morphometry of the ovary and oviduct of inapparently healthy adult laying Japanese quail ...

Monopol suretab kohaliku loomakasvataja / Oleg Gross ; interv . Illar Mõttus

Index Scriptorium Estoniae

Gross, Oleg, 1952-

2005-01-01

Väike-Maarja jäätmetehase monopoolse seisundi vastu sõna võtnud OG Elektra omanik Oleg Gross on kindel, et jäätmetehasega suretatakse kohalikud väiksemad lihatootjad välja. Kommenteerivad talupidaja Jüri Järvet ja Rakvere Lihakombinaadi direktor Olle Horm

Surgical Instrument Sets for Special Operations Expeditionary Surgical Teams.

Science.gov (United States)

Hale, Diane F; Sexton, Justin C; Benavides, Linda C; Benavides, Jerry M; Lundy, Jonathan B

The deployment of surgical assets has been driven by mission demands throughout years of military operations in Iraq and Afghanistan. The transition to the highly expeditious Golden Hour Offset Surgical Transport Team (GHOST- T) now offers highly mobile surgical assets in nontraditional operating rooms; the content of the surgical instrument sets has also transformed to accommodate this change. The 102nd Forward Surgical Team (FST) was attached to Special Operations assigned to southern Afghanistan from June 2015 to March 2016. The focus was to decrease overall size and weight of FST instrument sets without decreasing surgical capability of the GHOST-T. Each instrument set was evaluated and modified to include essential instruments to perform damage control surgery. The overall number of main instrument sets was decreased from eight to four; simplified augmentation sets have been added, which expand the capabilities of any main set. The overall size was decreased by 40% and overall weight decreased by 58%. The cardiothoracic, thoracotomy, and emergency thoracotomy trays were condensed to thoracic set. The orthopedic and amputation sets were replaced with an augmentation set of a prepackaged orthopedic external fixator set). An augmentation set to the major or minor basic sets, specifically for vascular injuries, was created. Through the reorganization of conventional FST surgical instrument sets to maintain damage control capabilities and mobility, the 102nd GHOST-T reduced surgical equipment volume and weight, providing a lesson learned for future surgical teams operating in austere environments. 2017.

Dislocation of total hip replacement in patients with fractures of the femoral neck

OpenAIRE

Enocson, Anders; Hedbeck, Carl-Johan; Tidermark, Jan; Pettersson, Hans; Ponzer, Sari; Lapidus, Lasse J

2009-01-01

Background Total hip replacement is increasingly used in active, relatively healthy elderly patients with fractures of the femoral neck. Dislocation of the prosthesis is a severe complication, and there is still controversy regarding the optimal surgical approach and its influence on stability. We analyzed factors influencing the stability of the total hip replacement, paying special attention to the surgical approach. Patients and methods We included 713 consecutive hips in a series of 698 p...

A quantitative evaluation of gross versus histologic neuroma formation in a rabbit forelimb amputation model: potential implications for the operative treatment and study of neuromas

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Kuiken Todd A

2011-10-01

Full Text Available Abstract Background Surgical treatment of neuromas involves excision of neuromas proximally to the level of grossly "normal" fascicles; however, proximal changes at the axonal level may have both functional and therapeutic implications with regard to amputated nerves. In order to better understand the retrograde "zone of injury" that occurs after nerve transection, we investigated the gross and histologic changes in transected nerves using a rabbit forelimb amputation model. Methods Four New Zealand White rabbits underwent a forelimb amputation with transection and preservation of the median, radial, and ulnar nerves. After 8 weeks, serial sections of the amputated nerves were then obtained in a distal-to-proximal direction toward the brachial plexus. Quantitative histomorphometric analysis was performed on all nerve specimens. Results All nerves demonstrated statistically significant increases in nerve cross-sectional area between treatment and control limbs at the distal nerve end, but these differences were not observed 10 mm more proximal to the neuroma bulb. At the axonal level, an increased number of myelinated fibers were seen at the distal end of all amputated nerves. The number of myelinated fibers progressively decreased in proximal sections, normalizing at 15 mm proximally, or the level of the brachial plexus. The cross-sectional area of myelinated fibers was significantly decreased in all sections of the treatment nerves, indicating that atrophic axonal changes proceed proximally at least to the level of the brachial plexus. Conclusions Morphologic changes at the axonal level extend beyond the region of gross neuroma formation in a distal-to-proximal fashion after nerve transection. This discrepancy between gross and histologic neuromas signifies the need for improved standardization among neuroma models, while also providing a fresh perspective on how we should view neuromas during peripheral nerve surgery.

Comparison of Gross Anatomy Test Scores Using Traditional Specimens vs. Quicktime Virtual Reality Animated Specimens

Science.gov (United States)

Maza, Paul Sadiri

2010-01-01

In recent years, technological advances such as computers have been employed in teaching gross anatomy at all levels of education, even in professional schools such as medical and veterinary medical colleges. Benefits of computer based instructional tools for gross anatomy include the convenience of not having to physically view or dissect a…

Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation.

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Parisa Azimi

Full Text Available Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH. This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC. The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24-35. Post-surgical success was 79.9% (n = 123 at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6, 5.4 (SD = 1.9 and 6.5 (SD = 1.7, respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703-0.926. This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice.

Postoperative Haematocrit and Outcome in Critically Ill Surgical Patients.

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Lopes, Ana Martins; Silva, Diana; Sousa, Gabriela; Silva, Joana; Santos, Alice; Abelha, Fernando José

2017-08-31

Haematocrit has been studied as an outcome predictor. The aim of this study was to evaluate the correlation between low haematocrit at surgical intensive care unit admission and high disease scoring system score and early outcomes. This retrospective study included 4398 patients admitted to the surgical intensive care unit between January 2006 and July 2013. Acute physiology and chronic health evaluation and simplified acute physiology score II values were calculated and all variables entered as parameters were evaluated independently. Patients were classified as haematocrit if they had a haematocrit < 30% at surgical intensive care unit admission. The correlation between admission haematocrit and outcome was evaluated by univariate analysis and linear regression. A total of 1126 (25.6%) patients had haematocrit. These patients had higher rates of major cardiac events (4% vs 1.9%, p < 0.001), acute renal failure (11.5% vs 4.7%, p < 0.001), and mortality during surgical intensive care unit stay (3% vs 0.8%, p < 0.001) and hospital stay (12% vs 5.9%, p < 0.001). A haematocrit level < 30% at surgical intensive care unit admission was frequent and appears to be a predictor for poorer outcome in critical surgical patients. Patients with haematocrit had longer surgical intensive care unit and hospital stay lengths, more postoperative complications, and higher surgical intensive care unit and hospital mortality rates.

