Clinical relevance of hemoglobin level in cervical cancer patients administered definitive radiotherapy

International Nuclear Information System (INIS)

Serkies, Krystyna; Badzio, Andrzej; Jassem, Jacek

2006-01-01

The prognostic impact of pretreatment hemoglobin (Hb) level and its changes during definitive radiotherapy was evaluated by univariate and multivariate analysis in the group of 453 FIGO IB-IIIB cervical cancer patients. Pretreatment anemia (Hb 12 g/dl; p∼0.001). Baseline Hb =12 g/dl was also associated with longer disease-free survival and improved local control. Declining Hb level during radiotherapy predicted for impaired 5-year disease-free survival and local control probability. In multivariate analysis, low pretreatment Hb level remained associated with worse overall and disease-free survival, whereas adverse impact of declining Hb level on outcome was not observed. With regard to other clinical factors, stage and tumor extension (uni- or bilateral parametrium involvement for Stage III) were the only independent determinants of prognosis

Relevance in the science classroom: A multidimensional analysis

Science.gov (United States)

Hartwell, Matthew F.

While perceived relevance is considered a fundamental component of adaptive learning, the experience of relevance and its conceptual definition have not been well described. The mixed-methods research presented in this dissertation aimed to clarify the conceptual meaning of relevance by focusing on its phenomenological experience from the students' perspective. Following a critical literature review, I propose an identity-based model of perceived relevance that includes three components: a contextual target, an identity target, and a connection type, or lens. An empirical investigation of this model that consisted of two general phases was implemented in four 9th grade-biology classrooms. Participants in Phase 1 (N = 118) completed a series of four open-ended writing activities focused on eliciting perceived personal connections to academic content. Exploratory qualitative content analysis of a 25% random sample of the student responses was used to identify the main meaning-units of the proposed model as well as different dimensions of student relevance perceptions. These meaning-units and dimensions provided the basis for the construction of a conceptual mapping sentence capturing students' perceived relevance, which was then applied in a confirmatory analysis to all other student responses. Participants in Phase 2 (N = 139) completed a closed survey designed based on the mapping sentence to assess their perceived relevance of a biology unit. The survey also included scales assessing other domain-level motivational processes. Exploratory factor analysis and non-metric multidimensional scaling indicated a coherent conceptual structure, which included a primary interpretive relevance dimension. Comparison of the conceptual structure across various groups (randomly-split sample, gender, academic level, domain-general motivational profiles) provided support for its ubiquity and insight into variation in the experience of perceived relevance among students of different

Definition of the Situation of Children Demobilized Illegal Armed Groups in the Legal Acts and Psychoeducational Effects

Directory of Open Access Journals (Sweden)

Jaime Alberto Carmona Parra

2014-06-01

Full Text Available The article begins with a reflection on performative utterances, which are speech acts, to show that the right contributes to the creation of reality and subjectivity. Based on this argument examines five definitions of the situation of children demobilized from illegal armed groups in Colombia, named according to their effects psychoeducational: victimizing, pathologizing, criminalizing, idealizing and responsabilizing. Each definition is examined in terms of their philosophical affiliation, deterministic, nondeterministic or interactionist, its effects on the construction of the identity of minors and in his appeal to responsibility and legal insanity. At the end of the article shows the intervention proposals arising from each of the definitions and shows the role that restorative justice can play in building a model of care which confers responsibility to the children demobilized from illegal armed groups, and other victims of armed conflict, which guarantees the restitution of rights and also empowers them as key actors in redefining their social role and identity reconstruction.

Which aspects of functioning are relevant for patients with ankylosing spondylitis: results of focus group interviews.

Science.gov (United States)

Boonen, Annelies; van Berkel, Monique; Cieza, Alarcos; Stucki, Gerold; van der Heijde, Désirée

2009-11-01

To investigate whether concepts important to patients with ankylosing spondylitis (AS) are covered by disease-specific self-report health status instruments. A qualitative focus group study was conducted with AS patients on problems in daily functioning. Group sessions with 4 to 5 patients each were organized up to the point that no new information was brought forward. Group sessions were tape-recorded, transcribed, and divided into meaning units. Concepts contained in the meaning units were extracted. Self-report instruments on health status specific for AS were identified in a literature search. Using the International Classification of Functioning, Disability and Health (ICF) as a common reference, it was determined whether the concepts identified in the focus groups were covered by the instruments. Nineteen patients participated in 4 focus group interviews. In total, 332 unique meaning units were linked to 90 second-level ICF categories, of which 25 referred to body functions, 10 to body structures, 35 to activities and participation and 30 to environmental factors. In addition, several concepts relating to personal factors were identified. Only 47 categories were also covered by one of the self-report instruments in AS. Only a minority of concepts addressed by the AS-specific questionnaires were not revealed as relevant in the interviews. Relevant aspects of the influence of AS are not covered by the classic disease-specific instruments. In particular, the influence of AS on socializing and leisure and the relevance of environmental and personal factors are not adequately assessed by available instruments.

Is Information Still Relevant?

Science.gov (United States)

Ma, Lia

2013-01-01

Introduction: The term "information" in information science does not share the characteristics of those of a nomenclature: it does not bear a generally accepted definition and it does not serve as the bases and assumptions for research studies. As the data deluge has arrived, is the concept of information still relevant for information…

Does the applied polytrauma definition notably influence outcome and patient population? - a retrospective analysis.

Science.gov (United States)

Frenzel, Stephan; Krenn, Philipp; Heinz, Thomas; Negrin, Lukas Leopold

2017-08-31

Although the term "polytrauma" has been in use for decades, no generally accepted definition exists. The aim of this study was to demonstrate that different polytrauma definitions applied to a specific patient population result in diverse subgroups of individuals, who in turn present a varying outcome. All patients (≥18 years) treated at our level I trauma center within a time period of three years were classified according to 11 selected polytrauma definitions and included in our study, if they were rated "polytraumatized" by at least one of these definitions. All patients, who met the criteria of a certain definition, were combined to the relevant definition-positive group, thus resulting in 11 patient subgroups. Their demographic data (number of patients, mean patient age, mean Injury Severity Score value, median number of ventilator days, median length of stay at the intensive care unit and at the hospital, mortality rate and odds ratio) were statistically compared. Three hundred seventy-five patients (73% male) with a mean age of 47 years met the inclusion criteria and were allocated to the relevant subgroups; their patient number varied from 55 to 346 and their mean Injury Severity Score value ranged from 4 to 75. Not surprisingly, all examined parameters were subject to variations. Whereas most definition-positive groups showed a mortality rate of about 21% to 30%, 18% of the individuals, who met the criteria according to Blacker, and 40% of the polytrauma victims according to Schalamon died. The Pape 1-, Schalamon-, and Berlin-positive groups presented a significant odds ratio with regard to mortality that considerably exceeded 1. A polytrauma definition can only be a reliable tool in classifying trauma victims if it provides a significant odds ratio with regard to mortality that considerably exceeds 1 and if it succeeds in capturing patients with multiple severe injuries and a higher mortality rate without reducing the number of polytraumatized

Linking Keystone Species and Functional Groups: A New Operational Definition of the Keystone Species Concept

OpenAIRE

Robert D. Davic

2003-01-01

The concept of the "keystone species" is redefined to allow for the a priori prediction of these species within ecosystems. A keystone species is held to be a strongly interacting species whose top-down effect on species diversity and competition is large relative to its biomass dominance within a functional group. This operational definition links the community importance of keystone species to a specific ecosystem process, e.g., the regulation of species diversity, within functional groups ...

Cross-Cultural Validation of the Definition of Multimorbidity in the Bulgarian Language.

Science.gov (United States)

Assenova, Radost S; Le Reste, Jean Yves; Foreva, Gergana H; Mileva, Daniela S; Czachowski, Slawomir; Sowinska, Agnieszka; Nabbe, Patrice; Argyriadou, Stella; Lazic, Djurdjica; Hasaganic, Melida; Lingner, Heidrun; Lygidakis, Harris; Muñoz, Miguel-Angel; Claveria, Ana; Doerr, Chista; Van Marwijk, Harm; Van Royen, Paul; Lietard, Claire

2015-01-01

Multimorbidity is a health issue with growing importance. During the last few decades the populations of most countries in the world have been ageing rapidly. Bulgaria is affected by the issue because of the high prevalence of ageing population in the country with multiple chronic conditions. The AIM of the present study was to validate the translated definition of multimorbidity from English into the Bulgarian language. The present study is part of an international project involving 8 national groups. We performed a forward and backward translation of the original English definition of multimorbidity using a Delphi consensus procedure. The physicians involved accepted the definition with a high percentage of agreement in the first round. The backward translation was accepted by the scientific committee using the Nominal group technique. Some of the GPs provided comments on the linguistic expressions which arose in order to improve understanding in Bulgarian. The remarks were not relevant to the content. The conclusion of the discussion, using a meta-ethnographic approach, was that the differences were acceptable and no further changes were required. A native version of the published English multimorbidity definition has been finalized. This definition is a prerequisite for better management of multimorbidity by clinicians, researchers and policy makers.

The Pindiro Group (Triassic to Early Jurassic Mandawa Basin, southern coastal Tanzania): Definition, palaeoenvironment, and stratigraphy

Science.gov (United States)

Hudson, W. E.; Nicholas, C. J.

2014-04-01

This paper defines the Pindiro Group of the Mandawa Basin, southern coastal Tanzania based on studies conducted between 2006 and 2009 with the objective of understanding the evolution of this basin. This work draws upon field data, hydrocarbon exploration data, unconventional literature, and the scant published materials available. The paper focuses on the evolution, depositional environments, and definition of the lowermost sedimentary package, which overlies unconformably the metamorphic basement of Precambrian age. The package is described here as the Pindiro Group and it forms the basal group of the Mandawa Basin stratigraphy.

Renormalization group in the theory of fully developed turbulence. Problem of the infrared relevant corrections to the Navier-Stokes equation

International Nuclear Information System (INIS)

Antonov, N.V.; Borisenok, S.V.; Girina, V.I.

1996-01-01

Within the framework of the renormalization group approach to the theory of fully developed turbulence we consider the problem of possible IR relevant corrections to the Navier-Stokes equation. We formulate an exact criterion of the actual IR relevance of the corrections. In accordance with this criterion we verify the IR relevance for certain classes of composite operators. 17 refs., 2 tabs

Relevance of the new pre-cachexia and cachexia definitions for patients with rheumatoid arthritis

NARCIS (Netherlands)

van Bokhorst-de van der Schueren, M.A.E.; Konijn, N.P.C.; Bultink, I.E.M.; Lems, W.F.; Earthman, C.P.; van Tuyl, H.D.

2012-01-01

Background & aims: The recently proposed definitions of 'pre-cachexia' and 'cachexia' might offer new possibilities for the detection of malnutrition in patients with rheumatoid arthritis (RA). Methods: The prevalence of different components of nutritional status and the compiled definitions of

Towards a universal definition of competitive intelligence

Directory of Open Access Journals (Sweden)

Rene Pellissier

2013-10-01

Objectives: The purpose of this research is to review the current literature on CI with the aim of identifying and analysing CI definitions to establish the commonalities and differences, to propose a universal and comprehensive definition of CI and to set the borders of CI for common understanding amongst CI stakeholders. Method: The study was qualitative in nature and content analysis was conducted on all identified sources establishing and analysing CI definitions. To identify relevant literature, academic databases and search engines were used. A review of references in related studies led to more relevant sources, the references of which were further reviewed and analysed. Keywords ‘competitive intelligence’, ‘marketing intelligence’ and ‘business intelligence’ were used in search engines to find relevant sources. To ensure reliability, only peer-reviewed articles were used. Results: The majority of scholars define CI as a process and acknowledge that CI is collected from the internal and external or competitive environment. They also outline the goals of CI, which are to help in decision-making and provide a competitive advantage. Conclusion: The proposed definition outlines the process, purpose, source, deliverables, beneficiaries, benefit, ethicality and legality of CI, sets out the borders of CI and ensures a common understanding amongst CI stakeholders.

Focal versus diffuse anaplasia in Wilms tumor--new definitions with prognostic significance: a report from the National Wilms Tumor Study Group.

Science.gov (United States)

Faria, P; Beckwith, J B; Mishra, K; Zuppan, C; Weeks, D A; Breslow, N; Green, D M

1996-08-01

Anaplasia, defined by the presence of extreme nuclear and mitotic atypia, is a potent marker of adverse prognosis in Wilms tumor (WT). Anaplastic WT cells apparently have increased resistance to therapy rather than increased aggressiveness. The distribution of anaplasia should therefore have critical prognostic relevance. The original definitions for focal anaplasia (FA) and diffuse anaplasia (DA) were based on quantitative rather than topographical criteria and lacked prognostic significance. A new definition was developed based on the distribution of anaplastic changes within the tumor: FA applies only to tumors with anaplasia confined to one or a few discrete loci within the primary tumor, with no anaplasia or marked nuclear atypia elsewhere. This revised definition was evaluated in 165 cases with anaplastic WT entered on the third and fourth National Wilms Tumor Study. Only three relapses and one death occurred among 39 cases with FA, regardless of tumor stage, a result comparable to that for nonanaplastic WT. Eight children with metastases at diagnosis and FA in the primary tumor were alive and free of relapse; 22 of 23 children with stage IV DA WT died of tumor. This new definition reinforces the importance of carefully documenting the exact site from which each tumor section is obtained.

Making Learning Personally Meaningful: A New Framework for Relevance Research

Science.gov (United States)

Priniski, Stacy J.; Hecht, Cameron A.; Harackiewicz, Judith M.

2018-01-01

Personal relevance goes by many names in the motivation literature, stemming from a number of theoretical frameworks. Currently these lines of research are being conducted in parallel with little synthesis across them, perhaps because there is no unifying definition of the relevance construct within which this research can be situated. In this…

Case definition and classification of leukodystrophies and leukoencephalopathies

NARCIS (Netherlands)

Vanderver, Adeline; Prust, Morgan; Tonduti, Davide; Mochel, Fanny; Hussey, Heather M.; Helman, Guy; Garbern, James; Eichler, Florian; Labauge, Pierre; Aubourg, Patrick; Rodriguez, Diana; Patterson, Marc C.; van Hove, Johan L. K.; Schmidt, Johanna; Wolf, Nicole I.; Boespflug-Tanguy, Odile; Schiffmann, Raphael; van der Knaap, Marjo S.

2015-01-01

An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Thirteen experts at multiple institutions participated in iterative

Case definition and classification of leukodystrophies and leukoencephalopathies

NARCIS (Netherlands)

Vanderver, A.; Prust, M.; Tonduti, D.; Mochel, F.; Hussey, H.M.; Helman, G.; Garbern, J.; Eichler, F.; Labauge, P.; Aubourg, P.; Rodriguez, D.; Patterson, M.C.; van Hove, J.LK.; Schmidt, J; Wolf, N.I.; Boespflug-Tanguy, O.; Schiffmann, R.; van der Knaap, M.S.

2015-01-01

Objective: An approved definition of the term leukodystrophy does not currently exist. The lack of a precise case definition hampers efforts to study the epidemiology and the relevance of genetic white matter disorders to public health. Method: Thirteen experts at multiple institutions participated

Relevance as a Subjective and Situational Multidimensional Concept

NARCIS (Netherlands)

C. Eickhoff (Carsten)

2012-01-01

htmlabstractRelevance is the central concept of information retrieval. Although its important role is unanimously accepted among researchers, numerous different definitions of the term have emerged over the years. Considerable effort has been put into creating consistent and universally applicable

Linking Keystone Species and Functional Groups: A New Operational Definition of the Keystone Species Concept

Directory of Open Access Journals (Sweden)

Robert D. Davic

2003-07-01

Full Text Available The concept of the "keystone species" is redefined to allow for the a priori prediction of these species within ecosystems. A keystone species is held to be a strongly interacting species whose top-down effect on species diversity and competition is large relative to its biomass dominance within a functional group. This operational definition links the community importance of keystone species to a specific ecosystem process, e.g., the regulation of species diversity, within functional groups at lower trophic levels that are structured by competition for a limited resource. The a priori prediction of keystone species has applied value for the conservation of natural areas.

Relevant Market in Commercial Aviation of the European Union

Directory of Open Access Journals (Sweden)

Jakub Kociubiński

2011-06-01

Full Text Available The purpose of this paper is to provide a brief overview of the issue of definition of relevant market in civil aviation within the European Union. The liberalization of the market since the early 1990s has led to a rapid increase in the number of airlines operating in the EU. The increase in the competitiveness of the market has brought many positive changes for passengers, such as lower fares and a better network of connections. At the same time it has created a risk that the airlines, in order to gain a competitive edge, would infringe the rules of competition. This is especially important in the context of the phenomenon that is the development of the airline alliances, which could lead to an abuse of a dominant position. A clear definition of the relevant market is a first step in an assessment of whether such an abuse occurred. This paper focus on the elements that Internal Market regulator, the European Commission, takes into consideration when defining relevant market in the airline industry.

World disparities in risk definition and management of retinoblastoma: a report from the International Retinoblastoma Staging Working Group.

Science.gov (United States)

Chantada, Guillermo L; Doz, François; Orjuela, Manuela; Qaddoumi, Ibrahim; Sitorus, Rita S; Kepak, Tomas; Furmanchuk, Anna; Castellanos, Mauricio; Sharma, Tarun; Chevez-Barrios, Patricia; Rodriguez-Galindo, Carlos

2008-03-01

Following from the publication of the International Retinoblastoma Staging System, an open internet discussion group was created at the www.cure4kids.org resource. The results of a survey distributed among participants are discussed. Although most patients with retinoblastoma were treated under prospective protocols, there was a wide variation in the definition of risk criteria and in the criteria for giving adjuvant chemotherapy following enucleation. Definition of high-risk histological features and the criteria for use of adjuvant therapy will be standardized in future studies. Internet meetings are a valuable mechanism for enabling participation from under-resourced countries in the development of cooperative studies. (c) 2007 Wiley-Liss, Inc.

Brazilian industry of natural gas: criteria for definition of relevant markets concerning the defense of competition; Industria brasileira do gas natural: criterios de definicao dos mercados relevantes para efeito de defesa da concorrencia

Energy Technology Data Exchange (ETDEWEB)

Mano, Gustavo; Tiryaki, Gisele Ferreira [Universidade de Salvador (UNIFACS), BA (Brazil)

2008-07-01

A key point in the examination of the legality of antitrust practices is the delimitation of the relevant markets where the economic relations object of the analysis take place. This is the basis for the evaluation of the market power of the agents involved and the possible harm to competition they may cause. This work offers a study of the criteria for the determination of the relevant market in the scope of the natural gas industry in Brazil. It aims at identifying the performance of the agencies taking part in the Brazilian Antitrust System (SBDC) with regards to the examination of the related antitrust practices. These agencies work in connection with the National Petroleum, Natural Gas and Biofuels Regulatory Agency (ANP), which is responsible for issuing technical reports on the subjects related to its area of competence. The analysis presented here has the main goal of verifying if the most important technical, operational and legal aspects are being adequately considered by the SBDC and ANP in the definition of the relevant markets as a basis for the judgment of the antitrust practices, and if they are coherent with the principles for fostering economic competition. The results points out that, despite the successful cooperation between the SBDC and the ANP, there are the used definition of the relevant markets for the natural gas industry still needs refinement. (author)

Consensus statement on definition, diagnosis, and management of high-risk prostate cancer patients on behalf of the Spanish Groups of Uro-Oncology Societies URONCOR, GUO, and SOGUG.

Science.gov (United States)

Henríquez, I; Rodríguez-Antolín, A; Cassinello, J; Gonzalez San Segundo, C; Unda, M; Gallardo, E; López-Torrecilla, J; Juarez, A; Arranz, J

2018-03-01

Prostate cancer (PCa) is the most prevalent malignancy in men and the second cause of mortality in industrialized countries. Based on Spanish Register of PCa, the incidence of high-risk PCa is 29%, approximately. In spite of the evidence-based beneficial effect of radiotherapy and androgen deprivation therapy in high-risk PCa, these patients (pts) are still a therapeutic challenge for all specialists involved, in part due to the absence of comparative studies to establish which of the present disposable treatments offer better results. Nowadays, high-risk PCa definition is not well consensual through the published oncology guides. Clinical stage, tumour grade, and number of risk factors are relevant to be considered on PCa prognosis. However, these factors are susceptible to change depending on when surgical or radiation therapy is considered to be the treatment of choice. Other factors, such as reference pathologist, different diagnosis biopsy schedules, surgical or radiotherapy techniques, adjuvant treatments, biochemical failures, and follow-up, make it difficult to compare the results between different therapeutic options. This article reviews important issues concerning high-risk PCa. URONCOR, GUO, and SOGUG on behalf of the Spanish Groups of Uro-Oncology Societies have reached a consensus addressing a practical recommendation on definition, diagnosis, and management of high-risk PCa.

Autonomia e relevância dos regimes The autonomy and relevance of regimes

Directory of Open Access Journals (Sweden)

Gustavo Seignemartin de Carvalho

2005-12-01

of norms and rules that create patterns of behavior and allow the convergence of the expectations of their participants in specific issue areas, in order to solve coordination problems that could lead to non-pareto-efficient outcomes. Considering that such definitions based merely on the "efficiency" of regimes do not seem to be sufficient to explain their effectiveness, the present article proposes a different definition for regimes: political arrangements that allow a redistribution of the gains of cooperation among the participants in certain issue areas, within an interdependence context. Regimes would thus be effective due to their autonomy and relevance - that is, due to their objective existence autonomously from their participants and their influence on the participants' behavior and expectations in ways that cannot be reduced to the individual action of any of them. This article begins with a brief discussion about terminological problems related to regime studies and with a definition of the concepts of autonomy and relevance. Then it classifies the authors that take part in this debate according to two distinct perspectives, one that denies (non-autonomists and the other that attributes (autonomists autonomy and relevance to regimes, briefly analyzing the authors and traditions that are more significant for this debate, focusing on autonomist authors and on arguments that back the hypothesis here presented. Finally, the article proposes an analytic decomposition of regimes into four main elements that give them autonomy and relevance: normativity, actors, specificity of the issue area and complex interdependence as context.

National inventory of Global Change relevant research in Norway; Nasjonal kartlegging av global change-relevant forskning

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-05-01

The Norwegian Global Change Committee has made an inventory of global change research (GCR) projects funded by the Research Council of Norway (RCN) in 2001. In lack of a rigid definition, GCR was defined as research that can be considered relevant to the science agenda of the four major international global change programmes DIVERSITAS, IGBP, IHDP and WCRP. Relevance was judged based on the objectives stated for each of the international programmes and their core projects. It was not attempted to check whether the projects had any kind of link to the programmes they were considered relevant for. The grants provided by the RCN in 2001 to GCR as defined above amounts to about 77 mill. NOK. Based on a recent survey on climate change research it is reasonable to estimate that the RCN finances between 30 and 40 % of all GCR in Norway. Accordingly, the total value of Norwegian research relevant to the four international global change programmes in 2001 can be estimated to 192 - 254 mill. NOK.

Qualities in friendship - Within an outside perspective - Definitions expressed by adolescents with mild intellectual disabilities.

Science.gov (United States)

Sigstad, Hanne Marie Høybråten

2017-03-01

This study examined how adolescents with mild intellectual disabilities define qualities of friendship and discussed the extent to which these definitions adhere to established definitions of close friendship. The study was based on qualitative interviews with 11 adolescents in secondary school. The interviews were supplemented with information from six parents. A thematic structural analysis was used to identify themes. Qualities of friendship were categorized as mutual preference, mutual enjoyment, shared interactions, care, mutual trust and bonding. The criteria for close friendship seem to be fulfilled, albeit to a moderate degree. Closeness and reciprocity appear to be significant in this study, although these features have been considered less relevant within this target group in previous research. Differences in definitions may explain divergent results compared with other studies, and the need to achieve equivalence in friendship may be another.

On the definition of an admitted Lie group for stochastic differential equations with multi-Brownian motion

International Nuclear Information System (INIS)

Srihirun, B; Meleshko, S V; Schulz, E

2006-01-01

The definition of an admitted Lie group of transformations for stochastic differential equations has been already presented for equations with one-dimensional Brownian motion. The transformation of the dependent variables involves time as well, and it has been proven that Brownian motion is transformed to Brownian motion. In this paper, we will discuss this concept for stochastic differential equations involving multi-dimensional Brownian motion and present applications to a variety of stochastic differential equations

The essence of frailty: A systematic review and qualitative synthesis on frailty concepts and definitions.

Science.gov (United States)

Junius-Walker, Ulrike; Onder, Graziano; Soleymani, Dagmar; Wiese, Birgitt; Albaina, Olatz; Bernabei, Roberto; Marzetti, Emanuele

2018-05-31

One of the major threats looming over the growing older population is frailty. It is a distinctive health state characterised by increased vulnerability to internal and external stressors. Although the presence of frailty is well acknowledged, its concept and operationalisation are hampered by the extraordinary phenotypical and biological complexity. Yet, a widely accepted conception is needed to offer tailored policies and approaches. The ADVANTAGE Group aims to analyse the diverse frailty concepts to uncover the essence of frailty as a basis for a shared understanding. A systematic literature review was performed on frailty concepts and definitions from 2010 onwards. Eligible publications were reviewed using concept analysis that led to the extraction of text data for the themes "definition", "attributes", "antecedents", "consequences", and "related concepts". Qualitative description was used to further analyse the extracted text passages, leading to inductively developed categories on the essence of frailty. 78 publications were included in the review, and 996 relevant text passages were extracted for analysis. Five components constituted a comprehensive definition: vulnerability, genesis, features, characteristics, and adverse outcomes. Each component is described in more detail by a set of defining and explanatory criteria. An underlying functional perspective of health or its impairments is most compatible with the entity of frailty. The recent findings facilitate a focus on the relevant building blocks that define frailty. They point to the commonalities of the diverse frailty concepts and definitions. Based on these components, a widely accepted broad definition of frailty comes into range. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Fracture-related infection: A consensus on definition from an international expert group

NARCIS (Netherlands)

W.-J. Metsemakers (Willem-Jan); Morgenstern, M. (M.); McNally, M.A. (M. A.); Moriarty, T.F. (T. F.); McFadyen, I. (I.); Scarborough, M. (M.); N.A. Athanasou (Nicholas); P.E. Ochsner (P.); Kuehl, R. (R.); Raschke, M. (M.); Borens, O. (O.); Xie, Z. (Z.); Velkes, S. (S.); Hungerer, S. (S.); Kates, S.L. (S. L.); Zalavras, C. (C.); Giannoudis, P.V. (P. V.); Richards, R.G. (R. G.); M.H.J. Verhofstad (Michiel)

2017-01-01

textabstractFracture-related infection (FRI) is a common and serious complication in trauma surgery. Accurately estimating the impact of this complication has been hampered by the lack of a clear definition. The absence of a working definition of FRI renders existing studies difficult to evaluate or

A definition and ethical evaluation of overdiagnosis.

Science.gov (United States)

Carter, Stacy M; Degeling, Chris; Doust, Jenny; Barratt, Alexandra

2016-07-08

Overdiagnosis is an emerging problem in health policy and practice: we address its definition and ethical implications. We argue that the definition of overdiagnosis should be expressed at the level of populations. Consider a condition prevalent in a population, customarily labelled with diagnosis A. We propose that overdiagnosis is occurring in respect of that condition in that population when (1) the condition is being identified and labelled with diagnosis A in that population (consequent interventions may also be offered); (2) this identification and labelling would be accepted as correct in a relevant professional community; but (3) the resulting label and/or intervention carries an unfavourable balance between benefits and harms. We identify challenges in determining and weighting relevant harms, then propose three central ethical considerations in overdiagnosis: the extent of harm done, whether harm is avoidable and whether the primary goal of the actor/s concerned is to benefit themselves or the patient, citizen or society. This distinguishes predatory (avoidable, self-benefiting), misdirected (avoidable, other-benefiting) and tragic (unavoidable, other-benefiting) overdiagnosis; the degree of harm moderates the justifiability of each type. We end with four normative challenges: (1) methods for adjudicating between professional standards and identifying relevant harms and benefits should be procedurally just; (2) individuals, organisations and states are differently responsible for addressing overdiagnosis; (3) overdiagnosis is a matter for distributive justice: the burdens of both overdiagnosis and its prevention could fall on the least-well-off; and (4) communicating about overdiagnosis risks harming those unaware that they may have been overdiagnosed. These challenges will need to be addressed as the field develops. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Three new species of Macrelmis Motschulsky (Coleoptera: Elmidae: Elminae) from Southeastern Brazil with new definition of species groups to the genus.

Science.gov (United States)

Dos Passos, Maria Inês Silva; De Miranda, Gustavo Silva; Nessimian, Jorge Luiz

2015-12-16

Three new species of Macrelmis Motschulsky, 1859 are described and illustrated based on adult males from Rio de Janeiro, Minas Gerais and São Paulo states (southeastern Brazil). A new species groups definition is proposed for the genus, with a redefinition of the former six (aristeae sp. group, celsa sp. group, isus sp. group, granigera sp. group, milleri sp. group and striata sp. group) and designation of four new groups (alea new sp. group, amazonica new sp. group, grandis new sp. group and jureceki new sp. group). The male genitalia of M. clypeata is illustrated for the first time and distributional maps for all species of the genus are provided.

The softness of an atom in a molecule and a functional group softness definition; an LCAO scale

International Nuclear Information System (INIS)

Giambiagi, M.; Giambiagi, M.S. de; Pires, J.M.; Pitanga, P.

1987-01-01

We introduce a scale for the softness of an atom in different molecules and we similarly define a functional group softness. These definitions, unlike previous ones, are not tied to the finite difference approximation neither, hence, to valence state ionization potentials and electron affinities; they result from the LCAO calculation itself. We conclude that a) the softness of an atom in a molecule shows wide variations; b) the geometric average of the softnesses of the atoms in the molecule gives the most consistent results for the molecular softnesses; c) the functional group softness is transferable within a homologous series. (Author) [pt

28 CFR 32.33 - Definitions.

Science.gov (United States)

2010-07-01

... Administration DEPARTMENT OF JUSTICE PUBLIC SAFETY OFFICERS' DEATH, DISABILITY, AND EDUCATIONAL ASSISTANCE BENEFIT CLAIMS Educational Assistance Benefit Claims § 32.33 Definitions. Application means claim (i.e., a...) In the relevant tax year (with respect to a claim by virtue of the officer's disability). Educational...

Scientific Issues Relevant to Setting Regulatory Criteria to Identify Endocrine-Disrupting Substances in the European Union.

Science.gov (United States)

Slama, Rémy; Bourguignon, Jean-Pierre; Demeneix, Barbara; Ivell, Richard; Panzica, Giancarlo; Kortenkamp, Andreas; Zoeller, R Thomas

2016-10-01

Endocrine disruptors (EDs) are defined by the World Health Organization (WHO) as exogenous compounds or mixtures that alter function(s) of the endocrine system and consequently cause adverse effects in an intact organism, or its progeny, or (sub)populations. European regulations on pesticides, biocides, cosmetics, and industrial chemicals require the European Commission to establish scientific criteria to define EDs. We address the scientific relevance of four options for the identification of EDs proposed by the European Commission. Option 1, which does not define EDs and leads to using interim criteria unrelated to the WHO definition of EDs, is not relevant. Options 2 and 3 rely on the WHO definition of EDs, which is widely accepted by the scientific community, with option 3 introducing additional categories based on the strength of evidence (suspected EDs and endocrine-active substances). Option 4 adds potency to the WHO definition, as a decision criterion. We argue that potency is dependent on the adverse effect considered and is scientifically ambiguous, and note that potency is not used as a criterion to define other particularly hazardous substances such as carcinogens and reproductive toxicants. The use of potency requires a context that goes beyond hazard identification and corresponds to risk characterization, in which potency (or, more relevantly, the dose-response function) is combined with exposure levels. There is scientific agreement regarding the adequacy of the WHO definition of EDs. The potency concept is not relevant to the identification of particularly serious hazards such as EDs. As is common practice for carcinogens, mutagens, and reproductive toxicants, a multi-level classification of ED based on the WHO definition, and not considering potency, would be relevant (corresponding to option 3 proposed by the European Commission). Slama R, Bourguignon JP, Demeneix B, Ivell R, Panzica G, Kortenkamp A, Zoeller RT. 2016. Scientific issues relevant

Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group

DEFF Research Database (Denmark)

Lambert, Robert G W; Bakker, Pauline A C; van der Heijde, Désirée

2016-01-01

OBJECTIVES: To review and update the existing definition of a positive MRI for classification of axial spondyloarthritis (SpA). METHODS: The Assessment in SpondyloArthritis International Society (ASAS) MRI working group conducted a consensus exercise to review the definition of a positive MRI...... for inclusion in the ASAS classification criteria of axial SpA. Existing definitions and new data relevant to the MRI diagnosis and classification of sacroiliitis and spondylitis in axial SpA, published since the ASAS definition first appeared in print in 2009, were reviewed and discussed. The precise wording...... of the existing definition was examined in detail and the data and a draft proposal were presented to and voted on by the ASAS membership. RESULTS: The clear presence of bone marrow oedema on MRI in subchondral bone is still considered to be the defining observation that determines the presence of active...

The relevance of spirituality, religion and personal beliefs to health-related quality of life: themes from focus groups in Britain.

Science.gov (United States)

O'Connell, Kathryn A; Skevington, Suzanne M

2005-09-01

Generic health-related quality of life (QoL) instruments have not routinely assessed spirituality, religion, and personal beliefs (SRPB) in their measurement. This research addresses the perceived importance of 18 facets (dimensions) of SRPB, for example, inner peace, to QoL that are not specific to a religion, but address the experience of having this belief, in relation to health. Adult focus groups were structured according to beliefs from UK surveys. Quotas targeted gender and health status. Nine focus groups (N = 55, age 51, 47% male) contained sick and well people who were religious, Christians, Buddhists, Quakers (50.1%), agnostic (27.4%), or atheist (21.8%) participants. Qualitative and quantitative analysis showed considerable variability in the importance attributed to some concepts, although spiritual strength, meaning in life and inner peace were relevant to all groups. Spiritual strength (4.42), the meaning of life (4.09), wholeness/integration (4.06), and inner peace (4.02) were most important. Divine love, freedom to practice beliefs, and attachment/detachment were less relevant, conceptually confusing or had religious bias; atheists rated them as unimportant and as less important (p religious people. SRPB is relevant to health-related QoL and consensually important facets should be included in generic health care assessments. Their inclusion permits a more holistic assessment and improves the case for a biopsychosociospiritual model of health.

Are Validity and Reliability "Relevant" in Qualitative Evaluation Research?

Science.gov (United States)

Goodwin, Laura D.; Goodwin, William L.

1984-01-01

The views of prominant qualitative methodologists on the appropriateness of validity and reliability estimation for the measurement strategies employed in qualitative evaluations are summarized. A case is made for the relevance of validity and reliability estimation. Definitions of validity and reliability for qualitative measurement are presented…

25 CFR 83.1 - Definitions.

Science.gov (United States)

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Definitions. 83.1 Section 83.1 Indians BUREAU OF INDIAN... GROUP EXISTS AS AN INDIAN TRIBE § 83.1 Definitions. As used in this part: Area Office means a Bureau of... of the history, geography, culture and social organization of the petitioning group. Board means the...

[Self-determined but with professional leadership? On the effectiveness and definition of self-help groups].

Science.gov (United States)

Klytta, C; Wilz, G

2007-02-01

Because the effectiveness of self-help groups (SHGs) has not been proven yet and also since multi-focus reviews on SHGs are rare, the present article offers an overview of the current state of research. Possible reasons for the conflicting results in the literature are also investigated. An extensive literature search was done to review studies which used longitudinal design and control groups to measure the effectiveness of SHGs and so-called "support groups". Positive effects in comparison to the control groups were proven in four out of seven of the studies. In the remaining three studies the outcomes between the groups were the same. Considering the naturalistic designs of the studies, these results clearly indicate that SHGs are indeed effective. An insufficient consideration of the heterogeneity of the groups is held responsible for the difficulties associated with previous research on the topic, especially as far as the differentiation between SHGs and professionally led groups is concerned. The definition excludes professional leadership but, in fact, professional involvement in SHGs up to their leadership is the rule. The following suggestions have been derived from this literature analysis: uniform classifications for SHGs and professionally-led support groups should be established in order to make it possible to provide a clear distinction between these types of groups as well as to indicate the extent of professional involvement in them. A plea is made for a generally stronger consideration of organisational differences in the research of SHGs.

Students' Personal Connection with Science: Investigating the Multidimensional Phenomenological Structure of Self-Relevance

Science.gov (United States)

Hartwell, Matthew; Kaplan, Avi

2018-01-01

This paper presents findings from a two-phase mixed methods study investigating the phenomenological structure of self-relevance among ninth-grade junior high school biology students (Phase 1: N = 118; Phase 2: N = 139). We begin with a phenomenological multidimensional definition of self-relevance as comprising three dimensions: the academic…

[Definition of polytrauma in the German DRG system 2006. Up to 30% "incorrect classifications"].

Science.gov (United States)

Flohé, S; Buschmann, C; Nabring, J; Merguet, P; Luetkes, P; Lefering, R; Nast-Kolb, D; Ruchholtz, S

2007-07-01

Severely injured patients represent a relevant financial cost factor in the health system especially for high level trauma centres. The introduction of a"diagnosis-related group" (DRG) system in Germany further revealed the potential negative economic impact of severely injured patients for trauma centres. In recent years several changes of the specific DRG for severely injured patients occurred with the aim of a convenient reimbursement for the trauma patient. The present study analysed 38 multiply injured patients admitted in the first half of the year 2004. These patients were analysed in terms of the respective DRG that was attributed to the patient on the basis of the definition criteria for 2004 and 2005. In addition for the same patient group the total inpatient treatment costs were calculated according to the algorithm developed by the Working Group on Polytrauma of the German Trauma Society. The analysis revealed three major problems in the reimbursement for severely injured patients according to the German DRG system: (1) In spite of the additional payment for blood compounds on top of the DRG reimbursement in 2005 a mean economic deficit of more than 4000 euro remains for each severely injured patient. (2) In 30% of the analysed trauma patients the combination of the diagnosis and operations did not lead to a specific polytrauma DRG or to an intensive care medicine DRG. (3) In the patients that could not be attributed to a polytrauma DRG, the economic deficit was with an average of more than 9000 euro even higher. This attribution aspect is also currently relevant, since the definition criteria for a polytrauma DRG were not changed in 2006 or 2007. We conclude that besides the recent changes in the reimbursement for polytrauma DRGs, which have been at least partly adapted to the real financial burden of these patients, the definition of a severely injured patient in the German DRG system may also need to be revised.

On the minimal vacuum definition for spin 1 massive fields in Robertson-Walker universes

International Nuclear Information System (INIS)

Castagnino, M.; Laciana, C.; Chimento, L.

1986-01-01

A definition of quantum vacuum is introduced for spin 1, massive, neutral fields, in spatially flat Robertson-Walker universes. For this definition all relevant observables turn out to be devoid of ultraviolet divergencies. (author)

Developing a comprehensive definition of sustainability.

Science.gov (United States)

Moore, Julia E; Mascarenhas, Alekhya; Bain, Julie; Straus, Sharon E

2017-09-02

Understanding sustainability is one of the significant implementation science challenges. One of the big challenges in researching sustainability is the lack of consistent definitions in the literature. Most implementation studies do not present a definition of sustainability, even when assessing sustainability. The aim of the current study was to systematically develop a comprehensive definition of sustainability based on definitions already used in the literature. We searched for knowledge syntheses of sustainability and abstracted sustainability definitions from the articles identified through any relevant systematic and scoping reviews. The constructs in the abstracted sustainability definitions were mapped to an existing definition. The comprehensive definition of sustainability was revised to include emerging constructs. We identified four knowledge syntheses of sustainability, which identified 209 original articles. Of the 209 articles, 24 (11.5%) included a definition of sustainability. These definitions were mapped to three constructs from an existing definition, and nine new constructs emerged. We reviewed all constructs and created a revised definition: (1) after a defined period of time, (2) a program, clinical intervention, and/or implementation strategies continue to be delivered and/or (3) individual behavior change (i.e., clinician, patient) is maintained; (4) the program and individual behavior change may evolve or adapt while (5) continuing to produce benefits for individuals/systems. All 24 definitions were remapped to the comprehensive definition (percent agreement among three coders was 94%). Of the 24 definitions, 17 described the continued delivery of a program (70.8%), 17 mentioned continued outcomes (70.8%), 13 mentioned time (54.2%), 8 addressed the individual maintenance of a behavior change (33.3%), and 6 described the evolution or adaptation (25.0%). We drew from over 200 studies to identify 24 existing definitions of sustainability

Toward a better definition of massive transfusion: focus on the interval of hemorrhage control.

Science.gov (United States)

Sharpe, John P; Weinberg, Jordan A; Magnotti, Louis J; Croce, Martin A; Fabian, Timothy C

2012-12-01

In clinical research, massive transfusion (MT) is commonly defined as transfusion of 10 or more red blood cell (RBC) units within 24 hours. However, the clinical relevance of this definition remains poorly understood. In this study, we evaluated whether patients who reach the MT threshold during hemorrhage control differ clinically from those who reach it after hemorrhage control (i.e., after intensive care unit [ICU] arrival) but before 24 hours. Prospective data were collected on all Level I trauma resuscitations within 5.5 years. Patients transfused 10 or more RBCs in the first 24 hours of hospitalization were identified and stratified according to when the MT threshold was achieved: before ICU arrival (Pre-ICU) versus after ICU arrival but before 24 hours of hospitalization (Post-ICU). Clinical characteristics between groups were compared. Three hundred five patients received 10 or more units before ICU arrival, and 46 reached the MT threshold after ICU arrival but before 24 hours. Both groups were clinically similar with respect to age, sex, and Injury Severity Score, but the Post-ICU group had a larger proportion of blunt injuries (71 vs. 53%, p definition. However, they have a significantly decreased mortality risk at 24 hours and the potential to dilute the study cohort. For research purposes, restricting the MT definition to 10 or more RBCs during hemorrhage control may result in study cohorts with relatively more uniform mortality risks. Prognostic study, level II.

Using novel descriptor accounting for ligand-receptor interactions to define and visually explore biologically relevant chemical space.

Science.gov (United States)

Rabal, Obdulia; Oyarzabal, Julen

2012-05-25

The definition and pragmatic implementation of biologically relevant chemical space is critical in addressing navigation strategies in the overlapping regions where chemistry and therapeutically relevant targets reside and, therefore, also key to performing an efficient drug discovery project. Here, we describe the development and implementation of a simple and robust method for representing biologically relevant chemical space as a general reference according to current knowledge, independently of any reference space, and analyzing chemical structures accordingly. Underlying our method is the generation of a novel descriptor (LiRIf) that converts structural information into a one-dimensional string accounting for the plausible ligand-receptor interactions as well as for topological information. Capitalizing on ligand-receptor interactions as a descriptor enables the clustering, profiling, and comparison of libraries of compounds from a chemical biology and medicinal chemistry perspective. In addition, as a case study, R-groups analysis is performed to identify the most populated ligand-receptor interactions according to different target families (GPCR, kinases, etc.), as well as to evaluate the coverage of biologically relevant chemical space by structures annotated in different databases (ChEMBL, Glida, etc.).

A Unified Mathematical Definition of Classical Information Retrieval.

Science.gov (United States)

Dominich, Sandor

2000-01-01

Presents a unified mathematical definition for the classical models of information retrieval and identifies a mathematical structure behind relevance feedback. Highlights include vector information retrieval; probabilistic information retrieval; and similarity information retrieval. (Contains 118 references.) (Author/LRW)

ON THE FORMATION OF AMIDE POLYMERS VIA CARBONYL–AMINO GROUP LINKAGES IN ENERGETICALLY PROCESSED ICES OF ASTROPHYSICAL RELEVANCE

Energy Technology Data Exchange (ETDEWEB)

Förstel, Marko; Maksyutenko, Pavlo; Jones, Brant M.; Kaiser, Ralf I. [Department of Chemistry, University of Hawaii, 2545 McCarthy Mall, 96822 HI (United States); Sun, Bing J.; Lee, Huan C.; Chang, Agnes H. H., E-mail: ralfk@hawaii.edu, E-mail: hhchang@mail.ndhu.edu.tw [Department of Chemistry, National Dong Hwa University, Shoufeng, Hualien 974, Taiwan (China)

2016-04-01

We report on the formation of organic amide polymers via carbonyl–amino group linkages in carbon monoxide and ammonia bearing energetically processed ices of astrophysical relevance. The first group comprises molecules with one carboxyl group and an increasing number of amine moieties starting with formamide (45 u), urea (60 u), and hydrazine carboxamide (75 u). The second group consists of species with two carboxyl (58 u) and up to three amine groups (73 u, 88 u, and 103 u). The formation and polymerization of these linkages from simple inorganic molecules via formamide und urea toward amide polymers is discussed in an astrophysical and astrobiological context. Our results show that long chain molecules, which are closely related to polypeptides, easily form by energetically processing simple, inorganic ices at very low temperatures and can be released into the gas phase by sublimation of the ices in star-forming regions. Our experimental results were obtained by employing reflectron time-of-flight mass spectroscopy, coupled with soft, single photon vacuum ultraviolet photoionization; they are complemented by theoretical calculations.

ON THE FORMATION OF AMIDE POLYMERS VIA CARBONYL–AMINO GROUP LINKAGES IN ENERGETICALLY PROCESSED ICES OF ASTROPHYSICAL RELEVANCE

International Nuclear Information System (INIS)

Förstel, Marko; Maksyutenko, Pavlo; Jones, Brant M.; Kaiser, Ralf I.; Sun, Bing J.; Lee, Huan C.; Chang, Agnes H. H.

2016-01-01

We report on the formation of organic amide polymers via carbonyl–amino group linkages in carbon monoxide and ammonia bearing energetically processed ices of astrophysical relevance. The first group comprises molecules with one carboxyl group and an increasing number of amine moieties starting with formamide (45 u), urea (60 u), and hydrazine carboxamide (75 u). The second group consists of species with two carboxyl (58 u) and up to three amine groups (73 u, 88 u, and 103 u). The formation and polymerization of these linkages from simple inorganic molecules via formamide und urea toward amide polymers is discussed in an astrophysical and astrobiological context. Our results show that long chain molecules, which are closely related to polypeptides, easily form by energetically processing simple, inorganic ices at very low temperatures and can be released into the gas phase by sublimation of the ices in star-forming regions. Our experimental results were obtained by employing reflectron time-of-flight mass spectroscopy, coupled with soft, single photon vacuum ultraviolet photoionization; they are complemented by theoretical calculations

What Is A Homosexual? A Definitional Model.

Science.gov (United States)

Berger, Raymond M.

1983-01-01

Presents a definitional model to explain homosexuality and discusses its implications for practice. Contends that social workers must discard the traditional binary model of hetersexual versus homesexual for one incorporating relevant psychosocial factors including life experiences, social reaction, and association with others. (Author/JAC)

Autism-relevant traits interact with temporoparietal junction stimulation effects on social cognition: a high-definition transcranial direct current stimulation and electroencephalography study.

Science.gov (United States)

Donaldson, Peter H; Kirkovski, Melissa; Rinehart, Nicole J; Enticott, Peter G

2018-03-01

The temporoparietal junction (TPJ) is implicated in mental and emotional state attribution, processes associated with autism-relevant traits. Transcranial direct current stimulation (tDCS) to the TPJ can influence social-cognitive performance. However, associations with electrophysiology and autism-relevant traits remain relatively unexamined. This study had two aims: first, exploring links between Autism-Spectrum Quotient (AQ) scores and social-cognitive performance; second, examining interactions between AQ scores and high-definition-tDCS (HD-tDCS) applied to the right TPJ in terms of mental/emotional state attribution and neurophysiological outcomes. Fifty-three participants completed mental/emotional state attribution tasks before and after HD-tDCS. Pre-stimulation mental state attribution accuracy was reduced in participants with higher AQ Switching scores. Cathodal stimulation was associated with reduced emotion attribution performance in participants with higher AQ Switching and AQ Social scores (the latter at trend-level). Anodal stimulation more frequently interacted with AQ Social scores in terms of neurophysiology, in particular regarding reduced delta power in the left compared to right TPJ, and trend-level positive interactions with P100 and P300 latencies during the emotion recognition task. Elements of attention/switching (AQ Switching) may subserve or underpin elements of social cognition (AQ Social), and cathodal and anodal stimulation may have differing effects depending on trait levels in these domains. This study makes an important and original contribution in terms of increasing understanding of how such trait-level variation might interact with the effects of tDCS and also extending previous studies with regard to understanding potential roles of the rTPJ in both attention and social cognition and how autism-relevant traits might influence TPJ function. © 2017 Federation of European Neuroscience Societies and John Wiley & Sons Ltd.

On the definition of a DEMO (demonstration) reactor

International Nuclear Information System (INIS)

Cole, H.C.; Challender, R.S.

1987-01-01

The paper is an appendix to a study of the reactor relevance of the NET design concept. The latter study examines whether the technologies and design principles proposed for NET can be directly extrapolated to a demonstration (DEMO) reactor. The authors have suggested a definition of a DEMO, and listed what they considered to be the most important implications of this definition. A table of parameters is included comparing published DEMO's with typical commercial reactor and 'pre-DEMO' studies. (U.K.)

Prognostic relevance of motor talent predictors in early adolescence: A group- and individual-based evaluation considering different levels of achievement in youth football.

Science.gov (United States)

Höner, Oliver; Votteler, Andreas

2016-12-01

In the debate about the usefulness of motor diagnostics in the talent identification process, the prognostic validity for tests conducted in early adolescence is of critical interest. Using a group- and individual-based statistical approach, this prospective cohort study evaluated a nationwide assessment of speed abilities and technical skills regarding its relevance for future achievement levels. The sample consisted of 22,843 U12-players belonging to the top 4% in German football. The U12-results in five tests served as predictors for players' selection levels in U16-U19 (youth national team, regional association, youth academy, not selected). Group-mean differences proved the prognostic relevance for all predictors. Low individual selection probabilities demonstrated limited predictive values, while excellent test results proved their particular prognostic relevance. Players scoring percentile ranks (PRs) ≥ 99 had a 12 times higher chance to become youth national team players than players scoring PR talents) but also led to lower sensitivity (loss of talents). Extending the current research, these different approaches revealed the ambiguity of the diagnostics' prognostic relevance, representing both the usefulness and several pitfalls of nationwide diagnostics. Therefore, the present diagnostics can support but not substitute for coaches' subjective decisions for talent identification, and multidisciplinary designs are required.

Severe Chronic Upper Airway Disease (SCUAD) in children. Definition issues and requirements.

Science.gov (United States)

Karatzanis, A; Kalogjera, L; Scadding, G; Velegrakis, S; Kawauchi, H; Cingi, C; Prokopakis, E

2015-07-01

Upper airway diseases are extremely common, and a significant proportion of patients are not adequately controlled by contemporary treatment algorithms. The term SCUAD (Severe Chronic Upper Airway Disease) has been previously introduced to describe such cases. However, this term has not been adequately focused on children. This study aims to address the necessity of the term, as well as further details specifically for children. For this purpose, a review was performed of the current literature, with specific focus on issues regarding SCUAD in children. Paediatric SCUAD represents a heterogeneous group of patients and has significant clinical and socioeconomic implications. Relevant literature is generally lacking and questions regarding definition and pathogenesis remain unanswered. Accurate definition and acknowledgement of paediatric SCUAD cases may lead to better design of future clinical and molecular research protocols. This may provide improved understanding of the underlying disease processes, more accurate data regarding socioeconomic burden, and, above all, more successful treatment and prevention strategies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Time for a neonatal-specific consensus definition for sepsis.

Science.gov (United States)

Wynn, James L; Wong, Hector R; Shanley, Thomas P; Bizzarro, Matthew J; Saiman, Lisa; Polin, Richard A

2014-07-01

To review the accuracy of the pediatric consensus definition of sepsis in term neonates and to determine the definition of neonatal sepsis used. The review focused primarily on pediatric literature relevant to the topic of interest. Neonatal sepsis is variably defined based on a number of clinical and laboratory criteria that make the study of this common and devastating condition very difficult. Diagnostic challenges and uncertain disease epidemiology necessarily result from a variable definition of disease. In 2005, intensivists caring for children recognized that as new drugs became available, children would be increasingly studied and thus, pediatric-specific consensus definitions were needed. Pediatric sepsis criteria are not accurate for term neonates and have not been examined in preterm neonates for whom the developmental stage influences aberrations associated with host immune response. Thus, specific consensus definitions for both term and preterm neonates are needed. Such definitions are critical for the interpretation of observational studies, future training of scientists and practitioners, and implementation of clinical trials in neonates.

40 CFR 82.260 - Definitions.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Definitions. 82.260 Section 82.260... STRATOSPHERIC OZONE Halon Emissions Reduction § 82.260 Definitions. Halon-containing equipment means equipment.... This group consists of the three halogenated hydrocarbons known as Halon 1211, Halon 1301, and Halon...

An evaluation of HIV elite controller definitions within a large seroconverter cohort collaboration

NARCIS (Netherlands)

Olson, Ashley D.; Meyer, Laurence; Prins, Maria; Thiebaut, Rodolphe; Gurdasani, Deepti; Guiguet, Marguerite; Chaix, Marie-Laure; Amornkul, Pauli; Babiker, Abdel; Sandhu, Manjinder S.; Porter, Kholoud; del Amo, Julia; Bucher, Heiner C.; Chêne, Geneviève; Hamouda, Osamah; Pillay, Deenan; Rosinska, Magda; Sabin, Caroline; Touloumi, Giota; Olson, Ashley; Coughlin, Kate; Walker, Sarah; de Luca, Andrea; Fisher, Martin; Muga, Roberto; Kelleher, Tony; Cooper, David; Grey, Pat; Finlayson, Robert; Bloch, Mark; Ramacciotti, Tim; Gelgor, Linda; Smith, Don; Zangerle, Robert; Gill, John; Lutsar, Irja; Dabis, Francois; Masquelier, Bernard; Costagliola, Dominique; Vanhems, Philippe; Ghosn, Jade; Boufassa, Faroudy; Kücherer, Claudia; Bartmeyer, Barbara; Paparizos, V.; Gargalianos-Kakolyris, P.; Geskus, Ronald; van der Helm, Jannie; Schuitemaker, Hanneke; Reiss, Peter

2014-01-01

Understanding the mechanisms underlying viral control is highly relevant to vaccine studies and elite control (EC) of HIV infection. Although numerous definitions of EC exist, it is not clear which, if any, best identify this rare phenotype. We assessed a number of EC definitions used in the

Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer.

Science.gov (United States)

Rahbari, Nuh N; Weitz, Jürgen; Hohenberger, Werner; Heald, Richard J; Moran, Brendan; Ulrich, Alexis; Holm, Torbjörn; Wong, W Douglas; Tiret, Emmanuel; Moriya, Yoshihiro; Laurberg, Søren; den Dulk, Marcel; van de Velde, Cornelis; Büchler, Markus W

2010-03-01

Anastomotic leakage represents a major complication after anterior resection of the rectum. The incidence of anastomotic leakage varies considerably among clinical studies in part owing to the lack of a standardized definition of this complication. The aim of the present article was to propose a definition and severity grading of anastomotic leakage after anterior rectal resection. After a literature review a consensus definition and severity grading of anastomotic leakage was developed within the International Study Group of Rectal Cancer. Anastomotic leakage should be defined as a defect of the intestinal wall at the anastomotic site (including suture and staple lines of neorectal reservoirs) leading to a communication between the intra- and extraluminal compartments. Severity of anastomotic leakage should be graded according to the impact on clinical management. Grade A anastomotic leakage results in no change in patients' management, whereas grade B leakage requires active therapeutic intervention but is manageable without re-laparotomy. Grade C anastomotic leakage requires re-laparotomy. The proposed definition and clinical grading is applicable easily in the setting of clinical studies. It should be applied in future reports to facilitate valid comparison of the results of different studies. Copyright 2010 Mosby, Inc. All rights reserved.

European Population Genetic Substructure: Further Definition of Ancestry Informative Markers for Distinguishing Among Diverse European Ethnic Groups

Science.gov (United States)

Tian, Chao; Kosoy, Roman; Nassir, Rami; Lee, Annette; Villoslada, Pablo; Klareskog, Lars; Hammarström, Lennart; Garchon, Henri-Jean; Pulver, Ann E.; Ransom, Michael; Gregersen, Peter K.; Seldin, Michael F.

