Identifying suitable substrates for high-quality graphene-based heterostructures

Science.gov (United States)

Banszerus, L.; Janssen, H.; Otto, M.; Epping, A.; Taniguchi, T.; Watanabe, K.; Beschoten, B.; Neumaier, D.; Stampfer, C.

2017-06-01

We report on a scanning confocal Raman spectroscopy study investigating the strain-uniformity and the overall strain and doping of high-quality chemical vapour deposited (CVD) graphene-based heterostuctures on a large number of different substrate materials, including hexagonal boron nitride (hBN), transition metal dichalcogenides, silicon, different oxides and nitrides, as well as polymers. By applying a hBN-assisted, contamination free, dry transfer process for CVD graphene, high-quality heterostructures with low doping densities and low strain variations are assembled. The Raman spectra of these pristine heterostructures are sensitive to substrate-induced doping and strain variations and are thus used to probe the suitability of the substrate material for potential high-quality graphene devices. We find that the flatness of the substrate material is a key figure for gaining, or preserving high-quality graphene.

A prediction model to select PCOS patients suitable for IVM treatment based on anti-Mullerian hormone and antral follicle count.

Science.gov (United States)

Guzman, L; Ortega-Hrepich, C; Polyzos, N P; Anckaert, E; Verheyen, G; Coucke, W; Devroey, P; Tournaye, H; Smitz, J; De Vos, M

2013-05-01

Which baseline patient characteristics can help assisted reproductive technology practitioners to identify patients who are suitable for in-vitro maturation (IVM) treatment? In patients with polycystic ovary syndrome (PCOS) who undergo oocyte IVM in a non-hCG-triggered system, circulating anti-Müllerian hormone (AMH), antral follicle count (AFC) and total testosterone are independently related to the number of immature oocytes and hold promise as outcome predictors to guide the patient selection process for IVM. Patient selection criteria for IVM treatment have been described in normo-ovulatory patients, although patients with PCOS constitute the major target population for IVM. With this study, we assessed the independent predictive value of clinical and endocrine parameters that are related to oocyte yield in patients with PCOS undergoing IVM. Cohort study involving 124 consecutive patients with PCOS undergoing IVM whose data were prospectively collected. Enrolment took place between January 2010 and January 2012. Only data relating to the first IVM cycle of each patient were included. Patients with PCOS underwent oocyte retrieval for IVM after minimal gonadotrophin stimulation and no hCG trigger. Correlation coefficients were calculated to investigate which parameters are related to immature oocyte yield (patient's age, BMI, baseline hormonal profile and AMH, AFC). The independence of predictive parameters was tested using multivariate linear regression analysis. Finally, multivariate receiver operating characteristic (ROC) analyses for cumulus oocyte complexes (COC) yield were performed to assess the efficiency of the prediction model to select suitable candidates for IVM. Using multivariate regression analysis, circulating baseline AMH, AFC and baseline total testosterone serum concentration were incorporated into a model to predict the number of COC retrieved in an IVM cycle, with unstandardized coefficients [95% confidence interval (CI)] of 0.03 (0

Using On-scene EMS Responders' Assessment and Electronic Patient Care Records to Evaluate the Suitability of EMD-triaged, Low-acuity Calls for Secondary Nurse Triage in 911 Centers.

Science.gov (United States)

Scott, Greg; Clawson, Jeff; Fivaz, Mark C; McQueen, Jennie; Gardett, Marie I; Schultz, Bryon; Youngquist, Scott; Olola, Christopher H O

2016-02-01

Using the Medical Priority Dispatch System (MPDS) - a systematic 911 triage process - to identify a large subset of low-acuity patients for secondary nurse triage in the 911 center is a largely unstudied practice in North America. This study examines the ALPHA-level subset of low-acuity patients in the MPDS to determine the suitability of these patients for secondary triage by evaluating vital signs and necessity of lights-and-siren transport, as determined by attending Emergency Medical Services (EMS) ambulance crews. The primary objective of this study was to determine the clinical status of MPDS ALPHA-level (low-acuity) patients, as determined by on-scene EMS crews' patient care records, in two US agencies. A secondary objective was to determine which ALPHA-level codes are suitable candidates for secondary triage by a trained Emergency Communication Nurse (ECN). In this retrospective study, one full year (2013) of both dispatch data and EMS patient records data, associated with all calls coded at the ALPHA-level (low-acuity) in the dispatch protocol, were collected. The primary outcome measure was the number and percentage of ALPHA-level codes categorized as low-acuity, moderate-acuity, high-acuity, and critical using four common vital signs to assign these categories: systolic blood pressure (SBP), pulse rate (PR), oxygen saturation (SpO2), and Glasgow Coma Score (GCS). Vital sign data were obtained from ambulance crew electronic patient care records (ePCRs). The secondary endpoint was the number and percentage of ALPHA-level codes that received a "hot" (lights-and-siren) transport. Out of 19,300 cases, 16,763 (86.9%) were included in the final analysis, after excluding cases from health care providers and those with missing data. Of those, 89% of all cases did not have even one vital sign indicator of unstable patient status (high or critical vital sign). Of all cases, only 1.1% were transported lights-and-siren. With the exception of the low-acuity, ALPHA

Identifying suitable sites for Florida panther reintroduction

Science.gov (United States)

Thatcher, Cindy A.; van Manen, Frank T.; Clark, Joseph D.

2006-01-01

A major objective of the 1995 Florida Panther (Puma concolor cory) Recovery Plan is the establishment of 2 additional panther populations within the historic range. Our goal was to identify prospective sites for Florida panther reintroduction within the historic range based on quantitative landscape assessments. First, we delineated 86 panther home ranges using telemetry data collected from 1981 to 2001 in south Florida to develop a Mahalanobis distance (D2) habitat model, using 4 anthropogenic variables and 3 landscape variables mapped at a 500-m resolution. From that analysis, we identified 9 potential reintroduction sites of sufficient size to support a panther population. We then developed a similar D2 model at a higher spatial resolution to quantify the area of favorable panther habitat at each site. To address potential for the population to expand, we calculated the amount of favorable habitat adjacent to each prospective reintroduction site within a range of dispersal distances of female panthers. We then added those totals to the contiguous patches to estimate the total amount of effective panther habitat at each site. Finally, we developed an expert-assisted model to rank and incorporate potentially important habitat variables that were not appropriate for our empirical analysis (e.g., area of public lands, livestock density). Anthropogenic factors heavily influenced both the landscape and the expert-assisted models. Of the 9 areas we identified, the Okefenokee National Wildlife Refuge, Ozark National Forest, and Felsenthal National Wildlife Refuge regions had the highest combination of effective habitat area and expert opinion scores. Sensitivity analyses indicated that variability among key model parameters did not affect the high ranking of those sites. Those sites should be considered as starting points for the field evaluation of potential reintroduction sites.

Application of the Analytic Hierarchy Process to Identify the Most Suitable Lessor of Freight Car Finance Leasing

Directory of Open Access Journals (Sweden)

Lei Lei

2017-01-01

Full Text Available Finance leasing (also “equipment leasing” saves the cost, improves the efficiency and benefit, larger the manufacture supply channels, which is an optimal solution for equipment supply with uncertain freight demand. The article collects the definitions of Finance Leasing based on the four pillars theory of finance leasing, also divides the lessors in Freight Car finance leasing into three categories according to their major business: manufacturers, banks as the representative financial institutions, firms that specialized in finance leasing. To identify the most suitable lessor for each railway department, an indicator system is built and operated by Yaahp (a software based on Analytic Hierarchy Process.

Identifying plant traits: a key aspect for suitable species selection in ecological restoration of semiarid slopes

Science.gov (United States)

Bochet, Esther; García-Fayos, Patricio

2017-04-01

In the context of ecological restoration, one of the greatest challenges for practitioners and scientists is to select suitable species for revegetation purposes. In semiarid environments where restoration projects often fail, little attention has been paid so far to the contribution of plant traits to species success. The objective of this study was to (1) identify plant traits associated with species success on four roadside situations along an erosion-productivity gradient, and (2) to provide an ecological framework for selecting suitable species on the basis of their morphological and functional traits, applied to semiarid environments. We analyzed the association of 10 different plant traits with species success of 296 species surveyed on the four roadside situations in a semiarid region (Valencia, Spain). Plant traits included general plant traits (longevity, woodiness) and more specific root-, seed- and leaf-related traits (root type, sprouting ability, seed mucilage, seed mass, seed susceptibility to removal, specific leaf area and leaf dry matter content). All of them were selected according to the prevailing limiting ecogeomorphological processes acting along the erosion-productivity gradient. We observed strong shifts along the erosion-productivity gradient in the traits associated to species success. At the harshest end of the gradient, the most intensely eroded and driest one, species success was mainly associated to seed resistance to removal by runoff and to resistance to drought. At the opposite end of the gradient, the most productive one, species success was associated to a competitive-ruderal plant strategy (herbaceous successful species with high specific leaf area and low leaf dry matter content). Our study provides an ecologically-based approach for selecting suitable native species on the basis or their morphological and functional traits and supports a differential trait-based selection of species as regards roadslope type and aspect. In

Identifying Farm Pond Habitat Suitability for the Common Moorhen (Gallinula chloropus: A Conservation-Perspective Approach

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Chun-Hsien Lai

2018-04-01

Full Text Available The purpose of this study was to establish a habitat-suitability assessment model for Gallinula chloropus, or the Common Moorhen, to be applied to the selection of the most suitable farm pond for habitat conservation in Chiayi County, Taiwan. First, the fuzzy Delphi method was employed to evaluate habitat selection factors and calculate the weights of these factors. The results showed that the eight crucial factors, by importance, in descending order, were (1 area ratio of farmlands within 200 m of the farm pond; (2 pond area; (3 pond perimeter; (4 aquatic plant coverage of the pond surface; (5 drought period; (6 coverage of high and low shrubs around the pond bank; (7 bank type; and (8 water-surface-to-bank distance. Subsequently, field evaluations of 75 farm ponds in Chiayi County were performed. The results indicated that 15 farm ponds had highly-suitable habitats and were inhabited by unusually high numbers of Common Moorhens; these habitats were most in need of conservation. A total of two farm ponds were found to require habitat-environment improvements, and Common Moorhens with typical reproductive capacity could be appropriately introduced into 22 farm ponds to restore the ecosystem of the species. Additionally, the habitat suitability and number of Common Moorhens in 36 farm ponds were lower than average; these ponds could be used for agricultural irrigation, detention basins, or for recreational use by community residents. Finally, the total habitat suitability scores and occurrence of Common Moorhens in each farm pond were used to verify the accuracy of the habitat-suitability assessment model for the Common Moorhen. The overall accuracy was 0.8, and the Kappa value was 0.60, which indicates that the model established in this study exhibited high credibility. To sum up, this is an applicable framework not only to assess the habitat suitability of farm ponds for Common Moorhens, but also to determine whether a particular location may

Identification of patients with low-risk pulmonary embolism suitable for outpatient treatment using the pulmonary embolism severity index (PESI).

LENUS (Irish Health Repository)

McCabe, A

2013-06-01

There is increasing evidence that outpatient treatment of patients with low-risk stable pulmonary embolism (PE) is safe, effective and potentially reduces costs. It is not clear how many patients presenting to an Irish Emergency Department (ED) are potentially suitable for outpatient management.

Readability, complexity, and suitability of online resources for mastectomy and lumpectomy.

Science.gov (United States)

Tran, Bao Ngoc N; Singh, Mansher; Singhal, Dhruv; Rudd, Rima; Lee, Bernard T

2017-05-15

Nearly half of American adults have low or marginal health literacy. This negatively affects patients' participation, decision-making, satisfaction, and overall outcomes especially when there is a mismatch between information provided and the skills of the intended audience. Recommendations that patient information be written below the sixth grade level have been made for over three decades. This study compares online resources for mastectomy versus lumpectomy using expanded metrics including readability level, complexity, and density of data and overall suitability for public consumption. The 10 highest ranked Web sites for mastectomy and lumpectomy were identified using the largest Internet engine (Google). Each Web site was assessed for readability (Simple Measure of Gobbledygook), complexity (PMOSE/iKIRSCH), and suitability (Suitability Assessment of Materials). Scores were analyzed by each Web site and overall. Readability analysis showed a significant reading grade level difference between mastectomy and lumpectomy online information (15.4 and 13.9, P = 0.04, respectively). Complexity analysis via PMOSE/iKIRSCH revealed a mean score of 6.5 for mastectomy materials corresponding to "low" complexity and eighth to 12 th grade education. Lumpectomy literature had a lower PMOSE/iKIRSCH score of 5.8 corresponding to a "very low" complexity and fourth to eighth grade education (P = 0.05). Suitability assessment showed mean values of 41% and 46% (P = 0.83) labeled as the lowest level of "adequacy" for mastectomy and lumpectomy materials, respectively. Inter-rater reliability was high for both complexity and suitability analysis. Online resources for the surgical treatment of breast cancer are above the recommended reading grade level. The suitability level is barely adequate indicating a need for revision. Online resources for mastectomy have a higher reading grade level than do materials for lumpectomy and tend to be more complex. Copyright © 2017 Elsevier

Agroforestry suitability analysis based upon nutrient availability mapping: a GIS based suitability mapping

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Firoz Ahmad

2017-05-01

Full Text Available Agroforestry has drawn the attention of researchers due to its capacity to reduce the poverty and land degradation, improve food security and mitigate the climate change. However, the progress in promoting agroforestry is held back due to the lack of reliable data sets and appropriate tools to accurately map and to have an adequate decision making system for agroforestry modules. Agroforestry suitability being one special form of land suitability is very pertinent to study in the current times when there is tremendous pressure on the land as it is a limited commodity. The study aims for applying the geo-spatial tools towards visualizing various soil and environmental data to reveal the trends and interrelationships and to achieve a nutrient availability and agroforestry suitability map. Using weight matrix and ranks, individual maps were developed in ArcGIS 10.1 platform to generate nutrient availability map, which was later used to develop agroforestry suitability map. Watersheds were delineated using DEM in some part of the study area and were evaluated for prioritizing it and agroforestry suitability of the watersheds were also done as per the schematic flowchart. Agroforestry suitability regions were delineated based upon the weight and ranks by integrated mapping. The total open area was identified 42.4% out of which 21.6% area was found to have high suitability towards agroforestry. Within the watersheds, 22 village points were generated for creating buffers, which were further evaluated showing its proximity to high suitable agroforestry sites thus generating tremendous opportunity to the villagers to carry out agroforestry projects locally. This research shows the capability of remote sensing in studying agroforestry practices and in estimating the prominent factors for its optimal productivity. The ongoing agroforestry projects can be potentially diverted in the areas of high suitability as an extension. The use of ancillary data in GIS

Tolerability and suitability of brief group mindfulness-oriented interventions in psychiatric inpatients: a pilot study.

Science.gov (United States)

Nikolitch, Katerina; Laliberté, Vincent; Yu, Ching; Strychowsky, Natalie; Segal, Marilyn; Looper, Karl J; Rej, Soham

2016-09-01

Mindfulness-oriented therapies have a positive impact on patients' overall well-being and alleviate many psychiatric conditions. However, little is known about their use in people with severe mental illness. We aimed to identify which clinical and sociodemographic factors are associated with suitability/tolerability of a brief group mindfulness-oriented therapy. This retrospective study examines pre-/post-data from 40 psychiatric inpatients who underwent one session of a 10-min mindfulness-oriented group intervention between January and March 2014. The main outcome was 'suitability for and tolerating the brief mindfulness-oriented group intervention'. We assessed potential correlates of the main outcome, including female gender, shorter hospitalisation, the absence of psychosis and good pre-morbid functioning. The intervention was well tolerated (92.5%) and 50% of patients met both of our relatively stringent suitability and tolerability criteria. Sociodemographic and clinical variables were not associated with suitability/tolerability. Tai chi was the most suitable/tolerable compared to body scan and mindful eating (76.5% vs. 35.7% vs. 22.2%, Fisher's exact p = 0.01, Bonferroni p mindfulness therapy interventions are very well tolerated and often suitable for acutely hospitalised psychiatric inpatients, including those with acute psychosis. Mindfulness-oriented intervention with an active component (e.g., tai chi, mindful walking) may potentially be best suited for this population.

Suitability

NARCIS (Netherlands)

Bokdam, J.; Braeckel, van A.

2002-01-01

The suitability of grazing, burning, mowing and cutting as tools for succession control in peatland was assessed and expressed on a scale from 0 - 1. All management tools are suitable, but their effects are conditional. The suitability depends on the targeted vegetation transition and on their

Toward a patient-centered ambulatory after-visit summary: Identifying primary care patients' information needs.

Science.gov (United States)

Clarke, Martina A; Moore, Joi L; Steege, Linsey M; Koopman, Richelle J; Belden, Jeffery L; Canfield, Shannon M; Kim, Min S

2018-09-01

The purpose of this study was to determine the information needs of primary care patients as they review clinic visit notes to inform information that should be contained in an after-visit summary (AVS). We collected data from 15 patients with an acute illness and 14 patients with a chronic disease using semi-structured interviews. The acute patients reviewed seven major sections, and chronic patients reviewed eight major sections of a simulated, but realistic visit note to identify relevant information needs for their AVS. Patients in the acute illness group identified the Plan, Assessment and History of Present Illness the most as important note sections, while patients in the chronic care group identified Significant Lab Data, Plan, and Assessment the most as important note sections. This study was able to identify primary care patients' information needs after clinic visit. Primary care patients have information needs pertaining to diagnosis and treatment, which may be the reason why both patient groups identified Plan and Assessment as important note sections. Future research should also develop and assess an AVS based on the information gathered in this study and evaluate its usefulness among primary care patients. The results of this study can be used to inform the development of an after-visit summary that assists patients to fully understand their treatment plan, which may improve treatment adherence.

Wastewater Reuse: An Economic Perspective to Identify Suitable Areas for Poplar Vegetation Filter Systems for Energy Production

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Mauro Viccaro

2017-11-01

Full Text Available The increasing interest towards climate change, water and energy saving, and soil protection has led the research community to consider non-conventional water as a sustainable source for irrigation of energy crops. Vegetation filter systems are considered a reliable technique for sustainable biomass cultivation, enabling the use of reclaimed wastewater as water and nutrients sources during irrigation periods. In this study, a geographic information system (GIS-based spatial model was developed to identify areas potentially suitable for creating vegetation filter systems with poplars to size the plants of energy production. An economic assessment allowed us to identify the cost-effectiveness areas for biomass production that can be fertigated by reclaimed wastewater. Considering the Basilicata region as the test region, a surface area of 258,512 ha was investigated, identifying 73,331 ha of SRF soils sited downstream of 45 wastewater treatment plants (WWTPs. However, considering only areas that have positive net present value and are economically attractive, results indicate 1606 ha of SRF falling within the areas of influence of 39 WWTPs. The results show that the sector of dedicated crops, adjacent and linked with WWTPs, expresses a total capacity of 50.56 MW for thermal, 8.25 MW for electricity, and 31 MW for cogeneration (25.07 MWt and 5.94 MWe plants.

Evaluation of didactic suitability indicators from curricular orientations

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Pedro Arteaga

2012-12-01

Full Text Available Assessment of didactic suitability of mathematics teaching and learning processes requires suitable instruments to guide and support it. This paper presents a methodology for progressive improvement of such instruments to evaluate the suitability of mathematical instruction processes based on the analysis of curricular orientations. Analysis units are classifi ed according to the facets and components proposed by the Didactic Suitability Theory to identify norms and suitability indicators,which are compared with the system proposed by this theory, in order to point out agreements and complementarities. This methodology is exemplified through its application to the principles and standards of the National Council of Teachers of Mathematics (NCTM in the statistics content area at the level K-8.

Assessment of Climate Suitability of Maize in South Korea

Science.gov (United States)

Hyun, S.; Choi, D.; Seo, B.

2017-12-01

Assessing suitable areas for crops would be useful to design alternate cropping systems as an adaptation option to climate change adaptation. Although suitable areas could be identified by using a crop growth model, it would require a number of input parameters including cultivar and soil. Instead, a simple climate suitability model, e.g., EcoCrop model, could be used for an assessment of climate suitability for a major grain crop. The objective of this study was to assess of climate suitability for maize using the EcoCrop model under climate change conditions in Korea. A long term climate data from 2000 - 2100 were compiled from weather data source. The EcoCrop model implemented in R was used to determine climate suitability index at each grid cell. Overall, the EcoCrop model tended to identify suitable areas for maize production near the coastal areas whereas the actual major production areas located in inland areas. It is likely that the discrepancy between assessed and actual crop production areas would result from the socioeconomic aspects of maize production. Because the price of maize is considerably low, maize has been grown in an area where moisture and temperature conditions would be less than optimum. In part, a simple algorithm to predict climate suitability for maize would caused a relatively large error in climate suitability assessment under the present climate conditions. In 2050s, the climate suitability for maize increased in a large areas in southern and western part of Korea. In particular, the plain areas near the coastal region had considerably greater suitability index in the future compared with mountainous areas. The expansion of suitable areas for maize would help crop production policy making such as the allocation of rice production area for other crops due to considerably less demand for the rice in Korea.

Characteristics and suitability of waste dump sites in Owerri, Nigeria ...

African Journals Online (AJOL)

A five point criteria screening of the three major waste dumpsites in Owerri Municipality was identified, and a ranking procedure adopted to determine the suitability or otherwise of the dumpsites. The sites were screened and ranked hydro-geologically and geo-technically in order of suitable, moderately suitable, and not ...

A COMBINED FUZZY MCDM APPROACH FOR IDENTIFYING THE SUITABLE LANDS FOR URBAN DEVELOPMENT: AN EXAMPLE FROM BANDAR ABBS, IRAN

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Mohsen Dadras

2014-01-01

Full Text Available This study aims at identifying the suitable lands for urban dev elopment in Bandar Abbas city based on its real world use regarding specific crite ria and sub-criteria. The city of Bandar Abbas is considered as the most important commer cial and economic city of Iran. It is also considered as one of the major cities of Iran which has played a pivotal role in the country's development and progress in recen t years especially after the end of Iran-Iraq war owing to its embracing the country's m ain commercial ports. This process has caused the immigration rate into the city to rise significantly over the past 20 years. Thus, the development of the city is meanwhile c onsidered as a high priority. Bandar Abbas city does not have a rich capacity for g rowth and development due to its special geographical situation being located in coastal border. Among the limitations placed in the city's development way, natural limit ations (heights and sea shore in the northern and southern parts of the city and struc tural limitations (military centers in the east and west sides of the city may be referred . Therefore, identifying the suitable lands for urban development within Bandar Abbas city l imits is becoming an essential priority. Therefore, d ifferent quantitative and quali tative criteria have been studied in order to select and identify these lands. The struct ures of qualitative criteria for most parts involve ambiguities and vagueness. This leads us to use Fuzzy logic in this study as a natural method for determining the solutions fo r problems of Multi- criteria decision making (MCDM. In the current research, a com bination of MCDM methods has been presented for analysis. To assignee weights of the criteria Fuzzy AHP (analytic hierarchy process is used for land selection and Fuzzy TOPSIS (method for order priority by similarity to ideal solution is utilized to choose the alternative that is the most appropriate through these criteria weights. The

Suitability of current definitions of ambulatory care sensitive conditions for research in emergency department patients: a secondary health data analysis.

Science.gov (United States)

Frick, Johann; Möckel, Martin; Muller, Reinhold; Searle, Julia; Somasundaram, Rajan; Slagman, Anna

2017-10-22

The aim of this study was to investigate the suitability of existing definitions of ambulatory care sensitive conditions (ACSC) in the setting of an emergency department (ED) by assessing ACSC prevalence in patients admitted to hospital after their ED stay. The secondary aim was to identify ACSC suitable for specific application in the ED setting. Observational clinical study with secondary health data. Two EDs of the Charité-Universitätsmedizin Berlin. All medical ED patients of the 'The Charité Emergency Medicine Study' (CHARITEM) study, who were admitted as inpatients during the 1-year study period (n=13 536). Prevalence of ACSC. Prevalence of ACSC in the study population differed significantly depending on the respective ACSC set used. Prevalence ranged between 19.1% (95% CI 18.4% to 19.8%; n=2586) using the definition by Albrecht et al and 36.6% (95% CI 35.8% to 37.5%; n=4960) using the definition of Naumann et al . (pdefinitions) was 48.1% (95% CI 47.2% to 48.9%; n=6505). Some frequently observed diagnoses such as ' convulsion and epilepsy ' (prevalence: 3.4%, 95% CI 3.1% to 3.7%; n=455), ' diseases of the urinary system ' (prevalence: 1.4%; 95% CI 1.2% to 1.6%; n=191) or ' atrial fibrillation and flutter ' (prevalence: 1.0%, 95% CI 0.8% to 1.2%, n=134) are not included in all of the current ACSC definitions. The results highlight the need for an optimised, ED-specific ACSC definition. Particular ACSC diagnoses (such as ' convulsion and epilepsy ' or ' diseases of the urinary system ' and others) seem to be of special relevance in an ED population but are not included in all available ACSC definitions. Further research towards the development of a suitable and specific ACSC definition for research in the ED setting seems warranted. German Clinical Trials Register Deutsches Register für Klinische Studien: DRKS-ID: DRKS00000261. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved

Formulating a poorly water soluble drug into an oral solution suitable for paediatric patients; lorazepam as a model drug

NARCIS (Netherlands)

A.C. Van Der Vossen (Anna C.); I. Van Der Velde (Iris); O. Smeets (Oscar); Postma, D.J.; Eckhardt, M.; A. Vermes (Andras); B.C.P. Koch (Birgit C. P.); A.G. Vulto (Arnold); L.M. Hanff (Lidwien)

2017-01-01

textabstractIntroduction Many drugs are unavailable in suitable oral paediatric dosage forms, and pharmacists often have to compound drugs to provide paediatric patients with an acceptable formulation in the right dose. Liquid formulations offer the advantage of dosing flexibility and ease of

The ability of the general male public to assess their suitability to take 50-mg sildenafil: an assessment of the comprehension of patient information materials via internet survey.

Science.gov (United States)

Symonds, Tara; Coyne, Karin S; Margolis, Mary Kay; Schnetzler, Gabriel

2011-07-01

Erectile dysfunction (ED) is the most common male sexual dysfunction and has a negative impact on masculinity and self-esteem. Phosphodiesterase type 5 inhibitors, including sildenafil, are the first-line treatment option for ED. Providing appropriate information regarding suitability for using sildenafil is important. The purpose of this study was to assess whether a broad spectrum of men could appropriately evaluate their suitability for 50-mg sildenafil after reviewing patient information materials. Patient information (Pack) on appropriate use of 50-mg sildenafil and patient information leaflet (PIL), a Web survey including demographics, self-assessed suitability for sildenafil use, and suitability screener. A randomly selected, population-representative Web-based panel of males in the UK was recruited for this study. Eligible men answered a brief sociodemographic questionnaire and then were presented with the Pack. If a participant desired additional information, he could also review the PIL. The participants then rated the Pack and PIL (if reviewed), self-assessed their suitability for sildenafil use, and completed a previously validated screener for suitability. A total of 1,275 men aged 40 and above were included in these analyses; the mean age was 57.8 ± 9.9 years. A total of 1,054 men reported ED; 517 men (40.5%) deemed themselves suitable for sildenafil; 504 men (39.6%) deemed themselves unsuitable; and 254 (19.9%) were unsure. The concordance rate between screener-assessed suitability and self-assessed suitability was 70.9% (95% confidence interval [CI] = 68.1-73.7%). When accounting for men who would not take sildenafil even though they were suitable or would seek additional information from a healthcare professional prior to using sildenafil, the concordance rate was 84.2% (95% CI = 82.2-86.2%). The results of this study suggest that men in the general population are capable of using written sildenafil patient education materials to accurately assess

Web page classification on child suitability

NARCIS (Netherlands)

C. Eickhoff (Carsten); P. Serdyukov; A.P. de Vries (Arjen)

2010-01-01

htmlabstractChildren spend significant amounts of time on the Internet. Recent studies showed, that during these periods they are often not under adult supervision. This work presents an automatic approach to identifying suitable web pages for children based on topical and non-topical web page

Contemporary Management of Prostate Cancer Patients Suitable for Active Surveillance: A North American Population-based Study.

Science.gov (United States)

Moschini, Marco; Fossati, Nicola; Sood, Akshay; Lee, Justin K; Sammon, Jesse; Sun, Maxine; Pucheril, Dan; Dalela, Deepansh; Montorsi, Francesco; Karnes, R Jeffrey; Briganti, Alberto; Trinh, Quoc-Dien; Menon, Mani; Abdollah, Firas

2016-06-14

Active surveillance (AS) is increasingly recognized as a recommended treatment option for prostate cancer (PCa) patients with clinically localized, low-risk disease; however, previous studies suggested that its utilization is uncommon in the United States. We evaluated the nationwide utilization rate of AS in the contemporary era. We relied on the 2010-2011 Surveillance Epidemiology and End Results (SEER) database using all 18 SEER-based registries. We identified 9049 patients that fulfilled the University of California, San Francisco AS criteria (prostate-specific antigen level <10ng/ml, clinical T stage ≤2a, Gleason score ≤6 [no pattern 4 or 5], and percentage of positive biopsy cores <33%). Logistic regression analysis tested the relationship between receiving local treatment and all available predictors. Only 32% of AS candidates did not receive any active local treatment. This proportion varied widely among the SEER-based registries, ranging from 13% to 49% (p<0.001). In multivariable analyses, clinical stage T2a (odds ratio [OR]: 1.23; p=0.04) and percentage of positive cores (OR: 1.10 for each 2% increase; p<0.001) were associated with a higher probability of receiving local treatment. Conversely, older age (OR: 0.89 for each 2-yr increase; p<0.001), not being married (OR: 0.64; p<0.001), and uninsured status (OR: 0.55; p=0.008) were associated with a lower probability of receiving active local treatment. The study is limited by the fact that SEER does not distinguish among patients undergoing observation, AS, watchful waiting, or initial hormonal therapy. In the United States, a considerable proportion of patients suitable for AS receive local treatment for PCa. Proportions differ significantly among SEER registries. Having more extensive and palpable disease, having medical insurance, being married, and being younger are associated with an increased probability of receiving local treatment for low-risk prostate cancer. Copyright © 2016 European

Identifying Patients with Poststroke Mild Cognitive Impairment by Pattern Recognition of Working Memory Load-Related ERP

Directory of Open Access Journals (Sweden)

Xiaoou Li

2013-01-01

Full Text Available The early detection of subjects with probable cognitive deficits is crucial for effective appliance of treatment strategies. This paper explored a methodology used to discriminate between evoked related potential signals of stroke patients and their matched control subjects in a visual working memory paradigm. The proposed algorithm, which combined independent component analysis and orthogonal empirical mode decomposition, was applied to extract independent sources. Four types of target stimulus features including P300 peak latency, P300 peak amplitude, root mean square, and theta frequency band power were chosen. Evolutionary multiple kernel support vector machine (EMK-SVM based on genetic programming was investigated to classify stroke patients and healthy controls. Based on 5-fold cross-validation runs, EMK-SVM provided better classification performance compared with other state-of-the-art algorithms. Comparing stroke patients with healthy controls using the proposed algorithm, we achieved the maximum classification accuracies of 91.76% and 82.23% for 0-back and 1-back tasks, respectively. Overall, the experimental results showed that the proposed method was effective. The approach in this study may eventually lead to a reliable tool for identifying suitable brain impairment candidates and assessing cognitive function.

Identifying patients with poststroke mild cognitive impairment by pattern recognition of working memory load-related ERP.

Science.gov (United States)

Li, Xiaoou; Yan, Yuning; Wei, Wenshi

2013-01-01

The early detection of subjects with probable cognitive deficits is crucial for effective appliance of treatment strategies. This paper explored a methodology used to discriminate between evoked related potential signals of stroke patients and their matched control subjects in a visual working memory paradigm. The proposed algorithm, which combined independent component analysis and orthogonal empirical mode decomposition, was applied to extract independent sources. Four types of target stimulus features including P300 peak latency, P300 peak amplitude, root mean square, and theta frequency band power were chosen. Evolutionary multiple kernel support vector machine (EMK-SVM) based on genetic programming was investigated to classify stroke patients and healthy controls. Based on 5-fold cross-validation runs, EMK-SVM provided better classification performance compared with other state-of-the-art algorithms. Comparing stroke patients with healthy controls using the proposed algorithm, we achieved the maximum classification accuracies of 91.76% and 82.23% for 0-back and 1-back tasks, respectively. Overall, the experimental results showed that the proposed method was effective. The approach in this study may eventually lead to a reliable tool for identifying suitable brain impairment candidates and assessing cognitive function.

Global habitat suitability for framework-forming cold-water corals.

Directory of Open Access Journals (Sweden)

Andrew J Davies

Full Text Available Predictive habitat models are increasingly being used by conservationists, researchers and governmental bodies to identify vulnerable ecosystems and species' distributions in areas that have not been sampled. However, in the deep sea, several limitations have restricted the widespread utilisation of this approach. These range from issues with the accuracy of species presences, the lack of reliable absence data and the limited spatial resolution of environmental factors known or thought to control deep-sea species' distributions. To address these problems, global habitat suitability models have been generated for five species of framework-forming scleractinian corals by taking the best available data and using a novel approach to generate high resolution maps of seafloor conditions. High-resolution global bathymetry was used to resample gridded data from sources such as World Ocean Atlas to produce continuous 30-arc second (∼1 km(2 global grids for environmental, chemical and physical data of the world's oceans. The increased area and resolution of the environmental variables resulted in a greater number of coral presence records being incorporated into habitat models and higher accuracy of model predictions. The most important factors in determining cold-water coral habitat suitability were depth, temperature, aragonite saturation state and salinity. Model outputs indicated the majority of suitable coral habitat is likely to occur on the continental shelves and slopes of the Atlantic, South Pacific and Indian Oceans. The North Pacific has very little suitable scleractinian coral habitat. Numerous small scale features (i.e., seamounts, which have not been sampled or identified as having a high probability of supporting cold-water coral habitat were identified in all ocean basins. Field validation of newly identified areas is needed to determine the accuracy of model results, assess the utility of modelling efforts to identify vulnerable marine

Long-term outcome of endovascular treatment versus medical care for carotid artery stenosis in patients not suitable for surgery and randomised in the Carotid and Vertebral Artery Transluminal Angioplasty study (CAVATAS).

LENUS (Irish Health Repository)

Ederle, Jörg

2009-01-01

Optimal treatment of carotid stenosis in patients not suitable for surgery is unclear. The Carotid and Vertebral Artery Transluminal Angioplasty study contained a trial comparing medical and endovascular treatment in patients not suitable for surgery.

Comparison of mania patients suitable for treatment trials versus clinical treatment.

Science.gov (United States)

Talamo, Alessandra; Baldessarini, Ross J; Centorrino, Franca

2008-08-01

It remains uncertain whether bipolar disorder (BPD) patients in randomized-controlled trials (RCTs) are sufficiently representative of clinically encountered patients as to guide clinical-therapeutic practice. We complied inclusion/exclusion criteria by frequency from reports of 21 RCTs for mania, and applied them in a pilot study of patients hospitalized for DSM-IV BPD manic/mixed states to compare characteristics and clinical responses of patients who did versus did not meet exclusion criteria. From 27 initially identified inclusion/exclusion criteria ranked by citation frequency, we derived six inclusion, and 10 non-redundant-exclusion factors. Of 67 consecutive patients meeting inclusion criteria, 15 (22.4%) potential "research subjects" met all 10 exclusion criteria. The remaining 52 "clinical patients" differed markedly on exclusion criteria, including more psychiatric co-morbidity, substance abuse, involuntary hospitalization, and suicide attempts or violence, but were otherwise similar. In both groups responses to clinically determined inpatient treatments were similar, including improvement in mania ratings. Based on applying reported inclusion/exclusion criteria for RCTs to a pilot sample of hospitalized-manic patients, those likely to be included in modern RCTs were similar to patients who would be excluded, most notably in short-term antimanic-treatment responses. The findings encourage further comparisons of subjects included/excluded from RCTs to test potential clinical generalizability of research findings. The pilot study is limited in numbers and exposure times with which to test for the minor differences between "research subjects" and "clinical patients." (c) 2008 John Wiley & Sons, Ltd.

How can we identify low- and high-risk patients among unselected patients with possible acute coronary syndrome?

DEFF Research Database (Denmark)

Nielsen, Kirsten Melgaard; Færgeman, Ole; Larsen, Mogens Lytken

2007-01-01

Objective Prognosis among patients admitted with possible acute coronary syndrome (ACS) may differ from that of patients with definite ACS. The aim of this study was to identify risk factors for mortality among unselected patients and to use the statistical model to identify patients at low or high...... mortality risk. Methods From April 1, 2000, to March 31, 2002, we identified all consecutive patients aged 30 to 69 years admitted to the 2 coronary care units covering the municipality of Aarhus, Denmark (population, 138 290). ACS was considered a possible diagnosis if the physician at admission (1) had...

Assessing the suitability of written stroke materials: an evaluation of the interrater reliability of the suitability assessment of materials (SAM) checklist.

Science.gov (United States)

Hoffmann, Tammy; Ladner, Yvette

2012-01-01

Written materials are frequently used to provide education to stroke patients and their carers. However, poor quality materials are a barrier to effective information provision. A quick and reliable method of evaluating material quality is needed. This study evaluated the interrater reliability of the Suitability Assessment of Materials (SAM) checklist in a sample of written stroke education materials. Two independent raters evaluated the materials (n = 25) using the SAM, and ratings were analyzed to reveal total percentage agreements and weighted kappa values for individual items and overall SAM rating. The majority of the individual SAM items had high interrater reliability, with 17 of the 22 items achieving substantial, almost perfect, or perfect weighted kappa value scores. The overall SAM rating achieved a weighted kappa value of 0.60, with a percentage total agreement of 96%. Health care professionals should evaluate the content and design characteristics of written education materials before using them with patients. A tool such as the SAM checklist can be used; however, raters should exercise caution when interpreting results from items with more subjective scoring criteria. Refinements to the scoring criteria for these items are recommended. The value of the SAM is that it can be used to identify specific elements that should be modified before education materials are provided to patients.

Identifying Measures Used for Assessing Quality of YouTube Videos with Patient Health Information: A Review of Current Literature.

Science.gov (United States)

Gabarron, Elia; Fernandez-Luque, Luis; Armayones, Manuel; Lau, Annie Ys

2013-02-28

Recent publications on YouTube have advocated its potential for patient education. However, a reliable description of what could be considered quality information for patient education on YouTube is missing. To identify topics associated with the concept of quality information for patient education on YouTube in the scientific literature. A literature review was performed in MEDLINE, ISI Web of Knowledge, Scopus, and PsychINFO. Abstract selection was first conducted by two independent reviewers; discrepancies were discussed in a second abstract review with two additional independent reviewers. Full text of selected papers were analyzed looking for concepts, definitions, and topics used by its authors that focused on the quality of information on YouTube for patient education. In total, 456 abstracts were extracted and 13 papers meeting eligibility criteria were analyzed. Concepts identified related to quality of information for patient education are categorized as expert-driven, popularity-driven, or heuristic-driven measures. These include (in descending order): (1) quality of content in 10/13 (77%), (2) view count in 9/13 (69%), (3) health professional opinion in 8/13 (62%), (4) adequate length or duration in 6/13 (46%), (5) public ratings in 5/13 (39%), (6) adequate title, tags, and description in 5/13 (39%), (7) good description or a comprehensive narrative in 4/13 (31%), (8) evidence-based practices included in video in 4/13 (31%), (9) suitability as a teaching tool in 4/13 (31%), (10) technical quality in 4/13 (31%), (11) credentials provided in video in 4/13 (31%), (12) enough amount of content to identify its objective in 3/13 (23%), and (13) viewership share in 2/13 (15%). Our review confirms that the current topics linked to quality of information for patient education on YouTube are unclear and not standardized. Although expert-driven, popularity-driven, or heuristic-driven measures are used as proxies to estimate the quality of video information

Patient's medicines brought to hospital: an overlooked resource?

Science.gov (United States)

Ware, G J

1993-10-27

To quantify potential cost advantages and identify practical safeguards required for utilising patients own medicines while in hospital, and returning them on discharge. All medicines brought in by patients in two wards of a geriatric assessment and rehabilitation unit at Auckland Hospital were examined by the pharmacist, and their suitability for re-issue assessed. Medicines were regarded as suitable for use where they could be positively identified, had been dispensed within 3 months of admission, or if packed in foil, provided the expiry date and manufacturer identification were on the foil. Medicines (260 items) totalling $2,976, assessed over a 6 month period, were regarded as suitable for use by the patient, with a mean value of $11.36 per patient. Patients own medicines used within the hospital with a unit-of-issue distribution system, and taken home by them on discharge, would provide appreciable savings for the hospital medicine budget and reduction in waste of the overall health dollar.

Less is more: Strategic scale site suitability for concentrated solar thermal power in Western Australia

International Nuclear Information System (INIS)

Dawson, Lucas; Schlyter, Peter

2012-01-01

Concentrated Solar Thermal Power (CSP) represents a technology with a great deal of promise for low-emissions electricity generation. Several recent studies have identified large swathes of the world’s ‘sunbelt’ as technically suitable for the technology, but current estimates grossly overestimate site suitability for CSP. There is a need for more realistic suitability estimations in order to provide a more accurate basis for policy and investment decisions. This paper establishes a generally applicable GIS-based methodology to better enable identification of CSP-suitable sites at the continental scale. We test the methodology, identifying a large number of CSP suitable sites in Western Australia (WA). Our results indicate a 99.4% reduction from technically suitable areas to areas showing medium-to-very-high suitability in the current and near term in WA. The availability of infrastructure is critical to site suitability and the introduction of new major loads and infrastructure in currently under-developed regions is likely to open up further areas with medium to very high suitability. Despite the fact that current global/continental scale estimates of CSP potentials are likely overestimated by at least two orders of magnitude, truly CSP-suitable areas remain more than sufficient to motivate investment in utility-scale CSP and power potentials from this technology remain enormous. - Highlights: ► 1.78 million km 2 of Western Australia is identified as technically suitable. ► Hypothetical production potential of technically suitable area ≈908,000 TW h/year. ► Only 0.6% of technically suitable areas considered to be medium-very highly suitable. ► Site suitability highly dependent on availability of infrastructure and load. ► Suitable areas still more than sufficient to motivate CSP production.

Common Lung Microbiome Identified among Mechanically Ventilated Surgical Patients.

Directory of Open Access Journals (Sweden)

Ashley D Smith

Full Text Available The examination of the pulmonary microbiome in patients with non-chronic disease states has not been extensively examined. Traditional culture based screening methods are often unable to identify bacteria from bronchoalveolar lavage samples. The advancement of next-generation sequencing technologies allows for a culture-independent molecular based analysis to determine the microbial composition in the lung of this patient population. For this study, the Ion Torrent PGM system was used to assess the microbial complexity of culture negative bronchoalveolar lavage samples. A group of samples were identified that all displayed high diversity and similar relative abundance of bacteria. This group consisted of Hydrogenophaga, unclassified Bacteroidetes, Pedobacter, Thauera, and Acinetobacter. These bacteria may be representative of a common non-pathogenic pulmonary microbiome associated within this population of patients.

Identifying barriers to patient acceptance of active surveillance: content analysis of online patient communications.

Science.gov (United States)

Mishra, Mark V; Bennett, Michele; Vincent, Armon; Lee, Olivia T; Lallas, Costas D; Trabulsi, Edouard J; Gomella, Leonard G; Dicker, Adam P; Showalter, Timothy N

2013-01-01

Qualitative research aimed at identifying patient acceptance of active surveillance (AS) has been identified as a public health research priority. The primary objective of this study was to determine if analysis of a large-sample of anonymous internet conversations (ICs) could be utilized to identify unmet public needs regarding AS. English-language ICs regarding prostate cancer (PC) treatment with AS from 2002-12 were identified using a novel internet search methodology. Web spiders were developed to mine, aggregate, and analyze content from the world-wide-web for ICs centered on AS. Collection of ICs was not restricted to any specific geographic region of origin. NLP was used to evaluate content and perform a sentiment analysis. Conversations were scored as positive, negative, or neutral. A sentiment index (SI) was subsequently calculated according to the following formula to compare temporal trends in public sentiment towards AS: [(# Positive IC/#Total IC)-(#Negative IC/#Total IC) x 100]. A total of 464 ICs were identified. Sentiment increased from -13 to +2 over the study period. The increase sentiment has been driven by increased patient emphasis on quality-of-life factors and endorsement of AS by national medical organizations. Unmet needs identified in these ICs include: a gap between quantitative data regarding long-term outcomes with AS vs. conventional treatments, desire for treatment information from an unbiased specialist, and absence of public role models managed with AS. This study demonstrates the potential utility of online patient communications to provide insight into patient preferences and decision-making. Based on our findings, we recommend that multidisciplinary clinics consider including an unbiased specialist to present treatment options and that future decision tools for AS include quantitative data regarding outcomes after AS.

Identifying subgroups of patients using latent class analysis

DEFF Research Database (Denmark)

Nielsen, Anne Mølgaard; Kent, Peter; Hestbæk, Lise

2017-01-01

BACKGROUND: Heterogeneity in patients with low back pain (LBP) is well recognised and different approaches to subgrouping have been proposed. Latent Class Analysis (LCA) is a statistical technique that is increasingly being used to identify subgroups based on patient characteristics. However......, as LBP is a complex multi-domain condition, the optimal approach when using LCA is unknown. Therefore, this paper describes the exploration of two approaches to LCA that may help improve the identification of clinically relevant and interpretable LBP subgroups. METHODS: From 928 LBP patients consulting...... of statistical performance measures, qualitative evaluation of clinical interpretability (face validity) and a subgroup membership comparison. RESULTS: For the single-stage LCA, a model solution with seven patient subgroups was preferred, and for the two-stage LCA, a nine patient subgroup model. Both approaches...

Niche suitability affects development: skull asymmetry increases in less suitable areas.

Directory of Open Access Journals (Sweden)

Renan Maestri

Full Text Available For conservation purposes, it is important to take into account the suitability of a species to particular habitats; this information may predict the long-term survival of a species. In this sense, morphological measures of developmental stress, such as fluctuating asymmetry, can be proxies for an individual's performance in different regions. In this study, we conducted tests to determine whether areas with different levels of suitability for a species (generated by ecological niche models were congruent with morphological markers that reflect environmental stress and morphological variance. We generated a Maxent niche model and compared the suitability assessments of several areas with the skull morphology data (fluctuating asymmetry and morphological disparity of populations of the Atlantic forest endemic to Brazil rodent Akodon cursor. Our analyses showed a significant negative relationship between suitability levels and fluctuating asymmetry levels, which indicates that in less suitable areas, the individuals experience numerous disturbances during skull ontogeny. We have not found an association between morphological variance and environmental suitability. As expected, these results suggest that in environments with a lower suitability, developmental stress is increased. Such information is helpful in the understanding of the species evolution and in the selection of priority areas for the conservation of species.

Is Switzerland Suitable for the Invasion of Aedes albopictus?

Science.gov (United States)

Neteler, Markus; Metz, Markus; Rocchini, Duccio; Rizzoli, Annapaola; Flacio, Eleonora; Engeler, Luca; Guidi, Valeria; Lüthy, Peter; Tonolla, Mauro

2013-01-01

Background Over the last 30 years, the Asian tiger mosquito, Aedes albopictus, has rapidly spread around the world. The European distribution comprises the Mediterranean basin with a first appearance in Switzerland in 2003. Early identification of the most suitable areas in Switzerland allowing progressive invasion by this species is considered crucial to suggest adequate surveillance and control plans. Methodology/Principal Findings We identified the most suitable areas for invasion and establishment of Ae. albopictus in Switzerland. The potential distribution areas linked to the current climatic suitability were assessed using remotely sensed land surface temperature data recorded by the MODIS satellite sensors. Suitable areas for adult survival and overwintering of diapausing eggs were also identified for future climatic conditions, considering two different climate change scenarios (A1B, A2) for the periods 2020–2049 and 2045–2074. At present, the areas around Lake Geneva in western Switzerland provide suitable climatic conditions for Ae. albopictus. In northern Switzerland, parts of the Rhine valley, around Lake Constance, as well as the surroundings of Lake Neuchâtel, appear to be suitable for the survival at least of adult Ae. albopictus. However, these areas are characterized by winters currently being too cold for survival and development of diapausing eggs. In southern Switzerland, Ae. albopictus is already well-established, especially in the Canton of Ticino. For the years 2020–2049, the predicted possible spread of the tiger mosquito does not differ significantly from its potential current distribution. However, important expansions are obtained if the period is extended to the years 2045–2074, when Ae. albopictus may invade large new areas. Conclusions/Significance Several parts of Switzerland provide suitable climatic conditions for invasion and establishment of Ae. albopictus. The current distribution and rapid spread in other European

Ecological variables governing habitat suitability and the distribution ...

African Journals Online (AJOL)

governed by soil particle size distribution), in combination with the cover provided by trees, as the two ecological factors that best explained habitat suitability for Juliana's golden mole at the three localities. An IndVal analysis failed to identify ...

Identifying patient fear-avoidance beliefs by physical therapists managing patients with low back pain.

Science.gov (United States)

Calley, Darren Q; Jackson, Steven; Collins, Heather; George, Steven Z

2010-12-01

Cross-sectional. To evaluate the accuracy with which physical therapists identify fear-avoidance beliefs in patients with low back pain by comparing therapist ratings of perceived patient fear-avoidance to the Fear-Avoidance Beliefs Questionnaire (FABQ), Tampa Scale of Kinesiophobia 11-item (TSK-11), and Pain Catastrophizing Scale (PCS). To compare the concurrent validity of therapist ratings of perceived patient fear-avoidance and a 2-item questionnaire on fear of physical activity and harm, with clinical measures of fear-avoidance (FABQ, TSK-11, PCS), pain intensity as assessed with a numeric pain rating scale (NPRS), and disability as assessed with the Oswestry Disability Questionnaire (ODQ). The need to consider psychosocial factors for identifying patients at risk for disability and chronic low back pain has been well documented. Yet the ability of physical therapists to identify fear-avoidance beliefs using direct observation has not been studied. Eight physical therapists and 80 patients with low back pain from 3 physical therapy clinics participated in the study. Patients completed the FABQ, TSK-11, PCS, ODQ, NPRS, and a dichotomous 2-item fear-avoidance screening questionnaire. Following the initial evaluation, physical therapists rated perceived patient fear-avoidance on a 0-to-10 scale and recorded 2 influences on their ratings. Spearman correlation and independent t tests determined the level of association of therapist 0-to-10 ratings and 2-item screening with fear-avoidance and clinical measures. Therapist ratings of perceived patient fear-avoidance had fair to moderate interrater reliability (ICC2,1 = 0.663). Therapist ratings did not strongly correlate with FABQ or TSK-11 scores. Instead, they unexpectedly had stronger associations with ODQ and PCS scores. Both 2-item screening questions were associated with FABQ-physical activity scores, while the fear of physical activity question was also associated with FABQ-work, TSK-11, PCS, and ODQ scores

Identifying suitable piercement salt domes for nuclear waste storage sites

International Nuclear Information System (INIS)

Kehle, R.; e.

1980-08-01

Piercement salt domes of the northern interior salt basins of the Gulf of Mexico are being considered as permanent storage sites for both nuclear and chemically toxic wastes. The suitable domes are stable and inactive, having reached their final evolutionary configuration at least 30 million years ago. They are buried to depths far below the level to which erosion will penetrate during the prescribed storage period and are not subject to possible future reactivation. The salt cores of these domes are themselves impermeable, permitting neither the entry nor exit of ground water or other unwanted materials. In part, a stable dome may be recognized by its present geometric configuration, but conclusive proof depends on establishing its evolutionary state. The evolutionary state of a dome is obtained by reconstructing the growth history of the dome as revealed by the configuration of sedimentary strata in a large area (commonly 3,000 square miles or more) surrounding the dome. A high quality, multifold CDP reflection seismic profile across a candidate dome will provide much of the necessary information when integrated with available subsurface control. Additional seismic profiles may be required to confirm an apparent configuration of the surrounding strata and an interpreted evolutionary history. High frequency seismic data collected in the near vicinity of a dome are also needed as a supplement to the CDP data to permit accurate depiction of the configuration of shallow strata. Such data must be tied to shallow drill hole control to confirm the geologic age at which dome growth ceased. If it is determined that a dome reached a terminal configuration many millions of years ago, such a dome is incapable of reactivation and thus constitutes a stable storage site for nuclear wastes

Is Switzerland suitable for the invasion of Aedes albopictus [corrected]?

Science.gov (United States)

Neteler, Markus; Metz, Markus; Rocchini, Duccio; Rizzoli, Annapaola; Flacio, Eleonora; Engeler, Luca; Guidi, Valeria; Lüthy, Peter; Tonolla, Mauro

2013-01-01

Over the last 30 years, the Asian tiger mosquito, Aedes albopictus, has rapidly spread around the world. The European distribution comprises the Mediterranean basin with a first appearance in Switzerland in 2003. Early identification of the most suitable areas in Switzerland allowing progressive invasion by this species is considered crucial to suggest adequate surveillance and control plans. We identified the most suitable areas for invasion and establishment of Ae. albopictus in Switzerland. The potential distribution areas linked to the current climatic suitability were assessed using remotely sensed land surface temperature data recorded by the MODIS satellite sensors. Suitable areas for adult survival and overwintering of diapausing eggs were also identified for future climatic conditions, considering two different climate change scenarios (A1B, A2) for the periods 2020-2049 and 2045-2074. At present, the areas around Lake Geneva in western Switzerland provide suitable climatic conditions for Ae. albopictus. In northern Switzerland, parts of the Rhine valley, around Lake Constance, as well as the surroundings of Lake Neuchâtel, appear to be suitable for the survival at least of adult Ae. albopictus. However, these areas are characterized by winters currently being too cold for survival and development of diapausing eggs. In southern Switzerland, Ae. albopictus is already well-established, especially in the Canton of Ticino. For the years 2020-2049, the predicted possible spread of the tiger mosquito does not differ significantly from its potential current distribution. However, important expansions are obtained if the period is extended to the years 2045-2074, when Ae. albopictus may invade large new areas. Several parts of Switzerland provide suitable climatic conditions for invasion and establishment of Ae. albopictus. The current distribution and rapid spread in other European countries suggest that the tiger mosquito will colonize new areas in Switzerland

Comparing habitat suitability and connectivity modeling methods for conserving pronghorn migrations.

Directory of Open Access Journals (Sweden)

Erin E Poor

Full Text Available Terrestrial long-distance migrations are declining globally: in North America, nearly 75% have been lost. Yet there has been limited research comparing habitat suitability and connectivity models to identify migration corridors across increasingly fragmented landscapes. Here we use pronghorn (Antilocapra americana migrations in prairie habitat to compare two types of models that identify habitat suitability: maximum entropy (Maxent and expert-based (Analytic Hierarchy Process. We used distance to wells, distance to water, NDVI, land cover, distance to roads, terrain shape and fence presence to parameterize the models. We then used the output of these models as cost surfaces to compare two common connectivity models, least-cost modeling (LCM and circuit theory. Using pronghorn movement data from spring and fall migrations, we identified potential migration corridors by combining each habitat suitability model with each connectivity model. The best performing model combination was Maxent with LCM corridors across both seasons. Maxent out-performed expert-based habitat suitability models for both spring and fall migrations. However, expert-based corridors can perform relatively well and are a cost-effective alternative if species location data are unavailable. Corridors created using LCM out-performed circuit theory, as measured by the number of pronghorn GPS locations present within the corridors. We suggest the use of a tiered approach using different corridor widths for prioritizing conservation and mitigation actions, such as fence removal or conservation easements.

Comparing habitat suitability and connectivity modeling methods for conserving pronghorn migrations.

Science.gov (United States)

Poor, Erin E; Loucks, Colby; Jakes, Andrew; Urban, Dean L

2012-01-01

Terrestrial long-distance migrations are declining globally: in North America, nearly 75% have been lost. Yet there has been limited research comparing habitat suitability and connectivity models to identify migration corridors across increasingly fragmented landscapes. Here we use pronghorn (Antilocapra americana) migrations in prairie habitat to compare two types of models that identify habitat suitability: maximum entropy (Maxent) and expert-based (Analytic Hierarchy Process). We used distance to wells, distance to water, NDVI, land cover, distance to roads, terrain shape and fence presence to parameterize the models. We then used the output of these models as cost surfaces to compare two common connectivity models, least-cost modeling (LCM) and circuit theory. Using pronghorn movement data from spring and fall migrations, we identified potential migration corridors by combining each habitat suitability model with each connectivity model. The best performing model combination was Maxent with LCM corridors across both seasons. Maxent out-performed expert-based habitat suitability models for both spring and fall migrations. However, expert-based corridors can perform relatively well and are a cost-effective alternative if species location data are unavailable. Corridors created using LCM out-performed circuit theory, as measured by the number of pronghorn GPS locations present within the corridors. We suggest the use of a tiered approach using different corridor widths for prioritizing conservation and mitigation actions, such as fence removal or conservation easements.

Adaptive process triage system cannot identify patients with gastrointestinal perforation

DEFF Research Database (Denmark)

Bohm, Aske Mathias; Tolstrup, Mai-Britt; Gögenur, Ismail

2017-01-01

INTRODUCTION: Adaptive process triage (ADAPT) is a triage tool developed to assess the severity and address the priority of emergency patients. In 2009-2011, ADAPT was the most frequently used triage system in Denmark. Until now, no Danish triage system has been evaluated based on a selective group...... triaged as green or yellow had a GIP that was not identified by the triage system. CONCLUSION: ADAPT is incapable of identifying one of the most critically ill patient groups in need of emergency abdominal surgery. FUNDING: none. TRIAL REGISTRATION: HEH-2013-034 I-Suite: 02336....

Next-generation sequencing identifies a novel compound heterozygous mutation in MYO7A in a Chinese patient with Usher Syndrome 1B.

Science.gov (United States)

Wei, Xiaoming; Sun, Yan; Xie, Jiansheng; Shi, Quan; Qu, Ning; Yang, Guanghui; Cai, Jun; Yang, Yi; Liang, Yu; Wang, Wei; Yi, Xin

2012-11-20

Targeted enrichment and next-generation sequencing (NGS) have been employed for detection of genetic diseases. The purpose of this study was to validate the accuracy and sensitivity of our method for comprehensive mutation detection of hereditary hearing loss, and identify inherited mutations involved in human deafness accurately and economically. To make genetic diagnosis of hereditary hearing loss simple and timesaving, we designed a 0.60 MB array-based chip containing 69 nuclear genes and mitochondrial genome responsible for human deafness and conducted NGS toward ten patients with five known mutations and a Chinese family with hearing loss (never genetically investigated). Ten patients with five known mutations were sequenced using next-generation sequencing to validate the sensitivity of the method. We identified four known mutations in two nuclear deafness causing genes (GJB2 and SLC26A4), one in mitochondrial DNA. We then performed this method to analyze the variants in a Chinese family with hearing loss and identified compound heterozygosity for two novel mutations in gene MYO7A. The compound heterozygosity identified in gene MYO7A causes Usher Syndrome 1B with severe phenotypes. The results support that the combination of enrichment of targeted genes and next-generation sequencing is a valuable molecular diagnostic tool for hereditary deafness and suitable for clinical application. Copyright © 2012 Elsevier B.V. All rights reserved.

Land Suitability Assessment for Sugarcane in "Herois de Caxito" (Angola

Directory of Open Access Journals (Sweden)

Baert, G.

2005-01-01

Full Text Available The suitability of the soils surrounding the sugarcane plantation at "Herois de Caxito" (7068 ha is assessed. The main goal is to identify land suitability for the enlargement of the present plantation, using FAO land evaluation models (modified to suit Herois de Caxito conditions and GIS. Calculations of the radiationthermal production potential (RPP, land production potential (LPP, irrigation suitability index, and evaluation of the irrigation water quality are done. The water-limited production potential (WPP is found equal to the RPP, because water needs were fully met under irrigation. Maps showing the spatial distribution of the LPP and the suitability for irrigation are generated. The matching of irrigation and fertility indices has shown that, about 40% of the soils with good fertility for sugarcane production present low suitability for irrigation, the main limitations being the very fine texture and the drainage. The available surface water at Herois de Caxito (Dande river is of very good quality for irrigation of sugarcane.

