Dynamics of the middle atmosphere as observed by the ARISE project

Science.gov (United States)

Blanc, E.

2015-12-01

It has been strongly demonstrated that variations in the circulation of the middle atmosphere influence weather and climate all the way to the Earth's surface. A key part of this coupling occurs through the propagation and breaking of planetary and gravity waves. However, limited observations prevent to faithfully reproduce the dynamics of the middle atmosphere in numerical weather prediction and climate models. The main challenge of the ARISE (Atmospheric dynamics InfraStructure in Europe) project is to combine existing national and international observation networks including: the International infrasound monitoring system developed for the CTBT (Comprehensive nuclear-Test-Ban Treaty) verification, the NDACC (Network for the Detection of Atmospheric Composition Changes) lidar network, European observation infrastructures at mid latitudes (OHP observatory), tropics (Maïdo observatory), high latitudes (ALOMAR and EISCAT), infrasound stations which form a dense European network and satellites. The ARISE network is unique by its coverage (polar to equatorial regions in the European longitude sector), its altitude range (from troposphere to mesosphere and ionosphere) and the involved scales both in time (from seconds to tens of years) and space (from tens of meters to thousands of kilometers). Advanced data products are produced with the scope to assimilate data in the Weather Prediction models to improve future forecasts over weeks and seasonal time scales. ARISE observations are especially relevant for the monitoring of extreme events such as thunderstorms, volcanoes, meteors and at larger scales, deep convection and stratospheric warming events for physical processes description and study of long term evolution with climate change. Among the applications, ARISE fosters integration of innovative methods for remote detection of non-instrumented volcanoes including distant eruption characterization to provide notifications with reliable confidence indices to the

Primary extradural meningioma arising from the calvarium | Ravi ...

African Journals Online (AJOL)

Meningiomas are the most common intracranial tumours. Meningiomas arising at other locations are termed primary extradural meningiomas (EDMs) and are rare. Here we report a case of EDM arising from the calvarium – a primary calvarial meningioma (PCM).

Survival of mutations arising during invasions.

Science.gov (United States)

Miller, Judith R

2010-03-01

When a neutral mutation arises in an invading population, it quickly either dies out or 'surfs', i.e. it comes to occupy almost all the habitat available at its time of origin. Beneficial mutations can also surf, as can deleterious mutations over finite time spans. We develop descriptive statistical models that quantify the relationship between the probability that a mutation will surf and demographic parameters for a cellular automaton model of surfing. We also provide a simple analytic model that performs well at predicting the probability of surfing for neutral and beneficial mutations in one dimension. The results suggest that factors - possibly including even abiotic factors - that promote invasion success may also increase the probability of surfing and associated adaptive genetic change, conditioned on such success.

Endometrial Stromal Sarcoma Arising in Colorectal Endometriosis: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Qiao Wang

2015-01-01

Full Text Available Extrauterine endometrial stromal sarcoma (ESS arising in endometriosis is extremely rare, particularly in the colorectum. It should always be included in the differential diagnosis of primary tumors originating from gastrointestinal tract in females, given that preoperative endoscopical biopsy may reveal no specific changes. We reported a case of ESS arising in colorectal endometriosis and reviewed the previous 7 cases reported in the English literature. Our patient, who was unavailable for tumor resection and refused further adjuvant therapy, played a role in representing the natural history of low-grade extragenital ESS. This case was the only death from ESS arising in colorectal endometriosis.

Theoretical Framework to Extend Adverse Outcome Pathways to Include Pharmacokinetic Considerations

Science.gov (United States)

Adverse Outcome Pathways (AOPs) have generated intense interest for their utility in linking known population outcomes to a molecular initiating event (MIE) that can be quantified using in vitro methods. While there are tens of thousands of chemicals in commercial use, biology h...

Nipple adenoma arising from axillary accessory breast: a case report

Directory of Open Access Journals (Sweden)

Shioi Yoshihiro

2012-11-01

Full Text Available Abstract Nipple adenoma is a relatively rare benign breast neoplasm, and cases of the disease arising from the axillary accessory breast have very seldom been reported in the English literature. We report a case of nipple adenoma arising from axillary accessory breast including clinical and pathological findings. An 82-year-old woman presented with the complaint of a small painful mass in the right axilla. Physical examination confirmed a well-defined eczematous crusted mass that was 8 mm in size. The diagnosis of nipple adenoma was made from an excisional specimen on the basis of characteristic histological findings. Microscopic structural features included a compact proliferation of small tubules lined by epithelial and myoepithelial cells, and the merging of glandular epithelial cells of the adenoma into squamous epithelial cells in the superficial epidermal layer. Because clinically nipple adenoma may resemble Paget’s disease and pathologically can be misinterpreted as tubular carcinoma, the correct identification of nipple adenoma is an important factor in the differential diagnosis for axillary tumor neoplasms. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1186821489769063

[A case of carcinoma arising in a diverticulum of the transverse colon].

Science.gov (United States)

Nomi, Masako; Umemoto, Satoshi; Kikutake, Takashi; Hosaka, Seiji; Mase, Takahiro; Kawamoto, Shunji; Yoshida, Takahisa

2014-11-01

A 64 year-old woman presented with advanced, transverse colon cancer arising in the diverticulum. Tumor invasion extended beyond the serosa to the anal side of the colon. Anemia and fatigue progressed after 6 months of iron administration. The hemoglobin value was 5.3 g/dL and carcinoembryonic antigen (CEA) level was elevated to 44.2 ng/mL. A palpable and tender fist-sized mass was found in the right upper abdomen. Computed tomography (CT) revealed a low-density mass in the transverse colon invading beyond the serosa to the anal side of the colon. Right hemi-colectomy with lymph node dissection was performed. The resected specimen contained multiple diverticula including the one from which the tumor arose. Histological examination revealed a well-differentiated, tubular adenocarcinoma (UICC TNM T4bN0M0) arising in a transverse colon diverticulum. There has been no recurrence for 2 years. Colon cancer arising in a diverticulum may expand to the extra-serosa and easily invade to the adjacent organ. In such cases, malignancy should be considered.

Endogeneously arising network allocation rules

NARCIS (Netherlands)

Slikker, M.

2006-01-01

In this paper we study endogenously arising network allocation rules. We focus on three allocation rules: the Myerson value, the position value and the component-wise egalitarian solution. For any of these three rules we provide a characterization based on component efficiency and some balanced

Primary carcinoid tumor arising within mature teratoma of the kidney: report of a rare entity and review of the literature

Directory of Open Access Journals (Sweden)

Parwani Anil V

2007-05-01

Full Text Available Abstract Background Primary carcinoid tumor arising within mature teratoma of the kidney is extremely rare, and their clinicopathologic features are not well described. Our objective was to further define the clinical features and pathologic spectra of primary carcinoid tumor arising within mature teratoma of the kidney. Methods Six previously reported case reports were identified using MEDLINE and a subsequent bibliographic search of all pertinent reports and reviews was performed. We also searched the electronic medical archival records of our institution and identified one additional unreported case. Data were extracted on the demographics, predisposing factors, clinical presentation, radiographic features, gross pathology, microscopic pathology, immunophenotype, therapy, and outcome of each of these seven cases. Results Primary carcinoid tumor arising within mature teratoma of the kidney was found at a mean age of 41.4 years. Of the 7 cases, 3 were female and 4 were male. Two of the 7 cases (28.6% were associated with horseshoe kidney. It typically presented with abdominal pain without carcinoid syndrome. It typical radiologic appearance was well circumscribed partly calcified Bosniak II-III lesion. Histologically, the carcinoid tumor showed monotonous small round cells arranged in classic anastomosing cords/ribbons intermixed with solid nests. Surgery was curative, no additional treatment was required, no local recurrences occurred, and no metastases occurred in all 7 cases. The 3 cases with available outcome data were alive at the time of publication of their respective cases (mean, 5 months. Conclusion Primary carcinoid tumor arising within mature teratoma of the kidney is a rare tumor that typically presents with abdominal pain without carcinoid syndrome. It is not associated with local recurrence and metastasis, is surgically curable, and has excellent prognosis.

Carcinoma arising in thyroglossal remnants

NARCIS (Netherlands)

van Vuuren, P. A.; Balm, A. J.; Gregor, R. T.; Hilgers, F. J.; Loftus, B. M.; Delprat, C. C.; Rutgers, E. J.

1994-01-01

Three patients with a papillary carcinoma arising in a thyroglossal duct cyst are presented and the literature is reviewed. This rare malignancy is seen mostly in women between the ages of 20 and 50 years. The distribution of carcinoma subtypes differs from that of thyroid carcinomas and

Adenosarcoma arising in hepatic endometriosis

International Nuclear Information System (INIS)

N'Senda, P.; Dahan, H.; Tubiana, J.M.; Arrive, L.; Wendum, D.; Balladur, P.

2000-01-01

We report a case of adenosarcoma arising in hepatic endometriosis. Both CT and MR scans demontrated a huge heterogeneous mass containing septated, thick-walled cystic lesions. After enlarged right hepatectomy, the patient was asymptomatic with no abnormalities at liver and abdominal CT scan at 2-year follow-up. (orig.)

Adenosarcoma arising in hepatic endometriosis

Energy Technology Data Exchange (ETDEWEB)

N' Senda, P.; Dahan, H.; Tubiana, J.M.; Arrive, L. [Service de Radiologie, Hopital Saint-Antoine, 75 - Paris (France); Wendum, D. [Service d' Anatomie Pathologie, Hopital Saint-Antoine, 75 - Paris (France); Balladur, P. [Service de Chirurgie Digestive et Generale, Hopital Saint-Antoine, 75 - Paris (France)

2000-08-01

We report a case of adenosarcoma arising in hepatic endometriosis. Both CT and MR scans demontrated a huge heterogeneous mass containing septated, thick-walled cystic lesions. After enlarged right hepatectomy, the patient was asymptomatic with no abnormalities at liver and abdominal CT scan at 2-year follow-up. (orig.)

Simulating Arctic clouds during Arctic Radiation- IceBridge Sea and Ice Experiment (ARISE)

Science.gov (United States)

Bromwich, D. H.; Hines, K. M.; Wang, S. H.

2015-12-01

The representation within global and regional models of the extensive low-level cloud cover over polar oceans remains a critical challenge for quantitative studies and forecasts of polar climate. In response, the polar-optimized version of the Weather Research and Forecasting model (Polar WRF) is used to simulate the meteorology, boundary layer, and Arctic clouds during the September-October 2014 Arctic Radiation- IceBridge Sea and Ice Experiment (ARISE) project. Polar WRF was developed with several adjustments to the sea ice thermodynamics in WRF. ARISE was based out of Eielson Air Force Base near Fairbanks, Alaska and included multiple instrumented C-130 aircraft flights over open water and sea ice of the Beaufort Sea. Arctic boundary layer clouds were frequently observed within cold northeasterly flow over the open ocean and ice. Preliminary results indicate these clouds were primarily liquid water, with characteristics differing between open water and sea ice surfaces. Simulated clouds are compared to ARISE observations. Furthermore, Polar WRF simulations are run for the August-September 2008 Arctic Summer Cloud Ocean Study (ASCOS) for comparison to the ARISE. Preliminary analysis shows that simulated low-level water clouds over the sea ice are too extensive during the the second half of the ASCOS field program. Alternatives and improvements to the Polar WRF cloud schemes are considered. The goal is to use the ARISE and ASCOS observations to achieve an improved polar supplement to the WRF code for open water and sea ice that can be provided to the Polar WRF community.

Aphasia As a Predictor of Stroke Outcome.

Science.gov (United States)

Lazar, Ronald M; Boehme, Amelia K

2017-09-19

Aphasia is a common feature of stroke, affecting 21-38% of acute stroke patients and an estimated 1 million stroke survivors. Although stroke, as a syndrome, is the leading cause of disability in the USA, less is known about the independent impact of aphasia on stroke outcomes. During the acute stroke period, aphasia has been found to increase length of stay, inpatient complications, overall neurological disability, mortality, and to alter discharge disposition. Outcomes during the sub-acute and chronic stroke periods show that aphasia is associated with lower Functional Independence Measures (FIM) scores, longer stays in rehabilitation settings, poorer function in activities of daily living, and mortality. Factors that complicate the analysis of aphasia on post-stroke outcomes, however, include widely different systems of care across international settings that result in varying admission patterns to acute stroke units, allowable length of stays based on reimbursement, and criteria for rehabilitation placement. Aphasia arising from stroke is associated with worse outcomes both in the acute and chronic periods. Future research will have to incorporate disparate patterns in analytic models, and to take into account specific aphasia profiles and evolving methods of post-stroke speech-language therapy.

Cutaneous osteosarcoma arising from a burn scar

Energy Technology Data Exchange (ETDEWEB)

Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)

2017-04-15

Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

Squamous neoplasms arising within tattoos: clinical presentation, histopathology and management.

Science.gov (United States)

Junqueira, A L; Wanat, K A; Farah, R S

2017-08-01

Tattooing, which involves the placement of ink into the skin, is an ancient decorative technique that has remained popular in modern society. Tattoos have long been known to cause cutaneous reactions, which include the emergence of neoplasms such as keratoacanthoma (KA) and squamous cell carcinoma (SCC) in tattooed areas of the skin. We review the clinical presentations, histology and treatment options for squamous neoplasms, primarily KA and SCC, arising in tattoos. © 2017 British Association of Dermatologists.

32 CFR 537.19 - Demands arising from maritime claims.

Science.gov (United States)

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Demands arising from maritime claims. 537.19 Section 537.19 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY CLAIMS AND ACCOUNTS CLAIMS ON BEHALF OF THE UNITED STATES § 537.19 Demands arising from maritime claims. (a) It is...

Conducting Accessible Research: Including People With Disabilities in Public Health, Epidemiological, and Outcomes Studies.

Science.gov (United States)

Rios, Dianne; Magasi, Susan; Novak, Catherine; Harniss, Mark

2016-12-01

People with disabilities are largely absent from mainstream health research. Exclusion of people with disabilities may be explicit, attributable to poorly justified exclusion criteria, or implicit, attributable to inaccessible study documents, interventions, or research measures. Meanwhile, people with disabilities experience poorer health, greater incidence of chronic conditions, and higher health care expenditure than people without disabilities. We outline our approach to "accessible research design"-research accessible to and inclusive of people with disabilities. We describe a model that includes 3 tiers: universal design, accommodations, and modifications. Through our work on several large-scale research studies, we provide pragmatic examples of accessible research design. Making efforts to include people with disabilities in public health, epidemiological, and outcomes studies will enhance the interpretability of findings for a significant patient population.

Four Different Tumors Arising in a Nevus Sebaceous

Directory of Open Access Journals (Sweden)

Takeshi Namiki

2016-04-01

Full Text Available Nevus sebaceous is known by its association with one or more secondary tumors, but more than three multiple tumors arising from a nevus sebaceous is extremely rare. A 67-year-old female presented with a light brown plaque on the back of her head that contained a dome-shaped black node and an erosive lesion. Histopathological examination showed atypical basaloid cells in the black node. At the periphery of that node, structures resembling follicular germs extruded from interlacing cords in the upper portion and tumor nests with sebocytes were in the lower portion. In the erosive lesion, papillated structures with an apocrine epithelium were observed. In the light brown plaque, enlargement of sebaceous lobules was noted. From those histopathological features, a diagnosis of syringocystadenoma papilliferum, sebaceoma, trichoblastoma and basal cell carcinoma arising from a nevus sebaceous was made. We discuss the rarity of multiple tumors arising from a nevus sebaceous.

Conjunctival lymphoma arising from reactive lymphoid hyperplasia

Directory of Open Access Journals (Sweden)

Fukuhara Junichi

2012-09-01

Full Text Available Abstract Extra nodal marginal zone B-cell lymphoma (EMZL of the conjunctiva typically arises in the marginal zone of mucosa-associated lymphoid tissue. The pathogenesis of conjunctival EMZL remains unknown. We describe an unusual case of EMZL arising from reactive lymphoid hyperplasia (RLH of the conjunctiva. A 35-year-old woman had fleshy salmon-pink conjunctival tumors in both eyes, oculus uterque (OU. Specimens from conjunctival tumors in the right eye, oculus dexter (OD, revealed a collection of small lymphoid cells in the stroma. Immunohistochemically, immunoglobulin (Ig light chain restriction was not detected. In contrast, diffuse atypical lymphoid cell infiltration was noted in the left eye, oculus sinister (OS, and positive for CD20, a marker for B cells OS. The tumors were histologically diagnosed as RLH OD, and EMZL OS. PCR analysis detected IgH gene rearrangement in the joining region (JH region OU. After 11 months, a re-biopsy specimen demonstrated EMZL based on compatible pathological and genetic findings OD, arising from RLH. This case suggests that even if the diagnosis of the conjunctival lymphoproliferative lesions is histologically benign, confirmation of the B-cell clonality by checking IgH gene rearrangement should be useful to predict the incidence of malignancy.

Squamous cell carcinoma arising in mature cystic teratoma of ovary

Directory of Open Access Journals (Sweden)

Ranu Patni

2014-01-01

Full Text Available Squamous cell carcinoma of the ovary is a rare condition and usually arises in mature cystic teratoma (MCT or dermoid cyst of the ovary. The reported incidence of malignant transformation in MCT is approximately 2%. A case of squamous cell carcinoma arising in a dermoid cyst of the ovary presenting at an early stage is presented here. A 53-year-old postmenopausal lady, presented with the complaint of pain in right lower abdomen since one month and a large complex abdomino-pelvic mass on examination and investigations. Final histopathology was reported as squamous cell carcinoma of left ovary arising from dermoid cyst and a benign dermoid cyst in the right ovary. The patient was assigned to squamous cell carcinoma of the ovary arising in a mature cystic teratoma, surgical stage Ic2. In view of the poor prognosis, adjuvant chemotherapy was started.

32 CFR 536.108 - Claims payable under international agreements (for those arising in the United States).

Science.gov (United States)

2010-07-01

... arising within the North Atlantic Treaty Area, which includes CONUS and its territories and possessions north of the Tropic of Cancer (23.5 degrees north latitude). This excludes Puerto Rico, the Virgin...

ARISE: American renaissance in science education

Energy Technology Data Exchange (ETDEWEB)

NONE

1998-09-14

The national standards and state derivatives must be reinforced by models of curricular reform. In this paper, ARISE presents one model based on a set of principles--coherence, integration of the sciences, movement from concrete ideas to abstract ones, inquiry, connection and application, sequencing that is responsive to how people learn.

Issues arising in applying the BSS concepts

International Nuclear Information System (INIS)

Linsley, G.

1997-01-01

The following issues are discussed arising in applying the basic safety standard concepts: terminology, naturally occurring radionuclides, the exemption and clearance levels, management of very low level wastes, transboundary movements, the waste convention

Nodulocystic basal cell carcinoma arising directly from a seborrheic keratosis: A rare case report

Directory of Open Access Journals (Sweden)

Kana Shibao

2016-01-01

Full Text Available Seborrheic keratoses (SKs are common epidermal tumors composed of benign keratinocytes. Malignant skin tumors including basal cell carcinoma (BCC rarely arise within SKs. We report a rare case of an 82-year-old man with nodulocystic BCC that appeared at the center of a scaly hyperpigmented SK that had been presented for more than 10 years. It was histologically confirmed that CK19-positive BCC arose directly from the wall of the pseudohorn cyst, a part of the SK. Nodular and/or cystic BCC also rarely arise within SKs while the most common histologic type of BCC within SKs is the superficial type. Careful observation of SKs is important even though it is rarely a background condition for malignant transformation.

Electric reaction arising in bone subjected to mechanical loadings

Science.gov (United States)

Murasawa, Go; Cho, Hideo; Ogawa, Kazuma

2006-03-01

The aim of present study is the investigation of the electric reaction arising in bone subjected to mechanical loadings. Firstly, specimen was fabricated from femur of cow, and ultrasonic propagation in bone was measured by ultrasonic technique. Secondary, 4-point bending test was conducted up to fracture, and electric reaction arising in bone was measured during loading. Thirdly, cyclic 4-point bending test was conducted to investigate the effect of applied displacement speed on electric reaction.

Satisfactory patient-based outcomes after surgical treatment for idiopathic clubfoot: includes surgeon's individualized technique.

Science.gov (United States)

Mahan, Susan T; Spencer, Samantha A; Kasser, James R

2014-09-01

Treatment of idiopathic clubfoot has shifted towards Ponseti technique, but previously surgical management was standard. Outcomes of surgery have varied, with many authors reporting discouraging results. Our purpose was to evaluate a single surgeon's series of children with idiopathic clubfoot treated with a la carte posteromedial and lateral releases using the Pediatric Outcomes Data Collection Instrument (PODCI) with a minimum of 2-year follow-up. A total of 148 patients with idiopathic clubfoot treated surgically by a single surgeon over 15 years were identified, and mailed PODCI questionnaires. Fifty percent of the patients were located and responded, resulting in 74 complete questionnaires. Median age at surgery was 10 months (range, 5.3 to 84.7 mo), male sex 53/74 (71.6%), bilateral surgery 31/74 (41.9%), and average follow-up of 9.7 years. PODCI responses were compared with previously published normal healthy controls using t test for each separate category. Included in the methods is the individual surgeon's operative technique. In PODCIs where a parent reports for their child or adolescent, there was no difference between our data and the healthy controls in any of the 5 categories. In PODCI where an adolescent self-reports, there was no difference in 4 of 5 categories; significant difference was only found between our data (mean = 95.2; SD = 7.427) and normal controls (mean = 86.3; SD = 12.5) in Happiness Scale (P = 0.0031). In this group of idiopathic clubfoot patients, treated with judicious posteromedial release by a single surgeon, primarily when surgery was treatment of choice for clubfoot, patient-based outcomes are not different from their normal healthy peers through childhood and adolescence. While Ponseti treatment has since become the treatment of choice for clubfoot, surgical treatment, in some hands, has led to satisfactory results. Level III.

Population-based differences in treatment outcome following anticancer drug therapies.

Science.gov (United States)

Ma, Brigette By; Hui, Edwin P; Mok, Tony Sk

2010-01-01

Population-based differences in toxicity and clinical outcome following treatment with anticancer drugs have an important effect on oncology practice and drug development. These differences arise from complex interactions between biological and environmental factors, which include genetic diversity affecting drug metabolism and the expression of drug targets, variations in tumour biology and host physiology, socioeconomic disparities, and regional preferences in treatment standards. Some well-known examples include the high prevalence of activating epidermal growth factor receptor (EGFR) mutations in pulmonary adenocarcinoma among northeast (China, Japan, Korea) and parts of southeast Asia (excluding India) non-smokers, which predict sensitivity to EGFR kinase inhibitors, and the sharp contrast between Japan and the west in the management and survival outcome of gastric cancer. This review is a critical overview of population-based differences in the four most prevalent cancers in the world: lung, breast, colorectal, and stomach cancer. Particular attention is given to the clinical relevance of such knowledge in terms of the individualisation of drug therapy and in the design of clinical trials. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Anomalous Posterior Intercostal Arterial Trunk Arising From the Abdominal Aorta

Energy Technology Data Exchange (ETDEWEB)

Jie, Bing, E-mail: jbshh@163.com; Yu, Dong, E-mail: yudong-mail@126.com; Jiang, Sen, E-mail: jasfly77@vip.163.com [Tongji University School of Medicine, Department of Radiology, Shanghai Pulmonary Hospital (China)

2016-04-15

A common trunk of the ipsilateral posterior intercostal artery (PIA) arising from the thoracic aorta is usually an anatomical variation. However, a common trunk of bilateral posterior intercostal arterial trunk (PIAT) arising from the abdominal aorta is rare. It is important to recognize this anatomical variation of PIA when performing interventional radiological procedures. We present a rare case of an anomalous PIAT that originated from the abdominal aorta in a patient with hemoptysis caused by tuberculosis sequelae. Bilateral 4th to 11th PIAs arose from a common trunk and the trunk arising from the posterior aspect of the abdominal aorta at the level of T12/L1 intervertebral space. The pathological right 4th and 5th PIAs and bronchial arteries were embolized. Hemoptysis has been controlled for 3 months.

Multi-objective convex programming problem arising in multivariate ...

African Journals Online (AJOL)

user

Multi-objective convex programming problem arising in ... However, although the consideration of multiple objectives may seem a novel concept, virtually any nontrivial ..... Solving multiobjective programming problems by discrete optimization.

MYC Amplification in Angiosarcoma Arising from an Arteriovenous Graft Site

Directory of Open Access Journals (Sweden)

Kristen M. Paral

2015-01-01

Full Text Available Angiosarcoma arising in association with an arteriovenous graft (AVG or fistula is a unique clinicopathologic scenario that appears to be gaining recognition in the literature. Among reported cases, none has described high-level MYC gene amplification, a genetic aberration that is increasingly unifying the various clinicopathologic subdivisions of angiosarcoma. We therefore report the MYC gene status in a case of angiosarcoma arising at an AVG site.

Instrumental variable estimation of treatment effects for duration outcomes

NARCIS (Netherlands)

G.E. Bijwaard (Govert)

2007-01-01

textabstractIn this article we propose and implement an instrumental variable estimation procedure to obtain treatment effects on duration outcomes. The method can handle the typical complications that arise with duration data of time-varying treatment and censoring. The treatment effect we

Empiricism Verses Rationalism: Matters Arising in Medical Practice ...

African Journals Online (AJOL)

Empiricism Verses Rationalism: Matters Arising in Medical Practice. ... AFRREV STECH: An International Journal of Science and Technology ... entirely antagonistic to one another, one favoring the senses and the other favoring the mind.

Cellular schwannoma arising from sigmoid mesocolon presenting ...

African Journals Online (AJOL)

Schwannomas are a type of peripheral nerve sheath tumors with clinically indolent behavior. Though, they can occur anywhere in body, the incidence in retroperitoneum, mediastinum, and pelvis is exceedingly rare. We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon.

Cellular Schwannoma Arising from Sigmoid Mesocolon Presenting ...

African Journals Online (AJOL)

Schwannomas are a type of peripheral nerve sheath tumors with clinically indolent behavior. Though, they can occur anywhere in body, the incidence in retroperitoneum, mediastinum, and pelvis is exceedingly rare. We present a case of a 58‑year‑old female with a massive twisted tumor arising from sigmoid mesocolon.

Primary chondroid chordoma arising from the petrous temporal bone: a case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Young Uk; Youn, Eun Kyung [Koryo General Hospital, Seoul (Korea, Republic of)

1991-01-15

Chordomas are uncommon tumors which arise from remnants of the primitive notochord. They are situated chiefly in the anterior spinal axis with a predilection for the sacrococcygeal region and the basiocciput. About 50% of chordomas are sacrococcygeal, 35% are intracranial, and 15% arise from a vertebral body. As a histologic variant of chordoma, /chondroid chordoma' was first described by Heffelfinger et al. We present a rare case of primary chondroid chordoma arising from the petrous temporal bone. To our knowledge, only two other cases of this type have been reported earlier.

Primary chondroid chordoma arising from the petrous temporal bone: a case report

International Nuclear Information System (INIS)

Lee, Young Uk; Youn, Eun Kyung

1991-01-01

Chordomas are uncommon tumors which arise from remnants of the primitive notochord. They are situated chiefly in the anterior spinal axis with a predilection for the sacrococcygeal region and the basiocciput. About 50% of chordomas are sacrococcygeal, 35% are intracranial, and 15% arise from a vertebral body. As a histologic variant of chordoma, /chondroid chordoma' was first described by Heffelfinger et al. We present a rare case of primary chondroid chordoma arising from the petrous temporal bone. To our knowledge, only two other cases of this type have been reported earlier

Squamous cell carcinoma arising within a maxillary odontogenic keratocyst: A rare occurrence

International Nuclear Information System (INIS)

Jalali, Elnaz; Tadinada, Aditya; Rengasamy, Kandasamy; Ferneini, Elie M.

2017-01-01

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC

Squamous cell carcinoma arising within a maxillary odontogenic keratocyst: A rare occurrence

Energy Technology Data Exchange (ETDEWEB)

Jalali, Elnaz [Eliray Oral and Maxillofacial Radiology Consulting Services, Miami (United States); Tadinada, Aditya; Rengasamy, Kandasamy; Ferneini, Elie M. [University of Connecticut, School of Dental Medicine, Farmington (United States)

2017-06-15

Squamous cell carcinoma (SCC) arising within the lining of an odontogenic keratocyst (OKC) is a rare occurrence. Although potentially locally destructive, OKC is a benign odontogenic process that typically presents with clinical and radiographic features characteristic of a benign intraosseous neoplasm. We present the clinical and radiographic features of a maxillary mass that demonstrated SCC arising from the lining of an OKC. Although the initial clinical and radiographic presentation suggested an infection or malignant neoplasm, biopsies revealed an infiltrative well-differentiated SCC contiguous with and arising from the focus of a pre-existing OKC. The patient subsequently underwent a type II hemi-maxillectomy with neoadjuvant chemoradiation. This report discusses the clinical and radiographic features associated with intraosseous malignancies, especially those arising from an otherwise benign odontogenic lesion. While the majority of OKCs are benign, the current report illustrates the potential for carcinomatous transformation within the lining of an OKC.

Obstetric outcome of teenage pregnancies at a tertiary hospital in ...

African Journals Online (AJOL)

Context: Maternal age, parity, and socioeconomic class are important determinants of obstetric outcome of pregnancy. Teenage pregnancy constitutes a high risk pregnancy with complications arising from a combination of physiological, anatomical, and socioeconomic factors. Objective: The objective was to determine the ...

Differential diagnosis of pancreatic cancer from other solid tumours arising from the periampullary area on MDCT

Energy Technology Data Exchange (ETDEWEB)

Jang, Suk Ki [Bundang Jesaeng General Hospital, Departments of Radiology, Daejin Medical Center, Seognam-si, Gyeonggi-do (Korea, Republic of); Kim, Jung Hoon; Joo, Ijin; Jeon, Ju Hyun; Han, Joon Koo; Choi, Byung Ihn [Seoul National University College of Medicine, Department of Radiology and Institute of Radiation Medicine, Chongno-gu, Seoul (Korea, Republic of); Shin, Kyung Sook [Chungnam National University School of Medicine, Department of Radiology, 266 Munhwa-ro, Jung-gu, Daejeon (Korea, Republic of)

2015-10-15

To investigate CT features and differential diagnosis of pancreatic adenocarcinoma compared to other solid tumours arising in the periampullary area. One hundred and ninety-five patients with pathologically proven, solid periampullary tumours, including pancreatic adenocarcinoma (n = 98), neuroendocrine tumours (n = 52), gastrointestinal stromal tumours (n = 31), and solid pseudopapillary neoplasms (n = 14), underwent preoperative CT. Two radiologists reviewed CT features and rated the possibility of pancreatic adenocarcinoma. Statistically common findings for pancreatic adenocarcinoma included: patient age >50 years; ill-defined margin; completely solid mass; homogeneous enhancement; hypoenhancement on arterial and venous phases; atrophy; and duct dilatation. Statistically common findings for GIST included: heterogeneous enhancement; hyperenhancement on arterial and venous phases; rim enhancement; and prominent feeding arteries. The hyperenhancement on arterial and venous phases is statistically common in NET, and heterogeneous enhancement, hypoenhancement on the arterial and venous phases are statistically common in SPN. Diagnostic performance of CT for differentiating pancreatic adenocarcinomas from other solid periampullary tumours was 0.962 and 0.977 with excellent interobserver agreement (κ = 0.824). CT is useful not only for differentiating pancreatic adenocarcinoma form other solid tumours but also for differentiating between other solid tumours, including NET, SPN, and GIST, arising in the periampullary area. (orig.)

Occupancy statistics arising from weighted particle rearrangements

International Nuclear Information System (INIS)

Huillet, Thierry

2007-01-01

The box-occupancy distributions arising from weighted rearrangements of a particle system are investigated. In the grand-canonical ensemble, they are characterized by determinantal joint probability generating functions. For doubly non-negative weight matrices, fractional occupancy statistics, generalizing Fermi-Dirac and Bose-Einstein statistics, can be defined. A spatially extended version of these balls-in-boxes problems is investigated

Epilepsy with temporal encephalocele: Characteristics of electrocorticography and surgical outcome.

Science.gov (United States)

Panov, Fedor; Li, Yi; Chang, Edward F; Knowlton, Robert; Cornes, Susannah B

2016-02-01

Temporal lobe encephaloceles (TEs) are increasingly identified in patients with epilepsy due to advances in neuroimaging. Select patients become seizure-free with lesionectomy. In practice, however, many of these patients will undergo standard anterior temporal lobectomy. Herein we report on the first series of patients with refractory temporal lobe epilepsy (TLE) with encephalocele to undergo chronic or intraoperative electrocorticography (ECoG) in order to characterize the putative epileptogenic nature of these lesions and help guide surgical planning. This retrospective study includes nine adult patients with magnetic resonance imaging/computed tomography (MRI/CT)-defined temporal encephalocele treated between 2007 and 2014 at University of California San Francisco (UCSF). Clinical features, ECoG, imaging, and surgical outcomes are reviewed. Six patients underwent resective epilepsy surgery. Each case demonstrated abnormal epileptiform discharges around the cortical area of the encephalocele. Two underwent tailored lesionectomy and four underwent lesionectomy plus anterior medial temporal resection. Postoperatively, five patients, including both with lesionectomy only, had Engel class Ia surgical outcome, and one had a class IIb surgical outcome. The role of TE in the pathogenesis of epilepsy is uncertain. ECoG can confirm the presence of interictal epileptiform discharges and seizures arising from these lesions. Patients overall had a very good surgical prognosis, even with selective surgical approaches. Wiley Periodicals, Inc. © 2015 International League Against Epilepsy.

Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient

DEFF Research Database (Denmark)

Klarskov, Louise; Mogensen, Anne Mellon; Jespersen, Niels

2011-01-01

Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma in the i......Klarskov L, Mogensen AM, Jespersen N, Ingeholm P, Holck S. Filiform serrated adenomatous polyposis arising in a diverted rectum of an inflammatory bowel disease patient. APMIS 2011; 119: 393-8. A 54-year-old man, previously colectomized for inflammatory bowel disease, developed carcinoma...... during the adenoma carcinoma sequence included the acquisition of CK7 expression in the malignant portion. Gastric mucin may play a role in the initial step of the neoplastic evolution and CK7 may denote neoplastic progression. This case confirms the notion of a widely variegated morphology of precursor...

Malignancy arising within cutaneous tattoos: case of dermatofibrosarcoma protuberans and review of literature.

Science.gov (United States)

Reddy, Kavitha K; Hanke, C William; Tierney, Emily P

2011-08-01

Dermatofibrosarcoma protuberans (DFSP) is an uncommon tumor of the skin with high rates of local recurrence. Several reports describe a frequent history of local trauma. In one prior case, a DFSP arising in a tattoo site has been reported. Mohs micrographic surgery (MMS) has been used successfully for treatment. To present a case of dermatofibrosarcoma protuberans arising in the site of a prior and current tattoo, and treated with Mohs micrographic surgery. We present findings of a case of a DFSP arising in a tattoo and a review of Medline literature on the association between tattoos and cutaneous malignancy, and treatment of DFSP with MMS. Review of the literature confirms multiple reports of DFSP arising in sites of local trauma, as well as malignancies arising in sites of tattoos. The recurrence rate for MMS treatment of DFSP (0-6.6%) was found to be significantly lower than that for patients treated with wide local excision (13% to 95%). DFSP should be considered in the differential diagnosis of neoplasms arising within areas of tattoos. Sites of local trauma and tattoos may show predilection for benign and malignant changes and should be evaluated during regular skin exams. Review of the literature confirms MMS is an ideal treatment modality for DFSP as the tumor often extends far beyond clinical margins.

Two cases of basal cell carcinoma arising from chronic radiation dermatitis

International Nuclear Information System (INIS)

Wakamori, Takeshi; Takenaka, Hideya; Ueda, Eiichiro; Katoh, Norito; Kishimoto, Saburo

2003-01-01

A 48-year-old female and a 51-year-old male with basal cell carcinoma (BCC) arising from chronic radiation dermatitis are reviewed. They are treated with radiotherapy for hemangioma on their right cheek in their childhood. Review in the literature showed high incidence of the histological diagnosis of malignant skin tumors arising from chronic radiation dermatitis are follows: squamous cell carcinoma (SCC), BCC, sarcoma, and Bowen's disease. (author)

The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

Science.gov (United States)

Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

2016-08-01

To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

A randomized controlled trial of Internet-Based Cognitive Behavior Therapy for perfectionism including an investigation of outcome predictors.

Science.gov (United States)

Rozental, Alexander; Shafran, Roz; Wade, Tracey; Egan, Sarah; Nordgren, Lise Bergman; Carlbring, Per; Landström, Andreas; Roos, Stina; Skoglund, Malin; Thelander, Elisabet; Trosell, Linnéa; Örtenholm, Alexander; Andersson, Gerhard

2017-08-01

Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted. Copyright © 2017 Elsevier Ltd. All rights reserved.

Toward an Improved Representation of Middle Atmospheric Dynamics Thanks to the ARISE Project

Science.gov (United States)

Blanc, E.; Ceranna, L.; Hauchecorne, A.; Charlton-Perez, A.; Marchetti, E.; Evers, L. G.; Kvaerna, T.; Lastovicka, J.; Eliasson, L.; Crosby, N. B.; Blanc-Benon, P.; Le Pichon, A.; Brachet, N.; Pilger, C.; Keckhut, P.; Assink, J. D.; Smets, P. S. M.; Lee, C. F.; Kero, J.; Sindelarova, T.; Kämpfer, N.; Rüfenacht, R.; Farges, T.; Millet, C.; Näsholm, S. P.; Gibbons, S. J.; Espy, P. J.; Hibbins, R. E.; Heinrich, P.; Ripepe, M.; Khaykin, S.; Mze, N.; Chum, J.

2018-03-01

This paper reviews recent progress toward understanding the dynamics of the middle atmosphere in the framework of the Atmospheric Dynamics Research InfraStructure in Europe (ARISE) initiative. The middle atmosphere, integrating the stratosphere and mesosphere, is a crucial region which influences tropospheric weather and climate. Enhancing the understanding of middle atmosphere dynamics requires improved measurement of the propagation and breaking of planetary and gravity waves originating in the lowest levels of the atmosphere. Inter-comparison studies have shown large discrepancies between observations and models, especially during unresolved disturbances such as sudden stratospheric warmings for which model accuracy is poorer due to a lack of observational constraints. Correctly predicting the variability of the middle atmosphere can lead to improvements in tropospheric weather forecasts on timescales of weeks to season. The ARISE project integrates different station networks providing observations from ground to the lower thermosphere, including the infrasound system developed for the Comprehensive Nuclear-Test-Ban Treaty verification, the Lidar Network for the Detection of Atmospheric Composition Change, complementary meteor radars, wind radiometers, ionospheric sounders and satellites. This paper presents several examples which show how multi-instrument observations can provide a better description of the vertical dynamics structure of the middle atmosphere, especially during large disturbances such as gravity waves activity and stratospheric warming events. The paper then demonstrates the interest of ARISE data in data assimilation for weather forecasting and re-analyzes the determination of dynamics evolution with climate change and the monitoring of atmospheric extreme events which have an atmospheric signature, such as thunderstorms or volcanic eruptions.

Including Emotional Intelligence in Pharmacy Curricula to Help Achieve CAPE Outcomes

OpenAIRE

Nelson, Michael H.; Fierke, Kerry K.; Sucher, Brandon J.; Janke, Kristin K.

2015-01-01

The importance of emotional intelligence (EI) for effective teamwork and leadership within the workplace is increasingly apparent. As suggested by the 2013 CAPE Outcomes, we recommend that colleges and schools of pharmacy consider EI-related competencies to build self-awareness and professionalism among students. In this Statement, we provide two examples of the introduction of EI into pharmacy curricula. In addition, we provide a 4-phase process based on recommendations developed by EI exper...

Safety and Outcome of Intra-Arterial Treatment for Basilar Artery Occlusion

NARCIS (Netherlands)

van Houwelingen, Reinier C.; Luijckx, Gert-Jan; Mazuri, Aryan; Bokkers, Reinoud P. H.; Eshghi, Omid S.; Uyttenboogaart, Maarten

2016-01-01

IMPORTANCE After the many positive results in thrombectomy trials in ischemic stroke of the anterior circulation, the question arises whether these positive results also apply to the patient with basilar artery occlusion (BAO). OBJECTIVE To report up-to-date outcome data of intra-arterial (IA)

Unilateral Eye Blinking Arising From the Ictal Ipsilateral Occipital Area.

Science.gov (United States)

Falsaperla, Raffaele; Perciavalle, Valentina; Pavone, Piero; Praticò, Andrea Domenico; Elia, Maurizio; Ruggieri, Martino; Caraballo, Roberto; Striano, Pasquale

2016-07-01

We report on an 18-month-old boy with unilateral left eye blinking as a single ictal manifestation without facial twitching. The clinical onset of this phenomenon was first recorded (as an occasional event) at age 3 months, and it was overlooked. By age 6 months, the child's blinking increased to almost daily occurrence in clusters: during blinking the infant showed intact awareness and occasional jerks in the upper limbs and right leg. A video-electroencephalography (video-EEG) documented clinical correlation with a focal pattern arising from the left occipital region, and brain magnetic resonance imaging (MRI) revealed severe brain damage, consisting in poroencephalic hollows and increased spaces in the convexities involving a large area of the left cerebral hemisphere. The boy was prescribed sodium valproate (30 mg/kg/d), resulting in drastic reduction of his clinical seizures. Follow-up to his current age documented good general status, with persistent partial right hemilateral seizures. The blinking progressively disappeared, and is no longer recorded. The pathogenic hypotheses of the unilateral ictal blinking include involvement of the ipsilateral cerebral hemisphere and/or the cerebellar pathways. Review of previous reports of unilateral eye blinking, arising from the ictal ipsilateral brain, revealed that different damaged regions may give rise to blinking ictal phenomena, likely via the trigeminal fibres innervating the subdural intracranial structures and the pial vessels in the ipsilateral affected brain. The eye blinking in the present child represents a further example of an ictal phenomenon, which is predictive of the damaged brain region. © EEG and Clinical Neuroscience Society (ECNS) 2014.

Atypical Pharyngeal Pouch Arising Bilaterally between the Hyoid Bone and Thyroid Cartilage

Directory of Open Access Journals (Sweden)

Lawrence J. Oh

2017-01-01

Full Text Available Introduction. Pharyngoesophageal diverticuli are a common cause of dysphagia; they are associated with various morbidities and a decreased quality of life. There are several different types of the diverticuli, and they are divided based on the anatomical location of origin relative to the cricopharyngeal muscle; these include Zenker’s, Killian-Jamieson’s, and Laimer’s diverticula. The authors present a unique case of pharyngoesophageal diverticulum that has not been previously described. Case Presentation. A 65-year-old male presented with a 12-month history of dysphagia and odynophagia for solids. Barium swallow revealed bilateral moderately sized diverticuli that altered in size during the different phases of swallow. CT scan of the neck with oral contrast further identified the anatomy of the diverticuli, arising between the hyoid bone and thyroid cartilage. Discussion. An external transcervical approach was utilised to successfully repair the diverticuli. Subsequent cricopharyngeal spasm was treated with botulinum toxin, and the patient recovered with no ongoing symptoms. The barium swallow study is a commonly utilised initial investigation as it is easy to perform and safe and has good diagnostic value. Definitive management usually involves either endoscopic or open surgery. This case depicts a unique case of a pharyngeal diverticulum arising between the hyoid bone and thyroid cartilage.

On time-dependent diffusion coefficients arising from stochastic processes with memory

Science.gov (United States)

Carpio-Bernido, M. Victoria; Barredo, Wilson I.; Bernido, Christopher C.

2017-08-01

Time-dependent diffusion coefficients arise from anomalous diffusion encountered in many physical systems such as protein transport in cells. We compare these coefficients with those arising from analysis of stochastic processes with memory that go beyond fractional Brownian motion. Facilitated by the Hida white noise functional integral approach, diffusion propagators or probability density functions (pdf) are obtained and shown to be solutions of modified diffusion equations with time-dependent diffusion coefficients. This should be useful in the study of complex transport processes.

Squamous cell carcinoma arising in previously burned or irradiated skin

International Nuclear Information System (INIS)

Edwards, M.J.; Hirsch, R.M.; Broadwater, J.R.; Netscher, D.T.; Ames, F.C.

1989-01-01

Squamous cell carcinoma (SCC) arising in previously burned or irradiated skin was reviewed in 66 patients treated between 1944 and 1986. Healing of the initial injury was complicated in 70% of patients. Mean interval from initial injury to diagnosis of SCC was 37 years. The overwhelming majority of patients presented with a chronic intractable ulcer in previously injured skin. The regional relapse rate after surgical excision was very high, 58% of all patients. Predominant patterns of recurrence were in local skin and regional lymph nodes (93% of recurrences). Survival rates at 5, 10, and 20 years were 52%, 34%, and 23%, respectively. Five-year survival rates in previously burned and irradiated patients were not significantly different (53% and 50%, respectively). This review, one of the largest reported series, better defines SCC arising in previously burned or irradiated skin as a locally aggressive disease that is distinct from SCC arising in sunlight-damaged skin. An increased awareness of the significance of chronic ulceration in scar tissue may allow earlier diagnosis. Regional disease control and survival depend on surgical resection of all known disease and may require radical lymph node dissection or amputation

Solitary osteochondroma arising in lumbar spinous process: Case report

Directory of Open Access Journals (Sweden)

Khaled Hadhri

2016-12-01

Full Text Available Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up.

Some homological properties of skew PBW extensions arising in non-commutative algebraic geometry

Directory of Open Access Journals (Sweden)

Lezama Oswaldo

2017-06-01

Full Text Available In this short paper we study for the skew PBW (Poincar-Birkhoff-Witt extensions some homological properties arising in non-commutative algebraic geometry, namely, Auslander-Gorenstein regularity, Cohen-Macaulayness and strongly noetherianity. Skew PBW extensions include a considerable number of non-commutative rings of polynomial type such that classical PBW extensions, quantum polynomial rings, multiplicative analogue of the Weyl algebra, some Sklyanin algebras, operator algebras, diffusion algebras, quadratic algebras in 3 variables, among many others. Parametrization of the point modules of some examples is also presented.

Grasping the TLRP Nettle: Preliminary Analysis and Some Enduring Issues Surrounding the Improvement of Learning Outcomes

Science.gov (United States)

James, Mary; Brown, Sally

2005-01-01

The ESRC Teaching and Learning Research Programme is the largest ever programme of educational research in the UK. This article reports the purposes, processes, outcomes and issues arising from cross-programme thematic work on the conceptualization of, and research into, 'enhancing learning outcomes' which is a key aim of the programme. Early…

Post-transplant Lymphoproliferative Disorder Arising from Renal Allograft Parenchyma: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Park, Byung Kwan; Kim, Chan Kyo; Kwon, Ghee Young [Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

2010-06-15

Post-transplant lymphoproliferative disorder (PTLD) is a rare but serious complication that occurs in patients undergoing kidney transplantation. PTLD usually manifests as a renal hilar mass comprised of histologically B-lymphocytes. We report our experience of managing a patient with PTLD arising from renal parenchyma. Ultrasonographic and MR imaging features of this unusual PTLD suggested differentiated renal cell carcinoma arising from the renal allograft

Security risks arising from portable storage devices

CSIR Research Space (South Africa)

Molotsi, K

2012-10-01

Full Text Available of the security risks arising from the use of PSDs, and further provides possible security countermeasures to help organisations and users to protect their digital assets. APPROACH Literature review: ? To investigate security risks posed by PSDs... technology in the workplace. International Journal of Electronic Security and Digital Forensics. 3(1): 73?81 [3] Kim, K., Kim, E. & Hong S. (2009). Privacy information protection in portable device. Proceedings of International Conference on Convergence...

Measuring Outcomes in Adult Weight Loss Studies That Include Diet and Physical Activity: A Systematic Review

Directory of Open Access Journals (Sweden)

Rachel A. Millstein

2014-01-01

Full Text Available Background. Measuring success of obesity interventions is critical. Several methods measure weight loss outcomes but there is no consensus on best practices. This systematic review evaluates relevant outcomes (weight loss, BMI, % body fat, and fat mass to determine which might be the best indicator(s of success. Methods. Eligible articles described adult weight loss interventions that included diet and physical activity and a measure of weight or BMI change and body composition change. Results. 28 full-text articles met inclusion criteria. Subjects, settings, intervention lengths, and intensities varied. All studies measured body weight (−2.9 to −17.3 kg, 9 studies measured BMI (−1.1 to −5.1 kg/m2, 20 studies measured % body fat (−0.7 to −10.2%, and 22 studies measured fat mass (−0.9 to −14.9 kg. All studies found agreement between weight or BMI and body fat mass or body fat % decreases, though there were discrepancies in degree of significance between measures. Conclusions. Nearly all weight or BMI and body composition measures agreed. Since body fat is the most metabolically harmful tissue type, it may be a more meaningful measure of health change. Future studies should consider primarily measuring % body fat, rather than or in addition to weight or BMI.

Convex solutions of systems arising from Monge-Ampere equations

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Haiyan Wang

2009-10-01

Full Text Available We establish two criteria for the existence of convex solutions to a boundary value problem for weakly coupled systems arising from the Monge-Ampère equations. We shall use fixed point theorems in a cone.

Effects arising from charged particles overcoming of the light velocity barrier

International Nuclear Information System (INIS)

Afanas'ev, G.N.; Eliseev, S.M.; Stepanovskij, Yu.P.

1997-01-01

The effects arising from accelerated and decelerated motion of the charged point particle inside the medium are studied. It is shown explicitly that in addition to the Bremsstrahlung and Cherenkov shock wave, the electromagnetic shock wave arising from the charge overcoming the light velocity in the medium should be observed. This shock wave has the same singularity as the Cherenkov one and, therefore, it is more singular than the Bremsstrahlung shock wave. The space-time regions where these shock waves exist and conditions under which they appear are determined

Adenocarcinomas arising from primary retroperitoneal mature teratomas: CT and MR imaging

International Nuclear Information System (INIS)

Wang, Li-Jen; Wong, Yon-Cheong; Chu, Sheng-Hsien; Ng, Kwai-Fong

2002-01-01

An adenocarcinoma arising from mature teratoma is one form of teratoma with malignant transformation. It is extremely rare but highly malignant. The authors report two patients with adenocarcinomas arising from primary retroperitoneal teratomas. The CT and MRI findings of the tumors are presented with emphasis on imaging features implying the presence of malignant transformation and differing from those of pure benign mature teratoma. Correct diagnosis of the presence of malignant transformation from a benign mature teratoma can be made as early as possible by awareness of the imaging features. (orig.)

Transoral videolaryngoscopic surgery for papillary carcinoma arising in lingual thyroid.

Science.gov (United States)

Mogi, Chisato; Shinomiya, Hirotaka; Fujii, Natsumi; Tsuruta, Tomoyuki; Morita, Naruhiko; Furukawa, Tatsuya; Teshima, Masanori; Kanzawa, Maki; Hirokawa, Mitsuyoshi; Otsuki, Naoki; Nibu, Ken-Ichi

2018-05-15

Carcinoma arising in lingual thyroid is an extremely rare entity accounting for only 1% of all reported ectopic thyroids. Here, we report a case of carcinoma arising in lingual thyroid, which has been successfully managed by transoral resection and bilateral neck dissections. A lingual mass 4-cm in diameter with calcification was incidentally detected by computed tomography at medical check-up. No thyroid tissue was observed in normal position. Ultrasound examination showed bilateral multiple lymphadenopathies. Fine needle aspiration biopsy from lymph node in his right neck was diagnosed as Class III and thyroglobulin level of the specimen was 459ng/ml. Due to the difficulty in performing FNA of the lingual masses, right neck dissection was performed in advance for diagnostic purpose. Pathological examination showed existence of large and small follicular thyroid tissues in several lymph nodes, suggesting lymph node metastasis from thyroid carcinoma. Two months after the initial surgery, video-assisted transoral resection of lingual thyroid with simultaneous left neck dissection was performed. Postoperative course was uneventful. Papillary carcinoma was found in the lingual thyroid and thyroid tissues were also found in left cervical lymph nodes. Video-assisted transoral resection was useful for the treatment of thyroid cancer arising in lingual thyroid. Copyright © 2018 Elsevier B.V. All rights reserved.

Mucinous adenocarcinoma arising at the anastomotic site after operation for hirschsprung's disease: case report

International Nuclear Information System (INIS)

Kim, Hyung Soo; Yoon, Kwon Ha

2004-01-01

To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago

Spinal cord injury arising in anaesthesia practice.

Science.gov (United States)

Hewson, D W; Bedforth, N M; Hardman, J G

2018-01-01

Spinal cord injury arising during anaesthetic practice is a rare event, but one that carries a significant burden in terms of morbidity and mortality. In this article, we will review the pathophysiology of spinal cord injury. We will then discuss injuries relating to patient position, spinal cord hypoperfusion and neuraxial techniques. The most serious causes of spinal cord injury - vertebral canal haematoma, spinal epidural abscess, meningitis and adhesive arachnoiditis - will be discussed in turn. For each condition, we draw attention to practical, evidence-based measures clinicians can undertake to reduce their incidence, or mitigate their severity. Finally, we will discuss transient neurological symptoms. Some cases of spinal cord injury during anaesthesia can be ascribed to anaesthesia itself, arising as a direct consequence of its conduct. The injury to a spinal nerve root by inaccurate and/or incautious needling during spinal anaesthesia is an obvious example. But in many cases, spinal cord injury during anaesthesia is not caused by, related to, or even associated with, the conduct of the anaesthetic. Surgical factors, whether direct (e.g. spinal nerve root damage due to incorrect pedicle screw placement) or indirect (e.g. cord ischaemia following aortic surgery) are responsible for a significant proportion of spinal cord injuries that occur concurrently with the delivery of regional or general anaesthesia. © 2018 The Association of Anaesthetists of Great Britain and Ireland.

Kapteyn series arising in radiation problems

International Nuclear Information System (INIS)

Lerche, I; Tautz, R C

2008-01-01

In discussing radiation from multiple point charges or magnetic dipoles, moving in circles or ellipses, a variety of Kapteyn series of the second kind arises. Some of the series have been known in closed form for a hundred years or more, others appear not to be available to analytic persuasion. This paper shows how 12 such generic series can be developed to produce either closed analytic expressions or integrals that are not analytically tractable. In addition, the method presented here may be of benefit when one has other Kapteyn series of the second kind to consider, thereby providing an additional reason to consider such series anew

Solitary osteochondroma arising in lumbar spinous process: Case report.

Science.gov (United States)

Hadhri, Khaled; Tebourbi, Anis; Saidi, Mehdi; Kooli, Mondher

2016-12-01

Solitary osteochondromas rarely occur in the axial skeleton. Those tumors mostly arise on the posterior elements of the cervical column causing various symptoms especially when developing within the spinal canal. Exophytic lumbar variety is uncommon presenting with palpable mass or spinal deformity. We report a 20-year-old man presenting with a solid painless mass at the lower lumbar region. Radiological examinations revealed an exophytic lesion arising in the third lumbar spinous process appearing to be a solitary osteochondroma. The lesion was treated by en-bloc resection; histopathological examination confirmed the diagnosis of osteochondroma with no evidence of recurrence at the end of 2-year follow up. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Myoepithelial carcinoma arising within an adenomyoepithelioma of the breast: A case report

Energy Technology Data Exchange (ETDEWEB)

Kim, You Yeon; Cho, Kyu Ran; Song, Sung Eun [Dept. of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Seo, Bo Kyoung [Dept. of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Woo, Ok Hee [Dept. of Radiology, Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of); Lee, Jeong Hyun [Dept. of Radiology, Anam Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

2017-07-15

Adenomyoepithelioma of the breast is a rare tumor. A myoepithelial carcinoma arising within an adenomyoepithelioma is even more unusual. There are a limited number of reports discussing myoepithelial carcinoma; most of them describe pathological findings, but not imaging findings. We present a case of a 55-year-old woman who had a screen-detected myoepithelial carcinoma arising within an adenomyoepithelioma in her right breast. Upon the completion of a mammography and sonography an oval shaped mass with an indistinct margin in the upper portion of the right breast had been seen. It as appeared to be a spiculated, irregular-shaped, peripheral-enhancing mass on an MRI. On sonography-guided biopsy, an epithelial-myothelial tumor was confirmed, and the possibility of myoepithelial carcinoma was suggested. Breast-conserving surgery with a sentinel lymph node dissection was performed, and a pathological examination revealed a myoepithelial carcinoma arising within an adenomyoepithelioma.

Poorly Differentiated Squamous Cell Carcinoma Arising in Tattooed Skin

Science.gov (United States)

Sarma, Deba P.; Dentlinger, Renee B.; Forystek, Amanda M.; Stevens, Todd; Huerter, Christopher

2010-01-01

Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare. PMID:21274289

Poorly Differentiated Squamous Cell Carcinoma Arising in Tattooed Skin

Directory of Open Access Journals (Sweden)

Deba P. Sarma

2010-01-01

Full Text Available Introduction. Tattoos have increasingly become accepted by mainstream Western society. As a result, the incidence of tattoo-associated dermatoses is on the rise. The presence of a poorly differentiated squamous cell carcinoma in an old tattooed skin is of interest as it has not been previously documented. Case Presentation. A 79-year-old white homeless man of European descent presented to the dermatology clinic with a painless raised nodule on his left forearm arising in a tattooed area. A biopsy of the lesion revealed a poorly differentiated squamous cell carcinoma infiltrating into a tattoo. The lesion was completely excised and the patient remains disease-free one year later. Conclusion. All previous reports of squamous cell carcinomas arising in tattoos have been well-differentiated low-grade type or keratoacanthoma-type and are considered to be coincidental rather than related to any carcinogenic effect of the tattoo pigments. Tattoo-associated poorly differentiated invasive carcinoma appears to be extremely rare.