2009-01-01

The definition of European population genetic substructure and its application to understanding complex phenotypes is becoming increasingly important. In the current study using over 4000 subjects genotyped for 300 thousand SNPs we provide further insight into relationships among European population groups and identify sets of SNP ancestry informative markers (AIMs) for application in genetic studies. In general, the graphical description of these principal components analyses (PCA) of diverse European subjects showed a strong correspondence to the geographical relationships of specific countries or regions of origin. Clearer separation of different ethnic and regional populations was observed when northern and southern European groups were considered separately and the PCA results were influenced by the inclusion or exclusion of different self-identified population groups including Ashkenazi Jewish, Sardinian and Orcadian ethnic groups. SNP AIM sets were identified that could distinguish the regional and ethnic population groups. Moreover, the studies demonstrated that most allele frequency differences between different European groups could be effectively controlled in analyses using these AIM sets. The European substructure AIMs should be widely applicable to ongoing studies to confirm and delineate specific disease susceptibility candidate regions without the necessity to perform additional genome-wide SNP studies in additional subject sets. PMID:19707526

Developing a Construct to Evaluate Flares in Rheumatoid Arthritis: A Conceptual Report of the OMERACT RA Flare Definition Working Group

DEFF Research Database (Denmark)

Alten, Rieke; Choy, Ernest H; Christensen, Robin

2011-01-01

Rheumatoid arthritis (RA) patients and healthcare professionals (HCP) recognize that episodic worsening disease activity, often described as a "flare," is a common feature of RA that can contribute to impaired function and disability. However, there is no standard definition to enable measurement...... of its intensity and impact. The conceptual framework of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) RA Flare Definition Working Group includes an anchoring statement, developed at OMERACT 9 in 2008: "flare in RA" is defined as worsening of signs and symptoms of sufficient intensity....... The conceptual framework of flare takes into account validated approaches to measurement in RA: (1) various disease activity indices (e.g., Disease Activity Score, Clinical Disease Activity Index, Simplified Disease Activity Index); (2) use of patient-reported outcomes (PRO); and (3) characterization...

Deriving Prostate Alpha-Beta Ratio Using Carefully Matched Groups, Long Follow-Up and the Phoenix Definition of Biochemical Failure

International Nuclear Information System (INIS)

Shaffer, Richard; Pickles, Tom; Lee, Richard; Moiseenko, Vitali

2011-01-01

Purpose: Prior studies have derived low values of alpha-beta ratio (a/ss) for prostate cancer of approximately 1-2 Gy. These studies used poorly matched groups, differing definitions of biochemical failure, and insufficient follow-up. Methods and Materials: National Comprehensive Cancer Network low- or low-intermediate risk prostate cancer patients, treated with external beam radiotherapy or permanent prostate brachytherapy, were matched for prostate-specific antigen, Gleason score, T-stage, percentage of positive cores, androgen deprivation therapy, and era, yielding 118 patient pairs. The Phoenix definition of biochemical failure was used. The best-fitting value for a/ss was found for up to 90-month follow-up using maximum likelihood analysis, and the 95% confidence interval using the profile likelihood method. Linear quadratic formalism was applied with the radiobiological parameters of relative biological effectiveness = 1.0, potential doubling time = 45 days, and repair half-time = 1 hour. Bootstrap analysis was performed to estimate uncertainties in outcomes, and hence in a/ss. Sensitivity analysis was performed by varying the values of the radiobiological parameters to extreme values. Results: The value of a/ss best fitting the outcomes data was >30 Gy, with lower 95% confidence limit of 5.2 Gy. This was confirmed on bootstrap analysis. Varying parameters to extreme values still yielded best-fit a/ss of >30 Gy, although the lower 95% confidence interval limit was reduced to 0.6 Gy. Conclusions: Using carefully matched groups, long follow-up, the Phoenix definition of biochemical failure, and well-established statistical methods, the best estimate of a/ss for low and low-tier intermediate-risk prostate cancer is likely to be higher than that of normal tissues, although a low value cannot be excluded.

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality.

Directory of Open Access Journals (Sweden)

Belinda von Niederhäusern

Full Text Available To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research.We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes.Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives.Clinical research quality is often discussed but rarely defined. A framework defining clinical research quality across

Towards the development of a comprehensive framework: Qualitative systematic survey of definitions of clinical research quality

Science.gov (United States)

von Niederhäusern, Belinda; Schandelmaier, Stefan; Mi Bonde, Marie; Brunner, Nicole; Hemkens, Lars G.; Rutquist, Marielle; Bhatnagar, Neera; Guyatt, Gordon H.; Pauli-Magnus, Christiane; Briel, Matthias

2017-01-01

Objective To systematically survey existing definitions, concepts, and criteria of clinical research quality, both developed by stakeholder groups as well as in the medical literature. This study serves as a first step in the development of a comprehensive framework for the quality of clinical research. Study design and setting We systematically and in duplicate searched definitions, concepts and criteria of clinical research quality on websites of stakeholders in clinical research until no further insights emerged and in MEDLINE up to February 2015. Stakeholders included governmental bodies, regulatory agencies, the pharmaceutical industry, academic and commercial contract research organizations, initiatives, research ethics committees, patient organizations and funding agencies from 13 countries. Data synthesis involved descriptive and qualitative analyses following the Framework Method on definitions, concepts, and criteria of clinical research quality. Descriptive codes were applied and grouped into clusters to identify common and stakeholder-specific quality themes. Results Stakeholder concepts on how to assure quality throughout study conduct or articles on quality assessment tools were common, generally with no a priori definition of the term quality itself. We identified a total of 20 explicit definitions of clinical research quality including varying quality dimensions and focusing on different stages in the clinical research process. Encountered quality dimensions include ethical conduct, patient safety/rights/priorities, internal validity, precision of results, generalizability or external validity, scientific and societal relevance, transparency and accessibility of information, research infrastructure and sustainability. None of the definitions appeared to be comprehensive either in terms of quality dimensions, research stages, or stakeholder perspectives. Conclusion Clinical research quality is often discussed but rarely defined. A framework defining

Toward a functional definition of a "rare disease" for regulatory authorities and funding agencies.

Science.gov (United States)

Clarke, Joe T R; Coyle, Doug; Evans, Gerald; Martin, Janet; Winquist, Eric

2014-12-01

The designation of a disease as "rare" is associated with some substantial benefits for companies involved in new drug development, including expedited review by regulatory authorities and relaxed criteria for reimbursement. How "rare disease" is defined therefore has major financial implications, both for pharmaceutical companies and for insurers or public drug reimbursement programs. All existing definitions are based, somewhat arbitrarily, on disease incidence or prevalence. What is proposed here is a functional definition of rare based on an assessment of the feasibility of measuring the efficacy of a new treatment in conventional randomized controlled trials, to inform regulatory authorities and funding agencies charged with assessing new therapies being considered for public funding. It involves a five-step process, involving significant negotiations between patient advocacy groups, pharmaceutical companies, physicians, and public drug reimbursement programs, designed to establish the feasibility of carrying out a randomized controlled trial with sufficient statistical power to show a clinically significant treatment effect. The steps are as follows: 1) identification of a specific disease, including appropriate genetic definition; 2) identification of clinically relevant outcomes to evaluate efficacy; 3) establishment of the inherent variability of measurements of clinically relevant outcomes; 4) calculation of the sample size required to assess the efficacy of a new treatment with acceptable statistical power; and 5) estimation of the difficulty of recruiting an adequate sample size given the estimated prevalence or incidence of the disorder in the population and the inclusion criteria to be used. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

The Definitive Guide to NetBeans Platform

CERN Document Server

Bock, Heiko

2009-01-01

The Definitive Guide to NetBeans(t) Platform is a thorough and definitive introduction to the NetBeans Platform, covering all its major APIs in detail, with relevant code examples used throughout. The original German book on which this title is based was well received. The NetBeans Platform Community has put together this English translation, which author Heiko Bock updated to cover the latest NetBeans Platform 6.5 APIs. With an introduction by known NetBeans Platform experts Jaroslav Tulach, Tim Boudreau, and Geertjan Wielenga, this is the most up-to-date book on this topic at the moment. All

Toward a Meaningful Definition of Recovery After Hip Fracture: Comparing Two Definitions for Community-Dwelling Older Adults.

Science.gov (United States)

Auais, Mohammad; Morin, Suzanne N; Finch, Lois; Ahmed, Sara; Mayo, Nancy

2018-02-14

To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using 2 different definitions of recovery. Inception cohort with 8 assessments over 1 year. Participants were recruited from a tertiary-care hospital and followed up in the community. Community-dwelling hip fracture patients (N=47, 75% of all eligible; aged ≥65y). Not applicable. Prefracture functional level was used to identify subgroups of participants with similar trajectories of mobility over time. Recovery in functional mobility was defined in 2 ways: the "traditional" definition (return to prefracture level of functional mobility) and a "targeted recovery" definition (ability to climb 10 steps). Both were measured using the Lower Extremity Functional Scale. HRQL was measured using the RAND 36-Item Short-Form Health Survey. Participants were categorized into 3 subgroups with: low, medium, and high prefracture functional abilities. Agreement between the 2 definitions of recovery (quantified using κ coefficient) was strong for the medium group (.81; 95% confidence interval, .56-1.00), weak for the high group (.46; 95% confidence interval, 0.0-.99), and minimal for the low group (.12; 95% confidence interval, 0.0-.328). Contrary to the traditional definition, patients who achieved targeted recovery had statistically and clinically better HRQL than the rest of the cohort throughout the study (estimated average difference of 10.8 points on RAND 36-Item Short-Form Health Survey; 95% confidence interval, 6.67-15.07). The agreement between the 2 definitions of recovery ranged from minimal to strong according to patient group. Using a functional target to define recovery predicted HRQL better. It is vital to consider the definition of recovery carefully for research or clinical practice because it can influence subsequent decisions (eg, endorsing a specific intervention or discharging patients). Copyright © 2018 American Congress of Rehabilitation

Definition of a COPD self-management intervention: International Expert Group consensus

NARCIS (Netherlands)

Effing, T.W.; Vercoulen, Jan H.; Bourbeau, Jean; Trappenburg, Jaap C.A.; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W.M.A.; Bucknall, Christine E.; Dewan, Naresh A.; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J.A.; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L.; Singh, Sally J.; ZuWallack, Richard; Benzo, Roberto; Goldstein, Roger S.; Partridge, Martyn R.; van der Palen, Jacobus Adrianus Maria

2016-01-01

There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management

VALUE RELEVANCE OF GROUP FINANCIAL STATEMENTS BASED ON ENTITY VERSUS PARENT COMPANY THEORY: EVIDENCE FROM THE LARGEST THREE EUROPEAN CAPITAL MARKETS

Directory of Open Access Journals (Sweden)

Müller Victor-Octavian

2012-07-01

Full Text Available Financial statementsn#8217; main objective is to give information on the financial position, performance and changes in financial position of the reporting entity, which is useful to investors and other users in making economic decisions. In order to be useful, financial information needs to be relevant to the decision-making process of users in general, and investors in particular. Regarding consolidated financial statements, the accounting theory knows four perspectives (theories on which the preparation of those statements is based, namely, the proprietary theory, the parent company theory, the parent company extension theory and the entity theory (Baxter and Spinney, 1975. Of practical importance are especially the parent company extension perspective and the entity perspective. The IASB and FASB decided (within an ED regarding the Improvement of the Conceptual Framework that consolidated financial statements should be presented from the perspective of the group entity, and not from the perspective of the parent-company. However, this support for the entity theory is to our knowledge not backed by empirical findings in the academic literature. Therefore, in our paper we set to contribute with empirical arguments to finding an actual answer to the question about the superior market value relevance of one of the two concurrent perspectives (theories. We set to carry out an empirical association study on the problem of market value relevance of consolidated financial statements based on the entity theory respectively on the parent company (extension theory, searching for an answer to the above question. In this sense, we pursued an analysis of market value relevance of consolidated accounting information (based on the two perspectives of listed entities between 2003-2008 on the largest three European Stock Exchanges (London, Paris and Frankfurt. The obtained results showed that a n#8222;restrainedn#8221; entity perspective, which would combine

Prevalence of sarcopenia and sarcopenic obesity in older German men using recognized definitions: high accordance but low overlap!

Science.gov (United States)

Kemmler, W; Teschler, M; Weißenfels, A; Sieber, C; Freiberger, E; von Stengel, S

2017-06-01

The relevance of sarcopenia and sarcopenic Obesity (SO) is rising in our aging societies. Applying recognized definitions to 965 community-dwelling Bavarian men 70 years+ resulted in a prevalence for sarcopenia between 3.7 and 4.9 and between 2.1 and 4.1% for SO. Despite this high consistency, the overlap between the definitions/approaches was sarcopenia and sarcopenic obesity (SO) is rising steadily in the aging societies of most developed nations. However, different definitions, components, and cutoff points hinder the evaluation of the prevalence of sarcopenia and SO. The purpose of this contribution was to determine the prevalence of sarcopenia and SO in a cohort of community-dwelling German men 70+ applying established sarcopenia (European Working Group on Sarcopenia in Older People, Foundation National Institute of Health, International Working Group on Sarcopenia) and obesity definitions. Further, we addressed the overlap between the definitions. Altogether, 965 community-dwelling men 70 years and older living in Northern Bavaria, Germany, were assessed during the screening phase of the Franconian Sarcopenic Obesity project. Segmental multi-frequency bio-impedance analysis (BIA) was applied to determine weight and body composition. Applying the definitions of EWGSOP, IWGS, and FNIH, 4.9, 3.8, and 3.7% of the total cohort were classified as sarcopenic, respectively. When further applying body fat to diagnose obesity, SO prevalence in the total cohort ranged from 4.1% (EWGSOP + body fat >25%) to 2.1% (IWGS + body fat >30%). Despite the apparently high consistency of the approaches with respect to prevalence, the overlap in individual sarcopenia diagnosis between the sarcopenia definitions was rather low (sarcopenia and SO in community-dwelling German men 70 years+ is relatively low (sarcopenia diagnosis varies considerably between the three definitions. Since sarcopenia is now recognized as an independent condition by the International Classification of

Guidance for Modifying the Definition of Diseases: A Checklist.

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Doust, Jenny; Vandvik, Per O; Qaseem, Amir; Mustafa, Reem A; Horvath, Andrea R; Frances, Allen; Al-Ansary, Lubna; Bossuyt, Patrick; Ward, Robyn L; Kopp, Ina; Gollogly, Laragh; Schunemann, Holger; Glasziou, Paul

2017-07-01

No guidelines exist currently for guideline panels and others considering changes to disease definitions. Panels frequently widen disease definitions, increasing the proportion of the population labeled as unwell and potentially causing harm to patients. We set out to develop a checklist of issues, with guidance, for panels to consider prior to modifying a disease definition. We assembled a multidisciplinary, multicontinent working group of 13 members, including members from the Guidelines International Network, Grading of Recommendations Assessment, Development and Evaluation working group, and the World Health Organisation. We used a 5-step process to develop the checklist: (1) a literature review of issues, (2) a draft outline document, (3) a Delphi process of feedback on the list of issues, (4) a 1-day face-to-face meeting, and (5) further refinement of the checklist. The literature review identified 12 potential issues. From these, the group developed an 8-item checklist that consisted of definition changes, number of people affected, trigger, prognostic ability, disease definition precision and accuracy, potential benefits, potential harms, and the balance between potential harms and benefits. The checklist is accompanied by an explanation of each item and the types of evidence to assess each one. We used a panel's recent consideration of a proposed change in the definition of gestational diabetes mellitus (GDM) to illustrate use of the checklist. We propose that the checklist be piloted and validated by groups developing new guidelines. We anticipate that the use of the checklist will be a first step to guidance and better documentation of definition changes prior to introducing modified disease definitions.

The participative method of subject definition as used in the quantitative modelling of hospital laundry services.

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Hammer, K A; Janes, F R

1995-01-01

The objectives for developing the participative method of subject definition were to gain all the relevant information to a high level of fidelity in the earliest stages of the work and so be able to build a realistic model at reduced labour cost. In order to better integrate the two activities--information acquisition and mathematical modelling--a procedure was devised using the methods of interactive management to facilitate teamwork. This procedure provided the techniques to create suitable working relationships between the two groups, the informants and the modellers, so as to maximize their free and accurate intercommunication, both during the initial definition of the linen service and during the monitoring of the accuracy and reality of the draft models. The objectives of this project were met in that the final model was quickly validated and approved, at a low labour cost.

A proposed universal medical and public health definition of terrorism.

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Arnold, Jeffrey L; Ortenwall, Per; Birnbaum, Marvin L; Sundnes, Knut Ole; Aggrawal, Anil; Anantharaman, V; Al Musleh, Abdul Wahab; Asai, Yasufumi; Burkle, Frederick M; Chung, Jae Myung; Cruz-Vega, Felipe; Debacker, Michel; Della Corte, Francesco; Delooz, Herman; Dickinson, Garth; Hodgetts, Timothy; Holliman, C James; MacFarlane, Campbell; Rodoplu, Ulkumen; Stok, Edita; Tsai, Ming-Che

2003-01-01

The lack of a universally applicable definition of terrorism has confounded the understanding of terrorism since the term was first coined in 18th Century France. Although a myriad of definitions of terrorism have been advanced over the years, virtually all of these definitions have been crisis-centered, frequently reflecting the political perspectives of those who seek to define it. In this article, we deconstruct these previously used definitions of terrorism in order to reconstruct a definition of terrorism that is consequence-centered, medically relevant, and universally harmonized. A universal medical and public health definition of terrorism will facilitate clinical and scientific research, education, and communication about terrorism-related events or disasters. We propose the following universal medical and public definition of terrorism: The intentional use of violence--real or threatened--against one or more non-combatants and/or those services essential for or protective of their health, resulting in adverse health effects in those immediately affected and their community, ranging from a loss of well-being or security to injury, illness, or death.

Three suggestions on the definition of terms for the safety and reliability analysis of digital systems

International Nuclear Information System (INIS)

Kim, Man Cheol; Smidts, Carol S.

2015-01-01

As digital instrumentation and control systems are being progressively introduced into nuclear power plants, a growing number of related technical issues are coming to light needing to be resolved. As a result, an understanding of relevant terms and basic concepts becomes increasingly important. Under the framework of the OECD/NEA WGRISK DIGREL Task Group, the authors were involved in reviewing definitions of terms forming the supporting vocabulary for addressing issues related to the safety and reliability analysis of digital instrumentation and control (SRA of DI and C). These definitions were extracted from various standards regulating the disciplines that form the technical and scientific basis of SRA DI and C. The authors discovered that different definitions are provided by different standards within a common discipline and used differently across various disciplines. This paper raises the concern that a common understanding of terms and basic concepts has not yet been established to address the very specific technical issues facing SRA DI and C. Based on the lessons learned from the review of the definitions of interest and the analysis of dependency relationships existing between these definitions, this paper establishes a set of recommendations for the development of a consistent terminology for SRA DI and C. - Highlights: ●We reviewed definitions of terms used in reliability analysis of digital systems. ●Different definitions are provided by different standards within a common discipline. ●Acyclic and cyclic structures of dependency in defining terms are compared. ●Three recommendations for the development of a consistent terminology provided

Definitions of Idioms in Preadolescents, Adolescents, and Adults

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Chan, Yen-Ling; Marinellie, Sally A.

2008-01-01

The purpose of this study was to expand the current literature on word definitions by focusing on definitions of idioms provided by several age groups. Preadolescents, young adolescents, older adolescents, and adults wrote definitions for 10 frequently used idioms and also rated their familiarity with the idiomatic expressions. Participants'…

Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group.

Science.gov (United States)

Rodeghiero, Francesco; Stasi, Roberto; Gernsheimer, Terry; Michel, Marc; Provan, Drew; Arnold, Donald M; Bussel, James B; Cines, Douglas B; Chong, Beng H; Cooper, Nichola; Godeau, Bertrand; Lechner, Klaus; Mazzucconi, Maria Gabriella; McMillan, Robert; Sanz, Miguel A; Imbach, Paul; Blanchette, Victor; Kühne, Thomas; Ruggeri, Marco; George, James N

2009-03-12

Diagnosis and management of immune thrombocytopenic purpura (ITP) remain largely dependent on clinical expertise and observations more than on evidence derived from clinical trials of high scientific quality. One major obstacle to the implementation of such studies and in producing reliable meta-analyses of existing data is a lack of consensus on standardized critical definitions, outcome criteria, and terminology. Moreover, the demand for comparative clinical trials has dramatically increased since the introduction of new classes of therapeutic agents, such as thrombopoietin receptor agonists, and innovative treatment modalities, such as anti-CD 20 antibodies. To overcome the present heterogeneity, an International Working Group of recognized expert clinicians convened a 2-day structured meeting (the Vicenza Consensus Conference) to define standard terminology and definitions for primary ITP and its different phases and criteria for the grading of severity, and clinically meaningful outcomes and response. These consensus criteria and definitions could be used by investigational clinical trials or cohort studies. Adoption of these recommendations would serve to improve communication among investigators, to enhance comparability among clinical trials, to facilitate meta-analyses and development of therapeutic guidelines, and to provide a standardized framework for regulatory agencies.

Research on the nutrition and cognition of high-risk stroke groups in community and the relevant factors.

Science.gov (United States)

Zhao, N-N; Zeng, K-X; Wang, Y-L; Sheng, P-J; Tang, C-Z; Xiao, P; Liu, X-W

2017-12-01

To investigate the prevalence rate of nutritional risk in high-risk stroke groups in community, analyze its influencing factors, and analyze and compare the relationship between nutritional risk or malnutrition assessed by different nutritional evaluation methods and cognitive function, so as to provide the basis and guidance for clinical nutritional assessment and support. A cross-sectional survey was performed for 1196 cases in high-risk stroke groups in community from December 2015 to January 2017. At the same time, the nutritional status of patients was evaluated using the mini nutritional assessment (MNA) and MNA-short form (MNA-SF), and the cognitive status of patients was evaluated using the mini-mental state examination (MMSE). Moreover, the relevant influencing factors of nutritional risk and MMSE score were analyzed and compared. High-risk stroke groups in community suffered from a high risk of malnutrition. MNA-SF had a higher specificity and lower false positive rate than MNA. Nutritional risk occurred more easily in high-risk stroke groups in community with a history of diabetes mellitus, less physical exercise or light manual labor, daily use of multiple drugs, and higher age. Those with a higher nutritional risk were more prone to cognitive impairment. High-risk stroke groups in community, complicated with hyperhomocysteinemia, daily use of three or more kinds of prescription drugs, and a previous history of stroke, were accompanied by cognitive impairment easily. MNA-SF can be used for the nutritional screening of high-risk stroke groups in community. For the high-risk stroke groups in community, the rational nutritional diet should be publicized, blood sugar should be controlled in a scientific manner and physical exercise should be moderately increased.

Definition of containment issues

International Nuclear Information System (INIS)

Walker, D.H.

1982-01-01

Public Law 96-567 Nuclear Safety Research, Development and Demonstration Act of 1980, directed the US Department of Energy (DOE) to provide an accelerated and coordinated program for developing practical generic improvements that would enhance the capability for safe, reliable and economical operation of Light Water Nuclear Reactor Power Stations. The DOE approach to defining such a program will consist of two phases, (1) definition of program requirements and (2) implementation of the program plan. This paper summarizes the results of the program definition phase for the containment integrity function. The definition phase effort was carried out by two groups of knowledgeable technical experts from the nuclear industry, one of which addressed containment integrity. Tabulated in the paper are the issues identified by the working groups and their associated priorities. Also tabulated are those high priority issues for which ongoing programs do not appear to provide sufficient information to resolve the issue. The results of this review show that existing programs to a great extent address existing issues in a manner such that the issues should be resolved by the programs

Common Ground? The Concordance of Sarcopenia and Frailty Definitions

NARCIS (Netherlands)

Reijnierse, Esmee M.; Trappenburg, Marijke C.; Blauw, Gerard Jan; Verlaan, Sjors; de van der Schueren, Marian A.E.; Meskers, Carel G.M.; Maier, Andrea B.

2016-01-01

Objectives: This study aimed to explore the concordance between definitions of sarcopenia and frailty in a clinically relevant population of geriatric outpatients. Design: Data were retrieved from a cross-sectional study. Setting: The study was performed in a geriatric outpatient clinic of a

Relative entropy of steering: on its definition and properties

International Nuclear Information System (INIS)

Kaur, Eneet; Wilde, Mark M

2017-01-01

In Gallego and Aolita (2015 Phys. Rev . X 5 041008), the authors proposed a definition for the relative entropy of steering and showed that the resulting quantity is a convex steering monotone. Here we advocate for a different definition for relative entropy of steering, based on well grounded concerns coming from quantum Shannon theory. We prove that this modified relative entropy of steering is a convex steering monotone. Furthermore, we establish that it is uniformly continuous and faithful, in both cases giving quantitative bounds that should be useful in applications. We also consider a restricted relative entropy of steering which is relevant for the case in which the free operations in the resource theory of steering have a more restricted form (the restricted operations could be more relevant in practical scenarios). The restricted relative entropy of steering is convex, monotone with respect to these restricted operations, uniformly continuous, and faithful. (paper)

Guidelines for target volume definition in post-operative radiotherapy for prostate cancer, on behalf of the EORTC Radiation Oncology Group

International Nuclear Information System (INIS)

Poortmans, Philip; Bossi, Alberto; Vandeputte, Katia; Bosset, Mathieu; Miralbell, Raymond; Maingon, Philippe; Boehmer, Dirk; Budiharto, Tom; Symon, Zvi; Bergh, Alfons C.M. van den; Scrase, Christopher; Poppel, Hendrik van; Bolla, Michel

2007-01-01

The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing post-operative radiotherapy for prostate cancer requires a standardisation of the target volume definition and delineation as well as standardisation of the clinical quality assurance procedures. Recommendations for this are presented on behalf of the European Organisation for Research and Treatment of Cancer (EORTC) Radiation Oncology Group and in addition to the already published guidelines for radiotherapy as the primary treatment

Physician empathy: Definition, outcome-relevance and its measurement in patient care and medical education [Ärztliche Empathie: Definition, Outcome-Relevanz und Messung in der Patientenversorgung und medizinischen Ausbildung

Directory of Open Access Journals (Sweden)

Neumann, Melanie

2012-02-01

Full Text Available [english] Objective: The present study gives a brief introduction into FurthermoreThe latter topic will be explored in detail as we conducted a pilot study on the German versions of two self-assessment instruments of empathy, which are mostly used in medical education research, namely the “Jefferson Scale of Physician Empathy, Student Version” (JSPE-S and the “Interpersonal Reactivity Index” (IRI.Methods: We first present an overview of the current empirical and theoretical literature on the definition and outcome-relevance of PE. Additionally, we conducted basic psychometric analyses of the German versions of the JSPE-S and the IRI. Data for this analyses is based on a cross-sectional pilot-survey in N=44 medical students and N=63 students of other disciplines from the University of Cologne. Results: PE includes the of the patient as well as verbal and non-verbal , which should result in a helpful therapeutic action of the physician. Patients’ health outcomes in different healthcare settings can be improved considerably from a high quality empathic encounter with their clinician. Basic psychometric results of the German JSPE-S and IRI measures show first promising results.Conclusion: PE as an essential and outcome-relevant element in the patient-physician relationship requires more consideration in the education of medical students and, thus, in medical education research. The German versions of the JSPE-S and IRI measures seem to be promising means to evaluate these education aims and to conduct medical education research on empathy.[german] Ziel: Die vorliegende Studie gibt einen kurzen Überblick Des Weiteren werden Letzteres Thema wird ausführlich behandelt, da eine Pilotstudie zur Testung zwei deutscher Versionen von Selbsteinschätzungsinstrumenten durchgeführt wurde, die derzeit am häufigsten in der internationalen Medizinischen Ausbildungsforschung genutzt werden. Dazu gehören die “Jefferson Scale of Physician Empathy

Criteria for Definition of Net Zero Energy Buildings

DEFF Research Database (Denmark)

Sartori, Igor; Marszal, Anna Joanna; Napolitano, Assunta

2010-01-01

The idea of a Net Zero Energy Building (Net ZEB) is understood conceptually, as it is understood that the way a Net ZEB is defined affects significantly the way it is designed in order to achieve the goal. However, little agreement exists on a common definition; the term is used commercially...... without a clear understanding and countries are enacting policies and national targets based on the concept without a clear definition in place. This paper presents a harmonised framework for describing the relevant characteristics of Net ZEBs in a series of criteria. Evaluation of the criteria...... and selection of the related options becomes a methodology for elaborating sound Net ZEB definitions in a formal, systematic and comprehensive way, creating the basis for legislations and action plans to effectively achieve the political targets. The common denominator for the different possible Net ZEB...

The anatomy of the squizzel The role of operational definitions in representing uncertainty

International Nuclear Information System (INIS)

Cooke, Roger

2004-01-01

An anecdotal introduction of the role of operational definitions in representing uncertainty is followed by a brief history of operational definitions, with particular attention to the foundations of probability and the fuzzy representations of uncertainty. A short summary of experience at the TU Delft points to relevant open questions. These in turn are illustrated by a recent application to NO x emissions in The Netherlands

41 CFR 105-60.305-1 - Definitions.

Science.gov (United States)

2010-07-01

... to the public and to private sector organizations; (2) Ensure that groups and individuals pay the... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Definitions. 105-60.305..., Orders, Policies, Interpretations, Manuals, and Instructions § 105-60.305-1 Definitions. For the purpose...

42 CFR 411.101 - Definitions.

Science.gov (United States)

2010-10-01

... Under Group Health Plans: General Provisions § 411.101 Definitions. As used in this subpart and in... individual States, Puerto Rico, the Virgin Islands, Guam, American Samoa, the Northern Mariana Islands, and... taxes on employers and employees under section 21 of the Internal Revenue Code. Group health plan (GHP...

Value Relevance of Consolidated Earnings -- Evaluation of Japanese Revolution and a New Proposal by FASB --

OpenAIRE

Takashi Obinata

2006-01-01

In 2000, the reform of consolidated financial statements changed the income statement section where amortization of goodwill and gains and losses from interest method should be disclosed. The results in this paper show that the reform may improve the value relevance of operating profits and ordinary income. We cannot find the evidence that the reform decreases the relevance of the multi-step earnings. Though we cannot definitively conclude that the reform was the best way for improving the va...

The Emergence of Groups and Inequality through Co-Adaptation.

Directory of Open Access Journals (Sweden)

Jon Atwell

Full Text Available The emergence of groups and of inequality is often traced to pre-existing differences, exclusionary practices, or resource accumulation processes, but can the emergence of groups and their differential success simply be a feature of the behaviors of a priori equally-capable actors who have mutually adapted? Using a simple model of behavioral co-adaptation among agents whose individual actions construct a common environment, we present evidence that the formation of unequal groups is endemic to co-adaptive processes that endogenously alter the environment; agents tend to separate into two groups, one whose members stop adapting earliest (the in-group, and another comprising agents who continue to adapt (the out-group. Over a wide range of model parameters, members of the in-group are rewarded more on average than members of the out-group. The primary reason is that the in-group is able to have a more profound influence on the environment and mold it to the benefit of its members. This molding capacity proves more beneficial than the persistence of adaptivity, yet, crucially, which agents are able to form a coalition to successfully exert this control is strongly contingent on random aspects of the set of agent behaviors. In this paper, we present the model, relevant definitions, and results. We then discuss its implications for the study of complex adaptive systems generally.

The Definitive Guide to NetBeans™ Platform 7

CERN Document Server

Bock, Heiko

2011-01-01

The NetBeans Platform is the world's only modular Swing application framework, used by very large organizations in mission-critical scenarios, such as at Boeing and Northrop Grumman, as well as in the financial sector and in the oil/gas industry. For these large customers in enterprises who are increasingly interested in Maven and OSGi, the book will have particular relevance. The Definitive Guide to NetBeans Platform 7 is a thorough and authoritative introduction to the open-source NetBeans Platform, covering all its major APIs in detail, with relevant code examples used throughout. * Provide

Reliability of digital ulcer definitions as proposed by the UK Scleroderma Study Group: A challenge for clinical trial design.

Science.gov (United States)

Hughes, Michael; Tracey, Andrew; Bhushan, Monica; Chakravarty, Kuntal; Denton, Christopher P; Dubey, Shirish; Guiducci, Serena; Muir, Lindsay; Ong, Voon; Parker, Louise; Pauling, John D; Prabu, Athiveeraramapandian; Rogers, Christine; Roberts, Christopher; Herrick, Ariane L

2018-06-01

The reliability of clinician grading of systemic sclerosis-related digital ulcers has been reported to be poor to moderate at best, which has important implications for clinical trial design. The aim of this study was to examine the reliability of new proposed UK Scleroderma Study Group digital ulcer definitions among UK clinicians with an interest in systemic sclerosis. Raters graded (through a custom-built interface) 90 images (80 unique and 10 repeat) of a range of digital lesions collected from patients with systemic sclerosis. Lesions were graded on an ordinal scale of severity: 'no ulcer', 'healed ulcer' or 'digital ulcer'. A total of 23 clinicians - 18 rheumatologists, 3 dermatologists, 1 hand surgeon and 1 specialist rheumatology nurse - completed the study. A total of 2070 (1840 unique + 230 repeat) image gradings were obtained. For intra-rater reliability, across all images, the overall weighted kappa coefficient was high (0.71) and was moderate (0.55) when averaged across individual raters. Overall inter-rater reliability was poor (0.15). Although our proposed digital ulcer definitions had high intra-rater reliability, the overall inter-rater reliability was poor. Our study highlights the challenges of digital ulcer assessment by clinicians with an interest in systemic sclerosis and provides a number of useful insights for future clinical trial design. Further research is warranted to improve the reliability of digital ulcer definition/rating as an outcome measure in clinical trials, including examining the role for objective measurement techniques, and the development of digital ulcer patient-reported outcome measures.

The Relevance of Causal Social Construction

Directory of Open Access Journals (Sweden)

Marques Teresa

2017-02-01

Full Text Available Social constructionist claims are surprising and interesting when they entail that presumably natural kinds are in fact socially constructed. The claims are interesting because of their theoretical and political importance. Authors like Díaz-León argue that constitutive social construction is more relevant for achieving social justice than causal social construction. This paper challenges this claim. Assuming there are socially salient groups that are discriminated against, the paper presents a dilemma: if there were no constitutively constructed social kinds, the causes of the discrimination of existing social groups would have to be addressed, and understanding causal social construction would be relevant to achieve social justice. On the other hand, not all possible constitutively socially constructed kinds are actual social kinds. If an existing social group is constitutively constructed as a social kind K, the fact that it actually exists as a K has social causes. Again, causal social construction is relevant. The paper argues that (i for any actual social kind X, if X is constitutively socially constructed as K, then it is also causally socially constructed; and (ii causal social construction is at least as relevant as constitutive social construction for concerns of social justice. For illustration, I draw upon two phenomena that are presumed to contribute towards the discrimination of women: (i the poor performance effects of stereotype threat, and (ii the silencing effects of gendered language use.

International consensus on preliminary definitions of improvement in adult and juvenile myositis.

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Rider, Lisa G; Giannini, Edward H; Brunner, Hermine I; Ruperto, Nicola; James-Newton, Laura; Reed, Ann M; Lachenbruch, Peter A; Miller, Frederick W

2004-07-01

To use a core set of outcome measures to develop preliminary definitions of improvement for adult and juvenile myositis as composite end points for therapeutic trials. Twenty-nine experts in the assessment of myositis achieved consensus on 102 adult and 102 juvenile paper patient profiles as clinically improved or not improved. Two hundred twenty-seven candidate definitions of improvement were developed using the experts' consensus ratings as a gold standard and their judgment of clinically meaningful change in the core set of measures. Seventeen additional candidate definitions of improvement were developed from classification and regression tree analysis, a data-mining decision tree tool analysis. Six candidate definitions specifying percentage change or raw change in the core set of measures were developed using logistic regression analysis. Adult and pediatric working groups ranked the 13 top-performing candidate definitions for face validity, clinical sensibility, and ease of use, in which the sensitivity and specificity were >/=75% in adult, pediatric, and combined data sets. Nominal group technique was used to facilitate consensus formation. The definition of improvement (common to the adult and pediatric working groups) that ranked highest was 3 of any 6 of the core set measures improved by >/=20%, with no more than 2 worse by >/=25% (which could not include manual muscle testing to assess strength). Five and 4 additional preliminary definitions of improvement for adult and juvenile myositis, respectively, were also developed, with several definitions common to both groups. Participants also agreed to prospectively test 6 logistic regression definitions of improvement in clinical trials. Consensus preliminary definitions of improvement were developed for adult and juvenile myositis, and these incorporate clinically meaningful change in all myositis core set measures in a composite end point. These definitions require prospective validation, but they are now

A Model Assessing Relevant Factors in Building Minority Library Service.

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Bonin, Kenneth Roy

1983-01-01

Presents research design applicable to definition of minority library service needs for any minority language group in Canada, focusing on French-speaking population outside Quebec. Profiles of the target group's population, culture, needs, and library services are highlighted. Five sources are given. (EJS)

Proposed consensus definitions for new-onset refractory status epilepticus (NORSE), febrile infection-related epilepsy syndrome (FIRES), and related conditions.

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Hirsch, Lawrence J; Gaspard, Nicolas; van Baalen, Andreas; Nabbout, Rima; Demeret, Sophie; Loddenkemper, Tobias; Navarro, Vincent; Specchio, Nicola; Lagae, Lieven; Rossetti, Andrea O; Hocker, Sara; Gofton, Teneille E; Abend, Nicholas S; Gilmore, Emily J; Hahn, Cecil; Khosravani, Houman; Rosenow, Felix; Trinka, Eugen

2018-04-01

We convened an international group of experts to standardize definitions of New-Onset Refractory Status Epilepticus (NORSE), Febrile Infection-Related Epilepsy Syndrome (FIRES), and related conditions. This was done to enable improved communication for investigators, physicians, families, patients, and other caregivers. Consensus definitions were achieved via email messages, phone calls, an in-person consensus conference, and collaborative manuscript preparation. Panel members were from 8 countries and included adult and pediatric experts in epilepsy, electroencephalography (EEG), and neurocritical care. The proposed consensus definitions are as follows: NORSE is a clinical presentation, not a specific diagnosis, in a patient without active epilepsy or other preexisting relevant neurological disorder, with new onset of refractory status epilepticus without a clear acute or active structural, toxic or metabolic cause. FIRES is a subcategory of NORSE, applicable for all ages, that requires a prior febrile infection starting between 2 weeks and 24 hours prior to onset of refractory status epilepticus, with or without fever at onset of status epilepticus. Proposed consensus definitions are also provided for Infantile Hemiconvulsion-Hemiplegia and Epilepsy syndrome (IHHE) and for prolonged, refractory and super-refractory status epilepticus. This document has been endorsed by the Critical Care EEG Monitoring Research Consortium. We hope these consensus definitions will promote improved communication, permit multicenter research, and ultimately improve understanding and treatment of these conditions. Wiley Periodicals, Inc. © 2018 International League Against Epilepsy.

Deciphering the crowd: modeling and identification of pedestrian group motion.

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Yücel, Zeynep; Zanlungo, Francesco; Ikeda, Tetsushi; Miyashita, Takahiro; Hagita, Norihiro

2013-01-14

Associating attributes to pedestrians in a crowd is relevant for various areas like surveillance, customer profiling and service providing. The attributes of interest greatly depend on the application domain and might involve such social relations as friends or family as well as the hierarchy of the group including the leader or subordinates. Nevertheless, the complex social setting inherently complicates this task. We attack this problem by exploiting the small group structures in the crowd. The relations among individuals and their peers within a social group are reliable indicators of social attributes. To that end, this paper identifies social groups based on explicit motion models integrated through a hypothesis testing scheme. We develop two models relating positional and directional relations. A pair of pedestrians is identified as belonging to the same group or not by utilizing the two models in parallel, which defines a compound hypothesis testing scheme. By testing the proposed approach on three datasets with different environmental properties and group characteristics, it is demonstrated that we achieve an identification accuracy of 87% to 99%. The contribution of this study lies in its definition of positional and directional relation models, its description of compound evaluations, and the resolution of ambiguities with our proposed uncertainty measure based on the local and global indicators of group relation.

Guidelines for time-to-event end-point definitions in trials for pancreatic cancer. Results of the DATECAN initiative (Definition for the Assessment of Time-to-event End-points in CANcer trials).

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Bonnetain, Franck; Bonsing, Bert; Conroy, Thierry; Dousseau, Adelaide; Glimelius, Bengt; Haustermans, Karin; Lacaine, François; Van Laethem, Jean Luc; Aparicio, Thomas; Aust, Daniela; Bassi, Claudio; Berger, Virginie; Chamorey, Emmanuel; Chibaudel, Benoist; Dahan, Laeticia; De Gramont, Aimery; Delpero, Jean Robert; Dervenis, Christos; Ducreux, Michel; Gal, Jocelyn; Gerber, Erich; Ghaneh, Paula; Hammel, Pascal; Hendlisz, Alain; Jooste, Valérie; Labianca, Roberto; Latouche, Aurelien; Lutz, Manfred; Macarulla, Teresa; Malka, David; Mauer, Muriel; Mitry, Emmanuel; Neoptolemos, John; Pessaux, Patrick; Sauvanet, Alain; Tabernero, Josep; Taieb, Julien; van Tienhoven, Geertjan; Gourgou-Bourgade, Sophie; Bellera, Carine; Mathoulin-Pélissier, Simone; Collette, Laurence

2014-11-01

Using potential surrogate end-points for overall survival (OS) such as Disease-Free- (DFS) or Progression-Free Survival (PFS) is increasingly common in randomised controlled trials (RCTs). However, end-points are too often imprecisely defined which largely contributes to a lack of homogeneity across trials, hampering comparison between them. The aim of the DATECAN (Definition for the Assessment of Time-to-event End-points in CANcer trials)-Pancreas project is to provide guidelines for standardised definition of time-to-event end-points in RCTs for pancreatic cancer. Time-to-event end-points currently used were identified from a literature review of pancreatic RCT trials (2006-2009). Academic research groups were contacted for participation in order to select clinicians and methodologists to participate in the pilot and scoring groups (>30 experts). A consensus was built after 2 rounds of the modified Delphi formal consensus approach with the Rand scoring methodology (range: 1-9). For pancreatic cancer, 14 time to event end-points and 25 distinct event types applied to two settings (detectable disease and/or no detectable disease) were considered relevant and included in the questionnaire sent to 52 selected experts. Thirty experts answered both scoring rounds. A total of 204 events distributed over the 14 end-points were scored. After the first round, consensus was reached for 25 items; after the second consensus was reached for 156 items; and after the face-to-face meeting for 203 items. The formal consensus approach reached the elaboration of guidelines for standardised definitions of time-to-event end-points allowing cross-comparison of RCTs in pancreatic cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

The definition and computation of average neutron lifetimes

International Nuclear Information System (INIS)

Henry, A.F.

1983-01-01

A precise physical definition is offered for a class of average lifetimes for neutrons in an assembly of materials, either multiplying or not, or if the former, critical or not. A compact theoretical expression for the general member of this class is derived in terms of solutions to the transport equation. Three specific definitions are considered. Particular exact expressions for these are derived and reduced to simple algebraic formulas for one-group and two-group homogeneous bare-core models

Extensions of positive definite functions applications and their harmonic analysis

CERN Document Server

Jorgensen, Palle E T; Tian, Feng

2016-01-01

This monograph deals with the mathematics of extending given partial data-sets obtained from experiments; Experimentalists frequently gather spectral data when the observed data is limited, e.g., by the precision of instruments; or by other limiting external factors. Here the limited information is a restriction, and the extensions take the form of full positive definite function on some prescribed group. It is therefore both an art and a science to produce solid conclusions from restricted or limited data. While the theory of is important in many areas of pure and applied mathematics, it is difficult for students and for the novice to the field, to find accessible presentations which cover all relevant points of view, as well as stressing common ideas and interconnections. We have aimed at filling this gap, and we have stressed hands-on-examples.

Regulation of non-relevant metabolites of plant protection products in drinking and groundwater in the EU: Current status and way forward.

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Laabs, V; Leake, C; Botham, P; Melching-Kollmuß, S

2015-10-01

Non-relevant metabolites are defined in the EU regulation for plant protection product authorization and a detailed definition of non-relevant metabolites is given in an EU Commission DG Sanco (now DG SANTE - Health and Food Safety) guidance document. However, in water legislation at EU and member state level non-relevant metabolites of pesticides are either not specifically regulated or diverse threshold values are applied. Based on their inherent properties, non-relevant metabolites should be regulated based on substance-specific and toxicity-based limit values in drinking and groundwater like other anthropogenic chemicals. Yet, if a general limit value for non-relevant metabolites in drinking and groundwater is favored, an application of a Threshold of Toxicological Concern (TTC) concept for Cramer class III compounds leads to a threshold value of 4.5 μg L(-1). This general value is exemplarily shown to be protective for non-relevant metabolites, based on individual drinking water limit values derived for a set of 56 non-relevant metabolites. A consistent definition of non-relevant metabolites of plant protection products, as well as their uniform regulation in drinking and groundwater in the EU, is important to achieve legal clarity for all stakeholders and to establish planning security for development of plant protection products for the European market. Copyright © 2015 Elsevier Inc. All rights reserved.

Tacit definitions of informal caregiving.

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Wrubel, J; Richards, T A; Folkman, S; Acree, M C

2001-01-01

This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time. There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to caregivers' understanding of what caregiving entails. These definitions are tacit because they arise from caregivers' taken-for-granted understanding rather than formally articulated positions concerning caregiving. A random sample of 60 men, all of whom were caregiving partners of men with acquired immunodeficiency syndrome (AIDS), was drawn from a larger cohort of 253 participants in the University of California San Francisco (UCSF) Coping Project (1990-1997). The caregivers were assessed bimonthly for 2 years with procedures that included a semi-structured interview focusing on a recent stressful event involving caregiving, and quantitative measures of well-being. Interpretive phenomenological case studies of the narrative accounts of the 60 caregivers produced three tacit definitions of caregiving - engagement, conflict and distance. These three tacit definitions were distinguished by differences in learning about caregiving, involvement in health care decisions, caregiving activities and reported sources of stress. The three groups differed on measures of dyadic adjustment, depression, anger and anxiety. Better understanding of caregivers' tacit definitions can facilitate and enhance effective support and interventions for caregivers.

Towards a practical definition of professional behaviour.

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Rogers, Wendy; Ballantyne, Angela

2010-04-01

Professionalism remains a challenging part of the medical curriculum to define, teach and evaluate. We suggest that one way to meet these challenges is to clarify the definition of professionalism and distinguish this from medical ethics. Our analysis is two staged. First, we reviewed influential definitions of professionalism and separated elements relating to (a) ethico-legal competencies, (b) clinical competence and (c) professionalism. In reference to professionalism, we then distinguished between aspirational virtues/values and specific behaviours. From these, we develop a working definition of medical professional behaviour consisting of six domains of behaviour: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection; collaboration and team work; and care of colleagues. Second, we tested this working definition against empirical data concerning disciplinary action against practising doctors using (a) sources in the literature and (b) an original analysis of complaints received by the Medical Board of South Australia. Our empirical analysis supports the relevance of four of the six potential domains: responsibility; relationships with and respect for patients; probity and honesty; self awareness and capacity for reflection. There are additional reasons for retaining 'collaboration and team work' in the medical professional behaviour curriculum but 'care of colleagues' may be better addressed in the ethico-legal curriculum. Our definition of professional behaviour is consistent with the theoretical literature, captures behaviours that predict future complaints against practitioners and is consistent with current complaints about professionalism in South Australian practitioners. This definition can further the teaching and assessing of professional behaviour in medical schools.

A Note on the Definition of a Smooth Curve

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Euler, Russell; Sadek, Jawad

2005-01-01

In many elementary calculus textbooks in use today, the definition of a "smooth curve" is slightly ambiguous from the students' perspective. Even when smoothness is defined carefully, there is a shortage of relevant exercises that would serve to elaborate on related subtle points which many students may find confusing. In this article, the authors…

Exploring definitions of financial abuse in elderly Korean immigrants: the contribution of traditional cultural values.

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Lee, Hee Yun; Lee, Sang E; Eaton, Charissa K

2012-10-01

The purpose of this study is to explore the cultural definitions of financial abuse from the perspective of 124 elderly Korean immigrants and to examine the role of traditional cultural values in their definitions by using a mixed methods approach. The qualitative analysis generated four themes relevant to definition of financial abuse. A binary logistic regression indicated that those with stronger cultural adherence to traditional values had higher odds of providing culture-based definitions of financial abuse. Education is needed for health professionals, social service providers, and adult protective workers to increase their understanding of culture-specific experiences of financial abuse among ethnic minority elders.

An integrated operational definition and conceptual model of asthma self-management in teens.

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Mammen, Jennifer; Rhee, Hyekyun; Norton, Sally A; Butz, Arlene M; Halterman, Jill S; Arcoleo, Kimberly

2018-01-19

A previous definition of adolescent asthma self-management was derived from interviews with clinicians/researchers and published literature; however, it did not incorporate perspectives of teens or parents. Therefore, we conducted in-depth interviews with teens and parents and synthesized present findings with the prior analysis to develop a more encompassing definition and model. Focal concepts were qualitatively extracted from 14-day self-management voice-diaries (n = 14) and 1-hour interviews (n = 42) with teens and parents (28 individuals) along with concepts found in the previous clinical/research oriented analysis. Conceptual structure and relationships were identified and key findings synthesized to develop a revised definition and model of adolescent asthma self-management. There were two primary self-management constructs: processes of self-management and tasks of self-management. Self-management was defined as the iterative process of assessing, deciding, and responding to specific situations in order to achieve personally important outcomes. Clinically relevant asthma self-management tasks included monitoring asthma, managing active issues through pharmacologic and non-pharmacologic strategies, preventing future issues, and communicating with others as needed. Self-management processes were reciprocally influenced by intrapersonal factors (both cognitive and physical), interpersonal factors (family, social and physical environments), and personally relevant asthma and non-asthma outcomes. This is the first definition of asthma self-management incorporating teen, parent, clinician, and researcher perspectives, which suggests that self-management processes and behaviors are influenced by individually variable personal and interpersonal factors, and are driven by personally important outcomes. Clinicians and researchers should investigate teens' symptom perceptions, medication beliefs, current approaches to symptom management, relevant outcomes, and

Towards the Baum-Connes' analytical assembly map for the actions of discrete quantum groups

International Nuclear Information System (INIS)

Goswami, D.; Kuku, A.O.

2002-07-01

Given an action of a discrete quantum group (in the sense of Van Daele, Kustermans and Effros-Ruan) A on a C*-algebra C, satisfying some regularity assumptions resembling the proper Γ-compact action for a classical discrete group Γ on some space, we are able to construct canonical maps μ r i (μ i respectively) (i=0,1) from the A-equivariant K-homology groups KK i A (C,C) to the K-theory groups K i (A-circumflex r ) (K i (A-circumflex) respectively), where A-circumflex r and A-circumflex stand for the quantum analogues of the reduced and full group C*-algebras. We follow the steps of the construction of the classical Baum-Connes map, although in the context of quantum group the nontrivial modular property of the invariant weights (and the related fact that the square of the antipode is not identity) has to be taken into serious consideration, making it somewhat tricky to guess and prove the correct definitions of relevant Hilbert module structures. (author)

Promoting Model-based Definition to Establish a Complete Product Definition.

Science.gov (United States)

Ruemler, Shawn P; Zimmerman, Kyle E; Hartman, Nathan W; Hedberg, Thomas; Feeny, Allison Barnard

2017-05-01

The manufacturing industry is evolving and starting to use 3D models as the central knowledge artifact for product data and product definition, or what is known as Model-based Definition (MBD). The Model-based Enterprise (MBE) uses MBD as a way to transition away from using traditional paper-based drawings and documentation. As MBD grows in popularity, it is imperative to understand what information is needed in the transition from drawings to models so that models represent all the relevant information needed for processes to continue efficiently. Finding this information can help define what data is common amongst different models in different stages of the lifecycle, which could help establish a Common Information Model. The Common Information Model is a source that contains common information from domain specific elements amongst different aspects of the lifecycle. To help establish this Common Information Model, information about how models are used in industry within different workflows needs to be understood. To retrieve this information, a survey mechanism was administered to industry professionals from various sectors. Based on the results of the survey a Common Information Model could not be established. However, the results gave great insight that will help in further investigation of the Common Information Model.

Proposal for refining the definition of dysgranulopoiesis in acute myeloid leukemia and myelodysplastic syndromes.

Science.gov (United States)

Goasguen, Jean E; Bennett, John M; Bain, Barbara J; Brunning, Richard; Vallespi, Maria-Teresa; Tomonaga, Masao; Zini, Gina; Renault, Alain

2014-04-01

Studies of morphology of myelodysplastic syndromes (MDS) or acute myeloid leukemia (AML) refer to the definitions produced by the French-American-British (FAB) group and by the World Health Organization expert group. To clarify some points regarding the dysgranulopoiesis that are still unclear we analyzed a series of 98 neutrophils from MDS patients with regard to granularity, nuclear segmentation, the appearance of the chromatin, the presence of giant neutrophils, and the presence of nuclear chromatin extensions. We found that cells with at least 2/3 reduction of the content of granules, Pelger-like neutrophils, dysplastic non-Pelger cells, neutrophils with abnormal clumping of the chromatin, and macropolycytes could be recognized as dysplastic and included in the 10% count recommended by these two classifications. In addition, we suggest that neutrophils with more than 4 nuclear projections could be recognized as a relevant dysplastic feature. Copyright © 2013 Elsevier Ltd. All rights reserved.

Developmental Psychopathology in a Racial/Ethnic Minority Group: Are Cultural Risks Relevant?

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Wei, Chiaying; Eisenberg, Ruth E; Ramos-Olazagasti, María A; Wall, Melanie; Chen, Chen; Bird, Héctor R; Canino, Glorisa; Duarte, Cristiane S

2017-12-01

The current study examined (a) the mediating role of parenting behaviors in the relationship between parental risks and youth antisocial behaviors (YASB), and (b) the role of youth cultural stress in a racial/ethnic minority group (i.e., Puerto Rican [PR] youth). This longitudinal study consisted of 3 annual interviews of PR youth (N = 1,150; aged 10-14 years at wave 1) and their caretakers from the South Bronx (SB) in New York City and from San Juan, Puerto Rico. Parents reported on parental risks, parenting behaviors, and YASB. Youth also self-reported on YASB and youth cultural stress. A lagged structural equation model examined the relationship between these variables across 3 yearly waves, with youth cultural stress as a moderator of the association between effective parenting behaviors and YASB. Findings supported the positive influence of effective parenting on YASB, independently of past parental risks and past YASB: higher effective parenting significantly predicted lower YASB at the following wave. Parenting also accounted for (mediated) the association between the composite of parental risks and YASB. Youth cultural stress at wave 1 was cross-sectionally associated with higher YASB and moderated the prospective associations between effective parenting and YASB, such that for youth who perceived higher cultural stress, the positive effect of effective parenting on YASB was weakened compared to those with lower/average cultural stress. Among PR families, both parental and cultural risk factors influence YASB. Such findings should be considered when treating racial/ethnic minority youth for whom cultural factors may be a relevant influence on determining behaviors. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Drought definitions and processes: how do humans fit in?

Science.gov (United States)

Van Loon, Anne; Van Lanen, Henny; Gleeson, Tom

2015-04-01

Drought is commonly defined as a temporary lack of water compared to normal conditions. In the traditional definition used in the natural sciences (climate science, hydrology, earth science) only natural drivers are included and the human effect on water resources is excluded. Drought impact studies, however, using observed crop yields, wildfire data, reservoir information, etc., can hardy make this division. The interdisciplinarity of drought asks for a broader definition that considers the interplay between the hazard, impacts and management. In flood research, human effects on the volume and timing of the flood event are traditionally taken into account and there is the awareness that human factors like channel modification, land surface changes and water supply engineering can both intensify and reduce flooding. Drought researchers can learn from the flooding community and try to elucidate the effects of human factors on drought duration and severity. This is not only a necessary step to answer relevant societal questions in the anthropocene, but also the IAHS Panta Rhei initiative urges hydrologists to include the connection with human systems. We propose a paradigm shift in the definition of drought, namely to expand it to include the effects of human action. Here, we will present a conceptual diagram that will do justice to the interdisciplinarity of drought. We will discuss the complex interconnected system of climate - hydrology - society - ecosystem and which processes in that system are most relevant to take into consideration when studying drought. The revised definition provides recognition and a common ground to researchers in all fields of research and is better aligned with drought impacts and with stakeholders' and policy maker's views on drought. We will also go into some of the pitfalls and challenges that come with applying this revised definition. For example, the natural and human-induced processes related to drought can have different scales

Rare cancers in children - The EXPeRT Initiative: a report from the European Cooperative Study Group on Pediatric Rare Tumors.

Science.gov (United States)

Bisogno, G; Ferrari, A; Bien, E; Brecht, I B; Brennan, B; Cecchetto, G; Godzinski, J; Orbach, D; Reguerre, Y; Stachowicz-Stencel, T; Schneider, D T

2012-10-01

The low incidence and the heterogeneity of very rare tumors (VRTs) demand for international cooperation. In 2008, EXPeRT (European Cooperative Study Group for Pediatric Rare Tumors) was founded by national groups from Italy, France, United Kingdom, Poland and Germany. The first aims of EXPeRT were to agree on a uniform definition of VRTs and to develop the currently most relevant scientific questions. Current initiatives include international data exchange, retrospective and prospective studies of specific entities, and the development of harmonized and internationally recognized guidelines. Moreover, EXPeRT established a network for expert consultation to assist in clinical decision in VRTs. © Georg Thieme Verlag KG Stuttgart · New York.