A comparative study to identify a suitable model of ownership for Iran football pro league clubs

Directory of Open Access Journals (Sweden)

Saeed Amirnejad

2018-01-01

Full Text Available Today the government ownership of the professional football clubs is absolutely illogical view point. Most of sports clubs are conducted by private sector using different models of ownership all over the world. In Iran, government credits benefit was main reason that the professional sport was firstly developed by government firms and organizations. Therefore, the sports team ownership is without the professionalization standards. The present comparative study was to examine the different football club ownership structures of the top leagues and the current condition of Iran football pro league ownership and then present a suitable ownership structure of Iran football clubs to leave behind the government club ownership. Among the initial 120 scientific texts, the thirty two cases including papers, books and reports were found relevant to this study. We studied the ownership prominence and several football club models of ownership focused on stock listing model of ownership, private investor model of ownership, supporter trust model of ownership and Japan partnership model of ownership; theoretical concepts, empirical studies, main findings, strengths and weaknesses were covered in analysis procedure. According to various models of ownership in leagues and the models’ productivity in football clubs, each model of ownership considering national environmental, economic, social conditions has strengths and weaknesses. So, we cannot present a definite model of ownership for Iran football pro league clubs due to different micro-environments of Iran clubs. We need a big planning to provide a supporter-investor mixed model of ownership to Iranian clubs. Considering strengths and weaknesses in the models of ownership as well as the micro and macro environment of Iran football clubs, German model and Japan partnership model are offered as suitable ones to probable new model of ownership in Iran pro league clubs. Consequently, more studies are required

Identifying patients with myasthenia for epidemiological research by linkage of automated registers

DEFF Research Database (Denmark)

Pedersen, Emil Greve; Hallas, Jesper; Hansen, Klaus

2011-01-01

We validated a new method of identifying patients with incident myasthenia in automated Danish registers for the purpose of conducting epidemiological studies of the disorder.......We validated a new method of identifying patients with incident myasthenia in automated Danish registers for the purpose of conducting epidemiological studies of the disorder....

A retrospective observational analysis to identify patient and treatment-related predictors of outcomes in a community mental health programme.

Science.gov (United States)

Green, Stuart A; Honeybourne, Emmi; Chalkley, Sylvia R; Poots, Alan J; Woodcock, Thomas; Price, Geraint; Bell, Derek; Green, John

2015-05-20

This study aims to identify patient and treatment factors that affect clinical outcomes of community psychological therapy through the development of a predictive model using historic data from 2 services in London. In addition, the study aims to assess the completeness of data collection, explore how treatment outcomes are discriminated using current criteria for classifying recovery, and assess the feasibility and need for undertaking a future larger population analysis. Observational, retrospective discriminant analysis. 2 London community mental health services that provide psychological therapies for common mental disorders including anxiety and depression. A total of 7388 patients attended the services between February 2009 and May 2012, of which 4393 (59%) completed therapy, or there was an agreement to end therapy, and were included in the study. Different combinations of the clinical outcome scores for anxiety Generalised Anxiety Disorder-7 and depression Patient Health Questionnaire-9 were used to construct different treatment outcomes. The predictive models were able to assign a positive or negative clinical outcome to each patient based on 5 independent pre-treatment variables, with an accuracy of 69.4% and 79.3%, respectively: initial severity of anxiety and depression, ethnicity, deprivation and gender. The number of sessions attended/missed were also important factors identified in recovery. Predicting whether patients are likely to have a positive outcome following treatment at entry might allow suitable modification of scheduled treatment, possibly resulting in improvements in outcomes. The model also highlights factors not only associated with poorer outcomes but inextricably linked to prevalence of common mental disorders, emphasising the importance of social determinants not only in poor health but also poor recovery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

A case of invasive Aspergillosis in a patient with no identifiable ...

African Journals Online (AJOL)

Invasive fungal infections usually affect patients with immunodeficiencies and very rarely patients with no known or identifiable risk factors. Diagnosis could be delayed in patients without previously known immunodeficiencies due to a low index of suspicion, leading to a delay in treatment and a potential poor outcome.

Predicting Greater Prairie-Chicken Lek Site Suitability to Inform Conservation Actions.

Directory of Open Access Journals (Sweden)

Torre J Hovick

Full Text Available The demands of a growing human population dictates that expansion of energy infrastructure, roads, and other development frequently takes place in native rangelands. Particularly, transmission lines and roads commonly divide rural landscapes and increase fragmentation. This has direct and indirect consequences on native wildlife that can be mitigated through thoughtful planning and proactive approaches to identifying areas of high conservation priority. We used nine years (2003-2011 of Greater Prairie-Chicken (Tympanuchus cupido lek locations totaling 870 unique leks sites in Kansas and seven geographic information system (GIS layers describing land cover, topography, and anthropogenic structures to model habitat suitability across the state. The models obtained had low omission rates (0.81, indicating high model performance and reliability of predicted habitat suitability for Greater Prairie-Chickens. We found that elevation was the most influential in predicting lek locations, contributing three times more predictive power than any other variable. However, models were improved by the addition of land cover and anthropogenic features (transmission lines, roads, and oil and gas structures. Overall, our analysis provides a hierarchal understanding of Greater Prairie-Chicken habitat suitability that is broadly based on geomorphological features followed by land cover suitability. We found that when land features and vegetation cover are suitable for Greater Prairie-Chickens, fragmentation by anthropogenic sources such as roadways and transmission lines are a concern. Therefore, it is our recommendation that future human development in Kansas avoid areas that our models identified as highly suitable for Greater Prairie-Chickens and focus development on land cover types that are of lower conservation concern.

Predicted deep-sea coral habitat suitability for the U.S. West coast.

Directory of Open Access Journals (Sweden)

John M Guinotte

Full Text Available Regional scale habitat suitability models provide finer scale resolution and more focused predictions of where organisms may occur. Previous modelling approaches have focused primarily on local and/or global scales, while regional scale models have been relatively few. In this study, regional scale predictive habitat models are presented for deep-sea corals for the U.S. West Coast (California, Oregon and Washington. Model results are intended to aid in future research or mapping efforts and to assess potential coral habitat suitability both within and outside existing bottom trawl closures (i.e. Essential Fish Habitat (EFH and identify suitable habitat within U.S. National Marine Sanctuaries (NMS. Deep-sea coral habitat suitability was modelled at 500 m×500 m spatial resolution using a range of physical, chemical and environmental variables known or thought to influence the distribution of deep-sea corals. Using a spatial partitioning cross-validation approach, maximum entropy models identified slope, temperature, salinity and depth as important predictors for most deep-sea coral taxa. Large areas of highly suitable deep-sea coral habitat were predicted both within and outside of existing bottom trawl closures and NMS boundaries. Predicted habitat suitability over regional scales are not currently able to identify coral areas with pin point accuracy and probably overpredict actual coral distribution due to model limitations and unincorporated variables (i.e. data on distribution of hard substrate that are known to limit their distribution. Predicted habitat results should be used in conjunction with multibeam bathymetry, geological mapping and other tools to guide future research efforts to areas with the highest probability of harboring deep-sea corals. Field validation of predicted habitat is needed to quantify model accuracy, particularly in areas that have not been sampled.

Suitability of asthma education materials for school-age children: Implications for health literacy.

Science.gov (United States)

Tzeng, Yu-Fen; Gau, Bih-Shya

2018-03-01

To investigate the suitability of asthma education materials for school-age children with asthma and elucidate how these children used their health-literacy abilities to identify whether the materials can be accepted, comprehended and applied. Effective asthma self-management education is influenced by the suitability of materials and an individual's health literacy. A mixed-method research design was developed using quantitative and qualitative surveys. The suitability of the materials was assessed on the basis of the Chinese version of the Suitability Assessment of Materials by five experts. In addition, five school-age children (age: 8-12 years) were recruited and interviewed. In total, 25 pieces of asthma education material for children were collected. On the basis of their type, the materials were categorised as nine brochures, 11 leaflets and five videos. Of the 25 materials, 17 were rated as superior materials, whereas eight were rated as adequate materials. The suitability scores of the video-based materials were significantly higher than those of the brochures and leaflets (p = .006). One print material was considered to have a reading level suitable for fifth-grade or younger children, whereas the remaining materials were considered suitable for sixth-grade or older children. The following six health-literacy domains were identified: recognising asthma through body knowledge, posing reflective questions, identifying self-care difficulties, receiving adult guidance, learning with enjoyment and addressing learning requirements. The video-based materials had integrated content and were appealing to children. Cartoon animations, interactive computer games, and skill demonstrations may enhance learning stimulation and motivation and increase learning effects in children. The present results may help healthcare providers to understand children's capacities to manage their disease, effectively address children's requirements and function as a key resource for

BLM Colorado Wild and Scenic Rivers Line Features (Suitable/Eligible)

Data.gov (United States)

Department of the Interior — KMZ File Format –- This line feature class represents the segments identified as eligible or suitable for Wild and Scenic River designation. These segments are part...

Seizure semiology identifies patients with bilateral temporal lobe epilepsy.

Science.gov (United States)

Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

2015-01-01

Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; p<0.001) and significantly more often lateralizing seizure phenomena pointing to bilateral seizure onset compared to patients with unilateral TLE (67% vs. 11%; p<0.001). The sensitivity of identical vs. different seizure semiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

Habitat suitability and movement corridors of grey wolf (Canis lupus) in Northern Pakistan

Science.gov (United States)

Kabir, Muhammad; Hameed, Shoaib; Ali, Hussain; Bosso, Luciano; Din, Jaffar Ud; Bischof, Richard; Redpath, Steve

2017-01-01

Habitat suitability models are useful to understand species distribution and to guide management and conservation strategies. The grey wolf (Canis lupus) has been extirpated from most of its historic range in Pakistan primarily due to its impact on livestock and livelihoods. We used non-invasive survey data from camera traps and genetic sampling to develop a habitat suitability model for C. lupus in northern Pakistan and to explore the extent of connectivity among populations. We detected suitable habitat of grey wolf using a maximum entropy approach (Maxent ver. 3.4.0) and identified suitable movement corridors using the Circuitscape 4.0 tool. Our model showed high levels of predictive performances, as seen from the values of area under curve (0.971±0.002) and true skill statistics (0.886±0.021). The main predictors for habitat suitability for C. lupus were distances to road, mean temperature of the wettest quarter and distance to river. The model predicted ca. 23,129 km2 of suitable areas for wolf in Pakistan, with much of suitable habitat in remote and inaccessible areas that appeared to be well connected through vulnerable movement corridors. These movement corridors suggest that potentially the wolf range can expand in Pakistan’s Northern Areas. However, managing protected areas with stringent restrictions is challenging in northern Pakistan, in part due to heavy dependence of people on natural resources. The habitat suitability map provided by this study can inform future management strategies by helping authorities to identify key conservation areas. PMID:29121089

Suitability of customer relationship management systems for the management of study participants in biomedical research.

Science.gov (United States)

Schwanke, J; Rienhoff, O; Schulze, T G; Nussbeck, S Y

2013-01-01

Longitudinal biomedical research projects study patients or participants over a course of time. No IT solution is known that can manage study participants, enhance quality of data, support re-contacting of participants, plan study visits, and keep track of informed consent procedures and recruitments that may be subject to change over time. In business settings management of personal is one of the major aspects of customer relationship management systems (CRMS). To evaluate whether CRMS are suitable IT solutions for study participant management in biomedical research. Three boards of experts in the field of biomedical research were consulted to get an insight into recent IT developments regarding study participant management systems (SPMS). Subsequently, a requirements analysis was performed with stakeholders of a major biomedical research project. The successive suitability evaluation was based on the comparison of the identified requirements with the features of six CRMS. Independently of each other, the interviewed expert boards confirmed that there is no generic IT solution for the management of participants. Sixty-four requirements were identified and prioritized in a requirements analysis. The best CRMS was able to fulfill forty-two of these requirements. The non-fulfilled requirements demand an adaption of the CRMS, consuming time and resources, reducing the update compatibility, the system's suitability, and the security of the CRMS. A specific solution for the SPMS is favored instead of a generic and commercially-oriented CRMS. Therefore, the development of a small and specific SPMS solution was commenced and is currently on the way to completion.

Identifying Malnutrition: Nutritional Status in Newly Diagnosed Patients With Cancer.

Science.gov (United States)

Krishnasamy, Karthikayini; Li Yoong, Tang; Mei Chan, Chong; Peng Choong, Lau; Chinna, Karuthan

2017-02-01

Malnutrition is common among patients with cancer, but little attention is given to its risks and consequences. The aim of this study is to assess the nutritional status and identify the factors associated with malnutrition among newly diagnosed patients with cancer. Patients admitted with newly diagnosed cancer at a teaching hospital in Malaysia were recruited from January to April 2015. Nutritional status was assessed before treatment initiation, and patients were classified into three categories. A total of 132 pretreatment patients were recruited into the study. About half were severely malnourished. Patients with stage III cancer had the highest prevalence of severe malnourishment. Clinical parameters and disease characteristics were significantly associated with nutritional status. Demographic variables were also statistically significantly associated with severe nutritional status.

Development of computational fluid dynamics--habitat suitability (CFD-HSI) models to identify potential passage--Challenge zones for migratory fishes in the Penobscot River

Science.gov (United States)

Haro, Alexander J.; Dudley, Robert W.; Chelminski, Michael

2012-01-01

A two-dimensional computational fluid dynamics-habitat suitability (CFD–HSI) model was developed to identify potential zones of shallow depth and high water velocity that may present passage challenges for five anadromous fish species in the Penobscot River, Maine, upstream from two existing dams and as a result of the proposed future removal of the dams. Potential depth-challenge zones were predicted for larger species at the lowest flow modeled in the dam-removal scenario. Increasing flows under both scenarios increased the number and size of potential velocity-challenge zones, especially for smaller species. This application of the two-dimensional CFD–HSI model demonstrated its capabilities to estimate the potential effects of flow and hydraulic alteration on the passage of migratory fish.

Identifying patients at high risk for obstructive sleep apnoea ...

African Journals Online (AJOL)

Background: Obstructive sleep apnoea is associated with significant health consequences. A significant proportion of hospitalized patients at risk for obstructive sleep apnoea were never identified and referred for polysomnography for diagnosis. The objective of this study was to determine the factors associated with high ...

The Use of Patient-Specific Induced Pluripotent Stem Cells (iPSCs to Identify Osteoclast Defects in Rare Genetic Bone Disorders

Directory of Open Access Journals (Sweden)

I-Ping Chen

2014-12-01

Full Text Available More than 500 rare genetic bone disorders have been described, but for many of them only limited treatment options are available. Challenges for studying these bone diseases come from a lack of suitable animal models and unavailability of skeletal tissues for studies. Effectors for skeletal abnormalities of bone disorders may be abnormal bone formation directed by osteoblasts or anomalous bone resorption by osteoclasts, or both. Patient-specific induced pluripotent stem cells (iPSCs can be generated from somatic cells of various tissue sources and in theory can be differentiated into any desired cell type. However, successful differentiation of hiPSCs into functional bone cells is still a challenge. Our group focuses on the use of human iPSCs (hiPSCs to identify osteoclast defects in craniometaphyseal dysplasia. In this review, we describe the impact of stem cell technology on research for better treatment of such disorders, the generation of hiPSCs from patients with rare genetic bone disorders and current protocols for differentiating hiPSCs into osteoclasts.

Suitability of voltage stability study methods for real-time assessment

DEFF Research Database (Denmark)

Perez, Angel; Jóhannsson, Hjörtur; Vancraeyveld, Pieter

2013-01-01

This paper analyzes the suitability of existing methods for long-term voltage stability assessment for real-time operation. An overview of the relevant methods is followed with a comparison that takes into account the accuracy, computational efficiency and characteristics when used for security...... assessment. The results enable an evaluation of the run time of each method with respect to the number of inputs. Furthermore, the results assist in identifying which of the methods is most suitable for realtime operation in future power system with production based on fluctuating energy sources....

Using Active Learning to Identify Health Information Technology Related Patient Safety Events.

Science.gov (United States)

Fong, Allan; Howe, Jessica L; Adams, Katharine T; Ratwani, Raj M

2017-01-18

The widespread adoption of health information technology (HIT) has led to new patient safety hazards that are often difficult to identify. Patient safety event reports, which are self-reported descriptions of safety hazards, provide one view of potential HIT-related safety events. However, identifying HIT-related reports can be challenging as they are often categorized under other more predominate clinical categories. This challenge of identifying HIT-related reports is exacerbated by the increasing number and complexity of reports which pose challenges to human annotators that must manually review reports. In this paper, we apply active learning techniques to support classification of patient safety event reports as HIT-related. We evaluated different strategies and demonstrated a 30% increase in average precision of a confirmatory sampling strategy over a baseline no active learning approach after 10 learning iterations.

Identifying Patient Attitudinal Clusters Associated with Asthma Control: The European REALISE Survey.

Science.gov (United States)

van der Molen, Thys; Fletcher, Monica; Price, David

Asthma is a highly heterogeneous disease that can be classified into different clinical phenotypes, and treatment may be tailored accordingly. However, factors beyond purely clinical traits, such as patient attitudes and behaviors, can also have a marked impact on treatment outcomes. The objective of this study was to further analyze data from the REcognise Asthma and LInk to Symptoms and Experience (REALISE) Europe survey, to identify distinct patient groups sharing common attitudes toward asthma and its management. Factor analysis of respondent data (N = 7,930) from the REALISE Europe survey consolidated the 34 attitudinal variables provided by the study population into a set of 8 summary factors. Cluster analyses were used to identify patient clusters that showed similar attitudes and behaviors toward each of the 8 summary factors. Five distinct patient clusters were identified and named according to the key characteristics comprising that cluster: "Confident and self-managing," "Confident and accepting of their asthma," "Confident but dependent on others," "Concerned but confident in their health care professional (HCP)," and "Not confident in themselves or their HCP." Clusters showed clear variability in attributes such as degree of confidence in managing their asthma, use of reliever and preventer medication, and level of asthma control. The 5 patient clusters identified in this analysis displayed distinctly different personal attitudes that would require different approaches in the consultation room certainly for asthma but probably also for other chronic diseases. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

Directory of Open Access Journals (Sweden)

Sheela Raja

Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

Original Research Identifying patients at high risk for obstructive ...

African Journals Online (AJOL)

determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

76 FR 82201 - General Site Suitability Criteria for Nuclear Power Stations

Science.gov (United States)

2011-12-30

... guidelines in identifying suitable candidate sites for nuclear power stations. The decision that a station... combination and a cost-benefit analysis comparing it with alternative site-plant combinations, as discussed in...

Exploring patient experiences with prescription medicines to identify unmet patient needs: implications for research and practice.

Science.gov (United States)

Kucukarslan, Suzan N; Lewis, Nancy J W; Shimp, Leslie A; Gaither, Caroline A; Lane, Daniel C; Baumer, Andrea L

2012-01-01

Pharmacy services are offered to patients, and often, they decline participation. Research is needed to better understand patients' unmet needs when taking prescribed medications. To identify and characterize patients' unmet needs related to using prescribed medication for chronic conditions. Focus groups of patients using prescription medication for chronic conditions discussed their experiences with medications, starting from initial diagnosis to ongoing management. Sessions involved 40 patients from 1 Midwestern U.S. state. Major themes were identified using content analysis. Three major themes emerged. First, patients seek information to understand their health condition and treatment rationale. Patients form an illness perception (its consequence, controllability, cause, and duration) that dictates their actions. Second, patients desire to be involved in treatment decisions, and they often feel that decisions are made for them without their understanding of the risk-to-benefit trade-off. Third, patients monitor the impact of treatment decisions to determine if anticipated outcomes are achieved. The results were consistent with Dowell's therapeutic alliance model (TAM) and Leventhal's common sense model (CSM). The TAM can be used to model the consultative services between pharmacists and patients. The impact of the new services (or interventions) can be evaluated using the CSM. Patients expressed a strong desire to be involved in their treatment decisions. The effectiveness of medication therapy management services may be enhanced if pharmacists build on patients' desire to be involved in their treatment decisions and assist them to understand the role of medications and their risks and expected outcomes within the context of the patients' perceptions of illness and desired coping strategies. Copyright © 2012 Elsevier Inc. All rights reserved.

Identification of suitable sites for mountain ginseng cultivation using GIS and geo-temperature.

Science.gov (United States)

Kang, Hag Mo; Choi, Soo Im; Kim, Hyun

2016-01-01

This study was conducted to explore an accurate site identification technique using a geographic information system (GIS) and geo-temperature (gT) for locating suitable sites for growing cultivated mountain ginseng (CMG; Panax ginseng), which is highly sensitive to the environmental conditions in which it grows. The study site was Jinan-gun, South Korea. The spatial resolution for geographic data was set at 10 m × 10 m, and the temperatures for various climatic factors influencing CMG growth were calculated by averaging the 3-year temperatures obtained from the automatic weather stations of the Korea Meteorological Administration. Identification of suitable sites for CMG cultivation was undertaken using both a conventional method and a new method, in which the gT was added as one of the most important factors for crop cultivation. The results yielded by the 2 methods were then compared. When the gT was added as an additional factor (new method), the proportion of suitable sites identified decreased by 0.4 % compared with the conventional method. However, the proportion matching real CMG cultivation sites increased by 3.5 %. Moreover, only 68.2 % corresponded with suitable sites identified using the conventional factors; i.e., 31.8 % were newly detected suitable sites. The accuracy of GIS-based identification of suitable CMG cultivation sites improved by applying the temperature factor (i.e., gT) in addition to the conventionally used factors.

A prospective clinical, economic, and quality-of-life analysis comparing endovascular aneurysm repair (EVAR), open repair, and best medical treatment in high-risk patients with abdominal aortic aneurysms suitable for EVAR: the Irish patient trial.

LENUS (Irish Health Repository)

Hynes, Niamh

2007-12-01

To report the results of a trial comparing endovascular aneurysm repair (EVAR) to open repair (OR) and best medical therapy (BMT) involving high-risk patients with abdominal aortic aneurysms (AAA) suitable for EVAR.

Rock suitability classification RSC 2012

Energy Technology Data Exchange (ETDEWEB)

McEwen, T. (ed.) [McEwen Consulting, Leicester (United Kingdom); Kapyaho, A. [Geological Survey of Finland, Espoo (Finland); Hella, P. [Saanio and Riekkola, Helsinki (Finland); Aro, S.; Kosunen, P.; Mattila, J.; Pere, T.

2012-12-15

This report presents Posiva's Rock Suitability Classification (RSC) system, developed for locating suitable rock volumes for repository design and construction. The RSC system comprises both the revised rock suitability criteria and the procedure for the suitability classification during the construction of the repository. The aim of the classification is to avoid such features of the host rock that may be detrimental to the favourable conditions within the repository, either initially or in the long term. This report also discusses the implications of applying the RSC system for the fulfilment of the regulatory requirements concerning the host rock as a natural barrier and the site's overall suitability for hosting a final repository of spent nuclear fuel.

Rock suitability classification RSC 2012

International Nuclear Information System (INIS)

McEwen, T.; Kapyaho, A.; Hella, P.; Aro, S.; Kosunen, P.; Mattila, J.; Pere, T.

2012-12-01

This report presents Posiva's Rock Suitability Classification (RSC) system, developed for locating suitable rock volumes for repository design and construction. The RSC system comprises both the revised rock suitability criteria and the procedure for the suitability classification during the construction of the repository. The aim of the classification is to avoid such features of the host rock that may be detrimental to the favourable conditions within the repository, either initially or in the long term. This report also discusses the implications of applying the RSC system for the fulfilment of the regulatory requirements concerning the host rock as a natural barrier and the site's overall suitability for hosting a final repository of spent nuclear fuel

A Case Of Invasive Aspergillosis In A Patient With No identifiable Immunodeficiencies

Directory of Open Access Journals (Sweden)

Carey MP

2008-01-01

Full Text Available Invasive fungal infections usually affect patients with immunodeficiencies and very rarely patients with no known or identifiable risk factors. Diagnosis could be delayed in patients without previously known immunodeficiencies due to a low index of suspicion, leading to a delay in treatment and a potential poor outcome. We report a case of a postpartum woman with no history of immuno-compromised disease who developed left hemiparesis with evidence of invasive aspergollosis affecting the nervous system, and leading to fatal outcome. The patient had a mass-like lesion in the neuroimaging with soft tissue shadowing in the chest x-ray leading to initial diagnosis of tuberculosis. The brain biopsy showed changes consistent with a diagnosis of aspergillosis. The source of the aspergillus infection was not clear. Aspergillus infection should be considered in patients with no identifiable immunodeficiencies who have abnormal brain imaging and chest x-ray, as early treatment may alter the outcome.

The prognostic value of thrombelastography in identifying neurosurgical patients with worse prognosis

DEFF Research Database (Denmark)

Windeløv, Nis A; Welling, Karen-Lise; Ostrowski, Sisse R

2011-01-01

Coagulopathy in patients with intracranial haemorrhage or traumatic brain injury (TBI) is associated with clinical deterioration and worse outcome. Whole blood viscoelastic haemostatic assays, like thrombelastography (TEG), might aid conventional coagulation assays in identification of patients w...... prognosis. Low concordance with conventional coagulation assays indicates that TEG might be valuable in identifying patients with clinically relevant coagulopathy....

Suitable reference tissues for quantitative susceptibility mapping of the brain.

Science.gov (United States)

Straub, Sina; Schneider, Till M; Emmerich, Julian; Freitag, Martin T; Ziener, Christian H; Schlemmer, Heinz-Peter; Ladd, Mark E; Laun, Frederik B

2017-07-01

Since quantitative susceptibility mapping (QSM) quantifies magnetic susceptibility relative to a reference value, a suitable reference tissue has to be available to compare different subjects and stages of disease. To find such a suitable reference tissue for QSM of the brain, melanoma patients with and without brain metastases were measured. Twelve reference regions were chosen and assessed for stability of susceptibility values with respect to multiple intra-individual and inter-individual measurements, age, and stage of disease. Cerebrospinal fluid (CSF), the internal capsule and one region in the splenium of the corpus callosum are the regions with the smallest standard deviations of the mean susceptibility value. The mean susceptibility is 0.010 ± 0.014 ppm for CSF in the atrium of the lateral ventricles (csf post ), -0.060 ± 0.019 ppm for the posterior limb of the internal capsule (ci2), and -0.008 ± 0.019 ppm for the splenium of the corpus callosum. csf post and ci2 show nearly no dependence on age or stage of disease, whereas some other regions, e.g., the red nucleus, show moderate dependence on age or disease. The internal capsule and CSF appear to be the most suitable reference regions for QSM of the brain in the melanoma patients studied. Both showed virtually no dependence on age or disease and small variations among patients. Magn Reson Med 78:204-214, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Identifying Predictive Factors for Incident Reports in Patients Receiving Radiation Therapy

Energy Technology Data Exchange (ETDEWEB)

Elnahal, Shereef M., E-mail: selnaha1@jhmi.edu [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Blackford, Amanda [Department of Oncology Biostatistics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States); Smith, Koren; Souranis, Annette N.; Briner, Valerie; McNutt, Todd R.; DeWeese, Theodore L.; Wright, Jean L.; Terezakis, Stephanie A. [Department of Radiation Oncology and Molecular Radiation Sciences, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland (United States)

2016-04-01

Purpose: To describe radiation therapy cases during which voluntary incident reporting occurred; and identify patient- or treatment-specific factors that place patients at higher risk for incidents. Methods and Materials: We used our institution's incident learning system to build a database of patients with incident reports filed between January 2011 and December 2013. Patient- and treatment-specific data were reviewed for all patients with reported incidents, which were classified by step in the process and root cause. A control group of patients without events was generated for comparison. Summary statistics, likelihood ratios, and mixed-effect logistic regression models were used for group comparisons. Results: The incident and control groups comprised 794 and 499 patients, respectively. Common root causes included documentation errors (26.5%), communication (22.5%), technical treatment planning (37.5%), and technical treatment delivery (13.5%). Incidents were more frequently reported in minors (age <18 years) than in adult patients (37.7% vs 0.4%, P<.001). Patients with head and neck (16% vs 8%, P<.001) and breast (20% vs 15%, P=.03) primaries more frequently had incidents, whereas brain (18% vs 24%, P=.008) primaries were less frequent. Larger tumors (17% vs 10% had T4 lesions, P=.02), and cases on protocol (9% vs 5%, P=.005) or with intensity modulated radiation therapy/image guided intensity modulated radiation therapy (52% vs 43%, P=.001) were more likely to have incidents. Conclusions: We found several treatment- and patient-specific variables associated with incidents. These factors should be considered by treatment teams at the time of peer review to identify patients at higher risk. Larger datasets are required to recommend changes in care process standards, to minimize safety risks.

Identifying Predictive Factors for Incident Reports in Patients Receiving Radiation Therapy

International Nuclear Information System (INIS)

Elnahal, Shereef M.; Blackford, Amanda; Smith, Koren; Souranis, Annette N.; Briner, Valerie; McNutt, Todd R.; DeWeese, Theodore L.; Wright, Jean L.; Terezakis, Stephanie A.

2016-01-01

Purpose: To describe radiation therapy cases during which voluntary incident reporting occurred; and identify patient- or treatment-specific factors that place patients at higher risk for incidents. Methods and Materials: We used our institution's incident learning system to build a database of patients with incident reports filed between January 2011 and December 2013. Patient- and treatment-specific data were reviewed for all patients with reported incidents, which were classified by step in the process and root cause. A control group of patients without events was generated for comparison. Summary statistics, likelihood ratios, and mixed-effect logistic regression models were used for group comparisons. Results: The incident and control groups comprised 794 and 499 patients, respectively. Common root causes included documentation errors (26.5%), communication (22.5%), technical treatment planning (37.5%), and technical treatment delivery (13.5%). Incidents were more frequently reported in minors (age <18 years) than in adult patients (37.7% vs 0.4%, P<.001). Patients with head and neck (16% vs 8%, P<.001) and breast (20% vs 15%, P=.03) primaries more frequently had incidents, whereas brain (18% vs 24%, P=.008) primaries were less frequent. Larger tumors (17% vs 10% had T4 lesions, P=.02), and cases on protocol (9% vs 5%, P=.005) or with intensity modulated radiation therapy/image guided intensity modulated radiation therapy (52% vs 43%, P=.001) were more likely to have incidents. Conclusions: We found several treatment- and patient-specific variables associated with incidents. These factors should be considered by treatment teams at the time of peer review to identify patients at higher risk. Larger datasets are required to recommend changes in care process standards, to minimize safety risks.

Identifying Adult Dengue Patients at Low Risk for Clinically Significant Bleeding.

Directory of Open Access Journals (Sweden)

Joshua G X Wong

Full Text Available Clinically significant bleeding is important for subsequent optimal case management in dengue patients, but most studies have focused on dengue severity as an outcome. Our study objective was to identify differences in admission parameters between patients who developed clinically significant bleeding and those that did not. We sought to develop a model for discriminating between these patients.We conducted a retrospective study of 4,383 adults aged >18 years who were hospitalized with dengue infection at Tan Tock Seng Hospital, Singapore from 2005 to 2008. Patients were divided into those with clinically significant bleeding (n = 188, and those without (n = 4,195. Demographic, clinical, and laboratory variables on admission were compared between groups to determine factors associated with clinically significant bleeding during hospitalization.On admission, female gender (p38°C (p38°C (aOR 1.81; 95% CI: 1.27-2.61, nausea/vomiting (aOR 1.39; 95% CI: 0.94-2.12, ANC (aOR 1.3; 95% CI: 1.15-1.46, ALC (aOR 0.4; 95% CI: 0.25-0.64, hematocrit percentage (aOR 0.96; 95% CI: 0.92-1.002 and platelet count (aOR 0.993; 95% CI: 0.988-0.998. At the cutoff of -3.919, the model achieved an AUC of 0.758 (sensitivity:0.87, specificity: 0.38, PPV: 0.06, NPV: 0.98.Clinical risk factors associated with clinically significant bleeding were identified. This model may be useful to complement clinical judgement in triaging adult dengue patients given the dynamic nature of acute dengue, particularly in pre-identifying those less likely to develop clinically significant bleeding.

Geographical information system (GIS) suitability analysis of radioactive waste repository site in Pahang, Malaysia

International Nuclear Information System (INIS)

Faizal Azrin Abd Razalim; Noraini Surip; Ahmad Hasnulhadi; Nazran Harun; Nurul Nadia Abd Malek; Roziah Che Musa

2010-01-01

The aim of this project is to identify a suitable site for radioactive waste repository in Pahang using remote sensing and geographical information system (GIS) technologies. There are ten parameters considered in the analysis, which divided into Selection Criteria and Exclusion Criteria. The Selection Criteria parameters consists of land use, rainfall, lineament, slope, groundwater potential and elevation while Exclusion Criteria parameters consist of urban, protected land and island. Furthermore, all parameters were integrated, given weight age and ranked for site selection evaluation in GIS environment. At the first place, about twelve sites have been identified as suitable sites for radioactive waste repository throughout the study area. These sites were further analysed by ground checking on the physical setting including geological, drainage, and population density in order to finalise three most suitable sites for radioactive waste repository. (author)

Identifying patients with hypertension: a case for auditing electronic health record data.

Science.gov (United States)

Baus, Adam; Hendryx, Michael; Pollard, Cecil

2012-01-01

Problems in the structure, consistency, and completeness of electronic health record data are barriers to outcomes research, quality improvement, and practice redesign. This nonexperimental retrospective study examines the utility of importing de-identified electronic health record data into an external system to identify patients with and at risk for essential hypertension. We find a statistically significant increase in cases based on combined use of diagnostic and free-text coding (mean = 1,256.1, 95% CI 1,232.3-1,279.7) compared to diagnostic coding alone (mean = 1,174.5, 95% CI 1,150.5-1,198.3). While it is not surprising that significantly more patients are identified when broadening search criteria, the implications are critical for quality of care, the movement toward the National Committee for Quality Assurance's Patient-Centered Medical Home program, and meaningful use of electronic health records. Further, we find a statistically significant increase in potential cases based on the last two or more blood pressure readings greater than or equal to 140/90 mm Hg (mean = 1,353.9, 95% CI 1,329.9-1,377.9).

Fast identification of folded human protein domains expressed in E. coli suitable for structural analysis

Directory of Open Access Journals (Sweden)

Schlegel Brigitte

2004-03-01

Full Text Available Abstract Background High-throughput protein structure analysis of individual protein domains requires analysis of large numbers of expression clones to identify suitable constructs for structure determination. For this purpose, methods need to be implemented for fast and reliable screening of the expressed proteins as early as possible in the overall process from cloning to structure determination. Results 88 different E. coli expression constructs for 17 human protein domains were analysed using high-throughput cloning, purification and folding analysis to obtain candidates suitable for structural analysis. After 96 deep-well microplate expression and automated protein purification, protein domains were directly analysed using 1D 1H-NMR spectroscopy. In addition, analytical hydrophobic interaction chromatography (HIC was used to detect natively folded protein. With these two analytical methods, six constructs (representing two domains were quickly identified as being well folded and suitable for structural analysis. Conclusion The described approach facilitates high-throughput structural analysis. Clones expressing natively folded proteins suitable for NMR structure determination were quickly identified upon small scale expression screening using 1D 1H-NMR and/or analytical HIC. This procedure is especially effective as a fast and inexpensive screen for the 'low hanging fruits' in structural genomics.

Preliminary geological suitability assessment for LILW disposal

International Nuclear Information System (INIS)

Tomse, P.; Mele, I.

2001-01-01

outcome of this stage a number of potentially suitable areas is expected. The final confirmation of site suitability will be gained by detailed field investigations during the site characterisation and site confirmation stages. The progress of this phase of site selection process will strongly depend on the response of local communities where potentially suitable areas will be identified, and on the successfulness and efficiency of the mediator conducting the negotiations with local communities. According to the most optimistic scenario the final site will be selected and confirmed by the period 2004 -2005.(author)

Integration of Remote Sensing and other public GIS data source to identify suitable zones for groundwater exploitation by manual drilling

Science.gov (United States)

Fussi, Fabio; Fava, Francesco; Di Mauro, Biagio; Bonomi, Tullia; Fumagalli, Letizia; DI Leo, Margherita; Hamidou Kane, Cheik; Faye, Gayane; Niang, Magatte; Wade, Souleye; Hamidou, Barry; Colombo, Roberto

2015-04-01

In several countries of the world the situation of water supply is still critical, far from the international target defined by United Nations for 2015 (Millenium Development Goals) and producing a huge impact on health and living condition of the population. Manual drilling (it means techniques to drill boreholes for water using human or animal power) is well known and practiced for centuries in many countries. In recent years, it has been considered a potential strategy to increase water access in poor countries and has raised the attention of national governments and international organizations. Manual drilling is applicable only where hydrogeological context is suitable, according to the following conditions: thick layers of unconsolidated sediments and shallow water table. Mapping of zones with suitable hydrogeological context has been carried out in several countries in Africa, but the results have evident limitations; previous methods are based on existing direct data and qualitative experience, leading to unreliable interpretation when direct data are limited. This research aims to develop a methodology to estimate shallow hydrogeological features and asses the distribution of suitable zones for manual drilling through the integration of indirect information obtained from remote sensing and other existing source of data. The research is carried out in two different study areas, in Senegal and Guinea (Western Africa), with semi-arid climate, moderate vegetation cover, unconsolidated sandy and clay deposits overlaying sedimentary and igneous rocks A set of variables have been obtained through processing of three categories of data, listed below: - geology, geomorphology, soil and land cover, obtained from existing thematic maps; - vegetation phenology, apparent thermal inertia, and soil moisture, obtained from analysis of multitemporal optical (MOD13Q1), thermal (MOD11A1), and radar (ASAR) remotely sensed data: -morphometric parameters, obtained from public

THREAT helps to identify epistaxis patients requiring blood transfusions

Science.gov (United States)

2013-01-01

Objective To analyze the characteristics of patients who needed a blood transfusion due to epistaxis-caused anemia and to define potential risk factors. Design Retrospective cohort study. Setting A total cohort of 591 epistaxis patients, prospectively included between March 2007 and April 2008 at the ENT department of the University Hospital of Zurich, was evaluated concerning the need for blood transfusions. Methods The clinical charts and medical histories of these patients were evaluated. Main outcome measures Common parameters that increase the risk for severe anemia due to epistaxis. Results Twenty-two patients required blood transfusions due to their medical condition. 22.7% suffered from traumatic nosebleeds. Another 27.3% had a known medical condition with an increased bleeding tendency. These proportions were significantly higher than in the group of patients without need of blood transfusion. The odds ratio for receiving a blood transfusion was 14.0 in patients with hematologic disorders, 4.3 in traumatic epistaxis and 7.7 in posterior bleeders. The transfusion-dependent epistaxis patients suffered significantly more often from severe posterior nosebleeds with the need for a surgical therapeutic approach. Conclusions Patients with severe nosebleeds either from the posterior part of the nose or with known hematologic disorders or traumatic epistaxis should be closely monitored by blood parameter analyses to evaluate the indication for hemotransfusion. The acronym THREAT (Trauma, Hematologic disorder, and REAr origin of bleeding → Transfusion) helps to remember and identify the factors associated with an increased risk of receiving blood transfusion. PMID:23663751

Familial adenomatous polyposis patients without an identified APC germline mutation have a severe phenotype

DEFF Research Database (Denmark)

Bisgaard, M L; Ripa, R; Knudsen, Anne Louise

2004-01-01

BACKGROUND: Development of more than 100 colorectal adenomas is diagnostic of the dominantly inherited autosomal disease familial adenomatous polyposis (FAP). Germline mutations can be identified in the adenomatous polyposis coli (APC) gene in approximately 80% of patients. The APC protein...... comprises several regions and domains for interaction with other proteins, and specific clinical manifestations are associated with the mutation assignment to one of these regions or domains. AIMS: The phenotype in patients without an identified causative APC mutation was compared with the phenotype...... in patients with a known APC mutation and with the phenotypes characteristic of patients with mutations in specific APC regions and domains. PATIENTS: Data on 121 FAP probands and 149 call up patients from 70 different families were extracted from the Danish Polyposis register. METHODS: Differences in 16...

Comparison of the MASCC and CISNE scores for identifying low-risk neutropenic fever patients: analysis of data from three emergency departments of cancer centers in three continents.

Science.gov (United States)

Ahn, Shin; Rice, Terry W; Yeung, Sai-Ching J; Cooksley, Tim

2018-05-01

Patients with febrile neutropenia are a heterogeneous group with a minority developing serious medical complications. Outpatient management of low-risk febrile neutropenia has been shown to be safe and cost-effective. Scoring systems, such as the Multinational Association for Supportive Care in Cancer (MASCC) score and Clinical Index of Stable Febrile Neutropenia (CISNE), have been developed and validated to identify low-risk patients. We aimed to compare the performance of these two scores in identifying low-risk febrile neutropenic patients. We performed a pooled analysis of patients presenting with febrile neutropenia to three tertiary cancer emergency centers in the USA, UK, and South Korea in 2015. The primary outcome measures were the occurrence of serious complications. Admission to an intensive care unit (ICU) and 30-day mortality were secondary outcomes. The predictive performance of each score was analyzed. Five hundred seventy-one patients presented with febrile neutropenia. With MASCC risk index, 508 (89.1%) were classified as low-risk febrile neutropenia, compared to 60 (10.5%) with CISNE classification. Overall, the MASCC score had a greater discriminatory power in the detection of low-risk patients than the CISNE score (AUC 0.772, 95% CI 0.726-0.819 vs. 0.681, 95% CI 0.626-0.737, p = 0.0024). Both MASCC and CISNE scores have reasonable discriminatory value in predicting patients with low-risk febrile neutropenia. Risk scores should be used in conjunction with clinical judgment for the identification of patients suitable for outpatient management of neutropenic fever. Developing more accurate scores, validated in prospective settings, will be useful in facilitating more patients being managed in an outpatient setting.

Land Suitability and Insurance Premiums: A GIS-based Multicriteria Analysis Approach for Sustainable Rice Production

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Md Monjurul Islam

2018-05-01

Full Text Available The purpose of this research is to develop a land suitability model for rice production based on suitability levels and to propose insurance premiums to obtain maximum returns based on the harvest index and subsidy dependence factor for the marginal and moderately suitable lands in the northern part of Bangladesh. A multicriteria analysis was undertaken and a rice land suitability map was developed using geographical information system and analytical hierarchy process. The analysis identified that 22.74% of the area was highly suitable, while 14.86% was marginally suitable, and 28.54% was moderately suitable for rice production. However, 32.67% of the area, which was occupied by water bodies, rivers, forests, and settlements, is permanently not suitable; 1.19% is presently not suitable. To motivate low-quality land owners to produce rice, there is no alternative but to provide protection through crop insurance. We suggest producing rice up to marginally suitable lands to obtain support from insurance. The minimum coverage is marginal coverage (70% to cover the production costs, while the maximum coverage is high coverage (90% to enable a maximum return. This new crop insurance model, based on land suitability can be a rational support for owners of different quality land to increase production.

[Climatic suitability of citrus in subtropical China].

Science.gov (United States)

Duan, Hai-Lai; Qian, Huai-Sui; Li, Ming-Xia; Du, Yao-Dong

2010-08-01

By applying the theories of ecological suitability and the methods of fuzzy mathematics, this paper established a climatic suitability model for citrus, calculated and evaluated the climatic suitability and its spatiotemporal differences for citrus production in subtropical China, and analyzed the climatic suitability of citrus at its different growth stages and the mean climatic suitability of citrus in different regions of subtropical China. The results showed that the citrus in subtropical China had a lower climatic suitability and a higher risk at its flower bud differentiation stage, budding stage, and fruit maturity stage, but a higher climatic suitability and a lower risk at other growth stages. Cold damage and summer drought were the key issues affecting the citrus production in subtropical China. The citrus temperature suitability represented a latitudinal zonal pattern, i. e., decreased with increasing latitude; its precipitation suitability was high in the line of "Sheyang-Napo", medium in the southeast of the line, low in the northwest of the line, and non in high mountainous area; while the sunlight suitability was in line with the actual duration of sunshine, namely, higher in high-latitude areas than in low-latitude areas, and higher in high-altitude areas than in plain areas. Limited by temperature factor, the climatic suitability was in accordance with temperature suitability, i. e., south parts had a higher suitability than north parts, basically representing latitudinal zonal pattern. From the analysis of the inter-annual changes of citrus climatic suitability, it could be seen that the citrus climatic suitability in subtropical China was decreasing, and had obvious regional differences, suggesting that climate change could bring about the changes in the regions suitable for citrus production and in the key stages of citrus growth.

A proposed new imaging pathway for patients with suspected lung cancer

International Nuclear Information System (INIS)

Macpherson, R.; Benamore, R.; Panakis, N.; Sayeed, R.; Breen, D.; Bradley, K.; Carter, R.; Baldwin, D.; Craig, J.; Gleeson, F.

2012-01-01

Aims: PET-CT scans are routinely performed in patients with lung cancer after investigation by chest x-ray (CXR) and CT scan, when these have demonstrated potentially curable disease. If the majority of patients with lung cancer potentially suitable for curative treatment could be identified earlier in the diagnostic pathway on the basis of CXR findings they could be referred for PET-CT imaging without a prior CT scan. We investigated the clinical and financial implications of adopting such a strategy. Materials and methods: The details of 1187 patients referred with suspected lung cancer between July 2006 and August 2009 were analysed. The initial CXR and subsequent imaging of patients fit for curative treatment (Performance Status 0/1, FEV1 > 1.0) were reviewed (n = 251). The clinical and financial implications of referring patients for first line PET-CT if deemed potentially curable based on CXR findings were assessed. Results: 107 of 1187 patients had potentially curable lung cancer on PS, lung function, CT and PET-CT. 96 of these 107 patients (90%) were correctly identified on CXR. 149 patients overall were diagnosed as potentially curable on CXR. Referring suitable patients for an immediate PET-CT scan resulted in a reduction in the time to complete staging investigations. Conclusions: Early PET-CT scanning for patients with suspected lung cancer, potentially suitable for curative therapy could result in more efficient staging with little additional cost.

A proposed new imaging pathway for patients with suspected lung cancer

Energy Technology Data Exchange (ETDEWEB)

Macpherson, R.; Benamore, R. [Department of Radiology, Churchill Hospital, Oxford (United Kingdom); Panakis, N. [Department of Clinical Oncology, Churchill Hospital, Oxford (United Kingdom); Sayeed, R. [Department of Cardiothoracic Surgery, John Radcliffe Hospital, Oxford (United Kingdom); Breen, D. [Department of Respiratory Medicine, Churchill Hospital, Oxford (United Kingdom); Bradley, K.; Carter, R. [Department of Radiology, Churchill Hospital, Oxford (United Kingdom); Baldwin, D. [Department of Respiratory Medicine, Nottingham City Hospital, Nottingham (United Kingdom); Craig, J. [York Health Economics Consortium Ltd, University of York, York (United Kingdom); Gleeson, F., E-mail: fergus.gleeson@nds.ox.ac.uk [Department of Radiology, Churchill Hospital, Oxford (United Kingdom)

2012-06-15

Aims: PET-CT scans are routinely performed in patients with lung cancer after investigation by chest x-ray (CXR) and CT scan, when these have demonstrated potentially curable disease. If the majority of patients with lung cancer potentially suitable for curative treatment could be identified earlier in the diagnostic pathway on the basis of CXR findings they could be referred for PET-CT imaging without a prior CT scan. We investigated the clinical and financial implications of adopting such a strategy. Materials and methods: The details of 1187 patients referred with suspected lung cancer between July 2006 and August 2009 were analysed. The initial CXR and subsequent imaging of patients fit for curative treatment (Performance Status 0/1, FEV1 > 1.0) were reviewed (n = 251). The clinical and financial implications of referring patients for first line PET-CT if deemed potentially curable based on CXR findings were assessed. Results: 107 of 1187 patients had potentially curable lung cancer on PS, lung function, CT and PET-CT. 96 of these 107 patients (90%) were correctly identified on CXR. 149 patients overall were diagnosed as potentially curable on CXR. Referring suitable patients for an immediate PET-CT scan resulted in a reduction in the time to complete staging investigations. Conclusions: Early PET-CT scanning for patients with suspected lung cancer, potentially suitable for curative therapy could result in more efficient staging with little additional cost.

Challenges of implementing collaborative models of decision making with trans-identified patients.

Science.gov (United States)

Dewey, Jodie M

2015-10-01

Factors health providers face during the doctor-patient encounter both impede and assist the development of collaborative models of treatment. I investigated decision making among medical and therapeutic professionals who work with trans-identified patients to understand factors that might impede or facilitate the adoption of the collaborative decision-making model in their clinical work. Following a grounded theory approach, I collected and analysed data from semi-structured interviews with 10 U.S. physicians and 10 U.S. mental health professionals. Doctors and therapists often desire collaboration with their patients but experience dilemmas in treating the trans-identified patients. Dilemmas include lack of formal education, little to no institutional support and inconsistent understanding and application of the main documents used by professionals treating trans-patients. Providers face considerable risk in providing unconventional treatments due to the lack of institutional and academic support relating to the treatment for trans-people, and the varied interpretation and application of the diagnostic and treatment documents used in treating trans-people. To address this risk, the relationship with the patient becomes crucial. However, trust, a component required for collaboration, is thwarted when the patients feel obliged to present in ways aligned with these documents in order to receive desired treatments. When trust cannot be established, medical and mental health providers can and do delay or deny treatments, resulting in the imbalance of power between patient and provider. The documents created to assist in treatment actually thwart professional desire to work collaboratively with patients. © 2013 John Wiley & Sons Ltd.

Identifying game elements suitable for MOOCs

NARCIS (Netherlands)

Antonaci, Alessandra; Klemke, Roland; Stracke, Christian M.; Specht, Marcus

2017-01-01

Massive Online Open Courses (MOOCs) have increasingly become objects of research interest and studies in recent years. While MOOCs could be a means to address massive audiences, they suffer from high drop-out rates and low user engagement. Gamification is known as the application of game

Tuberculosis: Which patients do not identify their contacts?

Directory of Open Access Journals (Sweden)

J. Josaphat

2014-09-01

Full Text Available Setting: It is not known what the magnitude of non-identified TB contacts is in our country, or the reasons why contacts at risk are not identified. Objective: The purpose of this study was to analyze the determinants associated with non-identification of contacts. Design: This cross-sectional study included all cases of pulmonary tuberculosis diagnosed and treated in the Chest Disease Centre of Vila Nova de Gaia and their contacts, from 1st January to 31st December 2010. It included information collected from patients related to the identification of contacts in risk, and the information collected by the Public Health Unit during home, work and social places visits. Results: During the period of study, 61 cases of pulmonary TB were diagnosed: 41 cases (67.2% identified all their contacts and 20 cases (32.8% did not. 646 contacts were identified: 154 (23.8% were identified only by the Public Health Unit (mean age of 40.67, and 492 (76.2% were identified by the index cases (mean age of 33.25, (p = 0.001. A mean of 10.59 contacts were identified per index case, of which, 83 (19.3% screened positive. From those identified by the Public Health Unit, 10 (9.8% had LTBI and 5 (4.9% had active TB, and by the index case 61 (18.6% had LTBI and 7 (2.1% had active TB (crude OR = 1.52; CI = 0.83–2.79. The multivariate analysis showed that employment (adjusted OR = 4.82; 95%CI = 1.71–13.54 was associated to non-identification of contacts and patients preferably tended to identify relatives and co-habitants (adjusted OR = 0.22; 95%CI = 0.10–0.47. Conclusion: TB patients tend to identify relatives and co-habitant contacts; contact at place of employment was found to be an independent risk factor for not being identified. Resumo: Contexto: Não é conhecida a magnitude dos contactos de TB não identificados no nosso país, nem os motivos porque os contactos em risco não são identificados

Identifying areas suitable for wine tourism through the use of multi-criteria and geographic information system: the method and its application in the countryside around Mount Etna (Sicily

Directory of Open Access Journals (Sweden)

Lara Riguccio

2017-06-01

Full Text Available Vineyards are among the crops that shape quality landscapes. Many places in the world are famous for their unique wine landscapes which play an important role in the development of tourism in the rural areas. Among these, the wine landscape surrounding mount Etna (Sicily emerges due to its undisputed value, as it is an important component of the territory recognised as a World Heritage Site by UNESCO. This work was conducted with that in mind, in order to identify the most suitable areas for wine tourism on the slopes of our volcano. The method used assigns a great importance to the quality of the landscape, an indispensable resource for encouraging wine tourism, and considers it to be of equal importance with the production of the wines themselves. The present work uses multi-criteria analysis in combination with geographic information system (GIS. Numerous indicators describing local resources were weighed and spatialized. The GIS analysis allowed for the development of various intermediate maps, which allowed to draw up the final suitability map for wine tourism, identifying areas larger than those of the actual vineyards. The value of these areas and the quality of their landscapes are closely connected to the production of the wines in the zone. It could be the target for specific plans and projects aimed at using the available resources, to develop wine tourism in rural areas. Although the study only covers a limited geographical area, the methodology used has general validity and could be used in other contexts.

Identifying an Inciting Antigen Is Associated With Improved Survival in Patients With Chronic Hypersensitivity Pneumonitis

Science.gov (United States)

Swigris, Jeffrey J.; Forssén, Anna V.; Tourin, Olga; Solomon, Joshua J.; Huie, Tristan J.; Olson, Amy L.; Brown, Kevin K.

2013-01-01

Background: The cornerstone of hypersensitivity pneumonitis (HP) management is having patients avoid the inciting antigen (IA). Often, despite an exhaustive search, an IA cannot be found. The objective of this study was to examine whether identifying the IA impacts survival in patients with chronic HP. Methods: We used the Kaplan-Meier method to display, and the log-rank test to compare, survival curves of patients with well-characterized chronic HP stratified on identification of an IA exposure. A Cox proportional hazards (PH) model was used to identify independent predictors in time-to-death analysis. Results: Of 142 patients, 67 (47%) had an identified IA, and 75 (53%) had an unidentified IA. Compared with survivors, patients who died (n = 80, 56%) were older, more likely to have smoked, had lower total lung capacity % predicted and FVC % predicted, had higher severity of dyspnea, were more likely to have pulmonary fibrosis, and were less likely to have an identifiable IA. In a Cox PH model, the inability to identify an IA (hazard ratio [HR], 1.76; 95% CI, 1.01-3.07), older age (HR, 1.04; 95% CI, 1.01-1.07), the presences of pulmonary fibrosis (HR, 2.43; 95% CI, 1.36-4.35), a lower FVC% (HR, 1.36; 95% CI, 1.10-1.68), and a history of smoking (HR, 2.01; 95% C1, 1.15-3.50) were independent predictors of shorter survival. After adjusting for mean age, presence of fibrosis, mean FVC%, mean diffusing capacity of the lung for carbon monoxide (%), and history of smoking, survival was longer for patients with an identified IA exposure than those with an unidentified IA exposure (median, 8.75 years vs 4.88 years; P = .047). Conclusions: Among patients with chronic HP, when adjusting for a number of potentially influential predictors, including the presence of fibrosis, the inability to identify an IA was independently associated with shortened survival. PMID:23828161

On the suitability of fast and frugal heuristics for designing values clarification methods in patient decision aids: a critical analysis.

Science.gov (United States)

Pieterse, Arwen H; de Vries, Marieke

2013-09-01

Increasingly, patient decision aids and values clarification methods (VCMs) are being developed to support patients in making preference-sensitive health-care decisions. Many VCMs encourage extensive deliberation about options, without solid theoretical or empirical evidence showing that deliberation is advantageous. Research suggests that simple, fast and frugal heuristic decision strategies sometimes result in better judgments and decisions. Durand et al. have developed two fast and frugal heuristic-based VCMs. To critically analyse the suitability of the 'take the best' (TTB) and 'tallying' fast and frugal heuristics in the context of patient decision making. Analysis of the structural similarities between the environments in which the TTB and tallying heuristics have been proven successful and the context of patient decision making and of the potential of these heuristic decision processes to support patient decision making. The specific nature of patient preference-sensitive decision making does not seem to resemble environments in which the TTB and tallying heuristics have proven successful. Encouraging patients to consider less rather than more relevant information potentially even deteriorates their values clarification process. Values clarification methods promoting the use of more intuitive decision strategies may sometimes be more effective. Nevertheless, we strongly recommend further theoretical thinking about the expected value of such heuristics and of other more intuitive decision strategies in this context, as well as empirical assessments of the mechanisms by which inducing such decision strategies may impact the quality and outcome of values clarification. © 2011 John Wiley & Sons Ltd.

A Feasibility study of remote consultation to determine suitability for surgery in stroke rehabilitation

NARCIS (Netherlands)

Buurke, Jaap; Kleissen, R.F.M.; Nene, A.V.; Bloo, J.K.C.; Renzenbrink, G.J.; Zeegers, A.V.C.M.; Doederlein, L.; Hermens, Hermanus J.

2004-01-01

We studied knowledge transfer for the determination of the suitability of stroke patients for a specialist surgical procedure (split anterior tibial tendon transfer). Gait analysis data from patients at a general hospital were discussed with an expert in another country using personal computers, an

CHARACTERISTICS AND SUITABILITY EVALUATION OF THE ...

African Journals Online (AJOL)

Ifedotun Aina

suggested that the soils were not currently suitable for the production of the two ... crop – land suitability analysis has been used for achieving optimum utilization of the available ... Two methods of land suitability evaluation (FAO frame work and parametric) ..... Characterization and Classification of Onwu River Floodplain.

Identifying research priorities for patient safety in mental health: an international expert Delphi study

Science.gov (United States)

Murray, Kevin; Thibaut, Bethan; Ramtale, Sonny Christian; Adam, Sheila; Darzi, Ara; Archer, Stephanie

2018-01-01

Objective Physical healthcare has dominated the patient safety field; research in mental healthcare is not as extensive but findings from physical healthcare cannot be applied to mental healthcare because it delivers specialised care that faces unique challenges. Therefore, a clearer focus and recognition of patient safety in mental health as a distinct research area is still needed. The study aim is to identify future research priorities in the field of patient safety in mental health. Design Semistructured interviews were conducted with the experts to ascertain their views on research priorities in patient safety in mental health. A three-round online Delphi study was used to ascertain consensus on 117 research priority statements. Setting and participants Academic and service user experts from the USA, UK, Switzerland, Netherlands, Ireland, Denmark, Finland, Germany, Sweden, Australia, New Zealand and Singapore were included. Main outcome measures Agreement in research priorities on a five-point scale. Results Seventy-nine statements achieved consensus (>70%). Three out of the top six research priorities were patient driven; experts agreed that understanding the patient perspective on safety planning, on self-harm and on medication was important. Conclusions This is the first international Delphi study to identify research priorities in safety in the mental field as determined by expert academic and service user perspectives. A reasonable consensus was obtained from international perspectives on future research priorities in patient safety in mental health; however, the patient perspective on their mental healthcare is a priority. The research agenda for patient safety in mental health identified here should be informed by patient safety science more broadly and used to further establish this area as a priority in its own right. The safety of mental health patients must have parity with that of physical health patients to achieve this. PMID:29502096

Land use suitability screening for power plant sites in Maryland

International Nuclear Information System (INIS)

Dobson, J.E.

1975-01-01

Since 1974 Oak Ridge National Laboratory (ORNL) has been engaged in developing an automated procedure for land use suitability screening. The Nuclear Regulatory Commission has funded the project to aid in the selection of power plant sites in Maryland. Its purpose is to identify candidate areas from which specific candidate sites can be chosen for detailed analyses. The ORNL approach assures that certain key variables are examined empirically for every cell in the study region before candidate sites are selected. Each variable is assigned an importance weight and compatibility score based upon its effect on the economic, social, or ecologic costs associated with construction in a given cell. The weighted scores for each variable are aggregated and output as a suitability score for each cell

Identifying patients with AAA with the highest risk following endovascular repair.

Science.gov (United States)

Cadili, Ali; Turnbull, Robert; Hervas-Malo, Marilou; Ghosh, Sunita; Chyczij, Harold

2012-08-01

It has been demonstrated that endovascular repair of arterial disease results in reduced perioperative morbidity and mortality compared to open surgical repair. The rates of complications and need for reinterventions, however, have been found to be higher than that in open repair. The purpose of this study was to identify the predictors of endograft complications and mortality in patients undergoing endovascular abdominal aortic aneurysm (AAA) repair; specifically, our aim was to identify a subset of patients with AAA whose risk of periprocedure mortality was so high that they should not be offered endovascular repair. We undertook a prospective review of patients with AAA receiving endovascular therapy at a single institution. Collected variables included age, gender, date of procedure, indication for procedure, size of aneurysm (where applicable), type of endograft used, presence of rupture, American Society of Anesthesiologists (ASA) class, major medical comorbidities, type of anesthesia (general, epidural, or local), length of intensive care unit (ICU) stay, and length of hospital stay. These factors were correlated with the study outcomes (overall mortality, graft complications, morbidity, and reintervention) using univariate and multivariate logistic regression. A total of 199 patients underwent endovascular AAA repair during the study period. The ICU stay, again, was significantly correlated with the primary outcomes (death and graft complications). In addition, length of hospital stay greater than 3 days, also emerged as a statistically significant predictor of graft complications in this subgroup (P = .024). Survival analysis for patients with AAA revealed that age over 85 years and ICU stay were predictive of decreased survival. Statistical analysis for other subgroups of patients (inflammatory AAA or dissection) was not performed due to the small numbers in these subgroups. Patients with AAA greater than 85 years of age are at a greater risk of mortality

Comparing the Ability of Anthropometric Indicators in Identifying Metabolic Syndrome in HIV Patients.