Basal Cell Carcinoma Arising in a Breast Augmentation Scar.

Science.gov (United States)

Edwards, Lisa R; Cresce, Nicole D; Russell, Mark A

2017-04-01

We report a case of a 46-year-old female who presented with a persistent lesion on the inferior right breast. The lesion was located within the scar from a breast augmentation procedure 12 years ago. The lesion had been treated as several conditions with no improvement. Biopsy revealed a superficial and nodular basal cell carcinoma, and the lesion was successfully removed with Mohs micrographic surgery. Basal cell carcinoma arising in a surgical scar is exceedingly rare with only 13 reported cases to date. This is the first reported case of basal cell carcinoma arising in a breast augmentation scar. We emphasize the importance of biopsy for suspicious lesions or those refractory to treatment, particularly those lesions that form within a scar. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Report of the expert committee on the review of data on atmospheric fallout arising from British nuclear tests in Australia

International Nuclear Information System (INIS)

1984-01-01

The terms of reference of the committee were to review the published scientific literature and other relevant scientific data on the short and long-term effects of fallout arising from British nuclear tests in Australia; to comment on the adequacy of the data available and the collection methodology; to assess the fallout levels arising from each of the tests, the immediate and subsequent hazards from the fallout to the Australian population and individual Australians, including Australian personnel involved and aborigines in South Australia, and the adequacy of the criteria for safe firing of each of the tests. A comparison is made of radiation protection standards adopted during the nuclear test period with current standards. The recommendations include the setting up of a public inquiry to determine how the conduct and consequences of the British nuclear tests affected the health and well-being of Australians

Outcome and value uncertainties in global-change policy

International Nuclear Information System (INIS)

Hammitt, J.K.

1995-01-01

Choices among environmental policies can be informed by analysis of the potential physical, biological, and social outcomes of alternative choices, and analysis of social preferences among these outcomes. Frequently, however, the consequences of alternative policies cannot be accurately predicted because of substantial outcome uncertainties concerning physical, chemical, biological, and social processes linking policy choices to consequences. Similarly, assessments of social preferences among alternative outcomes are limited by value uncertainties arising from limitations of moral principles, the absence of economic markets for many environmental attributes, and other factors. Outcome and value uncertainties relevant to global-change policy are described and their magnitudes are examined for two cases: stratospheric-ozone depletion and global climate change. Analysis of information available in the mid 1980s, when international ozone regulations were adopted, suggests that contemporary uncertainties surrounding CFC emissions and the atmospheric response were so large that plausible ozone depletion, absent regulation, ranged from negligible to catastrophic, a range that exceeded the plausible effect of the regulations considered. Analysis of climate change suggests that, important as outcome uncertainties are, uncertainties about values may be even more important for policy choice. 53 refs., 3 figs., 3 tabs

High grade angiosarcoma arising in fibroadenoma

Science.gov (United States)

2011-01-01

Primary angiosarcoma of the breast is a rare tumour that account for fewer than 0.05% of all malignant mammary tumours. Angiosarcoma may have an perfidious clinical onset. Radiologic findings are often nonspecific and may appear completely normal in one-third of cases with primary angiosarcoma. The prognosis is usually poor because of the high rates of local recurrence and early development of metastases. Aggressive surgical resection is the mainstay of treatment. The role of adjuvant therapy has not yet been well established. Here we present a case of a 53 year old, postmenopausal women with primary angiosarcoma arising in fibroadenoma. To our knowledge, this is the first case described in the literature to date. PMID:22185665

Periorbital nodular fasciitis arising during pregnancy

Directory of Open Access Journals (Sweden)

Brandon N Phillips

2014-01-01

Full Text Available Nodular fasciitis (NF is a benign proliferation of fibroblasts and myofibroblasts that rarely occurs in the periorbital region. We report what we believe to be the first case of periorbital NF associated with pregnancy. A case of intravascular fasciitis, a NF variant, has been reported during pregnancy, but it was not located in the periorbital region. A weak presence of estrogen receptors has been reported in NF. This may make it more susceptible to the hormone-related changes during pregnancy and contribute to the development of the lesion by stimulating fibroblasts and smooth muscle cell types. Although rare, NF should be considered in the differential diagnosis of periorbital soft-tissue masses arising during pregnancy.

Sound radiation quantities arising from a resilient circular radiator

NARCIS (Netherlands)

Aarts, R.M.; Janssen, A.J.E.M.

2009-01-01

Power series expansions in ka are derived for the pressure at the edge of a radiator, the reaction force on the radiator, and the total radiated power arising from a harmonically excited, resilient, flat, circular radiator of radius a in an infinite baffle. The velocity profiles on the radiator are

The influence of the cathodic process on the interpretation of electrochemical noise signals arising from pitting corrosion of stainless steels

Energy Technology Data Exchange (ETDEWEB)

Klapper, Helmuth Sarmiento [Federal Institute for Materials Research and Testing, Unter den Eichen 87, 12205 Berlin (Germany)], E-mail: Helmuth.sarmiento-klapper@bam.de; Goellner, Joachim [Otto von Guericke University Magdeburg, P.O. Box 4120, Magdeburg (Germany); Heyn, Andreas [Federal Institute for Materials Research and Testing, Unter den Eichen 87, 12205 Berlin (Germany); Otto von Guericke University Magdeburg, P.O. Box 4120, Magdeburg (Germany)

2010-04-15

The use of electrochemical noise (EN) measurements for the investigation and monitoring of corrosion has allowed many interesting advances in the corrosion science in recent years. A special advantage of EN measurements includes the possibility to detect and study the early stages of localized corrosion. Nevertheless, the understanding of the electrochemical information included in the EN signal is actually very limited. The role of the cathodic process on the EN signals remains uncertain and has not been sufficiently investigated to date. Thus, an accurate understanding of the influence of the cathodic process on the EN signal is still lacking. On the basis of different kinetics of the oxygen reduction it was established that the anodic amplitude of transients arising from pitting corrosion on stainless steel can be decreased by the corresponding electron consumption of the cathodic process. Therefore, the stronger the electron consumption, the weaker the anodic amplitude of the EN signal becomes. EN signals arising from pitting corrosion on stainless steel can be measured because the cathodic process is inhibited by the passive layer. This was confirmed by means of EN measurements under cathodic polarisation. Since the cathodic process plays a decisive role on the form of transients arising from pitting corrosion, its influence must be considered in the evaluation and interpretation of the EN signals.

Squamous cell carcinoma arising in a mature cystic teratoma

Directory of Open Access Journals (Sweden)

Gupta Vishwanath

2009-04-01

Full Text Available Two cases of squamous cell carcinoma (SCC arising in a mature cystic teratoma (MCT are being discussed for their rarity and pattern of infiltration of tumor cells in the stroma (alpha mode, beta mode and gamma mode, which is a key factor in deciding the prognosis and patient survival.

Variant mannose-binding lectin alleles are not associated with susceptibility to or outcome of invasive pneumococcal infection in randomly included patients

DEFF Research Database (Denmark)

Kronborg, Gitte; Weis, Nina; Madsen, Hans O

2002-01-01

for pneumococcal infections. To assess the influence of MBL genotypes on the course and outcome of invasive pneumococcal disease, clinical data for 141 adult patients were collected prospectively and their genotypes were determined. All patients included had positive blood cultures for Streptococcus pneumoniae....... The distribution of variant MBL alleles related to low MBL serum concentrations was similar among the patients and healthy individuals, and MBL genotype was not associated with infection outcome. Thus, in a random adult population with invasive pneumococcal infection, MBL does not seem to play a role......Invasive pneumococcal disease is a serious infection that primarily affects very young children and elderly or immunocompromised individuals but also affects previously healthy people. Variant mannose-binding lectin (MBL) alleles are associated with recurrent infections and may be a risk factor...

Proceedings of the Symposium on Recycling of Metals arising from Operation and Decommissioning of Nuclear Facilities

International Nuclear Information System (INIS)

2014-04-01

The Symposium for the Recycling of Metals Arising from Operation and decommissioning of Nuclear Facilities was held in April 2014 at Studsvik's facility in Nykoeping, Sweden. The Symposium, hosted by Studsvik in conjunction with the Nuclear Energy Agency (NEA) of the Organisation for Economic Co-operation and Development (OECD) and the International Atomic Energy Agency (IAEA), covered a wide range of topics concerning current practice, experiences and innovations within the management of contaminated metallic radioactive material. The primary objective was to understand the differing approaches to clearance and recycling of materials from the nuclear industry across Europe in order to appreciate the issues faced from recovering resources once the material meets a country's clearance requirements. The outcome of the symposium has provided some interesting reflections for national and international bodies to consider when developing waste management guidance and policies. Over the three days of the symposium, presentations split into six topical sessions and posters regarding the recycling of contaminated metals were viewed by more than 150 people from 19 different countries. A series of group discussions were also held following each session to promote learning about current practices, highlight strategic issues related to metals recycling and develop professional networks across the industry. To stimulate discussion, a series of questions were posed at each group and the outcomes captured for inclusion within this report

Intraosseous verrucous carcinoma arising from an orthokeratinized odontogenic keratocyst: A report of a rarest entity

Directory of Open Access Journals (Sweden)

Nagaraju Kamarthi

2016-01-01

Full Text Available Intraosseous verrucous carcinomas (VCs arising from odontogenic cysts are a rare entity. An unusual case of a VC arising from the orthokeratinized odontogenic cyst is described for the first time. The microscopic features of the lesion are presented.

Endoscopic full-thickness resection for gastric submucosal tumors arising from the muscularis propria layer.

Science.gov (United States)

Huang, Liu-Ye; Cui, Jun; Lin, Shu-Juan; Zhang, Bo; Wu, Cheng-Rong

2014-10-14

To evaluate the efficacy, safety and feasibility of endoscopic full-thickness resection (EFR) for the treatment of gastric submucosal tumors (SMTs) arising from the muscularis propria. A total of 35 gastric SMTs arising from the muscularis propria layer were resected by EFR between January 2010 and September 2013. EFR consists of five major steps: injecting normal saline into the submucosa; pre-cutting the mucosal and submucosal layers around the lesion; making a circumferential incision as deep as the muscularis propria around the lesion using endoscopic submucosal dissection and an incision into the serosal layer around the lesion with a Hook knife; a full-thickness resection of the tumor, including the serosal layer with a Hook or IT knife; and closing the gastric wall with metallic clips. Of the 35 gastric SMTs, 14 were located at the fundus, and 21 at the corpus. EFR removed all of the SMTs successfully, and the complete resection rate was 100%. The mean operation time was 90 min (60-155 min), the mean hospitalization time was 6.0 d (4-10 d), and the mean tumor size was 2.8 cm (2.0-4.5 cm). Pathological examination confirmed the presence of gastric stromal tumors in 25 patients, leiomyomas in 7 and gastric autonomous nerve tumors in 2. No gastric bleeding, peritonitis or abdominal abscess occurred after EFR. Postoperative contrast roentgenography on the third day detected no contrast extravasation into the abdominal cavity. The mean follow-up period was 6 mo, with no lesion residue or recurrence noted. EFR is efficacious, safe and minimally invasive for patients with gastric SMTs arising from the muscularis propria layer. This technique is able to resect deep gastric lesions while providing precise pathological information about the lesion. With the development of EFR, the indications of endoscopic resection might be extended.

Entanglement witnesses arising from exposed positive linear maps

OpenAIRE

Ha, Kil-Chan; Kye, Seung-Hyeok

2011-01-01

We consider entanglement witnesses arising from positive linear maps which generate exposed extremal rays. We show that every entanglement can be detected by one of these witnesses, and this witness detects a unique set of entanglement among those. Therefore, they provide a minimal set of witnesses to detect all entanglement in a sense. Furthermore, if those maps are indecomposable then they detect large classes of entanglement with positive partial transposes which have nonempty relative int...

High-Grade Leiomyosarcoma Arising in a Previously Replanted Limb

Directory of Open Access Journals (Sweden)

Tiffany J. Pan

2015-01-01

Full Text Available Sarcoma development has been associated with genetics, irradiation, viral infections, and immunodeficiency. Reports of sarcomas arising in the setting of prior trauma, as in burn scars or fracture sites, are rare. We report a case of a leiomyosarcoma arising in an arm that had previously been replanted at the level of the elbow joint following traumatic amputation when the patient was eight years old. He presented twenty-four years later with a 10.8 cm mass in the replanted arm located on the volar forearm. The tumor was completely resected and pathology examination showed a high-grade, subfascial spindle cell sarcoma diagnosed as a grade 3 leiomyosarcoma with stage pT2bNxMx. The patient underwent treatment with brachytherapy, reconstruction with a free flap, and subsequently chemotherapy. To the best of our knowledge, this is the first case report of leiomyosarcoma developing in a replanted extremity. Development of leiomyosarcoma in this case could be related to revascularization, scar formation, or chronic injury after replantation. The patient remains healthy without signs of recurrence at three-year follow-up.

Multiple Ectopic Hepatocellular Carcinomas Arising in the Abdominal Cavity

Directory of Open Access Journals (Sweden)

Toru Miyake

2012-09-01

Full Text Available Ectopic hepatocellular carcinoma (HCC is a very rare clinical entity that is defined as HCC arising from extrahepatic liver tissue. This report presents a case of ectopic multiple HCC arising in the abdominal cavity. A 42-year-old otherwise healthy male presented with liver dysfunction at a general health checkup. Both HCV antibody and hepatitis B surface antigen were negative. Laboratory examination showed elevations in serum alpha-fetoprotein and PIVKA-II. Ultrasonography and computed tomography revealed multiple nodular lesions in the abdominal cavity with ascites without a possible primary tumor. Exploratory laparoscopy was performed, which revealed bloody ascites and multiple brown nodular tumors measuring approximately 10 mm in size that were disseminated on the perineum and mesentery. A postoperative PET-CT scan was performed but it did not reveal any evidence of a tumor in the liver. The tumors resected from the peritoneum were diagnosed as HCC. The present case of HCC was thought to have possibly developed from ectopic liver on the peritoneum or mesentery.

Squamous Cell Carcinoma Arising in Mature Teratoma of the Ovary Masquerading as Abdominal Tuberculosis

Directory of Open Access Journals (Sweden)

Shreeya Taresh Indulkar

2018-01-01

Full Text Available Pure squamous cell carcinoma (SCC of the ovary is rare. SCC can arise in a mature teratoma (MT, ovarian endometriosis or in a Brenner tumor. SCC is the most common malignant transformation arising in MT and comprises 80% of all cases. Such neoplastic transformations are extremely difficult either to predict or detect early. The mechanism of malignant transformation has not been completely understood. Due to the rarity and the aggressive course, diagnosis and treatment constitute a big challenge. We report a case of SCC arising in MT presenting with a huge abdominopelvic mass and abundant peritoneal collections clinically masquerading as abdominal tuberculosis. A review of literature with special emphasis on prognosis and treatment modalities is also presented.

Characterization of Rayleigh backscattering arising in various two-mode fibers

NARCIS (Netherlands)

Yu, Dawei; Fu, Songnian; Cao, Zizheng; Tang, Ming; Deng, Lei; Liu, Deming; Giles, I.; Koonen, T.; Okonkwo, C.

2016-01-01

We experimentally characterize the mode dependent characteristics of Rayleigh backscattering (RB) arising in various two-mode fibers (TMFs). With the help of an all-fiber photonic lantern, we are able to measure the RB power at individual modes. Consequently, mode dependent power distribution of RB

Comparing Outcomes and Cost of 3 Surgical Treatments for Sagittal Synostosis: A Retrospective Study Including Procedure-Related Cost Analysis.

Science.gov (United States)

Garber, Sarah T; Karsy, Michael; Kestle, John R W; Siddiqi, Faizi; Spanos, Stephen P; Riva-Cambrin, Jay

2017-10-01

Neurosurgical techniques for repair of sagittal synostosis include total cranial vault (TCV) reconstruction, open sagittal strip (OSS) craniectomy, and endoscopic strip (ES) craniectomy. To evaluate outcomes and cost associated with these 3 techniques. Via retrospective chart review with waiver of informed consent, the last consecutive 100 patients with sagittal synostosis who underwent each of the 3 surgical correction techniques before June 30, 2013, were identified. Clinical, operative, and process of care variables and their associated specific charges were analyzed along with overall charge. The study included 300 total patients. ES patients had fewer transfusion requirements (13% vs 83%, P cost savings compared with the TCV reconstruction. The charges were similar to those incurred with OSS craniectomy, but patients had a shorter length of stay and fewer revisions. Copyright © 2017 by the Congress of Neurological Surgeons

Problems arising in the evaluation of collective dose commitment

International Nuclear Information System (INIS)

Coulon, R.; Beau, P.

1979-01-01

In order to apply the concept of optimization it is necessary to evaluate the collective dose commitment for the population as a whole. This is found by summing the dose commitments for the different population groups involved, including persons occupationally exposed and members of the public both locally and globally. The average dose received by each of these groups can vary considerably: for occupational exposure it is about one order of magnitude below the limits, whereas for the general public it is far below, although certain local groups may be subjected to a much higher exposure than the overall average. The question arises, therefore, whether certain groups should not be weighted differently in order to take into account the heterogeneity of the distribution of exposure. As far as the validity of forecast evaluations is concerned, one may assume that for occupational exposure the dose commitment over the whole period of operation of a facility can be estimated fairly accurately. The overall collective dose commitment for the public is relatively insensitive to local variations in the environment and in the public itself but is strongly dependent on long-term developments which cannot at present be forecast. For the evaluation of dose equivalent to the critical group, local variations are of considerable importance and need to be foreseen, which is not always possible. By taking into account a period which includes the annual maximum collective dose equivalent one can make some of these difficulties less severe. (author)

Chondrosarcoma arising within a radiation-induced osteochondroma several years following childhood total body irradiation: Case report

Energy Technology Data Exchange (ETDEWEB)

Nagata, Shuji [Kurume University Hospital, Department of Radiology, Fukuoka (Japan); Shen, Robert K. [Mayo Clinic, Department of Surgery, Rochester, MN (United States); Laack, Nadia N. [Mayo Clinic, Department of Radiation Oncology, Rochester, MN (United States); Inwards, Carrie Y. [Mayo Clinic, Department of Pathology, Rochester, MN (United States); Wenger, Doris E.; Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, MN (United States)

2013-08-15

Malignant degeneration arising in radiation-induced osteochondromas is extremely rare. We report a case of a 34-year-old man with a chondrosarcoma arising from an osteochondroma of the left posterior eighth rib that developed following total body irradiation received as part of the conditioning regimen prior to bone marrow transplantation at age 8. To our knowledge, this is only the fourth reported case of a chondrosarcoma arising within a radiation-induced osteochondroma and the first case occurring following childhood total body irradiation. (orig.)

Chondrosarcoma arising within a radiation-induced osteochondroma several years following childhood total body irradiation: Case report

International Nuclear Information System (INIS)

Nagata, Shuji; Shen, Robert K.; Laack, Nadia N.; Inwards, Carrie Y.; Wenger, Doris E.; Amrami, Kimberly K.

2013-01-01

Malignant degeneration arising in radiation-induced osteochondromas is extremely rare. We report a case of a 34-year-old man with a chondrosarcoma arising from an osteochondroma of the left posterior eighth rib that developed following total body irradiation received as part of the conditioning regimen prior to bone marrow transplantation at age 8. To our knowledge, this is only the fourth reported case of a chondrosarcoma arising within a radiation-induced osteochondroma and the first case occurring following childhood total body irradiation. (orig.)

The management of intermediate-level radioactive wastes arising from reprocessing operations

International Nuclear Information System (INIS)

Elsden, A.D.

1984-01-01

The reprocessing of spent nuclear fuel results in the generation of radioactive wastes in the form of liquids, gases and solids. This paper outlines the principles and major elements of the waste management systems currently in use or under development for the category of waste known as intermediate-level wastes. To enable implementation of an optimized waste management system, engineering process evaluations, development and design in the following areas are required: The definition of cost effective options taking account of constraints which may arise from other operations in the overall system, e.g. from transport requirements or from criteria derived from environmental impact assessments of alternative disposal routes; Plant and equipment development to enable acceptable system and active plant operations on an industrial scale; Safety and reliability studies to ensure adequate protection of both the general public and plant operators during all stages of the waste management system including disposal

Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

International Nuclear Information System (INIS)

Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu

2015-01-01

Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor

Multi-focal lobular carcinoma in situ arising in benign phylodes tumor: A case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Taeg Ki; Choi, Chang Hwan; Kim, Youn Jeong; Kim, Mi Young; Lee, Kyung Hee; Cho, Soon Gu [Inha University Hospital, Incheon (Korea, Republic of)

2015-08-15

Coexistent breast malignancy arising in phyllodes tumor is extremely rare, and most of them are incidental reports after surgical excision. Coexistent malignancy in phyllodes tumor can vary from in-situ to invasive carcinoma. Lobular neoplasia is separated into atypical lobular hyperplasia and lobular carcinoma in situ (LCIS). LCIS is known to have a higher risk of developing invasive cancer. We reported imaging findings of multifocal LCIS arising in benign phyllodes tumor.

Radiation-induced squamous carcinoma arising within a seborrhoeic keratosis

Energy Technology Data Exchange (ETDEWEB)

Suvarna, S.K.; Bagary, M.; Glazer, G. (Saint Mary' s Hospital, London (United Kingdom))

1993-04-01

Seborrhoeic keratoses (SK) are common skin tumours. They are benign, and present little difficulty in management. However, rare malignant transformation is recognized. The authors report a case of a squamous cell carcinoma arising from dysplastic changes within a long-standing SK on the chest wall of a 75-year-old retired radiologist, and consider the role of radiation in inducing malignant change within SKs. (author).

Radiation-induced squamous carcinoma arising within a seborrhoeic keratosis

International Nuclear Information System (INIS)

Suvarna, S.K.; Bagary, M.; Glazer, G.

1993-01-01

Seborrhoeic keratoses (SK) are common skin tumours. They are benign, and present little difficulty in management. However, rare malignant transformation is recognized. The authors report a case of a squamous cell carcinoma arising from dysplastic changes within a long-standing SK on the chest wall of a 75-year-old retired radiologist, and consider the role of radiation in inducing malignant change within SKs. (author)

Mucinous adenocarcinoma arising at the anastomotic site after operation for hirschsprung's disease: case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Hyung Soo; Yoon, Kwon Ha [College of Medicine, Wonkwang Univ., Iksan (Korea, Republic of)

2004-02-01

To our knowledge, rectal cancer arising at the anastomotic site after surgery for Hirschsprung's disease has not been reported. We report a case of mucinous adenocarcinoma arising at the anastomotic site after Soave operation 26 years ago.

Toward an Improved Representation of Middle Atmospheric Dynamics Thanks to the ARISE Project

Czech Academy of Sciences Publication Activity Database

Blanc, E.; Ceranna, L.; Hauchecorne, A.; Charlton-Perez, A.; Marchetti, E.; Evers, L.G.; Kvaerna, T.; Laštovička, Jan; Eliasson, L.; Crosby, N. B.; Blanc-Benon, P.; Le Pichon, A.; Brachet, N.; Pilger, C.; Keckhut, P.; Assink, J.D.; Smets, P. S. M.; Lee, C. F.; Kero, J.; Šindelářová, Tereza; Kämpfer, N.; Rüfenacht, R.; Farges, T.; Millet, C.; Näsholm, S. P.; Gibbons, S. J.; Espy, P. J.; Hibbins, R. E.; Heinrich, P.; Ripepe, M.; Khaykin, S.; Mze, N.; Chum, Jaroslav

2018-01-01

Roč. 39, č. 2 (2018), s. 171-225 ISSN 0169-3298 EU Projects: European Commission(XE) 284387 - ARISE; European Commission(XE) 653980 - ARISE2 Institutional support: RVO:68378289 Keywords : Atmospheric dynamics * Middle atmosphere * Infrasound * Gravity waves * Volcanoes * Atmospheric disturbances * Extreme events * stratospheric temperature trends * total solar eclipse * wave momentum flux * natural infrasound * acoustic-waves * polar-low * model simulations * sudden warmings * Doppler lidar Subject RIV: DG - Athmosphere Sciences, Meteorology OBOR OECD: Meteorology and atmospheric sciences Impact factor: 4.413, year: 2016 https://link.springer.com/article/10.1007/s10712-017-9444-0

Adenocarcinoma arising in female urethral diverticulum

International Nuclear Information System (INIS)

Patanaphan, V.; Prempree, T.; Sewchand, W.; Hafiz, M.A.; Jaiwatana, J.

1983-01-01

Cancer arising from a female urethral diverticulum is rare, and because of its rarity, a review of the medical literature reveals significant nonuniformity in its management. We report an additional 2 cases of this disease, one of which has an even rarer feature of being mucin-producing. The management of our 2 cases is presented in detail and in line with the management of female urethral cancer. From our extensive literature search, diverticulectomy alone showed poor results with the highest rate of recurrence (67%). Extensive surgery, either in the form of cystourethrectomy or anterior exenteration, offered results comparable with those of combined therapy (diverticulectomy and full course of irradiation for early cases; preoperative irradiation followed by cystourethrectomy for late cases). Individualization of radiation treatment and cooperative effort between urologist and radiation oncologist are essential if best results are to be achieved

Primary diffuse large B cell lymphoma arising from a leiomyoma of the uterine corpus.

Science.gov (United States)

Zhao, Lianhua; Ma, Qiang; Wang, Qiushi; Zeng, Ying; Luo, Qingya; Xiao, Hualiang

2016-01-20

Primary diffuse large B cell lymphoma (DLBCL) of the uterus is rare, and primary DLBCL arising from a uterine leiomyoma (collision tumor) has not been reported in the literature. We describe the clinical, histological, immunohistochemical, and molecular features of primary DLBCL arising from a leiomyoma in the uterine corpus. A 73-year-old female patient had a uterine mass for 23 years. An ultrasound scan revealed marked enlargement of the uterus, measuring 18.2 × 13 × 16.3 cm, with a 17.6 × 10.9 × 11.6 cm hypoechoic mass in the uterine corpus. The tumors consisted of medium- to large-sized cells exhibiting a diffuse pattern of growth with a well-circumscribed leiomyoma. The neoplastic cells strongly expressed CD79α, CD20 and PAX5. Molecular analyses indicated clonal B-cell receptor gene rearrangement. To the best of our knowledge, no previous cases of primary DLBCL arising from a leiomyoma have been reported. It is necessary to differentiate a diagnosis of primary DLBCL arising from a leiomyoma from that of leiomyoma with florid reactive lymphocytic infiltration (lymphoma-like lesion). Careful analysis of clinical, histological, immunophenotypic, and genetic features is required to establish the correct diagnosis.

Testicular artery arising from an aberrant right renal artery | Suluba ...

African Journals Online (AJOL)

This case report we discovered the rare variation of the origin of the right testicular artery arising from the right aberrant renal artery with double renal artery irrigating both left and right kidneys. These variations in the testicular arteries and renal arteries have implication to surgical procedures such as orchidopexy repair for ...

Primary intraosseous carcinoma arising from odontogenic keratocyst with parotid lymph node metastasis. A case report

Directory of Open Access Journals (Sweden)

Siddesh Shenoy

2007-01-01

Full Text Available Squamous cell carcinoma (SCC arising from odontogenic cyst lining is rare. The exact incidence of carcinoma arising in odontogenic cyst is unknown, but it is estimated to vary between 1 and 2/1000. The pathogenesis is unknown, but a long-standing inflammation and continuous intracystic pressure have been suggested as possible causative factors. Metastasis from these lesions is not common (< 20%, and most of the carcinomas are moderately to well differentiated. To qualify as a primary intraosseous carcinoma, there must be no initial connection with the oral mucosa, overlying skin, or antral or nasal mucosa. This paper presents a case of primary intraosseous carcinoma arising from odontogenic keratocyst in the anterior mandible with metastasis to left parotid lymph nodes.

Microbial diversity arising from thermodynamic constraints

Science.gov (United States)

Großkopf, Tobias; Soyer, Orkun S

2016-01-01

The microbial world displays an immense taxonomic diversity. This diversity is manifested also in a multitude of metabolic pathways that can utilise different substrates and produce different products. Here, we propose that these observations directly link to thermodynamic constraints that inherently arise from the metabolic basis of microbial growth. We show that thermodynamic constraints can enable coexistence of microbes that utilise the same substrate but produce different end products. We find that this thermodynamics-driven emergence of diversity is most relevant for metabolic conversions with low free energy as seen for example under anaerobic conditions, where population dynamics is governed by thermodynamic effects rather than kinetic factors such as substrate uptake rates. These findings provide a general understanding of the microbial diversity based on the first principles of thermodynamics. As such they provide a thermodynamics-based framework for explaining the observed microbial diversity in different natural and synthetic environments. PMID:27035705

Microbial diversity arising from thermodynamic constraints.

Science.gov (United States)

Großkopf, Tobias; Soyer, Orkun S

2016-11-01

The microbial world displays an immense taxonomic diversity. This diversity is manifested also in a multitude of metabolic pathways that can utilise different substrates and produce different products. Here, we propose that these observations directly link to thermodynamic constraints that inherently arise from the metabolic basis of microbial growth. We show that thermodynamic constraints can enable coexistence of microbes that utilise the same substrate but produce different end products. We find that this thermodynamics-driven emergence of diversity is most relevant for metabolic conversions with low free energy as seen for example under anaerobic conditions, where population dynamics is governed by thermodynamic effects rather than kinetic factors such as substrate uptake rates. These findings provide a general understanding of the microbial diversity based on the first principles of thermodynamics. As such they provide a thermodynamics-based framework for explaining the observed microbial diversity in different natural and synthetic environments.

Adenocarcinoma arising in rectal duplication cyst: case report and review of the literature.

Science.gov (United States)

Shivnani, Anand T; Small, William; Benson, Al; Rao, Sambasiva; Talamonti, Mark S

2004-11-01

Duplication cyst of the gastrointestinal (GI) tract is a rare congenital anomaly, and rectal duplication cysts comprise a small fraction these cases. Most patients present for the first time in adulthood, and the origin of rectal duplication cysts is unclear. Prior series document malignant transformation in approximately 20 per cent of cases. The following case report describes a carcinoma arising in a rectal duplication cyst. Given the lack of data demonstrating adequate control for patients with adenocarcinoma arising in a rectal duplication cyst and our experience with this patient, we recommend all patients undergo multidisciplinary evaluation prior to any therapy.

Measuring Population Health Outcomes

OpenAIRE

Parrish, R. Gibson

2010-01-01

An ideal population health outcome metric should reflect a population's dynamic state of physical, mental, and social well-being. Positive health outcomes include being alive; functioning well mentally, physically, and socially; and having a sense of well-being. Negative outcomes include death, loss of function, and lack of well-being. In contrast to these health outcomes, diseases and injuries are intermediate factors that influence the likelihood of achieving a state of health. On the basis...

Stochastic modelling of two-phase flows including phase change

International Nuclear Information System (INIS)

Hurisse, O.; Minier, J.P.

2011-01-01

Stochastic modelling has already been developed and applied for single-phase flows and incompressible two-phase flows. In this article, we propose an extension of this modelling approach to two-phase flows including phase change (e.g. for steam-water flows). Two aspects are emphasised: a stochastic model accounting for phase transition and a modelling constraint which arises from volume conservation. To illustrate the whole approach, some remarks are eventually proposed for two-fluid models. (authors)

28 CFR 45.2 - Disqualification arising from personal or political relationship.

Science.gov (United States)

2010-07-01

... political relationship. 45.2 Section 45.2 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) EMPLOYEE RESPONSIBILITIES § 45.2 Disqualification arising from personal or political relationship. (a) Unless authorized under paragraph (b) of this section, no employee shall participate in a criminal investigation or...

Do psychopathic traits assessed in mid-adolescence predict mental health, psychosocial, and antisocial, including criminal outcomes, over the subsequent 5 years?

Science.gov (United States)

Hemphälä, Malin; Hodgins, Sheilagh

2014-01-01

To determine whether psychopathic traits assessed in mid-adolescence predicted mental health, psychosocial, and antisocial (including criminal) outcomes 5 years later and would thereby provide advantages over diagnosing conduct disorder (CD). Eighty-six women and 61 men were assessed in mid-adolescence when they first contacted a clinic for substance misuse and were reassessed 5 years later. Assessments in adolescence include the Psychopathy Checklist-Youth Version (PCL-YV), and depending on their age, either the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Aged Children or the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID). Assessments in early adulthood included the SCID, self-reports of psychosocial functioning, aggressive behaviour, and criminality and official criminal records. The antisocial facet score positively predicted the number of anxiety symptoms and likelihood of receiving treatment for substance use disorders (SUDs). Lifestyle and antisocial facet scores negatively predicted Global Assessment of Functioning scores. By contrast, the interpersonal score and male sex independently and positively predicted the number of months worked or studied, as did the interaction of Lifestyle × Sex indicating that among men, but not women, an increase in lifestyle facet score was associated with less time worked or studied. Interpersonal and antisocial scores positively predicted school drop-out. Antisocial facet scores predicted the number of symptoms of antisocial personality disorder, alcohol and SUDs, and violent and nonviolent criminality but much more strongly among males than females. Predictions from numbers of CD symptoms were similar. Psychopathic traits among adolescents who misuse substances predict an array of outcomes over the subsequent 5 years. Information on the levels of these traits may be useful for planning treatment.

Factors affecting the amounts of emissions arising from fluidized bed combustion of solid fuels

International Nuclear Information System (INIS)

Horbaj, P.

1996-01-01

The factors affecting the amounts of nitrogen oxides (NO x ) and sulfur oxides (SO x , i.e. SO 2 + SO 3 ) formed during fluidized bed combustion of fossil fuels are analyzed using both theoretical concepts and experimental data. The factors treated include temperature, excess air, fuel parameters, pressure, degree of combustion gas recycling, combustion distribution along the combustion chamber height, and sulfur trapping processes for NO x , and the Ca/S ratio, fluidized layer height and fluidization rate, granulometry and absorbent type, fluidized layer temperature, and pressure during combustion for SO x . It is concluded that fluidized bed boilers are promising power generating facilities, mitigating the environmental burden arising from fossil fuel combustion. (P.A.). 12 figs., 9 refs

Surprises and pitfalls arising from (pseudo)symmetry

International Nuclear Information System (INIS)

Zwart, Peter H.; Grosse-Kunstleve, Ralf W.; Lebedev, Andrey A.; Murshudov, Garib N.; Adams, Paul D.

2008-01-01

The presence of pseudosymmetry can cause problems in structure determination and refinement. The relevant background and representative examples are presented. It is not uncommon for protein crystals to crystallize with more than a single molecule per asymmetric unit. When more than a single molecule is present in the asymmetric unit, various pathological situations such as twinning, modulated crystals and pseudo translational or rotational symmetry can arise. The presence of pseudosymmetry can lead to uncertainties about the correct space group, especially in the presence of twinning. The background to certain common pathologies is presented and a new notation for space groups in unusual settings is introduced. The main concepts are illustrated with several examples from the literature and the Protein Data Bank

28 CFR 68.53 - Review of an interlocutory order of an Administrative Law Judge in cases arising under section...

Science.gov (United States)

2010-07-01

... Administrative Law Judge in cases arising under section 274A or 274C. 68.53 Section 68.53 Judicial Administration... ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR IMMIGRATION... Administrative Law Judge in cases arising under section 274A or 274C. (a) Authority. In a case arising under...

Solitary fibrous tumor arising in an intrathoracic goiter

DEFF Research Database (Denmark)

Larsen, Stine Rosenkilde; Godballe, Christian; Krogdahl, Annelise

2010-01-01

. CONCLUSION: The histological appearance and immunohistochemical reaction pattern of SFT is characteristic. The entity should be considered when dealing with a spindle cell lesion in the thyroid gland. All cases of this site of origin reported have had a benign clinical course. As only a small number of cases......BACKGROUND: Solitary fibrous tumor (SFT) is a rare spindle cell tumor most often found in the mediastinal pleura. Nineteen cases of SFT arising in the thyroid gland have been reported. We report a case of SFT of the thyroid gland with immunohistochemical and cytogenetic investigation. SUMMARY: A 58...

Hepatocellular carcinoma arising from hepatocellular adenoma in a hepatitis B virus-associated cirrhotic liver

International Nuclear Information System (INIS)

Seo, J.M.; Lee, S.J.; Kim, S.H.; Park, C.K.; Ha, S.Y.

2012-01-01

Hepatocellular adenoma (HCA) is a rare, benign proliferation of hepatocytes that occurs mostly in a normal liver and in extreme rare cases, occurs in a cirrhotic liver. Hepatocellular carcinomas (HCC) arising within HCA through malignant transformation is rare. The specific incidence and mechanism of malignant transformation has not been established, but the long term use of oral contraceptives is considered a causative agent. We report a case of HCC arising from HCA detected in a hepatitis B-related cirrhotic liver with serial radiologic images.

Hepatocellular carcinoma arising from hepatocellular adenoma in a hepatitis B virus-associated cirrhotic liver

Energy Technology Data Exchange (ETDEWEB)

Seo, J.M. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, S.J., E-mail: lucia@skku.edu [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, S.H. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Park, C.K.; Ha, S.Y. [Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2012-04-15

Hepatocellular adenoma (HCA) is a rare, benign proliferation of hepatocytes that occurs mostly in a normal liver and in extreme rare cases, occurs in a cirrhotic liver. Hepatocellular carcinomas (HCC) arising within HCA through malignant transformation is rare. The specific incidence and mechanism of malignant transformation has not been established, but the long term use of oral contraceptives is considered a causative agent. We report a case of HCC arising from HCA detected in a hepatitis B-related cirrhotic liver with serial radiologic images.

Waste arisings from a high-temperature reactor with a uranium-thorium fuel cycle

International Nuclear Information System (INIS)

1979-09-01

This paper presents an equilibrium-recycle condition flow sheet for a high-temperature gas-cooled reactor (HTR) fuel cycle which uses thorium and high-enriched uranium (93% U-235) as makeup fuel. INFCE Working Group 7 defined percentage losses to various waste streams are used to adjust the heavy-element mass flows per gigawatt-year of electricity generated. Thorium and bred U-233 are recycled following Thorex reprocessing. Fissile U-235 is recycled one time following Purex reprocessing and then is discarded to waste. Plutonium and other transuranics are discarded to waste. Included are estimates of volume, radioactivity, and heavy-element content of wastes arising from HTR fuel element fabrication; HTR operation, maintenance, and decommissioning; and reprocessing spent fuel where the waste is unique to the HTR fuel cycle

Developing person-centred practice: nursing outcomes arising from changes to the care environment in residential settings for older people.

Science.gov (United States)

McCormack, Brendan; Dewing, Jan; Breslin, Liz; Coyne-Nevin, Ann; Kennedy, Kate; Manning, Mary; Peelo-Kilroe, Lorna; Tobin, Catherine; Slater, Paul

2010-06-01

To present the nursing outcomes from the evaluation of developments in the care environment in residential settings for older people. The evaluation data reported here is derived from a larger national programme of work that focused on the development of person-centred practice in residential services for older people using an emancipatory practice development framework. A multi-method evaluation framework was utilised. Outcome data were collected at three time points between December 2007 and September 2009. The data reported here were collected using an instrument called the 'Person-Centred Nursing Index'. Heavy workload was the main cause of stress among nurses. Personal and professional satisfaction with the job was scored highest by the total sample of nurses. Nineteen factors were examined using the Person-Centred Nursing Index. Statistically significant changes were observed in 12 of these. In addition, there were statistically significant changes in nurses' perceptions of caring, indicating a shift from a dominant focus on 'technical' aspects of care, to one where 'intimate' aspects of care were more highly valued. The findings highlight the importance of the development of effective teamwork, workload management, time management and staff relationships in order to create a culture where there is a more democratic and inclusive approach to practice and space for the formation of person-centred relationships. © 2010 Blackwell Publishing Ltd.

Saskatchewan resources. [including uranium

Energy Technology Data Exchange (ETDEWEB)

1979-09-01

The production of chemicals and minerals for the chemical industry in Saskatchewan are featured, with some discussion of resource taxation. The commodities mentioned include potash, fatty amines, uranium, heavy oil, sodium sulfate, chlorine, sodium hydroxide, sodium chlorate and bentonite. Following the successful outcome of the Cluff Lake inquiry, the uranium industry is booming. Some developments and production figures for Gulf Minerals, Amok, Cenex and Eldorado are mentioned.

Melanotic paraganglioma arising in the temporal horn following Langerhans cell histiocytosis

International Nuclear Information System (INIS)

Yoo, Jeong Hyun; Rivera, Andreana; Naeini, Ramin M.; Yedururi, Sireesha; Megahead, Hatem; Bayindir, Petek; Fuller, Gregory N.; Suh, Jeong Soo; Adesina, Adekunle M.; Hunter, Jill V.

2008-01-01

Intracerebral paragangliomas are rare because of the lack of paraganglial cells in the cerebral tissue. We report a rare case of melanotic paraganglioma arising from the temporal horn of the lateral ventricle in a patient with prior Langerhans cell histiocytosis (LCH) treated with chemotherapy and radiation. (orig.)

Obstetric outcomes after fresh versus frozen-thawed embryo transfers: A systematic review and meta-analysis.

Science.gov (United States)

Roque, Matheus; Valle, Marcello; Sampaio, Marcos; Geber, Selmo

2018-05-21

To evaluate if there are differences in the risks of obstetric outcomes in IVF/ICSI singleton pregnancies when compared fresh to frozen-thawed embryo transfers (FET). This was a systematic review and meta-analysis evaluating the obstetric outcomes in singleton pregnancies after FET and fresh embryo transfer. The outcomes included in this study were pregnancy-induced hypertension (PIH), pre-eclampsia, placenta previa, and placenta accreta. The search yielded 654 papers, 6 of which met the inclusion criteria and reported on obstetric outcomes. When comparing pregnancies that arose from FET or fresh embryo transfer, there was an increase in the risk of obstetric complications in pregnancies resulting from FET when compared to those emerging from fresh embryo transfers in PIH (aOR 1.82; 95% CI 1.24-2.68), pre-eclampsia (aOR 1.32, 95% CI 1.07, 1.63), and placenta accreta (aOR 3.51, 95% CI 2.04-6.05). There were no significant differences in the risk between the FET and fresh embryo transfer groups when evaluating placenta previa (aOR 0.70; 95% CI 0.46-1.08). The obstetric outcomes observed in pregnancies arising from ART may differ among fresh and FET cycles. Thus, when evaluating to perform a fresh embryo transfer or a freeze-all cycle, these differences found in obstetric outcomes between fresh and FET should be taken into account. The adverse obstetric outcomes after FET found in this study emphasize that the freeze-all policy should not be offered to all the patients, but should be offered to those with a clear indication of the benefit of this strategy.

Adenosquamous carcinoma arising within a retrorectal tailgut cyst: Report of a case

Institute of Scientific and Technical Information of China (English)

Zoran Krivokapic; Ivan Dimitrijevic; Goran Barisic; Velimir Markovic; Miodrag Krstic

2005-01-01

Retrorectal, developmental tail gut cysts, include dermoid cysts, rectal duplication cysts and retrorectal cyst-hamartomas. Retrorectal cyst-hamartomas (RCH) are derived from remnants of the tail gut, the most caudal part of the embryonic hind gut, which normally involutes by the 8th wk of embryonic development (3-8 mm stage). They have specific radiological and histopathological features that distinguish them from other similar formations (dermoid cysts, enteric duplication cysts and teratomas). We report a patient with adenosquamous carcinoma arising within RCH, who underwent complete resection of the cyst through anterior laparotomy, and reached complete (recurrencefree for 14 mo, so far) functional recovery. The cyst was incidentally discovered during hysterectomy 12 years ago.Diagnostic, therapeutic and histopathological aspects of this rare case are discussed. The mentioned period between diagnosis and surgical treatment suggests that RCH, given enough time, can develop malignant degeneration, and should be resected at the time of diagnosis.

A mild mutator phenotype arises in a mouse model for malignancies associated with neurofibromatosis type 1

International Nuclear Information System (INIS)

Garza, Rene; Hudson, Robert A.; McMahan, C. Alex; Walter, Christi A.; Vogel, Kristine S.

2007-01-01

Defects in genes that control DNA repair, proliferation, and apoptosis can increase genomic instability, and thus promote malignant progression. Although most tumors that arise in humans with neurofibromatosis type 1 (NF1) are benign, these individuals are at increased risk for malignant peripheral nerve sheath tumors (MPNST). To characterize additional mutations required for the development of MPNST from benign plexiform neurofibromas, we generated a mouse model for these tumors by combining targeted null mutations in Nf1 and p53, in cis. CisNf1+/-; p53+/- mice spontaneously develop PNST, and these tumors exhibit loss-of-heterozygosity at both the Nf1 and p53 loci. Because p53 has well-characterized roles in the DNA damage response, DNA repair, and apoptosis, and because DNA repair genes have been proposed to act as modifiers in NF1, we used the cisNf1+/-; p53+/- mice to determine whether a mutator phenotype arises in NF1-associated malignancies. To quantitate spontaneous mutant frequencies (MF), we crossed the Big Blue mouse, which harbors a lacI transgene, to the cisNf1+/-; p53+/- mice, and isolated genomic DNA from both tumor and normal tissues in compound heterozygotes and wild-type siblings. Many of the PNST exhibited increased mutant frequencies (MF = 4.70) when compared to normal peripheral nerve and brain (MF = 2.09); mutations occurred throughout the entire lacI gene, and included base substitutions, insertions, and deletions. Moreover, the brains, spleens, and livers of these cisNf1+/-; p53+/- animals exhibited increased mutant frequencies when compared to tissues from wild-type littermates. We conclude that a mild mutator phenotype arises in the tumors and tissues of cisNf1+/-; p53+/- mice, and propose that genomic instability influences NF1 tumor progression and disease severity

Malignant mixed mullerian tumor arising from the uterine cervix: A case report

International Nuclear Information System (INIS)

Shim, Jong Joon; Shim, Jae Chan; Lee, Kyoung Eun; Lee, Ghi Jai; Kim, Ho Kyun; Suh, Jung Ho; Lee, Hye Kyung

2012-01-01

Malignant mixed mullerian tumors (MMMTs) are a rare uterine tumor and contribute to approximately 1-3% of all corpus malignant tumors. MMMTs are usually in the uterine corpus, but can also arise from the uterine cervix, vagina, ovaries and fallofian tubes. MMMTs of the uterine cervix are extremely rare. MMMTs are highly malignant and tend to maintain a rapid growth and exhibit a high rate of recurrence. Therefore, the prognosis of patients diagnosed with these types of tumors is extremely poor. We report a rare case of a malignant mixed mullerian tumor arising from the uterine cervix and introduce CT and MRI findings. CT and magnetic resonance findings of the uterine cervical MMMT in our case show highly aggressive features, such as parametrial involvement, pelvic and paraaortic lymphadenopathy, and distant metastasis and high enhancement

On a Linear Equation Arising in Isometric Embedding of Torus-like Surface

Institute of Scientific and Technical Information of China (English)

Chunhe LI

2009-01-01

The solvability of a linear equation and the regularity of the solution are discussed.The equation is arising in a geometric problem which is concerned with the realization of Alexandroff's positive annul in R3.

Leggett-Garg tests of macrorealism for bosonic systems including double-well Bose-Einstein condensates and atom interferometers

Science.gov (United States)

Rosales-Zárate, L.; Opanchuk, B.; He, Q. Y.; Reid, M. D.

2018-04-01

We construct quantifiable generalizations of Leggett-Garg tests for macro- and mesoscopic realism and noninvasive measurability that apply when not all outcomes of measurement can be identified as arising from one of two macroscopically distinguishable states. We show how quantum mechanics predicts a negation of the Leggett-Garg premises for strategies involving ideal negative-result, weak, and minimally invasive ("nonclumsy") projective measurements on dynamical entangled systems, as might be realized with Bose-Einstein condensates in a double-well potential, path-entangled NOON states, and atom interferometers. Potential loopholes associated with each strategy are discussed.

Hausdorff dimension of certain sets arising in Engel expansions

Science.gov (United States)

Fang, Lulu; Wu, Min

2018-05-01

The present paper is concerned with the Hausdorff dimension of certain sets arising in Engel expansions. In particular, the Hausdorff dimension of the set is completely determined, where A n (x) can stand for the digit, gap and ratio between two consecutive digits in the Engel expansion of x and ϕ is a positive function defined on natural numbers. These results significantly extend the existing results of Galambos’ open problems on the Hausdorff dimension of sets related to the growth rate of digits.

Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

Science.gov (United States)

Marcus, Dawn A; Bernstein, Cheryl D; Haq, Adeel; Breuer, Paula

2014-06-01

Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact. The aim of the present study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme. Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities. Numerical rating scores for pain decreased by 10-13% (p Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p fibromyalgia treatment effectiveness. © 2013 John Wiley & Sons, Ltd.

Apocrine carcinoma arising in a complex fibroadenoma: a case report.

Science.gov (United States)

Mele, Marco; Vahl, Pernille; Funder, Jonas Amstrup; Sorensen, Anne Schmidt; Jensen, Vibeke

2014-01-01

A carcinoma arising in a fibroadenoma is a rare event, which often entails a diagnostic challenge. The most common type is the lobular carcinoma and secondary a ductal carcinoma. We present an extremely rare case of malignant development of an invasive apocrine carcinoma in a complex fibroadenoma and underline the importance for clinicians to recognize the possibility of benign and malignant co-existence especially in older women.

Partially thrombosed giant aneurysm arising from a distal anterior inferior cerebellar artery–posterior inferior cerebellar artery variant: A case report

Directory of Open Access Journals (Sweden)

Hidetoshi Ooigawa

2015-09-01

Full Text Available Anterior inferior cerebellar artery (AICA–posterior inferior cerebellar artery (PICA is a well-known variant in cerebral arteries. However, aneurysms located on the variant are rare and a giant one has not been reported. We report a case of a partially thrombosed giant aneurysm arising from an AICA–PICA variant. The patient was a 42-year-old man who presented with right hearing loss and facial numbness associated with left hemidysesthesia. Magnetic resonance imaging revealed an approximately 3.0-cm mass lesion at the right cerebello-pontine angle (CPA. Angiography showed a partially thrombosed aneurysm arising from the right AICA–PICA. The aneurysm was treated with endovascular trapping and surgical thrombectomy. Although cerebral aneurysm is known to occur at this site, this case provides awareness, that manifestations of aneurysms in the CPA include progressive multiple cranial nerve palsies and sensory disturbance caused by brainstem compression.

Airborne iodine-125 arising from surface contamination

International Nuclear Information System (INIS)

Kwok, C.S.; Hilditch, T.E.

1982-01-01

Measurements of airborne 125 I were made during the subdivision of 740 MBq stocks of 125 I iodide solution in a hospital dispensary. Within the fume cupboard the mean airborne 125 I concentration was 3.5 +- 2.9 kBqm -3 . No airborne concentration contamination was found outside the fume cupboard during these dispensing sessions. The airborne 125 I concentration arising from deliberate surface contamination (50 μl, 3.7-6.3 MBq) of the top of a lead pot was measured at a height simulating face level at an open work bench. There was a progressive fall in airborne concentration over seven days but even then the level was still significantly above background. Measurements made with the extraction system of the fume cupboard in operation were 2-3 times lower. (U.K.)

Clear Cell Adenocarcinoma Arising from Endometriosis in the Groin: Wide Resection and Reconstruction with a Fascia Lata Tensor Muscle Skin Flap

Directory of Open Access Journals (Sweden)

Shozo Yoshida

2018-01-01

Full Text Available We herein report a case of clear cell carcinoma arising from endometriosis in the groin in a 53-year-old woman. The findings of MRI and FDG/PET-CT indicated a malignant tumor, and surgical biopsy confirmed adenocarcinoma of the female genital tract. The tumor including a part of the abdominal rectus muscle and rectus sheath, subcutaneous fat, skin, and the right inguinal ligament was resected en bloc. The defect in the abdominal wall was reconstructed with a fascia lata tensor muscle skin flap. The tumor was composed of clear cell adenocarcinoma arising from extrapelvic endometriosis. The patient received chemotherapy with gemcitabine and carboplatin for 6 cycles and had no evidence of recurrence 7 months after the treatment. We herein described the diagnosis and surgical management of endometriosis-associated carcinoma in the groin.

Dealing with uncertainty arising out of probabilistic risk assessment

International Nuclear Information System (INIS)

Solomon, K.A.; Kastenberg, W.E.; Nelson, P.F.

1984-03-01

In addressing the area of safety goal implementation, the question of uncertainty arises. This report suggests that the Nuclear Regulatory Commission (NRC) should examine how other regulatory organizations have addressed the issue. Several examples are given from the chemical industry, and comparisons are made to nuclear power risks. Recommendations are made as to various considerations that the NRC should require in probabilistic risk assessments in order to properly treat uncertainties in the implementation of the safety goal policy. 40 references, 7 figures, 5 tables

CALCULUS FROM THE PAST: MULTIPLE DELAY SYSTEMS ARISING IN CANCER CELL MODELLING

KAUST Repository

WAKE, G. C.; BYRNE, H. M.

2013-01-01

Nonlocal calculus is often overlooked in the mathematics curriculum. In this paper we present an interesting new class of nonlocal problems that arise from modelling the growth and division of cells, especially cancer cells, as they progress through the cell cycle. The cellular biomass is assumed to be unstructured in size or position, and its evolution governed by a time-dependent system of ordinary differential equations with multiple time delays. The system is linear and taken to be autonomous. As a result, it is possible to reduce its solution to that of a nonlinear matrix eigenvalue problem. This method is illustrated by considering case studies, including a model of the cell cycle developed recently by Simms, Bean and Koeber. The paper concludes by explaining how asymptotic expressions for the distribution of cells across the compartments can be determined and used to assess the impact of different chemotherapeutic agents. Copyright © 2013 Australian Mathematical Society.

Where Cognitive Conflict Arises from?: The Structure of Creating Cognitive Conflict

Science.gov (United States)

Lee, Gyoungho; Yi, Jinseog

2013-01-01

In this study, our basic contention was that it is essential for researchers to answer the question, "Where does cognitive conflict really arise from?" with more precision than has heretofore been attempted. First, we examined how the term "cognitive conflict" has been treated in the existing literature and try to pinpoint some difficulties,…

Facial Cellulitis Arising from Dens Evaginatus: A Case Report

Directory of Open Access Journals (Sweden)

Chun-Ming Chen

2005-07-01

Full Text Available Dens evaginatus is a developmental anomaly that produces a tubercle on the occlusal surface of a tooth. It is found most frequently in the mandibular premolars. The occlusal tubercle easily causes occlusal interferences. Attrition or fracture of the tubercle can lead to pulpitis, pulp necrosis, periapical pathosis, and periapical infection. This case report illustrates the treatment of facial cellulitis arising from dens evaginatus with open apex. Calcium hydroxide was used for the apexification procedure. One year after canal obturation, radiography revealed no apical pathosis and the apical seal was evident.

The Settlement of Litigations Arising from the Interpretation and Enforcement of Administrative Contracts

Directory of Open Access Journals (Sweden)

Vasilica NEGRUŢ

2015-03-01

Full Text Available Regarded nowadays as an instrument of strategy implementation of government policy and establishment mechanism of public administration, the administrative contract raises many debates on its applicable regime, but also on the jurisdiction, to solve litigations arising from their interpretation and execution. In this paper we proposed, based on the analysis of the laws in force, doctrine, jurisprudence, and previous research results related to the subject, using the comparative method, to clarify the mentioned issues. The conclusions of this paper will strengthen the practice on the referral of courts competent to solve litigations arising from the implementation of the administrative contracts in the context where the administrative contract has profound implications in the administrative, economic and social field.

Energy principle with included boundary conditions

International Nuclear Information System (INIS)

Lehnert, B.

1994-01-01

Earlier comments by the author on the limitations of the classical form of the extended energy principle are supported by a complementary analysis on the potential energy change arising from free-boundary displacements of a magnetically confined plasma. In the final formulation of the extended principle, restricted displacements, satisfying pressure continuity by means of plasma volume currents in a thin boundary layer, are replaced by unrestricted (arbitrary) displacements which can give rise to induced surface currents. It is found that these currents contribute to the change in potential energy, and that their contribution is not taken into account by such a formulation. A general expression is further given for surface currents induced by arbitrary displacements. The expression is used to reformulate the energy principle for the class of displacements which satisfy all necessary boundary conditions, including that of the pressure balance. This makes a minimization procedure of the potential energy possible, for the class of all physically relevant test functions which include the constraints imposed by the boundary conditions. Such a procedure is also consistent with a corresponding variational calculus. (Author)

Epithelioid sarcoma and squamous cell carcinoma arising in a burn scar

Directory of Open Access Journals (Sweden)

Kusum D Jashnani

2011-01-01

Full Text Available Development of a malignant tumor is a well known complication of a chronic burn scar. Most of these tumors are squamous cell carcinomas and only 28 cases of burn scar sarcomas have been reported in literature. We report the first occurrence of the combination of squamous cell carcinoma and epithelioid sarcoma arising in a burn scar.