Direct Cost of Reprocessing Cotton-woven Surgical Drapes: a Case Study

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Mariana Fexina Tomé

Full Text Available OBJECTIVE Identify the direct cost of reprocessing double and single cotton-woven drapes of the surgical LAP package. METHOD A quantitative, exploratory and descriptive case study, performed at a teaching hospital. The direct cost of reprocessing cotton-woven surgical drapes was calculated by multiplying the time spent by professionals involved in reprocessing the unit with the direct cost of labor, adding to the cost of materials. The Brazilian currency (R$ originally used for the calculations was converted to US currency at the rate of US$0.42/R$. RESULTS The average total cost for surgical LAP package was US$9.72, with the predominance being in the cost of materials (US$8.70 or 89.65%. It is noteworthy that the average total cost of materials was mostly impacted by the cost of the cotton-woven drapes (US$7.99 or 91.90%. CONCLUSION The knowledge gained will subsidize discussions about replacing reusable cotton-woven surgical drapes for disposable ones, favoring arguments regarding the advantages and disadvantages of this possibility considering human resources, materials, as well as structural, environmental and financial resources.

Surgical management for displaced pediatric proximal humeral fractures: a cost analysis.

Science.gov (United States)

Shore, Benjamin J; Hedequist, Daniel J; Miller, Patricia E; Waters, Peter M; Bae, Donald S

2015-02-01

The purpose of this investigation was to determine which of the following methods of fixation, percutaneous pinning (PP) or intramedullary nailing (IMN), was more cost-effective in the treatment of displaced pediatric proximal humeral fractures (PPHF). A retrospective cohort of surgically treated PPHF over a 12-year period at a single institution was performed. A decision analysis model was constructed to compare three surgical strategies: IMN versus percutaneous pinning leaving the pins exposed (PPE) versus leaving the pins buried (PPB). Finally, sensitivity analyses were performed, assessing the cost-effectiveness of each technique when infection rates and cost of deep infections were varied. A total of 84 patients with displaced PPHF underwent surgical stabilization. A total of 35 cases were treated with IMN, 32 with PPE, and 17 with PPB. The age, sex, and preoperative fracture angulation were similar across all groups. A greater percentage of open reduction was seen in the IMN and PPB groups (p = 0.03), while a higher proportion of physeal injury was seen in the PPE group (p = 0.02). Surgical time and estimated blood loss was higher in the IMN group (p exposed implants approached 55 %. Leaving pins exposed after surgical fixation of PPHF is more cost-effective than either burying pins or using intramedullary fixation.

Total knee arthroplasty

DEFF Research Database (Denmark)

Schrøder, Henrik M.; Petersen, Michael M.

2016-01-01

Total knee arthroplasty (TKA) is a successful treatment of the osteoarthritic knee, which has increased dramatically over the last 30 years. The indication is a painful osteoarthritic knee with relevant radiographic findings and failure of conservative measures like painkillers and exercise...... surgeon seems to positively influence the rate of surgical complications and implant survival. The painful TKA knee should be thoroughly evaluated, but not revised except if a relevant indication can be established. The most frequent indications for revision are: aseptic loosening, instability, infection...

Investigating the use of quick response codes in the gross anatomy laboratory.

Science.gov (United States)

Traser, Courtney J; Hoffman, Leslie A; Seifert, Mark F; Wilson, Adam B

2015-01-01

The use of quick response (QR) codes within undergraduate university courses is on the rise, yet literature concerning their use in medical education is scant. This study examined student perceptions on the usefulness of QR codes as learning aids in a medical gross anatomy course, statistically analyzed whether this learning aid impacted student performance, and evaluated whether performance could be explained by the frequency of QR code usage. Question prompts and QR codes tagged on cadaveric specimens and models were available for four weeks as learning aids to medical (n = 155) and doctor of physical therapy (n = 39) students. Each QR code provided answers to posed questions in the form of embedded text or hyperlinked web pages. Students' perceptions were gathered using a formative questionnaire and practical examination scores were used to assess potential gains in student achievement. Overall, students responded positively to the use of QR codes in the gross anatomy laboratory as 89% (57/64) agreed the codes augmented their learning of anatomy. The users' most noticeable objection to using QR codes was the reluctance to bring their smartphones into the gross anatomy laboratory. A comparison between the performance of QR code users and non-users was found to be nonsignificant (P = 0.113), and no significant gains in performance (P = 0.302) were observed after the intervention. Learners welcomed the implementation of QR code technology in the gross anatomy laboratory, yet this intervention had no apparent effect on practical examination performance. © 2014 American Association of Anatomists.

Surgical orthodontics.

Science.gov (United States)

Strohl, Alexis M; Vitkus, Lauren

2017-08-01

The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery. This has the benefit of immediate improvement in facial aesthetics and shorter treatment times. The advent of virtual surgical planning has helped facilitate the development of this new paradigm by making surgical planning faster and easier. Furthermore, using intraoperative surgical navigation is improving overall precision and outcomes. A variety of surgical and nonsurgical treatments may be employed in the treatment of malocclusion. It is important to be familiar with all options available and tailor the patient's treatment plan accordingly. Surgery-first orthodontics, intraoperative surgical navigation, virtual surgical planning, and 3D printing are evolving new techniques that are producing shorter treatment times and subsequently improving patient satisfaction without sacrificing long-term stability.

77 FR 51706 - Gross Combination Weight Rating (GCWR); Definition

Science.gov (United States)

2012-08-27

... [Docket No. FMCSA-2012-0156] RIN 2126-AB53 Gross Combination Weight Rating (GCWR); Definition AGENCY... combination weight rating'' (GCWR) in our regulations. The definition currently prescribes how the GCWR is... comment, if submitted on behalf of an association, business, labor union, etc.). You may review a Privacy...

Feasibility study of transanal total mesorectal excision

NARCIS (Netherlands)

Velthuis, S.; Boezem, P.B. van den; Peet, D.L. van der; Cuesta, M.A.; Sietses, C.

2013-01-01

BACKGROUND: Laparoscopic resection of colorectal cancers is a safe alternative to open surgery. The conversion rate to open surgery remains fairly constant but is associated with increased morbidity. A new approach to the surgical excision of rectal cancer is transanal total mesorectal excision

Gross efficiency during rowing is not affected by stroke rate

NARCIS (Netherlands)

Hofmijster, M.J.; van Soest, A.J.; de Koning, J.J.