Directory of Open Access Journals (Sweden)

Rebeca Antunes Beraldo

Full Text Available Highly active antiretroviral therapy (HAART can cause side effects in HIV patients, as the metabolic syndrome. Early identification of risk for development of cardiovascular diseases using available reliable and practical methods is fundamental. On this basis, the aim of this study was to compare the effectiveness of anthropometric indicators to identify metabolic syndrome in HIV patients on HAART.It is a cross-sectional study. A number of 280 stable HIV patients were studied. It measured weight, height, waist circumference (WC, hip circumference (HP, thigh circumference (TC and calculated body mass index (BMI, body adiposity index (BAI, waist to hip ratio (WHR and waist to thigh ratio (WTR. There was also a performance of biochemical tests of lipid profile and fasting glucose. Systemic blood pressure was measured. The criteria proposed by the National Cholesterol Education Program III (NCEP-ATP III to metabolic syndrome classification was used. Individuals were divided in groups with or without metabolic alterations and their anthropometric indicators were compared. Receiver operating characteristic (ROC curves were designed for each anthropometric indicator using the metabolic syndrome classification to identify sensitivity and specificity.WC was a good tool to identify each metabolic disorder separately: total cholesterol (only females, p<0.05, triglycerides (only males, p<0.001, HDL cholesterol (p<0.05, LDL cholesterol (p<005 and fasting glycemic (p<005. WC also showed the best performance to identify metabolic syndrome in both genders (areas under the curve (AUCs: 0.79 and 0.76 for male and female, respectively, while BAI proved to be an inadequate indicator (AUCs: 0.63 and 0.67 for males and females, respectively, in this population.The central adiposity measure (WC had the best performance to identify metabolic syndrome, and it is a convenient, cheap and reliable tool that can be used in clinical practice routinely to prevent

Land Suitability Evaluation for Blueberry Crop by Determining the Qualitative Properties of the Identified Soil Type Related with the Antioxidant Capacity of Fruits

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Amalia Ioana BOT

2017-12-01

Full Text Available Organic and inorganic forms of nitrogen and carbon were measured in order to determine soil fertility. The amount of total nitrogen ranged between 0.849 g/kg and 1.755 g/kg in the samples gathered from soil in modified state and between 0.961 k/kg and 2.427 g/kg in the samples collected from the soil in natural state. Based on these results it could be concluded that in comparing with the previous year, plants used the soil nutrients for their development. The activities of different enzymes were measured as well. Nitrate reductase activity was also higher in samples collected from soil in modified state (from bilon than in the samples collected near plantations (control samples and the values ranged between 0.055 ± 0.012 μmol⋅h-1⋅g-1 and 1.018 ± 0.117 μmol⋅h-1⋅g-1 in samples from soil in natural state and between 0.013 ± 0.002 μmol⋅h-1⋅g-1 and 0.447 ± 0.083 μmol⋅h-1⋅g-1 in bilons. Using GIS techniques of spatial analysis to determine the exact type of soil from each studied blueberry plantation from the Northwest Region of Development and also based on the soil bio-chemical analyses, it was possible to achieve a qualitative characterization of the territory, taking into account the requirements of blueberries for cultivation and to achieve a land suitability for blueberry crop. Combining laboratory approach, consisting from soil bio-chemical and physico-chemical analyses and chemical analyses of blueberry fruits, with the techniques used in order to determine the soil type and land suitability, the study conducted in the Northwest Region of Development identified the best conditions for blueberry crop, based on the qualitative characterization of land.

Identifying the 'right patient': nurse and consumer perspectives on verifying patient identity during medication administration.

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Kelly, Teresa; Roper, Cath; Elsom, Stephen; Gaskin, Cadeyrn

2011-10-01

Accurate verification of patient identity during medication administration is an important component of medication administration practice. In medical and surgical inpatient settings, the use of identification aids, such as wristbands, is common. In many psychiatric inpatient units in Victoria, Australia, however, standardized identification aids are not used. The present paper outlines the findings of a qualitative research project that employed focus groups to examine mental health nurse and mental health consumer perspectives on the identification of patients during routine medication administration in psychiatric inpatient units. The study identified a range of different methods currently employed to verify patient identity, including technical methods, such as wristband and photographs, and interpersonal methods, such as patient recognition. There were marked similarities in the perspectives of mental health nurses and mental health consumers regarding their opinions and preferences. Technical aids were seen as important, but not as a replacement for the therapeutic nurse-patient encounter. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Risk analysis for dengue suitability in Africa using the ArcGIS predictive analysis tools (PA tools).

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Attaway, David F; Jacobsen, Kathryn H; Falconer, Allan; Manca, Germana; Waters, Nigel M

2016-06-01

Risk maps identifying suitable locations for infection transmission are important for public health planning. Data on dengue infection rates are not readily available in most places where the disease is known to occur. A newly available add-in to Esri's ArcGIS software package, the ArcGIS Predictive Analysis Toolset (PA Tools), was used to identify locations within Africa with environmental characteristics likely to be suitable for transmission of dengue virus. A more accurate, robust, and localized (1 km × 1 km) dengue risk map for Africa was created based on bioclimatic layers, elevation data, high-resolution population data, and other environmental factors that a search of the peer-reviewed literature showed to be associated with dengue risk. Variables related to temperature, precipitation, elevation, and population density were identified as good predictors of dengue suitability. Areas of high dengue suitability occur primarily within West Africa and parts of Central Africa and East Africa, but even in these regions the suitability is not homogenous. This risk mapping technique for an infection transmitted by Aedes mosquitoes draws on entomological, epidemiological, and geographic data. The method could be applied to other infectious diseases (such as Zika) in order to provide new insights for public health officials and others making decisions about where to increase disease surveillance activities and implement infection prevention and control efforts. The ability to map threats to human and animal health is important for tracking vectorborne and other emerging infectious diseases and modeling the likely impacts of climate change. Copyright © 2016 Elsevier B.V. All rights reserved.

A passive radon dosemeter suitable for workplaces

International Nuclear Information System (INIS)

Orlando, C.; Orlando, P.; Patrizii, L.; Tommasino, L.; Tonnarini, S.; Trevisi, R.; Viola, P.

2002-01-01

The results obtained in different international intercomparisons on passive radon monitors have been analysed with the aim of identifying a suitable radon monitoring device for workplaces. From this analysis, the passive radon device, first developed for personal dosimetry in mines by the National Radiation Protection Board, UK (NRPB), has shown the most suitable set of characteristics. This radon monitor consists of a diffusion chamber, made of conductive plastic with less than 2 cm height, containing a CR-39 film (Columbia Resin 1939), as track detector. Radon detectors in workplaces may be exposed only during the working hours, thus requiring the storage of the detectors in low-radon zones when not exposed. This paper describes how this problem can be solved. Since track detectors are also efficient neutron dosemeters, care should be taken when radon monitors are used in workplaces, where they may be exposed to neutrons, such as on high altitude mountains, in the surroundings of high energy X ray facilities (where neutrons are produced by (gamma, n) reactions) or around high energy particle accelerators. To this end, the response of these passive radon monitors to high energy neutron fields has been investigated. (author)

Landscape suitability in Botswana for the conservation of its six large African carnivores.

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Hanlie E K Winterbach

Full Text Available Wide-ranging large carnivores often range beyond the boundaries of protected areas into human-dominated areas. Mapping out potentially suitable habitats on a country-wide scale and identifying areas with potentially high levels of threats to large carnivore survival is necessary to develop national conservation action plans. We used a novel approach to map and identify these areas in Botswana for its large carnivore guild consisting of lion (Panthera leo, leopard (Panthera pardus, spotted hyaena (Crocuta crocuta, brown hyaena (Hyaena brunnea, cheetah (Acinonyx jubatus and African wild dog (Lycaon pictus. The habitat suitability for large carnivores depends primarily on prey availability, interspecific competition, and conflict with humans. Prey availability is most likely the strongest natural determinant. We used the distribution of biomass of typical wild ungulate species occurring in Botswana which is preyed upon by the six large carnivores to evaluate the potential suitability of the different management zones in the country to sustain large carnivore populations. In areas where a high biomass of large prey species occurred, we assumed interspecific competition between dominant and subordinated competitors to be high. This reduced the suitability of these areas for conservation of subordinate competitors, and vice versa. We used the percentage of prey biomass of the total prey and livestock biomass to identify areas with potentially high levels of conflict in agricultural areas. High to medium biomass of large prey was mostly confined to conservation zones, while small prey biomass was more evenly spread across large parts of the country. This necessitates different conservation strategies for carnivores with a preference for large prey, and those that can persist in the agricultural areas. To ensure connectivity between populations inside Botswana and also with its neighbours, a number of critical areas for priority management actions exist

Landscape suitability in Botswana for the conservation of its six large African carnivores.

Science.gov (United States)

Winterbach, Hanlie E K; Winterbach, Christiaan W; Somers, Michael J

2014-01-01

Wide-ranging large carnivores often range beyond the boundaries of protected areas into human-dominated areas. Mapping out potentially suitable habitats on a country-wide scale and identifying areas with potentially high levels of threats to large carnivore survival is necessary to develop national conservation action plans. We used a novel approach to map and identify these areas in Botswana for its large carnivore guild consisting of lion (Panthera leo), leopard (Panthera pardus), spotted hyaena (Crocuta crocuta), brown hyaena (Hyaena brunnea), cheetah (Acinonyx jubatus) and African wild dog (Lycaon pictus). The habitat suitability for large carnivores depends primarily on prey availability, interspecific competition, and conflict with humans. Prey availability is most likely the strongest natural determinant. We used the distribution of biomass of typical wild ungulate species occurring in Botswana which is preyed upon by the six large carnivores to evaluate the potential suitability of the different management zones in the country to sustain large carnivore populations. In areas where a high biomass of large prey species occurred, we assumed interspecific competition between dominant and subordinated competitors to be high. This reduced the suitability of these areas for conservation of subordinate competitors, and vice versa. We used the percentage of prey biomass of the total prey and livestock biomass to identify areas with potentially high levels of conflict in agricultural areas. High to medium biomass of large prey was mostly confined to conservation zones, while small prey biomass was more evenly spread across large parts of the country. This necessitates different conservation strategies for carnivores with a preference for large prey, and those that can persist in the agricultural areas. To ensure connectivity between populations inside Botswana and also with its neighbours, a number of critical areas for priority management actions exist in the

An approach for recreation suitability analysis to recreation planning in Gölcük Nature Park.

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Gül, Atila; Orücü, M Kamil; Karaca, Oznur

2006-05-01

Gölcük Nature Park (GNP) is an area protected by law in Turkey. It is an important nature park with rich flora, fauna, geomorphologic forms, landscape features, and recreational potential in the region. However, GNP does not have a recreation management plan. The purpose of this study was to determine the actual natural, cultural, and visual resources of GNP, determine the most suitable recreational sites with multiple factors, evaluate the demands and tendencies of visitors, and suggest recreational activities and facilities for the most suitable sites of GNP. However, it was also conceived as leading to a recreational plan and design of GNP in the future and identifying the entire appropriate and current data of GNP with the creation of various maps. This study used multifactor analysis to determine the most suitable recreation sites of GNP. Used recreation factors were established including degree of slope, proximity to water resources, accessibility, elevation, vegetation, soil, climate, aspect, current cultural facilities, visual values, and some limiting factors in accordance with the characteristics of GNP. Weighting and suitability values of factors were determined by 30 local expert surveys. All obtained data were evaluated and integrated in the Geographical Information Systems base. Obtained maps were overlapped. Thus, recreational suitability zones map were created manually. However, the demands and behaviours from visitor surveys in GNP were focused on the most suitable recreation sites of the park. Finally, 10% of GNP was identified as the most suitable sites for recreational use. Various recreational facilities and activities (including picnicking, sports facilities and playgrounds, camping sites, walking paths, food and local outlets, etc.) were recommended for nine of the most suitable areas on the proposed recreational map.

Multiple oncogenic viruses identified in Ocular surface squamous neoplasia in HIV-1 patients

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Bisson Gregory

2010-03-01

Full Text Available Abstract Background Ocular surface squamous neoplasia (OSSN is a rare cancer that has increased in incidence with the HIV pandemic in Africa. The underlying cause of this cancer in HIV-infected patients from Botswana is not well defined. Results Tissues were obtained from 28 OSSN and 8 pterygia patients. The tissues analyzed from OSSN patients were 83% positive for EBV, 75% were HPV positive, 70% were KSHV positive, 75% were HSV-1/2 positive, and 61% were CMV positive by PCR. Tissues from pterygium patients were 88% positive for EBV, 75% were HPV positive, 50% were KSHV positive, and 60% were CMV positive. None of the patients were JC or BK positive. In situ hybridization and immunohistochemistry analyses further identified HPV, EBV, and KSHV in a subset of the tissue samples. Conclusion We identified the known oncogenic viruses HPV, KSHV, and EBV in OSSN and pterygia tissues. The presence of these tumor viruses in OSSN suggests that they may contribute to the development of this malignancy in the HIV population. Further studies are necessary to characterize the molecular mechanisms associated with viral antigens and their potential role in the development of OSSN.

The meaning and classification of tattoos in the context of their suitability to identify corpses of unknown identity.

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Sadowski, Wojciech A; Borowska-Solonynko, Aleksandra B

2017-01-01

To present the most popular types of tattoos, their meaning and classification, and to assess the suitability of different forms of tattoos in the process of identification of corpses of unknown identity. The tattoos found on 729 cadavers who underwent post mortem examinations at the Department of Forensic Medicine in Warsaw in the years 2012-2015 were analyzed. The tattoos were photographed and identified in terms of their meaning domain and classified into groups. Tattoos belonging to all groups were found, according to the most popular tattoo classification, which is based on their nature and includes: criminal and prison tattoos (defining the prison hierarchy, criminal profession as well as intentions and goals, erotic tattoos, environmental, penitentiary), military and artistic. The novel classification, focusing on the utility of certain kinds of tattoos for identyfying corpses of unknown identity, was also developed. According to the above mentioned classification the following kinds of tattoos are distinguished: individual (artistic), group (e.g. penitentiary - indicating the fact of being imprisoned in a penitentiary institution or belonging to a "prison kites" subculture, or presenting criminal profession; group confined tattoo (indicating a staying in a specific penitentiary institution), group tattoo with individual data (indicating the fact of staying in a penitentiary institution as well as dates of imprisonment), and others (e.g. names of relatives, military tattoo, etc.). Analysis of individual types of tattoo can accelerate the process of identification of the cadavers. The proposed classification allows to quickly determine whether a particular tattoo can be helpful in initial individual identification (in the case of individual tattoos) or whether it can be used to reduce the group of people considered (in cases of different types of group tattoos).

Identifying the Risk of Swallowing-Related Pulmonary Complications in Older Patients With Hip Fracture.

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Meals, Clifton; Roy, Siddharth; Medvedev, Gleb; Wallace, Matthew; Neviaser, Robert J; O'Brien, Joseph

2016-01-01

To identify and potentially modify the risk of pulmonary complications in a group of older patients with hip fracture, the authors obtained speech and language pathology consultations for these patients. Then they performed a retrospective chart review of all patients 65 years and older who were admitted to their institution between June 2011 and July 2013 with acute hip fracture, were treated surgically, and had a speech and language pathology evaluation in the immediate perioperative period. The authors identified 52 patients who met the study criteria. According to the American Society of Anesthesiologists (ASA) classification system, at the time of surgery, 1 patient (2%) was classified as ASA I, 12 patients (23%) were ASA II, 26 (50%) were ASA III, and 12 (23%) were ASA IV. Based on a speech and language pathology evaluation, 22 patients (42%) were diagnosed with dysphagia. Statistical analysis showed that ASA III status and ASA IV status were meaningful predictors of dysphagia and that dysphagia itself was a strong risk factor for pulmonary aspiration, pneumonia, and aspiration pneumonitis. Evaluation by a speech and language pathologist, particularly of patients classified as ASA III or ASA IV, may be an efficient means of averting pulmonary morbidity that is common in older patients with hip fracture. Copyright 2016, SLACK Incorporated.

A target based approach identifies genomic predictors of breast cancer patient response to chemotherapy

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Hallett Robin M

2012-05-01

Full Text Available Abstract Background The efficacy of chemotherapy regimens in breast cancer patients is variable and unpredictable. Whether individual patients either achieve long-term remission or suffer recurrence after therapy may be dictated by intrinsic properties of their breast tumors including genetic lesions and consequent aberrant transcriptional programs. Global gene expression profiling provides a powerful tool to identify such tumor-intrinsic transcriptional programs, whose analyses provide insight into the underlying biology of individual patient tumors. For example, multi-gene expression signatures have been identified that can predict the likelihood of disease reccurrence, and thus guide patient prognosis. Whereas such prognostic signatures are being introduced in the clinical setting, similar signatures that predict sensitivity or resistance to chemotherapy are not currently clinically available. Methods We used gene expression profiling to identify genes that were co-expressed with genes whose transcripts encode the protein targets of commonly used chemotherapeutic agents. Results Here, we present target based expression indices that predict breast tumor response to anthracycline and taxane based chemotherapy. Indeed, these signatures were independently predictive of chemotherapy response after adjusting for standard clinic-pathological variables such as age, grade, and estrogen receptor status in a cohort of 488 breast cancer patients treated with adriamycin and taxotere/taxol. Conclusions Importantly, our findings suggest the practicality of developing target based indices that predict response to therapeutics, as well as highlight the possibility of using gene signatures to guide the use of chemotherapy during treatment of breast cancer patients.

Microneedle technology for immunisation: Perception, acceptability and suitability for paediatric use.

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Marshall, Sarah; Sahm, Laura J; Moore, Anne C

2016-02-03

To examine published research which explores the perception and acceptability of microneedle technology for immunisation and to investigate the suitability of this technology for paediatric use. A series of keywords and their synonyms were combined in various combinations and permutations using Boolean operators to sequentially search four databases (PubMed, Web of Science, Embase and CINAHL). Following removal of duplications and irrelevant results, 12 research articles were included in the final literature review. The opinions of patients, parents, children and healthcare professionals (HCP) were collated. A positive perception and a high level of acceptability predominated. Microneedle technology research has been focussed on demonstrating efficacy with minimal focus on determining HCP/public perception and acceptability for paediatric use, exemplified by the paucity of studies presented in this review. Commercial viability will depend on HCP/public acceptability of microneedle technology. An effort must be made to identify the barriers to acceptance and to overcome them by increasing awareness and education in stakeholder groups pertaining to the paediatric population. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sentinel nodes identified by computed tomography-lymphography accurately stage the axilla in patients with breast cancer

International Nuclear Information System (INIS)

Motomura, Kazuyoshi; Sumino, Hiroshi; Noguchi, Atsushi; Horinouchi, Takashi; Nakanishi, Katsuyuki

2013-01-01

Sentinel node biopsy often results in the identification and removal of multiple nodes as sentinel nodes, although most of these nodes could be non-sentinel nodes. This study investigated whether computed tomography-lymphography (CT-LG) can distinguish sentinel nodes from non-sentinel nodes and whether sentinel nodes identified by CT-LG can accurately stage the axilla in patients with breast cancer. This study included 184 patients with breast cancer and clinically negative nodes. Contrast agent was injected interstitially. The location of sentinel nodes was marked on the skin surface using a CT laser light navigator system. Lymph nodes located just under the marks were first removed as sentinel nodes. Then, all dyed nodes or all hot nodes were removed. The mean number of sentinel nodes identified by CT-LG was significantly lower than that of dyed and/or hot nodes removed (1.1 vs 1.8, p <0.0001). Twenty-three (12.5%) patients had ≥2 sentinel nodes identified by CT-LG removed, whereas 94 (51.1%) of patients had ≥2 dyed and/or hot nodes removed (p <0.0001). Pathological evaluation demonstrated that 47 (25.5%) of 184 patients had metastasis to at least one node. All 47 patients demonstrated metastases to at least one of the sentinel nodes identified by CT-LG. CT-LG can distinguish sentinel nodes from non-sentinel nodes, and sentinel nodes identified by CT-LG can accurately stage the axilla in patients with breast cancer. Successful identification of sentinel nodes using CT-LG may facilitate image-based diagnosis of metastasis, possibly leading to the omission of sentinel node biopsy

Marine Benthic Habitats and Seabed Suitability Mapping for Potential Ocean Current Energy Siting Offshore Southeast Florida

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Amanda Mulcan

2015-05-01

Full Text Available This study examines the legal framework for ocean current energy policy and regulation to develop a metric for assessing the biological and geological characteristics of a seabed area with respect to the siting of OCE devices, a framework of criteria by which to assess seabed suitability (seabed suitability framework that can facilitate the siting, and implementation of ocean current energy (OCE projects. Seafloor geology and benthic biological data were analyzed in conjunction with seafloor core sample geostatistical interpolation to locate suitable substrates for OCE anchoring. Existing submarine cable pathways were considered to determine pathways for power transmission cables that circumvent biologically sensitive areas. Suitability analysis indicates that areas east of the Miami Terrace and north of recently identified deep-sea coral mounds are the most appropriate for OCE siting due to abundance of sand/sediment substrate, existing underwater cable route access, and minimal biological presence (i.e., little to no benthic communities. Further reconnaissance requires higher resolution maps of geological substrate and benthic community locations to identify specific OCE development locations, classify benthic conditions, and minimize potentially negative OCE environmental impacts.

Advising Your Elderly Patients Concerning Safe Exercising

OpenAIRE

Myers, Anita

1987-01-01

With the emergence of physical activity programs geared specifically to senior citizens, family physicians will increasingly be called on to provide advice or approval concerning their patients' suitability for participation. In addition, family physicians have been identified as having a key role to play in the promotion of exercise for sedentary older adults. To assist the family practitioner in advising elderly patients concerning safe exercise patterns, this article discusses the document...

Identifying factors associated with the discharge of male State patients from Weskoppies Hospital

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Riaan G. Prinsloo

2017-12-01

Full Text Available Background: Designated psychiatric facilities are responsible for the care, treatment and reintegration of State patients. The necessary long-term care places a considerable strain on health-care resources. Resource use should be optimised while managing the risks that patients pose to themselves and the community. Identifying unique factors associated with earlier discharge may decrease the length of stay. Factors associated with protracted inpatient care without discharge could identify patients who require early and urgent intervention. Aim: We identify socio-economic, demographic, psychiatric and charge-related factors associated with the discharge of male State patients. Methods: We reviewed the files of discharged and admitted forensic State patients at Weskoppies Psychiatric Hospital. Data were captured in an electronic recording sheet. The association between factors and the outcome measure (discharged vs. admitted was determined using chi-squared tests and Fischer’s exact tests. Results: Discharged State patients were associated with being a primary caregiver (p = 0.031 having good insight into illness (p = 0.025 or offence (p = 0.005 and having had multiple successful leaves of absences. A lack of substance abuse during admission (p = 0.027, an absence of a diagnosis of substance use disorder (p = 0.013 and the absence of verbal and physical aggression (p = 0.002 and p = 0.016 were associated with being discharged. Prolonged total length of stay (9–12 years, p = 0.031 and prolonged length of stay in open wards (6–9 years, p = 0.000 were associated with being discharged. A history of previous offences (p = 0.022, a diagnosis of substance use disorder (p = 0.023, recent substance abuse (p = 0.018 and a history of physical aggression since admission (p = 0.017 were associated with continued admission. Conclusion: Discharge of State patients is associated with an absence of substance abuse, lack of aggression

The validity of using ICD-9 codes and pharmacy records to identify patients with chronic obstructive pulmonary disease

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Lee Todd A

2011-02-01

Full Text Available Abstract Background Administrative data is often used to identify patients with chronic obstructive pulmonary disease (COPD, yet the validity of this approach is unclear. We sought to develop a predictive model utilizing administrative data to accurately identify patients with COPD. Methods Sequential logistic regression models were constructed using 9573 patients with postbronchodilator spirometry at two Veterans Affairs medical centers (2003-2007. COPD was defined as: 1 FEV1/FVC Results 4564 of 9573 patients (47.7% had an FEV1/FVC Conclusion Commonly used definitions of COPD in observational studies misclassify the majority of patients as having COPD. Using multiple diagnostic codes in combination with pharmacy data improves the ability to accurately identify patients with COPD.

Prenatal radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.

2002-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has the right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data have shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% (ICRP84, 2000) up to 0.14% per 10 mSv (BEIR-V 1990). In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy (ICRP84, 2000), and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; 1. The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. 2. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period

Sex-related hearing impairment in Wolfram syndrome patients identified by inactivating WFS1 mutations

NARCIS (Netherlands)

Pennings, RJE; Huygen, PLM; van den Ouweland, JMW; Cryns, K; Dikkeschei, LD; Van Camp, G; Cremers, CWRJ

2004-01-01

This study examined the audiovestibular profile of 11 Wolfram syndrome patients (4 males, 7 females) from 7 families, with identified WFS1 mutations, and the audiometric profile of 17 related heterozygous carriers of WFS1 mutations. Patients with Wolfram syndrome showed a downsloping audiogram and

Sex-related hearing impairment in Wolfram syndrome patients identified by inactivating WFS1 mutations.

NARCIS (Netherlands)

Pennings, R.J.E.; Huygen, P.L.M.; Ouweland, J.M.W. van den; Cryns, K.; Dikkeschei, L.D.; Camp, G. van; Cremers, C.W.R.J.

2004-01-01

This study examined the audiovestibular profile of 11 Wolfram syndrome patients (4 males, 7 females) from 7 families, with identified WFS1 mutations, and the audiometric profile of 17 related heterozygous carriers of WFS1 mutations. Patients with Wolfram syndrome showed a downsloping audiogram and

Ensemble modeling to predict habitat suitability for a large-scale disturbance specialist

Science.gov (United States)

Quresh S. Latif; Victoria A. Saab; Jonathan G. Dudley; Jeff P. Hollenbeck

2013-01-01

To conserve habitat for disturbance specialist species, ecologists must identify where individuals will likely settle in newly disturbed areas. Habitat suitability models can predict which sites at new disturbances will most likely attract specialists. Without validation data from newly disturbed areas, however, the best approach for maximizing predictive accuracy can...

Data mining in bone marrow transplant records to identify patients with high odds of survival.

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Taati, Babak; Snoek, Jasper; Aleman, Dionne; Ghavamzadeh, Ardeshir

2014-01-01

Patients undergoing a bone marrow stem cell transplant (BMT) face various risk factors. Analyzing data from past transplants could enhance the understanding of the factors influencing success. Records up to 120 measurements per transplant procedure from 1751 patients undergoing BMT were collected (Shariati Hospital). Collaborative filtering techniques allowed the processing of highly sparse records with 22.3% missing values. Ten-fold cross-validation was used to evaluate the performance of various classification algorithms trained on predicting the survival status. Modest accuracy levels were obtained in predicting the survival status (AUC = 0.69). More importantly, however, operations that had the highest chances of success were shown to be identifiable with high accuracy, e.g., 92% or 97% when identifying 74 or 31 recipients, respectively. Identifying the patients with the highest chances of survival has direct application in the prioritization of resources and in donor matching. For patients where high-confidence prediction is not achieved, assigning a probability to their survival odds has potential applications in probabilistic decision support systems and in combination with other sources of information.

A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease.

Science.gov (United States)

Ciclitira, P J; Ellis, H J; Evans, D J; Lennox, E S

1985-03-01

Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9 X 10(-2)% wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease.

Computerized Tests of Team Performance and Crew Coordination Suitable for Military/Aviation Settings.

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Lawson, Ben D; Britt, Thomas W; Kelley, Amanda M; Athy, Jeremy R; Legan, Shauna M

2017-08-01

The coordination of team effort on shared tasks is an area of inquiry. A number of tests of team performance in challenging environments have been developed without comparison or standardization. This article provides a systematic review of the most accessible and usable low-to-medium fidelity computerized tests of team performance and determines which are most applicable to military- and aviation-relevant research, such as studies of group command, control, communication, and crew coordination. A search was conducted to identify computerized measures of team performance. In addition to extensive literature searches (DTIC, Psychinfo, PubMed), the authors reached out to team performance researchers at conferences and through electronic communication. Identified were 57 potential tests according to 6 specific selection criteria (e.g., the requirement for automated collection of team performance and coordination processes, the use of military-relevant scenarios). The following seven tests (listed alphabetically) were considered most suitable for military needs: Agent Enabled Decision Group Environment (AEDGE), C3Conflict, the C3 (Command, Control, & Communications) Interactive Task for Identifying Emerging Situations (NeoCITIES), Distributed Dynamic Decision Making (DDD), Duo Wondrous Original Method Basic Awareness/Airmanship Test (DuoWOMBAT), the Leader Development Simulator (LDS), and the Planning Task for Teams (PLATT). Strengths and weaknesses of these tests are described and recommendations offered to help researchers identify the test most suitable for their particular needs. Adoption of a few standard computerized test batteries to study team performance would facilitate the evaluation of interventions intended to enhance group performance in multiple challenging military and aerospace operational environments.Lawson BD, Britt TW, Kelley AM, Athy JR, Legan SM. Computerized tests of team performance and crew coordination suitable for military/aviation settings

Exome sequencing identifies CTSK mutations in patients originally diagnosed as intermediate osteopetrosis☆

Science.gov (United States)

Pangrazio, Alessandra; Puddu, Alessandro; Oppo, Manuela; Valentini, Maria; Zammataro, Luca; Vellodi, Ashok; Gener, Blanca; Llano-Rivas, Isabel; Raza, Jamal; Atta, Irum; Vezzoni, Paolo; Superti-Furga, Andrea; Villa, Anna; Sobacchi, Cristina

2014-01-01

Autosomal Recessive Osteopetrosis is a genetic disorder characterized by increased bone density due to lack of resorption by the osteoclasts. Genetic studies have widely unraveled the molecular basis of the most severe forms, while cases of intermediate severity are more difficult to characterize, probably because of a large heterogeneity. Here, we describe the use of exome sequencing in the molecular diagnosis of 2 siblings initially thought to be affected by “intermediate osteopetrosis”, which identified a homozygous mutation in the CTSK gene. Prompted by this finding, we tested by Sanger sequencing 25 additional patients addressed to us for recessive osteopetrosis and found CTSK mutations in 4 of them. In retrospect, their clinical and radiographic features were found to be compatible with, but not typical for, Pycnodysostosis. We sought to identify modifier genes that might have played a role in the clinical manifestation of the disease in these patients, but our results were not informative. In conclusion, we underline the difficulties of differential diagnosis in some patients whose clinical appearance does not fit the classical malignant or benign picture and recommend that CTSK gene be included in the molecular diagnosis of high bone density conditions. PMID:24269275

Evaluation of ICD-10 algorithms to identify hypopituitary patients in the Danish National Patient Registry

DEFF Research Database (Denmark)

Berglund, Agnethe; Olsen, Morten; Andersen, Marianne

2017-01-01

: Patients with International Classification of Diseases (10th edition [ICD-10]) diagnoses of hypopituitarism, or other diagnoses of pituitary disorders assumed to be associated with an increased risk of hypopituitarism, recorded in the DNPR during 2000-2012 were identified. Medical records were reviewed...... to confirm or disprove hypopituitarism. RESULTS: Hypopituitarism was confirmed in 911 patients. In a candidate population of 1,661, this yielded an overall positive predictive value (PPV) of 54.8% (95% confidence interval [CI]: 52.4-57.3). Using algorithms searching for patients recorded at least one, three...... or five times with a diagnosis of hypopituitarism (E23.0x) and/or at least once with a diagnosis of postprocedural hypopituitarism (E89.3x), PPVs gradually increased from 73.3% (95% CI: 70.6-75.8) to 83.3% (95% CI: 80.7-85.7). Completeness for the same algorithms, however, decreased from 90.8% (95% CI: 88...

Identification of suitable reference genes for gene expression studies of shoulder instability.

Directory of Open Access Journals (Sweden)

Mariana Ferreira Leal

Full Text Available Shoulder instability is a common shoulder injury, and patients present with plastic deformation of the glenohumeral capsule. Gene expression analysis may be a useful tool for increasing the general understanding of capsule deformation, and reverse-transcription quantitative polymerase chain reaction (RT-qPCR has become an effective method for such studies. Although RT-qPCR is highly sensitive and specific, it requires the use of suitable reference genes for data normalization to guarantee meaningful and reproducible results. In the present study, we evaluated the suitability of a set of reference genes using samples from the glenohumeral capsules of individuals with and without shoulder instability. We analyzed the expression of six commonly used reference genes (ACTB, B2M, GAPDH, HPRT1, TBP and TFRC in the antero-inferior, antero-superior and posterior portions of the glenohumeral capsules of cases and controls. The stability of the candidate reference gene expression was determined using four software packages: NormFinder, geNorm, BestKeeper and DataAssist. Overall, HPRT1 was the best single reference gene, and HPRT1 and B2M composed the best pair of reference genes from different analysis groups, including simultaneous analysis of all tissue samples. GenEx software was used to identify the optimal number of reference genes to be used for normalization and demonstrated that the accumulated standard deviation resulting from the use of 2 reference genes was similar to that resulting from the use of 3 or more reference genes. To identify the optimal combination of reference genes, we evaluated the expression of COL1A1. Although the use of different reference gene combinations yielded variable normalized quantities, the relative quantities within sample groups were similar and confirmed that no obvious differences were observed when using 2, 3 or 4 reference genes. Consequently, the use of 2 stable reference genes for normalization, especially

Identifying Patients at Risk and Patients in Need

DEFF Research Database (Denmark)

Schmidt, Thomas

2015-01-01

korttidssengeafsnit. Det viser sig at sygeplejerskernes anvendelse af patientmonitoreringsudstyret afhænger af tidspunkt på døgnet, og i hvilken sammenhæng systemet bruges. Behandling af patienter er udfordret af hvordan information indhentes og deles imellem klinikerne. Hyppigheden hvormed patienter monitoreres...

Identifying Facilitators and Barriers for Patient Safety in a Medicine Label Design System Using Patient Simulation and Interviews

DEFF Research Database (Denmark)

Dieckmann, Peter; Clemmensen, Marianne Hald; Sørensen, Trine Kart

2016-01-01

Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative and explora......Objectives Medicine label design plays an important role in improving patient safety. This study aimed at identifying facilitators and barriers in a medicine label system to prevent medication errors in clinical use by health care professionals. Methods The study design is qualitative...... of the system and some inconsistencies (different meaning of colors) posed challenges, when considered with the actual application context, in which there is little time to get familiar with the design features. Conclusions For optimizing medicine labels and obtaining the full benefit of label design features...

The suitability of quality-of-life questionnaires for psoriasis research - A systematic literature review

NARCIS (Netherlands)

de Korte, John; Mombers, Femke M. C.; Sprangers, Mirjam A. G.; Bos, Jan D.

2002-01-01

Objective: To critically appraise the suitability of current quality-of-life (QOL) questionnaires for psoriasis research. Data Sources: Computerized searches of 5 bibliographic databases. Questionnaire Selection: Predefined criteria were used to identify QOL questionnaires in dermatologic studies.

Using optical markers of nondysplastic rectal epithelial cells to identify patients with ulcerative colitis-associated neoplasia.

Science.gov (United States)

Bista, Rajan K; Brentnall, Teresa A; Bronner, Mary P; Langmead, Christopher J; Brand, Randall E; Liu, Yang

2011-12-01

Current surveillance guidelines for patients with long-standing ulcerative colitis (UC) recommend repeated colonoscopy with random biopsies, which is time-consuming, discomforting, and expensive. A less invasive strategy is to identify neoplasia by analyzing biomarkers from the more accessible rectum to predict the need for a full colonoscopy. The goal of this pilot study was to evaluate whether optical markers of rectal mucosa derived from a novel optical technique, partial-wave spectroscopic microscopy (PWS), could identify UC patients with high-grade dysplasia (HGD) or cancer (CA) present anywhere in their colon. Banked frozen nondysplastic mucosal rectal biopsies were used from 28 UC patients (15 without dysplasia and 13 with concurrent HGD or CA). The specimen slides were made using a touch prep method and underwent PWS analysis. We divided the patients into two groups: 13 as a training set and an independent 15 as a validation set. We identified six optical markers, ranked by measuring the information gain with respect to the outcome of cancer. The most effective markers were selected by maximizing the cross-validated training accuracy of a Naive Bayes classifier. The optimal classifier was applied to the validation data yielding 100% sensitivity and 75% specificity. Our results indicate that the PWS-derived optical markers can accurately predict UC patients with HGD/CA through assessment of rectal epithelial cells. By aiming for high sensitivity, our approach could potentially simplify the surveillance of UC patients and improve overall resource utilization by identifying patients with HGD/CA who should proceed with colonoscopy. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

Suitable Site Selection of Small Dams Using Geo-Spatial Technique: a Case Study of Dadu Tehsil, Sindh

Science.gov (United States)

Khalil, Zahid

2016-07-01

Decision making about identifying suitable sites for any project by considering different parameters, is difficult. Using GIS and Multi-Criteria Analysis (MCA) can make it easy for those projects. This technology has proved to be an efficient and adequate in acquiring the desired information. In this study, GIS and MCA were employed to identify the suitable sites for small dams in Dadu Tehsil, Sindh. The GIS software is used to create all the spatial parameters for the analysis. The parameters that derived are slope, drainage density, rainfall, land use / land cover, soil groups, Curve Number (CN) and runoff index with a spatial resolution of 30m. The data used for deriving above layers include 30 meter resolution SRTM DEM, Landsat 8 imagery, and rainfall from National Centre of Environment Prediction (NCEP) and soil data from World Harmonized Soil Data (WHSD). Land use/Land cover map is derived from Landsat 8 using supervised classification. Slope, drainage network and watershed are delineated by terrain processing of DEM. The Soil Conservation Services (SCS) method is implemented to estimate the surface runoff from the rainfall. Prior to this, SCS-CN grid is developed by integrating the soil and land use/land cover raster. These layers with some technical and ecological constraints are assigned weights on the basis of suitability criteria. The pair wise comparison method, also known as Analytical Hierarchy Process (AHP) is took into account as MCA for assigning weights on each decision element. All the parameters and group of parameters are integrated using weighted overlay in GIS environment to produce suitable sites for the Dams. The resultant layer is then classified into four classes namely, best suitable, suitable, moderate and less suitable. This study reveals a contribution to decision making about suitable sites analysis for small dams using geo-spatial data with minimal amount of ground data. This suitability maps can be helpful for water resource

Suitability of commercial transport for a shift to electric mobility

DEFF Research Database (Denmark)

Christensen, Linda; Kveiborg, Ole; Klauenberg, Jens

2016-01-01

the travel range of large vans is an important barrier for electrification due to the battery weight and the limitation of 3.5 tonnes gross vehicle weight for driving with a normal driving licence. The rule needs amendments for electric vehicles, as has been done in Germany. The paper recommends EU countries......This paper identifies commercial sectors suitable for a shift to electric mobility. The paper concludes that the construction and the health care service sectors are the most suitable for electric mobility because many vehicles are registered in these sectors and daily mileage is reasonably low....... They should be primary target groups of specific policy measures to promote the use of electric vehicles. Denmark has only had a few incentives to promote the use of commercial electric vehicles. Until now electric vehicles do generally not show economic benefits unless travel distance is high. However, today...

Text mining applied to electronic cardiovascular procedure reports to identify patients with trileaflet aortic stenosis and coronary artery disease.

Science.gov (United States)

Small, Aeron M; Kiss, Daniel H; Zlatsin, Yevgeny; Birtwell, David L; Williams, Heather; Guerraty, Marie A; Han, Yuchi; Anwaruddin, Saif; Holmes, John H; Chirinos, Julio A; Wilensky, Robert L; Giri, Jay; Rader, Daniel J

2017-08-01

Interrogation of the electronic health record (EHR) using billing codes as a surrogate for diagnoses of interest has been widely used for clinical research. However, the accuracy of this methodology is variable, as it reflects billing codes rather than severity of disease, and depends on the disease and the accuracy of the coding practitioner. Systematic application of text mining to the EHR has had variable success for the detection of cardiovascular phenotypes. We hypothesize that the application of text mining algorithms to cardiovascular procedure reports may be a superior method to identify patients with cardiovascular conditions of interest. We adapted the Oracle product Endeca, which utilizes text mining to identify terms of interest from a NoSQL-like database, for purposes of searching cardiovascular procedure reports and termed the tool "PennSeek". We imported 282,569 echocardiography reports representing 81,164 individuals and 27,205 cardiac catheterization reports representing 14,567 individuals from non-searchable databases into PennSeek. We then applied clinical criteria to these reports in PennSeek to identify patients with trileaflet aortic stenosis (TAS) and coronary artery disease (CAD). Accuracy of patient identification by text mining through PennSeek was compared with ICD-9 billing codes. Text mining identified 7115 patients with TAS and 9247 patients with CAD. ICD-9 codes identified 8272 patients with TAS and 6913 patients with CAD. 4346 patients with AS and 6024 patients with CAD were identified by both approaches. A randomly selected sample of 200-250 patients uniquely identified by text mining was compared with 200-250 patients uniquely identified by billing codes for both diseases. We demonstrate that text mining was superior, with a positive predictive value (PPV) of 0.95 compared to 0.53 by ICD-9 for TAS, and a PPV of 0.97 compared to 0.86 for CAD. These results highlight the superiority of text mining algorithms applied to electronic

Ecological suitability modeling for anthrax in the Kruger National Park, South Africa.

Directory of Open Access Journals (Sweden)

Pieter Johan Steenkamp

Full Text Available The spores of the soil-borne bacterium, Bacillus anthracis, which causes anthrax are highly resistant to adverse environmental conditions. Under ideal conditions, anthrax spores can survive for many years in the soil. Anthrax is known to be endemic in the northern part of Kruger National Park (KNP in South Africa (SA, with occasional epidemics spreading southward. The aim of this study was to identify and map areas that are ecologically suitable for the harboring of B. anthracis spores within the KNP. Anthrax surveillance data and selected environmental variables were used as inputs to the maximum entropy (Maxent species distribution modeling method. Anthrax positive carcasses from 1988-2011 in KNP (n = 597 and a total of 40 environmental variables were used to predict and evaluate their relative contribution to suitability for anthrax occurrence in KNP. The environmental variables that contributed the most to the occurrence of anthrax were soil type, normalized difference vegetation index (NDVI and precipitation. Apart from the endemic Pafuri region, several other areas within KNP were classified as ecologically suitable. The outputs of this study could guide future surveillance efforts to focus on predicted suitable areas for anthrax, since the KNP currently uses passive surveillance to detect anthrax outbreaks.

Land Suitability Assessment And Precision Farming Prospects For ...

African Journals Online (AJOL)

The soils on the farm were sampled and profiles classified using South African Binomial system of soil classification. The farm was divided into suitability classes of highly suitable (S1), suitable (S2), and unsuitable (N1), and permanently unsuitable (N2) classes. Maize-soybean suitability maps were produced based on soil ...

DIGE proteome analysis reveals suitability of ischemic cardiac in vitro model for studying cellular response to acute ischemia and regeneration.

Directory of Open Access Journals (Sweden)

Sina Haas

Full Text Available Proteomic analysis of myocardial tissue from patient population is suited to yield insights into cellular and molecular mechanisms taking place in cardiovascular diseases. However, it has been limited by small sized biopsies and complicated by high variances between patients. Therefore, there is a high demand for suitable model systems with the capability to simulate ischemic and cardiotoxic effects in vitro, under defined conditions. In this context, we established an in vitro ischemia/reperfusion cardiac disease model based on the contractile HL-1 cell line. To identify pathways involved in the cellular alterations induced by ischemia and thereby defining disease-specific biomarkers and potential target structures for new drug candidates we used fluorescence 2D-difference gel electrophoresis. By comparing spot density changes in ischemic and reperfusion samples we detected several protein spots that were differentially abundant. Using MALDI-TOF/TOF-MS and ESI-MS the proteins were identified and subsequently grouped by functionality. Most prominent were changes in apoptosis signalling, cell structure and energy-metabolism. Alterations were confirmed by analysis of human biopsies from patients with ischemic cardiomyopathy.With the establishment of our in vitro disease model for ischemia injury target identification via proteomic research becomes independent from rare human material and will create new possibilities in cardiac research.

Faecal corticosterone metabolite concentrations are not a good predictor of habitat suitability for common gartersnakes.

Science.gov (United States)

Halliday, William D; Gilmour, Kathleen M; Blouin-Demers, Gabriel

2015-01-01

Measuring habitat suitability is important in conservation and in wildlife management. Measuring the abundance or presence-absence of a species in various habitats is not sufficient to measure habitat suitability because these metrics can be poor predictors of population success. Therefore, having some measure of population success is essential in assessing habitat suitability, but estimating population success is difficult. Identifying suitable proxies for population success could thus be beneficial. We examined whether faecal corticosterone metabolite (fCM) concentrations could be used as a proxy for habitat suitability in common gartersnakes (Thamnophis sirtalis). We conducted a validation study and confirmed that fCM concentrations indeed reflect circulating corticosterone concentrations. We estimated abundance, reproductive output and growth rate of gartersnakes in field and in forest habitat and we also measured fCM concentrations of gartersnakes from these same habitats. Common gartersnakes were more abundant and had higher reproductive outputs and higher growth rates in field habitat than in forest habitat, but fCM concentrations did not differ between the same two habitats. Our results suggest either that fCM concentrations are not a useful metric of habitat suitability in common gartersnakes or that the difference in suitability between the two habitats was too small to induce changes in fCM concentrations. Incorporating fitness metrics in estimates of habitat suitability is important, but these metrics of fitness have to be sensitive enough to vary between habitats.

Realization of a universal patient identifier for electronic medical records through biometric technology.

Science.gov (United States)

Leonard, D C; Pons, Alexander P; Asfour, Shihab S

2009-07-01

The technology exists for the migration of healthcare data from its archaic paper-based system to an electronic one, and, once in digital form, to be transported anywhere in the world in a matter of seconds. The advent of universally accessible healthcare data has benefited all participants, but one of the outstanding problems that must be addressed is how the creation of a standardized nationwide electronic healthcare record system in the United States would uniquely identify and match a composite of an individual's recorded healthcare information to an identified individual patients out of approximately 300 million people to a 1:1 match. To date, a few solutions to this problem have been proposed that are limited in their effectiveness. We propose the use of biometric technology within our fingerprint, iris, retina scan, and DNA (FIRD) framework, which is a multiphase system whose primary phase is a multilayer consisting of these four types of biometric identifiers: 1) fingerprint; 2) iris; 3) retina scan; and 4) DNA. In addition, it also consists of additional phases of integration, consolidation, and data discrepancy functions to solve the unique association of a patient to their medical data distinctively. This would allow a patient to have real-time access to all of their recorded healthcare information electronically whenever it is necessary, securely with minimal effort, greater effectiveness, and ease.

Novel mutations in the homogentisate 1,2 dioxygenase gene identified in Jordanian patients with alkaptonuria.

Science.gov (United States)

Al-sbou, Mohammed

2012-06-01

This study was conducted to identify mutations in the homogentisate 1,2 dioxygenase gene (HGD) in alkaptonuria patients among Jordanian population. Blood samples were collected from four alkaptonuria patients, four carriers, and two healthy volunteers. DNA was isolated from peripheral blood. All 14 exons of the HGD gene were amplified using the polymerase chain reaction (PCR) technique. The PCR products were then purified and analyzed by sequencing. Five mutations were identified in our samples. Four of them were novel C1273A, T1046G, 551-552insG, T533G and had not been previously reported, and one mutation T847C has been described before. The types of mutations identified were two missense mutations, one splice site mutation, one frameshift mutation, and one polymorphism. We present the first molecular study of the HGD gene in Jordanian alkaptonuria patients. This study provides valuable information about the molecular basis of alkaptonuria in Jordanian population.

[Study of algorithms to identify schizophrenia in the SNIIRAM database conducted by the REDSIAM network].

Science.gov (United States)

Quantin, C; Collin, C; Frérot, M; Besson, J; Cottenet, J; Corneloup, M; Soudry-Faure, A; Mariet, A-S; Roussot, A

2017-10-01

The aim of the REDSIAM network is to foster communication between users of French medico-administrative databases and to validate and promote analysis methods suitable for the data. Within this network, the working group "Mental and behavioral disorders" took an interest in algorithms to identify adult schizophrenia in the SNIIRAM database and inventoried identification criteria for patients with schizophrenia in these databases. The methodology was based on interviews with nine experts in schizophrenia concerning the procedures they use to identify patients with schizophrenia disorders in databases. The interviews were based on a questionnaire and conducted by telephone. The synthesis of the interviews showed that the SNIIRAM contains various tables which allow coders to identify patients suffering from schizophrenia: chronic disease status, drugs and hospitalizations. Taken separately, these criteria were not sufficient to recognize patients with schizophrenia, an algorithm should be based on all of them. Apparently, only one-third of people living with schizophrenia benefit from the longstanding disease status. Not all patients are hospitalized, and coding for diagnoses at the hospitalization, notably for short stays in medicine, surgery or obstetrics departments, is not exhaustive. As for treatment with antipsychotics, it is not specific enough as such treatments are also prescribed to patients with bipolar disorders, or even other disorders. It seems appropriate to combine these complementary criteria, while keeping in mind out-patient care (every year 80,000 patients are seen exclusively in an outpatient setting), even if these data are difficult to link with other information. Finally, the experts made three propositions for selection algorithms of patients with schizophrenia. Patients with schizophrenia can be relatively accurately identified using SNIIRAM data. Different combinations of the selected criteria must be used depending on the objectives and

Reevaluating Suitability Estimates Based on Dynamics of Cropland Expansion in the Brazilian Amazon

Science.gov (United States)

Morton, Douglas C.; Noojipady, Praveen; Macedo, Marcia M.; Victoria, Daniel C.; Bolfe, Edson L.

2016-01-01

Agricultural suitability maps are a key input for land use zoning and projections of cropland expansion. Suitability assessments typically consider edaphic conditions, climate, crop characteristics, and sometimes incorporate accessibility to transportation and market infrastructure. However, correct weighting among these disparate factors is challenging, given rapid development of new crop varieties, irrigation, and road networks, as well as changing global demand for agricultural commodities. Here, we compared three independent assessments of cropland suitability to spatial and temporal dynamics of agricultural expansion in the Brazilian state of Mato Grosso during 2001 2012. We found that areas of recent cropland expansion identified using satellite data were generally designated as low to moderate suitability for rainfed crop production. Our analysis highlighted the abrupt nature of suitability boundaries, rather than smooth gradients of agricultural potential, with little additional cropland expansion beyond the extent of the flattest areas (0-2% slope). Satellite-based estimates of the interannual variability in the use of existing crop areas also provided an alternate means to assess suitability. On average, cropland areas in the Cerrado biome had higher utilization (84%) than croplands in the Amazon region of northern Mato Grosso (74%). Areas of more recent expansion had lower utilization than croplands established before 2002, providing empirical evidence for lower suitability or alternative management strategies (e.g., pasture soya rotations) for lands undergoing more recent land use transitions. This unplanted reserve constitutes a large area of potentially available cropland (PAC)without further expansion, within the management limits imposed for pest management and fallow cycles. Using two key constraints on future cropland expansion, slope and restrictions on further deforestation of Amazon or Cerrado vegetation, we found little available flat land for

Identifying seizure clusters in patients with psychogenic nonepileptic seizures.

Science.gov (United States)

Baird, Grayson L; Harlow, Lisa L; Machan, Jason T; Thomas, Dave; LaFrance, W C

2017-08-01

The present study explored how seizure clusters may be defined for those with psychogenic nonepileptic seizures (PNES), a topic for which there is a paucity of literature. The sample was drawn from a multisite randomized clinical trial for PNES; seizure data are from participants' seizure diaries. Three possible cluster definitions were examined: 1) common clinical definition, where ≥3 seizures in a day is considered a cluster, along with two novel statistical definitions, where ≥3 seizures in a day are considered a cluster if the observed number of seizures statistically exceeds what would be expected relative to a patient's: 1) average seizure rate prior to the trial, 2) observed seizure rate for the previous seven days. Prevalence of clusters was 62-68% depending on cluster definition used, and occurrence rate of clusters was 6-19% depending on cluster definition. Based on these data, clusters seem to be common in patients with PNES, and more research is needed to identify if clusters are related to triggers and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

A radioimmunoassay for wheat gliadin to assess the suitability of gluten free foods for patients with coeliac disease

International Nuclear Information System (INIS)

Ciclitira, P.J.; Ellis, H.J.; Evans, D.J.; Lennox, E.S.

1985-01-01

Coeliac disease is a clinical condition characterised by malabsorption secondary to abnormalities of the small intestine. The condition is known to be exacerbated by wheat gliadin, rye, barley and possibly oats. The only assays that are available for testing for the presence of wheat gluten in foods are double diffusion against rabbit anti-gliadin antiserum and measurement of Kjeldahl nitrogen in products derived from wheat flour. We have developed a radioimmunoassay for wheat gliadin with a detection limit of 1 ng. Nominally gluten free foods based on wheat starch have been shown to contain up to 1.9x10 -2 % wheat gliadin. Bread made from Nutregen wheat starch which has now been withdrawn contains 6.4 mg gliadin per standard 30 g slice. A radioimmunoassay for wheat gliadin could be used to define standards for the suitability of gluten free products based on wheat starch for patients with coeliac disease. (author)

Clinical assessment tools identify functional deficits in fragility fracture patients

Directory of Open Access Journals (Sweden)

Ames TD

2016-05-01

Full Text Available Tyler D Ames,1 Corinne E Wee,1 Khoi M Le,1 Tiffany L Wang,1 Julie Y Bishop,2 Laura S Phieffer,2 Carmen E Quatman2 1The Ohio State University College of Medicine, 2Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA Purpose: To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.Patients and methods: Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB, handgrip strength (handheld dynamometer, and lumbopelvic control (iPod Touch Level Belt, which were compared between fragility fracture patients and healthy controls.Results: Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042 and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026 when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020 and total components (P=0.010 of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003.Conclusion: The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. Keywords: fall risk, geriatric fracture, Nintendo Wii Balance Board, Level Belt, fragility fracture

Exome sequencing identifies CTSK mutations in patients originally diagnosed as intermediate osteopetrosis.

Science.gov (United States)

Pangrazio, Alessandra; Puddu, Alessandro; Oppo, Manuela; Valentini, Maria; Zammataro, Luca; Vellodi, Ashok; Gener, Blanca; Llano-Rivas, Isabel; Raza, Jamal; Atta, Irum; Vezzoni, Paolo; Superti-Furga, Andrea; Villa, Anna; Sobacchi, Cristina

2014-02-01

Autosomal Recessive Osteopetrosis is a genetic disorder characterized by increased bone density due to lack of resorption by the osteoclasts. Genetic studies have widely unraveled the molecular basis of the most severe forms, while cases of intermediate severity are more difficult to characterize, probably because of a large heterogeneity. Here, we describe the use of exome sequencing in the molecular diagnosis of 2 siblings initially thought to be affected by "intermediate osteopetrosis", which identified a homozygous mutation in the CTSK gene. Prompted by this finding, we tested by Sanger sequencing 25 additional patients addressed to us for recessive osteopetrosis and found CTSK mutations in 4 of them. In retrospect, their clinical and radiographic features were found to be compatible with, but not typical for, Pycnodysostosis. We sought to identify modifier genes that might have played a role in the clinical manifestation of the disease in these patients, but our results were not informative. In conclusion, we underline the difficulties of differential diagnosis in some patients whose clinical appearance does not fit the classical malignant or benign picture and recommend that CTSK gene be included in the molecular diagnosis of high bone density conditions. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Identifying Emergency Department Patients at Low Risk for a Variceal Source of Upper Gastrointestinal Hemorrhage.

Science.gov (United States)

Klein, Lauren R; Money, Joel; Maharaj, Kaveesh; Robinson, Aaron; Lai, Tarissa; Driver, Brian E

2017-11-01

Assessing the likelihood of a variceal versus nonvariceal source of upper gastrointestinal bleeding (UGIB) guides therapy, but can be difficult to determine on clinical grounds. The objective of this study was to determine if there are easily ascertainable clinical and laboratory findings that can identify a patient as low risk for a variceal source of hemorrhage. This was a retrospective cohort study of adult ED patients with UGIB between January 2008 and December 2014 who had upper endoscopy performed during hospitalization. Clinical and laboratory data were abstracted from the medical record. The source of the UGIB was defined as variceal or nonvariceal based on endoscopic reports. Binary recursive partitioning was utilized to create a clinical decision rule. The rule was internally validated and test characteristics were calculated with 1,000 bootstrap replications. A total of 719 patients were identified; mean age was 55 years and 61% were male. There were 71 (10%) patients with a variceal UGIB identified on endoscopy. Binary recursive partitioning yielded a two-step decision rule (platelet count > 200 × 10 9 /L and an international normalized ratio [INR] study must be externally validated before widespread use, patients presenting to the ED with an acute UGIB with platelet count of >200 × 10 9 /L and an INR of upper gastrointestinal hemorrhage. © 2017 by the Society for Academic Emergency Medicine.

Shifts in climate suitability for wine production as a result of climate change in a temperate climate wine region of Romania

Science.gov (United States)

Irimia, Liviu Mihai; Patriche, Cristian Valeriu; Quenol, Hervé; Sfîcă, Lucian; Foss, Chris

2018-02-01

Climate change is causing important shifts in the suitability of regions for wine production. Fine scale mapping of these shifts helps us to understand the evolution of vineyard climates, and to find solutions through viticultural adaptation. The aim of this study is to identify and map the structural and spatial shifts that occurred in the climatic suitability for wine production of the Cotnari wine growing region (Romania) between 1961 and 2013. Discontinuities in trends of temperature were identified, and the averages and trends of 13 climatic parameters for the 1961 to 1980 and 1981 to 2013 time periods were analysed. Using the averages of these climatic parameters, climate suitability for wine production was calculated at a resolution of 30 m and mapped for each time period, and the changes analysed. The results indicate shifts in the area's historic climatic profile, due to an increase of heliothermal resources and precipitation constancy. The area's climate suitability for wine production was modified by the loss of climate suitability for white table wines, sparkling wines and wine for distillates; shifts in suitability to higher altitudes by about 67 m, and a 48.6% decrease in the area suitable for quality white wines; and the occurrence of suitable climates for red wines at lower altitudes. The study showed that climate suitability for wine production has a multi-level spatial structure, with classes requiring a cooler climate being located at a higher altitude than those requiring a warmer climate. Climate change has therefore resulted in the shift of climate suitability classes for wine production to higher altitudes.

Suitability Analysis and Projected Climate Change Impact on Banana and Coffee Production Zones in Nepal

Science.gov (United States)

Sujakhu, Nani M.; Merz, Juerg; Kindt, Roeland; Xu, Jianchu; Matin, Mir A.; Ali, Mostafa; Zomer, Robert J.

2016-01-01

The Government of Nepal has identified opportunities in agricultural commercialization, responding to a growing internal demand and expansion of export markets to reduce the immense trade deficit. Several cash crops, including coffee and bananas, have been identified in the recently approved Agriculture Development Strategy. Both of these crops have encouraged smallholder farmers to convert their subsistence farming practices to more commercial cultivation. Identification of suitable agro-ecological zones and understanding climate-related issues are important for improved production and livelihoods of smallholder farmers. Here, the suitability of coffee and banana crops is analyzed for different agro-ecological zones represented by Global Environmental Stratification (GEnS). Future shifts in these suitability zones are also predicted. Plantation sites in Nepal were geo-referenced and used as input in species distribution modelling. The multi-model ensemble model suggests that climate change will reduce the suitable growing area for coffee by about 72% across the selected emission scenarios from now to 2050. Impacts are low for banana growing, with a reduction in suitability by about 16% by 2050. Bananas show a lot of potential for playing an important role in Nepal as a sustainable crop in the context of climate change, as this study indicates that the amount of area suited to banana growing will grow by 40% by 2050. Based on our analysis we recommend possible new locations for coffee plantations and one method for mitigating climate change-related problems on existing plantations. These findings are expected to support planning and policy dialogue for mitigation and support better informed and scientifically based decision-making relating to these two crops. PMID:27689354

A predictive model of suitability for minimally invasive parathyroid surgery in the treatment of primary hyperparathyroidism [corrected].

LENUS (Irish Health Repository)

Kavanagh, Dara O

2012-05-01

Improved preoperative localizing studies have facilitated minimally invasive approaches in the treatment of primary hyperparathyroidism (PHPT). Success depends on the ability to reliably select patients who have PHPT due to single-gland disease. We propose a model encompassing preoperative clinical, biochemical, and imaging studies to predict a patient\\'s suitability for minimally invasive surgery.

Using environmental niche modeling to find suitable habitats for the Hard-ground Barasingha in Madhya Pradesh, India

Directory of Open Access Journals (Sweden)

C. P. Singh

2015-09-01

Full Text Available The subspecies of Swamp Deer, the Hard-ground Barasingha (Rucervus duvaucelii branderi Pocock, is presently found only in Kanha Tiger Reserve (KTR in Madhya Pradesh, India. This subspecies is highly vulnerable to extinction, and reintroduction in suitable sites is the need of the hour.  Environmental niche models (GARP, SVM, ED, CSM aimed at providing a detailed prediction of species distribution by relating presence of species to 19 bioclimatic indices were developed, using swamp deer occurrence records in KTR. The predictions were appropriately weighted with the prevailing LU/LC classes to identify suitable habitats in Madhya Pradesh, India. The result shows that the southern region of Madhya Pradesh is suitable for the sustenance of Barasingha with varying degrees of habitability. Vicarious validation shows that most of these forest areas were the same as that of historical records dating back to 50 years. However, land use maps can help identify areas where this subspecies can be reintroduced. 