Consensus on the Definition of Advanced Parkinson’s Disease: A Neurologists-Based Delphi Study (CEPA Study

Directory of Open Access Journals (Sweden)

Maria-Rosario Luquin

2017-01-01

Full Text Available To date, no consensus exists on the key factors for diagnosing advanced Parkinson disease (APD. To obtain consensus on the definition of APD, we performed a prospective, multicenter, Spanish nationwide, 3-round Delphi study (CEPA study. An ad hoc questionnaire was designed with 33 questions concerning the relevance of several clinical features for APD diagnosis. In the first-round, 240 neurologists of the Spanish Movement Disorders Group participated in the study. The results obtained were incorporated into the questionnaire and both, results and questionnaire, were sent out to and fulfilled by 26 experts in Movement Disorders. Review of results from the second-round led to a classification of symptoms as indicative of “definitive,” “probable,” and “possible” APD. This classification was confirmed by 149 previous participating neurologists in a third-round, where 92% completely or very much agreed with the classification. Definitive symptoms of APD included disability requiring help for the activities of daily living, presence of motor fluctuations with limitations to perform basic activities of daily living without help, severe dysphagia, recurrent falls, and dementia. These results will help neurologists to identify some key factors in APD diagnosis, thus allowing users to categorize the patients for a homogeneous recognition of this condition.

What is "grazing"? Reviewing its definition, frequency, clinical characteristics, and impact on bariatric surgery outcomes, and proposing a standardized definition.

Science.gov (United States)

Conceição, Eva M; Mitchell, James E; Engel, Scott G; Machado, Paulo P P; Lancaster, Kathryn; Wonderlich, Stephen A

2014-01-01

Grazing, characterized by a repetitive eating pattern, has received increased attention among bariatric surgery patients. However, different definitions and terminology have been used, preventing the accurate measurement of this phenomenon and comparison of data across studies. To review existing definitions and associated clinical features of grazing among different samples and to propose a standardized definition that will allow for consistency in future work. University and Clinical Research Institute. Of the 39 studies found, 9 provided an original definition and 12 provided data of its association with weight outcomes. Six were studies of nonbariatric surgery populations. Based on this literature review, the most common criteria used in previous studies to define grazing were included in a survey that was sent to 24 individuals who have published work in the field. These experts were asked to provide their opinion on what should constitute grazing. Grazing is a frequent behavior in the bariatric surgery population as well as in eating disordered and community samples. Its association with psychopathology is not clear, but its negative impact on weight outcomes after bariatric surgery generally has been supported. Survey data provided a consensus regarding the definition of grazing as an eating behavior characterized by the repetitive eating (more than twice) of small/modest amounts of food in an unplanned manner, with what we characterize as compulsive and noncompulsive subtypes. Given the clinical relevance of grazing among bariatric surgery patients, a unique definition is crucial to better study its associated features and impact on different populations. Copyright © 2014 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Reliability and validity of four alternative definitions of rapid-cycling bipolar disorder.

Science.gov (United States)

Maj, M; Pirozzi, R; Formicola, A M; Tortorella, A

1999-09-01

This study tested the reliability and validity of four definitions of rapid cycling. Two trained psychiatrists, using the Schedule for Affective Disorders and Schizophrenia, independently assessed 210 patients with bipolar disorder. They checked whether each patient met four definitions of rapid cycling: one consistent with DSM-IV criteria, one waiving criteria for duration of affective episodes, one waiving such criteria and requiring at least one switch from mania to depression or vice versa during the reference year, and one waiving duration criteria and requiring at least 8 weeks of fully symptomatic affective illness during the reference year. The interrater reliability was calculated by Cohen's kappa statistic. Patients who met each definition according to both psychiatrists were compared to those who did not meet any definition (nonrapid-cycling group) on demographic and clinical variables. All patients were followed up for 1 year. Kappa values were 0.93, 0.73, 0.75, and 0.80, respectively, for the four definitions of rapid cycling. The groups meeting the second and third definitions included significantly more female and bipolar II patients than did the nonrapid-cycling group. Those two groups also had the lowest proportion of patients with a favorable lithium prophylaxis outcome and the highest stability of the rapid-cycling pattern on follow-up. The four groups of rapid-cycling patients did not differ significantly among themselves on any of the assessed variables. The expression "rapid cycling" encompasses a spectrum of conditions. The DSM-IV definition, although quite reliable, covers only part of this spectrum, and the conditions that are excluded are very typical in terms of key validators and are relatively stable over time.

Characterizing eating patterns: a comparison of eating occasion definitions.

Science.gov (United States)

Leech, Rebecca M; Worsley, Anthony; Timperio, Anna; McNaughton, Sarah A

2015-11-01

To date, many approaches have been used to define eating occasions (EOs). A standard definition for EOs is required to facilitate further research. In this study, we examined the influence of differing definitions of EOs on the characterization of eating patterns. Cross-sectional dietary data from two 24-h recalls collected during the 2011-12 Australian National Nutrition and Physical Activity Survey (n = 5242 adults, aged ≥19 y) were analyzed. Eight definitions were applied: participant-identified, time-of-day, and 6 neutral definitions (individual EOs separated by different time intervals and/or an additional energy criterion of 210 kJ). Frequency of and total energy intake from meals, snacks, and all EOs were estimated, as appropriate. Differences were tested by using F tests, stratified by sex and age group. Agreement between different definitions of meal and snack frequencies was assessed by using intraclass correlation coefficients (ICCs). For each definition, linear regression was used to estimate the proportion of variance in total energy intake (kJ) and amount of food intake (g) predicted by frequency of EOs and meals and snacks. Among both sexes and across all age groups, mean frequencies of meals differed between the participant-identified and time-of-day definitions (mean difference range = 0.1-0.3; P good agreement for snacks (men: ICC = 0.89; women: ICC = 0.87) but not meal frequencies (men: ICC = 0.38; women: ICC = 0.36) between the participant-identified and time-of-day definitions. The neutral definition (15-min time interval plus energy criterion) best predicted variance in total energy intake (R(2) range = 19.3-27.8). Different approaches to the definition of EOs affect how eating patterns are characterized, with the neutral definition best predicting variance in total energy intake. Further research that examines how different EO definitions affect associations with health outcomes is needed to develop consensus on a standard EO definition. �

Definition of drug-resistant epilepsy: is it evidence based?

Science.gov (United States)

Wiebe, Samuel

2013-05-01

Clinical case definitions are the cornerstone of clinical communication and of clinical and epidemiologic research. The ramifications of establishing a case definition are extensive, including potentially large changes in epidemiologic estimates of frequency, and decisions for clinical management. Yet, defining a condition entails numerous challenges such as defining the scope and purpose, incorporating the strongest evidence base with clinical expertise, accounting for patients' values, and considering impact on care. The clinical case definition of drug-resistant epilepsy, in addition, must address what constitutes an adequate intervention for an individual drug, what are the outcomes of relevance, what period of observation is sufficient to determine success or failure, how many medications should be tried, whether seizure frequency should play a role, and what is the role of side effects and tolerability. On the other hand, the principles of evidence-based medicine (EBM) aim at providing a systematic approach to incorporating the best available evidence into the process of clinical decision for individual patients. The case definition of drug-resistant epilepsy proposed by the the International League Against Epilepsy (ILAE) in 2009 is evaluated in terms of the principles of EBM as well as the stated goals of the authors of the definition. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

Definition of gross tumor volume in lung cancer: inter-observer variability

NARCIS (Netherlands)

van de Steene, Jan; Linthout, Nadine; de Mey, Johan; Vinh-Hung, Vincent; Claassens, Cornelia; Noppen, Marc; Bel, Arjan; Storme, Guy

2002-01-01

BACKGROUND AND PURPOSE: To determine the inter-observer variation in gross tumor volume (GTV) definition in lung cancer, and its clinical relevance. MATERIALS AND METHODS: Five clinicians involved in lung cancer were asked to define GTV on the planning CT scan of eight patients. Resulting GTVs were

Identifying factors relevant in the assessment of return-to-work efforts in employees on long-term sickness absence due to chronic low back pain: a focus group study

Directory of Open Access Journals (Sweden)

Muijzer Anna

2012-01-01

Full Text Available Abstract Background Efforts undertaken during the return to work (RTW process need to be sufficient to prevent unnecessary applications for disability benefits. The purpose of this study was to identify factors relevant to RTW Effort Sufficiency (RTW-ES in cases of sick-listed employees with chronic low back pain (CLBP. Methods Using focus groups consisting of Labor Experts (LE's working at the Dutch Social Insurance Institute, arguments and underlying grounds relevant to the assessment of RTW-ES were investigated. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model. Results Two focus groups yielded 19 factors, of which 12 are categorized in the ICF model under activities (e.g. functional capacity and in the personal (e.g. age, tenure and environmental domain (e.g. employer-employee relationship. The remaining 7 factors are categorized under intervention, job accommodation and measures. Conclusions This focus group study shows that 19 factors may be relevant to RTW-ES in sick-listed employees with CLBP. Providing these results to professionals assessing RTW-ES might contribute to a more transparent and systematic approach. Considering the importance of the quality of the RTW process, optimizing the RTW-ES assessment is essential.

Function- and User-related Definitions in Online Dictionaries

DEFF Research Database (Denmark)

Nielsen, Sandro

2011-01-01

A study of the existing literature shows that definitions play an important part in dictionary use and making. The discussions primarily concern printed dictionaries and show that definitions are static in that only one definition should be provided for each meaning of a lemma or entry word, as a....... The important point is that each definition has been written with a specific function and user group in mind taking into account the needs of users in specific types of user situation.......A study of the existing literature shows that definitions play an important part in dictionary use and making. The discussions primarily concern printed dictionaries and show that definitions are static in that only one definition should be provided for each meaning of a lemma or entry word......, as argued in e.g. Jackson (2002: 86-100). However, online dictionaries provide lexicographers with the option of taking a more flexible approach to lexicographic definitions in an attempt to give the best possible help to users. The “one-size-fits-all” approach to dictionary making has its limits...

The role of diseases, risk factors and symptoms in the definition of multimorbidity

DEFF Research Database (Denmark)

Willadsen, Tora Grauers; Bebe, Anna; Køster-Rasmussen, Rasmus

2016-01-01

until October 2013. One author extracted the information. Ambiguities were resolved, and consensus reached with one co-author. Outcome measures were: cut-off point for the number of conditions included in the definitions of multimorbidity; setting; data sources; number, kind, duration, and severity......Objective is to explore how multimorbidity is defined in the scientific literature, with a focus on the roles of diseases, risk factors, and symptoms in the definitions. DESIGN: Systematic review. METHODS: MEDLINE (PubMed), Embase, and The Cochrane Library were searched for relevant publications up......%). Sources of data were primarily self-reports (56 articles, 42%). Out of the 163 articles selected, 115 had individually constructed multimorbidity definitions, and in these articles diseases occurred in all definitions, with diabetes as the most frequent. Risk factors occurred in 98 (85%) and symptoms...

"Value Relevance of Consolidated Earnings -- Evaluation of Japanese Revolution and a New Proposal by FASB -- "(in Japanese)

OpenAIRE

Takashi Obinata

2006-01-01

In 2000, the reform of consolidated financial statements changed the income statement section where amortization of goodwill and gains and losses from interest method should be disclosed. The results in this paper show that the reform may improve the value relevance of operating profits and ordinary income. We cannot find the evidence that the reform decreases the relevance of the multi-step earnings. Though we cannot definitively conclude that the reform was the best way for improving the va...

Kidnapping by Terrorist Groups, 1970-2010: Is Ideological Orientation Relevant?

Science.gov (United States)

Forest, James J. F.

2012-01-01

This article examines whether a terrorist group's ideology has a meaningful impact on its involvement in kidnapping. On a global level, incident data (1970-2010) indicate that in the past decade the number of kidnappings by terrorist groups has increased, while Muslim extremists have replaced left-wing/Marxist revolutionaries as the world's…

Comparison of the Berlin definition with the American European consensus definition for acute respiratory distress syndrome in burn patients.

Science.gov (United States)

Bordes, Julien; Lacroix, Guillaume; Esnault, Pierre; Goutorbe, Philippe; Cotte, Jean; Dantzer, Eric; Meaudre, Eric

2014-06-01

Acute respiratory distress syndrome (ARDS) is a leading cause of mortality in burn patients. Smoke inhalation, pneumonia and inflammation process are the major causes of ARDS in burn patients. The American European Consensus Conference (AECC) definition proposed in 1994 has recently been revised by the Berlin definition. Our objective was to describe the epidemiology of ARDS comparing the Berlin definition with the AECC definition in a retrospective cohort of burn patients. We reviewed admitted burn adult patients for a two year period, and investigated patient who received mechanical ventilation for more than 48 h and in whom pneumonia was diagnosed. 40 patients were analyzed. According to the AECC definition, 11 patients met criteria for ALI (27.5%), and 29 patients for ARDS (72.5%). According to the Berlin definition, all patients met criteria for ARDS: 4 (10%) for a severe ARDS, 25 (62.5%) for a moderate ARDS, 11 (27.5%) for a mild ARDS. Inhalation injury was diagnosed in 10 patients (25%). Categorizing patients with the Berlin definition showed statistically significative difference of mortality within the three groups, but not with the AECC definition. The Berlin definition seems to be more accurate than the AECC definition to assess the severity of ARDS in term of outcome in burn patients. This definition may facilitate prompt recognition of ARDS in burn patients, and promote protective ventilation strategy to a larger number of patients. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Why relevance theory is relevant for lexicography

DEFF Research Database (Denmark)

Bothma, Theo; Tarp, Sven

2014-01-01

This article starts by providing a brief summary of relevance theory in information science in relation to the function theory of lexicography, explaining the different types of relevance, viz. objective system relevance and the subjective types of relevance, i.e. topical, cognitive, situational...... that is very important for lexicography as well as for information science, viz. functional relevance. Since all lexicographic work is ultimately aimed at satisfying users’ information needs, the article then discusses why the lexicographer should take note of all these types of relevance when planning a new...... dictionary project, identifying new tasks and responsibilities of the modern lexicographer. The article furthermore discusses how relevance theory impacts on teaching dictionary culture and reference skills. By integrating insights from lexicography and information science, the article contributes to new...

7 CFR 29.6020 - Group.

Science.gov (United States)

2010-01-01

... 7 Agriculture 2 2010-01-01 2010-01-01 false Group. 29.6020 Section 29.6020 Agriculture Regulations... INSPECTION Standards Definitions § 29.6020 Group. A type division consisting of one or more grades based on the general quality of tobacco. Groups in these types are: Binder (B), Stripper (C), Straight Stripped...

Discovering relevance knowledge in data: a growing cell structures approach.

Science.gov (United States)

Azuaje, F; Dubitzky, W; Black, N; Adamson, K

2000-01-01

Both information retrieval and case-based reasoning systems rely on effective and efficient selection of relevant data. Typically, relevance in such systems is approximated by similarity or indexing models. However, the definition of what makes data items similar or how they should be indexed is often nontrivial and time-consuming. Based on growing cell structure artificial neural networks, this paper presents a method that automatically constructs a case retrieval model from existing data. Within the case-based reasoning (CBR) framework, the method is evaluated for two medical prognosis tasks, namely, colorectal cancer survival and coronary heart disease risk prognosis. The results of the experiments suggest that the proposed method is effective and robust. To gain a deeper insight and understanding of the underlying mechanisms of the proposed model, a detailed empirical analysis of the models structural and behavioral properties is also provided.

Deciphering the Crowd: Modeling and Identification of Pedestrian Group Motion

Directory of Open Access Journals (Sweden)

Norihiro Hagita

2013-01-01

Full Text Available Associating attributes to pedestrians in a crowd is relevant for various areas like surveillance, customer profiling and service providing. The attributes of interest greatly depend on the application domain and might involve such social relations as friends or family as well as the hierarchy of the group including the leader or subordinates. Nevertheless, the complex social setting inherently complicates this task. We attack this problem by exploiting the small group structures in the crowd. The relations among individuals and their peers within a social group are reliable indicators of social attributes. To that end, this paper identifies social groups based on explicit motion models integrated through a hypothesis testing scheme. We develop two models relating positional and directional relations. A pair of pedestrians is identified as belonging to the same group or not by utilizing the two models in parallel, which defines a compound hypothesis testing scheme. By testing the proposed approach on three datasets with different environmental properties and group characteristics, it is demonstrated that we achieve an identification accuracy of 87% to 99%. The contribution of this study lies in its definition of positional and directional relation models, its description of compound evaluations, and the resolution of ambiguities with our proposed uncertainty measure based on the local and global indicators of group relation.

The relevance of thermal hydraulics pipeline simulation as a regulatory support tool

Energy Technology Data Exchange (ETDEWEB)

Silva, Patricia Mannarino; Santos, Almir Beserra dos [Agencia Nacional do Petroleo, Gas Natural e Biocombustiveis (ANP), Rio de Janeiro, RJ (Brazil)

2009-07-01

The capacity definition of a pipeline, along with its allocation, is very relevant to assure market transparency, nondiscriminatory access, security of supply, and also to give consistent signs for expansion needs. Nevertheless, the capacity definition is a controversial issue, and may widely vary depending on the technical and commercial assumptions made. To calculate a pipeline's nominal capacity, there are a variety of simulation tools, which include steady state, transient and on-line computer programs. It is desirable that the simulation tool is robust enough to predict the pipeline's capacity under different conditions. There are many variables that impact the flow through a pipeline, like gas characteristics, pipe and environmental variables. Designing a thermal model is a time-consuming task that requests understanding the level of detail need, in order to achieve success in its application. This article discusses the capacity definition, its role and calculation guidelines, describes ANP's experience with capacity calculation and further challenges according to the new regulation, and debates the role of thermal hydraulic simulation as a regulatory tool. (author)

Instability in Thoracolumbar Trauma: Is a New Definition Warranted?

Science.gov (United States)

Abbasi Fard, Salman; Skoch, Jesse; Avila, Mauricio J; Patel, Apar S; Sattarov, Kamran V; Walter, Christina M; Baaj, Ali A

2017-10-01

Review of the articles. The objective of this study was to review all articles related to spinal instability to determine a consensus statement for a contemporary, practical definition applicable to thoracolumbar injuries. Traumatic fractures of the thoracolumbar spine are common. These injuries can result in neurological deficits, disability, deformity, pain, and represent a great economic burden to society. The determination of spinal instability is an important task for spine surgeons, as treatment strategies rely heavily on this assessment. However, a clinically applicable definition of spinal stability remains elusive. A review of the Medline database between 1930 and 2014 was performed limited to papers in English. Spinal instability, thoracolumbar, and spinal stability were used as search terms. Case reports were excluded. We reviewed listed references from pertinent search results and located relevant manuscripts from these lists as well. The search produced a total of 694 published articles. Twenty-five articles were eligible after abstract screening and underwent full review. A definition for spinal instability was described in only 4 of them. Definitions were primarily based on biomechanical and classification studies. No definitive parameters were outlined to define stability. Thirty-six years after White and Panjabi's original definition of instability, and many classification schemes later, there remains no practical and meaningful definition for spinal instability in thoracolumbar trauma. Surgeon expertise and experience remains an important factor in stability determination. We propose that, at an initial assessment, a distinction should be made between immediate and delayed instability. This designation should better guide surgeons in decision making and patient counseling.

Cebollati group, Nico Perez terrane: Definition and age

International Nuclear Information System (INIS)

Gaucher, C; Chemale, F.; Bossi, J.; Castiglioni, E.; Castiglioni, E.

2010-01-01

The Cebollati Group (Nico Perez Terrane) is formally erected in this work to include a meta sedimentary succession informally known as L as Teta s Complex . It is shown that the stratigraphy of the unit can be reconstructed at a number of sections between Minas and Zapicìn, using sedimentary structures and stromatolites as geo petal indicators. The basement of the group is represented by metamorphic rocks and granitoids of the La China Complex, for which a new U-Pb zircon age of 3.029 ± 54 Ma is presented. The Cebollatií Group comprises, from base to top, three formations: the Arroyo Ma lo Formation (sandstones and petites), Cerro de Valuable Formation (dolostones, partly stromatolitic, and p elites) and the Cerro del Diamant e Formation (p elites, BIF, quartz-pebble conglomerates and sandstones). The mean thickness of the Cebollatií Group is ca. 2 km, being greatest in the south and diminishing to the north. Available ages for the unit suggested a Neoarchean depositional age of 2.75 Ga. However, in this work 12 Nd model ages are presented for sedimentary rocks of the Cebollatí Group, which are mostly younger than 2.75 Ga, the youngest being 1.64 Ga. These ages call into question the Neoarchean age accepted for the unit, suggesting a Meso proterozoic depositional age. The evidence supporting both views is discussed in view of the new data. The minimum age of the Cebollatí Group is 1.3 Ga on the basis of carbon isotope ratios of dolostones and deformational ages consistently around 1.25 Ga

High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

Science.gov (United States)

Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

2016-06-01

Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Pharmaceutical care: the PCNE definition 2013.

Science.gov (United States)

Allemann, Samuel S; van Mil, J W Foppe; Botermann, Lea; Berger, Karin; Griese, Nina; Hersberger, Kurt E

2014-06-01

Twenty-three years after Hepler and Strand published their well-known definition of Pharmaceutical Care (PhC), confusion remains about what the term includes and how to differentiate it from other terms. The board of the Pharmaceutical Care Network Europe (PCNE) felt the need to redefine PhC and to answer the question: "What is Pharmaceutical Care in 2013". The aims of this paper were to review existing definitions of PhC and to describe the process of developing a redefined definition. A literature search was conducted in the MEDLINE database (1964-January 2013). Keywords included "Pharmaceutical Care", "Medication (Therapy) Management", "Medicine Management", and "Pharmacist Care" in the title or abstract together with the term "defin*". To ease comparison between definitions, we developed a standardised syntax to paraphrase the definitions. During a dedicated meeting, a moderated discussion about the definition of PhC was organised. The initial literature search produced 186 hits, with eight unique PhC definitions. Hand searching identified a further 11 unique definitions. These 19 definitions were paraphrased using the standardised syntax (provider, recipient, subject, outcome, activities). Fourteen members of PCNE and 10 additional experts attended the moderated discussion. Working groups of increasing size developed intermediate definitions, which had similarities and differences to those retrieved in the literature search. At the end of the session, participants reached a consensus on a "PCNE definition of Pharmaceutical Care" reading: "Pharmaceutical Care is the pharmacist's contribution to the care of individuals in order to optimize medicines use and improve health outcomes". It was possible to paraphrase definitions of PhC using a standardised syntax focusing on the provider, recipient, subject, outcomes, and activities included in PhC practice. During a one-day workshop, experts in PhC research agreed on a definition, intended to be applicable for the

Isolation, speciation, and antibiogram of clinically relevant non-diphtherial Corynebacteria (Diphtheroids

Directory of Open Access Journals (Sweden)

B S Reddy

2012-01-01

Full Text Available Purpose: Coryneform or the non-diphtherial Corynebacterium species largely remains a neglected group with the traditional consideration of these organisms as contaminants. This concept, however, is slowly changing in the light of recent observations. This study has been done to find out the species distribution and antibiogram of various members of the clinically relevant Coryneform group, isolated from various clinical materials. Materials and Methods: One hundred and fourteen non-duplicate isolates of diphtheroids from various clinical isolates were selected for the study. The isolates were identified to the species level by using a battery of tests; and antimicrobial susceptibility was tested by using a combination of Clinical and Laboratory Standards Institute (CLSI and the British Society for Antimicrobial Chemotherapy (BSAC guidelines, in the absence of definitive CLSI guidelines. Results: Corynebacterium amycolatum was the predominant species (35.9% in our series followed by the CDC Group G organisms (15.7%. Each of the remaining 19 species comprised of less than 10% of the isolates. More than half the total isolates were resistant to the penicillins, erythromycin, and clindamycin; while excellent activity (all the strains being susceptible was shown by vancomycin, linezolid, and tigecycline. Chloramphenicol and tetracycline also had good activity in inhibiting more than 80% of the isolates. Multiply drug resistance was exhibited by all the species. Conclusion: This study was an attempt to establish the clinical significance of coryneform organisms. The high level of resistance shown by this group to some of the common antibacterial agents highlights the importance of processing these isolates in select conditions to guide the clinicians towards an appropriate therapy.

[How do adolescents in Germany define cyberbullying? A focus-group study of adolescents from a German major city].

Science.gov (United States)

Höher, Jonas; Scheithauer, Herbert; Schultze-Krumbholz, Anja

2014-01-01

A steadily growing number of empirical research on cyberbullying exists retaining the traditional definition of bullying. However, whether this scientific and theoretical definition represents youths' perceptions and experiences with cyberbullying is a subject of further investigation. Scenarios of cyberbullying incidents were used and later discussed in three focus groups with 20 adolescents (55 % boys, 45 % girls, 11-16 years old). Thematic and content analyses laid focus on the following questions: (1) Which terms are used by the adolescents to describe the behaviors in the incidents? (2) What are the roles of traditional bullying definition criteria (i. e. intention, repetition, and power imbalance) and two additional cyberbullying-specific criteria (i. e. anonymity and publicity)? (3) How are the behaviors perceived in comparison to each other? Results show that German adolescents perceive "cybermobbing" as the best term to describe the presented incidents. Impersonation was not perceived as cyberbullying by the adolescents, but rather viewed as a criminal act. In addition, adolescents perceived the intent to harm, the impact on the victim, and repetition relevant for defining cyberbullying. Moreover, analyses revealed an interdependence between criteria which suggests that anonymity and publicity have an effect on the severity of the behavior, however they were not essential for the definition of cyberbullying.

UX Professionals’ Definitions of Usability and UX

DEFF Research Database (Denmark)

Rajanen, Dorina; Clemmensen, Torkil; Iivari, Netta

2017-01-01

This paper examines the views of user experience (UX) professionals on the definitions of usability and UX, and compares the findings between countries and within different socio-cultural groups. A mixed-method analysis was employed on data gathered on 422 professionals through a survey in Turkey......, Finland, Denmark, France, and Malaysia. Usability appears to be an established concept, respondents across all countries agreeing on the importance of the ISO 9241-11 definition. There is also a tendency that UX professionals attach organizational perspective to usability. UX professionals diverge when...... defining UX, and there are systematic differences related to socio-cultural conditions. UX professionals in Finland and France incline more towards the definition highlighting the experiential qualities, when compared to Turkey and Malaysia that incline towards the definition reflecting the ease of use...

Definition and classification of hypertension: an update.

Science.gov (United States)

Giles, Thomas D; Materson, Barry J; Cohn, Jay N; Kostis, John B

2009-11-01

Since the publication of a paper by the American Society of Hypertension, Inc. Writing Group in 2003, some refinements have occurred in the definition of hypertension. Blood pressure is now recognized as a biomarker for hypertension, and a distinction is made between the various stages of hypertension and global cardiovascular risk. This paper discusses the logic underlying the refinements in the definition of hypertension. 2009 Wiley Periodical, Inc.

Experimental Models of Vaginal Candidiasis and Their Relevance to Human Candidiasis

Science.gov (United States)

Sobel, Jack D.

2016-01-01

Vulvovaginal candidiasis (VVC) is a high-incidence disease seriously affecting the quality of life of women worldwide, particularly in its chronic, recurrent forms (RVVC), and with no definitive cure or preventive measure. Experimental studies in currently used rat and mouse models of vaginal candidiasis have generated a large mass of data on pathogenicity determinants and inflammation and immune responses of potential importance for the control of human pathology. However, reflection is necessary about the relevance of these rodent models to RVVC. Here we examine the chemical, biochemical, and biological factors that determine or contrast the forms of the disease in rodent models and in women and highlight the differences between them. We also appeal for approaches to improve or replace the current models in order to enhance their relevance to human infection. PMID:26883592

On relevant boundary perturbations of unitary minimal models

International Nuclear Information System (INIS)

Recknagel, A.; Roggenkamp, D.; Schomerus, V.

2000-01-01

We consider unitary Virasoro minimal models on the disk with Cardy boundary conditions and discuss deformations by certain relevant boundary operators, analogous to tachyon condensation in string theory. Concentrating on the least relevant boundary field, we can perform a perturbative analysis of renormalization group fixed points. We find that the systems always flow towards stable fixed points which admit no further (non-trivial) relevant perturbations. The new conformal boundary conditions are in general given by superpositions of 'pure' Cardy boundary conditions

Hidden Curriculum: An Analytical Definition

Directory of Open Access Journals (Sweden)

Mohammad Reza Andarvazh

2018-03-01

Full Text Available Background: The concept of hidden curriculum was first used by Philip Jackson in 1968, and Hafferty brought this concept to the medical education. Many of the subjects that medical students learn are attributed to this curriculum. So far several definitions have been presented for the hidden curriculum, which on the one hand made this concept richer, and on the other hand, led to confusion and ambiguity.This paper tries to provide a clear and comprehensive definition of it.Methods: In this study, concept analysis of McKenna method was used. Using keywords and searching in the databases, 561 English and 26 Persian references related to the concept was found, then by limitingthe research scope, 125 abstracts and by finding more relevant references, 55 articles were fully studied.Results: After analyzing the definitions by McKenna method, the hidden curriculum is defined as follows: The hidden curriculum is a hidden, powerful, intrinsic in organizational structure and culture and sometimes contradictory message, conveyed implicitly and tacitly in the learning environment by structural and human factors and its contents includes cultural habits and customs, norms, values, belief systems, attitudes, skills, desires and behavioral and social expectations can have a positive or negative effect, unplanned, neither planners nor teachers, nor learners are aware of it. The ultimate consequence of the hidden curriculum includes reproducing the existing class structure, socialization, and familiarizing learners for transmission and joining the professional world.Conclusion: Based on the concept analysis, we arrived at an analytical definition of the hidden curriculum that could be useful for further studies in this area.Keywords: CONCEPT ANALYSIS, HIDDEN CURRICULUM, MCKENNA’S METHOD

A matter of definition--key elements identified in a discourse analysis of definitions of palliative care.

Science.gov (United States)

Pastrana, T; Jünger, S; Ostgathe, C; Elsner, F; Radbruch, L

2008-04-01

For more than 30 years, the term "palliative care" has been used. From the outset, the term has undergone a series of transformations in its definitions and consequently in its tasks and goals. There remains a lack of consensus on a definition. The aim of this article is to analyse the definitions of palliative care in the specialist literature and to identify the key elements of palliative care using discourse analysis: a qualitative methodology. The literature search focused on definitions of the term 'palliative medicine' and 'palliative care' in the World Wide Web and medical reference books in English and German. A total of 37 English and 26 German definitions were identified and analysed. Our study confirmed the lack of a consistent meaning concerning the investigated terms, reflecting on-going discussion about the nature of the field among palliative care practitioners. Several common key elements were identified. Four main categories emerged from the discourse analysis of the definition of palliative care: target groups, structure, tasks and expertise. In addition, the theoretical principles and goals of palliative care were discussed and found to be key elements, with relief and prevention of suffering and improvement of quality of life as main goals. The identified key elements can contribute to the definition of the concept 'palliative care'. Our study confirms the importance of semantic and ethical influences on palliative care that should be considered in future research on semantics in different languages.

Unified derivation of the various definitions of lattice cell diffusion coefficients

International Nuclear Information System (INIS)

Hughes, R.P.

1978-01-01

The various definitions of lattice cell diffusion coefficients are discussed within the context of a one-dimensional slab lattice in one energy group. It is shown how each definition, although originally derived in its own particular way, can be derived from a single approach. This makes clear the differences between, and the advantages of, the various definitions

Introduction to quantum groups

International Nuclear Information System (INIS)

Sudbery, A.

1996-01-01

These pedagogical lectures contain some motivation for the study of quantum groups; a definition of ''quasi triangular Hopf algebra'' with explanations of all the concepts required to build it up; descriptions of quantised universal enveloping algebras and the quantum double; and an account of quantised function algebras and the action of quantum groups on quantum spaces. (author)

Terms, definitions and measurements to describe sonographic features of myometrium and uterine masses

DEFF Research Database (Denmark)

Van den Bosch, Thierry; Dueholm, Margit; Leone, FP

2015-01-01

imaging. The terms and definitions described may form the basis for prospective studies to predict the risk of different myometrial pathologies, based on their ultrasound appearance, and thus should be relevant for the clinician in daily practice and for clinical research. The sonographic features and use......The MUSA (Morphological Uterus Sonographic Assessment) statement is a consensus statement on terms, definitions and measurements that may be used to describe and report the sonographic features of the myometrium using gray-scale sonography, color/power Doppler and three-dimensional ultrasound...

High Definition Colonoscopy Combined with i-SCAN Imaging Technology Is Superior in the Detection of Adenomas and Advanced Lesions Compared to High Definition Colonoscopy Alone.

Science.gov (United States)

Bowman, Erik A; Pfau, Patrick R; Mitra, Arnab; Reichelderfer, Mark; Gopal, Deepak V; Hall, Benjamin S; Benson, Mark E

2015-01-01

Background. Improved detection of adenomatous polyps using i-SCAN has mixed results in small studies. Utility of i-SCAN as a primary surveillance modality for colorectal cancer screening during colonoscopy is uncertain. Aim. Comparing high definition white light endoscopy (HDWLE) to i-SCAN in their ability to detect adenomas during colonoscopy. Methods. Prospective cohort study of 1936 average risk patients who had a screening colonoscopy at an ambulatory procedure center. Patients underwent colonoscopy with high definition white light endoscopy withdrawal versus i-SCAN withdrawal during endoscopic screening exam. Primary outcome measurement was adenoma detection rate for i-SCAN versus high definition white light endoscopy. Secondary measurements included polyp size, pathology, and morphology. Results. 1007 patients underwent colonoscopy with i-SCAN and 929 with HDWLE. 618 adenomas were detected in the i-SCAN group compared to 402 in the HDWLE group (p definition white light endoscopy.

Needs assessments in palliative care: an appraisal of definitions and approaches used.

Science.gov (United States)

Higginson, Irene J; Hart, Sam; Koffman, Jonathan; Selman, Lucy; Harding, Richard

2007-05-01

We report a systematic appraisal of definitions and approaches to needs assessment in palliative care. Electronic databases were searched, and relevant individuals and organizations were contacted to identify needs assessments in palliative care. Over 200 articles were identified giving general information on needs assessment, and 77 articles comprised palliative care-related needs assessment reports. The reports originated from Africa (37), Australia (1), Europe (including former central/eastern European states) (35), USA (1), Latin America (5), and Asia (7). Two underpinning definitions of need were identified, that of Maslow from the field of psychology, and that of Bradshaw from sociology. However, in conducting needs assessments, these definitions were operationalized, and here the National Health Service Executive definition of need as "the ability to benefit from health care" is helpful. We identified three main categories of approach to needs assessment--epidemiological, corporate, and comparative--that can be used in combination. Careful consideration must be paid to any needs assessment data to ensure that the assessment is implemented.

14 CFR 249.2 - Definitions.

Science.gov (United States)

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Definitions. 249.2 Section 249.2 Aeronautics and Space OFFICE OF THE SECRETARY, DEPARTMENT OF TRANSPORTATION (AVIATION PROCEEDINGS) ECONOMIC... other acquisition. Supporting papers (records) means any group of documentary papers, such as memoranda...

A framework for the definition of variants of high-level Petri nets

DEFF Research Database (Denmark)

Kindler, Ekkart; Petrucci, Laure

2009-01-01

with data-type specific issues, which often blocks the view for the really relevant parts. Even worse, supposedly simpler versions of high-level nets often are more difficult to define than high-level nets in general. This paper introduces the concepts and the mathematical tools to ease the definition...

Differences in Approach between Nuclear and Conventional Seismic Standards with regard to Hazard Definition - CSNI Integrity And Ageing Working Group

International Nuclear Information System (INIS)

Djaoudi, Ali; Labbe, Pierre; Murphy, Andrew; Kitada, Yoshio

2008-01-01

The Committee on the safety of Nuclear Installations (CSNI) of the OECD-NEA co-ordinates the NEA activities related to maintaining and advancing the scientific and technological knowledge base of the safety of nuclear installations. The Integrity and Ageing of Components and Structures Working Group of the CSNI is responsible for work related to the development and use of methods, data and information to assess the behaviour of materials and structures. It has three sub-groups, dealing with the integrity of metal components and structures, ageing of concrete structures, and the seismic behaviour of structures. The CSNI, at its meeting in June 2003, agreed to initiate an activity aimed to identify any difference between nuclear and non-nuclear conventional standards and their potential significance with regard to seismic hazards and design methods. There was a perception, mainly in some of the European countries that nuclear seismic hazard and design standards may be lagging behind developments in similar standards for conventional facilities. Adequate answer to such perception, need the examination of the following aspects and their significance on the seismic assessment of structures and components: - The safety philosophy behind the seismic nuclear and conventional standards. - The differences in approach regarding the seismic hazard definition. - The difference in approach regarding the design and the methods of analysis. These topics are examined in this report. Appendices A to H of this report contain a brief description of the conventional and the nuclear approaches in the NEA member countries: Belgium, Canada, Czech Republic, Germany, Japan, South Korea, Spain,and USA. The following general conclusions can be drawn: - The approach adopted by the nuclear seismic standards is more conservative and more reliable (in particular for meeting the continued operation criteria) than the recommended by the currently applicable force based conventional seismic codes

76 FR 54969 - Rate Increase Disclosure and Review: Definitions of “Individual Market” and “Small Group Market”

Science.gov (United States)

2011-09-06

... PHS Act are derived from definitions of employer and employee welfare benefit plan in ERISA section 3... respect to the program. The definition of `employee welfare benefit plan' in ERISA is grounded on the... associations. Comment: A trade association noted that section 3(5) of the Employee Retirement Income Security...

Much Ado About the New Definitions of Sepsis

Directory of Open Access Journals (Sweden)

Copotoiu Sanda-Maria

2016-04-01

Full Text Available Following the publication of the new definition of sepsis (Sepsis-3, a plethora of articles have been published in medical journals. Recognizing the epidemiological importance of the previous definitions, first issued in 1992 (Sepsis-1, and subsequently revised in 2001 (Sepsis-2, the most recent opinion emphasizes the failure “to provide adequate groups of patients with homogenous aetiologies, presentations and outcomes”, and blamed one of the causes “for the failure of several randomized controlled trials (RCTs, that tested the efficacy of adjuvant sepsis therapies”. This review summarizes the recent advances in sepsis definition.

Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients.

Science.gov (United States)

Schulman, S; Angerås, U; Bergqvist, D; Eriksson, B; Lassen, M R; Fisher, W

2010-01-01

The definition of major bleeding varies between studies on surgical patients, particularly regarding the criteria for surgical wound-related bleeding. This diversity contributes to the difficulties in comparing data between trials. The Scientific and Standardization Committee (SSC), through its subcommittee on Control of Anticoagulation, of the International Society on Thrombosis and Haemostasis has previously published a recommendation for a harmonized definition of major bleeding in non-surgical studies. That definition has been adopted by the European Medicines Agency and is currently used in several non-surgical trials. A preliminary proposal for a parallel definition for surgical studies was presented at the 54(th) Annual Meeting of the SSC in Vienna, July 2008. Based on those discussions and further consultations with European and North American surgeons with experience from clinical trials a definition has been developed that should be applicable to all agents that interfere with hemostasis. The definition and the text that follows have been reviewed and approved by relevant co-chairs of the subcommittee and by the Executive Committee of the SSC. The intention is to seek approval of this definition from the regulatory authorities to enhance its incorporation into future clinical trial protocols.

Towards a definition of neurodisability: a Delphi survey.

Science.gov (United States)

Morris, Christopher; Janssens, Astrid; Tomlinson, Richard; Williams, Jane; Logan, Stuart

2013-12-01

The aim of this study was to develop, systematically, a consensus-based definition for 'neurodisability' that is meaningful to health professionals and parents of children with neurological conditions. A multidisciplinary group of health professionals was recruited through child development teams and professional societies in the UK; several parents of children with neurological conditions worked with the research team. Professionals participated in three rounds of a Delphi survey. Participants rated their agreement with a proposed definition in each round, and feedback was used to refine the definition. Finally, a perspective was sought from international experts. Responses to the three rounds were as follows: round 1,245 out of 290 (84.4%); round 2,242 out of 300 (80.6%); and round 3,237 out of 297 (79.7%). Agreement with the proposed definition was extremely high in every round (89.0%, 90.1%, and 93.6% respectively). The final version of the definition was widely endorsed among professionals, parents, and a small number of international colleagues. The final definition is as follows: 'Neurodisability describes a group of congenital or acquired long-term conditions that are attributed to impairment of the brain and/or neuromuscular system and create functional limitations. A specific diagnosis may not be identified. Conditions may vary over time, occur alone or in combination, and include a broad range of severity and complexity. The impact may include difficulties with movement, cognition, hearing and vision, communication, emotion, and behaviour'. An agreed definition of neurodisability will be useful for conducting research or clinical evaluations with people affected by neurological problems. © 2013 Crown copyright. Developmental Medicine and Child Neurology © 2013 Mac Keith Press. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

45 CFR 61.3 - Definitions.

Science.gov (United States)

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Definitions. 61.3 Section 61.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION HEALTHCARE INTEGRITY AND PROTECTION DATA BANK... welfare association, public service group or organization or professional association; and (5) An...

Estimating the human exposure to chemical substances and radiation. Definition report

International Nuclear Information System (INIS)

Vermeire, T.G.; Van Veen, M.P.

1995-06-01

This report aims at boosting the human exposure assessment activities of the RIVM with regard to chemical substances and radiation. It is the result of thorough discussions with RIVM-experts. The report starts with an overview of past developments in the area of human exposure assessment at the RIVM and continues describing recent projects. Major developments outside the Institute are also discussed. An attempt is made to harmonize definitions which are relevant for exposure assessment, i.e. definitions on exposure, intake, uptake and dose. Important gaps in the human exposure assessment work at the RIVM are identified, leading to proposals for future work. 2 figs., 31 refs., 3 appendices

Microbial interactions with organic contaminants in soil: Definitions, processes and measurement

International Nuclear Information System (INIS)

Semple, Kirk T.; Doick, Kieron J.; Wick, Lukas Y.; Harms, Hauke

2007-01-01

There has been and continues to be considerable scientific interest in predicting bioremediation rates and endpoints. This requires the development of chemical techniques capable of reliably predicting the bioavailability of organic compounds to catabolically active soil microbes. A major issue in understanding the link between chemical extraction and bioavailability is the problem of definition; there are numerous definitions, of varying degrees of complexity and relevance, to the interaction between organic contaminants and microorganisms in soil. The aim of this review is to consider the bioavailability as a descriptor for the rate and extent of biodegradation and, in an applied sense, bioremediation of organic contaminants in soil. To address this, the review will (i) consider and clarify the numerous definitions of bioavailability and discuss the usefulness of the term 'bioaccessibility'; (ii) relate definition to the microbiological and chemical measurement of organic contaminants' bioavailability in soil, and (iii) explore the mechanisms employed by soil microorganisms to attack organic contaminants in soil. - Understanding organic contaminant's behaviour in soil is key to chemically predicting biodegradation

Development of a Gestational Age-Specific Case Definition for Neonatal Necrotizing Enterocolitis.

Science.gov (United States)

Battersby, Cheryl; Longford, Nick; Costeloe, Kate; Modi, Neena

2017-03-01

Necrotizing enterocolitis (NEC) is a major cause of neonatal morbidity and mortality. Preventive and therapeutic research, surveillance, and quality improvement initiatives are hindered by variations in case definitions. To develop a gestational age (GA)-specific case definition for NEC. We conducted a prospective 34-month population study using clinician-recorded findings from the UK National Neonatal Research Database between December 2011 and September 2014 across all 163 neonatal units in England. We split study data into model development and validation data sets and categorized GA into groups (group 1, less than 26 weeks' GA; group 2, 26 to less than 30 weeks' GA; group 3, 30 to less than 37 weeks' GA; group 4, 37 or more weeks' GA). We entered GA, birth weight z score, and clinical and abdominal radiography findings as candidate variables in a logistic regression model, performed model fitting 1000 times, averaged the predictions, and used estimates from the fitted model to develop an ordinal NEC score and cut points to develop a dichotomous case definition based on the highest area under the receiver operating characteristic curves [AUCs] and positive predictive values [PPVs]. Abdominal radiography performed to investigate clinical concerns. Ordinal NEC likelihood score, dichotomous case definition, and GA-specific probability plots. Of the 3866 infants, the mean (SD) birth weight was 2049.1 (1941.7) g and mean (SD) GA was 32 (5) weeks; 2032 of 3663 (55.5%) were male. The total included 2978 infants (77.0%) without NEC and 888 (23.0%) with NEC. Infants with NEC in group 1 were less likely to present with pneumatosis (31.1% vs 47.2%; P = .01), blood in stool (11.8% vs 29.6%; P definition were 2 or greater for infants in groups 1 and 2, 3 or greater for infants in group 3, and 4 or greater for infants in group 4. The ordinal NEC score and dichotomous case definition discriminated well between infants with (AUC, 87%) and without (AUC, 80%) NEC. The case

GroupFinder

DEFF Research Database (Denmark)

Bøgh, Kenneth Sejdenfaden; Skovsgaard, Anders; Jensen, Christian S.

2013-01-01

. Such groups are relevant to users who wish to conveniently explore several options before making a decision such as to purchase a specific product. Specifically, we demonstrate a practical proposal for finding top-k PoI groups in response to a query. We show how problem parameter settings can be mapped...

Determination of neuronal antibodies in suspected and definite Creutzfeldt-Jakob disease.

Science.gov (United States)

Grau-Rivera, Oriol; Sánchez-Valle, Raquel; Saiz, Albert; Molinuevo, José Luis; Bernabé, Reyes; Munteis, Elvira; Pujadas, Francesc; Salvador, Antoni; Saura, Júlia; Ugarte, Antonio; Titulaer, Maarten; Dalmau, Josep; Graus, Francesc

2014-01-01

Creutzfeldt-Jakob disease (CJD) and autoimmune encephalitis with antibodies against neuronal surface antigens (NSA-abs) may present with similar clinical features. Establishing the correct diagnosis has practical implications in the management of care for these patients. To determine the frequency of NSA-abs in the cerebrospinal fluid of patients with suspected CJD and in patients with pathologically confirmed (ie, definite) CJD. A mixed prospective (suspected) and retrospective (definite) CJD cohort study was conducted in a reference center for detection of NSA-abs. The population included 346 patients with suspected CJD and 49 patients with definite CJD. Analysis of NSA-abs in cerebrospinal fluid with brain immunohistochemistry optimized for cell-surface antigens was performed. Positive cases in the suspected CJD group were further studied for antigen specificity using cell-based assays. All definite CJD cases were comprehensively tested for NSA-abs, with cell-based assays used for leucine-rich glioma-inactivated 1 (LGI1), contactin-associated protein-like 2 (CASPR2), N-methyl-d-aspartate (NMDA), and glycine (GlY) receptors. Neuronal surface antigens were detected in 6 of 346 patients (1.7%) with rapid neurologic deterioration suggestive of CJD. None of these 6 patients fulfilled the diagnostic criteria for probable or possible CJD. The target antigens included CASPR2, LGI1, NMDAR, aquaporin 4, Tr (DNER [δ/notch-like epidermal growth factor-related receptor]), and an unknown protein. Four of the patients developed rapidly progressive dementia, and the other 2 patients had cerebellar ataxia or seizures that were initially considered to be myoclonus without cognitive decline. The patient with Tr-abs had a positive 14-3-3 test result. Small cell lung carcinoma was diagnosed in the patient with antibodies against an unknown antigen. All patients improved or stabilized after appropriate treatment. None of the 49 patients with definite CJD had NSA-abs. A low, but

The definitive guide to the C&A transformation process

CERN Document Server

Mehan, Julie E

2009-01-01

'The Definitive Guide to the C&A Transformation' is the first comprehensive manual that sets out to explain the current standards and best practices. The book provides all the information needed to recognize, implement and manage the relevant authorization requirements, and therefore to achieve compliance with federal, local and agency laws and policies. Each chapter not only provides a list of related references but also offers recommendations for additional reading.

S3T working group. Report 1: group aims

International Nuclear Information System (INIS)

Pouey, M.

1983-04-01

The work group S3T which is aimed to designing and developing devices using unconventional holographic optics is presented. These devices find applications that are classified here in four items high resolution spectrometers, high definition imaging, high flux devices, metrology and interferometry. The problems to solve and the aims of the group in each of these cases are presented. Three synthesis of lectures are in this report. The main one concerns stigmatism conditions of concave holographic gratings used in normal incidence. This new process of focusing is very interesting for hot plasma diagnostics [fr

Industry's View on Using Quality Control, Biorelevant, and Clinically Relevant Dissolution Tests for Pharmaceutical Development, Registration, and Commercialization.

Science.gov (United States)

Grady, Haiyan; Elder, David; Webster, Gregory K; Mao, Yun; Lin, Yiqing; Flanagan, Talia; Mann, James; Blanchard, Andy; Cohen, Michael J; Lin, Judy; Kesisoglou, Filippos; Hermans, Andre; Abend, Andreas; Zhang, Limin; Curran, David

2018-01-01

This article intends to summarize the current views of the IQ Consortium Dissolution Working Group, which comprises various industry companies, on the roles of dissolution testing throughout pharmaceutical product development, registration, commercialization, and beyond. Over the past 3 decades, dissolution testing has evolved from a routine and straightforward test as a component of end-product release into a comprehensive set of tools that the developer can deploy at various stages of the product life cycle. The definitions of commonly used dissolution approaches, how they relate to one another and how they may be applied in modern drug development, and life cycle management is described in this article. Specifically, this article discusses the purpose, advantages, and limitations of quality control, biorelevant, and clinically relevant dissolution methods. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

The MSFC Collaborative Engineering Process for Preliminary Design and Concept Definition Studies

Science.gov (United States)

Mulqueen, Jack; Jones, David; Hopkins, Randy

2011-01-01

This paper describes a collaborative engineering process developed by the Marshall Space Flight Center's Advanced Concepts Office for performing rapid preliminary design and mission concept definition studies for potential future NASA missions. The process has been developed and demonstrated for a broad range of mission studies including human space exploration missions, space transportation system studies and in-space science missions. The paper will describe the design team structure and specialized analytical tools that have been developed to enable a unique rapid design process. The collaborative engineering process consists of integrated analysis approach for mission definition, vehicle definition and system engineering. The relevance of the collaborative process elements to the standard NASA NPR 7120.1 system engineering process will be demonstrated. The study definition process flow for each study discipline will be will be outlined beginning with the study planning process, followed by definition of ground rules and assumptions, definition of study trades, mission analysis and subsystem analyses leading to a standardized set of mission concept study products. The flexibility of the collaborative engineering design process to accommodate a wide range of study objectives from technology definition and requirements definition to preliminary design studies will be addressed. The paper will also describe the applicability of the collaborative engineering process to include an integrated systems analysis approach for evaluating the functional requirements of evolving system technologies and capabilities needed to meet the needs of future NASA programs.

Proposal for a universal definition of cerebral infarction.

Science.gov (United States)

Saver, Jeffrey L

2008-11-01

Cerebral infarction is a leading cause of disability and death worldwide but has no uniform international definition. Recent diagnostic advances have revised fundamental concepts in cerebral and cardiac ischemia. Cardiologists, already possessed of a nosologic framework distinguishing myocardial infarction from unstable angina on the basis of tissue state, promulgated a new "universal" tissue definition of myocardial infarction incorporating insights afforded by assays of cardiac troponin, a serum biomarker exquisitely sensitive to myocardial injury. Concurrently, vascular neurologists proposed a new tissue, rather than time, criterion to distinguish transient ischemia attack from cerebral infarction, responding to perspectives provided by diffusion MRI and cerebral blood volume CT, imaging biomarkers highly sensitive to neuronal injury. To complete this conceptual realignment, vascular neurology must now advance a clear, uniform, and operationalizable tissue definition of cerebral infarction. This review proposes cerebral infarction be defined as brain or retinal cell death due to prolonged ischemia. This definition categorizes both pannecrosis and neuronal dropout ("complete" and "incomplete" infarcts in classic neuropathologic terminology) as cerebral infarcts. Making the presence of any neuronal or glial cell death essential yields a definition of cerebral infarction that has high relevance to patients, physicians, and policymakers; is more easily applied in clinical practice; fosters action in acute care; harmonizes with myocardial ischemia classification; and focuses diagnostic evaluation on the cause of brain ischemia and the occurrence of end organ injury. The term cerebral infarction should be used when there is evidence of brain or retinal cell death due to cerebral ischemia.

Characterization, Leaching, and Filtration Testing for Bismuth Phosphate Sludge (Group 1) and Bismuth Phosphate Saltcake (Group 2) Actual Waste Sample Composites

International Nuclear Information System (INIS)

Lumetta, Gregg J.; Buck, Edgar C.; Daniel, Richard C.; Draper, Kathryn; Edwards, Matthew K.; Fiskum, Sandra K.; Hallen, Richard T.; Jagoda, Lynette K.; Jenson, Evan D.; Kozelisky, Anne E.; MacFarlan, Paul J.; Peterson, Reid A.; Shimskey, Rick W.; Sinkov, Sergey I.; Snow, Lanee A.

2009-01-01

A testing program evaluating actual tank waste was developed in response to Task 4 from the M-12 External Flowsheet Review Team (EFRT) issue response plan.() The test program was subdivided into logical increments. The bulk water-insoluble solid wastes that are anticipated to be delivered to the Waste Treatment and Immobilization Plant (WTP) were identified according to type such that the actual waste testing could be targeted to the relevant categories. Eight broad waste groupings were defined. Samples available from the 222S archive were identified and obtained for testing. The actual waste-testing program included homogenizing the samples by group, characterizing the solids and aqueous phases, and performing parametric leaching tests. Two of the eight defined groups - bismuth phosphate sludge (Group 1) and bismuth phosphate saltcake (Group 2) - are the subjects of this report. The Group 1 waste was anticipated to be high in phosphorus and was implicitly assumed to be present as BiPO4 (however, results presented here indicate that the phosphate in Group 1 is actually present as amorphous iron(III) phosphate). The Group 2 waste was also anticipated to be high in phosphorus, but because of the relatively low bismuth content and higher aluminum content, it was anticipated that the Group 2 waste would contain a mixture of gibbsite, sodium phosphate, and aluminum phosphate. Thus, the focus of the Group 1 testing was on determining the behavior of P removal during caustic leaching, and the focus of the Group 2 testing was on the removal of both P and Al. The waste-type definition, archived sample conditions, homogenization activities, characterization (physical, chemical, radioisotope, and crystal habit), and caustic leaching behavior as functions of time, temperature, and hydroxide concentration are discussed in this report. Testing was conducted according to TP-RPP-WTP-467

49 CFR 218.93 - Definitions.

Science.gov (United States)

2010-10-01

... § 214.353 of this chapter for the purpose of establishing on-track safety for roadway work groups... TRANSPORTATION RAILROAD OPERATING PRACTICES Handling Equipment, Switches, and Fixed Derails § 218.93 Definitions... classification yard where rolling equipment is placed and made ready for an outgoing train movement. Employee...

24 CFR 70.3 - Definitions.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Definitions. 70.3 Section 70.3 Housing and Urban Development Office of the Secretary, Department of Housing and Urban Development USE OF... of individual volunteers in group insurance plans (such as liability, health, life, disability...

40 CFR 373.4 - Definitions.

Science.gov (United States)

2010-07-01

... COMMUNITY RIGHT-TO-KNOW PROGRAMS REPORTING HAZARDOUS SUBSTANCE ACTIVITY WHEN SELLING OR TRANSFERRING FEDERAL... definitions apply: (a) Hazardous substances means that group of substances defined as hazardous under CERCLA 101(14), and that appear at 40 CFR 302.4. (b) Storage means the holding of hazardous substances for a...

7 CFR 3415.2 - Definitions.

Science.gov (United States)

2010-01-01

... an assembled group of experts or consultants qualified by training and experience in particular... Definitions. As used in this part: (a) Ad hoc reviewers means experts or consultants qualified by training and... delegated. (d) Biotechnology means any technique that uses living organisms (or parts of organisms) to make...

PROPOSAL FOR A DEFINITION OF FILIO-PARENTAL VIOLENCE: CONSENSUS OF THE SPANISH SOCIETY FOR THE STUDY OF FILIO-PARENTAL VIOLENCE (SEVIFIP

Directory of Open Access Journals (Sweden)

Roberto Pereira

2017-09-01

Full Text Available In recent years, many scholars and professionals from social, healthcare, educational and judicial fields have begun to pay increasing attention to filio-parental or child-to-parent violence (CPV. This emerging phenomenon, however, does not seem to have a consensuated definition in the relevant scientific literature. The confusion found around this concept, as well as the disparate results arising from different research projects, lead us to wonder whether they are all referring to the same problem. The aim of this paper is to establish clearly what child-to-parent violence is, and to provide as neutral and clear as possible a definition of the term, which will be useful and accessible to everyone interested in this problem. This definition may also play a significant role as a tool in future research and intervention proposals. After selecting the main definitions from those available in the specific literature, these were scrutinized and codified to find the categories relevant to the analysis, which were then debated by 11 experts in a discussion forum. As a result, we provide a precise and useful definition of CPV that has been phrased using language with a gender perspective.