Aberrant ovarian artery arising from the common Iliac artery: Case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Won Kyung [Dept. of Radiology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Yang, Seung Boo; Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi (Korea, Republic of); Goo, Dong Erk; Kim, Yong Jae; Chang, Yun Woo [Dept. of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul (Korea, Republic of)

2013-01-15

A 46-year-old Vietnamese woman received embolization therapy in order to control postpartum hemorrhage. Angiography revealed an aberrant ovarian artery arising from the right common iliac artery. Superselective catheterization and subsequent embolization of the aberrant ovarian artery and bilateral uterine arteries were performed. Precise knowledge of the anatomic variations of the ovarian artery is important for successful embolization.

Aberrant ovarian artery arising from the common Iliac artery: Case report

International Nuclear Information System (INIS)

Kim, Won Kyung; Yang, Seung Boo; Lee, Jae Myeong; Goo, Dong Erk; Kim, Yong Jae; Chang, Yun Woo

2013-01-01

A 46-year-old Vietnamese woman received embolization therapy in order to control postpartum hemorrhage. Angiography revealed an aberrant ovarian artery arising from the right common iliac artery. Superselective catheterization and subsequent embolization of the aberrant ovarian artery and bilateral uterine arteries were performed. Precise knowledge of the anatomic variations of the ovarian artery is important for successful embolization.

Clear Cell Adenocarcinoma Arising from Abdominal Wall Endometriosis

Directory of Open Access Journals (Sweden)

Thouraya Achach

2008-01-01

Full Text Available Endometriosis is a frequent benign disorder. Malignancy arising in extraovarian endometriosis is a rare event. A 49-year-old woman is presented with a large painful abdominal wall mass. She underwent a myomectomy, 20 years before, for uterus leiomyoma. Computed tomography suggested that this was a desmoid tumor and she underwent surgery. Histological examination showed a clear cell adenocarcinoma associated with endometriosis foci. Pelvic ultrasound, computed tomography, and endometrial curettage did not show any malignancy or endometriosis in the uterus and ovaries. Adjuvant chemotherapy was recommended, but the patient was lost to follow up. Six months later, she returned with a recurrence of the abdominal wall mass. She was given chemotherapy and then she was reoperated.

Nonlinear electric reaction arising in dry bone subjected to 4-point bending

Science.gov (United States)

Murasawa, Go; Cho, Hideo; Ogawa, Kazuma

2007-04-01

Bone is a smart, self-adaptive and also partly self-repairing tissue. In recent years, many researchers seek to find how to give the effective mechanical stimulation to bone, because it is the predominant loading that determines the bone shape and macroscopic structure. However, the trial of regeneration of bone is still under way. On the other hand, it has been known that electrical potential generates from bone by mechanical stimulation (Yasuda, 1977; Williams, 1982; Starkebaum, 1979; Cochran, 1968; Lanyon, 1977; Salzstein, 1987a,b; Friedenberg, 1966). This is called "stress-generated potential (SGP)". The process of information transfer between "strain" and "cells" is not still clear. But, there is some possibility that SGP has something to do with the process of information transfer. If the electrical potential is more clear under some mechanical loadings, we will be able to regenerate bone artificially and freely. Therefore, it is important to investigate SGP in detail. The aim of present study is to investigate the electric reaction arising in dry bone subjected to mechanical loadings at high amplitude and low frequency strain. Firstly, specimen is fabricated from femur of cow. Next, the speeds of wave propagation in bone are tried to measure by laser ultra sonic technique and wavelet transform, because these have relationship with bone density. Secondary, 4-point bending test is conducted up to fracture. Then, electric reaction arising in bone is measured during loading. Finally, cyclic 4-point bending tests are conducted to investigate the electric reaction arising in bone at low frequency strain.

Radiological impact of the management of radioactive waste arising from the Argentine Nuclear Programme

International Nuclear Information System (INIS)

Migliori de Beninson, A.; Cancio, D.

1984-01-01

The Argentine nuclear programme, as it stands at present, provides for the construction of four nuclear power plants in addition to those of Atucha I and Embalse and for the establishment of such fuel cycle facilities as are required to supply all of these plants. This paper evaluates the radiological impact (collective dose commitment) expected from the management of the radioactive wastes arising in the facilities mentioned above throughout the useful life of the reactors. The maximum individual doses to be expected as a result of the planned high-level-waste repository are also estimated. The evaluations presented are partly specific to the sites under consideration, but they also include estimates of the total collective dose commitments resulting from the management of radioactive waste under the Argentine nuclear programme. (author)

Network meta-analysis of multiple outcome measures accounting for borrowing of information across outcomes.

Science.gov (United States)

Achana, Felix A; Cooper, Nicola J; Bujkiewicz, Sylwia; Hubbard, Stephanie J; Kendrick, Denise; Jones, David R; Sutton, Alex J

2014-07-21

Network meta-analysis (NMA) enables simultaneous comparison of multiple treatments while preserving randomisation. When summarising evidence to inform an economic evaluation, it is important that the analysis accurately reflects the dependency structure within the data, as correlations between outcomes may have implication for estimating the net benefit associated with treatment. A multivariate NMA offers a framework for evaluating multiple treatments across multiple outcome measures while accounting for the correlation structure between outcomes. The standard NMA model is extended to multiple outcome settings in two stages. In the first stage, information is borrowed across outcomes as well across studies through modelling the within-study and between-study correlation structure. In the second stage, we make use of the additional assumption that intervention effects are exchangeable between outcomes to predict effect estimates for all outcomes, including effect estimates on outcomes where evidence is either sparse or the treatment had not been considered by any one of the studies included in the analysis. We apply the methods to binary outcome data from a systematic review evaluating the effectiveness of nine home safety interventions on uptake of three poisoning prevention practices (safe storage of medicines, safe storage of other household products, and possession of poison centre control telephone number) in households with children. Analyses are conducted in WinBUGS using Markov Chain Monte Carlo (MCMC) simulations. Univariate and the first stage multivariate models produced broadly similar point estimates of intervention effects but the uncertainty around the multivariate estimates varied depending on the prior distribution specified for the between-study covariance structure. The second stage multivariate analyses produced more precise effect estimates while enabling intervention effects to be predicted for all outcomes, including intervention effects on

Mesenchymal chondrosarcoma arising from the intrascrotal extratesicular soft tissue;a case report

International Nuclear Information System (INIS)

Lim, Jong-Uk; Koo, Bong-Sik; Park, Byeong-Ho; Park, Chang-Sook; Nam, Kyung-Jin; Kweon, Heon-Young

2000-01-01

Intrascrotal extratesticular malignancies are rare, and the radiologic findings of extraskeletal chondrosarcoma have not been reported. We describe the radiologic findings of a case of mesenchymal chondrosarcoma arising from intrascrotal extratesticular soft tissue and represented by a complex, cystic, solid mass containing calcifications and hematoma

Positron scattering by atomic hydrogen including positronium formation

International Nuclear Information System (INIS)

Higgins, K.; Burke, P.G.

1993-01-01

Positron scattering by atomic hydrogen including positronium formation has been formulated using the R-matrix method and a general computer code written. Partial wave elastic and ground state positronium formation cross sections have been calculated for L ≤ 6 using a six-state approximation which includes the ground state and the 2s and 2p pseudostates of both hydrogen and positronium. The elastic scattering results obtained are in good agreement with those derived from a highly accurate calculation based upon the intermediate energy R-matrix approach. As in a previous coupled-channel static calculation, resonance effects are observed at intermediate energies in the S-wave positronium formation cross section. However, in the present results, the dominant resonance arises in the P-wave cross sections at an energy of 2.73 Ryd and with a width of 0.19 Ryd. (author)

Proceedings of the second FY87 meeting of the National Working Group for Reduction in Transuranic Waste Arisings

International Nuclear Information System (INIS)

1987-09-01

The Second FY87 Meeting of the National Working Group for Reduction in Transuranic Waste Arisings (NWGRTWA) was held at the Lawrence Livermore National Laboratory, Tuesday and Wednesday, July 28--29, 1987. The purpose of the meeting was to discuss (1) modeling programs for waste reduction, (2) proposed FY88 and out-year tasks including the SRL Pu incineration, immobilization improvement, erbia coating technology, and (3) improvements in up-stream recovery operations to effect waste reduction. In addition, tours were made of the LLNL Waste Operations, the Laser Fusion (NOVA), and the Magnetic Fusion (MFTF)

On the solution of a rational matrix equation arising in G-networks

NARCIS (Netherlands)

B. Meini (Beatrice); T. Nesti (Tommaso)

2017-01-01

textabstractWe consider the problem of solving a rational matrix equation arising in the solution of G-networks. We propose and analyze two numerical methods: a fixed point iteration and the Newton–Raphson method. The fixed point iteration is shown to be globally convergent with linear convergence

Techniques of treatment or conditioning for waste arising from 131I production

International Nuclear Information System (INIS)

Dellamono, J.C.

1989-07-01

Distillation, evaporation/crystallization, direct immobilization and some chemical like precipitation and reduction were studied as techniques of treatment or conditioning for waste arising from 131 I production. The description of all techniques studied, as well as evaluation and discussion of the results are presented. (author) [pt

Predictability of psychic outcome for exercise training and exercise training including relaxation therapy after myocardial infarction

NARCIS (Netherlands)

H.J. Duivenvoorden (Hugo); J. van Dixhoorn (J.)

1991-01-01

markdownabstractAbstract Predictability of the psychic outcome for two cardiac rehabilitation programmes was investigated in 119 myocardial infarction patients. They were randomly assigned to either a five-week daily exercise training or to an identical training in combination with six sessions

Management of Large Volumes of Waste Arising in a Nuclear or Radiological Emergency

International Nuclear Information System (INIS)

2017-10-01

This publication, prepared in light of the IAEA Action Plan on Nuclear Safety developed after the accident at the Fukushima Daiichi nuclear power plant, addresses the management of large volumes of radioactive waste arising in a nuclear or radiological emergency, as part of overall emergency preparedness. The management of large volumes of waste will be one of many efforts to be dealt with to allow recovery of affected areas, to support return of evacuated or relocated populations and preparations for normal social and economic activities, and/or to mitigate additional environmental impacts. The publication is intended to be of use to national planners and policy makers, facility and programme managers, and other professionals responsible for developing and implementing national plans and strategies to manage radioactive waste arising from nuclear or radiological emergencies.

The surgery of peripheral nerves (including tumors)

DEFF Research Database (Denmark)

Fugleholm, Kåre

2013-01-01

Surgical pathology of the peripheral nervous system includes traumatic injury, entrapment syndromes, and tumors. The recent significant advances in the understanding of the pathophysiology and cellular biology of peripheral nerve degeneration and regeneration has yet to be translated into improved...... surgical techniques and better outcome after peripheral nerve injury. Decision making in peripheral nerve surgery continues to be a complex challenge, where the mechanism of injury, repeated clinical evaluation, neuroradiological and neurophysiological examination, and detailed knowledge of the peripheral...... nervous system response to injury are prerequisite to obtain the best possible outcome. Surgery continues to be the primary treatment modality for peripheral nerve tumors and advances in adjuvant oncological treatment has improved outcome after malignant peripheral nerve tumors. The present chapter...

Arthroscopic Resection of Wrist Ganglion Arising from the Lunotriquetral Joint

OpenAIRE

Mak, Michael C. K.; Ho, Pak-cheong; Tse, W. L.; Wong, Clara W. Y.

2013-01-01

The dorsal wrist ganglion is the most common wrist mass, and previous studies have shown that it arises from the scapholunate interval in the vast majority of cases. Treatment has traditionally been open excision, and more recently arthroscopic resection has been established as an effective and less invasive treatment method. However, application of this technique to ganglia in atypical locations has not been reported, where open excision is the usual practice. This report describes two cases...

Merkel Cell Carcinomas Arising in Autoimmune Disease Affected Patients Treated with Biologic Drugs, Including Anti-TNF.

Science.gov (United States)

Rotondo, John Charles; Bononi, Ilaria; Puozzo, Andrea; Govoni, Marcello; Foschi, Valentina; Lanza, Giovanni; Gafà, Roberta; Gaboriaud, Pauline; Touzé, Françoise Antoine; Selvatici, Rita; Martini, Fernanda; Tognon, Mauro

2017-07-15

Purpose: The purpose of this investigation was to characterize Merkel cell carcinomas (MCC) arisen in patients affected by autoimmune diseases and treated with biologic drugs. Experimental Design: Serum samples from patients with MCC were analyzed for the presence and titer of antibodies against antigens of the oncogenic Merkel cell polyomavirus (MCPyV). IgG antibodies against the viral oncoproteins large T (LT) and small T (ST) antigens and the viral capsid protein-1 were analyzed by indirect ELISA. Viral antigens were recombinant LT/ST and virus-like particles (VLP), respectively. MCPyV DNA sequences were studied using PCR methods in MCC tissues and in peripheral blood mononuclear cells (PBMC). Immunohistochemical (IHC) analyses were carried out in MCC tissues to reveal MCPyV LT oncoprotein. Results: MCPyV DNA sequences identified in MCC tissues showed 100% homology with the European MKL-1 strain. PBMCs from patients tested MCPyV-negative. Viral DNA loads in the three MCC tissues were in the 0.1 to 30 copy/cell range. IgG antibodies against LT/ST were detected in patients 1 and 3, whereas patient 2 did not react to the MCPyV LT/ST antigen. Sera from the three patients with MCC contained IgG antibodies against MCPyV VP1. MCC tissues tested MCPyV LT-antigen-positive in IHC assays, with strong LT expression with diffuse nuclear localization. Normal tissues tested MCPyV LT-negative when employed as control. Conclusions: We investigated three new MCCs in patients affected by rheumatologic diseases treated with biologic drugs, including TNF. A possible cause-effect relationship between pharmacologic immunosuppressive treatment and MCC onset is suggested. Indeed, MCC is associated with MCPyV LT oncoprotein activity. Clin Cancer Res; 23(14); 3929-34. ©2017 AACR . ©2017 American Association for Cancer Research.

Management of radioactive solid waste arisings from PFR reprocessing

International Nuclear Information System (INIS)

Allardice, R.H.; Hackney, S.; Bailey, G.; Bremner, W.; Lillyman, E.; Pugh, O.; Reekie, J.

1982-01-01

A description is given of the solid radioactive waste management facilities for dealing with the arisings from PFR reprocessing at the Dounreay Nuclear Power Development Establishment. Four major categories of solid waste are identified. The 'La Calhene' posting system for the transfer of active wastes which has been installed is discussed. The three new retrievable stores for high α#betta##betta#, high α low #betta##betta# and low α high #betta##betta# are described. The methods of waste categorisation by non-destructive assay techniques are outlined. Finally a review of operating experience with the facilities is presented. (U.K.)

A Large Cystic Variant of Gastro-intestinal Stromal Tumour arising from the Jejunum: A Case Report

OpenAIRE

Shaikh, Salman Tehran; Upwanshi, Manish Harinarayan; Shetty, Tilakdas S.; Ghetla, Smruti R.; Gheewala, Hussain

2015-01-01

Gastrointestinal stromal tumours (GISTs) represent a mesenchymal neoplasm arising from the interstitial cells of cajal occurring mainly in the gastrointestinal tract. Here, we present a case of a large GIST arising from the jejunum with cystic presentation unlike the usual presentation as a solid mass. A 50-year-old male patient came with complaint of a painless mobile lump in abdomen of approximately 25 cm in size which had gradually increased over two years. Clinically mesenteric cyst was s...

Development of measures to assess the safety of existing NPPs and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches). Peer discussions on regulatory practices

International Nuclear Information System (INIS)

1996-09-01

This report arises from the fourth series of peer discussions on regulatory practices entitled D evelopment of measures to assess the safety of existing nuclear power plants and the effectiveness of regulations and regulatory actions (including 'prescriptive' and 'performance based' approaches) . Senior regulators from 23 Member States participated in four peer group discussions during 1995-1996. This report presents the outcome of these meetings and recommendations of good practices identified by these senior regulators. The purpose of this report is to disseminate the views which the senior regulators presented at the meetings relating to measures used for assessing the safety of existing nuclear power plants and evaluating the effectiveness of regulators and regulatory actions. The intention in doing this is to assist Member States in the enhancement of their regulatory practices by identifying commonly accepted good practices. This report is structured so that it covers the subject matter under the following main headings: 'Prescriptive and Performance Based' Approaches to Regulation; Common Features of Regulatory Approaches; Effectiveness of the Regulator and Regulatory Actions; Recommendations of Good Practice. It is important to note that recommendations of good practice are included if they have been identified by at least one of the groups. It does not follow that all of the groups or individual Member States would necessarily endorse all of the recommendations. However, it is considered that if a single group of senior regulators judge that a particular practice is worthy of recommendation then it should be included for serious consideration. In some cases the same recommendations arise from all of the Groups

Single string planning problem arising in liner shipping industries: A heuristic approach

DEFF Research Database (Denmark)

Gelareh, Shahin; Neamatian Monemi, Rahimeh; Mahey, Philippe

2013-01-01

We propose an efficient heuristic approach for solving instances of the Single String Planning Problem (SSPP) arising in the liner shipping industry. In the SSPP a Liner Service Provider (LSP) only revises one of its many operational strings, and it is assumed that the other strings are unchangea...

Achieving the Desired Transformation: Thoughts on Next Steps for Outcomes-Based Medical Education.

Science.gov (United States)

Holmboe, Eric S; Batalden, Paul

2015-09-01

Since the introduction of the outcomes-based medical education (OBME) movement, progress toward implementation has been active but challenging. Much of the angst and criticism has been directed at the approaches to assessment that are associated with outcomes-based or competency frameworks, particularly defining the outcomes. In addition, these changes to graduate medical education (GME) are concomitant with major change in health care systems--specifically, changes to increase quality and safety while reducing cost. Every sector, from medical education to health care delivery and financing, is in the midst of substantial change and disruption.The recent release of the Institute of Medicine's report on the financing and governance of GME highlights the urgent need to accelerate the transformation of medical education. One source of continued tension within the medical education community arises from the assumption that the much-needed increases in value and improvement in health care can be achieved by holding the current educational structures and architecture of learning in place while concomitantly withdrawing resources. The authors of this Perspective seek to reframe the important and necessary debate surrounding the current challenges to implementing OBME. Building on recent change and service theories (e.g., Theory U and coproduction), they propose several areas of redirection, including reexamination of curricular models and greater involvement of learners, teachers, and regulators in cocreating new training models, to help facilitate the desired transformation in medical education.

Gender, renal function, and outcomes on the liver transplant waiting list: assessment of revised MELD including estimated glomerular filtration rate.

Science.gov (United States)

Myers, Robert P; Shaheen, Abdel Aziz M; Aspinall, Alexander I; Quinn, Robert R; Burak, Kelly W

2011-03-01

The Model for End-Stage Liver Disease (MELD) allocation system for liver transplantation (LT) may present a disadvantage for women by including serum creatinine, which is typically lower in females. Our objectives were to investigate gender disparities in outcomes among LT candidates and to assess a revised MELD, including estimated glomerular filtration rate (eGFR), for predicting waiting list mortality. Adults registered for LT between 2002 and 2007 were identified using the UNOS database. We compared components of MELD, MDRD-derived eGFR, and the 3-month probability of LT and death between genders. Discrimination of MELD, MELDNa, and revised models including eGFR for mortality were compared using c-statistics. A total of 40,393 patients (36% female) met the inclusion criteria; 9% died and 24% underwent LT within 3 months of listing. Compared with men, women had lower median serum creatinine (0.9 vs. 1.0 mg/dl), eGFR (72 vs. 83 ml/min/1.73 m(2)), and mean MELD (16.5 vs. 17.2; all p discrimination for 3-month mortality (c-statistics: MELD 0.896, MELD-eGFR 0.894, MELDNa 0.911, MELDNa-eGFR 0.905). Women are disadvantaged under MELD potentially due to its inclusion of creatinine. However, since including eGFR in MELD does not improve mortality prediction, alternative refinements are necessary. Copyright © 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Correction of Proofs in "Purely Infinite Simple C*-algebras Arising from Free Product Constructions'' and a Subsequent Paper

DEFF Research Database (Denmark)

Ara, Pere; Dykema, Kenneth J.; Rørdam, Mikael

2013-01-01

The proofs of Theorem 2.2 of K. J. Dykema and M. Rørdam, Purely infinite simple C∗-algebras arising from free product constructions}, Canad. J. Math. 50 (1998), 323--341 and of Theorem 3.1 of K. J. Dykema, Purely infinite simple C∗-algebras arising from free product constructions, II, Math. Scand...

Radioisotopes: problems of responsibility arising from medicine

International Nuclear Information System (INIS)

Dupon, Michel.

1978-09-01

Radioisotopes have brought about great progress in the battle against illnesses of mainly tumoral origin, whether in diagnosis (nuclear medicine) or in treatment (medical radiotherapy). They are important enough therefore to warrant investigation. Such a study is attempted here, with special emphasis, at a time when medical responsibility proceedings are being taken more and more often on the medicolegal problems arising from their medical use. It is hoped that this study on medical responsibility in the use of radioisotopes will have shown: that the use of radioisotopes for either diagnosis or therapy constitutes a major banch of medicine; that this importance implies an awareness by the practitioner of a vast responsibility, especially in law where legislation to ensure protection as strict as in the field of ionizing radiations is lacking. The civil responsibility of doctors who use radioisotopes remains to be defined, since for want of adequate jurisprudence we are reduced to hypotheses based on general principles [fr

The pressure equation arising in reservoir simulation. Mathematical properties, numerical methods and upscaling

Energy Technology Data Exchange (ETDEWEB)

Nielsen, Bjoern Fredrik

1997-12-31

The main purpose of this thesis has been to analyse self-adjoint second order elliptic partial differential equations arising in reservoir simulation. It studies several mathematical and numerical problems for the pressure equation arising in models of fluid flow in porous media. The theoretical results obtained have been illustrated by a series of numerical experiments. The influence of large variations in the mobility tensor upon the solution of the pressure equation is analysed. The performance of numerical methods applied to such problems have been studied. A new upscaling technique for one-phase flow in heterogeneous reservoirs is developed. The stability of the solution of the pressure equation with respect to small perturbations of the mobility tensor is studied. The results are used to develop a new numerical method for a model of fully nonlinear water waves. 158 refs, 39 figs., 12 tabs.

The pressure equation arising in reservoir simulation. Mathematical properties, numerical methods and upscaling

Energy Technology Data Exchange (ETDEWEB)

Nielsen, Bjoern Fredrik

1998-12-31

The main purpose of this thesis has been to analyse self-adjoint second order elliptic partial differential equations arising in reservoir simulation. It studies several mathematical and numerical problems for the pressure equation arising in models of fluid flow in porous media. The theoretical results obtained have been illustrated by a series of numerical experiments. The influence of large variations in the mobility tensor upon the solution of the pressure equation is analysed. The performance of numerical methods applied to such problems have been studied. A new upscaling technique for one-phase flow in heterogeneous reservoirs is developed. The stability of the solution of the pressure equation with respect to small perturbations of the mobility tensor is studied. The results are used to develop a new numerical method for a model of fully nonlinear water waves. 158 refs, 39 figs., 12 tabs.

On the numerical solution of coupled eigenvalue differential equations arising in molecular spectroscopy

International Nuclear Information System (INIS)

Friedman, R.S.; Jamieson, M.J.; Preston, S.C.

1990-01-01

A method for solving coupled eigenvalue differential equations is given and its relation to an existing technique is shown. Use of the Gram-Schmidt process to overcome the severe instabilities arising in molecular problems is described in detail. (orig.)

Squamous Cell Carcinoma Arising from an Oral Lichenoid Lesion: A Case Report

Directory of Open Access Journals (Sweden)

Ali Taghavi Zenouz

2012-02-01

Full Text Available Lichenoid reactions represent a family of lesions with different etiologic factors and a common clinical and histologic appearance. Lichen planus is included with lichenoid reactions and is a relatively common chronic mucocutaneous disorder. The most important complication of lichenoid reactions is the possibility of malignant transformation. That is why it has been considered a precancerous condition. Although the malignant transformation rate varies widely in the literature, from 0.4 to 6.5 percent, in most studies it does not exceed 1%. The aim of this paper is to report a rare case of squamous cell carcinoma (SCC arising within an oral lichenoid lesion in a 17-year-old woman, where SCC is very uncommon. The patient did not have any risk factors and was healthy. The lesion was located on the border of the tongue. In view of the common occurrence of OLP (oral lichen planus and the unresolved issues regarding its premalignant potential, this case report illustrates the need for histologic confirmation and a close follow-up of clinical lesions with lichenoid features.

A Large Cystic Variant of Gastro-intestinal Stromal Tumour arising from the Jejunum: A Case Report.

Science.gov (United States)

Shaikh, Salman Tehran; Upwanshi, Manish Harinarayan; Shetty, Tilakdas S; Ghetla, Smruti R; Gheewala, Hussain

2015-04-01

Gastrointestinal stromal tumours (GISTs) represent a mesenchymal neoplasm arising from the interstitial cells of cajal occurring mainly in the gastrointestinal tract. Here, we present a case of a large GIST arising from the jejunum with cystic presentation unlike the usual presentation as a solid mass. A 50-year-old male patient came with complaint of a painless mobile lump in abdomen of approximately 25 cm in size which had gradually increased over two years. Clinically mesenteric cyst was suspected. Intra-operatively the mass was a 30x25 cm cyst with approximately 2500 ml serous fluid present inside it arising from the anti-mesenteric border of the jejunum, adherent to the jejunum, appendix and the dome of the bladder. The fluid was aspirated and the mass excised along with resection of the involved jejunal segment and appendectomy was done. Diagnosis was confirmed on immunohistochemistry study. Imatinib Mesylate 400 mg OD was started as adjuvant therapy in view of the high risk of metastasis.

Breast Cancer Arising Adjacent to an Involuting Fibroadenoma: Serial Changes in Radiologic Features

Science.gov (United States)

Park, Chae Jung; Kim, Eun-Kyung; Woo, Ha Young; Moon, Hee Jung; Yoon, Jung Hyun

2015-01-01

Fibroadenoma is a common benign breast lesion and its malignant transformation is rare. There have been several case reports and studies that retrospectively reviewed breast cancers that arose within fibroadenomas; however, none of these studies reported serial changes in radiologic features of the cancer, including findings from mammography and ultrasound (US). We report a case of breast cancer arising adjacent to an involuting fibro adenoma in a 39-year-old woman who was undergoing serial follow-up after her fibroadenoma was diagnosed. Seven years after her diagnosis, the lesion showed evidence of coarse calcifications, a typical sign of involution. Four years later, US revealed a newly developed hypoechoic lesion with irregular margins and peripherally located calcifications adjacent to the fibroadenoma. A core biopsy was performed, and histopathological examination resulted in a diagnosis of invasive ductal carcinoma. When new suspicious features are observed in a fibroadenoma, radiologists should raise the concern for breast cancer and proceed with diagnosis and treatment accordingly. PMID:26472981

Conservation laws arising in the study of forward-forward Mean-Field Games

KAUST Repository

Gomes, Diogo A.; Nurbekyan, Levon; Sedjro, Marc

2017-01-01

We consider forward-forward Mean Field Game (MFG) models that arise in numerical approximations of stationary MFGs. First, we establish a link between these models and a class of hyperbolic conservation laws as well as certain nonlinear wave equations. Second, we investigate existence and long-time behavior of solutions for such models.

Exploring Ethical Dilemmas for Principals Arising from Role Conflict with School Counsellors

Science.gov (United States)

Kimber, Megan; Campbell, Marilyn

2014-01-01

Acting in the best interests of students is central to the moral and ethical work of schools. Yet tensions can arise between principals and school counsellors as they work from at times opposing professional paradigms. In this article we report on principals' and counsellors' responses to scenarios covering confidentiality and the law,…

Conservation laws arising in the study of forward-forward Mean-Field Games

KAUST Repository

Gomes, Diogo A.

2017-04-24

We consider forward-forward Mean Field Game (MFG) models that arise in numerical approximations of stationary MFGs. First, we establish a link between these models and a class of hyperbolic conservation laws as well as certain nonlinear wave equations. Second, we investigate existence and long-time behavior of solutions for such models.

Self-Reported Health Experiences of Children Living with Congenital Heart Defects: Including Patient-Reported Outcomes in a National Cohort Study.

Science.gov (United States)

Knowles, Rachel Louise; Tadic, Valerija; Hogan, Ailbhe; Bull, Catherine; Rahi, Jugnoo Sangeeta; Dezateux, Carol

2016-01-01

Understanding children's views about living with congenital heart defects (CHDs) is fundamental to supporting their successful participation in daily life, school and peer relationships. As an adjunct to a health and quality of life outcomes questionnaire, we asked school-age children who survived infant heart procedures to describe their experiences of living with CHDs. In a UK-wide cohort study, children aged 10 to 14 years with CHDs self-completed postal questionnaires that included an open question about having a 'heart problem'. We compared the characteristics of children with more and less severe cardiac diagnoses and, through collaborative inductive content analysis, investigated the subjective experiences and coping strategies described by children in both clinical severity groups. Text and/or drawings were returned by 436 children (246 boys [56%], mean age 12.1 years [SD 1.0; range 10-14]); 313 had less severe (LS) and 123 more severe (MS) cardiac diagnoses. At the most recent hospital visit, a higher proportion of the MS group were underweight (more than two standard deviations below the mean for age) or cyanosed (underweight: MS 20.0%, LS 9.9%; cyanosed: MS 26.2%, LS 3.5%). Children in the MS group described concerns about social isolation and feeling 'different', whereas children with less severe diagnoses often characterised their CHD as 'not a big thing'. Some coping strategies were common to both severity groups, including managing health information to avoid social exclusion, however only children in the LS group considered their CHD 'in the past' or experienced a sense of survivorship. Children's reported experiences were not dependent on their cardiac diagnosis, although there were clear qualitative differences by clinical severity group. Children's concerns emphasised social participation and our findings imply a need to shift the clinical focus from monitoring cardiac function to optimising participation. We highlight the potential for informing

Giant Cell Tumor of Rib Arising Anteriorly as a Large Inframammary Mass: A Case Report and Review of the Literature

Directory of Open Access Journals (Sweden)

Amit Sharma

2012-01-01

posteriorly. The rarity of this tumor poses diagnostic and therapeutic problems for physicians, especially when it is located in the anterior arc of the rib in close proximity to the breasts in female patients. Case Presentation. We report the case of a 32-year-old Asian female with a giant cell tumor of her anterior rib, presenting as a large inframammary mass. Computed tomography showed a tumor arising from the 7th rib anteriorly with marginal sclerosis, cortical destruction, and a soft tissue mass. She was treated with surgical resection, and the defect was reconstructed primarily. The surgical specimen measured 28.0 × 24.0 cm. The microscopic examination showed a large number of multinucleate giant cells scattered over the parenchyma. Patient recovered uneventfully and continues to be recurrence-free six years after surgical resection. Conclusion. We report the largest known case of giant cell tumor arising from the anterior aspect of a rib. We recommend including giant cell tumor in the differential diagnosis of chest wall masses especially in female patients, regardless of the size on clinical examination.

Systematic review with meta-analysis: online psychological interventions for mental and physical health outcomes in gastrointestinal disorders including irritable bowel syndrome and inflammatory bowel disease.

Science.gov (United States)

Hanlon, I; Hewitt, C; Bell, K; Phillips, A; Mikocka-Walus, A

2018-06-14

Online psychotherapy has been successfully used as supportive treatment in many chronic illnesses. However, there is a lack of evidence on its role in the management of gastrointestinal (GI) diseases. To examine whether online psychological interventions improve mental and physical outcomes in gastrointestinal diseases. We searched CINAHL Plus, MEDLINE, EMBASE, Health Management Information Consortium, PsycINFO, British Nursing Index, Cochrane Library, a specialised register of the IBD/FBD Cochrane Group, MEDLINE (PubMed) WHO International Clinical Trial Registry, ClinicalTrials.gov, and reference lists of all papers included in the review. The Cochrane Risk of Bias Tool was used to assess internal validity. Where possible, data were pooled using random-effects meta-analysis. We identified 11 publications (encompassing nine studies) meeting inclusion criteria. One study had a high risk of selection bias (allocation concealment), all studies had a high risk of performance and detection bias. Eight studies were included in the meta-analyses (6 on irritable bowel syndrome [IBS] and two on inflammatory bowel disease [IBD]). Online cognitive behavioural therapy (CBT) was shown to significantly improve gastrointestinal symptom-specific anxiety (MD: -8.51, 95% CI -12.99 to -4.04, P = 0.0002) and lessen symptom-induced disability (MD: -2.78, 95% CI -5.43 to -0.12, P = 0.04) in IBS post intervention. There was no significant effect of online CBT on any other outcomes in IBS. No significant effect of online psychotherapy was demonstrated in IBD. There is insufficient evidence to demonstrate the effectiveness of online CBT to manage mental and physical outcomes in gastrointestinal diseases. © 2018 John Wiley & Sons Ltd.

Response of hatchling Komodo Dragons (Varanus komodoensis) at Denver Zoo to visual and chemical cues arising from prey.

Science.gov (United States)

Chiszar, David; Krauss, Susan; Shipley, Bryon; Trout, Tim; Smith, Hobart M

2009-01-01

Five hatchling Komodo Dragons (Varanus komodoensis) at Denver Zoo were observed in two experiments that studied the effects of visual and chemical cues arising from prey. Rate of tongue flicking was recorded in Experiment 1, and amount of time the lizards spent interacting with stimuli was recorded in Experiment 2. Our hypothesis was that young V. komodoensis would be more dependent upon vision than chemoreception, especially when dealing with live, moving, prey. Although visual cues, including prey motion, had a significant effect, chemical cues had a far stronger effect. Implications of this falsification of our initial hypothesis are discussed.

Conjunctival amelanotic malignant melanoma arising in primary acquired melanosis sine pigmento.

Science.gov (United States)

Jay, V; Font, R L

1998-01-01

The authors describe an amelanotic malignant melanoma of the conjunctiva in association with primary acquired melanosis (PAM) sine pigmento, and highlight the clinical and pathologic features of this rare entity. Histopathologic and immunohistochemical studies were performed on a conjunctival tumor in a 54-year-old white woman. Case report. Histopathologic examination revealed an invasive amelanotic melanoma of the conjunctiva, with anterior orbital extension arising from intraepithelial dysplastic melanocytes that lacked melanin pigment (PAM sine pigmento). Both the malignant melanoma cells and the intraepithelial dysplastic melanocytes in the areas of PAM exhibited S-100 and HMB-45 positivity. The patient underwent an orbital exenteration that disclosed tumor within the anterior orbit inferiorly. Amelanotic invasive malignant melanoma can arise in association with PAM sine pigmento, as seen in our patient who had orbital invasion necessitating exenteration. This aggressive form of conjunctival melanoma is often associated with a poor prognosis and risk of metastatic disease. Absence of conjunctival pigmentation in PAM sine pigmento prevents early clinical detection of this variant of PAM. This lack of pigmentation also makes clinical diagnosis virtually impossible, and diagnosis can only be established histopathologically. Awareness of this nonpigmented variety of PAM is crucial for early recognition and appropriate management of the associated melanoma.

Trends for minimization of radioactive waste arising from spent nuclear fuel reprocessing

International Nuclear Information System (INIS)

Polyakov, A.S.; Koltunov, V.S.; Marchenko, V.I.; Ilozhev, A.P.; Mukhin, I.V.

2000-01-01

Research and development of technologies for radioactive waste (RAW) minimization arising from spent nuclear fuel reprocessing are discussed. Novel reductants of Pu and Np ions, reagents of purification recycled extractant, possibility of the electrochemical methods are studied. The partitioning of high activity level waste are considered. Examples of microbiological methods decomposition of radioactive waste presented. (authors)

Chemodectomas arising in temporal bone structures

International Nuclear Information System (INIS)

Dickens, W.J.; Million, R.R.; Cassisi, N.J.; Singleton, G.T.

1982-01-01

Eighteen patients with chemodectomas arising in temporal bone structures were evaluated and treated at the University of Florida. Seventeen patients have each been followed a minimum of 3 years. Patients were retrospectively staged as having ''local'' or ''advanced'' disease, depending on the presence or absence of bone destruction and/or cranial nerve involvement. Fourteen of the patients received radiation therapy as all or part of their therapy; 6 patients were treated with radiation therapy alone, 3 patients were irradiated immediately postoperatively for residual disease, and 5 patients had radiation therapy for recurrence after operation. They were treated with cobalt-60 radiation with doses ranging from 3760 to 5640 rad. All irradiated patients demonstrated evidence of tumor regression, and none have had tumor recurrence with followup of 3-12 years. Of the 8 patients with cranial nerve paralysis prior to therapy, 5 had return of function of 1 or more cranial nerves. One of 6 patients treated initially with radiation therapy had a complication, while 6 of 8 patients irradiated postoperatively had complications. None of the complications were fatal. Three patients treated by operation for early disease limited to the hypotympanum had the disease controlled for 11-12 years. Guidelines for the selection of initial therapy are discussed

Digital holographic reconstruction detection of localized corrosion arising from scratches

Directory of Open Access Journals (Sweden)

LIANG WANG

2010-04-01

Full Text Available In this study, electrochemical methods and the digital holographic reconstruction technique were combined to detect the localized scratch-induced corrosion process of Alloy 690 in 0.50 mol dm-3 H2SO4 containing 0.10 mol dm-3 NaCl. The numerical reconstruction method has been proved to be an effective technique to detect changes of solution concentration. One can obtain direct information from the reconstructed images and capture subtle more revealing changes. It provides a method to detect localized corrosion arising from scratches.

Lifelong learning for musicians: critical issues arising from a case study of Connect

NARCIS (Netherlands)

Renshaw, Peter

2005-01-01

This article intends to focus on those critical issues arising from the Connect case study (Renshaw, 2005) that have wider applicability in contemporary professional practice in terms of lifelong learning. Special attention will be given to the following areas: • formal, non-formal and informal

Primary intraosseous squamous cell carcinoma of the mandible arising de novo.

Science.gov (United States)

Shamim, Thorakkal

2009-07-01

Primary intraosseous squamous cell carcinoma is an odontogenic tumour with aggressive behaviour usually noticed in 6th to 7th decades of life. The tumour is characterized by progressive swelling of the jaw, pain and loosening of teeth. Microscopically, the lesion is showing foci of keratinising cells separated by collagenous connective tissue stroma. A case of primary intraosseous squamous cell carcinoma of mandible arising de novo in a 40-year-old man is reported.

Multiple giant coronary aneurysms arising from coronary istula to the pulmonary artery revealed in aorta CT angiography

Energy Technology Data Exchange (ETDEWEB)

Kang, Eun Ju; Lee, Ki Nam [Dept. of Radiology, Dong A University Hospital, Dong-A University College of Medicine, Busan (Korea, Republic of); Lee, Jong Min [Dept. of Radiology, Kyungpook National University Hospital, Kyungpook National University College of Medicine, Daegu (Korea, Republic of)

2015-12-15

Coronary fistula is a rare coronary abnormality through which blood drains into the cardiac chamber, great vessel or other vessels. In addition, giant aneurysm arising from coronary fistula is rare pathologic manifestation. Herein, we presented a rare case of multiple giant coronary artery aneurysms arising from coronary to pulmonary artery fistula in a 79-year-old woman presenting with sudden loss of consciousness. The aneurysms were detected using thoracic computed tomography angiography and consequently confirmed by invasive coronary angiography.

Guidance notes for the protection of persons against ionising radiations arising from medical and dental use

International Nuclear Information System (INIS)

1988-01-01

Guidance notes have been prepared by the NRPB, the Health Departments and the Health and Safety Executive for the protection of all persons against ionising radiations arising from medical and dental use. The guidance notes are a guide to good radiation protection practice consistent with regulatory requirements. The areas covered include medical and dental radiology, diagnostic X-ray equipment for medical and dental radiography, beam therapy and remotely controlled after-loading, brachytherapy, diagnostic and therapeutic uses of unsealed radioactive substances, diagnostic uses of sealed or other solid radioactive sources, patients leaving hospital after administration of radioactive substances, precautions after death of a patient whom radioactive substances have been administered, storage and movement of radioactive substances, disposal of radioactive waste and contingency planning and emergency procedures. (U.K.)

Signet-Ring Cutaneous Squamous Cell Carcinoma Arising on the Back of the Finger

Directory of Open Access Journals (Sweden)

Koji Nakajima

2013-08-01

Full Text Available A variety of pathologic variants of cutaneous squamous cell carcinoma (SCC has been reported, and the signet-ring variant of cutaneous SCC is extremely uncommon. We reported an 83-year-old man with signet-ring SCC arising on the back of the finger. As far as we know, only 4 cases have been described in detail, and one dermatopathologic report focused on the presence of signet-ring cells briefly described in clinical data of 6 cases. Interestingly, in these reports, the skin lesions of 10 cases occurred exclusively in the head and neck area. This case involved a skin lesion on the back of the finger and is thus the first reported case of signet-cell cutaneous SCC that did not arise in the head and neck area. The location of this lesion, together with the histological findings compatible with actinic keratosis, support the hypothesis that the development of signet-ring SCC is related to ultraviolet light-induced damage.

Indirect causes of severe adverse maternal outcomes: a secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health.

Science.gov (United States)

Lumbiganon, P; Laopaiboon, M; Intarut, N; Vogel, J P; Souza, J P; Gülmezoglu, A M; Mori, R

2014-03-01

To assess the proportion of severe maternal outcomes resulting from indirect causes, and to determine pregnancy outcomes of women with indirect causes. Secondary analysis of the WHO Multicountry Survey on Maternal and Newborn Health. A total of 359 health facilities in 29 countries in Africa, Asia, Latin America, and the Middle East. A total of 314 623 pregnant women admitted to the participating facilities. We identified the percentage of women with severe maternal outcomes arising from indirect causes. We evaluated the risk of severe maternal and perinatal outcomes in women with, versus without, underlying indirect causes, using adjusted odds ratios and 95% confidence intervals, by a multilevel, multivariate logistic regression model, accounting for clustering effects within countries and health facilities. Severe maternal outcomes and preterm birth, fetal mortality, early neonatal mortality, perinatal mortality, low birthweight, and neonatal intensive care unit admission. Amongst 314 623 included women, 2822 were reported to suffer from severe maternal outcomes, out of which 20.9% (589/2822; 95% CI 20.1-21.6%) were associated with indirect causes. The most common indirect cause was anaemia (50%). Women with underlying indirect causes showed significantly higher risk of obstetric complications (adjusted odds ratio, aOR, 7.0; 95% CI 6.6-7.4), severe maternal outcomes (aOR 27.9; 95% CI 24.7-31.6), and perinatal mortality (aOR 3.8; 95% CI 3.5-4.1). Indirect causes were responsible for about one-fifth of severe maternal outcomes. Women with underlying indirect causes had significantly increased risks of severe maternal and perinatal outcomes. © 2014 RCOG The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Knowledge Protection and Input Complexity Arising from Open Innovation

DEFF Research Database (Denmark)

Peeters, Thijs; Sofka, Wolfgang

Controlling unique knowledge is of increasing importance to firms. Therefore, firms use knowledge protection mechanisms to prevent competitors from imitating their knowledge. We study the effects of the complexity of knowledge inputs that arises from open innovation on the importance of two widely...... used protection mechanisms: patents and trademarks. We argue that this complexity makes the threat of imitation less predictable, and thus makes knowledge protection more important. By analyzing survey data of 938 German firms, we find that patents are more important for firms in industries with higher...... knowledge input complexity. Furthermore, we show that the dynamics and not the level of knowledge input complexity positively affect the importance of trademarks....

28 CFR 68.54 - Administrative review of a final order of an Administrative Law Judge in cases arising under...

Science.gov (United States)

2010-07-01

... an Administrative Law Judge in cases arising under section 274A or 274C. 68.54 Section 68.54 Judicial... BEFORE ADMINISTRATIVE LAW JUDGES IN CASES INVOLVING ALLEGATIONS OF UNLAWFUL EMPLOYMENT OF ALIENS, UNFAIR... an Administrative Law Judge in cases arising under section 274A or 274C. (a) Authority of the Chief...

Isolated primary central nervous system lymphoma arising from the optic chiasm.

Science.gov (United States)

Vassal, F; Pommier, B; Boutet, C; Forest, F; Campolmi, N; Nuti, C

2014-12-01

A 58-year-old previously healthy woman rapidly developed progressive bilateral visual loss. Magnetic resonance imaging revealed a bulging appearance of the optic chiasm, with homogeneous enhancement after gadolinium administration, which suggested an optic glioma or inflammatory disease. In the absence of (para)clinical clues for a specific diagnosis despite extensive investigation, a biopsy of one optic nerve was performed, resulting in a diagnosis of non-Hodgkin B-cell lymphoma. There was no evidence of any other ocular or systemic involvement, therefore the conclusion was that this immunocompetent patient had a primary central nervous system lymphoma isolated in the anterior visual pathway. Treatment included two cycles of polychemotherapy (rituximab, methotrexate, carmustine, etoposide, methylprednisolone), followed by autologous peripheral blood stem cell transplantation and rituximab plus cytarabine consolidation therapy. Subsequently, the patient exhibited significant improvement in vision, and was still disease-free at the 1-year follow-up examination. The aim of the present paper was to provide well-documented clinical, radiological, and intraoperative features of isolated primary malignant lymphoma arising from the anterior visual pathway. A better recognition of this rare pathological entity is necessary for clinicians who may encounter similar presentations, as prompt management is crucial for both a visual and vital prognosis. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Nodular Hyperplasia Arising from the Lateral Aberrant Thyroid Tissue: A Case Report

International Nuclear Information System (INIS)

Jeong, Min Hye; Park, Jeong Seon; Lee, Young Jun

2012-01-01

The presence of aberrant thyroid tissue in the lateral neck is very rare. In addition, nodular hyperplasia in ectopic thyroid has rarely been reported. Due to the unusual location, the presence of lateral aberrant thyroid tissue could be misdiagnosed as a lymphadenopathy, neurogenic tumor, etc. We report on a case of nodular hyperplasia arising from the right lateral aberrant thyroid tissue.

Comparative estimates of risks arising from storage of intermediate level radioactive wastes

International Nuclear Information System (INIS)

Moore, D.

1986-04-01

Estimates are presented of risks arising from accidents occuring during storage of nine types of conditioned intermediate level waste. Additional data are introduced relating to the risks from accidents affecting raw waste, and to risks associated with the occupational doses received during normal operation of a waste store. Risks in all three categories are shown to be extremely small. (author)

Land-use change arising from rural land exchange : an agent-based simulation model

NARCIS (Netherlands)

Bakker, Martha M.; Alam, Shah Jamal; van Dijk, Jerry|info:eu-repo/dai/nl/29612642X; Rounsevell, Mark D. A.

Land exchange can be a major factor driving land-use change in regions with high pressure on land, but is generally not incorporated in land-use change models. Here we present an agent-based model to simulate land-use change arising from land exchange between multiple agent types representing

[Long-term outcomes after hypospadias surgery: Sexual reported outcomes and quality of life in adulthood].

Science.gov (United States)

Even, L; Bouali, O; Moscovici, J; Huyghe, E; Pienkowski, C; Rischmann, P; Galinier, P; Game, X

2015-09-01

To evaluate outcomes and long-term sexual quality of life after hypospadias surgery. Seventeen-years-old patients operated for a posterior hypospadias in childhood were included in a transversal study. Fifteen patients, among the forty children treated since 1997, accepted to participate. These young men (mean age at the first surgery was 27.9±20months) were clinically reviewed and responded to questionnaires (EUROQOL 5, IIEF15 and non-validated questionnaire). This study arises about 8.4±5years after the last visit in paediatric department. Mean study age was 21.2±4.7years. One third of patients thought that global quality of life was distorted. Although 33% of the patients had erectile dysfunction, 80% were satisfied with their sexual quality of life. The most important complains were relative to the penile appearance. Number of procedures was not predictive of patient's satisfaction about penile function and appearance. Thirty-three percents of the patients would have been satisfied to have psychological and medical support. They would be interested in having contact with patients who suffered from the same congenital abnormality. These patients had functional and esthetical disturbances. This visit leads to a specific visit in 20% cases. In this study, medical follow-up does not seem to be counselling and had to be adapted. Adequate follow-up transition between paediatric and adult departments especially during adolescence seems to be necessary. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Selective Short-Term Memory Deficits Arise from Impaired Domain-General Semantic Control Mechanisms

Science.gov (United States)

Hoffman, Paul; Jefferies, Elizabeth; Ehsan, Sheeba; Hopper, Samantha; Lambon Ralph, Matthew A.

2009-01-01

Semantic short-term memory (STM) patients have a reduced ability to retain semantic information over brief delays but perform well on other semantic tasks; this pattern suggests damage to a dedicated buffer for semantic information. Alternatively, these difficulties may arise from mild disruption to domain-general semantic processes that have…

Cardiac Arrest in Patients Managed for Convulsive Status Epilepticus: Characteristics, Predictors, and Outcome.

Science.gov (United States)

Legriel, Stephane; Bresson, Edouard; Deye, Nicolas; Grimaldi, David; Sauneuf, Bertrand; Lesieur, Olivier; Lascarrou, Jean-Baptiste; Argaud, Laurent; Chelly, Jonathan; Beuret, Pascal; Schnell, David; Chateauneuf, Anne-Laure; Holleville, Mathilde; Perier, François; Lemiale, Virginie; Bruel, Cedric; Cronier, Pierrick; Pichon, Nicolas; Mongardon, Nicolas; de-Prost, Nicolas; Dumas, Florence; Cariou, Alain

2018-05-08

Cardiac arrest is a catastrophic event that may arise during the management of convulsive status epilepticus. We aimed to report the clinical characteristics, outcomes, and early predictors of convulsive status epilepticus-related cardiac arrest. Retrospective multicenter study. Seventeen university or university affiliated participating ICUs in France and Belgium. Consecutive patients admitted to the participating ICUs for management of successfully resuscitated out-of-hospital cardiac arrest complicating the initial management of convulsive status epilepticus between 2000 and 2015. Patients were compared with controls without cardiac arrest identified in a single-center registry of convulsive status epilepticus patients, regarding characteristics, management, and outcome. None. We included 49 cases with convulsive status epilepticus-cardiac arrest and 235 controls. In the cases, median time from medical team arrival to cardiac arrest was 25 minutes (interquartile range, 5-85 min). First recorded rhythm was asystole in 25 patients (51%) and pulseless electrical activity in 13 patients (27%). A significantly larger proportion of patients had a favorable 1-year outcome (Glasgow Outcome Scale score of 5) among controls (90/235; 38%) than among cases (10/49; 21%; p = 0.02). By multivariate analysis, independent predictors of cardiac arrest were pulse oximetry less than 97% on scene (odds ratio, 2.66; 95% CI, 1.03-7.26; p = 0.04), drug poisoning as the cause of convulsive status epilepticus (odds ratio, 4.13; 95% CI, 1.27-13.53; p = 0.02), and complications during early management (odds ratio, 11.98; 95% CI, 4.67-34.69; p status epilepticus, relative hypoxemia, on-scene management complications, and drug poisoning as the cause of convulsive status epilepticus were strong early predictors of cardiac arrest, suggesting areas for improvement.

Using packaged software for solving two differential equation problems that arise in plasma physics

International Nuclear Information System (INIS)

Gaffney, P.W.

1980-01-01

Experience in using packaged numerical software for solving two related problems that arise in Plasma physics is described. These problems are (i) the solution of the reduced resistive MHD equations and (ii) the solution of the Grad-Shafranov equation

Survey indicated that core outcome set development is increasingly including patients, being conducted internationally and using Delphi surveys.

Science.gov (United States)

Biggane, Alice M; Brading, Lucy; Ravaud, Philippe; Young, Bridget; Williamson, Paula R

2018-02-17

There are numerous challenges in including patients in a core outcome set (COS) study, these can vary depending on the patient group. This study describes current efforts to include patients in the development of COS, with the aim of identifying areas for further improvement and study. Using the COMET database, corresponding authors of COS projects registered or published from 1 January 2013 to 2 February 2017 were invited via a personalised email to participate in a short online survey. The survey and emails were constructed to maximise the response rate by following the academic literature on enhancing survey responses. Personalised reminder emails were sent to non-responders. This survey explored the frequency of patient input in COS studies, who was involved, what methods were used and whether or not the COS development was international. One hundred and ninety-two COS developers were sent the survey. Responses were collected from 21 February 2017 until 7 May 2017. One hundred and forty-six unique developers responded, yielding a 76% response rate and data in relation to 195 unique COSs (as some developers had worked on multiple COSs). Of focus here are their responses regarding 162 COSs at the published, completed or ongoing stages of development. Inclusion of patient participants was indicated in 87% (141/162) of COSs in the published completed or ongoing stages and over 94% (65/69) of ongoing COS projects. Nearly half (65/135) of COSs included patient participants from two or more countries and 22% (30/135) included patient participants from five or more countries. The Delphi survey was reported as being used singularly or in combination with other methods in 85% (119/140) of projects. Almost a quarter (16/65) of ongoing studies reported using a combination of qualitative interviews, Delphi survey and consensus meeting. These findings indicated that the Delphi survey is the most popular method of facilitating patient participation, while the combination of

The clinico-anatomic explanation for tibial intraneural ganglion cysts arising from the superior tibiofibular joint

Energy Technology Data Exchange (ETDEWEB)

Spinner, Robert J. [Mayo Clinic, Department of Neurologic Surgery, Rochester, Minnesota (United States); Mayo Clinic, Department of Orthopedic Surgery, Rochester, Minnesota (United States); Mayo Clinic, Department of Anatomy, Rochester, Minnesota (United States); Mokhtarzadeh, Ali; Schiefer, Terry K. [Mayo Clinic College of Medicine, Rochester, Minnesota (United States); Krishnan, Kartik G. [Carl Gustav Carus University Hospital, Department of Neurological Surgery, Dresden (Germany); Kliot, Michel [University of Washington, Department of Neurosurgery, Seattle, Washington (United States); Amrami, Kimberly K. [Mayo Clinic, Department of Radiology, Rochester, Minnesota (United States)

2007-04-15

surface of the popliteus muscle before innervating the postero-inferior aspect of the superior tibiofibular joint. The clinical, MRI and anatomic features of tibial intraneural ganglion cysts are the posterior counterpart of the peroneal intraneural ganglion cysts arising from the anterior portion of the superior tibiofibular joint. These predictable features can be exploited and have implications for the pathogenesis of these intraneural cysts and treatment outcomes. These ganglion cysts are joint-related and provide further evidence to support the unifying articular theory. In each case the joint connection needs to be identified preoperatively, and the articular branches and the superior tibiofibular joint should be addressed operatively to prevent cyst recurrence. (orig.)

Self: an adaptive pressure arising from self-organization, chaotic dynamics, and neural Darwinism.

Science.gov (United States)

Bruzzo, Angela Alessia; Vimal, Ram Lakhan Pandey

2007-12-01

In this article, we establish a model to delineate the emergence of "self" in the brain making recourse to the theory of chaos. Self is considered as the subjective experience of a subject. As essential ingredients of subjective experiences, our model includes wakefulness, re-entry, attention, memory, and proto-experiences. The stability as stated by chaos theory can potentially describe the non-linear function of "self" as sensitive to initial conditions and can characterize it as underlying order from apparently random signals. Self-similarity is discussed as a latent menace of a pathological confusion between "self" and "others". Our test hypothesis is that (1) consciousness might have emerged and evolved from a primordial potential or proto-experience in matter, such as the physical attractions and repulsions experienced by electrons, and (2) "self" arises from chaotic dynamics, self-organization and selective mechanisms during ontogenesis, while emerging post-ontogenically as an adaptive pressure driven by both volume and synaptic-neural transmission and influencing the functional connectivity of neural nets (structure).

Retrospective analysis of factors associated with outcome of proximal interphalangeal joint arthrodesis in 82 horses including Warmblood and Thoroughbred sport horses and Quarter Horses (1992-2014).

Science.gov (United States)

Herthel, T D; Rick, M C; Judy, C E; Cohen, N D; Herthel, D J

2016-09-01

Outcomes associated with arthrodesis of the proximal interphalangeal (PIP) joint in Quarter Horses used for Western performance activities are well documented but little is known regarding outcomes for other types of horses. To identify factors associated with outcomes, including breed and activity, after arthrodesis of the PIP joint in Warmbloods, Thoroughbreds and Quarter Horses. Retrospective case series. Surgical case records of 82 Quarter Horses principally engaged in Western performance and Thoroughbred or Warmblood breeds principally engaged in showing, showjumping and dressage, with arthrodesis of the PIP joint were reviewed. Arthrodesis was performed with either 3 transarticular cortex bone screws placed in lag fashion, a dynamic compression plate (DCP) with 2 transarticular cortex bone screws placed in lag fashion, or a locking compression plate (LCP) with 2 transarticular cortex bone screws placed in lag fashion. Demographic data, clinical presentation, radiographic findings, surgical technique, post operative treatment and complications were recorded. Long-term follow-up was obtained for all 82 horses. Osteoarthritis of the PIP joint was the most common presenting condition requiring arthrodesis, which was performed with either the 3 screw technique (n = 41), DCP fixation (n = 22), or LCP fixation (n = 19). Post operatively, 23/31 (74%) Warmbloods/Thoroughbreds and 44/51 (87%) Quarter Horses achieved successful outcomes. Thirteen of 23 (57%) Warmbloods/Thoroughbreds and 24 of 38 (63%) Quarter Horses, used for athletic performance, returned to successful competition. Within this subgroup of horses engaged in high-level activity, regardless of breed type, horses undergoing hindlimb arthrodesis were significantly more likely to return to successful competition (73%; 33/45) than those with forelimb arthrodesis (25%; 4/16, P = 0.002). Arthrodesis of the PIP joint in Warmbloods/Thoroughbreds and Quarter Horses results in a favourable outcome for return to

Optimal control of switched systems arising in fermentation processes

CERN Document Server

Liu, Chongyang

2014-01-01

The book presents, in a systematic manner, the optimal controls under different mathematical models in fermentation processes. Variant mathematical models – i.e., those for multistage systems; switched autonomous systems; time-dependent and state-dependent switched systems; multistage time-delay systems and switched time-delay systems – for fed-batch fermentation processes are proposed and the theories and algorithms of their optimal control problems are studied and discussed. By putting forward novel methods and innovative tools, the book provides a state-of-the-art and comprehensive systematic treatment of optimal control problems arising in fermentation processes. It not only develops nonlinear dynamical system, optimal control theory and optimization algorithms, but can also help to increase productivity and provide valuable reference material on commercial fermentation processes.