The Spatial Suitable Habitat Model of Acacia decurrens in Mount Merbabu National Park

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Yoko Untoro

2017-09-01

Full Text Available Green wattle (Acacia decurrens is an invasive alien species (IAS found in the Mount Merbabu National Park (TNGMb. This study aim to obtain spatially studies on habitat suitability models of A. decurrens in TNGMb region. In fact, this species became as a high invasive and dominance in the TNGMb and contributes the negative impact to the ecosystem. In addition, the result of this study should be useful for controling activities of A. decurrens. Predictor variables in this research were (altitude, slope, rainfall, air temperature, distance from river, NDVI, NDMI, distance from hiking trail, and distance from burnt area. The survey was conducted with random sampling of presence or absence of A. decurrens by marking the coordinate point of location using GPS. Data analysis in this research was used binary logistic regression enter method. Binary logistic regression involves the data acquisition of the presence and absence of A. decurrens as the y variable, while the predictor variable map as the variable x. The type of spatial distribution of A. decurrens in the TNGMb was identified as clumped. The Nagelkerke R2 values obtained in the model was 39,2%, while 60,8% was explained by other variables were not used in the model. The results of the logistic regression model showed a high percentage of suitability of 64,29%, a medium suitability of 28,57%, and a low suitability of 7.14% then the Implications for controlling activities of A. decurrens in TNGMb could be prioritized in high suitability habitat. Keywords: Acacia decurrens, green wattle, invasive, spatial suitable habitat 

Comprehensive environment-suitability evaluation model about Carya cathayensis

International Nuclear Information System (INIS)

Da-Sheng, W.; Li-Juan, L.; Qin-Fen, Y.

2013-01-01

On the relation between the suitable environment and the distribution areas of Carya cathayensis Sarg., the current studies are mainly committed to qualitative descriptions, but did not consider quantitative models. The objective of this study was to establish a environment-suitability evaluation model which used to predict potential suitable areas of C. cathayensis. Firstly, the 3 factor data of soil type, soil parent material and soil thickness were obtained based on 2-class forest resource survey, and other factor data, which included elevation, slope, aspect, surface curvature, humidity index, and solar radiation index, were extracted from DEM (Digital Elevation Model). Additionally, the key affecting factors were defined by PCA (Principal Component Analysis), the weights of evaluation factors were determined by AHP (Analysis Hierarchy Process) and the quantitative classification of single factor was determined by membership function with fuzzy mathematics. Finally, a comprehensive environment-suitability evaluation model was established and which was also used to predict the potential suitable areas of C. cathayensis in Daoshi Town in the study region. The results showed that 85.6% of actual distribution areas were in the most suitable and more suitable regions and 11.5% in the general suitable regions

Land suitability maps for waste disposal siting

International Nuclear Information System (INIS)

Hrasna, M.

1996-01-01

The suitability of geoenvironment for waste disposal depends mainly on its stability and on the danger of groundwater pollution. Besides them, on the land suitability maps for the given purpose also those factors of the factors of the geoenvironment and the landscape should be taken into account, which enable another way of the land use, such as mineral resources, water resources, fertile soils, nature reserves, etc. On the base of the relevant factors influence evaluation - suitable, moderately suitable and unsuitable territorial units are delimited on the maps. The different way of various scale maps compilation is applied, taken into account their different representing feasibilities. (authors)

Suitability of teriparatide and level of acceptance of pharmacotherapeutic recommendations in a healthcare management areaSuitability of teriparatide and level of acceptance of pharmacotherapeutic recommendations in a healthcare management area DOI:\t10.7399/fh.2016.40.4.9953

Directory of Open Access Journals (Sweden)

Maria Rosa Cantudo-Cuenca

2016-07-01

Full Text Available Objective: To analyse the suitability of teriparatide prescriptions for osteoporosis treatment in a health management area, as well as the level of acceptance of pharmacotherapeutic recommendations made to physicians. Design: A prospective interventional study conducted from february 2015 to june 2015. Setting: South Seville Health Management Area. Participants: Patients receiving teriparatide. Main measurements: Suitability of teriparatide prescriptions according to Clinical Practice Guidelines and level of acceptance of pharmacotherapeutic recommendations. Results: Teriparatide prescriptions were unsuitable in 45 patients (68.2%; 11 due to no indication, 17 patients did not have previous treatments with first-line drugs, 6 due to contraindications and 9 patients were treated for more than 24 months with the drug. Besides, 4 prescriptions were unsuitable because of combination with other therapies. The acceptance of pharmacotherapeutic recommendations was 64.4%, leading to teriparatide discontinuation in 21 patients (72.4%, and a switch to alendronate or ibandronate in another 8 patients. Conclusions: A high percentage of teriparatide prescriptions is unsuitable in our health care management area, but it has decreased after pharmacist intervention.

Evaluation of CT in identifying colorectal carcinoma in the frail and disabled patient

International Nuclear Information System (INIS)

Ng, C.S.; Dixon, A.K.; Doyle, T.C.; Courtney, H.M.; Bull, R.K.; Freeman, A.H.; Pinto, E.M.; Prevost, A.T.; Campbell, G.A.

2002-01-01

Frail and physically or mentally disabled patients frequently have difficulty in tolerating formal colonic investigations. The aims of this study were to evaluate the accuracy of minimal-preparation CT in identifying colorectal carcinoma in this population and to determine the clinical indications and radiological signs with the highest yield for tumour. The CT technique involved helical acquisition (10-mm collimation, 1.5 pitch) following 2 days of preparation with oral contrast medium only. The outcome of 4 years of experience was retrospectively reviewed. The gold standards were pathological and cancer registration records, together with colonoscopy and barium enema when undertaken, with a minimum of 15 months follow-up. One thousand seventy-seven CT studies in 1031 patients (median age 80 years) were evaluated. CT correctly identified 83 of the 98 colorectal carcinomas in this group but missed 15 cases; sensitivity and specificity (with 95% confidence interval) 85% (78-92%) and 91% (90-93%), respectively. Multivariate analysis identified: (a) a palpable abdominal mass and anaemia to be the strongest clinical indications, particularly in combination (p<0.0025); and (b) lesion width and blurring of the serosal margin of lesions to be associated with tumours (p<0.0001). Computed tomography has a valuable role in the investigation of frail and otherwise disabled patients with symptoms suspicious for a colonic neoplasm. Although interpretation can be difficult, the technique is able to exclude malignancy with good accuracy. (orig.)

Readability, suitability, and characteristics of asthma action plans: examination of factors that may impair understanding.

Science.gov (United States)

Yin, H Shonna; Gupta, Ruchi S; Tomopoulos, Suzy; Wolf, Michael S; Mendelsohn, Alan L; Antler, Lauren; Sanchez, Dayana C; Lau, Claudia Hillam; Dreyer, Benard P

2013-01-01

Recognition of the complexity of asthma management has led to the development of asthma treatment guidelines that include the recommendation that all pediatric asthma patients receive a written asthma action plan. We assessed the readability, suitability, and characteristics of asthma action plans, elements that contribute to the effectiveness of action plan use, particularly for those with limited literacy. This was a descriptive study of 30 asthma action plans (27 state Department of Health (DOH)-endorsed, 3 national action plans endorsed by 6 states). (1) readability (as assessed by Flesch Reading Ease, Flesch-Kincaid, Gunning Fog, Simple Measure of Gobbledygook, Forcast), (2) suitability (Suitability Assessment of Materials [SAM], adequate: ≥ 0.4; unsuitable: typography (30.0%), learning stimulation/motivation (26.7%), and graphics (13.3%). There were no statistically significant differences between the average grade level or SAM score of state DOH developed action plans and those from or adapted from national organizations. Plans varied with respect to terms used, symptoms included, and recommended actions. Specific improvements in asthma action plans could maximize patient and parent understanding of appropriate asthma management and could particularly benefit individuals with limited literacy skills.

Mild soaps and radiotherapy: a survey of the UK public to identify brands of soap considered mild and analysis of these to ascertain suitability for recommendation in radiotherapy departments.

Science.gov (United States)

Robertson, K; Brown, P

2011-05-01

Cancer agencies recommend that patients use mild soap when undergoing external beam radiotherapy to minimise skin reactions. They define 'mild soap' as non-alkaline, lanolin free, unperfumed soap with a neutral pH. This study aimed to identify which soaps the UK public perceive as mild and ascertain if these were clinically mild and could potentially be recommended within radiotherapy departments. A survey of 237 participants identified eight top brands of mild soap, which were then tested for pH and analysed for potential irritants. All soaps were lanolin free and non-alkaline, with Simple and Johnson's the closest to pH 5.5. All contained fragrances except Simple and E45. Dove, Pears and Imperial Leather contained the highest concentration of fragrances. All soaps except E45 contained potential irritants. Only Simple and E45 fit the cancer agencies' definition of mild soap and could therefore be recommended for radiotherapy patients. Future research should identify current practices and recommendations in the UK as anecdotal evidence suggests large variations in skin care advice. Further scientific analysis could potentially identify cheaper brands that fit the definition of 'mild'. UK recommendations should be standardised and consistent with best practice to reduce skin reaction severity in radiotherapy patients. © 2010 Blackwell Publishing Ltd.

Measuring patient knowledge of asthma: a systematic review of outcome measures.

NARCIS (Netherlands)

Pink, J.; Pink, K.; Elwyn, G.

2009-01-01

BACKGROUND: Asthma self-management education is a key component of international guidelines. No gold standard patient centred outcome measure exists for asthma knowledge. Our aim was to identify high-quality, validated, and reliable outcome measures suitable for use in either the research or

Prenatal Radiation exposures at diagnostic procedures: methods to identify exposed pregnant patients

International Nuclear Information System (INIS)

Pettersson, H.; Sandborg, M.; Nilsson, J.; Olsson, S.; Hellman, S.; Helmrot, E.; Persliden, J.; Cederlund, T.

2003-01-01

Knowledge about frequency and doses to embryo/foetus from diagnostic radiology is of great importance both in the sense of estimating the radiation risks but also for optimizing the diagnostic procedures and making decisions regarding alternative procedures. In addition, the pregnant patient has a right to know the magnitude and type of radiation risks expected as a result of foetus exposure. From a risk perspective epidemiological data has shown that the embryo/foetus together with children experience higher radiation sensitivity in terms of induced leukemia and cancer compared to an adult population. Recent estimates give cancer excess lifetime mortality risks for whole body exposures of children and foetus (0-15 y age) of 0.06% up to 0.14% per 10 mSv. In addition to the risk of cancer induction effects of cell killing, e.g. CNS abnormalities, cataracts, malformations, growth retardation, may occur. However, these effects are believed to have a threshold, about 100-200 mGy, and such foetus doses are rarely reached in diagnostic radiology procedures. There are 2 principal situations where foetus exposures may occur in diagnostic radiology; The pregnancy of the patient is known at the time of examination, but due to the medical indications the examination can not be postponed or put forward in time, and there are no suitable alternative non-radiological procedures. The pregnancy of the patient is not known at the time of examination, either due to the fact that the patient is unaware of her pregnancy or the medical personnel failed to obtain this information. The former situation may occur during the first few weeks from conception, whereas the latter situation may cover a greater gestation period. The frequency of foetus exposure is not well documented. In Sweden, there are well-established routines to track down pregnant patients before examinations are being performed. However, there are no general obligations or routines to document the cases either (i) when

Using Geographic Information Systems to Determine Site Suitability for a Low-Level Radioactive Waste Storage Facility.

Science.gov (United States)

Wilson, Charles A; Matthews, Kennith; Pulsipher, Allan; Wang, Wei-Hsung

2016-02-01

Radioactive waste is an inevitable product of using radioactive material in education and research activities, medical applications, energy generation, and weapons production. Low-level radioactive waste (LLW) makes up a majority of the radioactive waste produced in the United States. In 2010, over two million cubic feet of LLW were shipped to disposal sites. Despite efforts from several states and compacts as well as from private industry, the options for proper disposal of LLW remain limited. New methods for quickly identifying potential storage locations could alleviate current challenges and eventually provide additional sites and allow for adequate regional disposal of LLW. Furthermore, these methods need to be designed so that they are easily communicated to the public. A Geographic Information Systems (GIS) based method was developed to determine suitability of potential LLW disposal (or storage) sites. Criteria and other parameters of suitability were based on the Code of Federal Regulation (CFR) requirements as well as supporting literature and reports. The resultant method was used to assess areas suitable for further evaluation as prospective disposal sites in Louisiana. Criteria were derived from the 10 minimum requirements in 10 CFR Part 61.50, the Nuclear Regulatory Commission's Regulatory Guide 0902, and studies at existing disposal sites. A suitability formula was developed permitting the use of weighting factors and normalization of all criteria. Data were compiled into GIS data sets and analyzed on a cell grid of approximately 14,000 cells (covering 181,300 square kilometers) using the suitability formula. Requirements were analyzed for each cell using multiple criteria/sub-criteria as well as surrogates for unavailable datasets. Additional criteria were also added when appropriate. The method designed in this project proved to be sufficient for initial screening tests in determining the most suitable areas for prospective disposal (or storage

Identifying Personal Goals of Patients With Long Term Condition: A Service Design Thinking Approach.

Science.gov (United States)

Lee, Eunji; Gammon, Deede

2017-01-01

Care for patients with long term conditions is often characterized as fragmented and ineffective, and fails to engage the resources of patients and their families in the care process. Information and communication technology can potentially help bridge the gap between patients' lives and resources and services provided by professionals. However, there is little attention on how to identify and incorporate the patients' individual needs, values, preferences and care goals into the digitally driven care settings. We conducted a case study with healthcare professionals and patients participated applying a service design thinking approach. The participants could elaborate some personal goals of patients with long term condition which can potentially be incorporated in digitally driven care plans using examples from their own experiences.

Quantitative Proteomics Identifies Activation of Hallmark Pathways of Cancer in Patient Melanoma.

Science.gov (United States)

Byrum, Stephanie D; Larson, Signe K; Avaritt, Nathan L; Moreland, Linley E; Mackintosh, Samuel G; Cheung, Wang L; Tackett, Alan J

2013-03-01

Molecular pathways regulating melanoma initiation and progression are potential targets of therapeutic development for this aggressive cancer. Identification and molecular analysis of these pathways in patients has been primarily restricted to targeted studies on individual proteins. Here, we report the most comprehensive analysis of formalin-fixed paraffin-embedded human melanoma tissues using quantitative proteomics. From 61 patient samples, we identified 171 proteins varying in abundance among benign nevi, primary melanoma, and metastatic melanoma. Seventy-three percent of these proteins were validated by immunohistochemistry staining of malignant melanoma tissues from the Human Protein Atlas database. Our results reveal that molecular pathways involved with tumor cell proliferation, motility, and apoptosis are mis-regulated in melanoma. These data provide the most comprehensive proteome resource on patient melanoma and reveal insight into the molecular mechanisms driving melanoma progression.

Glass compositions suitable for PFR wastes

International Nuclear Information System (INIS)

Boult, K.A.; Dalton, J.T.; Eccles, E.W.; Hough, A.; Marples, J.A.C.; Paige, E.L.; Sutcliffe, P.W.

1988-03-01

Previous work had identified glass compositions that were suitable for vitrifying current and future high level wastes from the Prototype Fast Reactor (PFR) fuel reprocessing plant. Further work on these glasses has shown that: a) Foaming and crystallisation can occur under certain conditions, both probably associated with the presence of iron in the waste. Either of these could lead to greater difficulties in processing. b) Inconel 690, the preferred JCM (Joule-heated Ceramic Melter) electrode material has an acceptable corrosion rate at 1200 0 C: ca 0.6mm.y -1 . c) The leach rates are unaffected by radiation damage. The density of the glass decreases slightly with α-dose, with a dependency that extrapolates, at infinite time, to an 0.13% linear expansion. d) The concentrations of the radiologically important elements Tc, Np, Pu and Am, observed in a 'repository simulation' leach test, were satisfactorily low. (author)

Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Mathijssen EGE

2018-03-01

Full Text Available Elke GE Mathijssen,1 Johanna E Vriezekolk,1 Agnes MM Eijsbouts,1 Frank HJ van den Hoogen,1,2 Bart JF van den Bemt3 1Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands; 2Department of Rheumatology, Radboud University Medical Centre, Nijmegen, the Netherlands; 3Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands Objective: The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs.Methods: Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes.Results: The following three themes that described support needs of patients with RA for medication use were identified in the data: 1 informational support; 2 practical support; and 3 emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient–health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients’ support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent.Conclusion: Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients’ perspective, eHealth technologies may

Identifying organizational cultures that promote patient safety.

Science.gov (United States)

Singer, Sara J; Falwell, Alyson; Gaba, David M; Meterko, Mark; Rosen, Amy; Hartmann, Christine W; Baker, Laurence

2009-01-01

Safety climate refers to shared perceptions of what an organization is like with regard to safety, whereas safety culture refers to employees' fundamental ideology and orientation and explains why safety is pursued in the manner exhibited within a particular organization. Although research has sought to identify opportunities for improving safety outcomes by studying patterns of variation in safety climate, few empirical studies have examined the impact of organizational characteristics such as culture on hospital safety climate. This study explored how aspects of general organizational culture relate to hospital patient safety climate. In a stratified sample of 92 U.S. hospitals, we sampled 100% of senior managers and physicians and 10% of other hospital workers. The Patient Safety Climate in Healthcare Organizations and the Zammuto and Krakower organizational culture surveys measured safety climate and group, entrepreneurial, hierarchical, and production orientation of hospitals' culture, respectively. We administered safety climate surveys to 18,361 personnel and organizational culture surveys to a 5,894 random subsample between March 2004 and May 2005. Secondary data came from the 2004 American Hospital Association Annual Hospital Survey and Dun & Bradstreet. Hierarchical linear regressions assessed relationships between organizational culture and safety climate measures. Aspects of general organizational culture were strongly related to safety climate. A higher level of group culture correlated with a higher level of safety climate, but more hierarchical culture was associated with lower safety climate. Aspects of organizational culture accounted for more than threefold improvement in measures of model fit compared with models with controls alone. A mix of culture types, emphasizing group culture, seemed optimal for safety climate. Safety climate and organizational culture are positively related. Results support strategies that promote group orientation and

Radioimmunoassay method suitable for analysis of salivary cortisol in patients with breast cancer in treatment by teletherapy - a preliminary study

International Nuclear Information System (INIS)

Souza, Kellen Verena S.; Santos, Jane Lima dos

2011-01-01

Determination of salivary cortisol using radioimmunoassay and the relationship between stress levels were investigated before and after of the psychological intervention of 21 patients during teletherapy treatment of breast cancer. The benefits of psychological intervention during cancer treatment has been observed in some studies and evidence show that the patient's emotional state directly influences adherence to treatment, good prognosis and under stress. Thus, in present study 21 patients aged 50-70 years, females in the treatment of breast cancer at the Radiotherapy Service of Santa Casa de Misericordia in Belo Horizonte, were divided randomly into two groups: control (without psychological intervention) and Group TCC (with psychological intervention). Salivary cortisol concentrations are reportedly about 5.10% of those in serum, the levels has been used as an objective marker of hypothalamic-pituitary-adrenal (HPA) axis activity and avoided the confounding effects of venepuncture stress on cortisol levels. The assessment of cortisol in saliva has proven a valid and reliable measure of unbound steroid in the circulation. The salivary cortisol measured by radioimmunoassay in control patients and TCC showed no significant differences. The radioimmunoassay method show be suitable for analysis of salivary cortisol because allows measure low detection limits and have high sensibility. The values of TCC group and Control group were higher than reference values, except for one patient of the control group. At the beginning of treatment, both groups were homogeneous for Teletherapy. Both the TCC group as the control group had . 80% of participants in phase with stress. It was observed in the TCC group after radiotherapy showing a reversal 60% of participants without stress. The data show that cognitive-behavioral therapy has benefits for the control of psychological stress and enhance relevance of the psychologist to provide reduction or stress control during

Radioimmunoassay method suitable for analysis of salivary cortisol in patients with breast cancer in treatment by teletherapy - a preliminary study

Energy Technology Data Exchange (ETDEWEB)

Souza, Kellen Verena S. [Departamento de Engenharia Nuclear. Universidade Federal de Minas Gerais, Pampulha, MG (Brazil); Santos, Jane Lima dos [Departamento de Ciencias Biologicas, Universidade Estadual de Santa Cruz, Ilheus, BA (Brazil)

2011-07-01

Determination of salivary cortisol using radioimmunoassay and the relationship between stress levels were investigated before and after of the psychological intervention of 21 patients during teletherapy treatment of breast cancer. The benefits of psychological intervention during cancer treatment has been observed in some studies and evidence show that the patient's emotional state directly influences adherence to treatment, good prognosis and under stress. Thus, in present study 21 patients aged 50-70 years, females in the treatment of breast cancer at the Radiotherapy Service of Santa Casa de Misericordia in Belo Horizonte, were divided randomly into two groups: control (without psychological intervention) and Group TCC (with psychological intervention). Salivary cortisol concentrations are reportedly about 5.10% of those in serum, the levels has been used as an objective marker of hypothalamic-pituitary-adrenal (HPA) axis activity and avoided the confounding effects of venepuncture stress on cortisol levels. The assessment of cortisol in saliva has proven a valid and reliable measure of unbound steroid in the circulation. The salivary cortisol measured by radioimmunoassay in control patients and TCC showed no significant differences. The radioimmunoassay method show be suitable for analysis of salivary cortisol because allows measure low detection limits and have high sensibility. The values of TCC group and Control group were higher than reference values, except for one patient of the control group. At the beginning of treatment, both groups were homogeneous for Teletherapy. Both the TCC group as the control group had . 80% of participants in phase with stress. It was observed in the TCC group after radiotherapy showing a reversal 60% of participants without stress. The data show that cognitive-behavioral therapy has benefits for the control of psychological stress and enhance relevance of the psychologist to provide reduction or stress control during

Modeling strategy to identify patients with primary immunodeficiency utilizing risk management and outcome measurement.

Science.gov (United States)

Modell, Vicki; Quinn, Jessica; Ginsberg, Grant; Gladue, Ron; Orange, Jordan; Modell, Fred

2017-06-01

This study seeks to generate analytic insights into risk management and probability of an identifiable primary immunodeficiency defect. The Jeffrey Modell Centers Network database, Jeffrey Modell Foundation's 10 Warning Signs, the 4 Stages of Testing Algorithm, physician-reported clinical outcomes, programs of physician education and public awareness, the SPIRIT® Analyzer, and newborn screening, taken together, generates P values of less than 0.05%. This indicates that the data results do not occur by chance, and that there is a better than 95% probability that the data are valid. The objectives are to improve patients' quality of life, while generating significant reduction of costs. The advances of the world's experts aligned with these JMF programs can generate analytic insights as to risk management and probability of an identifiable primary immunodeficiency defect. This strategy reduces the uncertainties related to primary immunodeficiency risks, as we can screen, test, identify, and treat undiagnosed patients. We can also address regional differences and prevalence, age, gender, treatment modalities, and sites of care, as well as economic benefits. These tools support high net benefits, substantial financial savings, and significant reduction of costs. All stakeholders, including patients, clinicians, pharmaceutical companies, third party payers, and government healthcare agencies, must address the earliest possible precise diagnosis, appropriate intervention and treatment, as well as stringent control of healthcare costs through risk assessment and outcome measurement. An affected patient is entitled to nothing less, and stakeholders are responsible to utilize tools currently available. Implementation offers a significant challenge to the entire primary immunodeficiency community.

Use of T-wave alternans in identifying patients with coronary artery disease.

Science.gov (United States)

Figliozzi, Stefano; Stazi, Alessandra; Pinnacchio, Gaetano; Laurito, Marianna; Parrinello, Rossella; Villano, Angelo; Russo, Giulio; Milo, Maria; Mollo, Roberto; Lanza, Gaetano A; Crea, Filippo

2016-01-01

Microvolt T-wave alternans (MTWA) has been found to predict fatal events in patients with coronary artery disease (CAD). In a previous study, we found that MTWA values are higher in patients with CAD, compared with apparently healthy individuals. In this study, we assessed the relation between CAD and MTWA in patients with a diagnosis based on coronary angiography results. We studied 98 consecutive patients undergoing coronary angiography for suspected CAD. All patients underwent a maximal exercise stress test (EST), and MTWA was measured in the precordial ECG leads. Patients were divided into three groups: 40 patients without any significant (>50%) stenosis (group 1); 47 patients with significant stenosis (group 2); and 11 patients with a previous percutaneous coronary intervention (PCI) who had no evidence of restenosis (group 3). EST was repeated after 1 month in 24 group 2 patients who underwent PCI and in 17 group 1 patients. MTWA was significantly higher in group 2 (58.7 ± 24 μV) compared with group 1 (34.2  ± 15 μV, P < 0.01) and group 3 (43.2 ± 24 μV, P < 0.05). An MTWA greater than 60 μV had 95% specificity and 82% positive predictive value for obstructive CAD. At 1-month follow-up, MTWA decreased significantly in patients treated with PCI (from 61.3 ± 22 to 43.5 ± 17 μV; P < 0.001), but not in group 1 patients (from 50.5 ± 22 to 44.3 ± 19 μV, P = 0.19). MTWA is increased in patients with obstructive CAD and is reduced by coronary revascularization. An assessment of MTWA can be helpful in identifying which patients with suspected CAD are likely to show obstructive CAD on angiography.

An integrated methodology on the suitability of offshore sites for wind farm development

Science.gov (United States)

Patlakas, Platon; Galanis, George; Péray, Marie; Filipot, Jean-François; Kalogeri, Christina; Spyrou, Christos; Diamantis, Dimitris; Kallos, Gerorge

2016-04-01

During, the last decades the potential and interest in wind energy investments has been constantly increasing in the European countries. As technology changes rapidly, more and more areas can be identified as suitable for energy applications. Offshore wind farms perfectly illustrate how new technologies allow to build bigger, more efficient and resistant in extreme conditions wind power plants. The current work proposes an integrated methodology to determine the suitability of an offshore marine area for the development of wind farm structures. More specifically, the region of interest is evaluated based both on the natural resources, connected to the local environmental characteristics, and potential constrains set by anthropogenic or other activities. State of the art atmospheric and wave models and a 10-year hindcast database are utilized in conjunction with local information for a number of potential constrains, leading to a 5-scale suitability index for the whole area. In this way, sub regions are characterized, at a high resolution mode, as poorly or highly suitable for wind farm development, providing a new tool for technical/research teams and decision makers. In addition, extreme wind and wave conditions and their 50-years return period are analyzed and used to define the safety level of the wind farms structural characteristics.

Identification of soybean genotypes adaptive to tropical area and suitable for industry

Science.gov (United States)

Adie, M. M.; Krisnawati, A.

2018-01-01

Soybeans in Indonesia are mostly used for raw material of tempeh industry. This study aims to identify 150 soybean genotypes for their suitability for raw materials of tempeh and adaptability to be developed in tropical area of Indonesia. The research material consisted of 150 soybean genotypes. The field research was conducted in Malang from February to May 2016, using a randomized block design with two replicates. The identification of 150 soybean genotypes showed 30.67% of super early maturity (soybeans with large seed size. In this research, G511H/Anj//Anj////Anjs-8-5 was suitable to be developed in Indonesia’s tropical climate and also preferred by industry for tempeh raw material due to its high yield, super early days to maturity, and large seed size.

Experience of US Patients Who Self-identify as Having an Overdiagnosed Thyroid Cancer

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Hendrickson, Chase D.; Hanson, Gregory S.

2017-01-01

Importance Overdiagnosis of cancer—the identification of cancers that are unlikely to progress—is a source of discomfort and challenge for patients, physicians, and health care systems. A major cause of this discomfort is the inability to know prospectively with certainty which cancers are overdiagnosed. In thyroid cancer, as patients have begun to understand this concept, some individuals are independently deciding not to intervene, despite this practice not yet being widely accepted. Objective To describe the current experience of people who independently self-identify as having an overdiagnosed cancer and elect not to intervene. Design, Setting, and Participants In this qualitative study, semistructured interviews were conducted between July 1 and December 31, 2015, with 22 community-dwelling adults aged 21 to 75 years who had an incidentally identified thyroid finding that was known or suspected to be malignant and who questioned the intervention recommended by their physicians. Verbatim transcripts were analyzed using constant comparative analysis. Main Outcomes and Measures The experience of individuals who self-identify as having an overdiagnosed cancer and elect not to intervene. Results Of the 22 people interviewed (16 females and 6 males; mean age, 48.5 years), 18 had elected not to intervene on their thyroid finding and had been living with the decision for a mean of 39 months (median, 40 months; range, 1-88 months). Twelve of the 18 participants reported that they experienced significant anxiety about cancer progression, but had considered reasons for choosing nonintervention: understanding issues of precision in diagnostic testing and the varied behavior of cancer, surgical risks, medication use, and low risk of death from the cancer. Twelve participants described their decisions as met with nonreassuring, unsupportive responses. Medical professionals, friends, and internet discussion groups told them they were “being stupid,” “were wrong

Targeted/exome sequencing identified mutations in ten Chinese patients diagnosed with Noonan syndrome and related disorders

Directory of Open Access Journals (Sweden)

Shanshan Xu

2017-10-01

Full Text Available Abstract Background Noonan syndrome (NS and Noonan syndrome with multiple lentigines (NSML are autosomal dominant developmental disorders. NS and NSML are caused by abnormalities in genes that encode proteins related to the RAS-MAPK pathway, including PTPN11, RAF1, BRAF, and MAP2K. In this study, we diagnosed ten NS or NSML patients via targeted sequencing or whole exome sequencing (TS/WES. Methods TS/WES was performed to identify mutations in ten Chinese patients who exhibited the following manifestations: potential facial dysmorphisms, short stature, congenital heart defects, and developmental delay. Sanger sequencing was used to confirm the suspected pathological variants in the patients and their family members. Results TS/WES revealed three mutations in the PTPN11 gene, three mutations in RAF1 gene, and four mutations in BRAF gene in the NS and NSML patients who were previously diagnosed based on the abovementioned clinical features. All the identified mutations were determined to be de novo mutations. However, two patients who carried the same mutation in the RAF1 gene presented different clinical features. One patient with multiple lentigines was diagnosed with NSML, while the other patient without lentigines was diagnosed with NS. In addition, a patient who carried a hotspot mutation in the BRAF gene was diagnosed with NS instead of cardiofaciocutaneous syndrome (CFCS. Conclusions TS/WES has emerged as a useful tool for definitive diagnosis and accurate genetic counseling of atypical cases. In this study, we analyzed ten Chinese patients diagnosed with NS and related disorders and identified their correspondingPTPN11, RAF1, and BRAF mutations. Among the target genes, BRAF showed the same degree of correlation with NS incidence as that of PTPN11 or RAF1.

A GIS model of habitat suitability for Solanum conocarpum (Solanaceae) in St. John, US Virgin Islands

Science.gov (United States)

Palumbo, Matthew D.; Fleming, Jonathan P.; Monsegur, Omar A.; Vilella, Francisco

2016-01-01

Solanum conocarpum (Solanaceae) (Marron Bacora) is a rare, dry-forest shrub endemic to the island of St. John, US Virgin Islands, considered for listing under the Endangered Species Act. Given its status as a species of conservation concern, we incorporated environmental characteristics of 3 observed populations and 5 additional known locations into a geographic information system (GIS) analysis to create a habitat-suitability model for the species on the island of St. John. Our model identified 1929.87 ha of highly suitable and moderately suitable habitat. Of these, 1161.20 ha (60.2%) occurred within the boundaries of Virgin Islands National Park. Our model provides spatial information on potential locations for future surveys and restoration sites for this endemic species of the US Virgin Islands.

45 CFR 12a.4 - Suitability determination.

Science.gov (United States)

2010-10-01

... underutilized will be reviewed for suitability no earlier than six months prior to the expected date when the... following: (1) The suitability determination for a particular piece of property, and the reasons for that...

Identifying the readiness of patients in implementing telemedicine in northern Louisiana for an oncology practice.

Science.gov (United States)

Gurupur, Varadraj; Shettian, Kruparaj; Xu, Peixin; Hines, Scott; Desselles, Mitzi; Dhawan, Manish; Wan, Thomas Th; Raffenaud, Amanda; Anderson, Lindsey

2017-09-01

This study identified the readiness factors that may create challenges in the use of telemedicine among patients in northern Louisiana with cancer. To identify these readiness factors, the team of investigators developed 19 survey questions that were provided to the patients or to their caregivers. The team collected responses from 147 respondents from rural and urban residential backgrounds. These responses were used to identify the individuals' readiness for utilising telemedicine through factor analysis, Cronbach's alpha reliability test, analysis of variance and ordinary least squares regression. The analysis results indicated that the favourable factor (positive readiness item) had a mean value of 3.47, whereas the unfavourable factor (negative readiness item) had a mean value of 2.76. Cronbach's alpha reliability test provided an alpha value of 0.79. Overall, our study indicated a positive attitude towards the use of telemedicine in northern Louisiana.

Value of platelet indices in identifying complete resolution of thrombus in deep venous thrombosis patients.

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Sevuk, Utkan; Altindag, Rojhat; Bahadir, Mehmet Veysi; Ay, Nurettin; Demirtas, Ertan; Ayaz, Fırat

2015-03-01

We aimed to evaluate whether mean platelet volume (MPV) and platelet distribution width (PDW) are helpful to identify complete thrombus resolution (CTR) after acute deep venous thrombosis (DVT). Patients who had first-time episode of acute proximal DVT were included in this retrospective study. 100 patients with DVT were divided into two groups according to absence (group 1; n = 68) or presence (group 2; n = 32) of CTR on doppler ultrasonography at month 6. There were no significant difference in admission MPV and PDW levels between group 1 and group 2. MPV (p = 0.03) and PDW (p venous thrombosis in DVT patients. Receiver operating characteristics analysis revealed that a 8.4 % decrease in admission MPV at month 6 provided 62 % sensitivity and 62 % specificity (AUC: 0.64) and a 15.4 % decrease in admission PDW at month 6 provided 87 % sensitivity and 94 % specificity (AUC: 0.89) for prediction of CTR in DVT patients. Percent change in admission MPV and PDW levels at month 6 may be used to identify the patients with CTR after a first episode of acute proximal DVT.

Campgrounds Suitability Evaluation Using GIS-based Multiple Criteria Decision Analysis: A Case Study of Kuerdening, China

Directory of Open Access Journals (Sweden)

Cuirong Wang

2016-04-01

Full Text Available The main objective of this study was to evaluate the suitability and select the most appropriate areas for building campgrounds in Kuerdening, China. To achieve this aim, AHP and GIS-based weighted overlay methods were adopted. AHP was used to determine the weights of the indexes, and ArcGIS 10 was used to calculate and map the campground suitability. In pursuit of minimum environmental effects and sustainable development, this paper identifies four factors to evaluate the suitability of areas for building campgrounds: natural environment condition, landscape condition, safety condition and infrastructure condition. The final outcome of this studywas the suitability map for building campgrounds. This research not only provides a theoretical guide for the construction of campgrounds in this area but also provides a scientific and efficientworkflow to evaluate the appropriateness of other areas. The result is reasonable and operable for camping facilities development and also useful for managers and planners working in local governments as well as investors.

Campgrounds Suitability Evaluation Using GIS-based Multiple Criteria Decision Analysis: A Case Study of Kuerdening, China

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Cuirong, Wang; Zhaoping, Yang; Huaxian, Liu; Fang, Han; Wenjin, Xia

2016-04-01

The main objective of this study was to evaluate the suitability and select the most appropriate areas for building campgrounds in Kuerdening, China. To achieve this aim, AHP and GIS-based weighted overlay methods were adopted. AHP was used to determine the weights of the indexes, and ArcGIS 10 was used to calculate and map the campground suitability. In pursuit of minimum environmental effects and sustainable development, this paper identifies four factors to evaluate the suitability of areas for building campgrounds: natural environment condition, landscape condition, safety condition and infrastructure condition. The final outcome of this studywas the suitability map for building campgrounds. This research not only provides a theoretical guide for the construction of campgrounds in this area but also provides a scientific and efficientworkflow to evaluate the appropriateness of other areas. The result is reasonable and operable for camping facilities development and also useful for managers and planners working in local governments as well as investors.

Prognostic value of IDH1 mutations identified with PCR-RFLP assay in acute myeloid leukemia patients

International Nuclear Information System (INIS)

Elsayed, Gh.M.; Zaher, A.; Elnoshokaty, E.H.; Nassar, H.R.; Moneer, M.M.

2014-01-01

Background: Somatic mutations in isocitrate dehydrogenase 1 (1DH1) gene occur frequently in primary brain tumors. Recently theses mutations were demonstrated in acute myeloid leukemia (AML). So far, assessment of these mutations relied on the DNA sequencing technique. Aim of the work: The aim of this study was to detect somatic mutations in IDH1 gene using mismatched primers suitable for endonuclease based detection, without the need for DNA sequencing, and to estimate its prognostic value, on patients with de novo AML. Methods: Residual DNA extracted from pretreatment bone marrow (BM) samples of 100 patients with de novo AML was used. The polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP) was adapted to IDHl gene, codon 132 mutations screening. Results: The frequency of IDH1 mutations was 13%. In the non-acute promyelocytic leukemia group (non-APL), IDH1 mutations were significantly associated with FLT3-ITD negative patients (p = 0.03). Patients with 1DH1 mutations did not achieve complete remission (CR). There was a trend for shorter overall survival (OS) in patients with IDH1 mutation compared to those with wild type (p = 0.08). Conclusion: IDH1 mutations are recurring genetic alterations in AML and they may have unfavorable impact on clinical outcome in adult AML. The PCR-RFLP method allows for a fast, inexpensive, and sensitive method for the detection of IDF11 mutations in AML.

Lipid ratio as a suitable tool to identify individuals with MetS risk: A case- control study.

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Abbasian, Maryam; Delvarianzadeh, Mehri; Ebrahimi, Hossein; Khosravi, Farideh

2017-11-01

This study aimed to compare the serum lipids ratio in staff with and without metabolic syndrome (MetS) who were working in Shahroud University of Medical Sciences. This case-control study was conducted in 2015 on 499 personnel aged 30-60 years old. ATP III criteria were used to diagnose patients with MetS. The data were analyzed by using logistic regression and ROC curve. Mean lipid ratio was higher in individuals having the MetS in both sexes compared with those without. In addition, the mean levels of lipid ratios significantly increased with increasing number of MetS components in both sexes. Also it could be concluded that TG/HDL-C ratio is the best marker for the diagnosis of MetS in men and women. Moreover, the cut-off point for the TG/HDL-C was 2.86 in women and 4.03 in men. It was found that for any unit of increases in the TG/HDL-C, the risk of developing the MetS will increase by 2.12 times. TG/HDL-C ratio is found to be the best clinical marker for the diagnosis of MetS compare with other lipid ratios, therefore it is recommended to be used as a feasible tool to identify individuals with MetS risk. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

A GIS based screening tool for locating and ranking of suitable stormwater harvesting sites in urban areas.

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Inamdar, P M; Cook, S; Sharma, A K; Corby, N; O'Connor, J; Perera, B J C

2013-10-15

There is the need to re-configure current urban water systems to achieve the objective of sustainable water sensitive cities. Stormwater represents a valuable alternative urban water source to reduce pressure on fresh water resources, and to mitigate the environmental impact of urban stormwater runoff. The selection of suitable urban stormwater harvesting sites is generally based on the judgement of water planners, who are faced with the challenge of considering multiple technical and socio-economic factors that influence the site suitability. To address this challenge, the present study developed a robust GIS based screening methodology for identifying potentially suitable stormwater harvesting sites in urban areas as a first pass for then more detailed investigation. The study initially evaluated suitability based on the match between harvestable runoff and demand through a concept of accumulated catchments. Drainage outlets of these accumulated catchments were considered as potential stormwater harvesting sites. These sites were screened and ranked under screening parameters namely demand, ratio of runoff to demand and weighted demand distance. The methodology described in this paper was successfully applied to a case study in Melbourne, Australia in collaboration with the local water utility. The methodology was found to be effective in supporting the selection of priority sites for stormwater harvesting schemes, as it provided the basis to identify, short-list and rank sites for further detailed investigation. The rapid identification of suitable sites for stormwater harvesting can assist planners in prioritising schemes in areas that will have the most impact on reducing potable water demand. Copyright © 2013 Elsevier Ltd. All rights reserved.

Identifying primary care patient safety research priorities in the UK: a James Lind Alliance Priority Setting Partnership.

Science.gov (United States)

Morris, Rebecca Lauren; Stocks, Susan Jill; Alam, Rahul; Taylor, Sian; Rolfe, Carly; Glover, Steven William; Whitcombe, Joanne; Campbell, Stephen M

2018-02-28

To identify the top 10 unanswered research questions for primary care patient safety research. A modified nominal group technique. UK. Anyone with experience of primary care including: patients, carers and healthcare professionals. 341 patients and 86 healthcare professionals submitted questions. A top 10, and top 30, future research questions for primary care patient safety. 443 research questions were submitted by 341 patients and 86 healthcare professionals, through a national survey. After checking for relevance and rephrasing, a total of 173 questions were collated into themes. The themes were largely focused on communication, team and system working, interfaces across primary and secondary care, medication, self-management support and technology. The questions were then prioritised through a national survey, the top 30 questions were taken forward to the final prioritisation workshop. The top 10 research questions focused on the most vulnerable in society, holistic whole-person care, safer communication and coordination between care providers, work intensity, continuity of care, suicide risk, complex care at home and confidentiality. This study was the first national prioritisation exercise to identify patient and healthcare professional priorities for primary care patient safety research. The research priorities identified a range of important gaps in the existing evidence to inform everyday practice to address primary care patient safety. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Identifying the bleeding trauma patient: predictive factors for massive transfusion in an Australasian trauma population.

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Hsu, Jeremy Ming; Hitos, Kerry; Fletcher, John P

2013-09-01

Military and civilian data would suggest that hemostatic resuscitation results in improved outcomes for exsanguinating patients. However, identification of those patients who are at risk of significant hemorrhage is not clearly defined. We attempted to identify factors that would predict the need for massive transfusion (MT) in an Australasian trauma population, by comparing those trauma patients who did receive massive transfusion with those who did not. Between 1985 and 2010, 1,686 trauma patients receiving at least 1 U of packed red blood cells were identified from our prospectively maintained trauma registry. Demographic, physiologic, laboratory, injury, and outcome variables were reviewed. Univariate analysis determined significant factors between those who received MT and those who did not. A predictive multivariate logistic regression model with backward conditional stepwise elimination was used for MT risk. Statistical analysis was performed using SPSS PASW. MT patients had a higher pulse rate, lower Glasgow Coma Scale (GCS) score, lower systolic blood pressure, lower hemoglobin level, higher Injury Severity Score (ISS), higher international normalized ratio (INR), and longer stay. Initial logistic regression identified base deficit (BD), INR, and hemoperitoneum at laparotomy as independent predictive variables. After assigning cutoff points of BD being greater than 5 and an INR of 1.5 or greater, a further model was created. A BD greater than 5 and either INR of 1.5 or greater or hemoperitoneum was associated with 51 times increase in MT risk (odds ratio, 51.6; 95% confidence interval, 24.9-95.8). The area under the receiver operating characteristic curve for the model was 0.859. From this study, a combination of BD, INR, and hemoperitoneum has demonstrated good predictability for MT. This tool may assist in the determination of those patients who might benefit from hemostatic resuscitation. Prognostic study, level III.

Selection of suitable e-learning approach using TOPSIS technique with best ranked criteria weights

Science.gov (United States)

Mohammed, Husam Jasim; Kasim, Maznah Mat; Shaharanee, Izwan Nizal Mohd

2017-11-01

This paper compares the performances of four rank-based weighting assessment techniques, Rank Sum (RS), Rank Reciprocal (RR), Rank Exponent (RE), and Rank Order Centroid (ROC) on five identified e-learning criteria to select the best weights method. A total of 35 experts in a public university in Malaysia were asked to rank the criteria and to evaluate five e-learning approaches which include blended learning, flipped classroom, ICT supported face to face learning, synchronous learning, and asynchronous learning. The best ranked criteria weights are defined as weights that have the least total absolute differences with the geometric mean of all weights, were then used to select the most suitable e-learning approach by using TOPSIS method. The results show that RR weights are the best, while flipped classroom approach implementation is the most suitable approach. This paper has developed a decision framework to aid decision makers (DMs) in choosing the most suitable weighting method for solving MCDM problems.

Assessing the suitability of stream water for five different uses and its aquatic environment.

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Fulazzaky, Mohamad Ali

2013-01-01

Surface water is one of the essential resources for supporting sustainable development. The suitability of such water for a given use depends both on the available quantity and tolerable quality. Temporary status for a surface water quality has been identified extensively. Still the suitability of the water for different purposes needs to be verified. This study proposes a water quality evaluation system to assess the aptitude of the Selangor River water for aquatic biota, drinking water production, leisure and aquatic sport, irrigation use, livestock watering, and aquaculture use. Aptitude of the water has been classified in many parts of the river segment as unsuitable for aquatic biota, drinking water production, leisure and aquatic sport as well as aquaculture use. The water quality aptitude classes of the stream water for nine locations along the river are evaluated to contribute to decision support system. The suitability of the water for five different uses and its aquatic ecosystem are verified.

Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.

Science.gov (United States)

Hernan, Andrea L; Giles, Sally J; Fuller, Jeffrey; Johnson, Julie K; Walker, Christine; Dunbar, James A

2015-09-01

Patients can have an important role in reducing harm in primary-care settings. Learning from patient experience and feedback could improve patient safety. Evidence that captures patients' views of the various contributory factors to creating safe primary care is largely absent. The aim of this study was to address this evidence gap. Four focus groups and eight semistructured interviews were conducted with 34 patients and carers from south-east Australia. Participants were asked to describe their experiences of primary care. Audio recordings were transcribed verbatim and specific factors that contribute to safety incidents were identified in the analysis using the Yorkshire Contributory Factors Framework (YCFF). Other factors emerging from the data were also ascertained and added to the analytical framework. Thirteen factors that contribute to safety incidents in primary care were ascertained. Five unique factors for the primary-care setting were discovered in conjunction with eight factors present in the YCFF from hospital settings. The five unique primary care contributing factors to safety incidents represented a range of levels within the primary-care system from local working conditions to the upstream organisational level and the external policy context. The 13 factors included communication, access, patient factors, external policy context, dignity and respect, primary-secondary interface, continuity of care, task performance, task characteristics, time in the consultation, safety culture, team factors and the physical environment. Patient and carer feedback of this type could help primary-care professionals better understand and identify potential safety concerns and make appropriate service improvements. The comprehensive range of factors identified provides the groundwork for developing tools that systematically capture the multiple contributory factors to patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not

Mapping anuran habitat suitability to estimate effects of grassland and wetland conservation programs

Science.gov (United States)

Mushet, David M.; Euliss, Ned H.; Stockwell, Craig A.

2012-01-01

The conversion of the Northern Great Plains of North America to a landscape favoring agricultural commodity production has negatively impacted wildlife habitats. To offset impacts, conservation programs have been implemented by the U.S. Department of Agriculture and other agencies to restore grassland and wetland habitat components. To evaluate effects of these efforts on anuran habitats, we used call survey data and environmental data in ecological niche factor analyses implemented through the program Biomapper to quantify habitat suitability for five anuran species within a 196 km2 study area. Our amphibian call surveys identified Northern Leopard Frogs (Lithobates pipiens), Wood Frogs (Lithobates sylvaticus), Boreal Chorus Frogs (Pseudacris maculata), Great Plains Toads (Anaxyrus cognatus), and Woodhouse’s Toads (Anaxyrus woodhousii) occurring within the study area. Habitat suitability maps developed for each species revealed differing patterns of suitable habitat among species. The most significant findings of our mapping effort were 1) the influence of deep-water overwintering wetlands on suitable habitat for all species encountered except the Boreal Chorus Frog; 2) the lack of overlap between areas of core habitat for both the Northern Leopard Frog and Wood Frog compared to the core habitat for both toad species; and 3) the importance of conservation programs in providing grassland components of Northern Leopard Frog and Wood Frog habitat. The differences in habitats suitable for the five species we studied in the Northern Great Plains, i.e., their ecological niches, highlight the importance of utilizing an ecosystem based approach that considers the varying needs of multiple species in the development of amphibian conservation and management plans.

The areal extent of brown shrimp habitat suitability in Mobile Bay, Alabama, USA: Targeting vegetated habitat restoration

Science.gov (United States)

Smith, L.M.; Nestlerode, J.A.; Harwell, L.C.; Bourgeois, P.

2010-01-01

The availability of wetlands and shallow water habitats significantly influences Gulf of Mexico (GOM) penaeid shrimp fishery productivity. However, the GOM region has the highest rate of wetland loss in the USA. Protection and management of these vital GOM habitats are critical to sustainable shrimp fisheries. Brown shrimp (Farfantepenaeus aztecus) are a major component of GOM fisheries. We present an approach for estimating the areal extent of suitable habitat for post-larval and juvenile brown shrimp in Mobile Bay, Alabama, using an existing habitat suitability index model for the northern GOM calculated from probabilistic survey of water quality and sediment data, land cover data, and submerged aquatic vegetation coverages. This estuarine scale approach is intended to support targeted protection and restoration of these habitats. These analyses indicate that approximately 60% of the area of Mobile Bay is categorized as suitable to near optimal for post-larval and juvenile shrimp and 38% of the area is marginally to minimally suitable. We identify potential units within Mobile Bay for targeted restoration to improve habitat suitability. ?? 2010 Springer Science+Business Media B.V.

Identifying What Matters to Hysterectomy Patients: Postsurgery Perceptions, Beliefs, and Experiences

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Andrew S. Bossick

2018-04-01

Full Text Available Purpose: Hysterectomy is the most common nonobstetrical surgery for women in the United States. Few investigations comparing hysterectomy surgical approaches include patient-centered outcomes. Methods: The study was performed at Henry Ford Health System (Detroit, MI between February 2015 and May 2015. A total of 1,038 eligible women — those 18 to 65 years of age and who had an electronic medical record-documented Current Procedural Terminology (CPT® code or an International Statistical Classification of Diseases, Ninth Edition (ICD-9 code of hysterectomy between December 2012 and December 2014 — were selected and recruited. A question guide was developed to investigate women’s experiences and feelings about the experience prior and subsequent to their hysterectomy. Analysis utilized the Framework Method. Study data were collected through structured focus groups with 24 posthysterectomy women in order to identify patient-centered outcomes to employ in a subsequent cohort study of hysterectomy surgical approaches. One pilot focus group and 5 additional focus groups were held. Qualitative data analysis, using data from coded transcripts of focus groups, was used to identify themes. Results: Focus groups with women who previously had a hysterectomy revealed their pre- and posthysterectomy perceptions. Responses were grouped into topics of pre- and postsurgical experiences, and information all women should know. Themes derived from responses: 1 decision-making; 2 the procedure (surgical experience; 3 recovery; 4 advice to past self; and 5 recommendations to other women. Conclusions: These analyzed data suggest a need for increased education and empowerment in the hysterectomy decision-making process, along with expanding information given for postoperative expectations and somatic changes that occur posthysterectomy. Findings about perceptions, beliefs, and attitudes of women having undergone hysterectomy could support health care providers

Identifying Patients at Risk of Deterioration in the Joint Emergency Department

DEFF Research Database (Denmark)

Schmidt, Thomas; Wiil, Uffe Kock

2015-01-01

at the case through the lenses of common information spaces. In particular, we apply Bossen’s seven-parameter framework to discover new dimensions of how Emergency Departments and individual clinicians identify and respond to unforeseen events, and how they handle the associated cognitive challenges. We......In recent years, Danish hospitals have merged their emergency facilities into Joint Emergency Departments. This poses new collaborative challenges across traditionally separated specialized departments, which now have to collaborate in a shared environment. Despite established protocols and patient...

A fuzzy approach to a multiple criteria and geographical information system for decision support on suitable locations for biogas plants

DEFF Research Database (Denmark)

Franco de los Rios, Camilo Andres; Bojesen, Mikkel; Hougaard, Jens Leth

The purpose of this paper is to model the multi-criteria decision problem of identifying the most suitable facility locations for biogas plants under an integrated decision support methodology. Here the Geographical Information System (GIS) is used for measuring the attributes of the alternatives...... according to a given set of criteria. Measurements are taken in interval form, expressing the natural imprecision of common data, and the Fuzzy Weighted Overlap Dominance (FWOD) procedure is applied for aggregating and exploiting this kind of data, obtaining suitability degrees for every alternative....... The estimation of criteria weights, which is necessary for applying the FWOD procedure, is done by means of the Analytical Hierarchy Process (AHP), such that a combined AHP-FWOD methodology allows identifying the more suitable sites for building biogas plants. We show that the FWOD relevance-ranking procedure...

Shaken but not stirred: Multiscale habitat suitability modeling of sympatric marten species (Martes martes and Martes foina) in the northern Iberian Peninsula

Science.gov (United States)

Maria Vergara; Samuel A. Cushman; Fermin Urra; Aritz Ruiz-Gonzalez

2016-01-01

Multispecies and multiscale habitat suitability models (HSM) are important to identify the environmental variables and scales influencing habitat selection and facilitate the comparison of closely related species with different ecological requirements. Objectives This study explores the multiscale relationships of habitat suitability for the pine (Martes...

Perceptions of teacher candidates concerning ethically suitable behaviours for teaching profession

Directory of Open Access Journals (Sweden)

Balcı Süleyman

2016-01-01

Full Text Available Identifying the perceptions of teacher candidates regarding effective teacher charactheristics and teaching is necessary for knowing their program experiences to consider the appropriateness of those perceptions in terms of professional purposes and practices. Moreover, professional ethics determined for teaching profession enable teachers to make decisions easily at any difficult situations in education. Purpose of this study is to describe perceptions of teacher candidates working for secondary schools concerning ethically suitable behaviors for teaching profession. Participants of this study includes graduates of Mathematics, Nursing, Sociology, Turkish Language Literature Departments. Of those participants (n=163, 42 are graduates of Mathematics, 35 are Nursing, 45 are Sociology, 41 are Turkish Language Literature Departments and completed preservice teacher education curriculum (pedagogical education program at Education Faculty of Kırıkkale University in 2014–2015 academic calender. According to the results of this study most of the participants are aware of ethically suitable behaviors for teaching profession.

Coding algorithms for identifying patients with cirrhosis and hepatitis B or C virus using administrative data.

Science.gov (United States)

Niu, Bolin; Forde, Kimberly A; Goldberg, David S

2015-01-01

Despite the use of administrative data to perform epidemiological and cost-effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies. We evaluated the positive predictive value (PPV) of ICD-9-CM codes for identifying chronic HBV or HCV among cirrhotic patients within the University of Pennsylvania Health System, a large network that includes a tertiary care referral center, a community-based hospital, and multiple outpatient practices across southeastern Pennsylvania and southern New Jersey. We reviewed a random sample of 200 cirrhotic patients with ICD-9-CM codes for HCV and 150 cirrhotic patients with ICD-9-CM codes for HBV. The PPV of 1 inpatient or 2 outpatient HCV codes was 88.0% (168/191, 95% CI: 82.5-92.2%), while the PPV of 1 inpatient or 2 outpatient HBV codes was 81.3% (113/139, 95% CI: 73.8-87.4%). Several variations of the primary coding algorithm were evaluated to determine if different combinations of inpatient and/or outpatient ICD-9-CM codes could increase the PPV of the coding algorithm. ICD-9-CM codes can identify chronic HBV or HCV in cirrhotic patients with a high PPV and can be used in future epidemiologic studies to examine disease burden and the proper allocation of resources. Copyright © 2014 John Wiley & Sons, Ltd.

Autofluorescence Lifetimes in Patients With Choroideremia Identify Photoreceptors in Areas With Retinal Pigment Epithelium Atrophy.

Science.gov (United States)

Dysli, Chantal; Wolf, Sebastian; Tran, Hoai Viet; Zinkernagel, Martin S

2016-12-01

The purpose of this study was to investigate fundus autofluorescence lifetimes in patients with choroideremia and to identify tissue-specific lifetime characteristics and potential prognostic markers. Autofluorescence lifetimes of the retina were measured in two spectral channels (498-560 nm and 560-720 nm) in patients with choroideremia and age-matched healthy controls. Furthermore, autofluorescence intensities and spectral-domain optical coherence tomography (OCT) data were acquired and compared to fundus autofluorescence lifetime data. Sixteen eyes from 8 patients with advanced choroideremia (mean ± SD age, 55 ± 13 years) were included in this study and compared with 10 age-matched healthy participants. Whereas fundus autofluorescence intensity measurement identified areas of remaining retinal pigment epithelium (RPE), autofluorescence lifetime maps identified areas with remaining photoreceptor layers in OCT but RPE atrophy. In these areas, mean (±SEM) lifetimes were 567 ± 59 ps in the short and 603 ± 49 ps in the long spectral channels (+98% and +88% compared to controls). In areas of combined RPE atrophy and loss of photoreceptors, autofluorescence lifetimes were significantly prolonged by 1116 ± 63 ps (+364%) in the short and by 915 ± 52 ps (+270%) in the long spectral channels compared with controls. Because autofluorescence lifetimes identify areas of remaining photoreceptors in the absence of RPE, this imaging modality may be useful to monitor disease progression in the natural course of disease and in context of potential future therapeutic interventions.

Forecasting Temporal and Spatial Climatological Influence for Land Suitability Evaluation in Bentota Sri Lanka

Directory of Open Access Journals (Sweden)

Gayani Ranasinghe

2017-01-01

Full Text Available Climate change has raised much concern regarding its impacts on future land use planning, varying by region, time, and socio-economic development path. The principle purpose of land suitability evaluation is to predict the potential and limitation of the land for crop production and other land uses. This study was carried out to predict the temperature and rainfall trends as one of the major factor for evaluating land suitability. Climatic data such as monthly mean temperature, total monthly rainfall, maximum daily rainfall and total annual rainfall during last 30 years of all weather stations located in Bentota River basin was collected and analyzed applying time series analysis, correlation analysis and Manna Kendall trend test methods. Spatial distribution of forecast rainfall values was illustrated applying Arc GIS software. The findings revealed that monthly mean temperature and maximum daily rainfall had a general increasing trend whereas, total monthly rainfall and total annual rainfall showed a general decreasing trend in  Bentota area. It was indicated relatively high rainfall situations during May and October while low rainfall situations during January and February by occurring flood situation in once per five year. During Yala season the area will be received comparatively more rainfall (331mm than Maha season (300mm in future. Community and the farmers in this area can be aware about the anticipated spatial distribution of total monthly rainfall during two major seasons and flood occurrence periods. Decision makers should evaluate land suitability of Bentota area by considering above climatological influences and its spatial distribution pattern that identified as major outcome of this research. The approach and the methodology adopted in this study will be useful for other researchers, agriculturalist and planners to identify the future climatological influences and its spatial distribution pattern for land suitability evaluations

Estimating Aquifer Storage and Recovery (ASR Regional and Local Suitability: A Case Study in Washington State, USA

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Maria T. Gibson

2018-01-01

Full Text Available Developing aquifers as underground water supply reservoirs is an advantageous approach applicable to meeting water management objectives. Aquifer storage and recovery (ASR is a direct injection and subsequent withdrawal technology that is used to increase water supply storage through injection wells. Due to site-specific hydrogeological quantification and evaluation to assess ASR suitability, limited methods have been developed to identify suitability on regional scales that are also applicable at local scales. This paper presents an ASR site scoring system developed to qualitatively assess regional and local suitability of ASR using 9 scored metrics to determine total percent of ASR suitability, partitioned into hydrogeologic properties, operational considerations, and regulatory influences. The development and application of a qualitative water well suitability method was used to assess the potential groundwater response to injection, estimate suitability based on predesignated injection rates, and provide cumulative approximation of statewide and local storage prospects. The two methods allowed for rapid assessment of ASR suitability and its applicability to regional and local water management objectives at over 280 locations within 62 watersheds in Washington, USA. It was determined that over 50% of locations evaluated are suitable for ASR and statewide injection potential equaled 6400 million liters per day. The results also indicate current limitations and/or potential benefits of developing ASR systems at the local level with the intent of assisting local water managers in strategic water supply planning.

Using Optical Markers of Non-dysplastic Rectal Epithelial Cells to Identify Patients With Ulcerative Colitis (UC) - Associated Neoplasia

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Bista, Rajan K.; Brentnall, Teresa A.; Bronner, Mary P.; Langmead, Christopher J.; Brand, Randall E.; Liu, Yang

2011-01-01

BACKGROUND Current surveillance guidelines for patients with long-standing ulcerative colitis (UC) recommend repeated colonoscopy with random biopsies, which is time-consuming, discomforting and expensive. A less invasive strategy is to identify neoplasia by analyzing biomarkers from the more accessible rectum to predict the need for a full colonoscopy. The goal of this pilot study is to evaluate whether optical markers of rectal mucosa derived from a novel optical technique – partial-wave spectroscopic microscopy (PWS) could identify UC patients with high-grade dysplasia (HGD) or cancer (CA) present anywhere in their colon. METHODS Banked frozen non-dysplastic mucosal rectal biopsies were used from 28 UC patients (15 without dysplasia and 13 with concurrent HGD or CA). The specimen slides were made using a touch prep method and underwent PWS analysis. We divided the patients into two groups: 13 as a training set and an independent 15 as a validation set. RESULTS We identified six optical markers, ranked by measuring the information gain with respect to the outcome of cancer. The most effective markers were selected by maximizing the cross validated training accuracy of a Naive Bayes classifier. The optimal classifier was applied to the validation data yielding 100% sensitivity and 75% specificity. CONCLUSIONS Our results indicate that the PWS-derived optical markers can accurately predict UC patients with HGD/CA through assessment of rectal epithelial cells. By aiming for a high sensitivity, our approach could potentially simplify the surveillance of UC patients and improve overall resource utilization by identifying patients with HGD/CA who should proceed with colonoscopy. PMID:21351200

Fall and winter microhabitat use and suitability for spring chinook salmon parr in a U.S. Pacific Northwest River

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Favrot, Scott D.; Jonasson, Brian C.; Peterson, James T.