2009-01-01

Purpose: It has been suggested that the optimal stroke rate in rowing is partly determined by the stroke-rate dependence of internal power losses. This should be reflected in a stroke-rate dependency of gross efficiency (e

Między brakiem a nadmiarem. Z Ireną Grudzińską-Gross rozmawia Joanna Tokarska-Bakir

Directory of Open Access Journals (Sweden)

Joanna Tokarska-Bakir

2012-12-01

Full Text Available Between overabundance and scarcity. Joanna Tokarska-Bakir in an interview with Irena Grudzińska Gross This conversation with Irena Grudzińska-Gross starts a series of interviews in “Studia Litteraria et Historica”, which motto is the title of the essay of Jan Stanisław Bystroń “On subjects I was advised not to pursue”. Among these subjects that Irena Grudzińska-Gross names are: war, family history, women.  Grudzińska-Gross tells also about the reactions to “Złote Żniwa” - a book that she wrote together with Jan Tomasz Gross, and about academic work of people of Eastern Europe living in the United States. One part of the interview concerns also a “collective hypnosis”, that Americans underwent after the 9/11 World Trade Center Attack and the price, that Susan Sontag had to pay for being critical about American militarism.   Między brakiem a nadmiarem. Z Ireną Grudzińską-Gross rozmawia Joanna Tokarska-Bakir Rozmowa z Ireną Grudzińską-Gross otwiera cykl wywiadów “Studia Litteraria et Historica”, których mottem jest tytuł eseju Jana Stanisława Bystronia: “Tematy, które mi odradzano”. Wśród “odradzanych” tematów, które wymienia Irena Grudzińska-Gross są między innymi: wojna, historia rodzinna, kobiety. Grudzińska-Gross opowiada także o reakcjach na książkę “Złote żniwa”, którą napisała wraz z Janem Tomaszem Grossem oraz o pracy akademickiej osób z Europy Wschodniej w Stanach Zjednoczonych. Część rozmowy dotyczy także “zbiorowej hipnozy”, której ulegli mieszkańcy USA po ataku 11 września 2001 na World Trade Center i ceny, jaką musiała zapłacić Susan Sontag za krytykę amerykańskiego militaryzmu.

A STUDY ON GROSS FEATURES AND DIFFERENT POSITIONS OF ADULTS VERMIFORM APPENDIX

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Kasukurthy Ashalatha

2016-07-01

.8%. CONCLUSION The knowledge of anatomy of appendix is very important for thorough understanding of the pathology, signs, and symptoms of acute appendicitis. This study of different positions and gross features of vermiform appendix will be of great help to the surgeons when they do laparotomy and plan for further any surgical procedures.

Rhabdomyolysis in Critically Ill Surgical Patients.

Science.gov (United States)

Kuzmanovska, Biljana; Cvetkovska, Emilija; Kuzmanovski, Igor; Jankulovski, Nikola; Shosholcheva, Mirjana; Kartalov, Andrijan; Spirovska, Tatjana

2016-07-27

Rhabdomyolysis is a syndrome of injury of skeletal muscles associated with myoglobinuria, muscle weakness, electrolyte imbalance and often, acute kidney injury as severe complication. of this study is to detect the incidence of rhabdomyolysis in critically ill patients in the surgical intensive care unit (ICU), and to raise awareness of this medical condition and its treatment among the clinicians. A retrospective review of all surgical and trauma patients admitted to surgical ICU of the University Surgical Clinic "Mother Teresa" in Skopje, Macedonia, from January 1 st till December 31 st 2015 was performed. Patients medical records were screened for available serum creatine kinase (CK) with levels > 200 U/l, presence of myoglobin in the serum in levels > 80 ng/ml, or if they had a clinical diagnosis of rhabdomyolysis by an attending doctor. Descriptive statistical methods were used to analyze the collected data. Out of totally 1084 patients hospitalized in the ICU, 93 were diagnosed with rhabdomyolysis during the course of one year. 82(88%) patients were trauma patients, while 11(12%) were surgical non trauma patients. 7(7.5%) patients diagnosed with rhabdomyolysis developed acute kidney injury (AKI) that required dialysis. Average values of serum myoglobin levels were 230 ng/ml, with highest values of > 5000 ng/ml. Patients who developed AKI had serum myoglobin levels above 2000 ng/ml. Average values of serum CK levels were 400 U/l, with highest value of 21600 U/l. Patients who developed AKI had serum CK levels above 3000 U/l. Regular monitoring and early detection of elevated serum CK and myoglobin levels in critically ill surgical and trauma patients is recommended in order to recognize and treat rhabdomyolysis in timely manner and thus prevent development of AKI.

Surgical resection of highly suspicious pulmonary nodules without a tissue diagnosis

International Nuclear Information System (INIS)

Heo, Eun-Young; Lee, Kyung-Won; Jheon, Sanghoon; Lee, Jae-Ho; Lee, Choon-Taek; Yoon, Ho-II

2011-01-01

The safety and efficacy of surgical resection of lung nodule without tissue diagnosis is controversial. We evaluated direct surgical resection of highly suspicious pulmonary nodules and the clinical and radiological predictors of malignancy. Retrospective analyses were performed on 113 patients who underwent surgical resection without prior tissue diagnosis for highly suspicious pulmonary nodules. Clinical and radiological characteristics were compared between histologically proven benign and malignant nodules after resection. Total costs, length of hospitalization and waiting time to surgery were compared with those of patients who had tissue diagnosis prior to surgery. Among 280 patients with pulmonary nodules suspicious for lung cancer, 113 (40.4%) underwent operation without prior tissue diagnosis. Lung nodules were diagnosed as malignant in 96 (85%) of the 113 patients. Except for forced expiratory volume in 1 s, clinical characteristics were not significantly different according to the pathologic results. Forty-five (90%) of 50 patients with ground-glass opacity nodules had a malignancy. Mixed ground-glass opacity, bubble lucency, irregular margin and larger size correlated with malignancy in ground-glass opacity nodules (P<0.05). Fifty-one (81%) of 67 patients with solid nodules had a malignancy. Spiculation, pre-contrast attenuation and contrast enhancement significantly correlated with malignancy in solid nodules (P<0.05). Surgical resection without tissue diagnosis significantly decreased total costs, hospital stay and waiting time (P<0.05). Direct surgical resection of highly suspicious pulmonary nodules can be a valid procedure. However, careful patient selection and further investigations are required to justify direct surgical resection. (author)

Quinacrine non-surgical female sterilization in Bangladesh.