An estimate of conditioned waste arisings to the years 2000 and 2010 for the Department of Energy power generation scenarios

International Nuclear Information System (INIS)

Fairclough, M.P.; Moore, D.C.; Tymons, B.J.

1984-09-01

An estimate of conditioned waste arisings to the years 2000 and 2010 has been made using evidence presented at the Sizewell 'B' public enquiry. The method of calculation has been based on the rate of arisings per GWe year and the power programmes of the Department of Energy. (author)

Radon in air concentrations arising from storage of articles containing radium or thorium

International Nuclear Information System (INIS)

Slater, M.; Gooding, M.

2006-01-01

A major component of public and occupational radiation exposure worldwide arises from the inhalation of radon and thoron gases, produced during the decay of naturally occurring uranium and thorium respectively. Whilst radon and thoron exposures are normally associated with the natural environment, there may also be a risk associated with sources, manufactured articles and waste produced through refining and concentration of naturally occurring radioactive material. Sources and articles manufactured from refined uranium do not normally give rise to the release of radon as the uranium progeny are largely removed during production and, if removed, will take thousands of years to reach full equilibrium with the uranium parent isotopes. Exposure to radon -222 ( 222 Rn) may, however, arise in areas where the uranium-238 ( 238 U) daughter radium-226 ( 226 Ra) is concentrated, for example in the form of sources, luminous articles or low-specific activity (LSA) scale. Exposure to radon- 220 ( 220 Rn), otherwise known as thoron, may occur in areas where thorium isotopes are concentrated, for example as manufactured laboratory thorium compounds. This paper explores the issues affecting radon and thoron release from manufactured articles containing uranium and thorium and their progeny. A methodology is provided for the calculation of 222 Rn and 220 Rn in air concentrations likely to arise as a result of the storage and use of articles containing radium-226 ( 226 Ra) or thorium-232 ( 232 Th). The methodology provided in the document allows derivation of the equilibrium equivalent radon concentration and the radon exposure rate in circumstances where the ventilation rate and volume of the facility can be reliably estimated and the quantities of 226 Ra or 232 Th held are known. A critical variable in the calculation is the release fraction (i.e. the proportion of radon generated that is release to atmosphere), and this paper considers methods for estimating this parameter

Cutaneous leiomyosarcoma arising in a smallpox scar.

Science.gov (United States)

Pol, Robert A; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J

2012-07-16

Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months' review the patient was doing well with no evidence of tumour recurrence. This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

Cutaneous leiomyosarcoma arising in a smallpox scar

Directory of Open Access Journals (Sweden)

Pol Robert A

2012-07-01

Full Text Available Abstract Background Cutaneous leiomyosarcoma (CLM is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case presentation A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence. Conclusions This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

Radiological emergencies arising from accidents in Italy

International Nuclear Information System (INIS)

Bazzan, A.

1986-01-01

The Nuclear Safety and Health Protection Directorate (DISP) of ENEA has organized a structure of officers and technicians on call whenever an accident related to the activity of ENEA-DISP should occur. The most frequent events arise from natural misfortunes, crime, and deficiencies in public services. As regards technical operations such as measurements, removals, decontaminations and transport, DISP requests utilization of the different structures and equipment available to ENEA research centres and, in particular and most frequently, of the Safety and Radioprotection Division of the main ENEA centre: the Casaccia Research Centre. The technicians of this division are always available via telephone or radio, with the firm duty to be present within one hour from the call. The co-operation between these two structures enables timely and efficient intervention in many circumstances so that population and environmental risks can be avoided. Typical accidental situations are earthquakes, adverse atmospheric events, landslides, collapses, railway and road accidents, lost sources discovery, and seizure of illegally detained sources by judicial power. The paper briefly describes some of the situations which have occurred, and the actions carried out to recover sources and to re-establish safe environmental conditions. (author)

Esophageal Adenocarcinoma Arising from Barrett's Epithelium in Taiwan

Directory of Open Access Journals (Sweden)

Chia-Hung Tu

2007-08-01

Full Text Available The prevalence of Barrett's esophagus (BE in Eastern countries is rising to match the prevalence in the West. However, a corresponding trend of BE-associated adenocarcinoma has yet to be observed in Asia. Historically, adenocarcinoma complicating BE has been considered a rare event in Taiwan. In the present report, we collected three Taiwanese cases of esophageal adenocarcinoma arising from BE. The first case was a 37-year-old man with an advanced cancer that developed on pre-existing BE after a 3-year interval without endoscopic surveillance. The second case was a 63-year-old man who presented with odynophagia and was found to have an ulcerative tumor centered on the characteristic Barrett's mucosa. The final case was a 44-year-old man who presented with gradual-onset dysphagia and weight loss, without typical reflux symptom. Our report emphasizes the need for an updated epidemiologic study to determine the incidence of BE-associated adenocarcinoma in Taiwan.

Learning Process and Learning Outcomes of Video Podcasts Including the Instructor and PPT Slides: A Chinese Case

Science.gov (United States)

Pi, Zhongling; Hong, Jianzhong

2016-01-01

Video podcasts have become one of the fastest developing trends in learning and teaching. The study explored the effect of the presenting mode of educational video podcasts on the learning process and learning outcomes. Prior to viewing a video podcast, the 94 Chinese undergraduates participating in the study completed a demographic questionnaire…

Beam-helicity asymmetry arising from deeply virtual Compton scattering measured with kinematically complete event reconstruction

International Nuclear Information System (INIS)

Airapetian, A.; Akopov, Z.

2012-06-01

The beam-helicity asymmetry in exclusive electroproduction of real photons by the longitudinally polarized HERA positron beam scattering off an unpolarized hydrogen target is measured at HERMES. The asymmetry arises from deeply virtual Compton scattering and its interference with the Bethe-Heitler process. Azimuthal amplitudes of the beam-helicity asymmetry are extracted from a data sample consisting of ep→epγ events with detection of all particles in the final state including the recoiling proton. The installation of a recoil detector, while reducing the acceptance of the experiment, allows the elimination of resonant background that was estimated to contribute an average of about 12% to the signal in previous HERMES publications. The removal of the resonant background from the present data sample is shown to increase the magnitude of the leading asymmetry amplitude by 0.054±0.016 to -0.328±0.027(stat.)±0.045(syst.).

Beam-helicity asymmetry arising from deeply virtual Compton scattering measured with kinematically complete event reconstruction

Energy Technology Data Exchange (ETDEWEB)

Airapetian, A. [Giessen Univ. (Germany). Physikalisches Inst.; Michigan Univ., Ann Arbor, MI (United States). Randall Lab. of Physics; Akopov, N. [Yerevan Physics Inst. (Armenia); Akopov, Z. [DESY, Hamburg (DE)] (and others)

2012-06-15

The beam-helicity asymmetry in exclusive electroproduction of real photons by the longitudinally polarized HERA positron beam scattering off an unpolarized hydrogen target is measured at HERMES. The asymmetry arises from deeply virtual Compton scattering and its interference with the Bethe-Heitler process. Azimuthal amplitudes of the beam-helicity asymmetry are extracted from a data sample consisting of ep{yields}ep{gamma} events with detection of all particles in the final state including the recoiling proton. The installation of a recoil detector, while reducing the acceptance of the experiment, allows the elimination of resonant background that was estimated to contribute an average of about 12% to the signal in previous HERMES publications. The removal of the resonant background from the present data sample is shown to increase the magnitude of the leading asymmetry amplitude by 0.054{+-}0.016 to -0.328{+-}0.027(stat.){+-}0.045(syst.).

Monotonicity of a Key Function Arised in Studies of Nematic Liquid Crystal Polymers

Directory of Open Access Journals (Sweden)

Hongyun Wang

2007-01-01

Full Text Available We revisit a key function arised in studies of nematic liquid crystal polymers. Previously, it was conjectured that the function is strictly decreasing and the conjecture was numerically confirmed. Here we prove the conjecture analytically. More specifically, we write the derivative of the function into two parts and prove that each part is strictly negative.

Prevalence of Helicobacter pylori cagA, babA2, and dupA genotypes andcorrelation with clinical outcome in Malaysian patients with dyspepsia

OpenAIRE

OSMAN, HUSSEIN ALI; HASAN, HABSAH; SUPPIAN, RAPEAH; HASSAN, SYED; ANDEE, DZULKARNAEN ZAKARIA; MAJID, NOORIZAN ABDUL; ZILFALIL, BIN ALWI

2015-01-01

Background/aim: The severity of disease outcome in dyspepsia has been attributed to Helicobacter pylori virulence genes. The aim of this study was to determine the distribution of H. pylori virulence genes (cagA, babA2, and dupA) and to determine whether or not there arises a significant correlation with clinical dyspepsia outcomes. Materials and methods: H. pylori genotypes cagA, babA2, and dupA were identified by polymerase chain reactions from gastric biopsy samples in 105 H. pylori-posit...

Effect size calculation in meta-analyses of psychotherapy outcome research.

Science.gov (United States)

Hoyt, William T; Del Re, A C

2018-05-01

Meta-analysis of psychotherapy intervention research normally examines differences between treatment groups and some form of comparison group (e.g., wait list control; alternative treatment group). The effect of treatment is normally quantified as a standardized mean difference (SMD). We describe procedures for computing unbiased estimates of the population SMD from sample data (e.g., group Ms and SDs), and provide guidance about a number of complications that may arise related to effect size computation. These complications include (a) incomplete data in research reports; (b) use of baseline data in computing SMDs and estimating the population standard deviation (σ); (c) combining effect size data from studies using different research designs; and (d) appropriate techniques for analysis of data from studies providing multiple estimates of the effect of interest (i.e., dependent effect sizes). Clinical or Methodological Significance of this article: Meta-analysis is a set of techniques for producing valid summaries of existing research. The initial computational step for meta-analyses of research on intervention outcomes involves computing an effect size quantifying the change attributable to the intervention. We discuss common issues in the computation of effect sizes and provide recommended procedures to address them.

Non-Gaussian signatures arising from warm inflation driven by geometric tachyon

International Nuclear Information System (INIS)

Bhattacharjee, Anindita; Deshamukhya, Atri

2014-01-01

In a warm inflationary scenario, the initial seeds of density perturbation arise from thermal fluctuations of the inflaton field. These fluctuations in principle have Gaussian distribution. In a Gaussian distribution the density perturbation can be expressed as the two point correlation function. Thus if in an inflationary model the density perturbation is expressed as correlation function of order higher than two, these fluctuations are non-Gaussian in nature. A simple inflationary model containing single scalar field, slow roll, canonical kinetic term and vacuum initial state can produce a tiny amount of non-Gaussianity which are very small to be detected by any experiment. Non-Gaussianity can also arise in inflationary models containing multiple scalar fields. For an inflationary scenario with single scalar field, non-Gaussianity can be expressed in terms of bi-spectrum however for multi field Inflation, it is expressed in terms of trispectrum etc. In this piece of work, the warm inflationary scenario, driven by a D3 brane due to the presence of a stack of k coincident NS 5 branes is considered and the non-Gaussian effects in such an inflationary scenario has been analysed by measuring the bispectrum of the gravitational field fluctuations generated during the warm inflation in strong dissipative regime. The bi-spectrum of the Inflation is expressed in terms of the parameter f NL and it is seen that the value of f NL parameter lies well within the limit observed by WMAP7

24 CFR 1000.54 - What procedures apply to complaints arising out of any of the methods of providing for Indian...

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false What procedures apply to complaints arising out of any of the methods of providing for Indian preference? 1000.54 Section 1000.54 Housing and... ACTIVITIES General § 1000.54 What procedures apply to complaints arising out of any of the methods of...

Primary extraskeletal mesenchymal chondrosarcoma arising from the iliac vein

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Hua Zhang

2017-10-01

Full Text Available The iliac vein is an extremely rare site for mesenchymal chondrosarcoma, and patients with primary extraskeletal mesenchymal chondrosarcoma arising from a vein always suffer a very poor prognosis. We report a case of a 45-year-old female who presented with a 5-month history of left leg edema in 2015. Contrast-enhanced computed tomography showed a large mass in the left iliac vein with scattered calcifications. Wide-margin resection was performed, and histopathologic and immunohistochemical analyses confirmed the presence of intraluminal mesenchymal chondrosarcoma with local invasion out of the vein wall. Due to poor patient compliance, postoperative neoadjuvant chemotherapy and radiotherapy were not started, and a bone scan performed 16 weeks postoperatively showed multiple bone metastases. The patient died on the twenty-fourth postoperative week.

P3-10: Crossmodal Perceptual Grouping Modulates Subjective Causality between Action and Outcome

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Takahiro Kawabe

2012-10-01

Full Text Available Agents have to determine which external events their action has causally produced. A sensation of causal relation between action and outcome is called subjective causality. Subjective causality has been linked to the comparator model. This model assumes that the brain compares an internal prediction for action outcome with an actual sensory outcome, distinguishing between self and externally produced outcomes depending on spatiotemporal congruency. However, recent studies have expressed some doubt about the idea that subjective causality arises depending solely on the spatiotemporal congruency, suggesting instead that other perceptual/cognitive factors play a critical role in determining subjective causality. We hypothesized that crossmodal grouping between action and outcome contributed to subjective causality. Crossmodal temporal grouping is an essential factor for crossmodal simultaneity judgments with ungrouped crossmodal signals likely to be judged as non-simultaneous. We predicted that subjective causality would decrease when an agent's action was not temporally grouped with action outcome. In the experiment, observers were asked to press a key in order to trigger a display change with some temporal delay. To disrupt temporal grouping between action and outcome, a task-irrelevant visual flash or tone was sometimes presented synchronously with the button press and/or the display change. Subjective causality was decreased when the flash or the tone was coincided with the button press. This demonstrates that perceptual grouping has a key role in determination of subjective causality, a result that is not accounted for by the standard comparator model.

Center-size as a predictor of weight-loss outcome in multicenter trials including a low-calorie diet

DEFF Research Database (Denmark)

Gasteyger, Christoph Rolf; Christensen, Robin; Larsen, Thomas Meinert

2010-01-01

weight loss. This is a post hoc analysis of an existing database: 701 obese subjects (77% women, 23% men, mean BMI: 38.9 kg/m(2)) were enrolled at 22 sites (4-85 subjects/site) in five countries to follow a LCD providing 800-1,000 kcal/day during 8 weeks. The main outcome measure was the percentage...

Metabolic syndrome: A review of the role of vitamin D in mediating susceptibility and outcome

Science.gov (United States)

Strange, Richard C; Shipman, Kate E; Ramachandran, Sudarshan

2015-01-01

Despite the well-recognised role of vitamin D in a wide range of physiological processes, hypovitaminosis is common worldwide (prevalence 30%-50%) presumably arising from inadequate exposure to ultraviolet radiation and insufficient consumption. While generally not at the very low levels associated with rickets, hypovitaminosis D has been implicated in various very different, pathophysiological processes. These include putative effects on the pathogenesis of neoplastic change, inflammatory and demyelinating conditions, cardiovascular disease (CVD) and diabetes. This review focuses on the association between hypovitaminosis D and the metabolic syndrome as well as its component characteristics which are central obesity, glucose homeostasis, insulin resistance, hypertension and atherogenic dyslipidaemia. We also consider the effects of hypovitaminosis D on outcomes associated with the metabolic syndrome such as CVD, diabetes and non-alcoholic fatty liver disease. We structure this review into 3 distinct sections; the metabolic syndrome, vitamin D biochemistry and the putative association between hypovitaminosis D, the metabolic syndrome and cardiovascular risk. PMID:26185598

Obesity, the endocannabinoid system, and bias arising from pharmaceutical sponsorship.

Directory of Open Access Journals (Sweden)

John M McPartland

Full Text Available Previous research has shown that academic physicians conflicted by funding from the pharmaceutical industry have corrupted evidence based medicine and helped enlarge the market for drugs. Physicians made pharmaceutical-friendly statements, engaged in disease mongering, and signed biased review articles ghost-authored by corporate employees. This paper tested the hypothesis that bias affects review articles regarding rimonabant, an anti-obesity drug that blocks the central cannabinoid receptor.A MEDLINE search was performed for rimonabant review articles, limited to articles authored by USA physicians who served as consultants for the company that manufactures rimonabant. Extracted articles were examined for industry-friendly bias, identified by three methods: analysis with a validated instrument for monitoring bias in continuing medical education (CME; analysis for bias defined as statements that ran contrary to external evidence; and a tally of misrepresentations about the endocannabinoid system. Eight review articles were identified, but only three disclosed authors' financial conflicts of interest, despite easily accessible information to the contrary. The Takhar CME bias instrument demonstrated statistically significant bias in all the review articles. Biased statements that were nearly identical reappeared in the articles, including disease mongering, exaggerating rimonabant's efficacy and safety, lack of criticisms regarding rimonabant clinical trials, and speculations about surrogate markers stated as facts. Distinctive and identical misrepresentations regarding the endocannabinoid system also reappeared in articles by different authors.The findings are characteristic of bias that arises from financial conflicts of interest, and suggestive of ghostwriting by a common author. Resolutions for this scenario are proposed.

Obesity, the endocannabinoid system, and bias arising from pharmaceutical sponsorship.

Science.gov (United States)

McPartland, John M

2009-01-01

Previous research has shown that academic physicians conflicted by funding from the pharmaceutical industry have corrupted evidence based medicine and helped enlarge the market for drugs. Physicians made pharmaceutical-friendly statements, engaged in disease mongering, and signed biased review articles ghost-authored by corporate employees. This paper tested the hypothesis that bias affects review articles regarding rimonabant, an anti-obesity drug that blocks the central cannabinoid receptor. A MEDLINE search was performed for rimonabant review articles, limited to articles authored by USA physicians who served as consultants for the company that manufactures rimonabant. Extracted articles were examined for industry-friendly bias, identified by three methods: analysis with a validated instrument for monitoring bias in continuing medical education (CME); analysis for bias defined as statements that ran contrary to external evidence; and a tally of misrepresentations about the endocannabinoid system. Eight review articles were identified, but only three disclosed authors' financial conflicts of interest, despite easily accessible information to the contrary. The Takhar CME bias instrument demonstrated statistically significant bias in all the review articles. Biased statements that were nearly identical reappeared in the articles, including disease mongering, exaggerating rimonabant's efficacy and safety, lack of criticisms regarding rimonabant clinical trials, and speculations about surrogate markers stated as facts. Distinctive and identical misrepresentations regarding the endocannabinoid system also reappeared in articles by different authors. The findings are characteristic of bias that arises from financial conflicts of interest, and suggestive of ghostwriting by a common author. Resolutions for this scenario are proposed.

An analysis of the perceived difficulties arising during the process of integrating management systems

Directory of Open Access Journals (Sweden)

Jesus Abad

2016-09-01

Originality/value: Most research emphasises the benefits of integrated management systems. By analysing the difficulties that arise during the integration process, this study contributes to fill a gap in the literature on the problems associated with processes of organisational change, in our case the integration of management systems.

The Feasibility and Acceptability of "Arise": An Online Substance Abuse Relapse Prevention Program.

Science.gov (United States)

Sanchez, Rebecca Polley; Bartel, Chelsea M

2015-04-01

The purpose of this study was to test the feasibility and acceptability of a novel online adolescent substance abuse relapse prevention tool, "Arise" (3C Institute, Cary, NC). The program uses an innovative platform including interactive instructional segments and skill-building games to help adolescents learn and practice coping skills training strategies. We conducted a pilot test with nine adolescents in substance abuse treatment (44 percent female) and a feasibility test with treatment providers (n=8; 50 percent female). Adolescents interacted with the program via a secure Web site for approximately 30 minutes for each of two instructional units. Treatment providers reviewed the same material at their own pace. All participants completed a questionnaire with items assessing usability, acceptability, understanding, and subjective experience of the program. Regarding feasibility, recruitment of this population within the study constraints proved challenging, but participant retention in the trial was high (no attrition). Adolescents and treatment providers completed the program with no reported problems, and overall we were able to collect data as planned. Regarding acceptability, the program received strong ratings from both adolescents and providers, who found the prototype informative, engaging, and appealing. Both groups strongly recommended continuing development. We were able to deliver the intervention as intended, and acceptability ratings were high, demonstrating the feasibility and acceptability of online delivery of engaging interactive interventions. This study contributes to our understanding of how interactive technologies, including games, can be used to modify behavior in substance abuse treatment and other health areas.

Percutaneous Image-Guided Screw Fixation of Bone Lesions in Cancer Patients: Double-Centre Analysis of Outcomes including Local Evolution of the Treated Focus

Energy Technology Data Exchange (ETDEWEB)

Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Koch, Guillaume, E-mail: guillaume.koch@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Buy, Xavier, E-mail: x.buy@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Ramamurthy, Nitin, E-mail: nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Tsoumakidou, Georgia, E-mail: georgia.tsoumakidou@chru-strasbourg.fr; Caudrelier, Jean, E-mail: jean.caudrelier@chru-strasbourg.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Catena, Vittorio, E-mail: v.catena@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Garnon, Julien, E-mail: juleiengarnon@gmail.com [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France); Palussiere, Jean, E-mail: j.palussiere@bordeaux.unicancer.fr [Institut Bergonié, Department of Radiology (France); Gangi, Afshin, E-mail: gangi@unistra.fr [Hôpitaux Universitaires de Strasbourg, HUS, Department of Interventional Radiology, Nouvel Hôpital Civil (France)

2016-10-15

AimTo review outcomes and local evolution of treated lesions following percutaneous image-guided screw fixation (PIGSF) of pathological/insufficiency fractures (PF/InF) and impeding fractures (ImF) in cancer patients at two tertiary centres.Materials and methodsThirty-two consecutive patients (mean age 67.5 years; range 33–86 years) with a range of tumours and prognoses underwent PIGSF for non/minimally displaced PF/InF and ImF. Screws were placed under CT/fluoroscopy or cone-beam CT guidance, with or without cementoplasty. Clinical outcomes were assessed using a simple 4-point scale (1 = worse; 2 = stable; 3 = improved; 4 = significantly improved). Local evolution was reviewed on most recent follow-up imaging. Technical success, complications, and overall survival were evaluated.ResultsThirty-six lesions were treated with 74 screws mainly in the pelvis and femoral neck (58.2 %); including 47.2 % PF, 13.9 % InF, and 38.9 % ImF. Cementoplasty was performed in 63.9 % of the cases. Technical success was 91.6 %. Hospital stay was ≤3 days; 87.1 % of lesions were improved at 1-month follow-up; three major complications (early screw-impingement radiculopathy; accelerated coxarthrosis; late coxofemoral septic arthritis) and one minor complication were observed. Unfavourable local evolution at imaging occurred in 3/24 lesions (12.5 %) at mean 8.7-month follow-up, including poor consolidation (one case) and screw loosening (two cases, at least 1 symptomatic). There were no cases of secondary fractures.ConclusionsPIGSF is feasible for a wide range of oncologic patients, offering good short-term efficacy, acceptable complication rates, and rapid recovery. Unfavourable local evolution at imaging may be relatively frequent, and requires close clinico-radiological surveillance.

Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

Directory of Open Access Journals (Sweden)

Jahagirdar Deepa

2012-11-01

Full Text Available Abstract Background Patient reported outcome measures (PROMs are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated stakeholder views on the accessibility and use of PROMs to develop suggestions for more inclusive practice. Methods Taking PROMs recommended for chronic obstructive pulmonary disease (COPD as an example, we conducted 8 interviews with people with low literacy skills and/or learning disabilities, and 4 focus groups with 20 health professionals and people with COPD. Discussions covered the format and delivery of PROMs using the EQ-5D and St George Respiratory Questionnaire as prompts. Thematic framework analysis focused on three main themes: Accessibility, Ease of Use, and Contextual factors. Results Accessibility included issues concerning the questionnaire format, and suggestions for improvement included larger font sizes and more white space. Ease of Use included discussion about PROMs’ administration. While health professionals suggested PROMs could be completed in waiting rooms, patients preferred settings with more privacy and where they could access help from people they know. Contextual Factors included other challenges and wider issues associated with completing PROMs. While health professionals highlighted difficulties created by the system in managing patients with low literacy/learning disabilities, patient participants stressed that understanding the purpose of PROMs was important to reduce intimidation. Conclusions Adjusting PROMs’ format, giving an explicit choice of where patients can complete them, and clearly conveying PROMs’ purpose and benefit to patients may help to prevent inequality when using PROMs in health services.

Do pigeons prefer alternatives that include near-hit outcomes?

Science.gov (United States)

Stagner, Jessica P; Case, Jacob P; Sticklen, Mary F; Duncan, Amanda K; Zentall, Thomas R

2015-07-01

Pigeons show suboptimal choice on a gambling-like task similar to that shown by humans. Humans also show a preference for gambles in which there are near hits (losses that come close to winning). In the present research, we asked if pigeons would show a preference for alternatives with near-hit-like trials. In Experiment 1, we included an alternative that presented a near hit, in which a stimulus associated with reinforcement (a presumed conditioned reinforcer) changed to a stimulus associated with the absence of reinforcement (a presumed conditioned inhibitor). The pigeons tended to avoid this alternative. In Experiment 2, we varied the duration of the presumed conditioned reinforcer (2 vs. 8 s) that changed to a presumed conditioned inhibitor (8 vs. 2 s) and found that the longer the conditioned reinforcer was presented, the more the pigeons avoided it. In Experiment 3, the near-hit alternative involved an ambiguous stimulus for 8 s that changed to a presumed conditioned reinforcer (or a presumed conditioned inhibitor) for 2 s, but the pigeons still avoided it. In Experiment 4, we controlled for the duration of the conditioned reinforcer by presenting it first for 2 s followed by the ambiguous stimulus for 8 s. Once again, the pigeons avoided the alternative with the near-hit trials. In all 4 experiments, the pigeons tended to avoid alternatives that provided near-hit-like trials. We concluded that humans may be attracted to near-hit trials because near-hit trials give them the illusion of control, whereas this does not appear to be a factor for pigeons. (c) 2015 APA, all rights reserved).

[Gender stereotypes arising in a state of gender awareness].

Science.gov (United States)

Ito, Y

2001-12-01

This study examined the structure of gender stereotypes which might arise in the state of gender awareness that was triggered by social situations where people perceived their gender differences strongly. Out of 1,500 residents in Tokyo aged between 20-60, 342 females and 313 males were randomly chosen and answered the questions about gender consciousness in the state of gender awareness. A factor analysis revealed that "maternity" and "trustworthiness" were the dominant dimensions of gender stereotypes in the state of gender awareness, and that trustworthiness particularly formed the basis of gender stereotypes. Generation differences in gender stereotypes were also revealed between women in their 40 s and 50 s, and between men in their 30 s and 40 s. Generally, power for men and nurture for women were more likely to be perceived in a state of gender awareness.

Dioxins: diagnostic and prognostic challenges arising from complex mechanisms

DEFF Research Database (Denmark)

Rysavy, Noel M.; Maaetoft-Udsen, Kristina; Turner, Helen

2013-01-01

Dioxins are ubiquitous environmental challenges to humans, with a pervasiveness that arises from 200?years of rapid industrialization and mechanization of Western societies and which is now extending into the developing world. In spite of their penetrance of the human biota, these compounds...... such as cancer and diabetes, which are already multifactorial and highly complex, creates the context for the current review paper. Here, we summarize dioxin exposure paradigms and the resulting physiological effects that have been documented in animals and humans. Novel insights into potential endogenous end...... exogenous ligands, as well as the mechanisms by which these ligands impact acute and chronic cellular processes, are discussed. We develop the idea that the diagnosis of dioxin exposure, the subtleties of the cellular effects of the compounds and prognosis of the long-term effects of exposure are problems...

[Chemical hazards arising from shale gas extraction].

Science.gov (United States)

Pakulska, Daria

2015-01-01

The development of the shale industry is gaining momentum and hence the analysis of chemical hazards to the environment and health of the local population is extreiely timely and important. Chemical hazards are created during the exploitation of all minerals, but in the case of shale gas production, there is much more uncertainty as regards to the effects of new technologies application. American experience suggests the increasing risk of environmental contamination, mainly groundwater. The greatest, concern is the incomplete knowledge of the composition of fluids used for fracturing shale rock and unpredictability of long-term effects of hydraulic fracturing for the environment and health of residents. High population density in the old continent causes the problem of chemical hazards which is much larger than in the USA. Despite the growing public discontent data on this subject are limited. First of all, there is no epidemiological studies to assess the relationship between risk factors, such as air and water pollution, and health effects in populations living in close proximity to gas wells. The aim of this article is to identify and discuss existing concepts on the sources of environmental contamination, an indication of the environment elements under pressure and potential health risks arising from shale gas extraction.

Bland-White-Garland syndrome of anomalous left coronary artery arising from the pulmonary artery (ALCAPA): a historical review

International Nuclear Information System (INIS)

Cowles, Robert A.; Berdon, Walter E.

2007-01-01

The landmark 1933 case report from Massachusetts General Hospital by Bland, White and Garland (Am Heart J 8:787-801) described a 3-month-old child with progressive feeding problems, cardiomegaly on chest radiography, and EKG evidence of left ventricular damage. Of interest was the fact that the vigilant father of the infant was Aubrey Hampton, a radiologist and future chairman of radiology at Massachusetts General Hospital. At autopsy, the left coronary artery originated from the pulmonary artery rather than from the aorta. Effective treatment for this condition was not available until 1960 when Sabiston, Neill and Taussig showed that the blood flowed from the left coronary artery toward the pulmonary artery. The anomalous left coronary artery was ligated at its junction with the pulmonary artery and the child survived. This historical review of Bland-White-Garland syndrome, now known as anomalous left coronary artery arising from the pulmonary artery (ALCAPA), stresses the continued diagnostic significance of cardiomegaly on chest radiography and EKG changes suggesting left ventricular damage in 2- to 3-month-old infants with feeding intolerance or irritability. With a high index of suspicion, an echocardiogram can be obtained to confirm the diagnosis. Modern surgical methods involve left coronary artery translocation and afford excellent outcomes. (orig.)

Olfactory neuroblastoma: the long-term outcome and late toxicity of multimodal therapy including radiotherapy based on treatment planning using computed tomography

International Nuclear Information System (INIS)

Mori, Takashi; Onimaru, Rikiya; Onodera, Shunsuke; Tsuchiya, Kazuhiko; Yasuda, Koichi; Hatakeyama, Hiromitsu; Kobayashi, Hiroyuki; Terasaka, Shunsuke; Homma, Akihiro; Shirato, Hiroki

2015-01-01

Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy. Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively. The median follow-up time was 95 months (range 8–173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7–115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients. Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB

Modification of the Absorption Edge of GaAs Arising from Hot-Electron Effects

DEFF Research Database (Denmark)

McGroddy, J. C.; Christensen, Ove

1973-01-01

We have observed a large enhancement of the electric-field-induced optical absorption arising from hot-electron effects in n-type GaAs at 77 K. The magnitude and field dependence of the enhancement can be approximately accounted for by a theory attributing the effect to broadening of the final...... states of the optical transitions by interaction with the nonequilibrium optical phonons produced by the hot electrons....

Review and Analysis of Solid Long-lived and High Level Radioactive Waste arising at the Chernobyl Nuclear Power Plant and the Restricted Zone

International Nuclear Information System (INIS)

Antropov, V.M.; Bugai, D.A.; Dutton, L.M.C.; Gerchikov, M.Y.; Kennett, E.J.; Ledenev, A.I.; Novikov, A.A.; Rudko, V.; Ziegenhagen, J.

2001-01-01

The study characterised potential waste arisings in the Exclusion Zone surrounding the Chernobyl Nuclear Power Plant. Studied sites include the Industrial Zone outside the Sarcophagus, three engineered disposal sites (the so-called PZRO), non-engineered near surface trench dumps (PVLRO), contaminated soil and sites of ''unauthorized'' disposal within the Exclusion Zone. Analysis of the previous methodology used for waste characterisation and inventory estimates identified a number of errors. A new database was established, which contains the most up-to date information on radwaste in the Exclusion Zone. Based on the analysis of the available information and potential radiological consequences, a judgement was taken regarding the priority of waste retrieval. In a number of cases it is necessary to carry out risk assessment to ensure that in-situ disposal would satisfy the Ukrainian regulations. Assessments of waste stream volumes for subsequent incineration, encapsulation, storage and disposal in the planned near-surface facilities have been made. It is judged that throughput and capacity of the planned waste management facilities specified by OSAT is, in general, appropriate to the likely waste arisings. (author)

Primary Extraskeletal Mesenchymal Chondrosarcoma Arising from the Pancreas

Energy Technology Data Exchange (ETDEWEB)

Oh, Bae Geun; Han, Yoon Hee; Lee, Byung Hoon; Kim, Su Young; Hwang, Yoon Joon; Seo, Jung Wook; Kim, Yong Hoon; Cha, Soon Joo; Hur, Gham; Joo, Mee [Inje University, School of Medicine, Goyang (Korea, Republic of)

2007-12-15

The CT scans showed a heterogeneously enhancing necrotic mass with numerous areas of coarse calcification, and this was located in the left side of the retroperitoneal space and involved the body and tail of the pancreas. Portal venography via the celiac axis also showed invasion of the splenic vein. It represents approximately 1% of all chondrosarcomas and it carries a poor prognosis. It can occur in extraskeletal locations and mainly in the soft tissues of the orbit, the cranial and spinal meningeal coverings and the lower limbs. To the best of our knowledge, there has been no reported case of primary extraskeletal mesenchymal chondrosarcoma of the pancreas. Only two instances of metastatic chondrosarcomas in the pancreas have been reported in the literature. We report here on a case of primary mesenchymal chondrosarcoma arising from the pancreas in a 41-year-old man. In summary, we present here a case of primary extraskeletal mesenchymal chondrosarcoma that arose from the pancreas. Radiologically, it manifested as a necrotic soft tissue mass with chondroid calcifications.

Incorporating outcome uncertainty and prior outcome beliefs in stated preferences

DEFF Research Database (Denmark)

Lundhede, Thomas; Jacobsen, Jette Bredahl; Hanley, Nick

2015-01-01

Stated preference studies tell respondents that policies create environmental changes with varying levels of uncertainty. However, respondents may include their own a priori assessments of uncertainty when making choices among policy options. Using a choice experiment eliciting respondents......’ preferences for conservation policies under climate change, we find that higher outcome uncertainty reduces utility. When accounting for endogeneity, we find that prior beliefs play a significant role in this cost of uncertainty. Thus, merely stating “objective” levels of outcome uncertainty...

Emergency Supplemental Appropriations for DoD Needs Arising from Hurricane Katrina at Selected DoD Components

National Research Council Canada - National Science Library

Granetto, Paul J; Marsh, Patricia A; Pfeil, Lorin T; Adu, Henry Y; Appiah, Emmanuel A; Lawrence, Charlisa D; Loftin, Sharon A; Straw, Richard W; Davis, Sonya T; Hart, Erin S

2007-01-01

.... The Inspector General (IG), DoD, performed this audit to determine if the emergency supplemental appropriations for DoD needs arising from Hurricane Katrina and others were used for their intended purposes...

Intracranial schwannomas arising from cranial nerves: Case series and review of literature

Directory of Open Access Journals (Sweden)

Rashmeet Kaur

2017-01-01

Full Text Available Tumors arising from the cranial nerve sheath are common intracranial neoplasms, with only few articles describing their imaging characteristics. In this present study of four cases of schwannomas originating from the cranial nerves in the head region, we are discussing the radiological features on imaging with the clinical presentation and contrasting them with other differentials in their respective locations. Magnetic resonance imaging and computed tomography were done in these cases and correlated with clinical and biopsy findings.

Short-term outcomes of the surgical management of acquired rectourethral fistulas: does technique matter?

Directory of Open Access Journals (Sweden)

Nfonsam VN

2013-01-01

Full Text Available Valentine N Nfonsam,1 James JL Mateka,2 Andrew D Prather,2 Jorge E Marcet21Department of Surgery, College of Medicine, University of Arizona, Tucson, AZ, USA; 2Department of Surgery, College of Medicine, University of South Florida, Tampa, FL, USABackground: Acquired rectourethral fistulas are uncommon and challenging to repair. Most arise as a complication of prostate cancer treatment. Several procedures have been described to repair rectourethral fistulas with varying outcomes. We review the etiology, management, and outcomes of patients with rectourethral fistulas at our institution.Materials and methods: A retrospective review of patients undergoing repair of rectourethral fistulas was undertaken. Data were collected on patient demographics, fistula etiology, operative procedure, fecal and urinary diversion, and clinical outcome. Patients with urinary and/or fecal diversion underwent radiographic evaluation to confirm closure of the fistula prior to reversal of the diversion.Results: Fistula repair was performed on 22 patients from 1999 to 2009. All the patients were male of an average age of 69 years (range: 39–82 years. All patients, except one, had prostate cancer. Fistula formation was associated with radiotherapy in 54.4% of patients, brachytherapy in 36.4% of patients, and with external beam radiation therapy in 18.2% of patients. Other causes included prostatectomy (seven patients, 31.8%, cryotherapy (two patients, 9.1%, and perianal abscess (one patient, 4.5%. Procedures performed for fistula repair included transanal repair (eleven patients, 50%, transperineal repair (five patients, 22.7%, transabdominal repair (three patients, 13.6%, and York–Mason repair (three patients, 13.6%. Fourteen patients (63.6% had urinary diversion. Fecal diversion was performed in 16 (72.7% patients. Five (22.7% patients had had previous attempts at fistula repair. Of the 22 patients treated, repair was successful in 20 patients (91%. The average

Invasive adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp and synchronous transverse colon cancer.

Science.gov (United States)

Chen, Chuang-Wei; Hsiao, Koung-Hong; Yue, Chung-Tai; Wang, Chia-Chi

2013-08-28

An admixture of hyperplastic and adenomatous components within the same polyp is unusual. Adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp (MHAP) occurs even more rarely. We report the first case of a 59-year-old male who presented with invasive adenocarcinoma originating from a MHAP at a sigmoid colon and synchronous transverse colon cancer.

Invasive adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp and synchronous transverse colon cancer

OpenAIRE

Chen, Chuang-Wei; Hsiao, Koung-Hong; Yue, Chung-Tai; Wang, Chia-Chi

2013-01-01

An admixture of hyperplastic and adenomatous components within the same polyp is unusual. Adenocarcinoma arising from a mixed hyperplastic/adenomatous polyp (MHAP) occurs even more rarely. We report the first case of a 59-year-old male who presented with invasive adenocarcinoma originating from a MHAP at a sigmoid colon and synchronous transverse colon cancer.

Carcinosarcoma of monoclonal origin arising in a dermoid cyst of ovary: a case report

International Nuclear Information System (INIS)

Cabibi, Daniela; Martorana, Anna; Cappello, Francesco; Barresi, Elisa; Di Gangi, Claudio; Rodolico, Vito

2006-01-01

Transformation of a cystic benign teratoma of the ovary into a 'carcinosarcoma' has very rarely been reported and its histogenetic origin is still debated. A case of carcinosarcoma arising from a dermoid cyst is reported. The tumor showed cystic areas delimited by normal squamous epithelium, with transitional areas through dysplastic epithelium to 'in situ' and infiltrating squamous cell carcinoma (SCC). The sarcomatous component showed compact tissue composed of round cells concentrically arranged around small vessels, spindle, and pleomorphic cells with a high nuclear-cytoplasmic ratio. Positive staining for vimentin, alpha smooth muscle actin and CD10, as well as P53 and P63, was found in the sarcomatous component and in some atypical basal cells of the squamous epithelium, which also showed the usual epithelial markers. To the best of our knowledge, this is the first case of carcinosarcoma arising from a dermoid cyst in which a histogenetic origin from totipotent stem cells, located in the basal squamous layer, is supported by immunohistochemical findings

Carcinosarcoma of monoclonal origin arising in a dermoid cyst of ovary: a case report

Directory of Open Access Journals (Sweden)

Di Gangi Claudio

2006-03-01

Full Text Available Abstract Background Transformation of a cystic benign teratoma of the ovary into a "carcinosarcoma" has very rarely been reported and its histogenetic origin is still debated. Case presentation A case of carcinosarcoma arising from a dermoid cyst is reported. The tumor showed cystic areas delimited by normal squamous epithelium, with transitional areas through dysplastic epithelium to "in situ" and infiltrating squamous cell carcinoma (SCC. The sarcomatous component showed compact tissue composed of round cells concentrically arranged around small vessels, spindle, and pleomorphic cells with a high nuclear-cytoplasmic ratio. Positive staining for vimentin, alpha smooth muscle actin and CD10, as well as P53 and P63, was found in the sarcomatous component and in some atypical basal cells of the squamous epithelium, which also showed the usual epithelial markers. Conclusion To the best of our knowledge, this is the first case of carcinosarcoma arising from a dermoid cyst in which a histogenetic origin from totipotent stem cells, located in the basal squamous layer, is supported by immunohistochemical findings.

On the Linearized Darboux Equation Arising in Isometric Embedding of the Alexandrov Positive Annulus

Institute of Scientific and Technical Information of China (English)

Chunhe LI

2013-01-01

In the present paper,the solvability condition of the linearized Gauss-Codazzi system and the solutions to the homogenous system are given.In the meantime,the Solvability of a relevant linearized Darboux equation is given.The equations are arising in a geometric problem which is concerned with the realization of the Alexandrov's positive annulus in R3.

Multimodality Imaging Approach towards Primary Aortic Sarcomas Arising after Endovascular Abdominal Aortic Aneurysm Repair: Case Series Report

Energy Technology Data Exchange (ETDEWEB)

Kamran, Mudassar, E-mail: kamranm@mir.wustl.edu; Fowler, Kathryn J., E-mail: fowlerk@mir.wustl.edu; Mellnick, Vincent M., E-mail: mellnickv@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States); Sicard, Gregorio A., E-mail: sicard@wudosis.wustl.edu [Washington University School of Medicine, Department of Surgery (United States); Narra, Vamsi R., E-mail: narrav@mir.wustl.edu [Washington University School of Medicine, Mallinckrodt Institute of Radiology (United States)

2016-06-15

Primary aortic neoplasms are rare. Aortic sarcoma arising after endovascular aneurysm repair (EVAR) is a scarce subset of primary aortic malignancies, reports of which are infrequent in the published literature. The diagnosis of aortic sarcoma is challenging due to its non-specific clinical presentation, and the prognosis is poor due to delayed diagnosis, rapid proliferation, and propensity for metastasis. Post-EVAR, aortic sarcomas may mimic other more common aortic processes on surveillance imaging. Radiologists are rarely knowledgeable about this rare entity for which multimodality imaging and awareness are invaluable in early diagnosis. A series of three pathologically confirmed cases are presented to display the multimodality imaging features and clinical presentations of aortic sarcoma arising after EVAR.

Clinical Outcome Assessments: Conceptual Foundation-Report of the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force.

Science.gov (United States)

Walton, Marc K; Powers, John H; Hobart, Jeremy; Patrick, Donald; Marquis, Patrick; Vamvakas, Spiros; Isaac, Maria; Molsen, Elizabeth; Cano, Stefan; Burke, Laurie B

2015-09-01

An outcome assessment, the patient assessment used in an endpoint, is the measuring instrument that provides a rating or score (categorical or continuous) that is intended to represent some aspect of the patient's health status. Outcome assessments are used to define efficacy endpoints when developing a therapy for a disease or condition. Most efficacy endpoints are based on specified clinical assessments of patients. When clinical assessments are used as clinical trial outcomes, they are called clinical outcome assessments (COAs). COAs include any assessment that may be influenced by human choices, judgment, or motivation. COAs must be well-defined and possess adequate measurement properties to demonstrate (directly or indirectly) the benefits of a treatment. In contrast, a biomarker assessment is one that is subject to little, if any, patient motivational or rater judgmental influence. This is the first of two reports by the ISPOR Clinical Outcomes Assessment - Emerging Good Practices for Outcomes Research Task Force. This report provides foundational definitions important for an understanding of COA measurement principles. The foundation provided in this report includes what it means to demonstrate a beneficial effect, how assessments of patients relate to the objective of showing a treatment's benefit, and how these assessments are used in clinical trial endpoints. In addition, this report describes intrinsic attributes of patient assessments and clinical trial factors that can affect the properties of the measurements. These factors should be considered when developing or refining assessments. These considerations will aid investigators designing trials in their choice of using an existing assessment or developing a new outcome assessment. Although the focus of this report is on the development of a new COA to define endpoints in a clinical trial, these principles may be applied more generally. A critical element in appraising or developing a COA is to

Chemical hazards arising from shale gas extraction

Directory of Open Access Journals (Sweden)

Daria Pakulska

2015-02-01

Full Text Available The development of the shale industry is gaining momentum and hence the analysis of chemical hazards to the environment and health of the local population is extremely timely and important. Chemical hazards are created during the exploitation of all minerals, but in the case of shale gas production, there is much more uncertainty as regards to the effects of new technologies application. American experience suggests the increasing risk of environmental contamination, mainly groundwater. The greatest concern is the incomplete knowledge of the composition of fluids used for fracturing shale rock and unpredictability of long-term effects of hydraulic fracturing for the environment and health of residents. High population density in the old continent causes the problem of chemical hazards which is much larger than in the USA. Despite the growing public discontent data on this subject are limited. First of all, there is no epidemiological studies to assess the relationship between risk factors, such as air and water pollution, and health effects in populations living in close proximity to gas wells. The aim of this article is to identify and discuss existing concepts on the sources of environmental contamination, an indication of the environment elements under pressure and potential health risks arising from shale gas extraction. Med Pr 2015;66(1:99–117

Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

LENUS (Irish Health Repository)

Lindsay, K L

2012-12-01

Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted.

Galectin-3 as a Potential Therapeutic Target in Tumors Arising from Malignant Endothelia

Directory of Open Access Journals (Sweden)

Kim D. Johnson

2007-08-01

Full Text Available Angiosarcoma (ASA in humans, hemangiosarcoma (HSA in dogs are deadly neoplastic diseases characterized by an aggressive growth of malignant cells with endothelial phenotype, widespread metastasis, poor response to chemotherapy. Galectin-3 (Gal-3, a p-galactoside-binding lectin implicated in tumor progression, metastasis, endothelial cell biology, angiogenesis, regulation of apoptosis, neoplastic cell response to cytotoxic drugs, has not been studied before in tumors arising from malignant endothelia. Here, we tested the hypothesis that Gal-3 could be widely expressed in human ASA, canine HSA, could play an important role in malignant endothelial cell biology. Immunohistochemical analysis demonstrated that 100% of the human ASA (10 of 10, canine HSA (17 of 17 samples analyzed expressed Gal-3. Two carbohydrate-based Gal-3 inhibitors, modified citrus pectin (MCP, lactulosyl-l-leucine (LL, caused a dose-dependent reduction of SVR murine ASA cell clonogenic survival through the inhibition of Gal-3 antiapoptotic function. Furthermore, both MCP, LL sensitized SVR cells to the cytotoxic drug doxorubicin to a degree sufficient to reduce the in vitro IC50 of doxorubicin by 10.7-fold, 3.64old, respectively. These results highlight the important role of Gal-3 in the biology of ASA, identify Gal-3 as a potential therapeutic target in tumors arising from malignant endothelial cells.

A safe transoral surgical approach to parapharyngeal tumor arising from deep lobe of parotid gland

Directory of Open Access Journals (Sweden)

Manuele Casale

2016-12-01

Full Text Available The management of parapharyngeal tumor is surgical, but the approach remains a challenge. Attention should be paid to avoidance intra-operative bleeding or cranial nerves damage. We report a case of a 67-year-old male complaining of left-ear fullness. A submucosal mass arising from the lateral wall of oropharynx on the left side was observed. Magnetic resonance imaging detected a mass arising from the parotid gland, in particular from the deep lobe, and a fine needle biopsy was compatible with “Warthin tumor.” We performed a mini-invasive transoral approach under magnification, previous isolation of homolateral vessels. The decision on which surgical approach to be used is determined by site, size vascularity, and histology of the tumor. A literature review of the main surgical approaches was performed. We performed a combined transoral dissection under magnification with cervicotomic exposure of the neck vascular bundle allowing to dissect the tumor and manage any intra-operative complications.

Obstetrical APS: is there a place for hydroxychloroquine to improve the pregnancy outcome?

Science.gov (United States)

Mekinian, Arsene; Costedoat-Chalumeau, Nathalie; Masseau, Agathe; Tincani, Angela; De Caroli, Sara; Alijotas-Reig, Jaume; Ruffatti, Amelia; Ambrozic, Ales; Botta, Angela; Le Guern, Véronique; Fritsch-Stork, Ruth; Nicaise-Roland, Pascale; Carbonne, Bruno; Carbillon, Lionel; Fain, Olivier

2015-01-01

The use of the conventional APS treatment (the combination of low-dose aspirin and LMWH) dramatically improved the obstetrical prognosis in primary obstetrical APS (OAPS). The persistence of adverse pregnancy outcome raises the need to find other drugs to improve obstetrical outcome. Hydroxychloroquine is widely used in patients with various autoimmune diseases, particularly SLE. Antimalarials have many anti-inflammatory, anti-aggregant and immune-regulatory properties: they inhibit phospholipase activity, stabilize lysosomal membranes, block the production of several pro-inflammatory cytokines and, in addition, impair complement-dependent antigen-antibody reactions. There is ample evidence of protective effects of hydroxychloroquine in OAPS similar to the situation in SLE arising from in vitro studies of pathophysiological working mechanism of hydroxychloroquine. However, the clinical data on the use of hydroxychloroquine in primary APS are lacking and prospective studies are necessary. Copyright © 2014 Elsevier B.V. All rights reserved.

Resolution of conflict between goal-directed actions: outcome encoding and neural control processes.

Science.gov (United States)

de Wit, Sanne; Ostlund, Sean B; Balleine, Bernard W; Dickinson, Anthony

2009-07-01

According to O-R theory of instrumental learning, incongruent biconditional discriminations should be impossible to solve in a goal-directed manner because the event acting as the outcome of one response also acts as a discriminative stimulus for an opposite response. Each event should therefore be associated with two competing responses. However, Dickinson and de Wit (2003) have presented evidence that rats can learn incongruent discriminations. The present study investigated whether rats were able to engage additional processes to solve incongruent discriminations in a goal-directed manner. Experiment 1 provides evidence that rats resolve the response conflict that arises in the incongruent discrimination by differentially encoding events in their roles as discriminative stimulus and as outcome. Furthermore, Experiment 2 shows that once goal-directed control has been established the dorsomedial prefrontal cortex is not directly involved in its maintenance but rather plays a central role in conflict resolution processes.

J-pouch vs. side-to-end anastomosis after hand-assisted laparoscopic low anterior resection for rectal cancer: A prospective randomized trial on short and long term outcomes including life quality and functional results.

Science.gov (United States)

Okkabaz, Nuri; Haksal, Mustafa; Atici, Ali Emre; Altuntas, Yunus Emre; Gundogan, Ersin; Gezen, Fazli Cem; Oncel, Mustafa

2017-11-01

To analyze the outcomes of j-pouch and side-to-end anastomosis in rectal cancer patients treated with laparoscopic hand-assisted low anterior resection. Prospective trial on cases randomized to have a colonic j-pouch or a side-to-end anastomosis after low anterior resection. Demographics, characteristics of disease and treatment, perioperative results, and functional outcomes and life quality were compared between the groups. Seventy four patients were randomized. Reservoir creation was withdrawn in 17 (23%) patients, mostly related to reach problem (n = 11, 64.7%). Anastomotic leakage rate was significantly higher in j-pouch group (8 [27.6%] vs. 0, p = 0.004). Stoma closure could not be achieved in 16 (28.1%) patients. Life quality and functional outcomes, measured 4, 8 and 12 months after the stoma reversal, were similar. Colonic j-pouch and side-to-end anastomosis are similar regarding perioperative measures including operation time, rates of postoperative complications, reoperation and 30-day mortality, and hospitalization period except anastomotic leak rate, which is higher in j-pouch group. Postoperative aspects are not different in patients receiving either technique including functional outcomes and life quality for the first year after stoma closure. In our opinion, both techniques may be preferred during the daily practice while performing laparoscopic surgery; but surgeons may be aware of a possibly higher anastomotic leak rate in case of a j-pouch. Copyright © 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Distribution-valued weak solutions to a parabolic problem arising in financial mathematics

Directory of Open Access Journals (Sweden)

Michael Eydenberg

2009-07-01

Full Text Available We study distribution-valued solutions to a parabolic problem that arises from a model of the Black-Scholes equation in option pricing. We give a minor generalization of known existence and uniqueness results for solutions in bounded domains $Omega subset mathbb{R}^{n+1}$ to give existence of solutions for certain classes of distributions $fin mathcal{D}'(Omega$. We also study growth conditions for smooth solutions of certain parabolic equations on $mathbb{R}^nimes (0,T$ that have initial values in the space of distributions.

Nuclear waste management and problems arising from constitutional law

International Nuclear Information System (INIS)

Rauschning, D.

1983-01-01

The author discusses the problems arising in the field of nuclear waste management on account of the constitutional law. Especially the difficulties emanating from the conflict between the provisions of section 9a of the Atomic Energy Act and the provisions of constitutional law are dealt with in detail, referring to the monography of H. Hofmann, 'legal aspects of nuclear waste management'. The author comes to the conclusion that the reqquirements laid down in section 9a-9c of the Atomic Energy Act are in agreement with the Basic law. There is, he says, no unreasonable risk for future generations, as the provisions of the nuclear law provide for sufficient safety of sites and equipment selected for the final storage of nuclear waste, ensuring that radioactive leakage is excluded over long periods of time. In the second part of his lecture, the author discusses the problem of competency and delegation of authority with regard to the reprocessing of radioactive waste. (BW) [de

Metaplastic Carcinoma with Chondroid Differentiation Arising in Microglandular Adenosis

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Ga-Eon Kim

2017-07-01

Full Text Available Microglandular adenosis (MGA of the breast is a rare, benign proliferative lesion but with a significant rate of associated carcinoma. Herein, we report an unusual case of metaplastic carcinoma with chondroid differentiation associated with typical MGA. Histologically, MGA showed a direct transition to metaplastic carcinoma without an intervening atypical MGA or ductal carcinoma in situ component. The immunohistochemical profile of the metaplastic carcinoma was mostly similar to that of MGA. In both areas, all the epithelial cells were positive for S-100 protein, but negative for estrogen receptor, progesterone receptor, HER2/neu, and epidermal growth factor receptor. An increase in the Ki-67 and p53 labelling index was observed from MGA to invasive carcinoma. To the best of our knowledge, this is the first case of metaplastic carcinoma with chondroid differentiation arising in MGA in Korea. This case supports the hypothesis that a subset of MGA may be a non-obligate morphologic precursor of breast carcinoma, especially the triple-negative subtype.

Improving Outcome of Psychosocial Treatments by Enhancing Memory and Learning

Science.gov (United States)

Harvey, Allison G.; Lee, Jason; Williams, Joseph; Hollon, Steven D.; Walker, Matthew P.; Thompson, Monique A.; Smith, Rita

2014-01-01

Mental disorders are prevalent and lead to significant impairment. Progress toward establishing treatments has been good. However, effect sizes are small to moderate, gains may not persist, and many patients derive no benefit. Our goal is to highlight the potential for empirically-supported psychosocial treatments to be improved by incorporating insights from cognitive psychology and research on education. Our central question is: If it were possible to improve memory for content of sessions of psychosocial treatments, would outcome substantially improve? This question arises from five lines of evidence: (a) mental illness is often characterized by memory impairment, (b) memory impairment is modifiable, (c) psychosocial treatments often involve the activation of emotion, (d) emotion can bias memory and (e) memory for psychosocial treatment sessions is poor. Insights from scientific knowledge on learning and memory are leveraged to derive strategies for a transdiagnostic and transtreatment cognitive support intervention. These strategies can be applied within and between sessions and to interventions delivered via computer, the internet and text message. Additional novel pathways to improving memory include improving sleep, engaging in exercise and imagery. Given that memory processes change across the lifespan, services to children and older adults may benefit from cognitive support. PMID:25544856

Exploring the outcomes in studies of primary frozen shoulder

DEFF Research Database (Denmark)

Rodgers, Sara; Brealey, Stephen; Jefferson, Laura

2014-01-01

PURPOSE: In our study we explored the need to define a core outcome set for primary frozen shoulder. METHODS: We investigated the outcomes used by studies included in a systematic review of the management of primary frozen shoulder; surveyed which primary outcome measures health care professionals...... and 104 respondents, respectively) were most often cited by health care professionals as the primary outcome measure that should be used. Searches identified one paper that included patients' views. Outcomes of importance to patients were pain at night, general pain, reduced mobility (resulting...