2018-01-01

Habitat degradation has been implicated as a primary threat to Pacific salmon Oncorhynchus spp. Habitat restoration and conservation are key toward stemming population declines; however, winter microhabitat use and suitability knowledge are lacking for small juvenile salmonids. Our objective was to characterize microhabitat use and suitability for spring Chinook Salmon Oncorhynchus tshawytscha parr during fall and winter. Using radiotelemetry techniques during October–February (2009–2011), we identified fall and winter microhabitat use by spring Chinook Salmon parr in Catherine Creek, northeastern Oregon. Tagged fish occupied two distinct gradient reaches (moderate and low). Using a mixed‐effects logistic regression resource selection function (RSF) model, we found evidence that microhabitat use was similar between free‐flowing and surface ice conditions. However, habitat use shifted between seasons; most notably, there was greater use of silt substrate and areas farther from the bank during winter. Between gradients, microhabitat use differed with greater use of large wood (LW) and submerged aquatic vegetation in the low‐gradient reach. Using a Bayesian RSF approach, we developed gradient‐specific habitat suitability criteria. Throughout the study area, deep depths and slow currents were most suitable, with the exception of the low‐gradient reach where moderate depths were optimal. Near‐cover coarse and fine substrates were most suitable in the moderate‐ and low‐gradient reaches, respectively. Near‐bank LW was most suitable throughout the study area. Multivariate principal component analyses (PCA) indicated co‐occurring deep depths supporting slow currents near cover were intensively occupied in the moderate‐gradient reach. In the low‐gradient reach, PCA indicated co‐occurring moderate depths, slow currents, and near‐bank cover were most frequently occupied. Our study identified suitable and interrelated microhabitat

Simple risk stratification at admission to identify patients with reduced mortality from primary angioplasty

DEFF Research Database (Denmark)

Thune, Jens Jakob; Hoefsten, Dan Eik; Lindholm, Matias Greve

2005-01-01

BACKGROUND: Randomized trials comparing fibrinolysis with primary angioplasty for acute ST-elevation myocardial infarction have demonstrated a beneficial effect of primary angioplasty on the combined end point of death, reinfarction, and disabling stroke but not on all-cause death. Identifying...... a patient group with reduced mortality from an invasive strategy would be important for early triage. The Thrombolysis in Myocardial Infarction (TIMI) risk score is a simple validated integer score that makes it possible to identify high-risk patients on admission to hospital. We hypothesized that a high...... as high risk. There was a significant interaction between risk status and effect of primary angioplasty (P=0.008). In the low-risk group, there was no difference in mortality (primary angioplasty, 8.0%; fibrinolysis, 5.6%; P=0.11); in the high-risk group, there was a significant reduction in mortality...

Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

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Yardlee Kauffman

2014-01-01

Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

Using in vivo corneal confocal microscopy to identify diabetic sensorimotor polyneuropathy risk profiles in patients with type 1 diabetes.

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Lewis, Evan J H; Perkins, Bruce A; Lovblom, Lief E; Bazinet, Richard P; Wolever, Thomas M S; Bril, Vera

2017-01-01

Diabetic sensorimotor peripheral neuropathy (DSP) is the most prevalent complication in diabetes mellitus. Identifying DSP risk is essential for intervening early in the natural history of the disease. Small nerve fibers are affected earliest in the disease progression and evidence of this damage can be identified using in vivo corneal confocal microscopy (IVCCM). We applied IVCCM to a cohort of 40 patients with type 1 diabetes to identify their DSP risk profile. We measured standard IVCCM parameters including corneal nerve fiber length (CNFL), and performed nerve conduction studies and quantitative sensory testing. 40 patients (53% female), with a mean age of 48±14, BMI 28.1±5.8, and diabetes duration of 27±18 years were enrolled between March 2014 and June 2015. Mean IVCCM CNFL was 12.0±5.2 mm/mm 2 (normal ≥15 mm/mm 2 ). Ten patients (26%) without DSP were identified as being at risk of future DSP with mean CNFL 11.0±2.1 mm/mm 2 . Six patients (15%) were at low risk of future DSP with mean CNFL 19.0±4.6 mm/mm 2 , while 23 (59%) had established DSP with mean CNFL 10.5±4.5 mm/mm 2 . IVCCM can be used successfully to identify the risk profile for DSP in patients with type 1 diabetes. This methodology may prove useful to classify patients for DSP intervention clinical trials.

Digital X-ray radiogrammetry better identifies osteoarthritis patients with a low bone mineral density than quantitative ultrasound

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Goerres, Gerhard W. [University Hospital Zurich, Institute of Diagnostic Radiology, Department of Medical Radiology, Zurich (Switzerland); University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); Frey, Diana; Studer, Annina; Hauser, Dagmar; Zilic, Nathalie [University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); Hany, Thomas F. [University Hospital Zurich, Institute of Nuclear Medicine, Department of Medical Radiology, Zurich (Switzerland); Seifert, Burkhardt [University of Zurich, Department of Biostatistics, Zurich (Switzerland); Haeuselmann, Hans J. [Center for Rheumatology and Bone Disease, Klinik im Park, Zurich (Switzerland); Michel, Beat A.; Uebelhart, Daniel [University Hospital Zurich, Osteoporosis Center, Zurich (Switzerland); University Hospital Zurich, Department of Rheumatology and Institute of Physical Medicine, Zurich (Switzerland); Hans, Didier [University Hospital Geneva, Division of Nuclear Medicine, Geneva (Switzerland)

2007-04-15

This study assessed the ability of quantitative ultrasound (QUS) and digital X-ray radiogrammetry (DXR) to identify osteopenia and osteoporosis in patients with knee osteoarthritis (OA). One hundred and sixty-one patients with painful knee OA (81 men, 80 women; age 62.6{+-}9.2 years, range 40-82 years) were included in this cross-sectional study and underwent dual-energy X-ray absorptiometry (DXA) of both hips and the lumbar spine, QUS of the phalanges and calcanei of both hands and heels, and DXR using radiographs of both hands. Unpaired t-test, Mann-Whitney U test, ROC analysis and Spearman's rank correlation were used for comparisons and correlation of methods. Using DXA as the reference standard, we defined a low bone mineral density (BMD) as a T-score {<=}-1.0 at the lumbar spine or proximal femur. In contrast to phalangeal or calcaneal QUS, DXR was able to discriminate patients with a low BMD at the lumbar spine (p<0.0001) or hips (p<0.0001). ROC analysis showed that DXR had an acceptable predictive power in identifying OA patients a low hip BMD (sensitivity 70%, specificity 71%). Therefore, DXR used as a screening tool could help in identifying patients with knee OA for DXA. (orig.)

Identifying Feasible Locations for Wetland Creation or Restoration in Catchments by Suitability Modelling Using Light Detection and Ranging (LiDAR Digital Elevation Model (DEM

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Evelyn Uuemaa

2018-04-01

Full Text Available Wetlands play a key role in controlling flooding and non-point-source (diffuse pollution. They are therefore an important tool for mitigating diffuse water pollution from farms. However, to use this tool, it is necessary to obtain detailed assessments and identification of potential wetland restoration or creation sites. This is complicated by the diversity of landscapes, environmental conditions, and land ownership. Site suitability for wetland restoration or creation depends on many factors: the underlying geology, soils, topography, hydrology, drainage, and land ownership. Local hydrology and soils are among the most important factors. However, the inventory and characterization of a site’s soils and hydrology often requires extensive, expensive, and time-consuming ground surveys, and it is therefore limited to small areas. Another possibility would be to consider topography, which strongly determines water movement patterns. Light detection and ranging (LiDAR data provides detailed topographic information and can be acquired by remote sensing. Our study showed that terrain analysis using high-resolution topographical data can produce suitability maps for wetlands that can be easily used by decision makers and planners in watershed management. The rapid methodology reveals potential wetland creation or restoration sites at a reasonable cost; with the resulting spatially explicit suitability map, managers can plan for wetland creation or restoration without having to wait for field-data collection.

Private prayer as a suitable intervention for hospitalised patients: a critical review of the literature.

Science.gov (United States)

Hollywell, Claire; Walker, Jan

2009-03-01

This critical review seeks to identify if there is evidence that private (personal) prayer is capable of improving wellbeing for adult patients in hospital. The review was conducted in the belief that the spiritual needs of hospitalised patients may be enhanced by encouragement and support to engage in prayer. Systematic review. A systematic approach was used to gather evidence from published studies. In the absence of experimental research involving this type of population, evidence from qualitative and correlational studies was critically reviewed. Results. The findings indicate that private prayer, when measured by frequency, is usually associated with lower levels of depression and anxiety. Most of the studies that show positive associations between prayer and wellbeing were located in areas that have strong Christian traditions and samples reported a relatively high level of religiosity, church attendance and use of prayer. Church attenders, older people, women, those who are poor, less well educated and have chronic health problems appear to make more frequent use of prayer. Prayer appears to be a coping action that mediates between religious faith and wellbeing and can take different forms. Devotional prayers involving an intimate dialogue with a supportive God appear to be associated with improved optimism, wellbeing and function. In contrast, prayers that involve pleas for help may, in the absence of a pre-existing faith, be associated with increased distress and possibly poorer function. Future research needs to differentiate the effects of different types of prayer. Encouragement to engage in prayer should be offered only following assessment of the patient's faith and likely content and form of prayer to be used. Hospitalised patients who lack faith and whose prayers involve desperate pleas for help are likely to need additional support from competent nursing and chaplaincy staff.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients.

Science.gov (United States)

Massart, Annick; Pallier, Annaïck; Pascual, Julio; Viklicky, Ondrej; Budde, Klemens; Spasovski, Goce; Klinger, Marian; Sever, Mehmet Sukru; Sørensen, Søren Schwartz; Hadaya, Karine; Oberbauer, Rainer; Dudley, Christopher; De Fijter, Johan W; Yussim, Alexander; Hazzan, Marc; Wekerle, Thomas; Berglund, David; De Biase, Consuelo; Pérez-Sáez, María José; Mühlfeld, Anja; Orlando, Giuseppe; Clemente, Katia; Lai, Quirino; Pisani, Francesco; Kandus, Aljosa; Baas, Marije; Bemelman, Frederike; Ponikvar, Jadranka Buturovic; Mazouz, Hakim; Stratta, Piero; Subra, Jean-François; Villemain, Florence; Hoitsma, Andries; Braun, Laura; Cantarell, Maria Carmen; Colak, Hulya; Courtney, Aisling; Frasca, Giovanni Maria; Howse, Matthew; Naesens, Maarten; Reischig, Tomas; Serón, Daniel; Seyahi, Nurhan; Tugmen, Cem; Alonso Hernandez, Angel; Beňa, Luboslav; Biancone, Luigi; Cuna, Vania; Díaz-Corte, Carmen; Dufay, Alexandre; Gaasbeek, André; Garnier, Arnaud; Gatault, Philippe; Gentil Govantes, Miguel Angel; Glowacki, François; Gross, Oliver; Hurault de Ligny, Bruno; Huynh-Do, Uyen; Janbon, Bénédicte; Jiménez Del Cerro, Luis Antonio; Keller, Frieder; La Manna, Gaetano; Lauzurica, Ricardo; Le Monies De Sagazan, Hervé; Thaiss, Friedrich; Legendre, Christophe; Martin, Séverine; Moal, Marie-Christine; Noël, Christian; Pillebout, Evangeline; Piredda, Gian Benedetto; Puga, Ana Ramírez; Sulowicz, Wladyslaw; Tuglular, Serhan; Prokopova, Michaela; Chesneau, Mélanie; Le Moine, Alain; Guérif, Pierrick; Soulillou, Jean-Paul; Abramowicz, Marc; Giral, Magali; Racapé, Judith; Maggiore, Umberto; Brouard, Sophie; Abramowicz, Daniel

2016-06-01

Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients, describe them and estimate their frequency for the first time. Seventeen coordinators distributed a questionnaire in 256 transplant centres and 28 countries in order to report as many 'operationally tolerant' patients (TOL; defined as having a serum creatinine <1.7 mg/dL and proteinuria <1 g/day or g/g creatinine despite at least 1 year without any immunosuppressive drug) and 'almost tolerant' patients (minimally immunosuppressed patients (MIS) receiving low-dose steroids) as possible. We reported their number and the total number of kidney transplants performed at each centre to calculate their frequency. One hundred and forty-seven questionnaires were returned and we identified 66 TOL (61 with complete data) and 34 MIS patients. Of the 61 TOL patients, 26 were previously described by the Nantes group and 35 new patients are presented here. Most of them were noncompliant patients. At data collection, 31/35 patients were alive and 22/31 still operationally tolerant. For the remaining 9/31, 2 were restarted on immunosuppressive drugs and 7 had rising creatinine of whom 3 resumed dialysis. Considering all patients, 10-year death-censored graft survival post-immunosuppression weaning reached 85% in TOL patients and 100% in MIS patients. With 218 913 kidney recipients surveyed, cumulative incidences of operational tolerance and almost tolerance were estimated at 3 and 1.5 per 10 000 kidney recipients, respectively. In kidney transplantation, operational tolerance and almost tolerance are infrequent findings associated with excellent long-term death-censored graft survival. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

[Ecology suitability study of Ephedra intermedia].

Science.gov (United States)

Ma, Xiao-Hui; Lu, You-Yuan; Huang, De-Dong; Zhu, Tian-Tian; Lv, Pei-Lin; Jin, Ling

2017-06-01

The study aims at predicting ecological suitability of Ephedra intermedia in China by using maximum entropy Maxent model combined with GIS, and finding the main ecological factors affecting the distribution of E. intermedia suitability in appropriate growth area. Thirty-eight collected samples of E. intermedia and E. intermedia and 116 distribution information from CVH information using ArcGIS technology were analyzed. MaxEnt model was applied to forecast the E. intermedia in our country's ecology. E. intermedia MaxEnt ROC curve model training data and testing data sets the AUC value was 0.986 and 0.958, respectively, which were greater than 0.9, tending to be 1.The calculated E. intermedia habitat suitability by the model showed a high accuracy and credibility, which indicated that MaxEnt model could well predict the potential distribution area of E. intermedia in China. Copyright© by the Chinese Pharmaceutical Association.

Are existing outcome instruments suitable for assessment of spinal trauma patients?

Science.gov (United States)

Stadhouder, Agnita; Buckens, Constantinus F M; Holtslag, Herman R; Oner, F Cumhur

2010-11-01

Valid outcome assessment tools specific for spinal trauma patients are necessary to establish the efficacy of different treatment options. So far, no validated specific outcome measures are available for this patient population. The purpose of this study was to assess the current state of outcome measurement in spinal trauma patients and to address the question of whether this group is adequately served by current disease-specific and generic health-related quality-of-life instruments. A number of widely used outcome measures deemed most appropriate were reviewed, and their applicability to spinal trauma outcome discussed. An overview of recent movements in the theoretical foundations of outcome assessment, as it pertains to spinal trauma patients has been attempted, along with a discussion of domains important for spinal trauma. Commonly used outcome measures that are recommended for use in trauma patients were reviewed from the perspective of spinal trauma. The authors further sought to select a number of spine trauma-relevant domains from the WHO's comprehensive International Classification of Functioning, Disability and Health (ICF) as a benchmark for assessing the content coverage of the commonly used outcome measurements reviewed. The study showed that there are no psychometrically validated outcome measurements for the spinal trauma population and there are no commonly used outcome measures that provide adequate content coverage for spinal trauma domains. Spinal trauma patients are currently followed either as a subset of the polytrauma population in the acute and early postacute setting or as a subset of neurological injury in the long-term revalidation medicine setting.

The genotypes of Orientia tsutsugamushi, identified in scrub typhus patients in northern Vietnam.

Science.gov (United States)

Nguyen, Hang L K; Pham, Hang T T; Nguyen, Tinh V; Hoang, Phuong Vm; Le, Mai T Q; Takemura, Taichiro; Hasebe, Futoshi; Hayasaka, Daisuke; Yamada, Akio; Hotta, Kozue

2017-03-01

There are an estimated one million patients with scrub typhus in the Asia-Pacific region. There are few reports describing the incidence of scrub typhus in Vietnam. Blood samples collected from 63 patients clinically diagnosed as having scrub typhus from July 2015 to September 2016 were subjected to genotyping of Orientia tsutsugamushi. Of these patients, 42 (67%) tested positive for O. tsutsugamushi, and the most common genotype was identified to be Karp (55%). Other genotypes, TA763, Gilliam type in Japan variant, and Kato were also found in 17%, 17% and 12% of patients, respectively. To better understand the epidemiological landscape of scrub typhus in Vietnam, a countrywide study is needed. LC110330-LC110333, LC110336-LC110351 and LC214804-LC214825. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The Laboratory-Based Intermountain Validated Exacerbation (LIVE Score Identifies Chronic Obstructive Pulmonary Disease Patients at High Mortality Risk

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Denitza P. Blagev

2018-06-01

Full Text Available Background: Identifying COPD patients at high risk for mortality or healthcare utilization remains a challenge. A robust system for identifying high-risk COPD patients using Electronic Health Record (EHR data would empower targeting interventions aimed at ensuring guideline compliance and multimorbidity management. The purpose of this study was to empirically derive, validate, and characterize subgroups of COPD patients based on routinely collected clinical data widely available within the EHR.Methods: Cluster analysis was used in 5,006 patients with COPD at Intermountain to identify clusters based on a large collection of clinical variables. Recursive Partitioning (RP was then used to determine a preferred tree that assigned patients to clusters based on a parsimonious variable subset. The mortality, COPD exacerbations, and comorbidity profile of the identified groups were examined. The findings were validated in an independent Intermountain cohort and in external cohorts from the United States Veterans Affairs (VA and University of Chicago Medicine systems.Measurements and Main Results: The RP algorithm identified five LIVE Scores based on laboratory values: albumin, creatinine, chloride, potassium, and hemoglobin. The groups were characterized by increasing risk of mortality. The lowest risk, LIVE Score 5 had 8% 4-year mortality vs. 56% in the highest risk LIVE Score 1 (p < 0.001. These findings were validated in the VA cohort (n = 83,134, an expanded Intermountain cohort (n = 48,871 and in the University of Chicago system (n = 3,236. Higher mortality groups also had higher COPD exacerbation rates and comorbidity rates.Conclusions: In large clinical datasets across different organizations, the LIVE Score utilizes existing laboratory data for COPD patients, and may be used to stratify risk for mortality and COPD exacerbations.

Identifying applicants suitable to a career in nursing: a value-based approach to undergraduate selection.

Science.gov (United States)

Traynor, Marian; Galanouli, Despina; Roberts, Martin; Leonard, Lawrence; Gale, Thomas

2017-06-01

The aim of this study was to complement existing evidence on the suitability of Multiple Mini Interviews as a potential tool for the selection of nursing candidates on to a BSc (Hons) nursing programme. This study aimed to trial the Multiple Mini Interview approach to recruitment with a group of first year nursing students (already selected using traditional interviews). Cross-sectional validation study. This paper reports on the evaluation of the participants' detailed scores from the Multiple Mini Interview stations; their original interview scores and their end of year results. This study took place in March 2015. Scores from the seven Multiple Mini Interview stations were analysed to show the internal structure, reliability and generalizability of the stations. Original selection scores from interviews and in-course assessment were correlated with the MMI scores and variation by students' age, gender and disability status was explored. Reliability of the Multiple Mini Interview score was moderate (G = 0·52). The Multiple Mini Interview score provided better differentiation between more able students than did the original interview score but neither score was correlated with the module results. Multiple Mini Interview scores were positively associated with students' age but not their gender or disability status. The Multiple Mini Interview reported in this study offers a selection process that is based on the values and personal attributes regarded as desirable for a career in nursing and does not necessarily predict academic success. Its moderate reliability indicates the need for further improvement but it is capable of discriminating between candidates and shows little evidence of bias. © 2016 John Wiley & Sons Ltd.

Accurately identifying patients who are excellent candidates or unsuitable for a medication: a novel approach

Directory of Open Access Journals (Sweden)

South C

2017-12-01

Full Text Available Charles South,1–3 A John Rush,4,* Thomas J Carmody,1–3 Manish K Jha,1,2 Madhukar H Trivedi1,2,*1Center for Depression Research and Clinical Care, 2Department of Psychiatry, 3Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA; 4Department of Psychiatry and Behavioral Sciences, Duke-National University of Singapore, Singapore; Duke Medical School, Durham, NC, USA*These authors contributed equally to this work Objective: The objective of the study was to determine whether a unique analytic approach – as a proof of concept – could identify individual depressed outpatients (using 30 baseline clinical and demographic variables who are very likely (75% certain to not benefit (NB or to remit (R, accepting that without sufficient certainty, no prediction (NP would be made.Methods: Patients from the Combining Medications to Enhance Depression Outcomes trial treated with escitalopram (S-CIT + placebo (n=212 or S-CIT + bupropion-SR (n=206 were analyzed separately to assess replicability. For each treatment, the elastic net was used to identify subsets of predictive baseline measures for R and NB, separately. Two different equations that estimate the likelihood of remission and no benefit were developed for each patient. The ratio of these two numbers characterized likely outcomes for each patient.Results: The two treatment cells had comparable rates of remission (40% and no benefit (22%. In S-CIT + bupropion-SR, 11 were predicted NB of which 82% were correct; 26 were predicted R – 85% correct (169 had NP. For S-CIT + placebo, 13 were predicted NB – 69% correct; 44 were predicted R – 75% correct (155 were NP. Overall, 94/418 (22% patients were identified with a meaningful degree of certainty (69%–85% correct. Different variable sets with some overlap were predictive of remission and no benefit within and across treatments, despite comparable outcomes.Conclusion: In two separate analyses with two

Predicting habitat suitability for rare plants at local spatial scales using a species distribution model.

Science.gov (United States)

Gogol-Prokurat, Melanie

2011-01-01

were not available at large extents. No single model met all habitat prioritization criteria, and the best models were overlaid to identify consensus areas of high suitability. Although the four species modeled here co-occur and are treated together for conservation planning, model accuracy and predicted suitable areas varied among species.

Identifying subgroups among poor prognosis patients with nonseminomatous germ cell cancer by tree modelling: a validation study.

NARCIS (Netherlands)

M.R. van Dijk (Merel); E.W. Steyerberg (Ewout); S.P. Stenning; J.D.F. Habbema (Dik)

2004-01-01

textabstractBACKGROUND: In order to target intensive treatment strategies for poor prognosis patients with non-seminomatous germ cell cancer, those with the poorest prognosis should be identified. These patients might profit most from more intensive treatment strategies. For

De-identifying an EHR Database

DEFF Research Database (Denmark)

Lauesen, Søren; Pantazos, Kostas; Lippert, Søren

2011-01-01

-identified a Danish EHR database with 437,164 patients. The goal was to generate a version with real medical records, but related to artificial persons. We developed a de-identification algorithm that uses lists of named entities, simple language analysis, and special rules. Our algorithm consists of 3 steps: collect...... lists of identifiers from the database and external resources, define a replacement for each identifier, and replace identifiers in structured data and free text. Some patient records could not be safely de-identified, so the de-identified database has 323,122 patient records with an acceptable degree...... of anonymity, readability and correctness (F-measure of 95%). The algorithm has to be adjusted for each culture, language and database....

Early data from project engage: a program to identify and transition medically hospitalized patients into addictions treatment

OpenAIRE

Pecoraro, Anna; Horton, Terry; Ewen, Edward; Becher, Julie; Wright, Patricia A; Silverman, Basha; McGraw, Patty; Woody, George E

2012-01-01

Background Patients with untreated substance use disorders (SUDs) are at risk for frequent emergency department visits and repeated hospitalizations. Project Engage, a US pilot program at Wilmington Hospital in Delaware, was conducted to facilitate entry of these patients to SUD treatment after discharge. Patients identified as having hazardous or harmful alcohol consumption based on results of the Alcohol Use Disorders Identification Test-Primary Care (AUDIT-PC), administered to all patients...

What Faces Reveal: A Novel Method to Identify Patients at Risk of Deterioration Using Facial Expressions.

Science.gov (United States)

Madrigal-Garcia, Maria Isabel; Rodrigues, Marcos; Shenfield, Alex; Singer, Mervyn; Moreno-Cuesta, Jeronimo

2018-07-01

To identify facial expressions occurring in patients at risk of deterioration in hospital wards. Prospective observational feasibility study. General ward patients in a London Community Hospital, United Kingdom. Thirty-four patients at risk of clinical deterioration. A 5-minute video (25 frames/s; 7,500 images) was recorded, encrypted, and subsequently analyzed for action units by a trained facial action coding system psychologist blinded to outcome. Action units of the upper face, head position, eyes position, lips and jaw position, and lower face were analyzed in conjunction with clinical measures collected within the National Early Warning Score. The most frequently detected action units were action unit 43 (73%) for upper face, action unit 51 (11.7%) for head position, action unit 62 (5.8%) for eyes position, action unit 25 (44.1%) for lips and jaw, and action unit 15 (67.6%) for lower face. The presence of certain combined face displays was increased in patients requiring admission to intensive care, namely, action units 43 + 15 + 25 (face display 1, p facial expressions can be identified in deteriorating general ward patients. This tool may potentially augment risk prediction of current scoring systems.

A Simple Model to Identify Risk of Sarcopenia and Physical Disability in HIV-Infected Patients.

Science.gov (United States)

Farinatti, Paulo; Paes, Lorena; Harris, Elizabeth A; Lopes, Gabriella O; Borges, Juliana P

2017-09-01

Farinatti, P, Paes, L, Harris, EA, Lopes, GO, and Borges, JP. A simple model to identify risk of sarcopenia and physical disability in HIV-infected patients. J Strength Cond Res 31(9): 2542-2551, 2017-Early detection of sarcopenia might help preventing muscle loss and disability in HIV-infected patients. This study proposed a model for estimating appendicular skeletal muscle mass (ASM) to calculate indices to identify "sarcopenia" (SA) and "risk for disability due to sarcopenia" (RSA) in patients with HIV. An equation to estimate ASM was developed in 56 patients (47.2 ± 6.9 years), with a cross-validation sample of 24 patients (48.1 ± 6.6 years). The model validity was determined by calculating, in both samples: (a) Concordance between actual vs. estimated ASM; (b) Correlations between actual/estimated ASM vs. peak torque (PT) and total work (TW) during isokinetic knee extension/flexion; (c) Agreement of patients classified with SA and RSA. The predictive equation was ASM (kg) = 7.77 (sex; F = 0/M = 1) + 0.26 (arm circumference; cm) + 0.38 (thigh circumference; cm) + 0.03 (Body Mass Index; kg·m) - 8.94 (R = 0.74; Radj = 0.72; SEE = 3.13 kg). Agreement between actual vs. estimated ASM was confirmed in validation (t = 0.081/p = 0.94; R = 0.86/p < 0.0001) and cross-validation (t = 0.12/p = 0.92; R = 0.87/p < 0.0001) samples. Regression characteristics in cross-validation sample (Radj = 0.80; SEE = 3.65) and PRESS (RPRESS = 0.69; SEEPRESS = 3.35) were compatible with the original model. Percent agreements for the classification of SA and RSA from indices calculated using actual and estimated ASM were of 87.5% and 77.2% (gamma correlations 0.72-1.0; p < 0.04) in validation, and 95.8% and 75.0% (gamma correlations 0.98-0.97; p < 0.001) in cross-validation sample, respectively. Correlations between actual/estimated ASM vs. PT (range 0.50-0.73, p ≤ 0.05) and TW (range 0.59-0.74, p ≤ 0.05) were similar in both samples. In conclusion, our model correctly estimated ASM

Midyear FY 1983 Richton Dome screening and suitability review

International Nuclear Information System (INIS)

1983-08-01

The NWTS screening of Gulf Coast salt domes for suitable nuclear waste repository sites identified three candidate domes. These are, in order of preference, Richton Dome, Mississippi; Vacherie Dome, Louisiana; and Cypress Creek Dome, Mississippi. A qualitative review of information obtained since this initial ranking gives no basis for revising this ranking. A review of unresolved siting issues at Richton Dome shows siting concerns presently center on the geologic stability and hydrology suitability of Richton Dome and vicinity. Tectonic concerns of regional uplift and faulting are examined, as are salt tectonic concerns related to salt dome movement and dissolution. Both geologic and geodetic data suggest the Mississippi Salt Basin is experiencing uplift. However, uplift rates estimated from geologic evidence are an order of magnitude less than rates estimated from releveling data. Faults are present throughout much of the basin, and most are the result of horizontal and vertical movements of the Louann Salt during the Cretaceous and Early Tertiary. Several faults are present in the sediments surrounding Richton Dome, but current evidence suggests no movements have occurred since the Miocene. Richton Dome's hydrologic suitability is considered in analysis of the regional ground-water flow system. A three-dimensional, ground-water flow model has been utilized to calculate travel paths and travel times for releases of contaminants from various points on the dome. Based on model analyses, a release at repository level would take nearly 39,000 years to reach the upper aquifer and would eventually discharge into the Leaf River or upper reaches of the Pascagoula River over 50 km from the dome. This estimate of travel time greatly exceeds the minimum 1000 year travel time required by proposed Department of Energy (DOE) guidelines. 76 references

Comparing the Workload Perceptions of Identifying Patient Condition and Priorities of Care Among Burn Providers in Three Burn ICUs.

Science.gov (United States)

McInnis, Ian; Murray, Sarah J; Serio-Melvin, Maria; Aden, James K; Mann-Salinas, Elizabeth; Chung, Kevin K; Huzar, Todd; Wolf, Steven; Nemeth, Christopher; Pamplin, Jeremy C

Multidisciplinary rounds (MDRs) in the burn intensive care unit serve as an efficient means for clinicians to assess patient status and establish patient care priorities. Both tasks require significant cognitive work, the magnitude of which is relevant because increased cognitive work of task completion has been associated with increased error rates. We sought to quantify this workload during MDR using the National Aeronautics and Space Administration Task Load Index (NASA-TLX). Research staff at three academic regional referral burn centers administered the NASA-TLX to clinicians during MDR. Clinicians assessed their workload associated with 1) "Identify(ing) if the patient is better, same, or worse than yesterday" and 2) "Identify(ing) the most important objectives of care for the patient today." Data were collected on clinician type, years of experience, and hours of direct patient care. Surveys were administered to 116 total clinicians, 41 physicians, 25 nurses, 13 medical students, and 37 clinicians in other roles. Clinicians with less experience reported more cognitive work when completing both tasks (P NASA-TLX was an effective tool for collecting perceptions of cognitive workload associated with MDR. Perceived cognitive work varied by clinician type and experience level when completing two key tasks. Less experience was associated with increased perceived work, potentially increasing mental error rates, and increasing risk to patients. Creating tools or work processes to reduce cognitive work may improve clinician performance.

Common Allergens Identified Based on Patch Test Results in Patients with Suspected Contact Dermatitis of the Scalp.

Science.gov (United States)

Aleid, Nouf M; Fertig, Raymond; Maddy, Austin; Tosti, Antonella

2017-03-01

Contact dermatitis of the scalp is common and might be caused by many chemicals including metals, ingredients of shampoos and conditioners, dyes, or other hair treatments. Eliciting a careful history and patch tests are necessary to identify the responsible allergen and prevent relapses. To identify allergens that may cause contact dermatitis of the scalp by reviewing patch test results. We reviewed the records of 1,015 patients referred for patch testing at the Dermatology Department of the University of Miami. A total of 226 patients (205 females and 21 males) with suspected scalp contact dermatitis were identified, and the patch test results and clinical data for those patients were analyzed. Most patients were referred for patch testing from a specialized hair clinic at our institution. The most common allergens in our study population were nickel (23.8%), cobalt (21.0%), balsam of Peru (18.2%), fragrance mix (14.4%), carba mix (11.6%), and propylene glycol (PG) (8.8%). The majority of patients were females aged 40-59 years, and scalp itching or burning were reported as the most common symptom. Frequent sources of allergens for metals include hair clasps, pins, and brushes, while frequent sources of allergens for preservatives, fragrance mix, and balsam of Peru include shampoos, conditioners, and hair gels. Frequent sources of allergens for PG include topical medications.

Common Allergens Identified Based on Patch Test Results in Patients with Suspected Contact Dermatitis of the Scalp

Science.gov (United States)

Aleid, Nouf M.; Fertig, Raymond; Maddy, Austin; Tosti, Antonella

2017-01-01

Background Contact dermatitis of the scalp is common and might be caused by many chemicals including metals, ingredients of shampoos and conditioners, dyes, or other hair treatments. Eliciting a careful history and patch tests are necessary to identify the responsible allergen and prevent relapses. Objectives To identify allergens that may cause contact dermatitis of the scalp by reviewing patch test results. Methods We reviewed the records of 1,015 patients referred for patch testing at the Dermatology Department of the University of Miami. A total of 226 patients (205 females and 21 males) with suspected scalp contact dermatitis were identified, and the patch test results and clinical data for those patients were analyzed. Most patients were referred for patch testing from a specialized hair clinic at our institution. Results The most common allergens in our study population were nickel (23.8%), cobalt (21.0%), balsam of Peru (18.2%), fragrance mix (14.4%), carba mix (11.6%), and propylene glycol (PG) (8.8%). The majority of patients were females aged 40–59 years, and scalp itching or burning were reported as the most common symptom. Conclusion Frequent sources of allergens for metals include hair clasps, pins, and brushes, while frequent sources of allergens for preservatives, fragrance mix, and balsam of Peru include shampoos, conditioners, and hair gels. Frequent sources of allergens for PG include topical medications. PMID:28611994

Patient-identified events implicated in the development of body dysmorphic disorder.

Science.gov (United States)

Weingarden, Hilary; Curley, Erin E; Renshaw, Keith D; Wilhelm, Sabine

2017-06-01

Little is known about the causes of body dysmorphic disorder (BDD), but researchers have proposed a diathesis-stress model. This study uses a patient-centered approach to identify stressful events to which patients attribute the development of their BDD symptoms. An Internet-recruited sample of 165 adults with BDD participated. A large minority of participants attributed the development of their BDD to a triggering event. Bullying experiences were the most commonly described type of event. Additionally, most events were interpersonal and occurred during grade school or middle school. There were no differences in severity of psychosocial outcomes between participants who did or did not attribute their BDD to a specific triggering event. However, participants who specifically attributed their BDD development to a bullying experience had poorer psychosocial outcomes (i.e., perceived social support, depression severity, functional impairment, quality of life) compared to those who attributed their BDD development to another type of triggering event. Copyright © 2017 Elsevier Ltd. All rights reserved.

Identifying barriers to remaining physically active after rehabilitation: differences in perception between physical therapists and older adult patients.

Science.gov (United States)

Zalewski, Kathryn; Alt, Carlynn; Arvinen-Barrow, Monna

2014-06-01

Cross-sectional study. To describe readiness for change and barriers to physical activity in older adults and to contrast perceptions of physical therapists and patients using the Barriers to Being Active Quiz. Regular physical activity is vital to recovery after discharge from physical therapy. Physical therapists are positioned to support change in physical activity habits for those transitioning to home care. Understanding of readiness for change and barriers to physical activity could optimize recovery. Thirteen physical therapists enrolled in the study and invited patients who met the inclusion criteria to enroll (79 patients enrolled). The physical therapists provided the ICD-9 code, the physical therapist diagnosis, and completed the Barriers to Being Active Quiz as they perceived their patients would. The enrolled patients provided demographics and filled out the Satisfaction With Life Scale, the stages-of-change scale for physical activity, and the Barriers to Being Active Quiz. Patients were predominantly in the early stages of readiness for change. Both patients and physical therapists identified lack of willpower as the primary barrier to physical activity. Patients identified lack of willpower and social influence as critical barriers more often than physical therapists, whereas physical therapists identified fear of injury and lack of time more often than their patients did. Differences between physical therapists and their patients were noted for fear of injury (z = 2.66, P = .008) and lack of time (z = 3.46, P = .001). The stage of change for physical activity impacted perception of social influence (χ2 = 9.64, Pbarriers to physical activity may allow physical therapists to better tailor intervention strategies to impact physical activity behavior change.

Modeling mountain pine beetle habitat suitability within Sequoia National Park

Science.gov (United States)

Nguyen, Andrew

Understanding significant changes in climate and their effects on timber resources can help forest managers make better decisions regarding the preservation of natural resources and land management. These changes may to alter natural ecosystems dependent on historical and current climate conditions. Increasing mountain pine beetle (MBP) outbreaks within the southern Sierra Nevada are the result of these alterations. This study better understands MPB behavior within Sequoia National Park (SNP) and model its current and future habitat distribution. Variables contributing to MPB spread are vegetation stress, soil moisture, temperature, precipitation, disturbance, and presence of Ponderosa (Pinus ponderosa) and Lodgepole (Pinus contorta) pine trees. These variables were obtained using various modeled, insitu, and remotely sensed sources. The generalized additive model (GAM) was used to calculate the statistical significance of each variable contributing to MPB spread and also created maps identifying habitat suitability. Results indicate vegetation stress and forest disturbance to be variables most indicative of MPB spread. Additionally, the model was able to detect habitat suitability of MPB with a 45% accuracy concluding that a geospatial driven modeling approach can be used to delineate potential MPB spread within SNP.

Comparing cancer vs normal gene expression profiles identifies new disease entities and common transcriptional programs in AML patients

DEFF Research Database (Denmark)

Rapin, Nicolas; Bagger, Frederik Otzen; Jendholm, Johan

2014-01-01

Gene expression profiling has been used extensively to characterize cancer, identify novel subtypes, and improve patient stratification. However, it has largely failed to identify transcriptional programs that differ between cancer and corresponding normal cells and has not been efficient in iden......-karyotype AML, which allowed for the generation of a highly prognostic survival signature. Collectively, our CvN method holds great potential as a tool for the analysis of gene expression profiles of cancer patients....

Identifying ozone-sensitive communities of (semi-)natural vegetation suitable for mapping exceedance of critical levels

International Nuclear Information System (INIS)

Mills, G.; Hayes, F.; Jones, M.L.M.; Cinderby, S.

2007-01-01

Using published data on the responses of individual species to ozone, 54 EUNIS (European Nature Information System) level 4 communities with six or more ozone-sensitive species (%OS) and c. 20% or more species tested for ozone sensitivity, were identified as potentially ozone-sensitive. The largest number of these communities (23) was associated with Grasslands, with Heathland, scrub and tundra, and Mires, bogs and fens having the next highest representation at 11 and 8 level 4 communities each respectively. Within the grasslands classification, E4 (Alpine and sub-alpine grasslands), E5 (Woodland fringes and clearings) and E1 (Dry grasslands) were the most sensitive with 68.1, 51.6 and 48.6%OS respectively. It is feasible to map the land-cover for these and other communities at level 2, but it may not be currently possible to map the land-cover for all communities identified to be ozone-sensitive at levels 3 and 4. - Grassland communities such as alpine and sub-alpine grasslands have the highest potential sensitivity ozone, based on the responses of their component species

How to Identify High-Risk APS Patients: Clinical Utility and Predictive Values of Validated Scores.

Science.gov (United States)

Oku, Kenji; Amengual, Olga; Yasuda, Shinsuke; Atsumi, Tatsuya

2017-08-01

Antiphospholipid syndrome (APS) is a clinical disorder characterised by thrombosis and/or pregnancy morbidity in the persistence of antiphospholipid (aPL) antibodies that are pathogenic and have pro-coagulant activities. Thrombosis in APS tends to recur and require prophylaxis; however, the stereotypical treatment for APS patients is inadequate and stratification of the thrombotic risks is important as aPL are prevalently observed in various diseases or elderly population. It is previously known that the multiple positive aPL or high titre aPL correlate to thrombotic events. To progress the stratification of thrombotic risks in APS patients and to quantitatively analyse those risks, antiphospholipid score (aPL-S) and the Global Anti-phospholipid Syndrome Score (GAPSS) were defined. These scores were raised from the large patient cohort data and either aPL profile classified in detail (aPL-S) or simplified aPL profile with classical thrombotic risk factors (GAPSS) was put into a scoring system. Both the aPL-S and GAPSS have shown a degree of accuracy in identifying high-risk APS patients, especially those at a high risk of thrombosis. However, there are several areas requiring improvement, or at least that clinicians should be aware of, before these instruments are applied in clinical practice. One such issue is standardisation of the aPL tests, including general testing of phosphatidylserine-dependent antiprothrombin antibodies (aPS/PT). Additionally, clinicians may need to be aware of the patient's medical history, particularly with respect to the incidence of SLE, which influences the cutoff value for identifying high-risk patients.

Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies.

Science.gov (United States)

Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma

2009-01-01

To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

Total serum homocysteine levels do not identify cognitive dysfunction in multimorbid elderly patients.

Science.gov (United States)

Hengstermann, S; Laemmler, G; Hanemann, A; Schweter, A; Steinhagen-Thiessen, E; Lun, A; Schulz, R-J

2009-02-01

Total blood homocysteine (Hcys) and folate levels have been investigated in association with cognitive dysfunction in healthy but not in multimorbid elderly patients. We hypothesized that total serum Hcys is an adequate marker to identify multimorbid elderly patients with cognitive dysfunction assessed by the Short Cognitive Performance Test (SKT) and Mini-Mental State Examination (MMSE). Cross-sectional study. The study center was an acute geriatric hospital. A total of 189 multimorbid elderly patients were recruited. Cognitive dysfunction was determined according to the SKT and MMSE. Biochemical parameters (Hcys, folate, vitamin B12, hemoglobin), nutritional status (BMI, Mini Nutritional Assessment, nutritional intake), and activities of daily living were assessed. According to the SKT, 25.4% of patients showed no cerebral cognitive dysfunction, 21.2% had suspected incipient cognitive dysfunction, 12.7% showed mild cognitive dysfunction, 9.0% had moderate cognitive dysfunction, and 31.7% of patients were demented. The median plasma Hcys value was elevated by approximately 20% in multimorbid elderly patients, independent of cognitive dysfunction. Serum folate and vitamin B12 concentrations were within normal ranges. We did not find significant differences in nutritional status, activities of daily living, numbers of diseases or medications, or selected biochemical parameters between the SKT groups. Elevated serum Hcys levels with normal plasma folate and vitamin B12 concentrations were observed in multimorbid elderly patients. The plasma Hcys level did not appear to be an important biological risk factor for cognitive dysfunction in multimorbid geriatric patients.

Identification of Suitable Reference Genes for Investigating Gene Expression in Anterior Cruciate Ligament Injury by Using Reverse Transcription-Quantitative PCR.

Directory of Open Access Journals (Sweden)

Mariana Ferreira Leal

Full Text Available The anterior cruciate ligament (ACL is one of the most frequently injured structures during high-impact sporting activities. Gene expression analysis may be a useful tool for understanding ACL tears and healing failure. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR has emerged as an effective method for such studies. However, this technique requires the use of suitable reference genes for data normalization. Here, we evaluated the suitability of six reference genes (18S, ACTB, B2M, GAPDH, HPRT1, and TBP by using ACL samples of 39 individuals with ACL tears (20 with isolated ACL tears and 19 with ACL tear and combined meniscal injury and of 13 controls. The stability of the candidate reference genes was determined by using the NormFinder, geNorm, BestKeeper DataAssist, and RefFinder software packages and the comparative ΔCt method. ACTB was the best single reference gene and ACTB+TBP was the best gene pair. The GenEx software showed that the accumulated standard deviation is reduced when a larger number of reference genes is used for gene expression normalization. However, the use of a single reference gene may not be suitable. To identify the optimal combination of reference genes, we evaluated the expression of FN1 and PLOD1. We observed that at least 3 reference genes should be used. ACTB+HPRT1+18S is the best trio for the analyses involving isolated ACL tears and controls. Conversely, ACTB+TBP+18S is the best trio for the analyses involving (1 injured ACL tears and controls, and (2 ACL tears of patients with meniscal tears and controls. Therefore, if the gene expression study aims to compare non-injured ACL, isolated ACL tears and ACL tears from patients with meniscal tear as three independent groups ACTB+TBP+18S+HPRT1 should be used. In conclusion, 3 or more genes should be used as reference genes for analysis of ACL samples of individuals with and without ACL tears.

Test plan for suitability assessment of five overcoring stress measurement techniques

International Nuclear Information System (INIS)

Gregory, E.C.; Rundle, T.A.; McCabe, W.M.; Kim, K.

1982-08-01

Tests are to be conducted at the Near-Surface Test Facility (NSTF) to assess the suitability of five overcoring techniques for in situ stress determination in a jointed basalt. The overcoring methods to be investigated use the following instrumentation to measure strain relief by overcoring a pilot borehole: USBM borehole deformation gage, CSIRO hollow inclusion stress cell, cast epoxy inclusion, the Lulea triaxial strain cell and the ''doorstopper'' biaxial strain cell. The tests are to provide data regarding the state of stress below the NSTF. This information is to be used in the evaluation of each method of overcoring. During the course of field testing, an attempt is to be made to adapt conventional overcoring techniques and analytical methods to the basalt medium. If overcoring stress determination in basalt is shown suitable, then additional studies will be identified to further adapt a technique for use at depth. In addition to the five overcoring techniques to be tested at the NSTF, stress measurements by Hydrofracturing are to be conducted to provide data for direct comparison with overcoring results. 16 refs., 18 figs

The Short Physical Performance Battery is a discriminative tool for identifying patients with COPD at risk of disability

Directory of Open Access Journals (Sweden)

Bernabeu-Mora R

2015-12-01

Full Text Available Roberto Bernabeu-Mora,1,2 Françesc Medina-Mirapeix,2 Eduardo Llamazares-Herrán,3 Gloria García-Guillamón,2 Luz María Giménez-Giménez,2 Juan Miguel Sánchez-Nieto1,4 1Division of Pneumology, Hospital Morales Meseguer, 2Department of Physical Therapy, University of Murcia, Murcia, 3Department of Physical Therapy, Alcala University, Alcala de Henares, 4Department of Intern Medical, University of Murcia, Murcia, Spain Background: Limited mobility is a risk factor for developing chronic obstructive pulmonary disease (COPD-related disabilities. Little is known about the validity of the Short Physical Performance Battery (SPPB for identifying mobility limitations in patients with COPD. Objective: To determine the clinical validity of the SPPB summary score and its three components (standing balance, 4-meter gait speed, and five-repetition sit-to-stand for identifying mobility limitations in patients with COPD.Methods: This cross-sectional study included 137 patients with COPD, recruited from a hospital in Spain. Muscle strength tests and SPPB were measured; then, patients were surveyed for self-reported mobility limitations. The validity of SPPB scores was analyzed by developing receiver operating characteristic curves to analyze the sensitivity and specificity for identifying patients with mobility limitations; by examining group differences in SPPB scores across categories of mobility activities; and by correlating SPPB scores to strength tests.Results: Only the SPPB summary score and the five-repetition sit-to-stand components showed good discriminative capabilities; both showed areas under the receiver operating characteristic curves greater than 0.7. Patients with limitations had significantly lower SPPB scores than patients without limitations in nine different mobility activities. SPPB scores were moderately correlated with the quadriceps test (r>0.40, and less correlated with the handgrip test (r<0.30, which reinforced convergent and

Name Recognition to Identify Patients of South Asian Ethnicity within the Cancer Registry

Directory of Open Access Journals (Sweden)

Savitri Singh-Carlson

2016-01-01

Full Text Available Objective: The goal of this project was to develop a list of forenames and surnames of South Asian (SA women that could be used to identify SA breast cancer patients within the cancer registry. This list was compiled, evaluated, and validated to ensure comprehensiveness, accuracy, and applicability of SA names. Methods: This project was conducted by Canadian researchers who are immersed in conducting behavioral studies with SA women diagnosed with cancer in the province of British Columbia. Recruiting SA cancer patients for research can be a difficult task due to social and cultural factors. Methods used by other researchers to identify ethnicity related unique names were employed to filter surnames and forenames that were not common to this ethnic group. Co-author (Gurpreet Oshan of SA ethnicity rigorously identified and deleted multiple lists and redundant entries along with common English forenames which resulted in a list of 16,888 SA forenames. All co-authors of Indian ethnicity (Gurpreet Oshan, Savitri Singh-Carlson, Harajit Lail were involved in critiquing and manually reviewing the names list throughout this process. Comprehensive lists of SA surnames and women′s forenames were reviewed to identify those that were unique to SA ethnicity. Accuracy was ensured by constantly filtering the redundancy by using an Excel program which helped to illustrate the number of times each name was spelled in different ways. Results: The final lists included 9112 surnames and 16,888 forenames of SA ethnicity. On the basis of the surname linkage only, the sensitivity of the list was 76.6%, specificity was 62.9%, and the positive predictive value was 58.5%. On the basis of both the surname and forename linkage, the specificity of the list was 88.6%. These lists include variations in spelling forenames and surnames as well. Conclusions: The list of surnames and forenames can be useful tools to identify SA ethnic groups from large population database in

Tools for monitoring system suitability in LC MS/MS centric proteomic experiments.

Science.gov (United States)

Bereman, Michael S

2015-03-01

With advances in liquid chromatography coupled to tandem mass spectrometry technologies combined with the continued goals of biomarker discovery, clinical applications of established biomarkers, and integrating large multiomic datasets (i.e. "big data"), there remains an urgent need for robust tools to assess instrument performance (i.e. system suitability) in proteomic workflows. To this end, several freely available tools have been introduced that monitor a number of peptide identification (ID) and/or peptide ID free metrics. Peptide ID metrics include numbers of proteins, peptides, or peptide spectral matches identified from a complex mixture. Peptide ID free metrics include retention time reproducibility, full width half maximum, ion injection times, and integrated peptide intensities. The main driving force in the development of these tools is to monitor both intra- and interexperiment performance variability and to identify sources of variation. The purpose of this review is to summarize and evaluate these tools based on versatility, automation, vendor neutrality, metrics monitored, and visualization capabilities. In addition, the implementation of a robust system suitability workflow is discussed in terms of metrics, type of standard, and frequency of evaluation along with the obstacles to overcome prior to incorporating a more proactive approach to overall quality control in liquid chromatography coupled to tandem mass spectrometry based proteomic workflows. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Immunosuppressive therapy after solid-organ transplantation: does the INTERMED identify patients at risk of poor adherence?

Directory of Open Access Journals (Sweden)

Michaud L

2016-12-01

Full Text Available Background: Lack of adherence to medication is a trigger of graft rejection in solid-organ transplant (SOT recipients. Objective: This exploratory study aimed to assess whether a biopsychosocial evaluation using the INTERMED instrument before transplantation could identify SOT recipients at risk of suboptimal post-transplantation adherence to immunosuppressant drugs. We hypothesized that complex patients (INTERMED>20 might have lower medication adherence than noncomplex patients (INTERMED≤20. Methods: Each patient eligible for transplantation at the University Hospital of Lausanne, Switzerland, has to undergo a pre-transplantation psychiatric evaluation. In this context the patient was asked to participate in our study. The INTERMED was completed pre-transplantation, and adherence to immunosuppressive medication was monitored post-transplantation by electronic monitors for 12 months. The main outcome measure was the implementation and persistence to two calcineurin inhibitors, cyclosporine and tacrolimus, according to the dichotomized INTERMED score (>20 or ≤20. Results: Among the 50 SOT recipients who completed the INTERMED, 32 entered the study. The complex (N=11 and noncomplex patients (N=21 were similar in terms of age, sex and transplanted organ. Implementation was 94.2% in noncomplex patients versus 87.8% in complex patients (non-significant p-value. Five patients were lost to follow-up: one was non-persistent, and four refused electronic monitoring. Of the four patients who refused monitoring, two were complex and withdrew early, and two were noncomplex and withdrew later in the study. Conclusion: Patients identified as complex pre-transplant by the INTERMED tended to deviate from their immunosuppressant regimen, but the findings were not statistically significant. Larger studies are needed to evaluate this association further, as well as the appropriateness of using a nonspecific biopsychosocial instrument such as INTERMED in highly

Report of early site suitability evaluation of the potential repository site at Yucca Mountain, Nevada

International Nuclear Information System (INIS)

Younker, J.L.; Andrews, W.B.; Fasano, G.A.; Herrington, C.C.; Mattson, S.R.; Murray, R.C.; Ballou, L.B.; Revelli, M.A.; Ducharme, A.R.; Shephard, L.E.; Dudley, W.W.; Hoxie, D.T.; Herbst, R.J.; Patera, E.A.; Judd, B.R.; Docka, J.A.; Rickertsen, L.D.

1992-01-01

This study evaluated the technical suitability of Yucca Mountain, Nevada, as a potential site for a mined geologic repository for the permanent disposal of radioactive waste. The evaluation was conducted primarily to determine early in the site characterization program if there are any features or conditions at the site that indicate it is unsuitable for repository development. A secondary purpose was to determine the status of knowledge in the major technical areas that affect the suitability of the site. This early site suitability evaluation (ESSE) was conducted by a team of technical personnel at the request of the Associate Director of the US Department of Energy (DOE) Office of Geologic Disposal, a unit within the DOE's Office of Civilian Radioactive Waste Management. The Yucca Mountain site has been the subject of such evaluations for over a decade. In 1983, the site was evaluated as part of a screening process to identify potentially acceptable sites. The site was evaluated in greater detail and found suitable for site characterization as part of the Environmental Assessment (EA) (DOE, 1986) required by the Nuclear Waste Policy Act of 1982 (NWPA). Additional site data were compiled during the preparation of the Site Characterization Plan (SCP) (DOE, 1988a). This early site suitability evaluation has considered information that was used in preparing both-documents, along with recent information obtained since the EA and SCP were published. This body of information is referred to in this report as ''current information'' or ''available evidence.''

Kinome expression profiling of human neuroblastoma tumors identifies potential drug targets for ultra high-risk patients.

Science.gov (United States)

Russo, Roberta; Cimmino, Flora; Pezone, Lucia; Manna, Francesco; Avitabile, Marianna; Langella, Concetta; Koster, Jan; Casale, Fiorina; Raia, Maddalena; Viola, Giampietro; Fischer, Matthias; Iolascon, Achille; Capasso, Mario

2017-10-01

Neuroblastoma (NBL) accounts for >7% of malignancies in patients younger than 15 years. Low- and intermediate-risk patients exhibit excellent or good prognosis after treatment, whereas for high-risk (HR) patients, the estimated 5-year survival rates is still <40%. The ability to stratify HR patients that will not respond to standard treatment strategies is critical for informed treatment decisions. In this study, we have generated a specific kinome gene signature, named Kinome-27, which is able to identify a subset of HR-NBL tumors, named ultra-HR NBL, with highly aggressive clinical behavior that not adequately respond to standard treatments. We have demonstrated that NBL cell lines expressing the same kinome signature of ultra-HR tumors (ultra-HR-like cell lines) may be selectively targeted by the use of two drugs [suberoylanilide hydroxamic acid (SAHA) and Radicicol], and that the synergic combination of these drugs is able to block the ultra-HR-like cells in G2/M phase of cell cycle. The use of our signature in clinical practice will allow identifying patients with negative outcome, which would benefit from new and more personalized treatments. Preclinical in vivo studies are needed to consolidate the SAHA and Radicicol treatment in ultra-HR NBL patients. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Measuring medicine-related experiences from the patient perspective: a systematic review.

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Katusiime, Barbra; Corlett, Sarah; Reeve, Joanne; Krska, Janet

2016-01-01

There is an increasing drive to measure and so improve patients' experiences and outcomes of health care. This also applies to medicines, given their ubiquity as health care interventions. Patients' experiences of using medicines vary, and instruments which measure these are seen as an essential component to improve care. We aimed to identify generic measures of patients' experiences of using prescription medicines and to examine their properties and suitability for use in research or practice. Multiple electronic databases were searched: MEDLINE, Embase, PsycINFO, PsycARTICLES, CINHAL Plus, PROQOLID ® , and Google Scholar. We identified, critically appraised, and summarized generic questionnaires assessing one or more aspects of the medicine use experience among adult patients using prescription medicines for chronic conditions, and the process of questionnaire development, degree of patient involvement, and/or validation processes. Fifteen questionnaires were included. Of these, nine measures were multidimensional, covering various aspects of medicine use. Six instruments covered only a single domain, assessing a specific facet of using medicines. Domains covered were the following: effectiveness; convenience, practicalities, and/or managing medicines; information, knowledge, and/or understanding; side effects; relationships and/or communication with health professionals; impact on daily living and/or social life; general satisfaction; attitudes; beliefs, concerns, and/or perceptions; medical follow-up and/or adherence-related issues; treatment- and/or medicine-related burden, perceived control, or autonomy; self-confidence about medicine use; availability and accessibility; and medicine-related quality of life. None of the identified questionnaires covered all domains. Instruments varied in the extent of patient involvement in both their development and validation. There is a scarcity of psychometrically sound, comprehensive, and generic measures of experiences

Habitat suitability index model of the sea cucumber Apostichopus japonicus (Selenka): A case study of Shandong Peninsula, China.

Science.gov (United States)

Zhang, Zhipeng; Zhou, Jian; Song, Jingjing; Wang, Qixiang; Liu, Hongjun; Tang, Xuexi

2017-09-15

A habitat suitability index (HSI) model for the sea cucumber Apostichopus japonicus (Selenka) was established in the present study. Based on geographic information systems, the HSI model was used to identify potential sites around the Shandong Peninsula suitable for restoration of immature (25g) A. japonicus. Six habitat factors were used as input variables for the HSI model: sediment classification, water temperature, salinity, water depth, pH and dissolved oxygen. The weighting of each habitat factor was defined through the Delphi method. Sediment classification was the most important condition affecting the HSI of A. japonicus in the different study areas, while water temperature was the most important condition in different seasons. The HSI of Western Laizhou Bay was relatively low, meaning the site was not suitable for aquaculture-based restoration of A. japonicus. In contrast, Xiaoheishan Island, Rongcheng Bay and Qingdao were preferable sites, suitable as habitats for restoration efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of reference gene suitability for quantitative expression analysis by quantitative polymerase chain reaction in the mandibular condyle of sheep.

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Jiang, Xin; Xue, Yang; Zhou, Hongzhi; Li, Shouhong; Zhang, Zongmin; Hou, Rui; Ding, Yuxiang; Hu, Kaijin

2015-10-01

Reference genes are commonly used as a reliable approach to normalize the results of quantitative polymerase chain reaction (qPCR), and to reduce errors in the relative quantification of gene expression. Suitable reference genes belonging to numerous functional classes have been identified for various types of species and tissue. However, little is currently known regarding the most suitable reference genes for bone, specifically for the sheep mandibular condyle. Sheep are important for the study of human bone diseases, particularly for temporomandibular diseases. The present study aimed to identify a set of reference genes suitable for the normalization of qPCR data from the mandibular condyle of sheep. A total of 12 reference genes belonging to various functional classes were selected, and the expression stability of the reference genes was determined in both the normal and fractured area of the sheep mandibular condyle. RefFinder, which integrates the following currently available computational algorithms: geNorm, NormFinder, BestKeeper, and the comparative ΔCt method, was used to compare and rank the candidate reference genes. The results obtained from the four methods demonstrated a similar trend: RPL19, ACTB, and PGK1 were the most stably expressed reference genes in the sheep mandibular condyle. As determined by RefFinder comprehensive analysis, the results of the present study suggested that RPL19 is the most suitable reference gene for studies associated with the sheep mandibular condyle. In addition, ACTB and PGK1 may be considered suitable alternatives.

Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

Science.gov (United States)

Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

2012-01-01

Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

Predischarge maximal exercise test identifies risk for cardiac death in patients with acute myocardial infarction

DEFF Research Database (Denmark)

Nielsen, J R; Mickley, H; Damsgaard, E M

1990-01-01

A maximal exercise test was performed in 54 patients with acute myocardial infarction (AMI) before discharge and in 49 age-matched control subjects. The long-term prognosis was assessed after an average follow-up of 7.6 years in AMI patients and 5.8 years in control subjects. The maximal work...... capacity and systolic blood pressure increase in AMI patients was 59% that of control subjects (p less than 0.001). Seventeen AMI patients had significant ST-segment shifts, 13 with ST depression and 4 with ST elevation. In AMI patients experiencing a cardiac death during follow-up the maximal work...... were of no significant value. In this study maximal work capacity turned out to be the best single exercise variable for identifying groups of AMI patients with very low and relative high risk of cardiac death. When all 3 exercise variables were combined, the predischarge maximal exercise test...

Delineation of Suitable Cropland Areas Using a GIS Based Multi-Criteria Evaluation Approach in the Tam Dao National Park Region, Vietnam

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Duong Dang Khoi

2010-07-01

Full Text Available Land degradation is recognized as one of the major threats to the buffer zones of protected areas (PAs in Vietnam. In particular, the expansion of land degradation into the PAs is exerting pressure on biodiversity conservation efforts. This degradation is partially the result of mismanagement: the utilization of the land is often unmatched with the inherent suitability of the land. Identification of the spatial distribution of suitable areas for cropland is essential for sustainable land-use recommendation. This paper aims to delineate the areas suitable for cropland in the Tam Dao National Park (TDNP region using a GIS-based multi-criteria evaluation of biophysical factors and Landsat ETM+ imagery. GIS is used to generate the factors, while MCE is used to aggregate them into a land suitability index. The results indicate the location and extent of crop farming areas at different suitability levels, i.e., most suitable (28.10%, moderately suitable (23.96%, marginally suitable (28.77%, and least suitable (19.17%. The current cropland covers 46.5% of the study area, while most and moderately suitable areas are estimated to be 52.06% of the territory. The results can be used to identify priority areas for crop farming and sustainable land-use management. The GIS-MCE approach provides an effective assessment tool for land-use managers working in protected areas of Vietnam.

