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Sample records for hifu-based external valvuloplasty

  1. Long-term results of external valvuloplasty in adult patients with isolated great saphenous vein insufficiency

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    Sarac A

    2014-04-01

    Full Text Available Atilla Sarac,1 Artan Jahollari,1 Sureyya Talay,1 Sevket Ozkaya,2 Ertugrul Ozal1 1Department of Cardiovascular Medicine, Samsun Medical Park Hospital, Samsun, Turkey; 2Department of Pulmonary Medicine, Faculty of Medicine, Bahcesehir University, Istanbul, Turkey Objective: The aim of this study is to present our 7-year results of external valvuloplasty for isolated great saphenous vein (GSV insufficiency. Methods: External valvuloplasty was applied in 83 patients with isolated GSV insufficiency. Follow-up consisted of venous color duplex scanning performed on the first postoperative day, the first postoperative month, and then annually. Valvular insufficiency, venous reflux, and venous thrombosis formation in the saphenofemoral junction were the main outcomes. Results: A complete clinical and radiological healing was observed in 50 patients (60%. In 13 cases (15.6%, a secondary surgical treatment was performed consisting of vena saphena magna high ligation/stripping and varicose vein excisions, mainly due to severe and progressive vena saphena magna valvular insufficiency and clinical persistence of symptoms. Eight patients (9.6% developed superficial vein thrombosis, and only one patient (1.2% developed deep vein thrombosis. Contact was lost from 32 patients (38.5% for different reasons. Conclusion: External valvuloplasty is an effective surgical technique for selected cases of isolated GSV insufficiency without extensive varicose dilatations. This alternative method can be safely administered as an alternative to high ligation and conventional GSV stripping. Keyword: vein, saphenous, insufficiency, external valv, valvuloplasty, varicosis

  2. Experimental investigation of thermal effects in HIFU-based external valvuloplasty with a non-spherical transducer, using high-resolution MR thermometry

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    Petrusca, Lorena; Salomir, Rares; Milleret, Réné; Pichot, Olivier; Rata, Mihaela; Cotton, François; Chapelon, Jean-Yves

    2009-09-01

    Real-time image-guided extracorporeal high intensity focused ultrasound (HIFU) has been suggested for minimally invasive treatment of valvular dysfunction in the saphenous vein. Local application of heat on the perimeter of the valve zone was previously reported to induce a partial shrinkage of the collagen, which may correct valvular function. In our study, a novel MR compatible HIFU device has been investigated. This device is based on a non-spherical geometry, with two active elements that create a focusing line which is orthogonal to the beam main axis, aiming to cover the valve longitudinally. The prototype performance was characterized by electro-acoustical measurements of the pressure field and by high-resolution MR thermometry. Pressure and thermal fields were found in good agreement with the theoretical predictions. To investigate the therapeutic potential, fresh samples of excised human veins were filled with an agarose gel, embedded in porcine muscle and exposed to HIFU. The power level applied during a fixed duration of 30 s was varied such that the absolute temperature at focus ranged between 52 °C and 83 °C. Targeting was achieved under MR guidance using a MR compatible XZ positioning system. A dedicated waterproof miniature loop coil was specifically built to achieve high-resolution MRI image-based targeting (0.25 mm × 0.25 mm × 3 mm voxel) and thermometry (0.4 mm × 0.4 mm × 4 mm voxel). The vein wall was clearly identified on MR images before and after HIFU treatment. The thermal buildup created by the non-spherical transducer could be characterized from MR thermometry data. Shrinkage of the vein wall (above 65 °C) was determined by absolute temperature and was not a cumulative thermal dose effect.

  3. Experimental investigation of thermal effects in HIFU-based external valvuloplasty with a non-spherical transducer, using high-resolution MR thermometry

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    Petrusca, Lorena; Salomir, Rares; Milleret, Rene; Pichot, Olivier; Rata, Mihaela; Chapelon, Jean-Yves [Inserm, U556, and Universite de Lyon, Lyon, F-69003 (France); Cotton, Francois [Universite Claude Bernard Lyon 1, Lyon, F-69003 (France)], E-mail: lorena.petrusca@inserm.fr

    2009-09-07

    Real-time image-guided extracorporeal high intensity focused ultrasound (HIFU) has been suggested for minimally invasive treatment of valvular dysfunction in the saphenous vein. Local application of heat on the perimeter of the valve zone was previously reported to induce a partial shrinkage of the collagen, which may correct valvular function. In our study, a novel MR compatible HIFU device has been investigated. This device is based on a non-spherical geometry, with two active elements that create a focusing line which is orthogonal to the beam main axis, aiming to cover the valve longitudinally. The prototype performance was characterized by electro-acoustical measurements of the pressure field and by high-resolution MR thermometry. Pressure and thermal fields were found in good agreement with the theoretical predictions. To investigate the therapeutic potential, fresh samples of excised human veins were filled with an agarose gel, embedded in porcine muscle and exposed to HIFU. The power level applied during a fixed duration of 30 s was varied such that the absolute temperature at focus ranged between 52 deg. C and 83 deg. C. Targeting was achieved under MR guidance using a MR compatible XZ positioning system. A dedicated waterproof miniature loop coil was specifically built to achieve high-resolution MRI image-based targeting (0.25 mm x 0.25 mm x 3 mm voxel) and thermometry (0.4 mm x 0.4 mm x 4 mm voxel). The vein wall was clearly identified on MR images before and after HIFU treatment. The thermal buildup created by the non-spherical transducer could be characterized from MR thermometry data. Shrinkage of the vein wall (above 65 deg. C) was determined by absolute temperature and was not a cumulative thermal dose effect.

  4. Improved external valvuloplasty, intravenous laser photocoagulation and local sclerotheraphy treatment of primary deep venous valvular insufficiency: long term result

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    Wang, Chun-xi; Han, Li-na; Gu, Ying; Liang, Fa-qi; Zhang, Li; Liu, Hong-yi; Zhao, Wen-guang; Wang, Qi; Wang, Xiao-ling

    2007-11-01

    The purpose of this article is to report long-term follow-up of improved external vulvuloplasty, intravenous laser photocoagulation and local sclerotherapy treatment of primary deep venous valvular insufficiency in eight hundred and seventy-two patients from Nov. 2000 to May 2006. Patients were evaluated clinically and with duplex ultrasound at 1, 3, and 12 months, and yearly thereafter until the fifth year to assess treatment efficacy and adverse reactions. Successful occlusion of the great saphenous vein and absence of deep vein reflux on color Doppler imaging, were noted in 956 limbs of 852 cases( 1 month follow-up), 946 limbs of 842 cases (6 month to 1 year follow-up), 717 of 626 (1~2 year follow-up), 501 of 417 (2~3 year follow-up), 352 of 296 (3~5year follow-up), 142 of 106 (5 year follow-up) after initial treatment. The cumulative total number of recurrence of reflux was fifteen cases. The respective competence rate was 95.18%, 96.23%, 94.23%, 95.25%, 94.23% and 94.12%. Of note, all recurrence occurred before 9 months, with the majority noted before 3 months. Bruising was noted in 0.7% of patients, tightness along the course of treated vein in 1.0% of limbs. There have been no paresthesia of cases, skin burns and deep vein thrombosis.

  5. 股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全%Treatment of primary deep venous valve insufficiency in lower limb by venous external valvuloplasty on the first valve of superficial femoral vein

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    陈寅; 黄惊鸿; 龚景庆

    2001-01-01

    Objective To evaluate the results of treatment of primary deepvenous insufficiency in lower limbs.Methods 55 patients were treated by venous external valvuloplasty on the first valve of superficial femoral vein with PTFE.Results All of the patients were followed up for 4 to 14 months after operation. The results of treatment were very good.Conclusions Primary deep venous valve insufficiency with mild to moderate venous reflux was treated by venous external valvuloplasty on the first valve of superficial femoral vein. It has advantages of few complications and simple operative technique with good results.%目的 评估应用股浅静脉第一对瓣膜包窄术治疗原发性下肢深静脉瓣膜功能不全的疗效。方法 对原发性下肢深静脉瓣膜功能不全的55例患者施以股浅静脉第一对瓣膜包窄术,包窄材料选用聚四氟乙烯人造血管。结果 本组病人术后均随访4~14个月,术前临床症状缓解,疗效好。结论 股浅静脉第一对瓣膜包窄术治疗瓣膜轻、中度倒流的原发性下肢深静脉瓣膜功能不全,有坚实的理论基础,并有并发症少,操作简单,疗效好等优点,值得推广。

  6. Percutaneous Valvuloplasty for Bioprosthetic Tricuspid Valve Stenosis

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    Malhotra, Rohit; Sharma, Anjali; Kakouros, Nikolaos

    2017-01-01

    Percutaneous transcatheter tricuspid balloon valvuloplasty (PTTBV) is an accepted treatment option for symptomatic severe native tricuspid valve stenosis, although surgical tricuspid valve replacement remains the treatment of choice. There have been few reports of successful PTTBV for bioprosthetic tricuspid valve stenosis. We present case reports of 3 patients from our hospital experience. Two of the 3 cases were successful, with lasting clinical improvement, whereas the 3rd patient failed to show a reduction in valve gradient. We describe the standard technique used for PTTBV. We present results from a literature review that identified 16 previously reported cases of PTTBV for bioprosthetic severe tricuspid stenosis, with overall favorable results. We conclude that PTTBV should perhaps be considered for a select patient population in which symptomatic improvement and hemodynamic stability are desired immediately, and particularly for patients who are inoperable or at high surgical risk.

  7. Percutaneous balloon valvuloplasty in mitral stenosis

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    Park, Jae Hyung; Oh, Byung Hee; Park, Kyung Ju; Kim, Seung Hyup; Lee, Young Woo; Han, Man Chung [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1989-02-15

    Percutaneous balloon valvuloplasty(PBV) was successfully performed in 8 mitral stenosis patients for recent 3 months. Five patients have aortic insufficiencies also and two patients have mitral regurgitations below grade II/IV. All patients showed sinus rhythm on EKG, and had no mitral valvular calcification on echocardiography and fluoroscopy. PBV resulted in an increase in mitral valve area from 1.22{+-}0.22 to 2.57{+-}0.86 cm{sup 2}, a decrease in mean left atrial pressure from 23.4{+-}9.6 to 7.5{+-}3.4 mmHg and a decrease in mean mitral pressure gradient from 21.3{+-}9.4 to 6.8{+-}3.1 mmHg. There were no significant complications except 2 cases of newly appeared and mildly aggravated mitral regurgitation. We believe that PBV will become a treatment modality of choice replacing surgical commissurotomy or valve replacement in a group of mitral stenosis patients, because of its effectiveness and safety.

  8. Right ventricular function before and after percutaneous balloon mitral valvuloplasty.

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    Burger, W; Brinkies, C; Illert, S; Teupe, C; Kneissl, G D; Schräder, R

    1997-01-01

    Aim of this study was to evaluate right ventricular performance in patients with mitral stenosis and its modification by balloon valvuloplasty. Right ventricular volumes of 24 patients with postrheumatic mitral stenosis were determined by thermodilution 1 or 2 days before and 1 or 2 days after valvuloplasty. Right ventricular ejection fraction at rest was 43 (36-47)% (median and interquartile range). Right ventricular end-diastolic volume was 100 (86-119) ml/m2. Supine bicycle exercise (50 Watt) reduced right ventricular ejection fraction to 30 (29-37)% (P volume to 124 (112-141) ml/m2 (P improvement of right ventricular ejection fraction correlated inversely with the value of this parameter before valvuloplasty (r = -0.88, P volume (r = 0.57, P < 0.01). The right ventricular function curve, disturbed before commissurotomy, was reestablished by the procedure. In conclusion, at the here investigated stage of mitral stenosis right ventricular function is reversibly impaired. This is predominantly caused by the hemodynamic consequences of the valvular defect and not by an impairment of right ventricular myocardial function.

  9. Assessment of the "long sheath" technique for percutaneous aortic balloon valvuloplasty

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    S. Plante (Sylvain); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); C. di Mario (Carlo); B. Meier (Bernard); P.W.J.C. Serruys (Patrick)

    1990-01-01

    textabstractA 100 cm-long 16.5 F valvuloplasty catheter introducer was assessed as an adjunct for percutaneous transluminal aortic valvuloplasty (PTAV) via the femoral artery in 31 patients with severe aortic stenosis. Observed improvements in peak systolic gradient (81.6 +/- 29.9 mm Hg vs. 35.5 +/-

  10. Pulmonary and tricuspid valvuloplasty in carcinoid heart disease.

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    Karimi, Ashkan; Pourafshar, Negiin; Fudge, James C

    2016-12-28

    A 26-year-old female with carcinoid heart disease consisting of severe pulmonary and tricuspid valve stenosis was admitted with line associated sepsis. She recovered from sepsis with antibiotics and aggressive fluid resuscitation but became grossly volume overloaded with evidence of tense ascites and lower extremity edema. She developed worsening renal and hepatic function due to congestive nephropathy and hepatopathy, which did not respond to intravenous diuretics, and she was deemed too sick for surgical pulmonary and tricuspid valve replacement. Pulmonary and tricuspid valvuloplasty was performed as a rescue measure to alleviate her congestive symptoms and improve her candidacy for valve replacement. © 2016 Wiley Periodicals, Inc.

  11. "ASSESSMENT OF BALLOON VALVULOPLASTY IN COMPARISON WITH SURGICAL VALVOTOMY FOR CONGENITAL AORTIC STENOSIS"

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    P. Akbari Asbagh A. Shahmohammadi

    2004-09-01

    Full Text Available Soon after successful results of balloon valvuloplasty in treatment of congenital pulmonary stenosis, use of this technique for relief of congenital aortic stenosis (AS was attempted in different parts of the world. With the purpose of assessment the value of valvuloplasty in comparison with surgical valvotomy in relief of congenital AS, we retrospectively studied 115 patients with valvar AS, 48 of whom underwent balloon valvuloplasty (mean age 9.63 years, and 67 subjected to surgical aortic valvotomy (mean age 10.32 years, in a six year period from 1991 to 1997 at Rajaie heart hospital. Comparison of balloon valvuloplasty with surgical valvotomy revealed that reduction in the mean pressure gradient in balloon valvuloplasty group was greater than those subjected to surgical valvotomy (73.54 vs. 45.03 mmHg, P < 0.0001. Decreased incidence of aortic insufficiency and mortality in balloon valvuloplasty in comparison with surgical valvotomy are other notable points in this study. Although it is difficult to compare the results of the two procedures and determine their different indications, our successful experience with balloon valvuloplasty for congenital AS and the safety of this procedure encourage us to use this technique for the patients with congenital AS more than ever. These results must be supported by future studies.

  12. The role of balloon aortic valvuloplasty in the era of transcatheter aortic valve implantation

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    Wilczek, Krzysztof; Pres, Damian; Krajewski, Adam; Poloński, Lech; Zembala, Marian; Gąsior, Mariusz

    2015-01-01

    Balloon aortic valvuloplasty is recommended in patients not suitable for transcatheter aortic valve implantation/aortic valve replacement (TAVI/AVR) or when such interventions are temporarily contraindicated. The number of performed balloon aortic valvuloplasty (BAV) procedures has been increasing in recent years. Valvuloplasty enables the selection of individuals with severe left ventricular dysfunction or with symptoms of uncertain origin resulting from concomitant disorders (including chronic obstructive pulmonary disease [COPD]) who can benefit from destination therapy (AVR/TAVI). Thanks to improved equipment, the number of adverse effects is now lower than it was in the first years after the advent of BAV. Valvuloplasty can be safely performed even in unstable patients, but long-term results remain poor. In view of the limited availability of TAVI in Poland, it is reasonable to qualify patients for BAV more often, as it is a relatively safe procedure improving the clinical condition of patients awaiting AVR/TAVI. PMID:26336471

  13. Audit of radiation dose during balloon mitral valvuloplasty procedure

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    Livingstone, Roshan S [Department of Radiology, Christian Medical College, Vellore-632004, TN (India); Chandy, Sunil [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); Peace, B S Timothy [Department of Radiology, Christian Medical College, Vellore-632004, TN (India); George, Paul [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); John, Bobby [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India); Pati, Purendra [Department of Cardiology, Christian Medical College, Vellore-632004, TN (India)

    2006-12-15

    Radiation doses to patients during cardiological procedures are of concern in the present day scenario. This study was intended to audit the radiation dose imparted to patients during the balloon mitral valvuloplasty (BMV) procedure. Thirty seven patients who underwent the BMV procedure performed using two dedicated cardiovascular machines were included in the study. The radiation doses imparted to patients were measured using a dose area product (DAP) meter. The mean DAP value for patients who underwent the BMV procedure from one machine was 19.16 Gy cm{sup 2} and from the other was 21.19 Gy cm{sup 2}. Optimisation of exposure parameters and radiation doses was possible for one machine with the use of appropriate copper filters and optimised exposure parameters, and the mean DAP value after optimisation was 9.36 Gy cm{sup 2}.

  14. Assessment of mitral valve reserve capacity before and after percutaneous balloon valvuloplasty with isoproterenol stress echocardiography

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    LIU Pin-ming; FU Xiang-yang; L(U) Jun-hao; WU Qun; Yang Fu-qing

    2002-01-01

    Objective: To explore whether successful valvuloplasty increases mitral valve reserve capacity in patients with mitral stenosis. Methods: Thirty-eight patients with pure rheumatic mitral stenosis underwent isoproterenol stress echocardiography before and after successful percutaneous balloon valvuloplasty. The mitral valve area (by direct planimetry of two-dimensional echocardiography), mean transmitral pressure gradient (by continuous-wave Doppler echocardiography), and cardiac output (by M-mode echocardiography)were measured at rest and under isoproterenol infusion to achieve heart rate of different stages. Results :Between the measurements before and after valvuloplasty, significant differences were observed in the mitral valve area (0. 91±0.28 vs 1.87±0.23 cm2, P<0.01), mean transmitral pressure gradient (12.5±6.3 vs 3. 9±1.9 mmHg, P<0. 01) and cardiac output (3.93±1.44 vs 4. 73±1.01 L/min, P<O. 05) at rest. Before valvuloplasty, the mean transmitral pressure gradient increased significantly (P<0. 01) as heart rate increased, but there were no significant differences in the measurements of mitral valve area and cardiac output (both P>0. 05). In contrast, there was a significant increase after valvuloplasty in the mean transmitral pressure gradient (P<0. 01), but both mitral valve area and cardiac output further increased (both P<0. 01) as beart rate increased. Moreover, valvuloplasty decreased the mean transmitral pressure gradient at peak heart rate from 23.0 ±4. 5 to 7.75 ±2. 30 mmHg (P<0.01) under submaximal stress. Conclusion:Successful percutaneous balloon valvuloplasty soon causes a significant increase of mitral valve reserve capacity in patients with mitral stenosis, which is conspicuously manifested under condition of hemodynamic stress.Stress echocardiography provides a safe, feasible and non-invasive means of assessing the reserve capacity.

  15. [Volume and function of the right ventricle before and after intraluminal pulmonary valvuloplasty].

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    Rangel-Abundis, A; López, H; Badui, E; Martínez-Becerril, A

    1991-01-01

    With the purpose of studying the right ventricular infundibulum response to the obstruction of the pulmonary blood flow, the authors inform the results of the right ventricular volumes, and function changes before and after pulmonary intraluminal valvuloplasty performed in six adult patients with congenital stenosis of the pulmonary valve. After the valvuloplasty, all right ventricular volumes increased but only slightly, except for the end systolic volume at the right infundibulum, which decreased after valvuloplasty (for alpha = 0.10, p less than 0.10). The ejection fraction of this infundibulum increased after valvuloplasty (for alpha = 0.05 p less than 0.03), while the ejection fraction of the inflow chamber remained unaltered. In the same way decreased the work and power of the inflow tract of the right ventricle, regardless the decreased in the ventricular overload post-valvuloplasty; however, the ratio work vs. end diastolic volume of the right ventricle decreased (for alpha = 0.05, p less than 0.03). The authors discuss these results in relation with the changes produced by the obstruction, acute or chronic, of the pulmonary blood flow on the infundibular wall tension and contractility, whose structure and behavior allow to propose that the function of the infundibulum by means of contraction protects the pulmonary vasculature, against right ventricle hypertension.

  16. How to perform combined cutting balloon and high pressure balloon valvuloplasty for dogs with subaortic stenosis.

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    Kleman, Mandi E; Estrada, Amara H; Maisenbacher, Herbert W; Prošek, Robert; Pogue, Brandon; Shih, Andre; Paolillo, Joseph A

    2012-01-01

    Subvalvular aortic stenosis (SAS) is one of the most common congenital cardiac malformations in dogs. Unfortunately, the long term success rate and survival data following either open heart surgery or catheter based intervention has been disappointing in dogs with severe subaortic stenosis. Medical therapy is currently the only standard recommended treatment option. A cutting balloon dilation catheter has been used successfully for resistant coronary artery and peripheral pulmonary arterial stenoses in humans. This catheter is unique in that it has the ability to cut, or score, the stenotic region prior to balloon dilatation of the stenosis. The use of cutting balloon valvuloplasty combined with high pressure valvuloplasty for dogs with severe subaortic stenosis has recently been reported to be a safe and feasible alternative therapeutic option. The following report describes this technique, outlines the materials required, and provides some 'tips' for successful percutaneous subaortic balloon valvuloplasty. Copyright © 2012 Elsevier B.V. All rights reserved.

  17. Isoproterenol Stress Echocardiography in Assessing Mitral Valve Area Reserve before and after Percutaneous Balloon Valvuloplasty

    Institute of Scientific and Technical Information of China (English)

    刘品明; 傅向阳; 吕俊豪; 吴群; 杨福庆

    2001-01-01

    Objective To determine whether successful valvuloplasty causes an increase of mitral valve area reserve in patients with mitral stenosis, isoproterenol stress echocardiography was used to compare mitral valve area and hemodynamic changes between pre- and post- valvuloplasty under conditions of increased cardiac work. Methods Thirtyeight patients with pure rheumatic mitral stenosis who had received successful percutaneous balloon valvulo plasty underwent isoproterenol stress echocardiography pre- and post- valvuloplasty. Mitral valve area (by direct planimetry of two- dimensional echocardiography), mean transmitral pressure gradient (by continuous-wave Doppler echocardiography), and cardiac output (by M -mode echocardiography) were measured at rest and under isoproterenol stress to achieve heart rate of different stages. Results Mitral valve area (0. 91± 0. 28 to 1. 87±0.23cm2, P <0.01), mean transmitral pressure gradient ( 12.5 ± 6. 3 to 3.9 ± 1.9mmHg, P < 0.01 ) and cardiac output (3.93 ± 1.44to 4. 73 ± 1.01 L/min, P < 0.05) at rest between pre - and post -valvuloplasty were significantly different.Pre-valvuloplasty, as heart rate increased under stress, mean transmitral pressure gradient increased significantly ( P < 0.01 ), but there were no significant differences in the measurements of mitral valve area and cardiac output (both P > 0.05). In contrast, as heart rate increased post- valvuloplasty, there was a significant increase in mean transmitral pressure gradient (P < 0.01), but both mitral valve area and cardiac output further increased significantly (both P < 0. 01) . Moreover, valvuloplasty decreased mean transmitral pressure gradient at peak heart rate from 23.0 ± 4. 5 to 7.75 ± 2.30 mmHg ( P < 0.01 ) under submaximal stress. Conclusions Successful percu taneous balloon valvuloplasty soon causes a significant increase of mitral valve area reserve in patients with mitral stenosis, which is markedly manifested under conditions of

  18. Aortic valvuloplasty of calcific aortic stenosis with monofoil and trefoil balloon catheters: practical considerations

    NARCIS (Netherlands)

    S. Plante (Sylvain); M.J.B.M. van den Brand (Marcel); L.C.P. van Veen; C. di Mario (Carlo); C.E. Essed; K.J. Beatt (Kevin); P.W.J.C. Serruys (Patrick)

    1990-01-01

    textabstractIn order to evaluate the relation between balloon design (monofoil, trefoil) and valvular configuration, experimental aortic valvuloplasty was performed in four post-mortem hearts with calcific aortic stenosis of various morphology. The degree of obstruction of the aortic orifice was ass

  19. Pulmonary valve balloon valvuloplasty compared across three age groups of children

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    Ghaffari S

    2012-05-01

    Full Text Available Shamsi Ghaffari,1 Mohammed Reza Ghaffari,2 Ali Reza Ghaffari,3 Somaie Sagafy11Department of Pediatric Cardiology, Cardiovascular Research Center, 2Department of Tuberculosis and Lung Research, 3Department of Internal Medicine, Tabriz University of Medical Sciences, Tabriz, IranAbstract: The aim of this study was to investigate the characteristics and outcomes of treating pulmonary stenosis with percutaneous valvuloplasty, and to compare them among three childhood age groups. All children under 15 years of age who had undergone pulmonary valve balloon valvuloplasty in Madani Heart Center from 2005–2009 were enrolled in this study. Data were analyzed using IBM SPSS software (SPSS, Inc, Chicago, IL. Mean (± standard deviation age of patients was 55.5 ± 47.4 months. Two-thirds of the subjects had moderate pulmonary valve stenosis. Balloon valvuloplasty failed in nearly one-fifth of the treated patients. There were 17 failures and two cases of mortality, descriptively less frequent among children >5 years; however, the observed difference was not statistically significant. Mild pulmonary valve insufficiency was a common finding.Keywords: childhood cardiology, pulmonary stenosis, percutaneous valvuloplasty

  20. Balloon aortic valvuloplasty as a bridge to aortic valve replacement in a patient with severe calcific aortic stenosis.

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    Swinkels, B M; Jaarsma, W; Wely, L Relik-van; van Swieten, H A; Ernst, J M P G; Plokker, H W M

    2003-03-01

    This case report describes a patient with severe calcific aortic stenosis who was initially considered inoperable because of a very poor left ventricular function and severe pulmonary hypertension. After balloon aortic valvuloplasty, the clinical and haemodynamic status of the patient improved to such an extent that subsequent aortic valve replacement was considered possible and eventually proved to be successful. Balloon aortic valvuloplasty has value as a potential bridge to aortic valve replacement when the risks for surgery are considered to be too high.

  1. Acute Pulmonary Reperfusion Hemorrhage: A Rare Complication After Oversized Percutaneous Balloon Valvuloplasty for Pulmonary Valve Stenosis

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    Hao-I Cheng

    2009-11-01

    Full Text Available Balloon valvuloplasty became the treatment of choice for valvular pulmonary stenosis following its first description in 1982 by Kan et al, and has almost replaced surgical pulmonary valvotomy in the present day. It is a safe and effective method for children for relief of right ventricular obstruction. The results of the procedure are excellent, without significant complications. This report describes the case of a 12-year-old boy who received successful balloon valvuloplasty for critical pulmonary valve stenosis complicated by an episode of acute pulmonary hemorrhage. Because of cyanosis, hypotension and bradycardia, he received emergent endotracheal intubation with 100% oxygen supplement and the highest infusion rate of inotropic agents. Venoarterial mode extracorporeal membrane oxygenation was indicated for life support due to the persistent high oxygenation index. Extracorporeal membrane oxygenation played a key role in the survival of this patient during the course of treatment.

  2. Palliative percutaneous balloon valvuloplasty in a cyanotic child with tetralogy of Fallot.

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    Mehta, A V; Perlman, P E

    1990-03-01

    We have presented the case of an 8-month-old child who had tetralogy of Fallot with severe pulmonary stenosis and minimal infundibular stenosis. Because of the relatively small annulus (10 mm) and young age of the infant, total correction was deferred, and a percutaneous palliative pulmonary balloon valvuloplasty was done. At the end of the procedure, he had neither cyanosis nor signs of congestive heart failure, and after four months of follow-up, he had only mild cyanosis with activities.

  3. Triple-balloon pulmonary valvuloplasty: an advantageous technique for percutaneous repair of pulmonary valve stenosis in the large pediatric and adult patients.

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    Escalera, Robert B; Chase, Thaddeus J; Owada, Carl Y

    2005-11-01

    This report describes a new valvuloplasty procedure for the treatment of pulmonary valve stenosis (PVS) and large pulmonary valve annulus (PVA) diameters using a triple-balloon valvuloplasty (TBV) technique. We sought to demonstrate the safety and efficacy of this new technique. Percutaneous balloon pulmonary valvuloplasty (BPV) is the preferred treatment for PVS. BPV in older patients with large PVA remains a challenge, even when the double-balloon valvuloplasty technique is performed. The technique was first attempted in a case where a large single balloon was unsuccessful and double-balloon valvuloplasty met with technical difficulties. Three subsequent patients underwent the procedure safely and successfully. An algorithm is presented to determine balloon size for TBV. The median PVA diameter was 23.9 mm. Balloon diameters ranged from 12 to 18 mm. The median peak right ventricular-to-pulmonary artery systolic pressure gradient was 43.5 mm Hg before valvuloplasty and was reduced to 12 mm Hg following intervention. No major complications were encountered. Percutaneous valvuloplasty using TBV can be performed safely and provides excellent clinical results. This technique offers advantages over single-balloon and double-balloon valvuloplasty techniques, especially in treatment of PVS in large pediatric or adult patients. Copyright 2005 Wiley-Liss, Inc.

  4. "I see the light!" trans-carotid balloon valvuloplasty in neonates and small infants utilizing continuous trans-esophageal echo guidance.

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    Lucas, Victor

    2015-11-01

    Continuous echo guidance may add to the safety of neonatal aortic balloon valvuloplasty Trans-carotid access is an alternative route to aortic balloon valvuloplasty in neonates Proof of preferred procedure (surgical or catheter based), procedure setting, and access site remains elusive as the disease is infrequent and single center experience remains small.

  5. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population.

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    Merino-Ingelmo, Raquel; Santos-de Soto, José; Coserria-Sánchez, Félix; Descalzo-Señoran, Alfonso; Valverde-Pérez, Israel

    2014-05-01

    Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  6. Preoperative Pulmonary Valvuloplasty in Tetralogy of Fallot with Right-To-Left Shunt

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    Baris Bugan

    2014-12-01

    Full Text Available Tetralogy of Fallot is the most common cyanotic congenital heart disease and characterized by right ventricular outflow tract obstruction, ventricular septal defect, overriding aorta, and right ventricular hypertrophy. Right ventricular outflow tract obstruction and ventricular septal defect are the major clinical components of the syndrome. Although most have undergone a corrective operation, an important minority of patients with tetralogy of Fallot have had a preoperative palliative procedure. Herein we reported a succesful palliative percutaneous balloon valvuloplasty of pulmonary stenosis at an 19-year-old female patient with tetralogy of Fallot who was considered as inoperable for corrective surgery due to right -to-left shunt.

  7. Computed Tomography During Experimental Balloon Dilatation For Calcific Aortic Stenosis. A Look into the Mechanism of Valvuloplasty

    NARCIS (Netherlands)

    C. di Mario (Carlo); L.C.P. van Veen; DE BAAT, L. (LEEN); C.E. Essed; K.J. Beatt (Kevin); O. Leborgne; SERRUYS, P.W. (PATRICK W.)

    1988-01-01

    textabstractThin‐slice contiguous computed tomographic scanning was performed in four postmortem hearts with calcific aortic valve stenosis (mean weight: 583 ± 78 g; mean age: 65 ± 10 years) before, during, and after balloon valvuloplasty. Balloons of increasing diameter (15–19 mm single balloons, a

  8. [Balloon pulmonary valvuloplasty, 15-year experience at the Siglo XXI IMSS National Medical Center].

    Science.gov (United States)

    Juárez Rodríguez, Mariano; Alva Espinosa, Carlos; Ledesma Velasco, Mariano; Lázala Rodríguez, Gustavo; Jiménez Arteaga, Santiago; Sánchez Soberanes, Agustín; Ortegón Cardeña, José; David Gómez, Felipe; Hernández González, Martha; Magaña Serrano, José

    2003-01-01

    To evaluate 15 years of experience with balloon pulmonary valvuloplasty in a single third level health care center. Hundred-fifty patients underwent the procedure, 73 (48%) men and 77 (52%) women, mean age 10.5 +/- 11.3 years. The initial systolic gradient decreased from 86 +/- 35 to 21.67 +/- 12.20 mm Hg, p < 0.001, whereas the initial right ventricular systolic pressure decreased from 106 +/- 34.8 to 53 +/- 27 mm Hg, p < 0.0001. At the end of the follow-up, 48 +/- 44 months, the systolic gradient was 13.43 +/- 8.73 mm Hg, p < 0.001. Major complications occurred in 9 (6.4%) patients. Immediate technical success was achieved in 111 (74%) patients and failure in 39 (26%). At the end of the follow-up period, successful outcomes were achieved in 104 (89.6%); in contrast, failures were present in 12 (10.4%) patients, p < 0.001. Death occurred in 2 (1.33%) patients. The predictors for failure were age < 1.5 +/- 1-33 years (p < 0.004), dysplastic valve (p < 0.001), high initial systolic gradient (p < 0.002), and high initial systolic right ventricular pressure (p < 0.0001). Balloon pulmonary valvuloplasty is an effective, safe, and first choice treatment for congenital pulmonary valve stenosis.

  9. Is autologous or heterologous pericardium better for valvuloplasty? A comparative study of calcification propensity.

    Science.gov (United States)

    Jiang, Wen-Jian; Cui, Yong-Chao; Li, Jin-Hua; Zhang, Xiu-Hui; Ding, Huan-Huan; Lai, Yong-Qiang; Zhang, Hong-Jia

    2015-06-01

    Pericardial calcification is detrimental to the long-term durability of valvuloplasty. However, whether calcification susceptibility differs between heterologous and autologous pericardium is unclear. In this study, we compared the progression of calcification in vivo between autologous and heterologous pericardium. We randomly divided 28 rabbits into 4 equal groups. Resected rabbit pericardium served as autologous pericardium, and commercial bovine pericardium served as heterologous pericardium. We subcutaneously embedded one of each pericardial patch in the abdominal walls of 21 of the rabbits. The 7 control rabbits (group A) received no implants. The embedded samples were removed at 2 months in group B, at 4 months in group C, and at 6 months in group D. Each collected sample was divided into 2 parts, one for calcium-content measurement by means of atomic-absorption spectroscopy, and one for morphologic and histopathologic examinations. When compared with the autologous pericardium, calcium levels in the heterologous pericardium were higher in groups B, C, and D (P pericardium increased faster than those in the autologous, especially in group D. Disorganized arrangements of collagenous fibers, marked calculus, and ossification were seen in the heterologous pericardium. Inflammatory cells-mainly lymphocytes and small numbers of macrophages-infiltrated the heterologous pericardium. The autologous pericardium showed a stronger ability to resist calcification. Our results indicate that autologous pericardium might be a relatively better choice for valvuloplasty.

  10. Percutaneous balloon aortic valvuloplasty in the era of transcatheter aortic valve implantation: a narrative review.

    Science.gov (United States)

    Keeble, Thomas R; Khokhar, Arif; Akhtar, Mohammed Majid; Mathur, Anthony; Weerackody, Roshan; Kennon, Simon

    2016-01-01

    The role of percutaneous balloon aortic valvuloplasty (BAV) in the management of severe symptomatic aortic stenosis has come under the spotlight following the development of the transcatheter aortic valve implantation (TAVI) technique. Previous indications for BAV were limited to symptom palliation and as a bridge to definitive therapy for patients undergoing conventional surgical aortic valve replacement (AVR). In the TAVI era, BAV may also be undertaken to assess the 'therapeutic response' of a reduction in aortic gradient in borderline patients often with multiple comorbidities, to assess symptomatic improvement prior to consideration of definitive TAVI intervention. This narrative review aims to update the reader on the current indications and practical techniques involved in undertaking a BAV procedure. In addition, a summary of the haemodynamic and clinical outcomes, as well as the frequently encountered procedural complications is presented for BAV procedures conducted during both the pre-TAVI and post-TAVI era.

  11. Extended aortic valvuloplasty: a new approach for the management of congenital valvar aortic stenosis.

    Science.gov (United States)

    Ilbawi, M N; DeLeon, S Y; Wilson, W R; Roberson, D A; Husayni, T S; Quinones, J A; Arcilla, R A

    1991-09-01

    A new technique for the treatment of congenital valvar aortic stenosis is described. It consists of augmenting the aortic cusp by extending the commissurotomy incision into the aortic wall around the leaflet insertion, mobilizing the valve cusp attachment at the commissures, and freeing the aortic insertion of the rudimentary commissure. The results of standard valvotomy performed on 48 patients (group 1) were compared with those of the new extended valvuloplasty carried out on 16 patients (group 2). The two groups were comparable in age at operation (2.7 +/- 2.1 years for group 1 versus 2.1 +/- 1.7 years for group 2; p = not significant) and in preoperative pressure gradient (58 +/- 25 mm Hg for group 1 versus 61 +/- 36 mm Hg for group 2; p = not significant). There was no operative mortality in either group. Follow-up is available on all patients, with a mean of 4.3 +/- 2.6 years for group 1 versus 1.7 +/- 0.5 years for group 2 (p = 0.05). There was one late death in group 1. Postoperative gradient was 47 +/- 13 mm Hg in group 1 versus 19 +/- 13 mm Hg in group 2 (p = 0.05). Moderate or severe regurgitation was present in 18 patients (38%) in group 1 and 2 patients (13%) in group 2 (p = not significant). Reoperation was needed in 8 patients (17%) in group 1 versus 2 patients (13%) in group 2 (p = not significant). The described valvuloplasty procedure addresses the unique pathological features of valvar aortic stenosis and provides better relief of the obstruction than the presently available techniques. Longer follow-up is needed to determine the late results of this approach.

  12. Effectiveness of balloon valvuloplasty for palliation of mitral stenosis after repair of atrioventricular canal defects.

    Science.gov (United States)

    Robinson, Joshua D; Marx, Gerald R; Del Nido, Pedro J; Lock, James E; McElhinney, Doff B

    2009-06-15

    Closure of a mitral valve (MV) cleft, small left-sided cardiac structures, and ventricular imbalance all may contribute to mitral stenosis (MS) after repair of atrioventricular canal (AVC) defects. MV replacement is the traditional therapy but carries high risk in young children. The utility of balloon mitral valvuloplasty (BMV) in postoperative MS is not established and may offer alternative therapy or palliation. Since 1996, 10 patients with repaired AVC defects have undergone BMV at a median age of 2.5 years (range 8 months to 14 years), a median of 2 years after AVC repair. At catheterization, the median value of mean MS gradients was 16 mm Hg (range 12 to 22) and was reduced by 34% after BMV. Before BMV, there was mild mitral regurgitation in 9 of 10 patients, which increased to severe in 1 patient. All patients were alive at follow-up (median 5.4 years). Repeat BMV was performed in 4 patients, 10 weeks to 18 months after initial BMV. One patient underwent surgical valvuloplasty; 3 underwent MV replacement 2, 3, and 28 months after BMV. In the 6 patients (60%) with a native MV at most recent follow-up (median 3.2 years), the mean Doppler MS gradient was 9 mm Hg, the median weight had doubled, and weight percentile had increased significantly. In conclusion, BMV provides relief of MS in most patients with repaired AVC defects; marked increases in mitral regurgitation are uncommon. Because BMV can incompletely relieve obstruction and increase mitral regurgitation, it will not be definitive in most patients but will usually delay MV replacement to accommodate a larger prosthesis.

  13. Effects of Mitral Balloon Valvuloplasty on Left Ventricular Systolic Functions: Assessment with Color Tissue Doppler

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    Cevat Kırma

    2010-04-01

    Full Text Available Objective: Left ventricular (LV systolic functions are generally depressed in Mitral Stenosis (MS. Recovery of LV systolic functions demonstrated with 2D echocardiography in some patients by mitral balloon valvuloplasty (MBV. Systolic mitral annular velocity (S' by Tissue Doppler Imaging (TDI predicts LV systolic function. We aimed to evaluate early effects of MBV on LV systolic function by TDI.Methods: Forty-eight consecutive patients included to the study (39 female, 36±10 years. A full transthoracic echocardiographic study (TTE including left ventricular ejection fraction assessment by teicholz method and mitral annular color TDI assessment was performed 24 hours before and after MBV in all patients. MBV performed by Inoue technique under guidance of TTE. Analysis of mitral lateral annular S' wave velocity was performed immediately after echocardiographic examination. Results: MBV performed successfully in 43 patients (Group A, and severe mitral regurgitation developed in 5 patients(Group B. Mitral valve area, and S’ wave velocity increased, mean and maximum mitral gradient, and left atrial diameter, and systolic pulmonary artery pressure (PAP were reduced significantly by MBV in group A patients (p<0.01, =0.046, <0.01, <0.01, <0.01, <0.01, respectively. But, only mitral valve area increased significantly ingroup B patients (p<0.01. LVEF by teicholz did not change significantly in both groups. Conclusion: Improvements of LV systolic functions after successfull MBV can easily showed by color TDI where2D echocardiography could not indicate.

  14. Transjugular approach to balloon mitral valvuloplasty helps overcome impediments caused by anatomical alterations.

    Science.gov (United States)

    Joseph, George; George, Oommen K; Mandalay, Asishkumar; Sathe, Sunil

    2002-11-01

    Ten patients who had anatomic alterations that cause impediments to successful completion of conventional transfemoral balloon mitral valvuloplasty (BMV) underwent transjugular BMV. They included six patients in whom conventional BMV could not be completed due to cardiac anatomic distortion; two patients with dextrocardia (one with visceroatrial situs solitus and the other with situs inversus); two patients with venous abnormalities (one with azygous continuation of the inferior vena cava and the other with bilateral iliac/femoral vein occlusion). Transjugular BMV was successful in all 10 patients (mean mitral valve area increasing from 0.68 +/- 0.17 to 1.92 +/- 0.40 cm(2); range, 1.56-2.76 cm(2)); it was quick (mean total fluoroscopy time, 10.5 +/- 2.7 min; range, 7.3-15.2 min); and it was safe (no major or minor complications except one patient who developed severe mitral regurgitation that only required medical therapy). The jugular approach to BMV overcomes many of the technical problems caused by anatomic changes that are encountered in transfemoral BMV and complements the latter approach. Copyright 2002 Wiley-Liss, Inc.

  15. High pacing rates for management of aortic insufficiency after balloon aortic valvuloplasty or transcatheter aortic valve replacement.

    Science.gov (United States)

    Ali, Omar; Salinger, Michael H; Levisay, Justin P; Feldman, Ted

    2014-01-01

    Aortic insufficiency (AI) after transcatheter aortic valve replacement (TAVR) is difficult to manage when associated with congestive heart failure. AI after balloon aortic valvuloplasty (BAV) may be catastrophic, especially in patients who are not candidates for TAVR. We describe the use of urgent temporary pacing, followed by permanent pacing, to increase the heart rate to diminish diastolic filling time for the short term management of AI after BAV or TAVR. The strategy is particularly useful in patients who already have permanent pacemakers, which are common in this population.

  16. Immediate Outcome of Balloon Mitral Valvuloplasty with JOMIVA Balloon during Pregnancy

    Science.gov (United States)

    Ramasamy, Ramona; Kaliappan, Tamilarasu; Gopalan, Rajendiran; Palanimuthu, Ramasmy; Anandhan, Premkrishna

    2017-01-01

    Introduction Rheumatic mitral stenosis is the most common Valvular Heart Disease encountered during pregnancy. Balloon Mitral Valvuloplasty (BMV) is one of the treatment option available if the symptoms are refractory to the medical management and the valve anatomy is suitable for balloon dilatation. BMV with Inoue balloon is the most common technique being followed worldwide. Over the wire BMV is a modified technique using Joseph Mitral Valvuloplasty (JOMIVA) balloon catheter which is being followed in certain centres. Aim To assess the immediate post procedure outcome of over the wire BMV with JOMIVA balloon. Materials and Methods Clinical and echocardiographic parameters of pregnant women with significant mitral stenosis who underwent elective BMV with JOMIVA balloon in our institute from 2005 to 2015 were analysed retrospectively. Severity of breathlessness (New York Heart Association Functional Class), and duration of pregnancy was included in the analysis. Pre procedural echocardiographic parameters which included severity of mitral stenosis and Wilkin’s scoring were analysed. Clinical, haemodynamic and echocardiographic outcomes immediately after the procedure were analysed. Results Among the patients who underwent BMV in our Institute 38 were pregnant women. Twenty four patients (63%) were in New York Heart Association (NYHA) Class III. All of them were in sinus rhythm except two (5%) who had atrial fibrillation. Thirty four patients (89.5%) were in second trimester of pregnancy at the time of presentation and four (10.5%) were in third trimester. Echocardiographic analysis of the mitral valve showed that the mean Wilkin’s score was 7.3. Mean mitral valve area pre procedure was 0.8 cm2. Mean gradient across the valve was 18 mmHg. Ten patients (26.5%) had mild mitral regurgitation and none had more than mild mitral regurgitation. Thirty six patients had pulmonary hypertension as assessed by tricuspid regurgitation jet velocity. All of them underwent BMV

  17. Balloon valvuloplasty as destination therapy in elderly with severe aortic stenosis:a cardiac catheterization study

    Institute of Scientific and Technical Information of China (English)

    Vasileios Kamperidis; Georgios K Efthimiadis; Georgios Parcharidis; Haralambos Karvounis; Stavros Hadjimiltiades; Antonios Ziakas; Georgios Sianos; Georgios Kazinakis; George Giannakoulas; Sophia-Anastasia Mouratoglou; Athanasia Sarafidou; Ioannis Ventoulis

    2015-01-01

    Background In the current era of transcatheter aortic valve replacement, there is renewed interest in balloon aortic valvuloplasty (BAV) and invasive hemodynamic evaluation of aortic stenosis (AS). The current report aimed to study the invasive hemodynamics of se-vere AS patients treated with BAV as destination therapy and to identify factors associated with better hemodynamic outcome and prognosis. Methods From 2009 to 2012, 63 high risk elderly patients were treated with BAV as destination therapy for symptomatic severe AS and were all prospectively included in the study. Their hemodynamics were invasively evaluated during catheterization, pre-and post-BAV at the same session. All Post-BAV patients were regularly followed-up. Results The patients (82 ± 6 years, 52%male) had post-BAV aortic valve area index (AVAi) significantly increased and mean pressure gradient (MPG) significantly reduced. During the follow-up of 0.9 (maximum 3.3) years, those with post-BAV AVAi<0.6 cm2/m2 compared with the AVAi≥0.6 cm2/m2 group had significantly higher mortality (60%vs. 28%, log-rank P=0.02), even after adjusting for age, gender, atrial fibrillation, chronic kidney disease, diabetes mellitus, coronary artery disease and EuroSCORE [HR:5.58, 95%confidence interval (CI):1.62−19.20, P=0.006]. The only independent predictor of moderate AS post-BAV was the pre-BAV AVAi increase by 0.1cm2/m2 (OR:3.81, 95%CI:1.33−10.89, P=0.01). Pre-BAV AVAi≥0.39 cm2/m2 could predict with sensitivity 84%and specificity 70%the post-BAV hemodynamic outcome. Conclusions BAV as destination therapy for se-vere AS offered immediate and significant hemodynamic improvement. The survival was significantly better when a moderate degree of AS was present.

  18. Persistent reduction in left ventricular strain using two-dimensional speckle-tracking echocardiography after balloon valvuloplasty in children with congenital valvular aortic stenosis.

    NARCIS (Netherlands)

    Marcus, K.A.; Korte, C.L. de; Feuth, T.; Thijssen, J.M.; Oort, A.M. van; Tanke, R.B.; Kapusta, L.

    2012-01-01

    BACKGROUND: The aim of this study was to investige serial changes of myocardial deformation using two-dimensional speckle-tracking echocardiographic (2DSTE) imaging in children undergoing balloon valvuloplasty for congenital valvular aortic stenosis (VAS). METHODS: Thirty-seven children with isolate

  19. Short-term follow-up results of percutaneous mitral balloon valvuloplasty: A single-center experience

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    Abdulkadir Yıldız

    2014-12-01

    Full Text Available Objective: We sought to analyze short-term clinical, echocardiographic, and hemodynamic consequences of percutaneous mitral balloon valvuloplasty (PMBV in the treatment of rheumatic mitral stenosis (MS in our clinic. Methods: We retrospectively reviewed 53 patients (49 females, 5 males; mean age 38±11 years who underwent PMBV for moderate or severe MS between January 2010 and October 2014. Procedural success was defined as the reaching a mitral valve area (MVA >1.5 cm2 and absence of grade 3 mitral regurgitation. Results: We were able to perform PMBV in 48 of 53 patients (91% and all the procedures that were completed were successful. PMBV couldn’t be performed in 3 patients due to inability to pass the mitral valve, 1 patient due to membranous obstructive vena cava and 1 patient due inability to perform septostomi. Two patients who underwent successful PMBV became symptomatic after an average of 14 months follow-up and mitral valve replacement was performed due to moderate-to-severe MS. Patients were followed for an average of 13 ± 8 months and atrial fibrillation development or embolic complications were not observed. Conclusion: Percutaneous mitral balloon valvuloplasty procedure is a safe and effective treatment approach with high success and low complication rates in experienced centers.

  20. ANP and BNP plasma levels in patients with rheumatic mitral stenosis after percutaneous balloon mitral valvuloplasty

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    Łukasz Mazurkiewicz

    2017-03-01

    Full Text Available Introduction: Atrial (ANP and B-type (BNP natriuretic peptides are hormones secreted by the heart as a response to volume expansion and pressure overload. Aim: To assess the changes of ANP and BNP after percutaneous balloon mitral valvuloplasty (PBMV and to investigate factors associated with endpoints. Material and methods: The study included 96 patients (90.7% females, age 51.6 ±12.2 years with rheumatic mitral valve stenosis (mitral valve area (MVA 1.18 (1.01–1.33 cm2, mean mitral gradient (MMG 8.2 (7.1–9.2 mm Hg, NYHA 2.09 (1.9–2.5. Patients were followed up for 29.1 months for the search of endpoints. Results : The PBMV was successful in all cases. After the procedure MVA increased (1.18–1.78 cm2, p < 0.01 and pulmonary capillary wedge pressure (PCWP decreased (29.8–21.8 mm Hg, p < 0.01. Concentration of ANP significantly rose 30 min after the PBMV (79.2 vs. 134.2 pg/ml, p = 0.012 and dropped significantly after 24 h (134.2 vs. 70.4 pg/ml, p = 0.01. Furthermore, after 36 months concentration of ANP did not differ from the baseline value (p = NS. BNP concentration at day 1 was lower than at baseline (94.5 vs. 80.2 pg/ml, p = 0.032. Moreover, during the follow-up period BNP continued to fall at all time points. In univariate analysis parameters associated with endpoint occurrence were baseline PAP (p = 0.023, baseline PCWP (p = 0.022, baseline NYHA (p = 0.041 and increase in 6-minute walk test (6MWT (p = 0.043. In multivariate analysis the only factor associated with endpoint occurrence was baseline NYHA (HR = 1.52, 95% CI: –1.3–1.91, p = 0.022. Conclusions : Patients with MS had increased levels of both BNP and ANP. Baseline NYHA class was found to be associated with outcomes after the procedure.

  1. Aortic Valvuloplasty as Bridging for TAVI in High-Risk Patients with Heyde’s Syndrome: A Case Report

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    Cosmo Godino

    2012-01-01

    Full Text Available There is a frequent association between aortic valve stenosis and gastrointestinal bleeding, also known as Heyde’s syndrome. In these patients, the aortic valve replacement should be recommended as “gold standard.” In high-surgical-risk patients, the Transcatheter Aortic Valve Implantation (TAVI is an alternative option. However, the risk of bleeding recurrence, related to double antiplatelet therapy started after TAVI, cannot be excluded especially in the first months. We present a case of a patient with a severe aortic valve stenosis and a history of previously documented angiodysplasia and recurrence of gastrointestinal bleeding initially treated only with balloon aortic valvuloplasty that excluded recurrence of bleeding during the subsequent six months of followup. Therefore, a definite transfemoral Edwards XT valve implantation was planned to be performed in case of recurrence of aortic stenosis.

  2. Combined percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation for rheumatic mitral stenosis and atrial fibrillation

    Energy Technology Data Exchange (ETDEWEB)

    Murdoch, Dale, E-mail: dale_murdoch@health.qld.gov.au [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia); McAulay, Laura [The Prince Charles Hospital, Brisbane (Australia); Walters, Darren L. [The Prince Charles Hospital, Brisbane (Australia); The University of Queensland, Brisbane (Australia)

    2014-11-15

    Rheumatic heart disease is a common cause of cardiovascular morbidity and mortality worldwide, mostly in developing countries. Mitral stenosis and atrial fibrillation often coexist, related to both structural and inflammatory changes of the mitral valve and left atrium. Both predispose to left atrial thrombus formation, commonly involving the left atrial appendage. Thromboembolism can occur, with devastating consequences. We report the case of a 62 year old woman with rheumatic heart disease resulting in mitral stenosis and atrial fibrillation. Previous treatment with warfarin resulted in life-threatening gastrointestinal bleeding and she refused further anticoagulant therapy. A combined procedure was performed, including percutaneous balloon mitral valvuloplasty and left atrial appendage occlusion device implantation with the Atritech® Watchman® device. No thromboembolic or bleeding complications were encountered at one year follow-up. Long-term follow-up in a cohort of patients will be required to evaluate the safety and efficacy of this strategy.

  3. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

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    Zhang-Qiang Chen

    2015-01-01

    Full Text Available Background: Tricuspid regurgitation (TR is frequently associated with severe mitral stenosis (MS, the importance of significant TR was often neglected. However, TR influences the outcome of patients. The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV procedure in rheumatic heart disease patients with mitral valve (MV stenosis and tricuspid valve regurgitation. Methods: Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR. Mitral balloon catheter made in China was used to expand MV. The following parameters were measured before and after PBMV: MV area (MVA, TR area (TRA, atrial pressure and diameter, and pulmonary artery pressure (PAP. The patients were followed for 6 months to 9 years. Results: After PBMV, the MVAs increased significantly (1.7 ± 0.3 cm 2 vs. 0.9 ± 0.3 cm 2 , P 0.05. The PAP and left ventricular ejection fraction appeared no statistical difference compared with the postoperative (P > 0.05, the remaining patients without serious complications. Conclusions: PBMV is a safe and effective procedure for MS combined with TR in patients of rheumatic heart disease. It can alleviate the symptoms and reduce the size of TR. It can also improve the quality-of-life and prognosis. Its recent and mid-term efficacy is certain. While its long-term efficacy remains to be observed.