Source terms for airborne radioactivity arising from uranium mill wastes

International Nuclear Information System (INIS)

O'Riordan, M.C.; Downing, A.L.

1978-01-01

One of the problems in assessing the radiological impact of uranium milling is to determine the rates of release to the air of material from the various sources of radioactivity. Such source terms are required for modelling the transport of radioactive material in the atmosphere. Activity arises from various point and area sources in the mill itself and from the mill tailings. The state of the tailings changes in time from slurry to solid. A layer of water may be maintained over the solids during the life of the mine, and the tailings may be covered with inert material on abandonment. Releases may be both gaseous and particulate. This paper indicates ways in which radon emanation and the suspension of long-lived particulate activity might be quantified, and areas requiring further exploration are identified

Radiological protection issues arising during and after the Fukushima nuclear reactor accident

International Nuclear Information System (INIS)

González, Abel J; Akashi, Makoto; Sakai, Kazuo; Yonekura, Yoshiharu; Boice Jr, John D; Chino, Masamichi; Homma, Toshimitsu; Ishigure, Nobuhito; Kai, Michiaki; Kusumi, Shizuyo; Lee, Jai-Ki; Menzel, Hans-Georg; Niwa, Ohtsura; Yamashita, Shunichi; Weiss, Wolfgang

2013-01-01

potential health effects are properly interpreted; the limitations of epidemiological studies for attributing radiation effects following low exposures are understood; any confusion on protection quantities and units is resolved; the potential hazard from the intake of radionuclides into the body is elucidated; rescuers and volunteers are protected with an ad hoc system; clear recommendations on crisis management and medical care and on recovery and rehabilitation are available; recommendations on public protection levels (including infant, children and pregnant women and their expected offspring) and associated issues are consistent and understandable; updated recommendations on public monitoring policy are available; acceptable (or tolerable) ‘contamination’ levels are clearly stated and defined; strategies for mitigating the serious psychological consequences arising from radiological accidents are sought; and, last but not least, failures in fostering information sharing on radiological protection policy after an accident need to be addressed with recommendations to minimise such lapses in communication. (memorandum)

Radiological protection issues arising during and after the Fukushima nuclear reactor accident.

Science.gov (United States)

González, Abel J; Akashi, Makoto; Boice, John D; Chino, Masamichi; Homma, Toshimitsu; Ishigure, Nobuhito; Kai, Michiaki; Kusumi, Shizuyo; Lee, Jai-Ki; Menzel, Hans-Georg; Niwa, Ohtsura; Sakai, Kazuo; Weiss, Wolfgang; Yamashita, Shunichi; Yonekura, Yoshiharu

2013-09-01

health effects are properly interpreted; the limitations of epidemiological studies for attributing radiation effects following low exposures are understood; any confusion on protection quantities and units is resolved; the potential hazard from the intake of radionuclides into the body is elucidated; rescuers and volunteers are protected with an ad hoc system; clear recommendations on crisis management and medical care and on recovery and rehabilitation are available; recommendations on public protection levels (including infant, children and pregnant women and their expected offspring) and associated issues are consistent and understandable; updated recommendations on public monitoring policy are available; acceptable (or tolerable) 'contamination' levels are clearly stated and defined; strategies for mitigating the serious psychological consequences arising from radiological accidents are sought; and, last but not least, failures in fostering information sharing on radiological protection policy after an accident need to be addressed with recommendations to minimise such lapses in communication.

Code of Practice for the Protection of Persons against Ionizing Radiations arising from Medical and Dental Use

Energy Technology Data Exchange (ETDEWEB)

1972-01-01

This Code is a revision of the 1964 Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use. This revised Code (which does not have the force of law) applies to the use of ionizing radiations arising from all forms of medical and dental practice and from allied research involving human subjects. It covers both workers, patients and members of the public. Although the arrangements recommended relate primarily to institutions they should be applied, as far as possible, by all medical and dental practitioners. The Code has been drawn up in the light of the recommendations of the International Commission on Radiological Protection (ICRP) and of the views of the Medical Research Council's Committee on Protection against Ionizing Radiations.

The calculation of individual radiation exposure rates arising from routine discharges of activity into an estuary or sea

International Nuclear Information System (INIS)

Maul, P.R.

1982-03-01

Simple methods are described which enable assessments to be made of exposure rates to individuals arising from the release of activity into an estuary or sea. These methods are based in the main on those employed by the Ministry of Agriculture Fisheries and Food together with models developed by the author. The exposure routes considered are the ingestion of seafood and external exposure from β and γ emitters arising from occupancy over contaminated sediments or beaches and the handling of fishing gear. These routes are generally the most important, but for any chosen site it will also be necessary to determine whether any other exposure routes are significant. (author)

The calculation of individual radiation exposure rates arising from routine discharges of activity into an estuary or sea

International Nuclear Information System (INIS)

Maul, P.R.

1982-11-01

Simple methods are described which enable assessments to be made of exposure rates to individuals arising from the release of activity into an estuary or sea. These methods are based in the main on those employed by the Ministry of Agriculture Fisheries and Food together with models developed by the author. The exposure routes considered are the ingestion of seafood and external exposure from ν and ν emitters arising from occupancy over contaminated sediments or beaches and the handling of fishing gear. These routes are generally the most important, but for any chosen site it will also be necessary to determine whether any other exposure routes are significant. (author)

Contingency bias in probability judgement may arise from ambiguity regarding additional causes.

Science.gov (United States)

Mitchell, Chris J; Griffiths, Oren; More, Pranjal; Lovibond, Peter F

2013-09-01

In laboratory contingency learning tasks, people usually give accurate estimates of the degree of contingency between a cue and an outcome. However, if they are asked to estimate the probability of the outcome in the presence of the cue, they tend to be biased by the probability of the outcome in the absence of the cue. This bias is often attributed to an automatic contingency detection mechanism, which is said to act via an excitatory associative link to activate the outcome representation at the time of testing. We conducted 3 experiments to test alternative accounts of contingency bias. Participants were exposed to the same outcome probability in the presence of the cue, but different outcome probabilities in the absence of the cue. Phrasing the test question in terms of frequency rather than probability and clarifying the test instructions reduced but did not eliminate contingency bias. However, removal of ambiguity regarding the presence of additional causes during the test phase did eliminate contingency bias. We conclude that contingency bias may be due to ambiguity in the test question, and therefore it does not require postulation of a separate associative link-based mechanism.

Embedding Affective Learning Outcomes in Library Instruction

Directory of Open Access Journals (Sweden)

Ellysa Stern Cahoy

2012-12-01

Full Text Available While information literacy in higher education has long been focused on cognitive learning outcomes, attention must be paid to students’ affective, emotional needs throughout the research process. This article identifies models for embedding affective learning outcomes within information literacy instruction, and provides strategies to help librarians discover, articulate, and address students’ self-efficacy, motivation, emotions and attitudes. Worksheets to assist in creating affective learning outcomes are included to bring structure to an area of learning that is often challenging to articulate and measure. Also included in the article are the results of a recent survey of instruction librarians’ familiarity and inclusion of affective learning outcomes within teaching and learning initiatives.

Exploring arising moments and mindfulness in occupational therapists working in diverse clinical practice areas.

Science.gov (United States)

Reid, Denise; Naseer, Zahid

2012-10-01

An online survey was conducted with 72 Canadian occupational therapists to (1) explore if and how occupational therapists were aware of "arising moments" in clinical practice, which are moments that give rise to emotions, sensations, and thoughts, and (2) to examine therapists' responses to questions related to mindfulness. Participants described arising moments through an open-ended survey question. Framework analysis was used to develop key themes and subthemes. A modified Philadelphia Mindfulness Awareness (PHLMS) subscale with two additional survey questions "understanding of living in the moment and being present, and awareness of mindfulness" (sum = PAM) were used as indicators of mindfulness. There were significant differences in the means of PHLMS mindfulness among therapists working in diverse practice areas (F = 3.63, p = .009). Posthoc analysis revealed that therapists working in mental health had higher mean PHLMS-mindfulness scores than in all other groups. There were no significant differences in PAM mindfulness among the practice areas (ANOVA, F = 2.15, p = .08). However, posthoc tests showed that the participants in the mental health practice area had a significant difference with one group, general physical health. Findings have implications for practice in occupational therapy and education about mindfulness in occupational therapy.

MR imaging findings of extraovarian endocervical mucinous borderline tumors arising from pelvic endometriosis

International Nuclear Information System (INIS)

Yeo, Dong Myung; Rha, Sung Eun; Byun, Jae Young; Lee, Ahwon; Kim, Mee Ran

2013-01-01

We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.

Repair of aorto-left ventricular tunnel arising from the left sinus of valsalva.

Science.gov (United States)

Nezafati, Mohammad Hassan; Maleki, Mahmood Hosseinzadeh; Javan, Hadi; Zirak, Nahid

2010-05-01

Aortico-left ventricular tunnel (ALVT) is a rare congenital cardiac defect that bypasses the aortic valve via a para-valvular connection from the left ventricle to the aorta. In most cases, the tunnel arises from the right aortic sinus. In this case report, we are presenting a case of ALVT, of which the aortic orifice arose from the left aortic sinus, requiring special attention to avoid the left coronary artery injury at the time of surgical repair.

MR imaging findings of extraovarian endocervical mucinous borderline tumors arising from pelvic endometriosis

Energy Technology Data Exchange (ETDEWEB)

Yeo, Dong Myung; Rha, Sung Eun; Byun, Jae Young; Lee, Ahwon; Kim, Mee Ran [Seoul St. Mary' s Hospital, The Catholic University of Korea, Seoul (Korea, Republic of)

2013-12-15

We report MR imaging findings of a rare case of endocervical mucinous borderline tumor (MBT) involving the cul-de-sac and left fallopian tube arising from extensive pelvic endometriosis with pathologic correlation in a 35-year-old woman presented with vague pelvic pain. Endocervical MBT is a type of endometriosis-associated carcinoma. Imaging findings of endocervical MBT are unilocular or oligolocular cystic lesions with enhancing mural nodules, which are different from those of the more common intestinal type MBT.

Squamous Cell Carcinoma Arising from Inverted Schneiderian Papilloma: A Case Report with Oral Involvement

Directory of Open Access Journals (Sweden)

Alexandre Simões Garcia

2014-01-01

Full Text Available Inverted Schneiderian papilloma is an uncommon benign tumor that presents tendency to recur and propensity to be associated with malignancy in approximately 10% of the cases. Some of these lesions are isolated in the maxillary sinus, and predominantly affect white males with mean age of 50 years. We report a case of squamous cell carcinoma arising from inverted Schneiderian papilloma in the maxillary sinus extending to the mouth. The patient was submitted to extraction of a maxillary molar tooth four months before the exacerbation of the symptoms of nasal airway obstruction and facial enlargement. Computed tomography scan revealed a sinonasal mass causing opacification of the right maxillary sinus with destruction of the lateral nasal wall and maxillary sinus floor. The patient was referred to an oncology center for treatment and died from tumor progression one year after the cancer was diagnosed. The intention of this report is to alert dentists to include the inverted Schneiderian papilloma, either associated with squamous cell carcinoma, or not, in the differential diagnosis of maxillary sinus tumors with aggressive behavior, which may extend to the oral cavity or involve roots of teeth.

Core Outcomes for Colorectal Cancer Surgery: A Consensus Study.

Directory of Open Access Journals (Sweden)

Angus G K McNair

2016-08-01

Full Text Available Colorectal cancer (CRC is a major cause of worldwide morbidity and mortality. Surgical treatment is common, and there is a great need to improve the delivery of such care. The gold standard for evaluating surgery is within well-designed randomized controlled trials (RCTs; however, the impact of RCTs is diminished by a lack of coordinated outcome measurement and reporting. A solution to these issues is to develop an agreed standard "core" set of outcomes to be measured in all trials to facilitate cross-study comparisons, meta-analysis, and minimize outcome reporting bias. This study defines a core outcome set for CRC surgery.The scope of this COS includes clinical effectiveness trials of surgical interventions for colorectal cancer. Excluded were nonsurgical oncological interventions. Potential outcomes of importance to patients and professionals were identified through systematic literature reviews and patient interviews. All outcomes were transcribed verbatim and categorized into domains by two independent researchers. This informed a questionnaire survey that asked stakeholders (patients and professionals from United Kingdom CRC centers to rate the importance of each domain. Respondents were resurveyed following group feedback (Delphi methods. Outcomes rated as less important were discarded after each survey round according to predefined criteria, and remaining outcomes were considered at three consensus meetings; two involving international professionals and a separate one with patients. A modified nominal group technique was used to gain the final consensus. Data sources identified 1,216 outcomes of CRC surgery that informed a 91 domain questionnaire. First round questionnaires were returned from 63 out of 81 (78% centers, including 90 professionals, and 97 out of 267 (35% patients. Second round response rates were high for all stakeholders (>80%. Analysis of responses lead to 45 and 23 outcome domains being retained after the first and

Establishing Core Outcome Domains in Hemodialysis: Report of the Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Consensus Workshop.

Science.gov (United States)

Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C; Evangelidis, Nicole; Tugwell, Peter; Crowe, Sally; Van Biesen, Wim; Winkelmayer, Wolfgang C; O'Donoghue, Donal; Tam-Tham, Helen; Shen, Jenny I; Pinter, Jule; Larkins, Nicholas; Youssouf, Sajeda; Mandayam, Sreedhar; Ju, Angela; Craig, Jonathan C

2017-01-01

Evidence-informed decision making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient centered. The Standardized Outcomes in Nephrology-Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis therapy. Key stakeholders including 8 patients/caregivers and 47 health professionals (nephrologists, policymakers, industry, and researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations, flexibility to consider evolving priorities over time, deconstruction of language and meaning for conceptual consistency and clarity, understanding of potential overlap and associations between outcomes, and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive, and validated outcome measures that could be used in clinical care (quality indicators) and trials (including pragmatic trials) and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment and improved patient outcomes. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Establishing Core Outcome Domains in Hemodialysis: Report of the Standardized Outcomes in Nephrology−Hemodialysis (SONG-HD) Consensus Workshop

Science.gov (United States)

Tong, Allison; Manns, Braden; Hemmelgarn, Brenda; Wheeler, David C.; Evangelidis, Nicole; Tugwell, Peter; Crowe, Sally; Van Biesen, Wim; Winkelmayer, Wolfgang C.; O’Donoghue, Donal; Tam-Tham, Helen; Shen, Jenny; Pinter, Jule; Larkins, Nicholas; Youssouf, Sajeda; Mandayam, Sreedhar; Ju, Angela; Craig, Jonathan C.

2017-01-01

Evidence-informed decision-making in clinical care and policy in nephrology is undermined by trials that selectively report a large number of heterogeneous outcomes, many of which are not patient-centered. The Standardized Outcomes in Nephrology−Hemodialysis (SONG-HD) Initiative convened an international consensus workshop on November 7, 2015, to discuss the identification and implementation of a potential core outcome set for all trials in hemodialysis. The purpose of this article is to report qualitative analyses of the workshop discussions, describing the key aspects to consider when establishing core outcomes in trials involving patients on hemodialysis. Key stakeholders including eight patients/caregivers and 47 health professionals (nephrologists, policy makers, industry, researchers) attended the workshop. Attendees suggested that identifying core outcomes required equitable stakeholder engagement to ensure relevance across patient populations; flexibility to consider evolving priorities over time; deconstruction of language and meaning for conceptual consistency and clarity; understanding of potential overlap and associations between outcomes; and an assessment of applicability to the range of interventions in hemodialysis. For implementation, they proposed that core outcomes must have simple, inexpensive and validated outcome measures that could be used in clinical care (quality ndicators) and trials (including pragmatic trials), and endorsement by regulatory agencies. Integrating these recommendations may foster acceptance and optimize the uptake and translation of core outcomes in hemodialysis, leading to more informative research, for better treatment, and improved patient outcomes. PMID:27497527

Network topologies and convergent aetiologies arising from deletions and duplications observed in individuals with autism.

Science.gov (United States)

Noh, Hyun Ji; Ponting, Chris P; Boulding, Hannah C; Meader, Stephen; Betancur, Catalina; Buxbaum, Joseph D; Pinto, Dalila; Marshall, Christian R; Lionel, Anath C; Scherer, Stephen W; Webber, Caleb

2013-06-01

Autism Spectrum Disorders (ASD) are highly heritable and characterised by impairments in social interaction and communication, and restricted and repetitive behaviours. Considering four sets of de novo copy number variants (CNVs) identified in 181 individuals with autism and exploiting mouse functional genomics and known protein-protein interactions, we identified a large and significantly interconnected interaction network. This network contains 187 genes affected by CNVs drawn from 45% of the patients we considered and 22 genes previously implicated in ASD, of which 192 form a single interconnected cluster. On average, those patients with copy number changed genes from this network possess changes in 3 network genes, suggesting that epistasis mediated through the network is extensive. Correspondingly, genes that are highly connected within the network, and thus whose copy number change is predicted by the network to be more phenotypically consequential, are significantly enriched among patients that possess only a single ASD-associated network copy number changed gene (p = 0.002). Strikingly, deleted or disrupted genes from the network are significantly enriched in GO-annotated positive regulators (2.3-fold enrichment, corrected p = 2×10(-5)), whereas duplicated genes are significantly enriched in GO-annotated negative regulators (2.2-fold enrichment, corrected p = 0.005). The direction of copy change is highly informative in the context of the network, providing the means through which perturbations arising from distinct deletions or duplications can yield a common outcome. These findings reveal an extensive ASD-associated molecular network, whose topology indicates ASD-relevant mutational deleteriousness and that mechanistically details how convergent aetiologies can result extensively from CNVs affecting pathways causally implicated in ASD.

Variational problems arising in classical mechanics and nonlinear elasticity

International Nuclear Information System (INIS)

Spencer, P.

1999-01-01

In this thesis we consider two different classes of variational problems. First, one-dimensional problems arising from classical mechanics where the problem is to determine whether there is a unique function η 0 (x) which minimises the energy functional of the form I(η) = ∫ a b L(x,η(x), η'(x)) dx. We will investigate uniqueness by making a change of dependent and independent variables and showing that for a class of integrands L with a particular kind of scaling invariance the resulting integrand is completely convex. The change of variables arises by applying results from Lie group theory as applied in the study of differential equations and this work is motivated by [60] and [68]. Second, the problem of minimising energy functionals of the form E(u) = ∫ A W(∇u(x)) dx in the case of a nonlinear elastic body occupying an annular region A contains R 2 with u : A-bar → A-bar. This work is motivated by [57] (in particular the example of paragraph 4). We will consider rotationally symmetric deformations satisfying prescribed boundary conditions. We will show the existence of minimisers for stored energy functions of the form W(F) = g-tilde(vertical bar-F-vertical bar, det(F)) in a class of general rotationally symmetric deformations of a compressible annulus and for stored energy functions of the form W(F) = g-bar(vertical bar-F-vertical bar) in a class of rotationally symmetric deformations of an incompressible annulus. We will also show that in each case the minimisers are solutions of the full equilibrium equations. A model problem will be considered where the energy functional is the Dirichlet integral and it will be shown that the rotationally symmetric solution obtained is a minimiser among admissible non-rotationally symmetric deformations. In the case of an incompressible annulus, we will consider the Dirichlet integral as the energy functional and show that the rotationally symmetric equilibrium solutions in this case are weak local minimisers in

An incidental primary papillary carcinoma arising in a thyroglossal duct cyst: Report of a rare finding

Directory of Open Access Journals (Sweden)

Mohammad Jaseem Hassan

2016-01-01

Full Text Available The thyroglossal duct cysts (TGDCs are the most common congenital anomaly of the thyroid, usually manifested as painless midline neck mass. Malignancy is very rare and is reported in around 1% of cases as an incidental finding after histopathological evaluation of resected cyst. Papillary carcinoma is the most common carcinoma reported in TGDC. Here, we report a case of 17-year-old-female, who presented with a gradually increasing midline neck mass which moves with swallowing. On imaging a diagnosis of infected TGDC was made. The Sistrunk operation was done and a diagnosis of primary papillary carcinoma arising in a TGDC was rendered histopathologically. The contemporary appearance of papillary carcinoma thyroid was reported in about 20% cases of TGDC carcinoma, thus it is essential to differentiate primary papillary carcinoma arising in a TGDC from those of metastatic papillary carcinoma thyroid by strict diagnostic criteria.

Basal cell carcinoma arising on the skin with chronic radiation dermatitis

International Nuclear Information System (INIS)

Tanaka, Yukiko; Ogusa, Yasuhiro; Tamura, Shinya

1986-01-01

In a 86-year-old woman, basal cell carcinoma (BCC) arose on the skin with chronic radiation dermatitis. She, at the age of 46, received irradiation to the abdomen for cancer of the uterine cervix. Radiation source and dose were unknown. A verrucous eruption appeared on the irradiated field of the right abdomen, and gradually expanded. Histological examination showed that proliferation of tumor cells with adenoid and cystose structure extended to the epidermis. Electron microscopic study showed both clear and dark tumor cells, although dark cells were few in number. A review of the literature showed that BCC arising on the skin with chronic radiation dermatitis is uncommon in Japan. (Namekawa, K.)

Pediatric hydrocephalus outcomes: a review

Directory of Open Access Journals (Sweden)

Vinchon Matthieu

2012-08-01

Full Text Available Abstract The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy, clinical outcome (neurological, sensory, cognitive sequels, epilepsy, schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review

Adherence to antiretroviral therapy and clinical outcomes among young adults reporting high-risk sexual behavior, including men who have sex with men, in coastal Kenya.

Science.gov (United States)

Graham, Susan M; Mugo, Peter; Gichuru, Evanson; Thiong'o, Alexander; Macharia, Michael; Okuku, Haile S; van der Elst, Elise; Price, Matthew A; Muraguri, Nicholas; Sanders, Eduard J

2013-05-01

African men who have sex with men (MSM) face significant stigma and barriers to care. We investigated antiretroviral therapy (ART) adherence among high-risk adults, including MSM, participating in a clinic-based cohort. Survival analysis was used to compare attrition across patient groups. Differences in adherence, weight gain, and CD4 counts after ART initiation were assessed. Among 250 HIV-1-seropositive adults, including 108 MSM, 15 heterosexual men, and 127 women, patient group was not associated with attrition. Among 58 participants who were followed on ART, 40 % of MSM had less than 95 % adherence, versus 28.6 % of heterosexual men and 11.5 % of women. Although MSM gained less weight after ART initiation than women (adjusted difference -3.5 kg/year), CD4 counts did not differ. More data are needed on barriers to adherence and clinical outcomes among African MSM, to ensure that MSM can access care and derive treatment and prevention benefits from ART.

Emergence of spatiotemporal chaos arising from far-field breakup of spiral waves in the plankton ecological systems

International Nuclear Information System (INIS)

Quan-Xing, Liu; Gui-Quan, Sun; Zhen, Jin; Bai-Lian, Li

2009-01-01

It has been reported that the minimal spatially extended phytoplankton–zooplankton system exhibits both temporal regular/chaotic behaviour, and spatiotemporal chaos in a patchy environment. As a further investigation by means of computer simulations and theoretical analysis, in this paper we observe that the spiral waves may exist and the spatiotemporal chaos emerge when the parameters are within the mixed Turing–Hopf bifurcation region, which arises from the far-field breakup of the spiral waves over a large range of diffusion coefficients of phytoplankton and zooplankton. Moreover, the spatiotemporal chaos arising from the far-field breakup of spiral waves does not gradually invade the whole space of that region. Our results are confirmed by nonlinear bifurcation of wave trains. We also discuss ecological implications of these spatially structured patterns. (general)

Code of Practice for the Protection of Persons against Ionizing Radiations arising from Medical and Dental Use

International Nuclear Information System (INIS)

1972-01-01

This Code is a revision of the 1964 Code of Practice for the protection of persons against ionizing radiations arising from medical and dental use. This revised Code (which does not have the force of law) applies to the use of ionizing radiations arising from all forms of medical and dental practice and from allied research involving human subjects. It covers both workers, patients and members of the public. Although the arrangements recommended relate primarily to institutions they should be applied, as far as possible, by all medical and dental practitioners. The Code has been drawn up in the light of the recommendations of the International Commission on Radiological Protection (ICRP) and of the views of the Medical Research Council's Committee on Protection against Ionizing Radiations. (NEA) [fr

Functional Outcomes for Clinical Evaluation of Implant Restorations

NARCIS (Netherlands)

Bassi, Francesco; Carr, Alan B.; Chang, Ting-Ling; Estafanous, Emad W.; Garrett, Neal R.; Happonen, Risto-Pekka; Koka, Sreenivas; Laine, Juhani; Osswald, Martin; Reintsema, Harry; Rieger, Jana; Roumanas, Eleni; Salinas, Thomas J.; Stanford, Clark M.; Wolfaardt, Johan

2013-01-01

The functional outcomes related to treating patients afflicted with tooth loss are an important hallmark in substantiating prosthodontic intervention. The Oral Rehabilitation Outcomes Network (ORONet) conducted two international workshops to develop a core set of outcome measures, including a

Distinct kinetics of inhibitory currents in thalamocortical neurons that arise from dendritic or axonal origin.

Directory of Open Access Journals (Sweden)

Sunggu Yang

Full Text Available Thalamocortical neurons in the dorsal lateral geniculate nucleus (dLGN transfer visual information from retina to primary visual cortex. This information is modulated by inhibitory input arising from local interneurons and thalamic reticular nucleus (TRN neurons, leading to alterations of receptive field properties of thalamocortical neurons. Local GABAergic interneurons provide two distinct synaptic outputs: axonal (F1 terminals and dendritic (F2 terminals onto dLGN thalamocortical neurons. By contrast, TRN neurons provide only axonal output (F1 terminals onto dLGN thalamocortical neurons. It is unclear if GABAA receptor-mediated currents originating from F1 and F2 terminals have different characteristics. In the present study, we examined multiple characteristics (rise time, slope, halfwidth and decay τ of GABAA receptor-mediated miniature inhibitory postsynaptic synaptic currents (mIPSCs originating from F1 and F2 terminals. The mIPSCs arising from F2 terminals showed slower kinetics relative to those from F1 terminals. Such differential kinetics of GABAAR-mediated responses could be an important role in temporal coding of visual signals.

Flow features that arise due to the interaction of a plane shock wave with concave profiles

CSIR Research Space (South Africa)

MacLucas, David A

2012-10-01

Full Text Available The focus of the author's thesis was the aerodynamic flow field that develops as a result of the interaction of a moving plane shock wave with concave profiles. In this presentation, he discusses some of the interesting flow phenomena that arise...

New homotopy analysis transform method for solving the discontinued problems arising in nanotechnology

International Nuclear Information System (INIS)

Khader, M. M.; Kumar, Sunil; Abbasbandy, S.

2013-01-01

We present a new reliable analytical study for solving the discontinued problems arising in nanotechnology. Such problems are presented as nonlinear differential—difference equations. The proposed method is based on the Laplace transform with the homotopy analysis method (HAM). This method is a powerful tool for solving a large amount of problems. This technique provides a series of functions which may converge to the exact solution of the problem. A good agreement between the obtained solution and some well-known results is obtained

Survey of EEC solid waste arisings and performance of non-destructive assay systems

International Nuclear Information System (INIS)

Bremner, W.B.; Adaway, D.W.; Yates, A.

1992-01-01

This report covers the work carried out during an one-year contract which surveyed the radioactive solid waste arisings in EEC Member States and also tabulated information on the performance of the non-destructive assay (NDA) system used. The work was jointly carried out with CEA partners at Cadarache and Paris. The tabulated data give information on types, packaging, associated activity, and NDA capability of the utilities or research organisations. Some short comings in NDA capabilities are identified and possible solutions are given

Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes.

Science.gov (United States)

Kappen, Isabelle Francisca Petronella Maria; Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom Fjmc; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

2017-05-01

No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (Pspeech assessment, and 11%-17% of the patients exhibited increased nasalance scores, assessed through nasometry. The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

[Outcome Quality in Medical Rehabilitation: Relationship Between "Patient-Reported Outcomes" (PROs) and Social Security Contributions].

Science.gov (United States)

Nübling, R; Kaluscha, R; Krischak, G; Kriz, D; Martin, H; Müller, G; Renzland, J; Reuss-Borst, M; Schmidt, J; Kaiser, U; Toepler, E

2017-02-01

Aim of the Study The outcome quality of medical rehabilitation is evaluated often by "Patient Reported Outcomes" (PROs). It is examined to what extent these PROs are corresponding with "hard" or "objective" outcomes such as payments of contributions to social insurance. Methods The "rehabilitation QM outcome study" includes self-reports of patients as well as data from the Rehabilitation Statistics Database (RSD) of the German pension insurance Baden-Wurttemberg. The sample for the question posed includes N=2 947 insured who were treated in 2011 in 21 clinics of the "health quality network" and who were either employed or unemployed at the time of the rehabilitation application (e. g. the workforce or labour force group, response rate: 55%). The sample turned out widely representative for the population of the insured persons. Results PROs and payment of contributions to pension insurance clearly correspond. In the year after the rehabilitation improved vs. not improved rehabilitees differed clearly with regard to their payments of contributions. Conclusions The results support the validity of PROs. For a comprehensive depiction of the outcome quality of rehabilitation PROs and payments of contributions should be considered supplementary. © Georg Thieme Verlag KG Stuttgart · New York.

Provider volume and outcomes for oncological procedures.

LENUS (Irish Health Repository)

Killeen, S D

2012-02-03

BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

Calculation of Rayleigh type sums for zeros of the equation arising in spectral problem

Science.gov (United States)

Kostin, A. B.; Sherstyukov, V. B.

2017-12-01

For zeros of the equation (arising in the oblique derivative problem) μ J n ‧ ( μ ) cos α + i n J n ( μ ) sin α = 0 , μ ∈ ℂ , with parameters n ∈ ℤ, α ∈ [-π/2, π/2] and the Bessel function Jn (μ) special summation relationships are proved. The obtained results are consistent with the theory of well-known Rayleigh sums calculating by zeros of the Bessel function.

Primary Follicular Carcinoma Arising in Ectopic Thyroid Tissue of the Lateral Neck: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Oh, Se Won; Park, Dong Woo; Kim, Soo Yeon; Hahm, Chang Kok; Lee, Young Jun; Lee, Seung Ro; Pyo, Ju Yeon; Oh, Young Ha; Park, Yong Wook [Hanyang University College of Medicine, Guri Hospital, Guri (Korea, Republic of)

2010-11-15

Ectopic thyroid tissue in the lateral neck is an uncommon congenital anomaly, and the occurrence of primary follicular carcinoma in this ectopic thyroid tissue is very rare. We report here on such a case of follicular carcinoma arising in ectopic thyroid tissue of the left lateral neck without any evidence of primary carcinoma in the original thyroid gland

Primary Follicular Carcinoma Arising in Ectopic Thyroid Tissue of the Lateral Neck: A Case Report

International Nuclear Information System (INIS)

Oh, Se Won; Park, Dong Woo; Kim, Soo Yeon; Hahm, Chang Kok; Lee, Young Jun; Lee, Seung Ro; Pyo, Ju Yeon; Oh, Young Ha; Park, Yong Wook

2010-01-01

Ectopic thyroid tissue in the lateral neck is an uncommon congenital anomaly, and the occurrence of primary follicular carcinoma in this ectopic thyroid tissue is very rare. We report here on such a case of follicular carcinoma arising in ectopic thyroid tissue of the left lateral neck without any evidence of primary carcinoma in the original thyroid gland

Computer simulation of the spatial distribution of optical radiation arising from knocked-out excited particles

International Nuclear Information System (INIS)

Gokov, S.P.; Gritsyna, V.V.; Koval', A.G.; Kovtunenko, Yu.I.; Shevchenko, D.I.

2004-01-01

The new approach for the explanation of the spatial distribution of the optical radiation arising from knocked-out excited particles is given. Calculated and experimental data for Al (λ=396.1 nm) and Mg (λ=383.8 nm) knocked-out by Ar + (20 keV) beam from MgAl 2 O 4 surface are compared [ru

Prospective outcomes of injury study.

Science.gov (United States)

Derrett, S; Langley, J; Hokowhitu, B; Ameratunga, S; Hansen, P; Davie, G; Wyeth, E; Lilley, R

2009-10-01

In New Zealand (NZ), 20% of adults report a disability, of which one-third is caused by injury. No prospective epidemiological studies of predictors of disability following all-cause injury among New Zealanders have been undertaken. Internationally, studies have focused on a limited range of predictors or specific injuries. Although these studies provide useful insights, applicability to NZ is limited given the importance of NZ's unique macro-social factors, such as NZ's no-fault accident compensation and rehabilitation scheme, the Accident Compensation Corporation (ACC). (1) To quantitatively determine the injury, rehabilitation, personal, social and economic factors leading to disability outcomes following injury in NZ. (2) To qualitatively explore experiences and perceptions of injury-related outcomes in face-to-face interviews with 15 Māori and 15 other New Zealanders, 6 and 12 months after injury. Four geographical regions within NZ. Prospective cohort study with telephone interviews 1, 4 and 12 months after injury. 2500 people (including 460 Māori), aged 18-64 years, randomly selected from ACC's entitlement claims register (people likely to be off work for at least 1 week or equivalent). Telephone interviews, electronic hospital and ACC injury data. Exposures include demographic, social, economic, work-related, health status, participation and/or environmental factors. Primary: disability (including WHODAS II) and health-related quality of life (including EQ-5D). Secondary: participation (paid and unpaid activities), life satisfaction and costs. Separate regression models will be developed for each of the outcomes. Repeated measures outcomes will be modelled using general estimating equation models and generalised linear mixed models.

A simultaneous facility location and vehicle routing problem arising in health care logistics in the Netherlands

NARCIS (Netherlands)

Veenstra, Marjolein; Roodbergen, Kees Jan; Coelho, Leandro C.; Zhu, Stuart X.

2018-01-01

This paper introduces a simultaneous facility location and vehicle routing problem that arises in health care logistics in the Netherlands. In this problem, the delivery of medication from a local pharmacy can occur via lockers, from where patients that are within the coverage distance of a locker

Primitive neuroectodermal tumor arising 8 years after chemotherapy and radiotherapy for acute lymphoblastic leukemia. Case report

International Nuclear Information System (INIS)

Yoshida, Yuya; Toma, Yasuo; Arai, Masayuki; Higashi, Ryo; Kashihara, Kengo; Kaizaki, Yasuharu

2005-01-01

We report a case of primitive neuroectodermal tumor (PNET) arising 8 years after chemotherapy and radiotherapy for acute lymphoblastic leukemia. A 15-year-old boy with a history of acute lymphoblastic leukemia, at the age of 7, underwent chemotherapy and 14 Gy of radiotherapy to the whole brain. He was admitted to our department due to the development of aphasia, right hemiparesis and generalized convulsive seizure. MRI showed an irregularly enhanced mass in the left frontal lobe. A gross total removal of the tumor was performed and histological examination showed it to be PNET. Postoperatively, the patient underwent 20 Gy of radiotherapy to the whole brain and 42 Gy of local radiotherapy. Follow-up MRI showed no evidence of recurrent tumor 4 months after the radiotherapy. This tumor was thought to be a secondary brain tumor arising in this survivor of childhood acute lymphoblastic leukemia and it is a rare complication of successful leukemia treatment. (author)

Scanning Laser Ophthalmoscope Measurement of Local Fundus Reflectance and Autofluorescence Changes Arising from Rhodopsin Bleaching and Regeneration

OpenAIRE

Morgan, Jessica I. W.; Pugh, Edward N.

2013-01-01

Rhodopsin was measured locally in the retina with a widely available, dual wavelength scanning laser ophthalmoscope that does not require pupil dilation. Increased autofluorescence attendant bleaching arises largely from transient removal of rhodopsin's screening of autofluorescent fluorochromes.

Pigmented Epithelioid Melanocytoma (PEM)/Animal Type Melanoma (ATM): Quest for an Origin. Report of One Unusual Case Indicating Follicular Origin and Another Arising in an Intradermal Nevus.

Science.gov (United States)

Tarasen, Ashley; Carlson, J Andrew; Leonard, M Kathryn; Merlino, Glenn; Kaetzel, David; Slominski, Andrzej T

2017-08-15

Pigmented epithelioid melanocytoma (PEM) is a tumor encompassing epithelioid blue nevus of Carney complex (EBN of CNC) and was previously termed animal-type melanoma. Histologically PEMs are heavily pigmented spindled and epithelioid dermal melanocytic tumors with infiltrative borders, however, their origin remains unclear. Stem cells for the epidermis and hair follicle are located in the bulge area of the hair follicle with the potential to differentiate into multiple lineages. Multiple cutaneous carcinomas, including follicular cutaneous squamous cell carcinoma (FSCC), are thought to arise from stem cells in the follicular bulge. We present two cases of PEM/ATM in a 63 year-old male on the scalp with follicular origin and a 72 year-old female on the upper back arising in an intradermal nevus. Biopsy of both cases revealed a proliferation of heavily pigmented dermal nests of melanocytes with atypia. The Case 1 tumor was in continuation with the outer root sheath of the hair follicle in the bulge region. Case 2 arose in an intradermal melanocytic nevus. Rare mitotic figures, including atypical mitotic figures, were identified in both cases. We present two cases of PEM, with histologic evidence suggesting two origins: one from the follicular bulb and one from an intradermal nevus.

Atypical leiomyoma arising in a hepatic vein with extension into the inferior vena cava and right atrium

International Nuclear Information System (INIS)

Dunlap, H.J.; Udjus, K.

1990-01-01

We report an atypical leiomyoma arising in a hepatic vein and extending into the inferior vena cava and right atrium in a fourteen year old boy. US, CT and MRI facilitated diagnosis and removal of this tumor. (orig.)

Maternal nutrition among women from Sub-Saharan Africa, with a focus on Nigeria, and potential implications for pregnancy outcomes among immigrant populations in developed countries.

Science.gov (United States)

Lindsay, K L; Gibney, E R; McAuliffe, F M

2012-12-01

Pregnant women in countries of Sub-Saharan Africa (SSA) are at risk of poor nutritional status and adverse outcomes as a result of poverty, food insecurity, sub-optimal healthcare facilities, frequent infections and frequent pregnancies. Studies from Nigeria, for example, have revealed a high prevalence of both under- and over-nutrition, as well as nutrient deficiencies, including iron, folate, vitamin D and vitamin A. Subsequently, obstetric complications, including hypertension, anaemia, neural tube defects, night-blindness, low birth weight and maternal and perinatal mortality, are common. Migration patterns from SSA to the Western world are on the rise in recent years, with Nigerians now representing the most prevalent immigrant African population in many developed countries. However, the effect of immigration, if any, on the nutritional status and pregnancy outcomes of these women in their host countries has not yet been studied. Consequently, it is unknown to what extent the nutritional deficiencies and pregnancy complications occurring in Nigeria, and other countries of SSA, present in these women post-emigration. This may result in missed opportunities for appropriate antenatal care of a potential high-risk group in pregnancy. The present review discusses the literature regarding nutrition in pregnancy among SSA women, using Nigeria as an example, the common nutrition-related complications that arise and the subsequent obstetric outcomes. The concept of dietary acculturation among immigrant groups is also discussed and deficiencies in the literature regarding studies on the diets of pregnant immigrant women are highlighted. © 2012 The Authors. Journal of Human Nutrition and Dietetics © 2012 The British Dietetic Association Ltd.

Factors contributing to outcome following traumatic brain injury.

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Ponsford, Jennie

2013-01-01

Traumatic brain injury results in some distinctive patterns of cognitive, behavioural and physical impairment which impact significantly on independent living skills and participation in work or study, social and leisure activities and interpersonal relationships. There is, however, still considerable variability in outcome across individuals in each of the reported domains. This has led to a significant body of research examining factors associated with outcome. A range of injury-related, personal and social factors have been shown to influence survival, as well as cognitive, functional and employment outcome. This paper reviews the factors associated with each of these aspects of outcome specifically injury-related factors, including neuroimaging findings, GCS and PTA, other injuries, and cognitive and behavioural impairments; demographic factors, including age, gender, genetic status, education, pre-injury IQ and employment status; and social factors including family and other social support, cultural factors, pre-injury psychiatric history and coping style. The paper identifies contributions and complex interrelationships of all of these factors to outcome following TBI. It concludes with a brief discussion of the implications of these factors for the rehabilitation process.

Simulations of tokamak disruptions including self-consistent temperature evolution

International Nuclear Information System (INIS)

Bondeson, A.

1986-01-01

Three-dimensional simulations of tokamaks have been carried out, including self-consistent temperature evolution with a highly anisotropic thermal conductivity. The simulations extend over the transport time-scale and address the question of how disruptive current profiles arise at low-q or high-density operation. Sharply defined disruptive events are triggered by the m/n=2/1 resistive tearing mode, which is mainly affected by local current gradients near the q=2 surface. If the global current gradient between q=2 and q=1 is sufficiently steep, the m=2 mode starts a shock which accelerates towards the q=1 surface, leaving stochastic fields, a flattened temperature profile and turbulent plasma behind it. For slightly weaker global current gradients, a shock may form, but it will dissipate before reaching q=1 and may lead to repetitive minidisruptions which flatten the temperature profile in a region inside the q=2 surface. (author)

[Combined forecasting system of peritonitis outcome].

Science.gov (United States)

Lebedev, N V; Klimov, A E; Agrba, S B; Gaidukevich, E K

To create a reliable system for assessing of severity and prediction of the outcome of peritonitis. Critical analysis of the systems for peritonitis severity assessment is presented. The study included outcomes of 347 patients who admitted at the Department of Faculty Surgery of Peoples' Friendship University of Russia in 2015-2016. The cause of peritonitis were destructive forms of acute appendicitis, cholecystitis, perforated gastroduodenal ulcer, various perforation of small and large intestines (including tumor). Combined forecasting system for peritonitis severity assessment is created. The system includes clinical, laboratory data, assessment of systemic inflammatory response (SIRS) and severity of organ failure (qSOFA). The authors focused on easily identifiable parameters which are available in virtually any surgical hospital. Threshold value (lethal outcome probability over 50%) is 8 scores in this system. Sensitivity, specificity and accuracy were 93.3, 99.7 and 98.9%, respectively according to ROC-curve that exceeds those parameters of MPI and APACHE II.

The Microbiome and Metabolome of Preterm Infant Stool Are Personalized and Not Driven by Health Outcomes, Including Necrotizing Enterocolitis and Late-Onset Sepsis.

Science.gov (United States)

Wandro, Stephen; Osborne, Stephanie; Enriquez, Claudia; Bixby, Christine; Arrieta, Antonio; Whiteson, Katrine

2018-06-27

The assembly and development of the gut microbiome in infants have important consequences for immediate and long-term health. Preterm infants represent an abnormal case for bacterial colonization because of early exposure to bacteria and frequent use of antibiotics. To better understand the assembly of the gut microbiota in preterm infants, fecal samples were collected from 32 very low birth weight preterm infants over the first 6 weeks of life. Infant health outcomes included health, late-onset sepsis, and necrotizing enterocolitis (NEC). We characterized bacterial compositions by 16S rRNA gene sequencing and metabolomes by untargeted gas chromatography-mass spectrometry. Preterm infant fecal samples lacked beneficial Bifidobacterium spp. and were dominated by Enterobacteriaceae , Enterococcus , and Staphylococcus organisms due to nearly uniform antibiotic administration. Most of the variance between the microbial community compositions could be attributed to the baby from which the sample derived (permutational multivariate analysis of variance [PERMANOVA] R 2 = 0.48, P PERMANOVA R 2 = 0.43, P < 0.001) and weakly associated with bacterial composition (Mantel statistic r = 0.23 ± 0.05, P < 0.05). No measured metabolites were found to be associated with necrotizing enterocolitis, late-onset sepsis, or a healthy outcome. Overall, preterm infant gut microbial communities were personalized and reflected antibiotic usage. IMPORTANCE Preterm infants face health problems likely related to microbial exposures, including sepsis and necrotizing enterocolitis. However, the role of the gut microbiome in preterm infant health is poorly understood. Microbial colonization differs from that of healthy term babies because it occurs in the NICU and is often perturbed by antibiotics. We measured bacterial compositions and metabolomic profiles of 77 fecal samples from 32 preterm infants to investigate the differences between microbiomes in health and disease. Rather than finding

A current value Hamiltonian Approach for Discrete time Optimal Control Problems arising in Economic Growth

OpenAIRE

Naz, Rehana

2018-01-01

Pontrygin-type maximum principle is extended for the present value Hamiltonian systems and current value Hamiltonian systems of nonlinear difference equations for uniform time step $h$. A new method termed as a discrete time current value Hamiltonian method is established for the construction of first integrals for current value Hamiltonian systems of ordinary difference equations arising in Economic growth theory.

The impact of alternate weekly collections on waste arisings

Energy Technology Data Exchange (ETDEWEB)

Williams, I.D., E-mail: idw@soton.ac.uk [Waste Management Research Group, Faculty of Engineering and the Environment, Lanchester Building, University of Southampton, University Rd, Highfield, SOUTHAMPTON, Hampshire, SO17 1BJ (United Kingdom); Cole, C. [Centre for Innovative and Collaborative Construction Engineering, School of Civil and Building Engineering, Loughborough University, Epinal Way, Loughborough, LE11 3TU (United Kingdom)

2013-02-15

Residual waste is commonly collected separately from recyclable and organic materials. Different forms of collection and disposal are used internationally since regional or municipal authorities have to adapt to their own circumstances. Many authorities have adopted an alternate weekly collection (AWC) of residual waste and recyclables to force/encourage householders to recycle; however, the degree to which they achieve waste reduction has yet to be reliably quantified. This study reports on how the introduction of AWCs affects household waste arisings. The paper evaluates single and dual stream collection methods and compares their performance with the previous system. Household waste collection trials were conducted between March and June 2009 in England (Lichfield). The trials examined changes to frequency of collection, type of container issued, amounts of sorting required of residents, household participation and productivity levels. A survey of households was completed before any changes were implemented. The quantity of recyclates collected was examined for 2008/2009 and 2009/2010. The study showed that the AWC scheme positively impacted on recycling rates and household behaviour, with no adverse impacts on public participation, household waste arisings or the local environment. No public health problems were reported. Both trials saw an increase in the quantities of recyclates collected per household during the trial period compared to the same period of time in the previous year. The dual stream performed better than the single stream, collecting an average of 5.94 kg/hh/week compared to an average of 5.63 kg/hh/week. The single stream system showed a greater increase in the weight of material collected (0.53 kg/hh/week vs. 0.48 kg/hh/week). Participation and set-out rates showed an increase during the trial period. The single stream option (comingled materials in one container) outperformed the dual stream service. The reduction in costs and improved

The impact of alternate weekly collections on waste arisings

International Nuclear Information System (INIS)

Williams, I.D.; Cole, C.

2013-01-01

Residual waste is commonly collected separately from recyclable and organic materials. Different forms of collection and disposal are used internationally since regional or municipal authorities have to adapt to their own circumstances. Many authorities have adopted an alternate weekly collection (AWC) of residual waste and recyclables to force/encourage householders to recycle; however, the degree to which they achieve waste reduction has yet to be reliably quantified. This study reports on how the introduction of AWCs affects household waste arisings. The paper evaluates single and dual stream collection methods and compares their performance with the previous system. Household waste collection trials were conducted between March and June 2009 in England (Lichfield). The trials examined changes to frequency of collection, type of container issued, amounts of sorting required of residents, household participation and productivity levels. A survey of households was completed before any changes were implemented. The quantity of recyclates collected was examined for 2008/2009 and 2009/2010. The study showed that the AWC scheme positively impacted on recycling rates and household behaviour, with no adverse impacts on public participation, household waste arisings or the local environment. No public health problems were reported. Both trials saw an increase in the quantities of recyclates collected per household during the trial period compared to the same period of time in the previous year. The dual stream performed better than the single stream, collecting an average of 5.94 kg/hh/week compared to an average of 5.63 kg/hh/week. The single stream system showed a greater increase in the weight of material collected (0.53 kg/hh/week vs. 0.48 kg/hh/week). Participation and set-out rates showed an increase during the trial period. The single stream option (comingled materials in one container) outperformed the dual stream service. The reduction in costs and improved

Myxofibrosarcoma: First report of myxofibrosarcoma of bone arising at a bone infarct.

Science.gov (United States)

Kayser, Dietrich; Walton, Zeke; Bruner, Evelyn; Chapin, Russell W

2017-08-01

Approximately 3300 new primary bone tumors will present to American physicians this year. This small but important group of malignancies has become more defined with developments in pathologic morphology, immunohistochemistry, and molecular studies. As tumor types are better partitioned, their specific characteristics are more readily observed. In this article we present the first reported case of a myxofibrosarcoma of bone developing within a bone infarct. With improved delineation of rarer tumor types, it is expected that additional cases of myxofibrosarcoma of bone will be recognized, potentially arising from a bone infarct. By framing the context, describing the case, and sharing pertinent figures, we hope to facilitate this recognition.

A comparative study of iterative solutions to linear systems arising in quantum mechanics

International Nuclear Information System (INIS)

Jing Yanfei; Huang Tingzhu; Duan Yong; Carpentieri, Bruno

2010-01-01

This study is mainly focused on iterative solutions with simple diagonal preconditioning to two complex-valued nonsymmetric systems of linear equations arising from a computational chemistry model problem proposed by Sherry Li of NERSC. Numerical experiments show the feasibility of iterative methods to some extent when applied to the problems and reveal the competitiveness of our recently proposed Lanczos biconjugate A-orthonormalization methods to other classic and popular iterative methods. By the way, experiment results also indicate that application specific preconditioners may be mandatory and required for accelerating convergence.

International and Interdisciplinary Identification of Health Care Transition Outcomes.

Science.gov (United States)

Fair, Cynthia; Cuttance, Jessica; Sharma, Niraj; Maslow, Gary; Wiener, Lori; Betz, Cecily; Porter, Jerlym; McLaughlin, Suzanne; Gilleland-Marchak, Jordan; Renwick, Amy; Naranjo, Diana; Jan, Sophia; Javalkar, Karina; Ferris, Maria

2016-03-01

There is a lack of agreement on what constitutes successful outcomes for the process of health care transition (HCT) among adolescent and young adults with special health care needs. To present HCT outcomes identified by a Delphi process with an interdisciplinary group of participants. A Delphi method involving 3 stages was deployed to refine a list of HCT outcomes. This 18-month study (from January 5, 2013, of stage 1 to July 3, 2014, of stage 3) included an initial literature search, expert interviews, and then 2 waves of a web-based survey. On this survey, 93 participants from outpatient, community-based, and primary care clinics rated the importance of the top HCT outcomes identified by the Delphi process. Analyses were performed from July 5, 2014, to December 5, 2014. Health care transition outcomes of adolescents and young adults with special health care needs. Importance ratings of identified HCT outcomes rated on a Likert scale from 1 (not important) to 9 (very important). The 2 waves of surveys included 117 and 93 participants as the list of outcomes was refined. Transition outcomes were refined by the 3 waves of the Delphi process, with quality of life being the highest-rated outcome with broad agreement. The 10 final outcomes identified included individual outcomes (quality of life, understanding the characteristics of conditions and complications, knowledge of medication, self-management, adherence to medication, and understanding health insurance), health services outcomes (attending medical appointments, having a medical home, and avoidance of unnecessary hospitalization), and a social outcome (having a social network). Participants indicated that different outcomes were likely needed for individuals with cognitive disabilities. Quality of life is an important construct relevant to HCT. Future research should identify valid measures associated with each outcome and further explore the role that quality of life plays in the HCT process. Achieving

Patient-reported outcomes in borderline personality disorder

Science.gov (United States)

Hasler, Gregor; Hopwood, Christopher J.; Jacob, Gitta A.; Brändle, Laura S.; Schulte-Vels, Thomas

2014-01-01

Patient-reported outcome (PRO) refers to measures that emphasize the subjective view of patients about their health-related conditions and behaviors. Typically, PROs include self-report questionnaires and clinical interviews. Defining PROs for borderline personality disorder (BPD) is particularly challenging given the disorder's high symptomatic heterogeneity, high comorbidity with other psychiatric conditions, highly fluctuating symptoms, weak correlations between symptoms and functional outcomes, and lack of valid and reliable experimental measures to complement self-report data. Here, we provide an overview of currently used BPD outcome measures and discuss them from clinical, psychometric, experimental, and patient perspectives. In addition, we review the most promising leads to improve BPD PROs, including the DSM-5 Section III, the Recovery Approach, Ecological Momentary Assessments, and novel experimental measures of social functioning that are associated with functional and social outcomes. PMID:25152662

Outcome of Minnesota's gambling treatment programs.

Science.gov (United States)

Stinchfield, R; Winters, K C

2001-01-01

This study measured the outcome of four state-supported outpatient gambling treatment programs in Minnesota. The programs were developed specifically for the treatment of pathological gamblers and offered multiple modalities of treatment including individual, group, education, twelve-step work, family groups, and financial counseling. The therapeutic orientation was eclectic with an emphasis on the twelve steps of Gamblers Anonymous (GA) and a treatment goal of abstinence. The sample included 348 men and 220 women treated between January 1992 and January 1995. A pretest-posttest design was utilized with multidimensional assessments obtained at intake, discharge, six-months, and twelve-months post-discharge. Variables assessed included a range of clinical and outcome variables. At six month follow-up, 28% reported that they had abstained from gambling during the six months following discharge and an additional 20% had gambled less than once per month. Almost half of the sample (48%) showed clinically significant improvement in gambling frequency at six month follow-up. Outcome variables of gambling frequency, SOGS scores, amount of money gambled, number of friends who gamble, psychosocial problems, and number of financial problems, all showed statistically significant improvements from pretreatment to follow-up. The treatment programs yielded outcome results similar to those reported for alcohol and drug abuse treatment programs.

Outcome of tunneled infusion catheters inserted via the right internal jugular vein

International Nuclear Information System (INIS)

Shin, Sung Wook; Do, Young Soo; Choo, Sung Wook; Yoo, Wi Kang; Choo, In Wook; Kim, Jae Hyung

2003-01-01

To assess the outcome of tunneled central venous catheter placement via the right internal jugular vein. Between June 2001 and May 2002, 670 consecutive Hickman catheters were placed in 654 patients via the right internal jugular vein. The procedural complications arising and follow-up data obtained from May to July 2002 were evaluated. The technical success rate for catheter placement was 99.9% (669/670). Procedural complications were limited to eight cases (1.2%), including three pneumothoraces, one early migration of the catheter, one clinically unimportant air embolism, one catheter injury, one catheter kinking and one primary malpositioning in the azygos vein. Catheter dwelling time ranged from 1 to 407 (mean 107.1) days. During the follow-up period, 416 catheter were removed for various reasons: treatment had ended (n=334), patients declined treatment or their drug regimen was changed (n=16), late complications arose (n=53), or other circumstances intervened (n=13). Late complications included 44 cases of catheter-related infection (6.6%), five of catheter migration (0.7%), two of catheter occlusion (0.3%), one of thrombophlebitis (0.15%), and one of catheter-related right atrial thrombosis (0.15%). Only one instance of symptomatic venous thrombosis or stenosis was noted, namely the one case of thrombophlebitis. Because the incidence of subsequent symptomatic venous thrombosis or stenosis is lower, the preferred route for tunneled central venous catheter placement is the right internal jugular vein

Potential for recycling of slightly radioactive metals arising from decommissioning within nuclear sector in Slovakia.

Science.gov (United States)

Hrncir, Tomas; Strazovec, Roman; Zachar, Matej

2017-09-07

The decommissioning of nuclear installations represents a complex process resulting in the generation of large amounts of waste materials containing various concentrations of radionuclides. Selection of an appropriate strategy of management of the mentioned materials strongly influences the effectiveness of decommissioning process keeping in mind safety, financial and other relevant aspects. In line with international incentives for optimization of radioactive material management, concepts of recycling and reuse of materials are widely discussed and applications of these concepts are analysed. Recycling of some portion of these materials within nuclear sector (e.g. scrap metals or concrete rubble) seems to be highly desirable from economical point of view and may lead to conserve some disposal capacity. However, detailed safety assessment along with cost/benefit calculations and feasibility study should be developed in order to prove the safety, practicality and cost effectiveness of possible recycling scenarios. Paper discussed the potential for recycling of slightly radioactive metals arising from decommissioning of NPPs within nuclear sector in Slovakia. Various available recycling scenarios are introduced and method for overall assessment of various recycling scenarios is outlined including the preliminary assessment of safety and financial aspects. Copyright © 2017 Elsevier Ltd. All rights reserved.

On the relationship of steady states of continuous and discrete models arising from biology.

Science.gov (United States)

Veliz-Cuba, Alan; Arthur, Joseph; Hochstetler, Laura; Klomps, Victoria; Korpi, Erikka

2012-12-01

For many biological systems that have been modeled using continuous and discrete models, it has been shown that such models have similar dynamical properties. In this paper, we prove that this happens in more general cases. We show that under some conditions there is a bijection between the steady states of continuous and discrete models arising from biological systems. Our results also provide a novel method to analyze certain classes of nonlinear models using discrete mathematics.