Using the Voronoi tessellation for grouping words and multipart symbols in documents

Science.gov (United States)

Burge, Mark J.; Monagan, Gladys

1995-08-01

We examine the importance of the definition of neighbors and neighborhoods for grouping in document understanding and list some previous definitions. We present a number of benefits to using the Voronoi neighborhood definition; however, we argue that definitions based upon the point Voronoi diagrams are insufficient in the general case (e.g. for grouping image elements in line drawings). We give the definition of a generalized (Euclidean distance measure, 2D Cartesian space, and an area based generator set) Voronoi tessellation and then present our algorithm for approximating this generalized tessellation. The algorithm is constructed from a normal point Voronoi tessellation algorithm. A parameterized Voronoi neighborhood graph (VNG) which can be derived from the tessellation is defined. A graph algorithm for grouping based on the VNG, its image elements, and Voronoi cell descriptors can then be easily derived. We show some results of how this algorithm was used in a map understanding system.

Subclinical Hypothyroidism in Children and Adolescents: Is It Clinically Relevant?

Directory of Open Access Journals (Sweden)

Aneta Gawlik

2015-01-01

Full Text Available Although subclinical hypothyroidism (SH is a common clinical problem, its diagnosis tends to be incidental. According to the definition, it should be asymptomatic, only detectable by screening. The presence or coincidence of any symptoms leads to L-thyroxine treatment. The clinical presentation, especially in younger patients with subclinical hypothyroidism, is still under dispute. Accordingly, the aim of this paper was to review the literature from the past seven years. The literature search identified 1,594 potentially relevant articles, of which 24 met the inclusion criteria. Few studies focus on the symptomatology of subclinical hypothyroidism, and most of them analyzed a small number of subjects. A significant correlation was found by some authors between subclinical hypothyroidism and a higher risk of hypertension, dyslipidemia, and migraine. No evidence of the impact of subclinical hypothyroidism on weight, growth velocity, and puberty was revealed. As the quality of most studies is poor and no definite conclusions can be drawn, randomized, large-scale studies in children and adolescents are warranted to determine the best care for patients with SH.

Formal Definition of Measures for BPMN Models

Science.gov (United States)

Reynoso, Luis; Rolón, Elvira; Genero, Marcela; García, Félix; Ruiz, Francisco; Piattini, Mario

Business process models are currently attaining more relevance, and more attention is therefore being paid to their quality. This situation led us to define a set of measures for the understandability of BPMN models, which is shown in a previous work. We focus on understandability since a model must be well understood before any changes are made to it. These measures were originally informally defined in natural language. As is well known, natural language is ambiguous and may lead to misunderstandings and a misinterpretation of the concepts captured by a measure and the way in which the measure value is obtained. This has motivated us to provide the formal definition of the proposed measures using OCL (Object Constraint Language) upon the BPMN (Business Process Modeling Notation) metamodel presented in this paper. The main advantages and lessons learned (which were obtained both from the current work and from previous works carried out in relation to the formal definition of other measures) are also summarized.

Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group

DEFF Research Database (Denmark)

Rudwaleit, M; Jurik, A G; Hermann, K-G A

2009-01-01

BACKGROUND: Magnetic resonance imaging (MRI) of sacroiliac joints has evolved as the most relevant imaging modality for diagnosis and classification of early axial spondyloarthritis (SpA) including early ankylosing spondylitis. OBJECTIVES: To identify and describe MRI findings in sacroiliitis and...... relevant for sacroiliitis have been defined by consensus by a group of rheumatologists and radiologists. These definitions should help in applying correctly the imaging feature "active sacroiliitis by MRI" in the new ASAS classification criteria for axial SpA.......BACKGROUND: Magnetic resonance imaging (MRI) of sacroiliac joints has evolved as the most relevant imaging modality for diagnosis and classification of early axial spondyloarthritis (SpA) including early ankylosing spondylitis. OBJECTIVES: To identify and describe MRI findings in sacroiliitis...... conditions which may mimic SpA. Descriptions of the pathological findings and technical requirements for the appropriate acquisition were formulated. In a consensual approach MRI findings considered to be essential for sacroiliitis were defined. RESULTS: Active inflammatory lesions such as bone marrow oedema...

49 CFR 543.4 - Definitions.

Science.gov (United States)

2010-10-01

..., DEPARTMENT OF TRANSPORTATION EXEMPTION FROM VEHICLE THEFT PREVENTION STANDARD § 543.4 Definitions. (a) Statutory terms. All terms defined in sections 2, 601, and 605 of the Motor Vehicle Information and Cost... a group of motor vehicles of the same make which have the same body or chassis, or otherwise are...

Dynamic Target Definition: A novel approach for PTV definition in ion beam therapy

International Nuclear Information System (INIS)

Cabal, Gonzalo A.; Jäkel, Oliver

2013-01-01

Purpose: To present a beam arrangement specific approach for PTV definition in ion beam therapy. Materials and methods: By means of a Monte Carlo error propagation analysis a criteria is formulated to assess whether a voxel is safely treated. Based on this a non-isotropical expansion rule is proposed aiming to minimize the impact of uncertainties on the dose delivered. Results: The method is exemplified in two cases: a Head and Neck case and a Prostate case. In both cases the modality used is proton beam irradiation and the sources of uncertainties taken into account are positioning (set up) errors and range uncertainties. It is shown how different beam arrangements have an impact on plan robustness which leads to different target expansions necessary to assure a predefined level of plan robustness. The relevance of appropriate beam angle arrangements as a way to minimize uncertainties is demonstrated. Conclusions: A novel method for PTV definition in on beam therapy is presented. The method show promising results by improving the probability of correct dose CTV coverage while reducing the size of the PTV volume. In a clinical scenario this translates into an enhanced tumor control probability while reducing the volume of healthy tissue being irradiated

7 CFR 932.7 - Variety group 2.

Science.gov (United States)

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Variety group 2. 932.7 Section 932.7 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Definitions § 932.7 Variety group 2. Variety group 2 means the following varieties and...

7 CFR 932.6 - Variety group 1.

Science.gov (United States)

2010-01-01

... 7 Agriculture 8 2010-01-01 2010-01-01 false Variety group 1. 932.6 Section 932.6 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements... Regulating Handling Definitions § 932.6 Variety group 1. Variety group 1 means the following varieties and...

Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

International Nuclear Information System (INIS)

Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Gonzalez, Jose; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Brabbins, Donald S.; Hollander, Jay; Chen, Peter Y.; Martinez, Alvaro A.

1996-01-01

Purpose: Biochemical control using serial posttreatment serum prostate specific antigen (PSA) levels is being increasingly used to assess treatment efficacy for localized prostate cancer. However, no standardized definition of biochemical control has been established. We reviewed our experience treating patients with localized prostate cancer and applied three different commonly used definitions of biochemical control to determine if differences in therapeutic outcome would be observed. Methods and Materials: Between January 1987 and December 1991, 480 patients with clinically localized prostate cancer received external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. The median dose to the prostate was 66.6 Gy (range 58-70.4) using a four-field or arc technique. Pretreatment and posttreatment serum PSA levels were recorded. Over 86% (414 of 480) of patients had a pretreatment PSA level available. Three different definitions of biochemical control were used: (a) PSA nadir 20), and 5-year actuarial rates of biochemical control were calculated using the three biochemical control and one clinical local control definitions. For Group 1, 5-year actuarial rates of biochemical control were 84%, 90%, and 96% for Definitions 1-3 and clinical local control, respectively. For Group 2, 5-year actuarial control rates were 45%, 54%, 74%, and 92% for the four definitions, respectively. For Group 3, 5-year actuarial control rates were 26%, 31%, 63%, and 100% for the four definitions, respectively. For Group 4, 5-year actuarial control rates were 24%, 24%, 50%, and 100% for the four definitions, respectively. Finally, for Group 5, 5-year actuarial control rates were 5%, 14%, 15%, and 89% for the four definitions, respectively. Depending on the definition used, statistically significant differences overall in outcome rates were observed. Differences between all four definitions for all pairwise comparisons ranged from 5 to 53% (p < 0

Introduction to group theory

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Canals B.

2012-03-01

Full Text Available This chapter is a concise mathematical introduction into the algebra of groups. It is build up in the way that definitions are followed by propositions and proofs. The concepts and the terminology introduced here will serve as a basis for the following chapters that deal with group theory in the stricter sense and its application to problems in physics. The mathematical prerequisites are at the bachelor level.1

Pulmonary exacerbation in adults with bronchiectasis: a consensus definition for clinical research.

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Hill, Adam T; Haworth, Charles S; Aliberti, Stefano; Barker, Alan; Blasi, Francesco; Boersma, Wim; Chalmers, James D; De Soyza, Anthony; Dimakou, Katerina; Elborn, J Stuart; Feldman, Charles; Flume, Patrick; Goeminne, Pieter C; Loebinger, Michael R; Menendez, Rosario; Morgan, Lucy; Murris, Marlene; Polverino, Eva; Quittner, Alexandra; Ringshausen, Felix C; Tino, Gregory; Torres, Antoni; Vendrell, Montserrat; Welte, Tobias; Wilson, Rob; Wong, Conroy; O'Donnell, Anne; Aksamit, Timothy

2017-06-01

There is a need for a clear definition of exacerbations used in clinical trials in patients with bronchiectasis. An expert conference was convened to develop a consensus definition of an exacerbation for use in clinical research.A systematic review of exacerbation definitions used in clinical trials from January 2000 until December 2015 and involving adults with bronchiectasis was conducted. A Delphi process followed by a round-table meeting involving bronchiectasis experts was organised to reach a consensus definition. These experts came from Europe (representing the European Multicentre Bronchiectasis Research Collaboration), North America (representing the US Bronchiectasis Research Registry/COPD Foundation), Australasia and South Africa.The definition was unanimously approved by the working group as: a person with bronchiectasis with a deterioration in three or more of the following key symptoms for at least 48 h: cough; sputum volume and/or consistency; sputum purulence; breathlessness and/or exercise tolerance; fatigue and/or malaise; haemoptysis AND a clinician determines that a change in bronchiectasis treatment is required.The working group proposes the use of this consensus-based definition for bronchiectasis exacerbation in future clinical research involving adults with bronchiectasis. Copyright ©ERS 2017.

The challenge of the definition of early symptomatic knee osteoarthritis: a proposal of criteria and red flags from an international initiative promoted by the Italian Society for Rheumatology.

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Migliore, Alberto; Scirè, Carlo Alberto; Carmona, Loreto; Herrero-Beaumont, Gabriel; Bizzi, Emanuele; Branco, Jaime; Carrara, Greta; Chevalier, Xavier; Collaku, Ledio; Aslanidis, Spiros; Denisov, Lev; Di Matteo, Luigi; Bianchi, Gerolamo; Diracoglu, Demirhan; Frediani, Bruno; Maheu, Emmanuel; Martusevich, Natalia; Bagnato, Gian Filippo; Scarpellini, Magda; Minisola, Giovanni; Akkoc, Nurullah; Ramonda, Roberta; Barskova, Tatiana; Babic-Naglic, Durda; Muelas, Jose Vicente Moreno; Ionescu, Ruxandra; Rashkov, Rasho; Damjanov, Nemanja; Cerinic, Marco Matucci

2017-08-01

The aim of this study was to establish consensus for potential early symptomatic knee osteoarthritis (ESKOA) clinical definition and referral criteria from primary care to rheumatologists, based on available data from literature and a qualitative approach, in order to perform studies on patients fulfilling such criteria and to validate the obtained ESKOA definition. A complex methodological approach was followed including: (1) three focus groups (FG), including expert clinicians, researchers and patients; (2) a systematic literature review (SLR); (3) two discussion groups followed by a Delphi survey. FG and SLR were performed in parallel to inform discussion groups in order to identify relevant constructs to be included in the modified Delphi survey. ESKOA is defined in the presence of: (a) two mandatory symptoms (knee pain in the absence of any recent trauma or injury and very short joint stiffness, lasting for less than 10 min, when starting movement) even in the absence of risk factors, or (b) knee pain, and 1 or 2 risk factors or (c) three or more risk factors in the presence of at least one mandatory symptom, with symptoms lasting less than 6 months. These criteria are applicable in the absence of active inflammatory arthritis, generalized pain, Kellgren-Lawrence grade >0, any recent knee trauma or injury, and age lower than 40 years. Knee pain in the absence of any recent trauma lasting for less than 6 months was considered as the referral criterion to the rheumatologist for the suspicion of ESKOA. This consensus process has identified provisional clinical definition of ESKOA and defined potential referral criterion to rheumatologist, in order to test ESKOA obtained definition in prospective validation studies.

Automating generation of textual class definitions from OWL to English.

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Stevens, Robert; Malone, James; Williams, Sandra; Power, Richard; Third, Allan

2011-05-17

Text definitions for entities within bio-ontologies are a cornerstone of the effort to gain a consensus in understanding and usage of those ontologies. Writing these definitions is, however, a considerable effort and there is often a lag between specification of the main part of an ontology (logical descriptions and definitions of entities) and the development of the text-based definitions. The goal of natural language generation (NLG) from ontologies is to take the logical description of entities and generate fluent natural language. The application described here uses NLG to automatically provide text-based definitions from an ontology that has logical descriptions of its entities, so avoiding the bottleneck of authoring these definitions by hand. To produce the descriptions, the program collects all the axioms relating to a given entity, groups them according to common structure, realises each group through an English sentence, and assembles the resulting sentences into a paragraph, to form as 'coherent' a text as possible without human intervention. Sentence generation is accomplished using a generic grammar based on logical patterns in OWL, together with a lexicon for realising atomic entities. We have tested our output for the Experimental Factor Ontology (EFO) using a simple survey strategy to explore the fluency of the generated text and how well it conveys the underlying axiomatisation. Two rounds of survey and improvement show that overall the generated English definitions are found to convey the intended meaning of the axiomatisation in a satisfactory manner. The surveys also suggested that one form of generated English will not be universally liked; that intrusion of too much 'formal ontology' was not liked; and that too much explicit exposure of OWL semantics was also not liked. Our prototype tools can generate reasonable paragraphs of English text that can act as definitions. The definitions were found acceptable by our survey and, as a result, the

Selection of relevant dietary indicators for health.

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Steingrímsdóttir, L; Ovesen, L; Moreiras, O; Jacob, S

2002-05-01

To define a set of dietary components that are relevant determinants for health in Europe. The selected components are intended to serve as nutrition indicators for health in the European Health Monitoring Programme and, as such, must be limited in number, relevant to health in Europe and practical for all involved countries with respect to data gathering and comparability of data. Major nutrition factors were determined by reviewing relevant epidemiological and clinical literature in nutrition and health as well as referring to reports from international expert groups, including the report from the project Nutrition and Diet for Healthy Lifestyles in Europe. The selection of factors was also based on the relative ease and cost involved for participating countries to obtain comparable and valid data. The selected factors include foods or food groups as well as individual nutrients. Biomarkers are suggested for selected nutrients that pose the greatest difficulty in obtaining valid and comparable data from dietary studies. The following list of diet indicators for health monitoring in Europe was agreed upon by the EFCOSUM group in 2001, in order of priority: vegetables, fruit, bread, fish, saturated fatty acids as percentage of energy (%E), total fat as %E, and ethanol in grams per day. Biomarkers were suggested for the following nutrients: folate, vitamin D, iron, iodine and sodium. Energy has to be assessed in order to calculate %E from total fat and saturated fatty acids.

Group Self-Definitions and Religious Collectivities in the 16th Book of the Theodosian Code. Notes on the Term coetus (with a Preliminary Analysis of populus

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Alessandro Saggioro

2015-06-01

Full Text Available This essay starts from the well-known definition of populus as well as it appears in some Cicero’s works and aims at analyze the religious significance of coetus, a term strictly connected with the first, at least focusing on the 16th book of the Theodosian Code. This article intends to cast light some transformations and representations of religious groups between Constantinian and Post-Constantinian ages.

The concept of presence in group psychotherapy: an operational definition.

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Crane-Okada, Rebecca

2012-07-01

The paper aims to operationally define the concept of presence, as developed and exhibited by the therapist leading a psychotherapy group, and illustrated with case examples. A group therapist, who addresses tangible, basic group survival needs, while integrating knowledge of psychotherapeutic processes, authentic and effective interpersonal communications, and genuine concern for individual members and the group as a whole, is best situated to enact presence in the context of group psychotherapy. Establishing presence can be achieved in a systematic way with an understanding of the meaning of being present at each step in the development of the group psychotherapeutic process. © 2011 Wiley Periodicals, Inc.

"I was in the darkness but the group brought me light": Development, relevance and feasibility of the Sondela HIV adjustment and coping intervention.

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Nwabisa Shai

Full Text Available Developing interventions that address psychosocial wellbeing of people living with HIV is critical to ensure strong linkages to and retention in HIV care. This paper describes the development of Sondela, an HIV adjustment and coping intervention for heterosexual men and women living with HIV, and its relevance and feasibility in the South African context. Sondela is a six three-hour, small group-based, participatory workshop series. We followed an iterative, multi-phased process of curriculum development that involved research, theoretical frameworks and piloting. A systematic review highlighted the absence of psychosocial interventions targeting heterosexual HIV positive populations living in high HIV prevalence and resource-poor settings. Formative studies demonstrated risk and social factors associated with adjustment and coping with HIV, emphasising the need for interventions that acknowledge gendered experiences. Our pilot of Sondela demonstrated high levels of relevance and feasibility. Men appreciated the workshop "space" to openly talk about their HIV positive status and what is means for their role as partners and fathers and friends. Women valued the skills and approaches because they were relevant to "real life" situations and not just about HIV. Sondela promises to be valuable in supporting health system initiatives and psychosocial support to strengthen linkages to and retention in HIV care, and this suggests a need for rigorous evaluation of Sondela to establish evidence for its effectiveness in a general population.

Definition dependent properties of the cortical silent period in upper-extremity muscles, a methodological study

NARCIS (Netherlands)

Kuijk, A.A. van; Bakker, C.D.; Hendriks, J.C.M.; Geurts, A.C.; Stegeman, D.F.; Pasman, J.W.

2014-01-01

BACKGROUND: To explore if stimulus-response (S-R) characteristics of the silent period (SP) after transcranial magnetic stimulation (TMS) are affected by changing the SP definition and by changing data presentation in healthy individuals. This information would be clinically relevant to predict

Definition dependent properties of the cortical silent period in upper-extremity muscles, a methodological study

NARCIS (Netherlands)

van Kuijk, A.A.; Bakker, C,; Hendriks, J.J.A.; Geurts, A.H.; Stegeman, D.F.; Pasman, J.W.

2014-01-01

Background: To explore if stimulus-response (S-R) characteristics of the silent period (SP) after transcranial magnetic stimulation (TMS) are affected by changing the SP definition and by changing data presentation in healthy individuals. This information would be clinically relevant to predict

Contemporary group estimates adjusted for climatic effects provide a finer definition of the unknown environmental challenges experienced by growing pigs.

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Guy, S Z Y; Li, L; Thomson, P C; Hermesch, S

2017-12-01

Environmental descriptors derived from mean performances of contemporary groups (CGs) are assumed to capture any known and unknown environmental challenges. The objective of this paper was to obtain a finer definition of the unknown challenges, by adjusting CG estimates for the known climatic effects of monthly maximum air temperature (MaxT), minimum air temperature (MinT) and monthly rainfall (Rain). As the unknown component could include infection challenges, these refined descriptors may help to better model varying responses of sire progeny to environmental infection challenges for the definition of disease resilience. Data were recorded from 1999 to 2013 at a piggery in south-east Queensland, Australia (n = 31,230). Firstly, CG estimates of average daily gain (ADG) and backfat (BF) were adjusted for MaxT, MinT and Rain, which were fitted as splines. In the models used to derive CG estimates for ADG, MaxT and MinT were significant variables. The models that contained these significant climatic variables had CG estimates with a lower variance compared to models without significant climatic variables. Variance component estimates were similar across all models, suggesting that these significant climatic variables accounted for some known environmental variation captured in CG estimates. No climatic variables were significant in the models used to derive the CG estimates for BF. These CG estimates were used to categorize environments. There was no observable sire by environment interaction (Sire×E) for ADG when using the environmental descriptors based on CG estimates on BF. For the environmental descriptors based on CG estimates of ADG, there was significant Sire×E only when MinT was included in the model (p = .01). Therefore, this new definition of the environment, preadjusted by MinT, increased the ability to detect Sire×E. While the unknown challenges captured in refined CG estimates need verification for infection challenges, this may provide a

Familial risks of breast and prostate cancers: does the definition of the at risk period matter?

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Brandt, Andreas; Bermejo, Justo Lorenzo; Sundquist, Jan; Hemminki, Kari

2010-03-01

'Being at familial risk' may have different connotations in studies on familial risk of cancer. The register-based definition of a family history considers individuals with an affected relative at familial risk independently of the family member's diagnostic time. Alternatively, the individuals are classified to be at familial risk only after the diagnosis date of their relative, relevant to clinical counselling and screening situations. The aim of this study was to compare familial breast and prostate cancer risks according to the two definitions. The nationwide Swedish Family-Cancer Database with information on cancers from 1958 to 2006 was used to calculate the hazard ratio of breast and prostate cancers according to family history using Cox regression. Family history was defined considering the number and type of affected relatives and the relative's diagnostic age, respectively. Individuals were considered at familial risk from their entry to the study or, alternatively, from the diagnostic time of the relative. Hazard ratios were equal whether individuals were considered at risk independent of the relative's diagnostic date or only after the relative's diagnostic date. These results indicate that studies on familial breast or prostate cancer risk which do not take the relative's diagnosis date into account are applicable to screening and clinical counselling situations. The estimates according to the register-based definition are based on larger numbers of patients, which may be crucial for analysis of small groups such as families of multiple cases. Copyright 2009 Elsevier Ltd. All rights reserved.

The new sepsis definition: limitations and contribution to research and diagnosis of sepsis.

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Verdonk, Franck; Blet, Alice; Mebazaa, Alexandre

2017-04-01

Based on recent clinical, epidemiological, and pathophysiological data, a third international consensus conference was carried out to define new criteria of sepsis in February 2016. This review presents the different items of this new definition, their limitations and their contribution to research and diagnosis of sepsis, in comparison with the previous definitions. Incidence, management, and pathophysiological knowledge of sepsis have improved over the past 20 years. However, sepsis still evolves to a mortal outcome, in one case out of five, with no new recent or specific therapy showing its efficacy on the patient's prognosis. These findings have led to the development of new definition. The new definition of sepsis incorporates relevant clinical and biological criteria such as SOFA score or serum lactate levels. It no longer takes into account the items of the systemic inflammatory response syndrome, which present a lack of specificity. It also simplifies the different stages of severity by deleting the term of 'severe sepsis' and by defining septic shock as a subset of sepsis. This definition, endorsed by only two international societies of intensive care, has some limitations and so merits prospective validation at different levels.

Definition of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage as an outcome event in clinical trials and observational studies: proposal of a multidisciplinary research group.

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Vergouwen, Mervyn D I; Vermeulen, Marinus; van Gijn, Jan; Rinkel, Gabriel J E; Wijdicks, Eelco F; Muizelaar, J Paul; Mendelow, A David; Juvela, Seppo; Yonas, Howard; Terbrugge, Karel G; Macdonald, R Loch; Diringer, Michael N; Broderick, Joseph P; Dreier, Jens P; Roos, Yvo B W E M

2010-10-01

In clinical trials and observational studies there is considerable inconsistency in the use of definitions to describe delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage. A major cause for this inconsistency is the combining of radiographic evidence of vasospasm with clinical features of cerebral ischemia, although multiple factors may contribute to DCI. The second issue is the variability and overlap of terms used to describe each phenomenon. This makes comparisons among studies difficult. An international ad hoc panel of experts involved in subarachnoid hemorrhage research developed and proposed a definition of DCI to be used as an outcome measure in clinical trials and observational studies. We used a consensus-building approach. It is proposed that in observational studies and clinical trials aiming to investigate strategies to prevent DCI, the 2 main outcome measures should be: (1) cerebral infarction identified on CT or MRI or proven at autopsy, after exclusion of procedure-related infarctions; and (2) functional outcome. Secondary outcome measure should be clinical deterioration caused by DCI, after exclusion of other potential causes of clinical deterioration. Vasospasm on angiography or transcranial Doppler can also be used as an outcome measure to investigate proof of concept but should be interpreted in conjunction with DCI or functional outcome. The proposed measures reflect the most relevant morphological and clinical features of DCI without regard to pathogenesis to be used as an outcome measure in clinical trials and observational studies.

Development of the Paris definition of early Crohn's disease for disease-modification trials: results of an international expert opinion process.

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Peyrin-Biroulet, Laurent; Billioud, Vincent; D'Haens, Geert; Panaccione, Remo; Feagan, Brian; Panés, Julian; Danese, Silvio; Schreiber, Stefan; Ogata, Haruhiko; Hibi, Toshifumi; Higgins, Peter D R; Beaugerie, Laurent; Chowers, Yehuda; Louis, Edouard; Steinwurz, Flávio; Reinisch, Walter; Rutgeerts, Paul; Colombel, Jean-Frédéric; Travis, Simon; Sandborn, William J

2012-12-01

We report the findings and outputs of an international expert opinion process to develop a definition of early Crohn's disease (CD) that could be used in future disease-modification trials. Nineteen experts on inflammatory bowel diseases held an international expert opinion meeting to discuss and agree on a definition for early CD to be used in disease-modification trials. The process included literature searches for the relevant basic-science and clinical evidence. A published preliminary definition of early CD was used as the basis for development of a proposed definition that was discussed at the expert opinion meeting. The participants then derived a final definition, based on best current knowledge, that it is hoped will be of practical use in disease-modification trials in CD.

Semantic Differences of Definitional skills between Persian Speaking Children with Specific Language Impairment and Normal Language Developing Children

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Mehri Mohammadi

2011-07-01

Full Text Available Objective: Linguistic and metalinguistic knowledge are the effective factors for definitional skills. This study investigated definitional skills both content and form in children with specific language impairment. Materials and Method: The participants were 32 Children in two groups of 16 SLI and 16 normal children, matched with age, sex and educational level. The SLI group was referred from Learning Difficulties Centers and Zarei Rehabilitation Center in Tehran, as well as the control group who was selected by randomized sampling from normal primary schools. The stimuli were 14 high frequency nouns from seven different categories. The reliability was calculated by interjudge agreement and the validity was assessed by content. Data was analyzed using independent T-test. Results: There were significant differences between mean scores of content and form of the definitional skills in two groups. The mean and SD scores of the content of word definition were M= 45.87, SD=12.22 in control group and M=33.18, SD= 17.60 for SLI one, out of possible 70 points (P= 0.025. The mean and SD scores of the form of word definition were M= 48.87, SD= 9.49 in control group and M= 38.18, SD= 12.85 for SLI one, out of 70 points (P= 0.012. Conclusion: Based on the results, it was concluded that, language problems of the SLI children may not let them semantic represention in order to form and present a complete process of word definition. Although this skill in children with SLI is inadequate, all the definitions given by SLI children were consistent with the categories of content and form of word definition used in this study. Therefore, an exact planning and intervention by speech and language pathologist can be effective for this skill. Linguistic intervention especially in semantic and grammatical aspects not only improves the definition of familiar words but also it might be useful for the definition of new words, consequently lead to educational and

Pregnancy after definitive treatment for Graves' disease--does treatment choice influence outcome?

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Elston, Marianne S; Tu'akoi, Kelson; Meyer-Rochow, Goswin Y; Tamatea, Jade A U; Conaglen, John V

2014-08-01

Women requiring thyroid hormone replacement after definitive therapy (surgery or radioiodine) for Graves' disease who later conceive require an early increase in levothyroxine dose and monitoring of thyroid hormone levels throughout pregnancy. In addition, as TSH receptor antibodies (TRAb) can cross the placenta and affect the fetus, measurement of these antibodies during pregnancy is recommended. To review the management of pregnancies following definitive treatment for Graves' disease in order to assess the rates of maternal hypothyroidism and TRAb measurement. Retrospective chart review of women who had undergone definitive treatment for Graves' disease at a tertiary hospital and subsequently had one or more pregnancies. A total of 29 women were identified, each of whom had at least one pregnancy since receiving definitive treatment for Graves' disease: there were a total of 49 pregnancies (22 in the surgical group and 27 in the radioiodine group). Both groups had high rates of hypothyroidism documented during pregnancy (47 and 50%, respectively). The surgical group was more likely to be euthyroid around the time of conception. Less than half of the women were referred to an endocrinologist or had TRAb measured during pregnancy. Neonatal thyroid function was measured in one-third of live births. One case of neonatal thyrotoxicosis was identified. Adherence to the current American Thyroid Association guidelines is poor. Further education of both patients and clinicians is important to ensure that treatment of women during pregnancy after definitive treatment follows the currently available guidelines. © 2014 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

Definition of infection after fracture fixation: A systematic review of randomized controlled trials to evaluate current practice.

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Metsemakers, W J; Kortram, K; Morgenstern, M; Moriarty, T F; Meex, I; Kuehl, R; Nijs, S; Richards, R G; Raschke, M; Borens, O; Kates, S L; Zalavras, C; Giannoudis, P V; Verhofstad, M H J

2018-03-01

One of the most challenging musculoskeletal complications in modern trauma surgery is infection after fracture fixation (IAFF). Although infections are clinically obvious in many cases, a clear definition of the term IAFF is crucial, not only for the evaluation of published research data but also for the establishment of uniform treatment concepts. The aim of this systematic review was to identify the definitions used in the scientific literature to describe infectious complications after internal fixation of fractures. The hypothesis of this study was that the majority of fracture-related literature do not define IAFF. A comprehensive search was performed in Embase, Cochrane, Google Scholar, Medline (OvidSP), PubMed publisher and Web-of-Science for randomized controlled trials (RCTs) on fracture fixation. Data were collected on the definition of infectious complications after fracture fixation used in each study. Study selection was accomplished through two phases. During the first phase, titles and abstracts were reviewed for relevance, and the full texts of relevant articles were obtained. During the second phase, full-text articles were reviewed. All definitions were literally extracted and collected in a database. Then, a classification was designed to rate the quality of the description of IAFF. A total of 100 RCT's were identified in the search. Of 100 studies, only two (2%) cited a validated definition to describe IAFF. In 28 (28%) RCTs, the authors used a self-designed definition. In the other 70 RCTs, (70%) there was no description of a definition in the Methods section, although all of the articles described infections as an outcome parameter in the Results section. This systematic review shows that IAFF is not defined in a large majority of the fracture-related literature. To our knowledge, this is the first study conducted with the objective to explore this important issue. The lack of a consensus definition remains a problem in current orthopedic

A balanced hazard ratio for risk group evaluation from survival data.

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Branders, Samuel; Dupont, Pierre

2015-07-30

Common clinical studies assess the quality of prognostic factors, such as gene expression signatures, clinical variables or environmental factors, and cluster patients into various risk groups. Typical examples include cancer clinical trials where patients are clustered into high or low risk groups. Whenever applied to survival data analysis, such groups are intended to represent patients with similar survival odds and to select the most appropriate therapy accordingly. The relevance of such risk groups, and of the related prognostic factors, is typically assessed through the computation of a hazard ratio. We first stress three limitations of assessing risk groups through the hazard ratio: (1) it may promote the definition of arbitrarily unbalanced risk groups; (2) an apparently optimal group hazard ratio can be largely inconsistent with the p-value commonly associated to it; and (3) some marginal changes between risk group proportions may lead to highly different hazard ratio values. Those issues could lead to inappropriate comparisons between various prognostic factors. Next, we propose the balanced hazard ratio to solve those issues. This new performance metric keeps an intuitive interpretation and is as simple to compute. We also show how the balanced hazard ratio leads to a natural cut-off choice to define risk groups from continuous risk scores. The proposed methodology is validated through controlled experiments for which a prescribed cut-off value is defined by design. Further results are also reported on several cancer prognosis studies, and the proposed methodology could be applied more generally to assess the quality of any prognostic markers. Copyright © 2015 John Wiley & Sons, Ltd.

The use of high definition colonoscopy versus standard definition: does it affect polyp detection rate?

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Richardson, John; Thaventhiran, Anthony; Mackenzie, Hugh; Stubbs, Benjamin

2017-11-03

Polyp detection rate (PDR) during lower gastrointestinal endoscopy (LGIE) is of clinical importance. Detecting adenomatous polyps early in the adenoma-carcinoma sequence can halt disease progression, enabling treatment at a favourable stage. High definition colonoscopy (HDC) has been used in our hospital alongside standard definition equipment since 2011. We aim to determine what affect the use of HDC has on PDR. Post-hoc analysis of a prospectively maintained database on all patients undergoing LGIE was performed (01/01/2012-31/12/2015), n = 15,448. Analysis tested the primary outcome of HD's effect on PDR across LGIE and secondary outcome stratified this by endoscopist group (Physician (PE), Surgeon (SE) and Nurse Endoscopist (NE)). Of 15,448 patients, 1353 underwent HDC. Unmatched analysis showed PDR increased by 5.3% in this group (p < 0.001). Matched analysis considered 2288 patients from the total cohort (1144 HDC) and showed an increase of 1% in PDR with HDC (p = 0.578). Further unmatched analysis stratified by endoscopist groups showed a PDR increase of 1.8% (p = 0.375), 5.4% (p = 0.008) and 4.6% (p = 0.021) by PE, SE and NE respectively. Matched analysis demonstrated an increase of 1% (p = 0.734) and 1.5% (p = 0.701) amongst PE and NE, with a decrease of 0.6% (p = 0.883) by SE. The introduction of HDC increased PDR across all LGIE in our hospital, though this was not clinically significant. This marginal benefit was present across all endoscopist groups with no group benefiting over another in matched analysis.

The relevance of uniform reporting in oral leukoplakia: Definition, certainty factor and staging based on experience with 275 patients

NARCIS (Netherlands)

Brouns, E.R.E.A.; Baart, J.A.; Bloemena, E.; Karagozoglu, H.; van der Waal, I.

2013-01-01

The aim of the present study was to evaluate the definition of oral leukoplakia, proposed by the WHO in 2005 and taking into account a previously reported classification and staging system, including the use of a Certainty factor of four levels with which the diagnosis of leukoplakia can be

Trust Levels Definition On Virtual Learning Platforms Through Semantic Languages

Directory of Open Access Journals (Sweden)

Carlos E. Montenegro-Marin

2010-12-01

Full Text Available Trust level concept is a topic that has opened a knowledge area about the profile evaluation and the people participation in Social Networks. These have presented a high knowledge profit, but at the same time it is necessary to analyze a group of variables to determine the trust participants’ degree.In addition, this is a topic that from some years ago has been presenting a big expectation to settle some alternatives to generate confidence in an activer community on internet. To establish these parameters it is important to define a model to abstract some variables that are involved in this process. For this, it is relevant to take into account the semantic languages as one of the alternatives that allow these kinds of activities. The purpose of this article is to analyze the Trust Levels definition in the contents that are shared on Open Source Virtual learning Platforms through the use of a model of representation of semantic languages. The last ones allow determining the trust in the use of learning objects that are shared in this kind of platforms

41 CFR 109-38.001 - Definitions.

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2010-07-01

... Classification Group (FSCG) 38; material handling equipment set forth in FSCG 39; and fire fighting equipment set... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Definitions. 109-38.001 Section 109-38.001 Public Contracts and Property Management Federal Property Management Regulations System...

Plant functional groups of potential restoration use in advancing edges of high Andean forests

International Nuclear Information System (INIS)

Castellanos Castro, Carolina; Bonilla, Maria Argenis

2011-01-01

The study of plant functional groups constitutes a useful tool in the identification of ecological characteristics relevant in community regeneration. The aim of this study was to identify plant's functional groups in high Andean forest advance edges and to evaluate their role during secondary succession in abandoned pasture lands. Based on 10 x 10 m vegetation relevees for the shrubby-arboreal stratum and 1 x 1 m plots for the herbaceous stratum and the revision of vital attributes for each of the species found, this study uses a multivariate approach to construct a trait-based emergent group's classification. The most important attributes in the definition of the groups were the dispersion mechanism and the presence of basal trunk ramification in woody species; in addition differences in the presence of vegetative propagation, specific leaf area index and the ratio height/diameter at breast height were found between groups of the shrubby-arboreal stratum. Four distinct groups were defined in the herbaceous layer and five in the shrubby-arboreal layer, each group contains species with similar colonization strategies. Among the defined groups, the herbaceous species dispersed by various abiotic factors, the shrubby species with basal ramification and dispersed by wind and the species dispersed by birds constitute key strategies in forest recovery in adjacent abandoned pasture lands dominated by Holcus lanatus, and facilitate the establishment of secondary forest species.

Proposal for a revised definition of dilated cardiomyopathy, hypokinetic non-dilated cardiomyopathy, and its implications for clinical practice : a position statement of the ESC working group on myocardial and pericardial diseases

NARCIS (Netherlands)

Pinto, Yigal M.; Elliott, Perry M.; Arbustini, Eloisa; Adler, Yehuda; Anastasakis, Aris; Boehm, Michael; Duboc, Denis; Gimeno, Juan; de Groote, Pascal; Imazio, Massimo; Heymans, Stephane; Klingel, Karin; Komajda, Michel; Limongelli, Giuseppe; Linhart, Ales; Mogensen, Jens; Moon, James; Pieper, Petronella G.; Seferovic, Petar M.; Schueler, Stephan; Zamorano, Jose L.; Caforio, Alida L. P.; Charron, Philippe

2016-01-01

In this paper the Working Group on Myocardial and Pericardial Disease proposes a revised definition of dilated cardiomyopathy (DCM) in an attempt to bridge the gap between our recent understanding of the disease spectrum and its clinical presentation in relatives, which is key for early diagnosis

Acute respiratory distress syndrome 40 years later: time to revisit its definition.

Science.gov (United States)

Phua, Jason; Stewart, Thomas E; Ferguson, Niall D

2008-10-01

Acute respiratory distress syndrome is a common disorder associated with significant mortality and morbidity. The aim of this article is to critically evaluate the definition of acute respiratory distress syndrome and examine the impact the definition has on clinical practice and research. Articles from a MEDLINE search (1950 to August 2007) using the Medical Subject Heading respiratory distress syndrome, adult, diagnosis, limited to the English language and human subjects, their relevant bibliographies, and personal collections, were reviewed. The definition of acute respiratory distress syndrome is important to researchers, clinicians, and administrators alike. It has evolved significantly over the last 40 years, culminating in the American-European Consensus Conference definition, which was published in 1994. Although the American-European Consensus Conference definition is widely used, it has some important limitations that may impact on the conduct of clinical research, on resource allocation, and ultimately on the bedside management of such patients. These limitations stem partially from the fact that as defined, acute respiratory distress syndrome is a heterogeneous entity and also involve the reliability and validity of the criteria used in the definition. This article critically evaluates the American-European Consensus Conference definition and its limitations. Importantly, it highlights how these limitations may contribute to clinical trials that have failed to detect a potential true treatment effect. Finally, recommendations are made that could be considered in future definition modifications with an emphasis on the significance of accurately identifying the target population in future trials and subsequently in clinical care. How acute respiratory distress syndrome is defined has a significant impact on the results of randomized, controlled trials and epidemiologic studies. Changes to the current American-European Consensus Conference definition are

Elementary construction of graded lie groups

International Nuclear Information System (INIS)

Scheunert, M.; Rittenberg, V.

1977-06-01

We show how the definitions of the classical Lie groups have to be modified in the case where Grassmann variables are present. In particular, we construct the general linear, the special linear and the orthosymplectic graded Lie groups. Special attention is paid to the question of how to formulate an adequate 'unitarity condition'. (orig.) [de

Late presentation to HIV testing is overestimated when based on the consensus definition.

Science.gov (United States)

Sasse, A; Florence, E; Pharris, A; De Wit, S; Lacor, P; Van Beckhoven, D; Deblonde, J; Delforge, M-L; Fransen, K; Goffard, J-C; Legrand, J-C; Moutschen, M; Piérard, D; Ruelle, J; Vaira, D; Vandercam, B; Van Ranst, M; Van Wijngaerden, E; Vandekerckhove, L; Verhofstede, C

2016-03-01

In 2011, a consensus was reached defining "late presenters" (LPs) as individuals presenting for care with a CD4 count account. Case surveillance data for newly diagnosed patients in Belgium in 1998-2012 were analysed, including CD4 count at diagnosis, the presence of AIDS-defining events, and recent infections (definition. Secondly, LPs were reclassified as "nonlate" if infections were reported as recent. A total of 7949 HIV diagnoses were included in the study. Recent infections were increasingly reported over time, accounting for 8.2% of new infections in 1998 and 37.5% in 2012. The consideration of clinical stage significantly modified the proportion of LPs: 18.2% of men who have sex with men (MSM) diagnosed in 2012 would be classified as LPs instead of 30.9% using the consensus definition (P definition. The impact of transient CD4 count on late presentation estimates should be assessed and, if relevant, the introduction of clinical stage in the definition of late presentation should be considered. © 2015 British HIV Association.

Reconsidering the definition of Major Depression based on Collaborative Psychiatric Epidemiology Surveys.

Science.gov (United States)

Rosenström, Tom; Jokela, Markus

2017-01-01

Diagnostic definitions for depressive disorders remain a debated topic, despite their central role in clinical practice and research. We use both recent evidence and nationally representative data to derive an empirically-based modification of DSM-IV/-5 Major Depressive Disorder (MDD). A modified MDD diagnosis was derived by analyzing data from Collaborative Psychiatric Epidemiology Surveys, a multistage probability sample of adults (n=20 013; age ≥ 18 years) in coterminous USA, Alaska and Hawaii. The old and the newly suggested MDD definitions were compared for their associated disability (WHO Disability Assessment Schedule and number of disability days in past month), suicide attempt, and other covariates. Our data-driven definition for major depression was "lack of interest to all or most things" plus four other symptoms from the set {weight gain, weight loss, insomnia, psychomotor retardation, fatigue, feelings of worthlessness, diminished ability to think/concentrate, suicidal ideation/attempt}. The new definition captured all the disability implied by MDD and excluded cases that showed no greater disability than the general population nor increased risk of suicide attempts. The lifetime prevalence of the new diagnosis was 14.7% (95% CI=14-15.4%) of the population, slightly less than for the old definition (16.4%; CI=15.4-17.3%). Only conservative modifications of MDD could be studied, because of restrictions in the symptom data. With only small adjusting, the new definition for major depression may be more clinically relevant than the old one, and could serve as a conservative replacement for the old definition. Copyright © 2016 Elsevier B.V. All rights reserved.

25 Years of Quantum Groups: from Definition to Classification

Directory of Open Access Journals (Sweden)

A. Stolin

2008-01-01

Full Text Available In mathematics and theoretical physics, quantum groups are certain non-commutative, non-cocommutative Hopf algebras, which first appeared in the theory of quantum integrable models and later they were formalized by Drinfeld and Jimbo. In this paper we present a classification scheme for quantum groups, whose classical limit is a polynomial Lie algebra. As a consequence we obtain deformed XXX and XXZ Hamiltonians. 

Agitation in cognitive disorders:International Psychogeriatric Association provisional consensus clinical and research definition

OpenAIRE

Cummings, Jeffrey; Mintzer, Jacobo; Brodaty, Henry; Sano, Mary; Banerjee, Sube; Devanand, D. P.; Gauthier, Serge; Howard, Robert; Lanctôt, Krista; Lyketsos, Constantine G.; Peskind, Elaine; Porsteinsson, Anton P.; Reich, Edgardo; Sampaio, Cristina; Steffens, David

2015-01-01

Background: Agitation is common across neuropsychiatric disorders and contributes to disability, institutionalization, and diminished quality of life for patients and their caregivers. There is no consensus definition of agitation and no widespread agreement on what elements should be included in the syndrome. The International Psychogeriatric Association formed an Agitation Definition Work Group (ADWG) to develop a provisional consensus definition of agitation in patients with cognitive diso...

Underinsurance in children with special health care needs: the impact of definition on findings.

Science.gov (United States)

Preskitt, Julie K; McEldowney, Rene P; Mulvihill, Beverly A; Wingate, Martha S; Menachemi, Nir

2013-10-01

To identify differences in groups of children with special healthcare needs (CSHCN) identified as underinsured by two alternate definitions and discuss implications for policy decisions based on using one definition over another. Secondary data from the National Survey of CSHCN 2005/2006 were analyzed. Only CSHCN who were continuously-insured for 12 months were included in analyses. We identified groups of underinsured CSHCN using two general definitions ("economic" and "attitudinal") and three mutually-exclusive groups (identified by both definitions, identified by attitudinal but not economic, and identified by economic but not attitudinal). Key variables included demographics and condition characteristics. Different underinsurance rates were identified [attitudinal = 30.9 % (n = 11,470); economic = 22.7 % (n = 8,447)] with fair agreement by kappa score (κ = 0.3194; Z = 65.91; p > 0.0001). Differences across mutually-exclusive groups included family income ≥400 % FPL (attitudinal only = 34.2 %, economic only = 16.3 %, both = 18.4 %; p needed equipment/supplies/home health (OR = 1.31, p needs.

Relevance of motion-related assessment metrics in laparoscopic surgery.

Science.gov (United States)

Oropesa, Ignacio; Chmarra, Magdalena K; Sánchez-González, Patricia; Lamata, Pablo; Rodrigues, Sharon P; Enciso, Silvia; Sánchez-Margallo, Francisco M; Jansen, Frank-Willem; Dankelman, Jenny; Gómez, Enrique J

2013-06-01

Motion metrics have become an important source of information when addressing the assessment of surgical expertise. However, their direct relationship with the different surgical skills has not been fully explored. The purpose of this study is to investigate the relevance of motion-related metrics in the evaluation processes of basic psychomotor laparoscopic skills and their correlation with the different abilities sought to measure. A framework for task definition and metric analysis is proposed. An explorative survey was first conducted with a board of experts to identify metrics to assess basic psychomotor skills. Based on the output of that survey, 3 novel tasks for surgical assessment were designed. Face and construct validation was performed, with focus on motion-related metrics. Tasks were performed by 42 participants (16 novices, 22 residents, and 4 experts). Movements of the laparoscopic instruments were registered with the TrEndo tracking system and analyzed. Time, path length, and depth showed construct validity for all 3 tasks. Motion smoothness and idle time also showed validity for tasks involving bimanual coordination and tasks requiring a more tactical approach, respectively. Additionally, motion smoothness and average speed showed a high internal consistency, proving them to be the most task-independent of all the metrics analyzed. Motion metrics are complementary and valid for assessing basic psychomotor skills, and their relevance depends on the skill being evaluated. A larger clinical implementation, combined with quality performance information, will give more insight on the relevance of the results shown in this study.

Characterization, Leaching, and Filtration Testing for Tributyl Phosphate (TBP, Group 7) Actual Waste Sample Composites

Energy Technology Data Exchange (ETDEWEB)

Edwards, Matthew K.; Billing, Justin M.; Blanchard, David L.; Buck, Edgar C.; Casella, Amanda J.; Casella, Andrew M.; Crum, J. V.; Daniel, Richard C.; Draper, Kathryn E.; Fiskum, Sandra K.; Jagoda, Lynette K.; Jenson, Evan D.; Kozelisky, Anne E.; MacFarlan, Paul J.; Peterson, Reid A.; Shimskey, Rick W.; Snow, Lanee A.; Swoboda, Robert G.

2009-03-09

.A testing program evaluating actual tank waste was developed in response to Task 4 from the M-12 External Flowsheet Review Team (EFRT) issue response plan. The bulk water-insoluble solid wastes that are anticipated to be delivered to the Waste Treatment and Immobilization Plant (WTP) were identified according to type such that the actual waste testing could be targeted to the relevant categories. Eight broad waste groupings were defined. Samples available from the 222S archive were identified and obtained for testing. The actual waste-testing program included homogenizing the samples by group, characterizing the solids and aqueous phases, and performing parametric leaching tests. The tributyl phosphate sludge (TBP, Group 7) is the subject of this report. The Group 7 waste was anticipated to be high in phosphorus as well as aluminum in the form of gibbsite. Both are believed to exist in sufficient quantities in the Group 7 waste to address leaching behavior. Thus, the focus of the Group 7 testing was on the removal of both P and Al. The waste-type definition, archived sample conditions, homogenization activities, characterization (physical, chemical, radioisotope, and crystal habit), and caustic leaching behavior as functions of time, temperature, and hydroxide concentration are discussed in this report. Testing was conducted according to TP-RPP-WTP-467.

DEFINING THE RELEVANT OUTCOME MEASURES IN MEDICAL DEVICE ASSESSMENTS: AN ANALYSIS OF THE DEFINITION PROCESS IN HEALTH TECHNOLOGY ASSESSMENT.

Science.gov (United States)

Jacobs, Esther; Antoine, Sunya-Lee; Prediger, Barbara; Neugebauer, Edmund; Eikermann, Michaela

2017-01-01

Defining relevant outcome measures for clinical trials on medical devices (MD) is complex, as there is a large variety of potentially relevant outcomes. The chosen outcomes vary widely across clinical trials making the assessment in evidence syntheses very challenging. The objective is to provide an overview on the current common procedures of health technology assessment (HTA) institutions in defining outcome measures in MD trials. In 2012-14, the Web pages of 126 institutions involved in HTA were searched for methodological manuals written in English or German that describe methods for the predefinition process of outcome measures. Additionally, the institutions were contacted by email. Relevant information was extracted. All process steps were performed independently by two reviewers. Twenty-four manuals and ten responses from the email request were included in the analysis. Overall, 88.5 percent of the institutions describe the type of outcomes that should be considered in detail and 84.6 percent agree that the main focus should be on patient relevant outcomes. Specifically related to MD, information could be obtained in 26 percent of the included manuals and email responses. Eleven percent of the institutions report a particular consideration of MD related outcomes. This detailed analysis on common procedures of HTA institutions in the context of defining relevant outcome measures for the assessment of MD shows that standardized procedures for MD from the perspective of HTA institutions are not widespread. This leads to the question if a homogenous approach should be implemented in the field of HTA on MD.

Relevance of few-nucleon problems to nuclear power

International Nuclear Information System (INIS)

Divatia, A.S.

1976-01-01

It is well known that the study of few-nucleon problems did not specifically start because they were relevant to nuclear power. However, as the need for power has become more urgent and the systems which may generate nuclear power in the future are likely to be highly complex, it has become necessary to examine the question of relevance of few-nucleon problems to nuclear power. The nuclear data needs for nuclear power have been studied exhaustively by many groups all over the world and The International Atomic Energy Agency, operating through the International Nuclear Data Committee and their Nuclear Data section, have compiled and evaluated these nuclear data needs. It is therefore possible to draw upon the various studies and compilations of the IAEA for examining the question of relevance. The relevant nuclear data needs for fission reactors, fusion reactors and nuclear safeguards programmes are examined. (Auth.)

Assessing Smoking Behaviour and Tobacco Smoke Exposure: Definitions and Methods

Directory of Open Access Journals (Sweden)

Gregg E

2014-12-01

Full Text Available In recent years, the increased availability of tobacco products other than conventional cigarettes, the use of puffing topography devices for smoking behaviour studies and the use of biomarkers to study smoke constituents exposure have generated the need for a more comprehensive set of definitions concerning smoking behaviour and exposure to smoke. The definitions offered in this paper are based on many years of practical experience and on consensus within a broad group of scientists working in these areas. It is intended that, with wider and more consistent usage, these definitions should reduce any misunderstandings and facilitate interpretation of future studies.

Clinical relevance of narrow-band imaging in flexible cystoscopy

DEFF Research Database (Denmark)

Drejer, Ditte; Béji, Sami; Munk Nielsen, Anna

2017-01-01

urological departments. Patients had either hematuria (n = 483) or known recurrent non-muscle-invasive bladder cancer (NMIBC) (n = 472). High-definition (HD) cystoscopy was performed in white light (WL) and a preliminary clinical decision was made. Then, a second cystoscopy was performed in NBI...... in NBI compared to WL (NBI: 100.0% vs WL: 83.2%, p decision making as a supplement to WL because it yields a significantly higher...... and a conclusive clinical decision was made. A difference between the two decisions that had a clinical impact on the patient was considered clinically relevant. RESULTS: Pathology was found in 216 WL cystoscopies, and additional pathology in 15 NBI cystoscopies (6.9%). Based on NBI, pathology was suspected in 23...

Relevance of blood groups in transfusion of sickle cell disease patients.

Science.gov (United States)

Noizat-Pirenne, France

2013-03-01

Blood groups are clinically significant in sickle cell disease (SCD) as transfusion remains a key treatment in this pathology. The occurrence of a delayed haemolytic transfusion reaction (DHTR) is not rare and is a life-threatening event. The main cause of DHTR is the production of alloantibodies against red blood cell antigens. The high rate of alloimmunization in SCD patients is mainly due to the differences of red blood groups between patients of African descent, and the frequently Caucasian donors. From an immuno-haematological point of view, DHTR in SCD patients has specific features: classical antibodies known to be haemolytic can be encountered, but otherwise non significant antibodies, autoantibodies and antibodies related to partial and rare blood groups are also frequently found in individuals of African descent. In some cases, there are no detectable antibodies. As alloimmunization remains the main cause of DHTR, it is extremely important to promote blood donation by individuals of African ancestry to make appropriate blood available. Copyright © 2012 Académie des sciences. Published by Elsevier SAS. All rights reserved.

A preliminary study on the definitions and differences of main types of business arrangements

Directory of Open Access Journals (Sweden)

Anderson Tiago Peixoto Gonçalves

2012-08-01

Full Text Available With the growth of competitiveness and market requirements, several companies have been jointly organized with the aim of forming partnerships, forming the so-called Business Arrangements, to ensure that competitive advantages are achieved. This article came from the need to review the definitions and differences between the main types of existing Business Arrangements, as in the literature have been used different nomenclatures and classifications, either in terms of how the Arrangement is managed, how it is organized, the according to which members carry out their activities, how is the flow of resources and information, the degree of coordination and interaction, the form of production organization, and the strategies adopted. It is a basic research, descriptive and literature, which sought to collect the relevant sources, definitions about each Arrangement to meet the goal of the article is to study the definitions and differences between the main types of Business Arrangements. The article is justified by the scarcity of uniform definitions in the literature that make it possible to visualize the differences between each of the types of Arrangements, especially those in which the definitions are more similar.

Definition of colorectal anastomotic leakage: A consensus survey among Dutch and Chinese colorectal surgeons.

Science.gov (United States)

van Rooijen, Stefanus J; Jongen, Audrey Chm; Wu, Zhou-Qiao; Ji, Jia-Fu; Slooter, Gerrit D; Roumen, Rudi Mh; Bouvy, Nicole D

2017-09-07

To determine the level of consensus on the definition of colorectal anastomotic leakage (CAL) among Dutch and Chinese colorectal surgeons. Dutch and Chinese colorectal surgeons were asked to partake in an online questionnaire. Consensus in the online questionnaire was defined as > 80% agreement between respondents on various statements regarding a general definition of CAL, and regarding clinical and radiological diagnosis of the complication. Fifty-nine Dutch and 202 Chinese dedicated colorectal surgeons participated in the online survey. Consensus was found on only one of the proposed elements of a general definition of CAL in both countries: 'extravasation of contrast medium after rectal enema on a CT scan'. Another two were found relevant according to Dutch surgeons: 'necrosis of the anastomosis found during reoperation', and 'a radiological collection treated with percutaneous drainage'. No consensus was found for all other proposed elements that may be included in a general definition. There is no universally accepted definition of CAL in the Netherlands and China. Diagnosis of CAL based on clinical manifestations remains a point of discussion in both countries. Dutch surgeons are more likely to report 'subclinical' leaks as CAL, which partly explains the higher reported Dutch CAL rates.

Cognitive frailty: rational and definition from an (I.A.N.A./I.A.G.G.) international consensus group.

Science.gov (United States)

Kelaiditi, E; Cesari, M; Canevelli, M; van Kan, G Abellan; Ousset, P-J; Gillette-Guyonnet, S; Ritz, P; Duveau, F; Soto, M E; Provencher, V; Nourhashemi, F; Salvà, A; Robert, P; Andrieu, S; Rolland, Y; Touchon, J; Fitten, J L; Vellas, B

2013-09-01

The frailty syndrome has recently attracted attention of the scientific community and public health organizations as precursor and contributor of age-related conditions (particularly disability) in older persons. In parallel, dementia and cognitive disorders also represent major healthcare and social priorities. Although physical frailty and cognitive impairment have shown to be related in epidemiological studies, their pathophysiological mechanisms have been usually studied separately. An International Consensus Group on "Cognitive Frailty" was organized by the International Academy on Nutrition and Aging (I.A.N.A) and the International Association of Gerontology and Geriatrics (I.A.G.G) on April 16th, 2013 in Toulouse (France). The present report describes the results of the Consensus Group and provides the first definition of a "Cognitive Frailty" condition in older adults. Specific aim of this approach was to facilitate the design of future personalized preventive interventions in older persons. Finally, the Group discussed the use of multidomain interventions focused on the physical, nutritional, cognitive and psychological domains for improving the well-being and quality of life in the elderly. The consensus panel proposed the identification of the so-called "cognitive frailty" as an heterogeneous clinical manifestation characterized by the simultaneous presence of both physical frailty and cognitive impairment. In particular, the key factors defining such a condition include: 1) presence of physical frailty and cognitive impairment (CDR=0.5); and 2) exclusion of concurrent AD dementia or other dementias. Under different circumstances, cognitive frailty may represent a precursor of neurodegenerative processes. A potential for reversibility may also characterize this entity. A psychological component of the condition is evident and concurs at increasing the vulnerability of the individual to stressors.