  4. The sapheno-femoral junction valvuloplasty in the post-thrombotic syndrome: a proposal with the use of a new device

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    Sante Camilli

    2014-05-01

    Full Text Available Before developing deep venous thrombosis (DVT, most patients suffering from postthrombotic syndrome (PTS have a normal great saphenous vein (GSV. After DVT, the GSV plays a vicarious function, but many patients develop secondary varicose veins (VVs and the previous positive contribution of the GSV vanishes. In these cases the ablative strategy is generally implemented with positive results in the short-term, but commonly with late varicose recurrences. In two cases the authors preferred a different approach to preserve and recover the GSV vicarious function by sapheno-femoral junction (SFJ valvuloplasty. Out of 43 cases we treated with SFJ stretching valvuloplasty performed with the new OSES device (V-OSES, we proposed this operation to two patients (A and B suffering from PTS and secondary VVs at an early stage, classified as C3 and C4 (Clinical-Etiology-Anatomy- Pathophysiology classification, CEAP. In the VOSES operation a gentle stretching force is applied onto the apex of the opposite valve commisures so that the valve cross-section becomes oval and the cusp’s length excess is retrieved. The operation was performed on the SFJ valve having incompetent, but floating cusps visible on ultrasound (US scan. This reparative technique was undertaken under local anesthesia and was combined with disconnection of the incompetent tributaries and/or perforators. The US-duplex scanning showed that the SFJ valves were competent at month 16 (B and 20 (A follow-up after surgery and the GSV vicarious function was preserved. The stretching valvuloplasty operation is intended to repair the SFJ valve incompetence and preserve the GSV vicarious function. This approach may be useful in primary VVs, but especially in PTS when superficial reflux appears and secondary VVs are at early stage. The SFJ reparative operation may be combined with the conventional GSV conservative strategies, including incompetent tributaries ablation/ disconnection. This approach does

  5. Mitral Valvuloplasty for the Treatment of Mitral Regurgitation%二尖瓣成形术治疗二尖瓣关闭不全

    Institute of Scientific and Technical Information of China (English)

    汤吟; 李亚雄; 吴剑

    2015-01-01

    The Mitral regurgitation is one of the most common heart valve disease.The main treatment of it are mitral valve replacement and mitral valvuloplasty. Patients can benefit from mitral valvuloplasty with keeping a good left ventricular function, reducing postoperative complications and raising postoperative survival rate rather then mitral valve replacement. So,it has been widely used in the treatment of mitral regurgitation. In order to achieve the best treatment ef ect, we can according to dif erent condition of mitral regurgitation with dif erent repair technology. With the development of minimal y invasive surgical technology ,minimal y invasive valve operations and robotic mitral valve reconstruction have applied to the mitral valvuloplasty. This review makes a overview focusing on the cur ent situation of mitral valvuloplasty for mitral regurgitation.%二尖瓣关闭不全是一种常见的心脏瓣膜疾病,其治疗的方法主要为二尖瓣置换术与二尖瓣成形术。二尖瓣成形术在保持良好的左心室结构形态、血流动力学及术后并发症发生、生存率等方面较二尖瓣置换术具有明显优越性。因此,其已广泛应用于二尖瓣关闭不全的治疗。针对二尖瓣关闭不全的不同病理改变,可以根据具体情况采用不同的成形技术,以达到最好的治疗效果。目前随着微创外科的发展,小切口二尖瓣成形和机器人辅助的二尖瓣成形技术也逐渐运用到二尖瓣成形中来。因此,我们将对二尖瓣成形术治疗二尖瓣关闭不全近几年来的诊疗现状做一综述。

  6. Resultados da valvoplastia por balão do grupo submetido a plastia mitral percutânea ou cirúrgica prévias com o tratado pela primeira vez: evolução do grupo com plastia prévia Balloon valvuloplasty outcome of a group previously submitted to mitral percutaneous or surgical valve repair versus first-time valvuloplasty patients: evolution of the group previously submitted to valve repair procedures

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    Edison Carvalho S. Peixoto

    2006-05-01

    Full Text Available OBJETIVO: Avaliar 501 procedimentos de valvoplastia mitral e as diferenças entre um grupo já submetido a plastia valvar prévia por balão ou cirúrgica, com 59 procedimentos e um grupo sem intervenção prévia, com 442 procedimentos. MÉTODOS: Foi utilizado balão único em 406 procedimentos, balão de Inoue em 89, e duplo balão em seis, não havendo diferença entre os balões utilizados nos dois grupos (p=0,6610. Estudou-se a evolução a longo prazo dos pacientes com plastia prévia. RESULTADOS: O grupo submetido a plastia valvar prévia era mais velho, com maior escore ecocardiográfico, maior porcentual de pacientes em fibrilação atrial, e dos seus 59 pacientes, 48 tinham sido submetidos à comissurotomia cirúrgica, oito a valvoplastia com balão e três à comissurotomia cirúrgica e à valvoplastia com balão. Os grupos da valvoplastia com plastia valvar prévia e da valvoplastia sem intervenção prévia apresentaram pré-valvoplastia: área valvar mitral ecocardiográfica de 0,99±0,21 e 0,94±0,21 cm² (p=0,0802 e área valvar mitral (Gorlin 0,94±0,18 e 0,91±0,21 cm² (p=0,2518 e área valvar mitral pós-valvoplastia mitral de 1,95±0,44 e 2,05±0,42 cm² (p=0,1059. CONCLUSÕES: O grupo com plastia valvar prévia apresentou o mesmo resultado imediato do grupo sem intervenção prévia. O subgrupo com plastia prévia seguido a longo prazo, apresentou evolução satisfatória.OBJECTIVE: To evaluate 501 procedures of mitral balloon valvuloplasty and the differences among the group already submitted the prior surgical or balloon valvuloplasty, with 59 procedures and the group without previous intervention, with 442 procedures. METHODS: It was used the single balloon in 403, Inoue balloon in 89 and a double balloon in six, with no difference between the 2 groups (p=0.6610. RESULTS: The prior surgical or balloon valvuloplasty group was older, with higher echo score and higher atrial fibrillation rate and of its 59 patients, 48 had

  7. Comparison of the Performance of the Warfarin Pharmacogenetics Algorithms in Patients with Surgery of Heart Valve Replacement and Heart Valvuloplasty.

    Science.gov (United States)

    Xu, Hang; Su, Shi; Tang, Wuji; Wei, Meng; Wang, Tao; Wang, Dongjin; Ge, Weihong

    2015-09-01

    A large number of warfarin pharmacogenetics algorithms have been published. Our research was aimed to evaluate the performance of the selected pharmacogenetic algorithms in patients with surgery of heart valve replacement and heart valvuloplasty during the phase of initial and stable anticoagulation treatment. 10 pharmacogenetic algorithms were selected by searching PubMed. We compared the performance of the selected algorithms in a cohort of 193 patients during the phase of initial and stable anticoagulation therapy. Predicted dose was compared to therapeutic dose by using a predicted dose percentage that falls within 20% threshold of the actual dose (percentage within 20%) and mean absolute error (MAE). The average warfarin dose for patients was 3.05±1.23mg/day for initial treatment and 3.45±1.18mg/day for stable treatment. The percentages of the predicted dose within 20% of the therapeutic dose were 44.0±8.8% and 44.6±9.7% for the initial and stable phases, respectively. The MAEs of the selected algorithms were 0.85±0.18mg/day and 0.93±0.19mg/day, respectively. All algorithms had better performance in the ideal group than in the low dose and high dose groups. The only exception is the Wadelius et al. algorithm, which had better performance in the high dose group. The algorithms had similar performance except for the Wadelius et al. and Miao et al. algorithms, which had poor accuracy in our study cohort. The Gage et al. algorithm had better performance in both phases of initial and stable treatment. Algorithms had relatively higher accuracy in the >50years group of patients on the stable phase. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. MRI planimetry for diagnosis and follow-up of valve area in mitral stenosis treated with valvuloplasty

    Energy Technology Data Exchange (ETDEWEB)

    Djavidani, B.; Lipke, C.; Nitz, W.; Feuerbach, S. [Inst. fuer Roentgendiagnostik, Universitaetsklinikum Regensburg (Germany); Debl, K.; Buchner, S.; Riegger, G.; Luchner, A. [Klinik und Poliklinik fuer Innere Medizin II, Universitaetsklinikum Regensburg (Germany)

    2006-08-15

    Purpose: we sought to determine whether noninvasive planimetry by magnetic resonance imaging (MRI) is suitably sensitive and reliable for visualizing the mitral valve area (MVA) and for detecting increases in the MVA after percutaneous balloon mitral valvuloplasty (PBMV). Materials and methods: in 8 patients with mitral valve stenosis, planimetry of the MVA was performed before and after PBMV with a 1.5 T MR scanner using a breath-hold balanced gradient echo sequence (true FISP). The data was compared to the echocardiographically determined MVA (ECHO-MVA) as well as to the invasively calculated MVA by the Gorlin formula at catheterization (CATH-MVA). Results: PBMV was associated with an increase of 0.79 {+-} 0.30 cm{sup 2} in the MVA ({delta} MRI-MVA). The correlation between {delta} MRI-MVA and {delta} CATH-MVA was 0.92 (p < 0.03) and that between {delta} MRI-MVA and {delta} ECHO-MVA was 0.90 (p < 0.04). The overall correlation between MRI-MVA and CATH-MVA was 0.95 (p < 0.0001) and that between MRI-MVA and ECHO-MVA was 0.98 (p < 0.0001). MRI-MVA slightly overestimated CATH-MVA by 8.0% (1.64 {+-} 0.45 vs. 1.51 {+-} 0.49 cm{sup 2}, p < 0.01) and ECHO-MVA by 1.8% (1.64 {+-} 0.45 vs. 1.61 {+-} 0.43 cm{sup 2}, n.s.). Conclusion: magnetic resonance planimetry of the mitral valve orifice is a sensitive and reliable method for the noninvasive quantification of mitral stenosis and visualization of small relative changes in the MVA. This new method is therefore capable of diagnosing as well as following the course of mitral stenosis. It must be taken into consideration that planimetry by MRI slightly overestimates the MVA as compared to cardiac catheterization. (orig.)

  9. Surgical treatment of Ebstein's anomaly by tricuspid valvuloplasty applying autologous pericardium%利用自体心包片修复三尖瓣治疗Ebstein畸形

    Institute of Scientific and Technical Information of China (English)

    刘琛; 邵孟平

    2013-01-01

    目的 介绍一种利用自体心包片修复三尖瓣治疗Ebstein畸形的新方法和临床经验.方法 2008年1月至2012年6月手术治疗8例Ebstein畸形患者,根据Carpentier病理分型,B型1例,C型6例,D型1例.术中在Carpentier术式的基础上,应用戊二醛处理过的自体心包片重建前瓣、后瓣,增加瓣叶对合面积.结果 围术期无死亡.三尖瓣成形术后超声心动图示三尖瓣反流明显减轻.随访3~48个月,超声心动图表现明显改善,所有患者心功能均恢复至Ⅰ~Ⅱ级.结论 利用自体心包片修复三尖瓣治疗Ebstein畸形拓宽了瓣膜成形的适应证,能够更好地恢复三尖瓣的解剖形态及功能.%Objective To introduce a new method for surgical treatment of Ebstein's anomaly by tricuspid valvuloplasty applying autologous pericardium and summarize the clinical experience. Methods Eight patients of Ebstein's anomaly were treated from Jan. ,2008 to June,2012,and divided into one of type B,6 of type C and one of type D based on the Carpentier' s criteria for pathological classification. During the operations, autologous pericardia treated with glutaraldehyde were used to rebuild anterior and posterior valves, and increase the closing area of valves on the basis of the Carpentier method. Results There was no death during the perioperative period. Tricuspid regurgitation was mitigated significantly as indicated by ultrasonic cardiograms after tricuspid valvuloplasty. In the follow-up period of 3 to 48 months, the ultrasonic cardiogram performance was significantly improved and the heart function was restored to NYHA Class I or Ⅱ in all the patients. Conclusions The application of tricuspid valvuloplasty to the treatment of Ebstein s anomaly by autologous pericardium broadens indications for valvoplasty,and is more effective in restoring the anatomical form and functionality of the tricuspid.

  10. [Long-term results of mitral percutaneous valvuloplasty with Inoue technique. Seven-years experience at the Cardiology Hospital of the National Medical Center "Siglo XXI", IMSS].

    Science.gov (United States)

    Flores Flores, Jesús; Ledesma Velasco, Mariano; Palomo Villada, José Antonio; Montoya Guerrero, Silvestre; Estrada Gallegos, Joel; Astudillo Sandoval, Raúl; Abundes Velasco, Arturo; González Díaz, Belinda; Argüero Sánchez, Rubén; Farell Campa, Javier

    2006-01-01

    Since the last decade, percutaneous balloon mitral valvuloplasty with Inoue catheter is considered the treatment of choice for selected patients (mobile valve, no calcification and minimal subvalvular disease) with rheumatic mitral stenosis. We present the seven-year follow-up experience of 456 patients treated with this technique in the catheter laboratory of the Cardiology Hospital in National Medical Center SXXI. It is a retrospective, transversal and observational study performed with data obtained from January 1994 and December 2000, with a follow-up of 58.5 +/- 26.6 months (range 12-96 mean 22). We achieve an initial success of 82.8%, improvement of initial mitral valve area from 0.9 +/- 0.1 to 1.8 +/- 0.3 cm2, with a gain area from 88 to 106% (p 90%. From these patients, 93.1% remained in NYHA-II or -I functional class and the incidence of restenosis decreased.

  11. Valvoplastia mitral percutânea complicada com tamponamento cardíaco em paciente gestante Percutaneous mitral valvuloplasty complicated by cardiac tamponade in a pregnant patient

    Directory of Open Access Journals (Sweden)

    Luís Seca

    2008-11-01

    Full Text Available A ocorrência de Hemopericárdio com Tamponamento Cardíaco é uma complicação da Valvoplastia Mitral Percutânea por balão (VMB, que apesar de pouco freqüente, pode ter graves conseqüências materno-fetais. Este artigo descreve o caso de um tamponamento cardíaco após VMB em uma mulher de 28 anos, com estenose mitral reumática severa na 20ª semana de gravidez.The occurrence of hemopericardium with cardiac tamponade is a complication of percutaneous balloon mitral valvuloplasty (BMV which, although uncommon, may have severe maternal and fetal consequences. This article describes a case of cardiac tamponade following BMV in a 28-year-old woman with severe rheumatic mitral stenosis in the 20th week of gestation.

  12. [Aortic Valve Replacement after Balloon Valvuloplasty for Aortic Valve Stenosis in a Dialysis Patient with Cardiogenic Shock;Report of a Case].

    Science.gov (United States)

    Takamatsu, Masanori; Hirotani, Takashi; Ohtsubo, Satoshi; Saito, Sumikatsu; Takeuchi, Shigeyuki; Hasegawa, Tasuku; Endo, Ayaka; Yamasaki, Yu; Hayashida, Kentaro

    2015-06-01

    A 67-year-old man on chronic hemodialysis was admitted with worsening congestive heart failure due to critical aortic stenosis. Echocardiography showed severe aortic stenosis with a valve area of 0.67 cm2 and an ejection fraction of 0.31. Cardiac catheterization revealed severe pulmonary hypertension with pulmonary artery pressures of 62/32 mmHg. In the middle of cardiac catheterization, the systolic pressure declined to 60 mmHg due to cardiogenic shock. Dopamine hydrochloride and dobutamine hydrochloride infusions were necessary to maintain a systolic pressure greater than 80 mmHg. Balloon aortic valvuloplasty was urgently performed. The patient's symptoms rapidly resolved except for angina on exertion. One month later, elective aortic valve replacement was performed. The postoperative course was uneventful and the he was discharged on the 60th postoperative day. A follow-up echocardiogram 6 months postoperatively revealed normal prosthetic valve function and an ejection fraction of 0.6.

  13. [A case report of aortic valvuloplasty by rasping technique for aortic stenosis with small annulus simultaneously performed with mitral valve replacement].

    Science.gov (United States)

    Taniyasu, N; Kou, E; Hiramatsu, T; Yokoyama, S; Takenaka, A; Ikawa, O

    1997-02-01

    The patient was a 48-year-old woman with aortic stenosis and regurgitation and mitral stenosis. Preoperative cardiac catheterization revealed LV-Ao pressure gradient of 30 mmHg and regurgitation of Sellers III. The aortic annulus was measured less than 19 mm. As operative findings, the aortic annulus seemed to be too small to be replaced with 19 mm prosthetic valve. Aortic valvuloplasty (AVP) with rasping technique was performed for the aortic valve and valve replacement was carried out for the mitral valve. After aortic declamping and occurring her beat, the transesophageal echocardiographic evaluation for AVP was effective. Postoperative course was uneventful. Postoperative cardiac catheterization have shown decreased transvalvular pressure gradient up to 10 mmHg and aortic regurgitation of Sellers I.

  14. Balloon aortic valvuloplasty as a bridge-to-decision in high risk patients with aortic stenosis: a new paradigm for the heart team decision making

    Science.gov (United States)

    Saia, Francesco; Moretti, Carolina; Dall'Ara, Gianni; Ciuca, Cristina; Taglieri, Nevio; Berardini, Alessandra; Gallo, Pamela; Cannizzo, Marina; Chiarabelli, Matteo; Ramponi, Niccolò; Taffani, Linda; Bacchi-Reggiani, Maria Letizia; Marrozzini, Cinzia; Rapezzi, Claudio; Marzocchi, Antonio

    2016-01-01

    Background Whilst the majority of the patients with severe aortic stenosis can be directly addressed to surgical aortic valve replacement (AVR) or transcatheter aortic valve implantation (TAVI), in some instances additional information may be needed to complete the diagnostic workout. We evaluated the role of balloon aortic valvuloplasty (BAV) as a bridge-to-decision (BTD) in selected high-risk patients. Methods Between 2007 and 2012, the heart team in our Institution required BTD BAV in 202 patients. Very low left ventricular ejection fraction, mitral regurgitation grade ≥ 3, frailty, hemodynamic instability, serious comorbidity, or a combination of these factors were the main drivers for this strategy. We evaluated how BAV influenced the final treatment strategy in the whole patient group and in each specific subgroup. Results Mean logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE) was 23.5% ± 15.3%, age 81 ± 7 years. In-hospital mortality was 4.5%, cerebrovascular accident 1% and overall vascular complications 4% (0.5% major; 3.5% minor). Of the 193 patients with BTD BAV who survived and received a second heart team evaluation, 72.6% were finally deemed eligible for definitive treatment (25.4% for AVR; 47.2% for TAVI): 96.7% of patients with left ventricular ejection fraction recovery; 70.5% of patients with mitral regurgitation reduction; 75.7% of patients who underwent BAV in clinical hemodynamic instability; 69.2% of frail patients and 68% of patients who presented serious comorbidities. Conclusions Balloon aortic valvuloplasty can be considered as bridge-to-decision in high-risk patients with severe aortic stenosis who cannot be immediate candidates for definitive transcatheter or surgical treatment. PMID:27582761

  15. Valvoplastia mitral em pacientes jovens com cardiopatia reumática Mitral valvuloplasty in young patients with rheumatic heart disease

    Directory of Open Access Journals (Sweden)

    Fernando Antônio Fantini

    1992-06-01

    , underwent mitral valvuloplasty. Ninety-three percent of the patients were in functional class III ou IV (NYHA. The basic surgical technique used in all patients was a modified measured assy metric anuloplasty which was associated in 69.7% of the cases with another plastic procedure. Intraoperative echodopplercardiography was always used and showed a good correlation with the postoperatoty echo studies, with 64% of the patients free from residual lesions. There was no hospitalar mortality. Fifty-three (94.6% patients were followed from 1 to 40 months (mean 16.3%. There was one sudden death 3 months after the operation. Four patients were reoperated upon, 3 of whom due to recurrent rheumatic carditis. The remainder are in functional class I or II (NYHA. We conclude based on these early results that assymetric mitral anuloplasty is an excellent procedure for young patients with rheumatic heart disease, being a good alternative to valve replacement or ring implantations.

  16. SU-C-18C-02: Specifcation of X-Ray Projection Angles Which Are Aligned with the Aortic Valve Plane From a Planar Image of a Valvuloplasty Balloon Inflated Across the Aortic Valve

    Energy Technology Data Exchange (ETDEWEB)

    Fetterly, K; Mathew, V [Mayo Clinic, Rochester, MN (United States)

    2014-06-01

    Purpose: Transcatheter aortic valve replacement (TAVR) procedures provide a method to implant a prosthetic aortic valve via a minimallyinvasive, catheter-based procedure. TAVR procedures require use of interventional fluoroscopy c-arm projection angles which are aligned with the aortic valve plane to minimize prosthetic valve positioning error due to x-ray imaging parallax. The purpose of this work is to calculate the continuous range of interventional fluoroscopy c-arm projection angles which are aligned with the aortic valve plane from a single planar image of a valvuloplasty balloon inflated across the aortic valve. Methods: Computational methods to measure the 3D angular orientation of the aortic valve were developed. Required inputs include a planar x-ray image of a known valvuloplasty balloon inflated across the aortic valve and specifications of x-ray imaging geometry from the DICOM header of the image. A-priori knowledge of the species-specific typical range of aortic orientation is required to specify the sign of the angle of the long axis of the balloon with respect to the x-ray beam. The methods were validated ex-vivo and in a live pig. Results: Ex-vivo experiments demonstrated that the angular orientation of a stationary inflated valvuloplasty balloon can be measured with precision less than 1 degree. In-vivo pig experiments demonstrated that cardiac motion contributed to measurement variability, with precision less than 3 degrees. Error in specification of x-ray geometry directly influences measurement accuracy. Conclusion: This work demonstrates that the 3D angular orientation of the aortic valve can be calculated precisely from a planar image of a valvuloplasty balloon inflated across the aortic valve and known x-ray geometry. This method could be used to determine appropriate c-arm angular projections during TAVR procedures to minimize x-ray imaging parallax and thereby minimize prosthetic valve positioning errors.

  17. Application of Percutaneous Balloon Mitral Valvuloplasty in Patients of Rheumatic Heart Disease Mitral Stenosis Combined with Tricuspid Regurgitation

    Institute of Scientific and Technical Information of China (English)

    Zhang-Qiang Chen; Lang Hong; Hong Wang; Lin-Xiang Lu; Qiu-Lin Yin; Heng-Li Lai; Hua-Tai Li

    2015-01-01

    Background:Tricuspid regurgitation (TR) is frequently associated with severe mitral stenosis (MS),the importance of significant TR was often neglected.However,TR influences the outcome of patients.The aim of this study was to investigate the efficacy and safety of percutaneous balloon mitral valvuloplasty (PBMV) procedure in rheumatic heart disease patients with mitral valve (MV) stenosis and tricuspid valve regurgitation.Methods:Two hundred and twenty patients were enrolled in this study due to rheumatic heart disease with MS combined with TR.Mitral balloon catheter made in China was used to expand MV.The following parameters were measured before and after PBMV:MV area (MVA),TR area (TRA),atrial pressure and diameter,and pulmonary artery pressure (PAP).The patients were followed for 6 months to 9 years.Results:After PBMV,the MVAs increased significantly (1.7 ± 0.3 cm2 vs.0.9 ± 0.3 cm2,P < 0.01);TRA significantly decreased (6.3 ± 1.7 cm2 vs.14.2 ± 6.5 cm2,P < 0.01),right atrial area (RAA) decreased significantly (21.5 ± 4.5 cm2 vs.25.4 ± 4.3 cm2,P < 0.05),TRA/RAA (%) decreased significantly (29.3 ± 3.2% vs.44.2 ± 3.6%,P < 0.01).TR velocity (TRV) and TR continue time (TRT) as well as TRV × TRT decreased significantly (183.4 ± 9.4 cm/s vs.254.5 ± 10.7 cm/s,P < 0.01;185.7 ± 13.6 ms vs.238.6 ± 11.3 ms,P < 0.01;34.2 ± 5.6 cm vs.60.7 ± 8.5 cm,P < 0.01,respectively).The postoperative left atrial diameter (LAD) significantly reduced (41.3 ± 6.2 mm vs.49.8 ± 6.8 mm,P < 0.01) and the postoperative right atrial diameter (RAD) significantly reduced (28.7 ± 5.6 mm vs.46.5 ± 6.3 mm,P < 0.01);the postoperative left atrium pressure significantly reduced (15.6 ± 6.1 mmHg vs.26.5 ± 6.6 mmHg,P < 0.01),the postoperative right atrial pressure decreased significantly (13.2 ± 2.4 mmHg vs.18.5 ± 4.3 mmHg,P < 0.01).The pulmonary arterial pressure decreased significantly after PBMV (48.2 ± 10.3 mmHg vs.60.6 ± 15.5 mmHg,P < 0.01).The

  18. External Otitis (Swimmer's Ear)

    Science.gov (United States)

    ... to Pneumococcal Vaccine Additional Content Medical News External Otitis (Swimmer's Ear) By Bradley W. Kesser, MD, Associate ... the Outer Ear Ear Blockages Ear Tumors External Otitis (Swimmer's Ear) Malignant External Otitis Perichondritis External otitis ...

  19. Mitral valvuloplasty for congenital mitral valve regurgitation in children%二尖瓣成形术治疗小儿先天性二尖瓣反流疗效分析

    Institute of Scientific and Technical Information of China (English)

    彭永宣; 鲁亚南; 丁文祥; 苏肇伉; 刘锦纷; 徐志伟

    2011-01-01

    目的 评价二尖瓣成形术在小儿先天性二尖瓣反流治疗中的应用效果.方法 对接受二尖瓣成形术治疗的78例二尖瓣反流患儿的手术指征、手术方式、疗效及随访结果 进行分析.结果 78例患儿平均随访时间12.6个月(0.5 ~73个月).术后死亡3例,均为住院期间死亡.术后15例(19.2%)出现并发症.再次手术4例,其中3例行二尖瓣置换术,1例行二次成形术.1例因术后心力衰竭再次入院.随访期间二尖瓣反流评分与术前相比均有明显下降(P<0.05).结论 二尖瓣成形术治疗小儿先天性二尖瓣反流近期效果理想,能适应患儿的生长,可以有效地延迟或避免行二尖瓣置换术.%Objective To evaluate the application of mitral valvuloplasty to congenital mitral valve regurgitation in children. Methods The surgical indications, procedures, therapeutic effects and follow-up results of 78 children with mitral valve regurgitation undergoing mitral valvuloplasty were analysed. Results The average duration of follow up was 12.6 months (0. 5 month to 73 months). Three patients died after operation during hospitalization. Postoperative complications occurred in 15 patients (19.2%). A second operation was performed in 4 patients, including mitral valve replacement ( n = 3) and redo mitral valvuloplasty ( n = 1) . One patient was re-hospitalised due to heart failure- During the follow up, grades of mitral valve regurgitation were significantly decreased compared to those before operation (P <0.05) . Conclusion Mitral valvuloplasty in children may lead to favorable early outcomes, adapt to children's growth, and effectively delay or avoid mitral valve replacement.

  20. Troca valvar com preservação de cordas e plástica na cirurgia da insuficiência mitral crônica Valve replacement with chordal preservation and valvuloplasty for chronic mitral insufficiency

    Directory of Open Access Journals (Sweden)

    José Luiz Dancini

    2004-03-01

    Full Text Available OBJETIVO: Comparar, clinica e laboratorialmente, três grupos de pacientes submetidos ao tratamento cirúrgico da insuficiência mitral crônica isolada; um grupo submetido à plástica valvar e dois à troca da valva mitral com diferentes técnicas de preservação das cordas. MÉTODOS: Operados 28 pacientes com idade média de 54,1 anos, sem doença coronariana, multivalvar ou reoperações: 9 tiveram plástica valvar, 10 troca valvar mitral com preservação das cordas de ambas as cúspides, e 9 apenas da cúspide posterior. Avaliações clínicas, ecodopplercardiográfica e radioisotópica foram realizadas até o 6º mês de seguimento. RESULTADOS: Ao final, 88,8% encontravam-se em classe funcional I. Um faleceu por hemorragia intracraniana durante tratamento anticoagulante. Houve queda no diâmetro diastólico (pOBJECTIVE: To compare, from the clinical and laboratory points of view, 3 groups of patients undergoing surgical treatment for isolated chronic mitral insufficiency. One group underwent valvuloplasty, and the other 2 groups underwent mitral valve replacement with different techniques for chordal preservation. METHODS: Twenty-eight patients with a mean age of 54.1 years, no coronary or multivalvular disease, and no reoperation, underwent surgery as follows: 9 underwent valvuloplasty; 10 underwent mitral valve replacement with chordal preservation in both leaflets; and 9 underwent mitral valve replacement with chordal preservation only in the posterior leaflet. Clinical, Doppler echocardiographic, and radionuclide ventriculographic assessments were performed until the 6th month of follow-up. RESULTS: At the end, 88.8% of the patients were in functional class I. One died due to intracranial hemorrhage during anticoagulant treatment. The left ventricular diastolic diameter (P<0.0001 and end-diastolic volume (P<0.0001 decreased in the 3 groups. Only the patients undergoing valvuloplasty had a decrease in systolic diameter (P=0.0003 and

  1. Safety and effectiveness of combined percutaneous coronary angioplasty and aortic valvuloplasty in an elderly patient with cardiogenic shock: effect on concomitant severe mitral regurgitation.

    Directory of Open Access Journals (Sweden)

    Emanuele Cecchi

    2013-08-01

    Full Text Available An 80-year-old diabetic man with severe aortic stenosis was admitted to our hospital for cardiogenic shock complicating non-ST-elevation myocardial infarction. Echocardiographic evaluation showed also a severe degree of both left ventricular dysfunction and mitral regurgitation. The patient was initially stabilized with inotropes and mechanical ventilation was necessary because of concurrent pulmonary edema. The day after, he was submitted to coronary angiography showing bivessel coronary disease. Given the high estimated operative risk, the patient was treated with angioplasty and bare metal stent implantation on both right coronary and circumflex artery; contemporarily, balloon aortic valvuloplasty (BAV was performed with anterograde technique, obtaining a significant increase in planimetric valve area and reduction in transvalvular peak gradient. Few days after the procedure echocardiogram showed an increase in left ventricular ejection fraction, moderate aortic stenosis with mild regurgitation and moderate mitral regurgitation. Hemodynamic and clinical stabilization were also obtained, allowing amine support discontinuation and weaning from mechanical ventilation. At three months follow-up, the patient reported a further clinical improvement from discharge, and echocardiographic evaluation showed moderate aortic stenosis and an additional increase in left ventricular function and decrease in mitral regurgitation degree. In conclusion, combined BAV and coronary angioplasty were associated in our patient with hemodynamic and clinical stabilization as well as with a significant reduction in transvalvular aortic gradient and mitral regurgitation and an increase in left ventricular ejection fraction both in-hospital and at three month follow-up; this case suggests that these procedures are feasible even in hemodynamically unstable patients and are associated with a significant improvement in quality of life.

  2. Long-term pulmonary regurgitation following balloon valvuloplasty for pulmonary stenosis risk factors and relationship to exercise capacity and ventricular volume and function.

    Science.gov (United States)

    Harrild, David M; Powell, Andrew J; Tran, Trang X; Trang, Trang X; Geva, Tal; Lock, James E; Rhodes, Jonathan; McElhinney, Doff B

    2010-03-09

    This study sought to examine the prevalence and predictors of pulmonary regurgitation (PR) following balloon dilation (BD) for pulmonary stenosis (PS) and to investigate its impact on ventricular volume and function, and exercise tolerance. Balloon pulmonary valvuloplasty relieves PS but can cause late PR. The sequelae of isolated PR are not well understood. Patients were at least 7 years of age and 5 years removed from BD, and had no other form of congenital heart disease or significant residual PS. Cardiac magnetic resonance imaging and exercise testing were performed prospectively to quantify PR fraction, ventricular volumes and function, and exercise capacity. Forty-one patients underwent testing a median of 13.1 years after BD. The median PR fraction was 10%; 14 patients (34%) had PR fraction >15%; 7 (17%) had PR >30%. PR fraction was associated with age at dilation (ln-transformed, R = -0.47, p = 0.002) and balloon:annulus ratio (R = 0.57, p or =2) was present in 14/35 patients (40%). PR fraction correlated closely with indexed RV end-diastolic volume (R = 0.79, p PR fraction >15% had significantly lower peak Vo(2) than those with less PR (85 +/- 17% vs. 96 +/- 16%, p = 0.03). Mild PR and RV dilation are common in the long term following BD. A PR fraction >15% is associated with lower peak Vo(2), suggesting that isolated PR and consequent RV dilation are related to impaired exercise cardiopulmonary function. Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  3. Valvoplastia sem suporte para insuficiência mitral degenerativa: resultados a longo prazo Unsupported valvuloplasty for degenerative mitral regurgitation: long-term results

    Directory of Open Access Journals (Sweden)

    Alexsandra L. Balbinot

    2008-06-01

    êutica adequada para determinados casos.BACKGROUND: The advantages of valve repair for treatment of degenerative mitral regurgitation are well established. The procedure is associated with low mortality and morbidity rates, and low indices of reoperation, thromboembolic events and endocarditis have been reported. In most series, annuloplasty rings are implanted, but some institutions give preference to unsupported valvuloplasty. OBJECTIVE: To assess the clinical outcome of patients submitted to unsupported valvuloplasty for degenerative mitral regurgitation. METHODS: Between January 1980 and January 2003, 116 patients were submitted to the procedure. A total of 62 (53.4% were men, and mean age was 47.2 ± 16.5 years. The procedures included: Wooler annuloplasty (65.5%, unilateral annuloplasty (15.5%, quadrangular resection of the posterior leaflet (35.3%, anterior chordal shortening (20.7%, posterior chordal shortening (6.9%, and calcium debridement (0.9%. Mean follow-up was 6.5 ± 5.1 years, and the longest follow-up was 24 years. RESULTS: Mortality was 0.86% (1 pt early and 6.03% (7 pt late. Actuarial survival was 85.3% in 20 years. Most patients (55.2% presented preoperative NYHA functional class III, whereas class I was more frequent in the postoperative period (66.4%. Thromboembolic complications were observed in 4 patients (3.4%, and no correlation was seen with atrial fibrillation. Freedom from thromboembolic events was 94.8%, and similar results were observed for bacterial endocarditis. Survival free from reoperation was 79%, and 53% at 5 and 10 years, respectively. CONCLUSION: Unsupported valvuloplasty is effective and safe for treatment of degenerative mitral regurgitation, representing an adequate therapeutic alternative for selected cases.

  4. The External Degree.

    Science.gov (United States)

    Houle, Cyril O.

    This book examines the external degree in relation to the extremes of attitudes, myths, and data. Emphasis is placed on the emergence of the American external degree, foreign external-degree programs, the purpose of the external degree, the current scene, institutional issues, and problems of general policy. (MJM)

  5. 经皮二尖瓣球囊扩张术394例随访结果%Follow-up of 394 patients with percutaneous balloon mitral valvuloplasty

    Institute of Scientific and Technical Information of China (English)

    侯子山; 欧知宏; 陈冠平; 胡仁欣; 徐同龙; 马建国; 刘欣

    2001-01-01

    Objective To evaluate the long-term effect of mitral valve stenosis treated by percutaneous balloon mitral valvuloplasty (PBMV). Methods 680 cases of rheumatic mitral valve stenosis were treated by PBMV with Inoue single balloon. 394 cases were observed 38±14 months. Results Mitral valve dilatation resulted in a decrease in left atrail diameter from (44±6)mm, a decline in transmitral valve pressure gradient from (18.2±6.8)mm?Hg to (7.2±3.8)mm?Hg, and an increase in mitral valve area from (1.04±0.21)cm2 to (1.98±0.55)cm2. 8 cases of severe restenesis developed. Among them a second PBMV is required in 5 cases, 3 cases received mitral replacement. Conclusion Follow-up data shows PBMV can achieve excellent long-term results. The condition of the valves especially the severity of the subvavular lesion are the most important factors which affect the long-term effect.%目的 观察经皮二尖瓣球囊扩张术(PBMV)治疗风湿性心脏病(风心病)二尖瓣狭窄的中、远期疗效。方法 采用Inoue单球囊对680例风心病二尖瓣狭窄者行PBMV术治疗,其中394例进行了随访。平均随访时间(36±14)个月。结果 二尖瓣平均跨瓣压差由(18.2±6.8)mm Hg降至(7.2±3.8)mm Hg,瓣口面积由(1.04±0.21)cm2增至(1.98±0.55)cm2,左房内径由(44±8)mm降至(38±6)mm;8例出现明显再狭窄,其中5例再次PBMV术,3例行瓣膜置换术。结论 随访结果证实,PBMV治疗风心病二尖瓣狭窄的中、远期效果良好,瓣膜条件特别是瓣下病变的程度是影响中、远期疗效的重要因素。

  6. Regulating multiple externalities

    DEFF Research Database (Denmark)

    Waldo, Staffan; Jensen, Frank; Nielsen, Max

    2016-01-01

    Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory instrume......Open access is a well-known externality problem in fisheries causing excess capacity and overfishing. Due to global warming, externality problems from CO2 emissions have gained increased interest. With two externality problems, a first-best optimum can be achieved by using two regulatory...

  7. ExternE National Implementation Finland

    Energy Technology Data Exchange (ETDEWEB)

    Pingoud, K.; Maelkki, H.; Wihersaari, M.; Pirilae, P. [VTT Energy, Espoo (Finland); Hongisto, M. [Imatran Voima Oy, Vantaa (Finland); Siitonen, S. [Ekono Energy Ltd, Espoo (Finland); Johansson, M. [Finnish Environment Institute, Helsinki (Finland)

    1999-07-01

    ExternE National Implementation is a continuation of the ExternE Project, funded in part by the European Commission's Joule III Programme. This study is the result of the ExternE National Implementation Project for Finland. Three fuel cycles were selected for the Finnish study: coal, peat and wood-derived biomass, which together are responsible for about 40% of total electricity generation in Finland and about 75% of the non-nuclear fuel based generation. The estimated external costs or damages were dominated by the global warming (GW) impacts in the coal and peat fuel cycles, but knowledge of the true GW impacts is still uncertain. From among other impacts that were valued in monetary terms the human health damages due to airborne emissions dominated in all the three fuel cycles. Monetary valuation for ecosystem impacts is not possible using the ExternE methodology at present. The Meri-Pori power station representing the coal fuel cycle is one of the world's cleanest and most efficient coal-fired power plants with a condensing turbine. The coal is imported mainly from Poland. The estimated health damages were about 4 mECU/kWh, crop damages an order of magnitude lower and damages caused to building materials two orders of magnitude lower. The power stations of the peat and biomass fuel cycles are of CHP type, generating electricity and heat for the district heating systems of two cities. Their fuels are of domestic origin. The estimated health damages allocated to electricity generation were about 5 and 6 mECU/kWh, respectively. The estimates were case-specific and thus an generalisation of the results to the whole electricity generation in Finland is unrealistic. Despite the uncertainties and limitations of the methodology, it is a promising tool in the comparison of similar kinds of fuel cycles, new power plants and pollution abatement technologies and different plant locations with each other. (orig.)

  8. Avaliação comparativa entre valvoplastia percutânea e comissurotomia a céu aberto na estenose mitral Comparison between percutaneous balloon valvuloplasty and open commissurotomy for mitral stenosis

    Directory of Open Access Journals (Sweden)

    Luiz Francisco Cardoso

    1998-06-01

    Full Text Available OBJETIVO: Comparar resultados imediatos e após 12 meses de seguimento entre valvoplastia por balão e comissurotomia na estenose mitral. MÉTODOS: Oitenta e oito portadores de estenose mitral sintomáticos com anatomia favorável foram randomizados nos dois grupos. Todos os pacientes submeteram-se a avaliação clínica e Doppler ecocardiográfica antes, imediatamente após e 12 meses depois do procedimento. RESULTADOS: Gradiente médio mitral (mmHg diminuiu (pPURPOSE: To compare immediate and late (12 months follow up of clinical and Doppler echocardiographic results between percutaneous mitral balloon valvuloplasty and open commissurotomy in a prospective and randomized trial. METHODS: Eighty eight symptomatic patients with severe mitral stenosis and favorable anatomy were randomized in a prospective trial comparing the two procedures. All patients were submitted to clinical and Doppler echocardiographic evaluation before the procedures and immediate and twelve months thereafter. RESULTS: Mean mitral gradient (mmHg decreased from 12.2±5.8 to 5.80±2.7 (p<0.001 in commissurotomy group (CG and from 11.7±6.1 to 5.0±2.4 (p<0.001 in the balloon valvuloplasty group (VG. Mitral valve area (cm² increased from 0.98±0.21 to 2.52±0.46 in CG and from 1.05±0.25 to 2.18±0.40 in VG (p<0.001. In both groups there was a slight decrease in mitral valve area at 12 month follow-up. There was no death in either group. One patient in the VG had moderate mitral regurgitation and underwent surgery. At the 12 month follow-up, all patients in CG and 97.7% of patients in VG were in New York Heart Association functional class I or II. CONCLUSION: Both procedures were safe and showed similar immediate improvement in mitral gradient and functional class. Mitral valve area had a greater increase immediately after commissurotomy, however there was a significantly greater reduction in the CG after 12 months of follow-up, when compared to balloon valvuloplasty. In

  9. ASH External Web Portal (External Portal) -

    Data.gov (United States)

    Department of Transportation — The ASH External Web Portal is a web-based portal that provides single sign-on functionality, making the web portal a single location from which to be authenticated...

  10. External radiation surveillance

    Energy Technology Data Exchange (ETDEWEB)

    Antonio, E.J.

    1995-06-01

    This section of the 1994 Hanford Site Environmental Report describes how external radiation was measured, how surveys were performed, and the results of these measurements and surveys. External radiation exposure rates were measured at locations on and off the Hanford Site using thermoluminescent dosimeters (TLD). External radiation and contamination surveys were also performed with portable radiation survey instruments at locations on and around the Hanford Site.

  11. Externally Verifiable Oblivious RAM

    Directory of Open Access Journals (Sweden)

    Gancher Joshua

    2017-04-01

    Full Text Available We present the idea of externally verifiable oblivious RAM (ORAM. Our goal is to allow a client and server carrying out an ORAM protocol to have disputes adjudicated by a third party, allowing for the enforcement of penalties against an unreliable or malicious server. We give a security definition that guarantees protection not only against a malicious server but also against a client making false accusations. We then give modifications of the Path ORAM [15] and Ring ORAM [9] protocols that meet this security definition. These protocols both have the same asymptotic runtimes as the semi-honest original versions and require the external verifier to be involved only when the client or server deviates from the protocol. Finally, we implement externally verified ORAM, along with an automated cryptocurrency contract to use as the external verifier.

  12. External Beam Therapy (EBT)

    Science.gov (United States)

    ... Esophageal Cancer Treatment Head and Neck Cancer Treatment Lung Cancer Treatment Prostate Cancer Treatment Brain Tumor Treatment Why is ... Radiation Oncology) Breast Cancer Treatment Esophageal Cancer Treatment Lung Cancer Treatment Images related to External Beam Therapy (EBT) Sponsored ...

  13. MALIGNANT EXTERNAL OTITIS

    OpenAIRE

    Massoud Moghaddam

    1993-01-01

    Two case reports of malignant external otitis in the elderly diabetics and their complications and management with regard to our experience at Amir Alam Hospital, Department of ENT will be discussed here.

  14. Checklists for external validity

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Kidholm, Kristian; Gerke, Oke;

    2014-01-01

    RATIONALE, AIMS AND OBJECTIVES: The quality of the current literature on external validity varies considerably. An improved checklist with validated items on external validity would aid decision-makers in judging similarities among circumstances when transferring evidence from a study setting...... to an implementation setting. In this paper, currently available checklists on external validity are identified, assessed and used as a basis for proposing a new improved instrument. METHOD: A systematic literature review was carried out in Pubmed, Embase and Cinahl on English-language papers without time restrictions....... The retrieved checklist items were assessed for (i) the methodology used in primary literature, justifying inclusion of each item; and (ii) the number of times each item appeared in checklists. RESULTS: Fifteen papers were identified, presenting a total of 21 checklists for external validity, yielding a total...

  15. Migration with fiscal externalities.

    Science.gov (United States)

    Hercowitz, Z; Pines, D

    1991-11-01

    "This paper analyses the distribution of a country's population among regions when migration involves fiscal externalities. The main question addressed is whether a decentralized decision making [by] regional governments can produce an optimal population distribution...or a centralized intervention is indispensable, as argued before in the literature.... It turns out that, while with costless mobility the fiscal externality is fully internalized by voluntary interregional transfers, with costly mobility, centrally coordinated transfers still remain indispensable for achieving the socially optimal allocation."

  16. Sen cycles and externalities

    OpenAIRE

    Piggins, Ashley; Salerno, Gillian

    2016-01-01

    It has long been understood that externalities of some kind are responsible for Sen’s (1970) theorem on the impossibility of a Paretian liberal. However, Saari and Petron (2006) show that for any social preference cycle generated by combining the weak Pareto principle and individual decisiveness, every decisive individual must suffer at least one strong negative externality. We show that this fundamental result only holds when individual preferences are strict. Building on their contribution,...

  17. Predictors of paravalvular aortic regurgitation following self-expanding Medtronic CoreValve implantation: the role of annulus size, degree of calcification, and balloon size during pre-implantation valvuloplasty and implant depth.

    Science.gov (United States)

    Ali, O F; Schultz, C; Jabbour, A; Rubens, M; Mittal, T; Mohiaddin, R; Davies, S; Di Mario, C; Van der Boon, R; Ahmad, A S; Amrani, M; Moat, N; De Jaegere, P P T; Dalby, M

    2015-01-20

    We sought to investigate the role of balloon size during pre-implantation valvuloplasty in predicting AR and optimal Medtronic CoreValve (MCS) implantation depth. Paravalvular aortic regurgitation (AR) is common following MCS implantation. A number of anatomical and procedural variables have been proposed as determinants of AR including degree of valve calcification, valve undersizing and implantation depth. We conducted a multicenter retrospective analysis of 282 patients who had undergone MCS implantation with prior cardiac CT annular sizing between 2007 and 2011. Native valve minimum (Dmin), maximum (Dmax) and arithmetic mean (Dmean) annulus diameters as well as agatston calcium score were recorded. Nominal and achieved balloon size was also recorded. AR was assessed using contrast angiography at the end of each procedure. Implant depth was measured as the mean distance from the nadir of the non- and left coronary sinuses to the distal valve frame angiographically. 29 mm and 26 mm MCS were implanted in 60% and 39% of patients respectively. The majority of patients (N=165) developed AR <2 following MCS implantation. AR ≥3 was observed in 16% of the study population. High agatston calcium score and Dmean were found to be independent predictors of AR ≥3 in multivariate analysis (P<0.0001). Nominal balloon diameter and the number of balloon inflations did not influence AR. However a small achieved balloon diameter-to-Dmean ratio (≤0.85) showed modest correlation with AR ≥3 (P=0.04). This observation was made irrespective of the degree of valve calcification. A small MCS size-to-Dmean ratio is also associated with AR ≥3 (P=0.001). A mean implantation depth of ≥8+2mm was also associated with AR ≥3. Implantation depth of ≥12 mm was associated with small MCS diameter-to-Dmean ratio and increased 30-day mortality. CT measured aortic annulus diameter and agatston calcium score remain important predictors of significant AR. Other procedural predictors

  18. Environmental external effects from wind power based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1998-01-01

    The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective...

  19. Externality or sustainability economics?

    Energy Technology Data Exchange (ETDEWEB)

    Bergh, Jeroen C.J.M. van den [ICREA, Barcelona (Spain); Department of Economics and Economic History and Institute for Environmental Science and Technology, Universitat Autonoma de Barcelona (Spain)

    2010-09-15

    In an effort to develop 'sustainability economics' Baumgaertner and Quaas (2010) neglect the central concept of environmental economics-'environmental externality'. This note proposes a possible connection between the concepts of environmental externality and sustainability. In addition, attention is asked for other aspects of 'sustainability economics', namely the distinction weak/strong sustainability, spatial sustainability and sustainable trade, distinctive sustainability policy, and the ideas of early 'sustainability economists'. I argue that both sustainability and externalities reflect a systems perspective and propose that effective sustainability solutions require that more attention is given to system feedbacks, notably other-regarding preferences and social interactions, and energy and environmental rebound. The case of climate change and policy is used to illustrate particular statements. As a conclusion, a list of 20 insights and suggestions for research is offered. (author)

  20. Metasurface external cavity laser

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Luyao, E-mail: luyaoxu.ee@ucla.edu; Curwen, Christopher A.; Williams, Benjamin S. [Department of Electrical Engineering, University of California, Los Angeles, California 90095 (United States); California NanoSystems Institute, University of California, Los Angeles, California 90095 (United States); Hon, Philip W. C.; Itoh, Tatsuo [Department of Electrical Engineering, University of California, Los Angeles, California 90095 (United States); Chen, Qi-Sheng [Northrop Grumman Aerospace Systems, Redondo Beach, California 90278 (United States)

    2015-11-30

    A vertical-external-cavity surface-emitting-laser is demonstrated in the terahertz range, which is based upon an amplifying metasurface reflector composed of a sub-wavelength array of antenna-coupled quantum-cascade sub-cavities. Lasing is possible when the metasurface reflector is placed into a low-loss external cavity such that the external cavity—not the sub-cavities—determines the beam properties. A near-Gaussian beam of 4.3° × 5.1° divergence is observed and an output power level >5 mW is achieved. The polarized response of the metasurface allows the use of a wire-grid polarizer as an output coupler that is continuously tunable.

  1. Stochastic Control - External Models

    DEFF Research Database (Denmark)

    Poulsen, Niels Kjølstad

    2005-01-01

    This note is devoted to control of stochastic systems described in discrete time. We are concerned with external descriptions or transfer function model, where we have a dynamic model for the input output relation only (i.e.. no direct internal information). The methods are based on LTI systems...

  2. Productivity Change and Externalities

    DEFF Research Database (Denmark)

    Kravtsova, Victoria

    2014-01-01

    firms and the economy as a whole. The approach used in the current research accounts for different internal as well as external factors that individual firms face and evaluates the effect on changes in productivity, technology as well as the efficiency of domestic firms. The empirical analysis focuses...... change in different types of firms and sectors of the economy...

  3. Multiple external root resorption.

    Science.gov (United States)

    Yusof, W Z; Ghazali, M N

    1989-04-01

    Presented is an unusual case of multiple external root resorption. Although the cause of this resorption was not determined, several possibilities are presented. Trauma from occlusion, periodontal and pulpal inflammation, and resorption of idiopathic origin are all discussed as possible causes.

  4. Interventional treatment of common congenital heart diseases: the common view of Chinese medical experts.Part Four:Percutaneous balloon valvuloplasty for pulmonary and aortic valve stenosis%常见先天性心脏病介入治疗中国专家共识四、经皮球囊肺动脉瓣与主动脉瓣成形术

    Institute of Scientific and Technical Information of China (English)

    中国医师协会心血管内科分会先心病工作委员会

    2011-01-01

    经皮球囊肺动脉瓣成形术已成为肺动脉瓣狭窄的首选治疗方法,先天性主动脉瓣狭窄亦可通过球囊扩张方法得到缓解.典型肺动脉瓣狭窄跨瓣压差≥ 40 mmHg,主动脉瓣狭窄跨瓣压差≥ 60 mmHg是球囊成形术的适应证.球囊成形术成功的关键在于谨慎选择合适的患者,熟练地掌握操作方法,严格挑选球囊的类型、大小和长度,避免损伤腱索和瓣膜周围组织.新生儿和婴幼儿的球囊扩张风险较大,要注意减少并发症的发生.%Percutaneous balloon valvuloplasty has become the treatment of first choice for pulmonary valve stenosis. Congenital aortic valve stenosis can also be relieved by percutaneous balloon dilatation.Percutaneous valvuloplasty is indicated for patients with isolated pulmonary valve stenosis when the transvalvular peak systolic pressure gradient is over 40 mmHg and for patients with aortic valve stenosis when the pressure gradient exceeds 60 mmHg. A careful selection of patients, standardized procedure,individualized selection of the balloon type , size and length, and careful avoidance of any damage to chorda tendineae and to surrounding tissue are keys to achieving a successful procedure. Balloon valvuloplasty should be selectively performed in new-born and in infant since complications of the procedure are inversely related to age. (J Intervent Radiol, 2011, 20: 253-260)

  5. RESULTADOS DE LA VALVULOPLASTIA MITRAL PERCUTÁNEA. EXPERIENCIA EN EL INSTITUTO DE CARDIOLOGÍA Y CIRUGÍA CARDIOVASCULAR DE CUBA (1998-2004 / Results of percutaneous mitral valvuloplasty. Experiences at the Cardiology and Cardiovascular Surgery Institute in Cuba (1998-2004

    Directory of Open Access Journals (Sweden)

    Raymid García Fernández

    2010-03-01

    Full Text Available Antecedents and Objectives: The percutaneous mitral valvuloplasty is the procedure of choice in patients with mitral stenosis and an adequate valvular anatomy. The cases treated in Cuba were few until 1998, and the first ones were carried out by foreign medical professionals. This article aims at showing the results of the development of this technique in Cuba. Method: A total of 110 consecutive percutaneous mitral valvuloplasties were carried out in 107 patients (three of them were repeated due to restenosis at the Cuban Cardiology and Cardiovascular Surgery Institute, between June 17th 1998 and June 30th 2004 (106 using the Inoue method and 4 by Multi-track. The average evolution time was 24.6 months (72 maximum and 1,93 minimum. Results: Before the procedure, 94.54 percent of the patients were within the functional classification III and IV of the NYHA; after the procedure 96,36 percent were within functional classification I and II. Using the Wilkins score ≤ 8, average areas of 2,18 cm2 were obtained; and between 9 and 12, areas of 1,81 cm2. The initial success of the procedure was 96,36 percent, and without complications 92,72 percent. Mortality was 0,9 percent, survival 100 percent, and 91,74 percent of the patients were free from complications. As an adverse event in the follow-up it was determined a mitral reestenosis in 5 patients (4,54 %. The average stay in hospital was of 1,36 days. The savings concerning hospitalization was of $ 4136775.39. Conclusions: Percutaneous mitral valvuloplasty is a safe and effective method in patients with mitral stenosis; its results remain in the sort, medium or long run.

  6. ExternE transport methodology for external cost evaluation of air pollution

    DEFF Research Database (Denmark)

    Jensen, S. S.; Berkowicz, R.; Brandt, J.

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AirGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Initially, a brief description of the ExternE Tranport methodology is given and it is summaris...

  7. The External Mind

    DEFF Research Database (Denmark)

    The External Mind: an Introduction by Riccardo Fusaroli, Claudio Paolucci pp. 3-31 The sign of the Hand: Symbolic Practices and the Extended Mind by Massimiliano Cappuccio, Michael Wheeler pp. 33-55 The Overextended Mind by Shaun Gallagher pp. 57-68 The "External Mind": Semiotics, Pragmatism......, Extended Mind and Distributed Cognition by Claudio Paolucci pp. 69-96 The Social Horizon of Embodied Language and Material Symbols by Riccardo Fusaroli pp. 97-123 Semiotics and Theories of Situated/Distributed Action and Cognition: a Dialogue and Many Intersections by Tommaso Granelli pp. 125-167 Building...... Action in Public Environments with Diverse Semiotic Resources by Charles Goodwin pp. 169-182 How Marking in Dance Constitutes Thinking with the Body by David Kirsh pp. 183-214 Ambiguous Coordination: Collaboration in Informal Science Education Research by Ivan Rosero, Robert Lecusay, Michael Cole pp. 215-240...