Suitability analysis for rice growing sites using a multicriteria evaluation and GIS approach in great Mwea region, Kenya.

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Kihoro, Joseph; Bosco, Njoroge J; Murage, Hunja

2013-12-01

Land suitability analysis is a prerequisite to achieving optimum utilization of the available land resources. Lack of knowledge on best combination of factors that suit production of rice has contributed to the low production. The aim of this study was to develop a suitability map for rice crop based on physical and climatic factors of production using a Multi-Criteria Evaluation (MCE) & GIS approach. The study was carried out in Kirinyaga, Embu and Mberee counties in Kenya. Biophysical variables of soil, climate and topography were considered for suitability analysis. All data were stored in ArcGIS 9.3 environment and the factor maps were generated. For MCE, Pairwise Comparison Matrix was applied and the suitable areas for rice crop were generated and graduated. The current land cover map of the area was developed from a scanned survey map of the rice growing areas. According to the present land cover map, the rice cultivated area was 13,369 ha. Finally, we overlaid the land cover map with the suitability map to identify variances between the present and potential land use. The crop-land evaluation results of the present study showed that, 75% of total area currently being used was under highly suitable areas and 25% was under moderately suitable areas. The results showed that the potential area for rice growing is 86,364 ha and out of this only 12% is under rice cultivation. This research provided information at local level that could be used by farmers to select cropping patterns and suitability.

Beyond reading level: a systematic review of the suitability of cancer education print and Web-based materials.

Science.gov (United States)

Finnie, Ramona K C; Felder, Tisha M; Linder, Suzanne Kneuper; Mullen, Patricia Dolan

2010-12-01

Consideration of categories related to reading comprehension--beyond reading level--is imperative to reach low literacy populations effectively. "Suitability" has been proposed as a term to encompass six categories of such factors: content, literacy demand graphics, layout/typography, learning stimulation, and cultural appropriateness. Our purpose was to describe instruments used to evaluate categories of suitability in cancer education materials in published reports and their findings. We searched databases and reference lists for evaluations of print and Web-based cancer education materials to identify and describe measures of these categories. Studies had to evaluate reading level and at least one category of suitability. Eleven studies met our criteria. Seven studies reported inter-rater reliability. Cultural appropriateness was most often assessed; four instruments assessed only surface aspects of cultural appropriateness. Only two of seven instruments used, the suitability assessment of materials (SAM) and the comprehensibility assessment of materials (SAM + CAM), were described as having any evidence of validity. Studies using Simplified Measure of Goobledygook (SMOG) and Fry reported higher average reading level scores than those using Flesh-Kincaid. Most materials failed criteria for reading level and cultural appropriateness. We recommend more emphasis on the categories of suitability for those developing cancer education materials and more study of these categories and reliability and validity testing of instruments.

Evaluation of the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers: a systematic review and documentary analysis.

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McGraw, Caroline; Drennan, Vari M

2015-02-01

To evaluate the suitability of root cause analysis frameworks for the investigation of community-acquired pressure ulcers. The objective was to identify the extent to which these frameworks take account of the setting where the ulcer originated as being the person's home rather than a hospital setting. Pressure ulcers involving full-thickness skin loss are increasingly being regarded as indicators of nursing patient safety failure, requiring investigation using root cause analysis frameworks. Evidence suggests that root cause analysis frameworks developed in hospital settings ignore the unique dimensions of risk in home healthcare settings. A systematic literature review and documentary analysis of frameworks used to investigate community-acquired grade three and four pressure ulcers by home nursing services in England. No published papers were identified for inclusion in the review. Fifteen patient safety investigative frameworks were collected and analysed. Twelve of the retrieved frameworks were intended for the investigation of community-acquired pressure ulcers; seven of which took account of the setting where the ulcer originated as being the patient's home. This study provides evidence to suggest that many of the root cause analysis frameworks used to investigate community-acquired pressure ulcers in England are unsuitable for this purpose. This study provides researchers and practitioners with evidence of the need to develop appropriate home nursing root cause analysis frameworks to investigate community-acquired pressure ulcers. © 2014 John Wiley & Sons Ltd.

The readability and suitability of sexual health promotion leaflets.

Science.gov (United States)

Corcoran, Nova; Ahmad, Fatuma

2016-02-01

To investigate the readability and suitability of sexual health promotion leaflets. Application of SMOG, FRY and SAM tests to assess the readability and suitability of a selection of sexual health leaflets. SMOG and FRY scores illustrate an average reading level of grade 9. SAM scores indicate that 59% of leaflets are superior in design and 41% are average in design. Leaflets generally perform well in the categories of content, literacy demand, typography and layout. They perform poorly in use of graphics, learning stimulation/motivation and cultural appropriateness. Sexual health leaflets have a reading level that is too high. Leaflets perform well on the suitability scores indicating they are reasonably suitable. There are a number of areas where sexual health leaflets could improve their design. Numerous practical techniques are suggested for improving the readability and suitability of sexual health leaflets. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Land suitability for waste disposal in metropolitan areas.

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Baiocchi, Valerio; Lelo, Keti; Polettini, Alessandra; Pomi, Raffaella

2014-08-01

Site selection for waste disposal is a complex task that should meet the requirements of communities and stakeholders. In this article, three decision support methods (Boolean logic, index overlay and fuzzy gamma) are used to perform land suitability analysis for landfill siting. The study was carried out in one of the biggest metropolitan regions of Italy, with the objective of locating suitable areas for waste disposal. Physical and socio-economic information criteria for site selection were decided by a multidisciplinary group of experts, according to state-of-the-art guidelines, national legislation and local normative on waste management. The geographic information systems (GIS) based models used in this study are easy to apply but require adequate selection of criteria and weights and a careful evaluation of the results. The methodology is arranged in three steps, reflecting the criteria defined by national legislation on waste management: definition of factors that exclude location of landfills or waste treatment plants; classification of the remaining areas in terms of suitability for landfilling; and evaluation of suitable sites in relation to preferential siting factors (such as the presence of quarries or dismissed plants). The results showed that more than 80% of the provincial territory falls within constraint areas and the remaining territory is suitable for waste disposal for 0.72% or 1.93%, according to the model. The larger and most suitable sites are located in peripheral areas of the metropolitan system. The proposed approach represents a low-cost and expeditious alternative to support the spatial decision-making process. © The Author(s) 2014.

Proteome screening of pleural effusions identifies galectin 1 as a diagnostic biomarker and highlights several prognostic biomarkers for malignant mesothelioma.

Science.gov (United States)

Mundt, Filip; Johansson, Henrik J; Forshed, Jenny; Arslan, Sertaç; Metintas, Muzaffer; Dobra, Katalin; Lehtiö, Janne; Hjerpe, Anders

2014-03-01

Malignant mesothelioma is an aggressive asbestos-induced cancer, and affected patients have a median survival of approximately one year after diagnosis. It is often difficult to reach a conclusive diagnosis, and ancillary measurements of soluble biomarkers could increase diagnostic accuracy. Unfortunately, few soluble mesothelioma biomarkers are suitable for clinical application. Here we screened the effusion proteomes of mesothelioma and lung adenocarcinoma patients to identify novel soluble mesothelioma biomarkers. We performed quantitative mass-spectrometry-based proteomics using isobaric tags for quantification and used narrow-range immobilized pH gradient/high-resolution isoelectric focusing (pH 4-4.25) prior to analysis by means of nano liquid chromatography coupled to MS/MS. More than 1,300 proteins were identified in pleural effusions from patients with malignant mesothelioma (n = 6), lung adenocarcinoma (n = 6), or benign mesotheliosis (n = 7). Data are available via ProteomeXchange with identifier PXD000531. The identified proteins included a set of known mesothelioma markers and proteins that regulate hallmarks of cancer such as invasion, angiogenesis, and immune evasion, plus several new candidate proteins. Seven candidates (aldo-keto reductase 1B10, apolipoprotein C-I, galectin 1, myosin-VIIb, superoxide dismutase 2, tenascin C, and thrombospondin 1) were validated by enzyme-linked immunosorbent assays in a larger group of patients with mesothelioma (n = 37) or metastatic carcinomas (n = 25) and in effusions from patients with benign, reactive conditions (n = 16). Galectin 1 was identified as overexpressed in effusions from lung adenocarcinoma relative to mesothelioma and was validated as an excellent predictor for metastatic carcinomas against malignant mesothelioma. Galectin 1, aldo-keto reductase 1B10, and apolipoprotein C-I were all identified as potential prognostic biomarkers for malignant mesothelioma. This analysis of the effusion proteome

Phenotype/genotype correlation in a case series of Stargardt's patients identifies novel mutations in the ABCA4 gene.

Science.gov (United States)

Gemenetzi, M; Lotery, A J

2013-11-01

To investigate phenotypic variability in terms of best-corrected visual acuity (BCVA) in patients with Stargardt disease (STGD) and confirmed ABCA4 mutations. Entire coding region analysis of the ABCA4 gene by direct sequencing of seven patients with clinical findings of STGD seen in the Retina Clinics of Southampton Eye Unit between 2002 and 2011.Phenotypic variables recorded were BCVA, fluorescein angiographic appearance, electrophysiology, and visual fields. All patients had heterozygous amino acid-changing variants (missense mutations) in the ABCA4 gene. A splice sequence change was found in a 30-year-old patient with severly affected vision. Two novel sequence changes were identified: a missense mutation in a mildly affected 44-year-old patient and a frameshift mutation in a severly affected 34-year-old patient. The identified ABCA4 mutations were compatible with the resulting phenotypes in terms of BCVA. Higher BCVAs were recorded in patients with missense mutations. Sequence changes, predicted to have more deleterious effect on protein function, resulted in a more severe phenotype. This case series of STGD patients demonstrates novel genotype/phenotype correlations, which may be useful to counselling of patients. This information may prove useful in selection of candidates for clinical trials in ABCA4 disease.

Identifying suitable sanitary landfill locations in the state of Morelos, México, using a Geographic Information System

Science.gov (United States)

Marín, Luis E.; Torres, Vicente; Bolongaro, Andrea; Reyna, José A.; Pohle, O.; Hernández-Espriú, A.; Chavarría, Jerónimo; García-Barrios, R.; Tabla, Hugo Francisco Parra

GIS is a powerful tool that may help to better manage natural resources. In this paper, we present a GIS model developed for the state of Morelos as an aid to determine whether a potential site, Loma de Mejia, met the Mexican Federal Guidelines. The Mexican Government has established federal guidelines for sanitary landfill site selection (NOM-083-SERMARNAT-2003). These guidelines were translated into a water-based Geographic Information System and applied to the state of Morelos, Mexico. For these examples, we used the SIGAM® (Sistema de Información Geográfico del Agua en México; a water-based GIS for Mexico) which has at least 60 layers from the National Water Commission (CONAGUA), the national mapping agency (INEGI; Instituto Nacional de Estadística, Geografía e Informática), NASA, and academic institutions. Results show that a GIS is a powerful tool that may allow federal, state and municipal policy makers to conduct an initial regional site reconnaissance rapidly. Once potential sites are selected, further characterization must be carried out in order to determine if proposed locations are suitable or not for a sanitary landfill. Based on the SIGAM© software, the Loma de Mejia would not comply with the Mexican Federal Guidelines.

Sinus lifting before Le Fort I maxillary osteotomy: a suitable method for oral rehabilitation of edentulous patients with skelettal class-III conditions: review of the literature and report of a case

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Meyer Ulrich

2007-01-01

Full Text Available Abstract Background Functional rehabilitation of patients afflicted with severe mandibular and maxillary alveolar atrophy might be challenging especially in malformed patients. Methods Treatment planning using sinus lifting and implant placement before Le Fort I maxillary osteotomy in a patient with severe mandibular and posterior maxillary alveolar atrophy and skelettal class-III conditions due to cleft palate are described. Results A full functional and esthetic rehabilitation of the patient was achieved by a stepwise surgical approach performed through sinus lifting as the primary approach followed by implant placement and subsequent Le Fort I maxillary osteotomy to correct the maxillo-mandibular relation. Conclusion Stabilisation of the maxillary complex by a sinus lifting procedure in combination with computer aided implant placement as preorthodontic planning procedure before Le Fort I maxillary osteotomy seems to be suitable in order to allow ideal oral rehabilitation especially in malformed patients.

Use of the Flugelman index for identifying patients who are difficult to discharge from the hospital

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Chiara Bozzano

2013-03-01

Full Text Available Introduction: To evaluate the use of multidimensional assessment based on the Fluegelman Index (FI to identify internal medicine patients who are likely to be difficult to discharge from the hospital. Materials and methods: Have been evaluated all patients admitted to the medical wards of the District General Hospital of Arezzo from September 1 to October 31, 2007. We collected data on age, sex, socioeconomic condition, cause of admission, comorbidity score preadmission functional status (Barthel Index, incontinence, feeding problems, length of hospitalization, condition at discharge, and type of discharge. The FI cut off for difficult discharge was > 17. Results: Of the 413 patients (mean age 80 + 11.37 years; percentage of women, 56.1% included in the study, 109 (26.39% had Flugelman Index > 17. These patients were significantly older than the patients with lower FIs (85 + 9.35 vs 78 + 11.58 years, p < 0.001, more likely to be admitted for pneumonia (22% vs. 4.9% of those with lower FIs; p < 0,001. They also had more comorbidity, loss of autonomy, cognitive impairment, social frailty, and nursing care needs. The subgroup with FIs>17 had significantly higher in-hospital mortality (30.28% vs 6.25%, p < 0.001, longer hospital stay (13 vs. 10 days, p < 0.05, and higher rates of discharge to nursing homes. Conclusions: Evaluation of internal medicine patients with the Flugelman Index may be helpful for identifying more critical patients likely to require longer hospitalization and to detect factors affecting the hospital stay. This information can be useful for more effective discharge planning.

Proteinuria in adult Saudi patients with sickle cell disease is not associated with identifiable risk factors

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Aleem Aamer

2010-01-01

Full Text Available Renal involvement in patients with sickle cell disease (SCD is associated with signi-ficant morbidity and mortality. Proteinuria is common in patients with SCD and is a risk factor for future development of renal failure. We sought to identify risk factors, if any, associated with pro-teinuria in adult Saudi patients with SCD. We studied 67 patients with SCD followed-up at the King Khalid University Hospital, Riyadh, Saudi Arabia. All patients underwent 24-hour urine collection to measure creatinine clearance and to quantify proteinuria. In addition, blood was examined for evaluation of hematological and biochemical parameters. Clinical information was gathered from review of the patients′ charts. A urine protein level of more than 0.150 grams/24 hours was consi-dered abnormal. Urine protein was correlated with various clinical and laboratory parameters. Thirty-one males and 36 females were evaluated. The mean age of the cohort was 23.8 (± 7.2 years. Twenty-seven patients (40.3% had proteinuria of more than 0.150 grams/24 hours. The study group had a mean hemoglobin level of 8.5 (± 2.8 g/dL and mean fetal hemoglobin (HbF level of 14.4% (± 7.3%. Majority of the patients (61 had hemoglobin SS genotype and six patients had S-β0 thala-ssemia. None of the parameters evaluated correlated with proteinuria although there was a border-line association with older age and higher systolic blood pressure (P = 0.073 and 0.061 respec-tively. Hydroxyurea use for more than a year was not beneficial. In conclusion, our study suggests that proteinuria in adult Saudi patients is not associated with any clear identifiable risk factors.

A Restoration Suitability Index Model for the Eastern Oyster (Crassostrea virginica) in the Mission-Aransas Estuary, TX, USA

Science.gov (United States)

Beseres Pollack, Jennifer; Cleveland, Andrew; Palmer, Terence A.; Reisinger, Anthony S.; Montagna, Paul A.

2012-01-01

Oyster reefs are one of the most threatened marine habitats on earth, with habitat loss resulting from water quality degradation, coastal development, destructive fishing practices, overfishing, and storm impacts. For successful and sustainable oyster reef restoration efforts, it is necessary to choose sites that support long-term growth and survival of oysters. Selection of suitable sites is critically important as it can greatly influence mortality factors and may largely determine the ultimate success of the restoration project. The application of Geographic Information Systems (GIS) provides an effective methodology for identifying suitable sites for oyster reef restoration and removes much of the uncertainty involved in the sometimes trial and error selection process. This approach also provides an objective and quantitative tool for planning future oyster reef restoration efforts. The aim of this study was to develop a restoration suitability index model and reef quality index model to characterize locations based on their potential for successful reef restoration within the Mission-Aransas Estuary, Texas, USA. The restoration suitability index model focuses on salinity, temperature, turbidity, dissolved oxygen, and depth, while the reef quality index model focuses on abundance of live oysters, dead shell, and spat. Size-specific Perkinsus marinus infection levels were mapped to illustrate general disease trends. This application was effective in identifying suitable sites for oyster reef restoration, is flexible in its use, and provides a mechanism for considering alternative approaches. The end product is a practical decision-support tool that can be used by coastal resource managers to improve oyster restoration efforts. As oyster reef restoration activities continue at small and large-scales, site selection criteria are critical for assisting stakeholders and managers and for maximizing long-term sustainability of oyster resources. PMID:22792410

Clinical and molecular characterization of a novel INS mutation identified in patients with MODY phenotype.

Science.gov (United States)

Piccini, Barbara; Artuso, Rosangela; Lenzi, Lorenzo; Guasti, Monica; Braccesi, Giulia; Barni, Federica; Casalini, Emilio; Giglio, Sabrina; Toni, Sonia

2016-11-01

Correct diagnosis of Maturity-Onset Diabetes of the Young (MODY) is based on genetic tests requiring an appropriate subject selection by clinicians. Mutations in the insulin (INS) gene rarely occur in patients with MODY. This study is aimed at determining the genetic background and clinical phenotype in patients with suspected MODY. 34 patients with suspected MODY, negative for mutations in the GCK, HNF1α, HNF4α, HNF1β and PDX1 genes, were screened by next generation sequencing (NGS). A heterozygous INS mutation was identified in 4 members of the same family. First genetic tests performed identified two heterozygous silent nucleotide substitutions in MODY3/HNF1α gene. An ineffective attempt to suspend insulin therapy, administering repaglinide and sulphonylureas, was made. DNA was re-sequenced by NGS investigating a set of 102 genes. Genes implicated in the pathway of pancreatic β-cells, candidate genes for type 2 diabetes mellitus and genes causative of diabetes in mice were selected. A novel heterozygous variant in human preproinsulin INS gene (c.125T > C) was found in the affected family members. The new INS mutation broadens the spectrum of possible INS phenotypes. Screening for INS mutations is warranted not only in neonatal diabetes but also in MODYx patients and in selected patients with type 1 diabetes mellitus negative for autoantibodies. Subjects with complex diseases without a specific phenotype should be studied by NGS because Sanger sequencing is ineffective and time consuming in detecting rare variants. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Hearing aid user guides: suitability for older adults.

Science.gov (United States)

Caposecco, Andrea; Hickson, Louise; Meyer, Carly

2014-02-01

The aim of this study was to analyse the content, design, and readability of printed hearing aid user guides to determine their suitability for older adults, who are the main users of hearing aids. Hearing aid user guides were assessed using four readability formulae and a standardized tool to assess content and design (SAM - Suitability Assessment of Materials). A sample of 36 hearing aid user guides (four user guides from nine different hearing aid manufacturers) were analysed. Sixty nine percent of user guides were rated 'not suitable' and 31% were rated 'adequate' for their suitability. Many scored poorly for scope, vocabulary, aspects of layout and typography, and learning stimulation and motivation. The mean reading grade level for all user guides was grade 9.6 which is too high for older adults. The content, design, and readability of hearing aid user guides are not optimal for older adults and thus may serve as a barrier to successful hearing aid outcomes for this population.

Stereotactic Body Radiotherapy: A Promising Treatment Option for the Boost of Oropharyngeal Cancers Not Suitable for Brachytherapy: A Single-Institutional Experience

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Al-Mamgani, Abrahim, E-mail: a.al-mamgani@erasmusmc.nl [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk, Rotterdam (Netherlands); Tans, Lisa; Teguh, David N. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk, Rotterdam (Netherlands); Rooij, Peter van [Department of Biostatistics, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk, Rotterdam (Netherlands); Zwijnenburg, Ellen M.; Levendag, Peter C. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Groene Hilledijk, Rotterdam (Netherlands)

2012-03-15

Purpose: To prospectively assess the outcome and toxicity of frameless stereotactic body radiotherapy (SBRT) as a treatment option for boosting primary oropharyngeal cancers (OPC) in patients who not suitable for the standard brachytherapy boost (BTB). Methods and Materials: Between 2005 and 2010, 51 patients with Stage I to IV biopsy-proven OPC who were not suitable for BTB received boosts by means of SBRT (3 times 5.5 Gy, prescribed to the 80% isodose line), after 46 Gy of IMRT to the primary tumor and neck (when indicated). Endpoints of the study were local control (LC), disease-free survival (DFS), overall survival (OS), and acute and late toxicity. Results: After a median follow-up of 18 months (range, 6-65 months), the 2-year actuarial rates of LC, DFS, and OS were 86%, 80%, and 82%, respectively, and the 3-year rates were 70%, 66%, and 54%, respectively. The treatment was well tolerated, as there were no treatment breaks and no Grade 4 or 5 toxicity reported, either acute or chronic. The overall 2-year cumulative incidence of Grade {>=}2 late toxicity was 28%. Of the patients with 2 years with no evidence of disease (n = 20), only 1 patient was still feeding tube dependent and 2 patients had Grade 3 xerostomia. Conclusions: According to our knowledge, this study is the first report of patients with primary OPC who received boosts by means of SBRT. Patients with OPC who are not suitable for the standard BTB can safely and effectively receive boosts by SBRT. With this radiation technique, an excellent outcome was achieved. Furthermore, the SBRT boost did not have a negative impact regarding acute and late side effects.

Genome-Wide Association Study Identifies Risk Variants for Lichen Planus in Patients With Hepatitis C Virus Infection.

Science.gov (United States)

Nagao, Yumiko; Nishida, Nao; Toyo-Oka, Licht; Kawaguchi, Atsushi; Amoroso, Antonio; Carrozzo, Marco; Sata, Michio; Mizokami, Masashi; Tokunaga, Katsushi; Tanaka, Yasuhito

2017-06-01

There is a close relationship between hepatitis C virus (HCV) infection and lichen planus, a chronic inflammatory mucocutaneous disease. We performed a genome-wide association study (GWAS) to identify genetic variants associated with HCV-related lichen planus. We conducted a GWAS of 261 patients with HCV infection treated at a tertiary medical center in Japan from October 2007 through January 2013; a total of 71 had lichen planus and 190 had normal oral mucosa. We validated our findings in a GWAS of 38 patients with HCV-associated lichen planus and 7 HCV-infected patients with normal oral mucosa treated at a medical center in Italy. Single-nucleotide polymorphisms in NRP2 (rs884000) and IGFBP4 (rs538399) were associated with risk of HCV-associated lichen planus (P lichen planus. The odds ratios for the minor alleles of rs884000, rs538399, and rs9461799 were 3.25 (95% confidence interval, 1.95-5.41), 0.40 (95% confidence interval, 0.25-0.63), and 2.15 (95% confidence interval, 1.41-3.28), respectively. In a GWAS of Japanese patients with HCV infection, we replicated associations between previously reported polymorphisms in HLA class II genes and risk for lichen planus. We also identified single-nucleotide polymorphisms in NRP2 and IGFBP4 loci that increase and reduce risk of lichen planus, respectively. These genetic variants might be used to identify patients with HCV infection who are at risk for lichen planus. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

Analysis of SOX10 mutations identified in Waardenburg-Hirschsprung patients: Differential effects on target gene regulation.

Science.gov (United States)

Chan, Kwok Keung; Wong, Corinne Kung Yen; Lui, Vincent Chi Hang; Tam, Paul Kwong Hang; Sham, Mai Har

2003-10-15

SOX10 is a member of the SOX gene family related by homology to the high-mobility group (HMG) box region of the testis-determining gene SRY. Mutations of the transcription factor gene SOX10 lead to Waardenburg-Hirschsprung syndrome (Waardenburg-Shah syndrome, WS4) in humans. A number of SOX10 mutations have been identified in WS4 patients who suffer from different extents of intestinal aganglionosis, pigmentation, and hearing abnormalities. Some patients also exhibit signs of myelination deficiency in the central and peripheral nervous systems. Although the molecular bases for the wide range of symptoms displayed by the patients are still not clearly understood, a few target genes for SOX10 have been identified. We have analyzed the impact of six different SOX10 mutations on the activation of SOX10 target genes by yeast one-hybrid and mammalian cell transfection assays. To investigate the transactivation activities of the mutant proteins, three different SOX target binding sites were introduced into luciferase reporter gene constructs and examined in our series of transfection assays: consensus HMG domain protein binding sites; SOX10 binding sites identified in the RET promoter; and Sox10 binding sites identified in the P0 promoter. We found that the same mutation could have different transactivation activities when tested with different target binding sites and in different cell lines. The differential transactivation activities of the SOX10 mutants appeared to correlate with the intestinal and/or neurological symptoms presented in the patients. Among the six mutant SOX10 proteins tested, much reduced transactivation activities were observed when tested on the SOX10 binding sites from the RET promoter. Of the two similar mutations X467K and 1400del12, only the 1400del12 mutant protein exhibited an increase of transactivation through the P0 promoter. While the lack of normal SOX10 mediated activation of RET transcription may lead to intestinal aganglionosis

IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

OpenAIRE

Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

2016-01-01

Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire ...

Mapping marginal croplands suitable for cellulosic feedstock crops in the Great Plains, United States

Science.gov (United States)

Gu, Yingxin; Wylie, Bruce K.

2016-01-01

Growing cellulosic feedstock crops (e.g., switchgrass) for biofuel is more environmentally sustainable than corn-based ethanol. Specifically, this practice can reduce soil erosion and water quality impairment from pesticides and fertilizer, improve ecosystem services and sustainability (e.g., serve as carbon sinks), and minimize impacts on global food supplies. The main goal of this study was to identify high-risk marginal croplands that are potentially suitable for growing cellulosic feedstock crops (e.g., switchgrass) in the US Great Plains (GP). Satellite-derived growing season Normalized Difference Vegetation Index, a switchgrass biomass productivity map obtained from a previous study, US Geological Survey (USGS) irrigation and crop masks, and US Department of Agriculture (USDA) crop indemnity maps for the GP were used in this study. Our hypothesis was that croplands with relatively low crop yield but high productivity potential for switchgrass may be suitable for converting to switchgrass. Areas with relatively low crop indemnity (crop indemnity marginal croplands in the GP are potentially suitable for switchgrass development. The total estimated switchgrass biomass productivity gain from these suitable areas is about 5.9 million metric tons. Switchgrass can be cultivated in either lowland or upland regions in the GP depending on the local soil and environmental conditions. This study improves our understanding of ecosystem services and the sustainability of cropland systems in the GP. Results from this study provide useful information to land managers for making informed decisions regarding switchgrass development in the GP.

Merging Children's Oncology Group Data with an External Administrative Database Using Indirect Patient Identifiers: A Report from the Children's Oncology Group.

Directory of Open Access Journals (Sweden)

Yimei Li

Full Text Available Clinical trials data from National Cancer Institute (NCI-funded cooperative oncology group trials could be enhanced by merging with external data sources. Merging without direct patient identifiers would provide additional patient privacy protections. We sought to develop and validate a matching algorithm that uses only indirect patient identifiers.We merged the data from two Phase III Children's Oncology Group (COG trials for de novo acute myeloid leukemia (AML with the Pediatric Health Information Systems (PHIS. We developed a stepwise matching algorithm that used indirect identifiers including treatment site, gender, birth year, birth month, enrollment year and enrollment month. Results from the stepwise algorithm were compared against the direct merge method that used date of birth, treatment site, and gender. The indirect merge algorithm was developed on AAML0531 and validated on AAML1031.Of 415 patients enrolled on the AAML0531 trial at PHIS centers, we successfully matched 378 (91.1% patients using the indirect stepwise algorithm. Comparison to the direct merge result suggested that 362 (95.7% matches identified by the indirect merge algorithm were concordant with the direct merge result. When validating the indirect stepwise algorithm using the AAML1031 trial, we successfully matched 157 out of 165 patients (95.2% and 150 (95.5% of the indirectly merged matches were concordant with the directly merged matches.These data demonstrate that patients enrolled on COG clinical trials can be successfully merged with PHIS administrative data using a stepwise algorithm based on indirect patient identifiers. The merged data sets can be used as a platform for comparative effectiveness and cost effectiveness studies.

Identifying the gaps: Armenian health care legislation and human rights in patient care protections.

Science.gov (United States)

Zopunyan, Violeta; Krmoyan, Suren; Quinn, Ryan

2013-12-12

Since the collapse of the Soviet Union, the Republic of Armenia has undergone an extensive legislative overhaul. Although a number of developments have aimed to improve the quality and accessibility of Armenia's health care system, a host of factors has prevented the country from fully introducing measures to ensure respect for human rights in patient care. In particular, inadequate health care financing continues to oblige patients to make both formal and informal payments to obtain basic medical care and services. More generally, a lack of oversight and monitoring mechanisms has obstructed the implementation of Armenia's commitments to human rights in several international agreements. Within the framework of a broader project on promoting human rights in patient care, research was carried out to examine Armenia’s health care legislation with the aim of identifying gaps in comparison with international and regional standards. This research was designed using the 14 rights enshrined in the European Charter on Patient Rights as guiding principles, along with domestic legal acts relevant to the rights of health care providers. The gaps analysis revealed numerous problems with Armenian legislation governing the relationships between stakeholders in health care service delivery. It also identified several practical inconsistencies with the international legal instruments ratified by the Armenian government. These legislative shortcomings are illustrated by highlighting key health-related rights violations experienced by patients and their health care providers, and by indicating opportunities for improved rights protections. A full list of human rights relevant to patient care and recommendations for promoting them in the Armenian context is provided in Tables 1 and 2. A number of initiatives must be undertaken in order to promote the full spectrum of human rights in patient care in Armenia. This section highlights certain recommendations flowing from the findings of

Development and testing of recipes suitable for patients with chronic ...

African Journals Online (AJOL)

Objectives: The main objectives of the study were to develop and test recipes that meet the nutritional requirements of and are acceptable to patients with chronic renal failure. The secondary objectives were to determine gender and racial differences in the participants' responses during consumer sensory testing. Design: ...

Augmentation Phalloplasty Patient Selection and Satisfaction Inventory: a novel questionnaire to evaluate patients considered for augmentation phalloplasty surgery because of penile dysmorphophobia.

Science.gov (United States)

Spyropoulos, Evangelos; Galanakis, Ioannis; Dellis, Athanasios

2007-08-01

To introduce a novel questionnaire by which we attempted to identify the most suitable candidates for augmentation phalloplasty surgery for penile dysmorphophobia and to objectively estimate the outcome. A total of 45 physically normal young adult men who presented with complaints of a "small penis" and were seeking surgical correction were included in the study. In addition to the ordinary evaluation, all completed the questionnaire devised by our department, the Augmentation Phalloplasty Patient Selection and Satisfaction Inventory (APPSSI). The APPSSI aims to quantitatively assess the severity of the condition and the degree of the patient's willingness to undergo penile augmentation and to numerically measure the postoperative result. The APPSSI consists of four questions, with each having five possible answers (scale 0 to 4). Questions 1 through 3 were asked preoperatively (suitability assessment) and questions 1, 2, and 4 postoperatively (outcome evaluation). The eligibility threshold for surgery was a preoperative score of 6 or less. The preoperative scores ranged from 0 (surgery justified) to 12 (surgery not justified), and the postoperative scores ranged from 0 (disappointed) to 12 (excited). The Student t test was used for statistical analysis, and P enlargement (n = 4), or celioplasty-penile lengthening (n = 2). Postoperatively, the score increased by 4.36 (mean 7.54, P <0.001), and the condition improved by 25% to 50% in 11 patients, 66.6% in 1, and remained unchanged (0%) in 1 patient. The APPSSI questionnaire properly identified patients who significantly benefited from augmentation phalloplasty. Nevertheless, because of the small sample size and nonrandomized study, the questionnaire's validation requires a larger number of patients tested in a randomized manner by more researchers to become a valuable clinical instrument and patient eligibility criterion for this type of surgery.

Suitability study of using a coincidence monitor for room air radioactivity monitoring in a PET center

International Nuclear Information System (INIS)

Roellig, D.; Reichelt, C.; Iwatschenko-Borho, M.

2001-01-01

The application of radioactive nuclides in medicine may cause as well radioactive exposure of personnel (Medical Technical Assistants). In the present case the exposure of personnel in the area of medical positron-emission tomography (PET) within the Research Center of Rossendorf due to exhalation of the injected activity by the patient shall be investigated. For this purpose it is necessary to measure the activity concentration of the room air. Conventional methods such as collecting samples on special filters are not suitable due to the short half-life time of the used nuclides. Standard type continuous monitors are hardly suitable as well, because the injected activity of the patient and various radioactive sources required for the calibration of the PET-Camera produce an increased gamma background. In order to eliminate these disturbing influences a monitor has been constructed which uses CCM (cobalt coincidence method) developed by the company Thermo Eberline ESM. This method is specially suitable because upon each radioactive decay of PET nuclides positrons are emitted which in turn annihilate via the simultaneous emission of two 511 keV gamma quanta under an angle of 180 . The air to be measured is sucked through a cavity with two scintillation detectors on opposite sides. The coincident pulses produced by annihilating positrons inside the cavity are counted by a suitable electronic. Gamma quanta from outside the cavity can produce a pulse only in one detector and are rejected. Therefore no heavy lead shielding is required. Besides the mechanical construction of the monitor optimization and calibration for different PET-nuclides had to be performed. Special attention was paid to the sampling system. The air intake had to be close to the breathing zone of the MTA. The hose to the monitor had to be as short as possible. The target of the work was to design a model for an industrial monitor. (orig.) [de

Selection of suitable sites for NPP in Slovenia (stage 3)

International Nuclear Information System (INIS)

Grgic, M.; Fabjan, L.; Premru, U.

1977-01-01

Selection of suitable sites for nuclear power plants in Slovenia is considered. This includes the studies of available data on regional and local characteristics specified in general site suitability criteria for NPP. The most suitable selected sites will be included into land use urbanistic planning of Slovenia

Evaluation of habitat suitability models for forest passerines using demographic data

Science.gov (United States)

Chadwick D. Rittenhouse; Frank R., III Thompson; William D. Dijak; Joshua J. Millspaugh; Richard L. Clawson

2010-01-01

Habitat suitability is often used as a surrogate for demographic responses (i.e., abundance, survival, fecundity, or population viability) in the application of habitat suitability index (HSI) models. Whether habitat suitability actually relates to demographics, however, has rarely been evaluated. We validated HSI models of breeding habitat suitability for wood thrush...

Multi-locus DNA barcoding identifies matK as a suitable marker for species identification in Hibiscus L.

Science.gov (United States)

Poovitha, Sundar; Stalin, Nithaniyal; Balaji, Raju; Parani, Madasamy

2016-12-01

The genus Hibiscus L. includes several taxa of medicinal value and species used for the extraction of natural dyes. These applications require the use of authentic plant materials. DNA barcoding is a molecular method for species identification, which helps in reliable authentication by using one or more DNA barcode marker. In this study, we have collected 44 accessions, representing 16 species of Hibiscus, distributed in the southern peninsular India, to evaluate the discriminatory power of the two core barcodes rbcLa and matK together with the suggested additional regions trnH-psbA and ITS2. No intraspecies divergence was observed among the accessions studied. Interspecies divergence was 0%-9.6% with individual markers, which increased to 0%-12.5% and 0.8%-20.3% when using two- and three-marker combinations, respectively. Differentiation of all the species of Hibiscus was possible with the matK DNA barcode marker. Also, in two-marker combinations, only those combinations with matK differentiated all the species. Though all the three-marker combinations showed 100% species differentiation, species resolution was consistently better when the matK marker formed part of the combination. These results clearly showed that matK is more suitable when compared to rbcLa, trnH-psbA, and ITS2 for species identification in Hibiscus.

Identification of suitable sites for rainwater harvesting structures in arid and semi-arid regions: A review

Directory of Open Access Journals (Sweden)

Ammar Adham

2016-06-01

Full Text Available Harvested rainwater is an alternative source of water in arid and semi-arid regions (ASARs around the world. Many researchers have developed and applied various methodologies and criteria to identify suitable sites and techniques for rainwater harvesting (RWH. Determining the best method or guidelines for site selection, however, is difficult. The main objective of this study was to define a general method for selecting suitable RWH sites in ASARs by assembling an inventory of the main methods and criteria developed during the last three decades. We categorised and compared four main methodologies of site selection from 48 studies published in scientific journals, reports of international organisations, or sources of information obtained from practitioners. We then identified three main sets of criteria for selecting RWH locations and the main characteristics of the most common RWH techniques used in ASARs. The methods were diverse, ranging from those based only on biophysical criteria to more integrated approaches including socio-economic criteria, especially after 2000. The most important criteria for the selection of suitable sites for RWH were slope, land use/cover, soil type, rainfall, distance to settlements/streams, and cost. The success rate of RWH projects tended to increase when these criteria were considered, but an objective evaluation of these selection methods is still lacking. Most studies now select RHW sites using geographic information systems in combination with hydrological models and multi-criteria analysis.

Elk habitat suitability map for North Carolina

Science.gov (United States)

Williams, Steven G.; Cobb, David T.; Collazo, Jaime A.

2015-01-01

Although eastern elk (Cervus elaphus canadensis) were extirpated from the eastern United States in the 19th century, they were successfully reintroduced in the North Carolina portion of the Great Smoky Mountains National Park in the early 2000s. The North Carolina Wildlife Resources Commission (NCWRC) is evaluating the prospect of reintroducing the species in other locations in the state to augment recreational opportunities. As a first step in the process, we created a state-wide elk habitat suitability map. We used medium-scale data sets and a two-component approach to iden- tify areas of high biological value for elk and exclude from consideration areas where elk-human conflicts were more likely. Habitats in the state were categorized as 66% unsuitable, 16.7% low, 17% medium, and <1% high suitability for elk. The coastal plain and Piedmont contained the most suitable habitat, but prospective reintroduction sites were largely excluded from consideration due to extensive agricultural activities and pervasiveness of secondary roads. We ranked 31 areas (≥ 500 km2) based on their suitability for reintroduction. The central region of the state contained the top five ranked areas. The Blue Ridge Mountains, where the extant population of elk occurs, was ranked 21st. Our work provides a benchmark for decision makers to evaluate potential consequences and trade-offs associated with the selection of prospective elk reintroduction sites.

[Ecology suitability study of Chinese materia medica Gentianae Macrophyllae Radix].

Science.gov (United States)

Lu, You-Yuan; Yang, Yan-Mei; Ma, Xiao-Hui; Zhang, Xiao-Bo; Zhu, Shou-Dong; Jin, Ling

2016-09-01

This paper is aimed to predict ecology suitability distribution of Gentianae Macrophyllae Radix and search the main ecological factors affecting the suitability distribution. The 313 distribution information about G. macrophylla, 186 distribution information about G. straminea, 343 distribution information about G. dauricaand 131 distribution information about G. crasicaulis were collected though investigation and network sharing platform data . The ecology suitable distribution factors for production Gentianae Macrophyllae Radix was analyzed respectively by the software of ArcGIS and MaxEnt with 55 environmental factors. The result of MaxEnt prediction was very well (AUC was above 0.9). The results of predominant factors analysis showed that precipitation and altitude were all the major factors impacting the ecology suitable of Getiana Macrophylla Radix production. G. macrophylla ecology suitable region was mainly concentrated in south of Gansu, Shanxi, central of Shaanxi and east of Qinghai provinces. G. straminea ecology suitable region was mainly concentrated in southwest of Gansu, east of Qinghai, north and northwest of Sichuan, east of Xizang province. G. daurica ecology suitable region was mainly concentrated in south and southwest of Gansu, east of Qinghai, Shanxi and north of Shaanxi province. G. crasicaulis ecology suitable region was mainly concentrated in Sichuan and north of Yunnan, east of Xizang, south of Gansu and east of Qinghai province. The ecological suitability distribution result of Gentianae Macrophyllae Radix was consistent with each species actual distribution. The study could provide reference for the collection and protection of wild resources, meanwhile, provide the basis for the selection of cultivation area of Gentiana Macrophylla Radix. Copyright© by the Chinese Pharmaceutical Association.

Ability of EDI-2 and EDI-3 to correctly identify patients and subjects at risk for eating disorders.

Science.gov (United States)

Segura-García, Cristina; Aloi, Matteo; Rania, Marianna; Ciambrone, Paola; Palmieri, Antonella; Pugliese, Valentina; Ruiz Moruno, Antonio José; De Fazio, Pasquale

2015-12-01

The prevention and early recognition of eating disorders (EDs) are important topics in public health. This study aims to compare the efficacy of the Eating Disorder Inventory 2 (EDI-2) with the new version, EDI-3 in recognising patients and identifying subjects at risk for EDs. The EDI-2 and EDI-3 were administered to 92 female patients with ED and 265 females from a population at risk for EDs. Experienced psychiatrists in this field held blind interviews with participants by means of the SCID-I to determine the diagnosis. According to the cut-offs suggested by the authors, the EDI-3 correctly identified nearly all of the ED patients (99%), while the EDI-2 divulged less than half (48%). Both versions of the test showed comparable capability to identify participants at risk for EDs but the EDI-3 seemed slightly more reliable than the EDI-2. The EDI-2 remains a valid and very specific test. However, the new EDI-3 seems to be experimentally superior, because it typifies nearly all patients across the ED span, including those with Binge Eating Disorder and Eating Disorder Not Otherwise Specified. In addition, it appears to be more reliable. Copyright © 2015 Elsevier Ltd. All rights reserved.

Using patient lists to add value to integrated data repositories.

Science.gov (United States)

Wade, Ted D; Zelarney, Pearlanne T; Hum, Richard C; McGee, Sylvia; Batson, Deborah H

2014-12-01

Patient lists are project-specific sets of patients that can be queried in integrated data repositories (IDR's). By allowing a set of patients to be an addition to the qualifying conditions of a query, returned results will refer to, and only to, that set of patients. We report a variety of use cases for such lists, including: restricting retrospective chart review to a defined set of patients; following a set of patients for practice management purposes; distributing "honest-brokered" (deidentified) data; adding phenotypes to biosamples; and enhancing the content of study or registry data. Among the capabilities needed to implement patient lists in an IDR are: capture of patient identifiers from a query and feedback of these into the IDR; the existence of a permanent internal identifier in the IDR that is mappable to external identifiers; the ability to add queryable attributes to the IDR; the ability to merge data from multiple queries; and suitable control over user access and de-identification of results. We implemented patient lists in a custom IDR of our own design. We reviewed capabilities of other published IDRs for focusing on sets of patients. The widely used i2b2 IDR platform has various ways to address patient sets, and it could be modified to add the low-overhead version of patient lists that we describe. Copyright © 2014 Elsevier Inc. All rights reserved.

SDOCT imaging to identify macular pathology in patients diagnosed with diabetic maculopathy by a digital photographic retinal screening programme.

Directory of Open Access Journals (Sweden)

Sarah Mackenzie

Full Text Available INTRODUCTION: Diabetic macular edema (DME is an important cause of vision loss. England has a national systematic photographic retinal screening programme to identify patients with diabetic eye disease. Grading retinal photographs according to this national protocol identifies surrogate markers for DME. We audited a care pathway using a spectral-domain optical coherence tomography (SDOCT clinic to identify macular pathology in this subset of patients. METHODS: A prospective audit was performed of patients referred from screening with mild to moderate non-proliferative diabetic retinopathy (R1 and surrogate markers for diabetic macular edema (M1 attending an SDOCT clinic. The SDOCT images were graded by an ophthalmologist as SDOCT positive, borderline or negative. SDOCT positive patients were referred to the medical retina clinic. SDOCT negative and borderline patients were further reviewed in the SDOCT clinic in 6 months. RESULTS: From a registered screening population of 17 551 patients with diabetes mellitus, 311 patients met the inclusion criteria between (March 2008 and September 2009. We analyzed images from 311 patients' SDOCT clinic episodes. There were 131 SDOCT negative and 12 borderline patients booked for revisit in the OCT clinic. Twenty-four were referred back to photographic screening for a variety of reasons. A total of 144 were referred to ophthalmology with OCT evidence of definite macular pathology requiring review by an ophthalmologist. DISCUSSION: This analysis shows that patients with diabetes, mild to moderate non-proliferative diabetic retinopathy (R1 and evidence of diabetic maculopathy on non-stereoscopic retinal photographs (M1 have a 42.1% chance of having no macular edema on SDOCT imaging as defined by standard OCT definitions of DME when graded by a retinal specialist. SDOCT imaging is a useful adjunct to colour fundus photography in screening for referable diabetic maculopathy in our screening population.

Projection of climatic suitability for Aedes albopictus Skuse (Culicidae) in Europe under climate change conditions

Science.gov (United States)

Fischer, Dominik; Thomas, Stephanie Margarete; Niemitz, Franziska; Reineking, Björn; Beierkuhnlein, Carl

2011-07-01

During the last decades the disease vector Aedes albopictus ( Ae. albopictus) has rapidly spread around the globe. The spread of this species raises serious public health concerns. Here, we model the present distribution and the future climatic suitability of Europe for this vector in the face of climate change. In order to achieve the most realistic current prediction and future projection, we compare the performance of four different modelling approaches, differentiated by the selection of climate variables (based on expert knowledge vs. statistical criteria) and by the geographical range of presence records (native range vs. global range). First, models of the native and global range were built with MaxEnt and were either based on (1) statistically selected climatic input variables or (2) input variables selected with expert knowledge from the literature. Native models show high model performance (AUC: 0.91-0.94) for the native range, but do not predict the European distribution well (AUC: 0.70-0.72). Models based on the global distribution of the species, however, were able to identify all regions where Ae. albopictus is currently established, including Europe (AUC: 0.89-0.91). In a second step, the modelled bioclimatic envelope of the global range was projected to future climatic conditions in Europe using two emission scenarios implemented in the regional climate model COSMO-CLM for three time periods 2011-2040, 2041-2070, and 2071-2100. For both global-driven models, the results indicate that climatically suitable areas for the establishment of Ae. albopictus will increase in western and central Europe already in 2011-2040 and with a temporal delay in eastern Europe. On the other hand, a decline in climatically suitable areas in southern Europe is pronounced in the Expert knowledge based model. Our projections appear unaffected by non-analogue climate, as this is not detected by Multivariate Environmental Similarity Surface analysis. The generated risk maps

GIS-based rapid-assessment of bighead carp Hypophthalmichthys nobilis (Richardson, 1845) suitability in reservoirs

Science.gov (United States)

Long, James M.; Liang, Yu; Shoup, Daniel E.; Dzialowski, Andrew R.; Bidwell, Joseph R.

2014-01-01

Broad-scale niche models are good for examining the potential for invasive species occurrences, but can fall short in providing managers with site-specific locations for monitoring. Using Oklahoma as an example, where invasive bighead carp (Hypophthalmichthys nobilis) are established in certain reservoirs, but predicted to be widely distributed based on broad-scale niche models, we cast bighead carp reproductive ecology in a site-specific geospatial framework to determine their potential establishment in additional reservoirs. Because bighead carp require large, long free-flowing rivers with suitable hydrology for reproduction but can persist in reservoirs, we considered reservoir tributaries with mean annual daily discharge ≥8.5 cubic meters per second (m3 /s) and quantified the length of their unimpeded portions. In contrast to published broad-scale niche models that identified nearly the entire state as susceptible to invasion, our site-specific models showed that few reservoirs in Oklahoma (N = 9) were suitable for bighead carp establishment. Moreover, this method was rapid and identified sites that could be prioritized for increased study or scrutiny. Our results highlight the importance of considering the environmental characteristics of individual sites, which is often the level at which management efforts are implemented when assessing susceptibility to invasion.

Eight Mutations of Three Genes (EDA, EDAR, and WNT10A) Identified in Seven Hypohidrotic Ectodermal Dysplasia Patients.

Science.gov (United States)

Zeng, Binghui; Xiao, Xue; Li, Sijie; Lu, Hui; Lu, Jiaxuan; Zhu, Ling; Yu, Dongsheng; Zhao, Wei

2016-09-19

Hypohidrotic ectodermal dysplasia (HED) is characterized by abnormal development of the teeth, hair, and sweat glands. Ectodysplasin A (EDA), Ectodysplasin A receptor (EDAR), and EDAR-associated death domain (EDARADD) are candidate genes for HED, but the relationship between WNT10A and HED has not yet been validated. In this study, we included patients who presented at least two of the three ectodermal dysplasia features. The four genes were analyzed in seven HED patients by PCR and Sanger sequencing. Five EDA and one EDAR heterozygous mutations were identified in families 1-6. Two WNT10A heterozygous mutations were identified in family 7 as a compound heterozygote. c.662G>A (p.Gly221Asp) in EDA and c.354T>G (p.Tyr118*) in WNT10A are novel mutations. Bioinformatics analyses results confirmed the pathogenicity of the two novel mutations. In family 7, we also identified two single-nucleotide polymorphisms (SNPs) that were predicted to affect the splicing of EDAR. Analysis of the patient's total RNA revealed normal splicing of EDAR. This ascertained that the compound heterozygous WNT10A mutations are the genetic defects that led to the onset of HED. Our data revealed the genetic basis of seven HED patients and expended the mutational spectrum. Interestingly, we confirmed WNT10A as a candidate gene of HED and we propose WNT10A to be tested in EDA-negative HED patients.

Solid waste dumping site suitability analysis using geographic ...

African Journals Online (AJOL)

Solid waste dumping is a serious problem in the urban areas because most solid wastes are not dumped in the suitable areas. Bahir Dar Town has the problem of solid waste dumping site identification. The main objective of this study was to select potential areas for suitable solid waste dumping sites for Bahir Dar Town, ...

A deep-learning classifier identifies patients with clinical heart failure using whole-slide images of H&E tissue.

Directory of Open Access Journals (Sweden)

Jeffrey J Nirschl

Full Text Available Over 26 million people worldwide suffer from heart failure annually. When the cause of heart failure cannot be identified, endomyocardial biopsy (EMB represents the gold-standard for the evaluation of disease. However, manual EMB interpretation has high inter-rater variability. Deep convolutional neural networks (CNNs have been successfully applied to detect cancer, diabetic retinopathy, and dermatologic lesions from images. In this study, we develop a CNN classifier to detect clinical heart failure from H&E stained whole-slide images from a total of 209 patients, 104 patients were used for training and the remaining 105 patients for independent testing. The CNN was able to identify patients with heart failure or severe pathology with a 99% sensitivity and 94% specificity on the test set, outperforming conventional feature-engineering approaches. Importantly, the CNN outperformed two expert pathologists by nearly 20%. Our results suggest that deep learning analytics of EMB can be used to predict cardiac outcome.

Positive Predictive Values of International Classification of Diseases, 10th Revision Coding Algorithms to Identify Patients With Autosomal Dominant Polycystic Kidney Disease

Directory of Open Access Journals (Sweden)

Vinusha Kalatharan

2016-12-01

Full Text Available Background: International Classification of Diseases, 10th Revision codes (ICD-10 for autosomal dominant polycystic kidney disease (ADPKD is used within several administrative health care databases. It is unknown whether these codes identify patients who meet strict clinical criteria for ADPKD. Objective: The objective of this study is (1 to determine whether different ICD-10 coding algorithms identify adult patients who meet strict clinical criteria for ADPKD as assessed through medical chart review and (2 to assess the number of patients identified with different ADPKD coding algorithms in Ontario. Design: Validation study of health care database codes, and prevalence. Setting: Ontario, Canada. Patients: For the chart review, 201 adult patients with hospital encounters between April 1, 2002, and March 31, 2014, assigned either ICD-10 codes Q61.2 or Q61.3. Measurements: This study measured positive predictive value of the ICD-10 coding algorithms and the number of Ontarians identified with different coding algorithms. Methods: We manually reviewed a random sample of medical charts in London, Ontario, Canada, and determined whether or not ADPKD was present according to strict clinical criteria. Results: The presence of either ICD-10 code Q61.2 or Q61.3 in a hospital encounter had a positive predictive value of 85% (95% confidence interval [CI], 79%-89% and identified 2981 Ontarians (0.02% of the Ontario adult population. The presence of ICD-10 code Q61.2 in a hospital encounter had a positive predictive value of 97% (95% CI, 86%-100% and identified 394 adults in Ontario (0.003% of the Ontario adult population. Limitations: (1 We could not calculate other measures of validity; (2 the coding algorithms do not identify patients without hospital encounters; and (3 coding practices may differ between hospitals. Conclusions: Most patients with ICD-10 code Q61.2 or Q61.3 assigned during their hospital encounters have ADPKD according to the clinical

Suitability Assessment of Printed Dietary Guidelines for Pregnant Women and Parents of Infants and Toddlers From 7 European Countries.

Science.gov (United States)

Garnweidner-Holme, Lisa Maria; Dolvik, Stina; Frisvold, Cathrine; Mosdøl, Annhild

2016-02-01

To evaluate selected European printed dietary guidelines for pregnant women and parents of infants and toddlers using the suitability assessment of materials (SAM) method. A descriptive study to determine the suitability of 14 printed dietary guidelines from 7 European countries based on deductive quantitative analyses. Materials varied greatly in format and content: 35.7% of materials were rated superior and 64.3% were rated adequate according to the overall SAM score for patient education material. None of the materials were scored not suitable. Among the categories, the highest average scores were for layout and typography and the lowest average scores were for cultural appropriateness and learning stimulation and motivation. Interrater reliability ranged from Cohen's kappa of 0.37 to 0.62 (mean, 0.41), indicating fair to moderate agreement among the 3 investigators. Overall, the suitability of the assessed printed dietary guidelines was adequate. Based on the SAM methodology, printed dietary guidelines may increase in suitability by emphasizing aspects related to health literacy and accommodating the needs of different food cultures within a population. Copyright © 2016 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

The DESCARTES-Nantes survey of kidney transplant recipients displaying clinical operational tolerance identifies 35 new tolerant patients and 34 almost tolerant patients

NARCIS (Netherlands)

Massart, Annick; Pallier, Annaïck; Pascual, Julio; Viklicky, Ondrej; Budde, Klemens; Spasovski, Goce; Klinger, Marian; Sever, Mehmet Sukru; Sørensen, Søren Schwartz; Hadaya, Karine; Oberbauer, Rainer; Dudley, Christopher; de Fijter, Johan W.; Yussim, Alexander; Hazzan, Marc; Wekerle, Thomas; Berglund, David; de Biase, Consuelo; Pérez-Sáez, María José; Mühlfeld, Anja; Orlando, Giuseppe; Clemente, Katia; Lai, Quirino; Pisani, Francesco; Kandus, Aljosa; Baas, Marije; Bemelman, Frederike; Ponikvar, Jadranka Buturovic; Mazouz, Hakim; Stratta, Piero; Subra, Jean-François; Villemain, Florence; Hoitsma, Andries; Braun, Laura; Cantarell, Maria Carmen; Colak, Hulya; Courtney, Aisling; Frasca, Giovanni Maria; Howse, Matthew; Naesens, Maarten; Reischig, Tomas; Serón, Daniel; Seyahi, Nurhan; Tugmen, Cem; Alonso Hernandez, Angel; Beňa, Luboslav; Biancone, Luigi; Cuna, Vania; Díaz-Corte, Carmen; Dufay, Alexandre; Gaasbeek, André; Garnier, Arnaud; Gatault, Philippe; Gentil Govantes, Miguel Angel; Glowacki, François; Gross, Oliver; Hurault de Ligny, Bruno; Huynh-Do, Uyen; Janbon, Bénédicte; Jiménez del Cerro, Luis Antonio; Keller, Frieder; La Manna, Gaetano; Lauzurica, Ricardo; Le Monies de Sagazan, Hervé; Thaiss, Friedrich; Legendre, Christophe; Martin, Séverine; Moal, Marie-Christine; Noël, Christian; Pillebout, Evangeline; Piredda, Gian Benedetto; Puga, Ana Ramírez; Sulowicz, Wladyslaw; Tuglular, Serhan; Prokopova, Michaela; Chesneau, Mélanie; Le Moine, Alain; Guérif, Pierrick; Soulillou, Jean-Paul; Abramowicz, Marc; Giral, Magali; Racapé, Judith; Maggiore, Umberto; Brouard, Sophie; Abramowicz, Daniel

2016-01-01

Kidney recipients maintaining a prolonged allograft survival in the absence of immunosuppressive drugs and without evidence of rejection are supposed to be exceptional. The ERA-EDTA-DESCARTES working group together with Nantes University launched a European-wide survey to identify new patients,

Preoperative psychological assessment of patients seeking weight-loss surgery: identifying challenges and solutions

Directory of Open Access Journals (Sweden)

Edwards-Hampton SA

2015-11-01

Full Text Available Shenelle A Edwards-Hampton,1 Sharlene Wedin2 1Department of General Surgery, Wake Forest Baptist Medical Center, Medical Center Boulevard, Winston-Salem, NC, 2Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA Abstract: Preoperative psychosocial assessment is the standard of care for patients seeking weight-loss surgery (WLS. However, the assessment procedure varies widely by surgery site. Comprehensive assessments can provide a wealth of information that assists both the patient and the treatment team, anticipate and prepare for challenges associated with extensive behavioral and lifestyle changes that are required postsurgery. In this review, we provide an overview of the purpose of the preoperative psychosocial assessment and domains to be included. Challenges commonly identified in the assessment are discussed, including maladaptive eating behaviors, psychiatric comorbidities, and alcohol use. Potential solutions and approaches to these challenges are provided. Additionally, patient populations requiring special consideration are presented to include adolescents, those with cognitive vulnerabilities, and aging adults. Keywords: bariatric surgery, preoperative assessment, weight-loss surgery, challenges, adolescents, older adults, cognitive impairment, maladaptive eating, alcohol misuse

From Suitable Weak Solutions to Entropy Viscosity

KAUST Repository

Guermond, Jean-Luc

2010-12-16

This paper focuses on the notion of suitable weak solutions for the three-dimensional incompressible Navier-Stokes equations and discusses the relevance of this notion to Computational Fluid Dynamics. The purpose of the paper is twofold (i) to recall basic mathematical properties of the three-dimensional incompressible Navier-Stokes equations and to show how they might relate to LES (ii) to introduce an entropy viscosity technique based on the notion of suitable weak solution and to illustrate numerically this concept. © 2010 Springer Science+Business Media, LLC.

A delphi exercise to identify characteristic features of gout - opinions from patients and physicians, the first stage in developing new classification criteria.

Science.gov (United States)

Prowse, Rebecca L; Dalbeth, Nicola; Kavanaugh, Arthur; Adebajo, Adewale O; Gaffo, Angelo L; Terkeltaub, Robert; Mandell, Brian F; Suryana, Bagus P P; Goldenstein-Schainberg, Claudia; Diaz-Torne, Cèsar; Khanna, Dinesh; Lioté, Frederic; Mccarthy, Geraldine; Kerr, Gail S; Yamanaka, Hisashi; Janssens, Hein; Baraf, Herbert F; Chen, Jiunn-Horng; Vazquez-Mellado, Janitzia; Harrold, Leslie R; Stamp, Lisa K; Van De Laar, Mart A; Janssen, Matthijs; Doherty, Michael; Boers, Maarten; Edwards, N Lawrence; Gow, Peter; Chapman, Peter; Khanna, Puja; Helliwell, Philip S; Grainger, Rebecca; Schumacher, H Ralph; Neogi, Tuhina; Jansen, Tim L; Louthrenoo, Worawit; Sivera, Francisca; Taylor, William J; Alten, Rieke

2013-04-01

To identify a comprehensive list of features that might discriminate between gout and other rheumatic musculoskeletal conditions, to be used subsequently for a case-control study to develop and test new classification criteria for gout. Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index. Forty-four experienced physicians and 9 patients responded to all iterations. For physicians, 71 items were identified by literature review and 15 more were suggested by physicians. The physician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. The patients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory. Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms.

A retrospective analysis to identify the factors affecting infection in patients undergoing chemotherapy.

Science.gov (United States)

Park, Ji Hyun; Kim, Hyeon-Young; Lee, Hanna; Yun, Eun Kyoung

2015-12-01

This study compares the performance of the logistic regression and decision tree analysis methods for assessing the risk factors for infection in cancer patients undergoing chemotherapy. The subjects were 732 cancer patients who were receiving chemotherapy at K university hospital in Seoul, Korea. The data were collected between March 2011 and February 2013 and were processed for descriptive analysis, logistic regression and decision tree analysis using the IBM SPSS Statistics 19 and Modeler 15.1 programs. The most common risk factors for infection in cancer patients receiving chemotherapy were identified as alkylating agents, vinca alkaloid and underlying diabetes mellitus. The logistic regression explained 66.7% of the variation in the data in terms of sensitivity and 88.9% in terms of specificity. The decision tree analysis accounted for 55.0% of the variation in the data in terms of sensitivity and 89.0% in terms of specificity. As for the overall classification accuracy, the logistic regression explained 88.0% and the decision tree analysis explained 87.2%. The logistic regression analysis showed a higher degree of sensitivity and classification accuracy. Therefore, logistic regression analysis is concluded to be the more effective and useful method for establishing an infection prediction model for patients undergoing chemotherapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

Incorporating the Last Four Digits of Social Security Numbers Substantially Improves Linking Patient Data from De-identified Hospital Claims Databases.