Definition of blindness under National Programme for Control of Blindness: Do we need to revise it?

Science.gov (United States)

Vashist, Praveen; Senjam, Suraj Singh; Gupta, Vivek; Gupta, Noopur; Kumar, Atul

2017-02-01

A review appropriateness of the current definition of blindness under National Programme for Control of Blindness (NPCB), Government of India. Online search of peer-reviewed scientific published literature and guidelines using PubMed, the World Health Organization (WHO) IRIS, and Google Scholar with keywords, namely blindness and visual impairment, along with offline examination of reports of national and international organizations, as well as their cross-references was done until December 2016, to identify relevant documents on the definition of blindness. The evidence for the historical and currently adopted definition of blindness under the NPCB, the WHO, and other countries was reviewed. Differences in the NPCB and WHO definitions were analyzed to assess the impact on the epidemiological status of blindness and visual impairment in India. The differences in the criteria for blindness under the NPCB and the WHO definitions cause an overestimation of the prevalence of blindness in India. These variations are also associated with an over-representation of refractive errors as a cause of blindness and an under-representation of other causes under the NPCB definition. The targets for achieving elimination of blindness also become much more difficult to achieve under the NPCB definition. Ignoring differences in definitions when comparing the global and Indian prevalence of blindness will cause erroneous interpretations. We recommend that the appropriate modifications should be made in the NPCB definition of blindness to make it consistent with the WHO definition.

Definition of blindness under National Programme for Control of Blindness: Do we need to revise it?

Directory of Open Access Journals (Sweden)

Praveen Vashist

2017-01-01

Full Text Available A review appropriateness of the current definition of blindness under National Programme for Control of Blindness (NPCB, Government of India. Online search of peer-reviewed scientific published literature and guidelines using PubMed, the World Health Organization (WHO IRIS, and Google Scholar with keywords, namely blindness and visual impairment, along with offline examination of reports of national and international organizations, as well as their cross-references was done until December 2016, to identify relevant documents on the definition of blindness. The evidence for the historical and currently adopted definition of blindness under the NPCB, the WHO, and other countries was reviewed. Differences in the NPCB and WHO definitions were analyzed to assess the impact on the epidemiological status of blindness and visual impairment in India. The differences in the criteria for blindness under the NPCB and the WHO definitions cause an overestimation of the prevalence of blindness in India. These variations are also associated with an over-representation of refractive errors as a cause of blindness and an under-representation of other causes under the NPCB definition. The targets for achieving elimination of blindness also become much more difficult to achieve under the NPCB definition. Ignoring differences in definitions when comparing the global and Indian prevalence of blindness will cause erroneous interpretations. We recommend that the appropriate modifications should be made in the NPCB definition of blindness to make it consistent with the WHO definition.

What is preventable harm in healthcare? A systematic review of definitions

Directory of Open Access Journals (Sweden)

Nabhan Mohammed

2012-05-01

Full Text Available Abstract Background Mitigating or reducing the risk of harm associated with the delivery of healthcare is a policy priority. While the risk of harm can be reduced in some instances (i.e. preventable, what constitutes preventable harm remains unclear. A standardized and clear definition of preventable harm is the first step towards safer and more efficient healthcare delivery system. We aimed to summarize the definitions of preventable harm and its conceptualization in healthcare. Methods We conducted a comprehensive electronic search of relevant databases from January 2001 to June 2011 for publications that reported a definition of preventable harm. Only English language publications were included. Definitions were coded for common concepts and themes. We included any study type, both original studies and reviews. Two reviewers screened the references for eligibility and 28% (127/460 were finally included. Data collected from studies included study type, description of the study population and setting, and data corresponding to the outcome of interest. Three reviewers extracted the data. The level of agreement between the reviewers was calculated. Results One hundred and twenty seven studies were eligible. The three most prevalent preventable harms in the included studies were: medication adverse events (33/127 studies, 26%, central line infections (7/127, 6% and venous thromboembolism (5/127, 4%. Seven themes or definitions for preventable harm were encountered. The top three were: presence of an identifiable modifiable cause (58/132 definitions, 44%, reasonable adaptation to a process will prevent future recurrence (30/132, 23%, adherence to guidelines (22/132, 16%. Data on the validity or operational characteristic (e.g., accuracy, reproducibility of definitions were limited. Conclusions There is limited empirical evidence of the validity and reliability of the available definitions of preventable harm, such that no single one is supported by

Deep learning relevance

DEFF Research Database (Denmark)

Lioma, Christina; Larsen, Birger; Petersen, Casper

2016-01-01

train a Recurrent Neural Network (RNN) on existing relevant information to that query. We then use the RNN to "deep learn" a single, synthetic, and we assume, relevant document for that query. We design a crowdsourcing experiment to assess how relevant the "deep learned" document is, compared...... to existing relevant documents. Users are shown a query and four wordclouds (of three existing relevant documents and our deep learned synthetic document). The synthetic document is ranked on average most relevant of all....

An evaluation of HIV elite controller definitions within a large seroconverter cohort collaboration

DEFF Research Database (Denmark)

Olson, Ashley D; Meyer, Laurence; Prins, Maria

2014-01-01

ratios ranged from 12.5-19.0 for non-ECs compared to ECs). CONCLUSIONS: ECs are rare, less likely to progress to clinical disease, but may eventually lose control. We suggest definitions requiring individuals to have consecutive undetectable HIV-RNA measurements for ≥ six months or otherwise with >90......BACKGROUND: Understanding the mechanisms underlying viral control is highly relevant to vaccine studies and elite control (EC) of HIV infection. Although numerous definitions of EC exist, it is not clear which, if any, best identify this rare phenotype. METHODS: We assessed a number of EC...... definitions used in the literature using CASCADE data of 25,692 HIV seroconverters. We estimated proportions maintaining EC of total ART-naïve follow-up time, and disease progression, comparing to non-EC. We also examined HIV-RNA and CD4 values and CD4 slope during EC and beyond (while ART naïve). RESULTS...

Grouping techniques in a EFL Classroom

OpenAIRE

Ramírez Salas, Marlene

2005-01-01

This article focuses on the need for English language teachers to use group work as a means to foster communication among students. The writer presents a definition of group work, its advantages and disadvantages, some activities for using group work and some grouping techniques created or adapted by the writer to illustrate the topic. Este artículo manifiesta la importancia del trabajo grupal en el aula, para motivar la comunicación entre los estudiantes. Asimismo, presenta la definición de...

Working group 8: inspection tools

Energy Technology Data Exchange (ETDEWEB)

Billey, Deb; Kania, Richard; Nickle, Randy; Wang, Rick; Westwood, Stephen

2011-07-01

This eighth working group of the Banff 2011 conference discussed the inspection tools and techniques used by the upstream and downstream pipeline industry to evaluate pipeline integrity. Special attention was given to the challenges and successes related to in-line inspection (ILI) technology. The background of current dent assessment criteria in B31.8 was presented, including dent definition for ILI vendors and pipeline operators as well as codes (CSA Z662 and B31.8). The workshop described examples of dents and assessments showing inconsistency with current criteria as set out by TCPL and Marathon. This workshop produced a single, industry-wide definition of the dent. It was found that the strain based criteria were more practical because depth based is conservative and may miss shallow occurrences. The creation of joint industry group was proposed to develop strain based criteria for incorporation into CSAZ662 and B31.8.

Combining high-speed SVM learning with CNN feature encoding for real-time target recognition in high-definition video for ISR missions

Science.gov (United States)

Kroll, Christine; von der Werth, Monika; Leuck, Holger; Stahl, Christoph; Schertler, Klaus

2017-05-01

For Intelligence, Surveillance, Reconnaissance (ISR) missions of manned and unmanned air systems typical electrooptical payloads provide high-definition video data which has to be exploited with respect to relevant ground targets in real-time by automatic/assisted target recognition software. Airbus Defence and Space is developing required technologies for real-time sensor exploitation since years and has combined the latest advances of Deep Convolutional Neural Networks (CNN) with a proprietary high-speed Support Vector Machine (SVM) learning method into a powerful object recognition system with impressive results on relevant high-definition video scenes compared to conventional target recognition approaches. This paper describes the principal requirements for real-time target recognition in high-definition video for ISR missions and the Airbus approach of combining an invariant feature extraction using pre-trained CNNs and the high-speed training and classification ability of a novel frequency-domain SVM training method. The frequency-domain approach allows for a highly optimized implementation for General Purpose Computation on a Graphics Processing Unit (GPGPU) and also an efficient training of large training samples. The selected CNN which is pre-trained only once on domain-extrinsic data reveals a highly invariant feature extraction. This allows for a significantly reduced adaptation and training of the target recognition method for new target classes and mission scenarios. A comprehensive training and test dataset was defined and prepared using relevant high-definition airborne video sequences. The assessment concept is explained and performance results are given using the established precision-recall diagrams, average precision and runtime figures on representative test data. A comparison to legacy target recognition approaches shows the impressive performance increase by the proposed CNN+SVM machine-learning approach and the capability of real-time high-definition

[Incidence and follow-up characteristics of neurologically relevant psychogenic symptoms].

Science.gov (United States)

Franz, M; Schellberg, D; Reister, G; Schepank, H

1993-06-01

The author reports on the prevalence and stability of the course of neurologically relevant psychogenic symptoms as well as their dependence on age and sex. Altogether 240 probands from the Mannheim Cohort Study on the epidemiology of psychogenic disorders were examined for psychogenic impairment over a 10-year period during three investigation periods. On the whole, seven neurologically relevant groups of symptoms (headache, lumbar and cervical vertebral complaints, non-systematic vertigo, functional hyperkinesia, functional paresis, sleep disturbances, concentration disturbances) differ clearly in frequency, characteristics of the course and clinical relevance.

Musculoskeletal ultrasound including definitions for ultrasonographic pathology

DEFF Research Database (Denmark)

Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

2005-01-01

pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis....

Definition of storage strategy effective application conditions

OpenAIRE

Nefedov, N.; Zahartzev, A.

2008-01-01

The matter concerning the definition of order flow characteristics influencing on warehouse order process performance parameters and on storekeeping total expanses has been considered. On the basis of total expenses criterion the approach to various nomenclature groups of goods storekeeping strategy choice has been offered.

Towards a narrative definition of the American political thriller film

OpenAIRE

Echart, P. (Pablo); Castrillo, P. (Pablo)

2015-01-01

The Hollywood political thriller is a film genre of unique relevance in the United States, often acting as a reflection of the fears and anxieties of its historical times. At the same time, however, the definition of its identity and boundaries still leaves room for further specification, perhaps due to the frequent consideration of the political thriller as part of the broader categories of either thriller narratives or political films. By revising the available literature and filmography an...

Proposed definition of the vaginal cuff and paracolpium clinical target volume in postoperative uterine cervical cancer.

Science.gov (United States)

Murakami, Naoya; Norihisa, Yoshiki; Isohashi, Fumiaki; Murofushi, Keiko; Ariga, Takuro; Kato, Tomoyasu; Inaba, Koji; Okamoto, Hiroyuki; Ito, Yoshinori; Toita, Takafumi; Itami, Jun

2016-01-01

The aim of this study was to develop an appropriate definition for vaginal cuff and paracolpium clinical target volume (CTV) for postoperative intensity modulated radiation therapy in patients with uterine cervical cancer. A working subgroup was organized within the Radiation Therapy Study Group of the Japan Clinical Oncology Group to develop a definition for the postoperative vaginal cuff and paracolpium CTV in December 2013. The group consisted of 5 radiation oncologists who specialized in gynecologic oncology and a gynecologic oncologist. A comprehensive literature review that included anatomy, surgery, and imaging fields was performed and was followed by multiple discreet face-to-face discussions and e-mail messages before a final consensus was reached. Definitions for the landmark structures in all directions that demarcate the vaginal cuff and paracolpium CTV were decided by consensus agreement of the working group. A table was created that showed boundary structures of the vaginal cuff and paracolpium CTV in each direction. A definition of the postoperative cervical cancer vaginal cuff and paracolpium CTV was developed. It is expected that this definition guideline will serve as a template for future radiation therapy clinical trial protocols, especially protocols involving intensity modulated radiation therapy. Copyright © 2016 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.

Homotopy of operads and Grothendieck–Teichmüller groups part 1 the algebraic theory and its topological background

CERN Document Server

Fresse, Benoit

2017-01-01

The Grothendieck-Teichmüller group was defined by Drinfeld in quantum group theory with insights coming from the Grothendieck program in Galois theory. The ultimate goal of this book is to explain that this group has a topological interpretation as a group of homotopy automorphisms associated to the operad of little 2-discs, which is an object used to model commutative homotopy structures in topology. This volume gives a comprehensive survey on the algebraic aspects of this subject. The book explains the definition of an operad in a general context, reviews the definition of the little discs operads, and explains the definition of the Grothendieck-Teichmüller group from the viewpoint of the theory of operads. In the course of this study, the relationship between the little discs operads and the definition of universal operations associated to braided monoidal category structures is explained. Also provided is a comprehensive and self-contained survey of the applications of Hopf algebras to the definition of...

Quantitative Evidence for Revising the Definition of Primary Graft Dysfunction after Lung Transplant.

Science.gov (United States)

Cantu, Edward; Diamond, Joshua M; Suzuki, Yoshikazu; Lasky, Jared; Schaufler, Christian; Lim, Brian; Shah, Rupal; Porteous, Mary; Lederer, David J; Kawut, Steven M; Palmer, Scott M; Snyder, Laurie D; Hartwig, Matthew G; Lama, Vibha N; Bhorade, Sangeeta; Bermudez, Christian; Crespo, Maria; McDyer, John; Wille, Keith; Orens, Jonathan; Shah, Pali D; Weinacker, Ann; Weill, David; Wilkes, David; Roe, David; Hage, Chadi; Ware, Lorraine B; Bellamy, Scarlett L; Christie, Jason D

2018-01-15

Primary graft dysfunction (PGD) is a form of acute lung injury that occurs after lung transplantation. The definition of PGD was standardized in 2005. Since that time, clinical practice has evolved, and this definition is increasingly used as a primary endpoint for clinical trials; therefore, validation is warranted. We sought to determine whether refinements to the 2005 consensus definition could further improve construct validity. Data from the Lung Transplant Outcomes Group multicenter cohort were used to compare variations on the PGD definition, including alternate oxygenation thresholds, inclusion of additional severity groups, and effects of procedure type and mechanical ventilation. Convergent and divergent validity were compared for mortality prediction and concurrent lung injury biomarker discrimination. A total of 1,179 subjects from 10 centers were enrolled from 2007 to 2012. Median length of follow-up was 4 years (interquartile range = 2.4-5.9). No mortality differences were noted between no PGD (grade 0) and mild PGD (grade 1). Significantly better mortality discrimination was evident for all definitions using later time points (48, 72, or 48-72 hours; P definition can be simplified by combining lower PGD grades. Construct validity of grading was present regardless of transplant procedure type or use of mechanical ventilation. Additional severity categories had minimal impact on mortality or biomarker discrimination.

Recent Advances in Dengue: Relevance to Puerto Rico

Science.gov (United States)

Noyd, David H.; Sharp, Tyler M.

2015-01-01

Dengue represents an increasingly important public health challenge in Puerto Rico, with recent epidemics in 2007, 2010, and 2012–2013. Although recent advances in dengue vaccine development offer hope for primary prevention, the role of health professionals in the diagnosis and management of dengue patients is paramount. Case definitions for dengue, dengue with warning signs, and severe dengue provide a framework to guide clinical decision-making. Furthermore, the differentiation between dengue and other acute febrile illnesses, such as leptospirosis and chikungunya, is necessary for the appropriate diagnosis and management of cases. An understanding of dengue epidemiology and surveillance in Puerto Rico provides context for clinicians in epidemic and non-epidemic periods. This review aims to improve health professionals’ ability to diagnose dengue, and as highlight the relevance of recent advances in dengue prevention and management in Puerto Rico. PMID:26061055

The importance of being earnest when crafting definitions: science and scientism are not the same thing.

Science.gov (United States)

Nash, Michael R

2005-07-01

The APA Division 30 definition of hypnosis is laudable in some respects. For instance, the committee rightly defines the "induction" as nothing more or less than the first suggestion after the introduction. However, the definition stumbles over its nonposition on whether the word hypnosis must be uttered during the procedure. This equivocation invites research designs that preemptively define a hypnotic group and a control group in terms of whether or not the word hypnosis is used in the protocol. These designs represent a backslide into naive operationism; they reveal little new about human nature or hypnosis. The field deserves an optimally heuristic definition that preserves pluralism and is relatively resistant to the teflon shield of preemptive definition. Researchers and practioners require a definition that recognizes the incompleteness of our concepts, generates a level epistemological playing field, and enables hypnosis theories to "reach."

Imaging actinic keratosis by high-definition optical coherence tomography. Histomorphologic correlation

DEFF Research Database (Denmark)

Boone, Marc A L M; Norrenberg, Sarah; Jemec, Gregor B E

2013-01-01

With the continued development of non-invasive therapies for actinic keratosis such as PDT and immune therapies, the non-invasive diagnosis and monitoring become increasingly relevant. High-definition optical coherence tomography is a high-resolution imaging tool, with micrometre resolution in both...... transversal and axial directions, enable to visualize individual cells up to a depth of around 570 μm filling the imaging gap between conventional optical coherence tomography and reflectance confocal microscopy. We sought to determine the feasibility of detecting and grading of actinic keratosis...... by this technique using criteria defined for reflectance confocal microscopy compared to histology. In this pilot study, skin lesions of 17 patients with a histologically proven actinic keratosis were imaged by high-definition optical coherence tomography just before excision and images analysed qualitatively...

Response to the Comment by G. Emch on projective group representations in quaternionic Hilbert space

International Nuclear Information System (INIS)

Adler, S.L.

1996-01-01

We discuss the differing definitions of complex and quaternionic projective group representations employed by us and by Emch. The definition of Emch (termed here a strong projective representation) is too restrictive to accommodate quaternionic Hilbert space embeddings of complex projective representations. Our definition (termed here a weak projective representation) encompasses such embeddings, and leads to a detailed theory of quaternionic, as well as complex, projective group representations. copyright 1996 American Institute of Physics

The definition of massive transfusion in trauma: a critical variable in examining evidence for resuscitation.

Science.gov (United States)

Mitra, Biswadev; Cameron, Peter A; Gruen, Russell L; Mori, Alfredo; Fitzgerald, Mark; Street, Alison

2011-06-01

'Massive' transfusion is a poorly defined inclusion criteria for studies examining the blood and blood product that are used during trauma resuscitation. We aimed to compare the traditional definition of massive transfusion (≥10 units in 24 h) to a more acute definition of at least 5 units in 4 h. Multitrauma patients were subgrouped according to the traditional definition and compared with the acute definition. Demographics, presenting vital signs and blood results, management including transfusion practice and outcomes were retrospectively studied. Associations of transfused fresh frozen plasma:packed red blood cells (PRBC) ratios with mortality were studied. There were 927 patients who received PRBCs in the first 24 h, with 314 patients identified using the traditional definition and 303 patients using the acute definition. The patients identified using the traditional definition received 18 (12-29) units of PRBC in 24 h, significantly higher than those identified using the acute definition [15 (9-29) units, Pdefinition excluded a significant proportion of patients who died in the emergency department. By using the acute definition to select a study sample, there seems to be an increase in mortality with fresh frozen plasma:PRBC ratio of 1 : 1 ratio compared with a 1 : 2 ratio. The traditional 'massive' transfusion definition not only 'dilutes' the potential study samples with a less acute group of patients, but also further excludes patients who die early. This latter group is most likely to be benefitted from any change to resuscitation practice. An acute definition of massive transfusion should be adopted when examining clinical practice during initial trauma resuscitation.

Validity of Health Administrative Database Definitions for Hypertension: A Systematic Review.

Science.gov (United States)

Pace, Romina; Peters, Tricia; Rahme, Elham; Dasgupta, Kaberi

2017-08-01

Health administrative data are frequently used for hypertension surveillance. The aim of this systematic review was to determine the sensitivity and specificity of the commonly used hypertension case definition of 2 physician outpatient claims within a 2-year period or 1 hospital discharge abstract record. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched MEDLINE (from 1946) and EMBASE (from 1947) for relevant studies through September 2016 (keywords: "hypertension," "administrative databases," "validation studies"). Data with standardized forms and assessed quality using Quality Assessment of Diagnostic Accuracy Studies criteria were reviewed by 2 reviewers. Pooled sensitivity and specificity were estimated using a generalized linear-model approach to random-effects bivariate regression meta-analysis. The search strategy identified 1732 abstracts, among which 3 articles were deemed relevant. One of the articles incorporated 2 studies with differing reference standards and study populations; thus, we considered each separately. The quality scores of the retained studies ranged from 10-12 of a maximum 14. The sensitivity of the definition investigated to identify hypertension using administrative health databases was 71.2% (95% confidence interval [CI], 68.3-73.7) and the specificity was 94.5% (95% CI, 93.2-95.6) when compared with surveys or medical records. The 2 physician outpatient claims within a 2-year period or 1 hospital discharge abstract record hypertension case definition accurately classifies individuals as hypertensive in approximately 70% of cases and correctly identifies persons as nonhypertensive in approximately 95% of cases. This is likely sufficiently sensitive and specific for most research and surveillance purposes. Copyright © 2017 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Consensus Based Definition of Growth Restriction in the Newborn.

Science.gov (United States)

Beune, Irene M; Bloomfield, Frank H; Ganzevoort, Wessel; Embleton, Nicholas D; Rozance, Paul J; van Wassenaer-Leemhuis, Aleid G; Wynia, Klaske; Gordijn, Sanne J

2018-05-01

To develop a consensus definition of growth restriction in the newborn that can be used clinically to identify newborn infants at risk and in research to harmonize reporting and definition in the current absence of a gold standard. An international panel of pediatric leaders in the field of neonatal growth were invited to participate in an electronic Delphi procedure using standardized methods and predefined consensus rules. Responses were fed back at group-level and the list of participants was provided. Nonresponders were excluded from subsequent rounds. In the first round, variables were scored on a 5-point Likert scale; in subsequent rounds, inclusion of variables and cut-offs were determined with a 70% level of agreement. In the final round participants selected the ultimate algorithm. In total, 57 experts participated in the first round; 79% completed the procedure. Consensus was reached on the following definition: birth weight less than the third percentile, or 3 out of the following: birth weight definition for growth restriction in the newborn. This definition recognizes that infants with birth weights 10th percentile can be growth restricted. This definition can be adopted in clinical practice and in clinical trials to better focus on newborns at risk, and is complementary to the previously determined definition of fetal growth restriction. Copyright © 2017 Elsevier Inc. All rights reserved.

Post-colonoscopy colorectal cancer rate in the era of high-definition colonoscopy.

Science.gov (United States)

Iwatate, Mineo; Kitagawa, Tomoyuki; Katayama, Yasumi; Tokutomi, Naohiko; Ban, Shinichi; Hattori, Santa; Hasuike, Noriaki; Sano, Wataru; Sano, Yasushi; Tamano, Masaya

2017-11-14

To investigate the post-colonoscopy colorectal cancer (PCCRC) rate for high-definition (HD) colonoscopy compared with that for standard-definition colonoscopy reported previously. Using medical records at Sano Hospital (SH) and Dokkyo Medical University Koshigaya Hospital (DMUKH), we retrospectively obtained data on consecutive patients diagnosed as having CRC between January 2010 and December 2015. The definition of PCCRC was diagnosis of CRC between 7 and 36 mo after initial high-definition colonoscopy that had detected no cancer, and patients were divided into a PCCRC group and a non-PCCRC group. The primary outcome was the rate of PCCRC for HD colonoscopy. The secondary outcomes were factors associated with PCCRC and possible reason for occurrence of early and advanced PCCRC. Among 892 CRC patients, 11 were diagnosed as having PCCRC and 881 had non-PCCRC. The PCCRC rate was 1.7% (8/471) at SH and 0.7% (3/421) at DMUKH. In comparison with the non-PCCRC group, the PCCRC group had a significantly higher preponderance of smaller tumors (39 mm vs 19 mm, P = 0.002), a shallower invasion depth (T1 rate, 25.4% vs 63.6%, P = 0.01), a non-polypoid macroscopic appearance (39.0% vs 85.7%, P = 0.02) and an earlier stage (59.7% vs 90.9%, P = 0.03). Possible reasons for PCCRC were "missed or new" in 9 patients (82%), "incomplete resection" in 1 (9%), and "inadequate examination'" in 1 (9%). Among 9 "missed or new" PCCRC, the leading cause was non-polypoid shape for early PCCRC and blinded location for advanced PCCRC. The PCCRC rate for HD colonoscopy was 0.7%-1.7%, being lower than that for standard-definition colonoscopy (1.8%-9.0%) reported previously employing the same methodology.

Theoretical Issues in Clinical Social Group Work.

Science.gov (United States)

Randall, Elizabeth; Wodarski, John S.

1989-01-01

Reviews relevant issues in clinical social group practice including group versus individual treatment, group work advantages, approach rationale, group conditions for change, worker role in group, group composition, group practice technique and method, time as group work dimension, pretherapy training, group therapy precautions, and group work…

A consensus definition of cataplexy in mouse models of narcolepsy.

Science.gov (United States)

Scammell, Thomas E; Willie, Jon T; Guilleminault, Christian; Siegel, Jerome M

2009-01-01

People with narcolepsy often have episodes of cataplexy, brief periods of muscle weakness triggered by strong emotions. Many researchers are now studying mouse models of narcolepsy, but definitions of cataplexy-like behavior in mice differ across labs. To establish a common language, the International Working Group on Rodent Models of Narcolepsy reviewed the literature on cataplexy in people with narcolepsy and in dog and mouse models of narcolepsy and then developed a consensus definition of murine cataplexy. The group concluded that murine cataplexy is an abrupt episode of nuchal atonia lasting at least 10 seconds. In addition, theta activity dominates the EEG during the episode, and video recordings document immobility. To distinguish a cataplexy episode from REM sleep after a brief awakening, at least 40 seconds of wakefulness must precede the episode. Bouts of cataplexy fitting this definition are common in mice with disrupted orexin/hypocretin signaling, but these events almost never occur in wild type mice. It remains unclear whether murine cataplexy is triggered by strong emotions or whether mice remain conscious during the episodes as in people with narcolepsy. This working definition provides helpful insights into murine cataplexy and should allow objective and accurate comparisons of cataplexy in future studies using mouse models of narcolepsy.

Nursing ethical values and definitions: A literature review.

Science.gov (United States)

Shahriari, Mohsen; Mohammadi, Eesa; Abbaszadeh, Abbas; Bahrami, Masoud

2013-01-01

Ethical values offer a framework for behavior assessment, and nursing values influence nurses' goals, strategies, and actions. A literature review was adopted in order to determine and define ethical values for nurses. This literature review was conducted based on the Centre for Reviews and Dissemination guidelines. The key words used to search relevant sources were nursing, ethics, ethical values, and nursing values. The search of articles in English was carried out in Medline, CINAHL, PubMed, Scopus, Ovid, and Proquest databases. The search of articles in Persian was conducted in databases of Magiran, SID, and Irandoc publications. After assessing and analyzing the obtained data, 17 articles which had a distinct definition of ethical values were chosen and subjected to a thorough study. The search yielded 10 nursing ethical values: Human dignity, privacy, justice, autonomy in decision making, precision and accuracy in caring, commitment, human relationship, sympathy, honesty, and individual and professional competency. This study showed that common ethical values are generally shared within the global community. However, in several areas, influences of social, cultural, and economical status and religious beliefs on values result in a different definition of these values. This study revealed that based on humanistic nature of nursing, common values in nursing protect human dignity and respect to the patients. Recognizing and definition of ethical values can help to improve nursing practice and develop codes of ethics.

Defining and Classifying Interest Groups

DEFF Research Database (Denmark)

Baroni, Laura; Carroll, Brendan; Chalmers, Adam

2014-01-01

The interest group concept is defined in many different ways in the existing literature and a range of different classification schemes are employed. This complicates comparisons between different studies and their findings. One of the important tasks faced by interest group scholars engaged...... in large-N studies is therefore to define the concept of an interest group and to determine which classification scheme to use for different group types. After reviewing the existing literature, this article sets out to compare different approaches to defining and classifying interest groups with a sample...... in the organizational attributes of specific interest group types. As expected, our comparison of coding schemes reveals a closer link between group attributes and group type in narrower classification schemes based on group organizational characteristics than those based on a behavioral definition of lobbying....

Understanding the influence of the snack definition on the association between snacking and obesity: a review.

Science.gov (United States)

Gregori, Dario; Foltran, Francesca; Ghidina, Marco; Berchialla, Paola

2011-05-01

The aim of the present study is to understand how different definitions of snacking influence the estimated probability of obesity in the presence of concurrent risk factors. Factors influencing obesity were evaluated by reviewing the relevant literature through a PUBMED search. Six different modalities to define snack consumption were identified. A Bayesian network model in which nodes represent the variables that the retrieved studies indicate as affecting the probability of obesity was implemented and used to estimate the individual risk of developing obesity taking into account the concurrent effect of the considered risk factors. For a subject with a given profile of factors, the probability of obesity varies according to the chosen definition of snacking, up to maximum of 70%. The variability of the probability of obesity attributable to the chosen definition of snacking is very high and may threaten any conclusion about the effect of snacking, which may be related to the specific definitions adopted in the study.

Defining SNAP by cross-sectional and longitudinal definitions of neurodegeneration.

Science.gov (United States)

Wisse, L E M; Das, S R; Davatzikos, C; Dickerson, B C; Xie, S X; Yushkevich, P A; Wolk, D A

2018-01-01

Suspected non-Alzheimer's pathophysiology (SNAP) is a biomarker driven designation that represents a heterogeneous group in terms of etiology and prognosis. SNAP has only been identified by cross-sectional neurodegeneration measures, whereas longitudinal measures might better reflect "active" neurodegeneration and might be more tightly linked to prognosis. We compare neurodegeneration defined by cross-sectional 'hippocampal volume' only (SNAP/L-) versus both cross-sectional and longitudinal 'hippocampal atrophy rate' (SNAP/L+) and investigate how these definitions impact prevalence and the clinical and biomarker profile of SNAP in Mild Cognitive Impairment (MCI). 276 MCI patients from ADNI-GO/2 were designated amyloid "positive" (A+) or "negative" (A-) based on their florbetapir scan and neurodegeneration 'positive' or 'negative' based on cross-sectional hippocampal volume and longitudinal hippocampal atrophy rate. 74.1% of all SNAP participants defined by the cross-sectional definition of neurodegeneration also met the longitudinal definition of neurodegeneration, whereas 25.9% did not. SNAP/L+ displayed larger white matter hyperintensity volume, a higher conversion rate to dementia over 5 years and a steeper decline on cognitive tasks compared to SNAP/L- and the A- CN group. SNAP/L- had more abnormal values on neuroimaging markers and worse performance on cognitive tasks than the A- CN group, but did not show a difference in dementia conversion rate or longitudinal cognition. Using a longitudinal definition of neurodegeneration in addition to a cross-sectional one identifies SNAP participants with significant cognitive decline and a worse clinical prognosis for which cerebrovascular disease may be an important driver.

Team errors: definition and taxonomy

International Nuclear Information System (INIS)

Sasou, Kunihide; Reason, James

1999-01-01

In error analysis or error management, the focus is usually upon individuals who have made errors. In large complex systems, however, most people work in teams or groups. Considering this working environment, insufficient emphasis has been given to 'team errors'. This paper discusses the definition of team errors and its taxonomy. These notions are also applied to events that have occurred in the nuclear power industry, aviation industry and shipping industry. The paper also discusses the relations between team errors and Performance Shaping Factors (PSFs). As a result, the proposed definition and taxonomy are found to be useful in categorizing team errors. The analysis also reveals that deficiencies in communication, resource/task management, excessive authority gradient, excessive professional courtesy will cause team errors. Handling human errors as team errors provides an opportunity to reduce human errors

Cellular recovery kinetic studies relevant to combined-modality research and therapy

International Nuclear Information System (INIS)

Dethlefsen, L.A.

1979-01-01

The relevance of cellular recovery kinetics to combined-modality therapy is evaluated within the framework of an idealized experimental flow chart and published adriamycin data. Within this context, limitations for both experimental design and data interpretations are discussed. The effects of adriamycin have been documented extensively at the molecular and cellular level and its interactions with x-irradiation have been studied, both in vitro and in vivo. The limited in vivo results suggest that the end results of a given protocol correlate with cellular recovery kinetics; however, definitive experiments simply have not been done. For example, no one has used single-dose drug and irradiation data to predict the outcome and then confirm or refute the prediction even in a relatively simple 2-dose drug + 2-dose drug + 2-dose x-ray protocol. Thus, at this time, the extent of the correlations between cellular recovery kinetics and clinical response for either normal or malignant tissues is not known and the possible relevance of such studies cannot be discounted

Surveillance case definitions for work related upper limb pain syndromes

OpenAIRE

Harrington, J. M.; Carter, J. T.; Birrell, L.; Gompertz, D.

1998-01-01

OBJECTIVES: To establish consensus case definitions for several common work related upper limb pain syndromes for use in surveillance or studies of the aetiology of these conditions. METHODS: A group of healthcare professionals from the disciplines interested in the prevention and management of upper limb disorders were recruited for a Delphi exercise. A questionnaire was used to establish case definitions from the participants, followed by a consensus conference involving the core grou...

Definition, classification, and epidemiology of pulmonary arterial hypertension.

Science.gov (United States)

Hoeper, Marius M

2009-08-01

Pulmonary arterial hypertension (PAH) is a distinct subgroup of pulmonary hypertension that comprises idiopathic PAH, familial/heritable forms, and PAH associated with connective tissue disease, congenital heart disease, portal hypertension, human immunodeficiency virus (HIV) infection, and some other conditions. The hemodynamic definition of PAH was recently revised: PAH is now defined by a mean pulmonary artery pressure at rest > or =25 mm Hg in the presence of a pulmonary capillary wedge pressure or =30 mm Hg during exercise) that was used in the old definition of PAH has been removed because there are no robust data that would allow defining an upper limit of normal for the pulmonary pressure during exercise. The revised classification of pulmonary hypertension still consists of five major groups: (1) PAH, (2) pulmonary hypertension due to left heart disease, (3) pulmonary hypertension due to chronic lung disease and/or hypoxia, (4) chronic thromboembolic pulmonary hypertension, and (5) miscellaneous forms. Modifications have been made in some of these groups, such as the addition of schistosomiasis-related pulmonary hypertension and pulmonary hypertension in patients with chronic hemolytic anemia to group 1.

Customized Assessment Group Initiative: A Complementary Approach to Students' Learning

Science.gov (United States)

Akindayomi, Akinloye

2015-01-01

This study, conducted in a US setting, examines the importance of group dynamics that emphasize cooperative team building through the proposed grouping strategy called Customized Assessment Group Initiative (CAGI). CAGI is a student grouping strategy designed to operationalize the mutual accountability concept central to the definition of teams by…

Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics.

Science.gov (United States)

Gibson, Glenn R; Hutkins, Robert; Sanders, Mary Ellen; Prescott, Susan L; Reimer, Raylene A; Salminen, Seppo J; Scott, Karen; Stanton, Catherine; Swanson, Kelly S; Cani, Patrice D; Verbeke, Kristin; Reid, Gregor

2017-08-01

In December 2016, a panel of experts in microbiology, nutrition and clinical research was convened by the International Scientific Association for Probiotics and Prebiotics to review the definition and scope of prebiotics. Consistent with the original embodiment of prebiotics, but aware of the latest scientific and clinical developments, the panel updated the definition of a prebiotic: a substrate that is selectively utilized by host microorganisms conferring a health benefit. This definition expands the concept of prebiotics to possibly include non-carbohydrate substances, applications to body sites other than the gastrointestinal tract, and diverse categories other than food. The requirement for selective microbiota-mediated mechanisms was retained. Beneficial health effects must be documented for a substance to be considered a prebiotic. The consensus definition applies also to prebiotics for use by animals, in which microbiota-focused strategies to maintain health and prevent disease is as relevant as for humans. Ultimately, the goal of this Consensus Statement is to engender appropriate use of the term 'prebiotic' by relevant stakeholders so that consistency and clarity can be achieved in research reports, product marketing and regulatory oversight of the category. To this end, we have reviewed several aspects of prebiotic science including its development, health benefits and legislation.

Clinical Criteria Versus a Possible Research Case Definition in Chronic Fatigue Syndrome/Myalgic Encephalomyelitis.

Science.gov (United States)

Jason, Leonard A; McManimen, Stephanie; Sunnquist, Madison; Newton, Julia L; Strand, Elin Bolle

2017-01-01

The Institute of Medicine (IOM) recently developed clinical criteria for what had been known as chronic fatigue syndrome (CFS). Given the broad nature of the clinical IOM criteria, there is a need for a research definition that would select a more homogenous and impaired group of patients than the IOM clinical criteria. At the present time, it is unclear what will serve as the research definition. The current study focused on a research definition which selected homebound individuals who met the four IOM criteria, excluding medical and psychiatric co-morbidities. Our research criteria were compared to those participants meeting the IOM criteria. Those not meeting either of these criteria sets were placed in a separate group defined by 6 or more months of fatigue. Data analyzed were from the DePaul Symptom Questionnaire and the SF-36. Due to unequal sample sizes and variances, Welch's F tests and Games-Howell post hoc tests were conducted. Using a large database of over 1,000 patients from several countries, we found that those meeting a more restrictive research definition were even more impaired and more symptomatic than those meeting criteria for the other two groups. Deciding on a particular research case definition would allow researchers to select more comparable patient samples across settings, and this would represent one of the most significant methodologic advances for this field of study.

Definition of Videogames

Directory of Open Access Journals (Sweden)

Grant Tavinor

2008-01-01

Full Text Available Can videogames be defined? The new field of games studies has generated three somewhat competing models of videogaming that characterize games as new forms of gaming, narratives, and interactive fictions. When treated as necessary and sufficient condition definitions, however, each of the three approaches fails to pick out all and only videogames. In this paper I argue that looking more closely at the formal qualities of definition helps to set out the range of definitional options open to the games theorist. A disjunctive definition of videogaming seems the most appropriate of these definitional options. The disjunctive definition I offer here is motivated by the observation that there is more than one characteristic way of being a videogame.

Cultural competence in end-of-life care: terms, definitions, and conceptual models from the British literature.

Science.gov (United States)

Evans, Natalie; Meñaca, Arantza; Koffman, Jonathan; Harding, Richard; Higginson, Irene J; Pool, Robert; Gysels, Marjolein

2012-07-01

Cultural competency is increasingly recommended in policy and practice to improve end-of-life (EoL) care for minority ethnic groups in multicultural societies. It is imperative to critically analyze this approach to understand its underlying concepts. Our aim was to appraise cultural competency approaches described in the British literature on EoL care and minority ethnic groups. This is a critical review. Articles on cultural competency were identified from a systematic review of the literature on minority ethnic groups and EoL care in the United Kingdom. Terms, definitions, and conceptual models of cultural competency approaches were identified and situated according to purpose, components, and origin. Content analysis of definitions and models was carried out to identify key components. One-hundred thirteen articles on minority ethnic groups and EoL care in the United Kingdom were identified. Over half (n=60) contained a term, definition, or model for cultural competency. In all, 17 terms, 17 definitions, and 8 models were identified. The most frequently used term was "culturally sensitive," though "cultural competence" was defined more often. Definitions contained one or more of the components: "cognitive," "implementation," or "outcome." Models were categorized for teaching or use in patient assessment. Approaches were predominantly of American origin. The variety of terms, definitions, and models underpinning cultural competency approaches demonstrates a lack of conceptual clarity, and potentially complicates implementation. Further research is needed to compare the use of cultural competency approaches in diverse cultures and settings, and to assess the impact of such approaches on patient outcomes.

National Cholesterol Education Program Adult Treatment Panel III Versus International Diabetic Federation Definition of Metabolic Syndrome, Which One is Associated with Diabetes Mellitus and Coronary Artery Disease?

Science.gov (United States)

Rezaianzadeh, Abbas; Namayandeh, Seyedeh-Mahdieh; Sadr, Seyed-Mahmood

2012-08-01

A cluster of risk factors for cardiovascular diseases and type 2 diabetes mellitus, which occur together more often than by chance alone, have been known as the metabolic syndrome. Various definitions have been proposed by different organizations over the past decade. This study was designed to evaluate a new definition of the metabolic syndrome for the prediction of diabetes mellitus among the Iranian population. This study was carried out in an urban population, aged 20 to 74 years, from Yazd, a city in the center of Iran. The study is a part of the phase I of Yazd Healthy Heart Program, that is, a community-based intervention study for the prevention of cardiovascular disease. The significance level has been defined as Pdefinitions of NCEP and IDF criteria, and also, the most important relevant factors of stable angina were: Increased age, male sex, and metabolic syndrome by only IDF definitions, but the NCEP definition of the metabolic syndrome cannot predict diabetes mellitus independent of age and sex. This study showed that increased age and metabolic syndrome are the most important relevant factors for diabetes mellitus, especially by using the IDF criteria for definition of the metabolic syndrome.

What Is Lean Management in Health Care? Development of an Operational Definition for a Cochrane Systematic Review.

Science.gov (United States)

Rotter, Thomas; Plishka, Christopher; Lawal, Adegboyega; Harrison, Liz; Sari, Nazmi; Goodridge, Donna; Flynn, Rachel; Chan, James; Fiander, Michelle; Poksinska, Bonnie; Willoughby, Keith; Kinsman, Leigh

2018-01-01

Industrial improvement approaches such as Lean management are increasingly being adopted in health care. Synthesis is necessary to ensure these approaches are evidence based and requires operationalization of concepts to ensure all relevant studies are included. This article outlines the process utilized to develop an operational definition of Lean in health care. The literature search, screening, data extraction, and data synthesis processes followed the recommendations outlined by the Cochrane Collaboration. Development of the operational definition utilized the methods prescribed by Kinsman et al. and Wieland et al. This involved extracting characteristics of Lean, synthesizing similar components to establish an operational definition, applying this definition, and updating the definition to address shortcomings. We identified two defining characteristics of Lean health-care management: (1) Lean philosophy, consisting of Lean principles and continuous improvement, and (2) Lean activities, which include Lean assessment activities and Lean improvement activities. The resulting operational definition requires that an organization or subunit of an organization had integrated Lean philosophy into the organization's mandate, guidelines, or policies and utilized at least one Lean assessment activity or Lean improvement activity. This operational definition of Lean management in health care will act as an objective screening criterion for our systematic review. To our knowledge, this is the first evidence-based operational definition of Lean management in health care.

Analysis of agreement among definitions of metabolic syndrome in nondiabetic Turkish adults: a methodological study

Directory of Open Access Journals (Sweden)

Bersot Thomas P

2007-12-01

Full Text Available Abstract Background We aimed to explore the agreement among World Health Organization (WHO, European Group for the Study of Insulin Resistance (EGIR, National Cholesterol Education Program (NCEP, American College of Endocrinology (ACE, and International Diabetes Federation (IDF definitions of the metabolic syndrome. Methods 1568 subjects (532 men, 1036 women, mean age 45 and standard deviation (SD 13 years were evaluated in this cross-sectional, methodological study. Cardiometabolic risk factors were determined. Insulin sensitivity was calculated by HOMA-IR. Agreement among definitions was determined by the kappa statistic. ANOVA and post hoc Tukey's test were used to compare multiple groups. Results The agreement between WHO and EGIR definitions was very good (kappa: 0.83. The agreement between NCEP, ACE, and IDF definitions was substantial to very good (kappa: 0.77–0.84. The agreement between NCEP or ACE or IDF and WHO or EGIR definitions was fair (kappa: 0.32–0.37. The age and sex adjusted prevalence of metabolic syndrome was 38% by NCEP, 42% by ACE and IDF, 20% by EGIR and 19% by WHO definition. The evaluated definitions were dichotomized after analysis of design, agreement and prevalence: insulin measurement requiring definitions (WHO and EGIR and definitions not requiring insulin measurement (NCEP, ACE, IDF. One definition was selected from each set for comparison. WHO-defined subjects were more insulin resistant than subjects without the metabolic syndrome (mean and SD for log HOMA-IR, 0.53 ± 0.14 vs. 0.07 ± 0.23, respectively, p 0.05, but lower log HOMA-IR values (p Conclusion The metabolic syndrome definitions that do not require measurement of insulin levels (NCEP, ACE and IDF identify twice more patients with insulin resistance and increased Framingham risk scores and are more useful than the definitions that require measurement of insulin levels (WHO and EGIR.

Systematic review of validated case definitions for diabetes in ICD-9-coded and ICD-10-coded data in adult populations.

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Khokhar, Bushra; Jette, Nathalie; Metcalfe, Amy; Cunningham, Ceara Tess; Quan, Hude; Kaplan, Gilaad G; Butalia, Sonia; Rabi, Doreen

2016-08-05

With steady increases in 'big data' and data analytics over the past two decades, administrative health databases have become more accessible and are now used regularly for diabetes surveillance. The objective of this study is to systematically review validated International Classification of Diseases (ICD)-based case definitions for diabetes in the adult population. Electronic databases, MEDLINE and Embase, were searched for validation studies where an administrative case definition (using ICD codes) for diabetes in adults was validated against a reference and statistical measures of the performance reported. The search yielded 2895 abstracts, and of the 193 potentially relevant studies, 16 met criteria. Diabetes definition for adults varied by data source, including physician claims (sensitivity ranged from 26.9% to 97%, specificity ranged from 94.3% to 99.4%, positive predictive value (PPV) ranged from 71.4% to 96.2%, negative predictive value (NPV) ranged from 95% to 99.6% and κ ranged from 0.8 to 0.9), hospital discharge data (sensitivity ranged from 59.1% to 92.6%, specificity ranged from 95.5% to 99%, PPV ranged from 62.5% to 96%, NPV ranged from 90.8% to 99% and κ ranged from 0.6 to 0.9) and a combination of both (sensitivity ranged from 57% to 95.6%, specificity ranged from 88% to 98.5%, PPV ranged from 54% to 80%, NPV ranged from 98% to 99.6% and κ ranged from 0.7 to 0.8). Overall, administrative health databases are useful for undertaking diabetes surveillance, but an awareness of the variation in performance being affected by case definition is essential. The performance characteristics of these case definitions depend on the variations in the definition of primary diagnosis in ICD-coded discharge data and/or the methodology adopted by the healthcare facility to extract information from patient records. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Pathways to Advancing Aging Policy-Relevant Research in Academic Settings.

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Kietzman, Kathryn G; Troy, Lisa M; Green, Carmen R; Wallace, Steven P

2016-01-01

Policy-level changes have a significant influence on the health and well-being of aging populations. Yet there is often a gap between scientific knowledge and policy action. Although previous research has identified barriers and facilitators to effective knowledge translation, little attention has been given to the role of academic institutions in knowledge generation. This exploratory focus group study examines barriers and pathways to developing and maintaining an aging policy-relevant research agenda in academic settings, and additional challenges associated with minority group membership in this pursuit. Participants were personally committed to conducting policy-relevant research despite institutional barriers such as fewer funding opportunities and less value attributed to their research, particularly in the context of tenure and promotion. Although many viewed their research as an opportunity to make a difference, especially for underserved older adult populations, a number of minority group participants expressed that their policy research interests were marginalized. Participants offer individual and institutional-level strategies for addressing barriers, including collaborating with community members and colleagues and engaging mentors within and outside of their academic institutions. Reframing the valuation of policy research through the diversification of funding and publishing opportunities can better support scholars engaged in aging policy-relevant research.

Clinical relevance of positive voltage-gated potassium channel (VGKC)-complex antibodies: experience from a tertiary referral centre.

Science.gov (United States)

Paterson, Ross W; Zandi, Michael S; Armstrong, Richard; Vincent, Angela; Schott, Jonathan M

2014-06-01

Voltage-gated potassium channel (VGKC)-complex antibodies can be associated with a range of immunotherapy-responsive clinical presentations including limbic encephalitis, Morvan's syndrome and acquired neuromyotonia. However, there are patients with positive levels in whom the significance is uncertain. To evaluate the clinical significance associated with positive (>100 pM) VGKC-complex antibodies. Over a 4-year period, 1053 samples were sent for testing of which 55 were positive. The clinical presentations, final diagnoses and responses to immunotherapies, when given, were assessed retrospectively and the likelihood of autoimmunity was categorised as definite, possible, unlikely or undetermined (modified from Zuliani et al 2012). Only 4 of the 32 patients with low-positive (100-400 pM) levels were considered definitely autoimmune, 3 with peripheral nerve hyperexcitability and 1 with a thymoma; 3 were given immunotherapies. Of the remaining 28 with low-positive levels, 13 (3 of whom had tumours) were considered possibly autoimmune, and 15 were unlikely or undetermined; 1 was given immunotherapy unsuccessfully. Of the 23 patients with high-positive (>400 pM) levels, 12 were given immunotherapies, 11 of whom showed a good response. 11 were considered definitely autoimmune, 10 with limbic encephalitis (antibody specificity: 5 LGI1, 1 contactin2, 2 negative, 2 untested) and 1 with a tumour. In the remaining 12, autoimmunity was considered possible (n=9; most had not received immunotherapies), or unlikely (n=3). As antibody testing becomes more widely available, and many samples are referred from patients with less clear-cut diagnoses, it is important to assess the utility of the results. VGKC-complex antibodies in the range of 100-400 pM (0.1-0.4 nM) were considered clinically relevant in rare conditions with peripheral nerve hyperexcitability and appeared to associate with tumours (12.5%). By contrast high-positive (>400 pM; >0.4 nM) levels were considered definitely

Actionable findings and the role of IT support: report of the ACR Actionable Reporting Work Group.

Science.gov (United States)

Larson, Paul A; Berland, Lincoln L; Griffith, Brent; Kahn, Charles E; Liebscher, Lawrence A

2014-06-01

The ACR formed the Actionable Reporting Work Group to address the potential role of IT in the communication of imaging findings, especially in cases that require nonroutine communication because of the urgency of the findings or their unexpected nature. These findings that require special communication with referring clinicians are classified as "actionable findings." The work group defines 3 categories of actionable findings that require, respectively, communication and clinical decision within minutes (category 1), hours (category 2), or days (category 3). Although the work group does not believe that there can be definitive lists of such findings, it developed lists in each category that would apply in most general hospital settings. For each category, the work group discusses ways in which IT can assist interpreting radiologists in successfully communicating to the relevant clinicians to ensure optimal patient care. IT systems can also help document the communication and facilitate auditing of the documentation. The work group recommends that vendors develop platforms that can be customized on the basis of local preferences and needs. Whatever system is used, it should be highly reliable and fit seamlessly into radiologists' workflow. Copyright © 2014 American College of Radiology. Published by Elsevier Inc. All rights reserved.

[Primary care: A definition of the field to develop research].

Science.gov (United States)

Verga-Gérard, A

2018-03-01

Research in the field of primary care has dramatically increased in France in recent years, especially since 2013 with the introduction of primary care as a thematic priority for research proposals launched by the Ministry of Health (Direction générale de l'offre de soins). The RECaP (Research in Clinical Epidemiology and Public Health) network is a French research network supported by Inserm, which recently implemented a specific working group focusing on research in primary care, based on a multidisciplinary approach. Researchers from different specialties participate in this group. The first aim of the group was to reach a common definition of the perimeter and of the panel of healthcare professionals and structures potentially involved in the field of primary care. For this purpose, a selection of different data sets of sources defining primary care was analyzed by the group, each participant collecting a set of sources, from which a synthesis was made and discussed. A definition of primary care at different levels (international, European and French) was summarized. A special attention was given to the French context in order to adapt the perimeter to the characteristics of the French healthcare system, notably by illustrating the different key elements of the definition with the inclusion of primary care actors and the type of practice premises. In conclusion, this work illustrates the diversity of primary care in France and the potential offered for research purposes. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Imaging of basal cell carcinoma by high-definition optical coherence tomography

DEFF Research Database (Denmark)

Boone, M A L M; Norrenberg, S; Jemec, G B E

2012-01-01

With the continued development of noninvasive therapies for basal cell carcinoma (BCC) such as photodynamic therapy and immune therapies, noninvasive diagnosis and monitoring become increasingly relevant. High-definition optical coherence tomography (HD-OCT) is a high-resolution imaging tool, wit......, with micrometre resolution in both transversal and axial directions, enabling visualization of individual cells up to a depth of around 570 μm, and filling the imaging gap between conventional optical coherence tomography (OCT) and reflectance confocal microscopy (RCM)....

In search of an integral conceptual definition of frailty: opinions of experts.

Science.gov (United States)

Gobbens, Robbert J J; Luijkx, Katrien G; Wijnen-Sponselee, Maria Th; Schols, Jos M G A

2010-06-01

There are many different conceptual definitions of frailty in circulation. Most of these definitions focus mainly on physical problems affecting older people. Only a few also draw attention to other domains of human functioning such as the psychological domain. The authors of this article fear that this could lead to fragmentation of care for frail older people. The aim is to develop an integral conceptual definition of frailty that starts from the premise of a holistic view of the person. To achieve this, a literature search was carried out. Thereafter a group of experts (N=20) were consulted, both verbally during 2 expert meetings and via a written questionnaire. These experts were asked which existing conceptual definition of frailty places most stress on the integral functioning of older people. The experts expressed a clear preference for one of the conceptual definitions. The result of the literature search and the consultation with the experts led to a new integral conceptual definition of frailty. The conceptual definition is intended to offer a framework for an operational definition of frailty for identifying frail older people. Copyright 2010 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

Complementing the Latest APA Definition of Hypnosis: Sensory-Motor and Vascular Peculiarities Involved in Hypnotizability.

Science.gov (United States)

Santarcangelo, Enrica L; Scattina, Eliana

2016-01-01

The aim of this article is to complement the recently revised American Psychological Association (APA) definition of hypnotizability. It (a) lists a few differences in sensorimotor integration between subjects with high (highs) and low (lows) hypnotizability scores in the ordinary state of consciousness and in the absence of suggestions, (b) proposes that hypnotizability-related cerebellar peculiarities may account for them, (c) suggests that the cerebellum could also be involved in cognitive aspects of hypnotizability and (d) explains why the information derived from studies of sensorimotor and cardiovascular aspects of hypnotizability may be relevant to its definition and useful in orienting further experimental research in the field of hypnosis.

Consensus statement on panic disorder from the International Consensus Group on Depression and Anxiety.

Science.gov (United States)

Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Baldwin, D S; den Boer, J A; Kasper, S; Shear, M K

1998-01-01

To provide primary care clinicians with a better understanding of management issues in panic disorder and guide clinical practice with recommendations for appropriate pharmacotherapy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Four faculty invited by the chairman also participated: David S. Baldwin, Johan A. den Boer, Siegfried Kasper, and M. Katherine Shear. The consensus statement is based on the 6 review papers that are published in this supplement and on the scientific literature relevant to these issues. There were group meetings held during a 2-day period. On day 1, the group discussed each review paper and the chairman and discussant (Dr. Kasper) identified key issues for further debate. On day 2, the group discussed these key issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chairman and approved by all attendees. The consensus statement provides standard definitions for response and remission and identifies appropriate strategy for the management of panic disorder in a primary care setting. Serotonin selective reuptake inhibitors are recommended as drugs of first choice with a treatment period of 12 to 24 months. Pharmacotherapy should be discontinued slowly over a period of 4 to 6 months.

Multimedia Approach in Teaching Mathematics--Example of Lesson about the Definite Integral Application for Determining an Area

Science.gov (United States)

Milovanovic, Marina; Takaci, Durdica; Milajic, Aleksandar

2011-01-01

This article presents the importance of using multimedia in the math classes by an example of multimedia lesson about definite integral and the results of the research carried out among the students of the first years of faculty, divided into two groups of 25. One group had the traditional lecture about the definite integral, while the other one…

Not all choices are created equal: Task-relevant choices enhance motor learning compared to task-irrelevant choices.

Science.gov (United States)

Carter, Michael J; Ste-Marie, Diane M

2017-12-01

Lewthwaite et al. (2015) reported that the learning benefits of exercising choice (i.e., their self-controlled condition) are not restricted to task-relevant features (e.g., feedback). They found that choosing one's golf ball color (Exp. 1) or choosing which of two tasks to perform at a later time plus which of two artworks to hang (Exp. 2) resulted in better retention than did being denied these same choices (i.e., yoked condition). The researchers concluded that the learning benefits derived from choice, whether irrelevant or relevant to the to-be-learned task, are predominantly motivational because choice is intrinsically rewarding and satisfies basic psychological needs. However, the absence of a group that made task-relevant choices and the lack of psychological measures significantly weakened their conclusions. Here, we investigated how task-relevant and task-irrelevant choices affect motor-skill learning. Participants practiced a spatiotemporal motor task in either a task-relevant group (choice over feedback schedule), a task-irrelevant group (choice over the color of an arm-wrap plus game selection), or a no-choice group. The results showed significantly greater learning in the task-relevant group than in both the task-irrelevant and no-choice groups, who did not differ significantly. Critically, these learning differences were not attributed to differences in perceptions of competence or autonomy, but instead to superior error-estimation abilities. These results challenge the perspective that motivational influences are the root cause of self-controlled learning advantages. Instead, the findings add to the growing evidence highlighting that the informational value gained from task-relevant choices makes a greater relative contribution to these advantages than motivational influences do.