  8. External-Memory Multimaps

    CERN Document Server

    Angelino, Elaine; Mitzenmacher, Michael; Thaler, Justin

    2011-01-01

    Many data structures support dictionaries, also known as maps or associative arrays, which store and manage a set of key-value pairs. A \\emph{multimap} is generalization that allows multiple values to be associated with the same key. For example, the inverted file data structure that is used prevalently in the infrastructure supporting search engines is a type of multimap, where words are used as keys and document pointers are used as values. We study the multimap abstract data type and how it can be implemented efficiently online in external memory frameworks, with constant expected I/O performance. The key technique used to achieve our results is a combination of cuckoo hashing using buckets that hold multiple items with a multiqueue implementation to cope with varying numbers of values per key. Our external-memory results are for the standard two-level memory model.

  9. Balloon valvuloplasty for congenital aortic valve stenosis in children%经皮球囊瓣膜成形术治疗儿童主动脉瓣狭窄的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    吴琳; 齐春华; 何岚; 刘芳; 陆颖; 黄国英

    2014-01-01

    Objective To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty(PBAV) for congenital aortic valve stenosis in children.Method This is a retrospective clinical study including 14 children treated with PBAV for congenital aortic valve stenosis from October 2006 to December 2012 in our institute.During clinical follow-up,aortic residual stenosis and restenosis,left ventricular function and the procedure-related complications,including the approach artery injury,and aortic regurgitation were particularly assessed.Result A total of 14 patients consisting of 12 boys and 2 girls underwent the procedure,with mean age (17.1 ± 10.5) months (range from 8 days to 6 years) and the mean body weight (8.9 ± 5.5) kg (range from 1.9 kg to 23.0 kg).The indication for PBAV was a Doppler-derived peak instaneous gradient of ≥75 mmHg(1 mmHg =0.133 kPa) or a smaller gradient with signs of severe left ventricular dysfunction or left ventricular strain on the ECG.The mean ratio of balloon-annulus was 0.92 ± 0.09 (range from 0.75 to 1.09).The catheter-measured peak systolic valve gradient was successfully relieved in all the patients,decreasing from (69 ± 26) mmHg to (29 ± 13) mmHg immediately after balloon valvuloplasty (t =7.628,P =0.000).The Doppler-derived peak and mean gradient decreased from (95 ±21) mmHg and (50 ±7) mmHg to (49 ± 16) mmHg and (24 ± 11) mmHg,respectively(t =7.630,10.401 ; P =0.000,0.000).The mean follow-up period was 1 day to 61 months.At follow-up,2 patients (2/14,14%) underwent the second balloon valvuloplasty for the significant restenosis,and both showed successful relief of restenosis,however 1 patient required surgical Ross procedure due to significant recurrent systolic pressure gradient and moderate aortic regurgitation 4 years after the second balloon valvuloplasty.Among the 3 young infants who presented with congestive heart failure before intervention,1 died 1 day after the procedure,the other 2 patients had improved

  10. Regularization by External Variables

    DEFF Research Database (Denmark)

    Bossolini, Elena; Edwards, R.; Glendinning, P. A.

    2016-01-01

    Regularization was a big topic at the 2016 CRM Intensive Research Program on Advances in Nonsmooth Dynamics. There are many open questions concerning well known kinds of regularization (e.g., by smoothing or hysteresis). Here, we propose a framework for an alternative and important kind of regula...... of regularization, by external variables that shadow either the state or the switch of the original system. The shadow systems are derived from and inspired by various applications in electronic control, predator-prey preference, time delay, and genetic regulation....

  11. Clinical Application of Annuloplasty Ring in Tricuspid Valvuloplasty for the Treatment of Tricuspid Regurgitation%成形环在三尖瓣成形术治疗三尖瓣关闭不全中的临床应用

    Institute of Scientific and Technical Information of China (English)

    刘勇; 刘健; 黄击修; 李世樱; 林小彬; 付建

    2013-01-01

    目的 观察利用人工瓣环行三尖瓣成形术治疗风湿性心脏病继发性三尖瓣关闭不全患者的近、中期效果. 方法 2009年12月至201 1年9月四川省简阳市人民医院共有41例风湿性心脏病患者接受左心瓣膜置换术并同期置人人工瓣环行三尖瓣成形术,其中男12例、女29例,平均年龄49(21~67)岁.术前合并心房颤动38例,合并左心房血栓13例;三尖瓣微量反流2例,轻度反流5例,中度反流11例,重度反流23例;行二尖瓣置换术28例,二尖瓣+主动脉瓣置换术13例.所有患者术后均经门诊随访(术后每3个月门诊复查1次),术后6个月复查心脏彩色超声心动图观察三尖瓣反流情况. 结果 术后心功能较术前改善2~3级,心功能Ⅰ级和Ⅱ级共39例,差异有统计学意义(P<0.05);全组患者随访6~27个月,随访期内无死亡.术后6个月心脏彩色超声心动图检查提示:三尖瓣反流程度较术前明显减轻,微量反流和轻度反流共39例,差异有统计学意义(P<0.05);术后右心测值较术前明显缩小,右心室横径由术前20 mm降至术后17mm,差异有统计学意义(P<0.05). 结论 利用人工瓣环行三尖瓣成形术治疗继发性三尖瓣关闭不全,其近、中期疗效明确,远期疗效需要继续随访观察.%Objective To observe early and intermediate-term clinical outcomes of tricuspid valvuloplasty with annuloplasty ring for the treatment of secondary tricuspid regurgitation (TR) of patients with rheumatic heart disease. Methods From December 2009 to September 2011,41 patients with rheumatic heart disease underwent left-side heart valve replacement and concomitant tricuspid valvuloplasty with annuloplasty ring in Sichuan Jianyang People's Hospital. There were 12 males and 29 females with their mean age of 49 (21-67) years. Preoperatively, there were 38 patients with atrial fibrillation, 13 patients with left atrial thrombus; 2 patients with trivial TR, 5 patients with

  12. 三尖瓣成形对于左心瓣膜置换术后远期三尖瓣返流的预防作用%The Effect of Tricuspid Valvuloplasty on Preventing Tricuspid Regurgitation Long after Left-sided Valve Replacement

    Institute of Scientific and Technical Information of China (English)

    李虔桢; 陈道中; 陈良万; 吴锡阶

    2011-01-01

    Objective To discuss the effect of tricuspid valvuloplasty on preventing tricuspid re gurgitation(TR) long after left-sided valve replacement. Methods From January 2001 to June 2006 a to tal of 105 patients complicating slightly TR or not, were undergone left-sided valve replacement. The pa tients were divided into tricuspid-valvuloplasty group (group TA) and un-tricuspid-valvuloplasty group (group NTA) according to whether performed tricuspid valvuloplasty or not. Each patients was per formed echocardiography long term(≥5 years) after surgery, RV, RA, PA, TV AD and the degree of TR were compared bet-ween two groups. Results There were no demographic differences bet-ween two groups previous surgery. Long after surgery, the RV, RA, PAP and TV AD of group TA were im proved; the PAP of group NTA was improved too, but the RV and RA was not improved, and the TVAD was increased; The TVAD of group NTA was greater than group TA, -while the number and the degree of TR in group NTA was obviously serious than in group TA. Conclusion TR may take place in patients complicating slightly TR or not long after left-sided valve replacement. Tricuspid valvuloplasty can effec tively prevent TR long after surgery.%目的 探讨三尖瓣成形(TA)对于左心瓣膜置换术后远期三尖瓣返流(TR)的预防作用.方法 总结2001年1月-2006年6月105例术前无TR或合并轻度TR的左心瓣膜矫治手术病例.根据术中是否行TA术将患者分为成形组(TA组,n=46)和非成形组(NTA组,n=59).随访≥5年,复查超声心动图并比较右心室前后径(RV)、右心房前后径(RA)、肺动脉压力(PAP)、三尖瓣环直径(TVAD)及TR程度.结果 术前TA组与NTA组各指标无显著差别;远期随访TA组RV、RA、PAP、TVAD均比术前改善(P<0.05);NTA组PAP较术前改善(P <0.05),RV及RA与术前无明显差别,TVAD较术前扩大(P<0.05);NTA组中TVAD明显大于TA组,TR加重例数、程度明显高于TA组.结论 术前无TR或合并轻度TR的左心瓣

  13. External Measures of Cognition

    Directory of Open Access Journals (Sweden)

    Osvaldo eCairo

    2011-10-01

    Full Text Available The human brain is undoubtedly the most impressive, complex and intricate organ that has evolved over time. It is also probably the least understood, and for that reason, the one that is currently attracting the most attention. In fact, the number of comparative analyses that focus on the evolution of brain size in Homo sapiens and other species has increased dramatically in recent years. In neuroscience, no other issue has generated so much interest and been the topic of so many heated debates as the difference in brain size between socially defined population groups, both its connotations and implications. For over a century, external measures of cognition have been related to intelligence. However, it is still unclear whether these measures actually correspond to cognitive abilities. In summary, this paper must be reviewed with this premise in mind.

  14. External fixators in haemophilia.

    Science.gov (United States)

    Lee, V; Srivastava, A; PalaniKumar, C; Daniel, A J; Mathews, V; Babu, N; Chandy, M; Sundararaj, G D

    2004-01-01

    External fixators (EF) are not commonly used for patients with haemophilia. We describe the use of EF (Ilizarov, AO- uni- and bi-planar fixators and Charnley clamp) in nine patients (mean age: 19.2 years; range: 9-37) with haemophilia for the following indications - arthrodesis of infected joints, treatment of open fractures and osteoclasis. EF required an average of nine skin punctures [range: 4-17 were maintained for a period of 15 weeks (range: 8-29.5), without regular factor replacement, till bone healing was adequate and were removed with a single dose of factor infusion]. The mean preoperative factor level achieved was 85% (range: 64-102%). Much lower levels were subsequently maintained till wound healing. The average total factor consumption was 430 IU kg(-1) (range: 240-870), administered over a period of 17 days (range: 9-44). There were no major complications related to EF except in a patient who developed inhibitors. In conclusion, EF can be used safely in haemophilic patients who do not have inhibitors and does not require prolonged factor replacement.

  15. TRAUMA VALVULAR MITRAL EN UN LACTANTE DURANTE LA VALVULOPLASTIA AÓRTICA Y SU TRATAMIENTO QUIRÚRGICO / Mitral valve trauma in an infant during aortic valvuloplasty and its surgical treatment

    Directory of Open Access Journals (Sweden)

    Francisco Díaz Ramírez

    2013-04-01

    Full Text Available Resumen: La valvuloplastia con globo es ampliamente aceptada como tratamiento de elección de la estenosis aórtica congénita en recién nacidos y lactantes. Las complicaciones por el procedimiento son bien conocidas pero el daño valvular mitral es infrecuente. Se presenta un paciente masculino, de siete meses de edad, con el diagnóstico de coartación de la aorta y estenosis valvular aórtica a quién se le realizó dilatación de ambas lesiones por cateterismo intervencionista. A las 20 horas del procedimiento se diagnosticó insuficiencia cardíaca grave secundaria a lesión de la valva anterior mitral. Se intervino quirúrgicamente de urgencia y se observó un desgarro en forma de hendidura desde el borde libre hasta el anillo, el cual se reparó y se realizó anuloplastia en la comisura lateral. En el postoperatorio inmediato evolucionó sin complicaciones y al año de seguimiento presenta insuficiencia valvular mitral leve sin signos de recoartación ni de estenosis valvular aórticas. / Abstract: Balloon valvuloplasty is widely accepted as the treatment of choice for congenital aortic stenosis in newborns and infants. Complications from the procedure are well known but mitral valve damage is rare. This is the case of a 7-month-old male patient with the diagnosis of coarctation of the aorta and aortic valve stenosis who underwent dilation of both lesions via catheterization. At 20 hours of the procedure a severe heart failure secondary to an injury of the anterior mitral valve was diagnosed. The patient underwent emergency surgery and a slit-like tear from the free edge to the annulus was observed, which was repaired and annuloplasty in the lateral commissure was performed. In the immediate postoperative period the patient progressed without complications and at one year follow up he shows mild valve regurgitation without evidence of recoarctation or aortic valve stenosis.

  16. Skepticism, contextualism, externalism and modality

    National Research Council Canada - National Science Library

    Ron Wilburn

    2006-01-01

    .... However, because efforts to contextualize externalism via subjunctive conditional analysis court circularity, it is only on an internalistic interpretation that contextualist strategies can even be motivated...

  17. ExternE transport methodology for external cost evaluation of air pollution

    DEFF Research Database (Denmark)

    Jensen, S. S.; Berkowicz, R.; Brandt, J.

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AirGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Initially, a brief description of the ExternE Tranport methodology is given and it is summaris...... how the methodology has been applied so far in a previous Danish study. Finally, results of a case study are reported. Exposure factors have been calculated for various urban categories in the Greater Copenhagen Area...

  18. ExternE transport methodology for external cost evaluation of air pollution (DK)

    Energy Technology Data Exchange (ETDEWEB)

    Solvang Jensen, S.; Berkowicz, R.; Brandt, J. [National Environmental Research Inst., Dept. of Atmospheric Environment (Denmark); Willumsen, E.; Kristensen, N.B. [COWI (Denmark)

    2004-07-01

    The report describes how the human exposure estimates based on NERI's human exposure modelling system (AiGIS) can improve the Danish data used for exposure factors in the ExternE Transport methodology. Inititally, a brief description of the ExternE Transport methodology is given and it is summarised how the methodology has been applied so far in a previous Danish study. Finally, results of a case study are reported. Exposure factors have been calculated for various urban categories in the Greater Copenhagen Area. (au)

  19. External coating of colonic anastomoses

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Achiam, Michael Patrick; Rosenberg, Jacob

    2012-01-01

    Colon anastomotic leakage remains both a frequent and serious complication in gastrointestinal surgery. External coating of colonic anastomoses has been proposed as a means to lower the rate of this complication. The aim of this review was to evaluate existing studies on external coating of colonic...

  20. Retrofitting Systems for External Walls

    DEFF Research Database (Denmark)

    Rose, Jørgen

    1997-01-01

    In this report, 9 different external and internal retrofitting systems are analyzed using numerical calculations. The analysis focuses on the thermal bridge effects in the different systems, and on this basis it is discussed whether internal or external retrofitting has the most advantages...

  1. Performance Targets and External Benchmarking

    DEFF Research Database (Denmark)

    Friis, Ivar; Hansen, Allan; Vámosi, Tamás S.

    Research on relative performance measures, transfer pricing, beyond budgeting initiatives, target costing, piece rates systems and value based management has for decades underlined the importance of external benchmarking in performance management. Research conceptualises external benchmarking...... the conditions upon which the market mechanism is performing within organizations. This paper aims to contribute to research by providing more insight to the conditions for the use of external benchmarking as an element in performance management in organizations. Our study explores a particular type of external...... towards the conditions for the use of the external benchmarks we provide more insights to some of the issues and challenges that are related to using this mechanism for performance management and advance competitiveness in organizations....

  2. Adaptações fisiológicas precoces e tardias após valvotomia mitral por cateter balão Early and late physiological effects of balloon mitral valvuloplasty

    Directory of Open Access Journals (Sweden)

    Japy Angelini Oliveira Fº

    1998-02-01

    Full Text Available OBJETIVO: Avaliação não invasiva das respostas cardiopulmonares ao exercício a curto e longo prazo após valvotomia mitral por cateter balão. MÉTODOS: Estudaram-se 9 pacientes do sexo feminino, 35±9 anos, com estenose mitral, tipo funcional II ou III, em uso de digitálicos e diuréticos, através de teste ergoespirométrico, eletrocardiograma e ecocardiograma, antes e após valvotomia em fase precoce (3 a 5 dias e tardia (8 a 12 meses. RESULTADOS: Os pacientes evoluíram para tipo funcional II (44% ou I (56%, na fase tardia. Houve redução da freqüência cardíaca de repouso (87±11bpm vs 85±7bpm vs 75±9bpm e elevação do número de estágios (4±1 estágios vs 5±2 estágios vs 6±1 estágios; a capacidade aeróbia máxima aumentou apenas na fase tardia (16±3mL/kg/min vs 18±4mL/kg/min vs 22±7mL/kg/min. O limiar anaeróbio, a ventilação pulmonar e o equivalente ventilatório do O2 permaneceram inalterados. Nas cargas submáximas de exercício ocorreu redução da freqüência cardíaca (estágio I: 124±18bpm vs 112±13bpm vs 87±15bpm, consumo de O2 (estágio I: 10±2mL/kg/min vs 8±2mL/kg/min vs 8±mL/kg/min e ventilação pulmonar, nas fases precoce e tardia. A área valvar mitral mostrou reduções na fase tardia (0,94cm² vs 1,66cm² vs 1,20cm² . CONCLUSÃO: Apesar da tendência à reestenose parcial, houve melhora no tipo funcional e no desempenho cardiopulmonar com diminuição da sobrecarga circulatória no exercício submáximo.PURPOSE: To evaluate the early and late cardiorespiratory responses after balloon mitral valvuloplasty. METHODS: Nine female patients aged 35±9 years, with mitral stenosis, in class II or III (NYHA underwent upright ergoespirometric test, resting electrocardiogram and echocardiogram before, 3 to 5 days (early evaluation and 8 to 12 months (late evaluation after mitral valvuloplasty. All patients were treated with digitalis and diuretics. RESULTS: During late evaluation, 44% patients were in

  3. External costs related to power production technologies. ExternE national implementation for Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L.; Sieverts Nielsen, P.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results; to aggregate these site- and technology-specific results to more general figures. The current report covers the results of the national implementation for Denmark. Three different fuel cycles have been chosen as case studies. These are fuel cycles for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant based on biogas. The report covers all the details of the application of the methodology to these fuel cycles aggregation to a national level. (au) EU-JOULE 3. 59 tabs., 25 ills., 61 refs.

  4. External fuel thermionic reactor system.

    Science.gov (United States)

    Mondt, J. F.; Peelgren, M. L.

    1971-01-01

    Thermionic reactors are prime candidates for nuclear electric propulsion. The national thermionic reactor effort is concentrated on the flashlight concept with the external-fuel concept as the backup. The external-fuel concept is very adaptable to a completely modular power subsystem which is attractive for highly reliable long-life applications. The 20- to 25-cm long, externally-fueled converters have been designed, fabricated, and successfully tested with many thermal cycles by electrical heating. However, difficulties have been encountered during encapsulation for nuclear heated tests and none have been started to date. These nuclear tests are required to demonstrate the concept feasibility.

  5. Valvoplastia aórtica por cateter-balão em emergência materno-fetal na adolescência Valvuloplastia aórtica por catéter con balón en emergencia materno-fetal en la adolescencia Aortic valvuloplasty with balloon catheter in maternal-fetal emergency in adolescence

    Directory of Open Access Journals (Sweden)

    Walkiria Samuel Avila

    2009-12-01

    Full Text Available O aumento do débito cardíaco durante a gravidez é causa de insuficiência cardíaca em portadoras de estenose valvar aórtica grave. A valvoplastia aórtica percutânea tem sido associada a graves complicações e reestenose valvar em curto prazo. O presente caso mostrou que a valvoplastia aórtica percutânea permitiu o alcance do parto com sobrevida da mãe e do feto, e que a interrupção do tratamento no pós-parto resultou em morte materna no puerpério tardio.El aumento del gasto cardiaco durante el embarazo es la causa de insuficiencia cardiaca en portadoras de estenosis valvular aórtica severa. Se viene asociando la valvuloplastia aórtica percutánea a severas complicaciones y reestenosis valvular en corto plazo. El presente caso reveló que la valvuloplastia aórtica percutánea permitió el alcance del parto con sobrevida de la madre y del feto, y que la interrupción del tratamiento en el postparto resultó en muerte materna en el puerperio tardío.The increase of cardiac output during pregnancy is the cause of heart failure in women with severe aortic valvular stenosis. Percutaneous aortic valvuloplasty has been associated with severe complications and short-term valvar restenosis. This case showed that percutaneous aortic valvuloplasty allowed both mother and fetus to survive after childbirth, and that postpartum treatment interruption resulted in maternal death in late postpartum care.

  6. Combination of external loads

    Energy Technology Data Exchange (ETDEWEB)

    Frandsen, S.; Tarp Johansen, N.J.; Joergensen, H. [Forskningscenter Risoe, Roskilde (Denmark); Gravesen, H.; Soerensen, S.L. [Carl Bro, Glostrup (Denmark); Pedersen, J. [Elsam Engineering, Fredericia (Denmark); Zorn, R.; Hvidberg Knudsen, M. [DHI Water and Environment, Hoersholm (Denmark); Voelund, P. [Energi E2, Koebenhavn (Denmark)

    2003-09-01

    The project onbectives have been: To improve and consequently opimise the basis for design of offshore wind turbines. This is done through 1) mapping the wind, wave ice and current as well as correlations of these, and 2) by clarifyring how these external conditions transform into loads. A comprehensive effort has been made to get a thorough understanding of the uncertainties that govern the reliability of wind turbines with respect to wind and wave loading. One of the conclusions is that the reliability of wind turbines is generally lower, than the average reliability of building structures that are subject not only to environmental loads, which are very uncertain, but also imposed loads and self weight, which are less uncertain than the environmental loads. The implication is that, at the moment lower load partial safety factors for onshore wind turbines cannot be recommended. For the combination of wind and wave design loads the problem is twofold: 1). A very conservative design will be generated by simply adding the individual wind and wave design loads disregarding the independence of the short-term fluctuations of wind and wave loads. 2). Characteristic values and partial safety factors for wind and wave loads are not defined similarly. This implies that the reliability levels of turbine support structures subject to purely aerodynamic loads and subject to purely hydrodynamic loads are not identical. For the problem of combining aerodynamic design loads and hydrodynamic design loads two results have been obtained in the project: 1). By simple means a site specific wave load safety factor rendering the same safety level for hydrodynamic loads as for aerodynamic loads is derived, and next, by direct square summation of extreme fluctuations, the wind and wave load safety factors are weighted. 2). Under the assumptions that a deep water site is considered and that the wave loading is a fifty-fifty mix of drag and inertia the same wind and wave load safety factor

  7. 6月龄以下小婴儿危重型肺动脉瓣狭窄经皮球囊肺动脉瓣扩张成形术治疗的随访报告%Percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis in infants under 6 months of age and short and medium term follow-up

    Institute of Scientific and Technical Information of China (English)

    罗芳; 徐玮泽; 夏呈森; 施丽萍; 吴秀静; 马晓路; 陈正

    2011-01-01

    Objective To evaluate the effect and results of short and medium periods of follow-up of percutaneous balloon pulmonary valvuloplasty for critical pulmonary stenosis of neonates and infants under 6 months of age. Methods Between January 2002 and December 2008, 34 consecutive patients aged from 13to 175 days with critical pulmonary valvular stenosis underwent percutaneous balloon valvuloplasty. Patients records, catheterization data, angiograms and echocardiograms were reviewed. Patients were followed up for 6 months to 4 years ( mean 25.5 months ) by means of clinical examination and Doppler echocardiography.Results The pulmonary valvuloplasty was accomplished in 32 (94%) of 34 attempts. Immediately after dilation, right ventricular systolic pressure (RVSP) decreased from (96 ±28) mm Hg ( 1 mm Hg =0. 133kPa ) (49 ± 20 ) mm Hg ( P < 0. 01 ), the transvalvular peak to peak systolic gradient (△P) decreased from (89±25) mm Hg to (25 ± 12) mm Hg (P <0.01 ), and the right ventricular/aortic systolic pressure ratio decreased from 1.2 ± 0. 5 to 0. 7 ± 0. 3 ( P < 0. 01 ). One patient died because of cardiac tamponade following rupture of the pulmonary valve annulus, 2 patients developed pericardial effusion, 3 patients had infundibular spasm, 3 patients had a pre-dilation by small balloon and 1 patient had weakened femoral artery pollex. After a follow up period of 6 months to 4 years 3 of 31 patients lost to follow-up. Repeat valvuloplasty was performed in 5 patients (3 neonates), no patient required surgery, and the other 23 patients did not undergo further intervention, a mean peak systolic Doppler gradient of (20 ± 13) mm Hg was found and no significant pulmonary regurgitation was seen. Conclusions Percutaneous balloon pulmonary valvuloplasty was effective and safe for the treatment of critical pulmonary stenosis of neonates and infants under 6 months of age with good short and medium term results.%目的 探讨经皮球囊

  8. External costs related to power production technologies. ExternE national implementation for Denmark

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L.; Sieverts Nielsen, P. [eds.

    1997-12-01

    The objective of the ExternE National Implementation project has been to establish a comprehensive and comparable set of data on externalities of power generation for all EU member states and Norway. The tasks include the application of the ExternE methodology to the most important fuel cycles for each country as well as to update the already existing results, to aggregate these site- and technology-specific results to more general figures. The current report covers the detailed information concerning the ExternE methodology. Importance is attached to the computer system used in the project and the assessment of air pollution effects on health, materials and ecological effects. Also the assessment of global warming damages are described. Finally the report covers the detailed information concerning the national implementation for Denmark for an offshore wind farm and a wind farm on land, a decentralised CHP plant based on natural gas and a decentralised CHP plant base on biogas. (au) EU-JOULE 3. 79 tabs., 11 ills., 201 refs.

  9. Externality and burnout among dentists.

    Science.gov (United States)

    St-Yves, A; Freeston, M H; Godbout, F; Poulin, L; St-Amand, C; Verret, M

    1989-12-01

    This study investigates the relationship between burnout as measured by the Maslach Burnout Inventory and locus of control as measured by the Adult Nowicki-Strickland Internal-External Locus of Control (ANS-IE) for 82 dentists. Significant Pearson correlations between two Maslach subscales and locus of control show Personal Accomplishment to be negatively associated -.31 and Emotional Exhaustion to be positively correlated .21 to externality.

  10. Relatie interne en externe audit

    OpenAIRE

    Ghys, Emelie

    2011-01-01

    In het eerste hoofdstuk wordt de probleemstelling van deze eindverhandeling besproken. Interne en externe audit worden de laatste jaren internationaal en nationaal meer en meer erkend in het bedrijfsleven. Aanleiding voor de toenemende belangstelling van de interne en externe auditfunctie zijn de verschillende boekhoudschandalen rond corporate governance of deugdelijk bestuur. Deze financiële mislukkingen leidden wereldwijd tot diverse wetten, nieuwe regels en verbeterde standaarden om zo een...

  11. Performance Targets and External Benchmarking

    DEFF Research Database (Denmark)

    Friis, Ivar; Hansen, Allan; Vámosi, Tamás S.

    as a market mechanism that can be brought inside the firm to provide incentives for continuous improvement and the development of competitive advances. However, whereas extant research primarily has focused on the importance and effects of using external benchmarks, less attention has been directed towards...... towards the conditions for the use of the external benchmarks we provide more insights to some of the issues and challenges that are related to using this mechanism for performance management and advance competitiveness in organizations....

  12. Parallel External Memory Graph Algorithms

    DEFF Research Database (Denmark)

    Arge, Lars Allan; Goodrich, Michael T.; Sitchinava, Nodari

    2010-01-01

    In this paper, we study parallel I/O efficient graph algorithms in the Parallel External Memory (PEM) model, one o f the private-cache chip multiprocessor (CMP) models. We study the fundamental problem of list ranking which leads to efficient solutions to problems on trees, such as computing lowest...... an optimal speedup of ¿(P) in parallel I/O complexity and parallel computation time, compared to the single-processor external memory counterparts....

  13. External Costs Related to Power Production Technologies

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1997-01-01

    The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective...

  14. External Costs Related to Power Production Technologies

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1997-01-01

    The European Commission has launched a major study project, ExternE, to develop a methodology to quantify externalities. A “National Implementation Phase”, was started under the Joule II programme with the purpose of implementing the ExternE methodology in all member states. The main objective of...

  15. Thermodynamic cost of external control

    Science.gov (United States)

    Barato, Andre C.; Seifert, Udo

    2017-07-01

    Artificial molecular machines are often driven by the periodic variation of an external parameter. This external control exerts work on the system of which a part can be extracted as output if the system runs against an applied load. Usually, the thermodynamic cost of the process that generates the external control is ignored. Here, we derive a refined second law for such small machines that include this cost, which is, for example, generated by free energy consumption of a chemical reaction that modifies the energy landscape for such a machine. In the limit of irreversible control, this refined second law becomes the standard one. Beyond this ideal limiting case, our analysis shows that due to a new entropic term unexpected regimes can occur: the control work can be smaller than the extracted work and the work required to generate the control can be smaller than this control work. Our general inequalities are illustrated by a paradigmatic three-state system.

  16. Leveraging External Sources of Innovation

    DEFF Research Database (Denmark)

    West, Joel; Bogers, Marcel

    2014-01-01

    This paper reviews research on open innovation that considers how and why firms commercialize external sources of innovations. It examines both the “outside-in” and “coupled” modes of open innovation. From an analysis of prior research on how firms leverage external sources of innovation...... cited work beyond those journals. A review of 291 open innovation-related publications from these sources shows that the majority of these articles indeed address elements of this inbound open innovation process model. Specifically, it finds that researchers have front-loaded their examination...... external innovations create value rather than how firms capture value from those innovations. Finally, the interaction phase considers both feedback for the linear process and reciprocal innovation processes such as cocreation, network collaboration, and community innovation. This review and synthesis...

  17. Optimal Auctions with Financial Externalities

    NARCIS (Netherlands)

    Maasland, E.; Onderstal, A.M.

    2002-01-01

    We construct optimal auctions when bidders face financial externalities.In a Coasean World, in which the seller cannot prevent a perfect resale market, nor withhold the object, the lowest-price all-pay auction is optimal.In a Myersonean World, in which the seller can both prevent resale after the au

  18. Organizing for External Knowledge Sourcing

    DEFF Research Database (Denmark)

    Rabbiosi, Larissa; Reichstein, Toke

    2011-01-01

    The aim of this article is to provide an introduction to the special issue. We briefly consider the external knowledge sourcing and organizing for innovation literatures, which offer a background for the special issue, and we highlight their mutual dialogue. We then illustrate the main findings...

  19. Measuring Externalities in Program Evaluation

    NARCIS (Netherlands)

    Janssens, Wendy

    2005-01-01

    Impact evaluations of development programmes usually focus on a comparison of participants with a control group. However, if the programme generates externalities for non-participants such an approach will capture only part of the programme's impact. Based on a unique large-scale quantitative survey

  20. Lupus vulgaris of external nose.

    Science.gov (United States)

    Bhandary, Satheesh Kumar; Ranganna, B Usha

    2008-12-01

    Lupus vulgaris is the commonest form of cutaneous tuberculosis which commonly involve trunk and buttocks. Lupus vulgaris affecting nose and face, are rarely reported in India. This study reports an unusual case of lupus vulgaris involving the external nose that showed dramatic outcome after six months of anti- tubercular treatment.

  1. [Treatment by external insulin pump].

    Science.gov (United States)

    Clavel, Sylvaine

    2010-12-01

    Since the recent recommendations by the French speaking association for research on diabetes and metabolic illnesses (Alfediam), treatment by insulin pump has found itself in competition with basal-bolus, a procedure using similar injections of insulin which has become a benchmark treatment. The latest Alfediam guidelines focus on defining ways of treating diabetics with an external insulin pump.

  2. Matchings with Externalities and Attitudes

    DEFF Research Database (Denmark)

    Branzei, Simina; Michalak, Tomasz; Rahwan, Talal;

    2013-01-01

    Two-sided matchings are an important theoretical tool used to model markets and social interactions. In many real-life problems the utility of an agent is influenced not only by their own choices, but also by the choices that other agents make. Such an influence is called an externality. Whereas ...

  3. Post-external dacryocystorhinostomy lagophthalmos.

    Science.gov (United States)

    Odat, Thabit A; Odat, Haitham A; Khraisat, Heba; Odat, Mohannad A; Alzoubi, Firas Q

    2015-06-01

    To describe lagophthalmos and eyelid closure abnormality after external dacryocystorhinostomy (DCR). A retrospective review of medical records and postoperative photographs of 79 patients who underwent external DCR for nasolacrimal duct obstruction and developed eyelid closure abnormality and lagophthalmos with or without exposure keratopathy was conducted. Collected data included age, sex, indication for surgery, laterality, length and type of incision, length of follow-up duration, presence of punctate epithelial keratopathy, and time for resolution of eyelid closure abnormalities. Twenty-seven patients with 28 external dacryocystorhinostomy had postoperative eyelid closure abnormalities. Male to female ratio was 1:6. The mean age was 40.1 years (range 9-80 years). All surgeries were performed through diagonal skin incision. Lagophthalmos involving the medial third of the palpebral fissure was noticed in 28.6 % of cases. All patients had hypometric blink mainly of the upper eyelid. One patient had punctate epithelial keratopathy. Resolution of lagophthalmos was noticed over a period of 1-5 weeks with an average of 3 weeks. None of the patients continued to have residual hypometric blink or punctate keratopathy at the last follow-up time. The mean follow-up period was 4.2 months (range 3-6 months). Eyelid closure abnormality and lagophthalmos after external DCR are underestimated problems. Spontaneous resolution is seen in all cases weeks to months after surgery.

  4. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  5. Defensive externality and blame projection following failure.

    Science.gov (United States)

    Hochreich, D J

    1975-09-01

    This study focuses upon the relationship between internal-external control and defensive blame projection. Trust was used as a moderator variable for making differential predictions concerning the behavior of two subgroups of externals: defensive externals, whose externality is presumed to reflect primarily a verbal technique of defense, and congruent externals, whose externality reflects a more genuine belief that most outcomes are determined by forces beyond their personal control. As predicted, defensive externals showed a stronger tendency than did congruent externals and internals to resort to blame projection following failure at an achievement task. There were no group differences in attribution following task success. Defensive externals were found to be more responsive to negative feedback than were congruent externals.

  6. Dipolar fluids under external perturbations

    Energy Technology Data Exchange (ETDEWEB)

    Klapp, Sabine H L [Stranski-Laboratorium fuer Physikalische und Theoretische Chemie Sekretariat TC7, Technische Universitaet Berlin, Strasse des 17. Juni 124, D-10623 Berlin (Germany)

    2005-04-20

    We discuss recent developments and present new findings on the structural and phase properties of dipolar model fluids influenced by various external perturbations. We concentrate on systems of spherical particles with permanent (point) dipole moments. Starting from what is known about the three-dimensional systems, particular emphasis is given to dipolar fluids in different confining situations involving both simple and complex (disordered) pore geometries. Further topics concern the effect of quenched positional disorder, the influence of external (electric or magnetic) fields, and the fluid-fluid phase behaviour of various dipolar mixtures. It is demonstrated that due to the translational-orientational coupling and due to the long range of dipolar interactions even simple perturbations such as hard walls can have a profound impact on the systems. (topical review)

  7. External observer reflections on QBism

    CERN Document Server

    Khrennikov, Andrei

    2015-01-01

    In this short review I present my personal reflections on QBism. I have no intrinsic sympathy neither to QBism nor to subjective interpretation of probability in general. However, I have been following development of QBism from its very beginning, observing its evolution and success, sometimes with big surprise. Therefore my reflections on QBism can be treated as "external observer" reflections. I hope that my representation of this interpretation of quantum mechanics (QM) has some degree of objectivity. It may be useful for researchers who are interested in quantum foundations, but do not belong to the QBism-community, because I tried to analyze essentials of QBism critically (i.e., not just emphasizing its advantages, as in a typical publication of QBists). QBists may be interested as well - in comments of an external observer who monitored development of this approach to QM during last 16 years. The second part of the paper is devoted to interpretations of probability, objective versus subjective, and view...

  8. Firm Search for External Knowledge

    DEFF Research Database (Denmark)

    Sofka, Wolfgang; Grimpe, Christoph

    2012-01-01

    The innovation performance of modern firms is increasingly determined by their ability to search and absorb external knowledge. However, after a certain threshold firms "oversearch" their environment and innovation performance declines. In this paper, we argue that prior literature has largely...... ignored the institutional context that provides or denies access to external knowledge at the country level. Combining institutional and knowledge search theory, we suggest that the market orientation of the institutional environment and the magnitude of institutional change influence when firms begin...... to experience the negative performance effects of oversearch. Based on a comprehensive sample of almost 8,000 firms from ten European countries, we find that institutions matter considerably for firms' search activity. Higher market orientation of institutions increases the effectiveness of firms' search...

  9. MGR External Events Hazards Analysis

    Energy Technology Data Exchange (ETDEWEB)

    L. Booth

    1999-11-06

    The purpose and objective of this analysis is to apply an external events Hazards Analysis (HA) to the License Application Design Selection Enhanced Design Alternative 11 [(LADS EDA II design (Reference 8.32))]. The output of the HA is called a Hazards List (HL). This analysis supersedes the external hazards portion of Rev. 00 of the PHA (Reference 8.1). The PHA for internal events will also be updated to the LADS EDA II design but under a separate analysis. Like the PHA methodology, the HA methodology provides a systematic method to identify potential hazards during the 100-year Monitored Geologic Repository (MGR) operating period updated to reflect the EDA II design. The resulting events on the HL are candidates that may have potential radiological consequences as determined during Design Basis Events (DBEs) analyses. Therefore, the HL that results from this analysis will undergo further screening and analysis based on the criteria that apply during the performance of DBE analyses.

  10. Network externalities across financial institutions

    OpenAIRE

    Castro Iragorri, Carlos Alberto; Preciado Pua, Sergio Andrés; Ordóñez Herrera, Juan Sebastián

    2016-01-01

    We propose and estimate a financial distress model that explicitly accounts for the interactions or spill-over effects between financial institutions, through the use of a spatial continuity matrix that is build from financial network data of inter bank transactions. Such setup of the financial distress model allows for the empirical validation of the importance of network externalities in determining financial distress, in addition to institution specific and macroeconomic covariates. The re...

  11. Externe Kosten in der Energiewirtschaft

    OpenAIRE

    Voß, Alfred; Friedrich, Rainer

    1994-01-01

    Als externe Effekte werden unbeteiligte Dritte betreffende Zusatzkosten oder Zusatznutzen verstanden, die sich in den jeweiligen Güterpreisen nicht wiederfinden und denen die Betroffenen nicht indifferent gegenüberstehen. Die gegenwärtige Energiebereitstellung und -nutzung ist in vielen Bereichen eine wesentliche Quelle der Belastung von Umwelt und Natur. Begriffe und Schlagworte wie Waldsterben, Tankerunglücke, Tschernobyl und Treibhauseffekt seien in diesem Zusammenhang erwähnt.

  12. Matching Games with Additive Externalities

    DEFF Research Database (Denmark)

    Branzei, Simina; Michalak, Tomasz; Rahwan, Talal

    2012-01-01

    Two-sided matchings are an important theoretical tool used to model markets and social interactions. In many real life problems the utility of an agent is influenced not only by their own choices, but also by the choices that other agents make. Such an influence is called an externality. Whereas......, optimistic, and pessimistic behaviour, and provide both computational hardness results and polynomial-time algorithms for computing stable outcomes....

  13. ENDOSCOPIC DCR VERSUS EXTERNAL DCR

    Directory of Open Access Journals (Sweden)

    Rukma

    2015-04-01

    Full Text Available PURPOSE: To compare success rates of endoscopic dacryocystorhinostomy (DCR and external DCR for acquired nasolacrimal duct obstruction (NLDO. MATERIALS AND METHODS: A prospective comparative non randomized study of 64 patients who presented with acquired NLD obstruction to a tertiary hospital. They were fully evaluated to ascertain the site of obstruction and patients with distal obstruction were included in the study. 34 patients underwent endoscopic DCR and 30 patients underwent external DCR RESULTS: 64 patients were included in the study and 72 procedures carried out. Success was achieved in 65 cases and failure in 7. Of the 7 failed cases, anatomical obstruction at the fistula site was found in 3, whereas functional failure was found in 4. In our patients, endoscopic DCR had a significantly higher success rate than external DCR, 95.23% versus 83.33% (P = 0.03. CONCLUSIONS: The success rate of Endoscopic DCR for acquired NLDO in our group of patients was 95.23%, with endoscopic surgery showing better results.

  14. Conceptual challenges for internalising externalities

    DEFF Research Database (Denmark)

    Miguel, Brandão; Weidema, Bo Pedersen

    2013-01-01

    We analyse a number of different externalities to identify conceptual challenges for the practical implementation of their internalisation. Three issues were identified: i) The balance between compensation and technology change and the respective effects on the nominal and real GDP; ii) The relev......We analyse a number of different externalities to identify conceptual challenges for the practical implementation of their internalisation. Three issues were identified: i) The balance between compensation and technology change and the respective effects on the nominal and real GDP; ii......) The relevance and efficiency of different instruments for internalisation and compensation; and iii) Implementing internalisation over large geographical and temporal distances. We find taxation to be a more relevant and efficient tool for internalisation than insurance and litigation. With increasing...... geographical and especially temporal distance between the benefitting actor and the victim of the external cost, the involvement of a non-governmental intermediate actor becomes increasingly necessary to provide the short-term capital required to ensure a successful implementation....

  15. Individuals' insight into intrapersonal externalities

    Directory of Open Access Journals (Sweden)

    David J. Stillwell

    2012-07-01

    Full Text Available An intrapersonal externality exists when an individual's decisions affect the outcomes of her future decisions. It can result in decreasing or increasing average returns to the rate of consumption, as occurs in addiction or exercise. Experimentation using the Harvard Game, which models intrapersonal externalities, has found differences in decision making between drug users and control subjects, leading to the argument that these externalities influence the course of illicit drug use. Nevertheless, it is unclear how participants who behave optimally conceptualise the problem. We report two experiments using a simplified Harvard Game, which tested the differences in contingency knowledge between participants who chose optimally and participants who did not. Those who demonstrated optimal performance exhibited both a pattern of correct responses and systematic errors to questions about the payoff schedules. The pattern suggested that they learned explicit knowledge of the change in reinforcement on a trail-by-trial basis. They did not have, or need, a full knowledge of the historical interaction leading to each payoff. We also found no evidence of choice differences between participants who were given a guaranteed payment and participants who were paid contingent on their performance, but those given a guaranteed payment were able to report more contingency knowledge as the experiment progressed, suggesting that they explored more rather than settling into a routine. Experiment 2 showed that using a fixed inter-trial interval did not change the results.

  16. Skepticism, Contextualism, Externalism and Modality

    Directory of Open Access Journals (Sweden)

    Ron Wilburn

    2006-12-01

    Full Text Available In this paper, I argue for the following claims. Contextualist strategies to tame or localize epistemic skepticism are hopeless if contextualist factors are construed internalistically. However, because efforts to contextualize externalism via subjunctive conditional analysis court circularity, it is only on an internalistic interpretation that contextualist strategies can even be motivated. While these claims do not give us an argument for skepticism, they do give us an argument that contextualism, as such, is not likely to provide us with an argument against skepticism.

  17. Leveraging External Sources of Innovation

    DEFF Research Database (Denmark)

    West, Joel; Bogers, Marcel

    2014-01-01

    own specific set of mechanisms and conditions. Integrating innovations has been mostly studied from an absorptive capacity perspective, with less attention given to the impact of competencies and culture (including “not invented here”). Commercializing innovations puts the most emphasis on how......” in a way inconsistent with earlier definitions in innovation management. The paper concludes with recommendations for future research that include examining the end-to-end innovation commercialization process, and studying the moderators and limits of leveraging external sources of innovation....

  18. Empirical Evaluation On External Debt Of Malaysia

    OpenAIRE

    Nor’Aznin Abu Bakar; Sallahuddin Hassan

    2011-01-01

    This study analyzes the effects of external debts on economic growth in Malaysia. The analysis is conducted both at aggregate and disaggregate levels. The empirical results are based on VAR estimates using GDP, external debts, capital accumulation, labor force and human capital. Estimation results at the aggregate level indicate that total external debts affect economic growth positively. In particular, one percentage point increase in total external debts generates 1.29 percentage point of e...

  19. Targeted ultrasound-mediated delivery of nanoparticles: on the development of a new HIFU-based therapy and imaging device.

    Science.gov (United States)

    Seip, Ralf; Chin, Chien Ting; Hall, Christopher S; Raju, Balasundar I; Ghanem, Alexander; Tiemann, Klaus

    2010-01-01

    Ultrasound-mediated delivery (USMD) is an active research topic, as researchers develop applications for therapeutic ultrasound in addition to thermal ablation. In USMD, ultrasound is used in conjunction with microbubbles and drugs, nanoparticles, siRNA, pDNA, stem cells, etc., to facilitate their cellular delivery and uptake using pressure and temperature-mediated mechanisms to bring about a desired therapeutic effect. To investigate the potential of targeted USMD of nanoparticles, pDNA, and stem cells for cardiovascular and other applications, a general-purpose preclinical research tool, therapy imaging probe system (TIPS) was designed. It consists of a wideband annular array, a small-animal acoustic coupler, a motorized positioning system, integrated control software for ultrasound image-guided treatment planning and execution, and triggering electronics that allow ECG and respiration-gated ultrasound exposures. TIPS was then used to enhance delivery of nanoparticles into the murine myocardium and heart vessel walls to demonstrate the feasibility of the technology, pave the way for additional basic research in cardiovascular USMD, and begin to explore the requirements that USMD devices will have to meet to be useful in a clinical setting.

  20. Quantum Electrodynamics on background external fields

    CERN Document Server

    Marecki, P

    2003-01-01

    The quantum electrodynamics in presence of background external fields is developed. Modern methods of local quantum physics allow to formulate the theory on arbitrarily strong possibly time-dependent external fields. Non-linear observables which depend only locally on the external field are constructed. The tools necessary for this formulation, the parametrices of the Dirac operator, are investigated.

  1. 46 CFR 154.452 - External pressure.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 5 2010-10-01 2010-10-01 false External pressure. 154.452 Section 154.452 Shipping... Independent Tank Type C and Process Pressure Vessels § 154.452 External pressure. The design external pressure...) for tanks without a vacuum relief valve. P2=0, or the pressure relief valve setting for an enclosed...

  2. 46 CFR 64.19 - External pressure.

    Science.gov (United States)

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false External pressure. 64.19 Section 64.19 Shipping COAST... HANDLING SYSTEMS Standards for an MPT § 64.19 External pressure. (a) A tank without a vacuum breaker must be designed to withstand an external pressure of 71/2 psig or more. (b) A tank with a vacuum breaker...

  3. 49 CFR 195.108 - External pressure.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false External pressure. 195.108 Section 195.108 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Design Requirements § 195.108 External pressure. Any external pressure that will be exerted on the...

  4. Quantum electrodynamics on background external fields

    OpenAIRE

    2003-01-01

    The quantum electrodynamics in presence of background external fields is developed. Modern methods of local quantum physics allow to formulate the theory on arbitrarily strong possibly time-dependent external fields. Non-linear observables which depend only locally on the external field are constructed. The tools necessary for this formulation, the parametrices of the Dirac operator, are investigated.

  5. Externally Wetted Ionic Liquid Thruster

    Science.gov (United States)

    Lozano, P.; Martinez-Sanchez, M.; Lopez-Urdiales, J. M.

    2004-10-01

    This paper presents initial developments of an electric propulsion system based on ionic liquid ion sources (ILIS). Propellants are ionic liquids, which are organic salts with two important characteristics; they remain in the liquid state at room temperature and have negligible vapor pressure, thus allowing their use in vacuum. The working principles of ILIS are similar to those of liquid metal ion sources (LMIS), in which a Taylor cone is electrostatically formed at the tip of an externally wetted needle while ions are emitted directly from its apex. ILIS have the advantage of being able to produce negative ions that have similar masses than their positive counterparts with similar current levels. This opens up the possibility of achieving plume electrical neutrality without electron emitters. The possible multiplexing of these emitters is discussed in terms of achievable thrust density for applications other than micro-propulsion.

  6. External symmetry in general relativity

    CERN Document Server

    Cotaescu, I I

    2000-01-01

    We propose a generalization of the isometry transformations to the geometric context of the field theories with spin where the local frames are explicitly involved. We define the external symmetry transformations as isometries combined with suitable tetrad gauge transformations and we show that these form a group which is locally isomorphic with the isometry one. We point out that the symmetry transformations that leave invariant the equations of the fields with spin have generators with specific spin terms which represent new physical observables. The examples we present are the generators of the central symmetry and those of the maximal symmetries of the de Sitter and anti-de Sitter spacetimes derived in different tetrad gauge fixings. Pacs: 04.20.Cv, 04.62.+v, 11.30.-j

  7. ANALYSIS OF EXTERNAL FACTORS AFFECTING THE PRICING

    Directory of Open Access Journals (Sweden)

    Irina A. Kiseleva

    2013-01-01

    Full Text Available The external factors influencing the process of formation of tariffs of commercial services are considered in the article. External environment is known to be very diverse and changeable. Currently, pricing has become one of the key processes of strategic development of a company. Pricing in the service sector, in turn, is highly susceptible to changes in the external environment. Its components directly or indirectly affect the market of services, changing it adopted economic processes. As a rule, firms providing services can’t influence the changes in external factors. However, the service market is very flexible, which enables businesses to reshape pricing strategy, to adapt it to the new environment.

  8. Control of External Kink Instability

    Science.gov (United States)

    Navratil, Gerald

    2004-11-01

    A fundamental pressure and current limiting phenomenon in magnetically confined plasmas for fusion energy is the long wavelength ideal-MHD kink mode. These modes have been extensively studied in tokamak and reversed field pinch (RFP) devices. They are characterized by significant amplitude on the boundary of the confined plasma and can therefore be controlled by manipulation of the external boundary conditions. In the past ten years, the theoretically predicted stabilizing effect of a nearby conducting wall has been documented in experiments, which opens the possibility of a significant increase in maximum stable plasma pressure. While these modes are predicted to remain unstable when the stabilizing wall is resistive, their growth rates are greatly reduced from the hydrodynamic time scale to the time scale of magnetic diffusion through the resistive wall. These resistive wall slowed kink modes have been identified as limiting phenomena in tokamak (DIII-D, PBX-M, HBT-EP, JT-60U, JET, NSTX) and RFP (HBTX, Extrap, T2R) devices. The theoretical prediction of stabilization to nearly the ideal wall pressure limit by toroidal plasma rotation and/or active feedback control using coils has recently been realized experimentally. Sustained, stable operation at double the no-wall pressure limit has been achieved. Discovery of the phenomenon of resonant field amplification by marginally stable kink modes and its role in the momentum balance of rotationally stabilized plasmas has emerged as a key feature. A theoretical framework, based on an extension of the very successful treatment of the n=0 axisymmetric mode developed in the early 1990's, to understand the stabilization mechanisms and model the performance of active feedback control systems is now established. This allows design of kink control systems for burning plasma experiments like ITER.

  9. Percutaneous balloon valvuloplasty for severe and critical pulmonary valve stenosis in infants under six months%经皮肺动脉瓣球囊扩张成形术治疗小婴儿重度肺动脉瓣狭窄

    Institute of Scientific and Technical Information of China (English)

    刘芳; 吴琳; 黄国英; 张立风; 齐春华; 马晓静; 梁雪村

    2009-01-01

    目的 回顾性总结经皮肺动脉瓣球囊扩张成形术(PBPV)在重度肺动脉瓣狭窄小婴儿中的即刻治疗效果及6~32个月随访情况.方法 分析2006年6月至2008年8月复日.大学附属儿科医院行PBPV的18例6个月以内重度和极重度肺动脉瓣狭窄小婴儿.年龄8 d~6个月(86 ±63)d,其巾极重度肺动脉瓣狭窄11例,包括2例新生儿.12例采用全身麻醉,6例采用骶管加静脉复合麻醉.球囊直径为5~15 mm,其中6例患者应用2个球囊依次进行扩张,10例患者应用1个球囊扩张.结果 18例患儿中,2例因导管或球囊未能通过肺动脉瓣放弃扩张,余16例扩张成功,成功率88.9%.扩张后即刻导管测右心室与肺动脉收缩期压差自(87±24)mm Hg降至(30±19)mm Hg(1 mm Hg=0.133 kPa,P<0.01),扩张过程中或扩张后均无并发症发生.随访6~32个月,16例肺动脉跨瓣压差进一步降低或不变,2例逐渐升高,行第2次扩张,再扩张率12.5%;三尖瓣反流随访过程中均减轻共至消失;除1例为中度肺动脉瓣反流外,其余均为轻度;临床均无症状,生长发育良好.结论 经皮肺动脉瓣球囊扩张成形术在重度和极重度肺动脉瓣狭窄小婴儿中应用安全,效果好,并发症少,患儿痛苦小,应作为该类患儿首选治疗方法.%Objective To assess the effects and potential role of percutaneous balloon valvuloplasty as an alternative therapy of surgery in young infants with severe and critical pulmonary vatve stenosis.Methotis Eighteen patients aged 8 days to 6 months with severe and critical pulmonary vatve stenosis admitted to our hospital from June 2006 to August 2008 underwent batloon valvuloplasty.Among them.11 infants including 2 neonates had critical pulmonary stenosis.Severe tricuspid regurgiiration was seen jn 5 and moderate in 3.Right ventricular systolic pressure in all patients was greater than systemic pressure wilh right-to-left or bi-directional shunt at atrial level.Dilatation was Deriormed

  10. Externalities and Compensation : Primeval Games and Solutions

    NARCIS (Netherlands)

    Ju, Y.; Borm, P.E.M.

    2005-01-01

    The classical literature (Pigou (1920), Coase (1960), Arrow (1970)) and the relatively recent studies (cf.Varian (1994)) associate the externality problem with efficiency.This paper focuses explicitly on the compensation problem in the context of externalities.To capture the features of inter-indivi

  11. Concurrent sourcing and external supplier opportunism

    DEFF Research Database (Denmark)

    Mols, Niels Peter

    When a firm simultaneously makes and buys the same components then the firm uses concurrent sourcing. This paper presents an agency model for explaining how and when concurrent sourcing reduces the likelihood of external supplier opportunism. In the proposed model, the external supplier’s expected...

  12. Crossing boundaries : Involving external parties in innovation

    NARCIS (Netherlands)

    Slot, J.H.

    2013-01-01

    To improve the return on investments in innovation, firms increasingly open up their new product development (NPD) processes by inviting external parties to participate. This dissertation focuses on the involvement of three different types of external parties in the NPD process: suppliers, customers

  13. Computing betweenness centrality in external memory

    DEFF Research Database (Denmark)

    Arge, Lars; Goodrich, Michael T.; Walderveen, Freek van

    2013-01-01

    Betweenness centrality is one of the most well-known measures of the importance of nodes in a social-network graph. In this paper we describe the first known external-memory and cache-oblivious algorithms for computing betweenness centrality. We present four different external-memory algorithms...