Accounting for interactions and complex inter-subject dependency in estimating treatment effect in cluster-randomized trials with missing outcomes.

Science.gov (United States)

Prague, Melanie; Wang, Rui; Stephens, Alisa; Tchetgen Tchetgen, Eric; DeGruttola, Victor

2016-12-01

Semi-parametric methods are often used for the estimation of intervention effects on correlated outcomes in cluster-randomized trials (CRTs). When outcomes are missing at random (MAR), Inverse Probability Weighted (IPW) methods incorporating baseline covariates can be used to deal with informative missingness. Also, augmented generalized estimating equations (AUG) correct for imbalance in baseline covariates but need to be extended for MAR outcomes. However, in the presence of interactions between treatment and baseline covariates, neither method alone produces consistent estimates for the marginal treatment effect if the model for interaction is not correctly specified. We propose an AUG-IPW estimator that weights by the inverse of the probability of being a complete case and allows different outcome models in each intervention arm. This estimator is doubly robust (DR); it gives correct estimates whether the missing data process or the outcome model is correctly specified. We consider the problem of covariate interference which arises when the outcome of an individual may depend on covariates of other individuals. When interfering covariates are not modeled, the DR property prevents bias as long as covariate interference is not present simultaneously for the outcome and the missingness. An R package is developed implementing the proposed method. An extensive simulation study and an application to a CRT of HIV risk reduction-intervention in South Africa illustrate the method. © 2016, The International Biometric Society.

Incidental Finding of a Neuroendocrine Tumor Arising from Meckel Diverticulum During Hernia Repair - A Case Report and Literature Review.

Science.gov (United States)

Bacalbasa, Nicolae; Costin, Radu; Orban, Carmen; Iliescu, Laura; Hurjui, Ioan; Hurjui, Marcela; Niculescu, Nicoleta; Cristea, Mirela; Balescu, Irina

2016-04-01

Meckel diverticulum is the most common abnormality of the gastrointestinal tract arising from an incomplete obliteration of the vitelline duct during the intrauterine life. Although tumor development in Meckel diverticulum is not a common situation, it can occur due to the persistence of cellular islets with gastric, pancreatic or intestinal origin. The presence of a neuroendocrine tumor arising from Meckel diverticulum is even scarcer. We present the case of a 59-year-old patient in whom a Meckel diverticulum was found during surgery for inguinal hernia; the histopathological and immunohistochemical studies revealed the presence of a well-differentiated neuroendocrine tumor with low mitotic index. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report.

Science.gov (United States)

Sharatz, Steven M; Treviño, Taína A; Rodriguez, Luís; West, Jared H

2008-01-18

Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

Using the International Classification of Functioning, Disability, and Health to identify outcome domains for a core outcome set for aphasia: a comparison of stakeholder perspectives.

Science.gov (United States)

Wallace, Sarah J; Worrall, Linda; Rose, Tanya; Le Dorze, Guylaine

2017-11-12

This study synthesised the findings of three separate consensus processes exploring the perspectives of key stakeholder groups about important aphasia treatment outcomes. This process was conducted to generate recommendations for outcome domains to be included in a core outcome set for aphasia treatment trials. International Classification of Functioning, Disability, and Health codes were examined to identify where the groups of: (1) people with aphasia, (2) family members, (3) aphasia researchers, and (4) aphasia clinicians/managers, demonstrated congruence in their perspectives regarding important treatment outcomes. Codes were contextualized using qualitative data. Congruence across three or more stakeholder groups was evident for ICF chapters: Mental functions; Communication; and Services, systems, and policies. Quality of life was explicitly identified by clinicians/managers and researchers, while people with aphasia and their families identified outcomes known to be determinants of quality of life. Core aphasia outcomes include: language, emotional wellbeing, communication, patient-reported satisfaction with treatment and impact of treatment, and quality of life. International Classification of Functioning, Disability, and Health coding can be used to compare stakeholder perspectives and identify domains for core outcome sets. Pairing coding with qualitative data may ensure important nuances of meaning are retained. Implications for rehabilitation The outcomes measured in treatment research should be relevant to stakeholders and support health care decision making. Core outcome sets (agreed, minimum set of outcomes, and outcome measures) are increasingly being used to ensure the relevancy and consistency of the outcomes measured in treatment studies. Important aphasia treatment outcomes span all components of the International Classification of Functioning, Disability, and Health. Stakeholders demonstrated congruence in the identification of important

Epidermoid Cyst Arising in the Buccal Mucosa: Case Report and Literature

Directory of Open Access Journals (Sweden)

Fábio Wildson Gurgel Costa

2014-01-01

Full Text Available Epidermoid cysts are benign subcutaneous lesions, and the large majority of these cysts affect the floor of the mouth; however, the buccal mucosa is not the usual site of occurrence. To date, only 5 articles have been published with 6 cases of epidermoid cysts arising in the buccal mucosa. Therefore, the aim of this study was to describe the clinical, histopathological and immunohistochemical features of a case of an epidermoid cyst located in the buccal mucosa. To our knowledge, this is the first report of an oral epidermoid cyst describing an intense foreign body gigantocellular inflammatory reaction against epithelial keratin component. Although the usual diagnosis for epidermoid cysts is based on histopathological findings, this case report addresses novel information regarding the immunohistochemical pattern which may be found in these lesions.

Exposures to asbestos arising from bandsawing gasket material.

Science.gov (United States)

Fowler, D P

2000-05-01

A simulation of bandsawing sheet asbestos gasket material was performed as part of a retrospective exposure evaluation undertaken to assist in determining causation of a case of mesothelioma. The work was performed by bandsawing a chrysotile asbestos (80%)/neoprene gasket sheet with a conventional 16-inch woodworking bandsaw inside a chamber. Measurements of airborne asbestos were made using conventional area and personal sampling methods, with analysis of collected samples by transmission electron microscopy (TEM) and phase contrast microscopy (PCM). These were supplemented by qualitative scanning electron microscopy (SEM) examinations of some of the airborne particles collected on the filters. In contrast with findings from studies examining manual handling (installation and removal) of gaskets, airborne asbestos concentrations from this operation were found to be well above current Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) (eight-hour time-weighted average [TWA]) and excursion limit (30-minute) standards. Although some "encapsulation" effect of the neoprene matrix was seen on the particles in the airborne dust, unencapsulated individual fiber bundles were also seen. Suggestions for the implications of the work are given. In summary, the airborne asbestos concentrations arising from this work were quite high, and point to the need for careful observation of common sense precautions when manipulation of asbestos-containing materials (even those believed to have limited emissions potential) may involved machining operations.

Novel ethical dilemmas arising in geriatric clinical practice.

Science.gov (United States)

Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M

2015-05-01

The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population.

Irregular activity arises as a natural consequence of synaptic inhibition

International Nuclear Information System (INIS)

Terman, D.; Rubin, J. E.; Diekman, C. O.

2013-01-01

Irregular neuronal activity is observed in a variety of brain regions and states. This work illustrates a novel mechanism by which irregular activity naturally emerges in two-cell neuronal networks featuring coupling by synaptic inhibition. We introduce a one-dimensional map that captures the irregular activity occurring in our simulations of conductance-based differential equations and mathematically analyze the instability of fixed points corresponding to synchronous and antiphase spiking for this map. We find that the irregular solutions that arise exhibit expansion, contraction, and folding in phase space, as expected in chaotic dynamics. Our analysis shows that these features are produced from the interplay of synaptic inhibition with sodium, potassium, and leak currents in a conductance-based framework and provides precise conditions on parameters that ensure that irregular activity will occur. In particular, the temporal details of spiking dynamics must be present for a model to exhibit this irregularity mechanism and must be considered analytically to capture these effects

Irregular activity arises as a natural consequence of synaptic inhibition

Energy Technology Data Exchange (ETDEWEB)

Terman, D., E-mail: terman@math.ohio-state.edu [Department of Mathematics, The Ohio State University, Columbus, Ohio 43210 (United States); Rubin, J. E., E-mail: jonrubin@pitt.edu [Department of Mathematics, University of Pittsburgh, Pittsburgh, Pennsylvania 15260 (United States); Diekman, C. O., E-mail: diekman@njit.edu [Department of Mathematical Sciences, New Jersey Institute of Technology, Newark, New Jersey 07102 (United States)

2013-12-15

Irregular neuronal activity is observed in a variety of brain regions and states. This work illustrates a novel mechanism by which irregular activity naturally emerges in two-cell neuronal networks featuring coupling by synaptic inhibition. We introduce a one-dimensional map that captures the irregular activity occurring in our simulations of conductance-based differential equations and mathematically analyze the instability of fixed points corresponding to synchronous and antiphase spiking for this map. We find that the irregular solutions that arise exhibit expansion, contraction, and folding in phase space, as expected in chaotic dynamics. Our analysis shows that these features are produced from the interplay of synaptic inhibition with sodium, potassium, and leak currents in a conductance-based framework and provides precise conditions on parameters that ensure that irregular activity will occur. In particular, the temporal details of spiking dynamics must be present for a model to exhibit this irregularity mechanism and must be considered analytically to capture these effects.

Small cell carcinoma arising in Barrett's esophagus: a case report and review of the literature

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Markogiannakis Haridimos

2008-01-01

Full Text Available Abstract Introduction Gastrointestinal tract small cell carcinoma is an infrequent and aggressive neoplasm that represents 0.1–1% of gastrointestinal malignancies. Very few cases of small cell esophageal carcinoma arising in Barrett's esophagus have been reported in the literature. An extremely rare case of primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus is herein presented. Case presentation A 62-year-old man with gastroesophageal reflux history presented with epigastric pain, epigastric fullness, dysphagia, anorexia, and weight loss. Esophagogastroscopy revealed an ulceroproliferative, intraluminar mass in the distal esophagus obstructing the esophageal lumen. Biopsy showed small cell esophageal carcinoma. Contrast-enhanced chest and abdominal computed tomography demonstrated a large tumor of the distal third of the esophagus without any lymphadenopathy or distant metastasis. Preoperative chemotherapy with cisplatine and etoposide for 3 months resulted in a significant reduction of the tumor. After en block esophagectomy with two field lymph node dissection, proximal gastrectomy, and cervical esophagogastric anastomosis, the patient was discharged on the 14th postoperative day. Histopathology revealed a primary small cell carcinoma of the distal third of the esophagus arising from dysplastic Barrett's esophagus. The patient received another 3 month course of postoperative chemotherapy with the same agents and remained free of disease at 12 month review. Conclusion Although small cell esophageal carcinoma is rare and its association with dysplastic Barrett's esophagus is extremely infrequent, the high carcinogenic risk of Barrett's epithelium should be kept in mind. Prognosis is quite unfavorable; a better prognosis might be possible with early diagnosis and treatment strategies incorporating chemotherapy along with oncological radical surgery and/or radiotherapy as part of a

Radiological diagnosis of pulmonary sequestration: review of six cases, including one bilateral

International Nuclear Information System (INIS)

Brito Pacheco, E.M. de; Cazerta, N.M.G.; Marins, J.L.C.; Prando, A.

1989-01-01

Radiological diagnosis of pulmonary sequestration: review of six cases, including one bilateral. Pulmonary sequestration is an uncommon disorder consisting of aberrant pulmonary tissue that has no normal connection with the bronchial tree or with the pulmonary arteries, but is supplied by a systemic artery which usually arises from the aorta. Six cases of pulmonary sequestration are presented and the radiological manifestation of this rare congenital disorder are discussed. These sequestrations were intralobar/unilateral in four patients, extralobar/unilateral in one and extralobar/bilateral in the other patient. Special attention is given to the extremely uncommon bilateral sequestration. To our knowledge only four cases of this form of disease has been described in the literature. (author) [pt

Bilateral ovarian angiosarcoma arising from the mature cystic teratomas – A case report and review of the literature

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Erik Kudela

2018-01-01

Conclusion: This work summarizes the current knowledge in the diagnosis and treatment of angiosarcomas arising in the mature teratomas. Promising results are expected from the trials devoted to antiangiogenic strategies in treatment of aggressive sarcomas.

IgG4-positive extranodal marginal zone lymphoma arising in Hashimoto's thyroiditis: clinicopathological and cytogenetic features of a hitherto undescribed condition.

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Tan, Char-Loo; Ong, Yew-Kwang; Tan, Soo-Yong; Ng, Siok-Bian

2016-05-01

Hashimoto's thyroiditis was recently divided into IgG4-plasma cell-rich and IgG4-plasma cell-poor subtypes. The former, also known as IgG4 thyroiditis, is associated with clinical, serological, sonographic and morphological features that are distinctive from those of the non-IgG4 subgroup. We describe an interesting case of IgG4-positive mucosa-associated lymphoid tissue (MALT) lymphoma arising in a background of IgG4 thyroiditis. The thyroid gland showed typical features of IgG4 thyroiditis, including characteristic patterns of fibrosis. A dense lymphoplasmacytic infiltrate diffusely involved the entire gland without formation of a destructive tumour mass. Lymphoepithelial lesions were prominent. There were abundant IgG4-positive plasma cells, with the IgG4/IgG ratio exceeding 40%. The IgG4-positive plasma cells were monotypic for kappa light chain, and there was monoclonal IGH rearrangement. Fluorescence in-situ hybridization revealed IGH translocation without translocation of MALT1, bcl-10, or FOXP1. This represents the first case of IgG4-producing MALT lymphoma associated with IgG4 thyroiditis. IGH translocation with an unknown partner gene was identified. We suggest the performance of serum and immunohistochemical investigations for IgG and IgG4 in all cases of Hashimoto's thyroiditis to diagnose IgG4 thyroiditis. In addition, clonality assays and light chain studies are useful to exclude a low-grade lymphoma arising in this context. © 2015 John Wiley & Sons Ltd.

Angiosarcoma Arising in Chronic Expanding Hematoma: Five Cases of an Underrecognized Association.

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Burgert-Lon, Christine E; Riddle, Nicole D; Lackman, Richard D; Evenski, Andrea J; Brooks, John S J

2015-11-01

Little is known about the etiology or pathogenesis of angiosarcoma (AS). We describe a series of 5 cases of AS arising in chronic expanding hematomas. Inclusion criteria were the presence of a hematoma of at least 1-year duration and a thick fibrous wall surrounding the hematoma. Patients were 4 men and 1 woman; ages ranged from 43 to 71 years. Locations were the thigh (3), chest wall (1), and pelvic soft tissue involving the ischial bone (1). Hematoma duration ranged from 2 to 25 years. All cases had large cystic hematomas >10 cm; 2 had prior radiation. Thick fibrous walls surrounded the hematomas, with foci of hemosiderin and foamy histiocytes. Wall thickness ranged from 0.2 to 1.0 cm and varied within lesions. All AS were epithelioid, and in 3 cases the tumor invaded through the cyst wall. Immunoreactive nuclear c-myc was noted in 3/3 cases available for testing. Follow-up disclosed 4 patients developed metastatic disease, 3 of whom died of disease, 4, 8, and 15 months after diagnosis; the fourth patient is alive without disease after chemotherapy at 59 months. One patient without metastases is alive without disease 18 months after diagnosis; this tumor was confined to the cyst without penetration through the wall. We identified 4 similar cases in the literature, 3 as individual case reports (all epithelioid AS), and 1 as part of a series of AS. To our knowledge, this is the first series of AS arising in chronic expanding hematomas. Recognition of this unusual complication should alert clinicians to provide periodic clinical follow-up to these patients and to biopsy any case with sudden or uncontrolled enlargement. We recommend that excised chronic hematomas be well sampled histologically to search for AS and, if identified, to determine its extent and invasiveness.

Sound radiation quantities arising from a resilient circular radiator.

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Aarts, Ronald M; Janssen, Augustus J E M

2009-10-01

Power series expansions in ka are derived for the pressure at the edge of a radiator, the reaction force on the radiator, and the total radiated power arising from a harmonically excited, resilient, flat, circular radiator of radius a in an infinite baffle. The velocity profiles on the radiator are either Stenzel functions (1-(sigma/a)2)n, with sigma the radial coordinate on the radiator, or linear combinations of Zernike functions Pn(2(sigma/a)2-1), with Pn the Legendre polynomial of degree n. Both sets of functions give rise, via King's integral for the pressure, to integrals for the quantities of interest involving the product of two Bessel functions. These integrals have a power series expansion and allow an expression in terms of Bessel functions of the first kind and Struve functions. Consequently, many of the results in [M. Greenspan, J. Acoust. Soc. Am. 65, 608-621 (1979)] are generalized and treated in a unified manner. A foreseen application is for loudspeakers. The relation between the radiated power in the near-field on one hand and in the far field on the other is highlighted.

Evaluating stakeholder participation in water management: intermediary outcomes as potential indicators for future resource management outcomes

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Carr, Gemma; Bloeschl, Guenter; Loucks, Daniel Pete

2013-04-01

Evaluation of participation programmes, projects and activities is essential to identify whether stakeholder involvement has been successful in achieving its aims. Aims may include an improvement in water resource management such as enhanced ecological functioning, an improvement in human wellbeing and economic conditions, or overcoming a conflict between interest groups. Evaluating against "interest-based" resource management criteria requires that a desirable outcome can be identified, agreed upon and be measured at the time of evaluation. In many water management situations where collaborative approaches are applied, multiple interests and objectives are present, or stakeholders have not yet identified their own positions and priorities. Even if a resource management objective has been identified and strategy agreed upon, resource management changes tend to emerge over longer timescales and evaluation frequently takes place before they can be recognised. Evaluating against resource management criteria may lead evaluators to conclude that a programme has failed because it has not achieved a resource management objective at the time of evaluation. This presents a critical challenge to researchers assessing the effectiveness of stakeholder participation programmes. One strategy to overcome this is to conduct "goal-free" evaluation to identify what the programme is actually achieving. An evaluation framework that includes intermediary outcomes that are both tangible achievements such as innovation, creation of new organisations, and shared information and knowledge, as well as intangible achievements such as trust and network development can be applied to more broadly assess a programme's success. Analysis of case-studies in the published literature for which a resource management outcome has been achieved shows that intermediary outcomes frequently precede resource management outcomes. They seem to emerge over shorter timescales than resource management outcomes

Analytical approach to linear fractional partial differential equations arising in fluid mechanics

International Nuclear Information System (INIS)

Momani, Shaher; Odibat, Zaid

2006-01-01

In this Letter, we implement relatively new analytical techniques, the variational iteration method and the Adomian decomposition method, for solving linear fractional partial differential equations arising in fluid mechanics. The fractional derivatives are described in the Caputo sense. The two methods in applied mathematics can be used as alternative methods for obtaining analytic and approximate solutions for different types of fractional differential equations. In these methods, the solution takes the form of a convergent series with easily computable components. The corresponding solutions of the integer order equations are found to follow as special cases of those of fractional order equations. Some numerical examples are presented to illustrate the efficiency and reliability of the two methods

Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

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Wysham, Nicholas G; Abernethy, Amy P; Cox, Christopher E

2014-10-01

Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU. Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction. A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.

Cementoblastoma Arising in the Maxilla of an 8-Year-Old Boy: A Case Report

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Hiroyuki Harada

2011-01-01

Full Text Available Cementoblastoma is an uncommon disease, representing only 1–8% of all odontogenic tumours. Furthermore, this tumour is especially uncommon in children, as only five cases have been reported in this age group. Here, we describe a case of cementoblastoma arising in the maxilla of an 8-year-old boy, that was treated with a partial maxillectomy. The patient's facial appearance has remained satisfactory, and the tumour has not recurred in the 9 years after the operation.

Missed Total Occlusion Due to the Occipital Artery Arising from the Internal Carotid Artery

International Nuclear Information System (INIS)

Ustunsoz, Bahri; Gumus, Burcak; Koksal, Ali; Koroglu, Mert; Akhan, Okan

2007-01-01

A 56-year-old man was referred for digital subtraction angiography (DSA) with an ultrasound diagnosis of right proximal internal carotid artery (ICA) stenosis for possible carotid artery stenting. DSA revealed total occlusion of the ICA and an occipital artery arising from the stump and simulating continuation of the ICA. An ascending pharyngeal artery also arose from the same occipital artery. This case is of interest because this is a rare variation besides being a cause of misdiagnosis at carotid ultrasound

Sigmoid colon cancer arising in a diverticulum of the colon with involvement of the urinary bladder: a case report and review of the literature.

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Yagi, Yasumichi; Shoji, Yasuhiro; Sasaki, Shozo; Yoshikawa, Akemi; Tsukioka, Yuji; Fukushima, Wataru; Hirosawa, Hisashi; Izumi, Ryohei; Saito, Katsuhiko

2014-05-13

Colon cancer can arise from the mucosa in a colonic diverticulum. Although colon diverticulum is a common disease, few cases have been previously reported on colon cancer associated with a diverticulum. We report a rare case of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder, which presented characteristic radiographic images. A 73-year-old man was admitted to our hospital for macroscopic hematuria. Computed tomography and magnetic resonance imaging revealed a sigmoid colon tumor that protruded into the urinary bladder lumen. The radiographs showed a tumor with a characteristic dumbbell-shaped appearance. Colonoscopy showed a type 1 cancer and multiple diverticula in the sigmoid colon. A diagnosis of sigmoid colon cancer with involvement of the urinary bladder was made based on the pathological findings of the biopsied specimens. We performed sigmoidectomy and total resection of the urinary bladder with colostomy and urinary tract diversion. Histopathological findings showed the presence of a colovesical fistula due to extramurally growing colon cancer. Around the colon cancer, the normal colon mucosa was depressed sharply with lack of the muscular layer, suggesting that the colon cancer was arising from a colon diverticulum. The present case is the first report of sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder. Due to an accurate preoperative radiological diagnosis, we were able to successfully perform a curative resection for sigmoid colon cancer arising in a diverticulum with involvement of the urinary bladder.

Patient-Reported Outcome and Observer-Reported Outcome Assessment in Rare Disease Clinical Trials: An ISPOR COA Emerging Good Practices Task Force Report.

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Benjamin, Katy; Vernon, Margaret K; Patrick, Donald L; Perfetto, Eleanor; Nestler-Parr, Sandra; Burke, Laurie

Rare diseases (RDs) affect a small number of people within a population. About 5000 to 8000 distinct RDs have been identified, with an estimated 6% to 8% of people worldwide suffering from an RD. Approximately 75% of RDs affect children. Frequently, these conditions are heterogeneous; many are progressive. Regulatory incentives have increased orphan drug designations and approvals. To develop emerging good practices for RD outcomes research addressing the challenges inherent in identifying, selecting, developing, adapting, and implementing patient-reported outcome (PRO) and observer-reported outcome (ObsRO) assessments for use in RD clinical trials. This report outlines the challenges and potential solutions in determining clinical outcomes for RD trials. It follows the US Food and Drug Administration Roadmap to Patient-Focused Outcome Measurement in Clinical Trials. The Roadmap consists of three columns: 1) Understanding the Disease or Condition, 2) Conceptualizing Treatment Benefit, and 3) Selecting/Developing the Outcome Measure. Challenges in column 1 include factors such as incomplete natural history data and heterogeneity of disease presentation and patient experience. Solutions include using several information sources, for example, clinical experts and patient advocacy groups, to construct the condition's natural history and understand treatment patterns. Challenges in column 2 include understanding and measuring treatment benefit from the patient's perspective, especially given challenges in defining the context of use such as variations in age or disease severity/progression. Solutions include focusing on common symptoms across patient subgroups, identifying short-term outcomes, and using multiple types of COA instruments to measure the same constructs. Challenges in column 3 center around the small patient population and heterogeneity of the condition or study sample. Few disease-specific instruments for RDs exist. Strategies include adapting existing

Teleophthalmology: improving patient outcomes?

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Sreelatha OK

2016-02-01

Full Text Available Omana Kesary Sreelatha,1 Sathyamangalam VenkataSubbu Ramesh2 1Ophthalmology Department, Sultan Qaboos University Hospital, Muscat, Oman; 2Department of Optometry, School of Allied Health Sciences, Manipal University, Manipal, India Abstract: Teleophthalmology is gaining importance as an effective eye care delivery modality worldwide. In many developing countries, teleophthalmology is being utilized to provide quality eye care to the underserved urban population and the unserved remote rural population. Over the years, technological innovations have led to improvement in evidence and teleophthalmology has evolved from a research tool to a clinical tool. The majority of the current teleophthalmology services concentrate on patient screening and appropriate referral to experts. Specialty care using teleophthalmology services for the pediatric group includes screening as well as providing timely care for retinopathy of prematurity (ROP. Among geriatric eye diseases, specialty teleophthalmology care is focused toward screening and referral for diabetic retinopathy (DR, glaucoma, age-related macular degeneration (ARMD, and other sight-threatening conditions. Comprehensive vision screening and refractive error services are generally covered as part of most of the teleophthalmology methods. Over the past decades, outcome assessment of health care system includes patients’ assessments on their health, care, and services they receive. Outcomes, by and large, remain the ultimate validators of the effectiveness and quality of medical care. Teleophthalmology produces the same desired clinical outcome as the traditional system. Remote portals allow specialists to provide care over a larger region, thereby improving health outcomes and increasing accessibility of specialty care to a larger population. A high satisfaction level and acceptance is reported in the majority of the studies because of increased accessibility and reduced traveling cost and time

Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

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Isabelle Francisca Petronella Maria Kappen

2017-05-01

Full Text Available BackgroundNo consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP.MethodsThis was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation.ResultsForty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years. Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001. In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry.ConclusionsThe present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence.

Long-Term Follow-Up Study of Young Adults Treated for Unilateral Complete Cleft Lip, Alveolus, and Palate by a Treatment Protocol Including Two-Stage Palatoplasty: Speech Outcomes

Science.gov (United States)

Bittermann, Dirk; Janssen, Laura; Bittermann, Gerhard Koendert Pieter; Boonacker, Chantal; Haverkamp, Sarah; de Wilde, Hester; Van Der Heul, Marise; Specken, Tom FJMC; Koole, Ron; Kon, Moshe; Breugem, Corstiaan Cornelis; Mink van der Molen, Aebele Barber

2017-01-01

Background No consensus exists on the optimal treatment protocol for orofacial clefts or the optimal timing of cleft palate closure. This study investigated factors influencing speech outcomes after two-stage palate repair in adults with a non-syndromal complete unilateral cleft lip and palate (UCLP). Methods This was a retrospective analysis of adult patients with a UCLP who underwent two-stage palate closure and were treated at our tertiary cleft centre. Patients ≥17 years of age were invited for a final speech assessment. Their medical history was obtained from their medical files, and speech outcomes were assessed by a speech pathologist during the follow-up consultation. Results Forty-eight patients were included in the analysis, with a mean age of 21 years (standard deviation, 3.4 years). Their mean age at the time of hard and soft palate closure was 3 years and 8.0 months, respectively. In 40% of the patients, a pharyngoplasty was performed. On a 5-point intelligibility scale, 84.4% received a score of 1 or 2; meaning that their speech was intelligible. We observed a significant correlation between intelligibility scores and the incidence of articulation errors (P<0.001). In total, 36% showed mild to moderate hypernasality during the speech assessment, and 11%–17% of the patients exhibited increased nasalance scores, assessed through nasometry. Conclusions The present study describes long-term speech outcomes after two-stage palatoplasty with hard palate closure at a mean age of 3 years old. We observed moderate long-term intelligibility scores, a relatively high incidence of persistent hypernasality, and a high pharyngoplasty incidence. PMID:28573094

Cross-border issues that arise in conjunction with the execution of U.S.-Canadian natural gas contracts

International Nuclear Information System (INIS)

Martin, J. G.

1999-01-01

Development of the U.S.-Canadian natural gas market as it is today and the issues that may arise in cross-border transactions involving natural gas contracts between the two countries are reviewed. In this context, the paper reviews recent history of U.S.-Canadian trade relations culminating in the development of NAFTA, the U.S. regulatory and legislative framework surrounding cross-border natural gas transactions, and general U.S. foreign trade policy that may come into play at the U.S.- Canada border. The paper also examines certain issues arising in the U.S. commercial context that may be of interest to Canadian corporations, specifically the U.S. Uniform Commercial Code, state jurisdiction on the U.S. side of the border, state and federal tax concerns, and the mechanics and potential benefits for a Canadian parent company in forming a U.S.-based subsidiary to handle U.S.-Canada natural gas transactions. 71 refs

Micro-oxygenation of red wine: techniques, applications, and outcomes.

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Schmidtke, Leigh M; Clark, Andrew C; Scollary, Geoff R

2011-02-01

Wine micro-oxygenation (MOX) is the controlled addition of oxygen to wine in a manner designed to ensure that complete mass transfer of molecular oxygen from gaseous to dissolved state occurs. MOX was initially developed to improve the body, structure, and fruitfulness in red wines with high concentrations of tannins and anthocyanins, by replicating the ingress of oxygen thought to arise from barrel maturation, but without the need for putting all wine to barrel. This review describes the operational parameters essential for the effective performance of the micro-oxidation process as well as the chemical and microbiological outcomes. The methodologies for introducing oxygen into the wine, the rates of oxygen addition, and their relationship to oxygen solubility in the wine matrix are examined. The review focuses on the techniques used for monitoring the MOX process, including sensory assessment, physicochemical properties, and the critical balance of the rate of oxygen addition in relation to maintaining the sulfur dioxide concentration. The chemistry of oxygen reactivity with wine components, the changes in wine composition that occur as a consequence of MOX, and the potential for wine spoilage if proper monitoring is not adopted are examined. Gaps in existing knowledge are addressed focusing on the limitations associated with the transfer of concepts from research trials in small volume tanks to commercial practice, and the dearth of kinetic data for the various chemical and physical processes that are claimed to occur during MOX.

Unfavourable outcomes in orthognathic surgery

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Bonanthaya, Krishnamurthy; Anantanarayanan, P.

2013-01-01

Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician does not like. This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may be classified as belonging to one of the following periods A) Pre- Treatment B) During treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in both aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not. Also, inputs in diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable. In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts. During Treatment: Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself. Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution. PMID:24501454

Unfavourable outcomes in orthognathic surgery

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Krishnamurthy Bonanthaya

2013-01-01

Full Text Available Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician does not like. This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may be classified as belonging to one of the following periods A Pre- Treatment B During treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in both aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not. Also, inputs in diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable. In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts. During Treatment: Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself. Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution.

Unfavourable outcomes in orthognathic surgery.

Science.gov (United States)

Bonanthaya, Krishnamurthy; Anantanarayanan, P

2013-05-01

Unfavourable outcomes are part and parcel of performing surgeries of any kind. Unfavourable outcomes are results of such work, which the patient and or the clinician does not like. This is an attempt to review various causes for unfavorable outcomes in orthognathic surgery and discuss them in detail. All causes for unfavorable outcomes may be classified as belonging to one of the following periods A) Pre- Treatment B) During treatment Pre-Treatment: In orthognathic surgery- as in any other discipline of surgery- which involves changes in both aesthetics and function, the patient motivation for seeking treatment is a very important input which may decide, whether the outcome is going to be favorable or not. Also, inputs in diagnosis and plan for treatment and its sequencing, involving the team of the surgeon and the orthodontist, will play a very important role in determining whether the outcome will be favorable. In other words, an unfavorable outcome may be predetermined even before the actual treatment process starts. During Treatment: Good treatment planning itself does not guarantee favorable results. The execution of the correct plan could go wrong at various stages which include, Pre-Surgical orthodontics, Intra and Post-Operative periods. A large number of these unfavorable outcomes are preventable, if attention is paid to detail while carrying out the treatment plan itself. Unfavorable outcomes in orthognathic surgery may be minimized If pitfalls are avoided both, at the time of treatment planning and execution.

Treatment outcome and prognostic factor analysis in transplant-eligible Chinese myeloma patients receiving bortezomib-based induction regimens including the staged approach, PAD or VTD

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Chim Chor

2012-06-01

Full Text Available Abstract Background We have reported promising outcomes using a staged approach, in which bortezomib/thalidomide/dexamethasone was used only in 14 patients with suboptimal response to VAD (vincristine/adriamycin/dexamethasone before autologous stem cell transplantation (ASCT. Here we compared the outcomes of the staged approach with frontline PAD (bortezomib/doxorubicin/dexamethasone or VTD (bortezomib/thalidomide/dexamethasone induction, and analysed prognostic factors for outcome. Patients and methods Ninety-one transplant-eligible Chinese patients received three induction regimens prior to ASCT [staged approach (N = 25, PAD (N = 31, VTD (N = 35]. and received thalidomide maintenance for 2 years post-ASCT. Results 43 (47.3% patients had International Staging System (ISS III disease. By an intention-to-treat analysis, the overall CR/nCR rate were 37.4% post-induction, and 62.6% post-ASCT. Five-year overall (OS and event-free (EFS survivals were 66% and 45.1%. There was no difference of the post-induction CR/nCR rate, EFS or OS between patients induced by these three regimens. Moreover, ISS III disease did not affect CR/nCR rates. Multivariate analysis showed that ISS and post-ASCT CR/nCR impacted OS while ISS and post-induction CR/nCR impacted EFS. Conclusions These three induction regimens produced comparable and favorable outcomes in myeloma. The unfavorable outcome of ISS stage III persisted despite upfront/early use of bortezomib. CR/nCR predicted favorable survivals.

Giant serous cystadenoma arising from an accessory ovary in a morbidly obese 11-year-old girl: a case report

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Sharatz Steven M

2008-01-01

Full Text Available Abstract Introduction Ectopic ovarian tissue is an unusual entity, especially if it is an isolated finding thought to be of embryological origin. Case presentation An 11-year-old, morbidly obese female presented with left flank pain, nausea, and irregular menses. Various diagnostic procedures suggested a large ovarian cyst, and surgical resection was performed. Conclusion Histologically, the resected mass was not of tubal origin as suspected, but a serous cystadenoma arising from ovarian tissue. The patient's two normal, eutopic ovaries were completely uninvolved and unaffected. A tumor arising from ectopic ovarian tissue of embryological origin seems the most likely explanation. We suggest refining the descriptive nomenclature so as to more precisely characterize the various presentations of ovarian ectopia.

Cost-effectiveness analysis in severe mental illness : Outcome measures selection

NARCIS (Netherlands)

Stant, A. Dennis; Buskens, Erik; Jenner, Jack A.; Wiersma, Durk; TenVergert, Elisabeth M.

Background: Most economic evaluations conducted in mental healthcare did not include widely recommended preference-based health outcomes like the QALY (Quality-Adjusted Life Years). Instead, studies have mainly been designed as cost-effectiveness analyses that include single outcome measures aimed

A case of malignant fibrous histiocytoma arising in the irradiated maxilla

International Nuclear Information System (INIS)

Fukuta, Yoshiyasu; Yamada, Kazumi; Ohmura, Hiromi; Kudo, Keigo; Takeda, Yasunori

1994-01-01

A malignant fibrous histiocytoma (MFH) arising in the irradiated maxilla is reported. The patient was a 59-year-old Japanese female who was referred to us for a relatively well defined and lobulated tumor extending from the right buccal mucosa to left hard palate. Her past medical history revealed that she had had a squamous cell carcinoma of the right buccal mucosa treated by 145 Gy of radiotherapy 3 years previously. Although the patient underwent a bilateral partial maxillectomy, she died due to extensive local recurrence 14 months postoperatively. Histopathologically, proliferation of atypical tumor cells of non-epithelial origin, i.e., spindle-shaped fibroblastic cells, histiocytic cells and bizarre multinucleated giant cells, were noted. Furthermore, a storiform pattern was also seen in part of the lesion. These features suggested that this care was a postirradiation malignant fibrous histiocytoma. (author)

A case of malignant fibrous histiocytoma arising in the irradiated maxilla

Energy Technology Data Exchange (ETDEWEB)

Fukuta, Yoshiyasu; Yamada, Kazumi; Ohmura, Hiromi; Kudo, Keigo; Takeda, Yasunori (Iwate Medical Univ., Morioka (Japan). School of Dentistry)

1994-03-01

A malignant fibrous histiocytoma (MFH) arising in the irradiated maxilla is reported. The patient was a 59-year-old Japanese female who was referred to us for a relatively well defined and lobulated tumor extending from the right buccal mucosa to left hard palate. Her past medical history revealed that she had had a squamous cell carcinoma of the right buccal mucosa treated by 145 Gy of radiotherapy 3 years previously. Although the patient underwent a bilateral partial maxillectomy, she died due to extensive local recurrence 14 months postoperatively. Histopathologically, proliferation of atypical tumor cells of non-epithelial origin, i.e., spindle-shaped fibroblastic cells, histiocytic cells and bizarre multinucleated giant cells, were noted. Furthermore, a storiform pattern was also seen in part of the lesion. These features suggested that this care was a postirradiation malignant fibrous histiocytoma. (author).

Management of radioactive wastes arising from the use of Australian radioisotopes

International Nuclear Information System (INIS)

Costello, J.M.

1986-01-01

The medical, industrial and research use of radioisotopes in Australia has given rise to approximately 30 m 3 of solid radioactive waste containing about 5 TBq of radioactivity. This waste is stored at State hospitals, universities and research centres. A further 10 m 3 of waste containing 300 GBq of radioactivity is stored by the Commonwealth at the St Mary's Munitions Filling factory. About 700 m 3 of waste containing 1.5 PBq of radioactivity resulting from operation of the HIFAR nuclear reactor and the production of radioisotopes is in storage at the Lucas Heights Research Establishment. The source, nature and rate of arising of these wastes is reviewed, together with national developments in waste classification, storage procedures and eventual disposal. Some research at Lucas Heights on the conditioning of radioisotope waste to facilitate disposal is briefly noted

Consequences of Parenting on Adolescent Outcomes

Directory of Open Access Journals (Sweden)

Donna Hancock Hoskins

2014-09-01

Full Text Available In recent years, substantial gains have been made in our understanding of the influence of parenting behaviors and styles on adolescent emotional and behavioral outcomes. Empirical work focusing on the associations between parenting and adolescent outcomes is important because the influence of parenting during adolescence continues to affect behaviors into adulthood. Additionally, there has been considerable attention paid to the mechanisms that shape parenting that then influence adolescent outcomes. For instance, researchers have found that neighborhood conditions moderated the association between parenting and adolescent development. In this paper, several covariates and contextual effects associated with parenting and adolescent outcomes will be discussed. Also, parental behaviors, parental styles and adolescent outcomes are discussed in this literature review. This review provides an assessment of the literature on parenting and adolescent outcomes from the past decade and includes advancements in parenting research. The review concludes with a summary of major research findings, as well as a consideration of future directions and implications for practice and policy.

Psychosocial predictors of treatment outcome for trauma-affected refugees

DEFF Research Database (Denmark)

Sonne, Charlotte; Carlsson, Jessica; Bech, Per

2016-01-01

at the Competence Centre for Transcultural Psychiatry (CTP), Denmark. The CTP Predictor Index used in the study included 15 different possible outcome predictors concerning the patients' past, chronicity of mental health problems, pain, treatment motivation, prerequisites for engaging in psychotherapy, and social...... situation. The primary outcome measure was PTSD symptoms measured on the Harvard Trauma Questionnaire (HTQ). Other outcome measures included the Hopkins Symptom Check List-25, the WHO-5 Well-being Index, Sheehan Disability Scale, Hamilton Depression and Anxiety Scales, the somatisation scale of the Symptoms...

[Knowledge produced from the outcomes of the "Nursing Outcomes Classification--NOC": integrative review].

Science.gov (United States)

da Silva, Natália Chantal Magalhães; de Souza Oliveira, Ana Railka; de Carvalho, Emília Campos

2015-12-01

To identify the knowledge produced from the outcomes of the Nursing Outcomes Classification (NOC). A literature review using the integrative databases: Latin American and Caribbean Health Sciences (LILACS), US National Library of Medicine (PubMed), Cumulative Index to Nursing & Allied Health Literature (CINAHL) and Scopus Info Site (SCOPUS), during the months of August and September 2014. The review consisted of 21 articles that addressed different issues: Translation and Cultural adaptation (4.77%); Applicability in clinical practice (33.33%); and, Validation (63.90%). Analysis of these articles showed that the knowledge produced from the Nursing Outcomes Classification includes translation and cultural adaptation, evaluation of applicability and validation of its items. Considering the continuous evolution of this classification, periodic reviews should be carried out to identify the knowledge, use and effects of the NOC.

Optimizing outcomes with multifocal intraocular lenses

Directory of Open Access Journals (Sweden)

Gitansha Shreyas Sachdev

2017-01-01

Full Text Available Modern day cataract surgery is evolving from a visual restorative to a refractive procedure. The advent of multifocal intraocular lenses (MFIOLs allows greater spectacle independence and increased quality of life postoperatively. Since the inception in 1980s, MFIOLs have undergone various technical advancements including trifocal and extended depth of vision implants more recently. A thorough preoperative workup including the patients' visual needs and inherent ocular anatomy allows us to achieve superior outcomes. This review offers a comprehensive overview of the various types of MFIOLs and principles of optimizing outcomes through a comprehensive preoperative screening and management of postoperative complications.

Psychosocial determinants of outcomes in knee replacement.

Science.gov (United States)

Lopez-Olivo, Maria A; Landon, Glenn C; Siff, Sherwin J; Edelstein, David; Pak, Chong; Kallen, Michael A; Stanley, Melinda; Zhang, Hong; Robinson, Kausha C; Suarez-Almazor, Maria E

2011-10-01

To identify potential psychosocial and educational barriers to clinical success following knee replacement. The authors evaluated 241 patients undergoing total knee replacement, preoperatively and 6 months after surgery. Outcomes included the Western Ontario McMaster (WOMAC) scale and the Knee Society rating system (KSRS). Independent variables included: the medical outcome study-social support scale; depression, anxiety and stress scale; brief COPE inventory; health locus of control; arthritis self-efficacy scale and the life orientation test-revised. Multiple regression models evaluated associations of baseline demographic and psychosocial variables with outcomes at 6 months, controlling for body mass index, comorbidities and baseline outcome scores. Patients' mean age was 65 ± 9 years; 65% were women. Most patients improved outcomes after surgery. Several psychosocial variables were associated with outcomes. Regression analyses indicated lower education, less tangible support, depression, less problem-solving coping, more dysfunctional coping, lower internal locus of control were associated with worse WOMAC scores (R(2) contribution of psychosocial variables for pain 0.07; for function, 0.14). Older age, lower education, depression and less problem-solving coping were associated with poorer total KSRS scores (R(2) contribution of psychosocial variables to total KSRS model 0.09). Psychosocial variables as a set contributed from 25% to 74% of total explained variance across the models tested. Patients' level of education, tangible support, depression, problem-solving coping, dysfunctional coping and internal locus of control were associated with pain and functional outcomes after knee replacement. The findings suggest that, in addition to medical management, perioperative psychosocial evaluation and intervention are crucial in enhancing knee replacement outcomes.

RISKS IN THE ENFORCEMENT OF ASSIGNMENT OF CLAIM ARISING FROM A BANK LOAN AGREEMENT

Directory of Open Access Journals (Sweden)

Călin Viorel Iuga

2016-11-01

Full Text Available Identifying the risks generated in the matter of by the assignment of claim arising from a bank loan agreement following the review the of the court judgments delivered by courts within the Cluj Court of Appeal. The result of the study is practical, topical,with implications on the banking market in Romania of the practitionersidentified deem that the bank loan agreement loses its enforceability following the assignment of claim, and the novation of the assignee creditor during the enforcement did not occur.

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

A systematic review of evidence on culturally sensitive and environment-friendly outcome measures in ..... which included manual grass cutting/hoeing, assuming the Islamic ... who opined that the starting point for any outcome measure is to ...

Mathematics of flexible risers including pressure and internal flow affects

Energy Technology Data Exchange (ETDEWEB)

Seyed, F.B. (John Brown Engineers and Constructors Ltd., London (GB)); Patel, M.H. (University Coll., London (GB). Dept. of Mechanical Engineering)

1992-01-01

Derivations are presented for calculation of pressure and internal flow induced forces on flexible risers and other curved pipes using a mathematically rigorous approach. Approximate and exact methods are presented for calculation of pressure forces on straight and curved pipes in two dimensions. The mathematical identity of these equations with those for effective tension is illustrated. The force arising from the flow of an internal fluid of constant density is then calculated and combined with those for pressure forces in derivation of the catenary equations including pressure and internal flow terms. It is shown that internal flow contributes a new term to the expression for effective tension. These governing equations are then reduced for the specific cases of simple catenary, steep-S, lazy-S, steep-wave and lazy-wave risers. In each case, the solution method has been presented and the governing equilibrium and geometric compatability conditions cited. (author).

Health outcome after major trauma: what are we measuring?

Science.gov (United States)

Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

2014-01-01

Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

Rotastenting in an anomalously arising right coronary artery after an ugly dissection

Directory of Open Access Journals (Sweden)

Ashwin B. Mehta

2013-07-01

Full Text Available Rotational atherectomy is contraindicated in dissected coronary arteries since it can lead to progression of the dissection or perforation. In our case, the right coronary artery (RCA arose anomalously from the left coronary sinus. The lesion in the RCA was an undilatable calcified one. There was a dissection in the RCA due to high pressure balloon dilatation. Since the patient was hemodynamically unstable and there were no options besides rotablation, we proceeded with caution. Rotablation and stenting were successfully done. Our case report highlights the importance of the need for good guide catheter support even in the presence of anomalously arising arteries and the rotablation option for unyielding calcified coronary lesions, even in the setting of a dissection.

A case of multiple squamous cell carcinomas arising from red tattoo pigment

Directory of Open Access Journals (Sweden)

E. Maxim, BS, MS

2017-12-01

Full Text Available Ornamental tattooing involves the administration of exogenous pigments into the skin to create a permanent design. Our case focuses on a 62-year-old woman who presented with an inflamed enlarging nodule on her right proximal calf, which arose within the red pigment of an ornamental tattoo. The nodule was diagnosed as squamous cell carcinoma (SCC and subsequently excised. Over the course of the following year, the patient was diagnosed with a total of five additional SCCs that also arose within the red pigment of the tattoo. The increased popularity of tattooing and the lack of industry safety standards for tattoo ink production, especially metal-laden red pigments, may lead to more cases of skin cancer arising within tattoos among patients of all ages.

Study the Possibility of measuring Heavy Metals Arising from Gold Mining Sample using 252Cf Neutron Source

International Nuclear Information System (INIS)

Soliman, N.F.

2012-01-01

Mining activities contribute immensely to trace element pollution .The present work studied the possibility of measuring heavy metals arising from gold mining areas Eastern Desert in Egypt using the isotopic 252 Cf neutron source. 38.5 g of the sample is irradiated in a neutron field of 252 Cf for 36.75 days and 0.3 mg of the sample is irradiated at the Pneumatic Irradiation Rabbit System (PIRS) built in the vertical thermal column of the ET-RR-2 reactor . The induced activities in the samples are measured using two high resolution f ray spectrometry systems (including two calibrated HPGe detectors). The kο standardization neutron activation analysis (kο-NAA) method was used to analyze the sample under investigation. Thermal to epithermal flux ratio fat the two irradiation positions are measured. The obtained results indicated that the values of the suspected heavy metals such as sodium, magnesium, potassium, manganese, arsenic, ruthenium and tantalum were higher than the background values, signifying accumulation of these heavy metals due to gold mining activities .The accuracy and precision of the method has been evaluated

Using patient reported outcome measures in health services: A qualitative study on including people with low literacy skills and learning disabilities

NARCIS (Netherlands)

Jahagirdar, D.; Kroll, T.; Ritchie, K.; Wyke, S.

2012-01-01

ABSTRACT: BACKGROUND: Patient reported outcome measures (PROMs) are self-report measures of health status increasingly promoted for use in healthcare quality improvement. However people with low literacy skills or learning disabilities may find PROMs hard to complete. Our study investigated

A Multi-Depot Two-Echelon Vehicle Routing Problem with Delivery Options Arising in the Last Mile Distribution

NARCIS (Netherlands)

Zhou, Lin; Baldacci, Roberto; Vigo, Daniele; Wang, Xu

2018-01-01

In this paper, we introduce a new city logistics problem arising in the last mile distribution of e-commerce. The problem involves two levels of routing problems. The first requires a design of the routes for a vehicle fleet located at the depots to transport the customer demands to a subset of the

A Review of Educational Outcomes in the Children's Mental Health Treatment Literature

Science.gov (United States)

Becker, Kimberly D.; Brandt, Nicole Evangelista; Stephan, Sharon H.; Chorpita, Bruce F.

2014-01-01

We examined the measurement of educational outcomes related to children's mental health treatments. A total of 85 papers describing 88 randomized controlled trials that included at least one educational outcome and one mental health outcome were included in these analyses. Forty-five different measures were identified as the primary educational…

Persistent dorsal ophthalmic artery arising from the internal carotid artery: Report of three cases

Energy Technology Data Exchange (ETDEWEB)

Shin, Jae Hwan; Lee, Ghi Jai; Shim, Jae Chan; Lee, Kyoung Eun; Kim, Ho Kyun; Suh, Jung Ho [Dept. of Radiology, Seoul Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of)

2016-12-15

Normally, the ophthalmic artery (OA) arises from the supraclinoid segment of the internal carotid artery (ICA) and enters the orbit via the optic canal. A persistent dorsal OA is a rare variation that originates from the cavernous segment of the ICA and enters the orbit via the superior orbital fissure. To the best of our knowledge, persistent dorsal OA has not been described in the Korean literature. In this paper, we report three cases of persistent dorsal OA with review of the literature on embryogenesis and other origins of the OA.

Kaizen method for esophagectomy patients: improved quality control, outcomes, and decreased costs.

Science.gov (United States)

Iannettoni, Mark D; Lynch, William R; Parekh, Kalpaj R; McLaughlin, Kelley A

2011-04-01

The majority of costs associated with esophagectomy are related to the initial 3 days of hospital stay requiring intensive care unit stays, ventilator support, and intraoperative time. Additional costs arise from hospital-based services. The major cost increases are related to complications associated with the procedure. We attempted to define these costs and identify expense management by streamlining care through strict adherence to patient care maps, operative standardization, and rapid discharge planning to reduce variability. Utilizing methods of Kaizen philosophy we evaluated all processes related to the entire experience of esophageal resection. This process has taken over 5 years to achieve, with quality and cost being tracked over this time period. Cost analysis included expenses related to intensive care unit, anesthesia, disposables, and hospital services. Quality improvement measures were related to intraoperative complications, in-hospital complications, and postoperative outcomes. The Institutional Review Board approved the use of anonymous data from standard clinical practice because no additional treatment was planned (observational study). Utilizing a continuous process improvement methodology, a 43% reduction in cost per case has been achieved with a significant increase in contribution margin for esophagectomy. The length of stay has been reduced from 14 days to 5. With intraoperative and postoperative standardization the leak rate has dropped from 12% to less than 3% to no leaks in our current Kaizen modification of care in our last 64 patients. Utilizing lean manufacturing techniques and continuous process evaluation we have attempted to eliminate variability, standardized the phases of care resulting in improved outcomes, decreased length of stay, and improved contribution margins. These Kaizen improvements require continuous interventions, strict adherence to care maps, and input from all levels for quality improvements. Copyright © 2011 The

On a system of differential equations with fractional derivatives arising in rod theory

International Nuclear Information System (INIS)

Atanackovic, Teodor M; Stankovic, Bogoljub

2004-01-01

We study a system of equations with fractional derivatives, that arises in the analysis of the lateral motion of an elastic column fixed at one end and loaded by a concentrated follower force at the other end. We assume that the column is positioned on a viscoelastic foundation described by a constitutive equation of fractional derivative type. The stability boundary is determined. It is shown that as in the case of an elastic (Winkler) type of foundation the stability boundary remains the same as for the column without a foundation! Thus, with the solution analysed here, the column exhibits the so-called Hermann-Smith paradox

Hepatectomy for Hepatocellular Carcinoma with Bile Duct Tumor Thrombus, Including Cases with Obstructive Jaundice.

Science.gov (United States)

Orimo, Tatsuya; Kamiyama, Toshiya; Yokoo, Hideki; Wakayama, Kenji; Shimada, Shingo; Tsuruga, Yosuke; Kamachi, Hirofumi; Taketomi, Akinobu

2016-08-01

This study aimed to evaluate the short- and long-term outcomes of hepatectomy for hepatocellular carcinoma (HCC) with bile duct tumor thrombus (BDTT), including cases with obstructive jaundice. The study reviewed 42 HCC patients with BDTT, including six patients who needed preoperative biliary drainage due to obstructive jaundice, and 732 HCC patients without BDTT. The authors analyzed the impact of BDTT on the surgical outcomes and assessed the outcomes of hepatectomy for patients presenting with obstructive jaundice. The HCC patients with BDTT, almost all with stage 3 or 4 disease, had increased alpha-fetoprotein expression, larger tumors, and more portal vein invasion status. The survival of the HCC patients with BDTT was significantly inferior to that of the patients without BDTT (p = 0.0003). Survival did not differ significantly between the HCC patients with BDTT and those without BDTT when the two groups were matched by stage (p = 0.3366). The HCC patients with BDTT who presented with obstructive jaundice demonstrated outcomes similar to those for the HCC patients with BDTT who did not present with obstructive jaundice in terms of the overall survival rate (p = 0.5469). The perioperative outcomes for the HCC patients with BDTT did not depend on the presence or absence of preoperative jaundice. No patients in either BDTT group demonstrated 90-day mortality in this study. Hepatectomy should be considered for HCC patients with BDTT, even for patients with obstructive jaundice, because the surgical outcomes equivalent to those for HCC without BDTT can be achieved.

Implant rehabilitation of the atrophic edentulous maxilla including immediate fixed provisional restoration without the use of bone grafting: a review of 1-year outcome data from a long-term prospective clinical trial.

Science.gov (United States)

Toljanic, Joseph A; Baer, Russell A; Ekstrand, Karl; Thor, Andreas

2009-01-01

The literature suggests that predictable integration can be achieved when dental implant placement is combined with immediate fixed provisional restoration in a variety of clinical situations. Fewer data are available, however, regarding outcomes for immediate provisional restoration of implants in the edentulous maxilla. This report presents 1-year data acquired from a long-term prospective clinical trial designed to assess outcomes following the immediate provisional fixed restoration of implants in the atrophic edentulous maxilla without the use of bone augmentation. Fifty-one subjects diagnosed with an atrophic edentulous maxilla received a total of 306 implants (six implants per subject) followed by fixed provisional restoration within 24 hours of implant placement. No subjects underwent grafting to enhance bone volume in preparation for implant treatment. Data acquired included bone quantity and quality, implant dimensions, implant locations, and implant placement stability. Subjects returned for 1-year follow-up examinations to assess implant integration and restoration function. Periapical radiographs were obtained and compared to baseline images to assess marginal bone height maintenance. At the 3-month follow-up examination, 294 of 306 implants placed in 51 subjects were found to be integrated. This represents a cumulative implant survival rate of 96%. At the 1-year follow-up examination, mean marginal bone loss of 0.5 mm was noted, with no further loss of implants. These results support the contention that predictable long-term outcomes may be obtained for the atrophic edentulous maxilla when treated with an implant rehabilitation protocol that includes immediate fixed provisional restoration without the use of bone grafting. This strategy offers a promising treatment alternative for the patient with an atrophic edentulous maxilla.

Knowledge produced from the outcomes of the "Nursing Outcomes Classification - NOC": integrative review

Directory of Open Access Journals (Sweden)

Natália Chantal Magalhães da Silva

Full Text Available Objective: To identify the knowledge produced from the outcomes of the Nursing Outcomes Classification (NOC. Method: A literature review using the integrative databases: Latin American and Caribbean Health Sciences (LILACS, US National Library of Medicine (PubMed, Cumulative Index to Nursing & Allied Health Literature (CINAHL and Scopus Info Site (SCOPUS, during the months of August and September 2014. Results: The review consisted of 21 articles that addressed different issues: Translation and Cultural adaptation (4.77%; Applicability in clinical practice (33.33%; and, Validation (63.90%. Analysis of these articles showed that the knowledge produced from the Nursing Outcomes Classification includes translation and cultural adaptation, evaluation of applicability and validation of its items. Conclusion: Considering the continuous evolution of this classification, periodic reviews should be carried out to identify the knowledge, use and effects of the NOC.

On a Five-Dimensional Chaotic System Arising from Double-Diffusive Convection in a Fluid Layer

Directory of Open Access Journals (Sweden)

R. Idris

2013-01-01

Full Text Available A chaotic system arising from double-diffusive convection in a fluid layer is investigated in this paper based on the theory of dynamical systems. A five-dimensional model of chaotic system is obtained using the Galerkin truncated approximation. The results showed that the transition from steady convection to chaos via a Hopf bifurcation produced a limit cycle which may be associated with a homoclinic explosion at a slightly subcritical value of the Rayleigh number.

Outcomes of endovascular aortic repair in the modern era

DEFF Research Database (Denmark)

Budtz-Lilly, Jacob; Wanhainen, Anders; Mani, Kevin

2018-01-01

Monitoring outcomes following endovascular aortic repair (EVAR) is critical. Although evidence from randomized controlled trials has solidified the role of EVAR, the analysis of outcomes and "real-world" data has uncovered limitations, improved the selection of appropriate patients, and underscored...... the importance of instructions for use. Subsequent studies demonstrated the learning curve of EVAR and gradual improvement of outcomes over time. Outcomes analyses will continue to play an important role, particularly as technological growth of endovascular therapy has enabled treatment of more complex aneurysm...... pathologies and patients. The important analyses are herein reviewed, following the development of EVAR in the treatment of intact abdominal aortic aneurysms (AAA) to ruptured AAAs, and finally to complex aneurysms, including thoracoabdominal aortic aneurysms and mycotic aneurysms. This includes an overview...