Science.gov (United States)

Naessens, James M; Visscher, Sue L; Peterson, Stephanie M; Swanson, Kristi M; Johnson, Matthew G; Rahman, Parvez A; Schindler, Joe; Sonneborn, Mark; Fry, Donald E; Pine, Michael

2015-08-01

Assess algorithms for linking patients across de-identified databases without compromising confidentiality. Hospital discharges from 11 Mayo Clinic hospitals during January 2008-September 2012 (assessment and validation data). Minnesota death certificates and hospital discharges from 2009 to 2012 for entire state (application data). Cross-sectional assessment of sensitivity and positive predictive value (PPV) for four linking algorithms tested by identifying readmissions and posthospital mortality on the assessment data with application to statewide data. De-identified claims included patient gender, birthdate, and zip code. Assessment records were matched with institutional sources containing unique identifiers and the last four digits of Social Security number (SSNL4). Gender, birthdate, and five-digit zip code identified readmissions with a sensitivity of 98.0 percent and a PPV of 97.7 percent and identified postdischarge mortality with 84.4 percent sensitivity and 98.9 percent PPV. Inclusion of SSNL4 produced nearly perfect identification of readmissions and deaths. When applied statewide, regions bordering states with unavailable hospital discharge data had lower rates. Addition of SSNL4 to administrative data, accompanied by appropriate data use and data release policies, can enable trusted repositories to link data with nearly perfect accuracy without compromising patient confidentiality. States maintaining centralized de-identified databases should add SSNL4 to data specifications. © Health Research and Educational Trust.

Feasibility of a self-administered survey to identify primary care patients at risk of medication-related problems

Directory of Open Access Journals (Sweden)

Makowsky MJ

2014-02-01

Full Text Available Mark J Makowsky,1 Andrew J Cave,2 Scot H Simpson1 1Faculty of Pharmacy and Pharmaceutical Sciences, 2Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada Background and objectives: Pharmacists working in primary care clinics are well positioned to help optimize medication management of community-dwelling patients who are at high risk of experiencing medication-related problems. However, it is often difficult to identify these patients. Our objective was to test the feasibility of a self-administered patient survey, to facilitate identification of patients at high risk of medication-related problems in a family medicine clinic. Methods: We conducted a cross-sectional, paper-based survey at the University of Alberta Hospital Family Medicine Clinic in Edmonton, Alberta, which serves approximately 7,000 patients, with 25,000 consultations per year. Adult patients attending the clinic were invited to complete a ten-item questionnaire, adapted from previously validated surveys, while waiting to be seen by the physician. Outcomes of interest included: time to complete the questionnaire, staff feedback regarding impact on workflow, and the proportion of patients who reported three or more risk factors for medication-related problems. Results: The questionnaire took less than 5 minutes to complete, according to the patient's report on the last page of the questionnaire. The median age (and interquartile range of respondents was 57 (45–69 years; 59% were women; 47% reported being in very good or excellent health; 43 respondents of 100 had three or more risk factors, and met the definition for being at high risk of a medication-related problem. Conclusions: Distribution of a self-administered questionnaire did not disrupt patients, or the clinic workflow, and identified an important proportion of patients at high risk of medication-related problems. Keywords: screening tool, pharmacists, primary

Neural Network for Determining Risk Rate of Post-Heart Stroke Patients

Directory of Open Access Journals (Sweden)

Oldřich Trenz

2014-01-01

Full Text Available The ischemic heart disease presents an important health problem that affects a great part of the population and is the cause of one third of all deaths in the Czech Republic. The availability of data describing the patients’ prognosis enables their further analysis, with the aim of lowering the patients’ risk, by proposing optimum treatment. The main reason for creating the neural network model is not only to automate the process of establishing the risk rate of patients suffering from ischemic heart disease, but also to adapt it for practical use in clinical conditions. Our aim is to identify especially the specific group of risk-rate patients whose well-timed preventive care can improve the quality and prolong the length of their lives.The aim of the paper is to propose a patient-parameter structure, using which we could create a suitable model based on a self-taught neural network. The emphasis is placed on identifying key descriptive parameters (in the form of a reduction of the available descriptive parameters that are crucial for identifying the required patients, and simultaneously to achieve a portability of the model among individual clinical workplaces (availability of parameters.

Array-based molecular karyotyping in 115 VATER/VACTERL and VATER/VACTERL-like patients identifies disease-causing copy number variations.

Science.gov (United States)

Zhang, Rong; Marsch, Florian; Kause, Franziska; Degenhardt, Franziska; Schmiedeke, Eeberhard; Märzheuser, Stefanie; Hoppe, Bernd; Bachour, Haitham; Boemers, Thomas M; Schäfer, Matthias; Spychalski, Nicole; Neser, Jörg; Leonhardt, Johannes; Kosch, Ferdinand; Ure, Benno; Gómez, Barbara; Lacher, Martin; Deffaa, Oliver J; Palta, Markus; Wittekindt, Boris; Kleine, Katharina; Schmedding, Andrea; Grasshoff-Derr, Sabine; Ven, Amelie van der; Heilmann-Heimbach, Stefanie; Zwink, Nadine; Jenetzky, Ekkehart; Ludwig, Michael; Reutter, Heiko

2017-07-17

The acronym VATER/VACTERL refers to the rare nonrandom association of the following component features (CF): vertebral defects (V), anorectal malformations (A), cardiac defects (C), tracheoesophageal fistula with or without esophageal atresia, renal malformations (R), and limb defects (L). Patients presenting with at least three CFs are diagnosed as having VATER/VACTERL association while patients presenting with only two CFs are diagnosed as having VATER/VACTERL-like phenotypes. Recently, rare causative copy number variations (CNVs) have been identified in patients with VATER/VACTERL association and VATER/VACTERL-like phenotypes. To detect further causative CNVs we performed array based molecular karyotyping in 75 VATER/VACTERL and 40 VATER/VACTERL-like patients. Following the application of stringent filter criteria, we identified 13 microdeletions and seven microduplications in 20 unrelated patients all of which were absent in 1,307 healthy inhouse controls (n microdeletion at 17q12 was confirmed to be de novo. Three microdeletions at 5q23.1, 16q23.3, 22q11.21, and one microduplication at 10q11.21 were all absent in the available parent. Microdeletion of chromosomal region 22q11.21 was previously found in VATER/VACTERL patients rendering it to be causative in our patient. The remaining 15 CNVs were inherited from a healthy parent. In two of 115 patients' causative CNVs were found (2%). The remaining identified rare CNVs represent candidates for further evaluation. Rare inherited CNVs may constitute modifiers of, or contributors to, multifactorial VATER/VACTERL or VATER/VACTERL-like phenotypes. Birth Defects Research 109:1063-1069, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Two subgroups of antipsychotic-naive, first-episode schizophrenia patients identified with a Gaussian mixture model on cognition and electrophysiology

DEFF Research Database (Denmark)

Bak, N.; Ebdrup, B.H.; Oranje, B

2017-01-01

Deficits in information processing and cognition are among the most robust findings in schizophrenia patients. Previous efforts to translate group-level deficits into clinically relevant and individualized information have, however, been non-successful, which is possibly explained by biologically...... different disease subgroups. We applied machine learning algorithms on measures of electrophysiology and cognition to identify potential subgroups of schizophrenia. Next, we explored subgroup differences regarding treatment response. Sixty-six antipsychotic-naive first-episode schizophrenia patients...... be used to classify subgroups of schizophrenia patients. The two distinct subgroups, which we identified, were psychopathologically inseparable before treatment, yet their response to dopaminergic blockade was predicted with significant accuracy. This proof of principle encourages further endeavors...

Regional prediction of basin-scale brown trout habitat suitability

Directory of Open Access Journals (Sweden)

S. Ceola

2014-09-01

Full Text Available In this study we propose a novel method for the estimation of ecological indices describing the habitat suitability of brown trout (Salmo trutta. Traditional hydrological tools are coupled with an innovative regional geostatistical technique, aiming at the prediction of the brown trout habitat suitability index where partial or totally ungauged conditions occur. Several methods for the assessment of ecological indices are already proposed in the scientific literature, but the possibility of exploiting a geostatistical prediction model, such as Topological Kriging, has never been investigated before. In order to develop a regional habitat suitability model we use the habitat suitability curve, obtained from measured data of brown trout adult individuals collected in several river basins across the USA. The Top-kriging prediction model is then employed to assess the spatial correlation between upstream and downstream habitat suitability indices. The study area is the Metauro River basin, located in the central part of Italy (Marche region, for which both water depth and streamflow data were collected. The present analysis focuses on discharge values corresponding to the 0.1-, 0.5-, 0.9-empirical quantiles derived from flow-duration curves available for seven gauging stations located within the study area, for which three different suitability indices (i.e. ψ10, ψ50 and ψ90 are evaluated. The results of this preliminary analysis are encouraging showing Nash-Sutcliffe efficiencies equal to 0.52, 0.65, and 0.69, respectively.

Regional prediction of basin-scale brown trout habitat suitability

Science.gov (United States)

Ceola, S.; Pugliese, A.

2014-09-01

In this study we propose a novel method for the estimation of ecological indices describing the habitat suitability of brown trout (Salmo trutta). Traditional hydrological tools are coupled with an innovative regional geostatistical technique, aiming at the prediction of the brown trout habitat suitability index where partial or totally ungauged conditions occur. Several methods for the assessment of ecological indices are already proposed in the scientific literature, but the possibility of exploiting a geostatistical prediction model, such as Topological Kriging, has never been investigated before. In order to develop a regional habitat suitability model we use the habitat suitability curve, obtained from measured data of brown trout adult individuals collected in several river basins across the USA. The Top-kriging prediction model is then employed to assess the spatial correlation between upstream and downstream habitat suitability indices. The study area is the Metauro River basin, located in the central part of Italy (Marche region), for which both water depth and streamflow data were collected. The present analysis focuses on discharge values corresponding to the 0.1-, 0.5-, 0.9-empirical quantiles derived from flow-duration curves available for seven gauging stations located within the study area, for which three different suitability indices (i.e. ψ10, ψ50 and ψ90) are evaluated. The results of this preliminary analysis are encouraging showing Nash-Sutcliffe efficiencies equal to 0.52, 0.65, and 0.69, respectively.

Multi-criteria Decision Analysis to Model Ixodes ricinus Habitat Suitability.

Science.gov (United States)

Rousseau, Raphaël; McGrath, Guy; McMahon, Barry J; Vanwambeke, Sophie O

2017-09-01

Tick-borne diseases present a major threat to both human and livestock health throughout Europe. The risk of infection is directly related to the presence of its vector. Thereby it is important to know their distribution, which is strongly associated with environmental factors: the presence and availability of a suitable habitat, of a suitable climate and of hosts. The present study models the habitat suitability for Ixodes ricinus in Ireland, where data on tick distribution are scarce. Tick habitat suitability was estimated at a coarse scale (10 km) with a multi-criteria decision analysis (MCDA) method according to four different scenarios (depending on the variables used and on the weights granted to each of them). The western part of Ireland and the Wicklow mountains in the East were estimated to be the most suitable areas for I. ricinus in the island. There was a good level of agreement between results from the MCDA and recorded tick presence. The different scenarios did not affect the spatial outputs substantially. The current study suggests that tick habitat suitability can be mapped accurately at a coarse scale in a data-scarce context using knowledge-based methods. It can serve as a guideline for future countrywide sampling that would help to determine local risk of tick presence and refining knowledge on tick habitat suitability in Ireland.

Application of GIS to predict malaria hotspots based on Anopheles arabiensis habitat suitability in Southern Africa

Science.gov (United States)

Gwitira, Isaiah; Murwira, Amon; Zengeya, Fadzai M.; Shekede, Munyaradzi Davis

2018-02-01

Malaria remains a major public health problem and a principal cause of morbidity and mortality in most developing countries. Although malaria still presents health problems, significant successes have been recorded in reducing deaths resulting from the disease. As malaria transmission continues to decline, control interventions will increasingly depend on the ability to define high-risk areas known as malaria hotspots. Therefore, there is urgent need to use geospatial tools such as geographic information system to detect spatial patterns of malaria and delineate disease hot spots for better planning and management. Thus, accurate mapping and prediction of seasonality of malaria hotspots is an important step towards developing strategies for effective malaria control. In this study, we modelled seasonal malaria hotspots as a function of habitat suitability of Anopheles arabiensis (A. Arabiensis) as a first step towards predicting likely seasonal malaria hotspots that could provide guidance in targeted malaria control. We used Geographical information system (GIS) and spatial statistic methods to identify seasonal hotspots of malaria cases at the country level. In order to achieve this, we first determined the spatial distribution of seasonal malaria hotspots using the Getis Ord Gi* statistic based on confirmed positive malaria cases recorded at health facilities in Zimbabwe over four years (1996-1999). We then used MAXENT technique to model habitat suitability of A. arabiensis from presence data collected from 1990 to 2002 based on bioclimatic variables and altitude. Finally, we used autologistic regression to test the extent to which malaria hotspots can be predicted using A. arabiensis habitat suitability. Our results show that A. arabiensis habitat suitability consistently and significantly (p < 0.05) predicts malaria hotspots from 1996 to 1999. Overall, our results show that malaria hotspots can be predicted using A. arabiensis habitat suitability, suggesting

An open-access endoscopy screen correctly and safely identifies patients for conscious sedation.

Science.gov (United States)

Kothari, Darshan; Feuerstein, Joseph D; Moss, Laureen; D'Souza, Julie; Montanaro, Kerri; Leffler, Daniel A; Sheth, Sunil G

2016-11-01

Open-access scheduling is highly utilized for facilitating generally low-risk endoscopies. Preprocedural screening addresses sedation requirements; however, procedural safety may be compromised if screening is inaccurate. We sought to determine the reliability of our open-access scheduling system for appropriate use of conscious sedation. We prospectively and consecutively enrolled outpatient procedures booked at an academic center by open-access using screening after in-office gastroenterology (GI) consultation. We collected the cases inappropriately booked for conscious sedation and compared the characteristics for significant differences. A total of 8063 outpatients were scheduled for procedures with conscious sedation, and 5959 were booked with open-access. Only 78 patients (0.97%, 78/8063) were identified as subsequently needing anesthesiologist-assisted sedation; 44 (56.4%, 44/78) were booked through open-access, of which chronic opioid (47.7%, 21/44) or benzodiazepine use (34.1%, 15/44) were the most common reasons for needing anesthesiologist-assisted sedation. Patients on chronic benzodiazepines required more midazolam than those not on chronic benzodiazepines (P = .03) of those patients who underwent conscious sedation. Similarly, patients with chronic opioid use required more fentanyl than those without chronic opioid use (P = .04). Advanced liver disease and alcohol use were common reasons for patients being booked after in-office consultation and were significantly higher than those booked with open-access (both P open-access scheduling. © The Author(s) 2016. Published by Oxford University Press and Sixth Affiliated Hospital of Sun Yat-Sen University.

Using the Care Dependency Scale for identifying patients at risk for pressure ulcer.

Science.gov (United States)

Dijkstra, Ate; Kazimier, Hetty; Halfens, Ruud J G

2015-11-01

The aim of this study was to evaluate risk screening for pressure ulcer by using the Care Dependency Scale (CDS) for patients receiving home care or admitted to a residential or nursing home in the Netherlands. Pressure ulcer is a serious and persistent problem for patients throughout the Western world. Pressure ulcer is among the most common adverse events in nursing practice and when a pressure ulcer occurs it has many consequences for patients and healthcare professionals. Cross-sectional design. The convenience sample consisted of 13,633 study participants, of whom 2639 received home care from 15 organisations, 4077 were patients from 67 residential homes and 6917 were admitted in 105 nursing homes. Data were taken from the Dutch National Prevalence Survey of Care Problems that was carried out in April 2012 in Dutch healthcare settings. For the three settings, cut-off points above 80% sensitivity were established, while in the residential home sample an almost 60% combined specificity score was identified. The CDS items 'Body posture' (home care), 'Getting dressed and undressed' (residential homes) and 'Mobility' (nursing homes) were the most significant variables which affect PU. The CDS is able to distinguish between patients at risk for pressure ulcer development and those not at risk in both home care and residential care settings. In nursing homes, the usefulness of the CDS for pressure ulcer detection is limited. © 2015 John Wiley & Sons Ltd.

A rare case of ischaemic pneumatosis intestinalis and hepatic portal venous gas in an elderly patient with good outcome following conservative management

Directory of Open Access Journals (Sweden)

E.J. Nevins

2016-01-01

Conclusion: There are few reported cases of patient survival following conservative management of PI and HPVG secondary to ischaemic pathology. This case demonstrates the possibility of managing this condition without aggressive surgical intervention especially when surgery would likely result in mortality due to frailty and morbidity. Further work is required to identify suitable patients.

A web-based, patient driven registry for Angelman syndrome: the global Angelman syndrome registry.

Science.gov (United States)

Napier, Kathryn R; Tones, Megan; Simons, Chloe; Heussler, Helen; Hunter, Adam A; Cross, Meagan; Bellgard, Matthew I

2017-08-01

Angelman syndrome (AS) is a rare neurodevelopmental disorder that is characterised by severe global developmental delays, ataxia, loss of speech, epilepsy, sleep disorders, and a happy disposition. There is currently no cure for AS, though several pharmaceutical companies are anticipating drug trials for new therapies to treat AS. The Foundation for Angelman Therapeutics (FAST) Australia therefore identified a need for a global AS patient registry to identify patients for recruitment for clinical trials.The Global AS Registry was deployed in September 2016 utilising the Rare Disease Registry Framework, an open-source tool that enables the efficient creation and management of patient registries. The Global AS Registry is web-based and allows parents and guardians worldwide to register, provide informed consent, and enter data on individuals with AS. 286 patients have registered in the first 8 months since deployment.We demonstrate the successful deployment of the first patient-driven global registry for AS. The data generated from the Global AS Registry will be crucial in identifying patients suitable for clinical trials and in informing research that will identify treatments for AS, and ultimately improve the lives of individuals and their families living with AS.

Identifying criteria and establishing parameters for forest-based ecotourism in Northern Ontario, Canada

Science.gov (United States)

Stephen W. Boyd; Richard W. Butler; Wolfgang Haider

1995-01-01

This paper identifies the following criteria as indicators for ecotourism suitability within a Northern Ontario context: naturalness, wildlife, cultural heritage, landscape and community. A methodology is proposed which uses Geographical Information Systems (GIS) to identify ecotourism sites by linking criteria deemed important with actual landscape characteristics of...

Number of Gastrointestinal Symptoms is a Useful Means of Identifying Patients with Cancer for Dysphagia.

Science.gov (United States)

Tsukamoto, Machi; Manabe, Noriaki; Kamada, Tomoari; Hirai, Toshihiro; Hata, Jiro; Haruma, Ken; Inoue, Kazuhiko

2016-08-01

Dysphagia is a symptom suggestive of severe underlying pathology, although its causes include organic and non-organic disorders. The epidemiology of dysphagia is, however, poorly understood. We evaluated the prevalence of dysphagia in outpatients in Japan, measured the proportion ultimately found to have an organic cause, and recorded the nature of their symptoms and the underlying disorder. Of 5362 consecutive outpatients attending the Digestive Center at our hospital between June 1, 2010 and December 31, 2012, 186 patients (3.5 %) had dysphagia with a frequency score of ≥5 out of 6. The most common diagnosis was cancer (34 patients, 18.3 %), followed by gastroesophageal reflux disease (24 patients, 12.9 %). An esophageal motility disorder was diagnosed in 21 patients (11.3 %); the causes in the remaining 107 patients (57.5 %) were miscellaneous. Multivariable analysis identified the following predictors of cancer: age ≥ 54 years, weight loss, being a drinker of alcohol, and ≤2 gastrointestinal symptoms. Our findings can be used to inform the prioritization of referrals from primary care for investigation and treatment for patients with cancer for dysphagia.

Cooperative testing of a positive personnel identifier

International Nuclear Information System (INIS)

O'Callaghan, P.B.; Grambihler, A.J.; Graham, D.K.; Bradley, R.G.

1980-06-01

HEDL has a requirement to ensure the identification of remote computer terminal operators on a real-time nuclear inventory data base. The integrity of this data base depends on input from authorized individuals. Thus, a key to developing such a system is the ability to positively identify people attempting access to the system. Small scale tests of the Identimat 2000T hand geometry unit with an adjusting alogrithm have suggested a promising solution. To prove operational suitability, HEDL, in cooperation with Sandia Laboratories, has designed a large scale test of the Identimat 2000T. Data gathering on error rates, reliability, maintainability, and user acceptance will determine if the Identimat 2000T is suitable for the HEDL application. If proven acceptable, use of the Identimat 2000T can be broadened to many general applications where security information, locations and systems are required

EXPERT MODEL OF LAND SUITABILITY ASSESSMENT FOR CROPS

Directory of Open Access Journals (Sweden)

Boris Đurđević

2010-12-01

Full Text Available A total of 17404 soil samples (2003rd-2009th year were analysed in the eastern Croatia. The largest number of soil samples belongs to the Osijek-Baranya county, which together with both Eastern sugar beet Factories (Osijek and Županja, conduct the soil fertility control (~4200 samples/yr.. Computer model suitability assessment for crops, supported by GIS, proved to be fast, efficient enough reliable in terms of the number of analyzed soil samples. It allows the visualization of the agricultural area and prediction of its production properties for the purposes of analysis, planning and rationalization of agricultural production. With more precise data about the soil (soil, climate and reliable Digital Soil Map of Croatia, the model could be an acceptable, not only to evaluate the suitability for growing different crops but also their need for fertilizer, necessary machinery, repairs (liming, and other measures of organic matter input. The abovementioned aims to eliminate or reduce effects of limiting factors in primary agricultural production. Assessment of the relative benefits of soil presented by computer model for the crops production and geostatistical method kriging in the Osijek-Baranya county showed: 1 Average soil suitability being 60.06 percent. 2 Kriging predicted that 51751 ha (17.16% are of limited resources (N1 for growing crops whereas a 86142 ha (28.57% of land is limited suitably (S3, b 132789 ha (44.04% are moderately suitable (S2 and c 30772 ha (10.28% are of excellent fertility (S1. A large number of eastern Croatian land data showed that the computer-geostatistical model for determination of soil benefits for growing crops was automated, fast and simple to use and suitable for the implementation of GIS and automatically downloading the necessary benefit indicators from the input base (land, analytical and climate as well as data from the digital soil maps able to: a visualize the suitability for soil tillage, b predict the

Validation of suitable reference genes for expression normalization in Echinococcus spp. larval stages.

Science.gov (United States)

Espínola, Sergio Martin; Ferreira, Henrique Bunselmeyer; Zaha, Arnaldo

2014-01-01

In recent years, a significant amount of sequence data (both genomic and transcriptomic) for Echinococcus spp. has been published, thereby facilitating the analysis of genes expressed during a specific stage or involved in parasite development. To perform a suitable gene expression quantification analysis, the use of validated reference genes is strongly recommended. Thus, the aim of this work was to identify suitable reference genes to allow reliable expression normalization for genes of interest in Echinococcus granulosus sensu stricto (s.s.) (G1) and Echinococcus ortleppi upon induction of the early pre-adult development. Untreated protoscoleces (PS) and pepsin-treated protoscoleces (PSP) from E. granulosus s.s. (G1) and E. ortleppi metacestode were used. The gene expression stability of eleven candidate reference genes (βTUB, NDUFV2, RPL13, TBP, CYP-1, RPII, EF-1α, βACT-1, GAPDH, ETIF4A-III and MAPK3) was assessed using geNorm, Normfinder, and RefFinder. Our qPCR data showed a good correlation with the recently published RNA-seq data. Regarding expression stability, EF-1α and TBP were the most stable genes for both species. Interestingly, βACT-1 (the most commonly used reference gene), and GAPDH and ETIF4A-III (previously identified as housekeeping genes) did not behave stably in our assay conditions. We propose the use of EF-1α as a reference gene for studies involving gene expression analysis in both PS and PSP experimental conditions for E. granulosus s.s. and E. ortleppi. To demonstrate its applicability, EF-1α was used as a normalizer gene in the relative quantification of transcripts from genes coding for antigen B subunits. The same EF-1α reference gene may be used in studies with other Echinococcus sensu lato species. This report validates suitable reference genes for species of class Cestoda, phylum Platyhelminthes, thus providing a foundation for further validation in other epidemiologically important cestode species, such as those from the

Validation of Suitable Reference Genes for Expression Normalization in Echinococcus spp. Larval Stages

Science.gov (United States)

Espínola, Sergio Martin; Ferreira, Henrique Bunselmeyer; Zaha, Arnaldo

2014-01-01

In recent years, a significant amount of sequence data (both genomic and transcriptomic) for Echinococcus spp. has been published, thereby facilitating the analysis of genes expressed during a specific stage or involved in parasite development. To perform a suitable gene expression quantification analysis, the use of validated reference genes is strongly recommended. Thus, the aim of this work was to identify suitable reference genes to allow reliable expression normalization for genes of interest in Echinococcus granulosus sensu stricto (s.s.) (G1) and Echinococcus ortleppi upon induction of the early pre-adult development. Untreated protoscoleces (PS) and pepsin-treated protoscoleces (PSP) from E. granulosus s.s. (G1) and E. ortleppi metacestode were used. The gene expression stability of eleven candidate reference genes (βTUB, NDUFV2, RPL13, TBP, CYP-1, RPII, EF-1α, βACT-1, GAPDH, ETIF4A-III and MAPK3) was assessed using geNorm, Normfinder, and RefFinder. Our qPCR data showed a good correlation with the recently published RNA-seq data. Regarding expression stability, EF-1α and TBP were the most stable genes for both species. Interestingly, βACT-1 (the most commonly used reference gene), and GAPDH and ETIF4A-III (previously identified as housekeeping genes) did not behave stably in our assay conditions. We propose the use of EF-1α as a reference gene for studies involving gene expression analysis in both PS and PSP experimental conditions for E. granulosus s.s. and E. ortleppi. To demonstrate its applicability, EF-1α was used as a normalizer gene in the relative quantification of transcripts from genes coding for antigen B subunits. The same EF-1α reference gene may be used in studies with other Echinococcus sensu lato species. This report validates suitable reference genes for species of class Cestoda, phylum Platyhelminthes, thus providing a foundation for further validation in other epidemiologically important cestode species, such as those from the

Can tissue spectrophotometry and laser Doppler flowmetry help to identify patients at risk for wound healing disorders after neck dissection?

Science.gov (United States)

Rohleder, Nils H; Flensberg, Sandra; Bauer, Florian; Wagenpfeil, Stefan; Wales, Craig J; Koerdt, Steffen; Wolff, Klaus D; Hölzle, Frank; Steiner, Timm; Kesting, Marco R

2014-03-01

Microcirculation and oxygen supply in cervical skin were measured with an optical, noninvasive method in patients with or without radiotherapy before neck dissection. The course of wound healing was monitored after the surgical procedure to identify predictive factors for postoperative wound healing disorders. Tissue spectrophotometry and laser Doppler flowmetry were used to determine capillary oxygen saturation, hemoglobin concentration, blood flow, and blood velocity at 2-mm and 8-mm depths in the cervical skin of 91 patients before neck dissection in a maxillofacial unit of a university hospital in Munich, Germany. Parameters were evaluated for differences between patients with irradiation (24) and without (67) and patients with wound healing disorders (25) and without (66) (univariate or multivariate statistical analyses). Velocity at 2 mm was lower in irradiated skin (P = .016). Flow at 2 mm was higher in patients with wound healing disorders (P = .018). High flow values could help to identify patients at risk for cervical wound healing disorders. Copyright © 2014 Elsevier Inc. All rights reserved.

Generalizability of the Disease State Index Prediction Model for Identifying Patients Progressing from Mild Cognitive Impairment to Alzheimer's Disease

NARCIS (Netherlands)

Hall, A.; Munoz-Ruiz, M.; Mattila, J.; Koikkalainen, J.; Tsolaki, M.; Mecocci, P.; Kloszewska, I.; Vellas, B.; Lovestone, S.; Visser, P.J.; Lotjonen, J.; Soininen, H.

2015-01-01

Background: The Disease State Index (DSI) prediction model measures the similarity of patient data to diagnosed stable and progressive mild cognitive impairment (MCI) cases to identify patients who are progressing to Alzheimer's disease. Objectives: We evaluated how well the DSI generalizes across

The Search for Suitable Strategy: Threat-Based and Capabilities-Based Strategies in a Complex World

Science.gov (United States)

2016-05-26

the 1973 Arab-Israeli War show that the true path to suitable strategy is a measure of forethought and theoretical planning exercises to shape habits ...is a measure of forethought and theoretical planning exercises to shape habits of thought and identify risks or shortcomings inherent in a chosen...political direction to the military instrument of power , while military strategy links military means to those 22 Oxford Dictionaries, s.v. “Strategy

Technical suitability mapping of feedstocks for biological hydrogen production

NARCIS (Netherlands)

Panagiotopoulos, I.A.; Karaoglanoglou, L.S.; Koullas, D.P.; Bakker, R.R.; Claassen, P.A.M.; Koukios, E.G.

2015-01-01

The objective of this work was to map and compare the technical suitability of different raw materials for biological hydrogen production. Our model was based on hydrogen yield potential, sugar mobilization efficiency, fermentability and coproduct yield and value. The suitability of the studied

Types of pelvic floor dysfunctions in nulliparous, vaginal delivery, and cesarean section female patients with obstructed defecation syndrome identified by echodefecography.

Science.gov (United States)

Murad-Regadas, Sthela M; Regadas, Francisco Sérgio P; Rodrigues, Lusmar V; Oliveira, Leticia; Barreto, Rosilma G L; de Souza, Marcellus H L P; Silva, Flavio Roberto S

2009-10-01

This study aims to show pelvic floor dysfunctions in women with obstructed defecation syndrome (ODS), comparing nulliparous to those with vaginal delivery or cesarean section using the echodefecography (ECD). Three hundred seventy female patients with ODS were reviewed retrospectively and were divided in Group I-105 nulliparous, Group II-165 had at least one vaginal delivery, and Group III-comprised of 100 patients delivered only by cesarean section. All patients had been submitted to ECD to identify pelvic floor dysfunctions. No statistical significance was found between the groups with regard to anorectocele grade. Intussusception was identified in 40% from G I, 55.0% from G II, and 30.0% from G III, with statistical significance between Groups I and II. Intussusception was associated with significant anorectocele in 24.8%, 36.3%, and 18% patients from G I, II, and III, respectively. Anismus was identified in 39.0% from G I, 28.5% from G II, and 60% from G III, with statistical significance between Groups I and III. Anismus was associated with significant anorectocele in 22.8%, 15.7%, and 24% patients from G I, II, and III, respectively. Sigmoidocele/enterocele was identified in 7.6% from G I, 10.9% G II, and was associated with significant rectocele in 3.8% and 7.3% patients from G I and II, respectively. The distribution of pelvic floor dysfunctions showed no specific pattern across the groups, suggesting the absence of a correlation between these dysfunctions and vaginal delivery.

Newly identified psychiatric illness in one general practice: 12-month outcome and the influence of patients' personality.

Science.gov (United States)

Wright, A F; Anderson, A J

1995-01-01

BACKGROUND. Relatively little is known about the natural history and outcome of psychological problems in patients who present to general practitioners. Only a small proportion of such patients are seen by specialists. Clinical experience suggests that patient personality is one of the factors influencing outcome in patients diagnosed as having psychiatric illness. AIM. This study set out to examine prospectively the progress and 12-month outcome of patients with newly identified psychiatric illness, and the association of patients' personality with outcome. METHOD. One hundred and seventy one patients with clinically significant psychiatric illness attending one practice in a Scottish new town were followed up prospectively (96 presented with psychological symptoms and 75 with somatic symptoms), and were compared with a group of 127 patients with chronic physical illness. Patients were assessed in terms of psychiatric state, social problems and personality using both computer-based and pencil and paper tests in addition to clinical assessments at each consultation during the follow-up year and structured interview one year after recruitment. RESULTS. Most of the improvement in psychiatric state scores on the 28-item general health questionnaire occurred in the first six months of the illness. Of the 171 patients with psychiatric illness 34% improved quickly and remained well, 54% had an intermittent course but had improved at 12-month follow up while 12% pursued a chronic course without improvement. The mean number of consultations in the follow-up year was 8.4 for patients presenting with psychological symptoms, 7.2 for those presenting with somatic symptoms and 6.6 for patients with chronic physical illness. The Eysenck N score proved a strong predictor of the outcome of new psychiatric illness. CONCLUSION. Only one in three patients with newly identified psychiatric illness improved quickly and and remained well, reflecting the importance of continuing care of

Application of a GIS Multi-Criteria Decision Analysis for the Identification of Intrinsic Suitable Sites in Costa Rica for the Application of Managed Aquifer Recharge (MAR through Spreading Methods

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José Pablo Bonilla Valverde

2016-09-01

Full Text Available Costa Rica’s annual mean precipitation is above 3300 mm, but this precipitation is not evenly distributed in time or space, producing clear differentiated wet and dry seasons in most of the country. Droughts are also common phenomena which greatly affect the availability of water resources. Managed aquifer recharge (MAR schemes are being taken into consideration to enhance the underground water storage capacity of the country. The present study constitutes the first assessment for the identification of suitable sites for the implementation of MAR technology spreading methods (SM in Costa Rica. The suitable sites are identified by means of a geographic information system multi-criteria decision analysis (GIS-MCDA based on four criteria: hydrogeological aptitude, terrain slope, top soil texture and drainage network density. Four steps are performed in order to identify these sites: problem definition, screening for suitable areas, suitability mapping, and sensitivity analysis. The suitability map was divided in two zones after the screening: suitable and unsuitable, the first zone was further divided in five classes according to the weighted linear combination (WLC ranking. The results indicate that 61% of the country is suitable for conducting SM. This map is a tool for future implementation of MAR techniques in the country.

Diagnosed, identified, current and complete depression among patients attending primary care in southern Catalonia: different aspects of the same concept.

Science.gov (United States)

Montesó-Curto, Pilar; Ferré-Grau, Carme; Lleixà-Fortuño, Mar; Albacar-Riobóo, Nuria; Lejeune, Marylene

2014-02-01

The aims of this study were to explore the prevalence and the conceptualizations of depression detected by the healthcare system, identified by the patient or classified/identified in the validated Goldberg's questionnaire in a community. We conducted a cross-sectional evaluation of 317 patients. The different types of depression diagnosed, identified, current or total were stratified by age and gender groups. The difference in the conceptualization of depression from the medical or ordinary people point of view indicate that depression care requires the understanding of the lifestyle, beliefs, attitudes, family and social networks of the people the physicians and nurses care for. © 2014.

Identification of Suitable Endogenous Normalizers for qRT- PCR Analysis of Plasma microRNA Expression in Essential Hypertension

Science.gov (United States)

Solayman, Mohamed Hassan M.; Langaee, Taimour; Patel, Archanakumari; El-Wakeel, Lamia; El-Hamamsy, Manal; Badary, Osama; Johnson, Julie A.

2016-01-01

Circulating microRNAs (miRNAs) are promising biomarkers for many diseases. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) is a gold standard for miRNA expression profiling that requires proper data normalization. Since there is no universal normalizer, it is recommended to evaluate normalizers under every experimental condition. This study describes the identification of suitable endogenous normalizer(s) (ENs) for plasma miRNA expression in essential hypertension. Expression levels of 5 candidate ENs and 2 plasma quality markers were determined by qRT-PCR in plasma samples from 18 hypertensive patients and 10 healthy controls. NormFinder, GeNorm, and DataAssist software programs were used to select the best EN(s). Expression levels of the 5 candidate ENs were also analyzed in urine samples from hypertensive patients and compared to the plasma samples of the hypertensive patients. Among the analyzed candidates, hsa-miR-92a-3p was identified as the best EN, and hsa-miR-21-5p and hsa-miR-16-5p as next best. Moreover, hsa-miR-92a-3p showed the most consistent expression between plasma and urine In conclusion, this study showed that hsa-miR-92a-3p, hsa-miR-21-5p, and hsa-miR-16-5p may be used as normalizers for plasma miRNA expression data in essential hypertension studies. PMID:26798072

Proteomic identification of host and parasite biomarkers in saliva from patients with uncomplicated Plasmodium falciparum malaria

Directory of Open Access Journals (Sweden)

Huang Honglei

2012-05-01

Full Text Available Abstract Background Malaria cases attributed to Plasmodium falciparum account for approximately 600,000 deaths yearly, mainly in African children. The gold standard method to diagnose malaria requires the visualization of the parasite in blood. The role of non-invasive diagnostic methods to diagnose malaria remains unclear. Methods A protocol was optimized to deplete highly abundant proteins from saliva to improve the dynamic range of the proteins identified and assess their suitability as candidate biomarkers of malaria infection. A starch-based amylase depletion strategy was used in combination with four different lectins to deplete glycoproteins (Concanavalin A and Aleuria aurantia for N-linked glycoproteins; jacalin and peanut agglutinin for O-linked glycoproteins. A proteomic analysis of depleted saliva samples was performed in 17 children with fever and a positive–malaria slide and compared with that of 17 malaria-negative children with fever. Results The proteomic signature of malaria-positive patients revealed a strong up-regulation of erythrocyte-derived and inflammatory proteins. Three P. falciparum proteins, PFL0480w, PF08_0054 and PFI0875w, were identified in malaria patients and not in controls. Aleuria aurantia and jacalin showed the best results for parasite protein identification. Conclusions This study shows that saliva is a suitable clinical specimen for biomarker discovery. Parasite proteins and several potential biomarkers were identified in patients with malaria but not in patients with other causes of fever. The diagnostic performance of these markers should be addressed prospectively.

TP53 mutations identify younger mantle cell lymphoma patients who do not benefit from intensive chemoimmunotherapy

DEFF Research Database (Denmark)

Eskelund, Christian W.; Dahl, Christina; Hansen, Jakob W.

2017-01-01

Despite recent advances in lymphoma treatment, mantle cell lymphoma (MCL) remains incurable, and we are still unable to identify patients who will not benefit from the current standard of care. Here, we explore the prognostic value of recurrent genetic aberrations in diagnostic bone marrow (BM...

Integrating Larval Dispersal, Permitting, and Logistical Factors Within a Validated Habitat Suitability Index for Oyster Restoration

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Brandon J. Puckett

2018-04-01

Full Text Available Habitat suitability index (HSI models are increasingly used to guide ecological restoration. Successful restoration is a byproduct of several factors, including physical and biological processes, as well as permitting and logistical considerations. Rarely are factors from all of these categories included in HSI models, despite their combined relevance to common restoration goals such as population persistence. We developed a Geographic Information System (GIS-based HSI for restoring persistent high-relief subtidal oyster (Crassostrea virginica reefs protected from harvest (i.e., sanctuaries in Pamlico Sound, North Carolina, USA. Expert stakeholder input identified 17 factors to include in the HSI. Factors primarily represented physical (e.g., salinity and biological (e.g., larval dispersal processes relevant to oyster restoration, but also included several relevant permitting (e.g., presence of seagrasses and logistical (e.g., distance to restoration material stockpile sites considerations. We validated the model with multiple years of oyster density data from existing sanctuaries, and compared HSI output with distributions of oyster reefs from the late 1800's. Of the 17 factors included in the model, stakeholders identified four factors—salinity, larval export from existing oyster sanctuaries, larval import to existing sanctuaries, and dissolved oxygen—most critical to oyster sanctuary site selection. The HSI model provided a quantitative scale over which a vast water body (~6,000 km2 was narrowed down by 95% to a much smaller suite of optimal (top 1% HSI and suitable (top 5% HSI locations for oyster restoration. Optimal and suitable restoration locations were clustered in northeast and southwest Pamlico Sound. Oyster density in existing sanctuaries, normalized for time since reef restoration, was a positive exponential function of HSI, providing validation for the model. Only a small portion (10–20% of historical reef locations

A fuzzy approach to a multiple criteria and Geographical Information System for decision support on suitable locations for biogas plants

DEFF Research Database (Denmark)

Franco, Camilo; Bojesen, Mikkel; Hougaard, Jens Leth

2015-01-01

The purpose of this paper is to model the multi-criteria decision problem of identifying the most suitable facility locations for biogas plants under an integrated decision support methodology. Here the Geographical Information System (GIS) is used for measuring the attributes of the alternatives...... according to a given set of criteria. Measurements are taken in interval form, expressing the natural imprecision of common data, and the Fuzzy Weighted Overlap Dominance (FWOD) procedure is applied for aggregating and exploiting this kind of data, obtaining suitability degrees for every alternative...... suitable sites for building biogas plants. We show that the FWOD relevance-ranking procedure can also be successfully applied over the outcomes of different decision makers, in case a unique social solution is required to exist. The proposed methodology can be used under an integrated decision support...

Suitable or optimal noise benefits in signal detection

International Nuclear Information System (INIS)

Liu, Shujun; Yang, Ting; Tang, Mingchun; Wang, Pin; Zhang, Xinzheng

2016-01-01

Highlights: • Six intervals of additive noises divided according to the two constraints. • Derivation of the suitable additive noise to meet the two constraints. • Formulation of the suitable noise for improvability or nonimprovability. • Optimal noises to minimize P FA , maximize P D and maximize the overall improvement. - Abstract: We present an effective way to generate the suitable or the optimal additive noises which can achieve the three goals of the noise enhanced detectability, i.e., the maximum detection probability (P D ), the minimum false alarm probability (P FA ) and the maximum overall improvement of P D and P FA , without increasing P FA and decreasing P D in a binary hypothesis testing problem. The mechanism of our method is that we divide the discrete vectors into six intervals and choose the useful or partial useful vectors from these intervals to form the additive noise according to different requirements. The form of the optimal noise is derived and proven as a randomization of no more than two discrete vectors in our way. Moreover, how to choose suitable and optimal noises from the six intervals are given. Finally, numerous examples are presented to illustrate the theoretical analysis, where the background noises are Gaussian, symmetric and asymmetric Gaussian mixture noise, respectively.

Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

Energy Technology Data Exchange (ETDEWEB)

Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J. [University Hospital of Regensburg, Department of Internal Medicine 1, Regensburg (Germany); Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W. [University Hospital of Regensburg, Department of Radiology, Regensburg (Germany)

2008-08-15

The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

Percutaneous necrosectomy in patients with acute, necrotizing pancreatitis

International Nuclear Information System (INIS)

Bruennler, T.; Langgartner, J.; Lang, S.; Salzberger, B.; Schoelmerich, J.; Zorger, N.; Herold, T.; Feuerbach, S.; Hamer, O.W.

2008-01-01

The objective of this retrospective study was to evaluate the outcome of patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy. By searching the radiological, surgical and internal medicine databases, all patients with acute necrotizing pancreatitis treated by active percutaneous necrosectomy between 1992 and 2004 were identified. Demographic, laboratory, and clinical data, and details about invasive procedures were collected by reviewing patient charts, radiological and surgical reports. The computed tomography severity index (CTSI) scores were determined by reviewing CT images. Eighteen patients were identified. Median Ranson score on admission was 2. The Acute Physiology and Chronic Health Evaluation (APACHE) II score was median 22. Median CTSI score was 7. Initially all patients were treated with CT-guided drainage placement. Because passive drainage proved not to be effective, subsequent minimally invasive, percutaneous necrosectomy was performed. Eight out of 18 patients recovered fully without the need for surgery. Ten of 18 patients required additional surgical necrosectomy. For one of ten patients, percutaneous necrosectomy allowed postponing surgery by 39 days. Four of ten surgically treated patients died: three from septic multiorgan failure, one from pulmonary embolism. Percutaneous minimally invasive necrosectomy can be regarded as a safe and effective complementary treatment modality in patients with necrotizing pancreatitis. It is suitable for a subset of patients to avoid or delay surgery. (orig.)

Land Suitability Assessment for Pineapple Production in the A ...

African Journals Online (AJOL)

linking land resources assessment to any land use decision-making process. like elsewhere, land ... managers as decision-support tools, for instance, to outline the most suitable land areas for subsidy ...... increase rational decisions. In this ..... essentially dynamic. it is pertinent that land suitability analysis is framed within an ...

Patients Commonly Believe Their Heart Failure Hospitalizations Are Preventable and Identify Worsening Heart Failure, Nonadherence, and a Knowledge Gap as Reasons for Admission.

Science.gov (United States)

Gilotra, Nisha A; Shpigel, Adam; Okwuosa, Ike S; Tamrat, Ruth; Flowers, Deirdre; Russell, Stuart D

2017-03-01

There are few data describing patient-identified precipitants of heart failure (HF) hospitalization. We hypothesized a patient's perception of reason for or preventability of an admission may be related to 30-day readmission rates. Ninety-four patients admitted with decompensated HF from July 2014 to March 2015 completed a brief questionnaire regarding circumstances leading to admission. Thirty-day outcomes were assessed via telephone call and chart review. Mean age was 58 ± 14 years, with 60% blacks (n = 56) and 41% females (n = 39). Median left ventricular ejection fraction was 30%; 27 had preserved ejection fraction. Seventy-two patients identified their hospitalization to be due to HF (± another condition). Most common patient-identified precipitants of admission were worsening HF (n = 37) and dietary nonadherence (n = 11). Readmitted patients tended to have longer time until first follow-up appointment (21 vs 8 days). Seven of the 42 patients who identified their hospitalization as preventable were readmitted compared with 21/49 who believed their hospitalization was unpreventable (P = .012). On multivariate regression analysis, patients who thought their hospitalization was preventable were less likely to be readmitted (odds ratio 0.31; 95% confidence interval 0.10-0.91; P = .04). Almost 50% of patients believe their HF hospitalization is preventable, and these patients appear to be less likely to be readmitted within 30 days. Notably, patients cite nonadherence and lack of knowledge as reasons hospitalizations are preventable. These results lend insight into possible interventions to reduce HF readmissions. Copyright © 2016 Elsevier Inc. All rights reserved.

Placement suitability criteria of composite tape for mould surface in automated tape placement

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Zhang Peng

2015-10-01

Full Text Available Automated tape placement is an important automated process used for fabrication of large composite structures in aeronautical industry. The carbon fiber composite parts realized with this process tend to replace the aluminum parts produced by high-speed machining. It is difficult to determine the appropriate width of the composite tape in automated tape placement. Wrinkling will appear in the tape if it does not suit for the mould surface. Thus, this paper deals with establishing placement suitability criteria of the composite tape for the mould surface. With the assumptions for ideal mapping and by applying some principles and theorems of differential geometry, the centerline trajectory of the composite tape is identified to follow the geodesic. The placement suitability of the composite tape is examined on three different types of non-developable mould surfaces and four criteria are derived. The developed criteria have been used to test the deposition process over several mould surfaces and the appropriate width for each mould surface is obtained by referring to these criteria.

Electronic Health Record Based Algorithm to Identify Patients with Autism Spectrum Disorder.

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Todd Lingren

Full Text Available Cohort selection is challenging for large-scale electronic health record (EHR analyses, as International Classification of Diseases 9th edition (ICD-9 diagnostic codes are notoriously unreliable disease predictors. Our objective was to develop, evaluate, and validate an automated algorithm for determining an Autism Spectrum Disorder (ASD patient cohort from EHR. We demonstrate its utility via the largest investigation to date of the co-occurrence patterns of medical comorbidities in ASD.We extracted ICD-9 codes and concepts derived from the clinical notes. A gold standard patient set was labeled by clinicians at Boston Children's Hospital (BCH (N = 150 and Cincinnati Children's Hospital and Medical Center (CCHMC (N = 152. Two algorithms were created: (1 rule-based implementing the ASD criteria from Diagnostic and Statistical Manual of Mental Diseases 4th edition, (2 predictive classifier. The positive predictive values (PPV achieved by these algorithms were compared to an ICD-9 code baseline. We clustered the patients based on grouped ICD-9 codes and evaluated subgroups.The rule-based algorithm produced the best PPV: (a BCH: 0.885 vs. 0.273 (baseline; (b CCHMC: 0.840 vs. 0.645 (baseline; (c combined: 0.864 vs. 0.460 (baseline. A validation at Children's Hospital of Philadelphia yielded 0.848 (PPV. Clustering analyses of comorbidities on the three-site large cohort (N = 20,658 ASD patients identified psychiatric, developmental, and seizure disorder clusters.In a large cross-institutional cohort, co-occurrence patterns of comorbidities in ASDs provide further hypothetical evidence for distinct courses in ASD. The proposed automated algorithms for cohort selection open avenues for other large-scale EHR studies and individualized treatment of ASD.

Quantitative validation of a habitat suitability index for oyster restoration

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Seth eTheuerkauf

2016-05-01

Full Text Available Habitat suitability index (HSI models provide spatially explicit information on the capacity of a given habitat to support a species of interest, and their prevalence has increased dramatically in recent years. Despite caution that the reliability of HSIs must be validated using independent, quantitative data, most HSIs intended to inform terrestrial and marine species management remain unvalidated. Furthermore, of the eight HSI models developed for eastern oyster (Crassostrea virginica restoration and fishery production, none has been validated. Consequently, we developed, calibrated, and validated an HSI for the eastern oyster to identify optimal habitat for restoration in a tributary of Chesapeake Bay, the Great Wicomico River (GWR. The GWR harbors a high density, restored oyster population, and therefore serves as an excellent model system for assessing the validity of the HSI. The HSI was derived from GIS layers of bottom type, salinity, and water depth (surrogate for dissolved oxygen, and was tested using live adult oyster density data from a survey of high vertical relief reefs (HRR and low vertical relief reefs (LRR in the sanctuary network. Live adult oyster density was a statistically-significant sigmoid function of the HSI, which validates the HSI as a robust predictor of suitable oyster reef habitat for rehabilitation or restoration. In addition, HRR had on average 103-116 more adults m^−2 than LRR at a given level of the HSI. For HRR, HSI values ≥0.3 exceeded the accepted restoration target of 50 live adult oysters m^−2. For LRR, the HSI was generally able to predict live adult oyster densities that meet or exceed the target at HSI values ≥0.3. The HSI indicated that there remain large areas of suitable habitat for restoration in the GWR. This study provides a robust framework for HSI model development and validation, which can be refined and applied to other systems and previously developed HSIs to improve the efficacy of

Two subgroups of antipsychotic-naive, first-episode schizophrenia patients identified with a Gaussian mixture model on cognition and electrophysiology

DEFF Research Database (Denmark)

Bak, N.; Ebdrup, B.H.; Oranje, B

2017-01-01

Deficits in information processing and cognition are among the most robust findings in schizophrenia patients. Previous efforts to translate group-level deficits into clinically relevant and individualized information have, however, been non-successful, which is possibly explained by biologically...... and sixty-five healthy controls underwent extensive electrophysiological and neurocognitive test batteries. Patients were assessed on the Positive and Negative Syndrome Scale (PANSS) before and after 6 weeks of monotherapy with the relatively selective D2 receptor antagonist, amisulpride (280.3±159 mg per...... day). A reduced principal component space based on 19 electrophysiological variables and 26 cognitive variables was used as input for a Gaussian mixture model to identify subgroups of patients. With support vector machines, we explored the relation between PANSS subscores and the identified subgroups...

Obtaining shale oil suitable for lighting

Energy Technology Data Exchange (ETDEWEB)

Giraudel, M

1851-11-12

Treats with sulphuric acid and then with soda, obtaining 57 per cent of products suitable for lighting in place of the usual 35 to 40 per cent as obtained by present processes. The product has a less disagreeable odor.

Additional media studies for site suitability criteria

International Nuclear Information System (INIS)

Donich, T.R.; Kaufman, A.M.; Sauter, G.D.; Steinborn, T.L.; Towse, D.F.

1978-01-01

Site suitability studies have been made previously at LLL on bedded salt and shale. In the present study domed salt, basalt, and crystalline rock are compared with bedded salt and shale and with each other as possible repositories. The level of effort required to develop models for these media that are similar in quality to those available for bedded salt and shale is evaluated. The effort necessary to develop data bases on the physical and chemical properties comparable to that available for bedded salt and shale is also estimated. Each medium is evaluated as a suitable repository environment. The funding necessary for model and data base development is estimated

Suitability of non-energy GHGs for emissions trading

International Nuclear Information System (INIS)

Haites, E.; Proestos, A.

2000-01-01

This paper assesses the suitability of different sources of non-energy greenhouse gases for emissions trading. Different forms of emissions trading are defined and criteria for determining whether a source is suitable for emissions trading are proposed. The suitability for emissions trading is assessed for: methane (CH4) from oil and gas production; CH4 from coal mines; CH4 from landfills; CH4 from wastewater treatment; CH4 from enteric fermentation; CH4 from livestock manure, nitrous oxide (N2O) from adipic acid production; N2O from fertilizer use; N2O from nitric acid production, carbon dioxide (CO2) and perfluorocarbons (PFCs) from aluminum smelting; sulphur hexafluoride (SF6) from magnesium smelting and die casting; HFCs from HCFC production, other uses of SF6, PFCs and hydrofluorocarbons (HFCs); CO2 from ammonia production; lime and cement production, and iron ore reduction

Using text-mining techniques in electronic patient records to identify ADRs from medicine use

DEFF Research Database (Denmark)

Warrer, Pernille; Hansen, Ebba Holme; Jensen, Lars Juhl

2012-01-01

This literature review included studies that use text-mining techniques in narrative documents stored in electronic patient records (EPRs) to investigate ADRs. We searched PubMed, Embase, Web of Science and International Pharmaceutical Abstracts without restrictions from origin until July 2011. We...... included empirically based studies on text mining of electronic patient records (EPRs) that focused on detecting ADRs, excluding those that investigated adverse events not related to medicine use. We extracted information on study populations, EPR data sources, frequencies and types of the identified ADRs......, medicines associated with ADRs, text-mining algorithms used and their performance. Seven studies, all from the United States, were eligible for inclusion in the review. Studies were published from 2001, the majority between 2009 and 2010. Text-mining techniques varied over time from simple free text...

41 CFR 102-75.1175 - Who issues the suitability determination?

Science.gov (United States)

2010-07-01

... underutilized will be reviewed for suitability no earlier than six months prior to the expected date when the... following: (1) The suitability determination for a particular piece of property, and the reasons for that...

Mycobacterium leprae is identified in the oral mucosa from paucibacillary and multibacillary leprosy patients.

Science.gov (United States)

Morgado de Abreu, M A M; Roselino, A M; Enokihara, M; Nonogaki, S; Prestes-Carneiro, L E; Weckx, L L M; Alchorne, M M A

2014-01-01

In leprosy, the nasal mucosa is considered as the principal route of transmission for the bacillus Mycobacterium leprae. The objective of this study was to identify M. leprae in the oral mucosa of 50 untreated leprosy patients, including 21 paucibacillary (PB) and 29 multibacillary (MB) patients, using immunohistochemistry (IHC), with antibodies against bacillus Calmette-Guérin (BCG) and phenolic glycolipid antigen-1 (PGL-1), and polymerase chain reaction (PCR), with MntH-specific primers for M. leprae, and to compare the results. The material was represented by 163 paraffin blocks containing biopsy samples obtained from clinically normal sites (including the tongue, buccal mucosa and soft palate) and visible lesions anywhere in the oral mucosa. All patients and 158 available samples were included for IHC study. Among the 161 available samples for PCR, 110 had viable DNA. There was viable DNA in at least one area of the oral mucosa for 47 patients. M. leprae was detected in 70% and 78% of patients using IHC and PCR, respectively, and in 94% of the patients by at least one of the two diagnostic methods. There were no differences in detection of M. leprae between MB and PB patients. Similar results were obtained using anti-BCG and anti-PGL-1 antibodies, and immunoreactivity occurred predominantly on free-living bacteria on the epithelial surface, with a predilection for the tongue. Conversely, there was no area of predilection according to the PCR results. M. leprae is present in the oral mucosa at a high frequency, implicating this site as a potential means of leprosy transmission. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL

Science.gov (United States)

Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

2016-01-01

Introduction: One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. Patients and methods: This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. Results: The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals. PMID:27999486

Can Predictive Modeling Identify Head and Neck Oncology Patients at Risk for Readmission?

Science.gov (United States)

Manning, Amy M; Casper, Keith A; Peter, Kay St; Wilson, Keith M; Mark, Jonathan R; Collar, Ryan M

2018-05-01

Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests. One model (logistic regression) was then placed prospectively into the discharge workflow from March 2016 to May 2016 to determine the model's ability to predict which patients would be readmitted within 30 days. Results In total, 174 admissions had descriptive data. Thirty-two were excluded due to incomplete data. Logistic regression, CART, and random forest predictive models were constructed using the remaining 142 admissions. When applied to 106 consecutive prospective head and neck oncology patients at the time of discharge, the logistic regression model predicted readmissions with a specificity of 94%, a sensitivity of 47%, a negative predictive value of 90%, and a positive predictive value of 62% (odds ratio, 14.9; 95% confidence interval, 4.02-55.45). Conclusion Prospectively collected head and neck cancer databases can be used to develop predictive models that can accurately predict which patients will be readmitted. This offers valuable support for quality improvement initiatives and readmission-related cost reduction in head and neck cancer care.

Clinical coding of prospectively identified paediatric adverse drug reactions--a retrospective review of patient records.

Science.gov (United States)

Bellis, Jennifer R; Kirkham, Jamie J; Nunn, Anthony J; Pirmohamed, Munir

2014-12-17

National Health Service (NHS) hospitals in the UK use a system of coding for patient episodes. The coding system used is the International Classification of Disease (ICD-10). There are ICD-10 codes which may be associated with adverse drug reactions (ADRs) and there is a possibility of using these codes for ADR surveillance. This study aimed to determine whether ADRs prospectively identified in children admitted to a paediatric hospital were coded appropriately using ICD-10. The electronic admission abstract for each patient with at least one ADR was reviewed. A record was made of whether the ADR(s) had been coded using ICD-10. Of 241 ADRs, 76 (31.5%) were coded using at least one ICD-10 ADR code. Of the oncology ADRs, 70/115 (61%) were coded using an ICD-10 ADR code compared with 6/126 (4.8%) non-oncology ADRs (difference in proportions 56%, 95% CI 46.2% to 65.8%; p codes as a single means of detection. Data derived from administrative healthcare databases are not reliable for identifying ADRs by themselves, but may complement other methods of detection.

A RECURSIVE ALGORITHM SUITABLE FOR REAL-TIME MEASUREMENT

Directory of Open Access Journals (Sweden)

Giovanni Bucci

1995-12-01

Full Text Available This paper deals with a recursive algorithm suitable for realtime measurement applications, based on an indirect technique, useful in those applications where the required quantities cannot be measured in a straightforward way. To cope with time constraints a parallel formulation of it, suitable to be implemented on multiprocessor systems, is presented. The adopted concurrent implementation is based on factorization techniques. Some experimental results related to the application of the system for carrying out measurements on synchronous motors are included.

Whole exome sequencing identifies mutations in Usher syndrome genes in profoundly deaf Tunisian patients.

Science.gov (United States)

Riahi, Zied; Bonnet, Crystel; Zainine, Rim; Lahbib, Saida; Bouyacoub, Yosra; Bechraoui, Rym; Marrakchi, Jihène; Hardelin, Jean-Pierre; Louha, Malek; Largueche, Leila; Ben Yahia, Salim; Kheirallah, Moncef; Elmatri, Leila; Besbes, Ghazi; Abdelhak, Sonia; Petit, Christine

2015-01-01

Usher syndrome (USH) is an autosomal recessive disorder characterized by combined deafness-blindness. It accounts for about 50% of all hereditary deafness blindness cases. Three clinical subtypes (USH1, USH2, and USH3) are described, of which USH1 is the most severe form, characterized by congenital profound deafness, constant vestibular dysfunction, and a prepubertal onset of retinitis pigmentosa. We performed whole exome sequencing in four unrelated Tunisian patients affected by apparently isolated, congenital profound deafness, with reportedly normal ocular fundus examination. Four biallelic mutations were identified in two USH1 genes: a splice acceptor site mutation, c.2283-1G>T, and a novel missense mutation, c.5434G>A (p.Glu1812Lys), in MYO7A, and two previously unreported mutations in USH1G, i.e. a frameshift mutation, c.1195_1196delAG (p.Leu399Alafs*24), and a nonsense mutation, c.52A>T (p.Lys18*). Another ophthalmological examination including optical coherence tomography actually showed the presence of retinitis pigmentosa in all the patients. Our findings provide evidence that USH is under-diagnosed in Tunisian deaf patients. Yet, early diagnosis of USH is of utmost importance because these patients should undergo cochlear implant surgery in early childhood, in anticipation of the visual loss.

Whole exome sequencing identifies mutations in Usher syndrome genes in profoundly deaf Tunisian patients.