  14. Lattice Planar QED in external magnetic field

    CERN Document Server

    Cea, Paolo; Giudice, Pietro; Papa, Alessandro

    2011-01-01

    We investigate planar Quantum ElectroDynamics (QED) with two degenerate staggered fermions in an external magnetic field on the lattice. Our preliminary results indicate that in external magnetic fields there is dynamical generation of mass for two-dimensional massless Dirac fermions in the weak coupling region. We comment on possible implications to the quantum Hall effect in graphene.

  15. Internal and External Forces in Language Change.

    Science.gov (United States)

    Yang, Charles D.

    2000-01-01

    Develops a model of language change characterizing the dynamic interaction between internal universal grammar and external linguistic evidence, as mediated by language acquisition. Borrows insights from the study of biological evolution, where internal and external forces interact in similar fashion. Applies the model to explore the loss of the…

  16. Forms of Spanking and Children's Externalizing Behaviors

    Science.gov (United States)

    Lansford, Jennifer E.; Wager, Laura B.; Bates, John E.; Pettit, Gregory S.; Dodge, Kenneth A.

    2012-01-01

    Research suggests that corporal punishment is related to higher levels of child externalizing behavior, but there has been controversy regarding whether infrequent, mild spanking predicts child externalizing or whether more severe and frequent forms of corporal punishment account for the link. Mothers rated the frequency with which they spanked…

  17. Environmental externalities related to power production on biogas and natural gas based on the EU ExternE methodology

    DEFF Research Database (Denmark)

    Nielsen, Per Sieverts; Ibsen, Liselotte Schleisner

    1998-01-01

    This paper assesses the environmental impacts and external costs from selected electricity generation systems in Denmark. The assessment is carried out as part of the ExternE National Implementation, which is the second phase of the ExternE project and involves case studies from all Western Europ...... show that estimated damages due to the greenhouse effect are predominant, however, the uncertainty is high. The predominant damage at the local and regional level is related to emission of NOx, which results in effects on public health....... European countries. The project use a “bottom-up” methodology to evaluate the external costs associated with a wide range of different fuel cycles. The project has identified priority impacts, where most are impacts from air emissions. Externalities due to atmospheric emissions are calculated through...... the use of a software package, EcoSence, having an environmental database at both a local and regional level including population, crops, building materials and forest. The system also incorporates two air transport models, allowing local and regional scale modelling. The results of the Danish case study...

  18. Use of Automated External Defibrillators

    Energy Technology Data Exchange (ETDEWEB)

    Gregory K Christensen

    2009-02-01

    In an effort to improve survival from cardiac arrest, the American Heart Association (AHA) has promoted the Chain of Survival concept, describing a sequence of prehospital steps that result in improved survival after sudden cardiac arrest. These interventions include immediate deployment of emergency medical services, prompt cardiopulmonary resuscitation, early defibrillation when indicated, and early initiation of advanced medical care. Early defibrillation has emerged as the most important intervention with survival decreasing by 10% with each minute of delay in defibrillation. Ventricular Fibrillation (VF) is a condition in which there is uncoordinated contraction of the heart cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. VF is a medical emergency and if the arrhythmia continues for more than a few seconds, blood circulation will cease, and death can occur in a matter of minutes. During VF, contractions of the heart are not synchronized, blood flow ceases, organs begin to fail from oxygen deprivation and within 10 minutes, death will occur. When VF occurs, the victim must be defibrillated in order to establish the heart’s normal rhythm. On average, the wait for an ambulance in populated areas of the United States is about 11 minutes. In view of these facts, the EFCOG Electrical Safety Task Group initiated this review to evaluate the potential value of deployment and use of automated external defibrillators (AEDs) for treatment of SCA victims. This evaluation indicates the long term survival benefit to victims of SCA is high if treated with CPR plus defibrillation within the first 3-5 minutes after collapse. According to the American Heart Association (AHA), survival rates as high as 74% are possible if treatment and defibrillation is performed in the first 3 minutes. In contrast survival rates are only 5% where no AED programs have been established to provide prompt CPR and defibrillation. ["CPR statistics

  19. Concurrent sourcing and external supplier opportunism

    DEFF Research Database (Denmark)

    Mols, Niels Peter

    When a firm simultaneously makes and buys the same components then the firm uses concurrent sourcing. This paper presents an agency model for explaining how and when concurrent sourcing reduces the likelihood of external supplier opportunism. In the proposed model, the external supplier’s expected...... costs of opportunism are determined as a product of four factors. The four factors are: likelihood of discovering supplier opportunism, buyer’s internalized quantity as reaction to supplier opportunism, asset specificity of external supplier’s investments, and multiplicator effects. Each...

  20. Environment and externalization; Environnement et externalisation

    Energy Technology Data Exchange (ETDEWEB)

    Kremlis, G.; Renaud, R. [Association francaise des ingenieurs et techniciens de l' environnement, AFITE, 75 - Paris (France); Touron, M. [Veritas, 75 - Paris (France)] [and others

    2001-07-01

    This document presents the discussions of the 16 may 2000, concerning the externalization and the environment and proposes to answer the following questions: is the externalization a new strategy to better perceive, hopeful engineering department, the technological risks problems, the environment or the land pollution? Does the externalization allow a better organization of the enterprise? To analyse the situation, the document presents the white book of the environmental liability, the administration point of view, some enterprises examples and the importance of the environmental management. (A.L.B.)

  1. Leiomyosarcoma of the external iliac vein.

    Science.gov (United States)

    Fukuda, Wakako; Taniguchi, Satoshi; Fukuda, Ikuo

    2012-06-01

    Leiomyosarcoma of the iliac vein is an uncommon tumor. We report a case of a 63-year-old Japanese woman with leiomyosarcoma of the right external iliac vein. The patient complained of right inguinal pain and swelling. Computed tomography demonstrated a mass surrounding the right external iliac artery and vein. Metastases in the lungs and liver were found. Complete resection of the tumor along with the involved vessels was performed. Polytetrafluoroethylene grafts were used to reconstruct the vessels. Pathological examination revealed leiomyosarcoma of the external iliac vein. Although the prognosis of leiomyosarcoma is poor, en bloc tumor resection is the treatment of choice.

  2. The sustainability of Serbia's external position: The impact of fiscal adjustment and external shocks

    Directory of Open Access Journals (Sweden)

    Zildžović Emir

    2015-01-01

    Full Text Available This paper studies the impact of fiscal policy and external shocks on the sustainability of Serbia’s external position. The key determinants of Serbia's current account balance are identified using model averaging techniques and are compared with estimates obtained for other small open economies (Poland, Georgia, Morocco, Ukraine, and Estonia. The paper uses estimated influences of macrovariables on the current account balance to generate a rich set of possible outcomes for the external position of the country. The results suggest the importance of fiscal policy for the reduction of external imbalances in all countries in our sample. In particular, credible and sustained fiscal adjustment can reduce current account deficit and stabilize Serbia’s external position close to its current level over the medium term. The analysis also warns that lack of success in fiscal consolidation coupled with external shocks may easily push the external position onto an unsustainable path.

  3. Externality, environment, and obesity in children.

    Science.gov (United States)

    Stager, S F

    1981-07-01

    On the assumption that external responsiveness and environmental characteristics jointly determine whether a child will achieve an excessive weight gain, perpetuating and maintaining obesity, probability hierarchy was hypothesized and tested. Ss of the study were 24 obese and 24 average-weight, white boys, mean age 9 years, 5 months. An auditory distraction task and Kagan's Matching Familiar Figures Test were used to measure auditory and visual responsivity to external cues, respectively. Socioeconomic status was used as an indicator of the childhood environment. As predicted, the greatest percentages of obese children were observed in the lower-socioeconomic, external group, followed by the lower-socioeconomic, internal group and middle-socioeconomic, external group. The smallest percentage of obese children was observed in the middle-socioeconomic, internal group.

  4. Sleep disturbances in chronic progressive external ophthalmoplegia.

    NARCIS (Netherlands)

    Smits, B.W.; Westeneng, H.J.; Hal, M.A. van; Engelen, B.G.M. van; Overeem, S.

    2012-01-01

    BACKGROUND: Chronic progressive external ophthalmoplegia (CPEO) is a relatively common mitochondrial disorder. In addition to extraocular muscle weakness, various other organs can typically be affected, including laryngeal and limb muscles, cerebrum, cerebellum, and peripheral nerves. Given this mul

  5. Proceedings: National conference on environmental externalities

    Energy Technology Data Exchange (ETDEWEB)

    1990-12-31

    This report is the proceedings of the National Conference on Environmental Externalities. A environmental externality is the environmental impact of a process or a plant that society must endure. It is a social cost and is paid, but not by the company who produced it or the company`s customers who endure it. The main purpose of this report is to gather the many designs and ideas of how and why to internalize the externalities into the pricing systems of the public utility commissions, especially that of the electric utilities. Economic and sociological aspects of the internalization of these externalities are given in these proceedings. Individual papers are processed separately for databases. (MB)

  6. Owl Mountain Partnership : An external assessment

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — External review of the Owl Mountain Partnership (OMP) to identify benefits and successes associatedwith collaborative work through the perceptions of participating...

  7. Infrared limit in external field scattering

    CERN Document Server

    Herdegen, Andrzej

    2012-01-01

    Scattering of electrons/positrons by external classical electromagnetic wave packet is considered in infrared limit. In this limit the scattering operator exists and produces physical effects, although the scattering cross-section is trivial.

  8. reoperation rates following intramedullary nailing versus external ...

    African Journals Online (AJOL)

    Reasons for reoperation among EF patients were infection. (2 patients) ... fixation. Keywords: Orthopaedic surgery, Tanzania, Intramedullary nail, External fixation, Open tibia fracture. INTRODUCTION ..... of surgical site infection. Infect Control ...

  9. Consumption Externalities, Rental Markets and Purchase Clubs.

    OpenAIRE

    Suzanne Scotchmer

    2002-01-01

    A premise of general equilibrium theory is that private goods are rival. Nevertheless, many private goods are shared, e.g., through barter, through co-ownership, or simply because one person’s consumption affects another person’s wellbeing. We analyze consumption externalities from the perspective of club theory, and argue that, provided consumption externalities are limited in scope, they can be internalized through membership fees to groups. Our main applications are to rental markets and “...

  10. Operating protocols of external root cervical resorption

    OpenAIRE

    Luca Venuti

    2015-01-01

    Aim: Theme of this report is the external cervical root resorption and the sequence of clinical procedures to be implemented during the phases of treatment. The external cervical root resorption (ICR) presents particular pathological conditions such as to classify between resorption of inflammatory origin.1–3 It is generally presented as a complex clinical situation both in the diagnosis in a predictable prognosis.3–6 It's often associated with loss of calcified tissue: dentin, cementum, a...

  11. Inferential knowledge, externalism and self-knowledge.

    OpenAIRE

    R G Ford

    2004-01-01

    Privileged self-knowledge says, roughly, that we have non-empirical knowledge of our own thoughts. Externalism about mental content says, roughly, that our mental states are determined at least in part by our environment. It has been alleged that jointly assuming externalism about mental content and privileged self-knowledge are true has the consequence that any subject can have non-empirical knowledge of her own environment and this is intuitively absurd. The thesis investigates in various w...

  12. Operating protocols of external root cervical resorption

    OpenAIRE

    Venuti, Luca

    2015-01-01

    Aim: Theme of this report is the external cervical root resorption and the sequence of clinical procedures to be implemented during the phases of treatment. The external cervical root resorption (ICR) presents particular pathological conditions such as to classify between resorption of inflammatory origin.1–3 It is generally presented as a complex clinical situation both in the diagnosis in a predictable prognosis.3–6 It's often associated with loss of calcified tissue: dentin, cementum, a...

  13. Integrating Building Functions into Massive External Walls

    Directory of Open Access Journals (Sweden)

    Ahmed Hisham Hafez

    2016-05-01

    Full Text Available Well into the twentieth century, brick and stone were the materials used. Bricklaying and stonemasonry were the construction technologies employed for the exterior walls of virtually all major structures. However, with the rise in quality of life, the massive walls alone became incapable of fulfilling all the developed needs. Adjacent systems and layers had then to be attached to the massive layer. Nowadays, the external wall is usually composed of a layered construction. Each external wall function is usually represented by a separate layer or system. The massive layer of the wall is usually responsible for the load-bearing function.Traditional massive external walls vary in terms of their external appearance, their composition and attached layers. However, their design and construction process is usually a repeated process. It is a linear process where each discipline is concerned with a separate layer or system. These disciplines usually take their tasks away and bring them back to be re-integrated in a layered manner. New massive technologies with additional function have recently become available.Such technologies can provide the external wall with other functions in addition to its load-bearing function. The purpose of this research is to map the changes required to the traditional design and construction process when massive technologies with additional function are applied in external walls. Moreover, the research aims at assessing the performance of massive solutions with additional function when compared to traditional solutions in two different contexts, the Netherlands and Egypt.Through the analysis of different additional function technologies in external walls, a guidance scheme for different stakeholders is generated. It shows the expected process changes as related to the product level and customization level. Moreover, the research concludes that the performance of additional insulating technologies, and specifically Autoclaved

  14. External Prestressing Bridge Reinforcement Technology Review

    Directory of Open Access Journals (Sweden)

    Zhu Hanbing

    2015-01-01

    Full Text Available Externally prestressed bridge can not only limit and reduce the cracks and deformation of the structure, improve the rigidity and bearing capacity of structure, improve the stress state of structure, but also have less interference for bridge operation when it is operating and have the good economic efficiency. This paper introduces the advantages and disadvantages of external prestressed strengthening technique, its calculation theory and construction technology described in detail, and finally the paper discusses the deficiency of existing research.

  15. Nuclear waste storage and environmental intergenerational externalities

    OpenAIRE

    Fodha, Mouez

    2015-01-01

    International audience; This article analyzes the long-term consequences of nuclear waste storage within a general equilibrium framework. The objective is to determine the conditions for which the storage of waste, and thus the transfer of externalities towards the future, can be optimal. These conditions could explain the implementation of intergenerational externalities, justifying an intertemporal Not In My Back Yard behaviour. We first show that the choice of the policy instruments determ...

  16. External cost assessment for nuclear fuel cycle

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Heung [Korea National University of Transportation, Chungju (Korea, Republic of); Ko, Won Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-12-15

    Nuclear power is currently the second largest power supply method in Korea and the number of nuclear power plants are planned to be increased as well. However, clear management policy for spent fuels generated from nuclear power plants has not yet been established. The back-end fuel cycle, associated with nuclear material flow after nuclear reactors is a collection of technologies designed for the spent fuel management and the spent fuel management policy is closely related with the selection of a nuclear fuel cycle. Cost is an important consideration in selection of a nuclear fuel cycle and should be determined by adding external cost to private cost. Unlike the private cost, which is a direct cost, studies on the external cost are focused on nuclear reactors and not at the nuclear fuel cycle. In this research, external cost indicators applicable to nuclear fuel cycle were derived and quantified. OT (once through), DUPIC (Direct Use of PWR SF in CANDU), PWR-MOX (PWR PUREX reprocessing), and Pyro-SFR (SFR recycling with pyroprocessing) were selected as nuclear fuel cycles which could be considered for estimating external cost in Korea. Energy supply security cost, accident risk cost, and acceptance cost were defined as external cost according to precedent and estimated after analyzing approaches which have been adopted for estimating external costs on nuclear power generation.

  17. The ventilatory effect of external oscillation.

    Science.gov (United States)

    Isabey, D; Piquet, J

    1989-01-01

    High frequency ventilation (HFV) may be achieved by external oscillation (external HFV) applied around the chest wall (HFCWO) in large animals and humans, or over the entire body (HFBSO) in small animals, instead of being applied via the trachea (internal HFV). We present a synthesis of the results obtained with external HFV in both normal and bronchoconstricted subjects. Whereas external and internal HFV were found to be equivalent in terms of gas exchange in normal rats, external HFV was found to have a beneficial effect in bronchoconstricted rabbits, but internal HFV did not. From the frequency-oscillatory tidal volume relationship determined in normocapnic rabbits, HFBSO at 5 Hz was found to be the optimal frequency at which to ventilate with tidal volumes close to the dead space volume, and which was also shown to be the optimal volume to obtain normocapnia. Moreover, 5 Hz oscillations (HFCWO) at 20 ml and 40 ml superimposed on tidal breathing accelerated nitrogen washout, i.e., gas exchange in normal humans. Unfortunately, only oscillations with much smaller volumes (5-10 ml) were obtainable in COPD patients. Nevertheless, they produced a clear change in breathing pattern associated with a slight improvement in gas exchange and a potentially positive effect on inspiratory muscle fatigue. These results support the concept that non-invasive external HFV technique may be of use in assisting ventilation in bronchoconstricted subjects and may possibly replace conventional controlled ventilation, at least in subjects with high lung compliance, such as babies, neonates and normal adults.

  18. Negative ion source with external RF antenna

    Science.gov (United States)

    Leung, Ka-Ngo; Hahto, Sami K.; Hahto, Sari T.

    2007-02-13

    A radio frequency (RF) driven plasma ion source has an external RF antenna, i.e. the RF antenna is positioned outside the plasma generating chamber rather than inside. The RF antenna is typically formed of a small diameter metal tube coated with an insulator. An external RF antenna assembly is used to mount the external RF antenna to the ion source. The RF antenna tubing is wound around the external RF antenna assembly to form a coil. The external RF antenna assembly is formed of a material, e.g. quartz, which is essentially transparent to the RF waves. The external RF antenna assembly is attached to and forms a part of the plasma source chamber so that the RF waves emitted by the RF antenna enter into the inside of the plasma chamber and ionize a gas contained therein. The plasma ion source is typically a multi-cusp ion source. A converter can be included in the ion source to produce negative ions.

  19. Externalities - an analysis using the EU ExternE-results; Externaliteter - en analys utifraan EU:s ExternE-resultat

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2003-10-01

    The EU project ExternE quantified the externalities for the different energy technologies. In this work, the ExternE results are used in a MARKAL-analysis for the Nordic countries. The analysis does not go into detail, but gives some interesting indications: The external costs are not fully covered in the Nordic energy systems, the present taxes and charges are not high enough. The emissions from the energy systems would be strongly reduced, if taxes/environmental charges were set at the level ExternE calculate. The emissions from power production would be reduced most. Renewable energy sources and natural gas dominate the energy systems in the ExternE case.

  20. Internalizing Externalities through Payments for Environmental Services

    Directory of Open Access Journals (Sweden)

    Sudarsono Soedomo

    2012-08-01

    Full Text Available Forest ecosystems, including plantation forests, provide goods and services that are marketable and non-marketable. Positive externalities produced by forest ecosystems are rarely considered in pricing of marketable products that result in economic inefficiencies. Internalizing externalities is required to improve the economic efficiency. The traditional way to internalize an externality is by providing subsidies or imposing taxes. Recently, payments for environmental services  are receiving more attention as an instrument for internalizing externalities provided by forest ecosystems. This promising alternative to improve our environment needs to be studied more extensively. In this paper, it can be indicated theoretically that the Pigovian tax, as a traditional way of addressing environmental problems, is able to mimic the result derived from the employment of environmental services payment. The difference is that environmental services payment improves the welfare of environmental service producers, whereas the Pigovian tax reduces it. A positive Pigovian tax increases the optimal rotation, which is positively associated with environmental improvement, but certainly reduces forest owner's welfare. This difference should be taken into account in the public policymaking so that perverse incentive may be avoided. Payment for environmental services  as an additional income to forest growers, not as alternative source of income, is a potential tool to address simultaneously issues of environment and poverty that are frequently contested.Keywords: externalities, payments for environmental services, tax, perverse incentive, social welfare

  1. External-field-free magnetic biosensor

    Energy Technology Data Exchange (ETDEWEB)

    Li, Yuanpeng; Wang, Yi; Klein, Todd; Wang, Jian-Ping, E-mail: jpwang@umn.edu [Department of Electrical and Computer Engineering, University of Minnesota, Minneapolis, Minnesota 55455 (United States)

    2014-03-24

    In this paper, we report a magnetic nanoparticle (MNP) detection scheme without the presence of any external magnetic field. The proposed magnetic sensor uses a patterned groove structure within the sensor so that no external magnetic field is needed to magnetize the MNPs. An example is given based on a giant magnetoresistance (GMR) sensing device with a spin valve structure. For this structure, the detection of MNPs located inside the groove and near the free layer is demonstrated under no external magnetic field. Micromagnetic simulations are performed to calculate the signal to noise level of this detection scheme. A maximum signal to noise ratio (SNR) of 18.6 dB from one iron oxide magnetic nanoparticle with 8 nm radius is achieved. As proof of concept, this external-field-free GMR sensor with groove structure of 200 nm × 200 nm is fabricated using a photo and an electron beam integrated lithography process. Using this sensor, the feasibility demonstration of the detection SNR of 9.3 dB is achieved for 30 μl magnetic nanoparticles suspension (30 nm iron oxide particles, 1 mg/ml). This proposed external-field-free sensor structure is not limited to GMR devices and could be applicable to other magnetic biosensing devices.

  2. External GSM phone calls now made simpler

    CERN Multimedia

    2007-01-01

    On 2 July, the IT/CS Telecom Service introduced a new service making external calls from CERN GSM phones easier. A specific prefix is no longer needed for calls outside CERN. External calls from CERN GSM phones are to be simplified. It is no longer necessary to use a special prefix to call an external number from the CERN GSM network.The Telecom Section of the IT/CS Group is introducing a new system that will make life easier for GSM users. It is no longer necessary to use a special prefix (333) to call an external number from the CERN GSM network. Simply dial the number directly like any other Swiss GSM customer. CERN currently has its own private GSM network with the Swiss mobile operator, Sunrise, covering the whole of Switzerland. This network was initially intended exclusively for calls between CERN numbers (replacing the old beeper system). A special system was later introduced for external calls, allowing them to pass thr...

  3. Atomic excitation and recombination in external fields

    Energy Technology Data Exchange (ETDEWEB)

    Nayfeh, M.H.; Clark, C.W.

    1985-01-01

    This volume offers a timely look at Rydberg states of atoms in external fields and dielectronic recombination. Each topic provides authoritative coverage, presents a fresh account of a flourishing field of current atomic physics and introduces new opportunities for discovery and development. Topics considered include electron-atom scattering in external fields; observations of regular and irregular motion as exemplified by the quadratic zeeman effect and other systems; Rydberg atoms in external fields and the Coulomb geometry; crossed-field effects in the absorption spectrum of lithium in a magnetic field; precise studies of static electric field ionization; widths and shapes of stark resonances in sodium above the saddle point; studies of electric field effects and barium autoionizing resonances; autoionization and dielectronic recombination in plasma electric microfields; dielectronic recombination measurements on multicharged ions; merged beam studies of dielectronic recombination; Rydberg atoms and dielectronic recombination in astrophysics; and observations on dielectronic recombination.

  4. External Tonehole Interactions in Woodwind Instruments

    CERN Document Server

    Lefebvre, Antoine; Kergomard, Jean

    2012-01-01

    The transfer matrix method is often used to calculate the input impedance of woodwind instruments but it ignores the possible influence of the radiated sound from toneholes on other open holes. In this paper, a method is proposed to account for external tonehole interactions. It is found that the external tonehole interactions increase the amount of radiated energy, reduce slightly the lower resonance frequencies, and modify significantly the response near and above the tonehole lattice cutoff frequency. The results of simulations with the Finite Element Method, as well as experimental measurements, are presented and compared to the calculation with the method presented in this paper, confirming that the external tonehole interactions play a significant role in woodwind instrument.

  5. External-Memory Algorithms and Data Structures

    DEFF Research Database (Denmark)

    Arge, Lars; Zeh, Norbert

    2010-01-01

    . This is due to the huge difference in access time of fast internal memory and slower external memory such as disks. The goal of theoretical work in the area of external memory algorithms (also called I/O algorithms or out-of-core algorithms) has been to develop algorithms that minimize the Input......The data sets involved in many modern applications are often too massive to fit in main memory of even the most powerful computers and must therefore reside on disk. Thus communication between internal and external memory, and not actual computation time, becomes the bottleneck in the computation....../Output communication (or just I/O) performed when solving a given problem. The area was effectively started in the late eighties by Aggarwal and Vitter and subsequently I/O algorithms have been developed for several problem domain. Also I/O performance can often be improved if many disks can efficiently be used...

  6. DFB laser with attached external intensity modulator

    Energy Technology Data Exchange (ETDEWEB)

    Marcuse, D. (AT and T Bell Labs. Holmdel, NJ (US))

    1990-02-01

    This paper presents a theoretical study of the frequency pulling effect exerted on a DFB laser by an external amplitude modulator that is directly attached to it. The modulator consists of a piece of waveguide whose loss is modulated by means of an externally applied voltage. The modulator affects the laser due to residual reflections from its far end which appear as a variable effective reflectivity to the output end of the DFB laser. Modulation affects the magnitude as well as the phase of the effective reflection coefficient presented to the laser due to the coupling of the real and imaginary parts of the effective refractive index of the modulator waveguide. The tuning problem is formulated as an eigenvalue equation for the DFB laser in the presence of an externally attached lossy cavity.

  7. Performance Targets and External Market Prices

    DEFF Research Database (Denmark)

    Hansen, Allan; Friis, Ivar; Vámosi, Tamás S.

    In this paper we explore the processes of ‘bringing the market inside the firm’ to set performance targets and benchmark production workers productivity. We analyze attempts to use external suppliers’ bids in target setting in a Danish manufacturing company. The case study illustrates how...... the implementation of external market information in target setting – well known in transfer pricing, relative performance evaluation, beyond budgeting, target costing, piece rates systems and value based management – relate to challenging motivation and information problem. The analysis and discussion of those...... problems, in particular those related to accounting for the internal performance (that are going to be compared with the external target), calculating the ‘inside’ costs and defining controllability, contributes to the management accounting as well as the piece-rate literature....

  8. Human Sound Externalization in Reverberant Environments

    DEFF Research Database (Denmark)

    Catic, Jasmina

    occur. In this thesis, the spatial cues that arise from a combined effect of filtering due to the head, torso, and pinna and the acoustic environment were analysed and the impact of such cues for the perception of externalization in different frequency regions was investigated. Distant sound sources...... level differences (ILDs) that occurs in reverberant environments was altered via modifications of the signal envelope in the left and right ear. It was found that the dynamic ILDs had an effect on externalization for broadband and highpass filtered speech, while no effect was found for lowpass filtered......, this work contributes to the understanding of the auditory processing of spatial cues that are important for externalization in reverberant environments and may have implications for hearing instrument signal processing....

  9. The external microenvironment of healing skin wounds

    DEFF Research Database (Denmark)

    Kruse, Carla R; Nuutila, Kristo; Lee, Cameron Cy

    2015-01-01

    The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment...... methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen...

  10. Automatic Planning of External Search Engine Optimization

    Directory of Open Access Journals (Sweden)

    Vita Jasevičiūtė

    2015-07-01

    Full Text Available This paper describes an investigation of the external search engine optimization (SEO action planning tool, dedicated to automatically extract a small set of most important keywords for each month during whole year period. The keywords in the set are extracted accordingly to external measured parameters, such as average number of searches during the year and for every month individually. Additionally the position of the optimized web site for each keyword is taken into account. The generated optimization plan is similar to the optimization plans prepared manually by the SEO professionals and can be successfully used as a support tool for web site search engine optimization.

  11. Black holes under external influence

    Indian Academy of Sciences (India)

    Jiří Bičák

    2000-10-01

    The work on black holes immersed in external fields is reviewed in both test-field approximation and within exact solutions. In particular we pay attention to the effect of the expulsion of the flux of external fields across charged and rotating black holes which are approaching extremal states. Recently this effect has been shown to occur for black hole solutions in string theory. We also discuss black holes surrounded by rings and disks and rotating black holes accelerated by strings.

  12. External Link Policy | Division of Cancer Prevention

    Science.gov (United States)

    The following graphic notice means that you are leaving the DCP Web site: (link is external)This external link provides additional information that is consistent with the intended purpose of DCP.The National Cancer Institute (NCI) cannot attest to the accuracy of a non-federal site.Linking to a non-federal site does not constitute an endorsement by HHS or any of its employees of the sponsors or the information and products presented on the site.You will be subject to the destination site |

  13. The External Networking Behaviour of Public Managers

    DEFF Research Database (Denmark)

    Hansen, Morten Balle; Villadsen, Anders Ryom

    2017-01-01

    There has been an increasing focus on managerial external networking behaviour within public administration. While most previous quantitative research has analysed such behaviour one-dimensionally, we suggest a two-dimensional conceptualization based on the concepts of weak and strong ties....... Utilizing measures resembling previous research, we explore the utility of the approach in an exploratory study of Danish local government. Our findings suggest that the two dimensions of external networking behaviour are distinct. We discuss our approach compared to previous approaches and argue...

  14. Social Ontology Documentation for Knowledge Externalization

    Science.gov (United States)

    Aranda-Corral, Gonzalo A.; Borrego-Díaz, Joaquín; Jiménez-Mavillard, Antonio

    Knowledge externalization and organization is a major challenge that companies must face. Also, they have to ask whether is possible to enhance its management. Mechanical processing of information represents a chance to carry out these tasks, as well as to turn intangible knowledge assets into real assets. Machine-readable knowledge provides a basis to enhance knowledge management. A promising approach is the empowering of Knowledge Externalization by the community (users, employees). In this paper, a social semantic tool (called OntoxicWiki) for enhancing the quality of knowledge is presented.

  15. RAM-Efficient External Memory Sorting

    DEFF Research Database (Denmark)

    Arge, Lars; Thorup, Mikkel

    2013-01-01

    In recent years a large number of problems have been considered in external memory models of computation, where the complexity measure is the number of blocks of data that are moved between slow external memory and fast internal memory (also called I/Os). In practice, however, internal memory time...... often dominates the total running time once I/O-efficiency has been obtained. In this paper we study algorithms for fundamental problems that are simultaneously I/O-efficient and internal memory efficient in the RAM model of computation....

  16. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors and perceived parenting styles.

    NARCIS (Netherlands)

    Buschgens, C.J.M.; Aken, M.A. van; Swinkels, S.H.N.; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  17. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors and perceived parenting styles

    NARCIS (Netherlands)

    Buschgens, C.J.M.; van Aken, M.A.G.; Swinkels, S.H.N.; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  18. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors and perceived parenting styles

    NARCIS (Netherlands)

    Buschgens, C.J.M.; van Aken, M.A.G.; Swinkels, S.H.N.; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  19. Externalizing behaviors in preadolescents : familial risk to externalizing behaviors and perceived parenting styles

    NARCIS (Netherlands)

    Buschgens, Cathelijne J. M.; van Aken, Marcel A. G.; Swinkels, Sophie H. N.; Ormel, Johan; Verhulst, Frank C.; Buitelaar, Jan K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  20. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors and perceived parenting styles.

    NARCIS (Netherlands)

    Buschgens, C.J.M.; Aken, M.A. van; Swinkels, S.H.N.; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  1. Externalizing behaviors in preadolescents: Familial risk to externalizing behaviors and perceived parenting styles

    NARCIS (Netherlands)

    C.J.M. Buschgens (Cathelijne); M.A.G. van Aken (Marcel); S.H.N. Swinkels (Sophie); J. Ormel (Johan Hans); F.C. Verhulst (Frank); J.K. Buitelaar (Jan)

    2010-01-01

    textabstractThe aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAIL

  2. Externalizing behaviors in preadolescents : familial risk to externalizing behaviors and perceived parenting styles

    NARCIS (Netherlands)

    Buschgens, Cathelijne J. M.; van Aken, Marcel A. G.; Swinkels, Sophie H. N.; Ormel, Johan; Verhulst, Frank C.; Buitelaar, Jan K.

    2010-01-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large p

  3. International Labor Migration and External Debt.

    Science.gov (United States)

    Bustamante, Jorge A.

    1987-01-01

    Mexico and the United States have different perspectives on undocumented migrant workers. Possible solutions to this dilemma are (1) deciding on a common definition; (2) bilateral negotiations on the status of migrant workers; (3) addressing Mexico's external debt and scarce money resources; and (4) addressing the ways the American economy…

  4. network externalities into the technology acceptance model

    NARCIS (Netherlands)

    Song, Michael; Parry, Mark E.; Kawakami, Tomoko

    2009-01-01

    Research on network externalities has identified a number of product categories in which the market performance of an innovation (e.g., unit sales and revenues) is an increasing function of that innovation's installed base and the availability of complementary products. Innovation scholars have attr

  5. Ion Plasma Responses to External Electromagnetic Fields

    NARCIS (Netherlands)

    Naus, H.W.L.

    2010-01-01

    The response of ion plasmas to external radiation fields is investigated in a quantum mechanical formalism.We focus on the total electric field within the plasma. For general bandpass signals three frequency regions can be distinguished in terms of the plasma frequency. For low frequencies, the exte

  6. Rational bargaining in games with coalitional externalities

    NARCIS (Netherlands)

    Borm, Peter; Ju, Y.; Wettstein, D.

    This paper provides a flexible strategic framework to analyze bargaining and values in environments with coalitional externalities. Within this framework we propose a new value that extends the Shapley value to partition function form games, the so-called Rational Belief Shapley (RBS) value. We

  7. Thoughts on Internal and External Quality Assurance

    Science.gov (United States)

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  8. Fiscal externalities of becoming a parent.

    Science.gov (United States)

    Wolf, Douglas A; Lee, Ronald D; Miller, Timothy; Donehower, Gretchen; Genest, Alexandre

    2011-01-01

    Theoretical and empirical results suggest that there are externalities to childbearing, but those results usually assume that these externalities accrue uniformly within a homogeneous population. We advance this argument by developing separate estimates of the fiscal externalities associated with parents—those who devote time or material resources to minor children—and nonparents. Our analysis uses data from the US Panel Study of income Dynamics on the age profiles of taxes paid and publicly funded benefits consumed by parents and nonparents, together with a previously developed intertemporal economic-demographic accounting model. The accounting framework takes into account the net fiscal impacts of future generations as well as the present population. Our findings indicate that, with a 3 percent discount rate, parents produce a substantial net fiscal externality, about $217,000 in 2009 dollars. This is equivalent to a lifetime annuity of nearly $8,100 per year beginning at age 18. The results are sensitive to both the discount rate used and the proportion of parents within the cohort.

  9. External Environment and Upper Echelons Theory

    DEFF Research Database (Denmark)

    Escribá-Esteve, Alejandro; Nielsen, Sabina; Yamak, Sibel

    This work reviews empirical research on TMTs with a specific emphasis on the role of the external environment. We extend the existing research on upper echelons theory, which has largely focused on the team and firm level of analyses of top management teams (TMT). Considering institutional...

  10. Frequent external focus feedback enhances motor learning

    Directory of Open Access Journals (Sweden)

    Gabriele eWulf

    2010-11-01

    Full Text Available The present study examined the hypothesis that feedback inducing an external focus of attention enhances motor learning if it is provided frequently (i.e., 100% rather than less frequently. Children (10-12 year olds practiced a soccer throw-in task and were provided feedback about movement form. The feedback statements, provided either after every (100% or every third (33% practice trial, were similar in content but induced either an internal focus (body-movement related or external focus (movement-effect related. The results demonstrated that learning of the movement form was enhanced by external-focus feedback after every trial (100% relative to external-focus feedback after every third trial (33% or internal-focus feedback (100%, 33%, as demonstrated by immediate and delayed transfer tests without feedback. There was no difference between the two internal-focus feedback groups. These findings indicate that the attentional focus induced by feedback is an important factor in determining the effectiveness of different feedback frequencies. We argue that the informational properties of feedback cannot sufficiently account for these and related findings, and suggest that the attentional role of feedback be given greater consideration in future studies.

  11. External Approach Microsurgery of Retinal Dialysis

    Institute of Scientific and Technical Information of China (English)

    Ying Zhang; Piqing Hu; Lixin Shun; Xuechun Zhu; Yingwu Yi; Wen Liu

    2005-01-01

    Purpose: To explore the effect of external approach microsurgery in retinal dialysis.Methods: Consecutive 30 eyes of 28 patients with retinal dialysis were enrolled for this study. The progresses of the external approach microsurgery were following. Under the surgical microscopy, the preplacement of mattress sutures for buckling and/or encircling following retrobulbar anesthesia and scleral exposure, draining subretinal fluid, the cryotherapy of retinal breaks, checking the position of breaks on scleral buckle and gases injection were performed in turn.Results: After drainage of subretinal fluid, with scleral depression cryotherapy reaction around breaks could be observed clearly under the microscopy. All breaks were located on anterior slope of the buckle. Intraoperative complications were mild subretinal hemorrhage at drainage site and corneal epithelium exfoliation in 3 eyes, respectively.Postoperative complications were mainly secondary glaucoma and retinal redetachment.The one-operation reattachmentl rate was 96.7% (29 eyes), and the final reattachment rate was 100% after one eye had a second external approach microsurgery. The postoperative vision acuity (VA) was significantly better than the preoperative VA (X2=9.529, P< 0.01).Conclusion: External approach microsurgery has favourable effect on the surgery of retinal dialysis.

  12. A taxonomy of external and internal attention.

    Science.gov (United States)

    Chun, Marvin M; Golomb, Julie D; Turk-Browne, Nicholas B

    2011-01-01

    Attention is a core property of all perceptual and cognitive operations. Given limited capacity to process competing options, attentional mechanisms select, modulate, and sustain focus on information most relevant for behavior. A significant problem, however, is that attention is so ubiquitous that it is unwieldy to study. We propose a taxonomy based on the types of information that attention operates over--the targets of attention. At the broadest level, the taxonomy distinguishes between external attention and internal attention. External attention refers to the selection and modulation of sensory information. External attention selects locations in space, points in time, or modality-specific input. Such perceptual attention can also select features defined across any of these dimensions, or object representations that integrate over space, time, and modality. Internal attention refers to the selection, modulation, and maintenance of internally generated information, such as task rules, responses, long-term memory, or working memory. Working memory, in particular, lies closest to the intersection between external and internal attention. The taxonomy provides an organizing framework that recasts classic debates, raises new issues, and frames understanding of neural mechanisms.

  13. Identifying Cross-Sided Liquidity Externalities

    NARCIS (Netherlands)

    J.A. Skjeltorp (Johannes); E. Sojli (Elvira); W.W. Tham (Wing Wah)

    2013-01-01

    markdownabstract__Abstract__ We study the relevance of the cross-sided externality between liquidity makers and takers from the two-sided market perspective. We use exogenous changes in the make/take fee structure, minimum tick-size and technological shocks for liquidity takers and makers, as exper

  14. An Indicator for ecosystem externalities in fishing

    DEFF Research Database (Denmark)

    Ravn-Jonsen, Lars; Andersen, Ken Haste; Vestergaard, Niels

    a benefit indicator that explicitly divides the consequences of fishing into internal and external benefits. This analysis demonstrates that the forage fish fleet has a notable economic impact on the large fish fleet, but the reverse is not true. The impact can be either negative or positive, which entails...

  15. An indicator for ecosystem externalities in fishing

    DEFF Research Database (Denmark)

    Ravn-Jonsen, Lars; Andersen, Ken Haste; Vestergaard, Niels

    2016-01-01

    a benefit indicator that explicitly divides the consequences of fishing into internal and external benefits. This analysis demonstrates that the forage fish fleet has a notable economic impact on the large fish fleet, but the reverse is not true. The impact can be either negative or positive, which entails...

  16. External cervical resorption: diagnostic and treatment tips

    Directory of Open Access Journals (Sweden)

    Alberto Consolaro

    Full Text Available ABSTRACT External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature.

  17. 75 FR 70015 - External Defibrillators; Public Workshop

    Science.gov (United States)

    2010-11-16

    ... of innovative AED features such as automated integration into local 9-1-1 systems. FDA will work with... consumers, to share perspectives. II. Topics for Discussion at the Public Workshop The public workshop will... signals, or enhance the use of external defibrillators? III. Transcripts Please be advised that as soon...

  18. External cervical resorption: diagnostic and treatment tips

    Science.gov (United States)

    Consolaro, Alberto

    2016-01-01

    ABSTRACT External cervical resorption is caused, almost exclusively, by dental trauma - especially those characterized by concussion - and is a dental disease to be diagnosed and treated accurately by endodontists. However, the vast majority of the cases is initially diagnosed by an orthodontist, due to the imaging possibilities in standardized documentations. Among the causes of external cervical resorption, it is common to mistakenly attribute it to orthodontic treatment, traumatic occlusion or even to chronic inflammatory periodontal disease. External cervical resorption is associated to dental trauma in several situations mentioned in this paper. In old cases, and eventually still nowadays, it may have been induced by internal tooth bleaching, which is increasingly less frequent in endodontically treated teeth. There are some tips to be followed and some care that must be taken during the diagnosis and treatment of external cervical resorption clinical cases. The present study lists foundations that will allow the professional to perform safely and accurately in each specific case. Some of these tips and care measures are of orthodontic nature. PMID:27901225

  19. Externally definable sets and dependent pairs

    CERN Document Server

    Chernikov, Artem

    2010-01-01

    We prove that externally definable sets in first order NIP theories have honest definitions, giving a new proof of Shelah's expansion theorem. Also we discuss a weak notion of stable embeddedness true in this context. Those results are then used to prove a general theorem on dependent pairs, which in particular answers a question of Baldwin and Benedikt on naming an indiscernible sequence.

  20. External Tank CIL Closed Loop Verification System

    Science.gov (United States)

    Hartley, Eugene A., Jr.

    2005-01-01

    Lockheed Martin was requested to develop a closed loop CIL system following the Challenger accident. The system that was developed has proven to be very robust with minimal problems since implementation, having zero escapes in the last 7 years (27 External Tanks). We are currently investigating expansion of the CIL Closed Loop system to include "MI" CILs.

  1. The External Dimension of EU Migration Policy

    Directory of Open Access Journals (Sweden)

    Dorina Gjipali

    2017-01-01

    Defining the conditions of consistency and flexibility to which the Union’s external action can bring the management of migration - a management which will pursue all objectives of the EU’s migration policy in accordance with the its principles, such as solidarity and the protection of fundamental rights - is the focus of this paper.

  2. The external sector of the Serbian economy

    Directory of Open Access Journals (Sweden)

    Ristanović Vladimir

    2016-01-01

    Full Text Available The aim of this paper is to show the external sector of the Serbian economy, its features and peculiarities, as well as anomalies that afflicted it for years. In the analysis, data acquired from the Statistical Office of the Republic of Serbia will be used, as well as the official international methodology. The text will include the analysis of the structure of the external sector, market share, competitive position of Serbian economy and export products according to sectors of the economy and factor intensity. Since 2000, the structure of production and exports of the Serbian economy shows low comparative advantages and competitive position throughout the world. Unfavorable structure of the sectors, departments and the product groups affected the deepening of external imbalances and high foreign trade deficit. Exports of technology of predominantly low intensity, resources, and labor-intensive products, common for Serbian economy, represent no guarantee of economic growth in the long term. The causes of external imbalances should be sought in the absence of adequate export strategy, as well as in high speed of liberalization of foreign trade flows and exchange rate policy.

  3. Nonlinear External Kink Computing with NIMROD

    Science.gov (United States)

    Bunkers, K. J.; Sovinec, C. R.

    2016-10-01

    Vertical displacement events (VDEs) during disruptions often include non-axisymmetric activity, including external kink modes, which are driven unstable as contact with the wall eats into the q-profile. The NIMROD code is being applied to study external-kink-unstable tokamak profiles in toroidal and cylindrical geometries. Simulations with external kinks show the plasma swallowing a vacuum bubble, similar to. NIMROD reproduces external kinks in both geometries, using an outer vacuum region (modeled as a plasma with a large resistivity), but as the boundary between the vacuum and plasma regions becomes more 3D, the resistivity becomes a 3D function, and it becomes more difficult for algebraic solves to converge. To help allow non-axisymmetric, nonlinear VDE calculations to proceed without restrictively small time-steps, several computational algorithms have been tested. Flexible GMRES, using a Fourier and real space representation for the toroidal angle has shown improvements. Off-diagonal preconditioning and a multigrid approach were tested and showed little improvement. A least squares finite element method (LSQFEM) has also helped improve the algebraic solve. This effort is supported by the U.S. Dept. of Energy, Award Numbers DE-FG02-06ER54850 and DE-FC02-08ER54975.

  4. KEUNTUNGAN PENGGUNAAN EXTERNAL FUNCTION PADA DATABASE POSTGRESQL

    Directory of Open Access Journals (Sweden)

    Nahrun Hartono

    2015-02-01

    Full Text Available Database id a central data for an information system, there were many database system applications that revolve both paid and free. PostgreSQL is one of the free database system and it has the powerful feature, one of the feature that make it different with others sysem is a function features, where the users can make their function by them selves by using spesific programming language, then it can be called return for executed. In this research the writer tries for conducting additional data testing by using INSERT Query and External Function Query on the terminal/command prompt and web browser. From the result of the trial, the research found that the average of time in additional data processing on the terminal/command prompt by using INSERT Query was 185.293 ms and the average of time External Function Query proccess was 129.52 ms, while the average of time in additional data processing on web browser by using INSERT Query was 168.363 ms and External Function Query was 145.64 ms. There was a difference both of the query, but the important thing and should be noted that external function is a command was defined by stand alone by the user, this matter lets the user to determine a specify command that they need.

  5. Thoughts on Internal and External Quality Assurance

    Science.gov (United States)

    Zhang, Jianxin

    2012-01-01

    Quality assurance of higher education is made up of two parts: internal quality assurance (IQA) and external quality assurance (EQA). Both belong to a union of the coexistence and balance of yin and yang. But in reality there exists a paradox of "confusion of quality assurance (QA) subject consciousness, singularity of social QA and lack of QA…

  6. Dyadic Parenting and Children's Externalizing Symptoms

    Science.gov (United States)

    Meteyer, Karen B.; Perry-Jenkins, Maureen

    2009-01-01

    We explore dyadic parenting styles and their association with first-grade children's externalizing behavior symptoms in a sample of 85 working-class, dual-earner families. Cluster analysis is used to create a typology of parenting types, reflecting the parental warmth, overreactivity, and laxness of both mothers and fathers in two-parent families.…

  7. Dyadic Parenting and Children's Externalizing Symptoms

    Science.gov (United States)

    Meteyer, Karen B.; Perry-Jenkins, Maureen

    2009-01-01

    We explore dyadic parenting styles and their association with first-grade children's externalizing behavior symptoms in a sample of 85 working-class, dual-earner families. Cluster analysis is used to create a typology of parenting types, reflecting the parental warmth, overreactivity, and laxness of both mothers and fathers in two-parent families.…

  8. External fixation for phalangeal and metacarpal fractures

    NARCIS (Netherlands)

    Drenth, DJ; Klasen, HJ

    From 1987 to 1993 we treated 33 patients with 29 phalangeal and seven metacarpal fractures by external fixation using a mini-Hoffmann device. There were 27 open and 25 comminuted fractures, In 12 patients one or more tendons was involved, The mean follow-up was 4.4 years, Complications occurred in

  9. Video exams and the external examiners

    DEFF Research Database (Denmark)

    Qvist, Palle

    to the Master’s programme. The programme offers streamed videos in combination with other learning resources. Oral exams have been mediated with the help of Skype and later with Adobe Connect Professional. It has for all participants - students, examiners and external examiners – been both a challenge...

  10. Principles and Practices of EU External Representation.

    NARCIS (Netherlands)

    Blockmans, S.; Wessel, Ramses A.

    2012-01-01

    With this working paper, CLEER aims to offer a better insight into selected legal aspects concerning the European Union’s redefined diplomatic persona. In particular, the working paper will address issues pertaining to the Lisbon Treaty’s organising principles of EU external action, both under EU

  11. Health insurance and the obesity externality.

    Science.gov (United States)

    Bhattacharya, Jay; Sood, Neeraj

    2007-01-01

    If rational individuals pay the full costs of their decisions about food intake and exercise, economists, policy makers, and public health officials should treat the obesity epidemic as a matter of indifference. In this paper, we show that, as long as insurance premiums are not risk rated for obesity, health insurance coverage systematically shields those covered from the full costs of physical inactivity and overeating. Since the obese consume significantly more medical resources than the non-obese, but pay the same health insurance premiums, they impose a negative externality on normal weight individuals in their insurance pool. To estimate the size of this externality, we develop a model of weight loss and health insurance under two regimes--(1) underwriting on weight is allowed and (2) underwriting on weight is not allowed. We show that under regime (1), there is no obesity externality. Under regime (2), where there is an obesity externality, all plan participants face inefficient incentives to undertake unpleasant dieting and exercise. These reduced incentives lead to inefficient increases in bodyweight, and reduced social welfare. Using data on medical expenditures and bodyweight from the National Health and Interview Survey and the Medical Expenditure Panel Survey, we estimate that, in a health plan with a coinsurance rate of 17.5%, the obesity externality imposes a welfare cost of about $150 per capita. Our results also indicate that the welfare loss can be reduced by technological change that lowers the pecuniary and non-pecuniary costs of losing weight, and also by increasing the coinsurance rate.

  12. 21 CFR 878.3800 - External aesthetic restoration prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External aesthetic restoration prosthesis. 878... External aesthetic restoration prosthesis. (a) Identification. An external aesthetic restoration prosthesis... external prosthesis adhesive. The device is not intended to be implanted. (b) Classification. Class...

  13. 21 CFR 890.3500 - External assembled lower limb prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External assembled lower limb prosthesis. 890.3500... External assembled lower limb prosthesis. (a) Identification. An external assembled lower limb prosthesis... the lower extremity. Examples of external assembled lower limb prostheses are the following:...

  14. Cost-Effective Abatement of Multiple Production Externalities

    Science.gov (United States)

    Connor, Jeffery D.; Perry, Gregory M.; Adams, Richard M.

    1995-07-01

    This article explores the issue of multiple externalities through a case study of irrigated agricultural production in eastern Oregon. A mathematical programming model is used to demonstrate the manner in which a policy directed at one externality (soil erosion) may influence the incidence of another externality (groundwater pollution). A key determinant of multiple externality outcomes is interdependence in the processes producing agricultural commodities and externalities. Potential benefits from coordinating a policy to address multiple environmental objectives are discussed.

  15. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors, prenatal and perinatal risks, and their interactions.

    NARCIS (Netherlands)

    Buschgens, C.J.M.; Swinkels, S.H.N.; Aken, M.A. van; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2009-01-01

    BACKGROUND: Accumulating evidence indicates that there is a rich and varied interplay between persons and their environments, which strongly suggests that this involves gene-environment correlations and interactions. We investigated whether familial risk (FR) to externalizing behaviors and prenatal

  16. Cleaning MEG artifacts using external cues.

    Science.gov (United States)

    Tal, I; Abeles, M

    2013-07-15

    Using EEG, ECoG, MEG, and microelectrodes to record brain activity is prone to multiple artifacts. The main power line (mains line), video equipment, mechanical vibrations and activities outside the brain are the most common sources of artifacts. MEG amplitudes are low, and even small artifacts distort recordings. In this study, we show how these artifacts can be efficiently removed by recording external cues during MEG recordings. These external cues are subsequently used to register the precise times or spectra of the artifacts. The results indicate that these procedures preserve both the spectra and the time domain wave-shapes of the neuromagnetic signal, while successfully reducing the contribution of the artifacts to the target signals without reducing the rank of the data.

  17. The external microenvironment of healing skin wounds.

    Science.gov (United States)

    Kruse, Carla R; Nuutila, Kristo; Lee, Cameron C Y; Kiwanuka, Elizabeth; Singh, Mansher; Caterson, Edward J; Eriksson, Elof; Sørensen, Jens A

    2015-01-01

    The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen and carbon dioxide), pH, and anti-microbial treatment on the wound. These factors are well described in the literature and can be modified with treatment methods available in the clinic. Understanding the roles of these factors in wound pathophysiology is of central importance in wound treatment. © 2015 by the Wound Healing Society.

  18. OCCUPATIONAL EXPOSURE TO EXTERNAL RADIATION IN SWITZERLAND.

    Science.gov (United States)

    Mayer, S; Baechler, S; Damet, J; Elmiger, R; Frei, D; Giannini, S; Leupin, A; Sarott, F; Schuh, R

    2016-09-01

    Individual monitoring for both external and internal exposures is well regulated in Switzerland. The article gives an overview on the occupational exposure to external radiation of workers based on the data collected in the Swiss national dose registry (NDR) in 2013. The NDR records the monthly doses of radiation workers since the introduction of ICRP 60 recommendations and is manifested in the Swiss ordinance since 1994. Annual dose limits for effective dose are typically exceeded once a year in Switzerland, mostly in medicine. The NDR is a useful optimisation tool to identify and characterise areas with the highest exposures. While exceeded dose limits were often related to accidental acute exposure in the past, they are now more related to continuous exposure during normal work, especially in medicine.

  19. Dissemination of CERN Technologies Through External Entrepreneurs

    CERN Document Server

    Lande, Bjørnulf Visdal; Huuse, Henning

    2008-01-01

    This study focuses on dissemination of innovations through external entrepreneurs. The innovations studied are developed at the European Organization for Nuclear Research (CERN) and commercialized by entrepreneurs establishing spin-off companies on the outside of the Organization. The objective of this study is to provide knowledge to facilitate future external entrepreneurs to increase dissemination of CERN technologies. The research questions looks at the timeline from preparations for creating the spin-off company, until having a product for commercialization in the market. A qualitative cross case investigation was conducted to assess the experiences of four spin-off companies. A framework was created to structure the discussion by finding and categorizing impeding- and success factors seen from the entrepreneurs point of view. The findings where structured in three phases respectively, the time before starting the company, the beginning of the company and the final development before selling products. Th...

  20. Internal Versus External Knowledge Sourcing Of Subsidiaries

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; Pedersen, Torben

    2003-01-01

    When building up competences, a subsidiary of a multinational corporation (MNC) may rely onexternal knowledge sources like customers, suppliers, competitors or local science centers. Internalsourcing is also available through knowledge offered by headquarters or other affiliates. Thequestion...... is whether the two kinds of sources are mutual exclusive. A dilemma or organizationaltrade-off is foreseeable, since the more the subsidiary adapts its knowledge creation processes tohost country institutions, the less it will be able to utilize internal knowledge sources due to theinstitutional distance...... between the external and internal networks. However, newer organizationalforms, like the concept of the `differentiated MNC', imply a relatively smooth flow of knowledgeinside the MNC, indicating that we should not expect an organizational trade-off between internaland external sources. The subsidiary...