Science.gov (United States)

Bhuiyan, S N; Begum, R

2001-11-01

This study was undertaken to evaluate the efficacy, safety, and acceptability of transcervical applications of quinacrine along with other adjuvants, such as ampicillin and ibuprofen, for sterilization. The cohort consisted of 750 normal women who requested sterilization and volunteered for this method at the family planning clinic of a tertiary hospital and community clinics in Chittagong, Bangladesh. Several different protocols were followed from October 1989 to April 1999. Each woman received one or two insertions of 180 mg or 252 mg quinacrine with or without adjuvants including 55.5 mg ibuprofen or 125 mg ampicillin. Supplementary contraception was given in the form of combined oral contraceptive pills, barrier methods, or injection of depot medroxyprogesterone acetate for 3 months. Details of each protocol are described in the text. The gross pregnancy failure rate for insertion of 180 mg in 590 women was 3.9% compared to 1.9% for the 160 who received 252 mg. There were no serious complications, and side effects were transient. We conclude that quinacrine non-surgical sterilization is a safe, acceptably effective method when two insertions of 252 mg quinacrine with medroxyprogesterone injection as a supplement is used.

Relation between hand function and gross motor function in full term infants aged 4 to 8 months

Science.gov (United States)

Nogueira, Solange F.; Figueiredo, Elyonara M.; Gonçalves, Rejane V.; Mancini, Marisa C.

2015-01-01

Background: In children, reaching emerges around four months of age, which is followed by rapid changes in hand function and concomitant changes in gross motor function, including the acquisition of independent sitting. Although there is a close functional relationship between these domains, to date they have been investigated separately. Objective: To investigate the longitudinal profile of changes and the relationship between the development of hand function (i.e. reaching for and manipulating an object) and gross motor function in 13 normally developing children born at term who were evaluated every 15 days from 4 to 8 months of age. Method: The number of reaches and the period (i.e. time) of manipulation to an object were extracted from video synchronized with the Qualisys(r) movement analysis system. Gross motor function was measured using the Alberta Infant Motor Scale. ANOVA for repeated measures was used to test the effect of age on the number of reaches, the time of manipulation and gross motor function. Hierarchical regression models were used to test the associations of reaching and manipulation with gross motor function. Results: Results revealed a significant increase in the number of reaches (pgross motor function (pgross motor function (R2=0.84; pgross motor function (R2=0.13; p=0.02) from 4 to 6 months of age. Associations from 6 to 8 months of age were not significant. Conclusion: The relationship between hand function and gross motor function was not constant, and the age span from 4 to 6 months was a critical period of interdependency of hand function and gross motor function development. PMID:25714437

Effect of physical therapy frequency on gross motor function in children with cerebral palsy

OpenAIRE

Park, Eun-Young

2016-01-01

[Purpose] This study attempted to investigate the effect of physical therapy frequency based on neurodevelopmental therapy on gross motor function in children with cerebral palsy. [Subjects and Methods] The study sample included 161 children with cerebral palsy who attended a convalescent or rehabilitation center for disabled individuals or a special school for children with physical disabilities in South Korea. Gross Motor Function Measure data were collected according to physical therapy fr...

Evaluation of the contributions of four components of gross domestic product in various regions in China.

Science.gov (United States)

Wu, Sanmang; Lei, Yalin; Li, Li

2015-01-01

Four major components influence the growth of the gross domestic product in Chinese provinces: consumption, investment, transnational exports, and inter-provincial exports. By splitting a competitive input-output table into a non-competitive input-output table, this study used an input-output model to measure the contributions of the four components of gross domestic product in various regions in China. We found that international exports drove the growth of the gross domestic product more strongly in the eastern region than in other regions. Investment and inter-provincial exports were the major impetus for gross domestic product growth in the central and western regions. We also found that consumption played a minimal role in driving the growth of the gross domestic product in all regions in China. According to these findings, although various regions can share much in terms of policies to transform the impetus for economic growth, there should be different foci for different regions. Their shared policy is to increase the role of final consumption in stimulating economic growth. Region-specific policies mandate that the eastern region should strengthen the driving force provided by international exports and that the central and western regions should strengthen indigenous growth capabilities by improving scientific innovation, industrial support, and institutional innovation.

Evaluation of the contributions of four components of gross domestic product in various regions in China.

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Sanmang Wu

Full Text Available Four major components influence the growth of the gross domestic product in Chinese provinces: consumption, investment, transnational exports, and inter-provincial exports. By splitting a competitive input-output table into a non-competitive input-output table, this study used an input-output model to measure the contributions of the four components of gross domestic product in various regions in China. We found that international exports drove the growth of the gross domestic product more strongly in the eastern region than in other regions. Investment and inter-provincial exports were the major impetus for gross domestic product growth in the central and western regions. We also found that consumption played a minimal role in driving the growth of the gross domestic product in all regions in China. According to these findings, although various regions can share much in terms of policies to transform the impetus for economic growth, there should be different foci for different regions. Their shared policy is to increase the role of final consumption in stimulating economic growth. Region-specific policies mandate that the eastern region should strengthen the driving force provided by international exports and that the central and western regions should strengthen indigenous growth capabilities by improving scientific innovation, industrial support, and institutional innovation.

Awareness and use of Gross Motor Function Classification System ...

African Journals Online (AJOL)

Introduction The degree of disability in children with Cerebral Palsy (CP) can be evaluated with the Gross Motor Function Classification System (GMFCS), a valid tool which was designed for such purposes. However, there appears to be paucity of data on the awareness and use of the GMFCS particularly in the ...

Survey On Management Systems And Gross Profit Analysis Of ...

African Journals Online (AJOL)

Survey On Management Systems And Gross Profit Analysis Of Muturu In Southern Cross River State. ... in muturu rearing for commercial purposes. Cost price of muturu within the study area was uniform due to the influence of market associations. The selling price of muturu cattle is however influenced by the location.

Neonatal stroke causes poor midline motor behaviors and poor fine and gross motor skills during early infancy.

Science.gov (United States)

Chen, Chao-Ying; Lo, Warren D; Heathcock, Jill C

2013-03-01

Upper extremity movements, midline behaviors, fine, and gross motor skills are frequently impaired in hemiparesis and cerebral palsy. We investigated midline toy exploration and fine and gross motor skills in infants at risk for hemiplegic cerebral palsy. Eight infants with neonatal stroke (NS) and thirteen infants with typical development (TD) were assessed from 2 to 7 months of age. The following variables were analyzed: percentage of time in midline and fine and gross motor scores on the Bayley Scales of Infant Development (BSID-III). Infants with neonatal stroke demonstrated poor performance in midline behaviors and fine and gross motor scores on the BSID-III. These results suggest that infants with NS have poor midline behaviors and motor skill development early in infancy. Copyright © 2012 Elsevier Ltd. All rights reserved.