Directory of Open Access Journals (Sweden)

Zied Riahi

Full Text Available Usher syndrome (USH is an autosomal recessive disorder characterized by combined deafness-blindness. It accounts for about 50% of all hereditary deafness blindness cases. Three clinical subtypes (USH1, USH2, and USH3 are described, of which USH1 is the most severe form, characterized by congenital profound deafness, constant vestibular dysfunction, and a prepubertal onset of retinitis pigmentosa. We performed whole exome sequencing in four unrelated Tunisian patients affected by apparently isolated, congenital profound deafness, with reportedly normal ocular fundus examination. Four biallelic mutations were identified in two USH1 genes: a splice acceptor site mutation, c.2283-1G>T, and a novel missense mutation, c.5434G>A (p.Glu1812Lys, in MYO7A, and two previously unreported mutations in USH1G, i.e. a frameshift mutation, c.1195_1196delAG (p.Leu399Alafs*24, and a nonsense mutation, c.52A>T (p.Lys18*. Another ophthalmological examination including optical coherence tomography actually showed the presence of retinitis pigmentosa in all the patients. Our findings provide evidence that USH is under-diagnosed in Tunisian deaf patients. Yet, early diagnosis of USH is of utmost importance because these patients should undergo cochlear implant surgery in early childhood, in anticipation of the visual loss.

How well do discharge diagnoses identify hospitalised patients with community-acquired infections? - a validation study

DEFF Research Database (Denmark)

Henriksen, Daniel Pilsgaard; Nielsen, Stig Lønberg; Laursen, Christian Borbjerg

2014-01-01

-10 diagnoses was 79.9% (95%CI: 78.1-81.3%), specificity 83.9% (95%CI: 82.6-85.1%), positive likelihood ratio 4.95 (95%CI: 4.58-5.36) and negative likelihood ratio 0.24 (95%CI: 0.22-0.26). The two most common sites of infection, the lower respiratory tract and urinary tract, had positive likelihood......BACKGROUND: Credible measures of disease incidence, trends and mortality can be obtained through surveillance using manual chart review, but this is both time-consuming and expensive. ICD-10 discharge diagnoses are used as surrogate markers of infection, but knowledge on the validity of infections...... in general is sparse. The aim of the study was to determine how well ICD-10 discharge diagnoses identify patients with community-acquired infections in a medical emergency department (ED), overall and related to sites of infection and patient characteristics. METHODS: We manually reviewed 5977 patients...

Use of a combination of CEA and tumor budding to identify high-risk patients with stage II colon cancer.

Science.gov (United States)

Du, Changzheng; Xue, Weicheng; Dou, Fangyuan; Peng, Yifan; Yao, Yunfeng; Zhao, Jun; Gu, Jin

2017-07-24

High-risk patients with stage II colon cancer may benefit from adjuvant chemotherapy, but identifying this patient population can be difficult. We assessed the prognosis value for predicting tumor progression in patients with stage II colon cancer, of a panel of 2 biomarkers for colon cancer: tumor budding and preoperative carcinoembryonic antigen (CEA). Consecutive patients (N = 134) with stage II colon cancer who underwent curative surgery from 2000 to 2007 were included. Multivariate analysis was used to evaluate the association of CEA and tumor budding grade with 5-year disease-free survival (DFS). The prognostic accuracy of CEA, tumor budding grade and the combination of both (CEA-budding panel) was determined. The study found that both CEA and tumor budding grade were associated with 5-year DFS. The prognostic accuracy for disease progression was higher for the CEA-budding panel (82.1%) than either CEA (70.9%) or tumor budding grade (72.4%) alone. The findings indicate that the combination of CEA levels and tumor budding grade has greater prognostic value for identifying patients with stage II colon cancer who are at high-risk for disease progression, than either marker alone.

Developing and testing a landscape habitat suitability model for fisher (Martes pennanti) in forests of interior northern California

Science.gov (United States)

W.J. Zielinski; J. R. Dunk; J. S. Yaeger; D. W. LaPlante

2010-01-01

The fisher is warranted for protection under the Endangered Species Act in the western United States and, as such, it is especially important that conservation and management actions are based on sound scientific information. We developed a landscape-scale suitability model for interior northern California to predict the probability of detecting fishers and to identify...

Evaluation of the Reliability of Electronic Medical Record Data in Identifying Comorbid Conditions among Patients with Advanced Non-Small Cell Lung Cancer

International Nuclear Information System (INIS)

Muehlenbein, C. E.; Lawson, A.; Pohl, G.; Hoverman, R.; Gruschkus, S. K.; Forsyth, M.; Chen, C.; Lopez, W.; Hartnett, H. J.

2011-01-01

Traditional methods for identifying co morbidity data in EMRs have relied primarily on costly and time-consuming manual chart review. The purpose of this study was to validate a strategy of electronically searching EMR data to identify co morbidities among cancer patients. Methods. Advanced stage NSCLC patients ( N = 2,513) who received chemotherapy from 7/1/2006 to 6/30/2008 were identified using iKnowMed, US Oncology's proprietary oncology-specific EMR system. EMR data were searched for documentation of co morbidities common to advanced stage cancer patients. The search was conducted by a series of programmatic queries on standardized information including concomitant illnesses, patient history, review of systems, and diagnoses other than cancer. The validity of the co morbidity information that we derived from the EMR search was compared to the chart review gold standard in a random sample of 450 patients for whom the EMR search yielded no indication of co morbidities. Negative predictive values were calculated. Results. The overall prevalence of co morbidities of 22%. Overall negative predictive value was 0.92 in the 450 patients randomly sampled patients (36 of 450 were found to have evidence of co morbidities on chart review). Conclusion. Results of this study suggest that efficient queries/text searches of EMR data may provide reliable data on co morbid conditions among cancer patients.

Plasma Proteomic Analysis May Identify New Markers for Radiation-Induced Lung Toxicity in Patients With Non-Small-Cell Lung Cancer

International Nuclear Information System (INIS)

Cai Xuwi; Shedden, Kerby; Ao Xiaoping; Davis, Mary

2010-01-01

Purpose: To study whether radiation induces differential changes in plasma proteomics in patients with and without radiation-induced lung toxicity (RILT) of Grade ≥2 (RILT2). Methods and Materials: A total of 57 patients with NSCLC received radiation therapy (RT) were eligible. Twenty patients, 6 with RILT2 with tumor stage matched to 14 without RILT2, were enrolled for this analysis. Platelet-poor plasma was obtained before RT, at 2, 4, 6 weeks during RT, and 1 and 3 months after RT. Plasma proteomes were compared using a multiplexed quantitative proteomics approach involving ExacTag labeling, reverse-phase high-performance liquid chromatography and nano-LC electrospray tandem mass spectrometry. Variance components models were used to identify the differential protein expression between patients with and without RILT2. Results: More than 100 proteins were identified and quantified. After excluding proteins for which there were not at least 2 subjects with data for at least two time points, 76 proteins remained for this preliminary analysis. C4b-binding protein alpha chain, Complement C3, and Vitronectin had significantly higher expression levels in patients with RILT2 compared with patients without RILT2, based on both the data sets of RT start to 3 months post-RT (p < 0.01) and RT start to the end of RT (p < 0.01). The expression ratios of patients with RILT2 vs. without RILT2 were 1.60, 1.36, 1.46, and 1.66, 1.34, 1.46, for the above three proteins, respectively. Conclusions: This proteomic approach identified new plasma protein markers for future studies on RILT prediction.

[Study on ecological suitability regionalization of Eucommia ulmoides in Guizhou].

Science.gov (United States)

Kang, Chuan-Zhi; Wang, Qing-Qing; Zhou, Tao; Jiang, Wei-Ke; Xiao, Cheng-Hong; Xie, Yu

2014-05-01

To study the ecological suitability regionalization of Eucommia ulmoides, for selecting artificial planting base and high-quality industrial raw material purchase area of the herb in Guizhou. Based on the investigation of 14 Eucommia ulmoides producing areas, pinoresinol diglucoside content and ecological factors were obtained. Using spatial analysis method to carry on ecological suitability regionalization. Meanwhile, combining pinoresinol diglucoside content, the correlation of major active components and environmental factors were analyzed by statistical analysis. The most suitability planting area of Eucommia ulmoides was the northwest of Guizhou. The distribution of Eucommia ulmoides was mainly affected by the type and pH value of soil, and monthly precipitation. The spatial structure of major active components in Eucommia ulmoides were randomly distributed in global space, but had only one aggregation point which had a high positive correlation in local space. The major active components of Eucommia ulmoides had no correlation with altitude, longitude or latitude. Using the spatial analysis method and statistical analysis method, based on environmental factor and pinoresinol diglucoside content, the ecological suitability regionalization of Eucommia ulmoides can provide reference for the selection of suitable planting area, artificial planting base and directing production layout.

SUITABILITY OF CARAMBOLA ( AVERRHOA CARAMBOLA ) FRUIT ...

African Journals Online (AJOL)

SUITABILITY OF CARAMBOLA ( AVERRHOA CARAMBOLA ) FRUIT JUICE AS A SUBSTRATE FOR WINE FERMENTATION. ... The analysis of the sugars showed glucose, fructose and sucrose as the predominant sugars present. Vitamin C content was substantially high (35 mg/100 g), but fat content was low (0.25%).

Land suitability assessment on a watershed of Loess Plateau using the analytic hierarchy process.

Science.gov (United States)

Yi, Xiaobo; Wang, Li

2013-01-01

In order to reduce soil erosion and desertification, the Sloping Land Conversion Program has been conducted in China for more than 15 years, and large areas of farmland have been converted to forest and grassland. However, this large-scale vegetation-restoration project has faced some key problems (e.g. soil drying) that have limited the successful development of the current ecological-recovery policy. Therefore, it is necessary to know about the land use, vegetation, and soil, and their inter-relationships in order to identify the suitability of vegetation restoration. This study was conducted at the watershed level in the ecologically vulnerable region of the Loess Plateau, to evaluate the land suitability using the analytic hierarchy process (AHP). The results showed that (1) the area unsuitable for crops accounted for 73.3% of the watershed, and the main factors restricting cropland development were soil physical properties and soil nutrients; (2) the area suitable for grassland was about 86.7% of the watershed, with the remaining 13.3% being unsuitable; (3) an area of 3.95 km(2), accounting for 66.7% of the watershed, was unsuitable for forest. Overall, the grassland was found to be the most suitable land-use to support the aims of the Sloping Land Conversion Program in the Liudaogou watershed. Under the constraints of soil water shortage and nutrient deficits, crops and forests were considered to be inappropriate land uses in the study area, especially on sloping land. When selecting species for re-vegetation, non-native grass species with high water requirements should be avoided so as to guarantee the sustainable development of grassland and effective ecological functioning. Our study provides local land managers and farmers with valuable information about the inappropriateness of growing trees in the study area along with some information on species selection for planting in the semi-arid area of the Loess Plateau.

Use of thyroid-stimulating hormone tests for identifying primary hypothyroidism in family medicine patients.

Science.gov (United States)

Birk-Urovitz, Elizabeth; Elisabeth Del Giudice, M; Meaney, Christopher; Grewal, Karan

2017-09-01

To assess the use of thyroid-stimulating hormone (TSH) tests for identifying primary hypothyroidism in 2 academic family medicine settings. Descriptive study involving a retrospective electronic chart review of family medicine patients who underwent TSH testing. Two academic family practice sites: one site is within a tertiary hospital in Toronto, Ont, and the other is within a community hospital in Newmarket, Ont. A random sample of 205 adult family medicine patients who had 1 or more TSH tests for identifying potential primary hypothyroidism between July 1, 2009, and September 15, 2013. Exclusion criteria included a previous diagnosis of any thyroid condition or abnormality, as well as pregnancy or recent pregnancy within the year preceding the study period. The proportion of normal TSH test results and the proportion of TSH tests that did not conform to test-ordering guidelines. Of the 205 TSH test results, 200 (97.6%, 95% CI 94.4% to 99.2%) showed TSH levels within the normal range. All 5 patients with abnormal TSH test results had TSH levels above the upper reference limits. Nearly one-quarter (22.4%, 95% CI 16.9% to 28.8%) of tests did not conform to test-ordering guidelines. All TSH tests classified as not conforming to test-ordering guidelines showed TSH levels within normal limits. There was a significant difference ( P hypothyroidism case finding and screening was high, and the overall proportion of TSH tests that did not conform to test-ordering guidelines was relatively high as well. These results highlight a need for more consistent TSH test-ordering guidelines for primary hypothyroidism and perhaps some educational interventions to help curtail the overuse of TSH tests in the family medicine setting. Copyright© the College of Family Physicians of Canada.

Inhalable Antimicrobials for Treatment of Bacterial Biofilm-Associated Sinusitis in Cystic Fibrosis Patients

DEFF Research Database (Denmark)

Klodzinska, Sylvia Natalie; Priemel, Petra Alexandra; Rades, Thomas

2016-01-01

Bacterial biofilm-associated chronic sinusitis in cystic fibrosis (CF) patients caused by Pseudomonas aeruginosa infections and the lack of available treatments for such infections constitute a critical aspect of CF disease management. Currently, inhalation therapies to combat P. aeruginosa infec...... and management of biofilm infections caused by P. aeruginosa and discusses critical issues related to novel antimicrobial drug formulation design approaches.......Bacterial biofilm-associated chronic sinusitis in cystic fibrosis (CF) patients caused by Pseudomonas aeruginosa infections and the lack of available treatments for such infections constitute a critical aspect of CF disease management. Currently, inhalation therapies to combat P. aeruginosa....... aeruginosa from the respiratory tract after a first infection has been shown to delay chronic pulmonary infection with the bacteria for up to two years. The challenges with providing a suitable treatment for bacterial sinusitis include: (i) identifying a suitable antimicrobial compound; (ii) selecting...

Persistence of nondysplastic Barrett's esophagus identifies patients at lower risk for esophageal adenocarcinoma: results from a large multicenter cohort.

Science.gov (United States)

Gaddam, Srinivas; Singh, Mandeep; Balasubramanian, Gokulakrishnan; Thota, Prashanthi; Gupta, Neil; Wani, Sachin; Higbee, April D; Mathur, Sharad C; Horwhat, John D; Rastogi, Amit; Young, Patrick E; Cash, Brooks D; Bansal, Ajay; Vargo, John J; Falk, Gary W; Lieberman, David A; Sampliner, Richard E; Sharma, Prateek

2013-09-01

Recent population-based studies have shown a low risk of esophageal adenocarcinoma (EAC) in patients with nondysplastic Barrett's esophagus (NDBE). We evaluated whether persistence of NDBE over multiple consecutive surveillance endoscopic examinations could be used in risk stratification of patients with Barrett's esophagus (BE). We performed a multicenter outcomes study of a large cohort of patients with BE. Based on the number of consecutive surveillance endoscopies showing NDBE, we identified 5 groups of patients. Patients in group 1 were found to have NDBE at their first esophagogastroduodenoscopy (EGD). Patients in group 2 were found to have NDBE on their first 2 consecutive EGDs. Similarly, patients in groups 3, 4, and 5 were found to have NDBE on 3, 4, and 5 consecutive surveillance EGDs. A logistic regression model was built to determine whether persistence of NDBE independently protected against development of cancer. Of a total of 3515 patients with BE, 1401 patients met the inclusion criteria (93.3% white; 87.5% men; median age, 60 ±17 years). The median follow-up period was 5 ± 3.9 years (7846 patient-years). The annual risk of EAC in groups 1 to 5 was 0.32%, 0.27%, 0.16%, 0.2%, and 0.11%, respectively (P for trend = .03). After adjusting for age, sex, and length of BE, persistence of NDBE, based on multiple surveillance endoscopies, was associated with a gradually lower likelihood of progression to EAC. Persistence of NDBE over several endoscopic examinations identifies patients who are at low risk for development of EAC. These findings support lengthening surveillance intervals or discontinuing surveillance of patients with persistent NDBE. Copyright © 2013 AGA Institute. Published by Elsevier Inc. All rights reserved.

Comparison of dobutamine-stress magnetic resonance imaging and dipyridamole-Tl-201-SPECT as alternative strategies for the detection of coronary artery disease in patients not suitable for stress-echocardiography

International Nuclear Information System (INIS)

Schmidt, M.; Theissen, P.; Voth, E.; Schicha, H.; Jochims, M.; Baer, F.M.; Crnac, J.; Schneider, C.A.; Erdmann, E.

2001-01-01

Aim: During the past decade stress-echocardiography has gained increasing popularity for detection of myocardial ischemia in patients with coronary artery disease. However, about 10% to 15% of the patients submitted for stress-echocardiography do not have an adequate acoustic window. The purpose of this study was to compare high-dose dobutamine-stress magnetic resonance imaging (dobutamine-MRI) with dipyridamole-Tl-201-SPECT (dipyridamole-SPECT) as alternative strategies for detection of myocardial ischemia in patients with inadequate image quality by stress-echocardiography. Patients and Methods: Of 296 patients which were consecutively submitted to stress-echo-cardiography 45 patients (15%) had two or more segments that could not be evaluated according to the 16-segment-model of the American Society of Echocardiography. They underwent dobutamine-MRI and dipyridamole-SPECT studies, which were evaluated using a 28-segment modell. Myocardial segments were attributed to perfusion territories of the coronary arteries. The results of ischemia detection were compared to the results of coronary angiography (stenosis ≥50%). Results: In comparison to coronary angiography dobutamine-MRI yielded a sensitivity of 87%, a specificity of 86%, a positive predictive value of 93%, a negative predictive value of 75% and a diagnostic accuracy of 86%. For dipyridamole-SPECT results were 90%, 86%, 93%, 80% and 89%, respectively. These values were not significantly different. Conclusions: In patients not suitable for stress-echocardiography, both dobutamine-MRI and dipyridamole-SPECT are reliable strategies for detection of myocardial ischemia. Selection is dependent on the patient criteria, technical considerations, local logistics and experience of the observer. (orig.) [de

Can patients at risk for persistent negative symptoms be identified during their first episode of psychosis?

Science.gov (United States)

Malla, Ashok K; Norman, Ross M G; Takhar, Jatinder; Manchanda, Rahul; Townsend, Laurel; Scholten, Derek; Haricharan, Raj

2004-07-01

Patients with schizophrenia who show persistent negative symptoms are an important subgroup, but they are difficult to identify early in the course of illness. The objective of this study was to examine characteristics that discriminate between first-episode psychosis (FEP) patients in whom primary negative symptoms did or did not persist after 1 year of treatment. Patients with a DSM-IV diagnosis of FEP whose primary negative symptoms did (N = 36) or did not (N = 35) persist at 1 year were contrasted on their baseline and 1-year characteristics. Results showed that patients with persistent primary negative symptoms (N = 36) had a significantly longer duration of untreated psychosis (p < .005), worse premorbid adjustment during early (p < .001) and late adolescence (p < .01), and a higher level of affective flattening (p < .01) at initial presentation compared with patients with transitory primary negative symptoms. The former group also showed significantly lower remission rates at 1 year (p < .001). Multiple regression analysis confirmed the independent contribution of duration of untreated psychosis, premorbid adjustment, and affective flattening at baseline to the patients' likelihood of developing persistent negative symptoms. It may therefore be possible to distinguish a subgroup of FEP patients whose primary negative symptoms are likely to persist on the basis of characteristics shown at initial presentation for treatment.

Identifying protective and risk factors for injurious falls in patients hospitalized for acute care: a retrospective case-control study

Directory of Open Access Journals (Sweden)

Emmanuel Aryee

2017-11-01

Full Text Available Abstract Background Admitted patients who fall and injure themselves during an acute hospitalization incur increased costs, morbidity, and mortality, but little research has been conducted on identifying inpatients at high risk to injure themselves in a fall. Falls risk assessment tools have been unsuccessful due to their low positive predictive value when applied broadly to entire hospital populations. We aimed to identify variables associated with the risk of or protection against injurious fall in the inpatient setting. We also aimed to test the variables in the ABCs mnemonic (Age > 85, Bones-orthopedic conditions, anti-Coagulation and recent surgery for correlation with injurious fall. Methods We performed a retrospective case-control study at an academic tertiary care center comparing admitted patients with injurious fall to admitted patients without fall. We collected data on the demographics, medical and fall history, outcomes, and discharge disposition of injured fallers and control patients. We performed multivariate analysis of potential risk factors for injurious fall with logistic regression to calculate adjusted odds ratios. Results We identified 117 injured fallers and 320 controls. There were no differences in age, anti-coagulation use or fragility fractures between cases and controls. In multivariate analysis, recent surgery (OR 0.46, p = 0.003 was protective; joint replacement (OR 5.58, P = 0.002, psychotropic agents (OR 2.23, p = 0.001, the male sex (OR 2.08, p = 0.003 and history of fall (OR 2.08, p = 0.02 were significantly associated with injurious fall. Conclusion In this study, the variables in the ABCs parameters were among the variables not useful for identifying inpatients at risk of injuring themselves in a fall, while other non-ABCs variables demonstrated a significant association with injurious fall. Recent surgery was a protective factor, and practices around the care of surgical patients could be

Adipose-Derived Stem Cells in Novel Approaches to Breast Reconstruction: Their Suitability for Tissue Engineering and Oncological Safety.

Science.gov (United States)

O'Halloran, Niamh; Courtney, Donald; Kerin, Michael J; Lowery, Aoife J

2017-01-01

Adipose-derived stem cells (ADSCs) are rapidly becoming the gold standard cell source for tissue engineering strategies and hold great potential for novel breast reconstruction strategies. However, their use in patients with breast cancer is controversial and their oncological safety, particularly in relation to local disease recurrence, has been questioned. In vitro, in vivo, and clinical studies using ADSCs report conflicting data on their suitability for adipose tissue regeneration in patients with cancer. This review aims to provide an overview of the potential role for ADSCs in breast reconstruction and to examine the evidence relating to the oncologic safety of their use in patients with breast cancer.

Topic A. Have all the relevant issues been identified

International Nuclear Information System (INIS)

Bernero, R.M.

1994-01-01

This work is an answer to the question : have all the relevant issues been identified? The author tries to answer more particularly to the following three points : 1) can risk or responsibility for action be imposed on future generations. 2) Are current safety norms suitable for the future? 3) what controls are appropriate for inter generational cost/benefit evaluations. (O.L.)

Early prosthetic aortic valve infection identified with the use of positron emission tomography in a patient with lead endocarditis.

Science.gov (United States)

Amraoui, Sana; Tlili, Ghoufrane; Sohal, Manav; Bordenave, Laurence; Bordachar, Pierre

2016-12-01

18-Fluorodeoxyglucose positron emission tomography/computerized tomography (FDG PET/CT) scanning has recently been proposed as a diagnostic tool for lead endocarditis (LE). FDG PET/CT might be also useful to localize associated septic emboli in patients with LE. We report an interesting case of a LE patient with a prosthetic aortic valve in whom a trans-esophageal echocardiogram did not show associated aortic endocarditis. FDG PET/CT revealed prosthetic aortic valve infection. A second TEE performed 2 weeks after identified aortic vegetation. A longer duration of antimicrobial therapy with serial follow-up echocardiography was initiated. There was also increased uptake in the sigmoid colon, corresponding to focal polyps resected during a colonoscopy. FDG PET/CT scanning seems to be highly sensitive for prosthetic aortic valve endocarditis diagnosis. This promising diagnostic tool may be beneficial in LE patients, by identifying septic emboli and potential sites of pathogen entry.

suitability of burnt and crushed cow bones as partial replacement

African Journals Online (AJOL)

HOD

3 mix ratio measuring 150x150x150mm were tested for the compressive strength at 7, 14, 21 and 28 days respectively. ... the suitability of using waste products to produce lightweight ... suitability of machine crushed animal bones as partial or.

Identification of Patient Safety Risks Associated with Electronic Health Records: A Software Quality Perspective.

Science.gov (United States)

Virginio, Luiz A; Ricarte, Ivan Luiz Marques

2015-01-01

Although Electronic Health Records (EHR) can offer benefits to the health care process, there is a growing body of evidence that these systems can also incur risks to patient safety when developed or used improperly. This work is a literature review to identify these risks from a software quality perspective. Therefore, the risks were classified based on the ISO/IEC 25010 software quality model. The risks identified were related mainly to the characteristics of "functional suitability" (i.e., software bugs) and "usability" (i.e., interface prone to user error). This work elucidates the fact that EHR quality problems can adversely affect patient safety, resulting in errors such as incorrect patient identification, incorrect calculation of medication dosages, and lack of access to patient data. Therefore, the risks presented here provide the basis for developers and EHR regulating bodies to pay attention to the quality aspects of these systems that can result in patient harm.

Identifying thresholds for relationships between impacts of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: a correlational study.

Science.gov (United States)

Schubert, Maria; Clarke, Sean P; Glass, Tracy R; Schaffert-Witvliet, Bianca; De Geest, Sabina

2009-07-01

In the Rationing of Nursing Care in Switzerland Study, implicit rationing of care was the only factor consistently significantly associated with all six studied patient outcomes. These results highlight the importance of rationing as a new system factor regarding patient safety and quality of care. Since at least some rationing of care appears inevitable, it is important to identify the thresholds of its influences in order to minimize its negative effects on patient outcomes. To describe the levels of implicit rationing of nursing care in a sample of Swiss acute care hospitals and to identify clinically meaningful thresholds of rationing. Descriptive cross-sectional multi-center study. Five Swiss-German and three Swiss-French acute care hospitals. 1338 nurses and 779 patients. Implicit rationing of nursing care was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Other variables were measured using survey items from the International Hospital Outcomes Study battery. Data were summarized using appropriate descriptive measures, and logistic regression models were used to define a clinically meaningful rationing threshold level. For the studied patient outcomes, identified rationing threshold levels varied from 0.5 (i.e., between 0 ('never') and 1 ('rarely') to 2 ('sometimes')). Three of the identified patient outcomes (nosocomial infections, pressure ulcers, and patient satisfaction) were particularly sensitive to rationing, showing negative consequences anywhere it was consistently reported (i.e., average BERNCA scores of 0.5 or above). In other cases, increases in negative outcomes were first observed from the level of 1 (average ratings of rarely). Rationing scores generated using the BERNCA instrument provide a clinically meaningful method for tracking the correlates of low resources or difficulties in resource allocation on patient outcomes. Thresholds identified here provide parameters for administrators to

Twelve novel HGD gene variants identified in 99 alkaptonuria patients: focus on 'black bone disease' in Italy.

Science.gov (United States)

Nemethova, Martina; Radvanszky, Jan; Kadasi, Ludevit; Ascher, David B; Pires, Douglas E V; Blundell, Tom L; Porfirio, Berardino; Mannoni, Alessandro; Santucci, Annalisa; Milucci, Lia; Sestini, Silvia; Biolcati, Gianfranco; Sorge, Fiammetta; Aurizi, Caterina; Aquaron, Robert; Alsbou, Mohammed; Lourenço, Charles Marques; Ramadevi, Kanakasabapathi; Ranganath, Lakshminarayan R; Gallagher, James A; van Kan, Christa; Hall, Anthony K; Olsson, Birgitta; Sireau, Nicolas; Ayoob, Hana; Timmis, Oliver G; Sang, Kim-Hanh Le Quan; Genovese, Federica; Imrich, Richard; Rovensky, Jozef; Srinivasaraghavan, Rangan; Bharadwaj, Shruthi K; Spiegel, Ronen; Zatkova, Andrea

2016-01-01

Alkaptonuria (AKU) is an autosomal recessive disorder caused by mutations in homogentisate-1,2-dioxygenase (HGD) gene leading to the deficiency of HGD enzyme activity. The DevelopAKUre project is underway to test nitisinone as a specific treatment to counteract this derangement of the phenylalanine-tyrosine catabolic pathway. We analysed DNA of 40 AKU patients enrolled for SONIA1, the first study in DevelopAKUre, and of 59 other AKU patients sent to our laboratory for molecular diagnostics. We identified 12 novel DNA variants: one was identified in patients from Brazil (c.557T>A), Slovakia (c.500C>T) and France (c.440T>C), three in patients from India (c.469+6T>C, c.650-85A>G, c.158G>A), and six in patients from Italy (c.742A>G, c.614G>A, c.1057A>C, c.752G>A, c.119A>C, c.926G>T). Thus, the total number of potential AKU-causing variants found in 380 patients reported in the HGD mutation database is now 129. Using mCSM and DUET, computational approaches based on the protein 3D structure, the novel missense variants are predicted to affect the activity of the enzyme by three mechanisms: decrease of stability of individual protomers, disruption of protomer-protomer interactions or modification of residues in the region of the active site. We also present an overview of AKU in Italy, where so far about 60 AKU cases are known and DNA analysis has been reported for 34 of them. In this rather small group, 26 different HGD variants affecting function were described, indicating rather high heterogeneity. Twelve of these variants seem to be specific for Italy.

Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers.

Science.gov (United States)

Shahid, Shaouli; Durey, Angela; Bessarab, Dawn; Aoun, Samar M; Thompson, Sandra C

2013-11-04

Aboriginal Australians experience poorer outcomes from cancer compared to the non-Aboriginal population. Some progress has been made in understanding Aboriginal Australians' perspectives about cancer and their experiences with cancer services. However, little is known of cancer service providers' (CSPs) thoughts and perceptions regarding Aboriginal patients and their experiences providing optimal cancer care to Aboriginal people. Communication between Aboriginal patients and non-Aboriginal health service providers has been identified as an impediment to good Aboriginal health outcomes. This paper reports on CSPs' views about the factors impairing communication and offers practical strategies for promoting effective communication with Aboriginal patients in Western Australia (WA). A qualitative study involving in-depth interviews with 62 Aboriginal and non-Aboriginal CSPs from across WA was conducted between March 2006-September 2007 and April-October 2011. CSPs were asked to share their experiences with Aboriginal patients and families experiencing cancer. Thematic analysis was carried out. Our analysis was primarily underpinned by the socio-ecological model, but concepts of Whiteness and privilege, and cultural security also guided our analysis. CSPs' lack of knowledge about the needs of Aboriginal people with cancer and Aboriginal patients' limited understanding of the Western medical system were identified as the two major impediments to communication. For effective patient-provider communication, attention is needed to language, communication style, knowledge and use of medical terminology and cross-cultural differences in the concept of time. Aboriginal marginalization within mainstream society and Aboriginal people's distrust of the health system were also key issues impacting on communication. Potential solutions to effective Aboriginal patient-provider communication included recruiting more Aboriginal staff, providing appropriate cultural training for CSPs

The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission.

Science.gov (United States)

Baillie, Charles A; VanZandbergen, Christine; Tait, Gordon; Hanish, Asaf; Leas, Brian; French, Benjamin; Hanson, C William; Behta, Maryam; Umscheid, Craig A

2013-12-01

Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. Retrospective and prospective cohort. Healthcare system consisting of 3 hospitals. All adult patients admitted from August 2009 to September 2012. An automated readmission risk flag integrated into the EHR. Thirty-day all-cause and 7-day unplanned healthcare system readmissions. Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge. © 2013 Society of Hospital Medicine.

IDENTIFYING ELEVEN FACTORS OF SERVICE MARKETING MIX (4PS) EFFECTIVE ON TENDENCY OF PATIENTS TOWARD PRIVATE HOSPITAL.

Science.gov (United States)

Hosseini, Seyed Mojtaba; Etesaminia, Samira; Jafari, Mehrnoosh

2016-10-01

One of the important factors of correct management is to identify the reasons for patient tendency toward private hospitals. This study measures these factors based on service marketing mixes. This study used a cross sectional descriptive methodology. The study was conducted during 6 months in 2015. The studied population included patients of private hospitals in Tehran. Random sampling was used (n = 200). Data was collected by an author-made questionnaire for service marketing factors. Reliability and validity of the questionnaire were confirmed. Data analysis was done using factor analysis test in SPSS 20. The results showed that constant attendance of physicians and nurses has the highest effect (0.707%) on patient tendency toward private hospitals.

Identifying emergency department patients with chest pain who are at low risk for acute coronary syndromes [digest].

Science.gov (United States)

Markel, David; Kim, Jeremy

2017-07-21

Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing. The emerging role of new technologies, such as high-sensitivity troponin assays and advanced imaging techniques, are also presented. [Points & Pearls is a digest of Emergency Medicine Practice].

SU-E-I-75: Development of New Biological Fingerprints for Patient Recognition to Identify Misfiled Images in a PACS Server

Energy Technology Data Exchange (ETDEWEB)

Shimizu, Y; Yoon, Y; Iwase, K; Yasumatsu, S; Matsunobu, Y [Department of Health Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JP (Japan); Morishita, J [Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, Fukuoka, JP (Japan)

2015-06-15

Purpose: We are trying to develop an image-searching technique to identify misfiled images in a picture archiving and communication system (PACS) server by using five biological fingerprints: the whole lung field, cardiac shadow, superior mediastinum, lung apex, and right lower lung. Each biological fingerprint in a chest radiograph includes distinctive anatomical structures to identify misfiled images. The whole lung field was less effective for evaluating the similarity between two images than the other biological fingerprints. This was mainly due to the variation in the positioning for chest radiographs. The purpose of this study is to develop new biological fingerprints that could reduce influence of differences in the positioning for chest radiography. Methods: Two hundred patients were selected randomly from our database (36,212 patients). These patients had two images each (current and previous images). Current images were used as the misfiled images in this study. A circumscribed rectangular area of the lung and the upper half of the rectangle were selected automatically as new biological fingerprints. These biological fingerprints were matched to all previous images in the database. The degrees of similarity between the two images were calculated for the same and different patients. The usefulness of new the biological fingerprints for automated patient recognition was examined in terms of receiver operating characteristic (ROC) analysis. Results: Area under the ROC curves (AUCs) for the circumscribed rectangle of the lung, upper half of the rectangle, and whole lung field were 0.980, 0.994, and 0.950, respectively. The new biological fingerprints showed better performance in identifying the patients correctly than the whole lung field. Conclusion: We have developed new biological fingerprints: circumscribed rectangle of the lung and upper half of the rectangle. These new biological fingerprints would be useful for automated patient identification system

SU-E-I-75: Development of New Biological Fingerprints for Patient Recognition to Identify Misfiled Images in a PACS Server

International Nuclear Information System (INIS)

Shimizu, Y; Yoon, Y; Iwase, K; Yasumatsu, S; Matsunobu, Y; Morishita, J

2015-01-01

Purpose: We are trying to develop an image-searching technique to identify misfiled images in a picture archiving and communication system (PACS) server by using five biological fingerprints: the whole lung field, cardiac shadow, superior mediastinum, lung apex, and right lower lung. Each biological fingerprint in a chest radiograph includes distinctive anatomical structures to identify misfiled images. The whole lung field was less effective for evaluating the similarity between two images than the other biological fingerprints. This was mainly due to the variation in the positioning for chest radiographs. The purpose of this study is to develop new biological fingerprints that could reduce influence of differences in the positioning for chest radiography. Methods: Two hundred patients were selected randomly from our database (36,212 patients). These patients had two images each (current and previous images). Current images were used as the misfiled images in this study. A circumscribed rectangular area of the lung and the upper half of the rectangle were selected automatically as new biological fingerprints. These biological fingerprints were matched to all previous images in the database. The degrees of similarity between the two images were calculated for the same and different patients. The usefulness of new the biological fingerprints for automated patient recognition was examined in terms of receiver operating characteristic (ROC) analysis. Results: Area under the ROC curves (AUCs) for the circumscribed rectangle of the lung, upper half of the rectangle, and whole lung field were 0.980, 0.994, and 0.950, respectively. The new biological fingerprints showed better performance in identifying the patients correctly than the whole lung field. Conclusion: We have developed new biological fingerprints: circumscribed rectangle of the lung and upper half of the rectangle. These new biological fingerprints would be useful for automated patient identification system

CVExplorer: identifying candidate developers by mining and exploring their open source contributions.

CSIR Research Space (South Africa)

Greene, GJ

2016-09-01

Full Text Available Open source code contributions contain a large amount of technical skill information about developers, which can help to identify suitable candidates for a particular development job and therefore impact the success of a development team. We develop...

Climate change effects on Chikungunya transmission in Europe: geospatial analysis of vector's climatic suitability and virus' temperature requirements.

Science.gov (United States)

Fischer, Dominik; Thomas, Stephanie M; Suk, Jonathan E; Sudre, Bertrand; Hess, Andrea; Tjaden, Nils B; Beierkuhnlein, Carl; Semenza, Jan C

2013-11-12

Chikungunya was, from the European perspective, considered to be a travel-related tropical mosquito-borne disease prior to the first European outbreak in Northern Italy in 2007. This was followed by cases of autochthonous transmission reported in South-eastern France in 2010. Both events occurred after the introduction, establishment and expansion of the Chikungunya-competent and highly invasive disease vector Aedes albopictus (Asian tiger mosquito) in Europe. In order to assess whether these outbreaks are indicative of the beginning of a trend or one-off events, there is a need to further examine the factors driving the potential transmission of Chikungunya in Europe. The climatic suitability, both now and in the future, is an essential starting point for such an analysis. The climatic suitability for Chikungunya outbreaks was determined by using bioclimatic factors that influence, both vector and, pathogen. Climatic suitability for the European distribution of the vector Aedes albopictus was based upon previous correlative environmental niche models. Climatic risk classes were derived by combining climatic suitability for the vector with known temperature requirements for pathogen transmission, obtained from outbreak regions. In addition, the longest potential intra-annual season for Chikungunya transmission was estimated for regions with expected vector occurrences.In order to analyse spatio-temporal trends for risk exposure and season of transmission in Europe, climate change impacts are projected for three time-frames (2011-2040, 2041-2070 and 2071-2100) and two climate scenarios (A1B and B1) from the Intergovernmental Panel on Climate Change (IPCC). These climatic projections are based on regional climate model COSMO-CLM, which builds on the global model ECHAM5. European areas with current and future climatic suitability of Chikungunya transmission are identified. An increase in risk is projected for Western Europe (e.g. France and Benelux-States) in the

A cross-sectional study to identify organisational processes associated with nurse-reported quality and patient safety

Science.gov (United States)

Tvedt, Christine; Sjetne, Ingeborg Strømseng; Helgeland, Jon; Bukholm, Geir

2012-01-01

Objectives The purpose of this study was to identify organisational processes and structures that are associated with nurse-reported patient safety and quality of nursing. Design This is an observational cross-sectional study using survey methods. Setting Respondents from 31 Norwegian hospitals with more than 85 beds were included in the survey. Participants All registered nurses working in direct patient care in a position of 20% or more were invited to answer the survey. In this study, 3618 nurses from surgical and medical wards responded (response rate 58.9). Nurses' practice environment was defined as organisational processes and measured by the Nursing Work Index Revised and items from Hospital Survey on Patient Safety Culture. Outcome measures Nurses' assessments of patient safety, quality of nursing, confidence in how their patients manage after discharge and frequency of adverse events were used as outcome measures. Results Quality system, nurse–physician relation, patient safety management and staff adequacy were process measures associated with nurse-reported work-related and patient-related outcomes, but we found no associations with nurse participation, education and career and ward leadership. Most organisational structures were non-significant in the multilevel model except for nurses’ affiliations to medical department and hospital type. Conclusions Organisational structures may have minor impact on how nurses perceive work-related and patient-related outcomes, but the findings in this study indicate that there is a considerable potential to address organisational design in improvement of patient safety and quality of care. PMID:23263021

Transient elastography with the XL probe rapidly identifies patients with nonhepatic ascites

Directory of Open Access Journals (Sweden)

Mueller S

2012-05-01

significantly lower liver stiffness (<8 kPa as compared with the remaining patients with hepatic ascites (>30 kPa. Mean liver stiffness was 5.4 kPa ± 1.3 versus 66.2 ± 13.3 kPa.Conclusion: In conclusion, the presence of ascites and increased intra-abdominal pressure does not alter underlying liver stiffness as determined by transient elastography. We suggest that, using the XL probe, transient elastography can be used first-line to identify patients with nonhepatic ascites at an early stage.Keywords: ascites, liver stiffness, transient elastography, liver cirrhosis, noncirrhotic ascites, congestion, peritoneal carcinomatosis, intra-abdominal pressure, alcoholic liver disease

Albumin Homodimers in Patients with Cirrhosis: Clinical and Prognostic Relevance of a Novel Identified Structural Alteration of the Molecule.

Science.gov (United States)

Baldassarre, Maurizio; Domenicali, Marco; Naldi, Marina; Laggetta, Maristella; Giannone, Ferdinando A; Biselli, Maurizio; Patrono, Daniela; Bertucci, Carlo; Bernardi, Mauro; Caraceni, Paolo

2016-10-26

Decompensated cirrhosis is associated to extensive post-transcriptional changes of human albumin (HA). This study aims to characterize the occurrence of HA homodimerization in a large cohort of patients with decompensated cirrhosis and to evaluate its association with clinical features and prognosis. HA monomeric and dimeric isoforms were identified in peripheral blood by using a HPLC-ESI-MS technique in 123 cirrhotic patients hospitalized for acute decompensation and 50 age- and sex-comparable healthy controls. Clinical and biochemical parameters were recorded and patients followed up to one year. Among the monomeric isoforms identified, the N- and C-terminal truncated and the native HA underwent homodimerization. All three homodimers were significantly more abundant in patients with cirrhosis, acute-on-chronic liver failure and correlate with the prognostic scores. The homodimeric N-terminal truncated isoform was independently associated to disease complications and was able to stratify 1-year survival. As a result of all these changes, the monomeric native HA was significantly decreased in patients with cirrhosis, being also associated with a poorer prognosis. In conclusion homodimerization is a novel described structural alteration of the HA molecule in decompensated cirrhosis and contributes to the progressive reduction of the monomeric native HA, the only isoform provided of structural and functional integrity.

A habitat suitability model for Pacific oysters (Crassostrea gigas) in the Oosterschelde

NARCIS (Netherlands)

Schellekens, T.; Wijsman, J.W.M.; Brink, van den A.M.

2012-01-01

The modelled habitat suitability maps show a reasonable estimation of the suitability for oysters throughout the Delta and can be used to broadly indicate the consequences of the effect of climate change and infrastructural changes on the habitat suitability for oysters. The largest effect on the

Identifying and predicting subgroups of information needs among cancer patients: an initial study using latent class analysis.

Science.gov (United States)

Neumann, Melanie; Wirtz, Markus; Ernstmann, Nicole; Ommen, Oliver; Längler, Alfred; Edelhäuser, Friedrich; Scheffer, Christian; Tauschel, Diethard; Pfaff, Holger

2011-08-01

Understanding how the information needs of cancer patients (CaPts) vary is important because met information needs affect health outcomes and CaPts' satisfaction. The goals of the study were to identify subgroups of CaPts based on self-reported cancer- and treatment-related information needs and to determine whether subgroups could be predicted on the basis of selected sociodemographic, clinical and clinician-patient relationship variables. Three hundred twenty-three CaPts participated in a survey using the "Cancer Patients Information Needs" scale, which is a new tool for measuring cancer-related information needs. The number of information need subgroups and need profiles within each subgroup was identified using latent class analysis (LCA). Multinomial logistic regression was applied to predict class membership. LCA identified a model of five subgroups exhibiting differences in type and extent of CaPts' unmet information needs: a subgroup with "no unmet needs" (31.4% of the sample), two subgroups with "high level of psychosocial unmet information needs" (27.0% and 12.0%), a subgroup with "high level of purely medical unmet information needs" (16.0%) and a subgroup with "high level of medical and psychosocial unmet information needs" (13.6%). An assessment of sociodemographic and clinical characteristics revealed that younger CaPts and CaPts' requiring psychological support seem to belong to subgroups with a higher level of unmet information needs. However, the most significant predictor for the subgroups with unmet information needs is a good clinician-patient relationship, i.e. subjective perception of high level of trust in and caring attention from nurses together with high degree of physician empathy seems to be predictive for inclusion in the subgroup with no unmet information needs. The results of our study can be used by oncology nurses and physicians to increase their awareness of the complexity and heterogeneity of information needs among CaPts and of

Proteomic profiling of pretreatment serum from HIV-infected patients identifies candidate markers predictive of lymphoma development

DEFF Research Database (Denmark)

Vase, Maja Ølholm; Ludvigsen, Maja; Bendix, Knud

2016-01-01

. Differentially expressed proteins were identified by liquid chromatography-tandem mass spectrometry. A tissue microarray, containing diagnostic HIV-lymphoma tissue samples (N = 40), was used to investigate immunohistochemical expression of markers in tumoural lesions. RESULTS: Fourteen differentially expressed...... protein spots were detected. Using principal components analysis, spots containing immunoglobulin J chain, apolipoprotein A-I, procollagen C-endopeptidase enhancer-1 and complement C4-A were associated with lymphoma development (P ... with subsequent lymphoma compared with patients without subsequent lymphoma. In the tissue microarray, amyloid A was widely expressed, and high expression showed a tendency towards inferior outcome (log-rank 0.073). CONCLUSION: We identified several differentially expressed protein spots present already...

Gene Expression Profiling Identifies Downregulation of the Neurotrophin-MAPK Signaling Pathway in Female Diabetic Peripheral Neuropathy Patients.

Science.gov (United States)

Luo, Lin; Zhou, Wen-Hua; Cai, Jiang-Jia; Feng, Mei; Zhou, Mi; Hu, Su-Pei; Xu, Jin; Ji, Lin-Dan

2017-01-01

Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus (DM). It is not diagnosed or managed properly in the majority of patients because its pathogenesis remains controversial. In this study, human whole genome microarrays identified 2898 and 4493 differentially expressed genes (DEGs) in DM and DPN patients, respectively. A further KEGG pathway analysis indicated that DPN and DM share four pathways, including apoptosis, B cell receptor signaling pathway, endocytosis, and Toll-like receptor signaling pathway. The DEGs identified through comparison of DPN and DM were significantly enriched in MAPK signaling pathway, NOD-like receptor signaling pathway, and neurotrophin signaling pathway, while the "neurotrophin-MAPK signaling pathway" was notably downregulated. Seven DEGs from the neurotrophin-MAPK signaling pathway were validated in additional 78 samples, and the results confirmed the initial microarray findings. These findings demonstrated that downregulation of the neurotrophin-MAPK signaling pathway may be the major mechanism of DPN pathogenesis, thus providing a potential approach for DPN treatment.

Targeted individual exercise programmes for older medical patients are feasible, and may change hospital and patient outcomes: a service improvement project

Directory of Open Access Journals (Sweden)

Thomas Susie

2008-12-01

Full Text Available Abstract Background The aim of this project was primarily to assess the feasibility of individual exercise programs for older hospitalised patients at risk of functional decline, and secondarily to evaluate impact on discharge outcomes. Methods Design: Cohort service improvement project Setting: 500 bed acute metropolitan hospital Subjects: Patients aged 70 and older admitted to Flinders Medical Centre under the general medical, aged care and respiratory units from June to November 2006, at intermediate or high risk of functional decline, and able to commence exercise within 48 hours of admission Intervention: Functional Maintenance Program (FMP; an individually tailored exercise program to maintain functional mobility, prescribed and progressed by a physiotherapist, and supervised by an Allied Health Assistant (AHA, provided in addition to usual physiotherapy care Outcome measures: Feasibility (number of admissions suitable, commencing and complying with FMP. Impact (length of hospital stay (LOS, Aged Care Assessment Team (ACAT referrals and approvals, hospital readmissions within 28 days, and functional mobility (Elderly Mobility Scale Data Analysis: Descriptive and logistic regression analysis Results Of 1021 admissions of patients aged 70 or older to general medical, aged care and respiratory units, 22% (n = 220 were identified within 48 hours as suitable for FMP: 196 (89% commenced FMP within 48 hours of admission (FMP patients; 24 (11% received usual physiotherapy (usual care patients. Feasibility of individually tailored exercise programs for older medical patients was supported by high uptake (89%, low withdrawal (17% shown by those who commenced FMP, and good compliance with exercise sessions (70%. Logistic regression analysis showed a statistically significant decreased likelihood of referral for nursing home admission (OR = 0.228, 95% CI 0.088–0.587 and decreased likelihood of approval for admission to residential care (OR = 0

Footwear suitability in Turkish preschool-aged children.

Science.gov (United States)

Yurt, Yasin; Sener, Gul; Yakut, Yavuz

2014-06-01

Unsuitable footwear worn in childhood may cause some foot problems by interfering normal development of foot. To compare footwear suitability rate of indoor and outdoor footwear at all points in preschool children and investigate factors which could affect footwear suitability. A cross-sectional survey study. A total of 1000 healthy preschool children (4-6 years old) participated in this study. Indoor and outdoor footwear of children were evaluated through Turkish version of Footwear Assessment Score. Effect of factors like age, sex, number of siblings, educational and occupational situation of parents, and behavior of school management about selecting footwear was investigated. Children got better footwear score for outdoor than indoor ones (p footwear score for both indoor and outdoor ones than girls (p footwear score was found in favor of children who were going to schools that gave guidance about selecting footwear for both indoor and outdoor in comparison to children going to other schools (p footwear for their children. Performing education programs and investigation of their effect with comprehensive follow-up studies in future is essential. This study reflects footwear habits of Turkish preschool children and factors affecting this issue. Results may give way to education programs about suitable footwear worn in childhood for healthy foot development. © The International Society for Prosthetics and Orthotics 2013.

Genetic screening of Greek patients with Huntington’s disease phenocopies identifies an SCA8 expansion.

Science.gov (United States)

Koutsis, G; Karadima, G; Pandraud, A; Sweeney, M G; Paudel, R; Houlden, H; Wood, N W; Panas, M

2012-09-01

Huntington’s disease (HD) is an autosomal dominant disorder characterized by a triad of chorea, psychiatric disturbance and cognitive decline. Around 1% of patients with HD-like symptoms lack the causative HD expansion and are considered HD phenocopies. Genetic diseases that can present as HD phenocopies include HD-like syndromes such as HDL1, HDL2 and HDL4 (SCA17), some spinocerebellar ataxias (SCAs) and dentatorubral-pallidoluysian atrophy (DRPLA). In this study we screened a cohort of 21 Greek patients with HD phenocopy syndromes formutations causing HDL2, SCA17, SCA1, SCA2, SCA3,SCA8, SCA12 and DRPLA. Fifteen patients (71%) had a positive family history. We identified one patient (4.8% of the total cohort) with an expansion of 81 combined CTA/CTG repeats at the SCA8 locus. This falls within what is believed to be the high-penetrance allele range. In addition to the classic HD triad, the patient had features of dystonia and oculomotor apraxia. There were no cases of HDL2, SCA17, SCA1, SCA2, SCA3, SCA12 or DRPLA. Given the controversy surrounding the SCA8 expansion, the present finding may be incidental. However, if pathogenic, it broadens the phenotype that may be associated with SCA8 expansions. The absence of any other mutations in our cohort is not surprising, given the low probability of reaching a genetic diagnosis in HD phenocopy patients.

Spectrum of small-bowel mucosal abnormalities identified by capsule endoscopy in patients with portal hypertension of varied etiology.

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Chandrasekar, T S; Janakan, Gokul Bollu; Chandrasekar, Viveksandeep Thoguluva; Kalamegam, Raja Yogesh; Suriyanarayanan, Sathiamoorthy; Sanjeevaraya, Prasad Menta

2017-01-01

Bleeding from small intestinal ectopic varices and persistent anemia caused by portal hypertensive enteropathy (PHE) can be very challenging. Capsule endoscopy (CE) is one of the best noninvasive modalities in identifying such lesions. The aims of this study are to study the prevalence of small-bowel changes related to portal hypertension (PHT) and to correlate them with the observations related to the effects of portal hypertension in the esophagus, stomach, and colon. Thirty-two patients with various etiologies of PHT with either anemia or gastrointestinal bleed were included along with age- and sex-matched controls without PHT. All patients underwent blood tests, gastroscopy, colonoscopy, and CE. The small-bowel findings by CE were categorized as inflammatory-like and vascular lesions. The small-bowel changes were analyzed to find out any association with various demographic, clinical, and endoscopic variables. Thirty-one out of 32 patients with PHT (96.8%) had PHE identified by CE. Of them, 31 (96.8%) had inflammatory-like appearance, 11 (34.4%) had vascular lesions, and 2 (6.2%) had small-bowel varices. Inflammatory-like appearance was noted in eight (25%) and angiodysplastic lesions in two (6.2%) controls. Findings compatible with PHE were detected in 96.8% of the patients and 25% of the controls (X 2 =34.72, p=0.000).The presence of PHE was not associated with any of the above-mentioned variables. Small-bowel mucosal changes were seen in significantly higher number of patients with PHT with anemia.

ANALYSIS OF LAND RESOURCES SUITABILITY BY FUNCTIONAL MODEL IN EASTERN CROATIA REGION

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Vladimir Vukadinović

2011-06-01

Full Text Available A total of 17405 soil samples (2003rd-2009th years were analyzed in the eastern part of Croatia. The aim of this paper is to assess land suitability for crops i.e. to describe quantitatively land quality and indicate disadvantages of land using system in investigated area. The described mathematical model uses score functions for estimating indicators of soil suitability. Soil suitability assessment computer model for crops, supported by GIS, proved to be fast, efficient and enough reliable. Using GIS tool it is possible to visualize land suitability and present it in different cartographic bases such as maps whereas using geostatistical method – kriging enables to possible to provide regionalization of production area based on quantitative assessment of land suitability for crops.

Patient-specific fibre-based models of muscle wrapping

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Kohout, J.; Clapworthy, G. J.; Zhao, Y.; Tao, Y.; Gonzalez-Garcia, G.; Dong, F.; Wei, H.; Kohoutová, E.

2013-01-01

In many biomechanical problems, the availability of a suitable model for the wrapping of muscles when undergoing movement is essential for the estimation of forces produced on and by the body during motion. This is an important factor in the Osteoporotic Virtual Physiological Human project which is investigating the likelihood of fracture for osteoporotic patients undertaking a variety of movements. The weakening of their skeletons makes them particularly vulnerable to bone fracture caused by excessive loading being placed on the bones, even in simple everyday tasks. This paper provides an overview of a novel volumetric model that describes muscle wrapping around bones and other muscles during movement, and which includes a consideration of how the orientations of the muscle fibres change during the motion. The method can calculate the form of wrapping of a muscle of medium size and visualize the outcome within tenths of seconds on commodity hardware, while conserving muscle volume. This makes the method suitable not only for educational biomedical software, but also for clinical applications used to identify weak muscles that should be strengthened during rehabilitation or to identify bone stresses in order to estimate the risk of fractures. PMID:24427519

The right tree for the job? perceptions of species suitability for the provision of ecosystem services.

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Smaill, Simeon J; Bayne, Karen M; Coker, Graham W R; Paul, Thomas S H; Clinton, Peter W

2014-04-01

Stakeholders in plantation forestry are increasingly aware of the importance of the ecosystem services and non-market values associated with forests. In New Zealand, there is significant interest in establishing species other than Pinus radiata D. Don (the dominant plantation species) in the belief that alternative species are better suited to deliver these services. Significant risk is associated with this position as there is little objective data to support these views. To identify which species were likely to be planted to deliver ecosystem services, a survey was distributed to examine stakeholder perceptions. Stakeholders were asked which of 15 tree attributes contributed to the provision of five ecosystem services (amenity value, bioenergy production, carbon capture, the diversity of native habitat, and erosion control/water quality) and to identify which of 22 candidate tree species possessed those attributes. These data were combined to identify the species perceived most suitable for the delivery of each ecosystem service. Sequoia sempervirens (D.Don) Endl. closely matched the stakeholder derived ideotypes associated with all five ecosystem services. Comparisons to data from growth, physiological and ecological studies demonstrated that many of the opinions held by stakeholders were inaccurate, leading to erroneous assumptions regarding the suitability of most candidate species. Stakeholder perceptions substantially influence tree species selection, and plantations established on the basis of inaccurate opinions are unlikely to deliver the desired outcomes. Attitudinal surveys associated with engagement campaigns are essential to improve stakeholder knowledge, advancing the development of fit-for-purpose forest management that provides the required ecosystem services.

Using Machine Learning for Land Suitability Classification

African Journals Online (AJOL)

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West African Journal of Applied Ecology, vol. ... evidence for the utility of machine learning methods in land suitability classification especially MCS methods. ... Artificial intelligence tools. ..... Numerical values of index for the various classes.

Bedside teaching with unwell patients: Can it ever be appropriate?

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Jayakumar, Nithish

2017-03-01

Bedside teaching has seen a decline in its popularity since the heady days of Boerhaave and Osler; a number of hurdles have been noted in the literature including time constraints on senior clinicians. While organizing a bedside teaching course for final-year medical students, it was apparent that the availability of suitable patients was also a limiting factor. Often, we would be turned away from patients with physical signs because they were deemed to be too unwell for an examination. However, the benefits to medical students of examining unwell patients with physical signs cannot be underestimated. Identifying the unwell patient, and the associated physical signs relevant to the underlying diagnosis, should be a priority; although simulation is increasingly being used in teaching, it cannot fully replicate the learning experience gained in bedside teaching. As long as the patient is not under duress, bedside teaching with unwell patients should be encouraged.

A conceptual framework for evaluating data suitability for observational studies.

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Shang, Ning; Weng, Chunhua; Hripcsak, George

2017-09-08

To contribute a conceptual framework for evaluating data suitability to satisfy the research needs of observational studies. Suitability considerations were derived from a systematic literature review on researchers' common data needs in observational studies and a scoping review on frequent clinical database design considerations, and were harmonized to construct a suitability conceptual framework using a bottom-up approach. The relationships among the suitability categories are explored from the perspective of 4 facets of data: intrinsic, contextual, representational, and accessible. A web-based national survey of domain experts was conducted to validate the framework. Data suitability for observational studies hinges on the following key categories: Explicitness of Policy and Data Governance, Relevance, Availability of Descriptive Metadata and Provenance Documentation, Usability, and Quality. We describe 16 measures and 33 sub-measures. The survey uncovered the relevance of all categories, with a 5-point Likert importance score of 3.9 ± 1.0 for Explicitness of Policy and Data Governance, 4.1 ± 1.0 for Relevance, 3.9 ± 0.9 for Availability of Descriptive Metadata and Provenance Documentation, 4.2 ± 1.0 for Usability, and 4.0 ± 0.9 for Quality. The suitability framework evaluates a clinical data source's fitness for research use. Its construction reflects both researchers' points of view and data custodians' design features. The feedback from domain experts rated Usability, Relevance, and Quality categories as the most important considerations. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Geriatrics and radiation oncology. Pt. 1. How to identify high-risk patients and basic treatment principles

International Nuclear Information System (INIS)

Fels, Franziska; Kraft, Johannes W.; Grabenbauer, Gerhard G.

2010-01-01

Background: Until the mid of this century, 33% of the Western population will be ≥ 65 years old. The percentage of patients being ≥ 80 years old with today 5% will triple until 2050. Therefore, radiation oncologists must be familiar with special geriatric issues to meet the increasing demand for multidisciplinary cooperation and to offer useful and individual treatment concepts. Patients and Methods: This review article will provide basic data on the definition, identification and treatment of geriatric cancer patients. Results: The geriatric patient is defined by typical multimorbidity (15 items) and by age-related increased vulnerability. Best initial identification of geriatric patients will be provided by assessment including the Barthel Index evaluating self-care and activity in daily life, by the Mini-Mental Status Test that will address cognitive pattern, and by the Timed 'Up and Go' Test for evaluation of mobility. As for chemotherapy, standard treatment was associated with increased toxicity, consequently, dose modifications and supportive treatment are of special importance. Conclusion: Geriatric cancer patients need to be identified by special assessment instruments. Due to increased toxicity following chemotherapy, supportive measures seem important. Radiation treatment as a noninvasive and outpatient-based treatment remains an important and preferable option. (orig.)

Stereotactic body radiotherapy: a promising treatment option for the boost of oropharyngeal cancers not suitable for brachytherapy: a single-institutional experience.

NARCIS (Netherlands)

Al-Mamgani, A.; Tans, L.; Teguh, D.N.; Rooij, P. van; Zwijnenburg, E.M.; Levendag, P.C.

2012-01-01

PURPOSE: To prospectively assess the outcome and toxicity of frameless stereotactic body radiotherapy (SBRT) as a treatment option for boosting primary oropharyngeal cancers (OPC) in patients who not suitable for the standard brachytherapy boost (BTB). METHODS AND MATERIALS: Between 2005 and 2010,

Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's Disease).

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Meyer, Gesine; Hackemann, Annika; Reusch, Juergen; Badenhoop, Klaus

2012-05-01

Hypoglycemia can be a symptom in patients with Addison's disease. The common regimen of replacement therapy with oral glucocorticoids results in unphysiological low cortisol levels in the early morning, the time of highest insulin sensitivity. Therefore patients with Addison's disease are at risk for unrecognized and potentially severe nocturnal hypoglycemia also because of a disturbed counterregulatory function. Use of a continuous glucose monitoring system (CGMS) could help to adjust hydrocortisone treatment and to avoid nocturnal hypoglycemia in these patients. Thirteen patients with Addison's disease were screened for hypoglycemia wearing a CGMS for 3-5 days. In one patient we identified a hypoglycemic episode at 3:45 a.m. with a blood glucose level of 46 mg/dL, clearly beneath the 95% tolerance interval of minimal glucose levels between 2 and 4 a.m. (53.84 mg/dL). After the hydrocortisone replacement scheme was changed, the minimum blood glucose level between 2 and 4 a.m. normalized to 87 mg/dL. Continuous glucose monitoring can detect nocturnal hypoglycemia in patients with primary adrenal insufficiency and hence prevent in these patients an impaired quality of life and even serious adverse effects.

Clinical Findings and Treatment Outcomes in Patients with Extraprostatic Extension Identified on Prostate Biopsy.

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