  1. Enlargement of the External Mobility Programme

    CERN Multimedia

    HR Department

    2008-01-01

    The External Mobility Programme was launched at the end of September 2007. Initially, the programme was aimed at staff members on limited-duration contracts having received formal notification of the termination of their employment contract at CERN, to help them towards their next employment. The programme provides a privileged, fast-track entry into the recruitment process of partner companies. Despite the short time since its inception, the programme has already delivered some encouraging and concrete results in terms of interviews granted to participating staff. The Programme has attracted considerable interest from both CERN personnel as well as from several major European companies. The CERN Management has decided to broaden the scope of the External Mobility Programme. The Programme is now open to: All staff members whose limited duration contract will end in less than one year, as well as all those with indefinite contracts. All fellows who have been employed by CE...

  2. External Field QED on Cauchy Surfaces

    CERN Document Server

    Deckert, D -A

    2015-01-01

    The Shale-Stinespring Theorem (1965) together with Ruijsenaar's criterion (1977) provide a necessary and sufficient condition for the implementability of the evolution of external field quantum electrodynamics between constant-time hyperplanes on standard Fock space. The assertion states that an implementation is possible if and only if the spacial components of the external electromagnetic four-vector potential $A_\\mu$ are zero. We generalize this result to smooth, space-like Cauchy surfaces and, for general $A_\\mu$, show how the second-quantized Dirac evolution can always be implemented as a map between varying Fock spaces. Furthermore, we give equivalence classes of polarizations, including an explicit representative, that give rise to those admissible Fock spaces. We prove that the polarization classes only depend on the tangential components of $A_\\mu$ w.r.t. the particular Cauchy surface, and show that they behave naturally under Lorentz and gauge transformations.

  3. External jugular venous aneurysm: A clinical curiosity

    Science.gov (United States)

    Mohanty, Debajyoti; Jain, Bhupendra Kumar; Garg, Pankaj Kumar; Tandon, Anupama

    2013-01-01

    Jugular venous aneurysm is an extremely rare condition. The patients presented with a painless swelling in the neck that appears while coughing, straining, bending, or breath holding. Detection of a soft and compressible swelling in the course of an external jugular vein (EJV) superficial to the sternomastoid muscle, non-filling on compression of the EJV during Valsalva maneuver clinches the diagnosis of EJV aneurysm. Color Doppler ultrasound allows precise delineation of the lesion and is considered the gold standard for confirming the diagnosis. Surgical excision is indicated mostly for cosmetic reasons and symptomatic aneurysms. We, herein, report a patient with saccular external jugular venous aneurysm to highlight the typical clinical presentation and diagnosis of this rare entity. PMID:23633867

  4. Enlargement of the External Mobility Programme

    CERN Document Server

    HR Department

    2008-01-01

    The External Mobility Programme was launched at the end of September 2007. Initially, the programme was aimed at staff members on limited-duration contracts, having received formal notification of the termination of their employment contract at CERN, to help them towards their next employment. The programme provides a privileged, fast-track entry into the recruitment process of partner companies. Despite the short time since its inception, the programme has already delivered some encouraging and concrete results in terms of interviews granted to participating staff. The Programme has raised considerable interest from both CERN personnel as well as from several major European companies. CERN Management has decided to broaden the scope of the External Mobility Programme. The Programme is now open to: All staff members whose limited duration contract will end in less than one year, as well as all those with indefinite contracts. All fellows who have been employed by CERN fo...

  5. External ionization mechanisms for advanced thermionic converters

    Science.gov (United States)

    Hatziprokopiou, M. E.

    Ion generation and recombination mechanisms in the cesium plasma were investigated as they pertain to the advanced mode thermionic energy converters. The changes in plasma density and temperature within the converter were studied under the influence of several promising auxiliary ionization candidate sources. Three novel approaches of external cesium ion generation were investigated in some detail, namely vibrationally excited N2 as an energy source of ionization of Cs ions in a DC discharge, microwave power as a means of resonant sustenance of the cesium plasma, and ion generation in a pulse N2-Cs mixture. The experimental data obtained and discussed in this work show that all three techniques--i.e. the non-LTE high-voltage pulsing, the energy transfer from vibrationally excited diatomic gases, and the external pumping with a microwave power--have considerable promise as schemes in auxiliary ion generation applicable to the advanced thermionic energy converter.

  6. [Progressive external ophthalmoplegia and distal myopathy].

    Science.gov (United States)

    Damian, C

    1993-01-01

    A patient, 58 years old, presents progressive blepharoptosis, in both eyes and external ophthalmoplegia. The general somatic examination, shows, at the level of the higher limbs, distal myopathy with muscular hypotony and articular deformities fibrosis and tendinous retraction. On examining the eye bottom we found colloid degeneration in the muscle region. Within the same family a ten-year-old nephew presents congenital ptosis. The muscular biopsy from the levator palpebrae shows muscular degenerative lesions with the reduction of nuclei and the proliferation of conjunctive tissue. It is shown that progressive external ophthalmoplegia must be interpreted as an ocular myopathy. The association with the distal myopathy at the level of the higher limbs, in the presented observation, upholds this pathogeny.

  7. Renal transplantation using external continent urinary diversion.

    Science.gov (United States)

    Lucon, A M; Sabbaga, E; Ianhez, L E; Chocair, P R; Pestana, J O; Arap, S

    1994-02-01

    A 29-year-old man born with bladder exstrophy presented with end stage renal failure many years after ileal conduit diversion. Bilateral nephrectomy and continent external urinary diversion were performed, and 1.5 months later a cadaveric kidney was grafted into the right iliac fossa. The patient was well at 18 months with a serum creatinine level of 1.2 mg./dl. and he was completely dry with 4 or 5 daily catheterizations. Although followup is still short, renal transplantation with drainage into an external continent urinary diversion permits excellent quality of life and good renal function. Therefore, this alternative is worth consideration whenever other reconstructive alternatives are not possible in candidates for renal transplantation.

  8. Composite Vector Particles in External Electromagnetic Fields

    CERN Document Server

    Davoudi, Zohreh

    2015-01-01

    Lattice quantum chromodynamics (QCD) studies of electromagnetic properties of hadrons and light nuclei, such as magnetic moments and polarizabilities, have proven successful with the use of background field methods. With an implementation of nonuniform background electromagnetic fields, properties such as charge radii and higher electromagnetic multipole moments (for states of higher spin) can be additionally obtained. This can be achieved by matching lattice QCD calculations to a corresponding low-energy effective theory that describes the static and quasi-static response of hadrons and nuclei to weak external fields. With particular interest in the case of vector mesons and spin-1 nuclei such as the deuteron, we present an effective field theory of spin-1 particles coupled to external electromagnetic fields. To constrain the charge radius and the electric quadrupole moment of the composite spin-1 field, the single-particle Green's functions in a linearly varying electric field in space are obtained within t...

  9. Experiments with Externally Prestressed Continuous Composite Girders

    Directory of Open Access Journals (Sweden)

    M. Safan

    2001-01-01

    Full Text Available Steel-concrete composite girders have attractive potentials when applied in bridge construction. The serviceability performance of continuous composite girders is becoming more and more a deterministic parameter in the design of this type of structures. An effective method for improving this performance is to apply prestressing to control or completely eliminate concrete deck cracking caused by static and time dependent actions. Little literature has been found addressing the experimental analysis of continuous girders prestressed by means of external deviated tendons. The current research aims to investigate the behavior of a double-span steel composite beam externally prestressed by means of continuous tendons in terms of cracking characteristics, load deflection response, and load carrying capacity. The efficiency of prestressing is evaluated by comparing the results to those of a non-prestressed beam with similar cross sections and spans.

  10. Vertical external cavity surface emitting semiconductor lasers

    CERN Document Server

    Holm, M

    2001-01-01

    Active stabilisation showed a relative locked linewidth of approx 3 kHz. Coarse tuning over 7 nm was achieved using a 3-plate birefingent filter plate while fine-tuning using cavity length change allowed tuning over 250 MHz. Vertical external cavity semiconductor lasers have emerged as an interesting technology based on current vertical cavity semiconductor laser knowledge. High power output into a single transverse mode has attracted companies requiring good fibre coupling for telecommunications systems. The structure comprises of a grown semiconductor Bragg reflector topped with a multiple quantum well gain region. This is then included in an external cavity. This device is then optically pumped to promote laser action. Theoretical modelling of AIGaAs based VECSEL structures was undertaken, showing the effect of device design on laser characteristics. A simple 3-mirror cavity was constructed to assess the static characteristics of the structure. Up to 153 mW of output power was achieved in a single transver...

  11. External legitimation in international new ventures

    DEFF Research Database (Denmark)

    Turcan, Romeo V.

    2012-01-01

    This paper explores within the framework of new venture legitimation how and why international new ventures acquire external legitimacy and strive for survival in the face of critical events. Following a longitudinal multiple-case study methodology that was adopted for the purpose of theory...... threshold, and on the valuation of the venture are discussed and respective propositions are put forward to guide future research....

  12. Imaging findings in external snapping hip syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Krishnamurthy, Ganesh; Connolly, Bairbre L. [The Hospital for Sick Children, Image Guided Therapy, Diagnostic Imaging, Toronto (Canada); Narayanan, Unni [The Hospital for Sick Children, Pediatric Orthopedic Surgery, Toronto (Canada); Babyn, Paul S. [The Hospital for Sick Children, Diagnostic Imaging, Toronto (Canada)

    2007-12-15

    We describe a case of external snapping hip diagnosed by dynamic sonography. The case prompted us to retrospectively review the imaging findings of children who clinically had presented with snapping hip. From this review we identified the features on MRI and CT of either thickening of the iliotibial band or thickening of the anterior edge of the gluteus maximus muscle as the cause of snapping and atrophy of the bulk of gluteus maximus muscle as an important secondary sign associated with snapping. (orig.)

  13. External Performance in Low-Income Countries

    OpenAIRE

    Alessandro Prati; Luca A Ricci; Lone Engbo Christiansen; Stephen Tokarick; Thierry Tressel

    2011-01-01

    Assessments of exchange rate misalignments and external imbalances for low-income countries are challenging because methodologies developed for advanced and emerging economies cannot be automatically applied to poorer nations. This paper uses a large database, unique in the set of indicators and number of countries it covers, to estimate the relationship in low-income countries between a set of fundamentals in the medium to long term and the real effective exchange rate, the current account, ...

  14. The MNC as an Externally Embedded Organization

    DEFF Research Database (Denmark)

    Nell, Phillip Christopher; Ambos, Björn; Schlegelmilch, Bodo B.

    2011-01-01

    MNCs have been conceptualized as differentiated networks that, in turn, are embedded in external networks. Previous research has predominantly focused on the embeddedness of established subsidiaries into their local environment, omitting to shed light on the phenomenon of headquarters linkages to...... more overlapping network ties when subsidiaries are high performers, hold important resources, operate in turbulent environments, and are closely connected to multinational actors as opposed to purely domestic firms....

  15. Synchronization of cardiorhythm by weak external forcing

    Directory of Open Access Journals (Sweden)

    V. S. Anishchenko

    2000-01-01

    Full Text Available We study the possibility to synchronize cardiorhythm of a human by periodic and aperiodic sequences of light and sound pulses. Aperiodic forcing is defined by variation of RR intervals of another subject. Phase locking between cardiorhythm and weak external forcing is detected on finite time intervals. We observe the 1:1 synchronization for periodic forcing and n:m synchronization for aperiodic one.

  16. INTERNAL AND EXTERNAL NETWORK ENTERPRISES GENERAL APPROACHES

    OpenAIRE

    2014-01-01

    The aim of this paper is to make distinction between multiple uses of the word "network" considered both inside and outside the enterprise. Starting from the reference literature on supply chain management, logistic, networks of enterprises, this article presents the main features of internal and external enterprise networks and investigates their impact on enterprises' organization manner. We also explore the relationship between networks and innovation deployment.

  17. Internal entanglement amplification by external interactions

    OpenAIRE

    2007-01-01

    We propose a scheme to control the level of entanglement between two fixed spin-1/2 systems by interaction with a third particle. For specific designs, entanglement is shown to be "pumped" into the system from the surroundings even when the spin-spin interaction within the system is small or nonexistent. The effect of the external particle on the system is introduced by including a dynamic spinor in the Hamiltonian. Controlled amplification of the internal entanglement to its maximum value is...

  18. On Expressing Value Externalities in Position Auctions

    OpenAIRE

    Constantin, Florin; Rao, Malvika; Huang, Chien-Chung; Parkes, David C.

    2011-01-01

    We introduce a bidding language for expressing negative value externalities in position auctions for online advertising. The unit-bidder constraints (UBC) language allows a bidder to condition a bid on its allocated slot and on the slots allocated to other bidders. We introduce a natural extension of the Generalized Second Price (GSP) auction, the expressive GSP (eGSP) auction, that induces truthful revelation of constraints for a rich subclass of unit-bidder types,namely downward-monotonic U...

  19. Position Auctions with Externalities and Brand Effects

    OpenAIRE

    Hummel, Patrick; McAfee, R. Preston

    2014-01-01

    This paper presents models for predicted click-through rates in position auctions that take into account two possibilities that are not normally considered---that the identities of ads shown in other positions may affect the probability that an ad in a particular position receives a click (externalities) and that some ads may be less adversely affected by being shown in a lower position than others (brand effects). We present a general axiomatic methodology for how click probabilities are aff...

  20. External shocks, policy response and economic performance

    OpenAIRE

    Neary, J. Peter

    1993-01-01

    This paper examines the responsiveness of real income and the balance of payments to external shocks in a small open economy. It is shown that tariff restrictions and age rigidities tend to increase responsiveness and quota restrictions tend to educe it. The implications for policy response are considered and a micro-theoretic foundation for the distinction between expenditure-reducing and expenditure-switching policies is provided.

  1. Stabilization of Externally Slung Helicopter Loads

    Science.gov (United States)

    1974-08-01

    maximum slir^ Loao weighting and " vertical bounce ." The last question provides information on multi-point suspension of external 1oads. PHASE...an allowable cargo load, and vertical bounce . 110 Maximum Sling Load Weight The maximum sling load lifted by a CH-47B helicopter under...changes were made in their flying technique except for very smooth flight control inputs when lifting an ACL. Vertical Bounce Fifteen of the forty Army

  2. Lesions in the external auditory canal

    Directory of Open Access Journals (Sweden)

    Priyank S Chatra

    2011-01-01

    Full Text Available The external auditory canal is an S- shaped osseo-cartilaginous structure that extends from the auricle to the tympanic membrane. Congenital, inflammatory, neoplastic, and traumatic lesions can affect the EAC. High-resolution CT is well suited for the evaluation of the temporal bone, which has a complex anatomy with multiple small structures. In this study, we describe the various lesions affecting the EAC.

  3. Dynamic Range Reporting in External Memory

    CERN Document Server

    Nekrich, Yakov

    2010-01-01

    In this paper we describe a dynamic external memory data structure that supports range reporting queries in three dimensions in $O(\\log_B^2 N + \\frac{k}{B})$ I/O operations, where $k$ is the number of points in the answer and $B$ is the block size. This is the first dynamic data structure that answers three-dimensional range reporting queries in $\\log_B^{O(1)} N + O(\\frac{k}{B})$ I/Os.

  4. Immunopathological response in external dental resorption

    OpenAIRE

    Gabriela Wagner Ximenes; Alessandra Dutra da Silva; Paulo Oliva de Borba

    2015-01-01

    The study of root resorption and its immunopathogenesis is extremely important for preserving teeth within the oral cavity. Resorption may be infl ammatory or by substitution and it can be triggered by traumatism, induced movement of teeth, periapical disease, periodontal treatment and whitening of non-vital teeth. During odontogenesis, dentin is protected from the immune system and later this protection is provided externally by the cementum, cementoblasts and enamel and internally by the od...

  5. Markets, Herding and Response to External Information.

    Science.gov (United States)

    Carro, Adrián; Toral, Raúl; San Miguel, Maxi

    2015-01-01

    We focus on the influence of external sources of information upon financial markets. In particular, we develop a stochastic agent-based market model characterized by a certain herding behavior as well as allowing traders to be influenced by an external dynamic signal of information. This signal can be interpreted as a time-varying advertising, public perception or rumor, in favor or against one of two possible trading behaviors, thus breaking the symmetry of the system and acting as a continuously varying exogenous shock. As an illustration, we use a well-known German Indicator of Economic Sentiment as information input and compare our results with Germany's leading stock market index, the DAX, in order to calibrate some of the model parameters. We study the conditions for the ensemble of agents to more accurately follow the information input signal. The response of the system to the external information is maximal for an intermediate range of values of a market parameter, suggesting the existence of three different market regimes: amplification, precise assimilation and undervaluation of incoming information.

  6. Markets, Herding and Response to External Information.

    Directory of Open Access Journals (Sweden)

    Adrián Carro

    Full Text Available We focus on the influence of external sources of information upon financial markets. In particular, we develop a stochastic agent-based market model characterized by a certain herding behavior as well as allowing traders to be influenced by an external dynamic signal of information. This signal can be interpreted as a time-varying advertising, public perception or rumor, in favor or against one of two possible trading behaviors, thus breaking the symmetry of the system and acting as a continuously varying exogenous shock. As an illustration, we use a well-known German Indicator of Economic Sentiment as information input and compare our results with Germany's leading stock market index, the DAX, in order to calibrate some of the model parameters. We study the conditions for the ensemble of agents to more accurately follow the information input signal. The response of the system to the external information is maximal for an intermediate range of values of a market parameter, suggesting the existence of three different market regimes: amplification, precise assimilation and undervaluation of incoming information.

  7. Monetization of Environmental Externalities (Emissions from Bioenergy

    Directory of Open Access Journals (Sweden)

    Isabelle BROSE

    2008-01-01

    Full Text Available Bioenergy from agriculture is today in the heart of sustainabledevelopment, integrating its key components: environment and climate change,energy economics and energy supply, agriculture, rural and social development.Each bioenergy production route presents externalities that must be assessed inorder to compare one bioenergy route to another (bioenergy route. The lack ofprimary and reliable data on externalities is, nevertheless, an important nontechnologicalbarrier to the implementation of the best (bioenergy routes. In thisarticle, we want to monetize one environmental externality from bioenergy:emissions (GHG: CO2, CH4, N2O, O3; CO, NOx, SO2, metal, and PM. We have tomonetize emissions on the basis of their effects on health, global warming, and soiland water quality. Emissions will be quantified through Life Cycle Analysis (LCAand ECOINVENT database. Impacts on health will be monetized on the basis ofmortality (number of life expectancy years lost multiplied by Value Of Life Year(VOLY and morbidity (number of ill persons multiplied by Cost Of Illness(COI. Impacts on global warming will be monetized by Benefits Transfers fromthe Stern Review and its critics. Finally, impacts on soil and water quality will bemonetized by Averting Behaviour or Defensive Expenses methods. Monetizationresults will be gathered, weighted, and incorporated in states and firms’ decisionmakingtools. They would enhance capacity of policy makers and managers tochose the best (bioenergy routes.

  8. Carnap and Lewis on the External World

    Directory of Open Access Journals (Sweden)

    Ivan Ferreira da Cunha

    2014-08-01

    Full Text Available This paper compares the claims about our knowledge of the external world presented by Rudolf Carnap, in the book known as the Aufbau, to those of Clarence Irving Lewis, in Mind and the World-Order. This comparison is made in terms of the opposition to Kantian epistemology that both books establish; the Aufbau is regarded as the peak of the logicist tradition and Mind and the World-Order is taken in continuity with pragmatism. It is found that both books present knowledge of the external world as a consequence of a structural organization of human experience. However, there is an important point of divergence: the concept of verification each author adopts is different, such a concept was even a matter of discussion between Lewis and the Vienna Circle. This paper shows this disagreement but also shows how Carnap changed his point of view in the decade after the Aufbau was published, towards a standpoint which is much closer to Lewis’s ideas. In that process, nevertheless, Carnap changed his focus and did not deal with the problem of the external world anymore. This paper also seeks to draw attention to some features of the relation between Carnap and the pragmatist tradition which have only recently started to attract interest.

  9. Markets, Herding and Response to External Information

    Science.gov (United States)

    Carro, Adrián; Toral, Raúl; San Miguel, Maxi

    2015-01-01

    We focus on the influence of external sources of information upon financial markets. In particular, we develop a stochastic agent-based market model characterized by a certain herding behavior as well as allowing traders to be influenced by an external dynamic signal of information. This signal can be interpreted as a time-varying advertising, public perception or rumor, in favor or against one of two possible trading behaviors, thus breaking the symmetry of the system and acting as a continuously varying exogenous shock. As an illustration, we use a well-known German Indicator of Economic Sentiment as information input and compare our results with Germany’s leading stock market index, the DAX, in order to calibrate some of the model parameters. We study the conditions for the ensemble of agents to more accurately follow the information input signal. The response of the system to the external information is maximal for an intermediate range of values of a market parameter, suggesting the existence of three different market regimes: amplification, precise assimilation and undervaluation of incoming information. PMID:26204451

  10. Holographic Interferometry Applications In External Osteosynthesis

    Science.gov (United States)

    Jacquot, P.; Rastogi, P. K.; Pflug, L.

    1985-08-01

    In order to maintain fragments of fractured bones in a state of immobilization, the use of an external rigid frame has proved to be very advantageous. Confronted by contradictory requirements, the conception of external fixation has, however, been a difficult task. The present paper aims to show, through three examples of varied bearings, the interest of holographic interferometry in external osteosynthesis. The first example deals with the mechanical behavior of a key element of the fixation device the ball joint submitted to realistic loads. The last two examples compare two models of ball joints as to their characteristics of rigidity and of resistance to slipping. Whereas in the former case holographic interferometry primarily fulfills the function of a prelude to the modelization work, in the latter cases it serves to formulate an engineering diagnostic. The findings relate to the remarkable elastic behavior of the ball joint, to the effectiveness of a lightened bowl design, and to the fact that cousin models may behave quite differently as to their resistance to slipping rotations of the bar. In comparison with other experimental methods, holographic interferometry appears to be very competitive and result-oriented and, as such, is expected to multiply applications in similar evaluation tasks.

  11. Dynamic External Hashing: The Limit of Buffering

    CERN Document Server

    Wei, Zhewei; Zhang, Qin

    2008-01-01

    Hash tables are one of the most fundamental data structures in computer science, in both theory and practice. They are especially useful in external memory, where their query performance approaches the ideal cost of just one disk access. Knuth gave an elegant analysis showing that with some simple collision resolution strategies such as linear probing or chaining, the expected average number of disk I/Os of a lookup is merely $1+1/2^{\\Omega(b)}$, where each I/O can read a disk block containing $b$ items. Inserting a new item into the hash table also costs $1+1/2^{\\Omega(b)}$ I/Os, which is again almost the best one can do if the hash table is entirely stored on disk. However, this assumption is unrealistic since any algorithm operating on an external hash table must have some internal memory (at least $\\Omega(1)$ blocks) to work with. The availability of a small internal memory buffer can dramatically reduce the amortized insertion cost to $o(1)$ I/Os for many external memory data structures. In this paper we...

  12. Externalities, Floating Population and Spatial Agglomeration

    Institute of Scientific and Technical Information of China (English)

    Du Yu; Wang Chuansheng; Fan Jie

    2007-01-01

    With the further development of socialist market economy,the mobility of factor markets in China,especially the labor market.is strengthened.Extemalities interacts with the agglomeration of productive factors.Under the framework of new economic geographg this article presents a theoretical model involving the endogenous population density affected by urban externalities.Results show that the population density is more concentrated around the center because the degree and extent of interaction between individuals intensifies when the distance from the center decreases.When there are several extemalifies resonurces,the aggregation of externalities changes the configuration of spatial factor allocation.These results fit well with the empirical facts about the decreasing density of floating population along the cities of Guangzhou,Dongguan and Shenzhen in Guangdong Province which is situat d in the eastern coast of the Pearl River Delta.We find that under the impacts of externalities released from Hong Kong into the coast,floating population Was more concentrated around Shenzhen and Dongguan,which are more adjacent to Hong Kong compared with Guangzhou City.

  13. External CSR Communication in a Strategic Approach

    Directory of Open Access Journals (Sweden)

    Diana Corina GLIGOR-CIMPOIERU

    2014-12-01

    Full Text Available As part of a strategic approach, aimed at assuring mutual benefits for the social cause and the business organization, a good CSR - Corporate Social Responsibility communication is vital for the success of a CSR program. We argue that there is not a problem with the legitimacy of the CSR concept, but rather to its implementation. If a business organization implementing socially responsible initiatives is focusing only on reaping the image benefits from a simple public relations perspective, then it loses all the potential business benefits it could gain from a strategic approach focused on long term real results in a win-win perspective. The fact that the image benefit is one of the most important incentives that a business organization could obtain for engaging in CSR activities cannot be ignored, and that is the reason why we have chosen to analyse the topic of CSR communication, mainly external communication, as an important link in the process of implementing a CSR program, that plays an important part for the success of a CSR program. The approach on CSR communication should definitely be a strategic one, and long already common forms of external CSR communication like web pages or CSR annual reports new means of social media networks have an increasing importance. For the practical part of the paper, we were interested in analyzing how much of the external CSR communication in the Romanian business environment is oriented toward a traditional or a strategic approach.

  14. Classical Noncommutative Electrodynamics with External Source

    CERN Document Server

    Adorno, T C; Shabad, A E; Vassilevich, D V

    2011-01-01

    In a $U(1)_{\\star}$-noncommutative (NC) gauge field theory we extend the Seiberg-Witten (SW) map to include the (gauge-invariance-violating) external current and formulate - to the first order in the NC parameter - gauge-covariant classical field equations. We find solutions to these equations in the vacuum and in an external magnetic field, when the 4-current is a static electric charge of a finite size $a$, restricted from below by the elementary length. We impose extra boundary conditions, which we use to rule out all singularities, $1/r$ included, from the solutions. The selected solutions neither should nor do withstand the limiting transition $a \\rightarrow 0$. The static charge proves to be a magnetic dipole, with the magnetic moment depending on its size $a$. The external magnetic field modifies the long-range Coulomb field and some electromagnetic form-factors. We also analyze the ambiguity in the SW map and show that at least to the order studied here it is equivalent to the ambiguity of adding a ho...

  15. Malignant external otitis: early scintigraphic detection

    Energy Technology Data Exchange (ETDEWEB)

    Strashun, A.M.; Nejatheim, M.; Goldsmith, S.J.

    1984-02-01

    Pseudomonas otitis externa in elderly diabetics may extend aggressively to adjacent bone, cranial nerves, meninges, and vessels, leading to a clinical diagnosis of ''malignant'' external otitis. Early diagnosis is necessary for successful treatment. This study compares the findings of initial radiographs, thin-section tomography of temporal bone, CT scans of head and neck, technetium-99m methylene diphosphonate (MDP) and gallium-67 citrate scintigraphy, and single-photon emission computed tomography (SPECT) for detection of temporal bone osteomylitis in ten patients fulfilling the clinical diagnostic criteria of malignant external otitis. Skull radiographs were negative in all of the eight patients studied. Thin-section tomography was positive in one of the seven patients studied using this modality. CT scanning suggested osteomyelitis in three of nine patients. Both Tc-99m and Ga-67 citrate scintigraphy were positive in 10 of 10 patients. These results suggest that technetium and gallium scintigraphy are more sensitive than radiographs and CT scans for early detection of malignant external otitis.

  16. Ship emissions and their externalities for Greece

    Science.gov (United States)

    Tzannatos, Ernestos

    2010-06-01

    The existing and emerging international and European policy framework for the reduction of ship exhaust emissions dictates the need to produce reliable national, regional and global inventories in order to monitor emission trends and consequently provide the necessary support for future policy making. Furthermore, the inventories of ship exhaust emissions constitute the basis upon which their external costs are estimated in an attempt to highlight the economic burden they impose upon the society and facilitate the cost-benefit analysis of the proposed emission abatement technologies, operational measures and market-based instruments prior to their implementation. The case of Greece is of particular interest mainly because the dense ship traffic within the Greek seas directly imposes the impact of its exhaust emission pollutants (NO x, SO 2 and PM) upon the highly populated, physically sensitive and culturally precious Greek coastline, as well as upon the land and seas of Greece in general, whereas the contribution of Greece in the global CO 2 inventory at a time of climatic change awareness cannot be ignored. In this context, this paper presents the contribution of Greece in ship exhaust emissions of CO 2, NO x, SO 2 and PM from domestic and international shipping over the last 25 years (1984-2008), utilizing the fuel-based (fuel sales) emission methodology. Furthermore, the ship exhaust emissions generated within the Greek seas and their externalities are estimated for the year 2008, through utilizing the fuel-based (fuel sales) approach for domestic shipping and the activity-based (ship traffic) approach for international shipping. On this basis, it was found that during the 1984 to 2008 period the fuel-based (fuel sales) ship emission inventory for Greece increased at an average annual rate of 2.85%. In 2008, the CO 2, NO x, SO 2 and PM emissions reached 12.9 million tons (of which 12.4 million tons of CO 2) and their externalities were found to be around 3

  17. International labor migration and external debt.

    Science.gov (United States)

    Bustamante, J A

    1987-01-01

    The prevailing Mexican and US definitions of undocumented migration are poles apart. The US views it as a criminal problem. Mexicans view the undocumented migrants as actors in an economic game in which the rules are extremely disadvantageous to these migrants. Migrants themselves and their communities view the undocumented as a positive element. It is necessary to move toward a bilateral focus and bilateral negotiation on the issue of migratory workers. This proposal derives from several assumptions: 1) the external debt is a bilateral or multilateral issue, 2) it is important to avoid forcing debtor countries to choose between stimulating economic growth or making payment on their foreign debt, 3) prevailing public opinion in the US favors halting undocumented migration, 4) the US views the migration of undocumented Mexicans as the result of forces endogenous to Mexico and exogenous to the US, 5) the US views both Mexico's ability to make payment on its external debt and to halt emigration as tied to the Mexican government's ability or inability to reconcile political stability with scarce monetary resources, and 6) political instability in Mexico could augment emigration to the US and undermine Mexico's ability to address its foreign debt. The following proposal suggests means to link negotiation on the external debt to that of undocumented migration: 1) The Mexican government could reach an accord with the US to channel a portion of the actual interest on the external debt as a fund to be invested in Mexico to construct a system of labor intensive agroindustrial productive units designed to attract former or potential migratory workers; 2) the total amount of these funds would be deducted from interest payments on the principal of the actual external debt and redefined as an ad hoc loan to Mexico to finance these production units; 3) part of the production from these units would be incorporated into ongoing US food relief and food assistance programs; 4) the

  18. A Methodology Proposal to Calculate the Externalities of Liquid Biofuels

    Energy Technology Data Exchange (ETDEWEB)

    Galan, A.; Gonzalez, R.; Varela, M. [Ciemat. Madrid (Spain)

    1999-05-01

    The aim of the survey is to propose a methodology to calculate the externalities associated with the liquid bio fuels cycle. The report defines the externalities from a theoretical point of view and classifies them. The reasons to value the externalities are explained as well as the existing methods. Furthermore, an evaluation of specific environmental and non-environmental externalities is also presented. The report reviews the current situation of the transport sector, considering its environmental effects and impacts. The progress made by the ExternE and ExternE-transport projects related the externalities of transport sector is assessed. Finally, the report analyses the existence of different economic instruments to internalize the external effects of the transport sector as well as other aspects of this internalization. (Author) 58 refs.

  19. IMPORTANCE OF DELIVERY CONDITIONS IN THE EXTERNAL PRICE CALCULATION

    Directory of Open Access Journals (Sweden)

    Violeta ISAI

    2005-01-01

    Full Text Available The delivery conditions of the merchandise at export, established by the rules INCOTERMS2000, influence the external price structure. There are some conditions in which the external priceincludes only the value of the merchandise and other conditions in which, besides the value of themerchandise, the price includes also the external transport and insurance. In the case of the exportson commercial credit, when it appears the notion of external interest, this one may be included in theprice or may be invoiced separately, thus defining gross external prices and net external prices.

  20. Operating with External Arguments of Douady and Hubbard

    Directory of Open Access Journals (Sweden)

    G. Pastor

    2007-01-01

    Full Text Available The external arguments of the external rays theory of Douady and Hubbard is a valuable tool in order to analyze the Mandelbrot set, a typical case of discrete dynamical system used to study nonlinear phenomena. We suggest here a general method for the calculation of the external arguments of external rays landing at the hyperbolic components root points of the Mandelbrot set. Likewise, we present a general method for the calculation of the external arguments of external rays landing at Misiurewicz points.

  1. External NAD(P)H dehydrogenases in Acanthamoeba castellanii mitochondria.

    Science.gov (United States)

    Antos-Krzeminska, Nina; Jarmuszkiewicz, Wieslawa

    2014-09-01

    The mitochondrial respiratory chain of plants and some fungi contains multiple rotenone-insensitive NAD(P)H dehydrogenases, of which at least two are located on the outer surface of the inner membrane (i.e., external NADH and external NADPH dehydrogenases). Annotated sequences of the putative alternative NAD(P)H dehydrogenases of the protozoan Acanthamoeba castellanii demonstrated similarity to plant and fungal sequences. We also studied activity of these dehydrogenases in isolated A. castellanii mitochondria. External NADPH oxidation was observed for the first time in protist mitochondria. The coupling parameters were similar for external NADH oxidation and external NADPH oxidation, indicating similar efficiencies of ATP synthesis. Both external NADH oxidation and external NADPH oxidation had an optimal pH of 6.8 independent of relevant ubiquinol-oxidizing pathways, the cytochrome pathway or a GMP-stimulated alternative oxidase. The maximal oxidizing activity with external NADH was almost double that with external NADPH. However, a lower Michaelis constant (K(M)) value for external NADPH oxidation was observed compared to that for external NADH oxidation. Stimulation by Ca(2+) was approximately 10 times higher for external NADPH oxidation, while NADH dehydrogenase(s) appeared to be slightly dependent on Ca(2+). Our results indicate that external NAD(P)H dehydrogenases similar to those in plant and fungal mitochondria function in mitochondria of A. castellanii.

  2. In vitro test of external Qigong

    Directory of Open Access Journals (Sweden)

    Reading Melissa

    2004-03-01

    Full Text Available Abstract Background Practitioners of the alternative medical practice 'external Qigong' generally claim the ability to emit or direct "healing energy" to treat patients. We investigated the ability of experienced Qigong practitioners to enhance the healthy growth of cultured human cells in a series of studies, each following a rigorously designed protocol with randomization, blinding and controls for variability. Methods Qigong practitioners directed healing intentionality toward normal brain cell cultures in a basic science laboratory. Qigong treatments were delivered for 20 minutes from a minimum distance of 10 centimeters. Cell proliferation was measured by a standard colony-forming efficiency (CFE assay and a CFE ratio (CFE for treated samples/CFE for sham samples was the dependent measure for each experiment. Results During a pilot study (8 experiments, a trend of increased cell proliferation in Qigong-treated samples (CFE Qigong/sham ratios > 1.0 was observed (P = 0.162. In a formal study (28 experiments, a similar trend was observed, with Qigong-treated samples showing on average more colony formation than sham samples (P = 0.036. In a replication study (60 experiments, no significant difference between Qigong-treated samples and sham samples was observed (P = 0.465. Conclusion We observed an apparent increase in the proliferation of cultured cells following external Qigong treatment by practitioners under strictly controlled conditions, but we did not observe this effect in a replication study. These results suggest the need for more controlled and thorough investigation of external Qigong before scientific validation is claimed.

  3. Dollarization and External Sustainability of Turkey

    Directory of Open Access Journals (Sweden)

    Amira Karimova

    2015-06-01

    Full Text Available In this paper, we attempt to explain that expanding current account deficit of Turkey can be a highlighting signal of its dependency on foreign capital inflows. When private non-financial firms borrow in foreign currency, they face currency mismatch in their balance sheets. Statistical analyses of aggregated balance sheet data of non-financial sector revealed that the negative gap between firms’ dollarized assets and liabilities has been increasing considerably in Turkey. This creates financial exposure by private non-financial sector. Given a high level of liability dollarization by firms in Turkish economy, it is exposed dramatically to the changes in external and domestic conditions.

  4. Migration cost externality and interregional equilibrium.

    Science.gov (United States)

    Shin, C

    1994-01-01

    "This paper will investigate the characteristics of population allocation between two regions in the presence of migration cost. It will also examine both populations and the non-migration range of the initial population in which migration does not occur, in social optimum and market equilibrium with central government intervention, to reveal migration cost externality, and to propose a remedy for it." The author finds that "migration cost gives the social planner an additional burden of population reallocation, and it has an important effect upon an individual's decisions on migration in a decentralized market mechanism."

  5. Extremely Intense Magnetospheric Substorms : External Triggering? Preconditioning?

    Science.gov (United States)

    Tsurutani, Bruce; Echer, Ezequiel; Hajra, Rajkumar

    2016-07-01

    We study particularly intense substorms using a variety of near-Earth spacecraft data and ground observations. We will relate the solar cycle dependences of events, determine whether the supersubstorms are externally or internally triggered, and their relationship to other factors such as magnetospheric preconditioning. If time permits, we will explore the details of the events and whether they are similar to regular (Akasofu, 1964) substorms or not. These intense substorms are an important feature of space weather since they may be responsible for power outages.

  6. ISS External Payload Accommodations (EXPRESS pallet)

    Science.gov (United States)

    Shelton, Harvey L.

    1996-01-01

    The 'expedite the process of experiments to Space Station' (EXPRESS) pallet which is attached to the DS3 truss segment of the International Space Station (ISS) via the payload attach structure is illustrated. The EXPRESS pallet constitutes the primary ISS external payload carrier. Each pallet carries six robotically replaceable payload adapters which are capable of containing one or more payloads. The following aspects of the EXPRESS program and pallet are illustrated: the concept drivers; the physical integration; the installation and in-orbit replacement; and the experiments to be implemented. The program status is summarized.

  7. External insulation with cellular plastic materials

    DEFF Research Database (Denmark)

    Sørensen, Lars Schiøtt; Nielsen, Anker

    2014-01-01

    External thermal insulation composite systems (ETICS) can be used as extra insulation of existing buildings. The system can be made of cellular plastic materials or mineral wool. There is a European Technical guideline, ETAG 004, that describe the tests that shall be conducted on such systems....... This paper gives a comparison of systems with mineral wool and cellular plastic, based on experience from practice and literature. It is important to look at the details in the system and at long time stability of the properties such as thermal insulation, moisture and fire. Investigation of fire properties...... insulation....

  8. External Debt and Economic Growth in Tunisia

    Directory of Open Access Journals (Sweden)

    Nasfi Fkili Wahiba

    2014-12-01

    Full Text Available The objective of this study is to identify the effect of external debt on economic growth; we used the debt service as percentage of exports and debt indicators in the first and second degree. The econometric estimation showed that the sign of the coefficient of debt is positive and the debt squared is negative, and beyond a certain stock, the impact of debt on growth becomes negative and Tunisia must control its debts as additional increases will have adverse impacts on the economic performance of the country. Therefore, the borrowing should remain a necessity in cases of extreme emergency, not a solution to all economic problems experienced by the country.

  9. External combustion wankel engine for solar applications

    Energy Technology Data Exchange (ETDEWEB)

    Kovarsky, N.; Kaftori, D.; Gamzon, E.; Dgani, E. [Silver Arrow (Israel)

    1999-03-01

    An External Combustion Wankel Engine (ECWE), intended for use in a dish-engine solar power plant is discussed. The engine operates in a Brayton cycle using a gaseous working fluid, which is heated outside of the engine by concentrated solar radiation or fossil fuel. A computer simulation code that models the ECWE's operation and performance has been developed The program takes into account all of the engine's characteristics, subsystems and operating conditions. In the present work, the advantages and features of ECWE are considered in detail, together with simulation results of its performance. (authors)

  10. Cancer of the external auditory canal

    DEFF Research Database (Denmark)

    Nyrop, Mette; Grøntved, Aksel

    2002-01-01

    OBJECTIVE: To evaluate the outcome of surgery for cancer of the external auditory canal and relate this to the Pittsburgh staging system used both on squamous cell carcinoma and non-squamous cell carcinoma. DESIGN: Retrospective case series of all patients who had surgery between 1979 and 2000....... PATIENTS: Ten women and 10 men with previously untreated primary cancer. Median age at diagnosis was 67 years (range, 31-87 years). Survival data included 18 patients with at least 2 years of follow-up or recurrence. INTERVENTION: Local canal resection or partial temporal bone resection. MAIN OUTCOME...

  11. Weld pool visual sensing without external illumination

    DEFF Research Database (Denmark)

    Liu, Jinchao; Fan, Zhun; Olsen, Soren Ingvor

    2011-01-01

    Visual sensing in arc welding has become more and more important, but still remains challenging because of the harsh environment with extremely strong illumination from the arc. This paper presents a low-cost camera-based sensor system, without using external Illumination, but nevertheless able...... to sense and model the weld pool. Central is a carefully selected optical filtering as well as an active contour-based tracking of the weld pool boundary. The system is able to extract the 2D shape of the weld pool in real time. The reported experiments show the feasibility of this approach....

  12. Entrepreneurship and the Discipline of External Finance

    DEFF Research Database (Denmark)

    Nanda, Ramana

    I confirm the finding that the propensity to start a new firm rises sharply among those in the top five per­centiles of personal wealth. This pattern is more pronounced for entrants in less capital intensive sectors. Prior to entry, founders in this group earn about 6% less compared to those who ......, these findings suggest that the spike in entry at the top end of the wealth distribution is driven by low-ability individuals who can afford to start (and sometimes continue running) weaker firms because they do not face the discipline of external finance....

  13. Optimal External-Memory Planar Point Enclosure

    DEFF Research Database (Denmark)

    Arge, Lars; Samoladas, Vasilis; Yi, Ke

    2007-01-01

    In this paper we study the external memory planar point enclosure problem: Given N axis-parallel rectangles in the plane, construct a data structure on disk (an index) such that all K rectangles containing a query point can be reported I/O-efficiently. This problem has important applications in e...... term O(K/B) is desired. To show this we prove a general lower bound on the tradeoff between the size of the data structure and its query cost. We also develop a family of structures with matching space and query bounds....

  14. Externally definable sets and dependent pairs II

    CERN Document Server

    Chernikov, Artem

    2012-01-01

    We continue investigating the structure of externally definable sets in NIP theories and preservation of NIP after expanding by new predicates. Most importantly: types over finite sets are uniformly definable; over a model, a family of non-forking instances of a formula (with parameters ranging over a type-definable set) can be covered with finitely many invariant types; we give some criteria for the boundedness of an expansion by a new predicate in a distal theory; naming an arbitrary small indiscernible sequence preserves NIP, while naming a large one doesn't; there are models of NIP theories over which all 1-types are definable, but not all n-types.

  15. Learning from external environments using Soar

    Science.gov (United States)

    Laird, John E.

    1989-01-01

    Soar, like the previous PRODIGY and Theo, is a problem-solving architecture that attempts to learn from experience; unlike them, it takes a more uniform approach, using a single forward-chaining architecture for planning and execution. Its single learning mechanism, designated 'chunking', is domain-independent. Two developmental approaches have been employed with Soar: the first of these allows the architecture to attempt a problem on its own, while the second involves a degree of external guidance. This learning through guidance is integrated with general problem-solving and autonomous learning, leading to an avoidance of human interaction for simple problems that Soar can solve on its own.

  16. EXTERNAL AND INTERNAL CONTROL IN PLANT DEVELOPMENT

    Institute of Scientific and Technical Information of China (English)

    Beáta Oborny

    2003-01-01

    Bodies of plants are modularly organized. Development proceeds by adding new modules to open endings with a potential for branching. Each module is autonomous to some extent. Development relies on the self-organized patterns that emerge from the interactions of individual modules. Interactions include both competition and cooperation, and several types of positive and negative feedback loops are involved. Development can be open to external influences, thus enabling the plant to adjust its form to the environment, for example, to the spatial distribution of ecological resources. This paper provides a review on adaptive plasticity in plants.

  17. Capsules with external navigation and triggered release.

    Science.gov (United States)

    Shchukin, Dmitry G; Shchukina, Elena

    2014-10-01

    Encapsulation is an important technology for pharmaceutical industry, food production, et cetera. Its current level of development requires capsule functionalization. One of the interesting ideas to provide new functionality to the microcapsule and nanocapsule is layer-by-layer deposition of functional species. This technique provides step-by-step adsorption of various species (polyelectrolytes, nanoparticles, proteins) when the layer growth is controlled by electrostatic, hydrogen bonding, hydrophobic forces and forming multilayer shells with nanometer precision. This review article introduces recent achievements of layer-by-layer technique attaining external navigation ability and release properties the capsule shell.

  18. External cavity diode laser around 657 nm

    Institute of Scientific and Technical Information of China (English)

    Desheng Lǖ (吕德胜); Kaikai Huang (黄凯凯); Fengzhi Wang (王凤芝); DonghaiYang (杨东海)

    2003-01-01

    Operating a laser diode in an external cavity, which provides frequency-selective feedback, is a very effective method to tune the laser frequency to a range far from its free running frequency. For the Ca atomic Ramsey spectroscopy experiment, we have constructed a 657-nm laser system based on the LittmanMetcalf configuration with a 660-nm commercial laser diode. Continuously 10-GHz tuning range was achieved with about 100-kHz spectral linewidth, measured with beat-note spectrum of two identical laser systems.

  19. Intradermal melanocytic nevus of the external auditory canal.

    Science.gov (United States)

    Alves, Renato V; Brandão, Fabiano H; Aquino, José E P; Carvalho, Maria R M S; Giancoli, Suzana M; Younes, Eduado A P

    2005-01-01

    Intradermal nevi are common benign pigmented skin tumors. Their occurrence within the external auditory canal is uncommon. The clinical and pathologic features of an intradermal nevus arising within the external auditory canal are presented, and the literature reviewed.

  20. EU External Relations Law: Text, Cases and Materials

    DEFF Research Database (Denmark)

    Butler, Graham

    2014-01-01

    EU External Relations Law: Text, Cases and Materials, Bart Van Vooren and Ramses A. Wessel, Cambridge University Press, UK, 2014.......EU External Relations Law: Text, Cases and Materials, Bart Van Vooren and Ramses A. Wessel, Cambridge University Press, UK, 2014....

  1. Mass Media Orientation and External Communication Strategies: Exploring Organisational Differences

    NARCIS (Netherlands)

    Wonneberger, A.; Jacobs, S.

    2016-01-01

    This study assesses relationships between mass media orientations of communication professionals in organisations and their external communication strategies. We assume that mass media orientations within an organisation may affect an organisation’s external communication strategies of bridging and

  2. Cardiac valvuloplasty%心脏瓣膜成形术

    Institute of Scientific and Technical Information of China (English)

    耿希刚

    2004-01-01

    @@ 1953年美国医生Gibbon首次应用体外循环辅助治疗先天性心脏病获得成功,这一技术的应用才使得在直视下行心脏瓣膜成形及替换手术成为可能.Lillehei 1957年首次应用瓣环成形术来纠正二尖瓣关闭不全并获成功,1959年Nina Braunwald首次成功完成二尖瓣替换手术.

  3. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors and perceived parenting styles.

    Science.gov (United States)

    Buschgens, Cathelijne J M; van Aken, Marcel A G; Swinkels, Sophie H N; Ormel, Johan; Verhulst, Frank C; Buitelaar, Jan K

    2010-07-01

    The aim was to investigate the contribution of familial risk to externalizing behaviors (FR-EXT), perceived parenting styles, and their interactions to the prediction of externalizing behaviors in preadolescents. Participants were preadolescents aged 10-12 years who participated in TRAILS, a large prospective population-based cohort study in the Netherlands (N = 2,230). Regression analyses were used to determine the relative contribution of FR-EXT and perceived parenting styles to parent and teacher ratings of externalizing behaviors. FR-EXT was based on lifetime parental externalizing psychopathology and the different parenting styles (emotional warmth, rejection, and overprotection) were based on the child's perspective. We also investigated whether different dimensions of perceived parenting styles had different effects on subdomains of externalizing behavior. We found main effects for FR-EXT (vs. no FR-EXT), emotional warmth, rejection, and overprotection that were fairly consistent across rater and outcome measures. More specific, emotional warmth was the most consistent predictor of all outcome measures, and rejection was a stronger predictor of aggression and delinquency than of inattention. Interaction effects were found for FR-EXT and perceived parental rejection and overprotection; other interactions between FR-EXT and parenting styles were not significant. Correlations between FR-EXT and perceived parenting styles were absent or very low and were without clinical significance. Predominantly main effects of FR-EXT and perceived parenting styles independently contribute to externalizing behaviors in preadolescents, suggesting FR-EXT and parenting styles to be two separate areas of causality. The relative lack of gene-environment interactions may be due to the epidemiological nature of the study, the preadolescent age of the subjects, the measurement level of parenting and the measurement level of FR-EXT, which might be a consequence of both genetic and

  4. Successful external fertilization in turbulent environments.

    Science.gov (United States)

    Serrao, E A; Pearson, G; Kautsky, L; Brawley, S H

    1996-05-28

    Mathematical and experimental simulations predict that external fertilization is unsuccessful in habitats characterized by high water motion. A key assumption of such predictions is that gametes are released in hydrodynamic regimes that quickly dilute gametes. We used fucoid seaweeds to examine whether marine organisms in intertidal and subtidal habitats might achieve high levels of fertilization by restricting their release of gametes to calm intervals. Fucus vesiculosus L. (Baltic Sea) released high numbers of gametes only when maximal water velocities were below ca. 0.2 m/s immediately prior to natural periods of release, which occur in early evening in association with lunar cues. Natural fertilization success measured at two sites was always close to 100%. Laboratory experiments confirmed that (i) high water motion inhibits gamete release by F. vesiculosus and by the intertidal fucoids Fucus distichus L. (Maine) and Pelvetia fastigiata (J. Ag.) DeToni (California), and (ii) showed that photosynthesis is required for high gamete release. These data suggest that chemical changes in the boundary layer surrounding adults during photosynthesis and/or mechanosensitive channels may modulate gamete release in response to changing hydrodynamic conditions. Therefore, sensitivity to environmental factors can lead to successful external fertilization, even for species living in turbulent habitats.

  5. Porous photonic crystal external cavity laser biosensor

    Science.gov (United States)

    Huang, Qinglan; Peh, Jessie; Hergenrother, Paul J.; Cunningham, Brian T.

    2016-08-01

    We report the design, fabrication, and testing of a photonic crystal (PC) biosensor structure that incorporates a porous high refractive index TiO2 dielectric film that enables immobilization of capture proteins within an enhanced surface-area volume that spatially overlaps with the regions of resonant electromagnetic fields where biomolecular binding can produce the greatest shifts in photonic crystal resonant wavelength. Despite the nanoscale porosity of the sensor structure, the PC slab exhibits narrowband and high efficiency resonant reflection, enabling the structure to serve as a wavelength-tunable element of an external cavity laser. In the context of sensing small molecule interactions with much larger immobilized proteins, we demonstrate that the porous structure provides 3.7× larger biosensor signals than an equivalent nonporous structure, while the external cavity laser (ECL) detection method provides capability for sensing picometer-scale shifts in the PC resonant wavelength caused by small molecule binding. The porous ECL achieves a record high figure of merit for label-free optical biosensors.

  6. Containment atmosphere response to external sprays

    Energy Technology Data Exchange (ETDEWEB)

    Green, J.; Almenas, K. [Univ. of Maryland, College Park, MD (United States)

    1995-09-01

    The application of external sprays to a containment steel shell can be an effective energy removal method and has been proposed in the passive AP-600 design. Reduction of the steel shell temperature in contact with the containment atmosphere enhances both heat and mass transfer driving forces. Large scale experimental data in this area is scarce, therefore the measurements obtained from the E series tests conducted at the German HDR facility deserve special attention. These long term tests simulated various severe accident conditions, including external spraying of the hemispherical steel shell. This investigation focuses upon the integral response of the HDR containment atmosphere during spray periods and upon methods by which lumped parameter system codes, like CONTAIN, model the underlying condensation phenomena. Increases in spray water flowrates above a minimum value were ineffective at improving containment pressure reduction since the limiting resistance for energy transfer lies in the noncondensable-vapor boundary layer at the inner condensing surface. The spray created an unstable condition by cooling the upper layers of a heated atmosphere and thus inducing global natural circulation flows in the facility and subsequently, abrupt changes in lighter-than-air noncondensable (J{sub 2}/He) concentrations. Modeling results using the CONTAIN code are outlined and code limitations are delineated.

  7. The SNS External Antenna H- Ion Source

    Energy Technology Data Exchange (ETDEWEB)

    Welton, Robert F [ORNL; Stockli, Martin P [ORNL; Murray Jr, S N [ORNL; Crisp, Danny W [ORNL; Carmichael, Justin R [ORNL; Goulding, Richard Howell [ORNL; Han, Baoxi [ORNL; Pennisi, Terry R [ORNL; Santana, Manuel [ORNL

    2010-01-01

    The U.S. Spallation Neutron Source (SNS) is an accelerator-based, pulsed neutron-scattering facility, currently in the process of ramping up neutron production. In order to insure that we will meet our operational commitments as well as provide for future facility upgrades with high reliability, we have developed an RF-driven, H- ion source based on a ceramic aluminum nitride (AlN) plasma chamber [1]. This source is expected to be utilized by the SNS for neutron production starting in 2009. This report details the design of the production source which features an AlN plasma chamber, 2-layer external antenna, cooled-multicusp magnet array, Cs2CrO4 cesium system and a Molybdenum plasma ignition gun. Performance of the production source both on the SNS accelerator and SNS test stand is reported. The source has also been designed to accommodate an elemental Cs system with an external reservoir which has demonstrated unanalyzed beam currents up to ~100mA (60Hz, 1ms) on the SNS ion source test stand.

  8. Porous photonic crystal external cavity laser biosensor

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Qinglan [Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Peh, Jessie; Hergenrother, Paul J. [Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Cunningham, Brian T. [Department of Electrical and Computer Engineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States); Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801 (United States)

    2016-08-15

    We report the design, fabrication, and testing of a photonic crystal (PC) biosensor structure that incorporates a porous high refractive index TiO{sub 2} dielectric film that enables immobilization of capture proteins within an enhanced surface-area volume that spatially overlaps with the regions of resonant electromagnetic fields where biomolecular binding can produce the greatest shifts in photonic crystal resonant wavelength. Despite the nanoscale porosity of the sensor structure, the PC slab exhibits narrowband and high efficiency resonant reflection, enabling the structure to serve as a wavelength-tunable element of an external cavity laser. In the context of sensing small molecule interactions with much larger immobilized proteins, we demonstrate that the porous structure provides 3.7× larger biosensor signals than an equivalent nonporous structure, while the external cavity laser (ECL) detection method provides capability for sensing picometer-scale shifts in the PC resonant wavelength caused by small molecule binding. The porous ECL achieves a record high figure of merit for label-free optical biosensors.

  9. [Frequency of external congenital abnormalities in abortions].