The Effects of Basketball Basic Skills Training on Gross Motor Skills Development of Female Children

Science.gov (United States)

Bayazit, Betul

2015-01-01

The purpose of this study was to investigate the effects of basketball basic skills training on gross motor skills development of female children in Turkey. For that purpose, 40 female children took part in the study voluntarily. Basketball basic skills test was used to improve the gross motor skills of the female children in the study. Also,…

Gender differences in the acquisition of surgical skills

DEFF Research Database (Denmark)

Ali, Amir; Subhi, Yousif; Ringsted, Charlotte

2015-01-01

BACKGROUND: Females are less attracted than males to surgical specialties, which may be due to differences in the acquisition of skills. The aim of this study was to systematically review studies that investigate gender differences in the acquisition of surgical skills. METHODS: We performed...... a comprehensive database search using relevant search phrases and MeSH terms. We included studies that investigated the role of gender in the acquisition of surgical skills. RESULTS: Our search yielded 247 studies, 18 of which were found to be eligible and were therefore included. These studies included a total...... of 2,106 study participants. The studies were qualitatively synthesized in five categories (studies on medical students, studies on both medical students and residents, studies on residents, studies on gender differences in needed physical strength, and studies on other gender-related training...

Can a surgery-first orthognathic approach reduce the total treatment time?

Science.gov (United States)

Jeong, Woo Shik; Choi, Jong Woo; Kim, Do Yeon; Lee, Jang Yeol; Kwon, Soon Man

2017-04-01

Although pre-surgical orthodontic treatment has been accepted as a necessary process for stable orthognathic correction in the traditional orthognathic approach, recent advances in the application of miniscrews and in the pre-surgical simulation of orthodontic management using dental models have shown that it is possible to perform a surgery-first orthognathic approach without pre-surgical orthodontic treatment. This prospective study investigated the surgical outcomes of patients with diagnosed skeletal class III dentofacial deformities who underwent orthognathic surgery between December 2007 and December 2014. Cephalometric landmark data for patients undergoing the surgery-first approach were analyzed in terms of postoperative changes in vertical and horizontal skeletal pattern, dental pattern, and soft tissue profile. Forty-five consecutive Asian patients with skeletal class III dentofacial deformities who underwent surgery-first orthognathic surgery and 52 patients who underwent conventional two-jaw orthognathic surgery were included. The analysis revealed that the total treatment period for the surgery-first approach averaged 14.6 months, compared with 22.0 months for the orthodontics-first approach. Comparisons between the immediate postoperative and preoperative and between the postoperative and immediate postoperative cephalometric data revealed factors that correlated with the total treatment duration. The surgery-first orthognathic approach can dramatically reduce the total treatment time, with no major complications. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Non-observance of guidelines for surgical antimicrobial prophylaxis and surgical-site infections.

Science.gov (United States)

Lallemand, S; Thouverez, M; Bailly, P; Bertrand, X; Talon, D

2002-06-01

A prospective multicentre study was conducted to assess major aspects of surgical prophylaxis and to determine whether inappropriate antimicrobial prophylaxis was a factor associated (risk or protective factor) with surgical site infection (SSI). Surgical prophylaxis practices were assessed by analysing four variables: indication, antimicrobial agent, timing and duration. Univariate and multivariate analyses were carried out to identify predictors of SSI among patient-specific, operation-specific and antimicrobial prophylaxis-specific factors. The frequency of SSI was 2.7% (13 SSI in 474 observations). Total compliance of the prescription with guidelines was observed in 41.1% of cases (195 prescriptions). Of the 139 patients who received an inappropriate drug, 126 (90.6%) received a drug with a broader spectrum than the recommended drug. Prophylaxis was prolonged in 71 (87.7%) of the 81 patients who received prophylaxis for inappropriate lengths of time and 43 (61.4%) of the 70 patients who did not receive prophylaxis at the optimal moment were treated too late. Multivariate analysis clearly demonstrated that SSI was associated with multiple procedures (relative risk 8.5), short duration of prophylaxis (relative risk 12.7) and long-term therapy with antimicrobial agents during the previous year (relative risk 8.8). The ecological risk of the emergence of resistance associated with the frequent use of broad-spectrum antibiotics and prophylaxis for longer periods was not offset by individual benefit to the patients who received inappropriate prophylaxis.

Impact of surgical complications on length of stay after hip fracture surgery

DEFF Research Database (Denmark)

Foss, Nicolai Bang; Palm, Henrik; Krasheninnikoff, Michael

2006-01-01

BACKGROUND: Rehabilitation after hip fracture may be lengthy, with bed-day consumption accounting for up to 85% of the total cost of admission to hospital. Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact...... of surgical complications has not been examined in detail. METHODS: All 600 consecutive patients included were admitted with primary hip fracture and received primary surgical intervention with multimodal rehabilitation. Surgical complications were audited and classified as being due to a patient fall......, infection or suboptimal surgery, stratified into either requiring reoperation or not allowing mobilisation because of instability. RESULTS: Of the 600, 116 (19.3, 95% CI 16-22%) patients underwent reoperation or immobilisation; 27.1% of bed-day consumption resulted from surgical complications. The audit...

Early postoperative physical therapy for improving short-term gross motor outcome in infants with cyanotic and acyanotic congenital heart disease.

Science.gov (United States)

Haseba, Sumihito; Sakakima, Harutoshi; Nakao, Syuhei; Ohira, Misaki; Yanagi, Shigefumi; Imoto, Yutaka; Yoshida, Akira; Shimodozono, Megumi

2018-07-01

We analysed the gross motor recovery of infants and toddlers with cyanotic and acyanotic congenital heart disease (CHD) who received early postoperative physical therapy to see whether there was any difference in the duration to recovery. This study retrospectively evaluated the influence of early physical therapy on postoperative gross motor outcomes of patients with CHD. The gross motor ability of patients with cyanotic (n = 25, average age: 376.4 days) and acyanotic (n = 26, average age: 164.5 days) CHD was evaluated using our newly developed nine-grade mobility assessment scale. Physical therapy was started at an average of five days after surgery, during which each patient's gross motor ability was significantly decreased compared with the preoperative level. Patients (who received early postoperative physical therapy) with cyanotic (88.0%) and acyanotic CHD (96.2%) showed improved preoperative mobility grades by the time of hospital discharge. However, patients with cyanotic CHD had a significantly prolonged recovery period compared to those with acyanotic CHD (p congenital heart disease are likely at greater risk of gross motor delays and have a prolonged recovery period of gross motor ability compared to those with acyanotic congenital heart disease. Early postoperative physical therapy for patients with congenital heart disease after cardiac surgery promoted gross motor recovery. The postoperative recovery period to preoperative mobility grade was affected by pre-, intra-, and postoperative factors. Rehabilitation experts should consider the risk of gross motor delays of patients with congenital heart disease after cardiac surgery and the early postoperative physical therapy to promote their gross motor recovery.