[Relevant public health enteropathogens].

Science.gov (United States)

Riveros, Maribel; Ochoa, Theresa J

2015-01-01

Diarrhea remains the third leading cause of death in children under five years, despite recent advances in the management and prevention of this disease. It is caused by multiple pathogens, however, the prevalence of each varies by age group, geographical area and the scenario where cases (community vs hospital) are recorded. The most relevant pathogens in public health are those associated with the highest burden of disease, severity, complications and mortality. In our country, norovirus, Campylobacter and diarrheagenic E. coli are the most prevalent pathogens at the community level in children. In this paper we review the local epidemiology and potential areas of development in five selected pathogens: rotavirus, norovirus, Shiga toxin-producing E. coli (STEC), Shigella and Salmonella. Of these, rotavirus is the most important in the pediatric population and the main agent responsible for child mortality from diarrhea. The introduction of rotavirus vaccination in Peru will have a significant impact on disease burden and mortality from diarrhea. However, surveillance studies are needed to determine the impact of vaccination and changes in the epidemiology of diarrhea in Peru following the introduction of new vaccines, as well as antibiotic resistance surveillance of clinical relevant bacteria.

National critical incident reporting systems relevant to anaesthesia: a European survey.

Science.gov (United States)

Reed, S; Arnal, D; Frank, O; Gomez-Arnau, J I; Hansen, J; Lester, O; Mikkelsen, K L; Rhaiem, T; Rosenberg, P H; St Pierre, M; Schleppers, A; Staender, S; Smith, A F

2014-03-01

Critical incident reporting is a key tool in the promotion of patient safety in anaesthesia. We surveyed representatives of national incident reporting systems in six European countries, inviting information on scope and organization, and intelligence on factors determining success and failure. Some systems are government-run and nationally conceived; others started out as small, specialty-focused initiatives, which have since acquired a national reach. However, both national co-ordination and specialty enthusiasts seem to be necessary for an optimally functioning system. The role of reporting culture, definitional issues, and dissemination is discussed. We make recommendations for others intending to start new systems and speculate on the prospects for sharing patient safety lessons relevant to anaesthesia at European level.

Enhancing clinical decision making: development of a contiguous definition and conceptual framework.

Science.gov (United States)

Tiffen, Jennifer; Corbridge, Susan J; Slimmer, Lynda

2014-01-01

Clinical decision making is a term frequently used to describe the fundamental role of the nurse practitioner; however, other terms have been used interchangeably. The purpose of this article is to begin the process of developing a definition and framework of clinical decision making. The developed definition was "Clinical decision making is a contextual, continuous, and evolving process, where data are gathered, interpreted, and evaluated in order to select an evidence-based choice of action." A contiguous framework for clinical decision making specific for nurse practitioners is also proposed. Having a clear and unique understanding of clinical decision making will allow for consistent use of the term, which is relevant given the changing educational requirements for nurse practitioners and broadening scope of practice. Copyright © 2014 Elsevier Inc. All rights reserved.

Business group performance, context, and strategy: A meta-analysis

NARCIS (Netherlands)

M. Carney (Michael); E.R. Gedajlovic (Eric); P.P.M.A.R. Heugens (Pursey); M. van Essen (Marc); J. van Oosterhout (Hans)

2010-01-01

textabstractResearch on business groups ?legally independent firms tied together in a variety of formal and informal ways ?is accelerating, but four questions still lack a definitive answer: Does business group membership enhance or diminish firm performance? Are members comparatively better off in

An introduction to tensors and group theory for physicists

CERN Document Server

Jeevanjee, Nadir

2015-01-01

The second edition of this highly praised textbook provides an introduction to tensors, group theory, and their applications in classical and quantum physics.  Both intuitive and rigorous, it aims to demystify tensors by giving the slightly more abstract but conceptually much clearer definition found in the math literature, and then connects this formulation to the component formalism of physics calculations.  New pedagogical features, such as new illustrations, tables, and boxed sections, as well as additional “invitation” sections that provide accessible introductions to new material, offer increased visual engagement, clarity, and motivation for students.   Part I begins with linear algebraic foundations, follows with the modern component-free definition of tensors, and concludes with applications to physics through the use of tensor products. Part II introduces group theory, including abstract groups and Lie groups and their associated Lie algebras, then intertwines this material with that of Part...

Diagnosing acute respiratory distress syndrome in resource limited settings: the Kigali modification of the Berlin definition.

Science.gov (United States)

Riviello, Elisabeth D; Buregeya, Egide; Twagirumugabe, Theogene

2017-02-01

The acute respiratory distress syndrome (ARDS) was re-defined by a panel of experts in Berlin in 2012. Although the Berlin criteria improved upon the validity and reliability of the definition, it did not make diagnosis of ARDS in resource limited settings possible. Mechanical ventilation, arterial blood gas measurements, and chest radiographs are not feasible in many regions of the world. In 2014, we proposed and applied the Kigali modification of the Berlin definition in a hospital in Rwanda. This review synthesizes literature from the last 18 months relevant to the Kigali modification. In the last 18 months, the need for a universally applicable ARDS definition was reinforced by advances in supportive care that can be implemented in resource poor settings. Research demonstrating the variable impact of positive end expiratory pressure on hypoxemia, the validity of using pulse oximetry rather than arterial blood gas to categorize hypoxemia, and the accuracy of lung ultrasound support the use of the Kigali modification of the Berlin definition. Studies directly comparing the Berlin definition to the Kigali modification are needed. Ongoing clinical research on ARDS needs to include low-income countries.

Varied definitions of risk related to sensation seeking trait

International Nuclear Information System (INIS)

Daastoel, P.Oe.U.; Drottz-Sjoeberg, B.M.

1999-01-01

This pilot study is based on the assumption and the knowledge that previous results show that the normal use of the word risk varies across subjects. The risk definitions the subjects use have also been shown to be related to various educational interests. A related field of research has developed measures for Sensation Seeking personality trait, with four facets. Three independent groups of first year psychology students reported their normal definition of the word risk using one of three measurement formats. The results showed, e.g. that the typical open-ended response to the personal definition of risk was danger. Subjects who defined risk as the combination of probability and consequences tended to score higher on the total Sensation Seeking Scale, as compared to those defining risk as the probability of an event

Varied definitions of risk related to sensation seeking trait

Energy Technology Data Exchange (ETDEWEB)

Daastoel, P.Oe.U.; Drottz-Sjoeberg, B.M. [Norwegian Univ. of Science and Technology, Trondheim (Norway). Dept. of Psychology

1999-12-01

This pilot study is based on the assumption and the knowledge that previous results show that the normal use of the word risk varies across subjects. The risk definitions the subjects use have also been shown to be related to various educational interests. A related field of research has developed measures for Sensation Seeking personality trait, with four facets. Three independent groups of first year psychology students reported their normal definition of the word risk using one of three measurement formats. The results showed, e.g. that the typical open-ended response to the personal definition of risk was danger. Subjects who defined risk as the combination of probability and consequences tended to score higher on the total Sensation Seeking Scale, as compared to those defining risk as the probability of an event.

Exploring factors relevant in the assessment of the return-to-work process of employees on long-term sickness absence due to a depressive disorder: a focus group study

Directory of Open Access Journals (Sweden)

Muijzer Anna

2012-02-01

Full Text Available Abstract Background Efforts undertaken during the Return-to-Work (RTW process need to be sufficient in order to optimize the quality of the RTW process. The purpose of this study was to explore factors relevant to Return-to-Work Effort Sufficiency (RTW-ES in cases of sick-listed employees with a Depressive Disorder (DD. Method A case of a long-term sick-listed employee with a DD applying for disability benefits was used to gather arguments and grounds relevant to the assessment of RTW-ES. Two focus group meetings were held, consisting of Labor Experts working at the Dutch Social Insurance Institute. Factors were collected and categorized using the International Classification of Functioning, Disability and Health (ICF model. Results Sixteen factors relevant to RTW-ES assessment in a case of DD were found, categorized in the ICF-model under activities (e.g. functional capacity, personal (e.g. competencies, attitude and environmental domain (e.g. employer-employee relationship, or categorized under interventions, job accommodations and measures. Conclusions This study shows that 16 factors are relevant in the assessment of RTW-ES in employees sick-listed due to DD. Further research is necessary to expand this knowledge to other health conditions, and to investigate the impact of these results on the quality of the RTW-ES assessment.

Students' Guided Reinvention of Definition of Limit of a Sequence with Interactive Technology

Science.gov (United States)

Flores, Alfinio; Park, Jungeun

2016-01-01

In a course emphasizing interactive technology, 19 students, including 18 mathematics education majors, mostly in their first year, reinvented the definition of limit of a sequence while working in small cooperative groups. The class spent four sessions of 75 minutes each on a cyclical process of guided reinvention of the definition of limit of a…

Operational Definition of Active and Healthy Ageing (AHA)

DEFF Research Database (Denmark)

Bousquet, J; Kuh, D; Bewick, M

2015-01-01

Health is a multi-dimensional concept, capturing how people feel and function. The broad concept of Active and Healthy Ageing was proposed by the World Health Organisation (WHO) as the process of optimizing opportunities for health to enhance quality of life as people age. It applies to both...... individuals and population groups. A universal Active and Healthy Ageing definition is not available and it may differ depending on the purpose of the definition and/or the questions raised. While the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) has had a major impact......, a definition of Active and Healthy Ageing is urgently needed. A meeting was organised in Montpellier, France, October 20-21, 2014 as the annual conference of the EIP on AHA Reference Site MACVIA-LR (Contre les Maladies Chroniques pour un Vieillissement Actif en Languedoc Roussillon) to propose an operational...

Progress towards a new definition of the kelvin

Science.gov (United States)

Fischer, Joachim

2015-10-01

At its 24th meeting (2011) the General Conference on Weights and Measures noted the CIPM’s intention to express new definitions of the kilogram, ampere, kelvin, and mole in terms of fixed numerical values of the Planck constant, elementary charge, Boltzmann constant, and Avogadro constant, respectively. The changes proposed for the International System of Units will not actually be adopted until the experimental results on the new definitional constants that are proposed have reached a further stage of refinement. This paper provides an overview of the activities and progress of the research groups who are carrying out experiments to determine the Boltzmann constant. The most promising methods, acoustic gas thermometry, dielectric-constant gas thermometry, Johnson noise thermometry and Doppler-broadening thermometry, are reviewed. The prospects for meeting the requirements of the Consultative Committee for Thermometry for a new definition of the kelvin are discussed.

Scope Definition

DEFF Research Database (Denmark)

Bjørn, Anders; Owsianiak, Mikołaj; Laurent, Alexis

2018-01-01

The scope definition is the second phase of an LCA. It determines what product systems are to be assessed and how this assessment should take place. This chapter teaches how to perform a scope definition. First, important terminology and key concepts of LCA are introduced. Then, the nine items...... making up a scope definition are elaborately explained: (1) Deliverables. (2) Object of assessment, (3) LCI modelling framework and handling of multifunctional processes, (4) System boundaries and completeness requirements, (5) Representativeness of LCI data, (6) Preparing the basis for the impact...... assessment, (7) Special requirements for system comparisons, (8) Critical review needs and (9) Planning reporting of results. The instructions relate both to the performance and reporting of a scope definition and are largely based on ILCD....

Grouping techniques in a EFL Classroom

Directory of Open Access Journals (Sweden)

Ramírez Salas, Marlene

2005-03-01

Full Text Available This article focuses on the need for English language teachers to use group work as a means to foster communication among students. The writer presents a definition of group work, its advantages and disadvantages, some activities for using group work and some grouping techniques created or adapted by the writer to illustrate the topic. Este artículo manifiesta la importancia del trabajo grupal en el aula, para motivar la comunicación entre los estudiantes. Asimismo, presenta la definición de trabajo en grupo, sus ventajas, desventajas y algunas actividades y técnicas para formar grupos.

Group field theory with noncommutative metric variables.

Science.gov (United States)

Baratin, Aristide; Oriti, Daniele

2010-11-26

We introduce a dual formulation of group field theories as a type of noncommutative field theories, making their simplicial geometry manifest. For Ooguri-type models, the Feynman amplitudes are simplicial path integrals for BF theories. We give a new definition of the Barrett-Crane model for gravity by imposing the simplicity constraints directly at the level of the group field theory action.

Emotional collectives: How groups shape emotions and emotions shape groups.

Science.gov (United States)

van Kleef, Gerben A; Fischer, Agneta H

2016-01-01

Group settings are epicentres of emotional activity. Yet, the role of emotions in groups is poorly understood. How do group-level phenomena shape group members' emotional experience and expression? How are emotional expressions recognised, interpreted and shared in group settings? And how do such expressions influence the emotions, cognitions and behaviours of fellow group members and outside observers? To answer these and other questions, we draw on relevant theoretical perspectives (e.g., intergroup emotions theory, social appraisal theory and emotions as social information theory) and recent empirical findings regarding the role of emotions in groups. We organise our review according to two overarching themes: how groups shape emotions and how emotions shape groups. We show how novel empirical approaches break important new ground in uncovering the role of emotions in groups. Research on emotional collectives is thriving and constitutes a key to understanding the social nature of emotions.

To bail out or not to bail out systemically relevant financial institutions: The incentives of policy makers

Directory of Open Access Journals (Sweden)

Lucas Marc Fuhrer

2012-11-01

Full Text Available The recent financial crisis has shown that many financial institutions may be systemically relevant. Their bankruptcy would cause significant costs for the overall economy. However, a clear definition of systemic risks still does not exist. Thus, the decision, whether an institution is, or is not systemically relevant is in the end made by policy makers. This paper takes a closer look at the incentives available to policy makers and their influence on the bailout decision. In the model presented here it is possible to show, that too many financial institutions get bailed out, when assuming that policy makers tend to be more risk-averse than socially optimal. The costs due to this misallocation of resources can be significant.

Comparison of the perceived relevance of oral biology reported by students and interns of a Pakistani dental college.

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Farooq, I; Ali, S

2014-11-01

The purpose of this study was to analyse and compare the perceived relevance of oral biology with dentistry as reported by dental students and interns and to investigate the most popular teaching approach and learning resource. A questionnaire aiming to ask about the relevance of oral biology to dentistry, most popular teaching method and learning resource was utilised in this study. Study groups encompassed second-year dental students who had completed their course and dental interns. The data were obtained and analysed statistically. The overall response rate for both groups was 60%. Both groups reported high relevance of oral biology to dentistry. Perception of dental interns regarding the relevance of oral biology to dentistry was higher than that of students. Both groups identified student presentations as the most important teaching method. Amongst the most important learning resources, textbooks were considered most imperative by interns, whereas lecture handouts received the highest importance score by students. Dental students and interns considered oral biology to be relevant to dentistry, although greater relevance was reported by interns. Year-wise advancement in dental education and training improves the perception of the students about the relevance of oral biology to dentistry. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Symbolic Play in Mixed-Age and Same-Age Groups.

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Umek, Ljubica Marjanovic; Musek, Petra Lesnik

1997-01-01

Investigated the content, degree of complexity, and wholeness of the transformation in symbolic play among same-age and mixed-age groups of 4- to 7-year olds in Slovenia. Results confirm that, in mixed-age groups, the role definition in symbolic play is provided on a higher level than in same-age groups, which enables social imaginative play to…

Updating the definition and role of public health nursing to advance and guide the specialty.

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Bekemeier, Betty; Walker Linderman, Tessa; Kneipp, Shawn; Zahner, Susan J

2015-01-01

National changes in the context for public health services are influencing the nature of public health nursing practice. Despite this, the document that defines public health nursing as a specialty--The Definition and Role of Public Health Nursing--has remained in wide use since its publication in 1996 without a review or update. With support from the American Public Health Association (APHA) Public Health Nursing Section, a national Task Force, was formed in November 2012 to update the definition of public health nursing, using processes that reflected deliberative democratic principles. A yearlong process was employed that included a modified Delphi technique and various modes of engagement such as online discussion boards, questionnaires, and public comment to review. The resulting 2013 document consisted of a reaffirmation of the one-sentence 1996 definition, while updating supporting documentation to align with the current social, economic, political, and health care context. The 2013 document was strongly endorsed by vote of the APHA Public Health Nursing Section elected leadership. The 2013 definition and document affirm the relevance of a population-focused definition of public health nursing to complex systems addressed in current practice and articulate critical roles of public health nurses (PHN) in these settings. © 2014 Wiley Periodicals, Inc.

"Research on Infertility: Definition Makes a Difference" Revisited.

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Jacobson, Melanie H; Chin, Helen B; Mertens, Ann C; Spencer, Jessica B; Fothergill, Amy; Howards, Penelope P

2018-02-01

In a 1989 paper, Marchbanks et al. (Am J Epidemiol. 1989;130(2):259-267) noted inconsistent definitions of infertility across research and clinical practice and examined differences in prevalence estimates across definitions. Since their study, there have been substantial changes in society, technology, and clinical practice related to female reproductive health. In response, we revisited the original paper using data from a recent study among reproductive-aged women. Internal comparisons across various definitions of infertility were made by assessing how many and which women were classified as infertile, their age at infertility, and the probability of spontaneous pregnancy after infertility. Results were also compared with Marchbanks et al. Black women were more likely to be classified as infertile than white women based on the definition "12 months of unprotected intercourse" (40.1% vs. 33.7%) but less likely by "12 months of attempting pregnancy" (14.3% vs. 21.8%) and "visiting a doctor for help getting pregnant" (8.4% vs. 19.7%). After unprotected intercourse for 12 months, 36.1% of women who were attempting pregnancy spontaneously conceived by 6 months compared with 13.5% of women who were not attempting pregnancy. While our results for most infertility definitions were similar to those of Marchbanks et al., prevalence estimates continued to differ across demographic groups by definition. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Risk behaviour and group formation in microcredit groups in Eritrea

NARCIS (Netherlands)

Lensink, Robert; Mehrteab, Habteab T.

2003-01-01

We conducted a survey in 2001 among members and group leaders of borrowers who accessed loans from two microcredit programs in Eritrea. Using the results from this survey, this paper aims to provide new insights into the empirical relevance of the homogeneous matching hypothesis for microcredit

Risk Behaviour and Group Formation in Microcredit Groups in Eritrea

NARCIS (Netherlands)

Lensink, B.W.; Mehrteab, H.T.

2006-01-01

We conducted a survey in 2001 among members and group leaders of borrowers who accessed loans from two microcredit programs in Eritrea. Using the results from this survey, this paper aims to provide new insights into the empirical relevance of the homogeneous matching hypothesis for microcredit

Relevance and feasibility of Social Life Cycle Assessment from a Company Perspective

DEFF Research Database (Denmark)

Jørgensen, Andreas; Hauschild, Michael Zwicky; Jørgensen, Michael Søgaard

2009-01-01

Methodology development should reflect demands from the intended users: what are the needs of the user group and what is feasible in terms of requirements involving data and work? Mapping these questions of relevance and feasibility is thus a way to facilitate a higher degree of relevance...... of the developed methodology. For the emerging area of social life cycle assessment (SLCA), several different potential user groups may be identified. This article addresses the issues of relevance and feasibility of SLCA from a company perspective through a series of interviews among potential company users....... The empirical basis for the survey is a series of eight semi-structured interviews with larger Danish companies, all of which potentially have the capacity and will to use comprehensive social assessment methodologies. SLCA is not yet a well-defined methodology, but still it is possible to outline several...

DOE Waste Treatability Group Guidance

International Nuclear Information System (INIS)

Kirkpatrick, T.D.

1995-01-01

This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level

DOE Waste Treatability Group Guidance

Energy Technology Data Exchange (ETDEWEB)

Kirkpatrick, T.D.

1995-01-01

This guidance presents a method and definitions for aggregating U.S. Department of Energy (DOE) waste into streams and treatability groups based on characteristic parameters that influence waste management technology needs. Adaptable to all DOE waste types (i.e., radioactive waste, hazardous waste, mixed waste, sanitary waste), the guidance establishes categories and definitions that reflect variations within the radiological, matrix (e.g., bulk physical/chemical form), and regulated contaminant characteristics of DOE waste. Beginning at the waste container level, the guidance presents a logical approach to implementing the characteristic parameter categories as part of the basis for defining waste streams and as the sole basis for assigning streams to treatability groups. Implementation of this guidance at each DOE site will facilitate the development of technically defined, site-specific waste stream data sets to support waste management planning and reporting activities. Consistent implementation at all of the sites will enable aggregation of the site-specific waste stream data sets into comparable national data sets to support these activities at a DOE complex-wide level.

Contrasting lexical similarity and formal definitions in SNOMED CT: consistency and implications.

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Agrawal, Ankur; Elhanan, Gai

2014-02-01

To quantify the presence of and evaluate an approach for detection of inconsistencies in the formal definitions of SNOMED CT (SCT) concepts utilizing a lexical method. Utilizing SCT's Procedure hierarchy, we algorithmically formulated similarity sets: groups of concepts with similar lexical structure of their fully specified name. We formulated five random samples, each with 50 similarity sets, based on the same parameter: number of parents, attributes, groups, all the former as well as a randomly selected control sample. All samples' sets were reviewed for types of formal definition inconsistencies: hierarchical, attribute assignment, attribute target values, groups, and definitional. For the Procedure hierarchy, 2111 similarity sets were formulated, covering 18.1% of eligible concepts. The evaluation revealed that 38 (Control) to 70% (Different relationships) of similarity sets within the samples exhibited significant inconsistencies. The rate of inconsistencies for the sample with different relationships was highly significant compared to Control, as well as the number of attribute assignment and hierarchical inconsistencies within their respective samples. While, at this time of the HITECH initiative, the formal definitions of SCT are only a minor consideration, in the grand scheme of sophisticated, meaningful use of captured clinical data, they are essential. However, significant portion of the concepts in the most semantically complex hierarchy of SCT, the Procedure hierarchy, are modeled inconsistently in a manner that affects their computability. Lexical methods can efficiently identify such inconsistencies and possibly allow for their algorithmic resolution. Copyright © 2013 Elsevier Inc. All rights reserved.

General relation between the group delay and dwell time in multicomponent electron systems

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Zhai, Feng; Lu, Junqiang

2016-10-01

For multicomponent electron scattering states, we derive a general relation between the Wigner group delay and the Bohmian dwell time. It is found that the definition of group delay should account for the phase of the spinor wave functions of propagating modes. The difference between the group delay and dwell time comes from both the interference delay and the decaying modes. For barrier tunneling of helical electrons on a surface of topological insulators, our calculations including the trigonal-warping term show that the decaying modes can contribute greatly to the group delay. The derived relation between the group delay and the dwell time is helpful to unify the two definitions of tunneling time in a quite general situation.

Benefits of peer support groups in the treatment of addiction

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Tracy K

2016-09-01

.Conclusion: Peer support groups included in addiction treatment shows much promise; however, the limited data relevant to this topic diminish the ability to draw definitive conclusions. More rigorous research is needed in this area to further expand on this important line of research. Keywords: behavioral treatment, mentorship, substance use, alcohol, drugs, recovery

Healthcare service quality: towards a broad definition.

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Mosadeghrad, Ali Mohammad

2013-01-01

The main purpose of this study is to define healthcare quality to encompass healthcare stakeholder needs and expectations because healthcare quality has varying definitions for clients, professionals, managers, policy makers and payers. This study represents an exploratory effort to understand healthcare quality in an Iranian context. In-depth individual and focus group interviews were conducted with key healthcare stakeholders. Quality healthcare is defined as "consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient's needs and satisfies providers". Healthcare quality definitions common to all stakeholders involve offering effective care that contributes to the patient well-being and satisfaction. This study helps us to understand quality healthcare, highlighting its complex nature, which has direct implications for healthcare providers who are encouraged to regularly monitor healthcare quality using the attributes identified in this study. Accordingly, they can initiate continuous quality improvement programmes to maintain high patient-satisfaction levels. This is the first time a comprehensive healthcare quality definition has been developed using various healthcare stakeholder perceptions and expectations.

Scrutiny of the ASTRO consensus definition of biochemical failure in irradiated prostate cancer patients demonstrates its usefulness and robustness

International Nuclear Information System (INIS)

Hanlon, Alexandra L.; Hanks, Gerald E.

2000-01-01

Purpose: The goals of this study are: (1) to establish the robustness of the Fox Chase Cancer Center (FCCC) and the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definitions of failure by comparing biochemical estimates under various modifications of the censoring and failure time components to their respective unaltered definitions; (2) to isolate the source of variation between the two definitions of failure; and (3) to describe the hazard of failure over time for each definition. Methods: Between May 1989 and May 1997, 670 men were treated at Fox Chase Cancer Center for localized prostate cancer using three-dimensional conformal radiation therapy (3DCRT). These men were stratified into three groups for analysis: 111 men treated with adjuvant hormones; 204 men treated with radiation therapy alone and presenting with more favorable prognosis tumor characteristics; 255 men treated with radiation therapy alone and presenting with less favorable prognosis tumor characteristics. For each group, biochemical failure was estimated and compared using the FCCC and ASTRO definitions of failure. The robustness of each definition was evaluated by comparing estimates under the definition as stated to those under various modifications of the censoring and failure components. Analyses were also performed while excluding slow-progressing patients. To isolate the source of variation between the two failure definitions, estimates were compared for patients with agreement in failure status. Estimates of biochemical failure, and thus hazard rates, were made using Kaplan-Meier methodology. Results: ASTRO biochemical failure estimates were higher than the FCCC failure estimates in the first 5 years post-treatment. Beyond 5 years, ASTRO estimates level off, while the FCCC failure estimates continued to increase. These failure patterns were similar in all patient groups; however, patients treated with adjuvant hormones had a much higher risk of failure

Prebiotics: Definition and protective mechanisms.

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Valcheva, Rosica; Dieleman, Levinus A

2016-02-01

The increase in chronic metabolic and immunologic disorders in the modern society is linked to major changes in the dietary patterns. These chronic conditions are associated with intestinal microbiota dysbiosis where important groups of carbohydrate fermenting, short-chain fatty acids-producing bacteria are reduced. Dietary prebiotics are defined as a selectively fermented ingredients that result in specific changes in the composition and/or activity of the gastrointestinal microbiota, thus conferring benefit(s) upon host health. Application of prebiotics may then restore the gut microbiota diversity and activity. Unlike the previously accepted prebiotics definition, where a limited number of bacterial species are involved in the prebiotic activity, new data from community-wide microbiome analysis demonstrated a broader affect of the prebiotics on the intestinal microbiota. These new findings require a revision of the current definition. In addition, prebiotics may exert immunomodulatory effects through microbiota-independent mechanisms that will require future investigations involving germ-free animal disease models. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cooling towers - terms and definitions

International Nuclear Information System (INIS)

1991-02-01

In the field of cooling tower construction and operation, the use of publications has shown that a systematic glossary has not yet been developed. Therefore a dictionary of the terms used in this field, together with their clear definitions, is urgently required. This work has been started by the V.I.K. (Association for the Industrial Power Economy) in Essen and completed by the VDI-Group 'Energy Engineering'. Because of the strong international links and the increasing overseas trade in this field also the corresponding terms in other languages, English, French and Spanish are included. As to make it possible to find the German terms and definitions when starting from a foreign language, alphabetical lists are included for the various languages giving the number of the corresponding German term. In such cases where the technical term used in the United States is not identical with the corresponding term used in the United Kingdom, both terms are included. (orig./HP) [de

Effects of definitive and salvage radiotherapy on the distribution of lymphocyte subpopulations in prostate cancer patients

International Nuclear Information System (INIS)

Sage, Eva K.; Gehrmann, Mathias; Sedelmayr, Michael; Schmid, Thomas E.; Combs, Stephanie E.; Multhoff, Gabriele; Geinitz, Hans; Duma, Marciana N.

2017-01-01

Radiotherapy (RT) is an established treatment for patients with primary and recurrent prostate cancer. Herein, the effects of definitive and salvage RT on the composition of lymphocyte subpopulations were investigated in patients with prostate cancer to study potential immune effects. A total of 33 prostate cancer patients were treated with definitive (n = 10) or salvage RT (n = 23) after biochemical relapse. The absolute number of lymphocytes and the distribution of lymphocyte subpopulations were analyzed by multiparameter flow cytometry before RT, at the end of RT, and in the follow-up period. Absolute lymphocyte counts decreased significantly after RT in both patient groups and a significant drop was observed in the percentage of B cells directly after RT from 10.1 ± 1.3 to 6.0 ± 0.7% in patients with definitive RT and from 9.2 ± 0.8 to 5.8 ± 0.7% in patients with salvage RT. In contrast, the percentages of T and natural killer (NK) cells remained unaltered directly after RT in both patient groups. However, 1 year after RT, the percentage of CD3 + T cells was significantly lower in patients with definitive and salvage RT. The percentage of regulatory T cells was slightly upregulated in primary prostate cancer patients after definitive RT, but not after salvage RT. Definitive and salvage RT exert similar effects on the composition of lymphocyte subpopulations in prostate cancer patients. Total lymphocyte counts are lower in both patient groups compared to healthy controls and further decreased after RT. B cells are more sensitive to definitive and salvage RT than T and NK cells. (orig.) [de

An Empirical Exploration, Typology, and Definition of Corporate Sustainability

Directory of Open Access Journals (Sweden)

Manfred Max Bergman

2017-05-01

Full Text Available The relationship between business and society is evolving. On the one hand, social, environmental, and long-term economic issues subsumed under the UN 2030 Agenda for Sustainable Development are inspiring intergovernmental organizations, governments, NGOs, NPOs, foundations, and civic society to legislate and regulate corporate behavior toward a greater concern for the wellbeing of groups, regions, or entire societies. On the other, a growing trend toward protectionism, nationalism, and populism may be the consequence or expression of a dissatisfaction with the perceived dissociation of the private sector from society. As a form of self-regulation, corporate responsibility deals with the complex responsibilities businesses have toward society. However, it tends to be hampered by an emphasis on theology and philosophy-based business ethics, which are difficult to integrate into day-to-day business operations or to translate between national or corporate cultures. In this article, we argue that corporate sustainability could be a more useful concept to help improve on how government, the private sector, and academia understand the links between business and society, and how to translate the interdependence between business and society from one culture to another. For this purpose, we empirically analyzed the relevant academic literature on corporate sustainability, using Content Configuration Analysis. Our analyses revealed three conceptual types and nine subtypes of corporate sustainability. Based on their assessment, we suggest conceptual preferences and a definition of corporate sustainability, which fulfil criteria that may render the concept more useful to global political and socioeconomic negotiations among stakeholder groups for the long-term benefit of business and society.

Implementing the Institute of Medicine definition of disparities: an application to mental health care.

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McGuire, Thomas G; Alegria, Margarita; Cook, Benjamin L; Wells, Kenneth B; Zaslavsky, Alan M

2006-10-01

In a recent report, the Institute of Medicine (IOM) defines a health service disparity between population groups to be the difference in treatment or access not justified by the differences in health status or preferences of the groups. This paper proposes an implementation of this definition, and applies it to disparities in outpatient mental health care. Health Care for Communities (HCC) reinterviewed 9,585 respondents from the Community Tracking Study in 1997-1998, oversampling individuals with psychological distress, alcohol abuse, drug abuse, or mental health treatment. The HCC is designed to make national estimates of service use. Expenditures are modeled using generalized linear models with a log link for quantity and a probit model for any utilization. We adjust for group differences in health status by transforming the entire distribution of health status for minority populations to approximate the white distribution. We compare disparities according to the IOM definition to other methods commonly used to assess health services disparities. Our method finds significant service disparities between whites and both blacks and Latinos. Estimated disparities from this method exceed those for competing approaches, because of the inclusion of effects of mediating factors (such as income) in the IOM approach. A rigorous definition of disparities is needed to monitor progress against disparities and to compare their magnitude across studies. With such a definition, disparities can be estimated by adjusting for group differences in models for expenditures and access to mental health services.

EXTRACELLULAR VESICLES: CLASSIFICATION, FUNCTIONS AND CLINICAL RELEVANCE

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A. V. Oberemko

2014-12-01

Full Text Available This review presents a generalized definition of vesicles as bilayer extracellular organelles of all celular forms of life: not only eu-, but also prokaryotic. The structure and composition of extracellular vesicles, history of research, nomenclature, their impact on life processes in health and disease are discussed. Moreover, vesicles may be useful as clinical instruments for biomarkers, and they are promising as biotechnological drug. However, many questions in this area are still unresolved and need to be addressed in the future. The most interesting from the point of view of practical health care represents a direction to study the effect of exosomes and microvesicles in the development and progression of a particular disease, the possibility of adjusting the pathological process by means of extracellular vesicles of a particular type, acting as an active ingredient. Relevant is the further elucidation of the role and importance of exosomes to the surrounding cells, tissues and organs at the molecular level, the prospects for the use of non-cellular vesicles as biomarkers of disease.

Donor's understanding of the definition of sex as applied to predonation screening questions.

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O'Brien, S F; Ram, S S; Yi, Q-L; Goldman, M

2008-05-01

Predonation screening questions about sexual risk factors should provide an extra layer of safety from recently acquired infections that may be too early to be detected by testing. Donors are required to read a definition of sex as it applies to predonation screening questions each time they come to donate, but how well donors apply such definitions has not been evaluated. We aimed to determine how donors define sex when answering screening questions. In total, 1297 whole blood donors were asked in a private interview to select from a list of sexual activities which ones they believed were being asked about in sexual background questions. Donors' definitions were coded as under-inclusive, correct or over-inclusive in relation to the blood services' definition. Qualitative interviews were carried out with 21 donors to understand reasoning behind definitions. Most donors had an over-inclusive definition (58.7%) or the correct definition (31.9%). Of the 9.4% of donors who had an under-inclusive definition, 95% included both vaginal and anal sex, but not oral sex. About 9% in each group were first-time donors (P > 0.05) who had never read the definition. The qualitative interviews indicated that donors reason their definition based on their own concept of transmissible disease risk. Donors apply a range of definitions of sex when answering questions about their sexual background. This may be due to different concepts of risk activities, and required reading of the definition has little impact.

Definitions of urban areas feasible for examining urban health in the European Union.

Science.gov (United States)

Breckenkamp, Jürgen; Patterson, Lesley; Scharlach, Martina; Hellmeier, Wolfgang; Verma, Arpana

2017-05-01

As part of the EU-funded project, European Urban Health Indicator System (EURO-URHIS), a definition of urban areas (UAs) and of urban populations was needed to be able to identify comparable UAs in all member states. A literature review on existing definitions, as well as those used by other relevant projects, was performed. A survey of national experts in public health or land planning was also conducted. An algorithm was proposed to find UAs, which were feasible for the focus of EURO-URHIS. No unique general definition of UAs was found. Different fields of research define UAs differently. None of the definitions found were feasible for EURO-URHIS. All of them were found to have critical disadvantages when applied to an urban health project. An ideal definition for this type of project needs to provide a description of the situation without recourse to administrative boundaries yet inform the collection of routine data for urban health monitoring. These requirements were found to contradict each other and were not met in any existing definition. An algorithm was developed for the definition of UAs for the purpose of this study whereby national experts would select regions which are urban as an agglomeration or as a metropolitan area and which are potentially interesting in terms of public health; identify the natural boundaries, where countryside ends and residential or commercial areas of the region begin (e.g. by aerial photos); identify local government boundaries or other official boundaries used for routine data collection purposes which approximate the natural UA as closely as possible and list all administrative areas which are contained in the larger UA. The aggregation of all administrative areas within the original region formed the UA which was used in the project. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Region-Based Image Retrieval Using an Object Ontology and Relevance Feedback

Directory of Open Access Journals (Sweden)

Kompatsiaris Ioannis

2004-01-01

Full Text Available An image retrieval methodology suited for search in large collections of heterogeneous images is presented. The proposed approach employs a fully unsupervised segmentation algorithm to divide images into regions and endow the indexing and retrieval system with content-based functionalities. Low-level descriptors for the color, position, size, and shape of each region are subsequently extracted. These arithmetic descriptors are automatically associated with appropriate qualitative intermediate-level descriptors, which form a simple vocabulary termed object ontology. The object ontology is used to allow the qualitative definition of the high-level concepts the user queries for (semantic objects, each represented by a keyword and their relations in a human-centered fashion. When querying for a specific semantic object (or objects, the intermediate-level descriptor values associated with both the semantic object and all image regions in the collection are initially compared, resulting in the rejection of most image regions as irrelevant. Following that, a relevance feedback mechanism, based on support vector machines and using the low-level descriptors, is invoked to rank the remaining potentially relevant image regions and produce the final query results. Experimental results and comparisons demonstrate, in practice, the effectiveness of our approach.

Use of Indirect Calorimetry to Detect Overfeeding in Critically Ill Children: Finding the Appropriate Definition.

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Kerklaan, Dorian; Hulst, Jessie M; Verhoeven, Jennifer J; Verbruggen, Sascha C A T; Joosten, Koen F M

2016-10-01

Overfeeding during critical illness is associated with adverse effects such as metabolic disturbances and increased risk of infection. Because of the lack of sound studies with clinical endpoints, overfeeding is arbitrarily defined as the ratio caloric intake/measured resting energy expenditure (mREE) or alternatively as a comparison of measured respiratory quotient (RQ) to the predicted RQ based on the macronutrient intake (RQmacr). We aimed to compare definitions of overfeeding in critically ill mechanically ventilated children based on mREE, RQ, and caloric intake to find an appropriate definition. Indirect calorimetry measurements were performed in 78 mechanically ventilated children, median age 6.3 months. Enteral and/or parenteral nutrition was provided according to the local guidelines. Definitions used to indicate overfeeding were the ratio caloric intake/mREE of >110% and >120% and by the measured RQ > RQmacr + 0.05. The proportion of patients identified as overfed varied widely depending on the definition used, ranging from 22% (RQ > RQmacr + 0.05), to 40% and 50% (caloric intake/mREE of >120% and >110%, respectively). Linear regression analysis showed that all patients would be identified as overfed with the definition RQ > RQmacr + 0.05 when the ratio caloric intake/mREE exceeded 165%. Caloric intake was higher in children with a standard deviation-score weight for age definition applied. These currently used definitions fail to take into account several relevant factors affecting metabolism during critical illness and are therefore not generally applicable to the pediatric intensive care unit population.

Review and comparison of content growth in word definition of Persian speaking children with 4.5 to 7.5 years of age

Directory of Open Access Journals (Sweden)

Maryam Malekian

2014-10-01

Full Text Available Background and Aim: Word definition is one of the complicated language skills that require education and linguistic awareness. In this study , comparison was made in word definition ability of children between ages of 4.5 to 7.5 years.Methods: This study was cross-sectional and descriptive-analytical in nature . Participants included 107 girls and boys who where in age group 1 (54-65 months, age group 2 (66-77 months, and age group 3 (78-90 months. They were selected by multistage sampling method and recruited from nurseries and primary schools in 1, 7, and 17 municipal districts of Tehran . Word definition task was performed on each subject. The reliability was assessed by two independent values and the validity was determined by the content. Kruskal- Wallis and Mann-Whitney U statistical methods were used for analysis.Results: Mean score of the content in word definition was significantly increased by age (p=0.001. In the second and third age groups there was no significant difference in the content of word definition. The most response that used in all ages was the functional response. With increasing age, error rate (p=0.002 and identical (p=0.003 responses significantly decreased; however, percentage use of combination II (p<0.001 responses significantly increased.Conclusion: By increasing age, quality of definitions in terms of content is improved and definitions change from functional and concrete responses to c ombination II definitions.

Relevance of plastic limit loads to reference stress approach for surface cracked cylinder problems

International Nuclear Information System (INIS)

Kim, Yun-Jae; Shim, Do-Jun

2005-01-01

To investigate the relevance of the definition of the reference stress to estimate J and C* for surface crack problems, this paper compares finite element (FE) J and C* results for surface cracked pipes with those estimated according to the reference stress approach using various definitions of the reference stress. Pipes with part circumferential inner surface cracks and finite internal axial cracks are considered, subject to internal pressure and global bending. The crack depth and aspect ratio are systematically varied. The reference stress is defined in four different ways using (i) a local limit load (ii), a global limit load, (iii) a global limit load determined from the FE limit analysis, and (iv) the optimised reference load. It is found that the reference stress based on a local limit load gives overall excessively conservative estimates of J and C*. Use of a global limit load clearly reduces the conservatism, compared to that of a local limit load, although it can sometimes provide non-conservative estimates of J and C*. The use of the FE global limit load gives overall non-conservative estimates of J and C*. The reference stress based on the optimised reference load gives overall accurate estimates of J and C*, compared to other definitions of the reference stress. Based on the present findings, general guidance on the choice of the reference stress for surface crack problems is given

Treatment for cancer in the cervical esophagus. Surgery versus definitive chemoradiotherapy

International Nuclear Information System (INIS)

Umeno, Hirohito; Fujita, Hiromasa; Inoue, Youjirou

2012-01-01

Eighty-two patients with cervical esophageal cancer were treated by definitive chemoradiotherapy (10 patients) or surgery (72 patients) between 1989 and 2009 at the Kurume University Hospital. The 3-year overall survival rate after surgery was 51% and that after definitive chemoradiotherapy was 44%, showing no significant difference between the two groups. The 3-year local control rate after surgery was significantly better than that after definitive chemoradiotherapy. The overall 5-year survival rate of patients requiring a mediastinal tracheostomy was 11%, while that of those without a mediastinal tracheostomy was 39%. There was no significant difference between the two groups. The commencement of oral intake took a long time after treatment in patients with a T4 tumor who underwent chemoradiotherapy and who had vocal fold paralysis. Almost all patients who underwent esophageal reconstruction using the alimentary tract after pharyngolaryngoesophagectomy could take food within two weeks after surgery. On the other hand, in patients with vocal cord paralysis after cervical esophagectomy without laryngectomy, several months were needed after surgery to take food orally. (author)

Speaking the same language: underestimating financial impact when using diagnosis-related group versus ICD-9-based definitions for trauma inclusion criteria.

Science.gov (United States)

Deppe, Sharon; Truax, Christopher B; Opalek, Judy M; Santanello, Steven A

2009-04-01

Hospital accounting methods use diagnosis-related group (DRG) data to identify patients and derive financial analyses and reports. The National Trauma Data Bank and trauma programs identify patients with trauma by International Classification of Diseases, Ninth Edition (ICD-9)-based definitions for inclusion criteria. These differing methods of identifying patients result in economic reports that vary significantly and fail to accurately identify the financial impact of trauma services. Routine financial data were collected for patients admitted to our Trauma Service from July 1, 2005 to June 30, 2006 using two methods of identifying the cases; by trauma DRGs and by trauma registry database inclusion criteria. The resulting data were compared and stratified to define the financial impact on hospital charges, reimbursement, costs, contribution to margin, downstream revenue, and estimated profit or loss. The results also defined the impact on supporting services, market share and total revenue from trauma admissions, return visits, discharged trauma alerts, and consultations. A total of 3,070 patients were identified by the trauma registry as meeting ICD-9 inclusion criteria. Trauma-associated DRGs accounted for 871 of the 3,070 admissions. The DRG-driven data set demonstrated an estimated profit of $800,000 dollars; the ICD-9 data set revealed an estimated 4.8 million dollar profit, increased our market share, and showed substantial revenue generated for other hospital service lines. Trauma DRGs fail to account for most trauma admissions. Financial data derived from DRG definitions significantly underestimate the trauma service line's financial contribution to hospital economics. Accurately identifying patients with trauma based on trauma database inclusion criteria better defines the business of trauma.

Exploring Use of Self: Moving beyond Definitional Challenges

Science.gov (United States)

Liechty, Jeanne

2018-01-01

"Use of self" is a central concept throughout social work history and theory, yet no unified definition and little empirical research exist. Thus, a qualitative exploration was required. Three focus groups (n = 10) were conducted with experienced BSW educators. Participants defined use of self in the context of their students' beginning…

The definite article in Romance expletives and long weak definites

Directory of Open Access Journals (Sweden)

M.Teresa Espinal

2017-03-01

Full Text Available This paper focuses on some issues involving expletive articles and long weak definites in Romance (mainly Spanish, Brazilian Portuguese and Catalan, in comparison to DPs that elicit a strong reading. We show the similarities between expletive definites and long weak definites, and we argue for an analysis in common to other polarity items in terms of polarity sensitivity. We reach the conclusion that the definite article in Romance comes in two variants: the referentially unique variant (to be translated as the semantic 'iota 'operator and the polar variant, formally characterized with an abstract [+σ] feature, that encodes a weak bound reading (to be semantically translated by an existential operator.

Validating a pragmatic definition of shock in adult patients presenting to the ED.

Science.gov (United States)

Li, Yan-ling; Chan, Cangel Pui-yee; Sin, King-keung; Chan, Stewart S W; Lin, Pei-yi; Chen, Xiao-hui; Smith, Brendan E; Joynt, Gavin M; Graham, Colin A; Rainer, Timothy H

2014-11-01

The importance of the early recognition of shock in patients presenting to emergency departments is well recognized, but at present, there is no agreed practical definition for undifferentiated shock. The main aim of this study was to validate an a priori clinical definition of shock against 28-day mortality. This prospective, observational, cross-sectional, single-center study was conducted in Hong Kong, China. Data were collected between July 1, 2012, and January 31, 2013. An a priori definition of shock was designed, whereby patients admitted to the resuscitation room or high dependency area of the emergency department were divided into 1 of 3 groups-no shock, possible shock, and shock. The primary outcome was 28-day mortality. Secondary outcomes were in-hospital mortality or admission to the intensive or coronary care unit. A total of 111 patients (mean age, 67.2 ± 17.1 years; male = 69 [62%]) were recruited, of which 22 were classified as no shock, 54 as possible shock, and 35 as shock. Systolic blood pressure, mean arterial pressure, lactate, and base deficit correlated well with shock classifications (P definition of undifferentiated shock has been proposed and validated in a group of patients presenting to an emergency department in Hong Kong. This definition needs further validation in a larger population and other settings. Copyright © 2014 Elsevier Inc. All rights reserved.

A comparison of standard definitions and sagittal abdominal ...

Science.gov (United States)

Introduction: Metabolic syndrome (MeTS) is the cluster of several clinical symptoms that together represent the strongest risk factor for cardiovascular disease. The prevalence of MeTS in adolescents is difficult to estimate given that there are several, but no agreed upon definition of MeTS for this age group. It is important to estimate MeTS and identify at-risk adolescents early in order to provide effective interventions prior to the development of diabetes and coronary heart disease. Objective: Study objectives are to: (1) estimate the prevalence of MeTS in U.S. adolescents using three widely adopted definitions and (2) compare changes in prevalence of MeTS when utilizing sagittal abdominal diameter (SAD) as a component of MeTS. Methods: Data from U.S. adolescents ages 12–19 years (N=970) in the NHANES (2011–2014) were analyzed. MeTS standard definitions developed by Cook et al. (2003), deFerranti et al. (2007), and the International Disease Federation (IDF, 2007) were applied to estimate the sex-stratified, weighted prevalence of MeTS and its individual components (i.e., high waist circumference (WC), hypertension, blood lipid abnormalities, and high fasting blood glucose (FBG)). The definitions were modified by substituting SAD for WC, and weighted MeTS prevalence was re-estimated. Results: Regardless of gender and definition, abnormal blood lipids and high WC were the most prevalent MeTS components. For both sexes, estimated prevalence of componen

Leukosis/Sarcoma Group

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The leukosis/sarcoma (L/S) group of diseases designates a variety of transmissible benign and malignant neoplasms of chickens caused by members that belong to the family Retroviridae. Because the expansion of the literature on this disease, it is no longer feasible to cite all relevant publications ...

Cachexia in cancer: what is in the definition?

Science.gov (United States)

Vanhoutte, Greetje; van de Wiel, Mick; Wouters, Kristin; Sels, Michaël; Bartolomeeussen, Linda; De Keersmaecker, Sven; Verschueren, Caroline; De Vroey, Veronique; De Wilde, Annemieke; Smits, Elke; Cheung, Kin Jip; De Clerck, Liesbeth; Aerts, Petra; Baert, Didier; Vandoninck, Caroline; Kindt, Sofie; Schelfhaut, Sofie; Vankerkhoven, Marc; Troch, Annelies; Ceulemans, Lore; Vandenbergh, Hanne; Leys, Sven; Rondou, Tim; Dewitte, Elke; Maes, Kristel; Pauwels, Patrick; De Winter, Benedicte; Van Gaal, Luc; Ysebaert, Dirk; Peeters, Marc

2016-01-01

This study aimed to provide evidence-based results on differences in overall survival (OS) rate to guide the diagnosis of cancer cachexia. Data collection and clinical assessment was performed every 3 months (5 visits): baseline data, muscle strength, nutritional and psychosocial status. 2 definitions on cachexia using different diagnostic criteria were applied for the same patient population. Fearon et al 's definition is based on weight loss, body mass index (BMI) and sarcopenia. Evans et al nuances the contribution of sarcopenia and attaches additional attention to abnormal biochemistry parameters, fatigue and anorexia. The mean OS rates were compared between patients with and without cachexia for both definitions. Based on the population of 167 patients who enrolled, 70% developed cachexia according to Fearon et al 's definition and 40% according to Evans et al 's definition. The OS in the cachectic population is 0.97 and 0.55 years, respectively. The difference in OS between patients with and without cachexia is more significant using the diagnostic criteria of Evans et al . The focus of Fearon et al on weight loss and sarcopenia over-rates the assignment of patients to the cachectic group and OS rates have less prognostic value. This study presents a correlation with prognosis in favour of Evans et al ' definition as a tool for cachexia diagnosis. This means that weight loss and BMI decline are both key factors in patients with cancer leading to cachexia but less decisive as stated by Fearon et al . Instead, extra factors gain importance in order to predict survival, such as chronic inflammation, anaemia, protein depletion, reduced food intake, fatigue, decreased muscle strength and lean tissue depletion. B300201112334.

But Some Groups Are More Equal Than Others

DEFF Research Database (Denmark)

Thomsen, Frej Klem

2013-01-01

In this article I critically examine a standard feature in conceptions of discrimination: the group-criterion, specifically the idea that there is a limited and definablegroup of traits that can form the basis of discrimination. I review two types of argument for the criterion. One focuses...... on inherently relevant groups and relies ultimately on luck-egalitarian principles; the other focuses on contextually relevant groups and relies ultimately on the badness of outcomes. I conclude that as neither type of argument is convincing, the criterion is morally arbitrary, and as such untenable. Finally, I...

Systems resilience for multihazard environments: definition, metrics, and valuation for decision making.

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Ayyub, Bilal M

2014-02-01

The United Nations Office for Disaster Risk Reduction reported that the 2011 natural disasters, including the earthquake and tsunami that struck Japan, resulted in $366 billion in direct damages and 29,782 fatalities worldwide. Storms and floods accounted for up to 70% of the 302 natural disasters worldwide in 2011, with earthquakes producing the greatest number of fatalities. Average annual losses in the United States amount to about $55 billion. Enhancing community and system resilience could lead to massive savings through risk reduction and expeditious recovery. The rational management of such reduction and recovery is facilitated by an appropriate definition of resilience and associated metrics. In this article, a resilience definition is provided that meets a set of requirements with clear relationships to the metrics of the relevant abstract notions of reliability and risk. Those metrics also meet logically consistent requirements drawn from measure theory, and provide a sound basis for the development of effective decision-making tools for multihazard environments. Improving the resiliency of a system to meet target levels requires the examination of system enhancement alternatives in economic terms, within a decision-making framework. Relevant decision analysis methods would typically require the examination of resilience based on its valuation by society at large. The article provides methods for valuation and benefit-cost analysis based on concepts from risk analysis and management. © 2013 Society for Risk Analysis.

D-branes, orbifolds, and Ext groups

International Nuclear Information System (INIS)

Katz, Sheldon; Pantev, Tony; Sharpe, Eric

2003-01-01

In this note we extend previous work on massless Ramond spectra of open strings connecting D-branes wrapped on complex manifolds, to consider D-branes wrapped on smooth complex orbifolds. Using standard methods, we calculate the massless boundary Ramond sector spectra directly in BCFT, and find that the states in the spectrum are counted by Ext groups on quotient stacks (which provide a notion of homological algebra relevant for orbifolds). Subtleties that cropped up in our previous work also appear here. We also use the McKay correspondence to relate Ext groups on quotient stacks to Ext groups on (large radius) resolutions of the quotients. As stacks are not commonly used in the physics community, we include pedagogical discussions of some basic relevant properties of stacks

Goal Definition

DEFF Research Database (Denmark)

Bjørn, Anders; Laurent, Alexis; Owsianiak, Mikołaj

2018-01-01

The goal definition is the first phase of an LCA and determines the purpose of a study in detail. This chapter teaches how to perform the six aspects of a goal definition: (1) Intended applications of the results, (2) Limitations due to methodological choices, (3) Decision context and reasons...... for carrying out the study, (4) Target audience , (5) Comparative studies to be disclosed to the public and (6) Commissioner of the study and other influential actors. The instructions address both the conduct and reporting of a goal definition and are largely based on the ILCD guidance document (EC...

Nanostructure symmetry: Relevance for physics and computing

International Nuclear Information System (INIS)

Dupertuis, Marc-André; Oberli, D. Y.; Karlsson, K. F.; Dalessi, S.; Gallinet, B.; Svendsen, G.

2014-01-01

We review the research done in recent years in our group on the effects of nanostructure symmetry, and outline its relevance both for nanostructure physics and for computations of their electronic and optical properties. The exemples of C3v and C2v quantum dots are used. A number of surprises and non-trivial aspects are outlined, and a few symmetry-based tools for computing and analysis are shortly presented

Nanostructure symmetry: Relevance for physics and computing

Energy Technology Data Exchange (ETDEWEB)

Dupertuis, Marc-André; Oberli, D. Y. [Laboratory for Physics of Nanostructure, EPF Lausanne (Switzerland); Karlsson, K. F. [Department of Physics, Chemistry, and Biology (IFM), Linköping University (Sweden); Dalessi, S. [Computational Biology Group, Department of Medical Genetics, University of Lausanne (Switzerland); Gallinet, B. [Nanophotonics and Metrology Laboratory, EPF Lausanne (Switzerland); Svendsen, G. [Dept. of Electronics and Telecom., Norwegian University of Science and Technology, Trondheim (Norway)

2014-03-31

We review the research done in recent years in our group on the effects of nanostructure symmetry, and outline its relevance both for nanostructure physics and for computations of their electronic and optical properties. The exemples of C3v and C2v quantum dots are used. A number of surprises and non-trivial aspects are outlined, and a few symmetry-based tools for computing and analysis are shortly presented.

16 CFR 316.2 - Definitions.

Science.gov (United States)

2010-01-01

... or general partnership, corporation, or other business entity. (i) The definition of the term... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Definitions. 316.2 Section 316.2 Commercial... Definitions. (a) The definition of the term “affirmative consent” is the same as the definition of that term...

Goal setting in psychotherapy: the relevance of approach and avoidance goals for treatment outcome.

Science.gov (United States)

Wollburg, Eileen; Braukhaus, Christoph

2010-07-01

The present study is the first aimed at investigating the influence of goal definition on treatment outcome in a sample of depressed patients. Data from 657 inpatients admitted to a psychosomatic clinic in Germany being treated in a cognitive-behavioral therapy program were analyzed. Treatment goals were identified as either approach or avoidance, and the sample was classified accordingly. Patients who identified approach goals only were placed in the approach group, and those who identified at least one avoidance goal were placed in the avoidance group. Results showed that framing goals using avoidance terms was associated with less symptomatic improvement but did not affect goal attainment. Findings from this research should be utilized in practice not only for process management such as individual treatment planning but also to control outcome quality. Furthermore, goal definition should be considered as a control variable in research on depression.

Genomic analysis of NAC transcription factors in banana (Musa acuminata) and definition of NAC orthologous groups for monocots and dicots.

Science.gov (United States)

Cenci, Albero; Guignon, Valentin; Roux, Nicolas; Rouard, Mathieu

2014-05-01

Identifying the molecular mechanisms underlying tolerance to abiotic stresses is important in crop breeding. A comprehensive understanding of the gene families associated with drought tolerance is therefore highly relevant. NAC transcription factors form a large plant-specific gene family involved in the regulation of tissue development and responses to biotic and abiotic stresses. The main goal of this study was to set up a framework of orthologous groups determined by an expert sequence comparison of NAC genes from both monocots and dicots. In order to clarify the orthologous relationships among NAC genes of different species, we performed an in-depth comparative study of four divergent taxa, in dicots and monocots, whose genomes have already been completely sequenced: Arabidopsis thaliana, Vitis vinifera, Musa acuminata and Oryza sativa. Due to independent evolution, NAC copy number is highly variable in these plant genomes. Based on an expert NAC sequence comparison, we propose forty orthologous groups of NAC sequences that were probably derived from an ancestor gene present in the most recent common ancestor of dicots and monocots. These orthologous groups provide a curated resource for large-scale protein sequence annotation of NAC transcription factors. The established orthology relationships also provide a useful reference for NAC function studies in newly sequenced genomes such as M. acuminata and other plant species.