The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.

Science.gov (United States)

Spencer, Lisa; Rollo, Megan; Hauck, Yvonne; MacDonald-Wicks, Lesley; Wood, Lisa; Hutchesson, Melinda; Giglia, Roslyn; Smith, Roger; Collins, Clare

2015-01-01

What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women?The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women.The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching, including email or text message support. Around half of all women of reproductive age are either overweight or obese, with women aged 25-34 years having a greater risk of substantial weight gain compared with men of all ages. Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother, baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is a further long term complication of maternal obesity for offspring, which may persist in to adulthood. Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a meta-analysis with over 65,000 women showing that, compared to women who gained weight within recommendations during pregnancy, women with GWG

The Anterior Branch of the Left Inferior Phrenic Artery Arising from the Right Inferior Phrenic Artery: An Angiographic and CT Study

International Nuclear Information System (INIS)

Hieda, Masashi; Toyota, Naoyuki; Kakizawa, Hideaki; Ishikawa, Masaki; Horiguchi, Jun; Ito, Katsuhide

2009-01-01

The purpose of this study was to retrospectively analyze the frequency and anatomical pattern of the anterior branch of the left inferior phrenic artery (LIPA) arising from the right inferior phrenic artery (RIPA). Angiography of the RIPA for patients (n = 140) with hepatic malignancy was retrospectively reviewed. The frequency at which the anterior branch of the LIPA arose from the RIPA was 14.3% (20 of 140 patients [pts]). Among the three branches that may arise from the RIPA in these cases (the anterior branch of the LIPA and the anterior and posterior branches of the RIPA), the anterior branch of the LIPA was the first branch of the RIPA in 9 of 20 pts (45%), and the posterior branch of the RIPA in 11 of 20 pts (55%). The anterior branch of the LIPA ran along the ventral side of the esophagus or stomach and supplied the esophagogastric region and dome of the left diaphragm in all cases. In conclusion, the anterior branch of the LIPA arises from the RIPA at a comparatively high frequency. In embolization of the RIPA, to effectively treat and avoid possible complications, interventionalists should be aware of this potential variant anatomy.

Participation process and outcome interactions: Exploring participation in water resource management

Science.gov (United States)

Carr, G.; Loucks, D. P.; Blöschl, G.

2012-04-01

Evaluating participation programmes, projects and activities aids understanding of effective mechanisms and enables the identification of improvements to current strategies. Characteristics of participation processes, such whether the process is cost effective, adequately facilitated, accessible, includes a representative section of society or interest groups and allocates power equivalently between participants, are commonly described and evaluated in the literature. A key question concerns whether effective processes lead to desirable outcomes. Two types of outcomes can be identified from participation programmes - tangible and non-tangible. Tangible outcomes include resource management changes or resource quality changes. Non tangible outcomes include developing and strengthening communication and action networks, building trust between individuals and/or organisations, developing innovative solutions, or developing shared knowledge and understandings of issues. To better understand how participation impacts upon resource management it is necessary to identify i) how non-tangible outcomes lead to resource management outcomes and ii) which characteristics of the participation process are connected to achieving non-tangible outcomes. This has been attempted with a literature based meta-analysis. Literature has been analysed to identify outcomes from participations programmes, and the process characteristics present that are associated with promoting or inhibiting their achievement. Preliminary analysis shows that process characteristics such as representation, facilitation and accessibility are important for achieving non-tangible outcomes. The relationship between non-tangible outcomes and resource management outcomes is less clear in the literature. This may be due to the different timescales over which the different types of outcomes emerge (resource management outcomes emerge over longer time periods) and the different contexts or settings in which

Health outcome after major trauma: what are we measuring?

Directory of Open Access Journals (Sweden)

Karen Hoffman

Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

Neutrinos from WIMP annihilations in the Sun including neutrino oscillations

International Nuclear Information System (INIS)

Blennow, Mattias; Edsjö, Joakim; Ohlsson, Tommy

2011-01-01

The prospects to detect neutrinos from the Sun arising from dark matter annihilations in the core of the Sun are reviewed. Emphasis is placed on new work investigating the effects of neutrino oscillations on the expected neutrino fluxes.

Neutrinos from WIMP annihilations in the Sun including neutrino oscillations

International Nuclear Information System (INIS)

Blennow, Mattias; Edsjoe, Joakim; Ohlsson, Tommy

2006-01-01

The prospects for detecting neutrinos from the Sun arising from dark matter annihilations in the core of the Sun are reviewed. Emphasis is placed on new work investigating the effects of neutrino oscillations on the expected neutrino fluxes

Intermediate and Long-term Outcomes of Giant Fibroadenoma Excision in Adolescent and Young Adult Patients.

Science.gov (United States)

Cerrato, Felecia E; Pruthi, Sandhya; Boughey, Judy C; Simmons, Patricia S; Salje, Barbara; Nuzzi, Laura C; Lemaine, Valerie; Labow, Brian I

2015-01-01

Giant fibroadenomas (5 cm or greater) are benign breast masses that often present in adolescence and require surgical excision. Long-term outcomes, recurrence rates, and the need for additional reconstructive surgery in this population are unknown. Patients aged 11-25 years whose pathology reports indicated the presence of a giant fibroadenoma were eligible for this study. Medical records were reviewed for presentation, treatment, and outcomes. A subset of patients completed an investigator-designed long-term outcome survey to measure additional outcomes and the desire or need for subsequent reconstructive surgery. Forty-six patients with at least one giant fibroadenoma (mean size 7.4 ± 2.8 cm) were identified. Most patients underwent excision with a periaroeolar incision (n = 31), and an enucleation technique (n = 41), and four patients underwent immediate breast reconstruction. Thirty-three patients had complete medical records with a mean follow-up time of 2.2 ± 4.1 years and no complaints of asymmetry, additional breast deformities, or reconstructive surgery procedures documented. In addition, nine patients completed the investigator-designed survey with a mean follow-up time of 10.1 ± 8.7 years (range 1.5-27.0). Three of these patients reported postoperative breast asymmetry and the desire to pursue reconstructive surgery. Aesthetic outcomes of giant fibroadenoma excision may be satisfactory for many patients without immediate reconstruction, but for others, the need for reconstructive surgery may arise during development. Providers should address this potential need prior to discussing treatment options and during postoperative follow-up. Caution should be exercised before recommending immediate reconstruction. © 2015 Wiley Periodicals, Inc.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach.

Science.gov (United States)

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2016-01-15

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach and has several attractive features compared with the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, because the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. Copyright © 2015 John Wiley & Sons, Ltd.

Core Health Outcomes In Childhood Epilepsy (CHOICE): protocol for the selection of a core outcome set.

Science.gov (United States)

Morris, Christopher; Dunkley, Colin; Gibbon, Frances M; Currier, Janet; Roberts, Deborah; Rogers, Morwenna; Crudgington, Holly; Bray, Lucy; Carter, Bernie; Hughes, Dyfrig; Tudur Smith, Catrin; Williamson, Paula R; Gringras, Paul; Pal, Deb K

2017-11-28

There is increasing recognition that establishing a core set of outcomes to be evaluated and reported in trials of interventions for particular conditions will improve the usefulness of health research. There is no established core outcome set for childhood epilepsy. The aim of this work is to select a core outcome set to be used in evaluative research of interventions for children with rolandic epilepsy, as an exemplar of common childhood epilepsy syndromes. First we will identify what outcomes should be measured; then we will decide how to measure those outcomes. We will engage relevant UK charities and health professional societies as partners, and convene advisory panels for young people with epilepsy and parents of children with epilepsy. We will identify candidate outcomes from a search for trials of interventions for childhood epilepsy, statutory guidance and consultation with our advisory panels. Families, charities and health, education and neuropsychology professionals will be invited to participate in a Delphi survey following recommended practices in the development of core outcome sets. Participants will be able to recommend additional outcome domains. Over three rounds of Delphi survey participants will rate the importance of candidate outcome domains and state the rationale for their decisions. Over the three rounds we will seek consensus across and between families and health professionals on the more important outcomes. A face-to-face meeting will be convened to ratify the core outcome set. We will then review and recommend ways to measure the shortlisted outcomes using clinical assessment and/or patient-reported outcome measures. Our methodology is a proportionate and pragmatic approach to expediently produce a core outcome set for evaluative research of interventions aiming to improve the health of children with epilepsy. A number of decisions have to be made when designing a study to develop a core outcome set including defining the scope

The estimation of doses to the inhabitants arising from natural radiation source in the high background radiation area of Yangjiang, China

International Nuclear Information System (INIS)

Yuan Yongling; Shen Hong; Morishima, H.; Wei Lvxin; Jian Yuannu

2004-01-01

Objective: The purposes is to estimate the average annual effective dose of the inhabitants and absorbed dose in some human tissues and organs arising from natural radiation sources in the High Background Radiation Area (HBRA) of Yangjiang and in the neighboring Control Area (CA). In order to provide more effective evidence for analyzing the dose-effect relationships among the cohort members in the investigated areas, authors divided the local inhabitant into different dose-groups. Methods: The authors measured the environmental gamma external radiation levels and individual accumulated doses of 5293 people in the investigated areas. The concentrations for 222 Rn, 220 Rn and their decay products in air were also surveyed. The authors estimated the internal doses of natural radionuclides based on the results obtained from measurements in food, in drinking water, in human teeth, in several human tissues, in human placenta, and in activity concentration of exhaled 222 Rn and 220 Rn of the residents living in the investigated areas. Results: The estimation of average annual effective doses in HBRA and CA based on the data of environmental measurements of radiation level respectively are 2.12 ± 0.29 mSv a -1 and 0.69 ± 0.09 mSv a -1 . The sources of higher background radiation in HBRA are mainly contributed from terrestrial gamma radiation. The estimation of average annual effective doses to the residents arising from inhalation of 222 Rn, 220 Rn and their decay products was 3.28 mSv a -1 in HBRA, while that in CA was 1.03 mSv a -1 . The values of the absorbed dose of the residents in their trachea-bronchial tree and lung in HBRA arising from inhalation of 222 Rn, 220 Rn and their decay products are 5.40 mGy a -1 and 1.08 mGy a -1 respectively, which are about four times of the values of the absorbed dose in CA. The estimation of average annual effective doses to the inhabitants caused by 226 Ra and 228 Ra in HBRA and CA were 281.88 μSv a -1 and 84.54 μSv a -1

Maternal nutrition and birth outcomes.

Science.gov (United States)

Abu-Saad, Kathleen; Fraser, Drora

2010-01-01

In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

Environmental security benefits arising from Russian/Norwegian/US cooperation in the high Arctic

International Nuclear Information System (INIS)

Dyer, R.S.

1997-01-01

Past practices associated with the civilian and military use of nuclear power in NW Russia present large environmental security risks of international concern. These risks arise from a variety of practices associated with weapons production, testing, power production and waste management. The threats presented by these activities are multimedia in nature, span political boundaries and cannot be simply or inexpensively remediated. Today, cooperative efforts are being undertaken to improve environmental security by remediating existing and potential emission sources. Initial efforts focused on the upgrade and expansion of the Murmansk Low-level Liquid Waste Treatment Facility, Murmansk, Russia. This facility handles wastes generated during the decommissioning of Russian Nuclear Navy submarines and from the operation of the Russian commercial nuclear-powered icebreaker fleet. This upgraded facility is now being constructed and is expected to be completed by March 1998. Completion of this facility will result in the cessation of any future dumping of liquid radioactive wastes into the Barents and Kara Seas. Another large environmental security risk is the LEPSE. The LEPSE is a ship docked in Murmansk, Russia, that contains ∼650 spent fuel elements as well as other solid and liquid wastes from Russian nuclear vessels. International efforts are now being mounted to remove the spent and damaged fuel from this ship, including the safe removal and storage/disposal of the fuel elements. This paper will summarize the environmental security problems presented by these different sources and the likely environmental security benefits associated with their remediation. 5 refs., 1 fig., 1 tab

Uncertainty in soil-structure interaction analysis arising from differences in analytical techniques

International Nuclear Information System (INIS)

Maslenikov, O.R.; Chen, J.C.; Johnson, J.J.

1982-07-01

This study addresses uncertainties arising from variations in different modeling approaches to soil-structure interaction of massive structures at a nuclear power plant. To perform a comprehensive systems analysis, it is necessary to quantify, for each phase of the traditional analysis procedure, both the realistic seismic response and the uncertainties associated with them. In this study two linear soil-structure interaction techniques were used to analyze the Zion, Illinois nuclear power plant: a direct method using the FLUSH computer program and a substructure approach using the CLASSI family of computer programs. In-structure response from two earthquakes, one real and one synthetic, was compared. Structure configurations from relatively simple to complicated multi-structure cases were analyzed. The resulting variations help quantify uncertainty in structure response due to analysis procedures

Culturally Sensitive and Environment-Friendly Outcome Measures in

African Journals Online (AJOL)

Dr Olaleye

to review research studies on outcome measures that were developed for ... A systematic review of evidence on culturally sensitive and environment- ... Various databases including Google Scholar, PEDro and PubMed were accessed to search for relevant empirical ... utilization of disease-specific, patient-centered outcome.

Environmental Outcomes in the South African Learnership System ...

African Journals Online (AJOL)

Since 1994, the published environmental goals and objectives of the South African Government include environmental education outcomes in all education and ... of manifest and latent environmental outcomes distributed across learnerships and SETAs; a strong influence of occupational health and safety legislation; and a ...

Visual integration dysfunction in schizophrenia arises by the first psychotic episode and worsens with illness duration

OpenAIRE

Keane, Brian P.; Paterno, Danielle; Kastner, Sabine; Silverstein, Steven M.

2016-01-01

Visual integration dysfunction characterizes schizophrenia, but prior studies have not yet established whether the problem arises by the first psychotic episode or worsens with illness duration. To investigate the issue, we compared chronic schizophrenia patients (SZs), first episode psychosis patients (FEs), and well-matched healthy controls on a brief but sensitive psychophysical task in which subjects attempted to locate an integrated shape embedded in noise. Task difficulty depended on th...

[Hospital emergencies arising from nursing homes in a region: evolution, characteristics and appropriateness].

Science.gov (United States)

Sánchez-Pérez, Inma; Comes Garcia, Nuri; Romero Piniella, Lola; Prats Martos, Gemma; Arnau Bataller, Gemma; Coderch, Jordi

Hospital emergencies (HE) arising from nursing homes (NH) are on the rise. We analyse the evolution, characteristics and appropriateness of HE of NH residents in a region, as well as resulting hospital admissions. Retrospective descriptive study between 2010 and 2013 of institutionalised residents of 11 NH located in Baix Empordà (704 beds) and Palamós Hospital. Gender, age, morbidity and relative weight according to clinical risk groups (CRG), NH, length of stay, diagnosis of the emergency, appropriateness of HE according to Bermejo's criteria and the HE appropriateness protocol (HEAP), and appropriateness of hospitalisations according to the Appropriateness Evaluation Protocol (AEP). Sample to evaluate appropriateness: 159 HE and 91 hospitalisations. frequency, mean, standard deviation, percentiles, Fisher's exact test and ANOVA, with a confidence interval of 95% and using IBM SPSS Statistics 23. 1,474 people were enrolled, of which 73% were women. Group ≥85 years increased to 60.3% and the mean weight of morbidity was 3.2 to 4.0 (p <0.001). 1,805 HE were generated. The annual rate per 1,000 stays arising from NH increased from 1.64 to 2.05, of which 90.6% were appropriate according to Bermejo's criteria and 93.7% according to the HEAP. Of these, 502 involved hospitalisation. The annual rate per 10 emergencies fell from 2.96 to 2.64 and 98.9% were appropriate according to the AEP. Hospital emergencies and hospitalisations of NH residents are increasing and are appropriate. Increasing age and disease burden could explain this phenomenon. NH and hospitals should react appropriately, considering the specific needs of this population sector. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Vanishing viscosity limits of mixed hyperbolic–elliptic systems arising in multilayer channel flows

International Nuclear Information System (INIS)

Papaefthymiou, E S; Papageorgiou, D T

2015-01-01

This study considers the spatially periodic initial value problem of 2 × 2 quasi-linear parabolic systems in one space dimension having quadratic polynomial flux functions. These systems arise physically in the interfacial dynamics of viscous immiscible multilayer channel flows. The equations describe the spatiotemporal evolution of phase-separating interfaces with dissipation arising from surface tension (fourth-order) and/or stable stratification effects (second-order). A crucial mathematical aspect of these systems is the presence of mixed hyperbolic–elliptic flux functions that provide the only source of instability. The study concentrates on scaled spatially 2π-periodic solutions as the dissipation vanishes, and in particular the behaviour of such limits when generalized dissipation operators (spanning second to fourth-order) are considered. Extensive numerical computations and asymptotic analysis suggest that the existence (or not) of bounded vanishing viscosity solutions depends crucially on the structure of the flux function. In the absence of linear terms (i.e. homogeneous flux functions) the vanishing viscosity limit does not exist in the L ∞ -norm. On the other hand, if linear terms in the flux function are present the computations strongly suggest that the solutions exist and are bounded in the L ∞ -norm as the dissipation vanishes. It is found that the key mechanism that provides such boundedness centres on persistent spatiotemporal hyperbolic–elliptic transitions. Strikingly, as the dissipation decreases, the flux function becomes almost everywhere hyperbolic except on a fractal set of elliptic regions, whose dimension depends on the order of the regularized operator. Furthermore, the spatial structures of the emerging weak solutions are found to support an increasing number of discontinuities (measure-valued solutions) located in the vicinity of the fractally distributed elliptic regions. For the unscaled problem, such spatially

Injury done to vegetation by gases arising from certain manufacturing processes

Energy Technology Data Exchange (ETDEWEB)

Hamburger, S

1884-04-29

The question of damage done to vegetation by smoke and acid gases escaping from the chimneys of manufacturing establishments is comparatively of recent date, and complaints seem to have increased with the progress which industry has made in the last decades. Such complaints have principally been brought forward in districts where many manufactures were carried on, and the blame was always laid at the doors of chemical manufacturers, and especially the alkali makers, of whose works it was known that they gave rise to large quantities of acid gases. Lately this subject has been taken up by several unprejudiced investigators, and great credit is due to them for having shown that gases arising from other manufactures maybe equally noxious, and even more so. Much, however, still remains to be done in that direction. People somehow cling to their old belief, and every endeavor ought to be made to dispel that erroneous notion. That is the object of this paper.

Arisings of cladding wastes from nuclear fuel in the European Community

International Nuclear Information System (INIS)

Cottone, G.

1978-01-01

An inquiry has been made in the member states on composition, activation and amounts of cladding wastes arising in the European Community until 1990 from the following reactor types: BWR, PWR, SGHWR, AGR and FBR. The elaborated results of this inquiry are given in this report. On the basis of forecasted reprocessing capacities the cumulative amount of cladding waste in the Community was estimated to reach in 1985 and 1990, respectively, about 2,100 and 7,300 metric tons. This waste will mainly consist of zircaloy and of smaller amounts of stainless steel and nickel alloy. Assuming that 0.5% of the spent fuel remains with the cladding, the contamination has been estimated for cooling times varying from 1 to 1000 years. In the first centuries activation is prevailing, but contamination determines the long-term radioactivity; consequently better decontamination, removing the alpha-bearing compounds, would be beneficial in reducing the long term hazard

On some nonlinear problems arising in the physics of ionized gases

International Nuclear Information System (INIS)

Hilhorst-Goldman, D.

1981-01-01

The author reports results obtained by rigorous analysis of a nonlinear differential equation for the electron density nsub(e) in a specific type of electrical discharge. The problem is essentially two-dimensional. She discusses in particular the escape of electrons to infinity above a critical temperature and the boundary layer exhibited by nsub(e) near zero temperature. A singular boundary value problem arising in a pre-breakdown gas discharge is discussed. A Coulomb gas is considered in a special experimental situation: the pre-breakdown gas discharge between two electrodes. The equation for the negative charge density can be formulated as a nonlinear parabolic equation degenerate at the origin. The existence and uniqueness of the solution are proved as well as the asymptotic stability of its unique steady state. Some results are also given about the rate of convergence. The variational characterisation of the limit solution of a singular perturbation problem and variational analysis of a perturbed free boundary problem are considered. (Auth./C.F.)

Iterative solution of a nonlinear system arising in phase change problems

International Nuclear Information System (INIS)

Williams, M.A.

1987-01-01

We consider several iterative methods for solving the nonlinear system arising from an enthalpy formulation of a phase change problem. We present the formulation of the problem. Implicit discretization of the governing equations results in a mildly nonlinear system at each time step. We discuss solving this system using Jacobi, Gauss-Seidel, and SOR iterations and a new modified preconditioned conjugate gradient (MPCG) algorithm. The new MPCG algorithm and its properties are discussed in detail. Numerical results are presented comparing the performance of the SOR algorithm and the MPCG algorithm with 1-step SSOR preconditioning. The MPCG algorithm exhibits a superlinear rate of convergence. The SOR algorithm exhibits a linear rate of convergence. Thus, the MPCG algorithm requires fewer iterations to converge than the SOR algorithm. However in most cases, the SOR algorithm requires less total computation time than the MPCG algorithm. Hence, the SOR algorithm appears to be more appropriate for the class of problems considered. 27 refs., 11 figs

Defect Shape Recovering by Parameter Estimation Arising in Eddy Current Testing

International Nuclear Information System (INIS)

Kojima, Fumio

2003-01-01

This paper is concerned with a computational method for recovering a crack shape of steam generator tubes of nuclear plants. Problems on the shape identification are discussed arising in the characterization of a structural defect in a conductor using data of eddy current inspection. A surface defect on the generator tube ran be detected as a probe impedance trajectory by scanning a pancake type coil. First, a mathematical model of the inspection process is derived from the Maxwell's equation. Second, the input and output relation is given by the approximate model by virtue of the hybrid use of the finite element and boundary element method. In that model, the crack shape is characterized by the unknown coefficients of the B-spline function which approximates the crack shape geometry. Finally, a parameter estimation technique is proposed for recovering the crack shape using data from the probe coil. The computational experiments were successfully tested with the laboratory data

Re-Examination of the BEST Trial Using Composite Outcomes, Including Emergency Department Visits

DEFF Research Database (Denmark)

Shen, Li; Jhund, Pardeep S.; Mogensen, Ulrik M.

2017-01-01

that included emergency department (ED) visits. We also undertook an analysis of recurrent events primarily using the Lin, Wei, Ying, and Yang model. Results Overall, 448 (33%) patients on placebo and 411 (30%) patients on bucindolol died (hazard ratio [HR]: 0.90; 95% confidence interval [CI]: 0.78 to 1.02; p...... = 0.11). A total of 730 (54%) patients experienced CVD/HFH on placebo and 624 (46%) on bucindolol (HR: 0.80; 95% CI: 0.72 to 0.89; p 0.90; p

Outcomes management: incorporating and sustaining processes critical to using outcome data to guide practice improvement.

Science.gov (United States)

Hodges, Kay; Wotring, James R

2012-04-01

An outcomes management system (OMS) greatly facilitates an organization or state achieving requirements regarding accountability and use of empirically based interventions. A case example of the authors' experience with a successful and enduring OMS is presented, followed by a review of the literature and a proposed model delineating the key components and benefits of an OMS. Building capacity to measure performance requires embedding utilization of youth-specific, clinically meaningful outcome data into the organization's processes and structures. An OMS measures outcomes associated with services, facilitates implementation of evidence-based practices, informs case decision making, enables better and more efficient clinical management, and provides aggregated information used to improve services. A case-specific supervisory model based on instantaneously available information, including progress to date, helps maximize consumer outcomes. Continuous quality improvement activities, which are databased and goal-oriented, become a positive change management tool. This paper describes organizational processes that facilitate the development of a highly functional OMS.

Quenching rate for a nonlocal problem arising in the micro-electro mechanical system

Science.gov (United States)

Guo, Jong-Shenq; Hu, Bei

2018-03-01

In this paper, we study the quenching rate of the solution for a nonlocal parabolic problem which arises in the study of the micro-electro mechanical system. This question is equivalent to the stabilization of the solution to the transformed problem in self-similar variables. First, some a priori estimates are provided. In order to construct a Lyapunov function, due to the lack of time monotonicity property, we then derive some very useful and challenging estimates by a delicate analysis. Finally, with this Lyapunov function, we prove that the quenching rate is self-similar which is the same as the problem without the nonlocal term, except the constant limit depends on the solution itself.

A method for crack sizing using Bayesian inference arising in eddy current testing

International Nuclear Information System (INIS)

Kojima, Fumio; Kikuchi, Mitsuhiro

2008-01-01

This paper is concerned with a sizing methodology of crack using Bayesian inference arising in eddy current testing. There is often uncertainty about data through quantitative measurements of nondestructive testing and this can yield misleading inference of crack sizing at on-site monitoring. In this paper, we propose optimal strategies of measurements in eddy current testing using Bayesian prior-to-posteriori analysis. First our likelihood functional is given by Gaussian distribution with the measurement model based on the hybrid use of finite and boundary element methods. Secondly, given a priori distributions of crack sizing, we propose a method for estimating the region of interest for sizing cracks. Finally an optimal sensing method is demonstrated using our idea. (author)

Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

International Nuclear Information System (INIS)

Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung

2016-01-01

Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma

Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

Energy Technology Data Exchange (ETDEWEB)

Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

2016-01-15

Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma.

Treatment of wastes arising from decontamination process using citric acid as a decontaminate agent

International Nuclear Information System (INIS)

Mierzwa, J.C.; Riella, H.G.; Carvalho, E.U. de

1993-01-01

Wastes arising from equipment decontamination processes from nuclear fuel cycle facilities at Coordenacao de Projetos Especiais - Comissao Nacional de Energia Nuclear, Sao Paulo (COPESP-CNEN/SP) has been studied after using citric acid as a decontaminate agent. Precipitation of uranium and metallic impurities resulted from use of sodium hydroxide or calcium oxide plus a flocculation agent. The removal efficient of uranium was 95% and 99% for sodium hydroxide and calcium oxide respectively. The results shows that this process can be used to test wastes from decontamination processes which use citric acid. (B.C.A.). 03 refs, 08 figs, 04 tabs

Systematic Review of Treatment Outcome Measures for Vulvodynia.

Science.gov (United States)

Sadownik, Leslie A; Yong, Paul J; Smith, Kelly B

2018-07-01

To systematically evaluate the literature regarding vulvodynia treatment outcome measures. A systematic literature search on OVID, PubMed, and PsycINFO databases was conducted from inception until May 2016. Studies were included/excluded based on prespecified criteria. Reported outcome measures were organized into 6 core outcome domains recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT): pain; physical functioning, emotional functioning, participant ratings of global improvement and satisfaction with treatment, symptoms and adverse events, and participant disposition. Of the 206 articles identified for full-text screening, 33 met our criteria. One study adhered to all IMMPACT recommendations. The number of outcomes measured per study ranged from 1 to greater than 20. Patient-reported pain outcomes were found in the majority (27/33; 82%) of studies. Pain severity with intercourse was reported by 24 (73%) of 33 studies-9 different scales were used to measure this outcome. Clinician-reported outcomes were present in 14 (42%) of 33 studies. Methods of measuring vestibular sensitivity by "cotton swab" test were different in 8 of 10 studies. Other domains reported included; physical function (8/33 studies; 24%), sexual function (23/33 studies; 70%), and emotional function (13/33 studies; 39%). Symptoms and adverse events were reported by 15 (45%) of 33 studies. One study formally reported participant disposition using all the information recommended by CONSORT. Comparison of clinical trial results in vulvodynia is not possible because of a lack of standard treatment outcome measures. Vulvodynia researchers should apply the IMMPACT criteria to guide the development of a minimum core set of standard outcome measures that measure holistic health.

[Relationship experiences and therapeutic outcome in inpatient psychotherapy].

Science.gov (United States)

Sammet, Isa; Staats, Herrmann; Schauenburg, Henning

2004-01-01

Inpatient psychotherapy includes the patient's manifold contacts with different therapists, nurses and fellow patients. The present study investigated the association between these multiple relationships and therapy outcome. Pre-post measures of symptom load (Brief Symptom Inventory), interpersonal problems (IIP) and self-efficacy (SEB) were used to define three groups with positive (N=129), unchanged (N=44) or negative (N=40) outcome. These groups were compared 1) by their alliance with an individual therapist, their relationship to the therapeutic team, their experience of cohesion and climate concerning fellow patients in the ward (measured weekly by the "Stationserfahrungsbogen" SEB), and 2) by their differences in mean correlations between the courses of relationship experiences and symptom load. Cohesion and relationship to the therapeutic team were not associated with therapy outcome. Therapeutic alliance with the individual therapist and climate among fellow patients turned out to be moderate indicators of the therapeutic outcome. It is recommended to include these process parameters systematically into the process diagnostics of inpatient psychotherapy.

Squamous Cell Cancer Arising in an African American Male Cheek from Discoid Lupus: A Rare Case and Review of the Literature

Directory of Open Access Journals (Sweden)

Emanuel A. Shapera

2016-01-01

Full Text Available A 50-year-old African American male with Discoid Lupus Erythematosus (DLE presented to the dermatology clinic for a rapidly enlarging left cheek mass. The mass failed to resolve with conservative measures. A biopsy revealed poorly differentiated Squamous Cell Carcinoma (SCC. He was referred to Head and Neck Surgery and successfully underwent a resection with free flap reconstruction. Postoperatively he did well. Squamous cell skin carcinomas arising from lesions of Discoid Lupus are rare and aggressive tumors with greater likelihood of metastases. Cases have been reported among patients with different clinical characteristics; we present a rare case arising in an African American male on the face and involving the ear.

SCC, Bowen's disease and BCC arising on chronic radiation dermatitis due to radiation therapy for tinea pedis

International Nuclear Information System (INIS)

Aoki, Eri; Aoki, Mikako; Ikemura, Akiko; Igarashi, Tsukasa; Suzuki, Kayano; Kawana, Seiji

2000-01-01

We reported a case who developed three different types of skin cancers: SCC, BCC, and Bowen's disease, on the chronic radiation dermatitis. He had been treated for his tinea pedis et palmaris with radiotherapy in 1940's. It is very ratre that three different types of skin cancers arise in the same patient. This is a second case reported in Japan. (author)

Coexistence of mucous retention cyst and basal cell adenoma arising from the lining epithelium of the cyst. Report of two cases.

Science.gov (United States)

Antoniades, D; Epivatianos, A; Markopoulos, A; Kolokotronis, A; Zaraboukas, T

2009-01-01

To report 2 cases of coexisting mucous retention cyst and basal cell adenoma arising from the lining epithelium of the cyst. Two cases of painless swellings, well-demarcated, soft to palpation, and located in the submucosa of the upper lip were clinically examined with the provisional diagnosis of mucocele or salivary gland tumor. Histological examination showed the presence of a large unilocular cystic cavity in many parts surrounded by single or bilayered lining epithelium composed of flattened to cuboidal cells, and in other parts surrounded by projections of cells arranged in a trabecular pattern far into the cystic cavity. The trabeculae were composed of basal and low columnar cells that sometimes formed small duct-like structures. Immunohistochemistry showed that the lining epithelium of the cystic cavity and the cells of the projections expressed cytokeratin 7 and high-molecular-weight cytokeratins. The cells of the projections were weakly positive for S-100 protein and negative for vimentin and alpha-smooth muscle actin. Based on the results, a diagnosis of coexisting mucous retention cysts and basal cell adenomas arising from the lining epithelium of cysts was made. The coexistence of mucous retention cysts and basal cell adenomas arising from the lining epithelium of the cyst is reported. Copyright 2009 S. Karger AG, Basel.

The Popularity of Outcome Measures for Hip and Knee Arthroplasties.

Science.gov (United States)

Lovelock, Thomas M; Broughton, Nigel S; Williams, Cylie M

2018-01-01

The optimal methods of determining outcomes following hip and knee arthroplasty remain controversial. The objectives of this study were to determine the most frequently used outcome measures in randomized controlled trials (RCT) and study protocols registered with clinical trials registries (CTR) on hip and knee arthroplasty. A systematic search strategy was undertaken to identify the outcome measures used in RCT and CTR following joint arthroplasty. Databases searched included Embase, Ovid MEDLINE (including In-Process), Cochrane Central Register of Controlled Trials, CINAHL Plus, clinicaltrials.gov, ISRCTN registry, and ANZCTR. Differences in the use of outcome measures between RCT and CTR were assessed using logistic regression. There were 291 RCT and 113 CTR on hip arthroplasty and 452 RCT and 184 CTR on knee arthroplasty that met the inclusion criteria. The most popular outcome measures were the Harris Hip Score and the Knee Society Score. Multiple outcome measures were used in greater than 50% of the included studies. The Oxford Hip Score, Oxford Knee Score, EuroQol-5D, and Knee Injury and Osteoarthritis Outcome Score (all P < .001) were used in significantly more CTR than RCT. There is a clear preference for the use of the Harris Hip Score and Knee Society Score, contrary to existing international guidelines and reviews on the topic. Both measures require clinician input, which potentially influences their validity and increases their overall administration cost. Some patient-reported outcome measures, such as the Oxford Hip and Knee Scores, EuroQol-5D, and KOOS, appear to be increasing in popularity. Copyright © 2017 Elsevier Inc. All rights reserved.

Mild-moderate congenital hearing loss: secular trends in outcomes across four systems of detection.

Science.gov (United States)

Carew, P; Mensah, F K; Rance, G; Flynn, T; Poulakis, Z; Wake, M

2018-01-01

Universal newborn hearing screening (UNHS) targets moderate or greater hearing loss. However, UNHS also frequently detects children with mild loss that results in many receiving early treatment. The benefits of this approach are not yet established. We aimed to (i) compare language and psychosocial outcomes between four hearing loss detection systems for children aged 5-8 years with congenital mild-moderate hearing loss; (ii) determine whether age of detection predicts outcomes; and (iii) compare outcomes between children identified via well-established UNHS and the general population. Linear regression adjusted for potential confounding factors was used throughout. Via a quasi-experimental design, language and psychosocial outcomes were compared across four population-based Australian systems of hearing loss detection: opportunistic detection, born 1991-1993, n = 50; universal risk factor referral, born 2003-2005, n = 34; newly established UNHS, born 2003-2005, n = 41; and well-established UNHS, born 2007-2010, n = 21. In pooled analyses, we examined whether age of detection predicted outcomes. Outcomes were similarly compared between the current well-established UNHS system and typically developing children in the Early Language in Victoria Study, born 2003, n = 1217. Age at diagnosis and hearing aid fitting fell steadily across the four systems. For moderate losses, mean expressive language (P for trend .05) and receptive vocabulary (P for trend .06) improved across the four systems, but benefit was not obvious for mild losses. In pooled analyses, diagnosis before age six months predicted better language outcomes for moderate losses. Children with mild-moderate losses exposed to well-established UNHS continue to experience expressive language scores well below children in the general population (adjusted mean difference -8.9 points, 95% CI -14.7 to -3.1). Treatment arising from UNHS appears to be clearly benefitting children with moderate hearing

Sustainable Development and Spatial Planning: Some considerations arising from the Greek case

Directory of Open Access Journals (Sweden)

Pavlos Marinos Delladetsima

2012-03-01

Full Text Available The paper aims to elaborate on the notion of sustainable development in relation to spatial planning and to question its applicability based on the experience arising from the distinct socio-economic situation in Greece. Experience accumulated in the country with the adoption of sustainable development as a spatial policy concept proves to be in contradiction with perceptions that consider it as a basis for improving the plan making process and the planning system as whole. In this respect, it is argued that sustainable development is not a feasible proposition for planning in Greece and offers little to alleviate urban development and sprawl problems. Further, the paper highlights how a globalised approach to sustainable development and planning in Greece has made a negligible contribution to reinvigorating a weak and disjointed system, while also creating significant adverse effects in spatial policymaking.

Natural age dispersion arising from the analysis of broken crystals. Part I: Theoretical basis and implications for the apatite (U-Th)/He thermochronometer

Science.gov (United States)

Brown, Roderick W.; Beucher, Romain; Roper, Steven; Persano, Cristina; Stuart, Fin; Fitzgerald, Paul

2013-12-01

a similar magnitude to dispersion expected from differences in absolute grain size alone (spherical equivalent radii of 40-150 μm). This source of dispersion is significant compared with typical analytical uncertainties on individual grain analyses (c. 6%) and standard deviations on multiple grain analyses from a single sample (c. 10-20%). Where there is a significant difference in the U and Th concentration of individual grains (eU), the effect of radiation damage accumulation on 4He diffusivity (assessed using the RDAAM model of Flowers et al. (2009)) is the primary cause of dispersion for samples that have experienced a protracted thermal history, and can cause dispersion in excess of 100% for realistic ranges of eU concentration (i.e. 5-100 ppm). Expected natural dispersion arising from the combined effects of reasonable variations in grain size (radii 40-125 μm), eU concentration (5-150 ppm) and fragmentation would typically exceed 100% for complex thermal histories. In addition to adding a significant component of natural dispersion to analyses, the effect of fragmentation also acts to decouple and corrupt expected correlations between grain ages and absolute grain size and to a lesser extent between grain age and effective uranium concentration (eU). Considering fragmentation explicitly as a source of dispersion and analysing how the different sources of natural dispersion all interact with each other provides a quantitative framework for understanding patterns of dispersion that otherwise appear chaotic. An important outcome of these numerical experiments is that they demonstrate that the pattern of age dispersion arising from fragmentation mimics the pattern of 4He distribution within the whole grains, thus providing an important source of information about the thermal history of the sample. We suggest that if the primary focus of a study is to extract the thermal history information from (U-Th)/He analyses then sampling and analytical strategies should

Pediatric pancreas transplantation, including total pancreatectomy with islet autotransplantation.

Science.gov (United States)

Bondoc, Alexander J; Abu-El-Haija, Maisam; Nathan, Jaimie D

2017-08-01

Unlike other solid-organ transplants, whole pancreas transplantation in children is relatively rare, and it occurs more frequently in the context of multivisceral or composite organ transplantation. Because children only infrequently suffer severe sequelae of type 1 diabetes mellitus, pancreas transplantation is rarely indicated in the pediatric population. More commonly, pediatric pancreas transplant occurs in the setting of incapacitating acute recurrent or chronic pancreatitis, specifically islet autotransplantation after total pancreatectomy. In this clinical scenario, total pancreatectomy removes the nidus of chronic pain and debilitation, while autologous islet transplantation aims to preserve endocrine function. The published experiences with pediatric total pancreatectomy with islet autotransplantation (TPIAT) in children has demonstrated excellent outcomes including liberation from chronic opioid use, as well as improved mental and physical quality of life with good glycemic control. Given the complexity of the operation, risk of postoperative complication, and long-term physiologic changes, appropriate patient selection and comprehensive multidisciplinary care teams are critical to ensuring optimal outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

An unusual neonatal presentation of anomalous origin of the left coronary artery arising from the pulmonary artery.

Science.gov (United States)

Garty, Y; Guri, A; Shinwell, E S; Matitiau, A

2008-01-01

We describe a previously unreported neonatal presentation of an anomalous origin of the left coronary artery arising from the pulmonary artery. This is a full-term female infant after normal pregnancy and delivery. The baby was diagnosed at 2 days of age due to weak femoral pulses noted on the routine nursery discharge examination. The cardiac examination revealed weak pulses everywhere and mild tachypnea and tachycardia. An electrocardiogram showed clear signs of ischemia. Echocardiography demonstrated an anomalous origin of the left coronary artery arising from the pulmonary artery with bidirectional blood flow. There was a severely depressed left ventricular function and mild mitral valve regurgitation. At 4 days of age, the infant underwent complete successful surgical repair with reimplantation of the anomalous coronary artery to the aorta. She recovered slowly but well. Fifteen months later she is doing well with no cardiac residua. A neonatal presentation is very unusual due to protective high pulmonary resistance after birth, with gradual decline in pressure and gradual onset of heart failure. This case may be related to an unusually rapid drop in pulmonary vascular resistance causing very early cardiac ischemia. (c) 2007 S. Karger AG, Basel.

CD5-Positive Primary Intraocular B-Cell Lymphoma Arising during Methotrexate and Tumor Necrosis Factor Inhibitor Treatment

Directory of Open Access Journals (Sweden)

Kenji Nagata

2015-09-01

Full Text Available Purpose: To report a case of CD5+ primary intraocular B-cell lymphoma arising during methotrexate (MTX and tumor necrosis factor (TNF inhibitor treatment in a young patient with rheumatoid arthritis and uveitis. Case Presentation: A 39-year-old woman treated with MTX and a TNF inhibitor for rheumatoid arthritis and uveitis had steroid-resistant vitreous opacity. A vitreous sample was obtained by using diagnostic vitrectomy and was categorized as class V based on cytologic examination. Flow cytometric analysis of the vitreous sample revealed that abnormal cells were CD5+, CD10-, CD19+, CD20+ and immunoglobulin light-chain kappa+, suggesting the diagnosis of CD5+ primary intraocular B-cell lymphoma. Polymerase chain reaction (PCR detected immunoglobulin heavy-chain gene rearrangement. Epstein-Barr virus (EBV DNA was detected in the vitreous sample by using PCR, and immunohistochemistry revealed EBV latent membrane protein-1 expression in the abnormal cells infiltrating the vitreous. Optic nerve invasion was observed on magnetic resonance imaging. Conclusion: Primary intraocular lymphoma (PIOL may develop in patients receiving MTX and TNF inhibitor treatment. EBV infection may play an important role in the pathogenesis of PIOL arising during immunosuppressive therapy.

38 CFR 14.605 - Suits against Department of Veterans Affairs employees arising out of a wrongful act or omission...

Science.gov (United States)

2010-07-01

... MISCELLANEOUS CLAIMS Federal Tort Claims § 14.605 Suits against Department of Veterans Affairs employees arising... damage, personal injury, or death allegedly occurring as a result of malpractice or negligence committed... Health Administration. Accordingly, a malpractice or negligence suit for property damage, personal injury...

Critical group doses arising from routine aquatic discharges of activity from the Heysham 2 nuclear power station

International Nuclear Information System (INIS)

Maul, P.R.

1986-07-01

An assessment of critical group doses arising from routine discharges of activity to sea from the Heysham 2 nuclear power station has been undertaken using the CODAR2 computer program. The largest critical group dose rate was calculated to be 50 μSv/y, about 80 per cent of which arose from the external exposure of individuals occupying intertidal sediments of the Lune Estuary from the single nuclide 60 Co. CODAR2 employs a single well mixed local compartment for critical group calculations and can not include the effects of processes varying over the compartment. A more detailed study of the critical group exposure has been carried out using recently developed methods to assess the uncertainties and pessimisms involved in the CODAR2 calculations. It is concluded that these calculations are pessimistic by about a factor of 2, with a reference calculation using the more detailed methods giving a dose rate of 23 μSv/y for the Lune Estuary group. Further reductions in the dose estimate might be possible if site specific measurements of the concentration factor for Co on estuarine sediments and the sedimentation rate in the Lune Estuary could be made. (author)

Developing core economic outcome sets for asthma studies: a protocol for a systematic review.

Science.gov (United States)

Hounsome, Natalia; Fitzsimmons, Deborah; Phillips, Ceri; Patel, Anita

2017-08-11

Core outcome sets are standardised lists of outcomes, which should be measured and reported in all clinical studies of a specific condition. This study aims to develop core outcome sets for economic evaluations in asthma studies. Economic outcomes include items such as costs, resource use or quality-adjusted life years. The starting point in developing core outcome sets will be conducting a systematic literature review to establish a preliminary list of reporting items to be considered for inclusion in the core outcome set. We will conduct literature searches of peer-reviewed studies published from January 1990 to January 2017. These will include any comparative or observational studies (including economic models) and systematic reviews reporting economic outcomes. All identified economic outcomes will be tabulated together with the major study characteristics, such as population, study design, the nature and intensity of the intervention, mode of data collection and instrument(s) used to derive an outcome. We will undertake a 'realist synthesis review' to analyse the identified economic outcomes. The outcomes will be summarised in the context of evaluation perspectives, types of economic evaluation and methodological approaches. Parallel to undertaking a systematic review, we will conduct semistructured interviews with stakeholders (including people with personal experience of asthma, health professionals, researchers and decision makers) in order to explore additional outcomes which have not been considered, or used, in published studies. The list of outcomes generated from the systematic review and interviews with stakeholders will form the basis of a Delphi survey to refine the identified outcomes into a core outcome set. The review will not involve access to individual-level data. Findings from our systematic review will be communicated to a broad range of stakeholders including clinical guideline developers, research funders, trial registries, ethics

Using nationwide ‘big data’ from linked electronic health records to help improve outcomes in cardiovascular diseases:33 studies using methods from epidemiology, informatics, economics and social science in the ClinicAl disease research using LInked Bespoke studies and Electronic health Records (CALIBER) programme

OpenAIRE

Hemingway, Harry; Feder, Gene; Fitzpatrick, Natalie; Denaxas, Spiros; Shah, Amit; Timmis, A D

2017-01-01

BACKGROUND:Electronic health records (EHRs), when linked across primary and secondary care and curated for research use, have the potential to improve our understanding of care quality and outcomes.OBJECTIVE:To evaluate new opportunities arising from linked EHRs for improving quality of care and outcomes for patients at risk of or with coronary disease across the patient journey.DESIGN:Epidemiological cohort, health informatics, health economics and ethnographic approaches were used.SETTING:2...

Relationship between maternal hemoglobin and perinatal outcome

International Nuclear Information System (INIS)

Bakhtiar, U.J.; Khan, Y.; Nisar, R.

2007-01-01

To Study the Relationship between Maternal Hemoglobin and Perinatal outcome in a cohort of 860 pregnant women and to highlight the importance of antenatal care regarding maternal health and fetal outcome. All Singleton pregnancies delivering at Pakistan Railway Hospital Rawalpindi from January 2004 to December 2005 that fulfilled the required criteria were included. Out of the 860 patients, 402 were anemic (<11gm/dl) and 458 were non anemic. Perinatal outcome included preterm delivery, low birth weight, intrauterine growth retardation, perinatal death, low apgr scores and intrauterine fetal deaths. Risk of preterm and Low birth weight among anemic women was 3.4 and 1.8 times more than non anaemic women. The neonates of anemic woman also had 1.7 times increased risk of having low apgr scores at 1 min. Among anemic women there was 2.2 times greater risk of intrauterine fetal death than the non-anemic women. Regular antenatal care from first trimester has a vital role in assessing and managing maternal anemia timely and it directly affects the perinatal outcome. The patients with anemia have also higher risk of having low birth weight, preterm births and intra uterine fetal death. (author)

Unintended outcomes evaluation approach: A plausible way to evaluate unintended outcomes of social development programmes.

Science.gov (United States)

Jabeen, Sumera

2018-06-01

Social development programmes are deliberate attempts to bring about change and unintended outcomes can be considered as inherent to any such intervention. There is now a solid consensus among the international evaluation community regarding the need to consider unintended outcomes as a key aspect in any evaluative study. However, this concern often equates to nothing more than false piety. Exiting evaluation theory suffers from overlap of terminology, inadequate categorisation of unintended outcomes and lack of guidance on how to study them. To advance the knowledge of evaluation theory, methods and practice, the author has developed an evaluation approach to study unintended effects using a theory building, testing and refinement process. A comprehensive classification of unintended outcomes on the basis of knowability, value, distribution and temporality helped specify various type of unintended outcomes for programme evaluation. Corresponding to this classification, a three-step evaluation process was proposed including a) outlining programme intentions b) forecasting likely unintended effects c) mapping the anticipated and understanding unanticipated unintended outcomes. This unintended outcomes evaluation approach (UOEA) was then trialled by undertaking a multi-site and multi-method case study of a poverty alleviation programme in Pakistan and refinements were made to the approach.The case study revealed that this programme was producing a number of unintended effects, mostly negative, affecting those already disadvantaged such as the poorest, women and children. The trialling process demonstrated the effectiveness of the UOEA and suggests that this can serve as a useful guide for future evaluation practice. It also provides the discipline of evaluation with an empirically-based reference point for further theoretical developments in the study of unintended outcomes. Copyright © 2017 Elsevier Ltd. All rights reserved.

Predicting outcome of status epilepticus.

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Leitinger, M; Kalss, G; Rohracher, A; Pilz, G; Novak, H; Höfler, J; Deak, I; Kuchukhidze, G; Dobesberger, J; Wakonig, A; Trinka, E

2015-08-01

Status epilepticus (SE) is a frequent neurological emergency complicated by high mortality and often poor functional outcome in survivors. The aim of this study was to review available clinical scores to predict outcome. Literature review. PubMed Search terms were "score", "outcome", and "status epilepticus" (April 9th 2015). Publications with abstracts available in English, no other language restrictions, or any restrictions concerning investigated patients were included. Two scores were identified: "Status Epilepticus Severity Score--STESS" and "Epidemiology based Mortality score in SE--EMSE". A comprehensive comparison of test parameters concerning performance, options, and limitations was performed. Epidemiology based Mortality score in SE allows detailed individualization of risk factors and is significantly superior to STESS in a retrospective explorative study. In particular, EMSE is very good at detection of good and bad outcome, whereas STESS detecting bad outcome is limited by a ceiling effect and uncertainty of correct cutoff value. Epidemiology based Mortality score in SE can be adapted to different regions in the world and to advances in medicine, as new data emerge. In addition, we designed a reporting standard for status epilepticus to enhance acquisition and communication of outcome relevant data. A data acquisition sheet used from patient admission in emergency room, from the EEG lab to intensive care unit, is provided for optimized data collection. Status Epilepticus Severity Score is easy to perform and predicts bad outcome, but has a low predictive value for good outcomes. Epidemiology based Mortality score in SE is superior to STESS in predicting good or bad outcome but needs marginally more time to perform. Epidemiology based Mortality score in SE may prove very useful for risk stratification in interventional studies and is recommended for individual outcome prediction. Prospective validation in different cohorts is needed for EMSE, whereas

PEAK COVARIANCE STABILITY OF A RANDOM RICCATI EQUATION ARISING FROM KALMAN FILTERING WITH OBSERVATION LOSSES

Institute of Scientific and Technical Information of China (English)

Li XIE; Lihua XIE

2007-01-01

We consider the stability of a random Riccati equation with a Markovian binary jump coefficient. More specifically, we are concerned with the boundedness of the solution of a random Riccati difference equation arising from Kalman filtering with measurement losses. A sufficient condition for the peak covariance stability is obtained which has a simpler form and is shown to be less conservative in some cases than a very recent result in existing literature. Furthermore, we show that a known sufficient condition is also necessary when the observability index equals one.

Chondroblastoma arising in the triradiate cartilage. Report of two cases with review of the literature

Energy Technology Data Exchange (ETDEWEB)

Matsuno, Takeo; Hasegawa, Isao; Masuda, Takeshi

1987-04-01

Chondroblastoma is a relatively rare benign bone tumor of cartilage origin. Roentgenologically it presents usually as a region of lytic destruction of bone with a thin sclerotic rim in the epiphysis of long tubular bone. Less than 9% occur in the pelvic bones but show a tendency to arise from the triradiate cartilage. We present two cases of chondroblastoma originating in the triradiate cartilage, each showing extensive lytic bony destruction and an intrapelvic soft tissue mass. A review of the literature suggests that chondroblastoma of the triradiate cartilage shows an aggressive radiological appearance.

Cognitive outcome of surgery.

Science.gov (United States)

Gallagher, Anne; Jambaqué, Isabelle; Lassonde, Maryse

2013-01-01

Epilepsy surgery is now widely accepted as an effective therapeutic option for carefully selected children with medically refractory epilepsy. The surgical procedure may cause cognitive deficits or exacerbate existing impairments, but it may also improve cognitive abilities by the restoration of functions located in adjacent or contralateral areas that had been secondarily affected by the epilepsy or the underlying pathology. Compared to adults, better cognitive outcome has been reported in children, a finding probably due to the developing state of the brain, which possesses considerable structural and functional plasticity. More extensive and effective surgery such as hemispherectomy is more commonly used in the pediatric population, and this must also influence surgical outcome. However, studies related to cognitive outcome of epilepsy surgery in children are limited, and controversial results are often reported. In this chapter, we provide a current overview of the literature on cognitive outcomes in children who undergo different types of epilepsy surgery, including focal resections as well as corpus callosotomy and hemispherectomy. Early surgical intervention appears to be a rational option for the treatment of childhood epilepsy since many cognitive deficits are linked to the epileptic process and may disappear when seizures are controlled. Copyright © 2013 Elsevier B.V. All rights reserved.

Predicting unfavourable outcome in herpetic meningoencephalitis

DEFF Research Database (Denmark)

Erdem, Hakan; Cag, Yasemin; Karaahmetoglu, Gokhan

BACKGROUND: Herpetic meningoencephalitis is the most frequent form of sporadic fatal encephalitis in the world and accounts for 10- 20% of all viral encephalitides. There were studies assessing the outcomes particularly by comparing the efficacies of antiviral drugs in the past. To the best of our...... knowledge, no datum exists in the literature on the mortality indicators of HME patients with definite microbiological diagnosis. Thus, our study makes use of the largest case series ever reported in the literature to provide data for the predictors of unfavorable outcome in HME cases. METHODS...... outcome in HME. Thus, it appears that both host and therapeutic parameters contribute to success in these cases. Table. Final model including independent predictors of unfavorable outcome 95% CIs OR [1] Low High p Age (years) 1.04 1.02 1.05 0.000 Glasgow coma scale 0.84 0.77 0.93 0.000 Elapsed time [2] >2...

Persistent ovarian masses and pregnancy outcomes.

Science.gov (United States)

Goh, William A; Rincon, Monica; Bohrer, Justin; Tolosa, Jorge E; Sohaey, Roya; Riaño, Rene; Davis, James; Zalud, Ivica

2013-07-01

To determine if persistent ovarian masses in pregnancy are associated with increased adverse outcomes. This is a retrospective cohort of 126 pregnant women with a persistent ovarian mass measuring 5 cm or greater who delivered at two university hospitals between 2001 and 2009. Maternal outcomes included gestational age (GA) at diagnosis, delivery and surgery as well as miscarriage, preterm birth (PTB), ovarian torsion and hospital admission for pain. Neonatal outcomes included birth weight, respiratory distress syndrome (RDS), intra-ventricular hemorrhage (IVH), death and sepsis. A total of 1225 ovarian masses were identified (4.9%) in 24,868 patients. A persistent ovarian mass was found in 0.7%. Average GA at diagnosis was 17.8 weeks. Miscarriage rate was 3.3%. Average GA at delivery was 37.9 weeks. Of the patients, 8.5% had ovarian torsion, 10.3% had admission for pain and 9.3% had PTBs. The mean cesarean delivery rate was 46.3%. The average neonatal weight was 3273 g. There was one neonatal death in this cohort. The rate of RDS was 2.8%, IVH 0.9% and neonatal sepsis 1.9%. The most common surgical pathologic diagnosis was dermoids (37.6%). No overt malignancies were seen. A persistent ovarian mass in pregnancy does not confer an increased risk of adverse pregnancy outcomes.

76 FR 67530 - Generalized System of Preferences (GSP): Notice of Actions Arising Out of the 2010 Annual GSP Review

Science.gov (United States)

2011-11-01

... OFFICE OF THE UNITED STATES TRADE REPRESENTATIVE Generalized System of Preferences (GSP): Notice of Actions Arising Out of the 2010 Annual GSP Review AGENCY: Office of the United States Trade Representative. ACTION: Notice of a petition accepted for review; and request for comments. SUMMARY: In September...

Primary Care Research in the Patient-Centered Outcomes Research Institute's Portfolio.

Science.gov (United States)

Selby, Joe V; Slutsky, Jean R

2016-04-01

In their article in this issue, Mazur and colleagues analyze the characteristics of early recipients of funding from the Patient-Centered Outcomes Research Institute (PCORI). Mazur and colleagues note correctly that PCORI has a unique purpose and mission and suggest that it should therefore have a distinct portfolio of researchers and departments when compared with other funders such as the National Institutes of Health (NIH). Responding on behalf of PCORI, the authors of this Commentary agree with the characterization of PCORI's mission as distinct from that of NIH and others. They agree too that data found on PCORI's Web site demonstrate that PCORI's portfolio of researchers and departments is more diverse and more heavily populated with clinician researchers, as would be expected. The authors take issue with Mazur and colleagues' suggestion that because half of clinical visits occur within primary care settings, half of PCORI's funded research should be based in primary care departments. PCORI's portfolio reflects what patients and others tell PCORI are the critical questions. Many of these do, in fact, occur with more complex conditions in specialty care. The authors question whether the research of primary care departments is too narrowly focused and whether it sufficiently considers study of these complex conditions. Research on more complex conditions including heart failure, coronary artery disease, and multiple comorbid conditions could be highly valuable when approached from the primary care perspective, where many of the comparative effectiveness questions first arise.

Early Adolescent Affect Predicts Later Life Outcomes.