Regression of Ophthalmopathic Exophthalmos in Graves' Disease After Total Thyroidectomy: a Prospective Study of a Surgical Series.

Science.gov (United States)

Bhargav, P R K; Sabaretnam, M; Kumar, S Chandra; Zwalitha, S; Devi, N Vimala

2017-12-01

Autoimmune ophthalmopathy is one of the salient clinical features associated with Graves' disease. Exophthalmos is one of the commonest manifestations of Graves' associated ophthalmopathy. It is reported to regress after thyroidectomy favourably compared to radioiodine or antithyroid drug therapy. In this context, we present our experience based on a surgical series of Graves' disease. This is a prospective study of 15 patients of Graves' disease associated with ophthalmopathic exophthalmos. Preoperative and monthly postoperative evaluation of exophthalmos was done with Hertel's exophthalmometer, apart from documenting lid, extra-ocular muscle and orbital involvement. The minimum follow-up of the cohort was 12 months. The female to male ratio was 12:3 and the mean age of the subjects was 33.4 years (18-55). Exophthalmos was bilateral in 13 and unilateral in 2 patients. All the 15 patients underwent total thyroidectomy without any major morbidity. Exophthalmos regressed in 12 patients at a mean follow-up of 15.6 ± 6.4 months (14-38) and was static in 3. None of the cases had worsened ophthalmopathy at the final follow-up. Mean regression of exophthalmos was 2.1 mm (1-5). The regression was statistically significant at P value = 0.035. Surgery has a positive impact on the regression of ophthalmopathic exophthalmos associated with Graves' disease.

Effect of extradural blockage upon glucose and urea kinetics in surgical patients

Energy Technology Data Exchange (ETDEWEB)

Shaw, J.H.; Galler, L.; Holdaway, I.M.; Holdaway, C.M.

1987-09-01

We have determined the metabolic effects induced by the use of extradural blockage with 0.5 per cent bupivacaine hydrochloride in a group of surgical patients. Turnover rates of glucose and urea were determined isotopically using radioisotopes and studies were performed both in the basal state and during total parenteral nutrition. In the basal state, extradural blockade resulted in a decrease in the turnover rates of both glucose and urea. In addition, when extradural blockade was instituted while the patients were receiving total parenteral nutrition, there was also a significant fall in glucose turnover. We conclude that the use of extradural blockade is effective as a means of conserving bodily resources in surgical patients both in the basal state and during total parenteral nutrition.

Effect of extradural blockage upon glucose and urea kinetics in surgical patients

International Nuclear Information System (INIS)

Shaw, J.H.; Galler, L.; Holdaway, I.M.; Holdaway, C.M.

1987-01-01

We have determined the metabolic effects induced by the use of extradural blockage with 0.5 per cent bupivacaine hydrochloride in a group of surgical patients. Turnover rates of glucose and urea were determined isotopically using radioisotopes and studies were performed both in the basal state and during total parenteral nutrition. In the basal state, extradural blockade resulted in a decrease in the turnover rates of both glucose and urea. In addition, when extradural blockade was instituted while the patients were receiving total parenteral nutrition, there was also a significant fall in glucose turnover. We conclude that the use of extradural blockade is effective as a means of conserving bodily resources in surgical patients both in the basal state and during total parenteral nutrition

Hotspots of gross emissions from the land use sector: patterns, uncertainties, and leading emission sources for the period 2000-2005 in the tropics

Science.gov (United States)

Roman-Cuesta, Rosa Maria; Rufino, Mariana C.; Herold, Martin; Butterbach-Bahl, Klaus; Rosenstock, Todd S.; Herrero, Mario; Ogle, Stephen; Li, Changsheng; Poulter, Benjamin; Verchot, Louis; Martius, Christopher; Stuiver, John; de Bruin, Sytze

2016-07-01

According to the latest report of the Intergovernmental Panel on Climate Change (IPCC), emissions must be cut by 41-72 % below 2010 levels by 2050 for a likely chance of containing the global mean temperature increase to 2 °C. The AFOLU sector (Agriculture, Forestry and Other Land Use) contributes roughly a quarter ( ˜ 10-12 Pg CO2e yr-1) of the net anthropogenic GHG emissions mainly from deforestation, fire, wood harvesting, and agricultural emissions including croplands, paddy rice, and livestock. In spite of the importance of this sector, it is unclear where the regions with hotspots of AFOLU emissions are and how uncertain these emissions are. Here we present a novel, spatially comparable dataset containing annual mean estimates of gross AFOLU emissions (CO2, CH4, N2O), associated uncertainties, and leading emission sources, in a spatially disaggregated manner (0.5°) for the tropics for the period 2000-2005. Our data highlight the following: (i) the existence of AFOLU emissions hotspots on all continents, with particular importance of evergreen rainforest deforestation in Central and South America, fire in dry forests in Africa, and both peatland emissions and agriculture in Asia; (ii) a predominant contribution of forests and CO2 to the total AFOLU emissions (69 %) and to their uncertainties (98 %); (iii) higher gross fluxes from forests, which coincide with higher uncertainties, making agricultural hotspots appealing for effective mitigation action; and (iv) a lower contribution of non-CO2 agricultural emissions to the total gross emissions (ca. 25 %), with livestock (15.5 %) and rice (7 %) leading the emissions. Gross AFOLU tropical emissions of 8.0 (5.5-12.2) were in the range of other databases (8.4 and 8.0 Pg CO2e yr-1 in FAOSTAT and the Emissions Database for Global Atmospheric Research (EDGAR) respectively), but we offer a spatially detailed benchmark for monitoring progress in reducing emissions from the land sector in the tropics. The location of

Effect of hippotherapy on gross motor function in children with cerebral palsy: a randomized controlled trial.