Facilitating Group Decision-Making: Facilitator's Subjective Theories on Group Coordination

Directory of Open Access Journals (Sweden)

Michaela Kolbe

2008-10-01

Full Text Available A key feature of group facilitation is motivating and coordinating people to perform their joint work. This paper focuses on group coordination which is a prerequisite to group effectiveness, especially in complex tasks. Decision-making in groups is a complex task that consequently needs to be coordinated by explicit rather than implicit coordination mechanisms. Based on the embedded definition that explicit coordination does not just happen but is purposely executed by individuals, we argue that individual coordination intentions and mechanisms should be taken into account. Thus far, the subjective perspective of coordination has been neglected in coordination theory, which is understandable given the difficulties in defining and measuring subjective aspects of group facilitation. We therefore conducted focused interviews with eight experts who either worked as senior managers or as experienced group facilitators and analysed their approaches to group coordination using methods of content analysis. Results show that these experts possess sophisticated mental representations of their coordination behaviour. These subjective coordination theories can be organised in terms of coordination schemes in which coordination-releasing situations are facilitated by special coordination mechanisms that, in turn, lead to the perception of specific consequences. We discuss the importance of these subjective coordination theories for effectively facilitating group decision-making and minimising process losses. URN: urn:nbn:de:0114-fqs0901287

Musculoskeletal ultrasound including definitions for ultrasonographic pathology

DEFF Research Database (Denmark)

Wakefield, RJ; Balint, PV; Szkudlarek, Marcin

2005-01-01

Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joints...... in a short period of time. However, there are scarce data regarding its validity, reproducibility, and responsiveness to change, making interpretation and comparison of studies difficult. In particular, there are limited data describing standardized scanning methodology and standardized definitions of US...... pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis....

Women, money, and psychodynamic group psychotherapy.

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Motherwell, Lise

2002-01-01

Developmental concerns and sociocultural expectations may keep female patients and therapists from addressing financial issues openly in group psychotherapy. Interpersonal theory provides a different view of nurturing that may help women leaders deal better with financial discussions in group. This paper includes a review of the literature on group psychotherapy and fees; feminist literature relevant to leadership; money management in group therapy; countertransference; and case examples.

Postoperative versus definitive chemoradiation in early-stage anal cancer. Results of a matched-pair analysis

Energy Technology Data Exchange (ETDEWEB)

Berger, B.; Menzel, M.; Bamberg, M.; Weinmann, M. [Tuebingen Univ. (Germany). Dept. of Radiation Oncology; Breucha, G. [Kreiskrankenhaus Hechingen, Tuebingen Univ. (Germany). Dept. of Surgery

2012-07-15

Background and purpose: The goal of the present study was to comparatively assess the results of definitive chemoradiation (CRT) with or without previous macroscopically complete resection in patients with early-stage node-negative (T1-2 N0) anal carcinoma. Patients and methods: A total of 20 patients with T1-2 N0 anal carcinoma who received radiotherapy (RT) with or without chemotherapy following incidental R0/1 tumor resection (S/CRT group) were selected. These were matched to 20 comparable patients who underwent definitive chemoradiation without previous surgery (CRT group). Major objectives of this analysis were treatment outcomes in terms of locoregional tumor control (LRC), overall survival (OS), colostomy-free survival, and toxicity. Results: Patients treated postoperatively received significantly lower RT doses (median 54.0 Gy vs. 59.7 Gy; p < 0.001) and less frequently concomitant chemotherapy than those treated definitely. The 5-year LRC and 5-year OS rates were 97.5% and 90.0%, respectively, without significant differences between the S/CRT and the CRT groups. The distribution of acute and late toxicities was comparable, and the 5-year colostomy-free survival was 95% in both groups. Conclusion: This matched-pair comparison of incidental R0/1 resection plus dose-reduced CRT with standard definitive CRT of early-stage anal cancer shows similar treatment results. Thus, dose-reduced RT with or without chemotherapy may be considered in R0/1 resected patients with T1-2 N0 anal carcinoma. (orig.)

Alternative Definitions of Hispanics: Consequences in a Alcohol Survey.

Science.gov (United States)

Caetano, Raul

1986-01-01

Examines impact of different definitions of Hispanic ethnicity on sociodemographic characteristics, drinking patterns, and rate of alcohol problems among 1,453 Hispanic-American respondents. Defines Hispanic ethnicity by ethnicity of family of origin, national group, country most ancestors came from, and birthplace. Finds major differences between…

A Development of Group Decision Support System for Strategic Item Classification using Analytic Hierarchy Process

International Nuclear Information System (INIS)

Yoon, Sung Ho; Tae, Jae Woong; Yang, Seung Hyo; Shin, Dong Hoon

2016-01-01

Korea has carried out export controls on nuclear items that reflect the Nuclear Suppliers Group (NSG) guidelines (Notice on Trade of Strategic Item of Foreign Trade Act) since joining the NSG in 1995. Nuclear export control starts with classifications that determine whether export items are relevant to nuclear proliferation or not according to NSG guidelines. However, due to qualitative characteristics of nuclear item definition in the guidelines, classification spends a lot of time and effort to make a consensus. The aim of this study is to provide an analysis of an experts' group decision support system (GDSS) based on an analytic hierarchy process (AHP) for the classification of strategic items. The results of this study clearly demonstrated that a GDSS based on an AHP proved positive, systematically providing relative weight among the planning variables and objectives. By using an AHP we can quantify the subjective judgements of reviewers. An order of priority is derived from a numerical value. The verbal and fuzzy measurement of an AHP enables us reach a consensus among reviewers in a GDSS. An AHP sets common weight factors which are a priority of each attribute that represent the views of an entire group. It makes a consistency in decision-making that is important for classification

A Development of Group Decision Support System for Strategic Item Classification using Analytic Hierarchy Process

Energy Technology Data Exchange (ETDEWEB)

Yoon, Sung Ho; Tae, Jae Woong; Yang, Seung Hyo; Shin, Dong Hoon [Korea Institute of Nuclear Nonproliferation and Control, Daejeon (Korea, Republic of)

2016-05-15

Korea has carried out export controls on nuclear items that reflect the Nuclear Suppliers Group (NSG) guidelines (Notice on Trade of Strategic Item of Foreign Trade Act) since joining the NSG in 1995. Nuclear export control starts with classifications that determine whether export items are relevant to nuclear proliferation or not according to NSG guidelines. However, due to qualitative characteristics of nuclear item definition in the guidelines, classification spends a lot of time and effort to make a consensus. The aim of this study is to provide an analysis of an experts' group decision support system (GDSS) based on an analytic hierarchy process (AHP) for the classification of strategic items. The results of this study clearly demonstrated that a GDSS based on an AHP proved positive, systematically providing relative weight among the planning variables and objectives. By using an AHP we can quantify the subjective judgements of reviewers. An order of priority is derived from a numerical value. The verbal and fuzzy measurement of an AHP enables us reach a consensus among reviewers in a GDSS. An AHP sets common weight factors which are a priority of each attribute that represent the views of an entire group. It makes a consistency in decision-making that is important for classification.

Comparison of Prevalence and Outcomes of Pediatric Acute Respiratory Distress Syndrome Using Pediatric Acute Lung Injury Consensus Conference Criteria and Berlin Definition.

Science.gov (United States)

Gupta, Samriti; Sankar, Jhuma; Lodha, Rakesh; Kabra, Sushil K

2018-01-01

Our objective was to compare the prevalence and outcomes of pediatric acute respiratory distress syndrome using the Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria and Berlin definitions. We screened case records of all children aged 1 month to 17 years of age admitted to the Pediatric Intensive Care Unit (PICU) over a 3-year period (2015-2017) for presence of any respiratory difficulty at admission or during PICU stay. We applied both PALICC and Berlin criteria to these patients. Data collection included definition and outcome related variables. Data were compared between the "PALICC only group" and the "Berlin with or without PALICC" group using Stata 11. Of a total of 615 admissions, 246 were identified as having respiratory difficulty at admission or during PICU stay. A total of 61 children (prevalence 9.9%; 95% CI: 7.8-12.4) fulfilled the definition of acute respiratory distress syndrome (ARDS) with either of the two criteria. While 60 children (98%) fulfilled PALICC criteria, only 26 children (43%) fulfilled Berlin definition. There was moderate agreement between the two definitions (Kappa: 0.51; 95% CI: 0.40-0.62; observed agreement 85%). Greater proportion of patients had severe ARDS in the "Berlin with or without PALICC group" as compared to the "PALICC only" group (50 vs. 19%). There was no difference between the groups with regard to key clinical outcomes such as duration of ventilation (7 vs. 8 days) or mortality [51.4 vs. 57.7%: RR (95% CI): 0.99 (0.64-1.5)]. In comparison to Berlin definition, the PALICC criteria identified more number of patients with ARDS. Proportion with severe ARDS and complications was greater in the "Berlin with or without PALICC" group as compared to the "PALICC only" group. There were no differences in clinical outcomes between the groups.

Life is hard: countering definitional pessimism concerning the definition of life

Science.gov (United States)

Smith, Kelly C.

2016-10-01

Cleland and Chyba published a classic piece in 2002 that began a movement I call definitional pessimism, where it is argued that there is no point in attempting anything like a general definition of life. This paper offers a critical response to the pessimist position in general and the influential arguments offered by Cleland and her collaborators in particular. One such argument is that all definitions of life fall short of an ideal in which necessary and sufficient conditions produce unambiguous categorizations that dispose of all counterexamples. But this concept of definition is controversial within philosophy; a fact that greatly diminishes the force of the admonition that biologists should conform to such an ideal. Moreover, biology may well be fundamentally different from logic and the physical sciences from which this ideal is drawn, to the point where definitional conformity misrepresents biological reality. Another idea often pushed is that the prospects for definitional success concerning life are on a par with medieval alchemy's attempts to define matter - that is, doomed to fail for lack of a unifying scientific theory. But this comparison to alchemy is both historically inaccurate and unfair. Planetary science before the discovery of the first exoplanets offers a much better analogy, with much more optimistic conclusions. The pessimists also make much of the desirability of using microbes as models for any universal concept of life, from which they conclude that certain types of 'Darwinian' evolutionary definitions are inadequate. But this argument posits an unrealistic ideal, as no account of life can both be universal and do justice to the sorts of precise causal mechanisms microbes exemplify. The character of biology and the demand for universality in definitions of life thus probably accords better with functional rather than structural categories. The bottom line is that there is simply no viable alternative, either pragmatically or

Micro worlds versus boundary objects in group model building; evidence from the literature on problem definition and model conceptulization

Energy Technology Data Exchange (ETDEWEB)

Zagonel, Aldo A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States). Systems Engineering & Analysis; Andersen, David F. [University in Albany, NY (United States). The Rockefeller College of Public Affairs & Policy

2007-03-01

Based upon participant observation in group model building and content analysis of the system dynamics literature, we postulate that modeling efforts have a dual nature. On one hand, the modeling process aims to create a useful representation of a real-world system. This must be done, however, while aligning the clients’ mental models around a shared view of the system. There is significant overlap and confusion between these two goals and how they play out on a practical level. This research clarifies these distinctions by establishing an ideal-type dichotomy. To highlight the differences, we created two straw men: “micro world” characterizes a model that represents reality and “boundary object” represents a socially negotiated model. Using this framework, the literature was examined, revealing evidence for several competing views on problem definition and model conceptualization. The results are summarized in the text of this article, substantiated with strikingly polarized citations, often from the same authors. We also introduce hypotheses for the duality across the remaining phases of the modeling process. Finally, understanding and appreciation of the differences between these ideal types can promote constructive debate on their balance in system dynamics theory and practice.

The relation of metabolic syndrome according to five definitions to cardiovascular risk factors - a population-based study

Directory of Open Access Journals (Sweden)

Lai Ming-May

2009-12-01

Full Text Available Abstract Background Although National Cholesterol Education Program (NCEP, International Diabetes Federation (IDF, American Heart Association and National Heart, Lung and Blood Institute (AHA/NHLBI, World Health Organization (WHO, and the European Group for the Study of Insulin Resistance (EGIR definitions of metabolic syndrome (MetS have been commonly used by studies, little is known about agreement among these five definitions. We examined the agreement among these five definitions and explored their relationship with risk factors of cardiovascular disease in a Taiwan population. Methods A total of 1305 subjects aged 40 years and over in Taiwan were analyzed. Biomedical markers and anthropometric indices were measured. Agreement among definitions was determined by the kappa statistic. Logistic regression models were fit to estimate the odds of a high cardiovascular risk group for five definitions of MetS. Results The agreement among the NCEP, IDF, and AHA/NHLBI definitions was from substantial to very good, and agreement between the WHO and EGIR definitions was also substantial. All MetS definitions were significantly associated prevalence of microalbuminuria, elevated highly sensitive CRP (hs-CRP, and arterial stiffness only in women. In men, MetS by NCEP and AHA/NHLBI was associated with elevated level of hs-CRP and arterial stiffness. MetS by WHO and EGIR were significantly associated with microalbuminuria. And MetS by WHO was the only MetS definition that significantly associated with prevalence of arterial stiffness (OR: 2.75, 95% CI: 1.22-6.19. Conclusions The associations of these five definitions with cardiovascular risk factors were similar in women, and it was evident that the five definitions performed better in women than in men, with higher ORs observed in relation to arterial stiffness, elevated hs-CRP, and higher Framingham risk scores.

Probiotics: definition, scope and mechanisms of action.

Science.gov (United States)

Reid, Gregor

2016-02-01

For a subject area of science, medicine and commerce to be so recently defined and investigated, few can compare to probiotics for the controversy they have incited. Barely a paper is published without the use of a different definition, or challenging the most used one, or proposing a different nuance of it. The situation has become even more surreal with the European Food and Safety Authority banning the word probiotic for use on labels. The reiteration of the FAO/WHO definition by the world's leading group of probiotic experts, should provide relative consistency in the near future, but what are the causes of these aberrations? This review will discuss the rationale for the definition, and the scope of the subject area and why alternatives emerge. While mechanisms of action are not widely proven, in vitro and some in vivo experiments support several. Ultimately, the goal of any field or product is to be understood by lay people and experts alike. Probiotics have come a long way in 100 years since Metchnikoff and 10 years since their globalization, but their evolution is far from over. Copyright © 2015 Elsevier Ltd. All rights reserved.

Group-level self-definition and self-investment : A hierarchical (multicomponent) model of in-group identification

NARCIS (Netherlands)

Leach, Colin Wayne; van Zomeren, Martijn; Zebel, Sven; Vliek, Michael L. W.; Pennekamp, Sjoerd F.; Doosje, Bertjan; Ouwerkerk, Jaap W.; Spears, Russell

Recent research shows individuals' identification with in-groups to be psychologically important and socially consequential. However, there is little agreement about how identification should be conceptualized or measured. On the basis of previous work, the authors identified 5 specific components

The energy policy relevance of the 2014 IPCC Working Group III report on the macro-economics of mitigating climate change

International Nuclear Information System (INIS)

Rosen, Richard A.; Guenther, Edeltraud

2016-01-01

Research which attempted to determine the macroeconomic importance of mitigating climate change through 2100 was presented primarily in Chapter 6 of the 2014 IPCC Working Group III report. Some of the findings of this chapter were then summarized in the Summary for Policy Makers (SPMs) of both the Synthesis Report, and the WGIII report. Unfortunately, these SPMs omitted key aspects of what the overall macroeconomic results for the costs and benefits of mitigating climate change actually did and did not include, how they were produced, and a careful assessment of their uncertainty and scientific validity. Yet, many of the major omissions were acknowledged deep in the text of Chapter 6, but were not revealed to the public. We conclude, therefore, that neither of these SPMs was useful for energy policy makers and energy managers, and they were misleading due to their many key omissions. Finally, we recommend several improvements that can be made to integrated assessment modeling methodologies so that the macroeconomic analysis of mitigating climate change resulting from the use of such models can be more relevant and useful to energy policy makers in the future, and can be communicated to them better. - Highlights: •The 2014 IPCC Working Group III Report has major omissions in its economic analysis. •Many well-known benefits of mitigation are not included in its economic results. •The Summary for Policy Makers is not very useful for energy policy decision makers. •The upcoming Sixth IPCC WGIII analysis should be structured quite differently.

Clinical relevance of surgical site infection as defined by the criteria of the Centers for Disease Control and Prevention

DEFF Research Database (Denmark)

Henriksen, N A; Meyhoff, C S; Wetterslev, J

2010-01-01

Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant (C...... a suitable standard definition for monitoring and identifying SSI, even if some cases of less clinically significant superficial SSI are included.......Surgical site infection (SSI) is a common complication after abdominal surgery and the Centers for Disease Control and Prevention (CDC) criteria are commonly used for diagnosis and surveillance. The aim of this study was to evaluate whether SSI diagnosed according to CDC is clinically relevant...... hospital stay or referral to an intensive care unit for SSI. The rate of CRSSI was 38 of 54 (70%) in patients with CDC-diagnosed SSI and none in patients without a CDC-diagnosed SSI. Sixty-one percent of the CDC-diagnosed SSIs were superficial, of which 48% were considered clinically relevant...

LD Definition.

Science.gov (United States)

Learning Disability Quarterly, 1987

1987-01-01

The position paper (1981) of the National Joint Committee on Learning Disabilities presents a revised definition of learning disabilities and identifies issues and concerns (such as the limitation to children and the exclusion clause) associated with the definition included in P.L. 94-142, the Education for All Handicapped Children Act. (DB)

49 CFR 173.121 - Class 3-Assignment of packing group.

Science.gov (United States)

2010-10-01

... packing group shall be determined by applying the following criteria: Packing group Flash point (closed-cup) Initial boiling point I ≤35°C (95 °F) II 35 °C (95 °F) III ≥23 °C, ≤60 °C (≥73 °F, ≤140 °F) >35...-GENERAL REQUIREMENTS FOR SHIPMENTS AND PACKAGINGS Definitions Classification, Packing Group Assignments...

User perspectives on relevance criteria

DEFF Research Database (Denmark)

Maglaughlin, Kelly L.; Sonnenwald, Diane H.

2002-01-01

, partially relevant, or not relevant to their information need; and explained their decisions in an interview. Analysis revealed 29 criteria, discussed positively and negatively, that were used by the participants when selecting passages that contributed or detracted from a document's relevance......This study investigates the use of criteria to assess relevant, partially relevant, and not-relevant documents. Study participants identified passages within 20 document representations that they used to make relevance judgments; judged each document representation as a whole to be relevant...... matter, thought catalyst), full text (e.g., audience, novelty, type, possible content, utility), journal/publisher (e.g., novelty, main focus, perceived quality), and personal (e.g., competition, time requirements). Results further indicate that multiple criteria are used when making relevant, partially...

The case for expanding the definition of 'key populations' to include ...

African Journals Online (AJOL)

The case for expanding the definition of 'key populations' to include high-risk groups in the general population ... South African Medical Journal ... to formal housing and services, access to higher education, and broad economic transformation.

Case definition for progressive multifocal leukoencephalopathy following treatment with monoclonal antibodies.

Science.gov (United States)

Mentzer, Dirk; Prestel, Jürgen; Adams, Ortwin; Gold, Ralf; Hartung, Hans-Peter; Hengel, Hartmut; Kieseier, Bernd C; Ludwig, Wolf-Dieter; Keller-Stanislawski, Brigitte

2012-09-01

Novel immunosuppressive/modulating therapies with monoclonal antibodies (MABs) have been associated with progressive multifocal leukoencephalopathy (PML), a potentially fatal disease of the brain caused by the JC virus. Taking the complex diagnostic testing and heterogeneous clinical presentation of PML into account, an agreed case definition for PML is a prerequisite for a thorough assessment of PML. A working group was established to develop a standardised case definition for PML which permits data comparability across clinical trials, postauthorisation safety studies and passive postmarketing surveillance. The case definition is designed to define levels of diagnostic certainty of reported PML cases following treatment with MABs. It was subsequently used to categorise retrospectively suspected PML cases from Germany reported to the Paul-Ehrlich-Institute as the responsible national competent authority. The algorithm of the case definition is based on clinical symptoms, PCR for JC virus DNA in cerebrospinal fluid, brain MRI, and brain biopsy/autopsy. The case definition was applied to 119 suspected cases of PML following treatment with MABs and is considered to be helpful for case ascertainment of suspected PML cases for various MABs covering a broad spectrum of indications. Even if the available information is not yet complete, the case definition provides a level of diagnostic certainty. The proposed case definition permits data comparability among different medicinal products and among active as well as passive surveillance settings. It may form a basis for meaningful risk analysis and communication for regulators and healthcare professionals.

Metabolic syndrome: definitions and controversies

Directory of Open Access Journals (Sweden)

Kaltsas Gregory

2011-05-01

Full Text Available Abstract Metabolic syndrome (MetS is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular atherosclerotic diseases and diabetes mellitus type 2. Currently, several different definitions of MetS exist, causing substantial confusion as to whether they identify the same individuals or represent a surrogate of risk factors. Recently, a number of other factors besides those traditionally used to define MetS that are also linked to the syndrome have been identified. In this review, we critically consider existing definitions and evolving information, and conclude that there is still a need to develop uniform criteria to define MetS, so as to enable comparisons between different studies and to better identify patients at risk. As the application of the MetS model has not been fully validated in children and adolescents as yet, and because of its alarmingly increasing prevalence in this population, we suggest that diagnosis, prevention and treatment in this age group should better focus on established risk factors rather than the diagnosis of MetS.

Assessment and clinical relevance of non-fasting and postprandial triglycerides

DEFF Research Database (Denmark)

Kolovou, Genovefa D; Mikhailidis, Dimitri P; Kovar, Jan

2011-01-01

An Expert Panel group of scientists and clinicians met to consider several aspects related to non-fasting and postprandial triglycerides (TGs) and their role as risk factors for cardiovascular disease (CVD). In this context, we review recent epidemiological studies relevant to elevated non...

Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) "cachexia-anorexia in chronic wasting diseases" and "nutrition in geriatrics".

Science.gov (United States)

Muscaritoli, M; Anker, S D; Argilés, J; Aversa, Z; Bauer, J M; Biolo, G; Boirie, Y; Bosaeus, I; Cederholm, T; Costelli, P; Fearon, K C; Laviano, A; Maggio, M; Rossi Fanelli, F; Schneider, S M; Schols, A; Sieber, C C

2010-04-01

Chronic diseases as well as aging are frequently associated with deterioration of nutritional status, loss muscle mass and function (i.e. sarcopenia), impaired quality of life and increased risk for morbidity and mortality. Although simple and effective tools for the accurate screening, diagnosis and treatment of malnutrition have been developed during the recent years, its prevalence still remains disappointingly high and its impact on morbidity, mortality and quality of life clinically significant. Based on these premises, the Special Interest Group (SIG) on cachexia-anorexia in chronic wasting diseases was created within ESPEN with the aim of developing and spreading the knowledge on the basic and clinical aspects of cachexia and anorexia as well as of increasing the awareness of cachexia among health professionals and care givers. The definition, the assessment and the staging of cachexia, were identified as a priority by the SIG. This consensus paper reports the definition of cachexia, pre-cachexia and sarcopenia as well as the criteria for the differentiation between cachexia and other conditions associated with sarcopenia, which have been developed in cooperation with the ESPEN SIG on nutrition in geriatrics. Copyright 2009 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

Using an inductive approach for definition making: Monotonicity and boundedness of sequences

Directory of Open Access Journals (Sweden)

Deonarain Brijlall

2009-09-01

Full Text Available The study investigated fourth–year students’ construction of the definitions of monotonicity and boundedness of sequences, at the Edgewood Campus of the University of KwaZulu –Natal in South Africa. Structured worksheets based on a guided problem solving teaching model were used to help students to construct the twodefinitions. A group of twenty three undergraduateteacher trainees participated in the project. These students specialised in the teaching of mathematics in the Further Education and Training (FET (Grades 10 to 12 school curriculum. This paper, specifically, reports on the investigation of students’ definition constructions based on a learnig theory within the context of advanced mathematical thinking and makes a contribution to an understanding of how these students constructed the two definitions. It was found that despite the intervention of a structured design, these definitions were partially or inadequately conceptualised by some students.

Self-verification motives at the collective level of self-definition.

Science.gov (United States)

Chen, Serena; Chen, Karen Y; Shaw, Lindsay

2004-01-01

Three studies examined self-verification motives in relation to collective aspects of the self. Several moderators of collective self-verification were also examined--namely, the certainty with which collective self-views are held, the nature of one's ties to a source of self-verification, the salience of the collective self, and the importance of group identification. Evidence for collective self-verification emerged across all studies, particularly when collective self-views were held with high certainty (Studies 1 and 2), perceivers were somehow tied to the source of self-verification (Study 1), the collective self was salient (Study 2), and group identification was important (Study 3). To the authors' knowledge, these studies are the first to examine self-verification at the collective level of self-definition. The parallel and distinct ways in which self-verification processes may operate at different levels of self-definition are discussed.

Involving stakeholders in policy research should not imply that they control the problem definition: lessons from a case study on new analgesics

NARCIS (Netherlands)

Moret-Hartman, M.; van der Wilt, G.J.; Grin, J.

2009-01-01

The Dutch Health Care Insurance Board (HCIB) commissions research to guide their policy recommendations. However, the studies conducted do not always yield relevant information. This may result from differences in problem definitions held by the HCIB and target populations. To compensate these

Long-term applicability of the new ILAE definition of epilepsy. Results from the PRO-LONG study.

Science.gov (United States)

Beretta, Simone; Carone, Davide; Zanchi, Clara; Bianchi, Elisa; Pirovano, Marta; Trentini, Claudia; Padovano, Giada; Colombo, Matteo; Cereda, Diletta; Scanziani, Sofia; Giussani, Giorgia; Gasparini, Sara; Bogliun, Graziella; Ferrarese, Carlo; Beghi, Ettore

2017-09-01

The new epilepsy definition adopted by the International League Against Epilepsy (ILAE) includes patients with one unprovoked seizure with a probability of further seizures, similar to the general recurrence risk after two unprovoked seizures, occurring in a 10-year period. Long-term follow-up of patients diagnosed after a single seizure is needed to assess the applicability of the new epilepsy definition in clinical practice. Patients with newly diagnosed epilepsy were recruited retrospectively with a minimum follow-up of 10 years. Patients were stratified in two groups depending on the occurrence of one (new definition, ND) or two or more unprovoked seizures (traditional definition, TD) at the time of epilepsy diagnosis and compared for disease characteristics and factors predicting seizure recurrence. The primary outcome was the occurrence of a new unprovoked seizure during follow-up in the ND group. The secondary outcome was the achievement of an early remission in both groups. Among 1,006 patients with newly diagnosed epilepsy, 152 (15.1%) were diagnosed after a single seizure. Compared to patients diagnosed using the TD, patients diagnosed according to the ND showed a higher proportion of subjects with an abnormal neurologic examination (19.9% vs. 13.7%, p = 0.0504) and with focal seizures (69.3% vs. 60.4%, p = 0.0021). The two samples differed in the presence of at least one of the factors predicting seizure recurrence (focal seizures or abnormal findings in at least one among the following: neurologic examination, electroencephalography [EEG], and neuroimaging) (94.6% vs. 89.1%, p = 0.0376). Long-term recurrence in patients diagnosed with the new definition was 83.6% at 10 years and 89.1% at 15 years. The probability of early remission did not differ between the two groups. Our results support the applicability of the new epilepsy definition in clinical practice. Individual patient characteristics and a personalized diagnostic approach can justify

A pragmatic definition of therapeutic synergy suitable for clinically relevant in vitro multicompound analyses.

Science.gov (United States)

Kashif, Muhammad; Andersson, Claes; Åberg, Magnus; Nygren, Peter; Sjöblom, Tobias; Hammerling, Ulf; Larsson, Rolf; Gustafsson, Mats G

2014-07-01

For decades, the standard procedure when screening for candidate anticancer drug combinations has been to search for synergy, defined as any positive deviation from trivial cases like when the drugs are regarded as diluted versions of each other (Loewe additivity), independent actions (Bliss independence), or no interaction terms in a response surface model (no interaction). Here, we show that this kind of conventional synergy analysis may be completely misleading when the goal is to detect if there is a promising in vitro therapeutic window. Motivated by this result, and the fact that a drug combination offering a promising therapeutic window seldom is interesting if one of its constituent drugs can provide the same window alone, the largely overlooked concept of therapeutic synergy (TS) is reintroduced. In vitro TS is said to occur when the largest therapeutic window obtained by the best drug combination cannot be achieved by any single drug within the concentration range studied. Using this definition of TS, we introduce a procedure that enables its use in modern massively parallel experiments supported by a statistical omnibus test for TS designed to avoid the multiple testing problem. Finally, we suggest how one may perform TS analysis, via computational predictions of the reference cell responses, when only the target cell responses are available. In conclusion, the conventional error-prone search for promising drug combinations may be improved by replacing conventional (toxicology-rooted) synergy analysis with an analysis focused on (clinically motivated) TS. ©2014 American Association for Cancer Research.

Cognitive Profiles of Mathematical Problem Solving Learning Disability for Different Definitions of Disability

Science.gov (United States)

Tolar, Tammy D.; Fuchs, Lynn; Fletcher, Jack M.; Fuchs, Douglas; Hamlett, Carol L.

2014-01-01

Three cohorts of third-grade students (N = 813) were evaluated on achievement, cognitive abilities, and behavioral attention according to contrasting research traditions in defining math learning disability (LD) status: low achievement versus extremely low achievement and IQ-achievement discrepant versus strictly low-achieving LD. We use methods from these two traditions to form math problem solving LD groups. To evaluate group differences, we used MANOVA-based profile and canonical analyses to control for relations among the outcomes and regression to control for group definition variables. Results suggest that basic arithmetic is the key distinguishing characteristic that separates low-achieving problem solvers (including LD, regardless of definition) from typically achieving students. Word problem solving is the key distinguishing characteristic that separates IQ-achievement-discrepant from strictly low-achieving LD students, favoring the IQ-achievement-discrepant students. PMID:24939971

About a definition of metric over an abelian linearly ordered group

Directory of Open Access Journals (Sweden)

Bice Cavallo

2012-06-01

Full Text Available A G-metric over an abelian linearly ordered group G = (G,⊙,≤ is a binary operation, d G , verifying suitable properties. We consider a particular G metric derived by the group operation ⊙ and the total weak order ≤, and show that it provides a base for the order topology associated to G.

48 CFR 2402.101 - Definitions.

Science.gov (United States)

2010-10-01

... GENERAL DEFINITIONS OF WORDS AND TERMS Definitions 2402.101 Definitions. Accounting Office means the Office of Accounting Operations within the Office of the Chief Financial Officer and includes that Office... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Definitions. 2402.101...

Revision of clinical case definitions: influenza-like illness and severe acute respiratory infection

Science.gov (United States)

Qasmieh, Saba; Mounts, Anthony Wayne; Alexander, Burmaa; Besselaar, Terry; Briand, Sylvie; Brown, Caroline; Clark, Seth; Dueger, Erica; Gross, Diane; Hauge, Siri; Hirve, Siddhivinayak; Jorgensen, Pernille; Katz, Mark A; Mafi, Ali; Malik, Mamunur; McCarron, Margaret; Meerhoff, Tamara; Mori, Yuichiro; Mott, Joshua; Olivera, Maria Teresa da Costa; Ortiz, Justin R; Palekar, Rakhee; Rebelo-de-Andrade, Helena; Soetens, Loes; Yahaya, Ali Ahmed; Zhang, Wenqing; Vandemaele, Katelijn

2018-01-01

Abstract The formulation of accurate clinical case definitions is an integral part of an effective process of public health surveillance. Although such definitions should, ideally, be based on a standardized and fixed collection of defining criteria, they often require revision to reflect new knowledge of the condition involved and improvements in diagnostic testing. Optimal case definitions also need to have a balance of sensitivity and specificity that reflects their intended use. After the 2009–2010 H1N1 influenza pandemic, the World Health Organization (WHO) initiated a technical consultation on global influenza surveillance. This prompted improvements in the sensitivity and specificity of the case definition for influenza – i.e. a respiratory disease that lacks uniquely defining symptomology. The revision process not only modified the definition of influenza-like illness, to include a simplified list of the criteria shown to be most predictive of influenza infection, but also clarified the language used for the definition, to enhance interpretability. To capture severe cases of influenza that required hospitalization, a new case definition was also developed for severe acute respiratory infection in all age groups. The new definitions have been found to capture more cases without compromising specificity. Despite the challenge still posed in the clinical separation of influenza from other respiratory infections, the global use of the new WHO case definitions should help determine global trends in the characteristics and transmission of influenza viruses and the associated disease burden. PMID:29403115

Working Definitions of the Roles and an Organizational Structure in Health Professions Education Scholarship: Initiating an International Conversation.

Science.gov (United States)

Varpio, Lara; Gruppen, Larry; Hu, Wendy; O'Brien, Bridget; Ten Cate, Olle; Humphrey-Murto, Susan; Irby, David M; van der Vleuten, Cees; Hamstra, Stanley J; Durning, Steven J

2017-02-01

Health professions education scholarship (HPES) is an important and growing field of inquiry. Problematically, consistent use of terminology regarding the individual roles and organizational structures that are active in this field are lacking. This inconsistency impedes the transferability of current and future findings related to the roles and organizational structures of HPES. Based on data collected during interviews with HPES leaders in Canada, Australia, New Zealand, the United States, and the Netherlands, the authors constructed working definitions for some of the professional roles and an organizational structure that support HPES. All authors reviewed the definitions to ensure relevance across multiple countries. The authors define and offer illustrative examples of three professional roles in HPES (clinician educator, HPES research scientist, and HPES administrative leader) and an organizational structure that can support HPES participation (HPES unit). These working definitions are foundational and not all-encompassing and, thus, are offered as stimulus for international dialogue and understanding. With these working definitions, scholars and administrative leaders can examine HPES roles and organizational structures across and between national contexts to decide how lessons learned in other contexts can be applied to their local contexts. Although rigorously constructed, these definitions need to be vetted by the international HPES community. The authors argue that these definitions are sufficiently transferable to support such scholarly investigation and debate.

Impulsive suicide attempts: a systematic literature review of definitions, characteristics and risk factors.

Science.gov (United States)

Rimkeviciene, Jurgita; O'Gorman, John; De Leo, Diego

2015-01-15

Extensive research on impulsive suicide attempts, but lack of agreement on the use of this term indicates the need for a systematic literature review of the area. The aim of this review was to examine definitions and likely correlates of impulsive attempts. A search of Medline, Psychinfo, Scopus, Proquest and Web of Knowledge databases was conducted. Additional articles were identified using the cross-referencing function of Google Scholar. 179 relevant papers were identified. Four different groups of research criteria used to assess suicide attempt impulsivity emerged: (a) time-related criteria, (b) absence of proximal planning/preparations, (c) presence of suicide plan in lifetime/previous year, and (d) other. Subsequent analysis used these criteria to compare results from different studies on 20 most researched hypotheses. Conclusions regarding the characteristics of impulsive attempts are more consistent than those on the risk factors specific to such attempts. No risk factors were identified that uniformly related to suicide attempt impulsivity across all criteria groups, but relationships emerged between separate criteria and specific characteristics of suicide attempters. Only published articles were included. Large inconsistencies in methods of the studies included in this review prevented comparison of effect sizes. The vast disparities in findings on risk factors for impulsive suicide attempts among different criteria groups suggest the need to address the methodological issues in defining suicide attempt impulsivity before further research into correlates of such attempts can effectively progress. Specific recommendations are offered for necessary research. Copyright © 2014 Elsevier B.V. All rights reserved.

The Termination Level of the Dural Sac Relevant to Caudal Epidural Block in Lumbosacral Transitional Vertebrae: A Comparison between Sacralization and Lumbarization Groups.

Science.gov (United States)

Jeon, Ji Young; Jeong, Yu Mi; Lee, Sheen-Woo; Kim, Jeong Ho; Choi, Hye-Young; Ahn, Yong

2018-01-01

Lumbosacral transitional vertebrae (LSTV) are a relatively common variant and have been considered as one of the reasons for back pain. It is not unusual for clinicians to encounter patients with LSTV who require caudal epidural block (CEB) for pain management. We investigated the termination level of the dural sac (DS) and anatomical features of the lumbosacral region relevant to CEB in patients with LSTV and compared these findings between sacralization and lumbarization groups. A retrospective evaluation. A university hospital with inpatient and outpatient LSTV cases presenting low back pain. Four hundred ninety-four LSTV patients were included and categorized into sacralization (n = 201) or lumbarization groups (n = 293). Magnetic resonance imaging (MRI) of all of the LSTV patients were reviewed to determine the level of DS termination, the shortest distance between the apex of the sacral hiatus and DS, and the presence and the caudal level of sacral perineural cysts. Each lumbosacral vertebra column was divided into 3 equal portions (upper, middle, and lower thirds). The MRI findings in both of the groups were compared and analyzed. The distribution frequency of the levels of DS termination demonstrated a significant difference between the 2 groups. The mean caudal DS level in the lumbarization group was significantly lower than the sacralization group (lower third of the S2 [131 {44.7%} of 293 patients] vs. lower third of the S1 [78 {38.8%} of 201 patients]). The DS terminated at the S3 in more than 19% of the lumbarization group, whereas in only one case of the sacralization group. Although the incidence of perineural cysts was not significantly different between the 2 groups, the mean level of caudal margin of perineural cysts in the lumbarization group was significantly lower than the sacralization group (middle third of the S3 [10 {35.7%} of 28 cases] vs. middle third of the S2 [11 {44%} of 25 cases]). This study reveals several limitations including the

Accuracy of clinical diagnosis versus the World Health Organization case definition in the Amoy Garden SARS cohort.

Science.gov (United States)

Wong, W N; Sek, Antonio C H; Lau, Rick F L; Li, K M; Leung, Joe K S; Tse, M L; Ng, Andy H W; Stenstrom, Robert

2003-11-01

To compare the diagnostic accuracy of emergency department (ED) physicians with the World Health Organization (WHO) case definition in a large community-based SARS (severe acute respiratory syndrome) cohort. This was a cohort study of all patients from Hong Kong's Amoy Garden complex who presented to an ED SARS screening clinic during a 2-month outbreak. Clinical findings and WHO case definition criteria were recorded, along with ED diagnoses. Final diagnoses were established independently based on relevant diagnostic tests performed after the ED visit. Emergency physician diagnostic accuracy was compared with that of the WHO SARS case definition. Sensitivity, specificity, predictive values and likelihood ratios were calculated using standard formulae. During the study period, 818 patients presented with SARS-like symptoms, including 205 confirmed SARS, 35 undetermined SARS and 578 non-SARS. Sensitivity, specificity and accuracy were 91%, 96% and 94% for ED clinical diagnosis, versus 42%, 86% and 75% for the WHO case definition. Positive likelihood ratios (LR+) were 21.1 for physician judgement and 3.1 for the WHO criteria. Negative likelihood ratios (LR-) were 0.10 for physician judgement and 0.67 for the WHO criteria, indicating that clinician judgement was a much more powerful predictor than the WHO criteria. Physician clinical judgement was more accurate than the WHO case definition. Reliance on the WHO case definition as a SARS screening tool may lead to an unacceptable rate of misdiagnosis. The SARS case definition must be revised if it is to be used as a screening tool in emergency departments and primary care settings.

q-trace for quantum groups and q-deformed Yang-Mills theory

International Nuclear Information System (INIS)

Isaev, A.P.; Popowicz, Z.

1992-01-01

The definitions of orbits and q-trace for the quantum groups are introduced. Then the q-trace is used to construct the invariants for the quantum group orbits and to formulate the q-deformed Yang-Mills theory. The amusing formal relation of the Weinberg type mixing angle with the quantum group deformation parameter is discussed. (orig.)

Building a Definition of Irritability From Academic Definitions and Lay Descriptions.

Science.gov (United States)

Barata, Paula C; Holtzman, Susan; Cunningham, Shannon; O'Connor, Brian P; Stewart, Donna E

2016-04-08

The current work builds a definition of irritability from both academic definitions and lay perspectives. In Study 1, a quantitative content analysis of academic definitions resulted in eight main content categories (i.e., behaviour, emotion or affect, cognition, physiological, qualifiers, irritant, stability or endurance, and other). In Study 2, a community sample of 39 adults participated in qualitative interviews. A deductive thematic analysis resulted in two main themes. The first main theme dealt with how participants positioned irritability in relation to other negative states. The second dealt with how participants constructed irritability as both a loss of control and as an experience that should be controlled. The discussion integrates the findings of both studies and provides a concise, but comprehensive definition.

Snake venoms: A brief treatise on etymology, origins of terminology, and definitions.

Science.gov (United States)

Weinstein, Scott A

2015-09-01

The ancient perceptions of "venomous" and "poisonous snakes", as well as the Indo-European (IE) etymological origins of the term "venom" specifically associated with snakes are considered. Although several ancient cultures perceived snakes as symbols of fecundity and renewal, concurrent beliefs also associated venomous snakes with undesirable human characteristics or as portending non-propitious events. The respective IE roots of the terms "venom" and "poison", "wen" and "poi" refer to desire or the act of ingesting liquids. The origin of the term, "venom", is associated with polytheistic cults that emphasized attainment of desires sometimes assisted by "love potions", a term later interpolated with the word, "poison". Specific interpretation of the term, venom, has varied since its first probable use in the mid-Thirteenth Century. The definition of snake venom has long been contended, and interpretations have often reflected emphasis on the pharmacological or experimental toxicity of medically relevant snake venoms with less regard for the basic biological bases of these venoms, as well as those from snakes with no known medical significance. Several definitions of "snake venom" and their defining criteria are reviewed, and critical consideration is given to traditional criteria that might facilitate the future establishment of a biologically accurate definition. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Is [Rural] Property Tax Relevant?

OpenAIRE

Villaveces-Niño, Marta-Juanita

2015-01-01

The present document presents the general notions and the definition of property taxation and, as part of it, the working definition of rural property taxation emphasizing that property taxation is a matter of “property” and rural property taxation is linked with rural property, specifically with land ownership. In addition, the document presents some facts about the performance of property taxation based on a secondary source of cross-country analysis. In order to giv...

Food security in the context of HIV: towards harmonized definitions and indicators.

Science.gov (United States)

Anema, Aranka; Fielden, Sarah J; Castleman, Tony; Grede, Nils; Heap, Amie; Bloem, Martin

2014-10-01

Integration of HIV and food security services is imperative to improving the health and well-being of people living with HIV. However, consensus does not exist on definitions and measures of food security to guide service delivery and evaluation in the context of HIV. This paper reviews definitions and indicators of food security used by key agencies; outlines their relevance in the context of HIV; highlights opportunities for harmonized monitoring and evaluation indicators; and discusses promising developments in data collection and management. In addition to the commonly used dimensions of food availability, access, utilization and stability, we identify three components of food security-food sufficiency, dietary quality, and food safety-that are useful for understanding and measuring food security needs of HIV-affected and other vulnerable people. Harmonization across agencies of food security indicators in the context of HIV offers opportunities to improve measurement and tracking, strengthen coordination, and inform evidence-based programming.

Angiostrongylus spp. in the Americas: geographical and chronological distribution of definitive hosts versus disease reports.

Science.gov (United States)

Valente, Romina; Robles, Maria Del Rosario; Navone, Graciela T; Diaz, Julia I

2018-03-01

Angiostrongyliasis is an infection caused by nematode worms of the genus Angiostrongylus. The adult worms inhabit the pulmonary arteries, heart, bronchioles of the lung, or mesenteric arteries of the caecum of definitive host. Of a total of 23 species of Angiostrongylus cited worldwide, only nine were registered in the American Continent. Two species, A. cantonensis and A. costaricensis, are considered zoonoses when the larvae accidentally parasitise man. In the present study, geographical and chronological distribution of definitive hosts of Angiostrongylus in the Americas is analysed in order to observe their relationship with disease reports. Moreover, the role of different definitive hosts as sentinels and dispersers of infective stages is discussed. The study area includes the Americas. First records of Angiostrongylus spp. in definitive or accidental hosts were compiled from the literature. Data were included in tables and figures and were matched to geographic information systems (GIS). Most geographical records of Angiostrongylus spp. both for definitive and accidental hosts belong to tropical areas, mainly equatorial zone. In relation to those species of human health importance, as A. cantonensis and A. costaricensis, most disease cases indicate a coincidence between the finding of definitive host and disease record. However, in some geographic site there are gaps between report of definitive host and disease record. In many areas, human populations have invaded natural environments and their socioeconomic conditions do not allow adequate medical care. Consequently, many cases for angiostrongyliasis could have gone unreported or unrecognised throughout history and in the nowadays. Moreover, the population expansion and the climatic changes invite to make broader and more complete range of observation on the species that involve possible epidemiological risks. This paper integrates and shows the current distribution of Angiostrongylus species in America

Angiostrongylus spp. in the Americas: geographical and chronological distribution of definitive hosts versus disease reports

Science.gov (United States)

Valente, Romina; Robles, Maria del Rosario; Navone, Graciela T; Diaz, Julia I

2018-01-01

BACKGROUND Angiostrongyliasis is an infection caused by nematode worms of the genus Angiostrongylus. The adult worms inhabit the pulmonary arteries, heart, bronchioles of the lung, or mesenteric arteries of the caecum of definitive host. Of a total of 23 species of Angiostrongylus cited worldwide, only nine were registered in the American Continent. Two species, A. cantonensis and A. costaricensis, are considered zoonoses when the larvae accidentally parasitise man. OBJECTIVES In the present study, geographical and chronological distribution of definitive hosts of Angiostrongylus in the Americas is analysed in order to observe their relationship with disease reports. Moreover, the role of different definitive hosts as sentinels and dispersers of infective stages is discussed. METHODS The study area includes the Americas. First records of Angiostrongylus spp. in definitive or accidental hosts were compiled from the literature. Data were included in tables and figures and were matched to geographic information systems (GIS). FINDINGS Most geographical records of Angiostrongylus spp. both for definitive and accidental hosts belong to tropical areas, mainly equatorial zone. In relation to those species of human health importance, as A. cantonensis and A. costaricensis, most disease cases indicate a coincidence between the finding of definitive host and disease record. However, in some geographic site there are gaps between report of definitive host and disease record. In many areas, human populations have invaded natural environments and their socioeconomic conditions do not allow adequate medical care. MAIN CONCLUSIONS Consequently, many cases for angiostrongyliasis could have gone unreported or unrecognised throughout history and in the nowadays. Moreover, the population expansion and the climatic changes invite to make broader and more complete range of observation on the species that involve possible epidemiological risks. This paper integrates and shows the

Statement on gender-affirmative approach to care from the pediatric endocrine society special interest group on transgender health.

Science.gov (United States)

Lopez, Ximena; Marinkovic, Maja; Eimicke, Toni; Rosenthal, Stephen M; Olshan, Jerrold S

2017-08-01

The purpose of this Position Statement is to emphasize the importance of an affirmative approach to the health care of transgender individuals, as well as to improve the understanding of the rights of transgender youth. Transgender youth have optimal outcomes when affirmed in their gender identity, through support by their families and their environment, as well as appropriate mental health and medical care. The Pediatric Endocrine Society Special Interest Group on Transgender Health joins other academic societies involved in the care of children and adolescents in supporting policies that promote a safe and accepting environment for gender nonconforming/transgender youth, as well as adequate mental health and medical care. This document provides a summary of relevant definitions, information and current literature on which the medical management and affirmative approach to care of transgender youth are based.

Exploring Mathematical Definition Construction Processes

Science.gov (United States)

Ouvrier-Buffet, Cecile

2006-01-01

The definition of "definition" cannot be taken for granted. The problem has been treated from various angles in different journals. Among other questions raised on the subject we find: the notions of "concept definition" and "concept image", conceptions of mathematical definitions, redefinitions, and from a more axiomatic point of view, how to…

15 CFR 922.81 - Definitions.

Science.gov (United States)

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Definitions. 922.81 Section 922.81... Definitions. In addition to those definitions found at § 922.3, the following definitions apply to this... or otherwise manifesting intention not to undertake or to cease salvage efforts, or when the owner...

Culturally relevant model program to prevent and reduce agricultural injuries.

Science.gov (United States)

Helitzer, D L; Hathorn, G; Benally, J; Ortega, C

2014-07-01

Limited research has explored pesticide injury prevention among American Indian farmers. In a five-year agricultural intervention, a university-community partnership, including the University of New Mexico School of Medicine, New Mexico State University, Shiprock Area Cooperative Extension Service, and Navajo Nation communities, used a culturally relevant model to introduce and maintain safe use of integrated pest management techniques. We applied the Diffusion of Innovations theory and community-based approaches to tailor health promotion strategies for our intervention. In a longitudinal study with repeated measures, we trained six "model farmers" to be crop management experts in pesticide safety, application, and control. Subsequently, these model farmers worked with 120 farm families randomized into two groups: intervention (Group 1) and delayed intervention (Group 2). Measurements included a walk-through analysis, test of knowledge and attitudes, and yield analysis. Both groups demonstrated improvements in pesticide storage behaviors after training. Test scores regarding safety practices improved significantly: from 57.3 to 72.4 for Group 1 and from 52.6 to 76.3 for Group 2. Group 1 maintained their knowledge and safety practices after the intervention. Attitudes about pesticides and communication of viewpoints changed across the study years. With pesticides and fertilizer, the number of corn ears increased by 56.3% and yield (kg m(-2)) of alfalfa increased by 41.2%. The study combined traditional farming practices with culturally relevant approaches and behavior change theory to affect knowledge, safety practices, attitudes, communication channels, and crop yield. Storage behaviors, use of pesticides and safety and application equipment, and safety practice knowledge changed significantly, as did attitudes about social networking, social support, and the compatibility and relative advantage of pesticides for farms.

The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report.

Science.gov (United States)

Levey, Andrew S; de Jong, Paul E; Coresh, Josef; El Nahas, Meguid; Astor, Brad C; Matsushita, Kunihiro; Gansevoort, Ron T; Kasiske, Bertram L; Eckardt, Kai-Uwe

2011-07-01

The definition and classification for chronic kidney disease was proposed by the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NKF-KDOQI) in 2002 and endorsed by the Kidney Disease: Improving Global Outcomes (KDIGO) in 2004. This framework promoted increased attention to chronic kidney disease in clinical practice, research and public health, but has also generated debate. It was the position of KDIGO and KDOQI that the definition and classification should reflect patient prognosis and that an analysis of outcomes would answer key questions underlying the debate. KDIGO initiated a collaborative meta-analysis and sponsored a Controversies Conference in October 2009 to examine the relationship of estimated glomerular filtration rate (GFR) and albuminuria to mortality and kidney outcomes. On the basis of analyses in 45 cohorts that included 1,555,332 participants from general, high-risk, and kidney disease populations, conference attendees agreed to retain the current definition for chronic kidney disease of a GFR 30 mg/g, and to modify the classification by adding albuminuria stage, subdivision of stage 3, and emphasizing clinical diagnosis. Prognosis could then be assigned based on the clinical diagnosis, stage, and other key factors relevant to specific outcomes. KDIGO has now convened a workgroup to develop a global clinical practice guideline for the definition, classification, and prognosis of chronic kidney disease.

Profinite graphs and groups

CERN Document Server

Ribes, Luis

2017-01-01

This book offers a detailed introduction to graph theoretic methods in profinite groups and applications to abstract groups. It is the first to provide a comprehensive treatment of the subject. The author begins by carefully developing relevant notions in topology, profinite groups and homology, including free products of profinite groups, cohomological methods in profinite groups, and fixed points of automorphisms of free pro-p groups. The final part of the book is dedicated to applications of the profinite theory to abstract groups, with sections on finitely generated subgroups of free groups, separability conditions in free and amalgamated products, and algorithms in free groups and finite monoids. Profinite Graphs and Groups will appeal to students and researchers interested in profinite groups, geometric group theory, graphs and connections with the theory of formal languages. A complete reference on the subject, the book includes historical and bibliographical notes as well as a discussion of open quest...

How Long Should Routine EEG Be Recorded to Get Relevant Information?

Science.gov (United States)

Doudoux, Hannah; Skaare, Kristina; Geay, Thomas; Kahane, Philippe; Bosson, Jean L; Sabourdy, Cécile; Vercueil, Laurent

2017-03-01

The optimal duration of routine EEG (rEEG) has not been determined on a clinical basis. This study aims to determine the time required to obtain relevant information during rEEG with respect to the clinical request. All rEEGs performed over 3 months in unselected patients older than 14 years in an academic hospital were analyzed retrospectively. The latency required to obtain relevant information was determined for each rEEG by 2 independent readers blinded to the clinical data. EEG final diagnoses and latencies were analyzed with respect to the main clinical requests: subacute cognitive impairment, spells, transient focal neurologic manifestation or patients referred by epileptologists. From 430 rEEGs performed in the targeted period, 364 were analyzed: 92% of the pathological rEEGs were provided within the first 10 minutes of recording. Slowing background activity was diagnosed from the beginning, whereas interictal epileptiform discharges were recorded over time. Moreover, the time elapsed to demonstrate a pattern differed significantly in the clinical groups: in patients with subacute cognitive impairment, EEG abnormalities appeared within the first 10 minutes, whereas in the other groups, data could be provided over time. Patients with subacute cognitive impairment differed from those in the other groups significantly in the elapsed time required to obtain relevant information during rEEG, suggesting that 10-minute EEG recordings could be sufficient, arguing in favor of individualized rEEG. However, this conclusion does not apply to intensive care unit patients.

Definition of gross tumor volume in lung cancer: inter-observer variability

International Nuclear Information System (INIS)

Van de Steene, Jan; Linthout, Nadine; Mey, Johan de; Vinh-Hung, Vincent; Claassens, Cornelia; Noppen, Marc; Bel, Arjan; Storme, Guy

2002-01-01

Background and purpose: To determine the inter-observer variation in gross tumor volume (GTV) definition in lung cancer, and its clinical relevance. Material and methods: Five clinicians involved in lung cancer were asked to define GTV on the planning CT scan of eight patients. Resulting GTVs were compared on the base of geometric volume, dimensions and extensions. Judgement of invasion of lymph node (LN) regions was evaluated using the ATS/LCSG classification of LN. Clinical relevance of the variation was studied through 3D-dosimetry of standard conformal plans: volume of critical organs (heart, lungs, esophagus, spinal cord) irradiated at toxic doses, 95% isodose volumes of GTVs, normal tissue complication probabilities (NTCP) and tumor control probabilities (TCP) were compared for evaluation of observer variability. Results: Before evaluation of observer variability, critical review of planning CT scan led to up- (two cases) and downstaging (one case) of patients as compared to the respective diagnostic scans. The defined GTVs showed an inter-observer variation with a ratio up to more than 7 between maximum and minimum geometric content. The dimensions of the primary tumor had inter-observer ranges of 4.2 (transversal), 7.9 (cranio-caudal) and 5.4 (antero-posterior) cm. Extreme extensions of the GTVs (left, right, cranial, caudal, anterior and posterior) varied with ranges of 2.8-7.3 cm due to inter-observer variation. After common review, only 63% of involved lymph node regions were delineated by the clinicians (i.e. 37% are false negative). Twenty-two percent of drawn in lymph node regions were accepted to be false positive after review. In the conformal plans, inter-observer ranges of irradiated normal tissue volume were on average 12%, with a maximum of 66%. The probability (in the population of all conformal plans) of irradiating at least 95% of the GTV with at least 95% of the nominal treatment dose decreased from 96 to 88% when swapping the matched GTV

Pangenomic Definition of Prokaryotic Species and the Phylogenetic Structure of Prochlorococcus spp.

Directory of Open Access Journals (Sweden)

Mikhail A. Moldovan

2018-03-01

Full Text Available The pangenome is the collection of all groups of orthologous genes (OGGs from a set of genomes. We apply the pangenome analysis to propose a definition of prokaryotic species based on identification of lineage-specific gene sets. While being similar to the classical biological definition based on allele flow, it does not rely on DNA similarity levels and does not require analysis of homologous recombination. Hence this definition is relatively objective and independent of arbitrary thresholds. A systematic analysis of 110 accepted species with the largest numbers of sequenced strains yields results largely consistent with the existing nomenclature. However, it has revealed that abundant marine cyanobacteria Prochlorococcus marinus should be divided into two species. As a control we have confirmed the paraphyletic origin of Yersinia pseudotuberculosis (with embedded, monophyletic Y. pestis and Burkholderia pseudomallei (with B. mallei. We also demonstrate that by our definition and in accordance with recent studies Escherichia coli and Shigella spp. are one species.

Parsimonious relevance models

NARCIS (Netherlands)

Meij, E.; Weerkamp, W.; Balog, K.; de Rijke, M.; Myang, S.-H.; Oard, D.W.; Sebastiani, F.; Chua, T.-S.; Leong, M.-K.