Science.gov (United States)

Kansky, Jessica; Allen, Joseph P; Diener, Ed

2016-07-01

Subjective well-being as a predictor for later behavior and health has highlighted its relationship to health, work performance, and social relationships. However, the majority of such studies neglect the developmental nature of well-being in contributing to important changes across the transition to adulthood. To examine the potential role of subjective well-being as a long-term predictor of critical life outcomes, we examined indicators of positive and negative affect at age 14 as predictors of relationship, adjustment, self-worth, and career outcomes a decade later at ages 23 to 25, controlling for family income and gender. We utilised multi-informant methods including reports from the target participant, close friends, and romantic partners in a demographically diverse community sample of 184 participants. Early adolescent positive affect predicted fewer relationship problems (less self-reported and partner-reported conflict, and greater friendship attachment as rated by close peers) and healthy adjustment to adulthood (lower levels of depression, anxiety, and loneliness). It also predicted positive work functioning (higher levels of career satisfaction and job competence) and increased self-worth. Negative affect did not significantly predict any of these important life outcomes. In addition to predicting desirable mean levels of later outcomes, early positive affect predicted beneficial changes across time in many outcomes. The findings extend early research on the beneficial outcomes of subjective well-being by having an earlier assessment of well-being, including informant reports in measuring a large variety of outcome variables, and by extending the findings to a lower socioeconomic group of a diverse and younger sample. The results highlight the importance of considering positive affect as an important component of subjective well-being distinct from negative affect. © 2016 The International Association of Applied Psychology.

Antecedents, mediators, and outcomes of authentic leadership in healthcare: A systematic review.

Science.gov (United States)

Alilyyani, Bayan; Wong, Carol A; Cummings, Greta

2018-04-07

Leaders are essential in every organization to achieve patient safety and healthy work environments. Authentic leadership is a relational leadership style purported to promote healthy work environments that influence staff performance and organizational outcomes. Given recent growth in authentic leadership research in healthcare and the importance of new knowledge to inform leadership development, there is an obligation to determine what is known about the antecedents and outcomes of authentic leadership in healthcare settings and clarify mechanisms by which authentic leadership affects healthcare staff and patient outcomes. The aim of this systematic review was to examine the antecedents, mediators and outcomes associated with authentic leadership in healthcare. Systematic review. The search strategy included 11 electronic databases: ABI Inform Dateline, Academic Search Complete, Cochrane Database of Systematic Reviews, PubMed, CINAHL, Embase, ERIC, PsycINFO, Scopus, Web of Science, and ProQuest Dissertations & Theses. The search was conducted in January 2017. Published English-only quantitative research that examined the antecedents, mediators and outcomes of authentic leadership practices of leaders in healthcare settings was included. Quality assessment, data extractions, and analysis were completed on all included studies. Data extracted from included studies were analyzed through descriptive and narrative syntheses. Content analysis was used to group antecedents, outcomes and mediators into categories which were then compared to authentic leadership theory. 1036 titles and abstracts were screened yielding 136 manuscripts for full-text review which resulted in 21 included studies reported in 38 manuscripts. Significant associations between authentic leadership and 43 outcomes were grouped into two major themes: healthcare staff outcomes with 5 subthemes (personal psychological states, satisfaction with work, work environment factors, health & well-being, and

Efficient Algorithms for Electrostatic Interactions Including Dielectric Contrasts

Directory of Open Access Journals (Sweden)

Christian Holm

2013-10-01

Full Text Available Coarse-grained models of soft matter are usually combined with implicit solvent models that take the electrostatic polarizability into account via a dielectric background. In biophysical or nanoscale simulations that include water, this constant can vary greatly within the system. Performing molecular dynamics or other simulations that need to compute exact electrostatic interactions between charges in those systems is computationally demanding. We review here several algorithms developed by us that perform exactly this task. For planar dielectric surfaces in partial periodic boundary conditions, the arising image charges can be either treated with the MMM2D algorithm in a very efficient and accurate way or with the electrostatic layer correction term, which enables the user to use his favorite 3D periodic Coulomb solver. Arbitrarily-shaped interfaces can be dealt with using induced surface charges with the induced charge calculation (ICC* algorithm. Finally, the local electrostatics algorithm, MEMD(Maxwell Equations Molecular Dynamics, even allows one to employ a smoothly varying dielectric constant in the systems. We introduce the concepts of these three algorithms and an extension for the inclusion of boundaries that are to be held fixed at a constant potential (metal conditions. For each method, we present a showcase application to highlight the importance of dielectric interfaces.

Long-term outcome of craniopharyngioma in children. A review

International Nuclear Information System (INIS)

Tamiya, Takashi; Okada, Masaki; Miyake, Keisuke; Kawai, Nobuyuki

2011-01-01

The treatment for pediatric craniopharyngioma remains challenging and controversial. Although this tumor is histologically benign, the treatments include radical surgery, conservative surgery, radiotherapy, intracystic chemotherapy and multimodality approaches. In addition, the long-term functional outcomes including visual function, endocrine function, cognitive function, hypothalamic function, and quality of life are complex and major problems among survivors. In this paper, we reviewed the recent treatments for pediatric craniopharyngioma and the long-term outcomes after treatment in literatures. (author)

Occupational exposures and health outcomes among Latina hotel cleaners.

Science.gov (United States)

Hsieh, Yu-Chin Jerrie; Apostolopoulos, Yorghos; Hatzudis, Kiki; Sönmez, Sevil

2014-01-01

The poor working conditions of Latina hotel cleaners render them particularly vulnerable to elevated occupational hazards that lead to adverse health outcomes. This article presents a comprehensive review of occupational risks (including physical, chemical, biological, and psychosocial risk factors) and health outcomes (including musculoskeletal disorders, respiratory diseases, dermatological diseases and allergies, and psychological disorders) for Latina hotel cleaners, within their unique sociocultural contexts. Preventive interventions for improving Latina hotel cleaners' work and health conditions are recommended.

Response to Therapy and Outcomes in Oropharyngeal Cancer Are Associated With Biomarkers Including Human Papillomavirus, Epidermal Growth Factor Receptor, Gender, and Smoking

International Nuclear Information System (INIS)

Kumar, Bhavna; Cordell, Kitrina G.; Lee, Julia S.; Prince, Mark E.; Tran, Huong H.; Wolf, Gregory T.; Urba, Susan G.; Worden, Francis P.; Chepeha, Douglas B.; Teknos, Theodoros N.; Eisbruch, Avraham; Tsien, Christina I.; Taylor, Jeremy; D'Silva, Nisha J.; Yang, Kun; Kurnit, David M.; Bradford, Carol R.

2007-01-01

Induction chemotherapy and concurrent chemoradiation for responders or immediate surgery for non-responders is an effective treatment strategy head and neck squamous cell carcinoma (HNSCC) of the larynx and oropharynx. Biomarkers that predict outcome would be valuable in selecting patients for therapy. In this study, the presence and titer of high risk human papilloma virus (HPV) and expression of epidermal growth factor receptor (EGFR) in pre-treatment biopsies, as well as smoking and gender were examined in oropharynx cancer patients enrolled in an organ sparing trial. HPV16 copy number was positively associated with response to therapy and with overall and disease specific survival, whereas EGFR expression, current or former smoking behavior, and female gender (in this cohort) were associated with poor response and poor survival in multivariate analysis. Smoking cessation and strategies to target EGFR may be useful adjuncts for therapy to improve outcome in the cases with the poorest biomarker profile

Impact of a pain protocol including hypnosis in major burns.

Science.gov (United States)

Berger, Mette M; Davadant, Maryse; Marin, Christian; Wasserfallen, Jean-Blaise; Pinget, Christophe; Maravic, Philippe; Koch, Nathalie; Raffoul, Wassim; Chiolero, René L

2010-08-01

Pain is a major issue after burns even when large doses of opioids are prescribed. The study focused on the impact of a pain protocol using hypnosis on pain intensity, anxiety, clinical course, and costs. All patients admitted to the ICU, aged >18 years, with an ICU stay >24h, accepting to try hypnosis, and treated according to standardized pain protocol were included. Pain was scaled on the Visual Analog Scale (VAS) (mean of daily multiple recordings), and basal and procedural opioid doses were recorded. Clinical outcome and economical data were retrieved from hospital charts and information system, respectively. Treated patients were matched with controls for sex, age, and the burned surface area. Forty patients were admitted from 2006 to 2007: 17 met exclusion criteria, leaving 23 patients, who were matched with 23 historical controls. Altogether patients were 36+/-14 years old and burned 27+/-15%BSA. The first hypnosis session was performed after a median of 9 days. The protocol resulted in the early delivery of higher opioid doses/24h (ppatient. A pain protocol including hypnosis reduced pain intensity, improved opioid efficiency, reduced anxiety, improved wound outcome while reducing costs. The protocol guided use of opioids improved patient care without side effects, while hypnosis had significant psychological benefits.

Universal Preschool Programs and Long-Term Child Outcomes

DEFF Research Database (Denmark)

Dietrichson, Jens; Kristiansen, Ida Lykke; Viinholt Nielsen, Bjørn Christian

2018-01-01

This systematic review included 25 studies using natural experiments to estimate the effects of universal preschool programs for children aged 0-6 years on child outcomes measured from third grade to adulthood. Studies comparing preschool with parental, family, or other informal modes of care...... alternative types of universal preschool programs in terms of long-term outcomes....

Fetomaternal outcome in triplet pregnancy

International Nuclear Information System (INIS)

Mazhar, S.B.; Furukh, T; Rahim, F.

2008-01-01

To determine maternal outcome as antenatal and postnatal complications and neonatal outcome as birth weight, morbidity and mortality in triplet gestation. All the patients with triplet pregnancy beyond 28 weeks gestation, who delivered at the study place during above period were included in the study. The primary outcome measures were frequency of maternal complications and neonatal birth, weight and morbidity. Secondary outcome measures included the frequency of assisted conception in the studied cohart. Eighteen women had triplet pregnancy beyond 28 weeks. Nine were booked, 6 non-booked and 3 of them were referred. Mean duration of gestation was 237.8 days (33.8 weeks). The antenatal complications were preterm delivery in 50%, hypertension in 50%, anemia in 44.4% and obstetric cholestasis in 5.6%. Eight patients (44.4%) suffered postpartum hemorrhage. One patient had peripartum hysterectomy and later expired in intensive care unit after three weeks. Maternal mortality ratio was 5.6%. Fifty five percent women had induction of ovulation with Clomiphene, while none had In Vitro Fertilization (IVF) or Intracytoplasmic Insemination (ICSI) or received gonadotrophins. Fifteen sets of triplets were delivered abdominally. Mean birth weights of 1st, 2nd and 3rd triplet were 1651, 1640 and 1443 grams respectively. Five sets of triplets (27.8%) had more than 25% discordance for birth weight. The mean Apgar scores of the babies at 1 and 10 minutes after birth were 6.0 and 8.0, 5.6 and 7.5; and 5.2 and 7.0 respectively. Of the 54 infants, 18 required Neonatal Intensive Care Unit (NICU) admission and 14 were admitted in nursery. Two died shortly after birth. Total perinatal mortalities were 13 including 4 cases of intra-uterine demise. Three babies suffered from jaundice, 7 had sepsis and 8 had respiratory distress syndrome. Triplet gestation had a high rate of fetomaternal complications. Majority had history of assisted conception. (author)

[Outcomes after planned home births].

Science.gov (United States)

Blix, Ellen; Øian, Pål; Kumle, Merethe

2008-11-06

About 150 planned home births take place in Norway annually. Professionals have different opinions on whether such births are safe or not. The aim of the present study was to perform a systematic literature review on maternal and neonatal outcomes after planned home births. A review was performed of literature retrieved from searches in MEDLINE, PubMed, Embase, Cinahl and The Cochrane Library and relevant references found in the articles. The searches were limited to studies published in 1985 and later. 10 studies with data from 30 204 women who had planned and were selected to home birth at the onset of labour were included. Three of the studies had control groups including women with planned hospital births. All included studies were assessed to be of medium quality. Between 9.9 and 23.1 % of women and infants were transferred to hospital during labour or after birth. There were few caesarean sections, other interventions or complications in the studies assessed; the total perinatal mortality rate was 2.9/1000 and the intrapartum mortality rate 0.8/1000. There is no sound basis for discouraging low-risk women from planning a home birth. Results from the included studies do not directly apply to Norwegian conditions. Outcomes and transfers after planned home births should be systematically registered.

Clinical Outcomes Used in Clinical Pharmacy Intervention Studies in Secondary Care

Directory of Open Access Journals (Sweden)

Lene Juel Kjeldsen

2017-05-01

Full Text Available The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases: “Intervention(s” and “pharmacist(s” and “controlled” and “outcome(s” or “effect(s”. Primary research studies in English of controlled, clinical pharmacy intervention studies, including outcome evaluation, were selected. Titles, abstracts and full-text papers were assessed individually by two reviewers, and inclusion was determined by consensus. In total, 37 publications were included in the review. The publications presented similar intervention elements but differed in study design. A large variety of outcome measures (135 had been used to evaluate the effect of the interventions; most frequently clinical measures/assessments by physician and health care service use. No apparent pattern was established among primary outcome measures with significant effect in favour of the intervention, but positive effect was most frequently related to studies that included power calculations and sufficient inclusion of patients (73% vs. 25%. This review emphasizes the importance of considering the relevance of outcomes selected to assess clinical pharmacy interventions and the importance of conducting a proper power calculation.

Health Outcomes Survey - Limited Data Set

Data.gov (United States)

U.S. Department of Health & Human Services — The Medicare Health Outcomes Survey (HOS) limited data sets (LDS) are comprised of the entire national sample for a given 2-year cohort (including both respondents...

Cardinal features of involuntary force variability can arise from the closed-loop control of viscoelastic afferented muscles

Science.gov (United States)

Laine, Christopher M.; Valero-Cuevas, Francisco J.

2018-01-01

Involuntary force variability below 15 Hz arises from, and is influenced by, many factors including descending neural drive, proprioceptive feedback, and mechanical properties of muscles and tendons. However, their potential interactions that give rise to the well-structured spectrum of involuntary force variability are not well understood due to a lack of experimental techniques. Here, we investigated the generation, modulation, and interactions among different sources of force variability using a physiologically-grounded closed-loop simulation of an afferented muscle model. The closed-loop simulation included a musculotendon model, muscle spindle, Golgi tendon organ (GTO), and a tracking controller which enabled target-guided force tracking. We demonstrate that closed-loop control of an afferented musculotendon suffices to replicate and explain surprisingly many cardinal features of involuntary force variability. Specifically, we present 1) a potential origin of low-frequency force variability associated with co-modulation of motor unit firing rates (i.e.,‘common drive’), 2) an in-depth characterization of how proprioceptive feedback pathways suffice to generate 5-12 Hz physiological tremor, and 3) evidence that modulation of those feedback pathways (i.e., presynaptic inhibition of Ia and Ib afferents, and spindle sensitivity via fusimotor drive) influence the full spectrum of force variability. These results highlight the previously underestimated importance of closed-loop neuromechanical interactions in explaining involuntary force variability during voluntary ‘isometric’ force control. Furthermore, these results provide the basis for a unifying theory that relates spinal circuitry to various manifestations of altered involuntary force variability in fatigue, aging and neurological disease. PMID:29309405

Cardinal features of involuntary force variability can arise from the closed-loop control of viscoelastic afferented muscles.

Science.gov (United States)

Nagamori, Akira; Laine, Christopher M; Valero-Cuevas, Francisco J

2018-01-01

Involuntary force variability below 15 Hz arises from, and is influenced by, many factors including descending neural drive, proprioceptive feedback, and mechanical properties of muscles and tendons. However, their potential interactions that give rise to the well-structured spectrum of involuntary force variability are not well understood due to a lack of experimental techniques. Here, we investigated the generation, modulation, and interactions among different sources of force variability using a physiologically-grounded closed-loop simulation of an afferented muscle model. The closed-loop simulation included a musculotendon model, muscle spindle, Golgi tendon organ (GTO), and a tracking controller which enabled target-guided force tracking. We demonstrate that closed-loop control of an afferented musculotendon suffices to replicate and explain surprisingly many cardinal features of involuntary force variability. Specifically, we present 1) a potential origin of low-frequency force variability associated with co-modulation of motor unit firing rates (i.e.,'common drive'), 2) an in-depth characterization of how proprioceptive feedback pathways suffice to generate 5-12 Hz physiological tremor, and 3) evidence that modulation of those feedback pathways (i.e., presynaptic inhibition of Ia and Ib afferents, and spindle sensitivity via fusimotor drive) influence the full spectrum of force variability. These results highlight the previously underestimated importance of closed-loop neuromechanical interactions in explaining involuntary force variability during voluntary 'isometric' force control. Furthermore, these results provide the basis for a unifying theory that relates spinal circuitry to various manifestations of altered involuntary force variability in fatigue, aging and neurological disease.

Internet interventions for chronic pain including headache: A systematic review

Directory of Open Access Journals (Sweden)

Monica Buhrman

2016-05-01

Full Text Available Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12 were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = −0.39, for pain intensity Hedge's g = −0.33, for catastrophizing Hedge's g = −0.49 and for mood variables (depression Hedge's g = −0.26.

Squamous Cell Carcinoma of the Larynx Arising in Multifocal Pharyngolaryngeal Oncocytic Papillary Cystadenoma

Science.gov (United States)

Stenner, Markus; Müller, Klaus-Michael; Koopmann, Mario; Rudack, Claudia

2014-01-01

Abstract We report on a rare case of a laryngeal carcinoma arising in a multifocal pharyngolaryngeal oncocytic papillary cystadenoma (OPC). The disease of a 63-year-old man is well documented by computed and positron emission tomography, histology, and electron microscopy. We could show that an OPC can even develop in the pharynx. The coexistence of both tumors makes this a challenging diagnosis for pathologists. Treated by surgery and radiotherapy, both lesions dissolved. Based on the literature available, we discuss the theory that the laryngeal carcinoma might be the result of a true metaplasia facilitated by chronic irritation and recommend a regular follow-up for OPC too. As in benign oncocytic lesions, we could show that the detection of numerous mitochondria is a diagnostic indicator for malignant variants as well. PMID:25211046

Outcomes after colon trauma in the 21st century: an analysis of the U.S. National Trauma Data Bank.

Science.gov (United States)

Hatch, Quinton; Causey, Marlin; Martin, Matthew; Stoddard, Douglas; Johnson, Eric; Maykel, Justin; Steele, Scott

2013-08-01

Most colon trauma data arise from institutional series that provide descriptive analysis. We investigated the outcome of these patients by analyzing a nationwide database. We queried the U.S. National Trauma Data Bank (2007-2009) using primary International Classification of Diseases, 9th edition, Clinical Modification codes to identify colon injuries. Outcomes were stratified by injury mechanism (blunt versus penetrating), segment of colon injured, and management strategy (diversion versus in continuity). There were 6,817 patients who suffered primary colon injuries; 82% were male and 48% experienced blunt injuries. Blunt colon trauma patients were older, had lengthier intensive care stays, and greater rates of morbidity and mortality than those with penetrating injuries (all P colon injuries (24%). The overall fecal diversion rate was 9%, with the highest rates seen in patients with sigmoid colon injuries (15%). Diverted patients were older, had higher injury severity scores, and increased mortality (22% vs 12%; P colon injuries seem to be managed with fecal diversion more often than other segmental injuries. Neither blunt mechanism nor fecal diversion were independently associated with adverse outcomes in colon trauma. Copyright © 2013 Mosby, Inc. All rights reserved.

Influence of peer review on the reporting of primary outcome(s) and statistical analyses of randomised trials.

Science.gov (United States)

Hopewell, Sally; Witt, Claudia M; Linde, Klaus; Icke, Katja; Adedire, Olubusola; Kirtley, Shona; Altman, Douglas G

2018-01-11

primary outcome, or funding source. Thirty-six percent (n = 94) of authors had been asked to include additional analyses that had not been included in the original manuscript; in 77% (n = 72) these were not pre-specified in the protocol. Twenty-three percent (n = 60) had been asked to modify their overall conclusion, usually (n = 53; 88%) to provide a more cautious conclusion. Overall, most changes, as a result of the peer review process, resulted in improvements to the published manuscript; there was little evidence of a negative impact in terms of post hoc changes of the primary outcome. However, some suggested changes might be considered inappropriate, such as unplanned additional analyses, and should be discouraged.

Effects of massage therapy on pain and anxiety arising from intrathecal therapy or bone marrow aspiration in children with cancer.

Science.gov (United States)

Çelebioğlu, Ayda; Gürol, Ayşe; Yildirim, Zuhal Keskin; Büyükavci, Mustafa

2015-12-01

Cancer and its treatment are stressful and reduce the quality of life in children. The aim of this study was to investigate the effect of massage therapy on pain and anxiety arising from intrathecal therapy or bone marrow aspiration in children with cancer. We conducted a controlled pretest/posttest quasi-experimental study at a paediatric oncology unit in Turkey. Twenty-five children were enrolled in this study. Their pain and anxiety were determined using a visual analogue scale. When the pretest and posttest pain and anxiety levels of the groups were compared, no statistically significant difference was found (P > 0.05). It was determined that pain and anxiety levels in the experimental group decreased significantly. This study provides preliminary evidence for the effectiveness in children of massage in reducing pain and anxiety arising from intrathecal therapy or bone marrow aspiration. © 2014 Wiley Publishing Asia Pty Ltd.

Psychological distress and in vitro fertilization outcome.

Science.gov (United States)

Pasch, Lauri A; Gregorich, Steven E; Katz, Patricia K; Millstein, Susan G; Nachtigall, Robert D; Bleil, Maria E; Adler, Nancy E

2012-08-01

To examine whether psychological distress predicts IVF treatment outcome as well as whether IVF treatment outcome predicts subsequent psychological distress. Prospective cohort study over an 18-month period. Five community and academic fertility practices. Two hundred two women who initiated their first IVF cycle. Women completed interviews and questionnaires at baseline and at 4, 10, and 18 months' follow-up. IVF cycle outcome and psychological distress. In a binary logistic model including covariates (woman's age, ethnicity, income, education, parity, duration of infertility, and time interval), pretreatment depression and anxiety were not significant predictors of the outcome of the first IVF cycle. In linear regression models including covariates (woman's age, income, education, parity, duration of infertility, assessment point, time since last treatment cycle, and pre-IVF depression or anxiety), experiencing failed IVF was associated with higher post-IVF depression and anxiety. IVF failure predicts subsequent psychological distress, but pre-IVF psychological distress does not predict IVF failure. Instead of focusing efforts on psychological interventions specifically aimed at improving the chance of pregnancy, these findings suggest that attention be paid to helping patients prepare for and cope with treatment and treatment failure. Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Stress fractures of the rib arising from the manufactory assembly line

International Nuclear Information System (INIS)

Arima, Toru; Iwasaki, Masayuki

2007-01-01

We investigated stress injuries of the rib arising from the assembly line. The patients, all males, were 20 in number and divided into two groups; those with stress fracture (n=13) and those with ''pre-fracture'' (n=7). The former group with the average age of 37 years was involved by a single fracture in 10 patients and multiple fractures in 3, ranging from 5th to 8th ribs, with the affected side on the right in 9 and the left in 4. All 13 fractures occurred in the posterior half of the rib, in which 5 were located in its lateral portion, 5 in the middle, and 3 in the posterior. The latter group with the average age of 32 years were involved on the right side in 4 and the left in 3. The working pattern causing rib injuries was either repeated raising of the upper extremity or forward pushing of the shoulder girdle. The symptom was back pain, and aggravated especially in elevation of the arm, deep breathing and sneezing. Local tenderness over the fracture site was noted in all cases. X-ray findings at initial examination revealed fractures in most cases and 3D-CT was employed in 9 questionable cases to assess fracture conditions. In the ''pre-fracture'' group, although the fracture was not recognized on X-ray, the diagnosis was made as an impending fracture based on the localized tenderness on the rib. As to treatment, bust band fixation and work load reduction were performed. Stress fractures of the rib have been occasionally reported in sports medicine, but not so much in industrial medicine. This specific injury has been treated in literature as muscle strain because of the absence of apparent trauma. It is important to recognize the underlying pathology to make the correct diagnosis. In the early stage of rib fractures, 3D-CT was more useful than X-ray in making diagnosis and assessing the bony union. As to the pathomechanism of this condition, it was postulated that repeated raising or forward pushing of the arm applying excessive traction to the origin of the

Clinical outcomes research in gynecologic oncology.

Science.gov (United States)

Melamed, Alexander; Rauh-Hain, J Alejandro; Schorge, John O

2017-09-01

Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology. Copyright © 2017. Published by Elsevier Inc.

Nursing Practice Environment and Outcomes for Oncology Nursing

Science.gov (United States)

Shang, Jingjing; Friese, Christopher R.; Wu, Evan; Aiken, Linda H.

2012-01-01

Background It is commonly assumed that oncology nurses experience high job-related burnout and high turnover because their work involves inherent stressors such as caring for patients with serious and often life-threatening illness. Objectives The objectives of this study were to examine the differences in outcomes such as job dissatisfaction and burnout between oncology nurses and medical-surgical nurses, and to identify factors that affect oncology nurse outcomes. Methods A secondary analysis of nurse survey data collected in 2006 including 4047 nurses from 282 hospitals in 3 states was performed; t test and χ2 test compared differences between oncology nurses and medical-surgical nurses in nurse outcomes and their assessments of nurse practice environment, as measured by the Practice Environment Scale of the Nursing Work Index. Logistic regression models estimated the effect of nurse practice environment on 4 nurse-reported outcomes: burnout, job dissatisfaction, intention to leave the current position, and perceived quality of care. Results Oncology nurses reported favorable practice environments and better outcomes than did medical-surgical nurses. All 4 subscales of the Practice Environment Scale of the Nursing Work Index studied were significantly associated with outcomes. Specifically, nurses who reported favorable nursing foundations for quality of care (eg, active in-service or preceptorship programs) were less likely to report burnout and leave their current position. Conclusions Better practice environments, including nurse foundations for quality care, can help to achieve optimal nurse outcomes. Implications for Practice Improving hospital practice environments holds significant potential to improve nurse well-being, retention, and quality of care. Specifically, hospitals should consider preceptor programs and continuing education and increase nurses’ participation in hospital decision making. PMID:22751101

A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention

Science.gov (United States)

Kennedy, Caitlin E.; Fonner, Virginia A.; O'Reilly, Kevin R.; Sweat, Michael D.

2013-01-01

Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. We conducted a systematic review by searching electronic databases from 1990-2012, examining secondary references, and hand searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of 5,218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with 6 conducted in sub-Saharan Africa, 3 in South or Southeast Asia, and 3 in Latin America and the Caribbean. Target populations included adult women (N=6), female sex workers/bar workers (N=3), and youth/orphans (N=3). All studies targeted females except 2 among youth/orphans. Study rigor was moderate, with 2 group-randomized trials and 2 individual-randomized trials. All interventions except 3 included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these interventions may have important effects

A systematic review of income generation interventions, including microfinance and vocational skills training, for HIV prevention.

Science.gov (United States)

Kennedy, Caitlin E; Fonner, Virginia A; O'Reilly, Kevin R; Sweat, Michael D

2014-01-01

Income generation interventions, such as microfinance or vocational skills training, address structural factors associated with HIV risk. However, the effectiveness of these interventions on HIV-related outcomes in low- and middle-income countries has not been synthesized. The authors conducted a systematic review by searching electronic databases from 1990 to 2012, examining secondary references, and hand-searching key journals. Peer-reviewed studies were included in the analysis if they evaluated income generation interventions in low- or middle-income countries and provided pre-post or multi-arm measures on behavioral, psychological, social, care, or biological outcomes related to HIV prevention. Standardized forms were used to abstract study data in duplicate and study rigor was assessed. Of the 5218 unique citations identified, 12 studies met criteria for inclusion. Studies were geographically diverse, with six conducted in sub-Saharan Africa, three in South or Southeast Asia, and three in Latin America and the Caribbean. Target populations included adult women (N = 6), female sex workers/bar workers (N = 3), and youth/orphans (N = 3). All studies targeted females except two among youth/orphans. Study rigor was moderate, with two group-randomized trials and two individual-randomized trials. All interventions except three included some form of microfinance. Only a minority of studies found significant intervention effects on condom use, number of sexual partners, or other HIV-related behavioral outcomes; most studies showed no significant change, although some may have had inadequate statistical power. One trial showed a 55% reduction in intimate partner violence (adjusted risk ratio 0.45, 95% confidence interval 0.23-0.91). No studies measured incidence/prevalence of HIV or sexually transmitted infections among intervention recipients. The evidence that income generation interventions influence HIV-related behaviors and outcomes is inconclusive. However, these

Severe embrittlement of neutron irradiated austenitic steels arising from high void swelling

Energy Technology Data Exchange (ETDEWEB)

Neustroev, V.S. [FSUE ' SSC RF Research Institute of Atomic Reactors' , Dimitrovgrad (Russian Federation)], E-mail: neustroev@niiar.ru; Garner, F.A. [Pacific Northwest National Laboratory, Richland, WA (United States)

2009-04-30

Data are presented from BOR-60 irradiations showing that significant radiation-induced swelling causes severe embrittlement in austenitic stainless steels, reducing the service life of structural components and introducing limitations on low temperature handling especially. It is shown that the degradation is actually a form of quasi-embrittlement arising from intense flow localization with high levels of localized ductility involving micropore coalescence and void-to-void cracking. Voids initially serve as hardening components whose effect is overwhelmed by the void-induced reduction in shear and Young's moduli at high swelling levels. Thus the alloy appears to soften even as the ductility plunges toward zero on a macroscopic level although a large amount of deformation occurs microscopically at the failure site. Thus the failure is better characterized as 'quasi-embrittlement' which is a suppression of uniform deformation. This case should be differentiated from that of real embrittlement which involves the complete suppression of the material's capability for plastic deformation.

Platform and receptacle: Musings of modernity arising from Utzon׳s own houses

Directory of Open Access Journals (Sweden)

Xing Ruan

2016-09-01

Full Text Available Utzon throughout his life time designed and built three houses for himself and his family. A study of these houses shows the slow development of a doubt, albeit understated, on his early architectural belief that was much celebrated in his public buildings, such as the Sydney Opera House. But Utzon is not unique in this instance. Some other modern architects too had experienced a similar change, gradual or sudden, in their attitudes towards life and the world, hence the transformation of their architecture as a consequence. This change, on the surface and as represented in architecture, is from a building that boldly embraces outside vista to that of a more internalized receptacle. But unlike Corbusier, Utzon, instead of a complete transformation, showed an inner conflict arising from this doubt, which is between the modern urge to conquer the capacious space out there and a yearning for an interior life.

Early neurodevelopmental outcomes of extremely preterm infants.

Science.gov (United States)

Rogers, Elizabeth E; Hintz, Susan R

2016-12-01

Infants born at extreme preterm gestation are at risk for both death and disability. Although rates of survival have improved for this population, and some evidence suggests a trend toward decreased neuromotor impairment over the past decades, a significant improvement in overall early neurodevelopmental outcome has not yet been realized. This review will examine the rates and types of neurodevelopmental impairment seen after extremely preterm birth, including neurosensory, motor, cognitive, and behavioral outcomes. We focus on early outcomes in the first 18-36 months of life, as the majority of large neonatal studies examining neurodevelopmental outcomes stop at this age. However, this early age is clearly just a first glimpse into lifetime outcomes; the neurodevelopmental effects of extreme prematurity may last through school age, adolescence, and beyond. Importantly, prematurity appears to be an independent risk factor for adverse development, but this population demonstrates considerable variability in the types and severity of impairments. Understanding both the nature and prevalence of neurodevelopmental impairment among extremely preterm infants is important because it can lead to targeted interventions that in turn may lead to improved outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

Symptom outcomes important to women with anal incontinence: a conceptual framework.

Science.gov (United States)

Sung, Vivian W; Rogers, Rebecca G; Bann, Carla M; Arya, Lily; Barber, Matthew D; Lowder, Jerry; Lukacz, Emily S; Markland, Alayne; Siddiqui, Nazema; Wilmot, Amanda; Meikle, Susan F

2014-05-01

To develop a framework that describes the most important symptom outcomes for anal incontinence treatment from the patient perspective. A conceptual framework was developed by the Pelvic Floor Disorders Network based on four semistructured focus groups and confirmed in two sets of 10 cognitive interviews including women with anal incontinence. We explored: 1) patient-preferred terminology for describing anal incontinence symptoms; 2) patient definitions of treatment "success"; 3) importance of symptoms and outcomes in the framework; and 4) conceptual gaps (defined as outcomes not previously identified as important). Sessions were conducted according to grounded theory transcribed, coded, and qualitatively and quantitatively analyzed to identify relevant themes. Content and face validity of the framework were further assessed using cognitive interviews. Thirty-four women participated in focus groups and 20 in cognitive interviews. Overall, 29 (54%) were aged 60 years or older, 42 (78%) were white, and 10 (19%) had a high school degree or less. Two overarching outcome themes were identified: "primary bowel leakage symptoms" and "ancillary bowel symptoms." Subdomains important in primary bowel leakage symptoms included leakage characteristics (symptom frequency, amount of leakage, symptom bother) and conditions when bowel leakage occurs (predictability, awareness, urgency). Subdomains important under ancillary bowel symptoms included emptying disorders (constipation, obstructed defecation, and wiping issues) and discomfort (pain, burning). New outcomes identified included predictability, awareness, wiping issues, and discomfort. Women with anal incontinence desire a wide range of symptom outcomes after treatment. These are captured in our conceptual framework, which can aid clinicians and researchers in assessing anal incontinence. LEVEL OF EVIEDENCE: II.

Outcome after relapse of acute lymphoblastic leukemia in adult patients included in four consecutive risk-adapted trials by the PETHEMA Study Group.

Science.gov (United States)

Oriol, Albert; Vives, Susana; Hernández-Rivas, Jesús-María; Tormo, Mar; Heras, Inmaculada; Rivas, Concepción; Bethencourt, Concepción; Moscardó, Federico; Bueno, Javier; Grande, Carlos; del Potro, Eloy; Guardia, Ramon; Brunet, Salut; Bergua, Juan; Bernal, Teresa; Moreno, Maria-José; Calvo, Carlota; Bastida, Pilar; Feliu, Evarist; Ribera, Josep-Maria

2010-04-01

About one half of adults with acute lymphoblastic leukemia are not cured of the disease and ultimately die. The objective of this study was to explore the factors influencing the outcome of adult patients with relapsed acute lymphoblastic leukemia. We analyzed the characteristics, the outcome and the prognostic factors for survival after first relapse in a series of 263 adult patients with acute lymphoblastic leukemia (excluding those with mature B-cell acute lymphoblastic leukemia) prospectively enrolled in four consecutive risk-adapted PETHEMA trials. The median overall survival after relapse was 4.5 months (95% CI, 4-5 months) with a 5-year overall survival of 10% (95% CI, 8%-12%); 45% of patients receiving intensive second-line treatment achieved a second complete remission and 22% (95% CI, 14%-30%) of them remained disease free at 5 years. Factors predicting a good outcome after rescue therapy were age less than 30 years (2-year overall survival of 21% versus 10% for those over 30 years old; P<0.022) and a first remission lasting more than 2 years (2-year overall survival of 36% versus 17% among those with a shorter first remission; P<0.001). Patients under 30 years old whose first complete remission lasted longer than 2 years had a 5-year overall survival of 38% (95% CI, 23%-53%) and a 5-year disease-free survival of 53% (95% CI, 34%-72%). The prognosis of adult patients with acute lymphoblastic leukemia who relapse is poor. Those aged less than 30 years with a first complete remission lasting longer than 2 years have reasonable possibilities of becoming long-term survivors while patients over this age or those who relapse early cannot be successfully rescued using the therapies currently available.

Retrospective comparison of perinatal outcomes following emergency cervical cerclage with or without prolapsed membranes.

Science.gov (United States)

Steenhaut, Patricia; Hubinont, Corinne; Bernard, Pierre; Debiève, Frédéric

2017-06-01

To compare perinatal outcomes following emergency cerclage between patients with singleton pregnancies with prolapsed and non-prolapsed membranes. The present retrospective cohort study included data from women who underwent physical examination-indicated emergency cerclage at between 15 and 25 weeks of pregnancy at Saint Luc University Hospital, Brussels, Belgium, between January 1, 2000, and December 31, 2014. Outcomes were compared based on the presence of prolapsed or non-prolapsed membranes. The primary outcome measures were the duration of pregnancy at delivery and the interval between cerclage and delivery. Secondary outcomes included delivery weight, fetal or neonatal death, and neonatal morbidity, including neonatal intensive care unit admission. Data were included from 140 patients with cervical dilation of at least 1 cm; 85 women had non-prolapsed membranes and 55 women had prolapsed membranes. Among patients with non-prolapsed membranes, the mean duration of pregnancy at delivery was later (Pmembranes was associated with improved perinatal outcomes following emergency cerclage. © 2017 International Federation of Gynecology and Obstetrics.

Long-term functional outcome of pediatric stroke survivors.

Science.gov (United States)

Hurvitz, Edward; Warschausky, Seth; Berg, Michelle; Tsai, Shane

2004-01-01

To examine the long-term functional, psychosocial, and medical outcome of pediatric stroke survivors. This was a descriptive survey performed on patients with childhood stroke who participated in an earlier study. Measures included the Vineland Adaptive Behavior Scales (VABS) and the Diener Satisfaction with Life Scale. Current information on living situation, school placement, employment, and medical outcome were obtained. Twenty-nine (58%) patients participated. The mean age was 19.3 years (SD = 6.6), mean age of onset of stroke was 7.0 years (SD = 5.4), and mean follow-up time was 11.9 years (SD = 3.9). Diagnoses included hemorrhagic (31%) and ischemic (69%) stroke. All but one adult had finished high school, and the majority of participants had gone to college. 60% of patients over age 16 were employed. The average VABS levels for communication, daily living skills, socialization, and adaptive behavior fell into the moderately low range. Use of seizure medications and ADL dependence were the predictors for lower VABS levels (p life satisfaction. Patients who scored below adequate on VABS tended toward lower life satisfaction. Pediatric stroke survivors had good educational and mobility outcomes, but communication, ADL, and socialization fell into the low-moderate range. The different predictors of functional and subjective quality of life outcomes suggest that functional outcomes may mediate the relations between medical factors and satisfaction with life.

Spectral-analysis-based extraction of land disturbances arising from oil and gas development in diverse landscapes

Science.gov (United States)

Zhang, Ying; Lantz, Nicholas; Guindon, Bert; Jiao, Xianfen

2017-01-01

Accurate and frequent monitoring of land surface changes arising from oil and gas exploration and extraction is a key requirement for the responsible and sustainable development of these resources. Petroleum deposits typically extend over large geographic regions but much of the infrastructure required for oil and gas recovery takes the form of numerous small-scale features (e.g., well sites, access roads, etc.) scattered over the landscape. Increasing exploitation of oil and gas deposits will increase the presence of these disturbances in heavily populated regions. An object-based approach is proposed to utilize RapidEye satellite imagery to delineate well sites and related access roads in diverse complex landscapes, where land surface changes also arise from other human activities, such as forest logging and agriculture. A simplified object-based change vector approach, adaptable to operational use, is introduced to identify the disturbances on land based on red-green spectral response and spatial attributes of candidate object size and proximity to roads. Testing of the techniques has been undertaken with RapidEye multitemporal imagery in two test sites located at Alberta, Canada: one was a predominant natural forest landscape and the other landscape dominated by intensive agricultural activities. Accuracies of 84% and 73%, respectively, have been achieved for the identification of well site and access road infrastructure of the two sites based on fully automated processing. Limited manual relabeling of selected image segments can improve these accuracies to 95%.

Numerical study of nonlinear singular fractional differential equations arising in biology by operational matrix of shifted Legendre polynomials

Directory of Open Access Journals (Sweden)

D. Jabari Sabeg

2016-10-01

Full Text Available In this paper, we present a new computational method for solving nonlinear singular boundary value problems of fractional order arising in biology. To this end, we apply the operational matrices of derivatives of shifted Legendre polynomials to reduce such problems to a system of nonlinear algebraic equations. To demonstrate the validity and applicability of the presented method, we present some numerical examples.

Partitioning of actinide from simulated high level wastes arising from reprocessing of PHWR fuels: counter current extraction studies using CMPO

International Nuclear Information System (INIS)

Deshingkar, D.S.; Chitnis, R.R.; Wattal, P.K.; Theyyunni, T.K.; Nair, M.K.T.; Ramanujam, A.; Dhami, P.S.; Gopalakrishnan, V.; Rao, M.K.; Mathur, J.N.; Murali, M.S.; Iyer, R.H.; Badheka, L.P.; Banerji, A.

1994-01-01

High level wastes (HLW) arising from reprocessing of pressurised heavy water reactor (PHWR) fuels contain actinides like neptunium, americium and cerium which are not extracted in the Purex process. They also contain small quantities of uranium and plutonium in addition to fission products. Removal of these actinides prior to vitrification of HLW can effectively reduce the active surveillance period of final waste form. Counter current studies using indigenously synthesised octyl (phenyl)-N, N-diisobutylcarbamoylmethylphosphine oxide (CMPO) were taken up as a follow-up of successful runs with simulated sulphate bearing low acid HLW solutions. The simulated HLW arising from reprocessing of PHWR fuel was prepared based on presumed burnup of 6500 MWd/Te of uranium, 3 years cooling period and 800 litres of waste generation per tonne of fuel reprocessed. The alpha activity of the HLW raffinate after extraction with the CMPO-TBP mixture could be brought down to near background level. (author). 13 refs., 2 tabs., 12 figs

Partitioning of actinide from simulated high level wastes arising from reprocessing of PHWR fuels: counter current extraction studies using CMPO

Energy Technology Data Exchange (ETDEWEB)

Deshingkar, D S; Chitnis, R R; Wattal, P K; Theyyunni, T K; Nair, M K.T. [Bhabha Atomic Research Centre, Bombay (India). Process Engineering and Systems Development Div.; Ramanujam, A; Dhami, P S; Gopalakrishnan, V; Rao, M K [Bhabha Atomic Research Centre, Bombay (India). Fuel Reprocessing Group; Mathur, J N; Murali, M S; Iyer, R H [Bhabha Atomic Research Centre, Bombay (India). Radiochemistry Div.; Badheka, L P; Banerji, A [Bhabha Atomic Research Centre, Bombay (India). Bio-organic Div.

1994-12-31

High level wastes (HLW) arising from reprocessing of pressurised heavy water reactor (PHWR) fuels contain actinides like neptunium, americium and cerium which are not extracted in the Purex process. They also contain small quantities of uranium and plutonium in addition to fission products. Removal of these actinides prior to vitrification of HLW can effectively reduce the active surveillance period of final waste form. Counter current studies using indigenously synthesised octyl (phenyl)-N, N-diisobutylcarbamoylmethylphosphine oxide (CMPO) were taken up as a follow-up of successful runs with simulated sulphate bearing low acid HLW solutions. The simulated HLW arising from reprocessing of PHWR fuel was prepared based on presumed burnup of 6500 MWd/Te of uranium, 3 years cooling period and 800 litres of waste generation per tonne of fuel reprocessed. The alpha activity of the HLW raffinate after extraction with the CMPO-TBP mixture could be brought down to near background level. (author). 13 refs., 2 tabs., 12 figs.

Unfavorable surgical outcomes in partial epilepsy with secondary bilateral synchrony: Intracranial electroencephalography study.

Science.gov (United States)

Sunwoo, Jun-Sang; Byun, Jung-Ick; Moon, Jangsup; Lim, Jung-Ah; Kim, Tae-Joon; Lee, Soon-Tae; Jung, Keun-Hwa; Park, Kyung-Il; Chu, Kon; Kim, Manho; Chung, Chun-Kee; Jung, Ki-Young; Lee, Sang Kun

2016-05-01

Secondary bilateral synchrony (SBS) indicates bilaterally synchronous epileptiform discharges arising from a focal cortical origin. The present study aims to investigate SBS in partial epilepsy with regard to surgical outcomes and intracranial EEG findings. We retrospectively reviewed consecutive patients who underwent epilepsy surgery following extraoperative intracranial electroencephalography (EEG) study from 2008 to 2012. The presence of SBS was determined based upon the results of scalp EEG monitoring performed for presurgical evaluations. We reviewed scalp EEG, neuroimaging, intracranial EEG findings, and surgical outcomes in patients with SBS. We found 12 patients with SBS who were surgically treated for intractable partial epilepsy. Nine (75%) patients had lateralized ictal semiology and only two (16.6%) patients showed localized ictal onset in scalp EEG. Brain MRI showed epileptogenic lesion in three (25%) patients. Intracranial EEG demonstrated that ictal onset zone was widespread or non-localized in six (50%) patients. Low-voltage fast activity was the most common ictal onset EEG pattern. Rapid propagation of ictal onset was noted in 10 (83.3%) patients. Eleven patients underwent resective epilepsy surgery and only two patients (18.2%) achieved seizure-freedom (median follow-up 56 months). MRI-visible brain lesions were associated with favorable outcomes (p=0.024). Patients with SBS, compared to frontal lobe epilepsy without SBS, showed lesser localization in ictal onset EEG (p=0.029) and more rapid propagation during evolution of ictal rhythm (p=0.015). The present results suggested that resective surgery for partial epilepsy with SBS should be decided carefully, especially in case of nonlesional epilepsy. Poor localization and rapid spread of ictal onset were prominent in intracranial EEG, which might contribute to incomplete resection of the epileptogenic zone and poor surgical outcomes. Copyright © 2016 Elsevier B.V. All rights reserved.

Psychiatric outcomes after pediatric sports-related concussion.

Science.gov (United States)

Ellis, Michael J; Ritchie, Lesley J; Koltek, Mark; Hosain, Shahid; Cordingley, Dean; Chu, Stephanie; Selci, Erin; Leiter, Jeff; Russell, Kelly

2015-12-01

The objectives of this study were twofold: (1) to examine the prevalence of emotional symptoms among children and adolescents with a sports-related concussion (SRC) who were referred to a multidisciplinary pediatric concussion program and (2) to examine the prevalence, clinical features, risk factors, and management of postinjury psychiatric outcomes among those in this clinical population. The authors conducted a retrospective chart review of all patients with SRC referred to a multidisciplinary pediatric concussion program between September 2013 and October 2014. Clinical assessments carried out by a single neurosurgeon included clinical history, physical examination, and Post-Concussion Symptom Scale (PCSS) scoring. Postinjury psychiatric outcomes were defined as a subjective worsening of symptoms of a preinjury psychiatric disorder or new and isolated suicidal ideation or diagnosis of a novel psychiatric disorder (NPD). An NPD was defined as a newly diagnosed psychiatric disorder that occurred in a patient with or without a lifetime preinjury psychiatric disorder after a concussion. Clinical resources, therapeutic interventions, and clinical and return-to-play outcomes are summarized. One hundred seventy-four patients (mean age 14.2 years, 61.5% male) were included in the study. At least 1 emotional symptom was reported in 49.4% of the patients, and the median emotional PCSS subscore was 4 (interquartile range 1-8) among those who reported at least 1 emotional symptom. Overall, 20 (11.5%) of the patients met the study criteria for a postinjury psychiatric outcome, including 14 patients with an NPD, 2 patients with isolated suicidal ideation, and 4 patients with worsening symptoms of a preinjury psychiatric disorder. Female sex, a higher initial PCSS score, a higher emotional PCSS subscore, presence of a preinjury psychiatric history, and presence of a family history of psychiatric illness were significantly associated with postinjury psychiatric outcomes

Effects of metabolic syndrome on the functional outcomes of corticosteroid injection for De Quervain tenosynovitis.

Science.gov (United States)

Roh, Y H; Noh, J H; Gong, H S; Baek, G H

2017-06-01

Metabolic syndrome is a constellation of medical conditions that arise from insulin resistance and abnormal adipose deposition and function. In patients with metabolic syndrome and De Quervain tenosynovitis this might affect the outcome of treatment by local corticosteroid injection. A total of 64 consecutive patients with De Quervain tenosynovitis and metabolic syndrome treated with corticosteroid injection were age- and sex-matched with 64 control patients without metabolic syndrome. The response to treatment, including visual analogue scale score for pain, objective findings consistent with De Quervain tenosynovitis (tenderness at first dorsal compartment, Finkelstein test result), and Disability of the Arm, Shoulder, and Hand score were assessed at 6, 12, and 24 weeks follow-up. Treatment failure was defined as persistence of symptoms or surgical intervention. Prior to treatment, patients with metabolic syndrome had mean initial pain visual analogue scale and Disability of the Arm, Shoulder, and Hand scores similar to those in the control group. The proportion of treatment failure in the metabolic syndrome group (43%) was significantly higher than that in the control group (20%) at 6 months follow-up. The pain visual analogue scale scores in the metabolic syndrome group were higher than the scores in the control group at the 12- and 24-week follow-ups. The Disability of the Arm, Shoulder, and Hand scores of the metabolic syndrome group were higher (more severe symptoms) than those of the control group at the 12- and 24-week follow-ups. Although considerable improvements in symptom severity and hand function will likely occur in patients with metabolic syndrome, corticosteroid injection for De Quervain tenosynovitis is not as effective in these patients compared with age- and sex-matched controls in terms of functional outcomes and treatment failure. III.

Assessment of Outcome in Hypospadias Surgery - A Review

Directory of Open Access Journals (Sweden)

Alexander eSpringer

2014-01-01

Full Text Available Hypospadias is a challenging field of urogenital reconstructive surgery with different techniques being currently used. Modern surgery claims that it is possible to create a functionally and cosmetically normal penis. Continuous reevaluation and assessment of outcome may have a major impact on future clinical practice. Assessment of outcome includes: complication rate, cosmetic appearance of the penis, functional outcome (micturition, sexuality and psychological factors such as quality of life and psychosexual life. This article briefly reviews current strategies of outcome assessment and outlines that in the future long-term assessment should be designed in web-based prospective studies multicenter studies. Somehow in the future we will be able to give an accurate estimation of the long-term consequences of being born with hypospadias.

Perinatal outcomes among Asian-white interracial couples.

Science.gov (United States)

Nystrom, Michael J; Caughey, Aaron B; Lyell, Deirdre J; Druzin, Maurice L; El-Sayed, Yasser Y

2008-10-01

To investigate whether perinatal outcomes among interracial Asian-white couples are different than among Asian-Asian and white-white couples. This was a retrospective study of Asian, white, and Asian-white couples delivered at the Lucile Packard Children's Hospital from 2000-2005. Asian-white couples were subdivided into white-mother/Asian-father or Asian-mother/white-father. Perinatal outcomes included gestational diabetes, hypertensive disorders of pregnancy, preterm delivery, birth weight >4000 g and interracial Asian-white couples.

Korean Clinic Based Outcome Measure Studies

Directory of Open Access Journals (Sweden)

Jongbae Park

2003-02-01

Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures

Workload and surgeon's specialty for outcome after colorectal cancer surgery

DEFF Research Database (Denmark)

Archampong, David; Borowski, David; Wille-Jørgensen, Peer

2012-01-01

A large body of research has focused on investigating the effects of healthcare provider volume and specialization on patient outcomes including outcomes of colorectal cancer surgery. However there is conflicting evidence about the role of such healthcare provider characteristics in the management...

Striatal Activity and Reward Relativity: Neural Signals Encoding Dynamic Outcome Valuation.

Science.gov (United States)

Webber, Emily S; Mankin, David E; Cromwell, Howard C

2016-01-01

The striatum is a key brain region involved in reward processing. Striatal activity has been linked to encoding reward magnitude and integrating diverse reward outcome information. Recent work has supported the involvement of striatum in the valuation of outcomes. The present work extends this idea by examining striatal activity during dynamic shifts in value that include different levels and directions of magnitude disparity. A novel task was used to produce diverse relative reward effects on a chain of instrumental action. Rats ( Rattus norvegicus ) were trained to respond to cues associated with specific outcomes varying by food pellet magnitude. Animals were exposed to single-outcome sessions followed by mixed-outcome sessions, and neural activity was compared among identical outcome trials from the different behavioral contexts. Results recording striatal activity show that neural responses to different task elements reflect incentive contrast as well as other relative effects that involve generalization between outcomes or possible influences of outcome variety. The activity that was most prevalent was linked to food consumption and post-food consumption periods. Relative encoding was sensitive to magnitude disparity. A within-session analysis showed strong contrast effects that were dependent upon the outcome received in the immediately preceding trial. Significantly higher numbers of responses were found in ventral striatum linked to relative outcome effects. Our results support the idea that relative value can incorporate diverse relationships, including comparisons from specific individual outcomes to general behavioral contexts. The striatum contains these diverse relative processes, possibly enabling both a higher information yield concerning value shifts and a greater behavioral flexibility.

Bio-inspired computational heuristics to study Lane-Emden systems arising in astrophysics model.

Science.gov (United States)

Ahmad, Iftikhar; Raja, Muhammad Asif Zahoor; Bilal, Muhammad; Ashraf, Farooq

2016-01-01

This study reports novel hybrid computational methods for the solutions of nonlinear singular Lane-Emden type differential equation arising in astrophysics models by exploiting the strength of unsupervised neural network models and stochastic optimization techniques. In the scheme the neural network, sub-part of large field called soft computing, is exploited for modelling of the equation in an unsupervised manner. The proposed approximated solutions of higher order ordinary differential equation are calculated with the weights of neural networks trained with genetic algorithm, and pattern search hybrid with sequential quadratic programming for rapid local convergence. The results of proposed solvers for solving the nonlinear singular systems are in good agreements with the standard solutions. Accuracy and convergence the design schemes are demonstrated by the results of statistical performance measures based on the sufficient large number of independent runs.

Left bronchial artery arising from a replaced left hepatic artery in a patient with massive hemoptysis

Energy Technology Data Exchange (ETDEWEB)

Khil, Eun Kyung; Lee, Jae Myung [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2015-09-15

A 70-year-old man with a 3-year history of bronchiectasis presented with massive hemoptysis that had lasted for 3 days. In our attempt to perform bronchial artery embolization, upper abdominal angiography was required to locate the left bronchial artery, which in this case was of anomalous origin, arising from a replaced left hepatic artery, which arose from the left gastric artery-a very unusual anatomical variant. We performed embolization with polyvinyl alcohol particles, and the patient's symptoms resolved completely, with no additional complications after conservative treatment.

Dorsally exophytic glioblastoma arising from the medulla oblongata in an adult presenting as 4th ventricular mass

Science.gov (United States)

Das, Kuntal Kanti; Bettaswamy, Guru Prasad; Mehrotra, Anant; Jaiswal, Sushila; Jaiswal, Awadhesh Kumar; Behari, Sanjay

2017-01-01

Brainstem gliomas are relatively rare in adults (medulla oblongata in a 55-year-old lady who presented with a 4th ventricular mass, and present a brief review of the literature. Till now, six cases of glioblastoma arising from the medulla oblongata have been reported. So, ours is the seventh such report. To the best of our knowledge, it also happens to be the sixth reported case of dorsally exophytic brainstem glioblastoma till date. PMID:28484537

The imaging manifestation of intracranial schwannomas not arising from cranial nerves

International Nuclear Information System (INIS)

Luo Boning; Sun Gengxi; Liang Kangfu

2003-01-01

Objective: To report 4 cases of operation-confirmed intracranial schwannomas not arising from cranial nerves, and to discuss the histogenesis and CT and MRI manifestation combining with the literature. Methods: CT and MRI findings of these 4 intracranial schwannomas were analyzed retrospectively and their pathologic characteristics were reviewed. Results: The tumors demonstrated low-iso mixed density with necrotic and cystic areas. Large degeneration even became the prominent characteristics on CT scan. Low-signal to iso-signal intensity on T 1 -weighted images and heterogeneous high-signal intensity on T 2 -weighted images were revealed. The solid portion and the wall of the tumors were moderately enhanced on enhanced CT and MRI scans. Hematoxylin and eosin-stained sections showed two corresponding histological patterns: Antoni Type A and Antoni Type B pattern. The tumor cells exhibited a strong positive staining pattern for s-100 protein. Conclusion: The imaging manifestations of these tumors were similar to that of cranial nerve schwannomas except that the former had higher cystic degeneration rate. We should take that diagnosis into consideration when the mass is not located on cranial nerve but its image feature resembles schwannomas

Clinical and economic outcomes assessment in nuclear cardiology

International Nuclear Information System (INIS)

Shaw, L.J.; Miller, D.D.; Berman, D.S.; Hachamovitch, R.

2000-01-01

The future of nuclear medicine procedures, as understood within our current economic climate, depends upon its ability to provide relevant clinical information at similar or lower comparative costs. With an ever-increasing emphasis on cost containment, outcome assessment forms the basis of preserving the quality of patient care. Today, outcomes assessment encompasses a wide array of subjects including clinical, economic, and humanistic (i.e., quality of life) outcomes. For nuclear cardiology, evidence-based medicine would require a threshold level of evidence in order to justify the added cost of any test in a patient's work-up. This evidence would include large multicenter, observational series as well as randomized trial data in sufficiently large and diverse patient populations. The new movement in evidence-based medicine is also being applied to the introduction of new technologies, in particular when comparative modalities exist. In the past 5 years, it has seen a dramatic shift in the quality of outcomes data published in nuclear cardiology. This includes the use of statistically rigorous risk-adjusted techniques as well as large populations (i.e., >500 patients) representing multiple diverse medical care settings. This has been the direct result of the development of multiple outcomes databases that have now amassed thousands of patients worth of data. One of the benefits of examining outcomes in large patient datasets is the ability to assess individual endpoints (e.g., cardiac death) as compared with smaller datasets that often assess combined endpoints (e.g., death, myocardial infarction, or unstable angina). New technologies for the diagnosis of coronary artery disease have contributed to the rising costs of care. In the United States and in Europe, costs of care have risen dramatically, consuming an ever-increasing amount of available resources. The overuse of diagnostic angiography often leads to unnecessary revascularization that does not lead to