Science.gov (United States)

Kwon, Jeong-Yi; Chang, Hyun Jung; Yi, Sook-Hee; Lee, Ji Young; Shin, Hye-Yeon; Kim, Yun-Hee

2015-01-01

To examine whether hippotherapy has a clinically significant effect on gross motor function in children with cerebral palsy (CP). Randomized controlled trial. Outpatient therapy center. Ninety-two children with CP, aged 4-10 years, presenting variable function (Gross Motor Function Classification System [GMFCS] levels I-IV). Hippotherapy (30 minutes twice weekly for 8 consecutive weeks). Gross Motor Function Measure (GMFM)-88, GMFM-66, and Pediatric Balance Scale. Pre- and post-treatment measures were completed by 91 children (45 in the intervention group and 46 in the control group). Differences in improvement on all three measures significantly differed between groups after the 8-week study period. Dimensions of GMFM-88 improved significantly after hippotherapy varied by GMFCS level: dimension E in level I, dimensions D and E in level II, dimensions C and D in level III, and dimensions B and C in level IV. Hippotherapy positively affects gross motor function and balance in children with CP of various functional levels.

Higher rate of compensation after surgical treatment versus conservative treatment for acute Achilles tendon rupture

DEFF Research Database (Denmark)

Sveen, Thor-Magnus; Troelsen, Anders; Barfod, Kristoffer Weisskirchner

2015-01-01

in the period from 1992 to 2010 in the DPIA database were identified and patient records were reviewed manually. RESULTS: The compensation awarded for the 18-year period totalled 18,147,202 DKK with 41% of patient claims being recognised. Out of 180 surgically treated patients, 79 received a total compensation...... of 14,051,377 DKK, median 47,637 (range: 5,000-3,577,043). Of 114 non-surgically treated patients, 40 received 3,715,224 DKK in compensation, with a median amount of 35,788 DKK (range: 5,000-830,073). CONCLUSION: Compensation after surgical treatment was 3.8 times higher than compensation after non......-surgical treatment. It is noteworthy that 34.5% of patients had an overlooked diagnosis which underlines the importance of a correct primary diagnosis. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

Self-perceived readiness to perform at the attending level following surgical specialist training in Denmark

DEFF Research Database (Denmark)

Fabricius, Rasmus; Sillesen, Martin; Hansen, Morten Sejer

2017-01-01

not previously been studied. In the present study, we aim to investigate the role of supervision in the national surgical residency programme and the self-perceived readiness to undertake the role of a specialist doctor in gastrointestinal surgery in a cohort of gastrointestinal surgeons graduating in 2012......: A total of 30 graduated residents (55%) responded to the Danish survey. Among those, 14 (47%) felt ready to be a specialist in surgery. A total of 25 (83%) answered that increased supervision would have increased their selfperceived competencies to serve as a surgical specialist. Self -perceived readiness...... was significantly associated with level of supervision during surgical training (p = 0.02), whereas no association with operative volume could be established. CONCLUSIONS: A worryingly high number of graduates did not feel ready to undertake their role as a gastrointestinal surgical specialist. Adequate supervision...

Clinical Performance of Emergency Surgical Officers in Southern ...

African Journals Online (AJOL)

GB

The proportion of cesarean and instrumental deliveries over the total deliveries were 13% and 0.7%, respectively. Explorative laparotomies and appendectomies were the majority of the non-obstetric emergency operations. Interviewed staff in the respective hospitals stated that ESOs' clinical decision making, surgical skill ...

Instability after total hip arthroplasty

Science.gov (United States)

Werner, Brian C; Brown, Thomas E

2012-01-01

Instability following total hip arthroplasty (THA) is an unfortunately frequent and serious problem that requires thorough evaluation and preoperative planning before surgical intervention. Prevention through optimal index surgery is of great importance, as the management of an unstable THA is challenging even for an experienced joints surgeon. However, even after well-planned surgery, a significant incidence of recurrent instability still exists. Non-operative management is often successful if the components are well-fixed and correctly positioned in the absence of neurocognitive disorders. If conservative management fails, surgical options include revision of malpositioned components; exchange of modular components such as the femoral head and acetabular liner; bipolar arthroplasty; tripolar arthroplasty; use of a larger femoral head; use of a constrained liner; soft tissue reinforcement and advancement of the greater trochanter. PMID:22919568

Catheter for Cleaning Surgical Optics During Surgical Procedures: A Possible Solution for Residue Buildup and Fogging in Video Surgery.

Science.gov (United States)

de Abreu, Igor Renato Louro Bruno; Abrão, Fernando Conrado; Silva, Alessandra Rodrigues; Corrêa, Larissa Teresa Cirera; Younes, Riad Nain

2015-05-01

Currently, there is a tendency to perform surgical procedures via laparoscopic or thoracoscopic access. However, even with the impressive technological advancement in surgical materials, such as improvement in quality of monitors, light sources, and optical fibers, surgeons have to face simple problems that can greatly hinder surgery by video. One is the formation of "fog" or residue buildup on the lens, causing decreased visibility. Intracavitary techniques for cleaning surgical optics and preventing fog formation have been described; however, some of these techniques employ the use of expensive and complex devices designed solely for this purpose. Moreover, these techniques allow the cleaning of surgical optics when they becomes dirty, which does not prevent the accumulation of residue in the optics. To solve this problem we have designed a device that allows cleaning the optics with no surgical stops and prevents the fogging and residue accumulation. The objective of this study is to evaluate through experimental testing the effectiveness of a simple device that prevents the accumulation of residue and fogging of optics used in surgical procedures performed through thoracoscopic or laparoscopic access. Ex-vivo experiments were performed simulating the conditions of residue presence in surgical optics during a video surgery. The experiment consists in immersing the optics and catheter set connected to the IV line with crystalloid solution in three types of materials: blood, blood plus fat solution, and 200 mL of distilled water and 1 vial of methylene blue. The optics coupled to the device were immersed in 200 mL of each type of residue, repeating each immersion 10 times for each distinct residue for both thirty and zero degrees optics, totaling 420 experiments. A success rate of 98.1% was observed after the experiments, in these cases the device was able to clean and prevent the residue accumulation in the optics.

77 FR 65497 - Gross Combination Weight Rating (GCWR); Definition

Science.gov (United States)

2012-10-29

... [Docket No. FMCSA-2012-0156] RIN 2126-AB53 Gross Combination Weight Rating (GCWR); Definition AGENCY... combination weight rating'' (GCWR) in 49 CFR parts 383 and 390. The DFR would have taken effect on October 26... submitted on behalf of an association, business, labor union, etc.). You may review a Privacy Act notice...

Gross Motor Skill Acquisition in Adolescents with Down Syndrome

Science.gov (United States)

Meegan, Sarah; Maraj, Brian K. V.; Weeks, Daniel; Chua, Romeo

2006-01-01

The purpose of this study was to assess whether verbal-motor performances deficits exhibited by individuals with Down syndrome limited their ability to acquire gross motor skills when given visual and verbal instruction together and then transferred to either a visual or verbal instructional mode to reproduce the movement. Nine individuals with…

Interrater reliability assessment using the Test of Gross Motor Development-2.