    Science.gov (United States)

    Arredondo de Arreola, G; López-Serna, N; Treviño-Alanís, M G; Russildi, J M; Arreola-Arredondo, B; Borrego, S A

    1992-01-01

    The purpose of this study was to calculate the incidence of external birth defects found in 1,650 aborted fetuses studied from September 1978 to February 1983 at the Department of Gynecology and Obstetrics of the University Hospital "Dr. José Eleuterio González" of the U.A.N.L. Medical School. Ninety five of fetuses had external birth defects and 85 had abnormalities in annexes. The Fisher exact test was applied to find the relationship between these abnormalities; no relationship was found. 67.4% had only one birth defect; 32.1% showed several defects. Those defects which were lethal constituted 67%, the majority being of the central nervous system. Defects found in the abdominal wall took second place in frequency followed by abnormalities in either extremity and ear defects. The birth defects seen in early gestational ages differ from those seen in live newborn babies. It is important to carry out morphological and teratological studies, not only in newborns but also during the embrion and fetal periods.

  10. Composite vector particles in external electromagnetic fields

    Science.gov (United States)

    Davoudi, Zohreh; Detmold, William

    2016-01-01

    Lattice quantum chromodynamics (QCD) studies of electromagnetic properties of hadrons and light nuclei, such as magnetic moments and polarizabilities, have proven successful with the use of background field methods. With an implementation of nonuniform background electromagnetic fields, properties such as charge radii and higher electromagnetic multipole moments (for states of higher spin) can additionally be obtained. This can be achieved by matching lattice QCD calculations to a corresponding low-energy effective theory that describes the static and quasistatic responses of hadrons and nuclei to weak external fields. With particular interest in the case of vector mesons and spin-1 nuclei such as the deuteron, we present an effective field theory of spin-1 particles coupled to external electromagnetic fields. To constrain the charge radius and the electric quadrupole moment of the composite spin-1 field, the single-particle Green's functions in a linearly varying electric field in space are obtained within the effective theory, providing explicit expressions that can be used to match directly onto lattice QCD correlation functions. The viability of an extraction of the charge radius and the electric quadrupole moment of the deuteron from the upcoming lattice QCD calculations of this nucleus is discussed.

  11. Plasmonic external cavity laser refractometric sensor.

    Science.gov (United States)

    Zhang, Meng; Lu, Meng; Ge, Chun; Cunningham, Brian T

    2014-08-25

    Combining the high sensitivity properties of surface plasmon resonance refractive index sensing with a tunable external cavity laser, we demonstrate a plasmonic external cavity laser (ECL) for high resolution refractometric sensing. The plasmonic ECL utilizes a plasmonic crystal with extraordinary optical transmission (EOT) as the wavelength-selective element, and achieves single mode lasing at the transmission peak of the EOT resonance. The plasmonic ECL refractometric sensor maintains the high sensitivity of a plasmonic crystal sensor, while simultaneously providing a narrow spectral linewidth through lasing emission, resulting in a record high figure of merit for refractometric sensing with an active or passive optical resonator. We demonstrate single-mode and continuous-wave operation of the electrically-pumped laser system, and show the ability to measure refractive index changes with a 3σ detection limit of 1.79 × 10(-6) RIU. The demonstrated approach is a promising path towards label-free optical biosensing with enhanced signal-to-noise ratios for challenging applications in small molecule drug discovery and pathogen sensing.

  12. Building Protection Against External Ionizing Fallout Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Dillon, Michael B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Homann, Steven G. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2016-12-01

    A nuclear explosion has the potential to injure or kill tens to hundreds of thousands of people through exposure to fallout (external gamma) radiation. Existing buildings can protect their occupants (reducing external radiation exposures) by placing material and distance between fallout particles and indoor individuals. This protection is not well captured in current fallout risk assessment models and so the US Department of Defense is implementing the Regional Shelter Analysis methodology to improve the ability of the Hazard Prediction and Assessment Capability (HPAC) model to account for building protection. This report supports the HPAC improvement effort by identifying a set of building attributes (next page) that, when collectively specified, are sufficient to calculate reasonably accurate, i.e., within a factor of 2, fallout shelter quality estimates for many individual buildings. The set of building attributes were determined by first identifying the key physics controlling building protection from fallout radiation and then assessing which building attributes are relevant to the identified physics. This approach was evaluated by developing a screening model (PFscreen) based on the identified physics and comparing the screening model results against the set of existing independent experimental, theoretical, and modeled building protection estimates. In the interests of transparency, we have developed a benchmark dataset containing (a) most of the relevant primary experimental data published by prior generations of fallout protection scientists as well as (b) the screening model results.

  13. A Perspective on External Field QED

    CERN Document Server

    Deckert, D -A

    2015-01-01

    In light of the conference Quantum Mathematical Physics held in Regensburg in 2014, we give our perspective on the external field problem in quantum electrodynamics (QED), i.e., QED without photons in which the sole interaction stems from an external, time-dependent, four-vector potential. Among others, this model was considered by Dirac, Schwinger, Feynman, and Dyson as a model to describe the phenomenon of electron-positron pair creation in regimes in which the interaction between electrons can be neglected and a mean field description of the photon degrees of freedom is valid (e.g., static field of heavy nuclei or lasers fields). Although it may appear as second easiest model to study, it already bares a severe divergence in its equations of motion preventing any straight-forward construction of the corresponding evolution operator. In informal computations of the vacuum polarization current this divergence leads to the need of the so-called charge renormalization. In an attempt to provide a bridge between...

  14. VAC® for external fixation of flail chest

    Directory of Open Access Journals (Sweden)

    Rikke Winge

    2012-06-01

    Full Text Available A large anterior chest wall defect following tumor resection was reconstructed with a Gore- Tex® membrane and a combined musculocutaneous rectus femoris and tensor fasciae latae free flap. Subsequent paradoxical respiration impeded weaning from the ventilator. Appliance of Vacuum Assisted Closure® (VAC® resulted in immediate chest wall stability and a decrease in the patient’s need for respiratory support. Shortly thereafter, the VAC® was discontinued and the patient was discharged from the intensive care unit (ICU. This case report is the first to describe the successful use of VAC® as an adjuvant to a one-stage procedure for large thoracic wall reconstruction, allowing sufficient temporary external fixation to eliminate paradoxical respiration and plausibly shorten the stay in the ICU. No adverse effects on flap healing or haemodynamics were recorded. It is likely that external VAC® can improve thoracic stability and pulmonary function in a patient with flail chest and decrease the need for mechanical ventilation.

  15. External Otitis: An Unusual Presentation in Neonates

    Directory of Open Access Journals (Sweden)

    Peymaneh Alizadeh Taheri

    2016-01-01

    Full Text Available Acute otitis externa (AOE is an infection of the external auditory canal, the auricle, and the outer surface of the tympanic membrane. Although AOE is one of the most common otologic conditions encountered in pediatric population, it is known to primarily affect children older than 2 years. We report a case of AOE caused by Staphylococcus aureus in a 23-day-old neonate. A 23-day-old female infant presented to our neonatology clinic with irritability and discharge from the right ear. There were yellow otorrhea, mild erythema, and edema of right external ear canal. There was no sign of otitis media on otoscopy. The results of laboratory tests were insignificant. The discharge culture grew colonies of methicillin-sensitive Staphylococcus aureus. After 48 hours of treatment with intravenous cloxacillin, significant improvement was observed. The present case highlights an unusual presentation of staphylococcal infection in a neonate. This is the first case of methicillin-sensitive Staphylococcus aureus otitis externa in an immunocompetent newborn.

  16. 21 CFR 870.1750 - External programmable pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External programmable pacemaker pulse generator... External programmable pacemaker pulse generator. (a) Identification. An external programmable pacemaker pulse generators is a device that can be programmed to produce one or more pulses at...

  17. Externalities and the Coase Theorem: A Diagrammatic Presentation

    Science.gov (United States)

    Halteman, James

    2005-01-01

    In intermediate microeconomic textbooks the reciprocal nature of externalities is presented using numerical examples of costs and benefits. This treatment of the Coase theorem obscures the fact that externality costs and benefits are best understood as being on a continuum where costs vary with the degree of intensity of the externality. When…

  18. External costs of photovoltaics. What is it based on?

    Energy Technology Data Exchange (ETDEWEB)

    De Wild-Scholten, M.J. [ECN Solar Energy, Petten (Netherlands); Alsema, E.A. [Utrecht University, Utrecht (Netherlands)

    2004-06-01

    The main aim of the European ExternE research projects was to develop a methodology to calculate the external costs caused by energy production and consumption. External costs are defined as the monetary quantification of the socio-environmental damage, expressed in eurocents per kWh. As such, it can provide a scientific basis for policy decisions and legislative proposals like subsidizing cleaner technologies and energy taxes to 'internalize' the external costs. The ExternE 2003 brochure gives the impression that electricity production from photovoltaics leads to a greater health damage than the electricity production from gas or nuclear power. However, the external cost figures for electricity production in the EU and in Germany are given without references, so it is not clear on which information it is based. This paper aims to retrieve the input data that was used for the calculation of the external costs of photovoltaic systems. Apparently, the two tables 'External cost figures for electricity production in the EU for existing technologies' and 'Quantified marginal external costs of electricity production in Germany' are based on different calculations. For example the sum of external costs for the different technologies given in the first table are not equal to the values presented in the second.

  19. Externalities as a Basis for Regulation: A Philosophical View

    NARCIS (Netherlands)

    Claassen, R.J.G.

    2016-01-01

    Externalities are an important concept in economic theories of market failure, aiming to justify state regulation of the economy. This paper explores the concept of externalities from a philosophical perspective. It criticizes the utilitarian nature of economic analyses of externalities, showing how

  20. 78 FR 47016 - Submission for Review: Request for External Review

    Science.gov (United States)

    2013-08-02

    ... MANAGEMENT Submission for Review: Request for External Review AGENCY: U.S. Office of Personnel Management... on a new information collection request (ICR) 3206-NEW, Request for External Review. As required by... March 11, 2013, 78 FR 15560, which outlined an external review process that would be available...

  1. An association of external and internal enamel pearls.

    OpenAIRE

    Mahajan S; Charan C

    2005-01-01

    We report a rare case of an association of external enamel pearl with internal enamel pearl on the root of a molar. To the best of our knowledge, association of external and internal enamel pearls has not been previously reported. We discussed the histogenesis of enamel pearls and proposed that internal enamel pearl formation may be a continuation of formation of external enamel pearl.

  2. Autism and Externalizing Behaviors: Buffering Effects of Parental Emotion Coaching

    Science.gov (United States)

    Wilson, Beverly J.; Berg, Jessica L.; Zurawski, Megan E.; King, Kathleen A.

    2013-01-01

    The purpose of this study was to examine the relation between parental emotion coaching and externalizing behaviors in children with autism spectrum disorders (ASD). Children with ASD often exhibit externalizing behaviors, particularly emotionally driven externalizing behaviors, at a higher rate than their typically developing peers. An…

  3. 21 CFR 870.5550 - External transcutaneous cardiac pacemaker (noninvasive).

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External transcutaneous cardiac pacemaker... § 870.5550 External transcutaneous cardiac pacemaker (noninvasive). (a) Identification. An external transcutaneous cardiac pacemaker (noninvasive) is a device used to supply a periodic electrical pulse intended to...

  4. External influences on local institutions: spatial dependence and openness

    NARCIS (Netherlands)

    Faber, G.; Gerritsen, M.J.

    There are both empirical and theoretical arguments for the thesis that external factors have an impact on domestic institutional quality. Consequently, external factors may have large effects on domestic income via local institutions. This paper investigates the role of external factors by

  5. Autism and Externalizing Behaviors: Buffering Effects of Parental Emotion Coaching

    Science.gov (United States)

    Wilson, Beverly J.; Berg, Jessica L.; Zurawski, Megan E.; King, Kathleen A.

    2013-01-01

    The purpose of this study was to examine the relation between parental emotion coaching and externalizing behaviors in children with autism spectrum disorders (ASD). Children with ASD often exhibit externalizing behaviors, particularly emotionally driven externalizing behaviors, at a higher rate than their typically developing peers. An…

  6. QED in external fields, a functional point of view

    OpenAIRE

    Alexandre, Jean

    2001-01-01

    A functional partial differential equation is set for the proper graphs generating functional of QED in external electromagnetic fields. This equation leads to the evolution of the proper graphs with the external field amplitude and the external field gauge dependence of the complete fermion propagator and vertex is derived non-perturbativally.

  7. Externalizing behaviors in preadolescents: familial risk to externalizing behaviors, prenatal and perinatal risks, and their interactions

    NARCIS (Netherlands)

    Buschgens, C.J.M.; Swinkels, S.H.N.; van Aken, M.A.G.; Ormel, J.; Verhulst, F.C.; Buitelaar, J.K.

    2009-01-01

    Background Accumulating evidence indicates that there is a rich and varied interplay between persons and their environments, which strongly suggests that this involves gene-environment correlations and interactions. We investigated whether familial risk (FR) to externalizing behaviors and prenatal a

  8. External costs of electricity; Les couts externes de l'electricite

    Energy Technology Data Exchange (ETDEWEB)

    Rabl, A. [Ecole des Mines de Paris, 75 (France); Spadaro, J.V. [International Atomic Energy Agency (IAEA), Vienna (Austria)

    2005-07-01

    This article presents a synthesis of the ExternE project (External costs of Energy) of the European community about the external costs of power generation. Pollution impacts are calculated using an 'impact pathways' analysis, i.e. an analysis of the emission - dispersion - dose-response function - cost evaluation chain. Results are presented for different fuel cycles (with several technological variants) with their confidence intervals. The environmental impact costs are particularly high for coal: for instance, in France, for coal-fired power plants it is of the same order as the electricity retail price. For natural gas, this cost is about a third of the one for coal. On the contrary, the environmental impact costs for nuclear and renewable energies are low, typically of few per cent of the electricity price. The main part of these costs corresponds to the sanitary impacts, in particular the untimely mortality. In order to avoid any controversy about the cost evaluation of mortality, the reduction of the expectation of life due to the different fuel cycles is also indicated and the risks linked with nuclear energy are presented using several comparisons. (J.S.)

  9. External effects related to biogas and wind power

    DEFF Research Database (Denmark)

    Ibsen, Liselotte Schleisner; Nielsen, Per Sieverts

    1998-01-01

    Energy produced by wind power and biogas is today more expensive than energy produced by fossil fuels. However, by including external costs related to the technologies, the renewable technologies are expected to result in social benefits compared to the conventional power technologies. The paper...... will focus on estimates of externalities related to wind and biogas energy supplies using the ExternE methodology developed in a major study launched by the European Comission. External costs are the costs imporsed on society that are not included in the market price (e.g. effects of air pollution on health...

  10. The avoided external costs of using wind energy

    Energy Technology Data Exchange (ETDEWEB)

    Markandya, A. [Harvard Inst. for International Development, Cambridge, MA (United States)

    1995-12-31

    This article discusses the external costs of electricity generated by conventional fossil fuel sources, such as coal and nuclear power. It compares the costs of electricity generated with coal with that generated with wind. A measure of the benefits of wind energy is the difference between these two external costs. The methodology used for the estimation of the external costs, as well as the estimates of these costs, are taken from the EC ExternE study, financed by DGXII of the European Commission. The present author was a lead economist for that study. (author)

  11. Externally Dispersed Interferometry for Precision Radial Velocimetry

    Energy Technology Data Exchange (ETDEWEB)

    Erskine, D J; Muterspaugh, M W; Edelstein, J; Lloyd, J; Herter, T; Feuerstein, W M; Muirhead, P; Wishnow, E

    2007-03-27

    Externally Dispersed Interferometry (EDI) is the series combination of a fixed-delay field-widened Michelson interferometer with a dispersive spectrograph. This combination boosts the spectrograph performance for both Doppler velocimetry and high resolution spectroscopy. The interferometer creates a periodic spectral comb that multiplies against the input spectrum to create moire fringes, which are recorded in combination with the regular spectrum. The moire pattern shifts in phase in response to a Doppler shift. Moire patterns are broader than the underlying spectral features and more easily survive spectrograph blurring and common distortions. Thus, the EDI technique allows lower resolution spectrographs having relaxed optical tolerances (and therefore higher throughput) to return high precision velocity measurements, which otherwise would be imprecise for the spectrograph alone.

  12. Externalization and Border-induced Displacement

    DEFF Research Database (Denmark)

    Lemberg-Pedersen, Martin

    This multidisciplinary Ph.D. dissertation engages with the timely and much debated topic of European border control. The first two chapters discuss several moral arguments claiming that border control facilitates solidarity and autonomy. These are assessed with reference to central debates in pol...... in-depth research of the privatization of border control through the cases of G4S, Finmeccanica and the EU’s EUROSUR system. The chapter links externalization of border control with European state-driven export markets and shows how states’ export credit agencies, the arms industry...... and the international banking sector all have overlapping interests in privatized border control. Chapter five identifies the multiple flows, technological, personnel, funds and data, maintaining Europe’s border infrastructure, As migrants are circulated between detention camps and countries, dumped in deserts...

  13. Random matrix theory with an external source

    CERN Document Server

    Brézin, Edouard

    2016-01-01

    This is a first book to show that the theory of the Gaussian random matrix is essential to understand the universal correlations with random fluctuations and to demonstrate that it is useful to evaluate topological universal quantities. We consider Gaussian random matrix models in the presence of a deterministic matrix source. In such models the correlation functions are known exactly for an arbitrary source and for any size of the matrices. The freedom given by the external source allows for various tunings to different classes of universality. The main interest is to use this freedom to compute various topological invariants for surfaces such as the intersection numbers for curves drawn on a surface of given genus with marked points, Euler characteristics, and the Gromov–Witten invariants. A remarkable duality for the average of characteristic polynomials is essential for obtaining such topological invariants. The analysis is extended to nonorientable surfaces and to surfaces with boundaries.

  14. Power outages, power externalities, and baby booms.

    Science.gov (United States)

    Burlando, Alfredo

    2014-08-01

    Determining whether power outages have significant fertility effects is an important policy question in developing countries, where blackouts are common and modern forms of family planning are scarce. Using birth records from Zanzibar, this study shows that a month-long blackout in 2008 caused a significant increase in the number of births 8 to 10 months later. The increase was similar across villages that had electricity, regardless of the level of electrification; villages with no electricity connections saw no changes in birth numbers. The large fertility increase in communities with very low levels of electricity suggests that the outage affected the fertility of households not connected to the grid through some spillover effect. Whether the baby boom is likely to translate to a permanent increase in the population remains unclear, but this article highlights an important hidden consequence of power instability in developing countries. It also suggests that electricity imposes significant externality effects on rural populations that have little exposure to it.

  15. Coupled external cavity photonic crystal enhanced fluorescence.

    Science.gov (United States)

    Pokhriyal, Anusha; Lu, Meng; Ge, Chun; Cunningham, Brian T

    2014-05-01

    We report a fundamentally new approach to enhance fluorescence in which surface adsorbed fluorophore-tagged biomolecules are excited on a photonic crystal surface that functions as a narrow bandwidth and tunable mirror of an external cavity laser. This scheme leads to ∼10× increase in the electromagnetic enhancement factor compared to ordinary photonic crystal enhanced fluorescence. In our experiments, the cavity automatically tunes its lasing wavelength to the resonance wavelength of the photonic crystal, ensuring optimal on-resonance coupling even in the presence of variable device parameters and variations in the density of surface-adsorbed capture molecules. We achieve ∼10(5) × improvement in the limit of detection of a fluorophore-tagged protein compared to its detection on an unpatterned glass substrate. The enhanced fluorescence signal and easy optical alignment make cavity-coupled photonic crystals a viable approach for further reducing detection limits of optically-excited light emitters that are used in biological assays.

  16. Secondary emission electron gun using external primaries

    Science.gov (United States)

    Srinivasan-Rao, Triveni; Ben-Zvi, Ilan

    2009-10-13

    An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

  17. External Cylindrical Nozzle with Controlled Vacuum

    Directory of Open Access Journals (Sweden)

    V. N. Pil'gunov

    2015-01-01

    Full Text Available There is a developed design of the external cylindrical nozzle with a vacuum camera. The paper studies the nozzle controllability of flow rate via regulated connection of the evacuated chamber to the atmosphere through an air throttle. Working capacity of the nozzle with inlet round or triangular orifice are researched. The gap is provided in the nozzle design between the external wall of the inlet orifice and the end face of the straight case in the nozzle case. The presented mathematical model of the nozzle with the evacuated chamber allows us to estimate the expected vacuum amount in the compressed section of a stream and maximum permissible absolute pressure at the inlet orifice. The paper gives experimental characteristics of the fluid flow process through the nozzle for different values of internal diameter of a straight case and an extent of its end face remoteness from an external wall of the inlet orifice. It estimates how geometry of nozzle constructive elements influences on the volume flow rate. It is established that the nozzle capacity significantly depends on the shape of inlet orifice. Triangular orifice nozzles steadily work in the mode of completely filled flow area of the straight case at much more amounts of the limit pressure of the flow. Vacuum depth in the evacuated chamber also depends on the shape of inlet orifice: the greatest vacuum is reached in a nozzle with the triangular orifice which 1.5 times exceeds the greatest vacuum with the round orifice. Possibility to control nozzle capacity through the regulated connection of the evacuated chamber to the atmosphere was experimentally estimated, thus depth of flow rate regulation of the nozzle with a triangular orifice was 45% in comparison with 10% regulation depth of the nozzle with a round orifice. Depth of regulation calculated by a mathematical model appeared to be much more. The paper presents experimental dependences of the flow coefficients of nozzle input orifice

  18. Identifying external influences on global precipitation

    Energy Technology Data Exchange (ETDEWEB)

    Marvel, K.; Bonfils, C.

    2013-11-11

    Changes in global (ocean and land) precipitation are among the most important and least well-understood consequences of climate change. Increasing greenhouse gas concentrations are thought to affect the zonal-mean distribution of precipitation through two basic mechanisms. First, increasing temperatures will lead to an intensification of the hydrological cycle (“thermodynamic” changes). Second, changes in atmospheric circulation patterns will lead to poleward displacement of the storm tracks and subtropical dry zones and to a widening of the tropical belt (“dynamic” changes). We demonstrate that both these changes are occurring simultaneously in global precipitation, that this behavior cannot be explained by internal variability alone, and that external influences are responsible for the observed precipitation changes. Whereas existing model experiments are not of sufficient length to differentiate between natural and anthropogenic forcing terms at the 95% confidence level, we present evidence that the observed trends result from human activities.

  19. External-Memory Algorithms and Data Structures

    DEFF Research Database (Denmark)

    Arge, Lars; Zeh, Norbert

    2010-01-01

    The data sets involved in many modern applications are often too massive to fit in main memory of even the most powerful computers and must therefore reside on disk. Thus communication between internal and external memory, and not actual computation time, becomes the bottleneck in the computation....../Output communication (or just I/O) performed when solving a given problem. The area was effectively started in the late eighties by Aggarwal and Vitter and subsequently I/O algorithms have been developed for several problem domain. Also I/O performance can often be improved if many disks can efficiently be used...... of the following simultaneously: Abstract away the details of how I/O is performed so that programmers need only deal with a simple high level interface.Implement I/O-optimal paradigms for large scale computation that are efficient not only in theory, but also in practice.Remain flexible, allowing programmers...

  20. Externally Dispersed Interferometry for Precision Radial Velocimetry

    CERN Document Server

    Erskine, D J; Edelstein, J; Lloyd, J; Herter, T; Feuerstein, W M; Muirhead, P; Wishnow, E

    2007-01-01

    Externally Dispersed Interferometry (EDI) is the series combination of a fixed-delay field-widened Michelson interferometer with a dispersive spectrograph. This combination boosts the spectrograph performance for both Doppler velocimetry and high resolution spectroscopy. The interferometer creates a periodic spectral comb that multiplies against the input spectrum to create moire fringes, which are recorded in combination with the regular spectrum. The moire pattern shifts in phase in response to a Doppler shift. Moire patterns are broader than the underlying spectral features and more easily survive spectrograph blurring and common distortions. Thus, the EDI technique allows lower resolution spectrographs having relaxed optical tolerances (and therefore higher throughput) to return high precision velocity measurements, which otherwise would be imprecise for the spectrograph alone.

  1. Secondary emission electron gun using external primaries

    Science.gov (United States)

    Srinivasan-Rao, Triveni; Ben-Zvi, Ilan; Kewisch, Jorg; Chang, Xiangyun

    2007-06-05

    An electron gun for generating an electron beam is provided, which includes a secondary emitter. The secondary emitter includes a non-contaminating negative-electron-affinity (NEA) material and emitting surface. The gun includes an accelerating region which accelerates the secondaries from the emitting surface. The secondaries are emitted in response to a primary beam generated external to the accelerating region. The accelerating region may include a superconducting radio frequency (RF) cavity, and the gun may be operated in a continuous wave (CW) mode. The secondary emitter includes hydrogenated diamond. A uniform electrically conductive layer is superposed on the emitter to replenish the extracted current, preventing charging of the emitter. An encapsulated secondary emission enhanced cathode device, useful in a superconducting RF cavity, includes a housing for maintaining vacuum, a cathode, e.g., a photocathode, and the non-contaminating NEA secondary emitter with the uniform electrically conductive layer superposed thereon.

  2. The properties of external accretion discs

    Energy Technology Data Exchange (ETDEWEB)

    Pringle, J.E. (Space Telescope Science Inst., Baltimore, MD (USA))

    1991-02-15

    The properties of external accretion discs (discs with a central source of angular momentum) are explored both analytically and numerically. An illustrative example of the effect of a disc of material around a binary star on the stellar separation is considered. We consider a Greens-function-type solution in which an initial ring of matter is put in orbit around the central binary. We find that the solution splits temporally into three parts. First, the disc evolves as a standard accretion disc unaware of the inner boundary condition. Secondly, the disc interacts with the inner boundary and changes its character to become, thirdly, an outflowing disc which is propelled outwards by the source of angular momentum at the centre. (author).

  3. Stellar Tidal Streams in External Galaxies

    CERN Document Server

    Carlin, Jeffrey L; Martinez-Delgado, David; Gabany, R Jay

    2016-01-01

    To place the highly substructured stellar halos of the Milky Way and M31 in a larger context of hierarchical galaxy formation, it is necessary to understand the prevalence and properties of tidal substructure around external galaxies. This chapter details the current state of our observational knowledge of streams in galaxies in and beyond the Local Group, which are studied both in resolved stellar populations and in integrated light. Modeling of individual streams in extragalactic systems is hampered by our inability to obtain resolved stellar kinematics in the streams, though many streams contain alternate luminous kinematic tracers, such as globular clusters or planetary nebulae. We compare the observed structures to the predictions of models of galactic halo formation, which provide insight in the number and properties of streams expected around Milky Way like galaxies. More specifically, we discuss the inferences that can be made about stream progenitors based only on observed morphologies. We expand our...

  4. On population resilience to external perturbations

    CERN Document Server

    Roques, Lionel

    2010-01-01

    We study a spatially explicit harvesting model in periodic or bounded environments. The model is governed by a parabolic equation with a spatially dependent nonlinearity of Kolmogorov--Petrovsky--Piskunov type, and a negative external forcing term $-\\delta$. Using sub- and supersolution methods and the characterization of the first eigenvalue of some linear elliptic operators, we obtain existence and nonexistence results as well as results on the number of stationary solutions. We also characterize the asymptotic behavior of the evolution equation as a function of the forcing term amplitude. In particular, we define two critical values $\\delta^*$ and $\\delta_2$ such that, if $\\delta$ is smaller than $\\delta^*$, the population density converges to a "significant" state, which is everywhere above a certain small threshold, whereas if $\\delta$ is larger than $\\delta_2$, the population density converges to a "remnant" state, everywhere below this small threshold. Our results are shown to be useful for studying th...

  5. Social externalities, overlap and the poverty trap.

    Science.gov (United States)

    Kim, Young-Chul; Loury, Glenn C

    2014-12-01

    Previous studies find that some social groups are stuck in poverty traps because of network effects. However, these studies do not carefully analyze how these groups overcome low human capital investment activities. Unlike previous studies, the model in this paper includes network externalities in both the human capital investment stage and the subsequent career stages. This implies that not only the current network quality, but also the expectations about future network quality affect the current investment decision. Consequently, the coordinated expectation among the group members can play a crucial role in the determination of the final state. We define "overlap" for some initial skill ranges, whereby the economic performance of a group can be improved simply by increasing expectations of a brighter future. We also define "poverty trap" for some ranges, wherein a disadvantaged group is constrained by its history, and we explore the egalitarian policies to mobilize the group out of the trap.

  6. The Importance of Engine External's Health

    Science.gov (United States)

    Stoner, Barry L.

    2006-01-01

    Engine external components include all the fluid carrying, electron carrying, and support devices that are needed to operate the propulsion system. These components are varied and include: pumps, valves, actuators, solenoids, sensors, switches, heat exchangers, electrical generators, electrical harnesses, tubes, ducts, clamps and brackets. The failure of any component to perform its intended function will result in a maintenance action, a dispatch delay, or an engine in flight shutdown. The life of each component, in addition to its basic functional design, is closely tied to its thermal and dynamic environment .Therefore, to reach a mature design life, the component's thermal and dynamic environment must be understood and controlled, which can only be accomplished by attention to design analysis and testing. The purpose of this paper is to review analysis and test techniques toward achieving good component health.

  7. RMB:Depreciating Internationally while Appreciating Externally

    Institute of Scientific and Technical Information of China (English)

    贝多广; 朱晓莉

    2008-01-01

    RMB has been depreciating internally while appreciating externally since 2002. This new monetary phenomenon, has been strengthened in the context that US dollar depreciates internationally and that domestic economy is overwhelmed with excessive liquidities. Certainly the monetary phenomenon is the reflection of the actual economy: continued trade surplus, triggered robustly by the export-driven economy, is bringing a huge amount of exchange reserve which accelerates sequentially the expansion of domestic money supply. Furthermore, a refrained appreciation of RMB tends to deteriorate the domestic inflation, which is not simply a traditional concept of CPI but a broad inflation parameter including a variety of asset prices. It’s sure that the new phenomenon is becoming a new challenge to the macroeconomic equilibrium as well as the decision maker of monetary policy.

  8. Treatment of acromegaly by external irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Macleod, A.F.; Clarke, D.G.; Pambakian, H.; Lowy, C.; Sonksen, P.H.; Collins, C.D. (Saint Thomas' Hospital, London (UK))

    1989-03-01

    Despite hypophysectomy as the primary treatment in acromegaly, external radiotherapy maintains a role as a relatively slow but effective therapy for inadequately treated patients or those unsuitable for operation. Over the last 25 years the authors' regimen has differed from published series in that they give a larger dose per fraction, with fewer treatments. They have analysed the efficacy and side-effects of this regimen in 27 subjects with acromegaly. Growth hormone levels have fallen by, on average, 27% per year in the first five years, 83% of subjects achieving a basal growth hormone of <10mU/1. The acute and chronic side-effects of irradiation are discussed, including the relevance of estimates of biological potency, for example Time Dose Fraction (TDF). One patient suffered visual loss that was most likely to be secondary to the radiotherapy. Histological appearances of the pituitary fossa in five subjects previously treated with radiotherapy are reported. (author).

  9. Optical complexity in external cavity semiconductor laser

    Science.gov (United States)

    Rondoni, Lamberto; Ariffin, M. R. K.; Varatharajoo, Renuganth; Mukherjee, Sayan; Palit, Sanjay K.; Banerjee, Santo

    2017-03-01

    In this article, the window based complexity and output modulation of a time delayed chaotic semiconductor laser (SL) model has been investigated. The window based optical complexity (OC), is measured by introducing the recurrence sample entropy (SampEn). The analysis has been done without and in the presence of external noise. The significant changes in the dynamics can be observed under induced noise with weak strength. It has also been found that there is a strong positive correlation between the output power and the complexity of the system with various sets of parameters. The laser intensity, as well as the OC can be increased with the incremental noise strength and the associated system parameters. Thus, optical complexity quantifies the system dynamics and its instabilities, since is strongly correlated with the laser outputs. This analysis can be applied to measure the laser instabilities and modulation of output power.

  10. The suitability of internal versus external successors

    DEFF Research Database (Denmark)

    Boyd, Britta; Royer, Susanne

    2012-01-01

    of family business succession in order to understand when family successors are preferred because of their family-specific experiential knowledge. A case study analysis from the German-Danish border region explores how a family firm has used internal successors for the last 12 successions. We argue...... that in industries where tacit knowledge forms the basis for competitive advantage, the use of internal successors can help family firms excel after a transition of power has occurred. Theoretical and practical implications are discussed to enhance the long-term perspective for family businesses.......Understanding knowledge transfer in family firm succession is important for the survival of family firms. Previous research has begun to explore the suitability of internal versus external successor in family firms with regard to relevant knowledge types. This paper builds on the contingency model...

  11. Photonic water dynamically responsive to external stimuli

    Science.gov (United States)

    Sano, Koki; Kim, Youn Soo; Ishida, Yasuhiro; Ebina, Yasuo; Sasaki, Takayoshi; Hikima, Takaaki; Aida, Takuzo

    2016-08-01

    Fluids that contain ordered nanostructures with periodic distances in the visible-wavelength range, anomalously exhibit structural colours that can be rapidly modulated by external stimuli. Indeed, some fish can dynamically change colour by modulating the periodic distance of crystalline guanine sheets cofacially oriented in their fluid cytoplasm. Here we report that a dilute aqueous colloidal dispersion of negatively charged titanate nanosheets exhibits structural colours. In this `photonic water', the nanosheets spontaneously adopt a cofacial geometry with an ultralong periodic distance of up to 675 nm due to a strong electrostatic repulsion. Consequently, the photonic water can even reflect near-infrared light up to 1,750 nm. The structural colour becomes more vivid in a magnetic flux that induces monodomain structural ordering of the colloidal dispersion. The reflective colour of the photonic water can be modulated over the entire visible region in response to appropriate physical or chemical stimuli.

  12. Behaviour of ferrocholesterics under external magnetic fields

    Science.gov (United States)

    Petrescu, Emil; Motoc, Cornelia

    2001-08-01

    The influence of an external magnetic field on the orientational behaviour of a ferrocholesteric with a positive magnetic anisotropy is investigated. Both the phenomena arising when the field was switched on or switched off are considered. It is found that the field needed for a ferrocholesteric-ferronematic transition BFC↑ is higher when compared to that obtained for the pure cholesteric ( BC↑). A similar result was obtained when estimating the critical field for the homeotropic ferronematic-ferrocholesteric (focal conic) transition, occurring when the magnetic field was decreased or switched off. We found that BFC↓> BC↓. These results are explained when considering that the magnetic moments of the magnetic powder are not oriented parallel to the liquid crystal molecular directors, therefore hindering their orientation under a magnetic field.

  13. Some new external flavonoids from American ferns

    Energy Technology Data Exchange (ETDEWEB)

    Wollenweber, E.

    1979-01-01

    American gymnogrammoid ferns have been analysed for the flavonoid aglycones present in frond exudates. They are predominantly methylated chalcones, dihydrochalcones, flavones, and flavonols, occurring mostly as farinose deposit (''ceraceous indument''). This is the first report of external flavonoids on Pterozonium species; a chalcone has been identified. On Cheilanthes kaulfussii and Cheilanthes viscida traces of flavonoid aglycones are observed, dissolved in lipophilic exudate material. On Pellaea longimucronata a flavonol is found even on leaves which appear glaucous. 2',4',6'-Trihydroxychalcone is found for the second time in the plant kingdom on Adiantum sulphureum. Galangin-3,7-dimethylether is found as a new natural flavonol on Cheilanthes kaulfussii. In addition, samples of Pityrogramma chrysoconia and Pit. triangularis var. maxonii have been investigated. The results indicate chemotaxonomic implication of flavonoid patterns.

  14. Magnetospheric ULF waves driven by external sources

    CERN Document Server

    Agapitov, Oleksiy

    2015-01-01

    The multi-spacecraft missions (Cluster and THEMIS) observations allowed to collect large data base for Ultra Low Frequency (ULF) waves properties, their localization, and sources. Mainly here we focused on these recent results. Studying of the source and characteristics of ULF waves can help in the understanding of the interaction and energy transport from solar wind to the magnetosphere. Here we present peculiarities of ULF waves generated by different solar wind phenomenon: surface magnetopause instability, magnetosphere cavity modes and solar wind dynamic pressure sudden impulses (SI) penetration into the magnetosphere. Permanent observations of ULF waves involve existence of the permanent source and, as the previous studies showed, the contributions to Pc4-Pc5 ULF wave power from the external sources are larger than the contribution from internal magnetosphere sources. The Kelvin-Helmholtz instability (KHI) can generate on the magnetosphere flanks classical ULF resonant waves with spatially localized ampl...

  15. External trabeculectomy with T-Flux implant.

    LENUS (Irish Health Repository)

    Jungkim, S

    2012-02-03

    PURPOSE: To evaluate the efficacy and safety of T-Flux implant in nonpenetrating glaucoma surgery. METHODS: This clinical interventional case series study included 35 eyes of 35 patients with medically uncontrolled primary open angle glaucoma. External trabeculectomy with T-Flux (ETTF) is a technique of nonpenetrating glaucoma surgery, in which after removing deep scleral tissue and un-roofing the canal of Schlemn (CS) the external trabecular tissue is peeled off to enhance the aqueous drainage without opening the anterior chamber. A non-absorbable T-Flux implant (IOL TECH Laboratories, France) was sutured in deep intrascleral space to keep it patent. Snellen\\'s best-corrected visual acuity, slit lamp biomicroscopy, intraocular pressure (IOP), gonioscopy, funduscopy, and optic disc assessment were performed preoperatively and postoperatively at 1 day, 1 week, and 1, 3 , 6, and 12 months. Visual field testing was performed preoperatively and at 6 and 12 months postoperatively. RESULTS: For three eyes, surgery was converted to standard trabeculectomy owing to the perforation of trabeculo-Descemet\\'s membrane and iris prolapse and excluded from the study. The results of the remaining 32 eyes were included in the study. Preoperative IOP (mean +\\/- SD) of 32.88 +\\/- 5.7 mmHg decreased to 15.44 +\\/- 1.6 mmHg after 12 months. Ten eyes (28.6%) had microhyphema that resolved spontaneously; 3 eyes (8.6%) had microperforation without iris prolapse so ETTF was proceeded routinely. The preoperative number of antiglaucoma medications per patient reduced from (mean +\\/- SD) 2.74 +\\/- 0.61 to 0.11 +\\/- 0.32 postoperatively at 12 months. Visual acuity and visual fields remained stable. CONCLUSIONS: ETTF appears to provide significant control of IOP and have low incidence of complications.

  16. Variable velocity in solar external receivers

    Science.gov (United States)

    Rodríguez-Sánchez, M. R.; Sánchez-González, A.; Acosta-Iborra, A.; Santana, D.

    2017-06-01

    One of the major problems in solar external receivers is tube overheating, which accelerates the risk of receiver failure. It can be solved implementing receivers with high number of panels. However, it exponentially increases the pressure drop in the receiver and the parasitic power consumption of the Solar Power Tower (SPT), reducing the global efficiency of the SPT. A new concept of solar external receiver, named variable velocity receiver, is able to adapt their configuration to the different flux density distributions. A set of valves allows splitting in several independent panels those panels in which the wall temperature is over the limit. It increases the velocity of the heat transfer fluid (HTF) and its cooling capacity. This receiver does not only reduce the wall temperature of the tubes, but also simplifies the control of the heliostat field and allows to employ more efficient aiming strategies. In this study, it has been shown that variable velocity receiver presents high advantages with respect to traditional receiver. Nevertheless, more than two divisions per panels are not recommendable, due to the increment of the pressure drop over 70 bars. In the design point (12 h of the Spring Equinox), the use of a variable number of panels between 18 and 36 (two divisions per panel), in a SPT similar to Gemasolar, improves the power capacity of the SPT in 5.7%, with a pressure drop increment of 10 bars. Off-design, when the flux distribution is high and not symmetric (e.g. 10-11 h), the power generated by the variable velocity receiver is 18% higher than the generated by the traditional receiver, at these hours the pressure drop increases almost 20 bars.

  17. 经皮球囊二尖瓣成形术前后一氧化氮、内皮素变化的研究%The changes of NO and ET in plasma before and after percutaneaus mitral balloon valvuloplasty

    Institute of Scientific and Technical Information of China (English)

    姜醒华; 程晓曙; 苏海; 吴清华; 吴延庆; 李菊香; 张润香

    2001-01-01

    目的 探讨风湿性心脏病二尖瓣狭窄患者经皮球囊二尖瓣成形术(PBMV)前后肺动脉及左心房血浆中内皮素(ET)、一氧化氮(NO)变化。方法选择符合行PBMV适应证的风湿性二尖瓣狭窄患者50例,PBMV术前及术后30min监测肺动脉压、左心房压,并同时取肺动脉血、左心房血分别用重氮法和放射免疫法测定NO和ET值及NO/ET值。结果PBMV术后,肺动脉压、左心房压明显下降,肺动脉平均压由((51.7±19.3)mm Hg(1 mm Hg=0.133 kPa)降至(21.5±7.0)mm Hg(P<0.01),左心房平均压由(25.3±6.7)mm Hg降至(13.2±9.7)mm Hg(P<0.01)。术前左心房血浆ET(51.1±10.6)pg/ml,NO(99.6±9.4)μmol/L,NO/ET=1.95±1.12;肺动脉血浆ET(131.1±19.3)pg/ml,NO(165.4?50)祄ol?L,NO?ET=1?26??78????????ET(31?1??1)pg?ml,NO(70?3?0?1)祄ol?L,NO ET=2.26±1.23;肺动脉血浆ET(87.49±14.86)pg/ml,NO(122.83±11.77)μmol/L,NO/ET=1.41±0.79;与术后术前比较,P均为<0.01。对上述结果进行相关分析,表明肺动脉平均压与肺动脉血浆内皮素浓度呈正相关(r=0.47,P≤0.05)。结论 患者经PBMV后随着肺动脉平均压、左房平均压的下降,肺动脉、左心房内血浆ET、NO均显著下降,ET下降幅度大于NO,使NO/ET比值上升,且肺动脉平均压与肺动脉血浆ET浓度呈正相关。%Objective To observe the changes of nitric oxide(NO) and endothelin(ET) in plasma of pulmonary artery and left atrium before and after percutaneaus balloon mitral valvuloplasty(PBMV) in patients with rheumatic mitral stenosis. Methods Fifty patients with rheumatic mitral stenosis were be selected to perform PBMV. Before and 30 min after PBMV we monitored the pulmonury mean pressure. Left atrial mean pressure and measured the levels of NO and ET in plasma of pulmonary artery and left atrium were at same time. Results After PBMV, the pulmonary and left atrium pressure were

  18. External Beam Radiation in Differentiated Thyroid Carcinoma

    Directory of Open Access Journals (Sweden)

    Salem Billan

    2016-01-01

    Full Text Available The treatment of differentiated thyroid carcinoma (DTC is surgery followed in some cases by adjuvant treatment, mostly with radioactive iodine (RAI. External beam radiotherapy (EBRT is less common and not a well-established treatment modality in DTC. The risk of recurrence depends on three major prognostic factors: extra-thyroid extension, patient’s age, and tumor with reduced iodine uptake. Increased risk for recurrence is a major factor in the decision whether to treat the patient with EBRT. Data about the use of EBRT in DTC are limited to small retrospective studies. Most series have demonstrated an increase in loco-regional control. The risk/benefit from giving EBRT requires careful patient selection. Different scoring systems have been proposed by different investigators and centers. The authors encourage clinicians treating DTC to become familiarized with those scoring systems and to use them in the management of different cases. The irradiated volume should include areas of risk for microscopic disease. Determining those areas in each case can be difficult and requires detailed knowledge of the surgery and pathological results, and also understanding of the disease-spreading pattern. Treatment with EBRT in DTC can be beneficial, and data support the use of EBRT in high-risk patients. Randomized controlled trials are needed for better confirmation of the role of EBRT.

  19. Efficacy of enhanced external counterpulsation: our experience

    Directory of Open Access Journals (Sweden)

    Chandra Mani Adhikari

    2014-11-01

    Full Text Available Aims Enhanced external counterpulsation therapy is a non-invasive, non-pharmacological outpatient treatment option for refractory angina pectoris. Our aim is to evaluate its efficacy in Nepalese refractory angina pectoris patients. Materials and methods It was single centre prospective study conducted from 2010 August to 2013 December. All thirty one (n=31 consecutive patients, referred for and received 35 hours of treatment were included in this study. The distance covered in six minute walk test before and after the treatment was recorded and compared. Patients were followed each with the questionnaires about their anginal symptoms before and after the treatment. Results In our study 19(61.3% were male and 12(38.7% female. The mean age was 65.7±9.3 years. Most patients had multi vessel disease. Twelve patients had previous history of revascularization. In 6 minute walk test there was significant difference in mean distance covered before and after the treatment. Most patients experienced decrease in the angina symptom. They had decreased in severity and frequency of angina, resulting in decreased use of sublingual nitrates. Conclusion EECP can be safe and effective treatment option for patients with RAP.

  20. Quantifying the synchronizability of externally driven oscillators.

    Science.gov (United States)

    Stefański, Andrzej

    2008-03-01

    This paper is focused on the problem of complete synchronization in arrays of externally driven identical or slightly different oscillators. These oscillators are coupled by common driving which makes an occurrence of generalized synchronization between a driving signal and response oscillators possible. Therefore, the phenomenon of generalized synchronization is also analyzed here. The research is concentrated on the cases of an irregular (chaotic or stochastic) driving signal acting on continuous-time (Duffing systems) and discrete-time (Henon maps) response oscillators. As a tool for quantifying the robustness of the synchronized state, response (conditional) Lyapunov exponents are applied. The most significant result presented in this paper is a novel method of estimation of the largest response Lyapunov exponent. This approach is based on the complete synchronization of two twin response subsystems via additional master-slave coupling between them. Examples of the method application and its comparison with the classical algorithm for calculation of Lyapunov exponents are widely demonstrated. Finally, the idea of effective response Lyapunov exponents, which allows us to quantify the synchronizability in case of slightly different response oscillators, is introduced.

  1. External Balance Payments – Macroeconomic Analysis Instrument

    Directory of Open Access Journals (Sweden)

    Madalina Dumbrava

    2006-04-01

    Full Text Available The foreign trade activity represents, on one side, the participation of one country to the international economic co-operation, on the basis of the labor international division as well as, on the other side, a factor of economic growth. The sold of the payments balance shows to what extent a country depends on external relationship. The foreign payments balance is conceived as an instrument of economic analysis, reflecting the actual financial flows, which are being established. In the paper we are dealing with the forms in which the payments balance is made, as well as the recording principles for its data. By its own structure, the foreign payment balance emphasizes the debts and the commitments undertaken by a country, within a given period of time. Aspects such as: the equilibrium of the payments balance; tehnicques meant to secure the equilibrium of the payments balance and policies meant to secure the equilibrium of the payments balance are also approached as an attempt to clarify the subject.

  2. The External Calibrator for Hydrogen Observatories

    CERN Document Server

    Jacobs, Daniel C; Bowman, Judd; Neben, Abraham R; Stinnett, Benjamin; Turner, Lauren

    2016-01-01

    Multiple instruments are pursuing constraints on dark energy, observing reionization and opening a window on the dark ages through the detection and characterization of the 21cm hydrogen line across the redshift spectrum, from nearby to z=25. These instruments, including CHIME in the sub-meter and HERA in the meter bands, are wide-field arrays with multiple-degree beams, typically operating in transit mode. Accurate knowledge of their primary beams is critical for separation of bright foregrounds from the desired cosmological signals, but difficult to achieve through astronomical observations alone. Previous beam calibration work has focused on model verification and does not address the need of 21cm experiments for routine beam mapping, to the horizon, of the as-built array. We describe the design and methodology of a drone-mounted calibrator, the External Calibrator for Hydrogen Observatories (ECHO), that aims to address this need. We report on a first set of trials to calibrate low-frequency dipoles and co...

  3. App-assisted external ventricular drain insertion.

    Science.gov (United States)

    Eftekhar, Behzad

    2016-09-01

    The freehand technique for insertion of an external ventricular drain (EVD) is based on fixed anatomical landmarks and does not take individual variations into consideration. A patient-tailored approach based on augmented-reality techniques using devices such as smartphones can address this shortcoming. The Sina neurosurgical assist (Sina) is an Android mobile device application (app) that was designed and developed to be used as a simple intraoperative neurosurgical planning aid. It overlaps the patient's images from previously performed CT or MRI studies on the image seen through the device camera. The device is held by an assistant who aligns the images and provides information about the relative position of the target and EVD to the surgeon who is performing EVD insertion. This app can be used to provide guidance and continuous monitoring during EVD placement. The author describes the technique of Sina-assisted EVD insertion into the frontal horn of the lateral ventricle and reports on its clinical application in 5 cases as well as the results of ex vivo studies of ease of use and precision. The technique has potential for further development and use with other augmented-reality devices.

  4. Dense Molecular Cores Being Externally Heated

    CERN Document Server

    Kim, Gwanjeong; Gopinathan, Maheswar; Jeong, Woong-Seob; Kim, Mi-Ryang

    2016-01-01

    We present results of our study on eight dense cores, previously classified as starless, using infrared (3-160 {\\micron}) imaging observations with \\textit{AKARI} telescope and molecular line (HCN and N$_2$H$^+$) mapping observations with \\textit{KVN} telescope. Combining our results with the archival IR to mm continuum data, we examined the starless nature of these eight cores. Two of the eight cores are found to harbor faint protostars having luminosity of $\\sim0.3-4.4$ L$_{\\odot}$. The other six cores are found to remain as starless and probably are in a dynamically transitional state. The temperature maps produced using multi-wavelength images show an enhancement of about 3-6 K towards the outer boundary of these cores, suggesting that they are most likely being heated externally by nearby stars and/or interstellar radiation fields. Large virial parameters and an over-dominance of red asymmetric line profiles over the cores may indicate that the cores are set into either an expansion or an oscillatory mot...

  5. Holographic fermions in external magnetic fields

    CERN Document Server

    Gubankova, E; Cubrovic, M; Schalm, K; Schijven, P; Zaanen, J

    2011-01-01

    We study the Fermi level structure of 2+1-dimensional strongly interacting electron systems in external magnetic field using the AdS/CFT correspondence. The gravity dual of a finite density fermion system is a Dirac field in the background of the dyonic AdS-Reissner-Nordstrom black hole. In the probe limit the magnetic system can be reduced to the non-magnetic one, with Landau-quantized momenta and rescaled thermodynamical variables. We find that at strong enough magnetic fields, the Fermi surface vanishes and the quasiparticle is lost either through a crossover to conformal regime or through a phase transition to an unstable Fermi surface. In the latter case, the vanishing Fermi velocity at the critical magnetic field triggers the non-Fermi liquid regime with unstable quasiparticles and a change in transport properties of the system. We associate it with a metal-"strange metal" phase transition. Next we compute compute the DC Hall and longitudinal conductivities using the gravity-dressed fermion propagators....

  6. External ventricular drains: Management and complications

    Directory of Open Access Journals (Sweden)

    Rajanandini Muralidharan

    2015-01-01

    Full Text Available Background: Insertion of an External Ventricular Drain (EVD is arguably one of the most common and important lifesaving procedures in neurologic intensive care unit. Various forms of acute brain injury benefit from the continuous intracranial pressure (ICP monitoring and cerebrospinal fluid (CSF diversion provided by an EVD. After insertion, EVD monitoring, maintenance and troubleshooting essentially become a nursing responsibility. Methods: Articles pertaining to EVD placement, management, and complications were identified from PubMed electronic database. Results: Typically placed at the bedside by a neurosurgeon or neurointensivist using surface landmarks under emergent conditions, this procedure has the ability to drain blood and CSF to mitigate intracranial hypertension, continuously monitor intracranial pressure, and instill medications. Nursing should ensure proper zeroing, placement, sterility, and integrity of the EVD collecting system. ICP waveform analysis and close monitoring of CSF drainage are extremely important and can affect clinical outcomes of patients. In some institutions, nursing may also be responsible for CSF sampling and catheter irrigation. Conclusion: Maintenance, troubleshooting, and monitoring for EVD associated complications has essentially become a nursing responsibility. Accurate and accountable nursing care may have the ability to portend better outcomes in patients requiring CSF drainage.

  7. Outcome comparison between transcanalicular and external dacryocystorhinostomy

    Institute of Scientific and Technical Information of China (English)

    Gunay; Uludag; Baris; Yeniad; Erdinc; Ceylan; Ayse; Yildiz-Tas; Lale; Kozer-Bilgin

    2015-01-01

    AIM: To compare the outcomes achieved with external dacryocystorhinostomy(EX-DCR) and transcanalicular dacryocystorhinostomy(TC-DCR) using a multidiode laser in patients with bilateral nasolacrimal duct obstruction(NLDO).METHODS: This prospective study was conducted on38 eyes of 19 patients with bilateral NLDO. Simultaneous bilateral surgery was performed on all patients. TC-DCR(Group 1) with a diode laser was used in the right eye,and EX-DCR(Group 2) was used in the left eye. All patients were placed under general anesthesia. Routine follow-ups were scheduled at 1wk; 1, 3, 6 and 12 mo postoperative intervals. Objective(lacrimal system irrigation) and subjective [tearing, irritation, pain,discharge and visual analogue scale(VAS) score]outcomes were evaluated.RESULTS: The overall objective success rate at 12 mo was 73.7%(14/19) in Group 1 and 89.5 %(17/19) in Group2. This difference was statistically significant. There were no significant between-group differences in the subjective results, such as tearing, pain and irritation.Only the discharge scores were found to be significantly higher in Group 1 compared to Group 2 at the 1y followup. The average VAS score was 6.8 in Group 1 and 8.7 in Group 2, with no statistically significant differences.CONCLUSION: Although TC-DCR allows surgeons to perform a minimally invasive and safe procedure, EX-DCR offers better objective and subjective outcomes than TC-DCR.

  8. External quality control for embryology laboratories.

    Science.gov (United States)

    Castilla, Jose Antonio; Ruiz de Assín, Rafael; Gonzalvo, Maria Carmen; Clavero, Ana; Ramírez, Juan Pablo; Vergara, Francisco; Martínez, Luis

    2010-01-01

    Participation in external quality control (EQC) programmes is recommended by various scientific societies. Results from an EQC programme for embryology laboratories are presented. This 5-year programme consisted of the annual delivery of (i) materials to test toxicity and (ii) a DVD/CD-ROM with images of zygotes and embryos on days 2 and 3, on the basis of which the participants were asked to judge the embryo quality and to take a clinical decision. A high degree of agreement was considered achieved when over 75% of the laboratories produced similar classifications. With respect to the materials analysed, the specificity was 68% and the sensitivity was 83%. Concerning embryo classification, the proportion of embryos on which a high degree of agreement was achieved increased during this period from 35% to 55%. No improvement was observed in the degree of agreement on the clinical decision to be taken. Day-3 embryos produced a higher degree of agreement (58%) than did day-2 embryos (32%) (Pembryology laboratories.