2008-01-01

We describe a method for applying parsimonious language models to re-estimate the term probabilities assigned by relevance models. We apply our method to six topic sets from test collections in five different genres. Our parsimonious relevance models (i) improve retrieval effectiveness in terms of

International consensus for a definition of disease flare in lupus.

Science.gov (United States)

Ruperto, N; Hanrahan, L M; Alarcón, G S; Belmont, H M; Brey, R L; Brunetta, P; Buyon, J P; Costner, M I; Cronin, M E; Dooley, M A; Filocamo, G; Fiorentino, D; Fortin, P R; Franks, A G; Gilkeson, G; Ginzler, E; Gordon, C; Grossman, J; Hahn, B; Isenberg, D A; Kalunian, K C; Petri, M; Sammaritano, L; Sánchez-Guerrero, J; Sontheimer, R D; Strand, V; Urowitz, M; von Feldt, J M; Werth, V P; Merrill, J T

2011-04-01

The Lupus Foundation of America (LFA) convened an international working group to obtain a consensus definition of disease flare in lupus. With help from the Paediatric Rheumatology International Trials Organization (PRINTO), two web-based Delphi surveys of physicians were conducted. Subsequently, the LFA held a second consensus conference followed by a third Delphi survey to reach a community-wide agreement for flare definition. Sixty-nine of the 120 (57.5%) polled physicians responded to the first survey. Fifty-nine of the responses were available to draft 12 preliminary statements, which were circulated in the second survey. Eighty-seven of 118 (74%) physicians completed the second survey, with an agreement of 70% for 9/12 (75%) statements. During the second conference, three alternative flare definitions were consolidated and sent back to the international community. One hundred and sixteen of 146 (79.5%) responded, with agreement by 71/116 (61%) for the following definition: "A flare is a measurable increase in disease activity in one or more organ systems involving new or worse clinical signs and symptoms and/or laboratory measurements. It must be considered clinically significant by the assessor and usually there would be at least consideration of a change or an increase in treatment." The LFA proposes this definition for lupus flare on the basis of its high face validity.

Metabolic syndrome definitions and components in predicting major adverse cardiovascular events after kidney transplantation.

Science.gov (United States)

Prasad, G V Ramesh; Huang, Michael; Silver, Samuel A; Al-Lawati, Ali I; Rapi, Lindita; Nash, Michelle M; Zaltzman, Jeffrey S

2015-01-01

Metabolic syndrome (MetS) associates with cardiovascular risk post-kidney transplantation, but its ambiguity impairs understanding of its diagnostic utility relative to components. We compared five MetS definitions and the predictive value of constituent components of significant definitions for major adverse cardiovascular events (MACE) in a cohort of 1182 kidney transplant recipients. MetS definitions were adjusted for noncomponent traditional Framingham risk factors and relevant transplant-related variables. Kaplan-Meier, logistic regression, and Cox proportional hazards analysis were utilized. There were 143 MACE over 7447 patient-years of follow-up. Only the World Health Organization (WHO) 1998 definition predicted MACE (25.3 vs 15.5 events/1000 patient-years, P = 0.019). Time-to-MACE was 5.5 ± 3.5 years with MetS and 6.8 ± 3.9 years without MetS (P < 0.0001). MetS was independent of pertinent MACE risk factors except age and previous cardiac disease. Among MetS components, dysglycemia provided greatest hazard ratio (HR) for MACE (1.814 [95% confidence interval 1.26-2.60]), increased successively by microalbuminuria (HR 1.946 [1.37-2.75]), dyslipidemia (3.284 [1.72-6.26]), hypertension (4.127 [2.16-7.86]), and central obesity (4.282 [2.09-8.76]). MetS did not affect graft survival. In summary, although the WHO 1998 definition provides greatest predictive value for post-transplant MACE, most of this is conferred by dysglycemia and is overshadowed by age and previous cardiac disease. © 2014 Steunstichting ESOT.

Bullying by Definition: An Examination of Definitional Components of Bullying

Science.gov (United States)

Goldsmid, Susan; Howie, Pauline

2014-01-01

Lack of definitional consensus remains an important unresolved issue within bullying research. This study examined the ability of definitional variables to predict overall level of victimisation (distress, power inequity, and provocation as predictors) and bullying (intention to harm, power inequity, and provocation as predictors) in 246…

Different use of medical terminology and culture-specific models of ...

African Journals Online (AJOL)

Where words were in the vocabulary of both groups, significant differences existed in the number and range of definitions, with many clinically significant discordances of definition being apparent. Some common examples relevant to paediatric respiratory problems are presented. Three culture-specific explanatory models ...

Teachers and Textbooks: On Statistical Definitions in Senior Secondary Mathematics

Science.gov (United States)

Dunn, Peter K.; Marshman, Margaret; McDougall, Robert; Wiegand, Aaron

2015-01-01

The new "Australian Senior Secondary Curriculum: Mathematics" contains more statistics than the existing Australian Curricula. This case study examines how a group of Queensland mathematics teachers define the word "statistics" and five statistical terms from the new curricula. These definitions are compared to those used in…

47 CFR 73.5008 - Definitions applicable for designated entity provisions.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 4 2010-10-01 2010-10-01 false Definitions applicable for designated entity provisions. 73.5008 Section 73.5008 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) BROADCAST... Administration's size standards for its industry grouping, as set forth in 13 CFR 121.201, at the time the...

Definitions for warning signs and signs of severe dengue according to the WHO 2009 classification: Systematic review of literature.

Science.gov (United States)

Morra, Mostafa Ebraheem; Altibi, Ahmed M A; Iqtadar, Somia; Minh, Le Huu Nhat; Elawady, Sameh Samir; Hallab, Asma; Elshafay, Abdelrahman; Omer, Omer Abedlbagi; Iraqi, Ahmed; Adhikari, Purushottam; Labib, Jonair Hussein; Elhusseiny, Khaled Mosaad; Elgebaly, Ahmed; Yacoub, Sophie; Huong, Le Thi Minh; Hirayama, Kenji; Huy, Nguyen Tien

2018-04-24

Since warning signs and signs of severe dengue are defined differently between studies, we conducted a systematic review on how researchers defined these signs. We conducted an electronic search in Scopus to identify relevant articles, using key words including dengue, "warning signs," "severe dengue," and "classification." A total of 491 articles were identified through this search strategy and were subsequently screened by 2 independent reviewers for definitions of any of the warning or severe signs in the 2009 WHO dengue classification. We included all original articles published in English after 2009, classifying dengue by the 2009 WHO classification or providing the additional definition or criterion of warning signs and severity (besides the information of 2009 WHO). Analysis of the extracted data from 44 articles showed wide variations among definitions and cutoff values used by physicians to classify patients diagnosed with dengue infection. The establishment of clear definitions for warning signs and severity is essential to prevent unnecessary hospitalization and harmonizing the interpretation and comparability of epidemiological studies dedicated to dengue infection. Copyright © 2018 John Wiley & Sons, Ltd.

Stakeholder Perceptions of Cyberbullying Cases: Application of the Uniform Definition of Bullying.

Science.gov (United States)

Moreno, Megan A; Suthamjariya, Nina; Selkie, Ellen

2018-04-01

The Uniform Definition of Bullying was developed to address bullying and cyberbullying, and to promote consistency in measurement and policy. The purpose of this study was to understand community stakeholder perceptions of typical cyberbullying cases, and to evaluate how these case descriptions align with the Uniform Definition. In this qualitative case analysis we recruited stakeholders commonly involved in cyberbullying. We used purposeful sampling to identify and recruit adolescents and young adults, parents, and professionals representing education and health care. Participants were asked to write a typical case of cyberbullying and descriptors in the context of a group discussion. We applied content analysis to case excerpts using inductive and deductive approaches, and chi-squared tests for mixed methods analyses. A total of 68 participants contributed; participants included 73% adults and 27% adolescents and young adults. A total of 650 excerpts were coded from participants' example cases and 362 (55.6%) were consistent with components of the Uniform Definition. The most frequently mentioned component of the Uniform Definition was Aggressive Behavior (n = 218 excerpts), whereas Repeated was mentioned infrequently (n = 19). Most participants included two to three components of the Uniform Definition within an example case; none of the example cases included all components of the Uniform Definition. We found that most participants described cyberbullying cases using few components of the Uniform Definition. Findings can be applied toward considering refinement of the Uniform Definition to ensure stakeholders find it applicable to cyberbullying. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Online drug databases: a new method to assess and compare inclusion of clinically relevant information.

Science.gov (United States)

Silva, Cristina; Fresco, Paula; Monteiro, Joaquim; Rama, Ana Cristina Ribeiro

2013-08-01

Evidence-Based Practice requires health care decisions to be based on the best available evidence. The model "Information Mastery" proposes that clinicians should use sources of information that have previously evaluated relevance and validity, provided at the point of care. Drug databases (DB) allow easy and fast access to information and have the benefit of more frequent content updates. Relevant information, in the context of drug therapy, is that which supports safe and effective use of medicines. Accordingly, the European Guideline on the Summary of Product Characteristics (EG-SmPC) was used as a standard to evaluate the inclusion of relevant information contents in DB. To develop and test a method to evaluate relevancy of DB contents, by assessing the inclusion of information items deemed relevant for effective and safe drug use. Hierarchical organisation and selection of the principles defined in the EGSmPC; definition of criteria to assess inclusion of selected information items; creation of a categorisation and quantification system that allows score calculation; calculation of relative differences (RD) of scores for comparison with an "ideal" database, defined as the one that achieves the best quantification possible for each of the information items; pilot test on a sample of 9 drug databases, using 10 drugs frequently associated in literature with morbidity-mortality and also being widely consumed in Portugal. Main outcome measure Calculate individual and global scores for clinically relevant information items of drug monographs in databases, using the categorisation and quantification system created. A--Method development: selection of sections, subsections, relevant information items and corresponding requisites; system to categorise and quantify their inclusion; score and RD calculation procedure. B--Pilot test: calculated scores for the 9 databases; globally, all databases evaluated significantly differed from the "ideal" database; some DB performed

What Is Real-World Data? A Review of Definitions Based on Literature and Stakeholder Interviews.

Science.gov (United States)

Makady, Amr; de Boer, Anthonius; Hillege, Hans; Klungel, Olaf; Goettsch, Wim

Despite increasing recognition of the value of real-world data (RWD), consensus on the definition of RWD is lacking. To review definitions publicly available for RWD to shed light on similarities and differences between them. A literature review and stakeholder interviews were used to compile data from eight groups of stakeholders. Data from documents and interviews were subjected to coding analysis. Definitions identified were classified into four categories: 1) data collected in a non-randomized controlled trial setting, 2) data collected in a non-interventional/non-controlled setting, 3) data collected in a non-experimental setting, and 4) others (i.e., data that do not fit into the other three categories). The frequency of definitions identified per category was recorded. Fifty-three documents and 20 interviews were assessed. Thirty-eight definitions were identified: 20 out of 38 definitions (53%) were category 1 definitions, 9 (24%) were category 2 definitions, 5 (13%) were category 3 definitions, and 4 (11%) were category 4 definitions. Differences were identified between, and within, definition categories. For example, opinions differed on the aspects of intervention with which non-interventional/non-controlled settings should abide. No definitions were provided in two interviews or identified in 33 documents. Most of the definitions defined RWD as data collected in a non-randomized controlled trial setting. A considerable number of definitions, however, diverged from this concept. Moreover, a significant number of authors and stakeholders did not have an official, institutional definition for RWD. Persisting variability in stakeholder definitions of RWD may lead to disparities among different stakeholders when discussing RWD use in decision making. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

[Immortal time bias in pharmacoepidemiological studies: definition, solutions and examples].

Science.gov (United States)

Faillie, Jean-Luc; Suissa, Samy

2015-01-01

Among the observational studies of drug effects in chronic diseases, many of them have found effects that were exaggerated or wrong. Among bias responsible for these errors, the immortal time bias, concerning the definition of exposure and exposure periods, is relevantly important as it usually tends to wrongly attribute a significant benefit to the study drug (or exaggerate a real benefit). In this article, we define the mechanism of immortal time bias, we present possible solutions and illustrate its consequences through examples of pharmacoepidemiological studies of drug effects. © 2014 Société Française de Pharmacologie et de Thérapeutique.

Clinical Relevance of Discourse Characteristics after Right Hemisphere Brain Damage

Science.gov (United States)

Blake, Margaret Lehman

2006-01-01

Purpose: Discourse characteristics of adults with right hemisphere brain damage are similar to those reported for healthy older adults, prompting the question of whether changes are due to neurological lesions or normal aging processes. The clinical relevance of potential differences across groups was examined through ratings by speech-language…

Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation.

Science.gov (United States)

Handy, Ariel B; Stanton, Amelia M; Meston, Cindy M

2018-04-01

Subjective sexual arousal (SSA) is positive, cognitive engagement in sexual activity. SSA is considered an important aspect of the sexual experience, as it has been found to facilitate sexual activity and, in situations of chronically low or absent arousal, potentially cause distress. Despite the clinical implications of SSA, a thorough review of how to manipulate SSA has yet to be conducted. To review the state of knowledge about SSA in women, including its definition, measurement, and the outcomes of studies attempting to manipulate SSA within a laboratory setting. A comprehensive search of the electronic databases of PubMed and PsycINFO was conducted. The generated list of articles was reviewed and duplicates were removed. Individual articles were assessed for inclusion and, when appropriate, relevant content was extracted. The potential effects of various manipulations of SSA in a laboratory setting was the main outcome. 44 studies were included in this review. Manipulations were grouped into 3 primary categories: pharmacological (n = 16), cognitive (n = 22), and those based on changes to the autonomic nervous system (n = 6). Results suggest that cognitive manipulation is the most effective method of increasing SSA. Altering the relative balance of the 2 branches of the autonomic nervous system (the sympathetic nervous system and the parasympathetic nervous system) also appears to be a promising avenue for increasing SSA. This review supports the use of cognitive manipulation for increasing women's SSA in a laboratory setting. Avenues for future research and recommendations for clinicians are discussed. Handy AB, Stanton AM, Meston CM. Understanding Women's Subjective Sexual Arousal Within the Laboratory: Definition, Measurement, and Manipulation. Sex Med Rev 2018;6:201-216. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Evaluation of a surveillance case definition for anogenital warts, Kaiser Permanente northwest.

Science.gov (United States)

Naleway, Allison L; Weinmann, Sheila; Crane, Brad; Gee, Julianne; Markowitz, Lauri E; Dunne, Eileen F

2014-08-01

Most studies of anogenital wart (AGW) epidemiology have used large clinical or administrative databases and unconfirmed case definitions based on combinations of diagnosis and procedure codes. We developed and validated an AGW case definition using a combination of diagnosis codes and other information available in the electronic medical record (provider type, laboratory testing). We calculated the positive predictive value (PPV) of this case definition compared with manual medical record review in a random sample of 250 cases. Using this case definition, we calculated the annual age- and sex-stratified prevalence of AGW among individuals 11 through 30 years of age from 2000 through 2005. We identified 2730 individuals who met the case definition. The PPV of the case definition was 82%, and the average annual prevalence was 4.16 per 1000. Prevalence of AGW was higher in females compared with males in every age group, with the exception of the 27- to 30-year-olds. Among females, prevalence peaked in the 19- to 22-year-olds, and among males, the peak was observed in 23- to 26-year-olds. The case definition developed in this study is the first to be validated with medical record review and has a good PPV for the detection of AGW. The prevalence rates observed in this study were higher than other published rates, but the age- and sex-specific patterns observed were consistent with previous reports.

Practical relevance of pattern uniqueness in forensic science.

Science.gov (United States)

Jayaprakash, Paul T

2013-09-10

Uniqueness being unprovable, it has recently been argued that individualization in forensic science is irrelevant and, probability, as applied for DNA profiles, should be applied for all identifications. Critiques against uniqueness have omitted physical matching, a realistic and tangible individualization that supports uniqueness. Describing case examples illustrating pattern matches including physical matching, it is indicated that individualizations are practically relevant for forensic science as they establish facts on a definitive basis providing firm leads benefitting criminal investigation. As a tenet of forensic identification, uniqueness forms a fundamental paradigm relevant for individualization. Evidence on the indeterministic and stochastic causal pathways of characteristics in patterns available in the related fields of science sufficiently supports the proposition of uniqueness. Characteristics involved in physical matching and matching achieved in patterned evidence existing in the state of nature are not events amenable for counting; instead these are ensemble of visible units occupying the entire pattern area stretching the probability of re-occurrence of a verisimilitude pattern into infinity offering epistemic support to uniqueness. Observational methods are as respectable as instrumental or statistical methods since they are capable of generating results that are tangible and obviously valid as in physical matching. Applying the probabilistic interpretation used for DNA profiles to the other patterns would be unbefitting since these two are disparate, the causal pathways of the events, the loci, in the manipulated DNA profiles being determinable. While uniqueness enables individualizations, it does not vouch for eliminating errors. Instead of dismissing uniqueness and individualization, accepting errors as human or system failures and seeking remedial measures would benefit forensic science practice and criminal investigation. Copyright © 2013

Assessing the relevance of ecotoxicological studies for regulatory decision making.

Science.gov (United States)

Rudén, Christina; Adams, Julie; Ågerstrand, Marlene; Brock, Theo Cm; Poulsen, Veronique; Schlekat, Christian E; Wheeler, James R; Henry, Tala R

2017-07-01

Regulatory policies in many parts of the world recognize either the utility of or the mandate that all available studies be considered in environmental or ecological hazard and risk assessment (ERA) of chemicals, including studies from the peer-reviewed literature. Consequently, a vast array of different studies and data types need to be considered. The first steps in the evaluation process involve determining whether the study is relevant to the ERA and sufficiently reliable. Relevance evaluation is typically performed using existing guidance but involves application of "expert judgment" by risk assessors. In the present paper, we review published guidance for relevance evaluation and, on the basis of the practical experience within the group of authors, we identify additional aspects and further develop already proposed aspects that should be considered when conducting a relevance assessment for ecotoxicological studies. From a regulatory point of view, the overarching key aspect of relevance concerns the ability to directly or indirectly use the study in ERA with the purpose of addressing specific protection goals and ultimately regulatory decision making. Because ERA schemes are based on the appropriate linking of exposure and effect estimates, important features of ecotoxicological studies relate to exposure relevance and biological relevance. Exposure relevance addresses the representativeness of the test substance, environmental exposure media, and exposure regime. Biological relevance deals with the environmental significance of the test organism and the endpoints selected, the ecological realism of the test conditions simulated in the study, as well as a mechanistic link of treatment-related effects for endpoints to the protection goal identified in the ERA. In addition, uncertainties associated with relevance should be considered in the assessment. A systematic and transparent assessment of relevance is needed for regulatory decision making. The relevance

The role of diseases, risk factors and symptoms in the definition of multimorbidity – a systematic review

Science.gov (United States)

Willadsen, Tora Grauers; Bebe, Anna; Køster-Rasmussen, Rasmus; Jarbøl, Dorte Ejg; Guassora, Ann Dorrit; Waldorff, Frans Boch; Reventlow, Susanne; Olivarius, Niels de Fine

2016-01-01

Objective is to explore how multimorbidity is defined in the scientific literature, with a focus on the roles of diseases, risk factors, and symptoms in the definitions. Design: Systematic review. Methods: MEDLINE (PubMed), Embase, and The Cochrane Library were searched for relevant publications up until October 2013. One author extracted the information. Ambiguities were resolved, and consensus reached with one co-author. Outcome measures were: cut-off point for the number of conditions included in the definitions of multimorbidity; setting; data sources; number, kind, duration, and severity of diagnoses, risk factors, and symptoms. We reviewed 163 articles. In 61 articles (37%), the cut-off point for multimorbidity was two or more conditions (diseases, risk factors, or symptoms). The most frequently used setting was the general population (68 articles, 42%), and primary care (41 articles, 25%). Sources of data were primarily self-reports (56 articles, 42%). Out of the 163 articles selected, 115 had individually constructed multimorbidity definitions, and in these articles diseases occurred in all definitions, with diabetes as the most frequent. Risk factors occurred in 98 (85%) and symptoms in 71 (62%) of the definitions. The severity of conditions was used in 26 (23%) of the definitions, but in different ways. The definition of multimorbidity is heterogeneous and risk factors are more often included than symptoms. The severity of conditions is seldom included. Since the number of people living with multimorbidity is increasing there is a need to develop a concept of multimorbidity that is more useful in daily clinical work. Key pointsThe increasing number of multimorbidity patients challenges the healthcare system. The concept of multimorbidity needs further discussion in order to be implemented in daily clinical practice.Many definitions of multimorbidity exist and most often a cut-off point of two or more is applied to a range of 4–147 different conditions

A decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping).

Science.gov (United States)

Arts, Josje H E; Hadi, Mackenzie; Irfan, Muhammad-Adeel; Keene, Athena M; Kreiling, Reinhard; Lyon, Delina; Maier, Monika; Michel, Karin; Petry, Thomas; Sauer, Ursula G; Warheit, David; Wiench, Karin; Wohlleben, Wendel; Landsiedel, Robert

2015-03-15

The European Centre for Ecotoxicology and Toxicology of Chemicals (ECETOC) 'Nano Task Force' proposes a Decision-making framework for the grouping and testing of nanomaterials (DF4nanoGrouping) that consists of 3 tiers to assign nanomaterials to 4 main groups, to perform sub-grouping within the main groups and to determine and refine specific information needs. The DF4nanoGrouping covers all relevant aspects of a nanomaterial's life cycle and biological pathways, i.e. intrinsic material and system-dependent properties, biopersistence, uptake and biodistribution, cellular and apical toxic effects. Use (including manufacture), release and route of exposure are applied as 'qualifiers' within the DF4nanoGrouping to determine if, e.g. nanomaterials cannot be released from a product matrix, which may justify the waiving of testing. The four main groups encompass (1) soluble nanomaterials, (2) biopersistent high aspect ratio nanomaterials, (3) passive nanomaterials, and (4) active nanomaterials. The DF4nanoGrouping aims to group nanomaterials by their specific mode-of-action that results in an apical toxic effect. This is eventually directed by a nanomaterial's intrinsic properties. However, since the exact correlation of intrinsic material properties and apical toxic effect is not yet established, the DF4nanoGrouping uses the 'functionality' of nanomaterials for grouping rather than relying on intrinsic material properties alone. Such functionalities include system-dependent material properties (such as dissolution rate in biologically relevant media), bio-physical interactions, in vitro effects and release and exposure. The DF4nanoGrouping is a hazard and risk assessment tool that applies modern toxicology and contributes to the sustainable development of nanotechnological products. It ensures that no studies are performed that do not provide crucial data and therefore saves animals and resources. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights

Consensus Guidelines for Delineation of Clinical Target Volume for Intensity-Modulated Pelvic Radiotherapy for the Definitive Treatment of Cervix Cancer

International Nuclear Information System (INIS)

Lim, Karen; Small, William; Portelance, Lorraine; Creutzberg, Carien; Juergenliemk-Schulz, Ina M.; Mundt, Arno; Mell, Loren K.; Mayr, Nina; Viswanathan, Akila; Jhingran, Anuja; Erickson, Beth; De Los Santos, Jennifer; Gaffney, David; Yashar, Catheryn; Beriwal, Sushil; Wolfson, Aaron

2011-01-01

Purpose: Accurate target definition is vitally important for definitive treatment of cervix cancer with intensity-modulated radiotherapy (IMRT), yet a definition of clinical target volume (CTV) remains variable within the literature. The aim of this study was to develop a consensus CTV definition in preparation for a Phase 2 clinical trial being planned by the Radiation Therapy Oncology Group. Methods and Materials: A guidelines consensus working group meeting was convened in June 2008 for the purposes of developing target definition guidelines for IMRT for the intact cervix. A draft document of recommendations for CTV definition was created and used to aid in contouring a clinical case. The clinical case was then analyzed for consistency and clarity of target delineation using an expectation maximization algorithm for simultaneous truth and performance level estimation (STAPLE), with kappa statistics as a measure of agreement between participants. Results: Nineteen experts in gynecological radiation oncology generated contours on axial magnetic resonance images of the pelvis. Substantial STAPLE agreement sensitivity and specificity values were seen for gross tumor volume (GTV) delineation (0.84 and 0.96, respectively) with a kappa statistic of 0.68 (p < 0.0001). Agreement for delineation of cervix, uterus, vagina, and parametria was moderate. Conclusions: This report provides guidelines for CTV definition in the definitive cervix cancer setting for the purposes of IMRT, building on previously published guidelines for IMRT in the postoperative setting.

Korrek, volledig, relevant

DEFF Research Database (Denmark)

Bergenholtz, Henning; Gouws, Rufus

2007-01-01

In explanatory dictionaries, both general language dictionaries and dictionaries dealing with languages for special purposes, the lexicographic definition is an important item to present the meaning of a given lemma. Due to a strong linguistic bias, resulting from an approach prevalent in the ear...

Safety of definitive in-theater repair of facial fractures.

Science.gov (United States)

Lopez, Manuel A; Arnholt, Jonathan L

2007-01-01

To determine the safety of definitive in-theater facial fracture repair on American military personnel wounded during Operation Iraqi Freedom. A retrospective review of all patients with head and neck trauma treated at the 322nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, from May 7, 2005, through September 18, 2005, was performed. This study focused on the outcomes of wounded American military personnel whose facial fractures were definitively repaired in theater. The criteria used to determine candidacy for definitive in-theater facial fracture repair on American military personnel were (1) the fracture site was exposed through either a soft tissue wound or because of an adjacent surgical approach, (2) treatment would not delay evacuation from theater, and (3) treatment would allow the military member to remain in theater. From May 2005 to September 2005, 207 patients were taken to the operating room and required 388 procedures. A total of 175 patients (85%) were operated on for traumatic injuries, and 52 of these patients required open reduction and internal fixation (ORIF) of a facial fracture. Of the 52 patients who underwent an ORIF, 17 were American military personnel. Of the 17 American patients who were definitively treated for their facial fractures in theater, 16 were contacted and/or followed up on the global military medical database. None of these patients developed an Acinetobacter baumannii infection or had a complication caused by the definitive in-theater ORIF. The range of follow-up was 2 months to 11 months, with a mean of 8.3 months. Definitive repair of facial fractures with ORIF on American military personnel in theater is advised when the aforementioned criteria are observed. An otolaryngologist is a crucial member of the head and neck trauma team.

Accuracy and computational time of a hierarchy of growth rate definitions for breeder reactor fuel

International Nuclear Information System (INIS)

Maudlin, P.J.; Borg, R.C.; Ott, K.O.

1979-01-01

For a hierarchy of four logically different definitions for calculating the asymptotic growth of fast breeder reactor fuel, an investigation is performed concerning the comparative accuracy and computational effort associated with each definition. The definition based on detailed calculation of the accumulating fuel in an expanding park of reactors asymptotically yields the most accurate value of the infinite time growth rate, γ/sup infinity/, which is used as a reference value. The computational effort involved with the park definition is very large. The definition based on the single reactor calculation of the equilibrium surplus production rate and fuel inventory gives a value for γ/sup infinity of comparable accuracy to the park definition and uses significantly less central processor unit (CPU) time. The third definition is based on a continuous treatment of the reactor fuel cycle for a single reactor and gives a value for γ/sup infinity/ that accurately approximates the second definition. The continuous definition requires very little CPU time. The fourth definition employs the isotopic breeding worths, w/sub i//sup */, for a projection of the asymptotic growth rate. The CPU time involved in this definition is practically nil if its calculation is based on the few-cycle depletion calculation normally performed for core design and critical enrichment evaluations. The small inaccuracy (approx. = 1%) of the breeding-worth-based definition is well within the inaccuracy range that results unavoidably from other sources such as nuclear cross sections, group constants, and flux calculations. This fully justifies the use of this approach in routine calculations

Concordance between European and US case definitions of healthcare-associated infections

Science.gov (United States)

2012-01-01

Background Surveillance of healthcare-associated infections (HAI) is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN) while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE) project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010). Concordance between case definitions was estimated with Cohen’s kappa statistic (κ). Results Differences in HAI definitions were found for bloodstream infection (BSI), pneumonia (PN), urinary tract infection (UTI) and the two key terms “intensive care unit (ICU)-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94) for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82) for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases) are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI (LCBI), were

Concordance between European and US case definitions of healthcare-associated infections

Directory of Open Access Journals (Sweden)

Hansen Sonja

2012-08-01

Full Text Available Abstract Background Surveillance of healthcare-associated infections (HAI is a valuable measure to decrease infection rates. Across Europe, inter-country comparisons of HAI rates seem limited because some countries use US definitions from the US Centers for Disease Control and Prevention (CDC/NHSN while other countries use European definitions from the Hospitals in Europe Link for Infection Control through Surveillance (HELICS/IPSE project. In this study, we analyzed the concordance between US and European definitions of HAI. Methods An international working group of experts from seven European countries was set up to identify differences between US and European definitions and then conduct surveillance using both sets of definitions during a three-month period (March 1st -May 31st, 2010. Concordance between case definitions was estimated with Cohen’s kappa statistic (κ. Results Differences in HAI definitions were found for bloodstream infection (BSI, pneumonia (PN, urinary tract infection (UTI and the two key terms “intensive care unit (ICU-acquired infection” and “mechanical ventilation”. Concordance was analyzed for these definitions and key terms with the exception of UTI. Surveillance was performed in 47 ICUs and 6,506 patients were assessed. One hundred and eighty PN and 123 BSI cases were identified. When all PN cases were considered, concordance for PN was κ = 0.99 [CI 95%: 0.98-1.00]. When PN cases were divided into subgroups, concordance was κ = 0.90 (CI 95%: 0.86-0.94 for clinically defined PN and κ = 0.72 (CI 95%: 0.63-0.82 for microbiologically defined PN. Concordance for BSI was κ = 0.73 [CI 95%: 0.66-0.80]. However, BSI cases secondary to another infection site (42% of all BSI cases are excluded when using US definitions and concordance for BSI was κ = 1.00 when only primary BSI cases, i.e. Europe-defined BSI with ”catheter” or “unknown” origin and US-defined laboratory-confirmed BSI

Graded Structure in Sexual Definitions: Categorizations of Having "Had Sex" and Virginity Loss Among Homosexual and Heterosexual Men and Women.

Science.gov (United States)

Horowitz, Ava D; Bedford, Edward

2017-08-01

Definitions of sexual behavior display a robust hierarchy of agreement regarding whether or not acts should be classed as, for example, sex or virginity loss. The current research offers a theoretical explanation for this hierarchy, proposing that sexual definitions display graded categorical structure, arising from goodness of membership judgments. Moderation of this graded structure is also predicted, with the focus here on how sexual orientation identity affects sexual definitions. A total of 300 18- to 30-year-old participants completed an online survey, rating 18 behaviors for how far each constitutes having "had sex" and virginity loss. Participants fell into one of four groups: heterosexual male or female, gay male or lesbian. The predicted ratings hierarchy emerged, in which bidirectional genital acts were rated significantly higher than unidirectional or nonpenetrative contact, which was in turn rated significantly higher than acts involving no genital contact. Moderation of graded structure was also in line with predictions. Compared to the other groups, the lesbian group significantly upgraded ratings of genital contact that was either unidirectional or nonpenetrative. There was also evidence of upgrading by the gay male sample of anal intercourse ratings. These effects are theorized to reflect group-level variation in experience, contextual perspective, and identity-management. The implications of the findings in relation to previous research are discussed. It is suggested that a graded structure approach can greatly benefit future research into sexual definitions, by permitting variable definitions to be predicted and explained, rather than merely identified.

Treatment outcomes of definitive chemoradiotherapy for patients with hypopharyngeal cancer

International Nuclear Information System (INIS)

Nakahara, Rie; Kodaira, Takeshi; Furutani, Kazuhisa

2012-01-01

We analyzed the efficacy of definitive chemoradiotherapy (CRT) for patients with hypopharyngeal cancer (HPC). Subjects comprised 97 patients who were treated with definitive CRT from 1990 to 2006. Sixty-one patients (62.9%) with resectable disease who aimed to preserve the larynx received induction chemotherapy (ICT), whereas 36 patients (37.1%) with resectable disease who refused an operation or who had unresectable disease received primary alternating CRT or concurrent CRT (non-ICT). The median dose to the primary lesion was 66 Gy. The median follow-up time was 77 months. The 5-year rates of overall survival (OS), progression-free survival (PFS), local control (LC), and laryngeal preservation were 68.7%, 57.5%, 79.1%, and 70.3%, respectively. The T-stage was a significant prognostic factor in terms of OS, PFS and LC in both univariate and multivariate analyses. The 5-year rates of PFS were 45.4% for the ICT group and 81.9% for the non-ICT group. The difference between these groups was significant with univariate analysis (P=0.006). Acute toxicity of Grade 3 to 4 was observed in 34 patients (35.1%). Grade 3 dysphagia occurred in 20 patients (20.6%). Twenty-nine (29.8%) of 44 patients with second primary cancer had esophageal cancer. Seventeen of 29 patients had manageable superficial esophageal cancer. The clinical efficacy of definitive CRT for HPC is thought to be promising in terms of not only organ preservation but also disease control. Second primary cancer may have a clinical impact on the outcome for HPC patients, and special care should be taken when screening at follow-up. (author)

Different groups, different motives: identity motives underlying changes in identification with novel groups.

Science.gov (United States)

Easterbrook, Matt; Vignoles, Vivian L

2012-08-01

Social identification is known to have wide-reaching implications, but theorists disagree about the underlying motives. Integrating motivated identity construction theory with recent social identity research, the authors predicted which motives underlie identification with two types of groups: interpersonal networks and social categories. In a five-wave longitudinal study of social identity processes among 268 new university residents, multilevel analyses showed that motives involved in identity enactment processes--self-esteem, belonging, and efficacy--significantly predicted within-person changes in identification with flatmates (an interpersonal network group), whereas motives involved in identity definition processes--meaning, self-esteem, and distinctiveness--significantly predicted within-person changes in identification with halls of residence (an abstract social category). This article discusses implications for research into identity motives and social identity.

Extremist Construction of Identity: How Escalating Demands for Legitimacy Shape and Define In-Group and Out-Group Dynamics

Directory of Open Access Journals (Sweden)

J.M. Berger

2017-04-01

Full Text Available This Research Paper examines how the white supremacist movement Christian Identity emerged from a non-extremist forerunner known as British Israelism. By examining ideological shifts over the course of nearly a century, the paper seeks to identify key pivot points in the movement’s shift toward extremism and explain the process through which extremist ideologues construct and define in-group and out-group identities. Based on these findings, the paper proposes a new framework for analysing and understanding the behaviour and emergence of extremist groups. The proposed framework can be leveraged to design strategic counter-terrorism communications programmes using a linkage-based approach that deconstructs the process of extremist in-group and out-group definition. Future publications will continue this study, seeking to refine the framework and operationalise messaging recommendations.

Defending definitions of life.

Science.gov (United States)

Mix, Lucas John

2015-01-01

Over the past 10 years, it has become unpopular to talk about definitions of life, under the assumption that attempts at a precise definition are counterproductive. Recent attempts have failed to meet strict philosophical criteria for definitions and have failed to reach consensus. I argue that provisional definitions are necessary for clear communications. Our current knowledge of biology justifies a number of universal claims about the category of life. Whether or not "life" represents a natural category, it maps to a number of important, observable processes. Given the importance of those processes and the extent of our knowledge, plural explicit definitions of life (and related categories) will be necessary for progress in astrobiology and origin-of-life studies as well as biology in general. I propose concrete categories related to, but not necessarily coextensive with, life for clear communication and hypothesis formation: Woese life, Darwin life, Haldane life.

Towards consensus in operational definitions in functional capacity evaluation: a Delphi Survey.

Science.gov (United States)

Soer, Remko; van der Schans, Cees P; Groothoff, Johan W; Geertzen, Jan H B; Reneman, Michiel F

2008-12-01

The problem of inconsistent terminology in functional capacity evaluation (FCE) has been widely addressed in the international literature. Many different terms seem to be used interchangeably while other terms appear to be interpreted differently. This may seriously hinder FCE research and clinical use. To gain consensus in operational definitions in FCE and conceptual framework to classify terminology used in FCE. A Delphi Survey with FCE experts was conducted which consisted of three rounds of questioning, using semi and full structured questions. The expert group was formed from international experts in FCE. Experts were selected if they met any of the following criteria: at least one international publication as first author and one as co-author in the field of FCE; or an individual who had developed an FCE that was subject of investigation in at least one publication in international literature. Consensus of definitions was considered when 75% or more of all experts agreed with a definition. In total, 22 international experts from 6 different countries in Australia, Europe and North America, working in different health related sectors, participated in this study. Consensus concerning conceptual framework of FCE was met in 9 out of 20 statements. Consensus on definitions was met in 10 out of 19 definitions. Experts agreed to use the ICF as a conceptual framework in which terminology of FCE should be classified and agreed to use pre-defined terms of the ICF. No consensus was reached about the definition of FCE, for which two potential eligible definitions remained. Consensus was reached in many terms used in FCE. For future research, it was recommended that researchers use these terms, use the ICF as a conceptual framework and clearly state which definition for FCE is used because no definition of FCE was consented.

A consistent homogenization procedure to obtain few-group cell parameters

International Nuclear Information System (INIS)

Pierini, G.

1979-01-01

The criterion, according to which one heterogeneous and one homogeneous cell are equivalent if they have the same boundary values of both the flux and the normal components of the current, is used to homogenize radially an axially infinite cylindrical cell, with azimuth independent properties and moderatur adequately described by diffusion theory. The method, which leads to the definition of a full matrix of diffusion coefficients, provides a new and simple definition of the few-group cell parameters, which are nearly independent of the environment. (orig.) [de

Outcome in elderly patients undergoing definitive surgery and radiation therapy for supratentorial glioblastoma multiforme at a tertiary care institution

International Nuclear Information System (INIS)

Mohan, Dasarahally S.; Suh, John H.; Phan, Jennifer L.; Kupelian, Patrick A.; Cohen, Bruce H.; Barnett, Gene H.

1998-01-01

Purpose: To determine the efficacy of definitive surgery and radiation in patients aged 70 years and older with supratentorial glioblastoma multiforme. Methods and Materials: We selected elderly patients (≥ 70 years) who had primary treatment for glioblastoma multiforme at our tertiary care institution from 1977 through 1996. The study group (n = 102) included 58 patients treated with definitive radiation, 19 treated with palliative radiation, and 25 who received no radiation. To compare our results with published findings, we grouped our patients according to the applicable prognostic categories developed by the Radiation Therapy Oncology Group (RTOG): RTOG group IV (n = 6), V (n = 70), and VI (n = 26). Patients were retrospectively assigned to prognostic group IV, V, or VI based on age, performance status, extent of surgery, mental status, neurologic function, and radiation dose. Treatment included surgical resection and radiation (n 49), biopsy alone (n = 25), and biopsy followed by radiation (n = 28). Patients were also stratified according to whether they were optimally treated (gross total or subtotal resection with postoperative definitive radiation) or suboptimally treated (biopsy, biopsy + radiation, surgery alone, or surgery + palliative radiation). Patients were considered to have a favorable prognosis (n = 39) if they were optimally treated and had a Karnofsky Performance Status (KPS) score of at least 70. Results: The median survival for patients according to RTOG groups IV, V, and VI was 9.2, 6.6, and 3.1 months, respectively (log-rank, p < 0.0004). The median overall survival was 5.3 months. The definitive radiation group (n = 58) had a median survival of 7.3 months compared to 4.5 months in the palliative radiation group (n = 19) and 1.2 months in the biopsy-alone group (p < 0.0001). Optimally treated patients had a median survival of 7.4 months compared to 2.4 months in those suboptimally treated (p < 0.0001). The favorable prognosis group had an

The Epidemiology of Transfusion-related Acute Lung Injury Varies According to the Applied Definition of Lung Injury Onset Time.

Science.gov (United States)

Vande Vusse, Lisa K; Caldwell, Ellen; Tran, Edward; Hogl, Laurie; Dinwiddie, Steven; López, José A; Maier, Ronald V; Watkins, Timothy R

2015-09-01

Research that applies an unreliable definition for transfusion-related acute lung injury (TRALI) may draw false conclusions about its risk factors and biology. The effectiveness of preventive strategies may decrease as a consequence. However, the reliability of the consensus TRALI definition is unknown. To prospectively study the effect of applying two plausible definitions of acute respiratory distress syndrome onset time on TRALI epidemiology. We studied 316 adults admitted to the intensive care unit and transfused red blood cells within 24 hours of blunt trauma. We identified patients with acute respiratory distress syndrome, and defined acute respiratory distress syndrome onset time two ways: (1) the time at which the first radiographic or oxygenation criterion was met, and (2) the time both criteria were met. We categorized two corresponding groups of TRALI cases transfused in the 6 hours before acute respiratory distress syndrome onset. We used Cohen's kappa to measure agreement between the TRALI cases and implicated blood components identified by the two acute respiratory distress syndrome onset time definitions. In a nested case-control study, we examined potential risk factors for each group of TRALI cases, including demographics, injury severity, and characteristics of blood components transfused in the 6 hours before acute respiratory distress syndrome onset. Forty-two of 113 patients with acute respiratory distress syndrome were TRALI cases per the first acute respiratory distress syndrome onset time definition and 63 per the second definition. There was slight agreement between the two groups of TRALI cases (κ = 0.16; 95% confidence interval, -0.01 to 0.33) and between the implicated blood components (κ = 0.15, 95% confidence interval, 0.11-0.20). Age, Injury Severity Score, high plasma-volume components, and transfused plasma volume were risk factors for TRALI when applying the second acute respiratory distress syndrome onset time definition

Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists

Science.gov (United States)

Remick, Amera K.; Catlin, Natasha R.; Quist, Erin M.; Steinbach, Thomas J.; Dixon, Darlene

2015-01-01

The Society of Toxicologic Pathology (STP) Education Committee and the STP Reproductive Special Interest Group held a North Carolina regional meeting entitled, “Juvenile Toxicology: Relevance and Challenges for Toxicologists and Pathologists” on March 13, 2015, at the National Institute of Environmental Health Sciences/National Toxicology Program in Research Triangle Park, North Carolina. The purpose of this regional meeting was to familiarize attendees with the topic of juvenile toxicity testing and discuss its relevance to clinical pediatric medicine, regulatory perspectives, challenges of appropriate study design confronted by toxicologists, and challenges of histopathologic examination and interpretation of juvenile tissues faced by pathologists. The 1-day meeting was a success with over 60 attendees representing industry, government, research organizations, and academia. PMID:26220944

Controversy around the definition of waste

CSIR Research Space (South Africa)

Oelofse, Suzanna HH

2009-11-20

Full Text Available This paper presents the information concerning the definition of waste. Discussing the importance of the clear definition, ongoing debates, broad definition of waste, problems with the broad definition, interpretation, current waste management model...

[Relevance between expectations before treatment, new symptoms and satisfaction after treatment in patients with pelvic organ prolapse].

Science.gov (United States)

Wang, Yu; Han, Jinsong; Zhang, Kun; Zhu, Fuli; Yang, Junfang; Wang, Yiting

2015-09-01

To investigate the relevance between expectations before treatment, new symptoms and satisfaction after treatment of the pelvic organ prolapse (POP) patients. Made a collection of 75 cases of POP patients at Peking University Third Hospital, who were affected by the POP symptoms and came to our clinic for treatment from January to December in 2013. Prospectively investigate the patients' expectations before treatment, which were the most troubling symptoms to be solved. According to treatment we divided the patients into surgery and pessary groups. Two groups were followed up with the degree to achieve the desired goals using patient global impression of improvement (PGI-I), new symptoms and satisfaction after treatment, try to find the relevance between expectations before treatment, new symptoms and satisfaction after treatment. There were 47 (63%, 47/75) patients in the surgical group and 28 (37%, 28/75) patients in the pessary group. The top three problems for patients were friction when walking (25%, 19/75), dysuria (23%, 17/75) and the feeling of vaginal prolapse (19%, 14/75). The follow-up rate was of 93% (70/75), follow-up time was (5 ± 4) months. Satisfaction score after treatment of surgical group was higher than that of pessary group [(4.9 ± 0.4) versus (4.0 ± 1.3) scores, P satisfaction scores was relevant (P = 0.021). The availability of new symptoms and satisfaction scores was relevant (P = 0.001). When achieving higher expectations to the treatment and no more new symptoms, the satisfaction score after treatment is higher.

Considerations on the EU definition of a nanomaterial: science to support policy making.

Science.gov (United States)

Bleeker, Eric A J; de Jong, Wim H; Geertsma, Robert E; Groenewold, Monique; Heugens, Evelyn H W; Koers-Jacquemijns, Marjorie; van de Meent, Dik; Popma, Jan R; Rietveld, Anton G; Wijnhoven, Susan W P; Cassee, Flemming R; Oomen, Agnes G

2013-02-01

In recent years, an increasing number of applications and products containing or using nanomaterials have become available. This has raised concerns that some of these materials may introduce new risks for humans or the environment. A clear definition to discriminate nanomaterials from other materials is prerequisite to include provisions for nanomaterials in legislation. In October 2011 the European Commission published the 'Recommendation on the definition of a nanomaterial', primarily intended to provide unambiguous criteria to identify materials for which special regulatory provisions might apply, but also to promote consistency on the interpretation of the term 'nanomaterial'. In this paper, the current status of various regulatory frameworks of the European Union with regard to nanomaterials is described, and major issues relevant for regulation of nanomaterials are discussed. This will contribute to better understanding the implications of the choices policy makers have to make in further regulation of nanomaterials. Potential issues that need to be addressed and areas of research in which science can contribute are indicated. These issues include awareness on situations in which nano-related risks may occur for materials that fall outside the definition, guidance and further development of measurement techniques, and dealing with changes during the life cycle. Copyright © 2012 Elsevier Inc. All rights reserved.

Engineering Definitional Interpreters

DEFF Research Database (Denmark)

Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

2013-01-01

A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

The definition of biochemical failure in patients treated with definitive radiotherapy

International Nuclear Information System (INIS)

Kattan, Michael W.; Fearn, Paul A.; Leibel, Steven; Potters, Louis

2000-01-01

Purpose: The American Society for Therapeutic Radiology and Oncology (ASTRO) published a definition for biochemical failure following treatment of prostate cancer. Others have noted difficulties with interpreting this definition and recommended modifications to accommodate special recurrence patterns. We have compared various modifications to the original ASTRO definition on our series of 1213 patients treated with transperineal permanent prostate brachytherapy. Methods and Materials: The ASTRO modifications we considered adjusted for (1) early censoring of nonrecurrent patients with rising prostate-specific antigen levels (PSA), (2) cumulative rather than consecutive rises (without a decrease) as evidence of recurrence, (3) both of the above, and (4) waiting 2 years before data analysis. The Kaplan-Meier method was used to compute the effects on recurrence rate for patients treated with and without neoadjuvant hormones. Results: With the original ASTRO definition, freedom from recurrence in our series of men who did not receive neoadjuvant hormones was 83% at 4 years. All of the modifications considered had statistically insignificant effects on freedom from recurrence rates, varying from 80% to 83% at 4 years. Patients treated with neoadjuvant hormones also showed very little sensitivity to the recurrence definition employed. Conclusion: Early censoring of equivocal patients and counting cumulative rather than consecutive rises in PSA (without a decrease) had little empiric effect on the ASTRO recurrence rates. However, we favor the addition of both these modifications to the ASTRO definition on conceptual grounds for evaluating patients following any modality (radiation or surgery), whereby a trend over multiple PSA values is used to judge failure.

Definition, diagnosis and treatment strategies for opioid-induced bowel dysfunction-Recommendations of the Nordic Working Group.

Science.gov (United States)

Drewes, Asbjørn M; Munkholm, Pia; Simrén, Magnus; Breivik, Harald; Kongsgaard, Ulf E; Hatlebakk, Jan G; Agreus, Lars; Friedrichsen, Maria; Christrup, Lona L

2016-04-01

Opioid-induced bowel dysfunction (OIBD) is an increasing problem due to the common use of opioids for pain worldwide. It manifests with different symptoms, such as dry mouth, gastro-oesophageal reflux, vomiting, bloating, abdominal pain, anorexia, hard stools, constipation and incomplete evacuation. Opioid-induced constipation (OIC) is one of its many symptoms and probably the most prevalent. The current review describes the pathophysiology, clinical implications and treatment of OIBD. The Nordic Working Group was formed to provide input for Scandinavian specialists in multiple, relevant areas. Seven main topics with associated statements were defined. The working plan provided a structured format for systematic reviews and included instructions on how to evaluate the level of evidence according to the GRADE guidelines. The quality of evidence supporting the different statements was rated as high, moderate or low. At a second meeting, the group discussed and voted on each section with recommendations (weak and strong) for the statements. The literature review supported the fact that opioid receptors are expressed throughout the gastrointestinal tract. When blocked by exogenous opioids, there are changes in motility, secretion and absorption of fluids, and sphincter function that are reflected in clinical symptoms. The group supported a recent consensus statement for OIC, which takes into account the change in bowel habits for at least one week rather than focusing on the frequency of bowel movements. Many patients with pain receive opioid therapy and concomitant constipation is associated with increased morbidity and utilization of healthcare resources. Opioid treatment for acute postoperative pain will prolong the postoperative ileus and should also be considered in this context. There are no available tools to assess OIBD, but many rating scales have been developed to assess constipation, and a few specifically address OIC. A clinical treatment strategy for OIBD

Association splitting of the sexual orientation-OCD-relevant semantic network.

Science.gov (United States)

Ching, Terence H W; Williams, Monnica T

2018-05-01

There is little research on treating symptoms of sexual orientation-obsessive-compulsive disorder (SO-OCD). Semantic networks represent a new cognitive approach for understanding cognitive mechanisms of SO-OCD. Specifically, we tested whether the self-help cognitive technique of association splitting (AS) developed from this approach would be efficacious in reducing SO-OCD symptoms and thought suppression. One hundred and twenty heterosexual undergraduates (82 females, 38 males) were randomly assigned to either the AS or waitlist control group. At baseline and four weeks later, participants completed items assessing SO-OCD symptoms, measures of sexual obsessions and thought suppression, and an association task in which they generated associations to different cue words. Generated associations were coded based on SO-OCD relevance and emotional valence. Results indicated reductions in SO-OCD-relevant associations across levels of emotional valence and SO-OCD-irrelevant negative associations, and increases in SO-OCD-irrelevant positive and neutral associations, only in the AS group. Furthermore, there were reductions in SO-OCD symptoms, sexual obsessions, and thought suppression only in the AS group. Importantly, these findings were obtained with overall large effect sizes. AS appears to be an efficacious self-help technique in reducing SO-OCD symptoms, sexual obsessions, and thought suppression. Clinical implications, limitations, and suggestions for future research are discussed.

Consensus statement on social anxiety disorder from the International Consensus Group on Depression and Anxiety.

Science.gov (United States)

Ballenger, J C; Davidson, J R; Lecrubier, Y; Nutt, D J; Bobes, J; Beidel, D C; Ono, Y; Westenberg, H G

1998-01-01

The goal of this consensus statement is to provide primary care clinicians with a better understanding of management issues in social anxiety disorder (social phobia) and guide clinical practice with recommendations for appropriate pharmacotherapy. The 4 members of the International Consensus Group on Depression and Anxiety were James C. Ballenger (chair), Jonathan R. T. Davidson, Yves Lecrubier, and David J. Nutt. Other faculty invited by the chair were Julio Bobes, Deborah C. Beidel, Yukata Ono, and Herman G. M. Westenberg. The consensus statement is based on the 7 review papers published in this supplement and on the scientific literature relevant to the issues reviewed in these papers. The group met over a 2-day period. On day 1, the group discussed each review paper, and the chair identified key issues for further debate. On day 2, the group discussed these issues to arrive at a consensus view. After the group meetings, the consensus statement was drafted by the chair and approved by all attendees. The consensus statement underlines the importance of recognizing social anxiety disorder and provides recommendations on how it may be distinguished from other anxiety disorders. It proposes definitions for response and remission and considers appropriate management strategies. Selective serotonin reuptake inhibitors are recommended as first-line therapy, and effective treatment should be continued for at least 12 months. Long-term treatment is indicated if symptoms are unresolved, the patient has a comorbid condition or a history of relapse, or there was an early onset of the disorder.

Mood, definiteness and specificity: a linguistic and a philosophical account of their similarities and differences

DEFF Research Database (Denmark)

Rijkhoff, Jan; Seibt, Johanna

2006-01-01

In this article we give a linguistic and a philosophical account of the relationship between some grammatical categories of the clause (realis) and the noun phrase (definiteness, specificity) that relate to the occurrence of an entity (thing, event) in the world of discourse. Our treatment differs...... in three important ways from previous work in this area. Firstly, we offer an explanation for both the symmetrical and the anti-symmetrical relations that appear to hold between (ir)realis mood and (in)definiteness. Secondly, we argue that any attempt to explain these relationships must make crucial...... reference to the grammatical category of specificity. Last but not least, we consider whether the identified linguistic symmetries and anti-symmetries are ontologically relevant and show that they are apparently best accounted for within an ontological theory that allows for dynamic and indeterminately...

The definition of cross polarization

DEFF Research Database (Denmark)

Ludwig, Arthur

1973-01-01

There are at least three different definitions of cross polarization used in the literature. The alternative definitions are discussed with respect to several applications, and the definition which corresponds to one standard measurement practice is proposed as the best choice....

Risk-adjusted Outcomes of Clinically Relevant Pancreatic Fistula Following Pancreatoduodenectomy: A Model for Performance Evaluation.

Science.gov (United States)

McMillan, Matthew T; Soi, Sameer; Asbun, Horacio J; Ball, Chad G; Bassi, Claudio; Beane, Joal D; Behrman, Stephen W; Berger, Adam C; Bloomston, Mark; Callery, Mark P; Christein, John D; Dixon, Elijah; Drebin, Jeffrey A; Castillo, Carlos Fernandez-Del; Fisher, William E; Fong, Zhi Ven; House, Michael G; Hughes, Steven J; Kent, Tara S; Kunstman, John W; Malleo, Giuseppe; Miller, Benjamin C; Salem, Ronald R; Soares, Kevin; Valero, Vicente; Wolfgang, Christopher L; Vollmer, Charles M

2016-08-01

To evaluate surgical performance in pancreatoduodenectomy using clinically relevant postoperative pancreatic fistula (CR-POPF) occurrence as a quality indicator. Accurate assessment of surgeon and institutional performance requires (1) standardized definitions for the outcome of interest and (2) a comprehensive risk-adjustment process to control for differences in patient risk. This multinational, retrospective study of 4301 pancreatoduodenectomies involved 55 surgeons at 15 institutions. Risk for CR-POPF was assessed using the previously validated Fistula Risk Score, and pancreatic fistulas were stratified by International Study Group criteria. CR-POPF variability was evaluated and hierarchical regression analysis assessed individual surgeon and institutional performance. There was considerable variability in both CR-POPF risk and occurrence. Factors increasing the risk for CR-POPF development included increasing Fistula Risk Score (odds ratio 1.49 per point, P ratio 3.30, P performance outliers were identified at the surgeon and institutional levels. Of the top 10 surgeons (≥15 cases) for nonrisk-adjusted performance, only 6 remained in this high-performing category following risk adjustment. This analysis of pancreatic fistulas following pancreatoduodenectomy demonstrates considerable variability in both the risk and occurrence of CR-POPF among surgeons and institutions. Disparities in patient risk between providers reinforce the need for comprehensive, risk-adjusted modeling when assessing performance based on procedure-specific complications. Furthermore, beyond inherent patient risk factors, surgical decision-making influences fistula outcomes.

Terms and definitions in the field of radiological technique. Dose quantities and units

International Nuclear Information System (INIS)

1985-12-01

The standard gives the terms and definitions of concepts, dose quantities and units. The radiation field condition 'secondary electron equilibrium', which forms part of the definition of standard ion dose, is given more precisely. The term 'free in air' is used in its original meaning, i.e. characterization of measuring conditions excluding avoidable stray radiation, which deviates from DIN 6814, part 3/06.72. Dosemeters for measurement of standard ion dose of air kerma are calibrated 'free in air', but this calibration condition is not part of the quantity definition. The quantities standard ion dose or air kerma therefore can also be measured in any other material. The qunatitative relationships between standard ion dose and the quantities 'exposure' and air kerma, as given in the ICRU publication 33 'Quantities and Units' (1980), are explained. The standard introduces the SI units Gray (for energy dose), Sievert (for dose equivalent), and Becquerel (for the activity of a radioactive substance). As the change to the SI units conceals the approximated equality of the numerical values of the standrd ion dose of photon radiation in roentgen, of the energy dose for soft tissue in rad, and of the dose equivalent in rem, new definitions are given in accordance with ICRU 33 for the quantities specified dose rate, dose rate constant, and area exposure product. These definitions use the terms 'energy dose' and 'kerma'. The dose concepts applied in the field of radiation protection, especially ambient dose and individual dose, are defined as dose equivalents in compliance with the Radiation Protection Ordinance. The relevant sections present information on the conversion of standard ion dose values to the corresponding values of kerma, energy dose, or dose equivalent. (orig./HP) [de

High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

Science.gov (United States)

Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

2015-01-01

High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.