Science.gov (United States)

Barnett, Lisa M; Minto, Christine; Lander, Natalie; Hardy, Louise L

2014-11-01

The aim was to examine interrater reliability of the object control subtest from the Test of Gross Motor Development-2 by live observation in a school field setting. Reliability Study--cross sectional. Raters were rated on their ability to agree on (1) the raw total for the six object control skills; (2) each skill performance and (3) the skill components. Agreement for the object control subtest and the individual skills was assessed by an intraclass correlation (ICC) and a kappa statistic assessed for skill component agreement. A total of 37 children (65% girls) aged 4-8 years (M = 6.2, SD = 0.8) were assessed in six skills by two raters; equating to 222 skill tests. Interrater reliability was excellent for the object control subset (ICC = 0.93), and for individual skills, highest for the dribble (ICC = 0.94) followed by strike (ICC = 0.85), overhand throw (ICC = 0.84), underhand roll (ICC = 0.82), kick (ICC = 0.80) and the catch (ICC = 0.71). The strike and the throw had more components with less agreement. Even though the overall subtest score and individual skill agreement was good, some skill components had lower agreement, suggesting these may be more problematic to assess. This may mean some skill components need to be specified differently in order to improve component reliability. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Patterns of Ninety-Day Readmissions Following Total Joint Replacement in a Bundled Payment Initiative.

Science.gov (United States)

Behery, Omar A; Kester, Benjamin S; Williams, Jarrett; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

2017-04-01

Alternative payment models aim to improve quality and decrease costs associated with total joint replacement. Postoperative readmissions within 90 days are of interest to clinicians and administrators as there is no additional reimbursement beyond the episode bundled payment target price. The aim of this study is to improve the understanding of the patterns of readmission which would better guide perioperative patient management affecting readmissions. We hypothesize that readmissions have different timing, location, and patient health profile patterns based on whether the readmission is related to a medical or surgical diagnosis. A retrospective cohort of 80 readmissions out of 1412 total joint replacement patients reimbursed through a bundled payment plan was analyzed. Patients were grouped by readmission diagnosis (surgical or medical) and the main variables analyzed were time to readmission, location of readmission, and baseline Perioperative Orthopaedic Surgical Home and American Society of Anesthesiologists scores capturing pre-existing state of health. Nonparametric tests and multivariable regressions were used to test associations. Surgical readmissions occurred earlier than medical readmissions (mean 18 vs 33 days, P = .011), and were more likely to occur at the hospital where the surgery was performed (P = .035). Perioperative Orthopaedic Surgical Home and American Society of Anesthesiologists scores did not predict medical vs surgical readmissions (P = .466 and .879) after adjusting for confounding variables. Readmissions appear to follow different patterns depending on whether they are surgical or medical. Surgical readmissions occur earlier than medical readmissions, and more often at the hospital where the surgery was performed. The results of this study suggest that these 2 types of readmissions have different patterns with different implications toward perioperative care and follow-up after total joint replacement. Copyright © 2016 Elsevier Inc

Surgical Stabilization of the Medial Capsulo-Ligamentous Envelope in Total Knee Arthroplasty

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Brandon Green, DO

2014-10-01

Full Text Available This study will evaluate an alternative method in which a four prong bone staple was used to repair the medial collateral ligament following over-release or avulsion injuries in (#6 cases during a total knee arthroplasty. The use of a four prong bone staple to repair medial collateral ligament injuries status post total knee replacement will provide satisfactory results with respect to post-operative knee stability and range of motion. Our retrospective review revealed that all six patients improved with regards to range of motion following the total knee arthroplasty. We feel that repair of the medial collateral ligament with a four-prong bone staple is a viable option after an over-release or avulsion injury sustained during a total knee arthroplasty.

The utility of preoperative diffusion tensor imaging in the surgical management of brainstem cavernous malformations.

Science.gov (United States)

Flores, Bruno C; Whittemore, Anthony R; Samson, Duke S; Barnett, Samuel L

2015-03-01

/DTT findings were important in the selection of the surgical approach. In 2 other patients, the results from preoperative DTI/DTT were important for selection of brainstem entry zones. All 11 patients underwent gross-total resection of their BSCMs. After a mean postoperative follow-up duration of 32.04 months, all 11 patients had excellent or good outcome (mRS Score 0-3) at the time of last outpatient clinic evaluation. DTI score did not correlate with long-term outcome. Preoperative DTI and DTT should be considered in the resection of symptomatic BSCMs. These imaging studies may influence the selection of surgical approach or brainstem entry zones, especially in deep-seated lesions without pial or ependymal presentation. DTI/DTT findings may allow for more aggressive management of lesions previously considered surgically inaccessible. Preoperative DTI/DTT changes do not appear to correlate with functional postoperative outcome in long-term follow-up.

Post-operative serious adverse events in a mixed surgical population

DEFF Research Database (Denmark)

Hansen, M S; Petersen, E E; Dahl, J B

2016-01-01

BACKGROUND: The number of surgical procedures is increasing, and knowledge of surgical risk factors, post-operative mortality and serious adverse events (SAE) is essential. The aim with our study was to determine the risk of a composite outcome of post-operative: death; myocardial infarction...... or gynaecological surgery was conducted retrieving data from The Danish Civil Registration System and the National Patient Register. Total observation time was from January 1, 2012 to June 6, 2013. RESULTS: A total7449 adult patients were included in the final analysis. The risk of the composite outcome during...... of 8.3% (7.8-9.0). The results are applicable in estimations of adequate sample sizes in future clinical trials investigating effects of interventions on SAEs....

Exploring challenges and solutions in the preparation of surgical patients

DEFF Research Database (Denmark)

Møller, Thea Palsgaard; Münter, Kristine Husum; Østergaard, Doris

2015-01-01

management system tasks, 26% of anaesthesia record tasks, 24% of medication tasks, 14% of blood test tasks and 12% of patient record tasks. In two workshops held for each of four specialties, a total of 21 participants mapped the preoperative patient journey with related responsibilities, tasks and written......, workshops including table simulations involving the various professions and specialties were held. RESULTS: In total, 314 surgical procedures were performed of which 196 were eligible for analysis. Emergency procedures showed the poorest results with non-completed tasks comprising 58% of electronic patient...... documentation. Furthermore, challenges and suggestions for solutions were identified. CONCLUSIONS: Completion of mandatory tasks for surgical patient preparation was poor. Workshops with table simulations actively involved the stakeholders from various professions and specialties in describing the patient...

Turkey's short-term gross annual electricity demand forecast by fuzzy logic approach