  9. External Balance Payments – Macroeconomic Analysis Instrument

    Directory of Open Access Journals (Sweden)

    Madalina Dumbrava

    2006-06-01

    Full Text Available The foreign trade activity represents, on one side, the participation of one country to the international economic co-operation, on the basis of the labor international division as well as, on the other side, a factor of economic growth. The sold of the payments balance shows to what extent a country depends on external relationship. The foreign payments balance is conceived as an instrument of economic analysis, reflecting the actual financial flows, which are being established. In the paper we are dealing with the forms in which the payments balance is made, as well as the recording principles for its data. By its own structure, the foreign payment balance emphasizes the debts and the commitments undertaken by a country, within a given period of time. Aspects such as: the equilibrium of the payments balance; tehnicques meant to secure the equilibrium of the payments balance and policies meant to secure the equilibrium of the payments balance are also approached as an attempt to clarify the subject.

  10. Genetics Reasoning with Multiple External Representations

    Science.gov (United States)

    Tsui, Chi-Yan; Treagust, David F.

    2003-02-01

    This paper explores a case study of a class of Year 10 students (n=24) whose learning of genetics involved activities of BioLogica, a computer program that features multiple external representations (MERs). MERs can be verbal/textual, visual-graphical, or in other formats. Researchers claim that the functions of MERs in supporting student learning are to complement information or processes, to constrain the interpretation of abstract concepts, and to construct new viable conceptions. Over decades, research has shown that genetics remains linguistically and conceptually difficult for high school students. This case study using data from multiple sources enabled students'' development of genetics reasoning to be interpreted from an epistemological perspective. Pretest-posttest comparison after six weeks showed that most of the students (n=20) had improved their genetics reasoning but only for easier reasoning types. Findings indicated that the MERs in BioLogica contributed to students'' development of genetics reasoning by engendering their motivation and interest but only when students were mindful in their learning. Based on triangulation of data from multiple sources, MERs in BioLogica appeared to support learning largely by constraining students'' interpretation of phenomena of genetics.

  11. In vivo dosimetry in external beam radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Mijnheer, Ben [Department of Radiation Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam 1066 CX (Netherlands); Beddar, Sam [Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas 77030 (United States); Izewska, Joanna [Division of Human Health, International Atomic Energy Agency, Vienna 1400 (Austria); Reft, Chester [Department of Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, Illinois 60637 (United States)

    2013-07-15

    In vivo dosimetry (IVD) is in use in external beam radiotherapy (EBRT) to detect major errors, to assess clinically relevant differences between planned and delivered dose, to record dose received by individual patients, and to fulfill legal requirements. After discussing briefly the main characteristics of the most commonly applied IVD systems, the clinical experience of IVD during EBRT will be summarized. Advancement of the traditional aspects of in vivo dosimetry as well as the development of currently available and newly emerging noninterventional technologies are required for large-scale implementation of IVD in EBRT. These new technologies include the development of electronic portal imaging devices for 2D and 3D patient dosimetry during advanced treatment techniques, such as IMRT and VMAT, and the use of IVD in proton and ion radiotherapy by measuring the decay of radiation-induced radionuclides. In the final analysis, we will show in this Vision 20/20 paper that in addition to regulatory compliance and reimbursement issues, the rationale for in vivo measurements is to provide an accurate and independent verification of the overall treatment procedure. It will enable the identification of potential errors in dose calculation, data transfer, dose delivery, patient setup, and changes in patient anatomy. It is the authors' opinion that all treatments with curative intent should be verified through in vivo dose measurements in combination with pretreatment checks.

  12. Study on external beam radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Mi Sook; Yoo, Seoung Yul; Yoo, Hyung Jun; Ji, Young Hoon; Lee, Dong Han; Lee, Dong Hoon; Choi, Mun Sik; Yoo, Dae Heon; Lee, Hyo Nam; Kim, Kyeoung Jung

    1999-04-01

    To develop the therapy technique which promote accuracy and convenience in external radiation therapy, to obtain the development of clinical treatment methods for the global competition. The contents of the R and D were 1. structure, process and outcome analysis in radiation therapy department. 2. Development of multimodality treatment in radiation therapy 3. Development of computation using networking techniques 4. Development of quality assurance (QA) system in radiation therapy 5. Development of radiotherapy tools 6. Development of intraoperative radiation therapy (IORT) tools. The results of the R and D were 1. completion of survey and analysis about Korea radiation therapy status 2. Performing QA analysis about ICR on cervix cancer 3. Trial of multicenter randomized study on lung cancers 4. Setting up inter-departmental LAN using MS NT server and Notes program 5. Development of ionization chamber and dose-rate meter for QA in linear accelerator 6. Development on optimized radiation distribution algorithm for multiple slice 7. Implementation on 3 dimensional volume surface algorithm and 8. Implementation on adaptor and cone for IORT.

  13. External-Compression Supersonic Inlet Design Code

    Science.gov (United States)

    Slater, John W.

    2011-01-01

    A computer code named SUPIN has been developed to perform aerodynamic design and analysis of external-compression, supersonic inlets. The baseline set of inlets include axisymmetric pitot, two-dimensional single-duct, axisymmetric outward-turning, and two-dimensional bifurcated-duct inlets. The aerodynamic methods are based on low-fidelity analytical and numerical procedures. The geometric methods are based on planar geometry elements. SUPIN has three modes of operation: 1) generate the inlet geometry from a explicit set of geometry information, 2) size and design the inlet geometry and analyze the aerodynamic performance, and 3) compute the aerodynamic performance of a specified inlet geometry. The aerodynamic performance quantities includes inlet flow rates, total pressure recovery, and drag. The geometry output from SUPIN includes inlet dimensions, cross-sectional areas, coordinates of planar profiles, and surface grids suitable for input to grid generators for analysis by computational fluid dynamics (CFD) methods. The input data file for SUPIN and the output file from SUPIN are text (ASCII) files. The surface grid files are output as formatted Plot3D or stereolithography (STL) files. SUPIN executes in batch mode and is available as a Microsoft Windows executable and Fortran95 source code with a makefile for Linux.

  14. External threat and the definition of deviance.

    Science.gov (United States)

    Laudedale, P; Smith-Cunnien, P; Parker, J; Inverarity, J

    1984-05-01

    Research ( Lauderdale , 1976; Schachter , 1951) suggests that an external threat to a group can lead to the rejection of deviant members of the group and alteration of group communication patterns and solidarity. This study sought to extend those findings, integrate them with concepts from Simmel 's (1917/1955) work on group conflict, and link them to key issues in the societal reaction approach to deviant behavior. We examined the effect of variation in level of threat, the relationship between deviant status and nonconformity to the central task norm, the role of high-status actors in deviance designation, the relationship between rejection and negative definition of the deviant, and the effects of rejection and negative definition on group solidarity. Hypotheses were tested in an experimental design involving three conditions (strong threat, weak threat, and no threat). The results suggest that (a) the level of threat is directly related to the extent of rejection and negative definition, (b) nonconformity to the central task norm is not systematically related to deviant status, (c) high-status actors are more involved in the rejection of the deviant, (d) sociometric rejection of the deviant is accompanied by negative definition in the strong-threat condition, and (e) the level of group solidarity is related to the extent of rejection and negative definition. Implications of these findings are discussed relative to the societal reaction approach to deviant behavior and analogous processes in other social groups.

  15. External costs of material recycling strategies for fusion power plants

    Energy Technology Data Exchange (ETDEWEB)

    Hallberg, B. E-mail: bengt.hallberg@studsvik.se; Aquilonius, K.; Lechon, Y.; Cabal, H.; Saez, R.M.; Schneider, T.; Lepicard, S.; Ward, D.; Hamacher, T.; Korhonen, R

    2003-09-01

    This paper is based on studies performed within the framework of the project Socio-Economic Research on Fusion (SERF3). Several fusion power plant designs (SEAFP Models 1-6) were compared focusing on part of the plant's life cycle: environmental impact of recycling the materials. Recycling was considered for materials replaced during normal operation, as well as materials from decommissioning of the plant. Environmental impact was assessed and expressed as external cost normalised with the total electrical energy output during plant operation. The methodology used for this study has been developed by the Commission of the European Union within the frame of the ExternE project. External costs for recycling, normalised with the energy production during plant operation, are very low compared with those for other energy sources. Results indicate that a high degree of recycling is preferable, at least when considering external costs, because external costs of manufacturing of new materials and disposal costs are higher.

  16. Assessment of the externalities of biomass energy for electricity production

    Energy Technology Data Exchange (ETDEWEB)

    Linares, P.; Leal, J.; Saez, R.M.

    1996-10-01

    This study presents a methodology for the quantification of the socioeconomic and environmental externalities of the biomass fuel cycle. It is based on the one developed by the ExternE Project of the European Commission, based in turn in the damage function approach, and which has been extended and modified for a better adaptation to biomass energy systems. The methodology has been applied to a 20 MW biomass power plant, fueled by Cynara cardunculus, in southern Spain. The externalities addressed have been macroeconomic effects, employment, CO{sub 2}, fixation, erosion, and non-point source pollution. The results obtained should be considered only as subtotals, since there are still other externalities to be quantified. anyway, and in spite of the uncertainty existing, these results suggest that total cost (those including internal and external costs) of biomass energy are lower than those of conventional energy sources, what, if taken into account, would make biomass more competitive than it is now. (Author)

  17. EXTERNAL MAGNETIC PULSE STRAIGHTENING – NEW TECHNOLOGY CAR BODY REPAIR

    Directory of Open Access Journals (Sweden)

    А. Gnatov

    2015-07-01

    Full Text Available Innovative equipment of external contactless magnetic impulse straightening developed by the laboratory of Electromagnetic Technology of Kharkiv National Automobile and Highway University is presented in this paper. The effect of metal hyper-plasticity at magnetic impulse acting is described. Suggestions concerning practical testing of advanced technology of damaged car body panels by external contactless magnetic impulse straightening are presented. The processing route of external contactless magnetic impulse straightening process is specified.

  18. Negativity in the Extended Hubbard Model under External Magnetic Field

    Institute of Scientific and Technical Information of China (English)

    YANG Zhen; NING Wen-Qiang

    2008-01-01

    We exactly calculate the negativity,a measurement of entanglement,in the two-site extended Hubbard model with external magnetic field.Its behaviour at different temperatures is presented.The negativity reduces with the increasing temperature or with the increasing uniform external magnetic field.It is also found that a non-uniform external magnetic field can be used to modulate or to increase the negativity.

  19. Semantic Externalism and Self Knowledge: Privileged Access to the World

    OpenAIRE

    Sawyer, Sarah

    2008-01-01

    The thesis is concerned to defend the compatibility of two plausible claims about the mind; semantic externalism and privileged access. It is further concerned to demonstrate one important implication of the conjunction of semantic externalism and privileged access, an implication which forces the rejection of the dichotomy between knowledge of one’s mind and knowledge of one’s world. Chapter one is a presentation of semantic externalism. Chapter two is a presentation of the claim of privileg...

  20. Review on studies for external cost of nuclear power generation

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Heung [Korea National University of Transportation, Chungju (Korea, Republic of); Ko, Won Il [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2015-12-15

    External cost is cost imposed on a third party when producing or consuming a good or service. Since the 1990s, the external costs of nuclear powered electricity production have been studied. Costs are a very important factor in policy decision and the external cost is considered for cost comparison on electricity production. As for nuclear fuel cycle, a chosen technology will determine the external cost. However, there has been little research on this issue. For this study, methods for external cost on nuclear power production have been surveyed and analyzed to develop an approach for evaluating external cost on nuclear fuel cycles. Before the Fukushima accident, external cost research had focused on damage costs during normal operation of a fuel cycle. However, accident cost becomes a major concern after the accident. Various considerations for external cost including accident cost have been used to different studies, and different methods have been applied corresponding to the considerations. In this study, the results of the evaluation were compared and analyzed to identify methodological applicability to the external cost estimation with nuclear fuel cycles.

  1. Externality in the nonobese: effects of environmental responsiveness on weight.

    Science.gov (United States)

    Rodin, J; Slochower, J

    1976-03-01

    The study considered whether external responsiveness in normal weight people would predict changes in eating behavior and weight following major alteration of environmetnal food cues. Normal weight children were tested for externality on measures of eating, slide recall, and extremity of affective responsiveness during the first week of a summer camp, and were weighed biweekly thereafter. There was a significant correlation between externality and weight change, indicating that the more externally responsive the children were, the more weight they gained. The implications of this finding for theories about the development of obesity were considered.

  2. Unrecorded origin of external pudendal artery with variant obturator vessels

    Directory of Open Access Journals (Sweden)

    El-Sawaf ME

    2010-08-01

    Full Text Available During routine dissection of a female cadaver for teaching purposes, the vessels in the ilioinguinal region in both sides showed some anatomical variations. In the right side, the external iliac artery gave off the obturator artery and a common trunk for both external pudendal artery and inferior epigastric artery. The obturator vein followed the variant obturator artery while the external pudendal vein showed a normal course. Meanwhile, the obturator artery in the left side originated from the inferior epigastric artery and the obturator vein drained into the external iliac vein. These anatomical findings may have important clinical implications.

  3. External Monitoring and Dynamic Behavior in Mutual Funds

    Directory of Open Access Journals (Sweden)

    Jian Wang

    2016-01-01

    Full Text Available This paper studies the impact of external monitoring on the behavior in mutual funds. Specifically, we investigate how and why external monitoring can alleviate contracting inefficiency caused by information asymmetry between investors and the manager. It is shown that efficiency loss emerges when investors contract with the manager just relying on her investment return history. The establishment of external monitoring that provides investors more information about the manager’s ability can improve contracting efficiency, which converges to first-best as external monitoring strengthens. These results provide strong support for tightening supervision in mutual fund industry.

  4. 21 CFR 890.3420 - External limb prosthetic component.

    Science.gov (United States)

    2010-04-01

    ... total prosthesis. Examples of external limb prosthetic components include the following: Ankle, foot... shoulder joint components; and cable and prosthesis suction valves. (b) Classification. Class I...

  5. III. Biological effects of radiation from external and internal sources

    Energy Technology Data Exchange (ETDEWEB)

    Stone, R.S.

    1948-05-24

    This report focuses on the hemotological effects of total body irradiation from external and internal sources observed in patients treated for arthritis with radioactive phosphorus administered intravenously.

  6. Optimization approaches for planning external beam radiotherapy

    Science.gov (United States)

    Gozbasi, Halil Ozan

    Cancer begins when cells grow out of control as a result of damage to their DNA. These abnormal cells can invade healthy tissue and form tumors in various parts of the body. Chemotherapy, immunotherapy, surgery and radiotherapy are the most common treatment methods for cancer. According to American Cancer Society about half of the cancer patients receive a form of radiation therapy at some stage. External beam radiotherapy is delivered from outside the body and aimed at cancer cells to damage their DNA making them unable to divide and reproduce. The beams travel through the body and may damage nearby healthy tissue unless carefully planned. Therefore, the goal of treatment plan optimization is to find the best system parameters to deliver sufficient dose to target structures while avoiding damage to healthy tissue. This thesis investigates optimization approaches for two external beam radiation therapy techniques: Intensity-Modulated Radiation Therapy (IMRT) and Volumetric-Modulated Arc Therapy (VMAT). We develop automated treatment planning technology for IMRT that produces several high-quality treatment plans satisfying provided clinical requirements in a single invocation and without human guidance. A novel bi-criteria scoring based beam selection algorithm is part of the planning system and produces better plans compared to those produced using a well-known scoring-based algorithm. Our algorithm is very efficient and finds the beam configuration at least ten times faster than an exact integer programming approach. Solution times range from 2 minutes to 15 minutes which is clinically acceptable. With certain cancers, especially lung cancer, a patient's anatomy changes during treatment. These anatomical changes need to be considered in treatment planning. Fortunately, recent advances in imaging technology can provide multiple images of the treatment region taken at different points of the breathing cycle, and deformable image registration algorithms can

  7. Therapeutic options for external genital warts.

    Science.gov (United States)

    Vender, Ronald; Bourcier, Marc; Bhatia, Neal; Lynde, Charles

    2013-12-01

    The primary goal of treatment for external genital warts (EGWs) is to eradicate visible lesions and address symptoms that may accompany them, but it does not address the underlying virus. Left untreated, warts may grow, remain the same, or spontaneously regress as a result of being cleared by the immune system. However, recurrence is common with or without treatment and may occur within 3 months of ending treatment in one-quarter to two-thirds of cases. Treatment options fall into two categories: provider or patient applied. Provider-based therapies include cryotherapy, trichloroacetic and bichloroacetic acid, electrocautery, surgical excision, and CO2 laser therapy. Patient-applied therapy choices include imiquimod and podophyllotoxin. Imiquimod 3.75% is a fairly new, patient-administered topical cream approved by Health Canada in 2011. Another recently approved patient-applied choice is sinecatechins, a green tea extract with immunomodulatory effects. Self-treatment options are attractive to patients because they offer privacy, convenience, and autonomy. In contrast, provider-administered therapies may boast increased precision (especially for areas that are hard to reach) and closer monitoring, which can be augmented by patient education and counseling. Available topical and surgical therapies vary widely in terms of cost, efficacy, adverse effects, dosage/frequency, and length of treatment. No one treatment is ideally suited to all patients or constitutes a gold standard. Treatment regimens must be tailored to each patient's needs and preferences. The health care provider's skills and experience will also factor into treatment decisions. In addition, the size, number, and location of lesions and whether the infection is new or recurrent will help guide the decision process toward the best treatment for a given patient.

  8. Report of an external basal annuloplasty device for mitral regurgitation (basal annuloplasty of the cardia externally device implantation

    Directory of Open Access Journals (Sweden)

    Milind Hote

    2015-01-01

    Full Text Available We report the successful implant of an external basal annuloplasty device (basal annuloplasty of the cardia externally, which is a dimethyl silicone band, slipped around the base of the heart at the atrioventricular groove and the sub-annular myocardium to provide external myocardial support and mitral annuloplasty. The patient had ischemic heart disease with moderate functional mitral regurgitation which was reduced to mild regurgitation. The patient underwent coronary artery bypass during the same surgery.

  9. External efficiency of schools in pre-vocational secondary education

    NARCIS (Netherlands)

    Timmermans, A. C.; Rekers-Mombarg, L. T. M.; Vreeburg, B. A. N. M.

    2016-01-01

    The extent to which students from a prevocational secondary school are placed in training programmes in senior secondary vocational education that match with their abilities can be estimated by an indicator called External Efficiency. However, estimating the external efficiency of secondary schools

  10. 77 FR 37879 - Cooperative Patent Classification External User Day

    Science.gov (United States)

    2012-06-25

    ... Patent and Trademark Office Cooperative Patent Classification External User Day AGENCY: United States Patent and Trademark Office, Commerce. ACTION: Notice. SUMMARY: The United States Patent and Trademark Office (USPTO) is hosting a Cooperative Patent Classification (CPC) External User Day event at...

  11. 21 CFR 870.3600 - External pacemaker pulse generator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External pacemaker pulse generator. 870.3600... pacemaker pulse generator. (a) Identification. An external pacemaker pulse generator is a device that has a power supply and electronic circuits that produce a periodic electrical pulse to stimulate the...

  12. Legal Obstacles to Comprehensive EU External Security Action

    NARCIS (Netherlands)

    Blockmans, S.; Spernbauer, M.

    2013-01-01

    Despite the unification of the EU legal order, the merger of external action objectives and the creation of hybrid coordination structures, the dichotomy between the CFSP and non-CFSP categories of EU external action has been maintained in the Lisbon Treaty. This article considers the legal implicat

  13. The external field dependence of the BCS critical temperature

    DEFF Research Database (Denmark)

    Frank, Rupert L.; Hainzl, Christian; Seiringer, Robert

    2016-01-01

    We consider the Bardeen-Cooper-Schrieffer free energy functional for particles interacting via a two-body potential on a microscopic scale and in the presence of weak external fields varying on a macroscopic scale. We study the influence of the external fields on the critical temperature. We show...

  14. High Power Diode Lasers with External Feedback: Overview and Prospects

    DEFF Research Database (Denmark)

    Chi, Mingjun; Petersen, Paul Michael

    2012-01-01

    In summary, different external-cavity feedback techniques to improve the spatial beam quality and narrow the linewidth of the output beam from both BALs and TDLs are presented. Broad-area diode laser system with external-cavity feedback around 800 nm can produce several Watts of output power...

  15. Spectral control of diode lasers using external waveguide circuits

    NARCIS (Netherlands)

    Oldenbeuving, Ruud

    2013-01-01

    We investigated spectral control of diode lasers using external waveguide circuits. The purpose of this work is to investigate such external control for providing a new class of diode lasers with technologically interesting properties, such as a narrow spectral bandwidth and spectrally tunable

  16. EXTERNAL BODY FORCE IN FINITE DIFFERENCE LATTICE BOLTZMANN METHOD

    Institute of Scientific and Technical Information of China (English)

    CHEN Sheng; LIU Zhao-hui; SHI Bao-chang; ZHENG Chu-guang

    2005-01-01

    A new finite difference lattice Boltzmann scheme is developed. Because of analyzing the influence of external body force roundly, the correct Navier-Stokes equations with the external body force are recovered, without any additional unphysical terms. And some numerical results are presented. The result which close agreement with analytical data shows the good performance of the model.

  17. Researching from within: External and Internal Ethical Engagement

    Science.gov (United States)

    Floyd, Alan; Arthur, Linet

    2012-01-01

    This article examines the superficial and deep ethical and moral dilemmas confronting "insider" researchers, which we term external and internal ethical engagement. External ethical engagement refers to the traditional, easily identifiable ethical issues that insider researchers attend to by submitting their application for ethical approval to…

  18. Spontaneous External Endometriosis in a Gorilla (Gorilla gorilla)

    OpenAIRE

    Doré, Monique; Lagacé, Andre

    1985-01-01

    The present report describes a case of external endometriosis in a 28 year old female gorilla (Gorilla gorilla). Microscopical examination of a pelvic mass observed at necropsy revealed ovarian tissue together with uterine glands and stroma, fibrous tissue and many siderophages. Theories of pathogenesis of external endometriosis are briefly reviewed.

  19. Chiral Symmetry Breaking in Planar QED in External Magnetic Fields

    CERN Document Server

    Cea, Paolo; Giudice, Pietro; Papa, Alessandro

    2012-01-01

    We investigate planar quantum electrodynamics (QED) with two degenerate staggered fermions in an external magnetic field on the lattice. We argue that in external magnetic fields there is dynamical generation of mass for two-dimensional massless Dirac fermions in the weak-coupling region. We extrapolate our lattice results to the quantum Hall effect in graphene.

  20. A Legal Institutional Perspective on the European External Action Service

    DEFF Research Database (Denmark)

    Van Vooren, Bart

    2011-01-01

    This article provides a legal perspective on the new European External Action Service (EEAS), and positions this new body in the reshuffled institutional balance of EU external relations. Towards that end, the paper examines the EEAS’ legal nature as compared to that of Council, Commission, their...

  1. External Representations for Data Distributions: In Search of Cognitive Fit

    Science.gov (United States)

    Lem, Stephanie; Onghana, Patrick; Verschaffel, Lieven; Van Dooren, Wim

    2013-01-01

    Data distributions can be represented using different external representations, such as histograms and boxplots. Although the role of external representations has been extensively studied in mathematics, this is less the case in statistics. This study helps to fill this gap by systematically varying the representation that accompanies a task…

  2. Unilateral external ophthalmoplegia in Miller Fisher syndrome: case report

    Directory of Open Access Journals (Sweden)

    Severn Philip

    2007-04-01

    Full Text Available Abstract Background A description of the diagnostic features of Miller Fisher syndrome. Case presentation The clinical presentation, investigation, and subsequent progress of our patient with clinical unilateral external ophthalmoplegia. Conclusion Our case demonstrates the presentation of clinical unilateral external ophthalmoplegia as part of the full triad of Miller Fisher syndrome.

  3. Spectral control of diode lasers using external waveguide circuits

    NARCIS (Netherlands)

    Oldenbeuving, R.M.

    2013-01-01

    We investigated spectral control of diode lasers using external waveguide circuits. The purpose of this work is to investigate such external control for providing a new class of diode lasers with technologically interesting properties, such as a narrow spectral bandwidth and spectrally tunable outpu

  4. Multidisciplinary Health Services as External Agents of Change

    DEFF Research Database (Denmark)

    Westerholm, Peter; Hasle, Peter; Fortuin, Rick

    2000-01-01

    A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises.......A discussion of the possibilities for professionals from the occupational health service to act as external agents of change in introducing preventive activities in enterprises....

  5. Evolution of Externally Excited Convective Cells in Plasmas

    DEFF Research Database (Denmark)

    Sugai, H.; Juul Rasmussen, Jens; Thomsen, Kenneth

    1983-01-01

    Convective cells are excited externally in a fully ionized magnetized plasma, and their space-time evolution is investigated by two-dimensional potential measurements. A positive cell is excited externally in the `scrape-off' layer of a plasma column produced by surface ionization. Its interaction...

  6. External Dynamics Influencing Tattooing among College Students: A Qualitative Analysis

    Science.gov (United States)

    Firmin, Michael; Tse, Luke; Foster, Janna; Angelini, Tammy

    2012-01-01

    The study utilized qualitative research methodology to assess external dynamics and their influences on tattooing practices among college students. Twenty-four undergraduates supplied in-depth interviews regarding the external variables related to college students' decisions to tattoo. The present research follows (Tse, Firmin, Angelini, &…

  7. External Dynamics Influencing Tattooing among College Students: A Qualitative Analysis

    Science.gov (United States)

    Firmin, Michael; Tse, Luke; Foster, Janna; Angelini, Tammy

    2012-01-01

    The study utilized qualitative research methodology to assess external dynamics and their influences on tattooing practices among college students. Twenty-four undergraduates supplied in-depth interviews regarding the external variables related to college students' decisions to tattoo. The present research follows (Tse, Firmin, Angelini, &…

  8. Vehicle Fuel-Efficiency Choices, Emission Externalities, and Urban Sprawl

    DEFF Research Database (Denmark)

    Kim, Jinwon

    of excessive sprawl arising from emission externalities is the uses of larger and less-fuel efficient vehicles by suburban residents, which is different from that of congestion externalities. We also analyze the effect of the Corporate Average Fuel Efficiency (CAFE) regulation on the urban spatial structure....

  9. External Dynamics Influencing Tattooing among College Students: A Qualitative Analysis

    Science.gov (United States)

    Firmin, Michael; Tse, Luke; Foster, Janna; Angelini, Tammy

    2012-01-01

    The study utilized qualitative research methodology to assess external dynamics and their influences on tattooing practices among college students. Twenty-four undergraduates supplied in-depth interviews regarding the external variables related to college students' decisions to tattoo. The present research follows (Tse, Firmin, Angelini, & Foster,…

  10. 21 CFR 878.3750 - External prosthesis adhesive.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false External prosthesis adhesive. 878.3750 Section 878.3750 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... adhesive. (a) Identification. An external prosthesis adhesive is a silicone-type adhesive intended to...

  11. Temperament profiles associated with internalizing and externalizing problems in preadolescence

    NARCIS (Netherlands)

    Oldehinkel, Albertine J.; Hartman, Catharina A.; Winter, Andrea F. de; Veenstra, René; Ormel, Johan

    2004-01-01

    This study investigates how temperament factors are linked to internalizing and externalizing problems in a Dutch population sample of preadolescents (N = 2230). Internalizing and externalizing problems were assessed by the Child Behavior Checklist and the Youth Self-Report and temperament was evalu

  12. Instructions to Adopt an External Focus Enhance Muscular Endurance

    Science.gov (United States)

    Marchant, David C.; Greig, Matt; Bullough, Jonathan; Hitchen, Daniel

    2011-01-01

    The influence of internal (movement focus) and external (outcome focus) attentional-focusing instructions on muscular endurance were investigated using three exercise protocols with experienced exercisers. Twenty-three participants completed a maximal repetition, assisted bench-press test on a Smith's machine. An external focus of attention…

  13. Separation of the Magnetic Field into External and Internal Parts

    DEFF Research Database (Denmark)

    Olsen, Nils; Glassmeier, K.-H.; Jia, X.

    2010-01-01

    The magnetic field of a planet or a planetary moon contains contributions from a variety of sources in the environment of the body (external sources) and its interior (internal sources). This chapter describes different methods that have been developed for the separation of external and internal...

  14. Southwick Osteotomy Stabilised with External Fixator

    Science.gov (United States)

    Grubor, Predrag; Mitkovic, Milorad; Grubor, Milan

    2014-01-01

    ABSTRACT Introduction: Epiphysiolysis of the femoral head is the most common accident occurring towards the end of pre-puberty and puberty growth. Case report: The author describes the experience in the treatment of chronic epiphysiolysis in two patients treated by Southwick osteotomy. The site is accessed by way of a 15-cm long lateral skin incision and the trochanteric region is reached through the layers. The osteotomy angles prepared beforehand on a thin aluminium model are used to mark the Southwick osteotomy site on the anterior and lateral sides at the level of the lesser trochanter. Before performing the trochanteric osteotomy, two Mitković convergent pins type M20 are applied distally and proximally, above the planned osteotomy site. A tenotomy of the iliopsas muscle is performed, and then the previously marked bone triangle is redissected up to three quarters of the width of the femur. The distal part of the femur is rotated inwards, so that the patella is turned towards the ceiling. The osteotomised fragments of the femur are adapted, repositioned and fixated by installing an external fixator on the previously placed pins. Two more pins are placed, one proximally and one distally, with a view to adequately stabilising the femur. The patient was mobile from day two after the surgery. If, after the surgery, the lead surgeon realises that there is a requirement to make a correction of 5, 10 and 15 degrees of the valgus, varus, anteversion or retroversion deformity, the correction shall be performed without surgically opening the patient, using the fixator pins. Conclusion: After performing a Southwick osteotomy it is easier to adapt, reposition and fixate the osteotomised fragments of the femur using a fixator type M20. Adequate stability allows regaining mobility quickly, which in turn is the best prevention of chondrolysis of the hip. It is possible to make post-operative valgus, varus, anteversion and retroversion corrections of 5, 10 and 15 degrees

  15. Radiology of external ear: indications, normal anatomy, and pathological processes.

    Science.gov (United States)

    Mazón, M; Pont, E; Montesinos, P; Carreres-Polo, J; Más-Estellés, F

    2016-01-01

    The external ear is accessible to direct examination; the clinical history and otoscopy are sufficient to diagnose and treat most diseases of the external ear. We aim to describe the normal anatomy of the external ear, specify the indications for imaging tests, and review the clinical and radiological manifestations of the most common diseases affecting the external ear. We classify these diseases according to their origin into congenital, inflammatory, infectious, or traumatic disease or benign bone tumors or malignant tumors. Imaging does not play an important role in diseases of the external ear, but in certain clinical scenarios it can be crucial for reaching a concrete diagnosis and establishing the best treatment. Computed tomography is the first-choice technique for most diseases. Magnetic resonance imaging complements computed tomography and makes it possible to differentiate among different tissue types and to evaluate the extension of disease accurately.

  16. External doses from radioactive fallout. Dosimetry and levels

    Energy Technology Data Exchange (ETDEWEB)

    Woehni, T.

    1995-12-31

    The design, manufacture and calibration of a TL-based dosemeter for measurement of low level external photon radiation are presented. The dosemeter is based on CaF{sub 2} with 2 mm brass filter for energy compensation. It is able to resolve a 8% dose increase relative to natural background radiation. With this dosemeter external dose measurements were made in 6 villages in a heavily contaminated region in Russia (Chernobyl fallout), in order to assess external doses to the population. The results were analyzed in the light of additional existing information on radioactive deposition, social habits, decontamination measures and other influencing technical and physical factors. The observed dose values were lower than theoretical estimates of external doses based on published values for external dose levels relative to the level of contamination. 84 refs., 7 figs., 5 tabs.

  17. Externalizing behaviors of Ukrainian children: The role of parenting.

    Science.gov (United States)

    Burlaka, Viktor

    2016-04-01

    The purpose of this study was to assess the association of positive and negative parenting with child externalizing problems. Quantitative data were collected during face-to-face interviews with 320 parents of children 9-16 years of age (50% males) in 11 communities in Eastern, Southern, and Central Ukraine. The study estimated the relationship between parenting practices and child externalizing behaviors such as aggression, delinquency, and attention problems. Results revealed that positive parenting, child monitoring, and avoidance of corporal punishment were associated with fewer child externalizing symptoms. Results also indicated that child male gender and single parenting had significant and positive association with child externalizing behaviors. This study extends international psychosocial knowledge on children and families. These findings can be used to design programs and foster dialogs about the role of family and social environments in the development of externalizing disorder among researchers, representatives of governmental and nongovernmental organizations, and mass media that work with child abuse prevention in Ukraine.

  18. Calculation of freight externality costs for South Africa

    Directory of Open Access Journals (Sweden)

    Stefaan Swarts

    2012-11-01

    Full Text Available The purpose of this study is to quantify the marginal external costs associated with freight transport in South Africa. Six cost elements are included as externality cost items, namely, costs related to accidents, emissions, roadway land availability, policing, noise and congestion. Inputs in the calculations were a gravity-oriented freight flow model, a road transport cost model, actual transport costs for other modes, a warehousing cost survey, an inventory delay calculation and various national sources of information such as accident statistics and government budgets. Estimation techniques resulted in advances for externality cost measurement in South Africa. The quantification of the cost elements will be used to update the South African Freight Demand Model. The results show that the cost of transportation would have been 20% more if external factors were taken into account. The marginal rates of externalities can be used to develop scenarios based on alternative choices for South Africa's freight transport infrastructure configuration.

  19. External Tank Program - Legacy of Success

    Science.gov (United States)

    Pilet, Jeffery C.; Diecidue-Conners, Dawn; Worden, Michelle; Guillot, Michelle; Welzyn, Kenneth

    2011-01-01

    The largest single element of Space Shuttle is the External Tank (ET), which serves as the structural backbone of the vehicle during ascent and provides liquid propellants to the Orbiter s three Main Engines. The ET absorbs most of the seven million pounds of thrust exerted by the Solid Rocket Boosters and Main Engines. The design evolved through several block changes, reducing weight each time. Because the tank flies to orbital velocity with the Space Shuttle Orbiter, minimization of weight is mandatory, to maximize payload performance. The initial configuration, the standard weight tank, weighed 76,000 pounds and was an aluminum 2219 structure. The light weight tank weighed 66,000 pounds and flew 86 missions. The super light weight tank weighed 58,500 pounds and was primarily an aluminum-lithium structure. The final configuration and low weight enabled system level performance sufficient for assembly of the International Space Station in a high inclination orbit, vital for international cooperation. Another significant challenge was the minimization of ice formation on the cryogenic tanks. This was essential due to the system configuration and the choice of ceramic thermal protection system materials on the Orbiter. Ice would have been a major debris hazard. Spray on foam insulation materials served multiple functions including thermal insulation, conditioning of cryogenic propellants, and thermal protection for the tank structure during ascent and entry. The tank is large, and unique manufacturing facilities, tooling, and handling, and transportation operations were developed. Weld processes and tooling evolved with the design as it matured through several block changes. Non Destructive Evaluation methods were used to assure integrity of welds and thermal protection system materials. The aluminum-lithium alloy was used near the end of the program and weld processes and weld repair techniques had to be refined. Development and implementation of friction stir

  20. COOPERATION AND COORDINATION BETWEEN INTERNAL AND EXTERNAL AUDITING

    Directory of Open Access Journals (Sweden)

    DIANA DUMITRESCU

    2016-02-01

    Full Text Available Between external and internal auditors it is necessary to be a good cooperation and coordination; both professionals have to be involved in building a good working relationship. Objectives of the external and internal auditors are different from the company point of view, but in the achievement of the specific goals, there are interactions and work cooperation. If the internal auditors work together with the external auditors the results will be an increasing of the quality and the effectiveness of the organization`s systems and activities. If the external auditors work together with the internal auditors will result a decreasing of the amount of the testing they do, and as consequences’ a reducing of the fees. Because there are many benefits of the cooperation between external and internal auditing it is important to find out how could be coordinated these two professional activities. This study has the purpose to examine the most important provisions that promote such kind of cooperation and work like necessary tools for coordination and to identify the Romanian`s internal and external auditors perceptions regarding that cooperation and coordination. The objective of the study is to identify the nature of the relationship between the internal audit function and the organizations’ external auditors regarding their interactions and their cooperation.

  1. EXTERNAL DEBTS SUSTAINABILITY, IMF POLICIES EFFECT AND TURKEY SAMPLE

    Directory of Open Access Journals (Sweden)

    Faik A EL K

    2008-10-01

    Full Text Available It is generally recognized that developing countries need substantial amounts of net transfer of resources at early stages of development in order to close their savings and foreign exchange gaps. External3 borrowing is a core element in nearly all developing countries’ development strategies. Foreign loans can be used to finance public spending aimed at increasing growth, development, and security. Debt sustainability and holding the debt burden at a reasonable level are the two main cornerstones of achieving macroeconomic stability. Solvency is derived from the intertemporal budget constraint which shows sustainability of current policies. Generally, when the expected value of the future resources devoted to debt service equals the current debt stock, solvency condition is satisfied. Developing countries\\' debt is external debt incurred by Third World countries, generally in quantities beyond that country\\'s ability to repay. Unpayable debt is a term used to describe external debt where the interest on the debt exceeds the amount that the country produces, thus preventing the debt ever being repaid. IMF’ policies through to the World Economy have been changed in the globalization processes. Those policies have been applied in different countries When Turkish economy is taken into consideration it is seen that; it has high debt stocks, the need of external debt continues to increase and the external debt indicators give rise to the anxieties about the issue of external debt sustainability. This paper responds to take forward on external debt-related vulnerabilities and balance sheet risks.

  2. The effect of childhood malnutrition on externalizing behavior.

    Science.gov (United States)

    Liu, Jianghong; Raine, Adrian

    2006-10-01

    Childhood externalizing behavior (aggression, hyperactivity, and conduct disorder) has been increasingly viewed as a public health problem because of its etiology and outcome. The association between malnutrition and externalizing behavior has begun to receive attention. This review summarizes recent empirical findings on malnutrition as a risk factor for the development of externalizing behavior, with an emphasis on micronutrient deficiency, and explores brain dysfunction as a possible mechanism. Externalizing behavior is associated with both macromalnutrition (e.g. protein) and micromalnutrition (e.g. iron and zinc). Both prenatal and postnatal malnutrition is implicated. The long-term effects of malnutrition on behavior could be reversible. The effects of docosahexaenoic acid/omega-3 long-chain essential fatty acid on externalizing behavior are more mixed. From animal and human findings, it is hypothesized that malnutrition impairs neurocognitive functioning by reducing neurons, alternating neurotransmitter functioning, and increasing neurotoxicity, and that such neurocognitive impairments predispose to externalizing behavior. Different lines of evidence support the view that poor nutrition contributes to the development of child behavior problems. More randomized, controlled trials that manipulate nutritional intake and evaluate behavior in children are needed to evaluate the etiological role of nutrition in externalizing behavior in order to inform intervention and prevention efforts.

  3. Estimating Externalities of Natural Gas Fuel Cycles, Report 4

    Energy Technology Data Exchange (ETDEWEB)

    Barnthouse, L.W.; Cada, G.F.; Cheng, M.-D.; Easterly, C.E.; Kroodsma, R.L.; Lee, R.; Shriner, D.S.; Tolbert, V.R.; Turner, R.S.

    1998-01-01

    This report describes methods for estimating the external costs (and possibly benefits) to human health and the environment that result from natural gas fuel cycles. Although the concept of externalities is far from simple or precise, it generally refers to effects on individuals' well being, that result from a production or market activity in which the individuals do not participate, or are not fully compensated. In the past two years, the methodological approach that this report describes has quickly become a worldwide standard for estimating externalities of fuel cycles. The approach is generally applicable to any fuel cycle in which a resource, such as coal, hydro, or biomass, is used to generate electric power. This particular report focuses on the production activities, pollution, and impacts when natural gas is used to generate electric power. In the 1990s, natural gas technologies have become, in many countries, the least expensive to build and operate. The scope of this report is on how to estimate the value of externalities--where value is defined as individuals' willingness to pay for beneficial effects, or to avoid undesirable ones. This report is about the methodologies to estimate these externalities, not about how to internalize them through regulations or other public policies. Notwithstanding this limit in scope, consideration of externalities can not be done without considering regulatory, insurance, and other considerations because these institutional factors affect whether costs (and benefits) are in fact external, or whether they are already somehow internalized within the electric power market. Although this report considers such factors to some extent, much analysis yet remains to assess the extent to which estimated costs are indeed external. This report is one of a series of reports on estimating the externalities of fuel cycles. The other reports are on the coal, oil, biomass, hydro, and nuclear fuel cycles, and on general

  4. External urethral sphincter pressure measurement: an accurate method for the diagnosis of detrusor external sphincter dyssynergia?

    Directory of Open Access Journals (Sweden)

    Carlos H Suzuki Bellucci

    Full Text Available BACKGROUND: Combined pelvic floor electromyography (EMG and videocystourethrography (VCUG during urodynamic investigation are the most acceptable and widely agreed methods for diagnosing detrusor external sphincter dyssynergia (DESD. Theoretically, external urethral sphincter pressure (EUSP measurement would provide enough information for the diagnosis of DESD and could simplify the urodynamic investigation replacing combined pelvic floor EMG and VCUG. Thus, we evaluated the diagnostic accuracy of EUSP measurement for DESD. PATIENTS #ENTITYSTARTX00026; METHODS: A consecutive series of 72 patients (36 women, 36 men with neurogenic lower urinary tract dysfunction able to void spontaneously was prospectively evaluated at a single university spinal cord injury center. Diagnosis of DESD using EUSP measurement (index test versus combined pelvic floor EMG and VCUG (reference standard was assessed according to the recommendations of the Standards for Reporting of Diagnostic Accuracy Initiative. RESULTS: Using EUSP measurement (index test and combined pelvic floor EMG and VCUR (reference standard, DESD was diagnosed in 10 (14% and in 41 (57% patients, respectively. More than half of the patients presented discordant diagnosis between the index test and the reference standard. Among 41 patients with DESD diagnosed by combined pelvic floor EMG and VCUR, EUSP measurement identified only 6 patients. EUSP measurement had a sensitivity of 15% (95% CI 5%-25%, specificity of 87% (95% CI 76%-98%, positive predictive value of 60% (95% CI 30%-90%, and negative predictive value of 56% (95% CI 44%-68% for the diagnosis of DESD. CONCLUSIONS: For diagnosis of DESD, EUSP measurement is inaccurate and cannot replace combined pelvic floor EMG and VCUR.

  5. Quantum mechanics in strong time dependent external fields

    Energy Technology Data Exchange (ETDEWEB)

    Pomeau, Y.

    1986-01-01

    In quantum mechanics, time dependent Hamiltonians are most often studied by perturbation methods, the amplitude of the unsteady force being assumed to be small. On two examples (two level system with a large time dependent coupling, and atoms in large external unsteady field). I show that the opposite limit (large time dependent field) can be analyzed in some details too. For a particle in a central potential and submitted to a large periodic external field, one is led to make a Kapitza averaging because the intrinsic frequency tends to zero when the external field diverges. In that way one has to introduce a steady effective potential with singular turning points.

  6. Using Reframing in the External Communication Process of the Organization

    Directory of Open Access Journals (Sweden)

    Cornel Marian Iosif

    2014-07-01

    Full Text Available Any organization, in order to avoid an information attack from the external environment, creates connections with key persons: leaders of opinion, administrators of rival companies, local officials. There are three types of external communication: operational, strategic and promotional. In the communication process there are at least three categories of barriers: language barriers, perception and environment barriers. Using reframing in the external communication allows its adjustment and optimization in order to send a certain message as correctly as possible. Using reframing allows for a certain situation to be approaches from different angles, it allows a better adaptation of the employees‘ behaviours to the environment, of the organization or customers‘ needs.

  7. Equatorial Rossby Solitary Wave Under the External Forcing

    Institute of Scientific and Technical Information of China (English)

    FU Zun-Tao; LIU Shi-Kuo; LIU Shi-Da

    2005-01-01

    A simple shallow-water model with influence of external forcing on a β-plane is applied to investigate the nonlinear equatorial Rossby waves in a shear flow. By the perturbation method, the extended variable-coefficient KdV equation under an external forcing is derived for large amplitude equatorial Rossby wave in a shear flow. And then various periodic-like structures for these equatorial Rossby waves are obtained with the help of Jacobi elliptic functions.It is shown that the external forcing plays an important role in various periodic-like structures.

  8. The current density in quantum electrodynamics in external potentials

    Energy Technology Data Exchange (ETDEWEB)

    Schlemmer, Jan, E-mail: jan.schlemmer@univie.ac.at [Fakultät für Physik, Universität Wien, Boltzmanngasse 5, 1090 Wien (Austria); Zahn, Jochen, E-mail: jochen.zahn@itp.uni-leipzig.de [Institut für Theoretische Physik, Universität Leipzig, Brüderstr. 16, 04103 Leipzig (Germany)

    2015-08-15

    We review different definitions of the current density for quantized fermions in the presence of an external electromagnetic field. Several deficiencies in the popular prescription due to Schwinger and the mode sum formula for static external potentials are pointed out. We argue that Dirac’s method, which is the analog of the Hadamard point-splitting employed in quantum field theory in curved space–times, is conceptually the most satisfactory. As a concrete example, we discuss vacuum polarization and the stress–energy tensor for massless fermions in 1+1 dimension. Also a general formula for the vacuum polarization in static external potentials in 3+1 dimensions is derived.

  9. External iliac artery dissection secondary to endofibrosis in a cyclist.

    Science.gov (United States)

    Willson, Thomas D; Revesz, Elizabeth; Podbielski, Francis J; Blecha, Matthew J

    2010-07-01

    Endofibrosis of the external iliac artery is an uncommon disease affecting primarily young, otherwise healthy, endurance athletes. Thigh pain during maximal exercise with quick resolution postexercise is characteristic of the so-called cyclist's iliac syndrome. We report an unusual case in which the typical endofibrotic plaque was accompanied by dissection of the external iliac artery. The patient was treated surgically with excision of the affected artery segment and placement of an interposition graft. This case highlights an unusual finding in association with external iliac artery endofibrosis and provides an opportunity to briefly review the literature on the subject.

  10. Problems with plastered external heat insulation. Probleme mit verputzter Aussenwaermedaemmung

    Energy Technology Data Exchange (ETDEWEB)

    Epple, H.; Foglia, A.; Preisig, H.; Pfefferkorn, J.

    1984-01-01

    Concerning execution, maintenance and service life, walls with plastered external heat insulation constitute an economic method. Owing to experience gained with plastered external heat insulation, it is possible today to provide reliable information on requirements made on ground material and operational execution. The author intends to contribute to a prevention of defects by giving concise examples. A survey on different types of external heat insulation is followed by a treatment of the problem areas of roof-edge connection, base end under ground, modernization of old buildings and cracks in plaster. Principal statements are made concerning steam diffusion, planning, materials and execution.

  11. External Service Providers to the National Security Technology Incubator

    Energy Technology Data Exchange (ETDEWEB)

    None

    2008-02-28

    This report documents the identification and assessment of external service providers to the National Security Technology Incubator (NSTI) program for southern New Mexico. The NSTI is being developed as part of the National Security Preparedness Project (NSPP), funded by a Department of Energy (DOE)/National Nuclear Security Administration (NNSA) grant to Arrowhead Center, New Mexico State University. This report contains 1) a summary of the services to be provided by NSTI; 2) organizational descriptions of external service providers; and 3) a comparison of NSTI services and services offered by external providers.

  12. Optimal condition of memristance enhancement circuit using external voltage source

    Directory of Open Access Journals (Sweden)

    Hiroya Tanaka

    2014-05-01

    Full Text Available Memristor provides nonlinear response in the current-voltage characteristic and the memristance is modulated using an external voltage source. We point out by solving nonlinear equations that an optimal condition of the external voltage source exists for maximizing the memristance in such modulation scheme. We introduce a linear function to describe the nonlinear time response and derive an important design guideline; a constant ratio of the frequency to the amplitude of the external voltage source maximizes the memristance. The analysis completely accounts for the memristance behavior.

  13. Geodesic Witten diagrams with an external spinning field

    Science.gov (United States)

    Nishida, Mitsuhiro; Tamaoka, Kotaro

    2017-05-01

    We explore AdS/CFT correspondence between geodesic Witten diagrams and conformal blocks (conformal partial waves) with an external symmetric traceless tensor field. We derive an expression for the conformal partial wave with an external spin-1 field and show that this expression is equivalent to the amplitude of the geodesic Witten diagram. We also show the equivalence by using a conformal Casimir equation in embedding formalism. Furthermore, we extend the construction of the amplitude of the geodesic Witten diagram to an external arbitrary symmetric traceless tensor field. We show that our construction agrees with the known result of the conformal partial waves.

  14. Geodesic Witten diagrams with an external spinning field

    CERN Document Server

    Nishida, Mitsuhiro

    2016-01-01

    We explore AdS/CFT correspondence between geodesic Witten diagrams and conformal blocks (conformal partial waves) with an external symmetric traceless tensor field. We derive an expression for the conformal partial wave with an external spin-1 field and show that this expression is equivalent to the amplitude of the geodesic Witten diagram. We also show the equivalence by using conformal Casimir equation in embedding formalism. Furthermore, we extend the construction of the amplitude of the geodesic Witten diagram to an external arbitrary symmetric traceless tensor field. We show our construction agrees with the known result of the conformal partial waves.

  15. External debt in developing economies: assessment and policy issues

    Directory of Open Access Journals (Sweden)

    Márcio Holland

    2007-01-01

    Full Text Available More than one decade after the external debt restructuring (the Brady Plan, a great amount of literature has been published concerning the balance sheet factors in developing countries. The staff of international multilateral institutions joined with reputable academics in this great controversy. The external debt problem of the developing countries is back and once more reflections on its cause and on policy recommendations are analytically distinct. Our main task is to reflect on the recent external debt dynamics and assess how this debt has evolved. Our findings indicate that the susceptibility of some developing countries to default is associated with global imbalance, that is, the way they borrow.

  16. Racing to define pharmaceutical R&D external innovation models.

    Science.gov (United States)

    Wang, Liangsu; Plump, Andrew; Ringel, Michael

    2015-03-01

    The pharmaceutical industry continues to face fundamental challenges because of issues with research and development (R&D) productivity and rising customer expectations. To lower R&D costs, move beyond me-too therapies, and create more transformative portfolios, pharmaceutical companies are actively capitalizing on external innovation through precompetitive collaboration with academia, cultivation of biotech start-ups, and proactive licensing and acquisitions. Here, we review the varying innovation strategies used by pharmaceutical companies, compare and contrast these models, and identify the trends in external innovation. We also discuss factors that influence these external innovation models and propose a preliminary set of metrics that could be used as leading indicators of success.

  17. Comparison of binaural microphones for externalization of sounds

    DEFF Research Database (Denmark)

    Cubick, Jens; Sánchez Rodríguez, C.; Song, Wookeun

    2015-01-01

    or with microphones placed inside the ear canals of a person. In this study, binaural room impulse responses (BRIRs) were measured with several commercially available binaural microphones, both placed inside the listeners’ ears (individual BRIR) and on a head and torso simulator (generic BRIR). The degree...... of externalization of speech and noise stimuli was tested in a listening experiment with a multi-stimulus test. No influence was found for the stimulus signal, but the externalization scores were found to be lower for 0◦ incidence. With all microphones, relatively high externalization scores were achieved...

  18. EDITORIAL: Colloidal dispersions in external fields Colloidal dispersions in external fields

    Science.gov (United States)

    Löwen, Hartmut

    2012-11-01

    Colloidal dispersions have long been proven as pivotal model systems for equilibrium phase transition such as crystallization, melting and liquid-gas phase transition. The last decades have revealed that this is also true for nonequilibrium phenomena. In fact, the fascinating possibility to track the individual trajectories of colloidal particles has greatly advanced our understanding of collective behaviour in classical many-body systems and has helped to reveal the underlying physical principles of glass transition, crystal nucleation, and interfacial dynamics (to name just a few typical nonequilibrium effects). External fields can be used to bring colloids out of equilibrium in a controlled way. Different kinds of external fields can be applied to colloidal dispersions, namely shear flow, electric, magnetic and laser-optical fields, and confinement. Typical research areas can be sketched with the by now traditional complexity diagram (figure 1). The complexity of the colloidal system itself as embodied in statistical degrees of freedom is shown on the x-axis while the complexity of the problem posed, namely bulk, an inhomogeneity in equilibrium, steady state nonequilibrium and full time-dependent nonequilibrium are shown on the y-axis. The different external fields which can be imposed are indicated by the different hatched areas. figure1 Figure 1. Diagram of complexity for colloidal dispersions in external fields: while the x-axis shows the complexity of the system, the y-axis shows the complexity of the problem. Regions which can be accessed by different kinds of external fields are indicated. The arrows indicate recent research directions. Active particles are also indicated with a special complexity of internal degrees of freedom [1]. This collection of papers reflects the scientific programme of the International Conference on Colloidal Dispersions in External Fields III (CODEF III) which took place in Bonn-Bad Godesberg from 20-23 March 2012. This was the

  19. Electricity generation and environmental externalities: Case studies, September 1995

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-09-28

    Electricity constitutes a critical input in sustaining the Nation`s economic growth and development and the well-being of its inhabitants. However, there are byproducts of electricity production that have an undesirable effect on the environment. Most of these are emissions introduced by the combustion of fossil fuels, which accounts for nearly 70 percent of the total electricity generated in the United States. The environmental impacts (or damages) caused by these emissions are labeled environmental ``externalities.`` Included in the generic term ``externality`` are benefits or costs resulting as an unintended byproduct of an economic activity that accrue to someone other than the parties involved in the activity. This report provides an overview of the economic foundation of externalities, the Federal and State regulatory approaches, and case studies of the impacts of the externality policies adopted by three States.

  20. Is external memory memory? Biological memory and extended mind.

    Science.gov (United States)

    Michaelian, Kourken

    2012-09-01

    Clark and Chalmers (1998) claim that an external resource satisfying the following criteria counts as a memory: (1) the agent has constant access to the resource; (2) the information in the resource is directly available; (3) retrieved information is automatically endorsed; (4) information is stored as a consequence of past endorsement. Research on forgetting and metamemory shows that most of these criteria are not satisfied by biological memory, so they are inadequate. More psychologically realistic criteria generate a similar classification of standard putative external memories, but the criteria still do not capture the function of memory. An adequate account of memory function, compatible with its evolution and its roles in prospection and imagination, suggests that external memory performs a function not performed by biological memory systems. External memory is thus not memory. This has implications for: extended mind theorizing, ecological validity of memory research, the causal theory of memory.

  1. Estimating Externalities of Coal Fuel Cycles, Report 3

    Energy Technology Data Exchange (ETDEWEB)

    Barnthouse, L.W.; Cada, G.F.; Cheng, M.-D.; Easterly, C.E.; Kroodsma, R.L.; Lee, R.; Shriner, D.S.; Tolbert, V.R.; Turner, R.S.

    1994-09-01

    The agreement between the US DOE and the EC established the specific objectives of the study: (a) to develop a methodological framework that uses existing data and models to quantify the external costs and benefits of energy; (b) to demonstrate the application of the framework to estimate the externalities of the coal, biomass, oil, natural gas, hydro, nuclear, photovoltaic, and wind fuel cycles (by agreement with the EC, the US addressed the first six of these); and (c) to identify major gaps in the availability of information to quantify impacts, damages, benefits, and externalities of fuel cycles; and to suggest priorities for future research. The main consideration in defining these objectives was a desire to have more information about externalities, and a better method for estimating them.

  2. Interpreting debris from satellite disruption in external galaxies

    NARCIS (Netherlands)

    Johnston, KV; Sackett, PD; Bullock, JS

    2001-01-01

    We examine the detectability and interpretation of debris trails caused by satellite disruption in external galaxies using semianalytic approximations for the dependence of streamer length, width, and surface brightness on satellite and primary galaxy characteristics. The semianalytic method is test

  3. Summary of External Peer Review and Public Comments and Disposition

    Science.gov (United States)

    This document summarizes the public and external peer review comments that the EPA’s Office of Pollution Prevention and Toxics (OPPT) received for the draft work plan risk assessment for n-Methylpyrrolidone (NMP).

  4. Does Monetary Policy Have Expansionary Bias with External Wealth?

    OpenAIRE

    Takamatsu, Satoko

    2008-01-01

    This paper investigates how the accumulation of external wealth affects a monetary policy. We demonstrate that though an expansionary bias emerges in a monetary policy, a fiscal method can eliminate such a bias.

  5. Outcome of complex tibial plateau fractures treated with external fixator

    Directory of Open Access Journals (Sweden)

    Sushil H Mankar

    2012-01-01

    Conclusion: We believe that minimally invasive treatment by percutaneous techniques and external fixation is a fairly reasonable treatment alternative, if near anatomical reduction of joint surface can be confirmed on fluoroscopy.

  6. External factors influencing the environmental performance of South African firms

    CSIR Research Space (South Africa)

    Peart, R

    2001-01-01

    Full Text Available This article reviews the external factors that influence environmental performance of companies in South Africa, drawing on international and local literature. After considering factors within the natural, social, economic and institutional...

  7. External knowledge search and use in new product development

    NARCIS (Netherlands)

    Peeters, T.J.G.

    2013-01-01

    With rapidly shifting technological frontiers, innovative organizations cannot rely solely on internally generated knowledge and technologies anymore. Therefore, externally developed knowledge and technologies are getting more and more important in the development of new products. Not surprisingly,

  8. IRIS Toxicological Review of Methanol (Noncancer) (Revised External Review Draft)

    Science.gov (United States)

    EPA is seeking additional public comment and external peer review of the scientific basis supporting the human health hazard and dose-response assessment of methanol (noncancer). Teleconference Details: The public may participate in th...

  9. Mindfulness training for adolescents with externalizing disorders and their parents

    NARCIS (Netherlands)

    Bögels, S.M.; Hoogstad, B.; van Dun, L.; de Schutter, S.E.R.; Restifo, K.

    2008-01-01

    Mindfulness training was evaluated as a new treatment for attention and impulsivity problems in adolescents with a variety of different externalizing disorders: attention deficithyperactivity disorder, oppositional-defiant and/or conduct disorder, and autism spectrum disorder if characterized by

  10. EXTERNAL EVALUATION OF LEARNING AS A GUARANTEE OF QUALITY EDUCATION

    Directory of Open Access Journals (Sweden)

    José Mª Arribas Estebaranz

    2014-12-01

    Almost all countries and all reports use contemplated, in varying degrees, the always-complementary external evaluation by the teachers-as an essential guarantee of educational quality at different levels of detail curriculum evaluation.

  11. On the Structure of Quantum Gauge Theories with External Fields

    CERN Document Server

    Falkenberg, S; Lavrov, P M; Moshin, P

    1998-01-01

    We consider generating functionals of Green's functions with external fields in the framework of BV and BLT quantization schemes for general gauge theories. The corresponding Ward identities are obtained, and the gauge dependence is studied.

  12. Buckling of elliptical rings under uniform external pressure

    Energy Technology Data Exchange (ETDEWEB)

    Tang, Y.

    1991-04-03

    A thin, elastic elliptical ring is subjected to uniform external pressure. The lowest critical pressure is computed and presented for various ratio of the major axis to the minor axis of the elliptical ring. It is found that the critical pressure for an elliptical ring is higher than that for the circular ring whose diameter is equal to the major axis of the elliptical ring. It can be shown that under the same external pressure, the axial force developed in the elliptical ring is less than that developed in the corresponding circular ring. Thus, a higher pressure is required to buckle the elliptical rings. Therefore, by changing the shape of the ring from circular to elliptical, the capability of the ring to sustain the external pressure can be increased substantially. The results of this study can be useful in the design of elliptical reinforcing rings and thin-walled tubes subjected to external pressure.

  13. failure analysis and shock protection of external hard disk drive

    African Journals Online (AJOL)

    user

    Technology for processing and storage of data in portable external storage hard disks has ... system was used to simulate the impact of stress on the structure of the hard disk before and ... highlighted [1] that mechanical vibration and shock.

  14. Design of a Typical Offshore Transportation System for External Corrosion

    Directory of Open Access Journals (Sweden)

    Shittu, A. A

    2016-07-01

    Full Text Available The external corrosion assessment of a typical offshore transportation system has been presented. Cathodic protection design was carried out for the pipeline and it was found that a bracelet square weld on anode of L = 195, G =101.6 , Thickness = 70, M = 149.75 , ∅ = 1.2235, N = 128 and s = 300was found to be satisfactory in providing secondary/ backup protection for the 48inchespipeline in the external environment provided. The external anticorrosion coating selected is the Three layer polyethylene (3LPE coating based on the dimensions of the pipeline and the design temperature of 80℃. The 3LPE external corrosioncoating will comprise of an inner layer fusion bond epoxy, a middle layer: adhesive and an outer layer: High density polyethylene (HDPE base with additives.

  15. Innovation types at smes and external influencing factors

    Directory of Open Access Journals (Sweden)

    Monika Walicka

    2014-12-01

    Full Text Available Stimulating innovation is one of the pressing policy challenges facing many countries in the world today. The paper analyses the external factors that Polish entrepreneurs find most detrimental to their innovative activity. A sample of 199 small and medium size enterprises (SMEs in Poland were subjected to a survey. The data collected revealed the innovation types of SMEs in Poland and external financial factors influencing innovation the most. The results show external factors such as legal regulations, access to external financing, bureaucracy of institutions, financial government support, the tax system, time necessary to comply with regulations, and crisis and instability are very important for SMEs. According to the results, process and marketing innovations are applied more frequently than product and organisational innovations. Finally, the results indicate that entrepreneurs indicate that lack of government support and weakness of tax incentives is an important barrier to the innovation process.

  16. Implications Of Using External Consultants In Diagnosing And ...

    African Journals Online (AJOL)

    The process of diagnosing need for the change, the problems/issues to be ... Some practical examples of the diagnosis by external consultants are also presented. ... Gaining co-operation from the client organization and the avoidance of ...

  17. Experimental demonstration of illusion optics with ``external cloaking'' effects

    Science.gov (United States)

    Li, Chao; Liu, Xiao; Liu, Guochang; Li, Fang; Fang, Guangyou

    2011-08-01

    A metamaterial "illusion optics" with "complementary medium" and "restoring medium" is designed by using inductor-capacitor (L-C) network medium. The unprecedented effects of "external cloaking" and "transforming one object to appear as another" are demonstrated experimentally. We also demonstrate that the non-resonant nature of the L-C network decreases the sensitivity of the "external cloaking" effect to the variation of the frequency and results in an acceptable bandwidth of the whole device.

  18. Entropic repulsion of an interface in an external field

    OpenAIRE

    Velenik, Yvan Alain

    2004-01-01

    We consider an interface above an attractive hard wall in the complete wetting regime, and submitted to the action of an external increasing, convex potential, and study its delocalization as the intensity of this potential vanishes. Our main motivation is the analysis of critical prewetting, which corresponds to the choice of a linear external potential. We also present partial results on critical prewetting in the two dimensional Ising model, as well as a few (weak) results on pathwise esti...

  19. Capacity Expansion in Markets with Intertemporal Consumption Externalities

    OpenAIRE

    Hiroshi Kitamura

    2007-01-01

    This paper analyzes market capacity expansion in the presence of intertemporal consumption externalities such as consumer learning, networks, or bandwagon effects. The externality leads to an endogenous shift of market demand that responds to past market capacity. Whereas market capacity grows in waves, its magnitude depends on the degree of market concentration. The competitive environment contributes to S-shaped time patterns of market capacity expansion that is slow from the social viewpoi...

  20. EXTERNAL FACTORS FOR THE MONETARY POLICY TRANSMISSION MECHANISM

    OpenAIRE

    Dan Horatiu

    2013-01-01

    This paper reviews and analyzes the effects that external (or exogenous) factors, defined as economic factors that cannot be controlled or influenced by the central bank, have on monetary policy and the monetary policy transmission mechanism. Adopting a theoretical research position, we aim at identifying the main external factors to monetary policy and discuss the ways in which these factors alter the economic environment and implicitly the monetary policy transmission mechanism. This is don...

  1. Melanoacanthoma of external ear: Report of two cases

    Directory of Open Access Journals (Sweden)

    Rashmi Patnayak

    2013-01-01

    Full Text Available Melanoacanthoma is a rare lesion. Melanoacanthoma of external ear is still rarer . We present two cases of melanoacanthoma of external ear in adults which presented as pigmented growths and clinically were suspected as malignant lesions. Histopathology was diagnostic as it demonstrated the characteristic elevated lesion with abundant melanin pigment. No recurrence of the lesion was reported after four years of initial diagnosis. These cases have been presented because of their uncommon location, highlighting the differential diagnoses.

  2. Externalities in a life cycle model with endogenous survival

    OpenAIRE

    Kuhn, Michael; Wrzaczek, Stefan; Prskawetz, Alexia; Feichtinger, Gustav

    2011-01-01

    We study socially vs. individually optimal lifecycle allocations of consumption and health care, when individual health expenditure curbs own mortality but also has a spillover effect on other persons' survival. Such spillovers arise, for instance, when health care activity at aggregate level triggers improvements in treatment through learningbydoing (positive externality) or a deterioration in the quality of care through congestion (negative externality). We combine an agestructured optimal ...

  3. The Domestic Origins of Sudan's External Debt Crisis

    OpenAIRE

    Abdel Rahman Ahmed Abdel Rahman

    1995-01-01

    Domestic factors played a significant role in Sudan's external debt crisis which emerged in the early 1980's. Personal rule and related political survival considerations undermined on-going economic adjustment programmes and prompted heavy external borrowing. Borrowing from abroad went unchecked because of the absence of an effective debt management system. It was also fuelled by economic corruption and the decline of cotton, Sudan's principal export crop. The absence of an effective debt man...

  4. Assessment of environmental external effects in the production of energy

    DEFF Research Database (Denmark)

    Schleisner, L.; Meyer, H.J.; Morthorst, P.E.

    1995-01-01

    A project in Denmark has been carried out with the purpose to assess the environmental damages and the external costs in the production of energy. The energy production technologies that will be reported in this paper are wind power and a conventional coal fired plant. In the project...... the environmental damages for the energy production technologies are compared, and externalities in the production of energy using renewable energy and fossil fuels are identified, estimated and monetized....

  5. LFP – A Logical Framework with External Predicates

    OpenAIRE

    2012-01-01

    International audience; The LFP Framework is an extension of the Harper-Honsell- Plotkin's Edinburgh Logical Framework LF with external pred- icates. This is accomplished by defining lock type constructors, which are a sort of ⋄-modality constructors, releasing their ar- gument under the condition that a possibly external predicate is satisfied on an appropriate typed judgement. Lock types are de- fined using the standard pattern of constructive type theory, i.e. via introduction, elimination...

  6. Burgers' turbulence problem with linear or quadratic external potential

    DEFF Research Database (Denmark)

    Barndorff-Nielsen, Ole Eiler; Leonenko, N.N.

    2005-01-01

    We consider solutions of Burgers' equation with linear or quadratic external potential and stationary random initial conditions of Ornstein-Uhlenbeck type. We study a class of limit laws that correspond to a scale renormalization of the solutions.......We consider solutions of Burgers' equation with linear or quadratic external potential and stationary random initial conditions of Ornstein-Uhlenbeck type. We study a class of limit laws that correspond to a scale renormalization of the solutions....

  7. CT findings of the osteoma of the external auditory canal

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ha Young; Song, Chang Joon; Yoon, Chung Dae; Park, Mi Hyun; Shin, Byung Seok [Chungnam National University, School of Medicine, Daejeon (Korea, Republic of)

    2006-07-15

    We wanted to report the CT image findings of the osteoma of the external auditory canal. Temporal bone CT scanning was performed on eight patients (4 males and 4 females aged between 8 and 41 years) with pathologically proven osteoma of the external auditory canal after operation, and the findings of the CT scanning were retrospectively reviewed. Not only did we analyze the size, shape, distribution and location of the osteomas, we also analyzed the relationship between the lesion and the tympanosqumaous or tympanomastoid suture line, and the changes seen on the CT scan images for the patients who were able to undergo follow-up. All the lesions of the osteoma of the external auditory canal were unilateral, solitary, pedunculated bony masses. In five patients, the osteomas occurred on the left side and for the other three patients, the osteomas occurred on the right side. The average size of the osteoma was 0.6 cm with the smallest being 0.5 cm and the largest being 1.2 cm. Each of the lesions was located at the osteochondral junction in the terminal part of the osseous external ear canal. The stalk of the osteoma of the external auditory canal was found to have occurred in the anteroinferior wall in five cases (63%), in the anterosuperior wall (the tympanosqumaous suture line) in two cases (25%), and in the anterior wall in one case. The osteoma of the external auditory canal was a compact form in five cases and it was a cancellous form in three cases. One case of the cancellous form was changed into a compact form 35 months later due to the advanced ossification. Osteoma of the external auditory canal developed in a unilateral and solitary fashion. The characteristic image findings show that it is attached to the external auditory canal by its stalk. Unlike our common knowledge about its occurrence, osteoma mostly occurred in the tympanic wall, and this is regardless of the tympanosquamous or tympanomastoid suture line.

  8. Do Farmers Internalise External Impacts of Pesticides in Production?

    OpenAIRE

    Skevas, Theodoros; Spiro E. Stefanou; Alfons G J M Oude Lansink

    2010-01-01

    In modern agriculture, pesticides feature so prominently in growers’ arsenal to reduce crop damage caused by various pests and diseases. But their indiscriminate use can harm human health and the environment and, eventually, impact agricultural productivity negatively. In an era of an increasing public awareness on the external effects of pesticides, the EU is trying to update its pesticide policy by establishing tax and levy schemes. An important question is whether the external impacts of p...

  9. A Comparison between External versus Internal Lateral Osteotomy in Rhinoplasty

    Directory of Open Access Journals (Sweden)

    M Hashemi

    2005-01-01

    Full Text Available Background: Lateral osteotomy is a major part of rhinoplasty for remodeling external facet of the nose and narrowing of nasal base and dorsum after removal of the hump. There are two techniques for lateral osteotomy known as external and internal. Each of these provide advantages and impose limitations. The purpose of our study was to compare the severity of postoperative edema and ecchymosis between internal and external osteotomy techniques. Methods: This study was designed as a clinical trial on 30 cases. With randomization, one side of the nasal bone was selected for internal approach, and the other side, for external approach. Then, on the 1st and 7th days after surgery, the patients were scored for the severity of edema and ecchymosis. Results: On the first day after surgery, not only edema, but also ecchymosis was lower with the external osteotomy than with the internal approach (P = 0.037, P = 0.002, respectively. The severity of ecchymosis, on the 7th postoperative day, was lower with the external approach, and the difference was significant (P = 0.011. The severity of both edema and ecchymosis on the first postoperative day was evaluated higher in females, with statistically significant differences (P = 0.05 for edema and P = 0.003 for ecchymosis. The extension of ecchymosis on the 7th postoperative day was higher in women (P = 0.05. There were no significant differences between the two approaches in medialization of the involved bones and no apparent asymmetries either. Conclusion: According to the results of this study, external osteotomy seems to be the approach of choice, provided that the surgeon has enough experience in doing it. Keywords: Rhinoplasty, Internal osteotomy, External osteotomy, Ecchymosis, Edema

  10. Endoscopic versus external approach dacryocystorhinostomy: A comparative analysis

    Directory of Open Access Journals (Sweden)

    Rinki Saha

    2013-01-01

    Full Text Available Background: Dacryocystorhinostomy (DCR consists of creating a lacrimal drainage pathway to the nasal cavity to restore permanent drainage of previously obstructed excreting system. Aim: To compare the result and advantages of both endonasal endoscopic and external DCR regarding the patency rate, patient compliance and complications. Study Design: Prospective non-randomized comparative study. Materials and Methods: Study was conducted for 16 months duration in a teaching hospital with 50 cases of endoscopic and 30 cases of external DCR with a follow-up of minimum 6 months. Data regarding surgical outcome and complications were analysed and compared using χ2 test. Results: Total 72 patients were included in the study with six having bilateral involvement, out of which 20 were male and 52 were female. The mean age for endoscopic and external DCR was 33.6 years and 46.0 years, respectively. Right eye (63.8% was involved more commonly than left eye (36.2%. Epiphora was the commonest presenting symptom (63.7%. Mean duration of surgery was much lengthier in external (mean 119.6 minutes than endoscopic (mean 49.0 minutes DCR. Bleeding was the most common immediate postoperative complication seen in 33.3% and 10.0% of external and endoscopic DCR cases, respectively. Primary surgical success rate was 90% and 96.7% for endoscopic and external DCR, respectively ( P = 0.046. Among the endoscopic DCR group, four patients underwent revision surgery giving a total successful surgical outcome of 98% at third month of follow-up. However, at 6 month of follow-up, success rate was 92% for endoscopic DCR and 93.3% for external DCR. The difference was not statistically significant ( P = 0.609. Conclusion: Intranasal endoscopic DCR is a simple, minimally invasive, day care procedure and had comparable result with conventional external DCR.

  11. External priors for the next generation of CMB experiments

    Energy Technology Data Exchange (ETDEWEB)

    Manzotti, Alessandro [Chicago U., KICP; Dodelson, Scott [Chicago U., KICP; Park, Youngsoo [Arizona U.

    2015-12-08

    Planned cosmic microwave background (CMB) experiments can dramatically improve what we know about neutrino physics, inflation, and dark energy. The low level of noise, together with improved angular resolution, will increase the signal to noise of the CMB polarized signal as well as the reconstructed lensing potential of high redshift large scale structure. Projected constraints on cosmological parameters are extremely tight, but these can be improved even further with information from external experiments. Here, we examine quantitatively the extent to which external priors can lead to improvement in projected constraints from a CMB-Stage IV (S4) experiment on neutrino and dark energy properties. We find that CMB S4 constraints on neutrino mass could be strongly enhanced by external constraints on the cold dark matter density $\\Omega_{c}h^{2}$ and the Hubble constant $H_{0}$. If polarization on the largest scales ($\\ell<50$) will not be measured, an external prior on the primordial amplitude $A_{s}$ or the optical depth $\\tau$ will also be important. A CMB constraint on the number of relativistic degrees of freedom, $N_{\\rm eff}$, will benefit from an external prior on the spectral index $n_{s}$ and the baryon energy density $\\Omega_{b}h^{2}$. Finally, an external prior on $H_{0}$ will help constrain the dark energy equation of state ($w$).

  12. Verrucous Carcinoma in External Auditory Canal – A Rare Case

    Directory of Open Access Journals (Sweden)

    Md Zillur Rahman

    2013-05-01

    Full Text Available Verrucous carcinoma is a variant of squamous cell carcinoma. It is of low grade malignancy and rarely present with distant metastasis. Oral cavity is the commonest site of this tumour, other sites are larynx, oesophagus and genitalia. Verrucous carcinoma in external auditory canal is extremely rare. This is the presentation of a 45 years old woman who came to the ENT & Head Neck Surgery department of Delta medical college, Dhaka, Bangladesh with discharging left ear and impairment of hearing on the same side for 7 years. Otoscopic examination showed a mass occupying almost whole of the external auditory canal and the overlying skin was thickened, papillary and blackish. Cytology from external auditory canal scrap showed hyperkeratosis and parakeratosis. External auditory canal bone was found eroded at some parts. Excision of the mass was done under microscope. Split thickness skin grafting was done in external auditory canal. The mass was diagnosed as verrucous carcinoma on histopathological examination. Afterwards she was given radiotherapy. Six months follow up showed no recurrence and healthy epithelialization of external auditory canal.

  13. A STUDY OF CONGENITAL MALFORMATIONS OF THE EXTERNAL EAR

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    Rubi Saikia

    2016-10-01

    Full Text Available BACKGROUND Congenital external ear malformations like Microtia, Anotia, Preauricular skin tags, etc. cause severe psychological problems in children. If accompanied with atresia of the external auditory canal and the middle ear; hearing loss, developmental delays are also associated with such malformations. AIM The aim of the present study is to evaluate the commonly occurring congenital external ear defects in this part of India. MATERIALS AND METHODS This study was undertaken in patients attending the Plastic Surgery OPD at Assam Medical College Hospital and Smile Train Centre at Srishti Hospitals and Research Centre at Dibrugarh, Assam, from July 2013 to July 2016. We did an analysis of 25 patients with visibly noticeable external ear deformities and recorded the findings as per proforma and took photographs. RESULTS Among the 25 cases, 9 (36% were males and 16 (64% were females. The most common congenital anomaly that we found was microtia 7 (28%. Of these, 1 (4% was isolated microtia and 6 (24% were associated with hemifacial microsomia. The second common finding was preauricular skin tags 5 (20%. 3 of the microtia cases also presented with external auditory canal atresia and hearing loss. CONCLUSION Congenital anomalies of the external ear can seriously change a child’s personality. Proper diagnosis and treatment of such cases will definitely reduce the possible psychological, physical and financial problems of the patient and family as most of them are surgically correctable.

  14. Estimating Externalities of Hydro Fuel Cycles, Report 6

    Energy Technology Data Exchange (ETDEWEB)

    Barnthouse, L.W.; Cada, G.F.; Cheng, M.-D.; Easterly, C.E.; Kroodsma, R.L.; Lee, R.; Shriner, D.S.; Tolbert, V.R.; Turner, R.S.

    1994-12-01

    There are three major objectives of this hydropower study: (1) to implement the methodological concepts that were developed in the background document (ORNL/RFF 1992) as a means of estimating the external costs and benefits of fuel cycles and, by so doing, to demonstrate their application to the hydroelectric fuel cycle (different fuel cycles have unique characteristics that need to be addressed in different ways); (2) to develop, given the time and resources, the best range of estimates of externalities associated with hydroelectric projects, using two benchmark projects at two reference sites in the US; and (3) to assess the state of the information that is available to support the estimation of externalities associated with the hydroelectric fuel cycle and, by so doing, to assist in identifying gaps in knowledge and in setting future research agendas. The main consideration in defining these objectives was a desire to have more information about externalities and a better method for estimating them. As set forth in the agreement between the US and the EC, the study is explicitly and intentionally not directed at any one audience. This study is about a methodology for estimating externalities. It is not about how to use estimates of externalities in a particular policy context.

  15. External priors for the next generation of CMB experiments

    Energy Technology Data Exchange (ETDEWEB)

    Manzotti, Alessandro; Dodelson, Scott; Park, Youngsoo

    2016-03-01

    Planned cosmic microwave background (CMB) experiments can dramatically improve what we know about neutrino physics, inflation, and dark energy. The low level of noise, together with improved angular resolution, will increase the signal to noise of the CMB polarized signal as well as the reconstructed lensing potential of high redshift large scale structure. Projected constraints on cosmological parameters are extremely tight, but these can be improved even further with information from external experiments. Here, we examine quantitatively the extent to which external priors can lead to improvement in projected constraints from a CMB-Stage IV (S4) experiment on neutrino and dark energy properties. We find that CMB S4 constraints on neutrino mass could be strongly enhanced by external constraints on the cold dark matter density $\\Omega_{c}h^{2}$ and the Hubble constant $H_{0}$. If polarization on the largest scales ($\\ell<50$) will not be measured, an external prior on the primordial amplitude $A_{s}$ or the optical depth $\\tau$ will also be important. A CMB constraint on the number of relativistic degrees of freedom, $N_{\\rm eff}$, will benefit from an external prior on the spectral index $n_{s}$ and the baryon energy density $\\Omega_{b}h^{2}$. Finally, an external prior on $H_{0}$ will help constrain the dark energy equation of state ($w$).

  16. Implications of environmental externalities assessments for solar thermal powerplants

    Science.gov (United States)

    Lee, A. D.; Baechler, M. C.

    1991-03-01

    Externalities are those impacts of one activity on other activities that are not priced in the marketplace. An externality is said to exist when two conditions hold: (1) the utility or operations of one economic agent, A, include nonmonetary variables whose values are chosen by another economic agent, B, without regard to the effects on A, and (2) B does not pay A compensation equal to the incremental costs inflicted on A. Electricity generation involves a wide range of potential and actual environmental impacts. Legislative, permitting, and regulatory requirements directly or indirectly control certain environmental impacts, implicitly causing them to become internalized in the cost of electricity generation. Electricity generation, however, often produces residual environmental impacts that meet the definition of an externality. Mechanisms have been developed by several states to include the costs associated with externalities in the cost-effectiveness analyses of new powerplants. This paper examines these costs for solar thermal plants and applies two states' scoring methodologies to estimate how including externalities would affect the levelized costs of power from a solar plant in the Pacific Northwest. It concludes that including externalities in the economics can reduce the difference between the levelized cost of a coal and solar plant by between 0.74 and 2.42 cents/kWh.

  17. Externalizing and internalizing subtypes of posttraumatic psychopathology and anger expression.

    Science.gov (United States)

    Castillo, Diane T; Joseph, Jeremy S; Tharp, Andra T; C'de Baca, Janet; Torres-Sena, Lorraine M; Qualls, Clifford; Miller, Mark W

    2014-02-01

    Subtypes of posttraumatic psychopathology were replicated and extended in 254 female veterans with posttraumatic stress disorder (PTSD). Cluster analyses on Minnesota Multiphasic Personality Inventory-2 and Personality Psychopathology Five scales (Harkness, McNulty, & Ben-Porath, ) yielded internalizing and externalizing psychopathology dimensions, with a third low psychopathology group (simple PTSD). Externalizers were higher than the internalizers and the simple PTSD groups on the antisocial, substance, and aggression scales; internalizers were higher on depression and anxiety scales. Further validation included an independent measure of psychopathology to examine anger (Buss-Durkee Hostility Inventory, [BDHI]; Buss & Durkee, ). Externalizers were higher on extreme behavioral anger scales (assault and verbal hostility); and externalizers and internalizers were higher than the simple PTSD subjects on other anger scales. Positive correlations between the BDHI scales and the PTSD symptom of "irritability and anger outbursts" were found across scales in the total sample (range: r = .19-.36), on the assault scale in externalizers (r = .59), and the verbal hostility scale in both internalizers (r = .30) and simple PTSD (r = .37) groups, suggesting the broad utility of the symptom in the diagnosis. The results demonstrate the generalizability of the internalizing/externalizing typology to the female veteran population and highlight clinically relevant distinctions in anger expression within PTSD.

  18. [The current views of the treatment of diffuse external otitis].

    Science.gov (United States)

    Fedorova, O V; Shadrin, G B

    2016-01-01

    The objective of the present study was to evaluate the clinical effectiveness and safety of the local application of triderm for the treatment of diffuse external otitis. The study included 68 patients presenting with bacterial and fungal diffuse external otitis. The treatment in the form of local empiric therapy was continued till the results of microbiological treatment became apparent. The beneficial outcome achieved in 91.2% of the patients was clinically manifest as the regression of the inflammatory process in the external auditory meatus. No complications, such as ototoxic events, either local or systemic allergic reactions, were documented. The authors substantiate the possibility of the application of the medication under consideration for the treatment of diffuse external otitis based on the knowledge of the mechanism of the actin of its constituent components, viz. betamethasone, dipropionate, gentamicin sulfate, and clotrimazole, taking into account the occurrence of the most common causative agents of diffuse external otitis. It is concluded that triderm is a safe medication for the local application and, probably, for the initial empiric therapy of diffuse external otitis to be continued till the results of the microbiological treatment become apparent.

  19. Attitude Estimation Using Kalman Filtering: External Acceleration Compensation Considerations

    Directory of Open Access Journals (Sweden)

    Romy Budhi Widodo

    2016-01-01

    Full Text Available Attitude estimation is often inaccurate during highly dynamic motion due to the external acceleration. This paper proposes extended Kalman filter-based attitude estimation using a new algorithm to overcome the external acceleration. This algorithm is based on an external acceleration compensation model to be used as a modifying parameter in adjusting the measurement noise covariance matrix of the extended Kalman filter. The experiment was conducted to verify the estimation accuracy, that is, one-axis and multiple axes sensor movement. Five approaches were used to test the estimation of the attitude: (1 the KF-based model without compensating for external acceleration, (2 the proposed KF-based model which employs the external acceleration compensation model, (3 the two-step KF using weighted-based switching approach, (4 the KF-based model which uses the threshold-based approach, and (5 the KF-based model which uses the threshold-based approach combined with a softened part approach. The proposed algorithm showed high effectiveness during the one-axis test. When the testing conditions employed multiple axes, the estimation accuracy increased using the proposed approach and exhibited external acceleration rejection at the right timing. The proposed algorithm has fewer parameters that need to be set at the expense of the sharpness of signal edge transition.

  20. Magnetized black holes in an external gravitational field

    Science.gov (United States)

    Kunz, Jutta; Nedkova, Petya; Yazadjiev, Stoytcho

    2017-07-01

    We obtain a family of exact solutions describing magnetized black holes in an external gravitational field. Locally the solutions can be interpreted as representing the near-horizon region of a black hole, which interacts with a surrounding matter distribution producing a strong magnetic field. Thus, the solutions reflect the influence of both a gravitational and an electromagnetic external potential in the strong field regime. The static members in the family are generalizations of the Schwarzschild solution in the described environment, while the rotating ones generalize the magnetized Reissner-Nordström solution when the influence of an external gravitational source is also taken into account. Technically, the solutions are obtained by means of a Harrison transformation, applied on the (electro-)vacuum distorted black holes constructed by Bretón et al. We examine the thermodynamical properties of the solutions, and compare them with the corresponding isolated black holes, and with the particular cases when the interaction with only one of the external potentials is taken into account. For the static black holes the influence of the external gravitational and magnetic fields is factorized in a sense, both affecting different properties, and leaving the rest intact. For the rotating solutions the external gravitational and magnetic fields are coupled through the conditions for avoiding conical singularities. The Meissner effect is observed for extremal rotating solutions only in the zero-charge limit, similar to the magnetized Reissner-Nordström black hole.

  1. Influence of external potentials on heterogeneous diffusion processes

    Science.gov (United States)

    Kazakevičius, Rytis; Ruseckas, Julius

    2016-09-01

    In this paper we consider heterogeneous diffusion processes with the power-law dependence of the diffusion coefficient on the position and investigate the influence of external forces on the resulting anomalous diffusion. The heterogeneous diffusion processes can yield subdiffusion as well as superdiffusion, depending on the behavior of the diffusion coefficient. We assume that not only the diffusion coefficient but also the external force has a power-law dependence on the position. We obtain analytic expressions for the transition probability in two cases: when the power-law exponent in the external force is equal to 2 η -1 , where 2 η is the power-law exponent in the dependence of the diffusion coefficient on the position, and when the external force has a linear dependence on the position. We found that the power-law exponent in the dependence of the mean square displacement on time does not depend on the external force; this force changes only the anomalous diffusion coefficient. In addition, the external force having the power-law exponent different from 2 η -1 limits the time interval where the anomalous diffusion occurs. We expect that the results obtained in this paper may be relevant for a more complete understanding of anomalous diffusion processes.

  2. Penetrating trauma to the external genitalia in Operation Iraqi Freedom.

    Science.gov (United States)

    Waxman, S; Beekley, A; Morey, A; Soderdahl, D

    2009-01-01

    This report details the incidence and description of trauma to the external genitalia experienced during Operation Iraqi Freedom at a United States Army Combat Support Hospital, and demonstrates that acceptable rates of testicular salvage are possible in the combat setting. The operating room logs and the Joint Theater Trauma Registry were used to conduct a retrospective review of the patients who sustained genitourinary (GU) injuries at an US Army Combat Support Hospital (CSH) in Iraq from 27 February 2007 to 14 August 2007. Of the 3595 battle trauma injuries seen at the CSH during the time period, 168 (4.7%) had one or more GU injuries for a total of 172 GU injuries. Of these patients, 115 (68%) with GU injuries had one or more injuries to the external genitalia for a total of 119 external GU injuries. Penetrating trauma to the penis and scrotum accounted for 59 of the injuries. In total, 43 testicles were injured in 34 patients (9 had bilateral injuries). In total, 32 testes were repaired primarily and 11 were removed. Injuries to the external genitalia continue to account for the vast majority of GU trauma in a combat setting. Of patients who presented with penetrating testicular trauma, there was a 74.4% salvage rate, which is higher than previous reports of combat external genitalia injuries. Treatment of penetrating trauma to the external genitalia in a combat setting requires attention to tissue preservation while coordinating associated surgical procedures.

  3. TURBULENCE,VORTEX AND EXTERNAL EXPLOSION INDUCED BY VENTING

    Institute of Scientific and Technical Information of China (English)

    姜孝海; 范宝春; 叶经方

    2004-01-01

    The process of explosion venting to air in a cylindrical vent vessel connected to a duct, filling with a stoichiometric methane-oxygen gas mixture, was simulated numerically by using a colocated grid SIMPLE scheme based on k-epsilon turbulent model and Eddydissipation combustion model. The characteristics of the combustible cloud, flame and pressure distribution in the external flow field during venting were analyzed in terms of the predicted results. The results show that the external explosion is generated due to violent turbulent combustion in the high pressure region within the external combustible cloud ignited by a jet flame. And the turbulence and vortex in the external flow field were also discussed in detail. After the jet flame penetrating into the external combustible cloud, the turbulent intensity is greater in the regions with greater average kinetic energy gradient, rather than in the flame front; and the vortex in the external flow field is generated primarily due to the baroclinic effect, which is greater in the regions where the pressure and density gradients are nearly perpendicular.

  4. Health-related external cost assessment in Europe: methodological developments from ExternE to the 2013 Clean Air Policy Package.

    Science.gov (United States)

    van der Kamp, Jonathan; Bachmann, Till M

    2015-03-03

    "Getting the prices right" through internalizing external costs is a guiding principle of environmental policy making, one recent example being the EU Clean Air Policy Package released at the end of 2013. It is supported by impact assessments, including monetary valuation of environmental and health damages. For over 20 years, related methodologies have been developed in Europe in the Externalities of Energy (ExternE) project series and follow-up activities. In this study, we aim at analyzing the main methodological developments over time from the 1990s until today with a focus on classical air pollution-induced human health damage costs. An up-to-date assessment including the latest European recommendations is also applied. Using a case from the energy sector, we identify major influencing parameters: differences in exposure modeling and related data lead to variations in damage costs of up to 21%; concerning risk assessment and monetary valuation, differences in assessing long-term exposure mortality risks together with assumptions on particle toxicity explain most of the observed changes in damage costs. These still debated influencing parameters deserve particular attention when damage costs are used to support environmental policy making.

  5. External iliac vein thrombosis in an athletic cyclist with a history of external iliac artery endofibrosis and thrombosis.

    Science.gov (United States)

    Nakamura, Kelly M; Skeik, Nedaa; Shepherd, Roger F; Wennberg, Paul W

    2011-11-01

    External iliac artery endofibrosis describes an intimal subendothelial fibrosis leading to wall thickening and stenosis that has been described in high-performance athletes. There are anatomical, mechanical, and probably metabolic factors that may contribute to this pathology. Ankle-brachial index (ABI) measurement with exercise testing, duplex ultrasound, computed tomography (CT) or magnetic resonance (MR) angiogram, and ultimately arteriography help to make the diagnosis. Management can be conservative, but most cases require surgical intervention. External iliac vein stenosis and thrombosis in cyclists has rarely been described in the literature. We report a case of extensive left lower limb deep venous thrombosis (DVT) including the external iliac vein diagnosed in a 57-year-old athletic cyclist with a history of external iliac artery thrombosis.

  6. Changes in Shoulder External Rotator Muscle Activity during Shoulder External Rotation in Various Arm Positions in the Sagittal Plane

    OpenAIRE

    Jang, Jun-Hyeok; Oh, Jae-Seop

    2014-01-01

    [Purpose] The aim of this study was to investigate changes in electromyographic (EMG) activity of the infraspinatus and posterior deltoid muscles during shoulder external rotation under different shoulder flexion angles. [Subjects] Thirteen participants were included in this study. [Methods] The participants performed isometric shoulder external rotation at 45°, 90°, and 135° of shoulder flexion. A surface EMG system recorded the EMG activity of the infraspinatus and posterior deltoid muscles...

  7. EXTERNAL FACTORS FOR THE MONETARY POLICY TRANSMISSION MECHANISM

    Directory of Open Access Journals (Sweden)

    Dan Horatiu

    2013-07-01

    Full Text Available This paper reviews and analyzes the effects that external (or exogenous factors, defined as economic factors that cannot be controlled or influenced by the central bank, have on monetary policy and the monetary policy transmission mechanism. Adopting a theoretical research position, we aim at identifying the main external factors to monetary policy and discuss the ways in which these factors alter the economic environment and implicitly the monetary policy transmission mechanism. This is done by changing the way in which monetary transmission channels work and deliver monetary policy decisions throughout the economy, with the final goal of producing central bank desired outcomes with regard to economic variables like inflation, employment, or the production level. We will begin this article with a brief introduction on the topic of monetary policy, the monetary policy transmission mechanism and the potential external factors that may influence the monetary policy and the functioning of its transmission mechanism. The main external factors are identified as linked to fiscal policy, commodity prices, financial market volatility or other globalization related processes. After this introduction, we will proceed with the analysis of the nature and influences of each of the above mentioned external factors on monetary policy and its transmission, indentifying the potential ways in which they can change the structure and internal processes of the transmission channels. As we will see in the study and highlight in our conclusion, the external factors cause decisive changes in the way monetary policy is transmitted, and thus will strongly influence the decisions that central banks take in order to alter key economic variables. The profound understanding of how these non-central bank controlled factors influence the monetary policy transmission mechanism is a key requirement for central banks, as only by being able to predict, recognize and evaluate the

  8. Biomechanical analysis of fracture fixation with external fixator in vivo

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To investigate the different ways of measuring the main axial strain during treatment with an external fixator and to find the suitable compression loaded by the external fixator at an early stage.Methods: Eighteen healthy big-ear rabbits were randomly divided into two groups according to different measuring methods: Group A and Group B. In Group A,a strain gauge was affixed to the external tibial cortex with 502 glue, and in Group B, a bone cement-coated strain gauge was installed on the internal tibial cortex. Groups A and B were divided into two subgroups A1, A2 and B1,B2, respectively, according to the pressure of half of and the same as the body weight. A Z-shaped left mid-shaft tibial osteotomy was performed and fixed by an external fixator. Results: The scaler curves of Group A changed dramatically during the early stage. The trendlines of the internal and external cortex went consistently after reaching the stable stage while the latter strain value was higher than the former. The time for Group B reaching the stable stage was short, but its absolute strain value was less than that of Group A. Before they were pressed to the stable stage, the declined speed of Subgroup A1 was more slowly than that of Subgroup A2 while the results of Subgroups B1 and B2 were same. Group A had an ascending trend after it declined while Group B didn't have. After they reached the stable stage, both Subgroups A1 and A2 had a declining trend while Subgroup A2 was more quickly than Subgroup Al, Subgroup B1 was kept at a definite level while Subgroup B2 fluctuated.Conclusions: The axial strain under external fixator can be measured by bone cement coated-strain gauge in vivo. The data may suggest that half of the body weight load was suitable for external fixator.

  9. Does PGA external stenting reduce compliance mismatch in venous grafts?

    Directory of Open Access Journals (Sweden)

    Zou Liang-jian

    2007-04-01

    Full Text Available Abstract Background Autogenous vein grafting is widely used in regular bypassing procedures. Due to its mismatch with the host artery in both mechanical property and geometry, the graft often over expands under high arterial blood pressure and forms a step-depth where eddy flow develops, thus causing restenosis, fibrous graft wall, etc. External stents, such as sheaths being used to cuff the graft, have been introduced to eliminate these mismatches and increase the patency. Although histological and immunochemical studies have shown some positive effects of the external stent, the mechanical mismatch under the protection of an external stent remains poorly analyzed. Methods In this study, the jugular veins taken from hypercholesterolemic rabbits were transplanted into the carotid arteries, and non-woven polyglycolic acid (PGA fabric was used to fabricate the external stents to study the effect of the biodegradable external stent. Eight weeks after the operation, the grafts were harvested to perform mechanical tests and histological examinations. An arc tangent function was suggested to describe the relationship between pressure and cross-sectional area to analyse the compliance of the graft. Results The results from the mechanical tests indicated that grafts either with or without external stents displayed large compliance in the low-pressure range and were almost inextensible in the high-pressure range. This was very different from the behavior of the arteries or veins in vivo. The data from histological tests showed that, with external stents, collagen fibers were more compact, whilst those in the graft without protection were looser and thicker. No elastic fiber was found in either kind of grafts. Furthermore, grafts without protection were over-expanded which resulted in much bigger cross-sectional areas. Conclusion The PGA external extent contributes little to the reduction of the mechanical mismatch between the graft and its host artery

  10. Assessment of environmental external effects in power generation

    Energy Technology Data Exchange (ETDEWEB)

    Meyer, H.; Morthorst, P.E.; Schleisner, L. [Risoe National Lab. (Denmark); Meyer, N.I.; Nielsen, P.S.; Nielsen, V. [The Technical Univ. of Denmark (Denmark)

    1996-12-01

    This report summarises some of the results achieved in a project carried out in Denmark in 1994 concerning externalities. The main objective was to identify, quantify and - if possible - monetize the external effects in the production of energy, especially in relation to renewable technologies. The report compares environmental externalities in the production of energy using renewable and non-renewable energy sources, respectively. The comparison is demonstrated on two specific case studies. The first case is the production of electricity based on wind power plants compared to the production of electricity based on a coal-fired conventional plant. In the second case heat/power generation by means of a combined heat and power plant based on biomass-generated gas is compared to that of a combined heat and power plant fuelled by natural gas. In the report the individual externalities from the different ways of producing energy are identified, the stress caused by the effect is assessed, and finally the monetary value of the damage is estimated. The method is applied to the local as well as the regional and global externalities. (au) 8 tabs., 7 ills., 4 refs.

  11. EXTERNAL FIXATOR IN THE MANAGEMENT OF UNSTABLE PELVIC FRACTURES

    Directory of Open Access Journals (Sweden)

    Devi prasad

    2014-08-01

    Full Text Available Universally, high- energy trauma is the major cause of mortality and morbidity in the younger age group. Usually pelvic fractures are caused by high energy trauma. Hence it affects not only the musculoskeletal system, but also the soft tissues and viscera contained in the pelvis leading to increased mortality and morbidity. Management of such patients remains a challenge to the trauma surgeon, even in the most sophisticated trauma centers. The aim of our study is to evaluate the role of external fixation in the management of pelvic fractures, both as a resuscitative measure and definitive treatment of unstable pelvic fractures (Type B & Type C. In our study, all patients underwent stabilization with external fixator and the mortality rate was zero with additional internal fixation with reconstruction plating being done in three patients. The primary advantage of external fixation in pelvic injury is to maintain the reduction by which it produces a tamponade effect and results in reduction in haemorrhage, and helps transportation of the patient. External stabilization for unstable pelvic fractures with external fixator is an established treatment procedure and we in our study confirm the usefulness of the procedure in an emergency situation and can be continued effectively as a definitive management for type B & C Pelvic injuries

  12. Gender inequalities in external cause mortality in Brazil, 2010

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    Erly Catarina de Moura

    2015-03-01

    Full Text Available Objective: To estimate mortality rate by external causes in Brazil.Methods: Mortality national 2010's data corrected by underreport and adjusted by direct method were evaluated by sex according to age, region of residence, race/skin color, education and conjugal situation.Results: The standardized mortality coefficient of external causes is higher among men (178 per thousand inhabitants than among women (24 per thousand inhabitants, being higher among young men (20 to 29 years old in all regions and decreasing with aging. The mortality rate reaches almost nine times higher among men comparably to women, being higher in North and Northeast regions. The death incidence by external causes is higher among men (36.4% than among women (10.9%, meaning 170% more risk for men. The risk is also higher among the youngest: 6.00 for men and 7.36 for women. The main kind of death by external causes among men is aggressions, followed by transport accidents, the opposite of women.Conclusions: Besides sex, age is the more important predictive factor of precocious death by external causes, pointing the need of many and various sectors in order to construct new identities of non violence.

  13. Scanning the business external environment for information: evidence from Greece

    Directory of Open Access Journals (Sweden)

    L. Kourteli

    2005-01-01

    Full Text Available Introduction. This paper examines the business external environment scanning theory for information in the context of Greece. Method. A questionnaire was developed to explore the relationships between general and task business environment, perceived uncertainty, scanning strategy, and sources of information with respect to type of environment, size and industry.The research was based on a sample of 144 private organizations operating in North Greece. Analysis. Data collected were analysed using SPSS. The statistical procedures of chi-squared homogeneity test, ANOVA, Duncan's test of homogeneity of means, and related samples t-test were followed for testing the hypotheses developed. Results. The results show that perceived uncertainty of the general and task business external environment factors depend on the type of the environment, size of organization, and industry where the organizations operate; organizations adapt their scanning strategy to the complexity of the environment; personal sources of information seem to be more important than impersonal sources; external sources of information are equally important with internal sources; and higher levels of environmental uncertainty are associated with higher levels of scanning the various sources. Conclusion. Business external environment scanning of information is influenced by the characteristics of the organizations themselves and by the characteristics of the external environment within which the organizations operate. The study contributes to both environmental scanning theory and has important messages for practitioners.

  14. Outcomes after External Iliac and Femoral Vascular Injuries.

    Science.gov (United States)

    Kim, Jerry J; Alipour, Hamid; Yule, Arthur; Plurad, David S; Koopmann, Matthew; Putnam, Brant; de Virgilio, Christian; Kim, Dennis Y

    2016-05-01

    Vascular injuries occurring at the junction of the trunk and lower extremity are uncommon yet challenging because of their location and potential for associated truncal injuries. The purpose of this study was to examine and compare outcomes among patients sustaining external iliac and femoral vascular injuries. We performed a 13-year retrospective analysis of our level 1 trauma center database to identify and compare patients with external iliac and femoral vessel injuries. Multiple logistic regression analysis was performed to identify independent predictors for mortality. During the study period, 135 patients with a median (interquartile range [IQR]) age of 25 (20-35) years were identified with external iliac (n = 29) and femoral vascular injuries (n = 106). The majority were male (85.9%) with a penetrating mechanism (84.5%), and the median (IQR) Injury Severity Score (ISS) was 16 (11-26). The overall mortality rate was 14.1%. In comparison with patients with femoral vascular injuries, patients with external iliac injuries presented with higher ISS (25 vs. 16, P vascular injuries, external iliac vascular injuries are associated with higher blood loss, more intense resuscitation, higher disability and mortality in patients sustaining junctional groin injuries. Early recognition and application of damage control techniques and resuscitative practices may result in improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Environmental external effects for wind power and coal

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, L.; Meyer, H.J.; Morthorst, P.E. [Risoe National Lab., Roskilde (Denmark). Systems Analysis Dept.

    1995-12-31

    This article summarises some of the results achieved in a project carried out in Denmark with the purpose to assess the environmental damages and the external costs in the production of energy. The project has especially handled renewable energy versus energy based on fossil fuels. The project has been a collaboration between the Technical University of Denmark and Riso National Laboratory. The research institutions have considered different energy production technologies in the project. The energy production technologies that have been considered by Risoe National Laboratory and will be reported and compared in this article are the following: (1) Wind power, (2) A coal-fired condensing plant. In the project the environmental damages are thus compared, and externalities in the production of energy using renewable energy and fossil fuels are identified, estimated and monetized. The following result applies in general to the applied technologies. Only the environmental externalities have been assessed in the project. Social and economical externalities, e.g. related to changes in employment or depletion of resources, are not included in the project. The cost concept is based on marginal damage cost, in principle taking as starting point the level of pollution that exists today. The methodology, which has been used in order to find and monetize the environmental externalities, consists of the different processes like Identification, quantification, Dose-response and Valuation

  16. Dental hygiene student experiences in external placements in Australia.

    Science.gov (United States)

    Taylor, Jane A; Hayes, Melanie J; Wallace, Linda

    2012-05-01

    While placements in external locations are being increasingly used in dental education globally, few studies have explored the student learning experience at such placements. The purpose of this study was to investigate student experiences while on external placement in a baccalaureate dental hygiene program. A self-reporting questionnaire was distributed to final-year dental hygiene students (n=77) at the University of Newcastle, Australia, in 2010. The questionnaire included questions regarding the type of placement, experiences offered, supervision, resources available, and lasting impressions. Responding students were generally positive about their external placement experience and indicated that the majority of facilities provided them with the opportunity to provide direct patient care and perform clinical tasks typical of a practicing hygienist. However, there was a statistically significant difference in their opinions about discipline-focused and community placements. Students indicated that their external placement experience provided opportunities to learn more about time and patient management, including hands-on experience with specific clinical tasks. Ongoing evaluations are necessary to ensure that external placements meet both student needs and intended learning outcomes within dental hygiene programs.

  17. Spatial distribution of external and internal intercostal activity in dogs

    Science.gov (United States)

    Legrand, Alexandre; De Troyer, André

    1999-01-01

    The observation that the external and internal interosseous intercostal muscles in the dog show marked regional differences in mechanical advantage has prompted us to re-examine the topographic distribution of electrical activity among these muscles during spontaneous breathing. Inspiratory activity was recorded only from the areas of the external intercostals with an inspiratory mechanical advantage, and expiratory activity was recorded only from the areas of the internal intercostals with an expiratory mechanical advantage. The expiratory discharges previously recorded from the caudal external intercostals and the inspiratory discharges recorded from the rostral internal intercostals were probably due to cross-contamination. Activity in each muscle area was also quantified relative to the activity measured during tetanic, supramaximal nerve stimulation (maximal activity). External intercostal inspiratory activity was consistently greater in the areas with a greater inspiratory advantage (i.e. the dorsal aspect of the rostral segments) than in the areas with a smaller inspiratory advantage, and internal intercostal expiratory activity was invariably greatest in the areas with the greatest expiratory advantage (i.e. the dorsal aspect of the caudal segments). This topographic distribution of neural drive confers to the external intercostal muscles an inspiratory action on the lung during breathing and to the internal interosseous intercostals an expiratory action. PMID:10373710

  18. Shear behavior of concrete beams externally prestressed with Parafil ropes

    Directory of Open Access Journals (Sweden)

    A.H. Ghallab

    2013-03-01

    Full Text Available Although extensive work has been carried out investigating the use of external prestressing system for flexural strengthening, a few studies regarding the shear behavior of externally prestressed beams can be found. Five beams, four of them were externally strengthened using Parafil rope, were loaded up to failure to investigate the effect of shear span/depth ratio, external prestressing force and concrete strength on their shear behavior. Test results showed that the shear span to depth ratio has a significant effect on both the shear strength and failure mode of the strengthened beams and the presence of external prestressing force increased the ultimate load of the tested beams by about 75%. Equations proposed by different codes for both the conventional reinforced concrete beams and for ordinary prestressed beams were used to evaluate the obtained experimental results. In general, codes equations showed a high level of conservatism in predicting the shear strength of the beams. Also, using the full strength rather than half of the concrete shear strength in the Egyptian code PC-method improves the accuracy of the calculated ultimate shear strength.

  19. Socio-economic research on fusion. SERF 1997-98. Macro Tast E2: External costs and benefits. Task 2: Comparison of external costs

    Energy Technology Data Exchange (ETDEWEB)

    Schleisner, Lotte; Korhonen, Riitta

    1998-12-01

    This report is part of the SERF (Socio-Economic Research on Fusion) project, Macro Task E2, which covers External Costs and Benefits. The report is the documentation of Task 2, Comparison of External Costs. The aim of Task 2 Comparison of External Costs, has been to compare the external costs of the fusion energy with those from other alternative energy generation technologies. In this task identification and quantification of the external costs for wind energy and photovoltaic have been performed by Risoe, while identification and quantification of the external cost for nuclear fission and fossil fuels have been discussed by VTT. The methodology used for the assessment of the externalities of the fuel cycles selected has been the one developed within the ExternE Project. First estimates for the externalities of fusion energy have been under examination in Macrotask E2. Externalities of fossil fuels and nuclear fission have already been evaluated in the ExternE project and a vast amount of material for different sites in various countries is available. This material is used in comparison. In the case of renewable wind energy and photovoltaic are assessed separately. External costs of the various alternatives may change as new technologies are developed and costs can to a high extent be avoided (e.g. acidifying impacts but also global warming due to carbon dioxide emissions). Also fusion technology can experience major progress and some important cost components probably can be avoided already by 2050. (EG) 36 refs.

  20. Effect of externally generated turbulence on wave boundary layer

    DEFF Research Database (Denmark)

    Fredsøe, Jørgen; Sumer, B. Mutlu; Kozakiewicz, A.

    2003-01-01

    This experimental study deals with the effect of externally generated turbulence on the oscillatory boundary layer to simulate the turbulence in the wave boundary layer under broken waves in the swash zone. The subject has been investigated experimentally in a U-shaped, oscillating water tunnel...... with a smooth bottom. Turbulence was generated ´externally´ as the flow in the oscillator was passed through a series of grids, that extended from the cover of the water tunnel to about mid-depth. Two different types of grid porosities were used. Direct measurements of the bed shear stress and velocity...... results. The mean and turbulence quantities in the outer flow region are increased substantially with the introduction of the grids. It is shown that the externally generated turbulence is able to penetrate the bed boundary layer, resulting in an increase in the bed shear stress, and therefore...